1. |
- Lazarus, Jeffrey V., et al.
(author)
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A multinational Delphi consensus to end the COVID-19 public health threat
- 2022
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In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687.
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Journal article (peer-reviewed)abstract
- Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.
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2. |
- Ahnquist, Johanna, et al.
(author)
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Economic hardships in adulthood and mental health in Sweden. the Swedish National Public Health Survey 2009
- 2011
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In: BMC Public Health. - : BMC. - 1471-2458. ; 11
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Journal article (peer-reviewed)abstract
- Background: Possible accumulative effects of a combined economic hardship's measure, including both income and non-income related economic hardships measures, on mental health has not been well investigated. The aim of this paper was to investigate; (i) independent associations between multiple measures of economic hardships and mental health problems, and (ii) associations between a combined economic hardships measure and mental health problems. Methods: We analysed data from the 2009 Swedish National Survey of Public Health comprising a randomly selected representative national sample combined with a randomly selected supplementary sample from four county councils and three municipalities consisting of 23,153 men and 28,261 women aged 16-84 years. Mental health problems included; psychological distress (GHQ-12), severe anxiety and use of antidepressant medication. Economic hardship was measured by a combined economic hardships measure including low household income, inability to meet expenses and lacking cash reserves. Results: The results from multivariate adjusted (age, country of birth, educational level, occupational status, employment status, family status and long term illness) logistic regression analysis indicate that self-reported current economic difficulties (inability to pay for ordinary bills and lack of cash reserves), were significantly associated with both women's and men's mental health problems (all indicators), while low income was not. In addition, we found a statistically significant graded association between mental health problems and levels of economic hardships. Conclusions: The findings indicate that indicators of self-reported current economic difficulties seem to be more strongly associated with poor mental health outcomes than the more conventional measure low income. Furthermore, the likelihood of mental health problems differed significantly in a graded fashion in relation to levels of economic hardships.
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3. |
- Ahnquist, Johanna, et al.
(author)
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Social determinants of health - A question of social or economic capital? Interaction effects of socioeconomic factors on health outcomes
- 2012
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In: Social Science and Medicine. - : Elsevier BV. - 1873-5347 .- 0277-9536. ; 74:6, s. 930-939
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Journal article (peer-reviewed)abstract
- Social structures and socioeconomic patterns are the major determinants of population health. However, very few previous studies have simultaneously analysed the "social" and the "economic" indicators when addressing social determinants of health. We focus on the relevance of economic and social capital as health determinants by analysing various indicators. The aim of this paper was to analyse independent associations, and interactions, of lack of economic capital (economic hardships) and social capital (social participation, interpersonal and political/institutional trust) on various health outcomes. Data was derived from the 2009 Swedish National Survey of Public Health, based on a randomly selected representative sample of 23,153 men and 28,261 women aged 16-84 year, with a participation rate of 53.8%. Economic hardships were measured by a combined economic hardships measure including low household income, inability to meet expenses and lacking cash reserves. Social capital was measured by social participation, interpersonal (horizontal) trust and political (vertical/institutional trust) trust in parliament. Health outcomes included; (i) self-rated health, (i) psychological distress (GHQ-12) and (iii) musculoskeletal disorders. Results from multivariate logistic regression show that both measures of economic capital and low social capital were significantly associated with poor health status, with only a few exceptions. Significant interactive effects measured as synergy index were observed between economic hardships and all various types of social capital. The synergy indices ranged from 1.4 to 2.3. The present study adds to the evidence that both economic hardships and social capital contribute to a range of different health outcomes. Furthermore, when combined they potentiate the risk of poor health. (C) 2012 Elsevier Ltd. All rights reserved.
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4. |
- Ahnquist, Johanna, et al.
(author)
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What has trust in the health-care system got to do with psychological distress? Analyses from the national Swedish survey of public health
- 2010
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In: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1464-3677 .- 1353-4505. ; 22:4, s. 250-258
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Journal article (peer-reviewed)abstract
- Mental health disorders are a rapidly growing public health problem. Despite the fact that lack of trust in the health-care system is considered to be an important determinant of health, there is scarcity of empirical evidence demonstrating its associations with health outcomes. This is the first study which aims to evaluate the association between trust in the health-care system and psychological distress. Cross-sectional study. The association between trust in the health-care system and psychological distress was analysed with multiple logistic regression analysis adjusting for other factors. A randomly selected representative sample of women and men aged 16-84 years from the Swedish population who responded to the 2006 Swedish National Survey of Public Health. A total of 26 305 men and 30 584 women participated in the study. None. The main outcome measure was psychological distress measured by the General Health Questionnaire. Very low trust in health-care services was associated with an increased risk for psychological distress among men (odds ratio = 1.59, 95% confidence intervals 1.25-2.02) and among women (odds ratio = 1.83, 95% confidence intervals 1.47-2.27) after controlling for age, country of birth, socioeconomic circumstances, long-term illness and interpersonal trust. Our results suggest that health-care system mistrust is associated with an increased likelihood of psychological distress. Although causal relationships cannot be established, patient mistrust of health-care providers may have detrimental implications on health. Public health policies should include strategies aimed at increasing access to health-care services, where trust plays a substantial role.
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5. |
- Akhavan, Sharareh, 1963-, et al.
(author)
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Health in relation to unemployment and sick leave among immigrants in Sweden from a gender perspective
- 2004
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In: Journal of Immigrant Health. ; 6:3, s. 103-118
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Journal article (peer-reviewed)abstract
- The purpose of this study was to analyze health in relation to unemployment and sick leave among immigrants from a gender perspective. Questionnaire, observations, and group discussions were used for data collection. The study group consisted of 60 unemployed persons with immigrant or refugee background, 30 women and 30 men. Slightly more than half of the participants considered theirhealth to be poor and experienced physical and/or mental disorders. The female participants in comparison to male participants experienced poorer health. The results show that there is a reciprocal influence between health, work, and migration. Immigration may cause poor health, which as a selection effect leads to unemployment and/or sick leave. Immigration may also bring about an inferior position in the labor market, which leads to poor health due to exposure effects. The influence on health is more marked for immigrant women than for immigrant men.
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6. |
- Akhavan, Sharareh, 1963-, et al.
(author)
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The health of female Iranian immigrants in Sweden : A qualitative six-year follow-up study
- 2007
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In: Health Care for Women International. - : Informa UK Limited. - 0739-9332 .- 1096-4665. ; 28:4, s. 339-359
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Journal article (peer-reviewed)abstract
- Immigration affects life and health in many different ways. The purpose of this study was to identify and analyze female Iranian immigrants' perception of various factors that influence their health over time. Data collection was based on semistructured interviews with 10 female Iranianimmigrants. Baseline interviews were conducted in 1996, with follow-up interviews in 2002. The results suggest that during the first decade after migration, female immigrants may overcome some health-related factors such as experiences of traumatic events. Other health determinants such as unemployment or experiences of discrimination and racism, however, were observed even two decades after migration.
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7. |
- Akhavan, Sharareh, 1963-, et al.
(author)
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Work-related health factors among female immigrants in Sweden
- 2007
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In: Work. - 1051-9815 .- 1875-9270. ; 28:2, s. 135-144
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Journal article (peer-reviewed)abstract
- Work-related health has been a focus of research since the rate of sickness-related absences began to increase in Sweden. The incidence of sickness-related absences and early retirement is higher among female immigrants than among others in the total population. This study is based on a questionnaire survey which was conducted in a municipality in Sweden. The study population consisted of 2 429 native and immigrant female employees. The aim was to study work-related health factors for female immigrants. The results of this study show that about 20% of female immigrants who participate in the survey have temporary employment while the proportion is 8% for native women. The perception of ethnic discrimination among female immigrants was three times as much as among native females. The results also show that 69% of female immigrants report having received no opportunity to discuss their wages with managers, in comparison to 63% of native females. About 40% of female immigrants and 35% of native women report that they do not get opportunities to upgrade their skills. Female immigrants over the age of 50 experience gender and ethnic discrimination and lack of access to skills training programs more often than younger immigrants. They also participate in health-care activities more often.
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8. |
- Akhavan, Sharareh, 1963-, et al.
(author)
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Work-related health factors among female immigrants in Sweden – A qualitative study on a sample of twenty workers.
- 2006
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In: Italian Journal of Public Health. - 1723-7807 .- 1723-7815. ; 3:1, s. 60-67
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Journal article (peer-reviewed)abstract
- Aims: The purpose of this study was to explore work-related health factors amongst female immigrants in Sweden.Methods: Qualitative methods were used in order to get the broadest possible picture of female immigrants’ perceptions on work-related health factors. Semi-structured interviews were conducted with twenty female immigrants who worked in different departments of a municipality adjacent to a large city in Sweden. Most of the interviewed women came from the Middle East, Africa and Latin America, while some came from eastern and southern Europe as well as Finland. The women had lived in Sweden for 5-27 years. Content analysis, which is based on analysis by topic, was used to analyse the data.Results: Results from the interviews show that female immigrants perceived that work-related health is strongly associated with class. The three aspects of class that arose from this study were wage, professional status and their position within the organisations hierarchy. Other factors that were identified as being associated to work-related health were discrimination due to ethnicity and gender, unfavourable physical and psychosocial work environment and lack of training opportunities for upgrading their skills.Conclusions: The public health implications of the findings in this study suggest that measures that ought to be taken to improve female immigrants working conditions and health are primarily systematic efforts to counteract discrimination because of gender and ethnicity in areas such as wage setting and opportunities for skill up-grade training. This should result in improved employment opportunities for female immigrants, particularly those who work in low status and low-paid jobs.
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9. |
- Ali, Sadiq Mohammad, et al.
(author)
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Gender differences in daily smoking prevalence in different age strata: A population-based study in southern Sweden.
- 2009
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 37:2, s. 146-152
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Journal article (peer-reviewed)abstract
- Objectives: To investigate gender differences in daily smoking prevalence in different age groups in southern Sweden. Methods: The 2004 public-health survey in Skåne is a cross-sectional study. A total of 27,757 persons aged 18-80 years answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate the associations between gender and daily smoking according to age. The multivariate analysis was performed to investigate the importance of possible confounders (country of origin, education, snus use, alcohol consumption, leisure-time physical activity, and BMI) on the gender differences in daily smoking in different age groups. Results: 14.9% of the men and 18.1% of the women were daily smokers. Middle-aged respondents were daily smokers to a significantly higher extent than young and old respondents. The prevalence of daily smoking also varied according to other demographic, socioeconomic, health related behaviour, and BMI characteristics. The crude odds ratios of daily smoking were 1.79 (1.42-2.26) among women compared to men in the 18-24 years age group, and 0.95 (0.80-1.12) in the 65-80 years age group. These odds ratios changed to 2.00 (1.49-2.67) and 0.95 (0.76-1.18), respectively, when all confounders were included. CONCLUSIONS: For the first time in Sweden women have a higher prevalence of daily smoking than men. The odds ratios of daily smoking are highest among women compared to men in the youngest age group of 18-24 years and the odds ratios decrease with increasing age. The findings point to a serious public health problem. Strategic interventions targeting young women's tobacco smoking are needed.
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10. |
- Bakeera, Solome K., et al.
(author)
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Community perceptions and factors influencing utilization of health services in Uganda
- 2009
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In: International Journal for Equity in Health. - : BIOMED CENTRAL LTD. - 1475-9276. ; 8
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Journal article (peer-reviewed)abstract
- Background: Healthcare utilization has particular relevance as a public health and development issue. Unlike material and human capital, there is little empirical evidence on the utility of social resources in overcoming barriers to healthcare utilization in a developing country context. We sought to assess the relevance of social resources in overcoming barriers to healthcare utilization. Study Objective: To explore community perceptions among three different wealth categories on factors influencing healthcare utilization in Eastern Uganda. Methods: We used a qualitative study design using Focus Group Discussions (FGD) to conduct the study. Community meetings were initially held to identify FGD participants in the different wealth categories, ('least poor', 'medium' and 'poorest') using poverty ranking based on ownership of assets and income sources. Nine FGDs from three homogenous wealth categories were conducted. Data from the FGDs was analyzed using content analysis revealing common barriers as well as facilitating factors for healthcare service utilization by wealth categories. The Health Access Livelihood Framework was used to examine and interpret the findings. Results: Barriers to healthcare utilization exist for all the wealth categories along three different axes including: the health seeking process; health services delivery; and the ownership of livelihood assets. Income source, transport ownership, and health literacy were reported as centrally useful in overcoming some barriers to healthcare utilization for the 'least poor' and 'poor' wealth categories. The 'poorest' wealth category was keen to utilize free public health services. Conversely, there are perceptions that public health facilities were perceived to offer low quality care with chronic gaps such as shortages of essential supplies. In addition to individual material resources and the availability of free public healthcare services, social resources are perceived as important in overcoming utilization barriers. However, there are indications that having access to social resources may compensate for the lack of material resources in relation to use of health care services mainly for the least poor wealth category. Conclusion: The differential patterning of social resources may explain or contribute to the persisting inequities in health care utilization. Additional research using quantitative analytical methods is needed to test the robustness of the contribution of social resources to the utilization of and access to healthcare services.
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11. |
- Deogan, Charlotte L., et al.
(author)
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A cost-effectiveness analysis of the Chlamydia Monday A community-based intervention to decrease the prevalence of chlamydia in Sweden
- 2010
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In: Scandinavian Journal of Public Health. - : SAGE PUBLICATIONS LTD. - 1403-4948 .- 1651-1905. ; 38:2, s. 141-150
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Journal article (peer-reviewed)abstract
- Aims: The study was undertaken to assess the cost-effectiveness of the Chlamydia Monday, 2007. This is a community-based intervention aimed at reducing the prevalence of chlamydia by information and increased availability of testing, treatment and contact tracing in Stockholm. The aim was to analyze the cost-effectiveness by estimating costs, savings and effects on health associated with the intervention, and to determine if cost-effectiveness varies between men and women. Methods: A societal perspective was adopted, meaning all significant costs and consequences were taken into consideration, regardless of who experienced them. A cost-effectiveness model was constructed including costs of the intervention, savings due to avoiding potential costs associated with medical sequels of chlamydia infection, and health gains measured as quality adjusted life years (QALY). Sensitivity analyses were done to explore model and result uncertainty. Results: Total costs were calculated to be (sic)66,787.21; total savings to (sic)30,370.14; and total health gains to 9.852324 QALYs (undiscounted figures). The discounted cost per QALY was (sic)8,346.05 ((sic)10,810.77/QALY for women and (sic)6,085.35/QALY for men). Sensitivity analyses included changes in effectiveness, variation of prevalence, reduced risk of sequel progression, inclusion of prevented future production loss and shortened duration for chronic conditions. The cost per QALY was consistently less than (sic)50,000, which is often regarded as cost-effective in a Swedish context. Conclusions: The Chlamydia Monday has been demonstrated by this study to be a cost-effective intervention and should be considered a wise use of society's resources.
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12. |
- Ehn, Maria, et al.
(author)
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Mobile Safety Alarms Based on GPS Technology in the Care of Older Adults : Systematic Review of Evidence Based on a General Evidence Framework for Digital Health Technologies.
- 2021
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In: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 23:10
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Journal article (peer-reviewed)abstract
- BACKGROUND: GPS alarms aim to support users in independent activities. Previous systematic reviews have reported a lack of clear evidence of the effectiveness of GPS alarms for the health and welfare of users and their families and for social care provision. As GPS devices are currently being implemented in social care, it is important to investigate whether the evidence of their clinical effectiveness remains insufficient. Standardized evidence frameworks have been developed to ensure that new technologies are clinically effective and offer economic value. The frameworks for analyzing existing evidence of the clinical effectiveness of GPS devices can be used to identify the risks associated with their implementation and demonstrate key aspects of successful piloting or implementation.OBJECTIVE: The principal aim of this study is to provide an up-to-date systematic review of evidence based on existing studies of the effects of GPS alarms on health, welfare, and social provision in the care of older adults compared with non-GPS-based standard care. In addition, the study findings were assessed by using the evidence standards framework for digital health technologies (DHTs) established by the National Institute for Health and Care Excellence (NICE) in the United Kingdom.METHODS: This review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Primary studies published in peer-reviewed journals and gray literature from January 2005 to August 2020 were identified through searches in 13 databases and several sources of gray literature. Included studies had individuals (aged ≥50 years) who were receiving social care for older adults or for persons with dementia; used GPS devices as an intervention; were performed in Canada, the United States, European Union, Singapore, Australia, New Zealand, Hong Kong, South Korea, or Japan; and addressed quantitative outcomes related to health, welfare, and social care. The study findings were analyzed by using the NICE framework requirements for active monitoring DHTs.RESULTS: Of the screened records, 1.6% (16/986) were included. Following the standards of the NICE framework, practice evidence was identified for the tier 1 categories Relevance to current pathways in health/social care system and Acceptability with users, and minimum evidence was identified for the tier 1 category Credibility with health, social care professionals. However, several evidence categories for tiers 1 and 2 could not be assessed, and no clear evidence demonstrating effectiveness could be identified. Thus, the evidence required for using DHTs to track patient location according to the NICE framework was insufficient.CONCLUSIONS: Evidence of the beneficial effects of GPS alarms on the health and welfare of older adults and social care provision remains insufficient. This review illustrated the application of the NICE framework in analyses of evidence, demonstrated successful piloting and acceptability with users of GPS devices, and identified implications for future research.
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13. |
- Eriksson, M, et al.
(author)
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Relationship between plasma fibrinogen and coronary heart disease in women
- 1999
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In: Arteriosclerosis, Thrombosis and Vascular Biology. - Karolinska Hosp, Dept Cardiol, S-10401 Stockholm, Sweden. Karolinska Hosp, Dept Clin Chem, S-10401 Stockholm, Sweden. Karolinska Inst, Natl Inst Psychosocial Factors & Hlth, Stockholm, Sweden. Deaconess Hosp, Inst Prevent Cardiovasc Dis, Boston, MA USA. : LIPPINCOTT WILLIAMS & WILKINS. - 1079-5642 .- 1524-4636. ; 19:1, s. 67-72
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Journal article (peer-reviewed)abstract
- Plasma fibrinogen is an independent risk factor for coronary heart disease (CHD) in men; however, its role in women is less clear. We examined the ability of plasma fibrinogen to predict CHD in a community-based, case-control study of women aged 65 years or younger living in the greater Stockholm area. Cases were all patients hospitalized for an acute coronary event between February 1991 and February 1994. Controls were randomly selected from the city census and were matched to cases by age and catchment area. Plasma fibrinogen was measured 3 to 6 months after hospitalization by using a fibrinogen assay based on fibrinogen polymerization time measurement. Of the 292 consecutive cases, 110 (37%) were hospitalized for an acute myocardial infarction and 182 (63%) for angina pectoris. The mean age+/-SD in both patients and controls was 56+/-7 years. Mean levels of plasma fibrinogen in patients and controls were 3.66+/-0.81 and 3.25+/-0.64 g/L (P<0.0001), respectively. The age-adjusted odds ratio (OR) for CHD in the highest versus the lowest quartile of plasma fibrinogen was 6.0 (95% confidence interval [CI], 3.5 to 10.4). After adjustment for age, cigarette smoking, body mass index, systolic blood pressure, total cholesterol, high density lipoprotein cholesterol, triglycerides, and educational level, the OR was 3.0 (95% CI, 1.6 to 5.5). Further adjustment for C-reactive protein yielded the same result. In both premenopausal and postmenopausal women, the multivariate adjusted ORs were 7.0 (95% CI, 1.8 to 28.3) and 2.1 (95% CI, 1.0 to 4.4), respectively. These results provide evidence that plasma fibrinogen is associated with an excess risk of CHD in women.
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14. |
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15. |
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16. |
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17. |
- Janszky, I., et al.
(author)
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Heart rate variability in long-term risk assessment in middle-aged women with coronary heart disease : The Stockholm Female Coronary Risk Study
- 2004
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In: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 255:1, s. 13-21
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Journal article (peer-reviewed)abstract
- Objectives. Low heart rate variability (HRV) is associated with poor prognosis after acute coronary events in men. In women, the prognostic impact is not well documented. The objective of this study was to assess the long-term predictive power of HRV on mortality amongst middle-aged women with coronary heart disease (CHD). Design, Settings and Subjects. Consecutive women below 65 years hospitalized for an acute coronary syndrome during a 3-year period in Stockholm were examined for cardiovascular prognostic factors including HRV, and followed for a median of 9 years. An ambulatory 24-h electrocardiograph was recorded during normal activities, 3-6 months after hospitalization. SDNN index (mean of the standard deviations of all normal to normal intervals for all 5-min segments of the entire recording) and the following frequency domain parameters were assessed: total power, high-frequency (HF) power, low-frequency (LF) power, very-low frequency (VLF) power and LF/HF ratio. Using Cox proportional hazards regression, the hazard ratios (HR) for each 25% decrease of the HRV parameters were assessed. Results. After controlling for the independent, significant predictors of mortality amongst the clinical variables, the following HRV parameters were found to be significant predictors of all-cause mortality: SDNN index [HR 1.56, 95% confidence intervals (CI) 1.19-2.05], total power (HR 1.21, 95% CI 1.08-1.35), VLF power (HR 1.22, 95% CI 1.09-1.36), LF power (HR 1.18 95%, CI 1.07-1.30) and HF power (HR 1.18, 95% CI 1.05-1.33). The results were essentially the same when cardiovascular mortality was used as end-points. The HRV parameters were stronger predictors of mortality in the first 5 years following the index event. Conclusion. Low HRV is a predictor of long-term mortality amongst middle-aged women with CHD when measured 3-6 months after hospitalization for an acute coronary syndrome, even after controlling for established clinical prognostic markers.
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18. |
- Kanyamurwa, J. M., et al.
(author)
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Differential returns from globalization to women smallholder coffee and food producers in rural Uganda
- 2013
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In: African Health Sciences. - : MAKERERE UNIV, FAC MED. - 1680-6905 .- 1729-0503. ; 13:3, s. 829-841
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Journal article (peer-reviewed)abstract
- Background: Globalization-related measures to liberalize trade and stimulate export production were applied in Uganda in the late 1980s, including in the coffee production sector, to revitalize agricultural production, increase incomes to farmers and improve rural food security. Objective: To explore the different effects of such measures on the health and dietary outcomes of female coffee and food small holder farmers in Uganda. Methods: We gathered evidence through a cross-sectional comparative interview survey of 190 female coffee producers and 191 female food producers in Ntungamo district. The study mostly employed quantitative methods of data collection, targeting the sampled households. We also utilized qualitative data; collected three months after the household survey data had been collected and their analysis had been accomplished. Using qualitative interviews based on an unstructured interview guide, extra qualitative information was collected from key informants at national, district and community levels. This was among other underlying principles to avoid relying on snapshot information earlier collected at household level in order to draw valid and compelling conclusions from the study. We used indicators of production, income, access to food and dietary patterns, women's health and health care. Of the two groups selected from the same area, female coffee producers represented a higher level of integration into liberalised export markets. Results: Document review suggests that, although Uganda's economy grew in the period, the household economic and social gains after the liberalization measures may have been less than expected. In the survey carried out, both food and coffee producers were similarly poor, involved in small-scale production, and of a similar age and education level. Coffee producers had greater land and livestock ownership, greater access to inputs and higher levels of income and used a wider variety of markets than food producers, but they had to work longer hours to obtain these economic returns, and spent more cash on health care and food from commercial sources. Their health outcomes were similar to those of the food producers, but with poorer dietary outcomes and greater food stress. Conclusions: The small-scale women farmers who are producing food cannot rely on the economic infrastructure to give them support for meaningful levels of production. However, despite having higher incomes than their food producing counterparts, the evidence showed that women who are producing coffee in Uganda as an export commodity cannot rely on the income from their crops to guarantee their health and nutritional wellbeing, and that the income advantage gained in coffee-producing households has not translated into consistently better health or food security outcomes. Both groups have limited levels of autonomy and control to address these problems.
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19. |
- Karim, K M Rabiul, et al.
(author)
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Gender and Women Development Initiatives in Bangladesh : A Study of Rural Mother Center
- 2016
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In: Journal of Health & Social Policy. - : Informa UK Limited. - 0897-7186 .- 1937-190X .- 1937-1918. ; 31:5, s. 369-386
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Journal article (peer-reviewed)abstract
- Women-focused development initiatives have become a controversial issue connected with women's health and welfare. Previous studies indicated that development initiatives might increase women's workload, family conflict, and marital violence. This study explored the gendered characteristics of a development initiative Rural Mother Center in Bangladesh. Data incorporated policy document and interviews of social workers working with the mother centers in two northwest subdistricts. The qualitative content analysis of data emerged a general theme of expanding women's responsibility while maintaining male privilege explaining gendered design and practice of the development initiative. The theme was supported by two gendered categories related to the design: (a) essentializing women's participation; (b) maintaining traditional gender, and four categories related to the practice; (c) inadequate gender knowledge and skills; (d) reinforcing traditional gender; (e) using women for improving office performance; and (f) upholding male privilege. The study suggests that though women-focused development initiatives need to be embraced with gender-redistributive policies, the social workers should be trained for attaining gender-transformative motivation and competencies.
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20. |
- Karim, KM Rabiul, et al.
(author)
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Water development projects and marital violence : experiences from rural Bangladesh
- 2012
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In: Health Care for Women International. - : Informa UK Limited. - 0739-9332 .- 1096-4665. ; 33:3, s. 200-216
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Journal article (peer-reviewed)abstract
- In this study, we explored the implications of a groundwater development project on women's workload and their experience of marital violence in a Bangladesh village. We believe that the project facilitated irrigation water but also that it resulted in seasonal domestic water shortages. Men used deep motorized pumps for irrigation, and women used shallow handpumps for domestic purposes. Many handpumps dried out, so women had to walk to distant wells. This increased their workload and challenged their possibilities of fulfilling household obligations, thereby increasing the risk of normative marital male violence against women as a punishment for their failure.
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21. |
- Karim, Rabiul, et al.
(author)
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Men's Perceptions of Women's Participation in Development Initiatives in Rural Bangladesh
- 2018
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In: American Journal of Men's Health. - : SAGE PUBLICATIONS INC. - 1557-9883 .- 1557-9891. ; 12:2, s. 398-410
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Journal article (peer-reviewed)abstract
- Without taking masculine issues into account, women's participation in development initiatives does not always guarantee their empowerment, health, and welfare in a male-dominated society. This study aimed to explore men's perceptions of women's participation in development (WPD) in rural Bangladesh. In adopting a qualitative approach, the study examined 48 purposively selected married and unmarried men aged 20-76 years in three northwest villages. Data collection was accomplished through four focus group discussions (FGDs) with 43 men clustered into four groups and through individual interviews with five other men. A qualitative content analysis of the data revealed an overall theme of feeling challenged by fears and hopes, indicating variations in men's views on women's participation in development initiatives as represented by three main categories: (a) fearing the loss of male authority, (b) recognizing women's roles in enhancing family welfare, and (c) valuing women's independence. In the context of dominant patriarchal traditions in Bangladesh, these findings provide new insight into dynamics and variations of men's views, suggesting a need to better engage men during different stages of women-focused development initiatives.
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22. |
- Karim, Rabiul, et al.
(author)
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Socioeconomic development initiatives and women’s experiences of marital violence in rural Bangladesh
- 2022
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In: International Social Work. - : SAGE Publications. - 0020-8728 .- 1461-7234. ; 65:5, s. 1000-1019
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Journal article (peer-reviewed)abstract
- Socioeconomic development initiatives (SDIs) have become a controversial issue. In giving skill trainings and credit supports, practitioners assume that SDI participation will enhance women’s income/dignity. Some studies have indicated that SDIs reduce women’s exposure to marital violence (MV), while others have shown that they increase spousal conflicts/MV. Our study explains how SDI participation may influence women’s marital life. This explorative study adopted a grounded theory design. Data included 17 participating-women’s interviews. It revealed that many women experienced further marital subordination, spousal conflicts, and MV. Yet women with strong motivation increased marital dignity/safety. Caring husbands facilitated this. If men can be involved in supporting women, impacts of SDIs will be substantial.
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23. |
- Kawachi, I., et al.
(author)
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Globalization and Health : Challenges and Prospects
- 2007
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In: Globalization and Health. - : Oxford University Press. - 9780199865659 - 9780195172997
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Book chapter (other academic/artistic)abstract
- This chapter begins with a brief description of the purpose of the book, which is to provide a survey of current and emerging global threats to health and to analyze the collective and institutional responses to globalization. It also addresses the role of key intergovernmental institutions (the World Bank, the IMF, the WTO, the World Health Organization (WHO), and the Group of Eight Nations (G8)) in protecting-or, some claim, threatening-the health of the global public. The chapter then discusses the concept of "globalization", and globalization through history. An overview of the subsequent chapters is presented.
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24. |
- Kawachi, I., et al.
(author)
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Poverty and Inequality in a Globalizing
- 2007
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In: Globalization and Health. - : Oxford University Press. - 9780199865659 - 9780195172997
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Book chapter (other academic/artistic)abstract
- This chapter describes trends in global poverty and inequality during the recent era of globalization. The first section reviews the evidence on global trends in poverty during the past two decades. The second section examines the evidence on trends in income inequality. The third section summarizes the current debates concerning whether the forces of globalization-in particular, increased trade and the closer integration of developing countries into the global economy-are responsible for the observed trends in poverty and inequality. The final section draws out some implications of globalization for the future of poverty and inequality in the world.
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25. |
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