scholarly journals Maternity health care: The experiences of Sub-Saharan African women in Sub-Saharan Africa and Australia

2017 ◽  
Vol 30 (4) ◽  
pp. 298-307 ◽  
Author(s):  
Hlengiwe Mohale ◽  
Linda Sweet ◽  
Kristen Graham
Keyword(s):  
Health Care ◽  
Sub Saharan Africa ◽  
African Women ◽  
Sub Saharan ◽  
Maternity Health ◽  
Maternity Health Care

scholarly journals SAT0640-HPR RHEUMATOLOGY CARE OF MIGRANTS FROM SUB-SAHARAN AFRICA; A QUALITATIVE PILOT STUDY OF PATIENTS’ PERSPECTIVES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1279.1-1279
Author(s):  
Z. Rutter-Locher ◽  
J. Galloway ◽  
H. Lempp
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Care ◽  
Health Care Providers ◽  
Unmet Need ◽  
Primary Care Providers ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Specialist Care ◽  
Sub Saharan ◽  
The Uk

Background:Rheumatological diseases are common in Sub-Saharan Africa [1] but specialist healthcare is limited and there are less than 150 rheumatologists currently serving 1 billion people in Sub-Saharan Africa [2]. Rheumatologists practising in the UK NHS are likely to be exposed to migrant patients. There is therefore, an unmet need for health care providers to understand the differences in rheumatology healthcare provision between Sub-Saharan Africa and the UK and the barriers which migrants face in their transition of rheumatology care.Objectives:To gain an understanding of the experiences of patients with rheumatological conditions, about their past healthcare in Sub-Saharan Africa and their transition of care to the UK.Methods:A qualitative study using semi-structured interviews was conducted. Participants were recruited from two rheumatology outpatient clinics in London. Thematic analysis was applied to identify key themes.Results:Seven participants were recruited. Five had rheumatoid arthritis, one had ankylosing spondylitis and one had undifferentiated inflammatory arthritis. Participants described the significant impact their rheumatological conditions had on their physical and emotional wellbeing, including their social and financial implications. Compared to the UK, rheumatology healthcare in Sub-Saharan Africa was characterised by higher costs, limited access to specialists, lack of investigations and treatments, the use of traditional medicines and poor communication by clinicians. Barriers to transition of rheumatology care to the UK were: poor understanding of rheumatological conditions by the public and primary care providers, lack of understanding of NHS entitlements by migrants, fear of data sharing with immigration services and delayed referral to specialist care. Patient, doctor and public education were identified by participants as important ways to improve access to healthcare.Conclusion:This study has described, for the first time, patients’ perspectives of rheumatology health care in Sub-Saharan Africa and the transition of their care to the UK. These initial findings allow healthcare providers in the UK to tailor management for this migrant population and suggests that migrants need more information about their NHS entitlements and specific explanations on what non-clinical data will be shared with immigration services. To increase access to appropriate care, a concerted effort by clinicians and public health authorities is necessary to raise awareness and provide better education to patients and migrant populations about rheumatological conditions.References:[1]G. Mody, “Rheumatology in Africa-challenges and opportunities,” Arthritis Res. Ther., vol. 19, no. 1, p. 49, 2017.[2]M. A. M. Elagib et al., “Sudan and Sweden Active Rheumatoid Arthritis in Central Africa: A Comparative Study Between,” J. Rheumatol. J. Rheumatol. January, vol. 43, no. 10, pp. 1777–1786, 2016.Acknowledgments:We are grateful to the patients involved in this study for their time and involvement.Disclosure of Interests:None declared

scholarly journals Pregnancy and childbirth in Mozambique: men as decision makers and women as caretakers?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Galle ◽  
H Cossa ◽  
N Osman ◽  
K Roelens ◽  
S Griffin ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Hiv Prevention ◽  
Health Care Providers ◽  
Male Involvement ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Pregnancy And Childbirth ◽  
Policy Level ◽  
Sub Saharan

Abstract Background Increasing male involvement during pregnancy is considered an important, but often overlooked intervention for improving maternal health in sub-Saharan Africa. This study explores the attitudes and beliefs of health policymakers, health care providers and local communities regarding men's involvement in maternal health in southern Mozambique. Methods Ten key informant interviews with stakeholders were carried out to assess their attitudes and perspectives regarding male involvement in maternal health, followed by 10 days of semi structured observations in health care centers. Subsequently 16 focus group discussions were conducted in the community and at provider level, followed by three in depth couple interviews. Analysis was done by applying a socio-ecological systems theory in thematic analysis. Results Results show a lack of strategy at policy level to stimulate male involvement in maternal health. Invitation cards for men are used as an isolated intervention in health facilities but these have not lead to the expected success. Providers have a rather passive attitude towards male involvement initiatives and women accompanied by a husband are often put in a submissive position. In the community however, male attendance at ANC is considered important and men are willing to take a more participating role. Main barriers are the association of male attendance at ANC with being HIV infected and strong social norms and gender roles. On the one hand men are seen as caretakers of the family by providing money and making the decisions. On the other hand, men supporting their wife by showing interest in their health or sharing household tasks are seen as weak or as a manifestation of HIV seropositivity. Conclusions A clear strategy at policy level and a multi-level approach is needed. Gender-equitable relationships between men and women should be encouraged in all maternal health interventions and health programs should step away from linking male involvement to HIV prevention. Key messages Linking the promotion of gender equality to male involvement is the key for success. Step away from linking HIV prevention to male involvement in maternal health.

scholarly journals Exploring country-wide equitable government health care facility access in Uganda

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nicholas Dowhaniuk
Keyword(s):  
Health Care ◽  
Random Forest ◽  
Health Center ◽  
Travel Time ◽  
Health Centers ◽  
Sub Saharan Africa ◽  
Walking Distance ◽  
Laboratory System ◽  
Government Health ◽  
Sub Saharan

Abstract Background Rural access to health care remains a challenge in Sub-Saharan Africa due to urban bias, social determinants of health, and transportation-related barriers. Health systems in Sub-Saharan Africa often lack equity, leaving disproportionately less health center access for the poorest residents with the highest health care needs. Lack of health care equity in Sub-Saharan Africa has become of increasing concern as countries enter a period of simultaneous high infectious and non-communicable disease burdens, the second of which requires a robust primary care network due to a long continuum of care. Bicycle ownership has been proposed and promoted as one tool to reduce travel-related barriers to health-services among the poor. Methods An accessibility analysis was conducted to identify the proportion of Ugandans within one-hour travel time to government health centers using walking, bicycling, and driving scenarios. Statistically significant clusters of high and low travel time to health centers were calculated using spatial statistics. Random Forest analysis was used to explore the relationship between poverty, population density, health center access in minutes, and time saved in travel to health centers using a bicycle instead of walking. Linear Mixed-Effects Models were then used to validate the performance of the random forest models. Results The percentage of Ugandans within a one-hour walking distance of the nearest health center II is 71.73%, increasing to 90.57% through bicycles. Bicycles increased one-hour access to the nearest health center III from 53.05 to 80.57%, increasing access to the tiered integrated national laboratory system by 27.52 percentage points. Significant clusters of low health center access were associated with areas of high poverty and urbanicity. A strong direct relationship between travel time to health center and poverty exists at all health center levels. Strong disparities between urban and rural populations exist, with rural poor residents facing disproportionately long travel time to health center compared to wealthier urban residents. Conclusions The results of this study highlight how the most vulnerable Ugandans, who are the least likely to afford transportation, experience the highest prohibitive travel distances to health centers. Bicycles appear to be a “pro-poor” tool to increase health access equity.

Women in Gabon

2021 ◽  
Author(s):  
Claire H. Griffiths
Keyword(s):  
Central Africa ◽  
Early Period ◽  
Sub Saharan Africa ◽  
African Women ◽  
Female Population ◽  
History Of ◽  
Sub Saharan ◽  
Tropical Woods ◽  
New Research ◽  
Export Revenue

Gabon, a small oil-rich country straddling the equator on the west coast of Africa, is the wealthiest of France’s former colonies. An early period of colonization in the 19th century resulted in disease, famine, and economic failure. The creation of French Equatorial Africa in 1910 marked the beginning of the sustained lucrative exploitation of Gabon’s natural resources. Gabon began off-shore oil production while still a colony of France. Uranium was also discovered in the last decade of the French Equatorial African empire. Coupled with rich reserves in tropical woods, Gabon has achieved, since independence in 1960, a higher level of export revenue per capita of population than any other country in sub-Saharan Africa in the postcolonial era. However, significant inequality has characterized access to wealth through paid employment throughout the recorded history of monetized labor. While fortunes have been amassed by a minute proportion of the female population of Gabon associated with the ruling regime, and a professional female middle-class has emerged, inequalities of opportunity and reward continue to mark women’s experience of life in this little-known country of West Central Africa. The key challenge facing scholars researching the history of women in Gabon remains the relative lack of historical resources. While significant strides have been made over the past decade, research on women’s history in Francophone Africa published in English or French remains embryonic. French research on African women began to make a mark in the last decade of colonization, notably with the work of Denise Paulme, but then remained a neglected area for decades. The publication in 1994 of Les Africaines by French historian Catherine Coquery-Vidrovitch was hailed at the time as a pioneering work in French historiography. But even this new research contained no analysis of and only a passing reference to women in Gabon.

scholarly journals Hiv-associated lipodystrophy and exercise

2006 ◽  
Vol 62 (2) ◽  
Author(s):  
E. Mutimura ◽  
A. Stewart ◽  
N. J. Crowther
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Sub Saharan Africa ◽  
Sufficient Evidence ◽  
Metabolic Dysfunction ◽  
Exercise Participation ◽  
Need To Evaluate ◽  
Sub Saharan ◽  
Hiv Lipodystrophy ◽  
Hiv Aids

As individuals affected by HIV/AIDS live longer due to the availability of HAART, the challenge to health care professionals is to manage and alleviate abnormalities associated with HAART. HIVlipodystrophy- altered body fat redistribution- is the most common stigmatising physical abnormality related to the use of HAART, which maybe alleviated by exercise participation. Currently, there is no reliable management standard care for HIV-associated lipodystrophy. However, there is sufficient evidence to support the benefits of exercise in adults with HIV infection. As various types of ARTs become available in the most HIV/AIDS stricken developing countries, there are inadequate studies to evaluate and promote exercise in alleviating HIV lipodystrophy and other related complications. The current paper reviews HIV-related lipodystrophy, related metabolic dysfunction, and the role of exercise in its management. The paper highlights the need to evaluate the effectiveness of exercise on HIV lipodystrophy syndrome. An emphasis needs to be put on raising awareness among health care professionals in Sub-Saharan Africa where the prevalence of HIV/AIDS is the  highest in the world.

scholarly journals Health system challenges affecting falls prevention in persons living with HIV: perspectives from physiotherapists in four sub-Saharan regions

2021 ◽  
Vol 22 ◽  
Author(s):  
Maria Y. Charumbira ◽  
Karina Berner ◽  
Quinette A. Louw
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health System ◽  
Fall Prevention ◽  
Falls Prevention ◽  
Sub Saharan Africa ◽  
Prevention Services ◽  
Persons Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv

Abstract Aim: The aim of this study was to explore the perspectives of physiotherapists in four selected regions of sub-Saharan Africa regarding health system challenges impacting the integration of physiotherapy-led falls prevention services in the primary care of persons living with HIV (PLWH). Background: Falls may pose a significant problem among younger PLWH in low- and middle-income countries. Physiotherapists’ role in optimising function and quality of life can do much in the prevention of falls in PLWH and reducing the harm that results. However, falls prevention strategies have not been implemented effectively especially in primary health care settings in sub-Saharan Africa. Physiotherapists’ account of the health system challenges they encounter may provide insights into potential strategies that may be considered in optimising fall prevention for PLWH in poorly resourced settings. Methods: A descriptive qualitative study was conducted in selected urban districts in the capital cities of four sub-Saharan African countries. In-depth interviews were conducted with 21 purposively selected physiotherapists involved in the primary care of PLWH. Audio recordings of interviews were transcribed verbatim and analysed using deductive thematic content analysis. Findings: The main results are presented in the theme ‘Health care system challenges’ and in nine categories informed by the WHO health system framework: lack of policies and clinical practice guidelines, shortage/Inaccessible falls prevention services, inadequate human resource, physiotherapists not adequately equipped in falls prevention, inaccessible/No facilities for BMD measurement, inefficient data capturing systems, lack of evidence regarding falls among PLWH, unclear physiotherapy role descriptions, inefficient referral system. Physiotherapists highlighted the need for more information and research regarding fall prevention for PLWH, promote their role in the primary care of PLWH and adopt a patient-centred approach to fall prevention.

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