Scholars@Duke
Joy Noel Baumgartner

Joy Noel Baumgartner

Adjunct Associate Professor of Global Health
Duke Global Health Institute
joy.baumgartner@duke.edu
Box 90519, Durham, NC 27708
310 Trent Drive, 328 Trent Hall, Durham, NC 27710

Selected Publications

Leveraging Community Health Workers and a Responsive Digital Health System to Improve Vaccination Coverage and Timeliness in Resource-Limited Settings: Protocol for a Cluster Randomized Type 1 Effectiveness-Implementation Hybrid Study.

Journal Article JMIR Res Protoc · January 12, 2024 BACKGROUND: Tanzania is 1 of 20 countries where the majority of unvaccinated and undervaccinated children reside. Prior research identified substantial rural-urban disparities in the coverage and timeliness of childhood vaccinations in Tanzania, with child ... Full text Link to item Cite

Functioning and quality of life among treatment-engaged adults with psychotic disorders in urban Tanzania: Baseline results from the KUPAA clinical trial.

Journal Article PloS one · January 2024 BackgroundThere is a treatment gap for those living with severe mental illnesses in low- and middle-income countries, yet not enough is known about those who are currently accessing clinical services. A better understanding of potentially modifiab ... Full text Cite

Study protocol for Sauti ya Vijana (The Voice of Youth): A hybrid-type 1 randomized trial to evaluate effectiveness and implementation of a mental health and life skills intervention to improve health outcomes for Tanzanian youth living with HIV.

Journal Article PLoS One · 2024 OBJECTIVE: Young people living with HIV (YPLWH) experience increased morbidity and mortality compared to all other age groups. Adolescence brings unique challenges related to sexual reproductive health, the elevated importance of peer groups, and often, em ... Full text Link to item Cite

Timeliness of Delivery Care and Maternal and Neonatal Health Outcomes in Private Facilities in Masaka Area, Uganda: A Quasi-Experimental Study.

Journal Article Matern Child Health J · November 2023 OBJECTIVES: While access to basic emergency obstetric and newborn care is necessary to reduce maternal and neonatal morbidity in low- and middle-income countries, data on the timeliness and quality of care at lower-level facilities is limited. This study e ... Full text Link to item Cite

Hopefulness among individuals living with schizophrenia and their caregivers in Tanzania: an actor-partner interdependence model.

Journal Article BMC psychiatry · July 2023 BackgroundHopefulness is a positive orientation or state of mind that can aid in the recovery and treatment of mental illness, as it can have significant impacts on clinical and psychosocial outcomes. As resource-constrained settings work to imple ... Full text Cite

Impact of the Child-optimized Financial Education (COFE) curriculum among savings group participants in Uganda: A cluster randomised controlled trial

Journal Article Journal of Development Effectiveness · January 1, 2023 This article reports on a post-test only cluster randomized controlled trial that assessed the impact of exposure to the Child-Optimized Financial Education (COFE) curriculum, delivered within Savings and Lending Communities (SILC) in Uganda, on caregivers ... Full text Cite

The Health Innovation Impact Checklist: a tool to improve the development and reporting of impact models for global health innovations.

Journal Article Global health action · December 2022 Donor financing is increasingly relying on performance-based measures that demonstrate impact. As new technologies and interventions enter the innovation space to address global health challenges, innovators often need to model their potential impact prior ... Full text Cite

A Recovery-Oriented Intervention for People With Psychosis: A Pilot Randomized Controlled Trial.

Journal Article Psychiatric services (Washington, D.C.) · November 2022 ObjectiveThis pilot randomized controlled trial evaluated the effectiveness of critical time intervention-task shifting (CTI-TS) for people with psychosis in Santiago, Chile, and Rio de Janeiro. CTI-TS is a 9-month intervention involving peer supp ... Full text Cite

Beyond coverage: Rural-urban disparities in the timeliness of childhood vaccinations in Tanzania.

Journal Article Vaccine · September 2022 BackgroundTimely vaccination maximizes efficacy for preventing infectious diseases. In the absence of national vaccination registries, representative sample survey data hold vital information on vaccination coverage and timeliness. This study char ... Full text Cite

Implementation challenges to patient safety in Guatemala: a mixed methods evaluation.

Journal Article BMJ Qual Saf · May 2022 BACKGROUND: Little is known about factors affecting implementation of patient safety programmes in low and middle-income countries. The goal of our study was to evaluate the implementation of a patient safety programme for paediatric care in Guatemala. MET ... Full text Open Access Link to item Cite

Perceived burden and family functioning among informal caregivers of individuals living with schizophrenia in Tanzania: a cross-sectional study.

Journal Article BMC psychiatry · January 2022 BackgroundGlobally, families play a critical role in providing care and support for persons living with schizophrenia. It is important to identify potentially modifiable factors that influence perceived caregiver burden in order to properly addres ... Full text Cite

Integrating Data to Evaluate a Global Health Grand Challenge

Journal Article Canadian Journal of Program Evaluation · January 1, 2022 This article describes the integrated, mixed methods (MM) design used to evaluate the Saving Lives at Birth (SL@B) program. SL@B is a multi-stakeholder, donor-supported global health initiative to tackle maternal and neonatal mortality via innovation. Sinc ... Full text Cite

Prevalence of self-reported diabetes risk factors and integration of diabetes screening and referral at two urban HIV care and treatment clinics in Zambia.

Journal Article PloS one · January 2022 People living with HIV (PLWH) on antiretroviral therapy (ART) are living longer and are at risk of HIV co-morbidities including non-communicable diseases (NCDs), particularly in low-resource settings. However, the evidence base for effectively integrating ... Full text Cite

The Effects of Antenatal Depression and Women's Perception of Having Poor Health on Maternal Health Service Utilization in Northern Ghana.

Journal Article Maternal and child health journal · November 2021 ObjectivesTo examine the effects of antenatal depression and women's perceived health during the antenatal period on maternal health service utilization in rural northern Ghana; including how the effect of antenatal depression on service use might ... Full text Cite

The impact of a maternal mental health intervention on intimate partner violence in Northern Ghana and the mediating roles of social support and couple communication: secondary analysis of a cluster randomized controlled trial.

Journal Article BMC public health · November 2021 BackgroundsDiverse intervention efforts are implemented to address intimate partner violence (IPV) against women. Via a syndemics theory lens and emerging empirical evidence, mental health interventions demonstrate promise to partially ameliorate ... Full text Cite

Correlates of early stimulation activities among mothers of children under age two in Siaya County, Kenya: Maternal mental health and other maternal, child, and household factors.

Journal Article Social science & medicine (1982) · October 2021 RationaleThe first two to three years of life are critical for early child development (ECD), which affects later life trajectories in health, development, and earning potential. Global calls for early stimulation activities to support optimal dev ... Full text Cite

Effect of a lay counselor delivered integrated maternal mental health and early childhood development group-based intervention in Siaya County, Kenya: A quasi-experimental longitudinal study.

Journal Article J Affect Disord · September 1, 2021 BACKGROUND: Maternal mental health is linked to early childhood development; yet there is a gap in evidence-based interventions for low-resource settings. This study estimates the impact of 'Integrated Mothers and Babies Course and Early Childhood Developm ... Full text Link to item Cite

Medical record bias in documentation of obstetric and neonatal clinical quality of care indicators in Uganda.

Journal Article Journal of clinical epidemiology · August 2021 ObjectiveTo achieve a high quality of care (QoC), accurate measurements are needed. This study evaluated the validity of QoC data from the medical records for childbirth deliveries and assessed whether medical records can be used to evaluate the e ... Full text Cite

Impact evaluation of a maternal and neonatal health training intervention in private Ugandan facilities.

Journal Article Health policy and planning · August 2021 Global and country-specific targets for reductions in maternal and neonatal mortality in low-resource settings will not be achieved without improvements in the quality of care for optimal facility-based obstetric and newborn care. This global call includes ... Full text Cite

Common mental disorders and intimate partner violence against pregnant women living with HIV in Cameroon: a cross-sectional analysis.

Journal Article BMC pregnancy and childbirth · March 2021 BackgroundWomen living with HIV are at increased risk of poor mental health and intimate partner violence (IPV). Mental health disorders have been consistently associated with suboptimal HIV-related outcomes. Little is known about the prevalence o ... Full text Cite

Prevalence and correlates of maternal early stimulation behaviors during pregnancy in northern Ghana: a cross-sectional survey.

Journal Article BMC pregnancy and childbirth · January 2021 BackgroundPer UNICEF's Nurturing Care Framework, early childhood development (ECD) begins during pregnancy and many lower-resource settings need data to inform their programs for optimal child development. The maternal-fetal relationship can be pa ... Full text Cite

The syndemic effects of mental ill health, household hunger, and intimate partner violence on adherence to antiretroviral therapy among pregnant women living with HIV in Yaoundé, Cameroon.

Journal Article PloS one · January 2021 BackgroundThis research advances understanding of interrelationships among three barriers to adherence to antiretroviral therapy (ART) among pregnant women living with HIV (WLWH) in Cameroon: probable common mental disorders (CMD), intimate partne ... Full text Cite

Improving global maternal and newborn survival via innovation: Stakeholder perspectives on the Saving Lives at Birth Grand Challenge.

Journal Article PloS one · January 2021 The Saving Lives at Birth (SL@B) funding partners joined in 2011 to source, support, and scale maternal and newborn health (MNH) innovations to improve maternal and newborn survival by focusing on the 24 hours around the time of birth. A multi-methods, ret ... Full text Cite

'I have a lot of faith in her': Value of community health workers in addressing family planning in rural Ghana.

Journal Article Global public health · October 2020 In rural settings with shortages in trained health care workers, community health workers (CHWs) play an important role in the delivery of health care services. The Ghana Health Service initiated a national CHW programme in 2016 to expand health services t ... Full text Cite

Parental concerns and uptake of childhood vaccines in rural Tanzania - a mixed methods study.

Journal Article BMC public health · October 2020 BackgroundVaccine hesitancy has been recognized as an important barrier to timely vaccinations around the world, including in sub-Saharan Africa. In Tanzania, 1 in 4 children is not fully vaccinated. The objective of this mixed methods study was t ... Full text Cite

Implementation Analysis of a Perioperative Patient Safety Program in Guatemala.

Journal Article World J Surg · July 2020 BACKGROUND: The implementation of programs to improve patient safety remains challenging in low- and middle-income countries. The goal of our study was to define the barriers and facilitators to implementation of a perioperative patient safety program in G ... Full text Link to item Cite

Depression and Sexual Trauma Among Adolescent Girls and Young Women in HIV-Prevention Research in Tanzania.

Journal Article Maternal and child health journal · May 2020 PurposeClinical trials are necessary to test HIV-prevention strategies among adolescent girls and young women in sub-Saharan Africa. Psychosocial risk factors that increase girls' and young women's vulnerability for HIV may also impact their exper ... Full text Cite

Beneath the Surface: A Comparison of Methods for Assessment of Quality of Care for Maternal and Neonatal Health Care in Rural Uganda.

Journal Article Maternal and child health journal · March 2020 ObjectivesEfforts to improve access to healthcare in low-income countries will not achieve the maternal and child health (MCH) Sustainable Development Goals unless a concomitant improvement in the quality of care (QoC) occurs. This study measures ... Full text Cite

Side effect concerns and their impact on women's uptake of modern family planning methods in rural Ghana: a mixed methods study.

Journal Article BMC women's health · March 2020 BackgroundDespite availability of modern contraceptive methods and documented unmet need for family planning in Ghana, many women still report forgoing modern contraceptive use due to anticipated side effects. The goal of this study was to examine ... Full text Cite

Prevalence and Correlates of Depression Among Pregnant Women Enrolled in a Maternal and Newborn Health Program in Rural Northern Ghana: a Cross-sectional Survey.

Journal Article Global social welfare : research, policy & practice · January 2020 Women in many sub-Saharan African countries are at elevated risk of depression during pregnancy. However, there are still gaps in the estimates of antenatal depression and associated risk factors in very low-resource settings such as Northern Ghana. This s ... Full text Cite

Integrated mental health screening for obstetric fistula patients in Mali: From evidence to policy.

Journal Article PloS one · January 2020 BackgroundObstetric fistula significantly impacts women's mental health and well-being. Routine screening for mental health in fistula repair programs can be a gateway to link patients to services, and can produce routine data to inform programmat ... Full text Cite

Nutritional status among young adolescents attending primary school in Tanzania: contributions of mid-upper arm circumference (MUAC) for adolescent assessment.

Journal Article BMC public health · November 2019 BackgroundAdolescence is a critical time of development and nutritional status in adolescence influences both current and future adult health outcomes. However, data on adolescent nutritional status is limited in low-resource settings. Mid-upper a ... Full text Cite

Stakeholder acceptability of adolescent participation in clinical trials for biomedical HIV prevention products: considerations from Tanzania and India.

Journal Article AIDS care · July 2019 Researchers and advocates have increasingly called for adolescent participation in clinical trials for new HIV prevention products, particularly adolescent girls in areas most affected by the epidemic. However, recent trials have highlighted the challenges ... Full text Cite

Do mobile phone-based reminders and conditional financial transfers improve the timeliness of childhood vaccinations in Tanzania? Study protocol for a quasi-randomized controlled trial.

Journal Article Trials · July 2019 BackgroundVaccination is a cost-effective strategy for reducing morbidity and mortality among children under 5 years old. To be fully protected from diseases such as tuberculosis, diphtheria, pertussis, and polio, children must receive all recomme ... Full text Cite

Implementing the protocol of a pilot randomized controlled trial for the recovery-oriented intervention to people with psychoses in two Latin American cities.

Journal Article Cadernos de saude publica · May 2019 Several Latin American countries have made remarkable strides towards offering community mental health care for people with psychoses. Nonetheless, mental health clinics generally have a very limited outreach in the community, tending to have weaker links ... Full text Cite

Identification of patients with recent-onset psychosis in KwaZulu Natal, South Africa: a pilot study with traditional health practitioners and diagnostic instruments.

Journal Article Social psychiatry and psychiatric epidemiology · March 2019 PurposeThere is considerable variation in epidemiology and clinical course of psychotic disorders across social and geographical contexts. To date, very little data are available from low- and middle-income countries. In sub-Saharan Africa, most p ... Full text Cite

Providing early detection and early intervention for autism spectrum disorder in South Africa: stakeholder perspectives from the Western Cape province.

Journal Article J Child Adolesc Ment Health · November 2018 We set out to examine key stakeholder perspectives on early detection and intervention for autism spectrum disorder (ASD) in South Africa. Early detection and intervention improves child and family outcomes and lessens long-term costs. We focused on stakeh ... Full text Link to item Cite

Motivation and satisfaction among community health workers administering rapid diagnostic tests for malaria in Western Kenya.

Journal Article Journal of global health · June 2018 BackgroundThe continued success of community case management (CCM) programs in low-resource settings depends on the ability of these programs to retain the community health workers (CHWs), many of whom are volunteers, and maintain their high-quali ... Full text Cite

Building a safety culture in global health: lessons from Guatemala.

Journal Article BMJ Glob Health · 2018 Programmes to modify the safety culture have led to lasting improvements in patient safety and quality of care in high-income settings around the world, although their use in low-income and middle-income countries (LMICs) has been limited. This analysis ex ... Full text Open Access Link to item Cite

Perceptions of Adolescent Pregnancy Among Teenage Girls in Rakai, Uganda

Journal Article Global Qualitative Nursing Research · August 7, 2017 The leading causes of death and disability among Ugandan female adolescents aged 15 to 19 years are pregnancy complications, unsafe abortions, and childbirth. Despite these statistics, our understanding of how girls perceive adolescent pregnancy is limited ... Full text Cite

Correlates of postpartum common mental disorders: results from a population-based study in Amhara region, Ethiopia.

Journal Article Archives of women's mental health · October 2016 Postpartum common mental disorders are prevalent among women in Ethiopia. Data on associated factors are limited. This population-based study assessed mental health among 1294 nonpregnant, postpartum women in Amhara region. Poor health of the last delivere ... Full text Cite

Substance use and duration of untreated psychosis in KwaZulu-Natal, South Africa

Journal Article South African Journal of Psychiatry · March 22, 2016 Background: Substance use and psychiatric disorders cause significant burden of disease in low- and middle-income countries. Co-morbid psychopathology and longer duration of untreated psychosis (DUP) can negatively affect treatment outcomes. Objectives: Th ... Full text Cite

Beyond symptom management: Family relations, unmet needs of persons living with severe mental illnesses, and potential implications for social work in South Africa.

Journal Article Social work in health care · January 2016 This study examined the quality of family relationships and its associations with the severity of unmet needs of individuals admitted to a tertiary psychiatric hospital in South Africa. The quality of family relations and perceived unmet needs were assesse ... Full text Cite

Mental health screenings for couples at churches in Nigeria: a strategy for enhancing community-based maternal mental health services in low-resource settings.

Journal Article Social psychiatry and psychiatric epidemiology · March 2015 The burden of perinatal mental disorders among women in low- and middle-income countries is substantial. The current integration of mental health into maternal, neonatal and child health service platforms is limited, despite global calls to prioritize such ... Full text Cite

Duration of untreated psychosis and the pathway to care in KwaZulu-Natal, South Africa.

Journal Article The Journal of nervous and mental disease · March 2015 Considerable controversy surrounds the role of traditional health practitioners (THPs) as first-contact service providers and their influence on the duration of untreated psychosis (DUP) in sub-Saharan Africa. This study examined first-contact patterns and ... Full text Cite

Domestic violence among adolescents in HIV prevention research in Tanzania: participant experiences and measurement issues.

Journal Article Maternal and child health journal · January 2015 Under-representation of female adolescents in HIV clinical trials may inhibit their access to future prevention technologies. Domestic violence, broadly defined as violence perpetrated by intimate partners and/or family members, may affect trial participat ... Full text Cite

Maternal mental health in Amhara region, Ethiopia: a cross-sectional survey.

Journal Article Global health, science and practice · December 2014 BackgroundPostpartum common mental disorders (CMD) such as depression and anxiety are increasingly recognized for their burden in low-resource countries such as Ethiopia. However, the magnitude of postpartum CMD in Ethiopia is not well-established ... Full text Cite

Integrating family planning services into HIV care and treatment clinics in Tanzania: evaluation of a facilitated referral model.

Journal Article Health policy and planning · August 2014 Featured Publication BackgroundMany clients of HIV care and treatment services have unmet contraceptive needs. Integrating family planning (FP) services into HIV services is an increasingly utilized strategy for meeting those unmet needs. However, numerous models for ... Full text Cite

Measuring social inclusion--a key outcome in global mental health.

Journal Article International journal of epidemiology · April 2014 BackgroundSocial inclusion is increasingly recognized as a key outcome for evaluating global mental health programmes and interventions. Whereas social inclusion as an outcome is not a new concept in the field of mental health, its measurement has ... Full text Cite

Comparing patterns of sexual risk among adolescent and young women in a mixed-method study in Tanzania: implications for adolescent participation in HIV prevention trials.

Journal Article Journal of the International AIDS Society · January 2014 IntroductionDespite the disproportionate impact of HIV on women, and adolescents in particular, those below age 18 years are underrepresented in HIV prevention trials due to ethical, safety and logistical concerns. This study examined and compared ... Full text Cite

Social integration in global mental health: what is it and how can it be measured?

Journal Article Epidemiology and psychiatric sciences · March 2013 Featured Publication Purpose. Global mental health movements increasingly highlight social integration as a key outcome for mental health services. This creates a pressing need to better articulate and measure this outcome. Much of the work in social integration ... Full text Cite

Sexual agency and ambivalence in the narratives of first time sexual experiences of adolescent girls in Jamaica: implications for sex education

Journal Article Sex Education · January 1, 2013 An analysis of descriptions of the first heterosexual experiences of thirty-two 14-17-year-old girls in Jamaica focused on the constructs of sexual agency and ambivalence about having sex. Three key results were identified. First, for many girls, there was ... Full text Cite

Impact of a provider job aid intervention on injectable contraceptive continuation in South Africa.

Journal Article Studies in family planning · December 2012 Featured Publication Arriving late for scheduled contraceptive reinjections is common in many countries and contributes to discontinuation when providers are unsure how to manage such clients. A clinic-randomized cohort and cross-sectional study with more than 5,000 clients us ... Full text Cite

Service delivery characteristics associated with contraceptive use among youth clients in integrated voluntary counseling and HIV testing clinics in Kenya.

Journal Article AIDS care · January 2012 Youth attending voluntary counseling and HIV testing (VCT) services often have unmet need for contraception. Integrated family planning (FP) and HIV services can address dual HIV and unintended pregnancy prevention needs. However, little is known about whi ... Full text Cite

Community integration of formerly homeless men and women with severe mental illness after hospital discharge.

Journal Article Psychiatric services (Washington, D.C.) · January 2012 ObjectiveThis exploratory study examined the impact of critical time intervention (CTI), a time-limited care coordination model, on community integration among formerly homeless adults with severe mental illness after discharge from inpatient psyc ... Full text Cite

Commentary: Sir Arthur Mitchell--pioneer of psychiatric epidemiology and of community care.

Journal Article International journal of epidemiology · December 2010 Full text Cite

"Being faithful" in a sexual relationship: perceptions of Tanzanian adolescents in the context of HIV and pregnancy prevention.

Journal Article AIDS care · September 2010 Little is known about what adolescents think about faithfulness and partner reduction for HIV prevention (the "B" in the ABC HIV prevention behavior change strategy), including how they understand its implementation within relationships. In addition, becau ... Full text Cite

Experiences of sexual coercion among adolescent women: qualitative findings from Rakai district, Uganda.

Journal Article Journal of interpersonal violence · December 2009 Limited data from low-income countries are available on the continuum of coercive experiences, the contexts in which they occur, and how adolescent women perceive and respond to coercion. This article presents results from focus group discussions and in-de ... Full text Cite

The influence of early sexual debut and sexual violence on adolescent pregnancy: a matched case-control study in Jamaica.

Journal Article International perspectives on sexual and reproductive health · March 2009 ContextContraceptive knowledge and use at first sex have increased over time among Jamaican adolescents, yet high unintended pregnancy rates persist. More information on risk factors for adolescent pregnancy is needed to inform programs.Method ... Full text Cite

The influence of early sexual debut and sexual violence on adolescent pregnancy: A matched case-control study in Jamaica

Journal Article International Family Planning Perspectives · January 1, 2009 CONTEXT: Contraceptive knowledge and use at first sex have increased over time among Jamaican adolescents, yet high unintended pregnancy rates persist. More information on risk factors for adolescent pregnancy is needed to inform programs. METHODS: Structu ... Full text Cite

Timeliness of contraceptive reinjections in South Africa and its relation to unintentional discontinuation.

Journal Article International family planning perspectives · June 2007 ContextResearch examining hormonal injectable contraceptive continuation has focused on clients' intentional discontinuation. Little attention, however, has been paid to unintentional discontinuation due to providers' management of clients who wou ... Full text Cite