scholarly journals Context matters in understanding the vulnerability of women: perspectives from southwestern Uganda

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Neema Murembe ◽  
Teddy Kyomuhangi ◽  
Kimberly Manalili ◽  
Florence Beinempaka ◽  
Primrose Nakazibwe ◽  
...  
Keyword(s):  
Health Workers ◽  
Geographical Location ◽  
Middle Income ◽  
Extreme Poverty ◽  
Economic Class ◽  
Individual Interviews ◽  
Resource Limited ◽  
The People ◽  
The Individual ◽  
Southwestern Uganda

Abstract Background Vulnerability at the individual, family, community or organization level affects access and utilization of health services, and is a key consideration for health equity. Several frameworks have been used to explore the concept of vulnerability and identified demographics including ethnicity, economic class, level of education, and geographical location. While the magnitude of vulnerable populations is not clearly documented and understood, specific indicators, such as extreme poverty, show that vulnerability among women is pervasive. Women in low and middle-income countries often do not control economic resources and are culturally disadvantaged, which exacerbates other vulnerabilities they experience. In this commentary, we explore the different understandings of vulnerability and the importance of engaging communities in defining vulnerability for research, as well as for programming and provision of maternal newborn and child health (MNCH) services. Methodology In a recent community-based qualitative study, we examined the healthcare utilization experiences of vulnerable women with MNCH services in rural southwestern Uganda. Focus group discussions were conducted with community leaders and community health workers in two districts of Southwestern Uganda. In addition, we did individual interviews with women living in extreme poverty and having other conventional vulnerability characteristics. Findings and discussion We found that the traditional criteria of vulnerability were insufficient to identify categories of vulnerable women to target in the context of MNCH programming and service provision in resource-limited settings. Through our engagement with communities and through the narratives of the people we interviewed, we obtained insight into how nuanced vulnerability can be, and how important it is to ground definitions of vulnerability within the specific context. We identified additional aspects of vulnerability through this study, including: women who suffer from alcoholism or have husbands with alcoholism, women with a history of home births, women that have given birth only to girls, and those living on fishing sites. Conclusion Engaging communities in defining vulnerability is critical for the effective design, implementation and monitoring of MNCH programs, as it ensures these services are reaching those who are most in need.

scholarly journals Cerai Lebe sebagai Inisiatif Lokal dalam Upaya Meminimalisir Praktek Perceraian Liar (Studi Kasus di Desa Cangkring Kabupaten Indramayu)

2020 ◽  
Vol 14 (1) ◽  
pp. 113-129
Author(s):  
Wardah Nuroniyah
Keyword(s):  
Social Action ◽  
Geographical Location ◽  
Legal Protection ◽  
Divorce Rate ◽  
Early Marriage ◽  
Cultural Conditions ◽  
The People ◽  
The Individual ◽  
The Village ◽  
Religious Courts

There are a lot of divorces conducted outside the court that occurs in Cangkring Village, Indramayu Regency. Uniquely in this village Lebe (a marriage registrar officer) became a facilitator in matters of divorce including in terms of handling administratively the data of divorced couples without submitting to the Religious Courts. Through a socio-juridical study, it is understandable as a choice for the community in resolving conflicts in marriages. There are many reasons for choosing divorce by Lebe, the individual reasons, such as the geographical location of the village that far from the court, economic factors, early marriage, low human resources, or local socio-cultural conditions that affect a person to do divorce through the Lebe. Based on the theory of social action by Talcott Parsons, the actors who chose divorce through Lebe are considered easier to achieve its goal of divorce. Divorce by Lebe in Cangkring village is intended to curb peace and legal protection for the people who have a very high divorce rate. The community was given convenience because the rules in divorce are not as complicated as the divorce process in the Religious Court, even though it is considered illegal.

scholarly journals Community Health Workers Can Provide Psychosocial Support to the People During COVID-19 and Beyond in Low- and Middle- Income Countries

2021 ◽  
Vol 9 ◽  
Author(s):  
Sabuj Kanti Mistry ◽  
Ben Harris-Roxas ◽  
Uday Narayan Yadav ◽  
Sadia Shabnam ◽  
Lal Bahadur Rawal ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Community Health ◽  
Community Health Workers ◽  
Health Systems ◽  
Health Workers ◽  
Psychosocial Support ◽  
Middle Income ◽  
Middle Income Countries ◽  
The People

The COVID-19 pandemic has been the most challenging public health issue which not only affected the physical health of the global population but also aggravated the mental health conditions such as stress, anxiety, fear, depression and anger. While mental health services are seriously hampered amid this COVID-19 pandemic, health services, particularly those of Low- and Middle- Income Countries (LMICs) are looking for alternatives to provide psychosocial support to the people amid this COVID-19 and beyond. Community Health Workers (CHWs) are an integral part of the health systems in many LMICs and played significant roles such as health education, contact tracing, isolation and mobilization during past emergencies and amid COVID-19 in many LMICs. However, despite their potentials in providing psychosocial support to the people amid this COVID-19 pandemic, they have been underutilized in most health systems in LMICs. The CHWs can be effectively engaged to provide psychosocial support at the community level. Engaging them can also be cost-saving as they are already in place and may cost less compared to other health professionals. However, they need training and supervision and their safety and security needs to be protected during this COVID-19. While many LMICs have mental health policies but their enactment is limited due to the fragility of health systems and limited health care resources. CHWs can contribute in this regard and help to address the psychosocial vulnerabilities of affected population in LMICs during COVID-19 and beyond.

scholarly journals Males in Enabling: Painting a portrait through narrative

2018 ◽  
Vol 9 (1) ◽  
pp. 9-22
Author(s):  
Frank Armstrong ◽  
Trixie James ◽  
Hermina Conradie ◽  
Shane Parker
Keyword(s):  
Qualitative Methodology ◽  
University Student ◽  
Male Students ◽  
Frames Of Reference ◽  
Individual Interviews ◽  
The People ◽  
Personal Experiences ◽  
Male Experience ◽  
The Individual ◽  
Number Of Males

The number of males entering higher education via an enabling pathway is slowly increasing; yet, males still battle with the anti-intellectual attitude that is prevalent in regional areas of Australia. Previous research undertaken by the authors began exploring the factors that inhibited or enhanced the male experience within an enabling course. This paper expands upon this research with a deeper focus on the male experience through personalised accounts derived from individual interviews. Using qualitative methodology and narrative inquiry, the findings provide a deeper understanding of the issues that males of different ages face when creating a new identity as a university student. This paper shares insights into what motivated the male students to enter university via an enabling pathway; the actual personal experiences both positive and negative during this time; and the effect that this commitment to study had on them personally and the people around them. The lens of transformative theory underpins this research through exploring frames of reference that align with the students’ experiences. Portraiture prose shares the individual stories which are analysed and the key findings extrapolated.

scholarly journals Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review

2021 ◽  
Vol 18 (11) ◽  
pp. 5796
Author(s):  
Damiano Pizzol ◽  
Mike Trott ◽  
Igor Grabovac ◽  
Mario Antunes ◽  
Anna Claudia Colangelo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Income ◽  
Health Workers ◽  
Open Appendectomy ◽  
Low Income Countries ◽  
Middle Income ◽  
Resource Limited ◽  
Stay Time ◽  
Operative Recovery ◽  
Operative Costs

Laparoscopy is a procedure that ultimately reduces hospital stay time and speeds up post-operative recovery. It is mainly performed in high-income countries but its implementation in many low- and middle-income countries (LMICs) is increasing. However, no aggregate data exist regarding the outcomes of this procedure in resource-limited settings. We retrospectively reviewed all cases of laparoscopy recorded from January 2007 to March 2017 at the Department of Surgery of Beira to assess the related outcomes. Moreover, we performed a systematic review of the laparoscopic practices and outcomes in low-income countries. Data from the Department of Surgery of Beira identified 363 laparoscopic procedures, mainly relating to gynecological diseases, cholelithiasis, and appendicectomy with only a 1.6% complication rate (6 cases) and a 1.9% conversion rate (7 cases) to open surgery. The systematic review showed a pooled risk of overall complications significantly lower in laparoscopic vs. open appendicectomy (OR = 0.43; 95% CI 0.19–0.97; I2 = 85.7%) and a significantly lower risk of infection (OR = 0.53; 95% CI 0.43–0.65; I2 = 0.00%). The pooled SMD in operation duration in laparoscopic vs. open appendectomy was 0.58 (95% CI −0.00; 1.15; I2 = 96.52), while the pooled SMD in hospitalization days was −1.35 (95% CI −1.87; −0.82; I2 = 96.41). Laparoscopy is an expensive procedure to adopt as it requires new equipment and specialized trained health workers. However, it could reduce post-operative costs and complications, especially in terms of infections. It is crucial to increase its accessibility, acceptability, and quality particularly in LMICs, especially during this COVID-19 era when the reduction of patient hospitalization is essential.

scholarly journals Influence of contextual socioeconomic position on hypertension risk in low- and middle-income countries: disentangling context from composition

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mustapha S. Abba ◽  
Chidozie U. Nduka ◽  
Seun Anjorin ◽  
Shukri F. Mohamed ◽  
Emmanuel Agogo ◽  
...  
Keyword(s):  
Kyrgyz Republic ◽  
Lifestyle Behaviour ◽  
Middle Income ◽  
Individual Level ◽  
Middle Income Countries ◽  
Country Level ◽  
Resource Limited ◽  
The Individual ◽  
Low And Middle Income ◽  
Deprived Areas

Abstract Background Hypertension has emerged as the single most significant modifiable risk factor for cardiovascular disease and death worldwide. Resource-limited settings are currently experiencing the epidemiological transition from infectious diseases to chronic non-communicable diseases, primarily due to modifications in diet and lifestyle behaviour. The objective of this study was to examine the influence of individual-, community- and country-level factors associated with hypertension in low- and middle-income countries (LMICs). Methods Multivariable multi-level logistic regression analysis was applied using 12 Demographic and Health Survey (DHS) datasets collected between 2011 and 2018 in LMICs. We included 888,925 respondents (Level 1) nested within 33,883 neighbourhoods (Level 2) from 12 LMICs (Level 3). Results The prevalence of hypertension ranged from 10.3% in the Kyrgyz Republic to 52.2% in Haiti. After adjusting for the individual-, neighbourhood- and country-level factors, we found respondents living in the least deprived areas were 14% more likely to have hypertension than those from the most deprived areas (OR = 1.14, 95% CI 1.10 to 1.17). We observed a significant variation in the odds of hypertension across the countries and the neighbourhoods. Approximately 26.3 and 47.6% of the variance in the odds of hypertension could be attributed to country- and neighbourhood-level factors, respectively. We also observed that respondents moving to a different neighbourhood or country with a higher risk of hypertension had an increased chance of developing hypertension, the median increase in their odds of hypertension was 2.83-fold (95% CI 2.62 to 3.07) and 4.04- fold (95% CI 3.98 to 4.08), respectively. Conclusions This study revealed that individual compositional and contextual measures of socioeconomic status were independently associated with the risk of developing hypertension. Therefore, prevention strategies should be implemented at the individual level and the socioeconomic and contextual levels to reduce the burden of hypertension.

scholarly journals Roles played by community cadres to support retention in PMTCT Option B+ in four African countries: a qualitative rapid appraisal

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020754 ◽  
Author(s):  
Donela Besada ◽  
Ameena Goga ◽  
Emmanuelle Daviaud ◽  
Sarah Rohde ◽  
Jacqueline Rose Chinkonde ◽  
...  
Keyword(s):  
Cote D'ivoire ◽  
Low Income ◽  
Côte D’Ivoire ◽  
Health Workers ◽  
Ministry Of Health ◽  
Cote D’Ivoire ◽  
Middle Income ◽  
Individual Interviews ◽  
Côte D'ivoire ◽  
Rapid Appraisal

ObjectivesTo explore the roles of community cadres in improving access to and retention in care for PMTCT (prevent mother-to-child transmission of HIV) services in the context of PMTCT Option B+ treatment scale-up in high burden low-income and lower-middle income countries.Design/MethodsQualitative rapid appraisal study design using semistructured in-depth interviews and focus group discussions (FGDs) between 8 June and 31 July 2015.Setting and participantsInterviews were conducted in the offices of Ministry of Health Staff, Implementing partners, district offices and health facility sites across four low-income and lower-middle income countries: Cote D’Ivoire, Democratic Republic of Congo (DRC), Malawi and Uganda. A range of individual interviews and FGDs with key stakeholders including Ministry of Health employees, Implementation partners, district management teams, facility-based health workers and community cadres. A total number of 18, 28, 31 and 83 individual interviews were conducted in Malawi, Cote d’Ivoire, DRC and Uganda, respectively. A total number of 15, 9, 10 and 16 mixed gender FGDs were undertaken in Malawi, Cote d’Ivoire, DRC and Uganda, respectively.ResultsCommunity cadres either operated solely in the community, worked from health centres or in combination and their mandates were PMTCT-specific or included general HIV support and other health issues. Community cadres included volunteers, those supported by implementing partners or employed directly by the Ministry of Health. Their complimentary roles along the continuum of HIV care and treatment include demand creation, household mapping of pregnant and lactating women, linkage to care, infant follow-up and adherence and retention support.ConclusionsCommunity cadres provide an integral link between communities and health facilities, supporting overstretched health workers in HIV client support and follow-up. However, their role in health systems is neither standardised nor systematic and there is an urgent need to invest in the standardisation of and support to community cadres to maximise potential health impacts.

The (Mis) Education of Immigrant Children in Today’s America

2019 ◽  
Vol 5 (2) ◽  
pp. 32
Author(s):  
Gabriela E. Gui
Keyword(s):  
General Education ◽  
Immigrant Students ◽  
Geographical Location ◽  
Personal Characteristics ◽  
Immigrant Children ◽  
Playing Field ◽  
Survey Interviews ◽  
The Individual ◽  
The Relationship ◽  
General Education Classrooms

In today’s America, not every child starts on a level playing field, and very few children move ahead based solely on hard work or talent. Generational poverty and a lack of cultural capital hold many students back, robbing them of the opportunity to move up professionally and socially. Children of immigrants are especially at-risk because, in addition to facing poverty, race, geographical location or economic disadvantages, they are also confronted with failure due to their limited or non-existent English proficiency. This study focuses on the degree to which teachers in a mid-sized urban school district take into consideration the individual needs of immigrant children in the process of their education. The study also examines the preparation teachers have had to equip them with knowledge of best practices in teaching immigrant children, and the relationship between teachers’ practices, beliefs, and their demographic and personal characteristics (age, gender, years of experience, level of education, etc.). Quantitative data was collected via a survey. Interviews with teachers and one central office administrator provided data for the qualitative section of the study. The findings revealed that teachers, in general, appeared to lack knowledge of specific policies for mainstreaming immigrant students into general education classrooms; their use of effective teaching practices for working with immigrant children were limited; and most of the teachers had not participated actively in professional development that focused on teaching immigrant children.

The relevance of dietetic approach of Ayurveda from the perspective of COVID-19 pandemic

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 748-752
Author(s):  
Swapnali Khabade ◽  
Bharat Rathi ◽  
Renu Rathi
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Healthy Person ◽  
World Health ◽  
Physical And Mental Health ◽  
Leading Role ◽  
Global Pandemic ◽  
The People ◽  
The World ◽  
Health Organization ◽  
The Individual

A novel, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes severe acute respiratory syndrome and spread globally from Wuhan, China. In March 2020 the World Health Organization declared the SARS-Cov-2 virus as a COVID- 19, a global pandemic. This pandemic happened to be followed by some restrictions, and specially lockdown playing the leading role for the people to get disassociated with their personal and social schedules. And now the food is the most necessary thing to take care of. It seems the new challenge for the individual is self-isolation to maintain themselves on the health basis and fight against the pandemic situation by boosting their immunity. Food organised by proper diet may maintain the physical and mental health of the individual. Ayurveda aims to promote and preserve the health, strength and the longevity of the healthy person and to cure the disease by properly channelling with and without Ahara. In Ayurveda, diet (Ahara) is considered as one of the critical pillars of life, and Langhana plays an important role too. This article will review the relevance of dietetic approach described in Ayurveda with and without food (Asthavidhi visheshaytana & Lanhgan) during COVID-19 like a pandemic.

IMPLEMENTATION OF FATWA ULAMA COUNCIL ACEH CONCERNING MAINTAINING FARDHU KIFAYAH FOR THE MUSLIM’S CORPSE INFECTED BY COVID 19 IN BANDA ACEH

2020 ◽  
Author(s):  
Andri Nirwana
Keyword(s):  
Health Workers ◽  
Descriptive Analysis ◽  
Body Fluids ◽  
The Body ◽  
Analysis Approach ◽  
Data Sets ◽  
Infected People ◽  
The Public ◽  
The People ◽  
Banda Aceh

Abstract: The phenomenon of the people who forcibly took covid's corpse 19 from the hospital to be taken care of by Fardhu Kifayah by his family and the community, became a conclusion that there was community doubt about the management of Tajhiz Mayat conducted by the hospital. Coupled with the circulation of the video of the Ruku movement 'in the corpse prayer conducted by unscrupulous parties at the Hospital, became added doubts from the public against the hospital. To solve this problem, this research uses a Descriptive Analysis approach, namely by formulating a question, namely How to arrange Covid 19's body in Banda Aceh and this question will be answered with several theories and data sets from the field. So it was concluded in a conclusion that answered the formulation of the problems mentioned. Theoretically the spread of covid 19 is very fast, the size of the virus is only 0.1 micrometer and is in body fluids, especially nasopharyngeal fluid and oropharyngeal fluids of infected people, fluids in the body of covid 19 bodies can get out through every gap of the body such as mouth, nose, eye and rectum, because it requires special techniques in its management. Fardhu kifayah to covid 19 bodies should be carried out by trained Ustad and trained health workers, so that the spread stopped. The results of this study concluded that the management of the Moslem bodies died at Zainal Abidin Hospital in Banda Aceh was in accordance with the Fatwa of the Aceh Ulama Council (MPU) and the bodies were handled by trained Ustad and health workers.

Whither the people in the ASEAN Community?

2020 ◽  
Vol 10 (3) ◽  
pp. 43-57
Author(s):  
See Seng Tan
Keyword(s):  
Southeast Asia ◽  
Political Ideology ◽  
Management Development ◽  
The Other ◽  
Asean Member ◽  
Derechos Humanos ◽  
The People ◽  
Droits Humains ◽  
The One ◽  
The Individual

Abstract: The longstanding effort to develop a people-based regionalism in Southeast Asia has been shaped by an inherent tension between the liberal inclination to privilege the individual and the community under formation, on the one hand, and the realist insistence on the primacy of the state, on the other. This article explores the conditions and constraints affecting ASEAN’s progress in remaking Southeast Asia into a people-focused and caring community in three areas: disaster management, development, and democratization (understood here as human rights). Arguably, the persistent gap in Southeast Asia between aspiration and expectation is determined less by political ideology than by the pragmatic responses of ASEAN member states to the forces of nationalism and protectionism, as well as their respective sense of local and regional responsibility.Resumen: El esfuerzo histórico para desarrollar un regionalismo basado en las personas del sudeste de Asia ha estado marcado por una tensión fundamental entre la inclinación liberal de privilegiar el individuo y la comunidad y la insistencia realista sobre la primacía del estado. Este artículo explora las condiciones y limitaciones que afectan el progreso de la ASEAN en la reestructuración de Asia sudoriental en una comunidad centrada en el cuidado de las personas en: gestión de desastres, desarrollo y democratización (i.e., derechos humanos). La brecha persistente en el sudeste asiático entre la aspiración y la expectativa está determinada por las respuestas pragmáticas de los miembros de la ASEAN sometidos a las fuerzas del nacionalismo y proteccionismo, así como su respectivo sentido de responsabilidad local y regional.Résumé: L’effort historique pour développer un régionalisme fondé sur les peuples en Asie du Sud-Est a été marqué par une tension fondamentale entre l’inclination libérale qui privilégie, d’une part, l’individu et la communauté et, d’autre part, l’insistance réaliste sur la primauté de l’État. Cet article explore les conditions et les contraintes qui nuisent aux progrès de l’ANASE dans le cadre d’une refonte de l’Asie du Sud-Est en une communauté centrée et attentive aux peuples dans trois domaines : la gestion des désastres, le développement et la démocratisation (en référence aux droits humains). Le fossé persistant en Asie du Sud-Est entre les aspirations et les attentes est vraisemblablement moins déterminé par l’idéologie politique que par les réponses pragmatiques des États membres de l’ANASE soumis aux forces du nationalisme et du protectionnisme ainsi que par leur sens respectif de la responsabilité locale et régionale.

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