ORCID Profile
0000-0001-6902-6602
Current Organisation
University of New South Wales
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Public Health and Health Services | Public Health And Health Services Not Elsewhere Classified | Public Policy | Human Bioethics | Sociology | Social Change | Social Program Evaluation | Social Policy | Political Science Not Elsewhere Classified | Applied Ethics | Law And Society | Primary Health Care | Preventive Medicine | Mental Health | Other Studies in Human Society | Language In Culture And Society (Sociolinguistics) | Counselling, Welfare and Community Services | Social Work Not Elsewhere Classified | Gender Specific Studies | Health And Community Services | Social Work | Policy and Administration | Preventive Medicine |
ANZSRC Socio-Economic Objective (SEO)
International aid | Social structure and health | Public services management | Women’s health | Public health not elsewhere classified | Civics and citizenship | The professions and professionalisation | Gender | Changing work patterns | Health education and promotion | Health policy evaluation | International relations not elsewhere classified | Ethnicity, Multiculturalism and Migrant Development and Welfare | Mental health | Families and Family Services | Preventive medicine | Treatments (e.g. chemicals, antibiotics) | Health Inequalities | Behaviour and health
Related Links
Publications
Closing the Gaps: Competing estimates of Indigenous Australian life expectancy in the scientific literature
Publisher: Elsevier BV
Date: 08-2013
Erratum: Erratum to “Deciding to tell: Qualitative configurational analysis of decisions to disclose experience of intimate partner violence in antenatal care” (Soc. Sci. Med. (2016) 154C (45–53))
Publisher: Elsevier BV
Date: 08-2016
Gendered disparities in quality of cataract surgery in a marginalised population in Pakistan: The Karachi marine fishing communities eye and general health survey
Publisher: Public Library of Science (PLoS)
Date: 17-07-2015
Oceans of need in the desert: Ethical issues identified while researching humanitarian agency response in Afghanistan
Publisher: Wiley
Date: 11-2002
Abstract: This paper describes the interventions by the International Committee of the Red Cross to support a hospital in Afghanistan during the mid 1990s. We present elements of the interventions introduced in Ghazni, Afghanistan, and consider a number of ethical issues stimulated by this analysis. Ethical challenges arise whenever humanitarian interventions to deal with complex political emergencies are undertaken: among those related to the case study presented are questions concerning: a) whether humanitarian support runs the risk of propping up repressive and irresponsible governments b) whether humanitarian relief activities can legitimately focus on a narrow range of interventions, or need to broaden to address the range of challenges facing the health system and c) whether sustainability and quality of care should be routinely considered in such settings. The paper concludes by highlighting the value of case studies, suggesting mechanisms for extending transparency and accountability in humanitarian health interventions, and highlighting the need of contextualising humanitarian work if the interventions are to be successful.
Violence against women: A neglected public health issue in less developed countries
Publisher: Elsevier BV
Date: 11-1994
DOI: 10.1016/0277-9536(94)90349-2
Abstract: Violence against women is a significant public health issue in countries of both the industrialized and less developed world. This paper describes the magnitude and health consequences of domestic violence and rape, with an emphasis on developing countries it recognizes, however, that there is a dearth of documentation regarding the wide range of activity opposing violence against women which is taking place in less developed countries. It briefly explores the factors that perpetuate violence against women and the strategies that have evolved to respond to the problem. It analyses the constellation of factors that may assist violence to emerge as a legitimate public health concern, and explores opportunities and obstacles to further progress in this field. Particular attention is devoted to the role of research in the policy-making process research areas which may assist those opposing violence against women in all its forms are tentatively suggested.
Human rights, health and development
Publisher: Informa UK Limited
Date: 07-2008
‘They aren't really black fellas but they are easy to talk to’: Factors which influence Australian Aboriginal women's decision to disclose intimate partner violence during pregnancy
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.MIDW.2016.08.004
Abstract: intimate partner violence is a significant global health problem but remains largely hidden. Understanding decisions about whether or not to disclose violence in response to routine enquiry in health settings can inform safe and responsive systems. Elevated rates of violence and systematic disadvantage found among Indigenous women globally, can impact on their decisions to disclose violence. This study aimed to test, among Indigenous women, a model for decisions on whether to disclose intimate partner violence in the context of antenatal routine screening. we employed Qualitative Configurative Analysis, a method developed for the social sciences to study complex phenomena with intermediate s le sizes. Data were drawn from single semi- structured interviews with Indigenous women 28+ weeks pregnant attending antenatal care. Interviews addressed decisions to disclose recent intimate partner violence in the context of routine enquiry during the antenatal care. Interview transcripts were binary coded for conditions identified a priori from the model being tested and also from themes identified within the current study and analysed using Qualitative Configurative Analysis to determine causal conditions for the outcome of disclosure or non-disclosure of violence experienced. five Aboriginal and Maternal Infant Health Services (two urban and three regional), and one mainstream hospital, in New South Wales, Australia. indigenous women who had experienced partner violence in the previous year and who had been asked about this as part of an antenatal booking-in visit. Of the 12 participants six had elected to disclose their experience of violence to the midwife, and six had chosen not to do so. pathways to disclosure and non-disclosure were mapped using Qualitative Configurative Analysis. Conditions relevant to decisions to disclose were similar to the conditions for non-Aboriginal women found in our earlier study. Unique to Aboriginal women's decisions to disclose abuse was cultural safety. Cultural safety included elements we titled: Borrowed trust, Build the relationship first, Come at it slowly and People like me are here. The absence of cultural safety Its absence was also a factor in decisions not to disclose experiences of violence by this group of women. cultural safety was central to Indigenous women's decision to disclose violence and processes for creating safety are identified. Other forms of safety which influenced disclosure included: safety from detection by the abuser safety from shame and safety from institutional control. Disclosure was promoted by direct asking by the midwife and a perception of care. Non-disclosure was associated with a lack of care and a lack of all four types of safety. Experiences of institutional racism were associated with Indigenous women's perceived risk of control by others, particularly child protection services. policies to ask abuse questions at first visits and models where continuity of care is not maintained, are problematic for Aboriginal women, among whom relationship building is important as is le warning about questions to be asked. Strategies are needed to build cultural safety to counter widespread racism and promote safe opportunities for Indigenous women to disclose intimate partner violence and receive support. Elements of cultural safety are necessary for vulnerable or marginalised populations to fully utilise available health services.
Opportunities for the development of drowning interventions in West Bengal, India: a review of policy and government programs
Publisher: Springer Science and Business Media LLC
Date: 15-05-2020
DOI: 10.1186/S12889-020-08868-2
Abstract: Four million people living in the Indian Sundarbans region in the state of West Bengal face a particularly high risk of drowning due to rurality, presence of open water, lack of accessible health systems and poor infrastructure. Although the World Health Organization has identified several interventions that may prevent drowning in rural low-and middle-income country contexts, none are currently implemented in this region. This study aims to conduct contextual policy analysis for the development of a drowning program. Implementation of a drowning program should consider leveraging existing structures and resources, as interventions that build on policy targets or government programs are more likely to be sustainable and scalable. A detailed content review of national and state policy (West Bengal) was conducted to identify policy principles and/or specific government programs that may be leveraged for drowning interventions. The enablers and barriers of these programs as well as their implementation reach were assessed through a systematic literature review. Identified policies and programs were also assessed to understand how they catered for underserved groups and their implications for equity. Three programs were identified that may be leveraged for the implementation of drowning interventions such as supervised childcare, provision of home-based barriers, swim and rescue skills training and community first responder training: the Integrated Child Development Scheme (ICDS), Self-Help Group (SHG) and Accredited Social Health Activist (ASHA) programs. All three had high coverage in West Bengal and considered underserved groups such as women and rural populations. Possible barriers to using these programs were poor government monitoring, inadequate resource provision and overburdening of community-based workers. This is the first systematic analysis of both policy content and execution of government programs to provide comprehensive insights into possible implementation strategies for a health intervention, in this case drowning. Programs targeting specific health outcomes should consider interventions outside of the health sector that address social determinants of health. This may enable the program to better align with relevant government agendas and increase sustainability.
Rehabilitating health services in Cambodia: The challenge of coordination in chronic political emergencies
Publisher: Oxford University Press (OUP)
Date: 09-1999
Abstract: The end of the Cold War brought with it opportunities to resolve a number of conflicts around the world, including those in Angola, Cambodia, El Salvador and Mozambique. International political efforts to negotiate peace in these countries were accompanied by significant aid programmes ostensibly designed to redress the worst effects of conflict and to contribute to the consolidation of peace. Such periods of political transition, and associated aid inflows, constitute an opportunity to improve health services in countries whose health indicators have been among the worst in the world and where access to basic health services is significantly diminished by war. This paper analyzes the particular constraints to effective coordination of health sector aid in situations of 'post'-conflict transition. These include: the uncertain legitimacy and competence of state structures donor choice of implementing channels and actions by national and international political actors which served to undermine coordination mechanisms in order to further their respective agendas. These obstacles hindered efforts by health professionals to establish an effective coordination regime, for ex le, through NGO mapping and the establishment of aid coordinating committees at national and provincial levels. These technical measures were unable to address the basic constitutional question of who had the authority to determine the distribution of scarce resources during a period of transition in political authority. The peculiar difficulties of establishing effective coordination mechanisms are important to address if the long-term effectiveness of rehabilitation aid is to be enhanced.
Towards enhancing national capacity for evidence informed policy and practice in falls management: A role for a Translation Task Group?
Publisher: Springer Science and Business Media LLC
Date: 31-05-2007
Women, Health and Humanitarian Aid in Conflict
Publisher: Wiley
Date: 09-1998
Abstract: The burden of political conflict on civilian populations has increased significantly over the last few decades. Increasingly, the provision of resources and services to these populations is coming under scrutiny we highlight here the limited attention to gender in their provision. Women and men have different exposures to situations that affect health and access to health-care and have differential power to influence decisions regarding the provision of health services. We argue that the role of women in planning is central to the provision of effective, efficient and sensitive health-care to conflict-affected populations.
Towards inclusive migrant healthcare
Publisher: BMJ
Date: 16-09-2019
DOI: 10.1136/BMJ.L4256
Gender, health and ageing in Fiji: a mixed methods analysis.
Publisher: Springer Science and Business Media LLC
Date: 14-09-2021
DOI: 10.1186/S12939-021-01529-9
Abstract: Women are disadvantaged by ageing: older women are more likely than older men to suffer from ill-health, have less access to health care and suffer discrimination within the health care system. Globally, there is a dearth of health research on gender and ageing with substantial knowledge gaps in low and middle-income country contexts. Part of a wider investigation on health and ageing in Fiji, our objective was to identify and describe gendered differences in healthy ageing in this Pacific Island context. We believe this to be the first such study in the Pacific region. Applying a health systems lens, we used a mixed-methods approach, encompassing analysis of cause of death data focus group discussion to gather community and family attitudes to health services and policy analysis, and then used data triangulation techniques to draw out key themes and insights. We found that gender affects health outcomes among older persons, attitudes towards and experience of healthy ageing, and an older person’s access to and use of health services. We also found that while Fiji’s policy response to ageing has recognised the importance of gender, to-date there has been limited action to address gender differences. Gender (as oppose to sex differences) has direct and indirect implications for the health of older Fijians, while gendered inequalities and patriarchal norms appear to affect both men and women’s experience of ageing and the health system response. Further, gender and age discrimination may be intersecting, intensifying their separate effects. This study demonstrates the feasibility and importance of applying a gender lens to the study of healthy ageing. Our findings from Fiji may be relevant to other island nations in the south Pacific which share similar challenges of population ageing, a constrained health budget and geographically-dispersed populations. The data triangulation methodology may be considered an efficient and insightful way to examine gendered responses to healthy ageing elsewhere.
Injuries in developing countries: Policy response needed now
Publisher: Oxford University Press (OUP)
Date: 11-1996
DOI: 10.1016/S0035-9203(96)90399-5
Abstract: From December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread rapidly, leading to a global pandemic. Little is known about possible relationships between SARS-CoV-2 and other viruses in the respiratory system affecting patient prognosis and outcomes. This study aims to characterize respiratory virome profiles in association with SARS-CoV-2 infection and disease severity, through the analysis in 89 nasopharyngeal swabs collected in a patient's cohort from the C ania region (Southern Italy). Results show coinfections with viral species belonging to Coronaviridae, Retroviridae, Herpesviridae, Poxviridae, Pneumoviridae, Pandoraviridae, and Anelloviridae families and only 2% of the cases (2/89) identified respiratory viruses.
Maternal and Child Health in South Sudan
Publisher: SAGE Publications
Date: 04-2015
Abstract: The Republic of South Sudan continues to face considerable challenges in meeting maternal, newborn and child health (MNCH) care needs and improving health outcomes. Ongoing instability and population displacement undermine scope for development, and damaged infrastructure, low coverage of health services, and limited government capacity and a human resource base have resulted in a fragmented health system. Despite considerable attention, effort and support, the issues and challenges facing South Sudan remain deep and sustained, and urban–rural disparities are considerable. There is a need to maintain investments in MNCH care and to support developing systems, institutions, and programs. This review of the literature offers a commentary and appraisal of the current MNCH situation in South Sudan. It explores the barriers and challenges of promoting MNCH gains, and identifies priorities that will contribute to addressing the Millennium Development Goals and the emerging health priorities for the post-2015 development agenda.
Area socioeconomic status and childhood injury morbidity in New South Wales, Australia
Publisher: BMJ
Date: 10-2007
Increasing the use of evidence in health policy: practice and views of policy makers and researchers
Publisher: Springer Science and Business Media LLC
Date: 24-08-2009
Implementing a crèche-based community drowning programme in rural Bangladesh: A process evaluation
Publisher: BMJ
Date: 26-02-2022
DOI: 10.1136/INJURYPREV-2020-044066
Abstract: Living and environmental conditions in rural Bangladesh expose children to drowning. The Anchal programme protects children through crèche-based supervision in an enclosed space run by locally recruited carers. It is unclear under what conditions the programme best operates to maximise protection. We conducted a process evaluation of Anchal to determine enabling factors and challenges to implementation. Quantitative programme data were analysed to calculate metrics including child participation and fidelity of implementation to defined processes. Qualitative data collection with programme participants and implementers provided insights into barriers and enablers of implementation. Analysis was guided by the UK Medical Research Council’s process evaluation framework. Anchal operated 400 centres with an average of 22.2 children enrolled, as per target. However, daily attendance averaged lower than the 80% target. Children aged 1–2 years old, who are most at risk of drowning, were least likely to enrol and attend regularly due to low engagement with activities and parental concerns for safety. Greater distances and lower educational attainment in some regions reduced attendance and increased carer attrition. The Anchal programme met most programme delivery targets. However, programme success could be improved through increasing supervision, providing communication training for implementing staff, designing programmes for children aged 1–2 years old, encouraging community ownership and providing child pick-up services. These contextual solutions can be adapted to similar programmes operating through grassroots-level engagement and recruitment of community health workers, to maximise their effectiveness and sustainability.
Population Movements
Publisher: Oxford University PressNew York
Date: 12-10-2009
DOI: 10.1093/ACPROF:OSO/9780195172997.003.0009
Abstract: This chapter analyzes migration and health with a focus on a broadly defined concept of forced or “compelled” migration. It highlights the influence of structures created through globalization on the level of agency of mobile populations. It argues that globalization has had a paradoxical effect on migration and the health particularly of the migrating populations. The primary focus of the discussion is on the ethical and humanitarian challenges presented by the “othering” of migrant groups.
Hearing the voices: mental health services in East Timor
Publisher: Elsevier BV
Date: 12-2002
Policy Forum: The World Bank and Internatinal Health
Publisher: Elsevier BV
Date: 2000
Measuring the Burden of Illness in General Populations
Publisher: Springer New York
Date: 1992
Mechanisms underpinning interventions to reduce sexual violence in armed conflict: A realist-informed systematic review
Publisher: Springer Science and Business Media LLC
Date: 13-07-2015
A case study in the use of evidence in a changing political context: an Aboriginal and Torres Strait Islander health service re-examines practice models, governance and financing
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/AH13221
Abstract: This paper examines the response of a regional body, the Institute for Urban Indigenous Health (IUIH), coordinating Aboriginal community controlled health organisations (ACCHOs) in south-east Queensland, to research evidence as they prioritise and plan services in response to internal economic and organisational factors, as well as external policy change. An event-based analysis of a quarterly management meeting of the IUIH allowed an exploration of how the IUIH uses a range of evidence to respond to the challenges faced within the Aboriginal community controlled health sector. The study identified three distinct but interconnected processes: (1) identifying evidence for change (2) exploring and reframing this evidence and (3) the application of this evidence at different levels of policy and practice. These processes were evident in each of the three major agendas addressed during the meeting, namely navigating current political change, reforming the ACCHO business model and reframing the available evidence for advocacy. The result has been the emergence of a new service delivery model, in which evidence supports accountability, change management, self-sufficiency and attempts to redefine community control.
Six months after routine screening for intimate partner violence: Attitude change, useful and adverse effects
Publisher: Informa UK Limited
Date: 28-04-2010
DOI: 10.1080/03630241003705060
Abstract: This evaluative study measured self-reported changes in abuse-related measures six months after routine screening for intimate partner violence. Participants were 122 women who disclosed abuse and 241 who did not report abuse, screened in antenatal, substance abuse, and mental health services according to an existing standardized protocol used in New South Wales, Australia. Six months after initial screening, abused women were more likely to report increased agreement with a number of attitudes relating to abuse, in particular that being hurt by a partner affects a woman's health and that health services should ask about abuse. The proportion reporting current abuse was significantly lower after six months. While 6% (7/119) reported negative emotional reactions, 34% (41/120) reported useful effects-most frequently re-evaluating their situation and reducing isolation. Women who had experienced abuse, but elected not to disclose it reported similar effects. The results of this study lend support to the use of protocols for asking about abuse and responding to disclosures of abuse.
Current debates in health policy
Publisher: Elsevier BV
Date: 12-1998
Preventing crime and violence
Publisher: BMJ
Date: 06-05-1995
Balancing Imbalances: Facilitating Community Perspectives in Times of Adversity
Publisher: Wiley
Date: 05-2008
Capture-recapture as a tool for programme evaluation
Publisher: BMJ
Date: 26-03-1994
Drawing them in: professional perspectives on the complexities of engaging ‘culturally diverse’ young people with sexual and reproductive health promotion and care in Sydney, Australia
Publisher: Informa UK Limited
Date: 26-09-2016
DOI: 10.1080/13691058.2016.1233354
Abstract: Young people from minority ethnic, migrant and refugee backgrounds are widely recognised as being under-served by mainstream sexual and reproductive healthcare in developed economy nations. This paper documents the views of professionals in Australia on the complexities of, and best practice approaches to, engaging members of this group with sexual and reproductive health promotion and care. Semi-structured interviews were conducted with 23 purposively selected key informants (health service providers, policymakers, academics and community advocates). Interviews were transcribed verbatim and coded in NVivo10 using interpretive thematic analysis. Principles of 'cultural competence' were employed to structure the interpretation of findings. Five key themes reveal pivotal aspects of how professionals work in, and make sense of, this complex field. These may be summarised as: (1) appreciating the complexities of cultural ersity (2) recognising structural barriers and disincentives to engagement (3) normalising sexual health (4) balancing 'youth-friendly' and 'culturally-competent' priorities and (5) going beyond simple translation. As migration to Australia continues to ersify the population, an integrated, national approach to the design and delivery of sexual and reproductive health promotion and care would be of value, along with training and support for those involved. Implications may have resonance for other countries similarly engaged in facilitating the successful settlement of migrants and refugees.
Militarism, militarization, health and the Third World
Publisher: Informa UK Limited
Date: 10-1991
DOI: 10.1080/07488009108409001
Abstract: This paper examines the relationship between militarism, militarization, health and development. It draws attention to the fact that world military expenditure has continued to soar since the Second World War. Wars increasingly exact a heavy civilian toll. Third World countries are consuming, producing, and exporting more armaments than ever before. The rate of growth of military expenditure in developing countries has been far greater than their rate of growth in gross national product or in foreign economic aid. Countries under military control tend to be more repressive and to have suffered more years at war than those under civilian rule. Widespread availability of arms makes the settlement of disputes through violence more likely. Internal wars and violence are stimulated by a range of factors including inequalities in political and economic power, uneven development, and lack of popular participation in policy decisions by the majority of the population. The support of the industrialized countries for armament sales should be monitored, challenged and made politically unpalatable. Local development and regional cooperation should be stimulated. Health workers, as witnesses to the destruction to public health caused by war and violence, should play a part in advocating a reduction in the arms trade and the promotion of development in Third World countries.
Decision-makers, donors and data: Factors influencing the development of mental health and psychosocial policy in the Solomon Islands
Publisher: Oxford University Press (OUP)
Date: 28-11-2011
Abstract: Mental disorders and psychosocial problems are common, and present a significant public health burden globally. Increasingly, attention has been devoted to these issues in the aftermath of violent conflict. The Solomon Islands, a small Pacific island nation, has in recent years experienced periods of internal conflict. This article examines how policy decisions regarding mental health and wellbeing were incorporated into the national agenda in the years which followed. The study reveals the policy shifts, contextual influences and players responsible. The Solomon Islands' experience reflects incremental change, built upon longstanding but modest concern with mental health and social welfare issues, reinforced by advocacy from the small mental health team. Armed conflict and ethnic tensions from 1998 to 2003 promoted wider recognition of unmet mental health needs and psychosocial problems. Additional impetus was garnered through the positioning of key health leaders, some of whom were trained in public health. Working together, with an understanding of culture and politics, and drawing on external support, they drove the agenda. Contextual factors, notably further violence and the ongoing risk of instability, a growing youth population, and emerging international and local evidence, also played a part.
Who tells and what happens: Disclosure and health service responses to screening for intimate partner violence
Publisher: Hindawi Limited
Date: 19-07-2010
DOI: 10.1111/J.1365-2524.2010.00943.X
Abstract: Routine screening of women for intimate partner violence (IPV) has been introduced in many health settings to improve identification and responsiveness to hidden abuse. This cross-sectional study aimed to understand more about how women use screening programmes to disclose and access information and services. It follows women screened in ten Australian health care settings, covering antenatal, drug and alcohol and mental health services. Two s les of women were surveyed between March 2007 and July 2008 those who reported abuse during screening 6 months previously (122) and those who did not report abuse at that time (241). Twenty-three per cent (27/120) of women who reported abuse on screening were revealing this for the first time to any other person. Of those who screened negative, 14% (34/240) had experienced recent or current abuse, but chose not to disclose this when screened. The main reasons for not telling were: not considering the abuse serious enough, fear of the offender finding out and not feeling comfortable with the health worker. Just over half of both the positive and negative screened groups received written information about IPV and 35% of the positive group accessed further services. The findings highlight the fact that much abuse remains hidden and that active efforts are required to make it possible for women to talk about their experiences and seek help. Screening programmes, particularly those with established protocols for asking and referral, offer opportunities for women to disclose abuse and receive further intervention.
Talking to migrant and refugee young people about sexual health in general practice
Publisher: The Royal Australian College of General Practitioners
Date: 08-2018
Preventing violence in New South Wales: data sources and their adequacy
Publisher: The Sax Institute
Date: 2007
DOI: 10.1071/NB07060
Abstract: To describe data sources that are relevant to violence in NSW and recommend strategies for improving data collection and dissemination. Literature review, interviews with stakeholders and a survey of data custodians within NSW Health. Data sources were mapped using a conceptual framework developed by the Australian Bureau of Statistics. We found that current data sources are only partially effective at characterising the burden of violence in NSW and there are inadequate mechanisms for data review and dissemination. Improving data collection and dissemination is the first step in the public health contribution towards reducing the burden of violence on society.
Improving the quality of private sector delivery of public health services: Challenges and strategies
Publisher: Oxford University Press (OUP)
Date: 1998
Abstract: Despite significant successes in controlling a number of communicable diseases in low and middle income countries, important challenges remain, one being that a large proportion of patients with conditions of public health significance, such as tuberculosis, malaria, or sexually transmitted diseases, seek care in the largely unregulated 'for profit' private sector. Private providers (PPs) often offer services which are perceived by users to be more attractive. However, the available evidence suggests that serious deficiencies in technical quality are often present. Evaluations of interventions to promote evidence-based care in high income countries have shown that multi-faceted strategies which increase provider knowledge have had some success in improving service quality. A wider range of factors needs to be considered in low and middle income countries (LMICs), especially factors which contribute to discrepancies between provider knowledge and practice. Studies have shown that PPs, especially, perceive or experience patient and community pressures to provide inappropriate treatments. LMIC governments also lack the capacity to enforce regulatory controls. Context-specific multi-faceted strategies are needed, including the local adaptation and dissemination to providers of relevant evidence, the education of patients and communities to adopt effective treatment-seeking and treatment-taking behaviour, and feasible mechanisms for ensuring and monitoring service quality, which may include a role for self-regulation by provider organizations or provider accreditation. Developing, implementing and evaluating strategies to improve the quality of service provision will depend on the involvement of the key stakeholders, including policy makers and PPs. Focusing on studies from Asia, Africa and Latin America, this paper develops a model for identifying the influences on PPs, mainly private medical practitioners, in their management of conditions of public health significance. Based on this, multi-faceted strategies for improving the quality of treatment provision are suggested. Interventions need to be inexpensive, practical, efficient, effective and sustainable over the medium to long term. Achieving this is a significant challenge.
Injury control in developing countries
Publisher: Oxford University Press (OUP)
Date: 1993
11.8 Forced migrants and other displaced populations
Publisher: Oxford University Press
Date: 2009
Concurrent Influenza and Shigellosis Outbreaks, Papua New Guinea, 2009
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 04-2011
International aid and global health
Publisher: Cambridge University Press
Date: 10-02-2011
Inequality in cataract blindness and services: Moving beyond unidimensional analyses of social position
Publisher: BMJ
Date: 22-02-2017
DOI: 10.1136/BJOPHTHALMOL-2016-309691
Abstract: Inequalities in cataract blindness are well known, but data are rarely disaggregated to explore the combined effects of a range of axes describing social disadvantage. We examined inequalities in cataract blindness and services at the intersection of three social axes. Three dichotomous social variables (sex (male/female) place of residence (urban/rural) literacy (literate/illiterate)) from cross-sectional national blindness surveys in Pakistan (2001-2004 n=16 507) and Nigeria (2005-2007 n=13 591) were used to construct eight subgroups, with disadvantaged subgroups selected a priori (ie, women, rural dwellers, illiterate). In each data set, the social distribution of cataract blindness, cataract surgical coverage (CSC) and effective cataract surgical coverage (eCSC) were examined. Inequalities were assessed comparing the best-off and worst-off subgroups using rate differences and rate ratios (RRs). Logistic regression was used to assess cumulative effects of multiple disadvantage. Disadvantaged subgroups experienced higher prevalence of cataract blindness, lower CSC and lower eCSC in both countries. A social gradient was present for CSC and eCSC, with coverage increasing as social position improved. Relative inequality in eCSC was approximately twice as high as CSC (Pakistan: eCSC RR 2.7 vs CSC RR 1.3 Nigeria: eCSC RR 8.7 vs CSC RR 4.1). Cumulative disadvantage was observed for all outcomes, deteriorating further with each additional axis along which disadvantage was experienced. Each outcome tended to be worse with the addition of each layer of social disadvantage. Illiterate, rural women fared worst in both settings. Moving beyond unidimensional analyses of social position identified subgroups in most need this permits a more nuanced response to addressing the inequitable distribution of cataract blindness.
Building health systems capacity in global health graduate programs: reflections from Australian educators
Publisher: Springer Science and Business Media LLC
Date: 24-08-2012
Brain Gains: A literature review of medical missions to low and middle-income countries
Publisher: Springer Science and Business Media LLC
Date: 29-05-2012
Concurrent Outbreaks of Cholera and Peripheral Neuropathy Associated with High Mortality among Persons Internally Displaced by a Volcanic Eruption
Publisher: Public Library of Science (PLoS)
Date: 02-09-2013
Pandora doesn't live here anymore: Normalization of screening for intimate partner violence in Australian antenatal, mental health, and substance abuse services
Publisher: Springer Publishing Company
Date: 2011
DOI: 10.1891/0886-6708.26.1.130
Abstract: Routine screening for intimate partner violence (IPV) has been widely introduced in health settings, yet screening rates are often low. A screening policy was introduced statewide in Australia in antenatal, mental health, and substance abuse services. Annual snapshot indicates a sustained screening rate of 62%–75% since 2003. Focus group research with health care workers from 10 services found that initial introduction of screening was facilitated by brief, scripted questions embedded into assessment schedules, training, and access to referral services. Over time, familiarity and women’s favorable reactions reinforced practice. Barriers remain, including lack of privacy, tensions about limited confidentiality, and frustration when women remain unsafe. Screening added to the complexity of work, but was well accepted by workers, and increased awareness of and responsiveness to IPV.
The implementation of a new Malaria Treatment Protocol in Timor-Leste: Challenges and constraints
Publisher: Oxford University Press (OUP)
Date: 29-03-2012
Learning about sex and relationships among migrant and refugee young people in Sydney, Australia: ‘I never got the talk about the birds and the bees’
Publisher: Informa UK Limited
Date: 30-04-2018
Did the first Global Fund grant (2003-2006) contribute to malaria control and health system strengthening in Timor-Leste?
Publisher: Springer Science and Business Media LLC
Date: 23-07-2012
Eye care service use and its determinants in marginalized communities in Pakistan: The karachi marine fishing communities eye and general health survey
Publisher: Informa UK Limited
Date: 02-04-2015
DOI: 10.3109/09286586.2015.1012592
Abstract: To examine gender, ethnic, and socioeconomic differences in access to eye care services in marine fishing communities in Karachi, Pakistan. The Karachi Marine Fishing Communities Eye and General Health Survey was a door-to-door, cross-sectional survey conducted between March 2009 and April 2010 in fishing communities in Keamari, Karachi, located on the coast of the Arabian Sea. Adults aged ≥50 years living on three islands and in four coastal areas were enrolled. Participants underwent a detailed interview regarding sociodemographics, eye problems and eye care service use, testing of presenting and best-corrected visual acuity with a reduced logMAR chart, and detailed eye examination. A total of 700 people were planned to be included in the study 638 (91.1%) were interviewed and examined. Most participants were extremely poor and had no formal education. Only 45.3% (95% confidence interval, CI, 41.4-49.2%) of participants reported having had an eye examination in the past 12.1% (95% CI 9.5-14.6%) and 30.9% (95% CI 27.3-34.5%) had seen an eye doctor within the last year or prior 5 years, respectively. In the multivariable analysis, ethnicity was the strongest independent predictor of eye care service use, followed by self-reported eye problems and diabetes. Ethnic Bengalis were 4.2 times less likely (adjusted odds ratio 0.24, 95% CI 0.15-0.38 p < 0.001) to have had an eye examination in the past than Kutchis. Despite a high prevalence of visual impairment and blindness, levels of eye care examinations in fishing communities, especially among ethnic Bengalis, are disappointingly low. Such communities deserve particular attention in Vision 2020 and other national and international strategies and plans.
Social isolation and loneliness in family caregivers of people with severe mental illness: A scoping review
Publisher: Wiley
Date: 11-08-2023
DOI: 10.1002/AJCP.12698
Abstract: Family caregivers of people with severe mental illness (SMI) have been increasingly observed to experience social isolation and/or loneliness (SI/L) which are risk factors for ill health. This scoping review aimed to map existing evidence and identify knowledge gaps in studies on SI/L in this population using the Arksey and O'Malley's framework. Parallel searches (2011–2021) conducted in 10 databases identified 51 publications from 18 countries fully meeting the inclusion criteria. Over half of the included studies were quantitative. We found that the definition of loneliness reached a consensus, while the definition of social isolation varied across studies. Risk factors and correlates of SI/L were grouped into sociodemographic factors, illness‐related factors, health and wellbeing, and stigma. The evidence showed a lack of comprehensive measurements assessing SI/L, few longitudinal studies, and little knowledge of interventions specifically addressing SI/L. Future studies are recommended to address these knowledge gaps and explore effective interventions on SI/L in family caregivers of people with SMI.
El informe mundial sobre la violencia y la salud.
Publisher: Instituto Nacional de Salud (Colombia)
Date: 12-2002
International health in the 21st Century: Trends and challenges
Publisher: Elsevier BV
Date: 06-2002
Carrot and stick: state mechanisms to influence private provider behaviour
Publisher: Oxford University Press (OUP)
Date: 03-1994
DOI: 10.1093/HEAPOL/9.1.1
Prospective policy analysis: How an epistemic community informed policymaking on intentional self poisoning in Sri Lanka
Publisher: Springer Science and Business Media LLC
Date: 17-06-2010
Commentary: Responding More Broadly and Ethically
Publisher: Cambridge University Press (CUP)
Date: 09-08-2006
HIV and AIDS in South Africa: What is an appropriate public health response?
Publisher: Oxford University Press (OUP)
Date: 1990
Listening to the silence: Doing better at responding to disasters
Publisher: SAGE Publications
Date: 03-2007
Humanitarian Tensions and Challenges
Publisher: Cambridge University Press (CUP)
Date: 04-2005
Factors influencing resource allocation decisions and equity in the health system of Ghana
Publisher: Elsevier BV
Date: 05-2009
DOI: 10.1016/J.PUHE.2009.02.006
Abstract: Allocation of financial resources in the health sector is often seen as a formula-driven activity. However, the decision to allocate a certain amount of resources to a particular health jurisdiction or facility may be based on a broader range of factors, sometimes not reflected in the existing resource allocation formula. This study explores the 'other' factors that influence the equity of resource allocation in the health system of Ghana. The extent to which these factors are, or can be, accounted for in the resource allocation process is analysed. An exploratory design focusing on different levels of the health system and erse stakeholders. Data were gathered through semi-structured qualitative interviews with health authorities at national, regional and district levels, and with donor representatives and local government officials in 2003 and 2004. The availability of human resources for health, local capacity to utilize funds, donor involvement in the health sector, and commitment to promote equity have considerable influence on resource allocation decisions and affect the equity of funding allocations. However, these factors are not accounted for adequately in the resource allocation process. This study highlights the need for a more transparent resource allocation system in Ghana based on needs, and takes into account key issues such as capacity constraints, the inequitable human resource distribution and donor-earmarked funding.
Towards an epidemiology of political violence in the third world
Publisher: Elsevier BV
Date: 1989
DOI: 10.1016/0277-9536(89)90210-4
Abstract: Political violence is distressingly widespread in many parts of the world. This paper reviews the forms and effects of political violence and devotes particular attention to experiences from Central America and Southern Africa. The forms of violence vary from those which are extensive such as civil unrest and war, to those which are intensive, such as assassinations, disappearances and torture. The effects of violence on health may be direct, such as deaths, disabilities, psychological stress and the destruction of health services, or indirect such as the erosion of innovative health policies in favour of increased military expenditure. Health workers have a role to play in opposing political violence, providing care for those affected by violence, and documenting and analysing its impact on health. Research needs include documenting the impact of different forms of violence on health, and analysing the social and political factors which promote and support political violence. It is hoped that increasing recognition of political violence and man-made violence as being of major public health concern will play a part in promoting a more peaceful world.
Migration and health: A global public health research priority
Publisher: Springer Science and Business Media LLC
Date: 08-08-2018
Improving science-policy interface: Lessons from the policy lab methodology in Nepal's community forest governance
Publisher: Elsevier BV
Date: 05-2019
Do truth commissions heal? The East Timor experience
Publisher: Elsevier BV
Date: 04-2006
Mobile phone-based syndromic surveillance system, Papua New Guinea
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 11-2013
Complexity in Implementing Community Drowning Reduction Programs in Southern Bangladesh: A Process Evaluation Protocol.
Publisher: MDPI AG
Date: 18-03-2019
Abstract: Living and geographical conditions in Bangladesh expose children to a high risk of drowning. Two programs operating in the Barishal Division of Bangladesh aim to reduce drowning risk through the provision of crèches (Anchal) and swim and rescue classes (SwimSafe). Anchal provides a safe environment with early childhood education to children aged 1–5 years old, while SwimSafe teaches children aged 6–10 years old basic swimming and rescue skills. Despite evidence for their effectiveness, it is unclear under which conditions these programs best operate. This protocol describes a project that seeks to conduct a process evaluation and gender analysis to identify implementation inefficiencies and contextual considerations for improved sustainability of the programs. A mixed- method approach using both qualitative and quantitative data will be used. Quantitative program data will be analysed to measure program utilisation, delivery and reach, while qualitative data will be collected via key informant in-depth interviews (IDIs), focus group discussions (FGDs) and observations. The process evaluation of the Anchal and SwimSafe programs provides an opportunity for implementers to identify practical strategies to improve program delivery and improve contextual adaptability of these programs. Furthermore, the findings may provide guidance to other implementers aiming to deliver community-based programs in rural lower-middle income contexts.
The world report on violence and health
Publisher: Elsevier BV
Date: 10-2002
Beyond emergency care: Challenges to health planning in complex emergencies: Editorial
Publisher: Wiley
Date: 12-2001
Trust, culture and communication: determinants of eye health and care among Indigenous people with diabetes in Australia
Publisher: BMJ
Date: 2020
DOI: 10.1136/BMJGH-2019-001999
Abstract: Our study aimed to identify factors that influence access to eye care and eye health outcomes for remote Indigenous Australians living with diabetes. In collaboration with Indigenous Community-Based Researchers (CBR) and Aboriginal Community Controlled Health Services (ACCHS), a qualitative, participatory action research approach was taken, drawing on Indigenist and decolonising methodologies. The study was undertaken in four remote communities, in the Katherine region, Northern Territory and north-western New South Wales, Australia. Interviews and focus groups were undertaken with Indigenous adults aged ≥40 years living with diabetes (n=110), and primary care clinicians working in ACCHSs (n=37). A series of interviews with CBRs (n=13) were undertaken before and after data collection to add cultural insights and validation to participant accounts. Data were analysed inductively using grounded theory, in-depth discussion and NVivo V.11. More than one-third of all patients had little to no knowledge of how diabetes affects eye health. Limited access to health information and interpreters, language barriers, distrust of health providers and services, and limited cultural responsivity among non-Indigenous clinicians, were identified as determining factors in eye health and care. We outline a need to address gaps in trust and communication, through increased access to and resourcing of Indigenous language interpreters and cultural brokers, understandable and culturally sensitive diabetic eye health information and cultural responsivity training for non-Indigenous clinicians. Centring Indigenous cultures in healthcare practice will enable a shared understanding between clinicians and Indigenous patients, and subsequently more equitable eye health outcomes.
Ministerial challenges: Post-conflict, post-election issues in Kosovo's health sector
Publisher: Oxford University Press (OUP)
Date: 06-2003
Abstract: On 17 November 2001, less than 900 days after the end of one of the largest population displacements since 1945, the, Kosovo electorate voted for their new self-government. An Assembly was formed in 2001 and a Health Minister, Dr Numan Balic, appointed in March 2002. He has inherited a health service that still reels from many years of neglect while it struggles to implement an ambitious health reform programme. An analysis of UNMIK Regulations and available grey literature within Kosovo has formed the basis of material for this article. In addition, the authors collected, by informal interview, the opinions of international and Kosovars actively employed within the health sector. The authors would wish to acknowledge the contribution of Dr Hannu Vuori, Principal International Officer, Ministry of Health, Kosovo for his insight and suggestions. The analysis reveals that the current health system is inequitable and inefficient. The health sector reforms initiated by the international community are desperately needed: it is purported that one-in-three Kosovars cannot afford to access health care when ill. However, the combined legacy of neglect, the current status of the health service and the new Assembly regulations present significant challenges to health reform. Under the gaze of the newly formed Assembly, as well as the watchful eye of the United Nations Interim Administrative Mission in Kosovo, the Minister will take on the arduous responsibility of governing the Kosovo health sector. In any context implementing reform is difficult, in Kosovo it may be even more so and the international community should not exclusively focus on other world-trouble spots when many challenges remain to be addressed.
ANC health policy for South Africa
Publisher: Elsevier BV
Date: 1994
Health policy development in wartime: Establishing the Baito health system in Tigray, Ethiopia
Publisher: Oxford University Press (OUP)
Date: 1997
Abstract: This paper documents health experiences and the public health activities of the Tigray People's Liberation Front (TPLF). The paper provides background data about Tigray and the emergence of its struggle for a democratic Ethiopia. The origins of the armed struggle are described, as well as the impact of the conflict on local health systems and health status. The health-related activities and public health strategies of the TPLF are described and critiqued in some detail, particular attention is focused on the development of the baito system, the emergent local government structures kindled by the TPLF as a means of promoting local democracy, accountability, and social and economic development. Important issues arise from this brief case-study, such as how emerging health systems operating in wartime can ensure that not only are basic curative services maintained, but preventive and public health services are developed. Documenting the experiences of Tigray helps identify constraints and possibilities for assisting health systems to adapt and cope with ongoing conflict, and raises possibilities that in their aftermath they leave something which can be built upon and further developed. It appears that promoting effective local government may be an important means of promoting primary health care.
Cholera risk factors, Papua New Guinea, 2010
Publisher: Springer Science and Business Media LLC
Date: 05-11-2012
Viewpoint: Management of malaria - Working with the private sector
Publisher: Wiley
Date: 05-1999
DOI: 10.1046/J.1365-3156.1999.00411.X
Abstract: Recent reviews have demonstrated that a substantial proportion of cases of malaria are managed in the private sector, and international policy initiatives routinely emphasize the need for malaria control programmes to collaborate with the private sector. However, information on how to develop successful partnerships between the public and private sectors remains limited. This paper reviews the current knowledge about the management of malaria by private providers, considers the potential of different strategies for influencing the quality of care provided, and identifies processes for facilitating public-private sector collaborations. We contend that public sector-led interventions, such as training of private providers or the distribution of prepackaged antimalarials through the private sector, are unlikely to scale up to sustainable national level programmes if they do not take into account a wide range of needs and concerns, represented by private provider organizations and other interest groups, including service users. These groups should be involved at key stages including the design and piloting of interventions, through to the dissemination and implementation of findings. Research priorities are outlined for the development of tools to facilitate public-private partnerships for improving the management of malaria.
P4.51 Engaging young people from migrant and refugee backgrounds with sexual and reproductive health promotion and care in sydney, australia
Publisher: BMJ Publishing Group Ltd
Date: 07-2017
Policy context and narrative leading to the commissioning of the Australian Indigenous Burden of Disease study
Publisher: Springer Science and Business Media LLC
Date: 15-03-2015
Benefits Associated with China’s Social Health Insurance Schemes: Trend Analysis and Associated Factors Since Health Reform
Publisher: MDPI AG
Date: 25-05-2021
Abstract: With the deepening of health insurance reform in China, the integration of social health insurance schemes was put on the agenda. This paper aims to illustrate the achievements and the gaps in integration by demonstrating the trends in benefits available from the three social health insurance schemes, as well as the influencing factors. Data were drawn from the three waves of the China Health and Nutrition Survey (2009, 2011, 2015) undertaken since health reforms commenced. χ2, Kruskal–Wallis test, and the Two-Part model were employed in the analysis. The overall reimbursement rate of the Urban Employee Basic Medical Insurance (UEBMI) is higher than that of Urban Resident Basic Medical Insurance (URBMI) or the New Rural Cooperative Medical Scheme (NRCMS) (p 0.001), but the gap has narrowed since health reform began in 2009. Both the outpatient and inpatient reimbursement amounts have increased through the URBMI and NRCMS. Illness severity, higher institutional level, and inpatient service were associated with significant increases in the amount of reimbursement received across the three survey waves. The health reform improved benefits covered by the URBMI and NRCMS, but gaps with the UEBMI still exist. The government should consider more the release of health benefits and how to lead toward healthcare equity.
People must be the priority in times of war, hears conference
Publisher: Elsevier BV
Date: 07-1999
Analysis of policy implications and challenges of the Cuban health assistance program related to human resources for health in the Pacific
Publisher: Springer Science and Business Media LLC
Date: 06-05-2012
Determinants of neonatal, infant and under-five mortality in a war-affected country: Analysis of the 2010 Household Health Survey in South Sudan
Publisher: BMJ
Date: 02-2018
DOI: 10.1136/BMJGH-2017-000510
Abstract: Under-five children born in a fragile and war-affected setting of South Sudan are faced with a high risk of death as reflecting in high under-five mortality. In South Sudan health inequities and inequitable condition of daily living play a significant role in childhood mortality. This study examines factors associated with under-five mortality in South Sudan. The study population includes 8125 singleton, live birth, under-five children born in South Sudan within 5 years prior to the 2010 South Sudan Household Survey. Factors associated with neonatal, infant and under-five deaths were examined using generalised linear latent and mixed models with the logit link and binomial family that adjusted for cluster and survey weights. The multivariate analysis showed that mothers who reported a previous death of a child reported significantly higher risk of neonatal (adjusted OR (AOR)=3.74, 95% confidence interval (CI 2.88 to 4.87), P .001), infant (AOR=3.19, 95% CI (2.62 to 3.88), P .001) and under-five deaths (AOR=3.07, 95% CI (2.58 to 3.64), P .001). Other associated factors included urban dwellers (AOR=1.37, 95% CI (1.01 to 1.87), P=0.045) for neonatal, (AOR=1.35, 95% CI (1.08 to 1.69), P=0.009) for infants and (AOR=1.39, 95% CI (1.13 to 1.71), P=0.002) for under-five death. Unimproved sources of drinking water were significantly associated with neonatal mortality (AOR=1.91, 95% CI (1.11 to 3.31), P=0.02). This study suggested that the condition and circumstances in which the child is born into, and lives with, play a role in under-five mortality, such as higher mortality among children born to teenage mothers. Ensuring equitable healthcare service delivery to all disadvantaged populations of children in both urban and rural areas is essential but remains a challenge, while violence continues in South Sudan.
Health, apartheid and the frontline states
Publisher: Elsevier BV
Date: 1988
A Global Political Economy Approach to AIDS: Ideology, Interests and Implications
Publisher: Routledge
Date: 26-10-2018
Translating compassion into psychosocial aid after the tsunami
Publisher: Elsevier BV
Date: 2005
A comprehensive framework for human resources for health system development in fragile and post-conflict states
Publisher: Public Library of Science (PLoS)
Date: 20-12-2011
Injuries, inequalities, and health: From policy vacuum to policy action
Publisher: Oxford University Press
Date: 23-11-2009
Health in southern Africa
Publisher: Elsevier BV
Date: 06-1990
Challenge of drowning prevention in low and middle income countries
Publisher: BMJ
Date: 06-1998
DOI: 10.1136/IP.4.2.162
Getting by on credit: How district health managers in Ghana cope with the untimely release of funds
Publisher: Springer Science and Business Media LLC
Date: 12-2006
Abstract: District health systems in Africa depend largely on public funding. In many countries, not only are these funds insufficient, but they are also released in an untimely fashion, thereby creating serious cash flow problems for district health managers. This paper examines how the untimely release of public sector health funds in Ghana affects district health activities and the way district managers cope with the situation. A qualitative approach using semi-structured interviews was adopted. Two regions (Northern and Ashanti) covering the northern and southern sectors of Ghana were strategically selected. Sixteen managers (eight directors of health services and eight district health accountants) were interviewed between 2003/2004. Data generated were analysed for themes and patterns. The results showed that untimely release of funds disrupts the implementation of health activities and demoralises district health staff. However, based on their prior knowledge of when funds are likely to be released, district health managers adopt a range of informal mechanisms to cope with the situation. These include obtaining supplies on credit, borrowing cash internally, pre-purchasing materials, and conserving part of the fourth quarter donor-pooled funds for the first quarter of the next year. While these informal mechanisms have kept the district health system in Ghana running in the face of persistent delays in funding, some of them are open to abuse and could be a potential source of corruption in the health system. Official recognition of some of these informal managerial strategies will contribute to eliminating potential risks of corruption in the Ghanaian health system and also serve as an acknowledgement of the efforts being made by local managers to keep the district health system functioning in the face of budgetary constraints and funding delays. It may boost the confidence of the managers and even enhance service delivery.
Keeping afloat: a case study tracing the emergence of drowning prevention as a health issue in Bangladesh 1999–2017
Publisher: BMJ
Date: 27-07-2020
DOI: 10.1136/INJURYPREV-2020-043720
Abstract: Drowning is a leading cause of child death in Bangladesh. The present study investigated the emergence of drowning reduction as a priority within Bangladesh and the position it currently holds on the national policy agenda. This case study documents the evolution of policy responses to drowning, reporting on data from semistructured interviews and a document analysis. To identify key factors that have facilitated the prioritisation of drowning prevention, data were synthesised using Shiffman and Smith’s 2007 Policy Prioritisation Framework. Furthermore, an inductive approach was used to identify key themes unique to drowning prevention that were not embedded in the framework. Four key phases of policy development for drowning prevention were distinguishable: (1) identification of issue and the emergence of actor support (2) enhanced leadership and the accumulation of issue characteristics (3) the formation of an internal frame and its impact on global support and (4) enhanced national recognition and supportive global normative factors. Four additional themes unique to the case of drowning were also identified: competing health priorities, limited issue awareness, shift of disease burden to non-communicable diseases and the multisectoral nature of drowning. This study demonstrates that the level of political prioritisation given to drowning prevention has evolved over the last decade and a half. A comprehensive understanding of factors that have elevated the issue onto the policy agenda will ensure future stakeholder engagement activities can be designed to foster deeper and more sustained commitment by key actors and organisations.
A social ecological approach to understanding service utilization barriers among male survivors of sexual violence in three refugee settings: a qualitative exploratory study
Publisher: Springer Science and Business Media LLC
Date: 08-07-2020
DOI: 10.1186/S13031-020-00288-8
Abstract: Post-sexual violence service utilization is often poor in humanitarian settings. Little is known about the service uptake barriers facing male survivors specifically. To gain insights into this knowledge gap, we undertook a qualitative exploratory study to better understand the barriers to service utilization among male survivors in three refugee-hosting countries. The study sites and populations included refugees who had travelled the central Mediterranean migration route through Libya living in Rome and Sicily, Italy Rohingya refugees in Cox’s Bazar, Bangladesh and refugees from eastern Democratic Republic of the Congo, Somalia, and South Sudan residing in urban areas of Kenya. Methods included document review, 55 semi-structured focus group discussions with 310 refugees, semi-structured key informant interviews with 148 aid workers and human rights experts, and observation of service delivery points. Data were thematically analyzed using NVivo 12. We identified eleven key barriers and situated them within a social ecological framework to describe impediments at the policy, community (inter-organizational), organizational, interpersonal, and in idual levels. Barriers entailed: 1) restrictions to accessing legal protection, 2) legislative barriers such as the criminalization of same-sex sexual relations, 3) few designated entry points, 4) poor or nonexistent referral systems, 5) lack of community awareness-raising and engagement, 6) limited staff capacity, 7) negative provider attitudes and practices, 8) social stigma, 9) limited knowledge (at the in idual level), 10) self-stigma, and 11) low formal help-seeking behaviors. The social ecological framework allowed us to better understand the multifaceted ways that the barriers facing male survivors operate and reinforce one another, and may be useful to inform efforts promoting service uptake. Additional research is warranted in other refugee settings.
Sexually transmitted diseases
Publisher: Elsevier BV
Date: 08-1998
Fair publication of qualitative research in health systems: a call by health policy and systems researchers
Publisher: Springer Science and Business Media LLC
Date: 22-06-2016
World report on violence and health - Exploring Australian responses
Publisher: Elsevier BV
Date: 10-2002
An Australian childhood obesity summit: The role of data and evidence in 'public' policy making
Publisher: Springer Science and Business Media LLC
Date: 20-07-2005
Abstract: Overweight and obesity in Australia has risen at an alarming rate over the last 20 years as in other industrialised countries around the world, yet the policy response, locally and globally, has been limited. Using a childhood obesity summit held in Australia in 2002 as a case study, this paper examines how evidence was used in setting the agenda, influencing the Summit debate and shaping the policy responses which emerged. The study used multiple methods of data collection including documentary analysis, key informant interviews, a focus group discussion and media analysis. The resulting data were content analysed to examine the types of evidence used in the Summit and how the state of the evidence base contributed to policy-making. Empirical research evidence concerning the magnitude of the problem was widely reported and largely uncontested in the media and in the Summit debates. In contrast, the evidence base for action was mostly opinion and ideas as empirical data was lacking. Opinions and ideas were generally found to be an acceptable basis for agreeing policy action coupled with thorough evaluation. However, the analysis revealed that the evidence was fiercely contested around food advertising to children and action agreed was therefore limited. The Summit demonstrated that policy action will move forward in the absence of strong research evidence. Where powerful and competing groups contest possible policy options, however, the evidence base required for action needs to be substantial. As with tobacco control, obesity control efforts are likely to face ongoing challenges around the nature of the evidence and interventions proposed to tackle the problem. Overcoming the challenges in controlling obesity will be more likely if researchers and public health advocates enhance their understanding of the policy process, including the role different types of evidence can play in influencing public debate and policy decisions, the interests and tactics of the different stakeholders involved and the part that can be played by time-limited yet high profile events such as Summits.
Reconstructing Tuberculosis Services after Major Conflict: Experiences and Lessons Learned in East Timor
Publisher: Public Library of Science (PLoS)
Date: 22-08-2006
Characteristics and Impacts of Sexual Violence Against Men and Boys in Conflict and Displacement: A Multicountry Exploratory Study
Publisher: SAGE Publications
Date: 29-10-2020
Abstract: Evidence of sexual violence against men and boys in many conflict-affected settings is increasingly recognized. Yet relatively little is currently known about the varied forms, sites, and impacts of this violence. Further, scant research on sexual violence against men and boys in displacement contexts has been undertaken to date. To begin to address these knowledge gaps, we undertook a multicountry, qualitative, exploratory study to gain insights into these issues. Study settings and populations were Rohingya refugees in Bangladesh refugees and migrants who had traveled through Libya residing in Italy and refugees from eastern Democratic Republic of the Congo (DRC), Somalia, and South Sudan residing in Nairobi and Mombasa, Kenya. Methods included 55 semi-structured focus group discussions with 310 refugees and semi-structured key informant interviews with 148 aid workers and human rights experts. Data were thematically analyzed using NVivo 12. Findings suggest that sexual violence against men and boys may not be rare in Myanmar (northern Rakhine state), Libya, eastern DRC, and South Sudan. Frequently reported forms of violence in these settings were genital violence, forced witnessing of sexual violence, and rape. Sites where violence was often reported included border crossings, along the roadside, and during imprisonment. In host countries, forms of sexual violence included sexual abuse of boys, sexual exploitation particularly of adolescents and persons with erse sexual orientation and gender identity, and rape. Impacts on survivors involved short- and long-term physical, mental, economic, and familial dimensions. These findings aim to inform sexual violence-related prevention, mitigation, and response efforts in humanitarian settings. More research is warranted, including on sexual violence against men and boys in Somalia, sexual violence by family and community members in conflict and displacement settings, sexual exploitation of adolescent boys, and sexual violence including sexual exploitation of persons with erse sexual orientation and gender identity.
The elusive search for definitive evidence on routine screening for intimate partner violence
Publisher: SAGE Publications
Date: 2009
Abstract: Routine screening for intimate partner violence (IPV) has been introduced in many health settings to improve identification and responsiveness to IPV. The debate about the level of evidence required to warrant routine screening continues. Three assumptions have impeded progress in measuring the impact of screening. The first is that routine screening is a test only which does not of itself have an impact on patients. The second is that it can be assessed by evaluating interventions provided to women after abuse is identified through screening. The third is that there can be an agreed appropriate intervention for IPV. Each of these assumptions is problematic. In addition, there are significant impediments to evaluating screening as an intervention through a randomized control trial. These include identification of the study group, isolating the control group from the intervention, ethics, lack of baseline data, and recall bias. A range of study designs is required and a rethink of assumptions is needed in researching this area.
Violence: a priority for public health? (part 2)
Publisher: BMJ
Date: 09-2007
Global protection and the health impact of migration interception
Publisher: Public Library of Science (PLoS)
Date: 14-06-2011
‘Yarn about it’: Aboriginal Australian women’s perceptions of the impact of routine enquiry for intimate partner violence
Publisher: Informa UK Limited
Date: 02-01-2019
DOI: 10.1080/13691058.2018.1519117
Abstract: Aboriginal women globally are disproportionately affected by intimate partner violence (IPV) and face additional barriers to help-seeking. It is crucial that interventions for IPV are made safe for Indigenous women, given inflated rates of statutory intervention and widespread institutional racism. As part of a larger study of antenatal IPV screening, we interviewed 12 Aboriginal Australian women about the perceived impact of an antenatal IPV routine enquiry intervention. Seven women reported positive impact, and five women reported the absence of positive impact. Qualitative comparative analysis was used to map pathways to perceived impact. Cultural safety - the practice of countering tendencies in health care that undermine safety - was a key condition for positive impact. Others included: (i) continuity of care (ii) asking about abuse without judgement and with care and (iii) support and validation. Absence of these factors also typified pathways for nil positive impact. Naming the abuse, a sense of connection, unburdening, taking steps to safety and enabling informed care were all reported benefits. Two women reported explicitly negative impacts: one noted a sense of intrusion, and the other, disengagement from the health service. Interventions for IPV have the potential to benefit Indigenous women where cultural safety is prioritised.
Book: War and Public Health
Publisher: BMJ
Date: 08-05-1999
Narrowing the gap between academic professional wisdom and community lay knowledge: Perceptions from partnerships
Publisher: Elsevier BV
Date: 05-2002
Assessing the burden of COVID-19 in developing countries: systematic review, meta-analysis and public policy implications
Publisher: BMJ
Date: 05-2022
DOI: 10.1136/BMJGH-2022-008477
Abstract: The infection fatality rate (IFR) of COVID-19 has been carefully measured and analysed in high-income countries, whereas there has been no systematic analysis of age-specific seroprevalence or IFR for developing countries. We systematically reviewed the literature to identify all COVID-19 serology studies in developing countries that were conducted using representative s les collected by February 2021. For each of the antibody assays used in these serology studies, we identified data on assay characteristics, including the extent of seroreversion over time. We analysed the serology data using a Bayesian model that incorporates conventional s ling uncertainty as well as uncertainties about assay sensitivity and specificity. We then calculated IFRs using in idual case reports or aggregated public health updates, including age-specific estimates whenever feasible. In most locations in developing countries, seroprevalence among older adults was similar to that of younger age cohorts, underscoring the limited capacity that these nations have to protect older age groups. Age-specific IFRs were roughly 2 times higher than in high-income countries. The median value of the population IFR was about 0.5%, similar to that of high-income countries, because disparities in healthcare access were roughly offset by differences in population age structure. The burden of COVID-19 is far higher in developing countries than in high-income countries, reflecting a combination of elevated transmission to middle-aged and older adults as well as limited access to adequate healthcare. These results underscore the critical need to ensure medical equity to populations in developing countries through provision of vaccine doses and effective medications.
Persist. Persist.: A qualitative study of women's decisions to disclose and their perceptions of the impact of routine screening for intimate partner violence
Publisher: American Psychological Association (APA)
Date: 04-2011
DOI: 10.1037/A0023136
Socializing accountability in humanitarian settings: A proposed framework
Publisher: Elsevier BV
Date: 09-2018
Experience of 'screening' for domestic violence in women's services
Publisher: Oxford University Press (OUP)
Date: 12-2001
Engaging Migrant and Refugee Young People with Sexual Health Care: Does Generation Matter More Than Culture?
Publisher: Springer Science and Business Media LLC
Date: 15-02-2018
Community perceptions of mental health needs: A qualitative study in the Solomon Islands
Publisher: Springer Science and Business Media LLC
Date: 2009
H1N1, Public Health Security, Bioethics, and Human Rights
Publisher: Elsevier BV
Date: 06-2017
Conflict and Development: Challenges in Responding to Sexual and Reproductive Health Needs in Timor-Leste
Publisher: Informa UK Limited
Date: 2008
Taking Stock – What Is Known About Suicide in Sri Lanka
Publisher: Hogrefe Publishing Group
Date: 03-2014
DOI: 10.1027/0227-5910/A000244
Abstract: Background: Suicide is and has been a major public health problem in Sri Lanka and has generated a wide range of literature. Aims: This review aimed to systematically appraise what is known about suicide in Sri Lanka. The patterns and content of articles were examined and recommendations for further research proposed. Method: The paper describes the systematic search, retrieval, and quality assessment of studies. Thematic analysis techniques were applied to the full text of the articles to explore the range and extent of issues covered. Results: Local authors generated a large body of evidence of the problem in early studies. The importance of the method of suicide, suicidal intention, and the high incidence of suicide were identified as key foci for publications. Neglected areas have been policy and health service research, gender analysis, and contextual issues. Conclusion: The literature reviewed has produced a broad understanding of the clinical factors, size of the problem, and social aspects. However, there remains limited evidence of prevention, risk factors, health services, and policy. A wide range of solutions have been proposed, but only regulation of pesticides and improved medical management proved to be effective to date.
Malaria control in Timor-Leste during a period of political instability: what lessons can be learned?
Publisher: Springer Science and Business Media LLC
Date: 12-2009
Our health and theirs: Forced migration, othering, and public health
Publisher: Elsevier BV
Date: 04-2006
DOI: 10.1016/J.SOCSCIMED.2005.08.061
Abstract: This paper uses 'othering' theory to explore how forced migrants are received in developed countries and considers the implications of this for public health. It identifies a variety of mechanisms by which refugees, asylum seekers and irregular migrants are positioned as 'the other' and are defined and treated as separate, distant and disconnected from the host communities in receiving countries. The paper examines how this process has the potential to affect health outcomes both for in iduals and communities and concludes that public health must engage with and challenge this othering discourse. It argues that public health practitioners have a critical role to play in reframing thinking about health services and health policies for forced migrants, by promoting inclusion and by helping shape a narrative which integrates and values the experiences of this population.
How should the health community respond to violent political conflict?
Publisher: Public Library of Science (PLoS)
Date: 19-10-2004
Beyond Compliance Checking: A Situated Approach to Visual Research Ethics
Publisher: Springer Science and Business Media LLC
Date: 19-03-2018
DOI: 10.1007/S11673-018-9850-0
Abstract: Visual research methods like photography and digital storytelling are increasingly used in health and social sciences research as participatory approaches that benefit participants, researchers, and audiences. Visual methods involve a number of additional ethical considerations such as using identifiable content and ownership of creative outputs. As such, ethics committees should use different assessment frameworks to consider research protocols with visual methods. Here, we outline the limitations of ethics committees in assessing projects with a visual focus and highlight the sparse knowledge on how researchers respond when they encounter ethical challenges in the practice of visual research. We propose a situated approach in relation to visual methodologies that encompasses a negotiated, flexible approach, given that ethical issues usually emerge in relation to the specific contexts of in idual research projects. Drawing on available literature and two case studies, we identify and reflect on nuanced ethical implications in visual research, like tensions between aesthetics and research validity. The case studies highlight strategies developed in-situ to address the challenges two researchers encountered when using visual research methods, illustrating that some practice implications are not necessarily addressed using established ethical clearance procedures. A situated approach can ensure that visual research remains ethical, engaging, and rigorous.
Interventions to improve access to cataract surgical services and their impact on equity in low- and middle-income countries
Publisher: Wiley
Date: 20-09-2014
Commentary: Life in the real world is more complicated
Publisher: BMJ
Date: 14-10-1995
Indigenous Australians at increased risk of COVID-19 due to existing health and socioeconomic inequities
Publisher: Elsevier BV
Date: 08-2020
Achieving convergence between a community-based measure of explosive anger and a clinical interview for intermittent explosive disorder in Timor-Leste
Publisher: Elsevier BV
Date: 09-2013
DOI: 10.1016/J.JAD.2013.06.006
Abstract: There is growing research interest in understanding and analyzing explosive forms of anger. General epidemiological studies have focused on the DSM-IV category of Intermittent Explosive Disorder (IED), while refugee and post-conflict research have used culturally-based indices of explosive anger. The aim of this study was to test the convergence of a culturally-sensitive community measure of explosive anger with a structured clinical interview diagnosis of IED in Timor-Leste, a country with a history of significant mass violence and displacement. A double-blind clinical concordance study was conducted amongst a stratified community s le in post-conflict Timor-Leste (n=85) to compare a community measure of anger against the Structured Clinical Interview (SCID) module for IED. Clinical concordance between the two measures was high: the area under the curve (AUC) index was 0.90 (95% CI: 0.83-0.98) sensitivity and specificity were 93.3% and 87.5% respectively. Response rates were modest due to the participant's time commitments. It is possible to achieve convergence between culturally-sensitive measures of explosive anger and the DSM-IV construct of IED, allowing comparison of findings across settings and populations.
Urban water security under a changing climate: Is Nepal's water policy on the right track?
Publisher: Wiley
Date: 11-2021
DOI: 10.1002/WWP2.12063
Abstract: Nepal's urban regions are facing increasing levels of water insecurity under a changing climate. The country has a long history of water policy development while climate‐related policies are also emerging at different levels of the new federal republic. It is unclear whether public policy is on the right track to ensure urban water security in the face of growing demand and increasingly variable supply. In this paper, we assess how Nepal's water policy is shaping urban adaptation. We focus on how policies have defined institutional arrangements for water supply and management, allocation of water rights, and the conservation of water source catchments. Policy attention to these issues is crucial for the adaptation of water systems to climate change. Drawing on the review of policy texts and the status of policy implementation in two towns (Dharan and Dhulikhel), we conclude that current policy frameworks and strategies neglect opportunities to facilitate urban water adaptation to climate change. The neglect is seen in escalating conflicts among institutions, an unclear framework for water rights, and inadequate incentives for catchment conservation. We highlight the need for a more coherent and risk sensitive approach to water policy, underpinned by deliberative, research‐informed, and learning‐based strategies.
Book reviews
Publisher: Oxford University Press (OUP)
Date: 1992
The emerging international policy agenda for reproductive health services in conflict settings
Publisher: Elsevier BV
Date: 12-1999
DOI: 10.1016/S0277-9536(99)00253-1
Abstract: Over the past 20 years, shifts in the nature of conflict and the sheer numbers of civilians affected have given rise to increasing concern about providing appropriate health services in unstable settings. Concurrently, international health policy attention has focused on sexual and reproductive health issues and finding effective methods of addressing them. This article reviews the background to the promotion and development of reproductive health services for conflict-affected populations. It employs qualitative methods to analyse the development of policy at international level. First we examine the extent to which reproductive health is on the policy agendas of organisations active in humanitarian contexts. We then discuss why and how this has come about, and whether the issue has sufficient support to ensure effective implementation. Our findings demonstrate that reproductive health is clearly on the agenda for agencies working in these settings, as measured by a range of established criteria including the amount of new resources being attracted to this area and the number of meetings and publications devoted to this issue. There are, however, barriers to the full and effective implementation of reproductive health services. These barriers include the hesitation of some field-workers to prioritise reproductive health and the number and ersity of the organisations involved in implementation. The reasons for these barriers are discussed in order to highlight areas for action before effective reproductive health service provision to these populations can be ensured.
Conflict, humanitarian assistance and older people
Publisher: Routledge
Date: 28-07-2017
Self-perceived barriers to eye care in a hard-to-reach population: The karachi marine fishing communities eye and general health survey
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 06-01-2015
Abstract: We examined self-reported barriers to eye care among marginalized, hard-to-reach fishing communities in Karachi, Pakistan. The Karachi Marine Fishing Communities Eye and General Health Survey was a cross-sectional survey conducted between March 2009 and April 2010 in fishing communities in Keamari, Karachi, located on the coast of the Arabian Sea. Adults aged ≥50 years living on seven islands and coastal areas were interviewed regarding sociodemographic background, experience of eye problems, eye care use, and barriers to access. They also were examined to determine visual acuity with a reduced logMAR chart and underwent a detailed eye examination. Of 700 people planned to be included in the study, 638 (91.1%) were interviewed and examined. Of these participants, 599 (93.9%) lived in extreme poverty and 84.3% had no school-based education, and 349 (54.7% 95% confidence interval [CI], 50.8-58.6) of them had never had an eye examination. The common barriers to access identified included a perceived lack of or low need (176/349 or 50.4%), financial hardships (36.4%), "fears" (8.6%), and social support constraints (6.3%). Of those reporting a "lack of need," 21.9% had significant visual loss. Financial hardships, "fears," and social support constraints were more prevalent among women than men. Bengalis compared to Kutchis and Sindhis, and in iduals with "poor/fragile" household financial status (self-reported) compared to those with "fine" status, were more likely to cite financial hardships. Access to eye care in this marginalized population is substantially hindered by perceived lack of need, financial hardships, and a range of "fears" and anxieties, despite a large unmet need. These barriers should be addressed while paying particular attention to gender, and ethnic and socioeconomic differences.
Equity and Blindness: Closing Evidence Gaps to Support Universal Eye Health
Publisher: Informa UK Limited
Date: 03-09-2015
DOI: 10.3109/09286586.2015.1077977
Abstract: The World Health Organization Program for the Prevention of Blindness adopted the principles of universal health coverage (UHC) in its latest plan, Universal Eye Health: A Global Action Plan, 2014-2019. This plan builds on the achievements of Vision 2020, which aimed to reduce the global prevalence of avoidable blindness, and its unequal distribution, by the year 2020. We reviewed the literature on health equity and the generation and use of evidence to promote equity, particularly in eye health. We describe the nature and extent of the equity-focused evidence to support and inform eye health programs on the path to universal eye health, and propose ways to improve the collection and reporting of this evidence. Blindness prevalence decreased in all regions of the world between 1990 and 2010, albeit not at the same rate or to the same extent. In 2010, the prevalence of blindness in West Africa (6.0%) remained 15 times higher than in high-income regions (0.4%) within all regions, women had a higher prevalence of blindness than men. Beyond inter-regional and sex differences, there is little comparable data on the distribution of blindness across social groups within regions and countries, or on whether this distribution has changed over time. Similarly, interventions known to address inequity in blindness are few, and equity-relevant goals, targets and indicators for eye health programs are scarce. Equity aims of eye health programs can benefit from the global momentum towards achieving UHC, and the progress being made on collecting, communicating and using equity-focused evidence.
Using digital storytelling to promote the sexual health and well-being of migrant and refugee young people: A scoping review
Publisher: SAGE Publications
Date: 13-12-2017
Abstract: Digital storytelling and other methods of self-expression and autobiography have become an increasingly important tool for those working with young people, including those from migrant, refugee or other ‘culturally erse’ backgrounds. A structured scoping review was undertaken to better understand the potential value and challenges of using digital stories to promote the health and well-being of these erse groups of young people and to identify key knowledge gaps. The review process comprised a systematic search of the literature and strategic consultations with professionals working with young people in the area of sexual and reproductive health promotion and care. A descriptive-analytic method was used to collate and synthesise the literature and apply narrative and thematic analyses. In total, 28 papers were deemed eligible for inclusion. Findings are presented as two analyses: what is known from the literature and key knowledge gaps. Identified themes included the use of digital stories as social activism and as research intervention, recognition of digital stories as complex terrain and recommendations for good practice. Three key gaps of particular relevance to our research aims were identified. These were (1) the lack of digital stories on sexual health and relationships by ‘culturally erse’ young people in Australia, (2) the need for discussion of the ethical considerations of using digital storytelling and related methods in sexual health fields and (3) the value of exploring opportunities to employ digital methods as self-representation and autobiography to generate new knowledge and build organisational capacity. As confirmed in discussions with professionals working in the youth, migrant and sexual health sectors, the literature highlighted the many potential applications of digital storytelling to promoting the sexual health and well-being of young people from erse backgrounds. Additional research is required to understand the particular ethical and contextual issues shaping, and at times constraining, this engagement in specific cultural contexts.
Intermittent Explosive Disorder amongst Women in Conflict Affected Timor-Leste: Associations with Human Rights Trauma, Ongoing Violence, Poverty, and Injustice
Publisher: Public Library of Science (PLoS)
Date: 07-08-2013
World Health Organization and emergency health: If not now, when?
Publisher: BMJ
Date: 28-01-2016
DOI: 10.1136/BMJ.I469
Human resources for health: lessons from the cholera outbreak in Papua New Guinea
Publisher: World Health Organization, Western Pacific Regional Office
Date: 02-07-2013
Violence involving children
Publisher: BMJ
Date: 25-11-1995
Comparison of the effectiveness of trauma services provided by secondary and tertiary hospitals in Malaysia
Publisher: Elsevier BV
Date: 2007
DOI: 10.1016/J.ANNEMERGMED.2006.08.019
Abstract: The trauma services provided by 6 hospitals operating at 2 levels of care (4 secondary or district general hospitals and 2 tertiary care hospitals) in Malaysia are compared in terms of mortality and disability for direct admissions to emergency departments to test the hypothesis that care at a tertiary care hospital is better than at a district general hospital. All cases were recruited prospectively for 1 year. The hospitals were purposefully selected as typical for Malaysia. There are 3 primary outcome measures: death, musculoskeletal impairment, and disability at discharge. Adjustment was made for potential covariates and within-hospital clustering by using multivariable random-effects logistic regression analysis. For direct admissions, logistic-regression-identified odds of dying were associated with older age (>55 years), odds ratio (OR) 1.9 (95% confidence interval [CI] 1.3 to 2.8) head injury, OR 2.7 (95% CI 1.9 to 3.9) arrival by means other than ambulance, OR 0.6 (95% CI 0.4 to 0.8) severe injuries (Injury Severity Score >15) at a district general hospital, OR 45.2 (95% CI 27.0 to 75.7) severe injuries at a tertiary care hospital, OR 11.2 (95% CI 7.3 to 17.3) and admission to a tertiary care hospital compared to a district general hospital if severely injured (Injury Severity Score >15), OR 0.2 (95% CI 0.1 to 0.4). Admission to a tertiary care hospital was associated with increased odds of disability (OR 1.9 95% CI 1.5 to 2.3) and musculoskeletal impairment (OR 3.5 95% CI 2.7 to 4.4) at discharge. Care at a tertiary care hospital was associated with reduced mortality (by 83% in severe injuries), but with a higher likelihood of disability and impairment, which has implications for improving access to trauma services for the severely injured in Malaysia and other low- and middle-income settings.
Occupational Asthma
Publisher: Springer New York
Date: 1989
Medium-term outcomes of a program to upgrade the nursing faculty in Cambodia: A qualitative study
Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1016/J.NEDT.2022.105438
Abstract: Continuous professional development is important for improving professional competencies, such as cognitive knowledge, technical skills, behaviors, and attitudes. Trainees who complete training programs can have a positive influence on their workplaces. However, it is challenging to establish a process that can facilitate in idual learning and help achieve training outcomes in educational and clinical workplaces. In Cambodia, a tumultuous history has played a part in the deficit of adequately prepared nursing faculty. Since the faculty development is vital to ensuring the quality of education, the application of upgraded nursing programs has started in 2011. After the completion of upgraded program, an immediate post-training study was conducted in 2014. Results showed that some faculty members did not accept trainees because they lacked an understanding about nursing concepts. The current study aimed to evaluate the medium-term outcomes of an established program that can improve nursing education and to identify relevant factors in light of the institutional development of educational and clinical facilities in Cambodia. A qualitative study incorporating focus group discussions, key-informant interviews, and teaching document reviews was performed with a thematic analysis using the four-level training evaluation model of Kirkpatrick. Finally, factors influencing outcomes were assessed based on the Bronfenbrenner's ecological system theory. Five themes for behavior and three themes for results were identified as medium-term outcomes from an institutional development aspect. The major enabling factors for the above-mentioned themes were the support of institutional managers, continuous networking among trainees, and supportive national policy. Compared with the immediate post-training study findings, the perceived medium-term outcomes became more strategically focused. Then, the impact of training at a considerably broader scale within the workplace was discussed. The findings highlighted the importance of medium-term program delivery and monitoring if one understands the role played in stimulating outcomes. Moreover, the importance of contextual factors including the influence of managers and policy environment were emphasized.
Exploring the relationship between functional limitations of the older adults and the health-related quality of life of their spouse in Shaanxi Province, China
Publisher: Springer Science and Business Media LLC
Date: 30-08-2021
DOI: 10.1186/S12955-021-01835-4
Abstract: With trends towards longer life expectancy, lifetime with disability has also been prolonged. It is increasingly recognized that not only the person with disability but also those around them are affected. The relationship between functional limitation (FL) of the older adults and health-related quality of life (HRQoL) of their spouse is of interest. So too is the determination of the factors aside from FL that influence HRQoL. The s le was derived from the 2013 National Health Service Survey conducted in Shaanxi Province in China. Married couples aged ≥ 60 years were selected (n = 3463). The European quality of life five dimensions (EQ-5D) and visual analogue scale were used to measure HRQoL. Both wife and husband reported lower HRQoL if either the male or female partner had some or serious FLs ( P 0.001). Other factors associated with lower HRQoL of the spouse included age, lower educational level, presence of chronic disease, and lower household economic status. Family size was associated with wife's HRQoL only when the male had no FL and lived with another 1–2 persons, or when the male had some FLs and lived in a larger family (n ≥ 5). Residential status did not relate to the HRQoL of spouses regardless of FL status. Older adults in Shaanxi province who have partners with FLs tend to report poorer EQ-5D, suggesting that couples amongst whom one has FL may be particularly vulnerable to lower HRQoL.
Regulation of nursing professionals in Cambodia and Vietnam: a review of the evolution and key influences
Publisher: Springer Science and Business Media LLC
Date: 03-07-2019
What has been the contribution of the first Global Fund grant (2003-2006) to malaria control and health system strengthening in Timor-Leste?
Publisher: Springer Science and Business Media LLC
Date: 20-10-2010
Shigella spp. antimicrobial drug resistance, papua new guinea, 2000-2009
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 11-2010
Investigating the process of evidence-informed health policymaking in Bangladesh: A systematic review
Publisher: Oxford University Press (OUP)
Date: 25-06-2019
Abstract: Over the last four decades, Bangladesh has made considerable improvements in population health, this is in part due to the use of evidence to inform policymaking. This systematic review aims to better understand critical factors that have facilitated the diffusion of scientific evidence into multiple phases of health policymaking in Bangladesh. To do this an existing policy framework designed by Shiffman and Smith in 2007, was used to extract and synthesize data from selected policy analyses. This framework was used to ensure the content, context and actors involved with evidence-informed policymaking were considered in each case where research had helped shape a health policy. The ‘PRISMA Checklist’ was employed to design pre-specified eligibility criteria for the selection of information sources, search strategy, inclusion and exclusion criteria, and process of data extraction and synthesis. Through our systematic search conducted from February to May 2017, we initially identified 1859 articles after removal of duplicates, followed by the screening of titles, abstracts and full-texts, 24 articles were included in the analysis. Health policy issues included the following topics: maternal and child health, tobacco control, reproductive health, infectious disease control and the impact and sustainability of knowledge translation platforms. Findings suggested that research evidence that could be used to meet key targets associated with the Millennium Development Goals (MDGs) were more likely to be considered as a political (and therefore policy) priority. Furthermore, avenues of engagement between research organizations and the government as well as collective action from civil-society organizations were important for the diffusion of evidence into policies. Through this article, it is apparent that the interface between evidence and policy formulation occurs when evidence is, disseminated by a cohesive policy-network with strong leadership and framed to deliver solutions for problems on both the domestic and global development agenda.
Child health in armed conflict: time to rethink
Publisher: Elsevier BV
Date: 06-2006
Injuries, inequalities and health in Europe
Publisher: Informa UK Limited
Date: 09-2001
VIOLENCE AGAINST CHILDREN AND ADOLESCENTS
Publisher: Elsevier BV
Date: 04-1998
DOI: 10.1016/S0031-3955(05)70016-X
Abstract: Selected topics of violence against children and adolescents that occur in countries outside of the United States are discussed. Focus is given to middle-income and low-income countries and emphasis is placed on the epidemiology of this pressing public health problem, particularly on conditions that are peculiar to children and adolescents in international settings, such as female genital mutilations, wars, displacements, and land mines. The discussion of child maltreatment is presented in the context of child rearing and discipline in different cultures. Recommendations for action and violence prevention are offered in the light of vast cultural differences.
Injury control in developing countries: Context more than content is crucial
Publisher: BMJ
Date: 06-1996
DOI: 10.1136/IP.2.2.91
Abstract: Early exposure to practical skills in surgical training is essential in order to master technically demanding procedures such as the design and execution of local skin flaps. Changes in working patterns, increasing subspecializations, centralization of surgical services, and the publication of surgeon-specific outcomes have all made hands-on-training in a clinical environment increasingly difficult to achieve for the junior surgeon. This has been further compounded by the COVID-19 pandemic. This necessitates alternative methods of surgical skills training. To date, there are no standardized or ideal simulation models for local skin flap teaching. This systematic review aims to summarize and evaluate local skin flap simulation and teaching models published in the literature. A systematic review protocol was developed and undertaken in accordance with PRISMA guidelines. Key search terms encompassed both "local skin flaps" and "models" or "surgical simulation". These were combined using Boolean logic and used to search Embase, Medline, and the Cochrane Library. Studies were collected and screened according to the inclusion criteria. The final included articles were graded for their level of evidence and recommendation based on a modified educational Oxford Center for evidence-based medicine classification system and assessed according to the CRe-DEPTH tool for articles describing training interventions in healthcare professionals. A total of 549 articles were identified, resulting in the inclusion of 16 full-text papers. Four articles used 3D simulators for local flap teaching and training, while two articles described computer simulation as an alternative method for local flap practicing. Four models were silicone based, while gelatin, Allevyn dressings, foam rubber, and ethylene-vinyl acetate-based local flap simulators were also described. Animal models such as pigs head, porcine skin, chicken leg, and rat, as well as a training model based on fresh human skin excised from body-contouring procedures, were described. Each simulation and teaching method was assessed by a group of candidates Many methods of simulation for the design and execution of local skin flaps have been described. However, most of these have been assessed only in small cohort numbers, and, therefore, larger candidate sizes and a standardized method for assessment are required. Moreover, some proposed simulators, although promising, are in a very preliminary stage of development. Further development and evaluation of promising high-fidelity models is required in order to improve training in such a complex area of surgery.
TUBERCULOSIS TREATMENT IN THE PUBLIC AND PRIVATE SECTORS — POTENTIAL FOR COLLABORATION
Publisher: PUBLISHED BY IMPERIAL COLLEGE PRESS AND DISTRIBUTED BY WORLD SCIENTIFIC PUBLISHING CO.
Date: 03-1999
Staff management and capacity building under conditions of insecurity: Lessons from developing mental health service and research programs in post-conflict Timor-Leste
Publisher: SAGE Publications
Date: 07-2011
DOI: 10.3109/10398562.2011.583076
Abstract: Objective: The task of staff capacity building is particularly important, albeit challenging, in low and middle income countries emerging from prolonged periods of persecution and conflict. Mental health professionals engaged in development and research projects are acutely aware of the impact of past and current conditions including trauma exposure, insecurity, and poverty on the capacity of local workers to acquire and apply skills. In this article we reflect on these challenges by drawing on our experience spanning 10 years of mental health work and capacity building in Timor-Leste. Conclusions: It is important to be proactive in identifying the needs and career objectives of workers early in any development initiative so that an effective program of capacity building can be initiated. Careful consideration needs to be given to ensure a compassionate and considered response to the psychosocial needs of staff, one that takes into account the impact of past trauma, ongoing insecurity and socioeconomic conditions on the capacity of workers to function effectively.
Young people from culturally diverse backgrounds and their use of services for sexual and reproductive health needs: a structured scoping review
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/SH15090
Abstract: Sexual and reproductive health needs are global health, development and human rights priorities, essential to the wellbeing of in iduals, couples and families. Despite widespread recognition of this, young people, including those from culturally erse backgrounds in wealthy nations such as Australia, remain largely hidden to, and underserved by, sexual and reproductive healthcare services. A scoping review was undertaken to describe the range of research on sexual and reproductive health among culturally erse young people in Australia, in order to identify gaps in the literature. This comprised a systematic literature search and key informant consultations, followed by descriptive thematic analysis of the included literature. One hundred and twenty papers were deemed eligible for inclusion, and findings are presented as three separate analyses. The first provides an overview of four dimensions identified in the literature: (i) cultural ersity (ii) the resettlement experiences of migrant communities (iii) the sexual and reproductive health needs of these communities and (iv) the practices of health services in this field. The second explores what is known from the literature about culturally erse young people’s needs for, use of, and engagement with services for sexual and reproductive health, while the third identifies two knowledge gaps: (1) the perspectives of culturally erse young people regarding sexual and reproductive health and health care and (2) the engagement of culturally erse young people with sexual and reproductive health services. New directions for a research agenda on sexual and reproductive health care for culturally erse young people in Australia are proposed, based on the identified knowledge gaps.
Emergency Research Ethics
Publisher: Routledge
Date: 02-03-2017
Health policy in less developed countries: Past trends and future directions
Publisher: Wiley
Date: 05-1995
Insider - Outsider positions in health-development research: Reflections for practice
Publisher: Informa UK Limited
Date: 16-01-2009
Misoprostol for the prevention of post-partum haemorrhage in Mozambique: An analysis of the interface between human rights, maternal health and development
Publisher: Springer Science and Business Media LLC
Date: 08-04-2020
DOI: 10.1186/S12914-020-00229-9
Abstract: Mozambique has high maternal mortality which is compounded by limited human resources for health, weak access to health services, and poor development indicators. In 2011, the Mozambique Ministry of Health (MoH) approved the distribution of misoprostol for the prevention of post-partum haemorrhage (PPH) at home births where oxytocin is not available. Misoprostol can be administered by a traditional birth attendant or self-administered. The objective of this paper is to examine, through applying a human rights lens, the broader contextual, policy and institutional issues that have influenced and impacted the early implementation of misoprostol for the prevention of PPH. We explore the utility of rights-based framework to inform this particular program, with implications for sexual and reproductive health programs more broadly. A human rights, health and development framework was used to analyse the early expansion phase of the scale-up of Mozambique’s misoprostol program in two provinces. A policy document review was undertaken to contextualize the human rights, health and development setting in Mozambique. Qualitative primary data from a program evaluation of misoprostol for the prevention of PPH was then analysed using a human rights lens these results are presented alongside three ex les where rights are constrained. Structural and institutional challenges exacerbated gaps in the misoprostol program, and sexual and reproductive health more generally. While enshrined in the constitution and within health policy documents, human rights were not fully met and many in iduals in the study were unaware of their rights. Lack of information about the purpose of misoprostol and how to access the medication contributed to power imbalances between the state, health care workers and beneficiaries. The accessibility of misoprostol was further limited due to dynamics of power and control. Applying a rights-based approach to the Mozambican misoprostol program is helpful in contextualising and informing the practical changes needed to improve access to misoprostol as an essential medicine, and in turn, preventing PPH. This study adds to the evidence of the interconnection between human rights, health and development and the importance of integrating the concepts to ensure women’s rights are prioritized within health service delivery.
Interventions to improve access to cataract surgical services and their impact on equity in low- and middle-income countries
Publisher: Wiley
Date: 09-11-2017
Re-examining the gap: A critical realist analysis of eye health inequity among Aboriginal and Torres Strait Islander Australians
Publisher: Elsevier BV
Date: 09-2021
Epilepsy and stigma
Publisher: Elsevier BV
Date: 04-2006
Deciding to tell: Qualitative configurational analysis of decisions to disclose experience of intimate partner violence in antenatal care
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.SOCSCIMED.2016.02.032
Abstract: Intimate partner violence (IPV) is a significant global public health risk causing premature death and morbidity that largely remains hidden. Understanding decisions about whether or not to disclose abuse when asked about it in health settings is important to ensuring that those experiencing violence are provided with access to services to support their safety and wellbeing. This study tested a model for women's decisions to disclose IPV in response to routine inquiry as part of antenatal assessment. Qualitative configurational analysis, suited to the study of causal pathways in complex social phenomena, was used to analyse interviews with 32 women who had experienced IPV in the past 12 months and who elected, when asked, to either disclose this to the midwife (n = 24) or not to do so (n = 8). Multiple pathways to disclosure were identified. While no single factor was necessary or sufficient for a decision to disclose, direct asking and care, defined as showing interest and a non-judgemental attitude, were found to be key conditions. The absence of care was also central to decisions not to disclose, as were perceptions of relevance of the abuse at the time of assessment. Confirming key elements of the original model, these findings highlight the importance of being asked about abuse in women's decisions to disclose, as well as the relational nature of this process. Trauma-informed practices for identifying and responding to intimate partner violence are needed.
Food as an Instrument of War in Contemporary African Famines: A Review of the Evidence
Publisher: Wiley
Date: 12-1992
DOI: 10.1111/J.1467-7717.1992.TB00412.X
Abstract: Famine is conventionally portrayed as a natural disaster expressed in terms of food scarcity and culminating in starvation. This view has attracted criticism in recent years as the political, legal and social dimensions of famine have become more clearly understood. This paper draws upon these criticisms to understand the particular conditions of famine creation in conflict situations. Following an examination of six contemporary African famines, it is suggested that the use of food as a weapon of war by omission, commission and provision has contributed to the creation of famine in recent decades. Despite the optimism for peace engendered by the demise of the Cold War, the momentum for conflict would seem to be sustained by internal factors, including economic and environmental decline, political instability and ethnic rivalry. Within these conflicts, the strategic importance of food is likely to remain central. This study highlights the need to link concerns with food security and public health to those of development, human rights and international relations.
Health and Human Rights in a Changing World
Publisher: Routledge
Date: 04-07-2013
Conflict and International Relief in Contemporary African Famines, Church House, London, 26 March 1992
Publisher: Wiley
Date: 09-1992
A triple burden for health sector reform: ‘Post’-conflict rehabilitation in Uganda
Publisher: Elsevier BV
Date: 04-1996
DOI: 10.1016/0277-9536(95)00338-X
Abstract: While conflict continues to threaten health development in many countries, relative peace has been secured in others. The transition from war to peace carries important political and economic opportunities for the reappraisal of social policy in general, and of health policy in particular. The health systems of countries recovering from prolonged periods of conflict often carry a double burden: the inheritance of an inappropriate and unaffordable health system developed in the pre-conflict era, and the particular, long-term effects of conflict on health and health services. This paper reports on the particular policies designed to rehabilitate the Ugandan health system, and argues that they exacerbated, rather than alleviated, the health crisis inherited in 1986. In this way they posed a third burden. By analyzing the context and process of policy formulation in the immediate post-conflict period, it explores the rationale which lay behind the adoption of these policies and identifies potential strategies for strengthening policy development in these unstable, resource-poor and health-deprived situations.
Mesothelioma in South Africa, 1976-84: Incidence and case characteristics
Publisher: Oxford University Press (OUP)
Date: 1989
DOI: 10.1093/IJE/18.2.320
Abstract: Malignant mesothelioma is a rare tumour known to be associated with prior exposure to asbestos. Previous studies have described the occupational and clinical features of cases of mesothelioma in the Republic of South Africa (RSA) but none has set out to determine incidence of this disease. To estimate incidence, a case register was compiled for 1976-84 by contacting all medical practitioners and institutions likely to have seen cases of mesothelioma in this period demographic, diagnostic and exposure details were sought. Cases were accepted if they provided evidence of histological diagnosis of mesothelioma. Fifty-two per cent of 1347 cases identified were in whites, 31% in blacks, 16% in coloureds and 1% in Asians. Seventy-three per cent of cases occurred in males. The majority of whites were aged 51-70 years, while the majority in other race groups were aged 41-60 years. The ratio of only pleural to only peritoneal mesothelioma was 11:1, although there were marked differences by race. Eighty-five per cent of males with exposure information available had prior exposure to asbestos, mostly occupational. A similar proportion of women had contact with asbestos but mostly through other types of exposure. Standardized incidence rates per million population aged 15 years and over were calculated for sex-race subgroups and were highest in white males (32.9 per million per year, 95% Cl 22.7-46.4), coloured males (24.8 per million per year, 95% Cl 16.2-36.9) and coloured females (13.9 per million per year, 95% Cl 7.7-23.5). These incidence rates are amongst the highest ever reported for a national population. Age-specific standardized incidence rates were highest in white males (over 100 per million per year in men over 55 years). Reasons for the differing rates by population group are likely to include differential access to health services. More rigorous control of asbestos exposure in the RSA is recommended.
Quality and equity of private sector care for sexually transmitted diseases in South Africa
Publisher: Oxford University Press (OUP)
Date: 12-2002
DOI: 10.1093/HEAPOL/17.SUPPL_1.40
Abstract: The private sector plays a major role in the delivery of health care in South Africa. Over the past two decades, the quality and equity of such provision has been questioned internationally. A study was conducted in Gauteng Province to explore these issues, using care for sexually transmitted disease (STD) as a case study. Private general practitioners (GPs) were interviewed by telephone. Each was presented with a set of STD syndromes and requested to describe how s/he would manage the patient, first if the patient was insured, then secondly if the patient was paying cash (uninsured). Reported prescriptions were costed and assessed for effectiveness against main causative pathogens using local standard clinical guidelines. Knowledge of recent developments in STD syndromic management and effectiveness of prescribed drugs was poor, especially for genital ulcer and pelvic inflammatory disease, and less than half the prescriptions overall were judged as effective. Although the effectiveness of prescriptions for insured and uninsured patients were similar, for most syndromes uninsured patients were offered significantly cheaper and less convenient antibiotic regimens. Effective regimens were also significantly more expensive than ineffective regimens. The results suggest that GPs' perceptions of patients' willingness or ability to pay for drugs have a bearing on quality of care. The paper concludes that STD patients who present to GPs are often offered poor quality of care, and the choice of inconvenient antibiotics impacts disproportionately on the poor. Improvements in the quality and equity of GP care will require interventions that address the factors that determine their behaviour.
Universal Health Coverage: Ensuring migrants and migration are included
Publisher: SAGE Publications
Date: 24-06-2020
Forum introduction: Moving the UHC agenda forward without waiting for the next health crisis
Publisher: SAGE Publications
Date: 13-05-2020
Changing the malaria treatment protocol policy in Timor-Leste: An examination of context, process, and actors' involvement
Publisher: Springer Science and Business Media LLC
Date: 15-05-2013
Pathways to evidence-informed policy and practice: A framework for action
Publisher: Public Library of Science (PLoS)
Date: 31-05-2005
Public health nurses' perspectives on collaborative partnerships in South Africa
Publisher: Wiley
Date: 05-2004
Social inequalities in injury risk: Implications for prevention
Publisher: Informa UK Limited
Date: 09-2001
Effects of recurrent violence on post-traumatic stress disorder and severe distress in conflict-affected Timor-Leste: a 6-year longitudinal study
Publisher: Elsevier BV
Date: 05-2014
Evidence for national universal eye health plans
Publisher: WHO Press
Date: 27-08-2018
Advance Australia Fair: Social democratic and conservative politicians' discourses concerning Aboriginal and Torres Strait Islander Peoples and their health 1972-2001
Publisher: Elsevier BV
Date: 2007
DOI: 10.1016/J.SOCSCIMED.2006.08.034
Abstract: This paper reports research undertaken as part of a larger project in which we examined whether and how values and beliefs communicated by Australian politicians have shaped decades of health policy and influenced health outcomes for Aboriginal and Torres Strait Islander Peoples of Australia. To first characterise those values and beliefs we analysed the public statements of the politicians responsible nationally for the health of Aboriginal and Torres Strait Islander Peoples 1972-2001, using critical discourse analysis. We found that four discourses, communicated through words, phrases, sentences and grammatical structures, dominated public statements over the study period. These four discourses focused on the competence and capacity of Aboriginal and Torres Strait Islander Peoples to "manage" matters of control of and responsibility for the health of Aboriginal and Torres Strait Islander Peoples Aboriginal and Torres Strait Islander Peoples as "Other" and the nature of the "problem" concerning the health of Aboriginal and Torres Strait Islander Peoples. Analysis of the discursive elements contributing to shaping these four discourses is reported in this paper.
How to do (or not to do).using capture-recapture in promoting public health
Publisher: Oxford University Press (OUP)
Date: 1995
Factors associated with different types of birth attendants for home deliveries: an analysis of the cross-sectional 2010 South Sudan household survey.
Publisher: Informa UK Limited
Date: 28-07-2016
DOI: 10.3402/GHA.V9.29693
Abstract: In South Sudan, birth deliveries attended by unskilled birth attendants put the mothers and their newborns at increased risk of perinatal morbidity and mortality. The aim of this study was to identify factors associated with delivery by unskilled birth attendants or by unassisted delivery. We examined data for 2,767 (weighted total) women aged 15-49 years who delivered at home 2 years prior to the South Sudan Household Health Survey 2010. Multinomial logistic regression analyses were used to identify factors associated with delivery by unskilled birth attendants or by unassisted delivery. The prevalence of delivery by unskilled birth attendants was 19% [95% confidence interval (CI) 17.0, 20.5], by skilled birth attendants (SBAs) was 45% (95% CI 42.4, 47.0), and by unassisted delivery was 36% (95% CI 34.2, 38.6). After adjusting for potential confounders, the following factors were associated with the increased odds for unassisted delivery or delivery by an unskilled birth attendant: mothers with no schooling, who did not attend antenatal care (ANC) during pregnancy, who had lower quality of ANC services, from poor households, or who had no prior knowledge about obstetric danger signs. We found that non-utilization of maternal health care services, such as ANC, was significantly associated with unattended birth delivery or delivery by unskilled health providers. The increased uptake of SBAs at delivery will require easier access to ANC services, health promotion on the importance and benefits of SBAs for delivery, targeting both mothers and their families, and the training and deployment of more SBAs across the country.
Great expectations: An analysis of researchers' and policy makers' perceptions of the potential value of the Australian indigenous burden of disease study for policy
Publisher: Wiley
Date: 30-07-2018
DOI: 10.1002/HPM.2445
Abstract: The "Burden of disease and injury in Aboriginal and Torres Strait Islander Peoples" was commissioned by the Australian government as part of the Australian Burden of Disease study. This paper explores the extent to which key actors in the research and policy communities expected the Indigenous Burden of Disease study's findings to inform, influence, or drive federal decisions concerning Indigenous health in Australia. This qualitative research undertook interviews with 13 key informants with significant involvement in the Indigenous Burden of Disease study: six researchers, five policy makers, and two knowledge brokers. Interviews were recorded, transcribed, and analyzed, and the findings were triangulated with a review of the literature. Policy makers and researchers anticipated that the Indigenous Burden of Disease study would improve the available information for policy deliberations about Indigenous health. Beyond that, their expectations about its policy influence differed substantially, with researchers more confident of the study's capacity to guide health priorities, and policy makers situating findings in the context of other critical inputs. Expectations of policy influence are shaped by the disciplinary perspectives of actors, and their relationship to policy outcomes and cannot be examined without also considering the policy, political, and financing context of the study being analyzed.
Addressing the human resources crisis: A case study of Cambodia's efforts to reduce maternal mortality (1980-2012)
Publisher: BMJ
Date: 2013
The political abuse of medicine and the challenge of opposing it
Publisher: Elsevier BV
Date: 1987
DOI: 10.1016/0277-9536(87)90092-X
Abstract: A fundamental aim of medicine is to protect and promote health. The practice of medicine has, however, been used to promote political aims which may be detrimental to health. The article attempts to isolate the ways in which political abuses may interfere with good medical practice: by allowing health policies to be influenced by undemocratic political considerations by using health services to reward or punish political supporters or opponents by direct medical involvement in political acts which contradict accepted medical ethics and by the support which conventional medical practises give to perpetuating inequalities in health and social services. Each of these is examined with the use of a number of ex les. The ways in which medical personnel have opposed the political abuse of medicine is explored by a brief review of the opposition of Chilean doctors to torture, the involvement of South African doctors in opposing the abuse of health services in perpetuating apartheid, and the growing medical movement in opposition to nuclear war. Some comments concerning the monitoring of a multitude of medical disciplines which are open to political abuse are made. The purpose of the paper is primarily to stimulate debate around this important issue and it does not attempt to provide a comprehensive review of the political abuse of medicine.
Commentary: Studying political violence: We should push for more from epidemiology
Publisher: Oxford University Press (OUP)
Date: 06-2002
DOI: 10.1093/IJE/31.3.585
Health Services, Effects of War and Political Violence on*
Publisher: Elsevier
Date: 2008
Vibrio cholerae O1 in 2 coastal villages, Papua New Guinea
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 2011
Policymaking 'under the radar': A case study of pesticide regulation to prevent intentional poisoning in Sri Lanka
Publisher: Oxford University Press (OUP)
Date: 20-12-2015
Equity in resource allocation for health: A comparative study of the Ashanti and Northern Regions of Ghana
Publisher: Elsevier BV
Date: 10-2006
DOI: 10.1016/J.HEALTHPOL.2006.03.013
Abstract: Debate over the equitable allocation of financial resources in the health sector has focused overwhelmingly on allocation from national to regional levels. More equitable allocation of such resources within regions has been virtually ignored, creating a vacuum in knowledge regarding how resources are allocated intra-regionally and their potential influence on promoting health equity. In this paper, we report an empirical study examining progress towards equity in intra-regional resource allocation in the Ashanti and Northern regions of Ghana. Relative deprivation across the 31 districts of the two regions was measured as a proxy of health needs. The result was used to develop an equity-adjusted share index (EAS) applied as a yardstick against which progress towards equity was assessed. The study found a significant correlation between districts' share of donor pooled funds (DPF) and the EAS in the Northern region for three of the 4 years investigated. In Ashanti region, a worsening trend in relation to equity in DPF allocation was discovered. The proportion of variance in the share of DPF that could be explained by the EAS reduced incrementally from 56% in 1999 to less than 1% in 2002. The study highlights the need for more emphasis on intra-regional equity in resource allocation in Ghana.
Aid policy in transition: A preliminary analysis of post'‐conflict rehabilitation of the health sector
Publisher: Wiley
Date: 07-1995
Assessing the Burden of COVID-19 in Developing Countries: Systematic Review, Meta-Analysis, and Public Policy Implications
Publisher: Cold Spring Harbor Laboratory
Date: 10-2021
DOI: 10.1101/2021.09.29.21264325
Abstract: The infection-fatality rate (IFR) of COVID-19 has been carefully measured and analyzed in high-income countries, whereas there has been no systematic analysis of age-specific seroprevalence or IFR for developing countries. We systematically reviewed the literature to identify all COVID-19 serology studies in developing countries that were conducted using population representative s les collected by early 2021. For each of the antibody assays used in these serology studies, we identified data on assay characteristics, including the extent of seroreversion over time. We analyzed the serology data using a Bayesian model that incorporates conventional s ling uncertainty as well as uncertainties about assay sensitivity and specificity. We then calculated IFRs using in idual case reports or aggregated public health updates, including age-specific estimates whenever feasible. Seroprevalence in many developing country locations was markedly higher than in high-income countries. In most locations, seroprevalence among older adults was similar to that of younger age cohorts, underscoring the limited capacity that these nations have to protect older age groups. Age-specific IFRs were roughly 2x higher than in high-income countries. The median value of the population IFR was about 0.5%, similar to that of high-income countries, because disparities in healthcare access were roughly offset by differences in population age structure. The burden of COVID-19 is far higher in developing countries than in high-income countries, reflecting a combination of elevated transmission to middle-aged and older adults as well as limited access to adequate healthcare. These results underscore the critical need to accelerate the provision of vaccine doses to populations in developing countries. - Age-stratified infection fatality rates (IFRs) of COVID-19 in developing countries are about twice those of high-income countries. - Seroprevalence (as measured by antibodies against SARS-CoV-2) is broadly similar across age cohorts, underscoring the challenges of protecting older age groups in developing countries. - Population IFR in developing countries is similar to that of high-income countries, because differences in population age structure are roughly offset by disparities in healthcare access as well as elevated infection rates among older age cohorts. - These results underscore the urgency of disseminating vaccines throughout the developing world.
Placing ethics in the centre: negotiating new spaces for ethical research in conflict situations.
Publisher: Informa UK Limited
Date: 10-2006
DOI: 10.1080/17441690600673866
Abstract: Issues of power and consent, confidentiality, trust, and benefit, risks to researchers, and potential harm to participants, are all contested when working with different cultures and within environments marked by violence and insecurity. Difficulty resolving these dilemmas may paralyse ethics committees, may fail to give the guidance sought by researchers, and will not help populations who are among the world's most vulnerable. Even where efforts are made to respond to ethical guidelines and to improve practice, considerable impediments are present in many developing countries, including lack of formal ethical review structures in unstable settings, lack of required skills, limited political and institutional recognition of ethical issues, competing interests, and limitations in clinical and research practice (Elsayed 2004, Macklin 2004). In conflict settings, these limitations are more marked, and the responsibilities of the researcher for ethical practice are greater, but the mechanisms for oversight are weaker. Moreover, the constant focus on vulnerabilities and problems, and the often almost total lack of recognition of strengths and resilience, can further disempower already exploited groups and in iduals. The capacity of refugees and communities in conflict to take an active role in the research process is seldom acknowledged, and undermines the potential for more innovative research which can help generate the evidence for better policy and practice.
Made Me Feel Connected: A Qualitative Comparative Analysis of Intimate Partner Violence Routine Screening Pathways to Impact.
Publisher: SAGE Publications
Date: 14-03-2019
Abstract: Intimate partner violence (IPV) routine screening is widely implemented, yet the evidence for pathways to impact remains unclear. Of the 32 abused women interviewed 16 weeks after antenatal IPV screening, 24 reported positive impact, six reported nil positive impact, and two reported negative impact. Using qualitative comparative analysis (QCA), key conditions for positive impact were care in asking, and support and validation from the midwife. Lack of these and lack of continuity of care were relevant to nil positive impact. Benefits included naming the abuse, connection, unburdening, taking steps to safety, and enabling informed care. Disclosure was not required for positive impact.
Patterns of injury in children and adolescents presenting to a South African township health centre.
Publisher: BMJ
Date: 03-1995
DOI: 10.1136/IP.1.1.26
Abstract: To describe the patterns and causes of childhood injury presenting to a South African township health centre in 1991. Retrospective review of clinic held case notes. Typical South-African urban township within Greater Johannesburg. 695 subjects aged 0-19 years presenting as a direct result of injury. Overall rates of presentation for injury were 6297/100,000/year (95% confidence interval 5463 to 7131) 35% of injuries were caused by violence, 14% by traffic, and 51% by other unintentional causes (such as falls and sport injuries). Males had higher rates of presentation than females for violent (p < 0.001) and unintentional injuries (p < 0.01), but rates were similar for traffic injuries. The highest rates were for injuries caused by violence in 15-19 year-old males and were 9319/100,000/year. Rates are lower than in more developed countries. However, they appear to represent the more severe end of the spectrum of injury severity. The rates are similar for those below age 10 years and higher for those above age 10 years compared with severe injury rates in other studies. These data are likely to underestimate true rates. The risk of injuries caused by violence increase with age and these injuries are more serious than those due to other causes. Males are at higher risk for all types of injury except traffic injury.
Did human security forget the humans? Critically assessing evaluations of interventions with a human security dimension in Sri Lanka
Publisher: Informa UK Limited
Date: 03-07-2020
Psychosocial health and human rights: fair weather friends? Examining post-tsunami interventions in conflict-affected areas
Publisher: Informa UK Limited
Date: 12-2005
Experience of domestic violence by women attending an inner city accident and emergency department
Publisher: BMJ
Date: 03-2004
Abstract: To identify the prevalence of domestic violence (DV) (defined as physical abuse perpetrated by intimate partners) in women attending an inner city accident and emergency department and to elicit women's response about being asked routinely about domestic violence in this setting. 22 nursing shifts were purposefully s led to be representative of day, night, and weekends. A questionnaire was administered to 198 consenting women who were not intoxicated, confused, or critically ill. The prevalence of acute trauma in women attributable to DV was 1% (95%CI 0.14 to 3.6), the prevalence of lifetime physical abuse was 34.8% (95%CI 28.2 to 41.5), of past year physical abuse was 6.1% (95%CI 3.2 to 10.3), and of lifetime life threatening physical abuse was 10.6% (95%CI 6.3 to 14.9). Seventy six per cent of women felt comfortable about being asked about DV and 60.5% of women felt that they should always or usually be asked about DV in this setting. This cross sectional survey adds to the body of knowledge showing that the prevalence of DV in women attending an accident and emergency department is high. Most women were in favour of being asked, and disclosure was associated with discomfort in few women. This sensitive area of history taking and referral could be undertaken by health professionals using a supportive approach.
Ethical Considerations of Using Walking Interviews to Engage Migrant and Refugee Young People in Health Service Research
Publisher: SAGE Publications Ltd
Date: 2019
Regulation of nursing professionals in Cambodia: strategies to overcome underpinning challenges
Publisher: Wiley
Date: 18-01-2021
DOI: 10.1111/INR.12658
Abstract: To elucidate (i) the challenges and constraints in the development and implementation of the regulatory framework for nursing professionals in Cambodia and (ii) the specific strategies adopted to address the challenges experienced in Cambodia. The health workforce will be critical to achieving the health‐related and wider Sustainable Development Goals in the years up to 2030. In 2006, the countries of the Association of Southeast Asian Nations signed a Mutual Recognition Arrangement in relation to nursing services in the region with the main aim of facilitating the mobility of nursing professionals between countries. To ensure the competency of the health workforce and the quality and safety of health services, member states are required to establish an appropriate regulatory framework. This is a qualitative descriptive study. Eighteen key informant interviews were conducted in Cambodia in 2018. Walt and Gilson’s policy analysis model was applied to organize and synthesize the data. Major challenges were identified such as conceptual and cultural issues, limited capacity of Cambodian stakeholders and an unstandardized system with limited coordination. In Cambodia, the nursing regulatory environment has expanded greatly over the last decade. Strategies adopted were ‘political leadership’, optimal utilization of ‘outsider’s capacity’, strengthening ‘insider’s capacity’, and ‘dedicated consultation and collaboration and consensus building’ involving all players. Policymakers in similar resource‐limited countries could apply and adapt similar strategic efforts when formulating and implementing health policies, legislation and regulations. ‘Outsiders’, in this case, represented by development partners can play a vital role in the process, but should not be leading the charge. They should be aligned with national priority to support recipient countries. It is imperative for these countries and development partners to invest in increasing the quantity and quality of nursing leaders who can develop and advance regulatory functions.
What Evidence Exists for Initiatives to Reduce Risk and Incidence of Sexual Violence in Armed Conflict and Other Humanitarian Crises? A Systematic Review
Publisher: Public Library of Science (PLoS)
Date: 15-05-2013
Occupational health and safety in South Africa: The perspectives of capital, state and unions
Publisher: Elsevier BV
Date: 1988
DOI: 10.1016/0277-9536(87)90329-7
Abstract: South Africa is one of the most technologically advanced countries of Africa. The main sectors are mining, agriculture and industry. Many work environments are dangerous. Since the early development of the mines in South Africa, occupational health and safety (OHS) has received the attention of the state, the employers, and the workers. Although there have been some advances in legislation, conditions are often still poor and enforcement of legislation is lacking. The paper outlines the history of concern with OHS issues, and draws attention to the Erasmus Commission of Enquiry (1976) into Occupational Health. The paper attempts to provide an overview of the different activities and perspectives of these interest groups: the state is concerned with minimising conflict and disruption of productivity, while ensuring that conditions do not deteriorate too badly the employers are concerned to maximise profits and to undertake improvements in OHS only insofar as these are profitable and in the interest of stable industrial relations and the union movement has sought to make work safer. These perspectives are different and conflicting. The only interest group with an unambiguous commitment to improving OHS is the union movement in South Africa. However, many difficulties and problems mitigate against the movement achieving its OHS objectives, including the limited number of workers which have been organised into unions and the many pressing issues which require the movement's immediate attention.
Planning for health sector reform in post-conflict situations: Kosovo 1999–2000
Publisher: Elsevier BV
Date: 03-2003
DOI: 10.1016/S0168-8510(02)00121-5
Abstract: The restoration and development of health care systems in post-conflict situations and complex emergencies are attracting attention. Kosovo is unique in being a post-conflict situation, in a former socialist country, with an unclear political future, under temporary UN administration. The World Health Organization (WHO) led a process of developing a health policy framework for the emergency period that included elements of health sector reform, a somewhat controversial initiative. Reform elements of the policy were consistent with normative health policies in much of eastern and central Europe. There was tension between the need to have a policy in place rapidly and the desire to be participatory. Policy to deal with emergency situations that is not available at the time required is of limited value. Although there was some tension between relief and development agendas, the policy process did direct significant resources and effort in directions that contributed to longer-term reform and development. A policy framework does not ensure compliance with policy unless issues of authority, mandate, and leadership are clear. A rapidly developed health policy framework at the onset of an emergency is desirable. Policy developers should be experienced, seen as being neutral and be relatively independent of any specific donor or interest group. WHO is well situated to play this role if it meets certain conditions.
“It’s not a yes or no question”: Disparities between women’s accounts of disclosing intimate partner violence and patient documentation in antenatal settings: A qualitative synthesis.
Publisher: American Psychological Association (APA)
Date: 03-2021
DOI: 10.1037/VIO0000367
Killer facts, politics and other influences: What evidence triggered early childhood intervention policies in Australia?
Publisher: Bristol University Press
Date: 2009
Abstract: Understanding the ‘evidence’ for policy is complicated. This article examines the relationship between evidence and policies on early childhood interventions in two states of Australia, revealing powerful insights into what constitutes the evidence for policy and the importance of ‘killer facts’ to decision makers. The nature of evidence in the policy environment is broad and complex, going well beyond research to incorporate policy context and processes. These findings reinforce an evidence-informed approach to health policy making and the need for researchers to develop a more sophisticated understanding of the policy context.
Beyond the log frame: A new tool for examining health and peacebuilding initiatives
Publisher: Informa UK Limited
Date: 02-2008
Health and peace: an opportunity to join forces
Publisher: Elsevier BV
Date: 10-2001
Forced migrants and other displaced populations
Publisher: Oxford University Press
Date: 02-2015
Related Organisations
London School Of Hygiene And Tropical Medicine
Location: United Kingdom of Great Britain and Northern Ireland
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Amount: $270,000.00
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Amount: $390,000.00
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View Funded ActivitySpecial Research Initiatives - Grant ID: SR0354621
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Amount: $10,000.00
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View Funded ActivityLinkage Projects - Grant ID: LP0669846
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Amount: $89,790.00
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View Funded ActivityLinkage Infrastructure, Equipment And Facilities - Grant ID: LE0453801
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Amount: $102,900.00
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View Funded ActivityDiscovery Projects - Grant ID: DP0987803
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Amount: $634,220.00
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View Funded ActivityLinkage Projects - Grant ID: LP190101183
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View Funded ActivitySpecial Research Initiatives - Grant ID: SR0354803
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Amount: $10,000.00
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View Funded ActivitySpecial Research Initiatives - Grant ID: SR0354508
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