Variations in the barriers and contributors to breastfeeding across industries have not been well characterized for vulnerable populations such as mothers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Our study used the Total Worker Health Framework to characterize workplace factors acting as barriers and/or contributors to breastfeeding among women participating in the New Hampshire WIC. Surveys were collected from WIC mothers (n = 682), which asked about employment, industry, and workplace accommodation and supports related to breastfeeding in the workplace. We found workplace policy factors supporting breastfeeding (i.e., having paid maternity leave, other maternity leave, and a breastfeeding policy) varied by industry. Women in specific service-oriented industries (i.e., accommodation and retail) reported the lowest rates of breastfeeding initiation and workplace supports for breastfeeding and pumping. Further, how a woman hoped to feed and having a private pumping space at work were significantly associated with industry, breastfeeding initiation, and breastfeeding duration. A substantial portion of women reported being not sure about their workplace environment, policies, and culture related to breastfeeding. Additional studies with larger sample sizes of women participating in WIC are needed to further characterize the barriers to breastfeeding associated with specific industries.

The current study examines perceived hunger, which may result from food insecurity, and its effect on academic and athletic performance in students on a liberal arts college campus in New Hampshire. It also examines how students compensate for hunger and their preferences for different types of resources to address hunger. A review of the literature on food insecurity in college students informed the development of a questionnaire on hunger. A mixed-method approach was used to collect qualitative/quantitative data from students of different disciplines. Three hundred and seventy-one students had complete surveys. Thirty-six percent and 34% of students reported that their academic and/or athletic performance, respectively, had been affected by hunger. Forty-seven percent of students responded they would consider taking advantage of an on-campus food pantry. In an open-ended question, students reported concerns about the social stigma related to economic instability and utilizing a food pantry. Our research findings support many on-campus initiatives including the creation of a student-run on-campus food pantry, longer dining common hours, a Swipe It Forward program, and the creation of a task force to address food insecurity on campus and to work with college systems to develop opportunities to better serve students at the college.

Adolescent health demands specific attention because adolescents have the lowest levels of health-care coverage of any age-group globally. The main objective as addressed in this article was to explore the lived experience of adolescent mothers and the services provided to them by community health assistants (CHAs) in rural Zambia. Because the number of adolescent mothers in rural Zambia is so high, it is even more critical to describe the lived experiences of health care among these young women with particular emphasis on primary health care as delivered by CHAs in rural Zambia. We used a mixed-methods design to address our research questions. Data were collected from nine focus groups, which were conducted with young mothers from four provinces and 10 districts (n = 60). To support our effort to better understand the delivery of maternal and child health care in rural Zambia, key informant interviews were conducted with adolescent mothers (n = 12). We also conducted surveys (n = 44) and one-on-one interviews (n = 22) with CHAs. To the best of our knowledge, this is the largest study focused on the intersection of adolescents, maternal child health, and CHA delivery of care in Zambia. The results of our study suggest opportunities for change to operational practices within the rural health-care setting and the need to develop structured and age-appropriate services that focus on adolescents. This work addresses the gap in research for adolescents in health care in rural Zambia and brings attention to the unique health-care needs of adolescent mothers within the rural health-care setting.

Introduction: Breastfeeding-friendly worksites are associated with longer breastfeeding durations, yet currently there is a dearth of research exploring women's experiences of workplace-based wellness programs designed to support continued lactation.Method: Using semi-structured interviews with a voluntary sample of participants from one rural New England town (N = 18), we examined women's experiences of returning to work at worksites with the Centers for Disease Control and Prevention (CDC)'s Worksite Health ScoreCard (HSC) “breastfeeding-friendly” designation.Results: Five key themes emerged from participants' narratives; three policy and workplace climate-related themes are described.Discussion: Collectively, findings indicate areas where HSC lactation-support questions might be modified to more precisely identify the psychosocial, structural, and sociocultural needs of breastfeeding employees.

Children living with and affected by HIV are at risk of poverty and mental health problems that can interfere with educational attainment. This review is a secondary analysis of educational attainment within a case-controlled study of children 10–17 years of age who were HIV-positive, HIV-affected by caregiver HIV status or by HIV in their family and HIV-unaffected in rural Rwanda. We evaluated caregiver and child-reported HIV-related stigma, anxiety/depression, conduct problems and social support and any likely associations with children being overage for their current grade in school. Overall, 90.4% of children were enrolled in school; however, 83.8% were overage for their current grade, with higher rates of overage for grade among HIV-positive and HIV-affected children. Interventions and policies that recognize and promote social support within education to address challenges of conduct problems among youth may help counteract the high rates of grade repetition among children in rural Rwanda.