ORCID Profile
0000-0002-1325-2640
Current Organisations
Københavns Universitet
,
IT University of Copenhagen
,
Centre for Public Health, Equity and Human Flourishing (PHEHF), Torrens University Australia
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Publisher: Scitechnol Biosoft Pvt. Ltd.
Date: 2016
Publisher: Emerald
Date: 21-09-2015
DOI: 10.1108/IJHRH-10-2014-0028
Abstract: – The purpose of this paper is to identify the potential socio-cultural determinants contributing to inequalities and the susceptibility of the Ojek to Human Immunodeficiency Virus (HIV) infection. – In 2010 a qualitative enquiry was employed to collect data concerning the susceptibility of the Ojek to HIV infection. Both one-on-one open-ended in-depth interviews and focus group discussions were employed. Participants included Ojek (hired motorcycle drivers), religious and community leaders, staff from the HIV/Acquired Immune Deficiency Syndrome (AIDS) Commission of Belu and staff from two HIV/AIDS non-governmental organisations. A thematic analysis and a framework approach were used to analyse the data. – The findings showed four socio-cultural determinants of susceptibility to HIV infection within the Ojek community. These included: first, mobility and migration second, patterns of sexual behaviours, sexual networks and sexual incentives third, cultural norms and social interactions and fourth, the lack of resources, knowledge and awareness of HIV/AIDS. Underpinned by these factors, the main determinant of HIV susceptibility for the Ojek is an in idual’s engagement in sexual intercourse with multiple sex partners, including female commercial sex workers (FCSWs). – There is a need to disseminate HIV/AIDS information and education throughout the Ojek communities, and to engage the general population in the promotion of sexual behavioural change among the Ojek in Belu. Empowerment strategies should also be employed to empower the general community, the Ojek and FCSWs in order to address HIV/AIDS transmission. – This paper provides evidence of the socio-cultural determinants of HIV inequalities within the Ojek community in Indonesia. An understanding of these determinants would enable the planning, implementation and application of a holistic approach addressing the determinants of HIV in Belu and other similar settings. Additionally, knowledge of such determinants would provide an understanding of the role of inter-sectoral collaboration and community participation in tackling the susceptibility to HIV infection within the Ojek community.
Publisher: Public Library of Science (PLoS)
Date: 25-07-2022
DOI: 10.1371/JOURNAL.PONE.0264462
Abstract: Access to HIV care services, including antiretroviral therapy (ART), is essential for improving health outcomes of people living with HIV (PLHIV) and reducing HIV transmission and AIDS-related deaths. As a part of a qualitative study in Belu, this paper describes the use of traditional medicines for HIV treatment and family and social influence as barriers to access to HIV care services among PLHIV. One-on-one in-depth interviews were employed to collect data from 46 PLHIV (26 women and 20 men) and 10 healthcare professionals. They were recruited using the snowball s ling technique. The study information sheets were initially posted on information boards in healthcare facilities. Potential participants who contacted to confirm their participation were recruited for an interview and then asked for help to distribute the information sheets to their eligible colleagues who might be willing to participate. Data analysis was performed using NVivo 12 software and guided by a qualitative data analysis framework. The findings showed that the use of traditional medicines, a well-known cultural practice in Belu, was a barrier to access to HIV care services among PLHIV. The influence of family in determining the use of traditional medicines for HIV treatment, supported by the lack of knowledge of ART, effectiveness of traditional medicines in treating other health issues, and social influence of relatives, neighbours, and friends, were also significant barriers to PLHIV’s access to HIV care services. The findings indicate the need for dissemination of HIV care-related information for PLHIV, family, and community members to increase their knowledge of the service, ART and its function, and to support and improve access to HIV care services especially ART by PLHIV.
Publisher: MDPI AG
Date: 20-08-2023
Abstract: HIV diagnosis and management have often caused disruption to the everyday life and imagined futures of people living with HIV, both at in idual and social levels. This disruption has been conceptualised, in a rather dystopian way, as ‘biographical disruption’. This paper explores whether or not biographical disruption of living with HIV encourages men living with HIV (MLHIV n = 40) in Yogyakarta and Belu, Indonesia, to reinvent their sense of self and future over time using internal and external assets. Our analysis uses the concepts of additive and subtractive resilience strategies, and we show how, rather than having a purely disrupted biography, participants talked about their experiences of ‘biographical reinvention’. Study participants were recruited using the snowball s ling technique, beginning with two HIV clinics as the settings. Data were collected using one-on-one in-depth interviews, and a qualitative framework analysis was used to guide step-by-step data analysis. The findings showed that, despite the disruptions in their everyday lives (i.e., mental health condition, work, activities, social relationships, etc.) following the HIV diagnosis and management, MLHIV in our study managed to utilise their internal assets or traits (i.e., hope, optimism, resilience) and mobilised external resources (i.e., support from families, friends and healthcare professionals) to cope with the disruptions. An interweaving of these internal assets and external resources enabled them to take on new activities and roles (additive resilience strategies) and give up health compromising behaviours (subtractive resilience strategies). These were effective for most MLHIV in our study, not only to cope with the HIV repercussions and improve their physical and mental health conditions, but to think or work on a ‘reinvented’ biography which encompassed resilience, hope and optimism for better health, life and future. The findings indicate the need for HIV interventions and healthcare systems that provide appropriate support for the development and maintenance of internal assets of PLHIV to enable them to cope with the repercussions of HIV and work on a ‘reinvented’ biography.
Publisher: Public Library of Science (PLoS)
Date: 15-08-2019
Publisher: Public Library of Science (PLoS)
Date: 06-05-2021
DOI: 10.1371/JOURNAL.PONE.0251274
Abstract: Caring for children with a disability can cause a range of psychological and socioeconomic challenges for parents and caregivers, such as anxiety, depression, inability to find affordable and appropriate childcare, loss of income and expenses related to disability specific treatment. As part of a study exploring the impacts of childhood disability on mothers or female caregivers and families, and the copy strategies they used, this paper describes strategies employed by mothers or female caregivers to cope with challenges associated with childhood disability within their family in Belu district, Indonesia. A qualitative approach using one-on-one in-depth interviews was used to collect data from participants (n = 22) who were recruited using a combination of purposive and snowball s ling techniques. Interviews were recorded, transcribed verbatim and imported to NVivo 12 for analysis. A qualitative framework analysis was used to guide data analysis. The conceptual framework of coping strategies guided the conceptualisation and discussion of the findings. The findings showed that active psychological coping strategies, including cognitive or acceptance strategies, knowledge of both health condition and socio-academic related development of children with a disability, and family relationship and support, were used by the participants to cope with psychological challenges facing them. Self-reliance and religious/spiritual coping strategies were also utilised. Sociocultural strategies, such as social withdrawal or disengagement, professional support and culture-based support, were used by the participants to cope with social impacts, stigma, and discrimination associated with childhood disability. Participants also reported using financial strategies such as selling of family assets to cope with the economic challenges. The findings indicate the need for programs and interventions that address the needs of mothers and female caregivers and their families, to assist with effectively managing the significant challenges they face when caring for a child with a disability. Further studies are needed, with a larger number of participants and the inclusion of fathers or male caregivers, in order to better understand the broader coping experience of childhood disability impacts within families.
Publisher: Cold Spring Harbor Laboratory
Date: 16-03-2022
DOI: 10.1101/2022.03.15.22272326
Abstract: The number of HIV infection among heterosexual men in Indonesia continues to increase. This paper describes social and environmental factors and the mechanisms through which these factors may have contributed to the transmission of HIV among men in Indonesia. A qualitative design using one-on-one and face-to-face in-depth interviews was employed to collect data from men living with HIV in Yogyakarta and Belu, from June to December 2019. Participants (n=40) were recruited using the snowball s ling technique. The logical model for socio-environmental determinants diagnosis was used to conceptualise the study and discuss the findings. The findings showed that social factors such as peer influence on sex, condom use and injecting drug use were contributing factors for HIV transmission among the participants. Other factors and drivers of HIV transmission included mobility, migration, and the environment the participants lived, worked and interacted, which facilitated their engagement in high-risk behaviours. The findings indicate the need for wide dissemination of information and education about HIV and condoms for men, within communities and migration areas in Indonesia and other similar settings globally in order to increase their understanding of the means of HIV transmission, and condom use for HIV prevention.
Publisher: Wiley
Date: 24-02-2022
DOI: 10.1111/ELE.13898
Abstract: Functional traits offer a rich quantitative framework for developing and testing theories in evolutionary biology, ecology and ecosystem science. However, the potential of functional traits to drive theoretical advances and refine models of global change can only be fully realised when species‐level information is complete. Here we present the AVONET dataset containing comprehensive functional trait data for all birds, including six ecological variables, 11 continuous morphological traits, and information on range size and location. Raw morphological measurements are presented from 90,020 in iduals of 11,009 extant bird species s led from 181 countries. These data are also summarised as species averages in three taxonomic formats, allowing integration with a global phylogeny, geographical range maps, IUCN Red List data and the eBird citizen science database. The AVONET dataset provides the most detailed picture of continuous trait variation for any major radiation of organisms, offering a global template for testing hypotheses and exploring the evolutionary origins, structure and functioning of bio ersity.
Publisher: MDPI AG
Date: 30-05-2022
Abstract: Human Immunodeficiency Virus (HIV) infection adds a significant burden to women in Low- and Middle-Income Countries (LMICs), often leading to severe detrimental impact, not only on themselves, but also on their families and communities. Given that more than half of all people living with HIV globally are females (53%), this review seeks to understand the psychological and social impact of HIV infection on Women Living with HIV (WLHIV) and their families in LMICs in Asia, and the interrelationships between one impact and another. A systematic review was conducted to find literature using the following databases: Medline, PsycINFO, CINAL, Emcare, Scopus and ProQuest. Research articles included in this review were selected based on the following inclusion criteria: conducted in LMICs in Asia, published in English language between 1 January 2004 and 31 December 2021, had full text available, involved WLHIV (married and unmarried) and explored the psychological and social impacts of HIV on these women and their families. Critical appraisal tools developed by Joanna Briggs Institute (JBI) were used to assess the methodological quality of the studies, and thematic narrative synthesis was used to analyse the findings. A total of 17 articles met the inclusion criteria. The review showed that HIV has a range of negative psychological consequences on WLHIV, such as stress, fear, worry, anxiety and depression, as well as social impacts on the women and their families, including stigma, discrimination and family separation. The findings indicate the need for targeted interventions—specific to WLHIV—that address the psychological challenges, stigma and discrimination these women and their families face. These interventions should also incorporate education and sustainable support structures for WLHIV and their families.
Publisher: Elsevier BV
Date: 09-2021
Publisher: BMJ
Date: 05-2023
DOI: 10.1136/BMJOPEN-2023-072118
Abstract: To synthesise evidence to determine whether, in contrast to medical male circumcision, traditional male circumcision (TMC) practices may contribute to HIV transmission and what the impacts of TMC are on the initiates, their families and societies. Systematic review. PubMed, CINHAL, SCOPUS, ProQuest, Cochrane database and Medline were searched between 15 and 30 October 2022. (1) Studies involving young men, young male adults, male adults and mixed male and female participants (2) studies on TMC involving men living with HIV (married and non-married) (3) studies on TMC, HIV transmission and impact in low-income and middle-income countries (4) qualitative, quantitative and mixed-method studies and (5) studies aimed at exploring TMC and how it contributes to HIV transmission and the impacts of HIV on circumcised men and their families. Data were extracted based on study details, study design, characteristics of participants and results. A total of 18 studies were included: 11 were qualitative studies, five were quantitative studies and two were mixed-method studies. All the studies included were conducted in areas where TMC was performed (17 in Africa and one in Papua New Guinea). The review’s findings were categorised into themes: TMC as a cultural practice, consequences of not being traditionally circumcised on men and their families and TMC-related risk of HIV transmission. This systematic review highlights that TMC practice and HIV risk could negatively impact men and their families. Existing evidence suggests that little attention has been paid to men and their families experiencing the impacts of TMC and HIV risk factors. The findings recommend the need for health intervention programmes such as safe circumcision and safe sexual behaviours following TMC and efforts to address psychological and social challenges in communities practising TMC. CRD42022357788.
Publisher: Springer Science and Business Media LLC
Date: 11-11-2020
Publisher: Springer Science and Business Media LLC
Date: 30-05-2018
Publisher: MDPI AG
Date: 03-11-2021
Abstract: Accessibility to healthcare and rehabilitation services for children with a disability (CWD) is essential to improving their health and wellbeing. However, access to the services, especially in many settings in developing countries with scarcity of resources, is still limited. As part of a qualitative study exploring impacts of caring for CWD on mothers or female caregivers and their coping strategies, this paper describes barriers for access to healthcare and rehabilitation services for CWD in Belu district, Indonesia. One-on-one, in-depth interviews were conducted with 22 mothers or female caregivers of CWD. Participants were recruited using a combination of purposive and snowball s ling techniques. These were supplemented with interviews with two staff of disability rehabilitation centers in Belu to understand any additional barriers. Data analysis was guided by a qualitative data analysis framework. Our analysis identified that lack of affordability of healthcare services (high costs and low financial capacity of mothers) was the key barrier for access to healthcare and rehabilitation services CWD. Religious or faith-based factors, such as being a non-Catholic (Belu is predominantly Catholic), converting from Catholic to other religions, and the belief in children’s disability condition as “God’s will”, were also influencing factors for lack of access to the services. Shortage of staff, distrust in the therapy skills of staff at rehabilitation centers, and unavailability of appropriately trained healthcare professionals were structural or system-related barriers. The findings indicate the need for government-owned and run disability rehabilitation centers (not faith-based), the provision of fully subsidised health insurance to provide free services, and the provision of qualified therapists and healthcare professionals (to build trust) in Belu and other similar settings in Indonesia.
Publisher: Canadian Center of Science and Education
Date: 07-05-2017
DOI: 10.5539/GJHS.V9N8P47
Abstract: A qualitative inquiry using in idual interviews explored determinants of unprotected sexual behaviours favouring HIV transmission among Men who Have sex with Men (MSM) in Yogyakarta, Indonesia. The study was conducted in July 2015 with 24 MSM participants recruited using convenience s ling technique. Data were analysed using a qualitative data analysis framework, with the Social Cognitive Theory (SCT) employed as the study conceptual framework. Findings were grouped into a reciprocal triadic relationship involving behavioural, personal (cognitive) and environmental determinants. Behavioural determinants comprised having multiple casual sex partners, engagement in group sex and transactional sex practices. Environmental factors associated with unprotected sexual behaviours included influence of unsafe sex from regular partners and lack of access to HIV-related services. Personal (cognitive) determinants favouring unprotected sexual behaviours identified were lack of knowledge of condom and HIV/AIDS, in iduals’ expectation of pleasurable sexual intercourse, and low self-efficacy to discuss condom use and HIV status with casual sex partners. As effort to address HIV in MSM in Indonesia is still at its infancy, the findings of the current study are insightful and will inform the development of evidence-based programs in addressing HIV/AIDS problem in MSM populations in Yogyakarta and other similar settings.
Publisher: Cold Spring Harbor Laboratory
Date: 03-2022
DOI: 10.1101/2022.02.28.22270871
Abstract: Access to HIV care service or antiretroviral therapy (ART) is essential for the improvement of health outcomes of people living with HIV (PLHIV) and in reducing HIV transmission and HIV-related deaths. As a part of a qualitative study in Belu, this paper describes the use of traditional treatment and the role of families in determining traditional treatment for their HIV-positive family member as barriers to access to HIV care service or ART among PLHIV. One-on-one in-depth interviews were employed to collect data from 46 PLHIV (26 women and 20 men) and 10 healthcare professionals recruited using the snowball s ling technique. Data analysis was performed using NVivo 12 software and guided by a qualitative data analysis framework. The findings showed that the use of traditional treatment, a well-known cultural practice in Belu, was a barrier to access to HIV care service or ART among PLHIV. The role of family in determining traditional treatment for HIV, supported by the lack of knowledge of ART, effectiveness of traditional medicines in treating other health issues, and social influence of families, neighbours and friends, were also significant barriers to PLHIV’s access to HIV care service or ART. The findings indicate the need for dissemination of HIV care-related information for PLHIV, family and community members to increase their knowledge on the service, ART and its function, and to support and improve access to ART by PLHIV.
Publisher: Cold Spring Harbor Laboratory
Date: 27-04-2022
DOI: 10.1101/2022.04.24.22274022
Abstract: This study aimed to understand barriers to accessing HIV care services in host countries among Indonesian, male, former (returned) migrant workers living with HIV. The study utilised a qualitative design employing in-depth interviews to collect data from twenty-two returned migrant workers from Eastern Indonesia, recruited using the snowball s ling technique. A qualitative data analysis framework was used to guide a step-by-step analysis of the findings. Findings demonstrated that limited host-country language proficiency, lack of knowledge regarding healthcare systems in host countries and having ‘undocumented’ worker status were barriers to accessing HIV care services. Data also revealed unavailability of HIV care services nearby migrants’ work locations, long distance travel to healthcare facilities, and challenges in accessing public transportation as barriers that impeded their access to the services. Other factors limiting the participants’ access to HIV services were identified as the transient and mobile nature of migrant work requiring frequent relocation and disrupting work life stability. Additionally, in lieu of formal HIV services, many participants self-medicated by using over-the-counter herbal or ‘traditional’ medicines, often because of peer or social group influence regarding selection of informal treatment options. Recommendations arising from this study demonstrate the need to improve pre-departure information for migrant workers regarding healthcare system and access procedure in potential host countries. Data from this study also indicate that social services should be available to assist potential migrants to access legal channels for migrant work overseas, to ensure that Indonesian migrants can safely access healthcare services in the countries for which they are providing migrant labour. Future studies to understand barriers to accessing HIV care services among various migrant groups living with HIV are warranted to build evidence for potential social policy change.
Publisher: MDPI AG
Date: 03-11-2022
Abstract: Migrant populations are one of the vulnerable groups to HIV transmission and its consequences. They are also reported to experience delayed entry or linkage into HIV services and have poorer HIV-related health outcomes. This study aimed to understand barriers to accessing HIV care services in host countries among Indonesian, male, former (returned) migrant workers living with HIV. The study was carried out from December 2020 to February 2021. It utilised a qualitative design employing in-depth interviews to collect data from twenty-two returned migrant workers from Eastern Indonesia, recruited using the snowball s ling technique. A qualitative data analysis framework was used to guide a step-by-step analysis of the findings. Findings demonstrated that limited host-country language proficiency, lack of knowledge regarding healthcare systems in host countries and having ‘undocumented’ worker status were barriers to accessing HIV care services. Data also revealed the unavailability of HIV care services nearby migrants’ work locations, long-distance travel to healthcare facilities, and challenges in accessing public transportation as barriers that impeded their access to the services. Other factors limiting the participants’ access to HIV services were identified as the transient and mobile nature of migrant work requiring frequent relocation and disrupting work–life stability. Additionally, in lieu of formal HIV services, many participants self-medicated by using over-the-counter herbal or ‘traditional’ medicines, often because of peer or social group influence regarding the selection of informal treatment options. Recommendations arising from this study demonstrate the need to improve pre-departure information for migrant workers regarding the healthcare system and access procedures in potential host countries. Data from this study also indicate that social services should be available to assist potential migrants to access legal channels for migrant work overseas, to ensure that Indonesian migrants can safely access healthcare services in the countries for which they are providing migrant labour. Future studies to understand barriers to accessing HIV care services among various migrant groups living with HIV are warranted to build evidence for potential social policy change.
Publisher: SAGE Publications
Date: 06-2018
Abstract: This study aimed to identify factors that influenced the intention of men who have sex with men (MSM) to participate in voluntary counseling and HIV testing (VCT) and in accessing free condoms. A qualitative inquiry using one-on-one in-depth interviews was conducted with MSM participants who were recruited using a purposive s ling technique. Data analysis was guided by a framework analysis for qualitative data by Ritchie and Spencer, and the Theory of Planned Behavior (TPB) framework was used to analyze the data. The findings were grouped into three themes—namely, (a) attitude encompassing knowledge about HIV/AIDS and HIV/AIDS services and the belief about the positive outcomes of the services (b) subjective norms including support from MSM peers and family members and motivation to comply with the support and (c) perceived behavioral control, which is associated with resource availability and having confidence and positive intention to participate in VCT and willingness to access free condoms. Findings indicated that personal, community, and structural factors were predictors to intention to accessing services. Interventions targeting large numbers of MSM population and further studies to understand what needs to be done by nongovernmental organizations and governmental institutions to halt the spread of HIV infections among MSM populations and increase their intention to use HIV/AIDS services are also recommended.
Publisher: Research Square Platform LLC
Date: 03-08-2019
Abstract: Background HIV infections among women cause a range of detrimental impacts on the affected women and their families. This review seeks to understand what impacts are associated with living with HIV in women and their families and how the identified impacts relate to each other. Methods A systematic review of literature was conducted to identify the impacts of HIV on women and their families in developing countries. We conducted a systematic search of literatures published up to September 2018 in the following databases: Medline, PsycINFO, CINAL, Emcare, Scopus and ProQuest. Articles were included if they were published in English language, with full text available, in developing countries, involving married and non-married women age 15 years and above with HIV and focusing on the impacts of HIV on women and their families. Critical appraisal tools developed by Joana Briggs Institute (JBI) were used to assess methodological quality of the studies and thematic narrative synthesis was used to analyse the findings of the included articles. Results A total of 20 articles were included in the review. The review indicated that HIV infections among women living with HIV (WLHIV) caused numerous negative impacts on WLHIV and their families. They included (i) psychological impacts, (ii) poor physical health and intimate partner violence, (iii) social impacts such as stigma and discrimination, disruption of children’s social life and education, family separation and child-parent conflict, and (iv) economic impacts including loss of job and increased family health expenditure leading to poor family economic condition, the sale of family assets, food insecurity and hunger and poverty. Conclusions The findings indicate the need for interventions that address among impacts, psychological, stigma and discrimination and economic consequences of HIV facing WLHIV and their families in developing countries.
Publisher: Cold Spring Harbor Laboratory
Date: 11-05-2022
DOI: 10.1101/2022.05.09.22274877
Abstract: Women living with HIV (WLHIV) are vulnerable to various mental health challenges. However, there is a paucity of studies globally and in the Indonesian context that have specifically explored mental health challenges among HIV-positive mothers who also have children living with HIV (CLHIV). This qualitative study explored mental health challenges and the associated factors in HIV-positive mothers with CLHIV in Yogyakarta, Indonesia. In-depth interviews were employed to collect data from the participants (n=23) who were recruited using the snowball s ling technique. A qualitative data analysis framework was used to guide the analysis of the findings. The findings showed that the mothers experienced a range of mental health issues due to their own, and their child’s diagnosis stress, depression, anxiety, fear, sadness, and guilt. Lack of knowledge about HIV, fear of death, shame, not knowing whom to talk with and what to do after their own HIV diagnosis, and the HIV diagnosis of their children were factors that challenged their mental health. Difficulties in dealing with daily life or social activities of their CLHIV, dilemma in addressing questions and complaints of their CLHIV about HIV treatment, and concerns about the health condition of their CLHIV and how their children cope with any potential negative social impacts also impacted the mothers’ mental health. Social factors such as unsympathetic expressions from friends towards them and their CLHIV and negatively worded religious-related advice from parents and relatives also contributed to their poor mental health. Our findings indicate the need for intervention programs that support HIV-positive mothers and their CLHIV. Future large-scale studies involving HIV-positive mothers with CLHIV in Indonesia and other settings globally are needed to obtain a comprehensive understanding of mental health challenges and the associated factors they face.
Publisher: Springer Science and Business Media LLC
Date: 10-2021
DOI: 10.1038/S41591-021-01498-0
Abstract: Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.
Publisher: Springer Science and Business Media LLC
Date: 08-05-2023
DOI: 10.1186/S12879-023-08195-Y
Abstract: Acute Severe Hepatitis of Unknown Etiology (ASHUE) emerged as a new global outbreak in Indonesia early May 2022, coinciding with the COVID-19 pandemic. This study aimed to understand public reactions and responses to the emergence of ASHUE Indonesia and to Government-led disease prevention responses. Understanding how the public perceived government-led preventive messaging about the hepatitis outbreak is crucial to controlling viral spread – particularly given the rapid and unforeseen emergence of ASHUE coincided with COVID-19 and public trust in the Indonesian Government to manage health outbreaks was already tenuous. Social media users’ responses to information disseminated via Facebook, YouTube, and Twitter were analyzed to understand public perceptions about ASHUE outbreak and their attitudes toward Government-led prevention measures. Data were extracted on a daily basis from 1st May 2022 to 30th May 2022 and analyzed manually. We inductively generated the codes, from which we formed a construct and then grouped to identify themes. A total of 137 response comments collected from 3 social medial platforms were analyzed. Of these, 64 were from Facebook, 57 were from YouTube, and 16 were from Twitter. We identified 5 main themes, including (1) disbelief in the existence of the infection (2) suspicion about a potential new business after COVID-19 (3) suspicion that COVID-19 vaccine(s) are the cause (4) religion-related fatalism and (5) trust in government measures. The findings advance knowledge about public perceptions, reactions and attitudes towards the emergence of ASHUE and the efficacy of disease countermeasures. The knowledge from this study will provide an understanding of why disease prevention measures might not be followed. It can be used to develop public awareness programs in Indonesia about both the ASHUE and its possible consequences and the available healthcare support.
Publisher: Springer Science and Business Media LLC
Date: 27-12-2022
Publisher: Public Library of Science (PLoS)
Date: 04-11-2020
Publisher: Public Library of Science (PLoS)
Date: 10-10-2022
DOI: 10.1371/JOURNAL.PONE.0275390
Abstract: HIV infection is a major public health concern, with a range of negative impacts on People Living with HIV (PLHIV). A qualitative study in Yogyakarta, Indonesia, using in-depth interviews with 26 Women Living with HIV (WLHIV) was conducted to understand HIV risk factors and impact and their access to HIV care services. This paper describes the self-response of WLHIV towards negative HIV-related experiences facing them and adds to the existing literature which tends to focus on HIV impact only, as opposed to strategies that many WLHIV have used to empower and educate themselves and their family/community. Participants were recruited using the snowball s ling technique. Data analysis was guided by a qualitative data analysis framework. Our study highlighted that WLHIV experienced psychological challenges, stigma and discrimination. However, they demonstrated remarkable self-response and capacity in pursuing effective strategies and support to protect themselves, and educating themselves and others around them to rebuild trust and regain respect and acceptance. Our findings indicate that the needs of WLHIV should be addressed through policy and practice to help them cope with HIV-related psychological and social challenges effectively. Family and community members seem to play an important role in those negative challenges against WLHIV, thus there is also a need for HIV education programs for family and community members to enhance their HIV-health literacy and acceptance of PLHIV.
Publisher: Elsevier BV
Date: 06-2021
Publisher: MDPI AG
Date: 04-06-2022
Abstract: Women living with HIV (WLHIV) are vulnerable to various mental health challenges. However, there is a paucity of studies globally and in the Indonesian context that have specifically explored mental health challenges among mothers living with HIV who also have children living with HIV (CLHIV). This qualitative study explored mental health challenges and the associated factors in mothers living with HIV who have CLHIV in Yogyakarta, Indonesia. In-depth interviews were employed to collect data from the participants (N = 23) who were recruited using the snowball s ling technique. A qualitative data analysis framework was used to guide the analysis of the findings. The findings showed that the mothers experienced a range of mental health issues due to their own, and their child’s diagnoses of stress, depression, anxiety, fear, sadness, and guilt. Lack of knowledge about HIV, fear of death, shame, not knowing whom to talk with and what to do after their own HIV diagnosis, and the HIV diagnosis of their children were factors that challenged their mental health. Difficulties in dealing with daily life or social activities of their CLHIV, dilemmas in addressing questions and complaints of their CLHIV about HIV treatment, and concerns about the health condition of their CLHIV and how their children cope with any potential negative social impacts also impacted the mothers’ mental health. Social factors such as unsympathetic expressions from friends towards them and their CLHIV and negatively worded religious-related advice from parents and relatives also contributed to their poor mental health. Our findings indicate the need for intervention programs that support mothers living with HIV and their CLHIV. Future large-scale studies involving mothers living with HIV who have CLHIV in Indonesia and other settings globally are needed to obtain a comprehensive understanding of mental health challenges and the associated factors they face.
Publisher: Public Library of Science (PLoS)
Date: 21-11-2018
Publisher: Springer Science and Business Media LLC
Date: 19-12-2022
DOI: 10.1186/S12916-022-02639-Z
Abstract: Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.
Publisher: Public Library of Science (PLoS)
Date: 05-06-2017
Publisher: Springer Science and Business Media LLC
Date: 07-02-2017
Publisher: Springer Science and Business Media LLC
Date: 05-05-2023
DOI: 10.1186/S12879-023-08221-Z
Abstract: Coronavirus disease (COVID-19) pandemic has a significant influence on the access to healthcare services. This study aimed to understand the views and experiences of people living with HIV (PLHIV) about barriers to their access to antiretroviral therapy (ART) service in Belu district, Indonesia, during the COVID-19 pandemic. This qualitative inquiry employed in-depth interviews to collect data from 21 participants who were recruited using a snowball s ling technique. Data analysis was guided by a thematic framework analysis. The findings showed that fear of contracting COVID-19 was a barrier that impeded participants’ access to ART service. Such fear was influenced by their awareness of their vulnerability to the infection, the possibility of unavoidable physical contact in public transport during a travelling to HIV clinic and the widespread COVID-19 infection in healthcare facilities. Lockdowns, COVID-19 restrictions and lack of information about the provision of ART service during the pandemic were also barriers that impeded their access to the service. Other barriers included the mandatory regulation for travellers to provide their COVID-19 vaccine certificate, financial difficulty, and long-distance travel to the HIV clinic. The findings indicate the need for dissemination of information about the provision of ART service during the pandemic and the benefits of COVID-19 vaccination for the health of PLHIV. The findings also indicate the need for new strategies to bring ART service closer to PLHIV during the pandemic such as a community-based delivery system. Future large-scale studies exploring views and experiences of PLHIV about barriers to their access to ART service during the COVID-19 pandemic and new intervention strategies are recommended.
Publisher: Research Square Platform LLC
Date: 19-10-2023
Publisher: Cold Spring Harbor Laboratory
Date: 19-02-2023
DOI: 10.1101/2023.02.18.23285810
Abstract: The coronavirus disease (COVID-19) pandemic has a significant influence on access to healthcare services. This study aimed to understand the views and experiences of people living with HIV (PLHIV) about barriers to their access to antiretroviral therapy (ART) service in Belu district, Indonesia, during the COVID-19 pandemic. This qualitative inquiry employed in-depth interviews to collect data from 21 participants who were recruited using a snowball s ling technique. Data analysis was guided by a thematic framework analysis. The findings showed that fear of contracting COVID-19 was a barrier that impeded participants’ access to ART service. Such fear was influenced by their awareness of their vulnerability to the infection, the possibility of unavoidable physical contact in public transport during a travelling to HIV clinic and the widespread COVID-19 infection in healthcare facilities. Lockdowns, COVID-19 restrictions and lack of information about the provision of ART service during the pandemic were also barriers that impeded their access to the service. Other barriers included the mandatory regulation for travellers to provide their COVID-19 vaccine certificate, financial difficulty, long-distance travel to the HIV clinic and a lack of public transport. The findings indicate the need for dissemination of information about the provision of ART service during the pandemic and the benefits of COVID-19 vaccination for the health of PLHIV. The findings also indicate the need for new strategies to bring ART service closer to PLHIV during the pandemic such as a community-based delivery system. Future large-scale studies exploring views and experiences of PLHIV about barriers to their access to ART service during the COVID-19 pandemic and new intervention strategies are recommended.
Publisher: MDPI AG
Date: 28-06-2022
Abstract: We conducted a qualitative study involving African migrants (n = 20) and service providers (n = 10) in South Australia to explore mental health stressors, access to mental health services and how to improve mental health services for African migrant populations. This paper presents the views and experiences of African migrants about the post-migration stressors they faced in resettlement that pose mental health challenges. The participants were recruited using the snowball s ling technique. To align with the COVID-19 pandemic protocol, the data collection was conducted using one-on-one online interviews through Zoom or WhatsApp video calls. Data analysis was guided by the framework analysis. The post-migration stressors, including separation from family members and significant others, especially spouses, imposed significant difficulties on care provision and in managing children’s attitudes and behavior-related troubles at school. African cultural practices involving the community, especially elders in care provision and disciplining children, were not consistent with Australian norms, compounding the mental health stressors for all involved. The African cultural norms, that do not allow young unmarried people to live together, also contributed to child–parent conflicts, enhancing parental mental stressors. Additionally, poor economic conditions and employment-related difficulties were post-migration stressors that the participants faced. The findings indicate the need for policy and intervention programs that address the above challenges. The provision of interventions, including social support such as subsidized or free childcare services, could help leverage their time and scheduled paid employment, creating time for effective parenting and improving their mental health and wellbeing. Future studies exploring what needs to be achieved by government and non-governmental institutions to support enhanced access to social and employment opportunities for the African migrant population are also recommended.
Publisher: Public Library of Science (PLoS)
Date: 15-11-2021
DOI: 10.1371/JOURNAL.PONE.0257906
Abstract: As a part of a larger qualitative study to understand HIV-risk factors and impacts on people living with HIV (PLHIV) (52 women and 40 men) in Belu and Yogyakarta, Indonesia, this paper reports the influences of cultural practices and religious beliefs on sexual relationships and behaviours of participants as contributors for HIV transmission. This study was conducted from June to December 2020. Data collection was conducted using one-one-one in-depth interviews. Participants were recruited using the snowball s ling technique. Data analysis was guided by a qualitative data analysis framework. The findings showed that cultural practices in Belu related to the use of bride wealth, managing spousal disputes, marriage, and condom use, influenced spousal relationships and sexual behaviours or practices which contributed to HIV transmission. Javanese cultural practices and expectation of an ‘ideal wife’, Islamic religious beliefs about expected husband-wife relationships, forbidden premarital sex, and the participants’ in idual interpretation of their religious beliefs about condom use spousal sexual relations, also influenced spousal sexual relations and behaviours, which supported HIV transmission among the participants. The findings indicate the need for HIV education programs that address cultural practices and religious beliefs for community members and population groups to enhance their understanding about HIV, condom use, and how cultural practices and religious beliefs play a role in HIV transmission. The findings also indicate the need for involvement of religious leaders in HIV education programs to bring insights to people and help them interpret their religious beliefs in health promoting ways. Future studies that explore different aspects of culture and religion which may contribute to HIV transmission are recommended.
Publisher: MDPI AG
Date: 19-09-2022
DOI: 10.20944/PREPRINTS202209.0268.V1
Abstract: The COVID-19 pandemic has caused detrimental impacts on different population groups throughout the world. This study aimed to explore the impacts of the COVID-19 pandemic& rsquo s mandatory lockdown protocols on activities and mental health conditions of community-dwelling older people in Jakarta, Indonesia. A qualitative design using one-on-one in-depth interviews was employed to collect data from the participants (n=24) who were recruited using the snowball s ling technique. Data analysis was guided by a qualitative data analysis framework. The findings showed that before the COVID-19 outbreak participants engaged in different kinds of regular in idual and social activities. However, the COVID-19 outbreak and its mandatory lockdown protocols significantly influenced both their activities and social life, which led to social disconnection and financial difficulties for them. COVID-19 outbreak, mandatory lockdown protocols, and disruption of in idual and social activities of the participants also caused mental health challenges to them, including feelings of loneliness, loss, sadness, stress, and anger. The findings suggest that there is a need for intervention programs addressing the socio-economic and mental health impacts of the COVID-19 pandemic on older populations to help them cope with these challenges. Future studies involving large-scale older populations to comprehensively understand COVID-19 impacts on them are recommended.
Publisher: MDPI AG
Date: 13-09-2022
Abstract: Migration has always been a feature of human populations, with people migrating and crisscrossing the globe for a wide range of reasons [...]
Publisher: Springer Science and Business Media LLC
Date: 20-04-2020
DOI: 10.1038/S41591-020-0807-6
Abstract: A double burden of malnutrition occurs when in iduals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of % in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic.
Publisher: Springer Science and Business Media LLC
Date: 07-12-2022
DOI: 10.1186/S12912-022-01131-6
Abstract: The outbreak of coronavirus disease (COVID-19) has impacted the lives of more than 580 million people and killed more than six million people globally. Nurses are one of the most impacted groups as they are at the frontline to fight against the virus and to try to save the lives of everyone affected. The present study aimed to explore the impact of working in COVID-19 wards on the mental health and wellbeing of nurses in the early stage of the pandemic in a hospital in East Nusa Tenggara, Indonesia. A qualitative study was conducted with 22 nurses, recruited using purposive s ling. Data collection was conducted from April to May 2022 and data analysis was guided by qualitative framework analysis. The findings show that nurses experienced a range of mental health impacts including fear of being infected and infecting loved ones fear of early death psychological distress related to the conflict between the lack of personal protective equipment (PPE) and both professionalism and moral responsibility for patients stress due to long waiting period to know the result of the COVID-19 tests stress and worry due to public indifference and lack of role models the negative impact of community doubt and distrust around COVID-19 and distress due to stigma and discrimination towards nurses caring for COVID-19 patients and their families. The current findings indicate further psychological intervention programs to support nurses, especially the ones in resource poor settings and enhance their psychological resilience.
Publisher: Hindawi Limited
Date: 07-2019
DOI: 10.1155/2019/6045726
Abstract: The study aimed to explore facilitators or enabling factors that enhance accessibility (defined as the opportunity to be able to use) to HIV/AIDS-related health services among HIV positive transgender women, also known as Waria in Yogyakarta, Indonesia. A qualitative study employing one-on-one in-depth interviews was conducted from December 2017 to February 2018. Participants were HIV positive Waria recruited using purposive and snowball s ling techniques. Data were analysed using the framework analysis for qualitative research. The findings showed that participants’ knowledge of HIV/AIDS and the availability of HIV/AIDS-related health services were enablers to the services accessibility. Emotional support from fellow Waria displayed in various ways, such as kind and caring attention, attentive listening, and encouraging words, was an important social support that played a role in supporting Waria’s accessibility to the services. HIV/AIDS-related health service information shared personally or jointly by fellow Waria and instrumental support including helping each other to collect antiretroviral (ARV) from hospitals or community health centres, contacting ambulance in emergency situations, accompanying each other to health service facilities, and helping those without the health insurance to receive free health services were also the social support enabling accessibility to the services among the study participants. Appraisal support such as providing constructive feedback and affirmation was another enabling factor to Waria ’s accessibility to the services. The findings indicate the needs to broadly disseminate information and educate Waria populations and their significant others about HIV/AIDS and related health services to raise their awareness of HIV/AIDS and acceptance of HIV/AIDS positive in iduals. Educating and broadly disseminating this information in other settings in the country will also increase accessibility to the HIV/AIDS services among Waria , their families, and communities addressing the currently existing inequities in health. The findings also reinforce the importance of the establishment of Waria peer-support groups within Waria communities and the involvement of Waria in HIV/AIDS activities and programs, which may increase their awareness of HIV/AIDS, and accessibility to HIV/AIDS-related health services.
Publisher: Cold Spring Harbor Laboratory
Date: 22-12-2022
DOI: 10.1101/2022.12.21.22283812
Abstract: Human Immunodeficiency Virus (HIV) is a major global public health issue that affects the quality of life (QoL) of people living with HIV (PLHIV) globally and in Indonesia. As a part of a large-scale qualitative study investigating HIV risk factors and impacts on PLHIV and facilitators of and barriers to their access to HIV care services in Yogyakarta and Belu, Indonesia, this paper describes their in-depth views and experiences of the influence of HIV on their QoL. 92 participants were recruited using the snowball s ling technique. Data were collected using in-depth interviews. In addition, the World Health Organisation Quality of Life questionnaire (WHOQOL – HIV BREF) was also distributed to each of them to fill out prior to the interviews. Chi-Square analysis was used to analyse data from the survey and qualitative data analysis was guided by a framework analysis. The findings reported several factors affecting the QoL of the participants. These included (i) environmental factors, such as living in rural areas, the unavailability of HIV care services and public transport, and long-distance travel to healthcare facilities (ii) personal beliefs associated with HIV (iii) sexual and social relationships and their influence of the QoL of participants and (iv) level of independence and physical health condition following HIV diagnosis. The findings indicate the need for intervention programs that address the availability and accessibility of HIV care services to PLHIV within rural communities, and support various physical, psychological, and financial needs of PLHIV. These can be implemented through the provision of supplements and nutritious food, HIV counselling and door-to-door/community-based ART service delivery to PLHIV which may increase their engagement in and adherence to the treatment and improve their physical and psychological condition and QoL.
Publisher: Cold Spring Harbor Laboratory
Date: 18-01-2023
DOI: 10.1101/2023.01.17.23284694
Abstract: Although traditional male circumcision (TMC) is still practiced in a number of countries, and its healing process may have a high risk of HIV and other STIs transmission, there have been no published systematic reviews on TMC, HIV risk, and impacts on circumcised men and their families. The aim of this study is to synthesise evidence of how TMC practices contribute to HIV transmission among males and the impacts of HIV on themselves and their families. The systematic search started with an initial search following the PICO (Population, Intervention, Comparison and Outcomes) framework. A systematic review was conducted to find literature using databases including PubMed, CINHAL, SCOPUS, ProQuest, Cochrane, and Medline. The search was limited to the English language, and with no year limit in order to capture as many articles as possible about circumcision, traditional male circumcision, HIV, and impact on men and their families. Critical appraisal tools developed by the Joanna Briggs Institute (JBI) for study design were used to assess the methodological quality of included studies. A total of 18 studies were included: 11 were qualitative studies, 5 were quantitative studies, and 2 were mixed-method studies. All the studies included were conducted in areas where traditional male circumcision was performed (17 in Africa and 1 in Papua New Guinea). The findings of the review were categorized into themes namely TMC as a cultural practice, consequences of not being traditionally circumcised on men and their families, and TMC-related risk of HIV transmission. The review showed that TMC and HIV risk could bring significant and negative challenges for men and their families. The findings indicated the need for targeted health intervention programs and efforts to address psychological and social challenges in communities practicing TMC. CRD42022357788.
Publisher: Research Square Platform LLC
Date: 21-09-2022
DOI: 10.21203/RS.3.RS-2001089/V1
Abstract: Background The outbreak of coronavirus disease (COVID-19) has impacted the lives of more than 580 million people worldwide and killed more than six million people globally. Nurses are one of the most impacted groups as they are at the frontline to fight against the virus and to save the life of everyone affected. The present study aimed to explore the impact of working in COVID-19 wards on mental health and wellbeing of nurses in the early stage of the pandemic in a hospital, in East Nusa Tenggara, Indonesia. Methods A qualitative study was conducted with 22 nurses. They were recruited using the purposive s ling technique. Data collection was conducted from April to May 2022 and data analysis was guided by a qualitative framework analysis. Results The findings show that nurses experienced a range of mental health impacts including fear of being infected and infecting loved ones fear of early death psychological distress related to the conflict between the lack of personal protective equipment (PPE) and professionality and moral responsibility for patients stress and worry due to public indifference and lack of role models the negative impact of community doubt and distrust around COVID-19 and distress due to stigma and discrimination towards nurses caring for COVID-19 patients and their families. Conclusions The current findings indicate further psychological intervention programs to support nurses, especially the ones in resource poor settings and enhance their psychological resilience.
Publisher: SAGE Publications
Date: 22-02-2018
Abstract: This study aimed to explore perceived determinants of condom use behaviors among male clients of female commercial sex workers (FCSWs) in Belu and Malaka districts, Indonesia. One-on-one in-depth interviews guided by the Health Belief Model (HBM) were used to collect the data from participants ( n = 42). The Framework analysis for qualitative data was employed to analyze the data. Results demonstrated several factors associated with lack of and inconsistent condom use among the participants. They included self-perceived risk of contracting HIV infection, knowledge of the severity of HIV illness and its impacts, and condom use: its benefits and its influencing factors. Additionally, factors including reduced sexual pleasure and the lack of knowledge of how and where to access condoms were important perceived barriers to condom use among participants. Having seen images of HIV-/AIDS-positive people, knowing friends and relatives suffering from HIV, and knowing FCSWs as a high-risk group for HIV infection were the cues to using condoms among several participants. Likewise, self-efficacy was also associated with condom use behaviors among the participants. The findings indicate the needs for HIV/AIDS interventions that include dissemination of HIV/AIDS knowledge, condom promotion, and improvement in the availability of condoms for both FCSWs and their clients.
Publisher: Public Library of Science (PLoS)
Date: 22-03-2023
DOI: 10.1371/JOURNAL.PONE.0273761
Abstract: COVID-19 has rapidly impacted societies on a global scale, with older people among the most affected. To care for older people living in their own homes, female family caregivers play a pivotal role. The current study aimed to explore the actions of female family caregivers and the challenges they faced in taking care of older people living at homes during the COVID-19 pandemic in Belu district, Indonesia. This qualitative study involved twenty female family caregivers, who were recruited using a combination of purposive and snowball s ling techniques. Findings were grouped into two main categories: (i) actions of female family caregivers in taking care of older adults during the COVID-19 pandemic. These included limiting both visitations of extended family members and older adults’ activities outside homes explaining the virus to older adults and controlling their access to news, social media and smartphones providing nutrition, supplement and maintaining daily diets and (ii) challenges they faced in taking care of older adults included excessive fear of contracting COVID-19 and possibility of transmitting it to older people feeling stressed tired and overburdened. The study highlights the significant role family caregivers played to protect older people living at home. The findings can inform government to develop intervention programs that address and support the needs of both family caregivers and older people living at home.
Publisher: Wiley
Date: 24-02-2022
DOI: 10.1111/ELE.13795
Publisher: Proceedings of the National Academy of Sciences
Date: 04-2019
Abstract: Avian ersification has been influenced by global climate change, plate tectonic movements, and mass extinction events. However, the impact of these factors on the ersification of the hyper erse perching birds (passerines) is unclear because family level relationships are unresolved and the timing of splitting events among lineages is uncertain. We analyzed DNA data from 4,060 nuclear loci and 137 passerine families using concatenation and coalescent approaches to infer a comprehensive phylogenetic hypothesis that clarifies relationships among all passerine families. Then, we calibrated this phylogeny using 13 fossils to examine the effects of different events in Earth history on the timing and rate of passerine ersification. Our analyses reconcile passerine ersification with the fossil and geological records suggest that passerines originated on the Australian landmass ∼47 Ma and show that subsequent dispersal and ersification of passerines was affected by a number of climatological and geological events, such as Oligocene glaciation and inundation of the New Zealand landmass. Although passerine ersification rates fluctuated throughout the Cenozoic, we find no link between the rate of passerine ersification and Cenozoic global temperature, and our analyses show that the increases in passerine ersification rate we observe are disconnected from the colonization of new continents. Taken together, these results suggest more complex mechanisms than temperature change or ecological opportunity have controlled macroscale patterns of passerine speciation.
Publisher: Emerald
Date: 08-05-2017
DOI: 10.1108/IJHRH-01-2017-0002
Abstract: The purpose of this paper is to explore the socio-economic impacts of AIDS on families caring for AIDS-orphaned children in Mbeya rural district, Tanzania. A qualitative inquiry employing one-on-one in-depth interviews was conducted in 2015. Purposive s ling technique was used to recruit participants ( n =24) comprising 20 heads of families caring for AIDS-orphaned children, two local government staff and two staff from Isangati Agricultural Development Organisation – a non-government organisation. Qualitative data were analysed using thematic and framework approach. Results demonstrated that families caring for AIDS-orphaned children experienced severe socio-economic impacts of the epidemic. Reduction in household savings, increase in living expenses on health care and increased education fees were the identified economic impacts on these families. Social impacts included labour shortage, withdrawal of children from school and increased demand for food. There is a need for urgent responses and for scaling up programmes delivered by organisations, institutions and the government of Tanzania to help families cope with these impacts. This study provides evidence on socio-economic impacts of AIDS on families caring for AIDS-orphaned children in Tanzania. An understanding of these impacts can help governmental and non-governmental institutions and programme planners to address the problem in their policies and develop evidence-based strategies and interventions in responding to the problem in Mbeya and Tanzania. Moreover, responses to reducing the impacts of AIDS on families require a holistic approach that encourages the involvement of all sectors and agents outside of the health sector.
Publisher: MDPI AG
Date: 24-08-2021
Abstract: International mobility has increased steadily in recent times, bringing along a myriad of health, social and health system challenges to migrants themselves and the host nations. Mental health issues have been identified as a significant problem among migrants, with poor accessibility and underutilisation of the available mental health services (MHSs) repeatedly reported, including in Australia. Using a qualitative inquiry and one-on-one in-depth interviews, this study explored perspectives of African migrants and service providers on barriers to accessing MHSs among African migrants in South Australia. The data collection took place during the COVID-19 pandemic with lockdown and other measures to combat the pandemic restricting face to face meetings with potential participants. Online platforms including Zoom and/or WhatsApp video calls were used to interview 20 African migrants and 10 service providers. Participants were recruited from community groups and/or associations, and organisations providing services for migrants and/or refugees in South Australia using the snowball s ling technique. Thematic framework analysis was used to guide the data analysis. Key themes centred on personal factors (health literacy including knowledge and the understanding of the health system, and poor financial condition), structural factors related to difficulties in navigating the complexity of the health system and a lack of culturally aware service provision, sociocultural and religious factors, mental health stigma and discrimination. The findings provide an insight into the experiences of African migrants of service provision to them and offer suggestions on how to improve these migrants’ mental health outcomes in Australia. Overcoming barriers to accessing mental health services would need a wide range of strategies including education on mental health, recognising variations in cultures for effective service provision, and addressing mental health stigma and discrimination which strongly deter service access by these migrants. These strategies will facilitate help-seeking behaviours as well as effective provision of culturally safe MHSs and improvement in access to MHSs among African migrants.
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/SH17137
Abstract: Background The spread of HIV infection among men in Indonesia continues to increase every year. Clients of female sex workers (FSWs) are a group at higher risk of acquiring HIV infection due to their frequent engagement in sexual acts with sex workers. This study aimed to identify factors of susceptibility to HIV infection among clients of FSWs. Methods: A qualitative inquiry using one-on-one in-depth interviews was conducted in the Belu and Malaka districts of Indonesia from January to April 2017. The study participants (n =42) were the clients of FSWs recruited using the snowball s ling technique. The inclusion criteria were: being a client of FSWs and being aged 18 years or more. Data were analysed using a framework analysis. Results: Findings were grouped into two main emerging themes that included behavioural and socioeconomic factors. Behavioural factors that mediated HIV susceptibility among clients of FSWs were: frequent engagement in unsafe sex with multiple sex workers low perceptions of the relevance of available HIV and AIDS services and limited access to these services and HIV stigma or fear of being labelled as HIV positive. Socioeconomic factors included: participants’ economic situation and in iduals’ household responsibility and ability to afford FSWs services. Conclusions: The study results indicate the need to reformulate and improve HIV and AIDS-related services, including increasing the level of availability of HIV service points and the dissemination of knowledge and information about HIV and AIDS and condom use and making them accessible to both FSWs and their clients in Belu and Malaka districts.
Publisher: Elsevier BV
Date: 10-2022
Publisher: MDPI AG
Date: 12-10-2022
Abstract: The COVID-19 pandemic has caused detrimental impacts on different population groups throughout the world. This study aimed to explore the impacts of the COVID-19 pandemic’s mandatory lockdown protocols on in idual and social activities and mental health conditions of community-dwelling older people in Jakarta, Indonesia. A qualitative design using one-on-one in-depth interviews was employed to collect data from the participants (n = 24) who were recruited using the snowball s ling technique. Data analysis was guided by the five steps proposed in a qualitative data analysis framework, including familiarisation with the data, identification of a thematic framework, indexing the data, charting the data and mapping and interpreting the data. The findings showed that before the COVID-19 outbreak participants engaged in different kinds of regular in idual and social activities. However, the COVID-19 outbreak and its mandatory lockdown protocols significantly influenced both their activities and social life, which led to social disconnection and financial difficulties for them. COVID-19 outbreak, mandatory lockdown protocols, and the disruption of in idual and social activities of the participants also caused mental health challenges to them, including feelings of loneliness, loss, sadness, stress, and anger. The findings suggest that there is a need for intervention programs addressing the socio-economic and mental health impacts of the COVID-19 pandemic on older populations to help them cope with these challenges. Future studies involving large-scale older populations to comprehensively understand COVID-19 impacts on them are recommended.
Publisher: Cold Spring Harbor Laboratory
Date: 22-08-2022
DOI: 10.1101/2022.08.22.22278860
Abstract: COVID-19 has rapidly impacted societies on a global scale, with older people among the most affected. To care for older people living in their own homes, female family caregivers play a pivotal role. The current study aimed to explore the actions of female family caregivers and the challenges they faced in taking care of older people living at homes during the COVID-19 pandemic in Belu district, Indonesia. This qualitative study involved twenty female family caregivers, who were recruited using a combination of purposive and snowball s ling techniques. Findings were grouped into two main categories: (i) actions of female family caregivers in taking care of older adults during the COVID-19 pandemic. These included limiting both visitations of extended family members and older adults’ activities outside homes explaining the virus to older adults and controlling their access to news, social media and smartphones providing nutrition, supplement and maintaining daily diets and (ii) challenges they faced in taking care of older adults included excessive fear of contracting COVID-19 and possibility of transmitting it to older people feeling stressed tired and overburdened. The study highlights the significant role family caregivers played to protect older people living at home. The findings can inform government to develop intervention programs that address and support the needs of both family caregivers and older people living at home.
Publisher: OMICS Publishing Group
Date: 2017
Publisher: Elsevier BV
Date: 11-2022
Publisher: Cold Spring Harbor Laboratory
Date: 16-04-2022
DOI: 10.1101/2022.04.16.22273930
Abstract: HIV infection adds a significant burden to women in low- and middle-income countries (LMICs), often leading to severe detrimental impact, not only on themselves, but also on their families and communities. Given that more than half of all people living with HIV globally are females (53%), this review seeks to understand the impact of HIV infection on women living with HIV (WLHIV) and their families in LMICs, and the interrelationships between one impact and another. A systematic review was conducted to find literature using the following databases: Medline, PsycINFO, CINAL, Emcare, Scopus and ProQuest. Research articles were included if they met the following inclusion criteria: conducted in LMICs, published in English language between January 1 st 1990 and October 31 st 2021, had full text available, involved WLHIV (married and unmarried), and focused on the impact of HIV on these women and their families. Critical appraisal tools developed by Joanna Briggs Institute (JBI) were used to assess the methodological quality of the studies and thematic narrative synthesis was used to analyse the findings. A total of 22 articles met the inclusion criteria. The review showed that HIV has a range of negative consequences on WLHIV and their families including: (i) psychological impact, (ii) poor physical health and intimate partner violence, (iii) social impact, and (iv) economic impact. The findings indicate the need for targeted interventions, specific to WLHIV, that address the inequity and discrimination they face. These interventions should also incorporate education and sustainable support structures for WLHIV and their families.
Publisher: MDPI AG
Date: 19-05-2021
Abstract: HIV stigma and discrimination are a major challenge facing people living with HIV (PLHIV) globally. As part of a larger qualitative study with PLHIV in Yogyakarta and Belu, Indonesia, this paper describes the participants’ perceptions about drivers of HIV stigma and discrimination towards them within families, communities and healthcare settings, and highlights issues of HIV stigma as a social process. Participants were recruited using a snowball s ling technique. Data analysis was guided by the framework analysis for qualitative data, and conceptualization and discussion of the study findings were guided by the HIV stigma framework. The findings showed that participants experienced stigma and discrimination across settings, including in families and communities by family and community members, and in healthcare settings by healthcare professionals. The lack of knowledge about HIV, fear of contracting HIV, social and moral perceptions about HIV and PLHIV were perceived facilitators or drivers of stigma and discrimination towards PLHIV. HIV stigma and discrimination were also identified as a process linked to the whole groups of people within families or communities, which occurred within social context in Yogyakarta and Belu. The findings indicate the need for HIV education for family and community members, and healthcare providers to enhance their knowledge of HIV and improve acceptance of PLHIV within families, communities and healthcare settings.
Publisher: Public Library of Science (PLoS)
Date: 09-10-2019
Publisher: Cold Spring Harbor Laboratory
Date: 02-09-2022
DOI: 10.1101/2022.09.02.22279532
Abstract: Human immunodeficiency virus (HIV) infection has detrimental impacts on the lives of different population groups living with HIV, including men who have sex with men (MSM). Using the World Health Organization Quality of Life Questionnaire (WHOQOL – HIV BREF), this study aimed to assess the Health-Related Quality of Life (HrQoL) of men living with HIV with different sexual orientations and determine the dominant influential factors. This cross-sectional study involved 206 men living with HIV. They were recruited from Sriwijaya Plus Foundation and a medical facility providing antiretroviral therapy (ART). Data were analyzed using Chi-square and binomial logistic regression. The analysis showed that the percentage of MSM patients was more than non-MSM/heterosexual men, accounting for 68.9% of the total population. Furthermore, depression status, social stigma, family support, therapy duration, and suffering duration were significantly associated with the quality of life of MSM and non-MSM (p-value .001). The multivariate logistic regression revealed that the most dominant influential factor was depression status (PR=5.417 95% CI=2.473-11.876), where the majority of the depressed patients were 5.417 times more at risk of lower life quality compared to others. Depression can lead to low quality of life among HIV patients. The findings suggest that there is a need for the development of intervention programs that address the psychological and social needs of PLHIV or support them to cope with depression and the social stigma facing them. Support from families and health workers can help them cope with psychological and social challenges faced by PLHIV and increase community acceptance of PLHIV.
Publisher: Springer Science and Business Media LLC
Date: 08-01-2021
DOI: 10.1186/S12916-020-01876-4
Abstract: Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. We performed an ecological study using VR data ranging from 2000 to 2017, dependent on in idual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Our subnational estimates of HIV mortality revealed significant spatial variation and erging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.
Publisher: Elsevier BV
Date: 12-2022
Publisher: Frontiers Media SA
Date: 12-05-2021
Abstract: Stigma and discrimination are major challenges facing People Living with HIV/AIDS (PLWHA) globally due to their HIV status. As part of a larger qualitative study in Yogyakarta and Belu, Indonesia, using in-depth interviews with 92 PLWHA (52 women, 40 men) and 20 healthcare providers, this paper describes perspectives and personal experiences of the 20 healthcare providers, relating to HIV stigma and discrimination toward PLWHA in both study settings. The healthcare providers were recruited from healthcare facilities providing HIV-related healthcare services, using a snowball s ling technique. A qualitative framework analysis was used to guide data analysis. Health stigma and discrimination framework guided the conceptualisation and discussion of the findings. The findings presented the views and perspectives of healthcare providers that HIV stigma and discrimination toward PLWHA still occurred within families, communities and healthcare settings. These were reflected in negative labelling, separation of personal belongings, avoidance, denial of treatment and rejection of PLWHA by healthcare providers, family and community members. Some healthcare providers reported that they had personally stigmatised and discriminated against PLWHA. A lack of knowledge about HIV, fear of contracting HIV, personal values, religious thoughts and sociocultural values and norms, were reported as drivers or facilitators behind this HIV-related stigma and discrimination. The findings indicate the importance of continued HIV/AIDS education for families, community members and healthcare providers, to raise awareness and to ensure that healthy and professional support systems are in place for PLWHA. The findings indicate the need to enhance improvement within the healthcare or HIV care system to adequately address the needs of PLWHA, which may facilitate their early initiation of HIV treatment and better treatment adherence and retention to increase Cluster of Differentiation 4 (CD4) count and suppress viral load. Future studies are also needed to explore the role that government and non-government institutions can play in improving health service delivery for people newly diagnosed with HIV and those living with HIV/AIDS.
Publisher: Informa UK Limited
Date: 22-01-2021
DOI: 10.1080/09540121.2020.1716934
Abstract: This study aimed to understand how transgender women living with human immunodeficiency virus (HIV) cope psychologically with the infection. A qualitative inquiry was conducted with 29 participants in Yogyakarta, Indonesia. Participants were recruited using purposive and snowball s ling techniques. Data analysis was guided by the framework analysis for qualitative research. The findings indicated that acceptance of HIV status by an in idual was related to the person's awareness of personal behaviours leading to HIV acquisition. This meaning-making, "a psychological process" helped their attitudes towards thinking positively about life, stopped self-blaming and acted as a mechanism to cope with the challenging circumstances related to HIV infection. Participants' awareness of the importance of friends and families who cared and loved them, the responsibility they had for their families and the willingness to contribute meaningfully to other people living with HIV (PLHIV) were additional supportive attributes that contributed to participants' coping with the HIV stressful situations. The processes of finding the meaning supported participants' commitment to undergo HIV treatment and being involved in activities for self-help, while helping other PLHIV to cope with their situations. The findings indicate the need for sustained counselling to help PLHIV to find positive meanings out of their condition.
Publisher: Springer Science and Business Media LLC
Date: 08-04-2021
DOI: 10.1038/S41586-021-03473-8
Abstract: A Correction to this paper has been published: 0.1038/s41586-021-03473-8.
Publisher: MDPI AG
Date: 12-07-2022
Abstract: This study aimed to understand Indonesian healthcare professionals’ (HCPs) perceptions and experiences regarding barriers to both HCP and community adherence to COVID-19 prevention guidelines in their social life. This methodologically qualitative study employed in-depth interviewing as its method for primary data collection. Twenty-three HCP participants were recruited using the snowball s ling technique. Data analysis was guided by the Five Steps of Qualitative Data Analysis introduced through Ritchie and Spencer’s Framework Analysis. The Theory of Planned Behaviour was used to guide study conceptualisation, data analysis and discussions of the findings. Results demonstrated that HCP adherence to COVID-19 prevention guidelines was influenced by subjective norms, such as social influence and disapproval towards preventive behaviours, and perceived behavioural control or external factors. Findings also demonstrated that HCPs perceived that community nonadherence to preventive guidelines was influenced by their behavioural intentions and attitudes, such as disbelief in COVID-19-related information provided by the government, distrust in HCPs, and belief in traditional ritual practices to ward off misfortune. Subjective norms, including negative social pressure and concerns of social rejection, and perceived behavioural control reflected in lack of personal protective equipment and poverty, were also barriers to community adherence. The findings indicate that policymakers in remote, multicultural locales in Indonesia such as East Nusa Tenggara (Nusa Tenggara Timur or NTT) must take into consideration that familial and traditional (social) ties and bonds override in idual agency where personal action is strongly guided by long-held social norms. Thus, while agency-focused preventive policies which encourage in idual actions (hand washing, mask wearing) are essential, in NTT they must be augmented by social change, advocating with trusted traditional (adat) and religious leaders to revise norms in the context of a highly transmissible pandemic virus. Future large-scale studies are recommended to explore the influence of socio-cultural barriers to HCP and community adherence to preventive guidelines, which can better inform health policy and practice.
Publisher: MDPI AG
Date: 19-01-2020
Abstract: It is well acknowledged that human immunodeficiency virus stigma (HIV stigma) challenges people living with HIV globally. There is a scarcity of information about determinants of HIV stigma and discrimination among married men in the Indonesian context. This study aimed to explore factors that contribute to stigma and discrimination against HIV-positive men married to women in Yogyakarta, Indonesia. Face-to-face in-depth interviews were conducted to collect data from participants using a snowball s ling technique. A framework analysis was used to guide the analysis of the data. HIV stigma framework was also applied in the conceptualisation and the discussion of the findings. The findings indicate that participants experienced external stigma within healthcare facilities, communities and families. This external stigma was expressed in various discriminatory attitudes and behaviours by healthcare professionals and community and family members. Similarly, participants experienced anticipated stigma as a result of HIV stigma and discrimination experienced by other people living with HIV. In idual moral judgement associating HIV status with amoral behaviours and participants’ negative self-judgement were determinants of perceived stigma. The current findings indicate the need for training programs about HIV stigma issues for healthcare professionals. There is also a need to disseminate HIV information and to improve HIV stigma knowledge among families and communities.
Publisher: Public Library of Science (PLoS)
Date: 13-07-2023
DOI: 10.1371/JOURNAL.PONE.0280087
Abstract: Human Immunodeficiency Virus (HIV) is a major global public health issue that affects the quality of life (QoL) of people living with HIV (PLHIV) globally and in Indonesia. As a part of a large-scale qualitative study investigating HIV risk factors and impacts on PLHIV and facilitators of and barriers to their access to HIV care services in Yogyakarta and Belu, Indonesia, this paper describes their in-depth views and experiences of the influence of HIV on their QoL. Ninety-two participants were recruited using the snowball s ling technique. Data were collected using in-depth interviews. In addition, the World Health Organisation Quality of Life questionnaire (WHOQOL–HIV BREF) was also distributed to each of them to fill out prior to the interviews. Chi-Square analysis was used to analyse data from the survey and a framework analysis was applied to guide qualitative data analysis. The findings reported several factors affecting the QoL of the participants. These included (i) environmental factors, such as living in rural areas, the unavailability of HIV care services and public transport, and long-distance travel to healthcare facilities (ii) personal beliefs associated with HIV (iii) sexual and social relationships and their influence of the QoL of participants and (iv) level of independence and physical health condition following HIV diagnosis. The findings indicate the need for intervention programs that address the availability and accessibility of HIV care services to PLHIV within rural communities and support various physical, psychological, and financial needs of PLHIV. These can be implemented by providing supplements and nutritious food, HIV counselling and door-to-door/community-based ART service delivery to PLHIV, which may increase their engagement in and adherence to the treatment and improve their physical and psychological condition and QoL.
Publisher: Springer Science and Business Media LLC
Date: 11-04-2023
DOI: 10.1186/S12905-023-02299-Y
Abstract: HIV infection and its sequelae continue to be a significant challenge among women and their families in developing countries despite the progress that has been made in the prevention and treatment of HIV. This paper describes the strategies employed by mothers with HIV to cope with the various challenges experienced following their own and their children’s HIV diagnosis. This paper uses previously unpublished data collected for a study that sought to explore the mental health challenges and coping strategies of mothers living with HIV (MLHIV) (n = 23) who have children living with HIV (CLHIV). Data collection was conducted using in-depth interviews, and participants were recruited using the snowball s ling technique. The concept of meaning-making was used to guide the conceptualisation, analysis, and discussion of the findings. Our analysis showed that meaning-making such as the awareness of how important mothers were to their children/CLHIV and families and religious meaning were used by participants to cope with HIV-related and mental health challenges they faced. The meaning of mother-child relationship which was supported and maintained through the provision of time, attention and fulfillment of CLHIV’s needs were also coping strategies employed by these women. Additional coping strategies used were to link their CLHIV to groups and activities of CLHIV. The connections made through these links enabled their children to know other CLHIV, build relationships, and share experiences. These findings are useful evidence that can inform policies and practices and indicate the need for the development of intervention programs that address the needs of MLHIV and their families to cope with HIV-related challenges of their children. Future large-scale studies involving MLHIV who have CLHIV are recommended to have a comprehensive understanding of strategies they employ to cope with HIV-related challenging circumstances and mental health issues that they continue to face.
Publisher: MDPI AG
Date: 28-05-2021
Abstract: Transgender populations are considered as a highly vulnerable group to HIV infection. This study aimed to understand structural, personal and socioenvironmental factors and the mechanisms through which these factors facilitate HIV transmission among transgender women (waria) in Yogyakarta, Indonesia. A qualitative inquiry using one-on-one in-depth interviews was employed to collect data from participants (n = 29). Thematic analysis was used to guide data analysis. Findings showed that poverty in families, a sense of responsibility to support family necessities, limited employment options and low education attainment were the structural factors driving participants’ engagement in sex work practices and unprotected anal intercourse, which facilitated HIV transmission among them. Personal need fulfilment and the desire for savings were personal factors driving their engagement in these high-risk practices that supported HIV transmission. Social relationships, social influence and the participants’ living environment were socioenvironmental factors that also supported sex work practices and HIV transmission among the participants. The findings indicate the need for capacity building in terms of knowledge and skills for waria populations to prepare and enable them to gain meaningful employment to prevent the vicious cycle of HIV transmission among them. As structural factors seemed to be the main drivers predisposing waria to HIV acquisition, further studies to explore effective HIV/AIDS interventions that address economic aspects of waria in Yogyakarta and other similar settings in Indonesia are recommended.
Publisher: Springer Science and Business Media LLC
Date: 30-05-2023
DOI: 10.1186/S13031-023-00524-X
Abstract: The war in Tigray, North Ethiopia which started in November 2020, has destroyed decades of the region’s healthcare success. There is some emerging published evidence on attacks on health care in the region, and we synthesized the available evidence on ‘perilous medicine’ in Tigray to understand the data source, subjects and content covered, and what gaps exist. We employed a systematic review and performed a systematic search of MEDLINE, PubMed, CINHAL, Web of Science and Scopus. We included English written documents published from 4 November 2020 to 18–19 October 2022 and updated the search on 23 January 2023. HG and NF independently performed title, abstract and full-text screening. We used Joanna Briggs Institute (JBI) tools to appraise and extract data, and applied content synthesis to analyze. The PROSPERO registration number is CRD42022364964. Our systematic review search yielded 8,039 documents, and we finally found 41 documents on conflict and health in Tigray. The areas were: (1) attacks on infrastructure, health or aid workers, patients, ambulances or aid trucks identified in 29 documents—the documents reported targeted attacks on health infrastructure and personnel (2) interruption of health or social services in 31 documents—the documents reported medical and humanitarian siege (3) outcomes and direct or indirect impacts in 33 documents—the documents reported increased magnitude of illnesses, and catastrophic humanitarian crises including the use of food, medicine and rape as tools of war and (4) responses, rebuilding strategies, and recommendations in 21 documents—the documents reported improvisation of services, and calling to seize fire, accountability and allow humanitarian. Despite promising studies on conflict and health in Tigray, the documents lack quality of designs and data sources, and depth and ersity of subjects and contents covered calling further primary studies on a prioritized future research agenda.
Publisher: Springer Science and Business Media LLC
Date: 02-07-2020
DOI: 10.1038/S41591-020-0972-7
Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Publisher: Elsevier BV
Date: 07-2022
Location: Netherlands
Location: Australia
No related grants have been discovered for Nelsensius Klau Fauk.