Patience Afulani, MBChB, MPH, PhD
Assistant Professor, Department of Epidemiology & Biostatistics
Dr. Afulani conducts research on the social and health system factors underlying disparities in reproductive, maternal, neonatal, and child health (RMNCH). Her research has extended the evidence on how RMNCH outcomes are shaped by quality of care in health facilities as well as by social determinants. In addition, she has contributed to improved measurement of person-centered reproductive health care, and to the development of evidence-based interventions to improve RMNCH outcomes and reduce disparities.
Dr. Afulani’s prior work examined sources of disparities in quality of antenatal care and how this affects use of skilled birth attendants and birth outcomes in Ghana and Burkina Faso. In addition, she led the development of the person-centered maternity care (PCMC) scale and supported the development of a person-centered family planning scale, both of which were validated in Kenya and India. She also conducted research into sources of disparities in PCMC and barriers to providing PCMC in Kenya. In addition, she has worked on projects to design and evaluate interventions to improve quality of care including PCMC in Ghana, Kenya, and India. She has also conducted research on the health and reproductive behavior of migrants from Africa, and on the consequences of food insecurity in the United States.
Dr. Afulani’s current projects include an NICHD K99/R00 award on addressing provider stress and unconscious bias to improve quality of person-centered maternal health care in Kenya; a UCSF Preterm Birth Initiative grant on measurement of PCMC among women at risk for preterm birth in California; and a Gates-funded project to improve quality of care (including PCMC) through low-tech simulation training of providers in India.
Education:
- University of California, Los Angeles, School of Public Health, PhD in Public Health
- University of California, Los Angeles, School of Public Health, MPH in Community Health Sciences
- University of Ghana Medical School, MBChB (Bachelor of Medicine and Surgery)
In the news:
- The role of bias in how women are treated during childbirth: A Kenya case study (op-ed) | The Conversation
- Responsive and respectful maternity care needs protection during COVID-19 crisis (op-ed) | The Conversation
- What drives abuse of women in childbirth? We asked those providing the care (op-ed) |The Conversation
- Antenatal care in Kenya needs improvement (op-ed) | The Conversation
- Subtle abuse affects women during childbirth (op-ed) | The Conversation
- Childbirth is hard: Health systems shouldn't make it harder (op-ed) | Apolitical
- Study shows women want men out of delivery rooms | Standard Digital
Publications:
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Person-centered maternity care and postnatal health: Associations with maternal and newborn health outcomes. AJOG Global Reports. 2021; (100005). Sudhinaraset M, Landrian A, Golub GM, Cotter SY, Afulani PA. . . View Publication.
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Understanding disparities in person-centred maternity care: the potential role of provider implicit and explicit bias. Health Policy Plan. 2021 Jan 25. Afulani PA, Ogolla BA, Oboke EN, Ongeri L, Weiss SJ, Lyndon A, Mendes WB. PMID: 33491086.
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Providing respectful maternity care in northern Ghana: A mixed-methods study with maternity care providers. Midwifery. 2020 Dec 11; 94:102904. Moyer CA, McNally B, Aborigo RA, Williams JEO, Afulani P. PMID: 33341537.
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The Relationship Between Counseling and Adherence to Antiretroviral Therapy Among Pregnant and Breastfeeding Women Enrolled in Option B. AIDS Educ Prev. 2020 10; 32(5):378-391. Nutor JJ, Slaughter-Acey JC, Afulani PA, Obimbo MM, Mojola SA. PMID: 33112676.
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Development and validation of a person-centered abortion scale: the experiences of care in private facilities in Kenya. BMC Womens Health. 2020 Sep 19; 20(1):208. Sudhinaraset M, Landrian A, Afulani PA, Phillips B, Diamond-Smith N, Cotter S. PMID: 32950052.
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Perceived preparedness to respond to the COVID-19 pandemic: a study with healthcare workers in Ghana. J Glob Health Sci. 2020; 2:e24. Patience A. Afulani, Akua O. Gyamerah, Raymond A. Aborigo, Jerry John Nutor, Hawa Malechi, Amos Laar, Mona Sterling, and John Koku Awoonor-Williams8. View Publication.
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Providers' perceptions of communication and women's autonomy during childbirth: a mixed methods study in Kenya. Reprod Health. 2020 Jun 03; 17(1):85. Afulani PA, Buback L, Kelly AM, Kirumbi L, Cohen CR, Lyndon A. PMID: 32493424.
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Providers' perceptions of disrespect and abuse during childbirth: a mixed-methods study in Kenya. Health Policy Plan. 2020 Jun 01; 35(5):577-586. Afulani PA, Kelly AM, Buback L, Asunka J, Kirumbi L, Lyndon A. PMID: 32154878.
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A Rapid Review of Available Evidence to Inform Indicators for Routine Monitoring and Evaluation of Respectful Maternity Care. Glob Health Sci Pract. 2020 03 30; 8(1):125-135. Afulani PA, Buback L, McNally B, Mbuyita S, Mwanyika-Sando M, Peca E. PMID: 32234844.
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Provider knowledge and perceptions following an integrated simulation training on emergency obstetric and neonatal care and respectful maternity care: A mixed-methods study in Ghana. Midwifery. 2020 Jun; 85:102667. Afulani PA, Dyer J, Calkins K, Aborigo RA, Mcnally B, Cohen SR. PMID: 32114318.
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Association between person-centered maternity care and newborn complications in Kenya. Int J Gynaecol Obstet. 2020 Jan; 148(1):27-34. Sudhinaraset M, Landrian A, Afulani PA, Diamond-Smith N, Golub G. PMID: 31544243.
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Accountability for respectful maternity care. Lancet. 2019 11 09; 394(10210):1692-1693. Afulani PA, Moyer CA. PMID: 31604661.
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Quality of antenatal care and associated factors in a rural county in Kenya: an assessment of service provision and experience dimensions. BMC Health Serv Res. 2019 Oct 07; 19(1):684. Afulani PA, Buback L, Essandoh F, Kinyua J, Kirumbi L, Cohen CR. PMID: 31590662.
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Providers and women's perspectives on person-centered maternity care: a mixed methods study in Kenya. Int J Equity Health. 2019 06 10; 18(1):83. Sudhinaraset M, Giessler K, Golub G, Afulani P. PMID: 31182105.
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Toward the development of a short multi-country person-centered maternity care scale. Int J Gynaecol Obstet. 2019 Jul; 146(1):80-87. Afulani PA, Feeser K, Sudhinaraset M, Aborigo R, Montagu D, Chakraborty N. PMID: 31004349.
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Measuring what matters for maternal and newborn health. Lancet Glob Health. 2019 05; 7(5):e544-e545. Diamond-Smith N, Afulani P. PMID: 30898496.
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Can integrated clinical simulation trainings improve person-centred maternity care? Results from a pilot project in Ghana. The Lancet Global Health. 2019 Mar 1; 7:s47. P Afulani, R Aborigo, S Cohen, C Moyer, D Walker, J Williams. .View in: Publisher Site Mentions:
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Can an integrated obstetric emergency simulation training improve respectful maternity care? Results from a pilot study in Ghana. Birth. 2019 09; 46(3):523-532. Afulani PA, Aborigo RA, Walker D, Moyer CA, Cohen S, Williams J. PMID: 30680785.
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Person-centred maternity care in low-income and middle-income countries: analysis of data from Kenya, Ghana, and India. Lancet Glob Health. 2019 Jan; 7(1):e96-e109. Afulani PA, Phillips B, Aborigo RA, Moyer CA. PMID: 30554766.
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Food insecurity, mental health, and use of mental health services among nonelderly adults in the United States. Journal of Hunger & Environmental Nutrition. 2018 Oct 29; 1-22. Patience A. Afulani, Alisha Coleman-Jensen, Dena Herman. .View in: Publisher Site Mentions:
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Politics and Public Service Provision in Africaâs New Democracies. International Journal of Politics, Culture, and Society. 2018 Sep 1; 31(3):207-227. Joseph Asunka, Patience A. Afulani. .View in: Publisher Site Mentions:
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Validation of the person-centered maternity care scale in India. Reprod Health. 2018 Aug 29; 15(1):147. Afulani PA, Diamond-Smith N, Phillips B, Singhal S, Sudhinaraset M. PMID: 30157877.
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Development of a Person-Centered Family Planning Scale in India and Kenya. Stud Fam Plann. 2018 09; 49(3):237-258. Sudhinaraset M, Afulani PA, Diamond-Smith N, Golub G, Srivastava A. PMID: 30069983.
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Predictors of person-centered maternity care: the role of socioeconomic status, empowerment, and facility type. BMC Health Serv Res. 2018 05 11; 18(1):360. Afulani PA, Sayi TS, Montagu D. PMID: 29751805.
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Companionship during facility-based childbirth: results from a mixed-methods study with recently delivered women and providers in Kenya. BMC Pregnancy Childbirth. 2018 May 10; 18(1):150. Afulani P, Kusi C, Kirumbi L, Walker D. PMID: 29747593.
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What makes or mars the facility-based childbirth experience: thematic analysis of women's childbirth experiences in western Kenya. Reprod Health. 2017 Dec 29; 14(1):180. PMID: 29284490.
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Conceptualizing pathways linking women's empowerment and prematurity in developing countries. BMC Pregnancy Childbirth. 2017 Nov 08; 17(Suppl 2):338. PMID: 29143627.
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Advancing a conceptual model to improve maternal health quality: The Person-Centered Care Framework for Reproductive Health Equity. Gates Open Res. 2017 Nov 06; 1:1. Sudhinaraset M, Afulani P, Diamond-Smith N, Bhattacharyya S, Donnay F, Montagu D. PMID: 29355215.View in: PubMed Mentions:
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Development of a tool to measure person-centered maternity care in developing settings: validation in a rural and urban Kenyan population. Reprod Health. 2017 Sep 22; 14(1):118. PMID: 28938885.
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Transnational ties and the health of sub-Saharan African migrants: The moderating role of gender and family separation. Soc Sci Med. 2016 11; 168:63-71. PMID: 27639482.
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Political accountability and public service provision in Africa: evidence from Ghana. Annals of Global Health. 2016 Aug 20; 82(3):332-333. J. Asunka, P. Afulani. .View in: Publisher Site Mentions:
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Explaining disparities in use of skilled birth attendants in developing countries: a new conceptual framework. Annals of Global Health. 2016 Aug 20; 82(3):375. Patience A. Afulani, Cheryl Moyer. .View in: Publisher Site Mentions:
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Determinants of stillbirths in Ghana: does quality of antenatal care matter? BMC Pregnancy Childbirth. 2016 06 02; 16(1):132. PMID: 27255155.
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Explaining Disparities in Use of Skilled Birth Attendants in Developing Countries: A Conceptual Framework. PLoS One. 2016; 11(4):e0154110. PMID: 27105309.
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Food Insecurity and Cost-Related Medication Underuse Among Nonelderly Adults in a Nationally Representative Sample. Am J Public Health. 2015 Oct; 105(10):e48-59. PMID: 26270308.
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Improve Antenatal Care in Ghanaâs Lower-Level Health Facilities. 2015. Afulani PA. . View Publication.
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Socialization, Adaptation, Transnationalism, and the Reproductive Behavior of Sub-Saharan African Migrants in France. Population Research and Policy Review. 2015 Aug 1; 34(4):561-592. Patience A. Afulani, Joseph Asunka. .View in: Publisher Site Mentions:
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Determinants of maternal health and health-seeking behavior in sub-Saharan Africa: The role of quality of care. 2015. Afulani PA. . View Publication.
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Deconstructing rural/urban and socioeconomic differentials in quality of antenatal care in Ghana. Annals of Global Health. 2015 Mar 12; 81(1):106. P.A. Afulani. .View in: Publisher Site Mentions:
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Rural/urban and socioeconomic differentials in quality of antenatal care in Ghana. PLoS One. 2015; 10(2):e0117996. PMID: 25695737.
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Food Insecurity and Health Outcomes Among Older Adults: The Role of Cost-Related Medication Underuse. J Nutr Gerontol Geriatr. 2015; 34(3):319-42. PMID: 26267444.
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Delaying and reducing medication use as a coping mechanism for food insecurity (268.6). The FASEB Journal. 2014 Apr 1; 28. Dena Herman, Patience Afulani, Gail Harrison, Alisha Coleman-Jensen. .View in: Publisher Site Mentions:
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Using community health workers in community-based growth promotion: what stakeholders think. Health Educ Res. 2012 Dec; 27(6):1005-17. PMID: 22791682.