While poverty and under-education continue to dampen contraception use in Nepal, exacerbating the country’s efforts to reduce maternal and child mortality rates, researchers say another, more surprising factor may be more intractable: Deeply held cultural preferences for sons over daughters. … Read the full story from the UCSD Newsroom

Dr. Anita RajFirst author Anita Raj, PhD, is a professor of medicine in the Division of Global Public Health and a Senior Fellow in the UC San Diego Center on Global Justice.

She focuses her global public health research on sexual and reproductive health, gender-based violence and substance misuse and abuse.

Funds from the Lucile and David Packard Foundation’s Population and Reproductive Health program support Dr. Raj’s study, Assessment of Girl Child Marriage and Adolescent Motherhood and Its Public Health Impact in South Asia.

The coauthors of the Nepal study report are three Division of Global Public Health colleagues: medical student Rohan J. Vilms, postdoctoral researcher Lotus McDougal and professor Jay G. Silverman, PhD.

Raj and Silverman are faculty members and Lotus McDougal is a graduate of the Global Health track of the UC San Diego – San Diego State University Joint Doctoral Program in Public Health.

Vilms is a second-year medical student who had the opportunity to take part in the Nepal study via a summer internship supported by UC San Diego’s National Institutes of Health Short-Term Research Training Grant for medical students.

His undergraduate degree is from the Global Health and Development track of the Human Biology program at Stanford University.

Rohan J. Vilms

Medical student Rohan J. Vilms

Vilms was born in the United States and spent his childhood years from age 3 to age 12 in India. Living in the two nations shaped his perceptions of disparities in standard of living and health outcomes because of social circumstances, he said.

He has particular concern for reproductive health.

“I think working for reproductive health is extremely important,” he said. “The standard of what we can do is not what we are doing. There are preventable deaths — infant and maternal mortality. That these still occur is a travesty.”

The Nepal project also attracted him because it gave him a chance to work with data from the Demographic and Health Surveys (DHS), a respected source of information from United States-conducted fieldwork around the world. The DHS database includes reproductive health information.

In working with the DHS data, he said, postdoctoral researcher Lotus McDougal gave him invaluable coaching and expert help.

Vilms makes the most of every opportunity to work and study in global public health. “I have had a lot of mentors,” he said. “I’m learning a lot.”

He has taken Dr. Richard Garfein’s San Quintin Field Course (FPM 244/MED248) three times, the maximum possible in the first two years of medical school.

Dr. Richard Garfein

Dr. Richard Garfein, professor in the Division of Global Public Health.

The San Quintin Field Course is associated with project VIIDAI: Viaje Interinstitucional de Integracion, Docente, Asistencia y de Investigacion (Retreat for Educational Integration, Assistance and Investigation), first conducted by Tijuana’s Universidad Autonoma de Baja California School of Medicine in 1981.

UCSD’s San Quintin Field Course is a School of Medicine elective built around VIIDAI’s academic and research field trips to rural regions in Baja California and Sonora. Students have the opportunity for hands-on clinical experience as well as public health research and practice. The course includes a required 3-day trip to the town of San Quintin on the west coast of Baja California.

Vilms hopes to arrange a global public health research year between his third and fourth years of medical school. Beyond that, his aspiration is to work in a setting where he can make a difference in health and in social justice.

In February, he presented data from the Nepal study as lead author of a poster presentation at the multidisciplinary Consortium of Universities for Global Health (CUGH) annual meeting in Washington, DC.

He said he couldn’t speak highly enough about the Global Public Health division faculty members and graduate students he has worked with.

Of Vilms and his contributions, Anita Raj said, “He worked incredibly hard and did a terrific job.”

More About Dr. Raj and Her Work

Earlier this month, Raj and Ulrike Boehmer, PhD, of the Boston University School of Public Health reported that rates of maternal and infant mortality are significantly higher in nations in which it is common for girls to be married before the age of 18.  |  Read the UCSD press release

At UC San Diego’s International Women’s Day event March 8, 2013, Raj spoke on “The Movement to End Rape Post-Delhi – Public Health Perspectives and Solutions.”

She was an online panelist on Public Radio International’s program The World February 25. The topic: whether there is a global movement for women’s safety in the wake of the Delhi rape protests.  |  Watch the video

In May 2012, Raj and her colleagues published a report in the Journal of the American Medical Association on the results of two decades of efforts to eliminate the practice of girl-child marriage in South Asia.  |  Read the UCSD press release  |  Read the report

Anita Raj is also affiliated with the Section of General Internal Medicine, Clinical Addiction Research and Education in the Department of Medicine at Boston University School of Medicine/Boston Medical Center.

Citation for the Nepal study report:  Anita Raj, Rohan J. Vilms, Lotus McDougal, Jay G. Silverman. Association between having no sons and using no contraception among a nationally representative sample of young wives in Nepal. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics – May 2013 (Vol. 121, Issue 2, Pages 162-165, DOI: 10.1016/j.ijgo.2012.12.011)  |  Read article abstract

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