Decision Making Cohort Study

Malawi 11 cropThe Role of Decision Making in Sexual and Reproductive Health Behaviors
(Principal Investigator: Dr. Alison Norris)

Background:
Understanding how women and men make health decisions, individually and
within couples, is critical to increasing the use of existing health promoting and
disease prevention technologies. While technologies to improve sexual and
reproductive health and reduce morbidity and mortality exist (such as contraception, HIV testing, or antiretroviral medications) some individuals who would benefit are nevertheless not utilizing them. The lower-than-expected utilization of many health technologies worldwide led to the development of the UTHA Cohort Study.

Purpose:
This community-based project, conducted via home-based visits, aims to understand factors associated with diminished health among men and women living in rural Malawi. The UTHA Cohort Study is being developed to serve as a platform to test clinical and community-based interventions to respond to health needs. Our long-term goal is to create interventions to improve health decision making thereby reduce risk for adverse outcomes.

  • Wave 1 (collected July 2014 until February 2015) was designed to measure health behaviors and risks relating to HIV testing and care, family planning, and safe childbirth, as well as many other self-reported measures of health.
  • Wave 2 (conducted May 2016 to August 2016) collected biological samples from participants, tested them in in-country laboratories, and established the prevalence of HIV and several other infectious diseases. These data have permitted us to assess associations between modifiable decision-making competencies, sexual and reproductive health behaviors, and biological outcomes.
  • Wave 3 (collected October 2016 until April 2017) was designed to assess a variety of fertility and family planning behavior outcomes, including contraceptive need and barriers and facilitators to contraception. The research findings will be used to develop an easy-to-implement counseling tool for clinicians and community health workers who counsel women and couples on family planning.