| 1. |
- Hussein, Julia, et al.
(författare)
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A review of health system infection control measures in developing countries : what can be learned to reduce maternal mortality
- 2011
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Ingår i: Globalization and Health. - : Springer Science and Business Media LLC. - 1744-8603. ; 7:14, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- A functional health system is a necessary part of efforts to achieve maternal mortality reduction in developing countries. Puerperal sepsis is an infection contracted during childbirth and one of the commonest causes of maternal mortality in developing countries, despite the discovery of antibiotics over eighty years ago. Infections can be contracted during childbirth either in the community or in health facilities. Some developing countries have recently experienced increased use of health facilities for labour and delivery care and there is a possibility that this trend could lead to rising rates of puerperal sepsis. Drug and technological developments need to be combined with effective health system interventions to reduce infections, including puerperal sepsis. This article reviews health system infection control measures pertinent to labour and delivery units in developing country health facilities. Organisational improvements, training, surveillance and continuous quality improvement initiatives, used alone or in combination have been shown to decrease infection rates in some clinical settings. There is limited evidence available on effective infection control measures during labour and delivery and from low resource settings. A health systems approach is necessary to reduce maternal mortality and the occurrence of infections resulting from childbirth. Organisational and behavioural change underpins the success of infection control interventions. A global, targeted initiative could raise awareness of the need for improved infection control measures during childbirth.
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| 2. |
- Kinsman, John
(författare)
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"A time of fear" : local, national, and international responses to a large Ebola outbreak in Uganda
- 2012
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Ingår i: Globalization and Health. - : BioMed Central. - 1744-8603. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This paper documents and analyses some of the responses to the largest Ebola outbreak on record, which took place in Uganda between September 2000 and February 2001. Four hundred and twenty five people developed clinical symptoms in three geographically distinct parts of the country (Gulu, Masindi, and Mbarara), of whom 224 (53%) died. Given the focus of previous social scientific Ebola research on experiences in those communities that have been directly affected, the article examines the ways in which fear, altruism, and stigma were felt and enacted in a wider variety of contexts - local, national, and international - over the course of the outbreak. METHODS: Responses to the outbreak were gauged through the articles, editorials, cartoons, and letters that were published in the country's two main English language daily national newspapers: the New Vision and the Monitor (now the Daily Monitor). All the relevant pieces from these two sources over the course of the epidemic were cut out, entered onto a computer, and the originals filed. The three a priori codes - based on the local, national, and international levels - were expanded into six, to include specific issues that emerged inductively during analysis. The data within each code were subsequently worked into coherent, chronological narratives. RESULTS: A total of 639 cuttings were included in the analysis. Strong and varied responses to the outbreak were identified from across the globe. These included, among others: confusion, anger, and serious stigma in affected communities; medical staff working themselves to exhaustion, with some quitting their posts; patients fleeing from hospitals; calls on spiritual forces for protection against infection; a well-coordinated national control strategy; and the imposition of some international travel restrictions. Responses varied both quantitatively and qualitatively according to the level (i.e. local, national, or international) at which they were manifested. CONCLUSIONS: The Ugandan experience of 2000/2001 demonstrates that responses to an Ebola outbreak can be very dramatic, but perhaps disproportionate to the actual danger presented. An important objective for any future outbreak control strategy must be to prevent excessive fear, which, it is expected, would reduce stigma and other negative outcomes. To this end, the value of openness in the provision of public information - and, critically, of being seen to be open - cannot be overstated.
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| 5. |
- Bagonza, Arthur, et al.
(författare)
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'I know those people will be approachable and not mistreat us' : a qualitative study of inspectors and private drug sellers' views on peer supervision in rural Uganda
- 2020
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Ingår i: Globalization and Health. - : Springer Nature. - 1744-8603. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Peer supervision improves health care delivery by health workers. However, in rural Uganda, self-supervision is what is prescribed for licensed private drug sellers by statutory guidelines. Evidence shows that self-supervision encourages inappropriate treatment of children less than 5 years of age by private drug sellers. This study constructed a model for an appropriate peer supervisor to augment the self-supervision currently practiced by drug sellers at district level in rural Uganda.METHODS: In this qualitative study, six Key informant interviews were held with inspectors while ten focus group discussions were conducted with 130 drug sellers. Data analysis was informed by the Kathy Charmaz constructive approach to grounded theory. Atlas ti.7 software package was used for data management.RESULTS: A model with four dimensions defining an appropriate peer supervisor was developed. The dimensions included; incentives, clearly defined roles, mediation and role model peer supervisor. While all dimensions were regarded as being important, all participants interviewed agreed that incentives for peer supervisors were the most crucial. Overall, an appropriate peer supervisor was described as being exemplary to other drug sellers, operated within a defined framework, well facilitated to do their role and a good go-between drug sellers and government inspectors.CONCLUSION: Four central contributions advance literature by the model developed by our study. First, the model fills a supervision gap for rural private drug sellers. Second, it highlights the need for terms of reference for peer supervisors. Third, it describes who an appropriate peer supervisor should be. Lastly, it elucidates the kind of resources needed for peer supervision.
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| 6. |
- Bardosh, Kevin Louis, et al.
(författare)
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Integrating the social sciences in epidemic preparedness and response : A strategic framework to strengthen capacities and improve Global Health security
- 2020
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Ingår i: Globalization and Health. - : Springer Nature. - 1744-8603. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The importance of integrating the social sciences in epidemic preparedness and response has become a common feature of infectious disease policy and practice debates. However to date, this integration remains inadequate, fragmented and under-funded, with limited reach and small initial investments. Based on data collected prior to the COVID-19 pandemic, in this paper we analysed the variety of knowledge, infrastructure and funding gaps that hinder the full integration of the social sciences in epidemics and present a strategic framework for addressing them.Methods: Senior social scientists with expertise in public health emergencies facilitated expert deliberations, and conducted 75 key informant interviews, a consultation with 20 expert social scientists from Africa, Asia and Europe, 2 focus groups and a literature review of 128 identified high-priority peer reviewed articles. We also analysed 56 interviews from the Ebola 100 project, collected just after the West African Ebola epidemic. Analysis was conducted on gaps and recommendations. These were inductively classified according to various themes during two group prioritization exercises. The project was conducted between February and May 2019. Findings from the report were used to inform strategic prioritization of global investments in social science capacities for health emergencies.Findings: Our analysis consolidated 12 knowledge and infrastructure gaps and 38 recommendations from an initial list of 600 gaps and 220 recommendations. In developing our framework, we clustered these into three areas: 1) Recommendations to improve core social science response capacities, including investments in: human resources within response agencies; the creation of social science data analysis capacities at field and global level; mechanisms for operationalizing knowledge; and a set of rapid deployment infrastructures; 2) Recommendations to strengthen applied and basic social sciences, including the need to: better define the social science agenda and core competencies; support innovative interdisciplinary science; make concerted investments in developing field ready tools and building the evidence-base; and develop codes of conduct; and 3) Recommendations for a supportive social science ecosystem, including: the essential foundational investments in institutional development; training and capacity building; awareness-raising activities with allied disciplines; and lastly, support for a community of practice.Interpretation: Comprehensively integrating social science into the epidemic preparedness and response architecture demands multifaceted investments on par with allied disciplines, such as epidemiology and virology. Building core capacities and competencies should occur at multiple levels, grounded in country-led capacity building. Social science should not be a parallel system, nor should it be “siloed” into risk communication and community engagement. Rather, it should be integrated across existing systems and networks, and deploy interdisciplinary knowledge “transversally” across all preparedness and response sectors and pillars. Future work should update this framework to account for the impact of the COVID-19 pandemic on the institutional landscape.
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| 7. |
- Elling, Devy, et al.
(författare)
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Sex differences and risk factors for diabetes mellitus - an international study from 193 countries
- 2018
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Ingår i: Globalization and Health. - : Springer Science and Business Media LLC. - 1744-8603. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Increases in overweight and obesity among youths have resulted in the diagnosis of Type 2 diabetes mellitus (T2DM) at earlier ages. The impact of lifestyle-related factors has been implicated; however, its relation to morbidity and mortality and sex differences remain unclear. We aimed to document the changes in risk factors and sex differences associated with T2DM-related morbidity and mortality during 1995-2015.Method: We used mortality rates and morbidity estimates from the Global Burden of Diseases Study 2016 using Disability-Adjusted Life Years (DALY). Multiple linear regression analyses were used to determine associations between T2DM-related mortality and related risk factors. DALYs were grouped by country income level, and were stratified by sex.Results: Increases in mortality were observed for both sexes, and females tended to have higher mortality rates per 100,000 persons. Body mass index (BMI) continued to be the leading risk factor for T2DM-related mortality, and increases in BMI were more common in low- and middle-income countries (LIC and MIC). Low physical activity was strongly associated with mortality rates, followed by dietary risks and smoking (2.4; 1.4; 0.8 per 100,000 persons, respectively). Similar patterns were observed after adjustments for income level, sex, and age. DALYs continued to show increasing trends across all income levels during 1995-2015 (high-income (HIC):16%; MIC: 36%; LIC: 12%). Stratification by sex showed similar results; males had fewer T2DM DALYs than females, though a greater increase was observed among males.Conclusion: Overall, T2DM related mortality was higher among females. Compared to in HIC, there appeared to be a considerable increase in the burden of T2DM in MIC and LIC, where BMI is the leading risk factor for T2DM-related mortality. Prevention programs should emphasize related risk factors according to the existing standard of care.
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| 9. |
- Irwin, Rachel
(författare)
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Misinformation and de-contextualization : international media reporting on Sweden and Covid-19
- 2020
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Ingår i: Globalization and Health. - : Springer Science and Business Media LLC. - 1744-8603. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- In the first month of the 2020 COVID-19 pandemic, Sweden took the same strategy as most other countries, working to “flatten the curve,” by slowing transmission so that the healthcare system could cope with the disease. However, unlike most other countries, much of Sweden’s implementation focused on voluntary and stepwise action, rather than legislation and compulsory measures, leading to considerable attention in the international media.Six main narratives emerged in the international media reporting on Sweden during the first month of the COVID-19 pandemic: (1) Life is normal in Sweden, (2) Sweden has a herd immunity strategy, (3) Sweden is not following expert advice, (4) Sweden is not following WHO recommendations (5) the Swedish approach is failing and (6) Swedes trust the government. While these narratives are partially grounded in reality, in some media outlets, the language and examples used to frame the story distorted the accuracy of the reporting.This debate examines the ways in which international media both constructs and represents a pandemic, and the implications for how researchers engage with news and social media. Cross-country comparison and the sharing of best practice are reliant on accurate information. The Swedish example underlines the importance of fact checking and source critique and the need for precision when presenting data and statistics. It also highlights limitations of using culture as an explanation for behavior, and the pitfalls of evaluating policy during a pandemic.
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| 10. |
- Irwin, Rachel
(författare)
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Sweden’s engagement in global health : a historical review
- 2019
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Ingår i: Globalization and Health. - : Springer Science and Business Media LLC. - 1744-8603. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sweden is a long-standing and significant contributor to overseas development aid. This commitment to global health and development is part of Sverigebilden, or the view of Sweden in the world that is formally promoted by the Swedish government. Sweden is seen by many in the global health community as leader on human rights and health and has traditionally been one of the most engaged countries in multilateral affairs more broadly.Results: This article places Sweden’s engagement in global health within the wider context of domestic changes, as well as transitions within the broader global health landscape in the post-World War Two (WWII)- era. In doing so, it reviews the globalization of health from a Swedish perspective. It also addresses broader questions about what it means for a country to be ‘active’ or ‘engaged’ in global health and responds to recent suggestions that Swedish influence in health has waned. The article finds that in Sweden there is wide political consensus that international development and global health engagement are important, and both are part of the maintenance of Sverigebilen. While there is a not one single Swedish approach to global health, there are norms and values that underpin global health engagement such as human rights, solidarity, equity and gender equality. A sustained focus on key issues, such as sexual and reproductive rights and health (SRHR), creates a tradition which feeds back into Sverigebilden.Conclusions: The Swedish experience demonstrates the linkages between foreign and domestic policies with regard to international health and development, and to the globalization of public health practice and diplomacy. In global health Sverigebilden is tied to credibility. Sweden is able to exercise influence because of a successful welfare model and strong research traditions; conversely, long-standing and new threats to this credibility and to Sverigebilden pose challenges to Sweden’s future engagement in global health.
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