About

Meredith Brooks is an Assistant Professor in the Department of Global Health at Boston University School of Public Health, having joined in July 2022. She holds an M.P.H. in Urban Health and a Ph.D. in Population Health from Northeastern University, and completed a Postdoctoral Fellowship in Tuberculosis Epidemiology at Harvard Medical School's Department of Global Health and Social Medicine. She also holds a certificate in Implementation Science from UCSF and is a Fellow of the 7th Cohort of HIV Implementation Science Training at Johns Hopkins University. Dr. Brooks is dedicated to improving the health and wellbeing of vulnerable populations globally. Her research focuses on identifying interventions and strategies to enhance detection, diagnosis, and care for children and adolescents with or at high risk of tuberculosis. She produces evidence to refine diagnostic algorithms, identify gaps in care and treatment, and advance surveillance efforts. Her work involves developing and applying advanced statistical and machine learning approaches to improve tuberculosis indicators and outcomes, utilizing implementation science methodology to promote the uptake of evidence-based interventions. She has extensive experience conducting large international clinical trials and collaborates with partners across multiple countries including Bangladesh, India, Mexico, Mongolia, Pakistan, Peru, Philippines, Russia, Sierra Leone, and South Africa. Supported by NIH, foundation, and institutional funding, her research program emphasizes improving tuberculosis prevention, screening, and treatment in real-world health systems, especially for children and adolescents. She is the Principal Investigator of an NIH NIAID K01 award examining pediatric and adolescent TB transmission using geospatial and epidemiologic methods, and a Co-Investigator on NIH R01-funded implementation trials. Her early career was supported by awards such as the Thrasher Research Fund Early Career Award, the American Lung Association Research Catalyst Award, and others. Dr. Brooks also serves as the Department of Global Health's representative and Chair of the Faculty Senate at BUSPH, and is on the editorial boards of PLOS One, BMJ Open, and BMC Global and Public Health.

Research topics

• Sociology
• Environmental health
• Demography
• Medicine
• Gynecology
• Nursing
• Family medicine
• Biology
• Psychology
• Economic growth

Selected publications

• Gender-transformative, community-based intervention and changes in long-acting reversible contraceptive use among adolescent girls and young women in underserved districts of Mozambique

  Research Square · 2026-04-06

  preprintOpen access
  PublisherOA PDFDOI

• Effect of a Gender-Synchronized Family Planning Intervention on Inequitable Gender Norms in a Cluster Randomized Control Trial Among Husbands of Married Adolescent Girls in Dosso, Niger

  Violence Against Women · 2025-08-11

  articleOpen access

  Gender inequitable norms have severe consequences for safety and health globally. Using data from a four-arm cluster randomized control trial of the Reaching Married Adolescents in Niger (RMA) intervention (2016–2019), this study assesses effects on gender norms among husbands of married adolescent girls ( n = 1,055). Using an adjusted hierarchical difference-in-differences model, we found assignment to the RMA small groups intervention to be associated with a 0.62 decrease in inequitable gender norms (95% CI: −1.05, −0.18). As a cost-effective, scalable, and transferable intervention, this small group intervention could be valuable for reducing the negative impact of inequitable gender norms in similar settings.

  PublisherDOI

• The Effect of Offspring Gender Composition on Modern Contraceptive Uptake Among Married Women of Reproductive Age in Pakistan: A Facility-Based Cross-Sectional Study

  International Journal of Environmental Research and Public Health · 2025-01-17 · 1 citations

  articleOpen access

  Introduction: Pakistan is confronted with the formidable challenge of high population growth, which is compounded by cultural norms that prioritize male offspring, leading to adverse implications for family planning efforts and demographic trends. Despite efforts to promote contraception, including a national family planning program, Pakistan continues to struggle with low and stagnant contraceptive prevalence rates among married women. The influence of gender composition on modern contraceptive uptake remains underexplored, necessitating research to elucidate its impact on reproductive behavior. Materials and methods: This study used the dataset of a facility-based cross-sectional survey conducted in six districts of the Sindh and Punjab provinces in Pakistan. A subset of 495 married women of reproductive age seeking health services from March to June 2019 was used for this study. Logistic regression analysis was employed to examine the association between the gender composition of children and modern contraceptive uptake, adjusting for covariates such as province, the age of the women, and the type of health facility. Results: The analysis revealed a significant association between the gender composition of children and modern contraceptive uptake among married women. As the number of daughters increased without sons, the likelihood of contraceptive uptake remained low (adjusted odds ratio [AOR]: 0.12; 95% CI: 0.04–0.34; p < 0.000), while having at least one son substantially increased the odds of contraceptive use (AOR: 19.91; 95% CI: 8.00–49.50; p < 0.000). Notably, the gender composition of having one daughter with two sons had the highest level of contraceptive uptake, potentially because of family composition preferences. Discussion: The findings highlight the pervasive influence of gender composition on reproductive decision-making in Pakistan, with a clear preference for sons driving modern contraceptive behavior. These results underscore the need for targeted interventions to address gender norms and biases while promoting equitable access to family planning services. Engaging men in family planning initiatives is crucial for challenging traditional gender norms and fostering informed decision-making regarding contraception. Conclusions: Gender preference influences modern contraceptive uptake among women in Pakistan, with the strong preference for sons driving reproductive behavior. Addressing gender norms and biases while promoting informed, self-determined choice is essential for enhancing modern contraceptive uptake and achieving sustainable population growth. Targeted interventions, including male engagement strategies, are needed to challenge societal gender norms and empower individuals to make autonomous decisions regarding family planning.

  PublisherOA PDFDOI

• Contraceptive decision-making and its association with contraceptive use among married adolescent girls in Niger

  Reproductive Health · 2025-02-21

  articleOpen access

  OBJECTIVE: Niger has among the highest rates of child marriage and lowest rates of modern contraceptive use in the world. This study analyzes the association between contraceptive decision-making and contraceptive use among married adolescent girls in rural Niger, including multiple assessments of decision-making and consideration of overt vs. covert contraceptive use. METHODS: We analyzed cross-sectional survey data collected from married adolescent females (n = 823) participating in the third round of data collection (October-November 2019) for the cluster-randomized controlled trial of a family planning intervention study. Contraceptive decision-making measures assessed participants' (a) participation in contraceptive decision-making, (b) final say in decision-making in case of spousal disagreement, and (c) satisfaction with participation in decision-making. Outcomes include contraceptive use ever categorized based on whether use was overt (with husband's knowledge) or covert (without husband's knowledge). Adjusted multinomial logistic regression models were used to test the associations between each decision-making item and each type of contraceptive use. RESULTS: Over half of participants reported ever using a contraceptive (59%) and that their husbands were the sole decision-makers regarding contraceptive use (60%). Adolescents' participation in decision-making was negatively associated with overt contraceptive use (ARRR = 0.41; 95%CI = 0.19-0.91) and positively associated with covert contraceptive use (ARRR = 8.76; 95%CI = 2.45-31.30). Women reporting joint decision-making were more likely to report covert use vs. no use (ARRR = 3.20; 95%CI = 1.14-8.99). Women having final say in contraceptive decision-making in case of disagreements were more likely to report covert contraceptive use over no use (ARRR = 9.14; 95%CI = 3.17-26.40). Women's satisfaction with decision-making was positively associated with contraceptive use ever (AOR = 2.72; 95%CI = 1.80-4.16), and overt (ARRR = 2.68; 95%CI = 1.75-4.01) and covert contraceptive use (ARRR = 10.9; 95%CI = 2.16-54.80). CONCLUSION: Male control over decision-making and female satisfaction with decision-making are associated with greater contraceptive use. Findings indicate that women's control over decision-making, and its relation to contraceptive use, is complex and requires more nuanced understanding for married adolescents.

  PublisherOA PDFDOI

• Contraceptive Care Visit Objectives and Outcomes: Evidence From Burkina Faso, Pakistan, and Tanzania

  Studies in Family Planning · 2024-12-01

  articleOpen access

  Globally, care experiences of the growing population of contraceptive users are not well-understood. We leverage a large client dataset (n = 71,602) from three countries (Burkina Faso, Pakistan, and Tanzania) to characterize contraceptive services sought (visit objective and method preference), assess whether these visit objectives were met and for whom, and explore if visit objective fulfillment was associated with care quality. Most people in all three countries said they were seeking to continue their current method or adopt a method for the first time. Clients seeking to change their method were least likely to have their objective met: 63.7 percent of clients in Burkina Faso, 73.3 percent in Pakistan, and 61.1 percent in Tanzania who wanted to switch actually achieved this during the visit. In Burkina Faso, people with lower socioeconomic standing, lower educational attainment, and lower parity less commonly had their switching objective, fulfilled. Method preference fulfillment was generally high, although approximately 15 percent of Tanzanian clients were given implants despite wanting another method. Among those seeking to adopt or restart a method in Pakistan and Tanzania, having this visit objective fulfilled, was correlated with better perceived treatment and higher person-centeredness of care.

  PublisherOA PDFDOI

• “I am forced to just give it to her because she is the one who wants it”: A qualitative study of providers’ perspectives on contraceptive counseling in Tanzania

  SSM - Qualitative Research in Health · 2024-11-13 · 2 citations

  articleOpen access

  Drawing on 29 in-depth interviews with health care providers in Dar es Salaam, Tanzania, this paper describes providers’ attitudes and beliefs about contraceptive methods and the extent to which providers consider client choice and autonomy when providing contraceptive care. Interviews were analyzed thematically using the constant comparative approach. Providers described a preference for long-acting reversible methods (i.e., implants and IUDs) primarily due to concerns regarding injectables’ slow return to fertility, exposure to hormones, and concerns about client adherence to pills or injectables. Providers understood the importance of centering a client’s preference to use a specific method and to have a method removed when the client desired. However, providers also described counseling clients toward their own preferences, highlighting a tension between what providers wanted for their clients and client preferences. While most providers described prioritizing client choice even when it contradicted their recommendation, some providers insisted on a certain outcome (e.g., a client taking up an implant), contradicting tenets of informed, full, and autonomous choice. Attention is needed to ensure providers center client autonomy and preferences and guarantee freedom from coercion in contraceptive care.

  PublisherDOI

• Characteristics of community change agents to promote equitable health services and combat harmful gender norms in climate-affected communities in Sindh province

  NUST Journal of Social Sciences and Humannities · 2024-12-31

  articleOpen accessSenior author

  The province of Sindh, Pakistan, faces heightened vulnerability to natural disasters due to its low-lying location in the flood-prone Indus floodplain. Pathfinder International implemented the Surmi project aimed at strengthening the resilience for climate shocks and emergencies by female volunteers called “Climate Champions” (CC) and trained them to support and provide women and girls the tools, knowledge, and resources they need to advocate for equitable health services and to combat harmful gender norms, including gender-based violence. A knowledge, attitude, and beliefs survey were conducted among 600 CCs aged 18-50 years residing in five intervention districts including, Thatta, Badin, Sanghar, Umer Kot, and Kamber Shahdad Kot. The results show that climate awareness is moderate among CC volunteers. Self-efficacy was strong within the group; 57% showed a fair or strong level of confidence in achieving life goals despite challenges. Unfortunately, strong gender norms remain prevalent among CCs; close to three-quarters (74%) had limited or no confidence in their ability to refuse a marriage that they did not desire. The qualitative data results show that CCs can be the change agents in climate-affected communities. The deeply entrenched gender norms that are pervasive in this community will require concerted efforts.

  PublisherOA PDFDOI

• Mediating effects of inequitable gender norms on intimate partner violence and contraceptive use in a cluster randomized control trial in Niger

  American Journal of Epidemiology · 2024-08-30 · 1 citations

  articleOpen access

  Previous research has demonstrated that the Reaching Married Adolescents intervention (RMA) was associated with changes in inequitable gender norms, intimate partner violence (IPV), and modern contraceptive use. This study seeks to understand if changes in inequitable gender norms mediate the RMA intervention's effects on contraceptive use and intimate partner violence (IPV). A 4-arm cluster randomized control trial was conducted to evaluate effects of the RMA intervention (household visits, small groups, combination, control) on married adolescent girls and their husbands in Dosso, Niger (baseline: 1042 dyads; 24 months follow-up: 737 dyads; 2016-2019). Mediation was assessed using inverse odds ratio weighting. In the small group intervention, of the total effect on IPV prevalence (8% reduction), indirect effects via inequitable gender norms are associated with a 2% decrease (95% CI, -0.07 to 0.12) and direct effects with a 6% decrease (95% CI, -0.20 to -0.02). For household visits, of the total effect on contraceptive use (20% increase), the indirect effect accounts for an 11% decrease (95% CI, -0.18 to -0.01) and direct effect, a 32% increase (95% CI, 0.13-0.44); this is similar to findings for the combination arm. This experimental evidence informs the value of changing underlying social norms to reduce IPV and increase contraception use.

  PublisherOA PDFDOI

• Effect of Gender Composition on Modern Contraceptive Uptake Among Married Women of Reproductive Age in Pakistan: A Facility-Based Cross-Sectional Study

  Preprints.org · 2024-10-24

  preprintOpen access

  Pakistan is confronted with a formidable challenge of high population growth, compounded by cultural norms prioritizing male offspring, leading to adverse implications for family planning (FP) efforts and demographic trends. Despite efforts to promote contraception, including a national family planning program, Pakistan continues to struggle with low and stagnant contraceptive prevalence rates and high unmet contraceptive needs among married women. The influence of gender composition on modern contraceptive uptake remains underexplored, necessitating research to elucidate its impact on reproductive behavior. This study was based on a secondary analysis of a facility-based cross-sectional survey conducted in six districts of Sindh and Punjab provinces in Pakistan. A subset of 495 married women of reproductive age (MWRA) seeking health services from March to June 2019 was used for this study. Logistic regression analysis was employed to examine the association between the gender composition of children and MWRA’s modern contraceptive uptake, adjusting for covariates such as province, age of women, and health facility type. The analysis revealed a significant association between the gender composition of children and modern contraceptive uptake among MWRA. As the number of daughters increased without sons, the likelihood of contraceptive uptake remained low (Adjusted odds ratio [AOR]: 0.12; 95% CI: 0.04–0.34, p < 0.000), while having at least one son substantially increased the odds of contraceptive use (AOR: 19.91; 95% CI: 8.00–49.50, p < 0.000). Notably, the gender composition of one daughter with two sons emerged as the most preferred gender composition, because the odds of contraceptive uptake were significantly increased. The findings highlight the pervasive influence of gender composition on reproductive decision-making in Pakistan, with a clear preference for sons driving modern contraceptive behavior among MWRA. These results underscore the need for targeted interventions to address gender norms and biases while promoting equitable access to FP services. Engaging men in FP initiatives is crucial for challenging traditional gender norms and fostering informed decision-making regarding contraception. Gender preference influences modern contraceptive uptake among MWRA in Pakistan, with a strong preference for sons driving reproductive behavior. Addressing gender norms and biases while promoting informed choice is essential for enhancing modern contraceptive uptake and achieving sustainable population growth. Targeted interventions, including male engagement strategies, are needed to challenge societal gender norms and empower individuals to make autonomous decisions regarding family planning.

  PublisherOA PDFDOI

• OC60 Temporal trends in complex feeding decisions a decade in a specialist clinic in a tertiary paediatric setting

  2023-07-01

  article

  <h3></h3> Decision making for patients with complex feeding issues have previously been made in isolation. It is advocated for cohesive decisions to be made in a multidisciplinary setting.¹ Since the 2013 appointment of a nurse specialist, complex feeding decisions are made in our tertiary MDT complex enteral feeding (CEN) clinic. We aim to describe clinical outcomes with reference to changes in medical and surgical therapies. From a prospectively gathered departmental database, all patients reviewed in CEN clinic (03/2013–12/2022) were assessed for: demographics; primary diagnosis; referral mode. Interventions of interest: fundoplication; jejunal feeding; blenderised diet (BD). Patients commenced on jejunal feeding or BD each year were calculated. Comparison of proportionate interventions for when dietetic support for BD was and was not resourced was performed by fisher’s exact test (sig p≤0.05). Of 201 patients reviewed: 61% had a severe neurodisability; 26% multisystem disease; 7% complex GI surgery; 4% complex cardiology; 2% isolated complex feeding issue. 62% male, median age at referral was 3.3 years. 58 fundoplications were performed, 99 received jejunal feeding (initiated with 37 nasojejunal; 58 gastrojejunal device; 4 surgical jejunostomy) and 57 patients of the 72 recommended started BD. BD has been advocated by team since 2016 as a feeding strategy for gastric intolerance of milk formula. Dietetic support to establish BD was resourced 2018–2020. Out-with this timeframe, availability was limited in certain areas. After rising incident cases of jejunal feeding, we observed a reduction with the introduction of dietetic resource to support BD initiation (2018–2020). This trend was reversed 2021–2022 with significantly higher jejunal initiation being required (p=0.0005) (figure 1). We observe a reduction in fundoplication from 11 to 3 per year, in line with increased in jejunal feeding and BD. A small minority required a period of parenteral nutrition (PN) support including 2 patients who received PN for &gt; 12 months. We report the longitudinal trends in intervention in a CEN clinic with reduction of fundoplication and rise then reduction in jejunal feeding when dietetic support for BD was available. The reduction in BD initiation 2021–2022 sits chronologically with the withdrawal of dietetic support and resulted in significant rise in jejunal feeding. We highlight the success of fundoplication for patients in our service with careful selection. This has driven service redesign within our institution. Jejunal feeding has become secondary to a trial of BD in our hierarchy due to BD benefits including: less invasive feeding modality; apparent better symptom control; parental wishes and cost saving. Effects of the pandemic and dietetic resource may have restricted access to BD in the last 2 years. <h3>Reference</h3> Broekaert IJ, Falconer J, <i>et al. JPGN.</i> 2019 Aug;<b>69</b>(2):239–258.

  PublisherDOI

Frequent coauthors

• Neeru Singh

  National Institute for Research in Tribal Health

  83 shared

• Blair J. Wylie

  Columbia University

  49 shared

• Davidson H. Hamer

  Boston University

  45 shared

• Jordan Tuchman

  United States Agency for International Development

  45 shared

• Kojo Yeboah‐Antwi

  45 shared

• Abanish Rizal

  Harvard University Press

  37 shared

• Katherine Joyce

  Henry Ford Health System

  36 shared

• Lora Sabin

  Boston University

  34 shared

Awards & honors

• Early Career Award from the Thrasher Research Fund
• Research Catalyst Award from the American Lung Association
• CFAR Developmental Award (PED-HATT)
• Dean’s Innovation Award supporting the CAMP-TB study
• Carlin Award for Public Health Innovation for the ADAPT-TB s…