Global Public Health最新文献

The world is facing a tremendous problem in the form of food insecurity that is posing a great challenge to achieving sustainable development goal 2 of creating a hunger-free world. Refugees and displaced populations are particularly vulnerable to food insecurity and malnutrition, who lack any productive assets and depend on aid. Rohingya refugees, displaced from Myanmar and took refuge in Cox's Bazar, Bangladesh, live in a crowded unhealthy environment and are severely vulnerable to food insecurity and malnutrition. In our recent study, we found that only 21.6% of the households in Rohingya refugee camps had acceptable food security status. Interestingly, this study further revealed that acceptable food security status was significantly higher among the households that had some additional income aside from aid, compared to those relying on aid alone. This shows the importance of promoting livelihood opportunities to improve food security status among the camp dwellers. In this paper, we presented our views on promoting livelihood opportunities to address the overwhelming food insecurity crisis among the Rohingya refugees in Bangladesh.

Women from low- and middle-income countries face challenges in accessing and utilising quality healthcare. Technologies can aid in overcoming these challenges and the present scoping review is aimed at summarising the range of technologies used by women and assessing their role in enabling Indian women to learn about and access healthcare services. We conducted a comprehensive search from the date of inception of database till 2022 in PubMed and Google Scholar. Data was extracted from 43 studies and were thematically analysed. The range of technologies used by Indian women included integrated voice response system, short message services, audio-visual aids, telephone calls and mobile applications operated by health workers. Majority of the studies were community-based (79.1%), from five states (60.5%), done in rural settings (58.1%) and with interventional design (48.8%). Maternal and child health has been the major focus of studies, with lesser representation in domains of non-communicable and communicable diseases. The review also summarised barriers related to using technology - from health system and participant perspective. Technology-based interventions are enabling women to improve awareness about and accessibility to healthcare in India. Imparting digital literacy and scaling up technology use are potential solutions to scale-up healthcare access among women in India.

Within global health and development, dissatisfaction with nongovernmental organisations' effectiveness (NGOs) is an increasingly pervasive aspect of programming. Today, the international community no longer accepts that NGOs are doing what they claim. This change in expectations has emphasised the importance of measuring organisational effectiveness for improved health and development impact. Using New Institutionalism as a theoretical framework, we investigated how institutional norms and expectations influence the adoption of structures and processes by NGOs, and Early Childhood Development (ECD) programming effectiveness in Rwanda - since little research connects these concepts. We employed qualitative methods: 45 in-depth interviews and 6 focus group discussions. Findings revealed a misalignment of 'organizational effectiveness' across scales, from global to local. Findings stress that, effectiveness, though an expectation of the institutional environment, may not be a valid construct for NGOs, generating implications for ECD programming. Findings also indicate measurement of global health interventions generally and the notion of effectiveness specifically can yield adverse implications for ECD programming. These findings are relevant for researchers and practitioners trying to better understand organisational effectiveness for ECD programmes because they suggest that effectiveness is socially constructed and measured differently across the different scales.

The UN's Zero Tolerance Policy, which bans all relationships between UN staff and locals, portrays all relationships as exploitative, fails to account for nuances in these relationships and does not acknowledge the agency of local women or communities. This study uses community-based qualitative data from eastern DRC that shares narratives on a wide variety of consensual relationships between peacekeepers and local women. Our paper uses a data-driven approach, including a post-colonial feminist lens, and ideas of structural agency to provide an expanded definition of agency that invites readers to re-examine their views of women in conflict settings. Finally, we provide clear recommendations for the UN and other international non-governmental agencies on policies related to sexual exploitation and abuse.

Certification is an essential stage in disease eradication efforts, encompassing epidemiological, managerial, and political complexities. The certification of smallpox eradication in the People's Republic of China (PRC, or China) exemplifies the multifaceted nature of the certification. Despite eradicating smallpox in the early 1960s, before the Global Smallpox Eradication Programme (SEP) intensified in 1967, China was one of the last countries certified as smallpox-free by the World Health Organization (WHO) in 1979. The WHO encountered notable resistance during the certification of smallpox eradication in China. This article examines the underlying motivations propelling China's resistance, the factors that contributed to the shifts in its stance, the challenges navigated by the WHO, and the ultimate achievement of certification despite controversies surrounding its transparency and credibility. Through the case of the certification of smallpox eradication, the article provides a historical context of China's selective engagement in global health governance, emphasising the critical importance of building a trusting relationship between the WHO and its member states. It offers insights for fostering effective collaboration among diverse stakeholders driven by varied political agendas in addressing shared global health challenges such as the coronavirus disease (COVID-19) pandemic.

Background: Due to the different factors affecting the maintenance of a constant supply of human blood in health facilities, this study aimed at exploring the knowledge, perceptions, and practices towards blood donation among under graduate medical students at Busitema University Faculty of Health Sciences (BUFHS).

Methods: Using a convergent parallel mixed methods study design, 384 students were recruited into the study. Questionnaires and focused group discussions were used to collect the data. Stata version 15.0 and thematic analysis were used to analyze quantitative and qualitative data respectively.

Results: Of the respondents, 151 (39.4%) had ever donated blood and 50.4% had good knowledge about blood donation. The commonest motivating factor towards blood donation was "to save someone's life". Factors associated with practices towards blood donation included: religion, year 2 of study and prior blood donation history. Being Jehovah's Witness reduced the willingness to donate blood by 88% compared to other religions. Thematic analysis revealed four themes namely; students' experiences and thoughts, driving forces to donate blood, fears and misconceptions, and suggestions to increase blood donors.

Conclusion: The proportion of undergraduate medical students who had adequate level of knowledge about blood donation was moderately high, however, some of their perceptions towards it were unconventional. To ensure safe and adequate blood supply, design of strategies and tailored programs that promote blood donation is highly recommended..

Young people in Colombia present high rates of mental health problems, to which the country's history of armed internal conflict contributes in complex ways. Mental health services in Colombia are fragmented, inadequate, and difficult to access for many. Young people's help-seeking is often hindered by mental health stigma and/or poor experiences with services. This paper presents a thematic analysis of qualitative data from a mixed-methods study aimed at developing and testing a mental health intervention for Colombian youths. We draw upon theoretical lenses from scholarly work on stigma and Sen's 'capabilities approach' to inform our analysis of interviews and group discussions with staff and young people involved in the state-funded human capital building programme 'Jovenes en Acción' (JeA). By illustrating how study participants talked about stigma, vulnerability, mental health services organisation, and the challenges of discussing mental health topics in a learning environment, we illuminate aspects of mental health support and anti-stigma interventions that might need enhancing. In particular, we suggest that more emphasis on 'community competencies' as complementary to and interrelated with individual competencies would strengthen young people's individual and collective resources for mental wellbeing while being in line with the sociocritical principles of existing human capital-enhancing programmes.

Integration has emerged as a key strategy for promoting equitable access to health services for refugees and host populations. This study explored the perceptions and experiences of stakeholders on the integration of health services for refugees and host populations in two purposefully selected refugee-hosting districts of Adjumani and Obongi in the West Nile region, Uganda. This study used a case study design. Key informant interviews were conducted with 28 purposefully selected respondents. Data were analysed thematically. Quirkos software was used to manage and analyse data. Respondents indicated that integration is enhancing health services, providing an opportunity to strengthen them and improve coverage and access for refugees and host populations. Factors affecting integration include gaps in policy and implementation, ineffective systems and structures for service delivery, inadequate coordination and management and inadequate funding. At the service level challenges including inadequate infrastructure, shortage of health workers and stock out of medicines and essential supplies affect the integration of health services. Overall, structural and systemic issues continue to affect the integration of health services. It is important to strengthen policy implementation and build the capacity of districts to support the integration of health services.

Global health photography has historically been commissioned and, therefore, dominated by the gaze of Western photographers on assignments in the Global South. This is changing as part of international calls to decolonise global health and stimulate 'empowerment', spawning a growing initiative to hire local photographers. This article, based on interviews with global health photographers, reflects on this paradigm shift. It highlights how behind the laudable aim of 'empowerment' of local global health photography there is a simultaneous exploitation of precarious photographer labour and the emergence of 'glocal' photography elites. The paper argues that empowerment of local photographers can become a euphemism for reducing image production costs and maintaining control over the image content, while extending the scope of mainstream global health visual culture without challenging it. Finally, the article amplifies the growing concern that uncritical engagement with institutionalised empowerment becomes a warrant for the reproduction of local inequalities behind the fashionable façade of cooperation and care.

Self-care interventions for sexual and reproductive health (SRH) empower individuals to autonomously access services, reducing their reliance on traditional healthcare settings. However, there is limited knowledge about community pharmacy-based SRH services in Rwanda. Therefore, this study aims to explore the experiences of community pharmacy-based SRH users and inform strategies to enhance service delivery effectiveness. This study employed a qualitative research approach employing a phenomenological design. Semi-structured in-depth interviews were conducted with 22 participants from 1st June 2023 to 20th March 2024, in 5 Districts of Rwanda. Participants were recruited using purposive sampling methods. The interviews were recorded, transcribed, and imported into NVivo 11 software for further analysis. Users of pharmacy-based SRH products intended for self-care interventions reported positive experiences. Three main themes emerged from the interviews: community pharmacies ensured the utmost confidentiality, provided fast service delivery with minimal procedures, and expressed user satisfaction with friendly communication. Users of community pharmacy-based SRH services intended for self-care use reported positive experiences with community pharmacies. They received the needed confidentiality, faster service delivery, and friendly communication with community pharmacists. There is a pressing need for close collaboration among the public, private, and stakeholders to empower citizens over their SRH.