| 1. |
- Zelaya Blandon, Elmer, et al.
(author)
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Breaking the cycles of poverty : Strategies, achievements, and lessons learned in Los Cuatro Santos, Nicaragua, 1990-2014
- 2017
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In: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 10:1
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Journal article (peer-reviewed)abstract
- Background: In a post-war frontier area in north-western Nicaragua that was severely hit by Hurricane Mitch in 1998, local stakeholders embarked on and facilitated multi-dimensional development initiatives to break the cycles of poverty. Objective: The aim of this paper is to describe the process of priority-setting, and the strategies, guiding principles, activities, achievements, and lessons learned in these local development efforts from 1990 to 2014 in the Cuatro Santos area, Nicaragua. Methods: Data were derived from project records and a Health and Demographic Surveillance System that was initiated in 2004. The area had 25,893 inhabitants living in 5,966 households in 2014. Results: A participatory process with local stakeholders and community representatives resulted in a long-term strategic plan. Guiding principles were local ownership, political reconciliation, consensus decision-making, social and gender equity, an environmental and public health perspective, and sustainability. Local data were used in workshops with communities to re-prioritise and formulate new goals. The interventions included water and sanitation, house construction, microcredits, environmental protection, school breakfasts, technical training, university scholarships, home gardening, breastfeeding promotion, and maternity waiting homes. During the last decade, the proportion of individuals living in poverty was reduced from 79 to 47%. Primary school enrolment increased from 70 to 98% after the start of the school breakfast program. Under-five mortality was around 50 per 1,000 live births in 1990 and again peaked after Hurricane Mitch and was approaching 20 per 1,000 in 2014. Several of the interventions have been scaled up as national programs. Conclusions: The lessons learned from the Cuatro Santos initiative underline the importance of a bottom- up approach and local ownership of the development process, the value of local data for monitoring and evaluation, and the need for multi-dimensional local interventions to break the cycles of poverty and gain better health and welfare.
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| 2. |
- Hedström, Jenny, 1979-, et al.
(author)
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Women’s sexual and reproductive health in war and conflict : are we seeing the full picture?
- 2023
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In: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 16:1
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Journal article (peer-reviewed)abstract
- It is well established that women’s sexual and reproductive health (SRHR) is negatively affected by war. While global health research often emphasises infrastructure and systematic factors as key impediments to women’s SRHR in war and postwar contexts, reports from different armed conflicts indicate that women’s reproduction may be controlled both by state and other armed actors, limiting women’s choices and access to maternal and reproductive health care even when these are available. In addition, it is important to examine and trace disparities in sexual reproductive health access and uptake within different types of wars, recognising gendered differences in war and postwar contexts. Adding feminist perspectives on war to global health research explanations of how war affects women's sexual and reproductive health might then contribute to further understanding the complexity of the different gendered effects war and armed conflicts have on women’s sexual and reproductive health.
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| 3. |
- Josefsson, Jonathan, 1979-
(author)
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Non-citizen Children and the Right to Stay : A Discourse Ethical Approach
- 2019
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In: Ethics & Global Politics. - : Routledge. - 1654-4951 .- 1654-6369. ; 12:3
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Journal article (peer-reviewed)abstract
- The increased efforts of democratic states to enforce immigration control and deportations have sparked heated public debates about the rights of non-citizen children to be granted asylum. Local communities, anti-deportation movements, and children themselves have rejected the justifications provided by state authorities and have mobilized claims in the public sphere for the rights of non-citizen children to stay. To date, scholars have primarily analyzed normative issues about the rights of non-citizen children with departure in legal positive rights as enshrined in domestic and international law; however, scholars have paid less attention to political theoretical aspects of the issue. This article takes its point of departure from claims for non-citizen children’s right to stay as formulated in the public sphere and uses discourse ethics to theorize in what ways these claims challenge state power and contemporary laws on asylum. In addition, this article contributes to the scholarly debates about the pressing global political issue of child migration and the political theory of human rights for children. Building on Seyla Benhabib’s concepts reciprocity and democratic iterations, this article develops a discourse theoretical approach that offers an alternative framework to a legalistic approach for the normative analysis of the rights of non-citizen children.
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| 4. |
- Rocklöv, Joacim, 1979-, et al.
(author)
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Comparing approaches for studying the effects of climate extremes : a case study of hospital admissions in Sweden during an extremely warm summer
- 2009
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In: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 2
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Journal article (peer-reviewed)abstract
- Background: Health effects induced by climate, weather and climatic change may act directly or indirectly on human physiology. The future total burden of global warming is uncertain, but in some areas and for specific outcomes, mortality and morbidity are likely to increase. One likely effect of global warming is an increasing number of extreme weather events, such as floods, storms and heat waves. The excess numbers of specific health outcomes attributable to climate-induced events can be estimated. This paper compares approaches for estimating excess numbers of outcomes associated with climate extremes, exemplified by a case study of hospital admissions during the extremely warm summer of 2006 in southern Sweden.Materials and methods: Daily hospital admission data were obtained from the Swedish National Board of Health and Welfare for six hospitals in the Skåne region of southern Sweden for the period 1998 to 2006. Daily temperature data for the region were obtained from the meteorological station in the city of Malmö. We used four established approaches for estimating the daily excess numbers associated with extreme heat. Time series of daily event rates were assumed to follow a Poisson distribution. Excess event rates were compared by using several approaches, such as standardised event ratios and generalised additive models to estimate the health risks attributable to the extreme climate event.Results: The four approaches yielded vastly different results. The estimates of excess were considerably biased when not accounting for time trends in previous years’ data. Three of four approaches showed a significant increase in excess hospitalisation rates attributable to the heat episode in Skåne in 2006. However, modelling the effect of temperature failed to describe the risks induced by the extreme heat.Conclusion: Estimates of excess events depend greatly on the approach used. Further research is needed to identify which method yielded the most accurate estimates. However, one of the approaches used generally seem to perform better than the others in estimating the excess rates associated with the heat episode. Further on, estimating relative risks of temperature or other determinants of disease may fail to incorporate the unique characteristics of particular weather events, such as the effect caused by very persistent heat exposure. Unless this can be incorporated into predictive models, such models may be less appropriate to use when predicting the future burden of heat waves on human health.
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| 5. |
- Gustafsson, Per E., et al.
(author)
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Meddling with middle modalities : a decomposition approach to mental health inequalities between intersectional gender and economic middle groups in northern Sweden
- 2016
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In: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 9
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Journal article (peer-reviewed)abstract
- BACKGROUND: Intersectionality has received increased interest within population health research in recent years, as a concept and framework to understand entangled dimensions of health inequalities, such as gender and socioeconomic inequalities in health. However, little attention has been paid to the intersectional middle groups, referring to those occupying positions of mixed advantage and disadvantage.OBJECTIVE: This article aimed to 1) examine mental health inequalities between intersectional groups reflecting structural positions of gender and economic affluence and 2) decompose any observed health inequalities, among middle groups, into contributions from experiences and conditions representing processes of privilege and oppression.DESIGN: Participants (N=25,585) came from the cross-sectional 'Health on Equal Terms' survey covering 16- to 84-year-olds in the four northernmost counties of Sweden. Six intersectional positions were constructed from gender (woman vs. men) and tertiles (low vs. medium vs. high) of disposable income. Mental health was measured through the General Health Questionnaire-12. Explanatory variables covered areas of material conditions, job relations, violence, domestic burden, and healthcare contacts. Analysis of variance (Aim 1) and Blinder-Oaxaca decomposition analysis (Aim 2) were used.RESULTS: Significant mental health inequalities were found between dominant (high-income women and middle-income men) and subordinate (middle-income women and low-income men) middle groups. The health inequalities between adjacent middle groups were mostly explained by violence (mid-income women vs. men comparison); material conditions (mid- vs. low-income men comparison); and material needs, job relations, and unmet medical needs (high- vs. mid-income women comparison).CONCLUSIONS: The study suggests complex processes whereby dominant middle groups in the intersectional space of economic affluence and gender can leverage strategic resources to gain mental health advantage relative to subordinate middle groups.
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| 6. |
- Mayer Labba, Cecilia, 1987, et al.
(author)
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Isolation, identification, and selection of strains as candidate probiotics and starters for fermentation of Swedish legumes
- 2020
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In: Food and Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 64, s. 4410-13
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Journal article (peer-reviewed)abstract
- Background : The non-dairy sector is growing, fermented alternatives to dairy are sparse. Adapted starter cultures to substituting raw materials needs to be developed. Objective : Aims of this study were to isolate, identify, and phenotypically characterize lactic acid bacteria (LAB) that inhabit Swedish legumes, and assess properties necessary for selecting strains with the ability to ferment a bean beverage and with potential health beneficial properties. Design : Isolates of presumed LAB were obtained from legumes collected at Öland, Sweden. Strain diversity was assessed by repetitive polymerase chain reaction (rep-PCR). The strains were identified using matrix- assisted laser desorption/ionization–time-of-flight mass spectrometry (MALDI-TOF MS). Species belonging to Enterococcus were predominant along with Pediococcus and closely related Bacillus. Strains were tested for tolerance to low pH, phenol, and bile as well as their bile salt hydrolase (BSH) activity. In addition, Enterococcus strains were tested for antibiotic resistance, and Pediococcus strains for their ability to ferment a bean beverage. Results : From the 25 strains char acterized, five were found resistant to low pH, bile, and phenol, suggesting that they can survive a passage through the gastrointestinal tract (GIT) and hence potentially exert beneficial effects in the host. These are suggested for further investigation on specific host-beneficial properties. Two of these, belonging to Pediococ cus pentosaceus, were able to ferment a bean beverage without any added nutrients, indicating that the Pediococcus strains are well adapted to the bean substrate. One of the P. pentosaceus strains were also able to markedly improve the reduction of phytate by the phytase-producing yeast strain Pichia kudriavzevii TY1322 during co-fermentation as well as increase the final cell count of the yeast strain. Conclusion : Strain isolation and characterization performed in this study aids in selecting starter cultures for legume fermentation. Nutritional properties can be improved by co-fermentation with yeast indicating that novel nutritious fermented non-dairy products could be developed.
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| 7. |
- Ompad, Danielle C., et al.
(author)
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The effectiveness of malaria camps as part of the Durgama Anchalare Malaria Nirakaran (DAMaN) program in Odisha, India: study protocol for a cluster-assigned quasi-experimental study
- 2021
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In: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 14:1
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Journal article (peer-reviewed)abstract
- The Indian state of Odisha has a longstanding battle with forest malaria. Many remote and rural villages have poor access to health care, a problem that is exacerbated during the rainy season when malaria transmission is at its peak. Approximately 62% of the rural population consists of tribal groups who are among the communities most negatively impacted by malaria. To address the persistently high rates of malaria in these remote regions, the Odisha State Malaria Control Program introduced ‘malaria camps’ in 2017 where teams of health workers visit villages to educate the population, enhance vector control methods, and perform village-wide screening and treatment. Malaria rates declined statewide, particularly in forested areas, following the introduction of the malaria camps, but the impact of the intervention is yet to be externally evaluated. This study protocol describes a cluster-assigned quasi-experimental stepped-wedge study with a pretest-posttest control group design that evaluates if malaria camps reduce the prevalence of malaria, compared to control villages which receive the usual malaria control interventions (e.g. IRS, ITNs), as detected by PCR.
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| 8. |
- Wilder-Smith, Annelies, et al.
(author)
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Novel tools for the surveillance and control of dengue : findings by the dengueTools research consortium
- 2018
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In: Global Health Action. - : TAYLOR & FRANCIS LTD. - 1654-9716 .- 1654-9880. ; 11:1
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Research review (peer-reviewed)abstract
- Background: Dengue fever persists as a major global disease burden, and may increase as a consequence of climate change. Along with other measures, research actions to improve diagnosis, surveillance, prevention, and predictive models are highly relevant. The European Commission funded the DengueTools consortium to lead a major initiative in these areas, and this review synthesises the outputs and findings of this work conducted from 2011 to 2016. Research areas: DengueTools organised its work into three research areas, namely [1] Early warning and surveillance systems; [2] Strategies to prevent dengue in children; and [3] Predictive models for the global spread of dengue. Research area 1 focused on case-studies undertaken in Sri Lanka, including developing laboratory-based sentinel surveillance, evaluating economic impact, identifying drivers of transmission intensity, evaluating outbreak prediction capacity and developing diagnostic capacity. Research area 2 addressed preventing dengue transmission in school children, with case-studies undertaken in Thailand. Insecticide-treated school uniforms represented an intriguing potential approach, with some encouraging results, but which were overshadowed by a lack of persistence of insecticide on the uniforms with repeated washing. Research area 3 evaluated potential global spread of dengue, particularly into dengue-naive areas such as Europe. The role of international travel, changing boundaries of vectors, developing models of vectorial capacity under different climate change scenarios and strategies for vector control in outbreaks was all evaluated. Concluding remarks: DengueTools was able to make significant advances in methods for understanding and controlling dengue transmission in a range of settings. These will have implications for public health agendas to counteract dengue, including vaccination programmes. Outlook: Towards the end of the DengueTools project, Zika virus emerged as an unexpected epidemic in the central and southern America. Given the similarities between the dengue and Zika viruses, with vectors in common, some of the DengueTools thinking translated readily into the Zika situation.
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| 9. |
- Wilder-Smith, Annelies, et al.
(author)
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ZikaPLAN : addressing the knowledge gaps and working towards a research preparedness network in the Americas
- 2019
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In: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 12:1
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Journal article (peer-reviewed)abstract
- Zika Preparedness Latin American Network (ZikaPLAN) is a research consortium funded by the European Commission to address the research gaps in combating Zika and to establish a sustainable network with research capacity building in the Americas. Here we present a report on ZikaPLAN`s mid-term achievements since its initiation in October 2016 to June 2019, illustrating the research objectives of the 15 work packages ranging from virology, diagnostics, entomology and vector control, modelling to clinical cohort studies in pregnant women and neonates, as well as studies on the neurological complications of Zika infections in adolescents and adults. For example, the Neuroviruses Emerging in the Americas Study (NEAS) has set up more than 10 clinical sites in Colombia. Through the Butantan Phase 3 dengue vaccine trial, we have access to samples of 17,000 subjects in 14 different geographic locations in Brazil. To address the lack of access to clinical samples for diagnostic evaluation, ZikaPLAN set up a network of quality sites with access to well-characterized clinical specimens and capacity for independent evaluations. The International Committee for Congenital Anomaly Surveillance Tools was formed with global representation from regional networks conducting birth defects surveillance. We have collated a comprehensive inventory of resources and tools for birth defects surveillance, and developed an App for low resource regions facilitating the coding and description of all major externally visible congenital anomalies including congenital Zika syndrome. Research Capacity Network (REDe) is a shared and open resource centre where researchers and health workers can access tools, resources and support, enabling better and more research in the region. Addressing the gap in research capacity in LMICs is pivotal in ensuring broad-based systems to be prepared for the next outbreak. Our shared and open research space through REDe will be used to maximize the transfer of research into practice by summarizing the research output and by hosting the tools, resources, guidance and recommendations generated by these studies. Leveraging on the research from this consortium, we are working towards a research preparedness network.
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