Although the indigenous populations of the United States experience substantial disparities in health outcomes, little information is available regarding barriers to their access to specifically baby friendly hospitals and baby friendly services in the United States. Access is important because indigenous patients, especially women, have higher infant mortality and childhood obesity than their white counterparts.
This systematic review seeks to uncover potential barriers to baby friendly hospital services for indigenous patients in the United States. This systematic review analyzed the current literature from select databases published between 2000 and 2020 and narrowed literature down into studies deemed relevant because of their focus on the BFHI or equivalent and on indigenous patients. 303 studies were found using a specialized search string and then after evaluation under exclusion and inclusion criteria, 21 were identified for use in this review.
Analysis of these selected studies revealed trends of barriers as well as disparities in indigenous participation in current research. The conclusion of this review is that baby friendly and its “Ten Steps to Successful Breastfeeding” must be altered to allow for implementation in different cultural settings, especially for indigenous patients. Additionally, there is a need for additional research that focuses on indigenous patients in this setting and is written by members of that community. Increased representation from this community will enhance future work towards deconstructing the barriers preventing indigenous patients to access BFHI resources.

Hygiene stigma can exist in tandem to gender stigma which could mean the marginalization of certain groups due to stigmatized identities, specifically women. The marginalization of women is important because of the United Nations Sustainable Development Goal 5: Empowering women and girls and achieving equity. Figuring out how hygiene stigma specifically affects women in Fiji required researching the effects of hygiene stigma, gender inequity and indigenous Fijian societies could influence respondents’ answers. After researching these different topics, these questions were developed: does hygiene stigma and gendered stigma have an overlap? If so, are men more biased than women when it comes to objectifying women? Do indigenous Fijian societies possess an immunity to objectifying women since are considered to have Fijian women have more agency? The data was retrieved from the Global Ethnohydrology Study from 2015-16 in the Viti Levu, Fiji, which was specifically researching whether hygiene stigma is an effective method of helping people have better hygiene norms. A thematic analysis was then conducted, and the data was coded. Based on the results from 28 respondents we were able to conclude that there is gendered stigma within Fijian populations. We found that both men and women objectified women at similar rates and Fiji is not immune to hygiene stigma. The limitations to this analysis were there was no statistical analysis to find correlations hygiene stigma and gendered stigma. There was only one specific code that was being analyzed in this research project which limits the other types of stigma that may exist.

As the public becomes increasingly aware of the morality of wildlife institutions like zoos and aquariums, these places are now having to face possible negativity and lack of support from their communities. In light of this, these institutions are now focusing their goals and efforts towards conservation education and outreach programs in order to continue contributing to biodiversity conservation. Research has proven that wildlife institutions like zoos and aquariums are effective ways to teach the community about wildlife and conservation. To measure how effective aquariums are at educating their patrons on conservation, a short survey was administered to 100 patrons of the OdySea Aquarium in Scottsdale, Arizona. The object of the survey was to assess which type of conservation messaging was preferred by the general public and if patrons of the aquarium were likely to engage in pro-conservation behaviors after their visit. It was found that the majority of respondents preferred interactive exhibits as their choice to learn about conservation and wildlife. In addition, almost all respondents agreed that they would continue practicing behaviors that supported pro-conservation actions after their visit to the aquarium. My results also showed that patrons of the aquarium were well educated about plastic pollution and the rehabilitation that OdySea accomplishes for the sea turtles due to their overexpression of mentioning plastic in their open-ended questions. My findings indicate that this aquarium is succeeding in promoting conservation and wildlife education as well as supporting cultivation within their patrons that will benefit the future health of this planet.

Menstruation - a stigmatized topic and a social taboo- has led to a lack of menstrual hygiene awareness and improper practices impacting women’s health adversely over generations in India. Akshara aims to increase menstrual hygiene education and reduce stigma in India. A creative children’s illustrated book, and interactive workshop curriculum about menstruation were designed and published in Hindi and English. Menstrual hygiene workshops, utilizing the designed tools, were conducted in Delhi and Ghaziabad, India to over 230 students through NGO partnerships in December 2018. The response to the menstrual hygiene and stigma workshops was overwhelmingly positive, and a significant increase in the knowledge and awareness survey scores was observed after the curriculum teachings and classroom discussions. This evaluation highlights and provides a potential solution path to eradicate the root cause of the menstruation stigma in underprivileged women through education and open conversations on the topic starting at a pivotal young age. The main aim of the workshop was to help eradicate the stigma associated with menstruation and menstrual health in India through education.

As obesity rates continue to rise, societal stigmas against individuals classified as "fat" or "obese" also rise. The topics of obesity, fat stigma, slim body ideals, body dissatisfaction and fat talk are all closely interwoven and are heavily influenced by countless human factors. This project attempts to find cross-cultural patterns in female self-perceptions and body preferences across nine culturally and economically diverse countries using both quantitative and qualitative analyses. The nine different countries included in this study are the United States, the United Kingdom, New Zealand, Iceland, Tajikistan, Paraguay, Guatemala, Japan, and South Korea. This study analyzes how satisfied women are with their current size and whether they feel as though they are judged for their size or shape.

The Culture, Health, and Environment Lab (CHEL) at Arizona State University uses anthropological methods and field-based studies to research how cultural knowledge may be used to help understand and respond to contemporary environmental and health issues—primarily the global challenges of water insecurity and obesity. In their efforts to research water insecurity and it implications, CHEL has been working on studying water insecurity through the Global Ethnohydrology Study (GES). The Global Ethnohydrology study examines local knowledge and perceptions of water issues, using transdisciplinary methods in a multi-year and cross-country program. In the 2015-2016 study, the GES examined water, hygiene norms, and hygiene stigma. It sought to investigate how hygiene norms are impacted by the level of water security, examining if water-poor communities have laxer laxer or more accommodating hygiene norms. This paper will explore the development of the codebook for this study, following the process in which the qualitative data from the GES 2015 was organized through a series of codes so that it may later be analyzed.

Background: Performance-based incentives (PBIs) have garnered global attention as a promising strategy to improve healthcare delivery to vulnerable populations. However, literature gaps in the context in which an intervention is implemented and how the PBIs were developed exist. Therefore, we (1) characterized the barriers and promoters to prevention of vertical transmission of HIV (PVT) service delivery in rural Mozambique, where the vertical transmission rate is 12 %, and (2) assessed the appropriateness for a PBI’s intervention and application to PVT.

Methods: We conducted 24 semi-structured interviews with nurses, volunteers, community health workers, and traditional birth attendants about the barriers and promoters they experienced delivering PVT services. We then explored emergent themes in subsequent focus group discussions (n = 7, total participants N = 92) and elicited participant perspectives on PBIs. The ecological motivation-opportunity-ability framework guided our iterative data collection and thematic analysis processes.

Results: The interviews revealed that while all health worker cadres were motivated intrinsically and by social recognition, they were dissatisfied with low and late remuneration. Facility-based staff were challenged by factors across the rest of the ecological levels, primarily in the opportunity domain, including the following: poor referral and record systems (work mandate), high workload, stock-outs, poor infrastructure (facility environment), and delays in obtaining patient results and donor payment discrepancies (administrative). Community-based cadres’ opportunity challenges included lack of supplies, distance (work environment), lack of incorporation into the health system (administration), and ability challenges of incorrect knowledge (health worker). PBIs based on social recognition and that enable action on intrinsic motivation through training, supervision, and collaboration were thought to have the most potential for targeting improvements in record and referral systems and better integrating community-based health workers into the health system. Concerns about the implementation of incentives included neglect of non-incentivized tasks and distorted motivation among colleagues.

Conclusions: We found that highly motivated health workers encountered severe opportunity challenges in their PVT mandate. PBIs have the potential to address key barriers that facility- and community-based health workers encounter when delivering PVT services, specifically by building upon existing intrinsic motivation and leveraging highly valued social recognition. We recommend a controlled intervention to monitor incentives’ effects on worker motivation and non-incentivized tasks to generate insights about the feasibility of PBIs to improve the delivery of PVT services.