49 results
Search Results
2. Impact of parasitic infection on mental health and illness in humans in Africa: a systematic review.
- Author
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Lampard-Scotford, Alexandra R., McCauley, Angela, Kuebel, Julius Arthur, Ibbott, Rachel, and Mutapi, Francisca
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MENTAL illness ,CLASSIFICATION of mental disorders ,PARASITIC diseases ,MENTAL health ,NEUROSES ,PEOPLE with mental illness - Abstract
A growing body of research implicates inflammation as a potential pathway in the aetiology and pathophysiology of some mental illnesses. A systematic review was conducted to determine the association between parasitic infection and mental illnesses in humans in Africa and reviewed the state of the evidence available. The search focused on publications from Africa documenting the relationship between parasites from two parasite groups, helminths and protozoans, and four classifications of mental illness: mood affective disorders, neurotic and stress-related disorders, schizotypal disorders and unspecified mental illnesses. In the 26 reviewed papers, the prevalence of mental illness was significantly higher in people with parasitic infection compared to those without infection, i.e., 58.2% vs 41.8% (P < 0.001). An overall odds ratio found that the association of having a mental illness when testing positive for a parasitic infection was four times that of people without infection. Whilst the study showed significant associations between parasite infection and mental illness, it also highlights gaps in the present literature on the pathophysiology of mental illness in people exposed to parasite infection. This study highlighted the importance of an integrated intervention for parasitic infection and mental illness. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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3. Gender-associated development of formal operations in Nigerian adolescents.
- Author
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Hollos M and Richards F
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- Africa, Africa South of the Sahara, Africa, Western, Age Factors, Behavior, Demography, Developing Countries, Nigeria, Population, Population Characteristics, Research, Social Sciences, Adolescent, Culture, Psychology, Sex Factors, Statistics as Topic
- Published
- 1993
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4. The long run impact of early childhood deworming on numeracy and literacy: Evidence from Uganda.
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Croke, Kevin and Atun, Rifat
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LONGITUDINAL method ,PRESCHOOL children ,LITERACY ,CHILDREN ,HELMINTHIASIS - Abstract
Background: Up to 1.45 billion people currently suffer from soil transmitted helminth infection, with the largest burden occurring in Africa and Asia. Safe and cost effective deworming treatment exists, but there is a debate about mass distribution of this treatment in high prevalence settings. While the World Health Organization recommends mass administration of anthelmintic drugs for preschool and school-aged children in high (>20%) prevalence settings, and several long run follow up studies of an influential trial have suggested large benefits that persist over time, recent systematic reviews have called this recommendation into question. Methods and findings: This paper analyzes the long-term impact of a cluster-randomized trial in eastern Uganda that provided mass deworming treatment to preschool aged children from 2000 to 2003 on the numeracy and literacy skills of children and young adults living in those villages in 2010-2015. This study uses numeracy and literacy data collected seven to twelve years after the end of the deworming trial in a randomly selected subset of communities from the original trial, by an education-focused survey that had no relationship to the deworming study. Building on an earlier working paper which used data from 2010 and 2011 survey rounds, this paper uses an additional four years of numeracy and literacy data (2012, 2013, 2014, and 2015). Aggregating data from all survey rounds, the difference between numeracy scores in treatment versus control communities is 0.07 standard deviations (SD) (95% CI -0.10, 0.24, p = 0.40), the difference in literacy scores is 0.05 SD (95% CI -0.16, 0.27, p = 0.62), and the difference in total scores is 0.07 SD (95% CI -0.11, 0.25, p = 0.44). There are significant differences in program impact by gender, with numeracy and literacy differentially positively affected for girls, and by age, with treatment effects larger for the primary school aged subsample. There are also significant treatment interactions for those living in households with more treatment-eligible children. There is no evidence of differential treatment effects on age at program eligibility or number of years of program eligibility. Conclusions: Mass deworming of preschool aged children in high prevalence communities in Uganda resulted in no statistically significant gains in numeracy or literacy 7-12 years after program completion. Point estimates were positive but imprecise; the study lacked sufficient power to rule out substantial positive effects or more modest negative effects. However, there is suggestive evidence that deworming was relatively more beneficial for girls, primary school aged children, and children living in households with other treated children. Research approval: As this analysis was conducted on secondary data which is publicly available, no research approval was sought or received. All individual records were anonymized by the data provider prior to public release. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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5. Student voices in studies on curriculum decolonisation: A scoping review.
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Maine, Kenneth and Wagner, Claire
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DECOLONIZATION ,PSYCHOLOGY ,HIGHER education ,CURRICULUM - Abstract
With the decolonisation and #feesmustfall movements in higher education going mainstream it is essential that the voices of students continue to be heard and that they occupy a prominent role in the decolonial project. Additionally, it is crucial to understand how their voices have been portrayed, analysed, and framed within scholarly work. This paper presents a scoping review of literature on the voices of students about the decolonisation of the social sciences that may inform the transformation of the research in psychology curriculum. Of the reviewed literature, only 12 articles were identified as relevant, and these generated four themes: complex reactions towards decolonisation, decolonial content, and ways of teaching; the importance of critical engagement and reflections on decolonisation; challenges with disrupting whiteness within higher education; and demographic change at universities. The findings revealed useful insights that could assist in guiding conversations with students about decolonising psychology in the classroom, such as creating safe spaces where students feel comfortable taking social and psychological risks when expressing their uniqueness. Published work on students and academics co-creating a transformed curriculum is lacking, and further studies on decolonisation in higher education in the global South are needed. [ABSTRACT FROM AUTHOR]
- Published
- 2021
6. Developing a mHealth intervention to promote uptake of HIV testing among African communities in the UK: a qualitative study.
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Evans, C., Turner, K., Suggs, L. S., Occa, A., Juma, A., and Blake, H.
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MOBILE health ,DIAGNOSIS of HIV infections ,PATIENT compliance ,TREATMENT effectiveness ,AFRICANS ,HEALTH Belief Model ,HEALTH ,HIV infections & psychology ,FOCUS groups ,MEDICAL care research ,MEDICAL screening ,SENSORY perception ,SOCIAL marketing ,STEREOTYPES ,TELEMEDICINE ,PSYCHOLOGY of Black people ,QUALITATIVE research ,TEXT messages ,PATIENTS' attitudes ,PSYCHOLOGY - Abstract
Background: HIV-related mHealth interventions have demonstrable efficacy in supporting treatment adherence, although the evidence base for promoting HIV testing is inconclusive. Progress is constrained by a limited understanding of processes used to develop interventions and weak theoretical underpinnings. This paper describes a research project that informed the development of a theory-based mHealth intervention to promote HIV testing amongst city-dwelling African communities in the conditions.Methods: A community-based participatory social marketing design was adopted. Six focus groups (48 participants in total) were undertaken and analysed using a thematic framework approach, guided by constructs from the Health Belief Model. Key themes were incorporated into a set of text messages, which were pre-tested and refined.Results: The focus groups identified a relatively low perception of HIV risk, especially amongst men, and a range of social and structural barriers to HIV testing. In terms of self-efficacy around HIV testing, respondents highlighted a need for communities and professionals to work together to build a context of trust through co-location in, and co-involvement of, local communities which would in turn enhance confidence in, and support for, HIV testing activities of health professionals. Findings suggested that messages should: avoid an exclusive focus on HIV, be tailored and personalised, come from a trusted source, allay fears and focus on support and health benefits.Conclusions: HIV remains a stigmatized and de-prioritized issue within African migrant communities in the UK, posing barriers to HIV testing initiatives. A community-based participatory social marketing design can be successfully used to develop a culturally appropriate text messaging HIV intervention. Key challenges involved turning community research recommendations into brief text messages of only 160 characters. The intervention needs to be evaluated in a randomized control trial. Future research should explore the application of the processes and methodologies described in this paper within other communities. [ABSTRACT FROM AUTHOR]- Published
- 2016
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7. A bibliometric review of positive psychology and well-being research in Africa.
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Fadiji, Angelina Wilson, Khumalo, Itumeleng P., Wissing, Marié Philipina, and Appiah, Richard
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POSITIVE psychology ,PSYCHOLOGICAL research ,SUBJECTIVE well-being (Psychology) ,PSYCHOLOGICAL well-being ,BIBLIOMETRICS ,BIBLIOTHERAPY ,PSYCHOLOGY - Abstract
Positive Psychology rapidly developed into an influential field of study and intervention, initially situated in Psychology, and later becoming multidisciplinary. Research interest in the study of (psychological) well-being has gained global popularity, with increasing salience in Africa. Although the global trends of these developments are relatively well-known, a bibliometric analysis of positive psychology research in Africa was necessary to shed light on the present hotspots and trends and future trajectories in this region of the world. The data source of the present bibliometric analysis study was Scopus, from which Positive Psychology and well-being research literature from Africa between 1983 and 2023 were searched. Using biblioshiny and VOSviewer, the 622 extracted articles were analysed, from which findings about the current condition, research hotspots, and thematic developmental patterns could be made. Africa experienced an initial slow growth period from 1983 until 2005, after which a rapid growth in research productivity, relevance and impact was experienced. In this regard, the results show that the focal point of scientific productivity is South Africa, with the dominance of South African institutions, particularly the North-West University, from where most positive psychology research is produced and cited. Even with potential access to international journal, African researchers seem to prefer to place their publications in the regional journals such as Journal of Psychology in Africa and South African Journal of Psychology. The research reviewed tends to be characterised by more dominant thematic clusters of positive psychology, psychological well-being, and subjective wellbeing, with a focus on human individuals. An increasing concern for contextual factors and potential antecedents and dynamics of well-being is also observed. The findings provide a good map from which identification of future research priorities can be deduced. As such, we speculate that future positive psychology research in Africa ought to be concerned with the following: greater distribution and intercountry collaborations across the continent, questions of conceptual clarity of terms, better understanding of contextual factors which influence well-being, and well-being research embracing the complexity of bio-psychosocial- ecological well-being, and science concerned with health-promotion interventions. [ABSTRACT FROM AUTHOR]
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- 2024
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8. Gambian cultural beliefs, attitudes and discourse on reproductive health and mortality: Implications for data collection in surveys from the interviewer’s perspective.
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Rerimoi, A. J., Niemann, J., Lange, I., and Timæus, I. M.
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MENSTRUATION ,ACQUISITION of data ,FOCUS groups ,REPRODUCTIVE health ,DEMOGRAPHIC surveys ,MATERNAL mortality - Abstract
Background: A community’s cultural beliefs, attitudes and discourse can affect their responses in surveys. Knowledge of these cultural factors and how to comply with them or adjust for them during data collection can improve data quality. Objective: This study describes implications of features of Gambian culture related to women’s reproductive health, and mortality, when collecting data in surveys. Methods: 13 in-depth interviews of female interviewers and a focus group discussion among male interviewers were conducted in two rural health and demographic surveillance systems as well as three key informant interviews in three regions in The Gambia. Results: From the fieldworker’s viewpoint, questions relating to reproduction were best asked by women as culturally pregnancies should be concealed, and menstruation is considered a sensitive topic. Gambians were reluctant to speak about decedents and the Fula did not like to be counted, potentially affecting estimation of mortality. Asking about siblings proved problematic among the Fula and Serahule communities. Proposals made to overcome these challenges were that culturally-appropriate metaphors and symbols should be used to discuss sensitive matters and to enumerating births/deaths singly instead of collecting summary totals, which had threatening connotations. This was as opposed to training interviewers to ask standardised and precise verbatim questions. Contribution: This paper presents indigenous Gambian solutions by fieldworkers to culturally sensitive topics when collecting pregnancy outcomes and mortality data in demographic and health surveys. For researchers collecting maternal mortality data, it highlights the potential shortcomings of the sibling history methodology. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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9. Using mathematical modeling to inform health policy: A case study from voluntary medical male circumcision scale-up in eastern and southern Africa and proposed framework for success.
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Njeuhmeli, Emmanuel, Schnure, Melissa, Vazzano, Andrea, Gold, Elizabeth, Stegman, Peter, Kripke, Katharine, Tchuenche, Michel, Bollinger, Lori, Forsythe, Steven, and Hankins, Catherine
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ACCESS control ,HEALTH policy ,CIRCUMCISION - Abstract
Background: Modeling contributes to health program planning by allowing users to estimate future outcomes that are otherwise difficult to evaluate. However, modeling results are often not easily translated into practical policies. This paper examines the barriers and enabling factors that can allow models to better inform health decision-making. Description: The Decision Makers’ Program Planning Tool (DMPPT) and its successor, DMPPT 2, are illustrative examples of modeling tools that have been used to inform health policy. Their use underpinned Voluntary Medical Male Circumcision (VMMC) scale-up for HIV prevention in southern and eastern Africa. Both examine the impact and cost-effectiveness of VMMC scale-up, with DMPPT used initially in global advocacy and DMPPT 2 then providing VMMC coverage estimates by client age and subnational region for use in country-specific program planning. Their application involved three essential steps: identifying and engaging a wide array of stakeholders from the outset, reaching consensus on key assumptions and analysis plans, and convening data validation meetings with critical stakeholders. The subsequent DMPPT 2 Online is a user-friendly tool for in-country modeling analyses and continuous program planning and monitoring. Lessons learned: Through three iterations of the DMPPT applied to VMMC, a comprehensive framework with six steps was identified: (1) identify a champion, (2) engage stakeholders early and often, (3) encourage consensus, (4) customize analyses, (5), build capacity, and (6) establish a plan for sustainability. This framework could be successfully adapted to other HIV prevention programs to translate modeling results to policy and programming. Conclusions: Models can be used to mobilize support, strategically plan, and monitor key programmatic elements, but they can also help inform policy environments in which programs are conceptualized and implemented to achieve results. The ways in which modeling has informed VMMC programs and policy may be applicable to an array of other health interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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10. Mental and Substance Use Disorders in Sub-Saharan Africa: Predictions of Epidemiological Changes and Mental Health Workforce Requirements for the Next 40 Years.
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Charlson, Fiona J., Diminic, Sandra, Lund, Crick, Degenhardt, Louisa, and Whiteford, Harvey A.
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MENTAL health facility employees ,MENTAL health personnel ,MENTAL health promotion - Abstract
The world is undergoing a rapid health transition, with an ageing population and disease burden increasingly defined by disability. In Sub-Saharan Africa the next 40 years are predicted to see reduced mortality, signalling a surge in the impact of chronic diseases. We modelled these epidemiological changes and associated mental health workforce requirements. Years lived with a disability (YLD) predictions for mental and substance use disorders for each decade from 2010 to 2050 for four Sub-Saharan African regions were calculated using Global Burden of Disease 2010 study (GBD 2010) data and UN population forecasts. Predicted mental health workforce requirements for 2010 and 2050, by region and for selected countries, were modelled using GBD 2010 prevalence estimates and recommended packages of care and staffing ratios for low- and middle-income countries, and compared to current staffing from the WHO Mental Health Atlas. Significant population growth and ageing will result in an estimated 130% increase in the burden of mental and substance use disorders in Sub-Saharan Africa by 2050, to 45 million YLDs. As a result, the required mental health workforce will increase by 216,600 full time equivalent staff from 2010 to 2050, and far more compared to the existing workforce. The growth in mental and substance use disorders by 2050 is likely to significantly affect health and productivity in Sub-Saharan Africa. To reduce this burden, packages of care for key mental disorders should be provided through increasing the mental health workforce towards targets outlined in this paper. This requires a shift from current practice in most African countries, involving substantial investment in the training of primary care practitioners, supported by district based mental health specialist teams using a task sharing model that mobilises local community resources, with the expansion of inpatient psychiatric units based in district and regional general hospitals. [ABSTRACT FROM AUTHOR]
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- 2014
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11. Perceived needs of health tutors in rural and urban health training institutions in Ghana: Implications for health sector staff internal migration control.
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Alhassan, Robert Kaba, Beyere, Christopher B., Nketiah-Amponsah, Edward, and Mwini-Nyaledzigbor, Prudence P.
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MEDICAL education ,RURAL health ,URBAN health ,HEALTH policy ,MEDICAL care - Abstract
Background: The population of Ghana is increasingly becoming urbanized with about 70% of the estimated 27 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32% of the national health sector workforce works. Moreover, the rural-urban disparities in the density of health tutors (staff responsible for pre-service training of health professionals) are enormous. This paper explores perceived needs of health tutors in rural and urban health training institutions in Ghana. Methods: This is a descriptive qualitative study conducted in the Greater Accra and Northern regions of Ghana. The Study used the deductive thematic and sub-thematic analysis approaches. Five health training institutions were randomly sampled, and 72 tutors engaged in separate focus group discussions with an average size of 14 participants per group in each training institution. Results: Perceived rural-urban disparities among health tutors were found in the payment of extra duty allowances; school infrastructure including libraries and internet connectivity; staff accommodation; and opportunities for scholarships and higher education. Health tutors in rural areas generally expressed more frustration with these work conditions than those in urban areas. Conclusions: There is the need to initiate and sustain work incentives that promote motivation of rural health tutors to control ongoing rural-urban migration of qualified staff. It is recommended the following incentives be prioritized to promote retention of qualified health tutors in rural health training schools: payment of research, book and rural allowances; early promotion of rural staff; prioritizing rural tutors for scholarships, and introduction of national best health tutor awards. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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12. Experiences of using life histories with health workers in post-conflict and crisis settings: methodological reflections.
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Witter, Sophie, Namakula, Justine, Alonso-Garbayo, Alvaro, Wurie, Haja, Theobald, Sally, Mashange, Wilson, Ros, Bandeth, Buzuzi, Stephen, Mangwi, Richard, and Martineau, Tim
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MEDICAL personnel ,CONFIDENTIAL communications ,POSTWAR reconstruction ,LEADERSHIP ,HEALTH policy ,CYNICISM ,PHYSICIAN-patient relations ,MOTIVATION (Psychology) ,QUALITATIVE research ,PSYCHOLOGY - Abstract
Introduction: Life history is a research tool which has been used primarily in sociology and anthropology to document experiences of marginalized individuals and communities. It has been less explored in relation to health system research. In this paper, we examine our experience of using life histories to explore health system trajectories coming out of conflict through the eyes of health workers.Methods: Life histories were used in four inter-related projects looking at health worker incentives, the impact of Ebola on health workers, deployment policies, and gender and leadership in the health sector. In total 244 health workers of various cadres were interviewed in Uganda, Sierra Leone, Zimbabwe and Cambodia. The life histories were one element within mixed methods research.Results: We examine the challenges faced and how these were managed. They arose in relation to gaining access, data gathering, and analysing and presenting findings from life histories. Access challenges included lack of familiarity with the method, reluctance to expose very personal information and sentiments, lack of trust in confidentiality, particularly given the traumatized contexts, and, in some cases, cynicism about research and its potential to improve working lives. In relation to data gathering, there was variable willingness to draw lifelines, and some reluctance to broach sensitive topics, particularly in contexts where policy-related issues and legitimacy are commonly still contested. Presentation of lifeline data without compromising confidentiality is also an ethical challenge.Conclusion: We discuss how these challenges were (to a large extent) surmounted and conclude that life histories with health staff can be a very powerful tool, particularly in contexts where routine data sources are absent or weak, and where health workers constitute a marginalized community (as is often the case for mid-level cadres, those serving in remote areas, and staff who have lived through conflict and crisis). [ABSTRACT FROM AUTHOR]- Published
- 2017
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13. Altruism and the pressure to share: Lab evidence from Tanzania.
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Di Falco, Salvatore, Lokina, Razack, Martinsson, Peter, and Pin, Paolo
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ALTRUISM ,PRESSURE ,SOCIAL networks ,SOCIAL psychology ,COGNITIVE science - Abstract
We propose a novel laboratory experiment to document the pressure to share income within social networks in Africa. We find that the redistributive pressure exerted via the possibility of receiving a claim increases altruism, while the possibility of hiding from such claim reduces it. Our results indicate that sharing norms are crucial drivers of giving to other members of the network. We also find that pressure to share has a detrimental effect on the undertaking of profitable but risky investments. [ABSTRACT FROM AUTHOR]
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- 2019
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14. Through the Prism of Black Psychology: A Critical Review of Conceptual and Methodological Issues in Africology as Seen Through the Paradigmatic Lens of Black Psychology.
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Jamison, DeReef F.
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PSYCHOLOGY education , *PSYCHOLOGY , *PSYCHOLOGISTS , *AFRICAN Americans , *BLACK people , *CURRICULUM , *SCHOLARS , *AFRICAN diaspora - Abstract
This paper attempts to address the invisibility of Africana psychological theory, research, and methodology in Africology by synthesizing the competing definitions, schools of thought, and research agendas in Black Psychology. Attention will be given to the various ways in which Black psychologists have attempted to deconstruct and reconstruct traditional psychological thought as well as construct new definitions, theories, measurements, and conceptual frameworks for understanding and interpreting the psychological experiences of people of African descent. Although psychology was identified by Karenga as one of the core components in the emerging discipline of African-American Studies, very few of the existing institutes, programs, and departments of African-American Studies include psychology as a major part of their curriculum. As a psycho-historical endeavor, a primary concern of Africana Psychology is with understanding how the historical experiences of being an African in America have impacted African-American psyches. Thus, it is argued that if the discipline of Africology is attempting to fully understand Africana experiences, Africology must reexamine the importance of psychology and its role in aiding Africana scholars interpret and understand the experiences of people of African descent in the Americas and throughout the diaspora. [ABSTRACT FROM AUTHOR]
- Published
- 2008
15. Is this a man’s world? The effect of gender diversity and gender equality on firm innovativeness.
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Ritter-Hayashi, Daniela, Vermeulen, Patrick, and Knoben, Joris
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GENDER inequality ,GENDER ,DEVELOPING countries ,DEVELOPED countries ,ECONOMIC geography ,SPECIES diversity - Abstract
Gender diversity is known to have a positive effect on innovation in developed countries. However, it is unclear whether the benefits of gender diversity for innovation also apply to the particular context of developing countries, which is characterized by diverse and lower levels of gender equality. We propose that gender diversity positively impacts innovation in the developing countries participating in our study. In addition, we expect that this effect is moderated by country-specific levels of gender equality. In a cross-country study covering 18,547 firms in 15 developing countries, we find that gender diversity among a firm’s owners and workforce as well as having a female top manager benefit innovation in developing countries. Yet, contradictory to our expectations, gender equality does not significantly moderate this relationship. As such, our results underline the importance of enabling and fostering gender diversity and have critical implications for firms and policy makers alike. [ABSTRACT FROM AUTHOR]
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- 2019
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16. The effect of maternal education on infant mortality in Ethiopia: A systematic review and meta-analysis.
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Kiross, Girmay Tsegay, Chojenta, Catherine, Barker, Daniel, Tiruye, Tenaw Yimer, and Loxton, Deborah
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INFANT mortality ,META-analysis ,PRESCHOOL education ,INFANT care ,MOTHER-infant relationship ,DATA extraction - Abstract
Introduction: Some studies in developing countries have shown that infant mortality is highly associated with maternal education, implying that maternal education might play an important role in the reduction of infant mortality. However, other research has shown that lower levels of maternal education does not have any significant contribution to infant survival. In this systematic review, we focus on the effect of different levels of maternal education on infant mortality in Ethiopia. Methods: MEDLINE, EMBASE, CINAHL, Scopus, and Maternity and Infant Care databases were searched between November 15, 2017 and February 20, 2018. All articles published until February 20, 2018 were included in the study. The data extraction was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA 2009) guidelines. An I
2 test was used to assess heterogeneity and a funnel plot was used to check publication bias. Findings: We retrieved 441 records after removing duplications. During screening, 31 articles were fully accessed for data extraction. Finally, five articles were included for analysis. The overall pooled estimate indicated that attending primary education was associated with a 28% reduction in the odds of infant mortality compared to those infants born to mothers who were illiterate, OR: 0.72 (95% CI = 0.66, 0.78). Another pooled estimate indicated that attending secondary education and above was associated with a 45% reduction in the odds of infant mortality compared to those infants born to mothers who were illiterate, OR: 0.55 (95% CI = 0.47, 0.64). Conclusion: From this study, understanding the long-term impact of maternal education may contribute to reduce infant mortality. Therefore, policy makers should give more attention in promoting the role of women through removing institutional and cultural barriers, which hinder women from access to education in order to reduce infant mortality in Ethiopia. [ABSTRACT FROM AUTHOR]- Published
- 2019
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17. Improved contraceptive use among women and men in Uganda between 1995-2016: A repeated cross-sectional population study.
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Namasivayam, Amrita, Lovell, Sarah, Namutamba, Sarah, and Schluter, Philip J.
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DEMOGRAPHIC surveys ,FAMILY planning services ,CROSS-sectional method ,MATERNAL mortality - Abstract
Background: Research on contraceptive behaviour changes over time in Uganda is scarce, yet it has among the highest fertility and maternal mortality rates of any country in the East African region. Understanding temporal patterns of contraceptive use for both women and men is vital in evaluating the effectiveness of family planning interventions and strategies, and identifying those with the most unmet need. Using repeated nationally representative cross-sectional samples, this study charts the changes in Uganda’s population-based contraceptive use over recent years. Methods: Five Demographic and Health Survey datasets for Uganda over 21 years, from 1995 to 2016, were sourced and interrogated. Eligible participants included all women aged 15–49 years and men aged 15–54 years. Responses to questions on modern and any (modern or traditional) contraceptive use were analysed. Stratified by gender, weighted regression analyses were employed to detect change over time. The patterns associated with key demographic variables were also investigated. Results: Overall, 50,027 women and 14,092 men were included within the study. In 2016, 30.3% of women and 39.9% of men were using any contraceptive method, a significant non-linear increase from 13.4% of women and 20.3% of men in 1995. Furthermore, 27.3% of women and 35.9% of men were using modern contraceptive methods in 2016, an increase from 7.4% of women and 10.4% of men in 1995. All considered demographic variables were significantly associated with contraceptive use for both women and men (all P<0.001); and for women, all variables differentially changed over time (all P<0.001). Conclusion: This study showed a significant increase and dynamism across key demographic variables in contraceptive uptake by both women and men. Sustained family planning programs and interventions have successfully resulted in behaviour change across the Ugandan population. However, continued efforts are needed to further reduce Uganda’s relatively high fertility and associated maternal mortality rates. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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18. Inter- and intra-household perceived relative inequality among disabled and non-disabled people in Liberia.
- Author
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Carew, Mark T., Colbourn, Tim, Cole, Ellie, Ngafuan, Richard, Groce, Nora, and Kett, Maria
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PEOPLE with disabilities ,POLITICAL participation ,EQUALITY ,SOCIAL participation ,HOUSEHOLDS ,COGNITIVE science ,SOCIAL integration - Abstract
Evidence suggests that people with disabilities are the most marginalised and vulnerable group within any population. However, little is known about the extent of inequality between people with and without disabilities in contexts where the majority of persons experience extreme poverty and hardship. This includes in Liberia, where very little is understood about the lives of disabled people in general. This study uses a multidimensional wellbeing framework to understand perceived relative inequality associated with disability by assessing several facets of wellbeing across and within households containing disabled members (N = 485) or households with no disabled members (N = 538) in Liberian communities (Total individuals surveyed, N = 2020). Statistical comparisons (adjusted for age, sex, education and wealth differences and clustered at the household, village and county level) reveal that disabled Liberians are managing similarly to non-disabled Liberians in terms of income and education, but experience many perceived relative inequalities including in life satisfaction, transport access, political participation and social inclusion. Our results further suggest that disability may lead to perceived relative inequality at the household level in terms of trust held in neighbours. However, they also show that being the head of a household may protect against perceived relative inequality in certain dimensions (e.g. healthcare and transport access, political participation) irrespective of disability status. Results are discussed in terms of practical implications for development efforts in Liberia and for disabled people in other low- and middle-income settings. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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19. The impact of acute adenolymphangitis in podoconiosis on caregivers: A case study in Wayu Tuka woreda, Oromia, Western Ethiopia. ‘If she was healthy, I would be free.’.
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Phillips, Clare, Samuel, Abdi, Tiruneh, Gemechu, Deribe, Kebede, and Davey, Gail
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ELEPHANTIASIS ,VOLCANIC ash, tuff, etc. ,SEMI-structured interviews ,THEMATIC analysis ,CAREGIVERS - Abstract
Background: Podoconiosis, also known as mossy foot or endemic non-filarial elephantiasis, is a preventable form of lower-leg lymphoedema caused by prolonged (typically barefoot) exposure to soil derived from volcanic rocks. Acute adenolymphangitis (also called ‘acute attack’) is a serious complication of podoconiosis resulting in significant symptoms and worsening disability. Despite the well-known morbidity associated with podoconiosis, to date there have been no studies looking at the impact, or burden, of podoconiosis on caregivers. This study explored the experiences and impact of acute attacks on the caregivers of those with podoconiosis in one endemic district of Ethiopia. Methods/Principal findings: This qualitative study was based in Wayu Tuka woreda (district), Oromia, Western Ethiopia. 27 semi-structured interviews of those with podoconiosis and their caregivers were conducted in June 2018. Here we report the findings from the caregiver’s interviews. Data were analysed using NVivo 12. Directed content analysis, a qualitative approach related to thematic analysis, was used to analyse the results. This study highlights a previously unreported impact of acute attacks on the caregivers of those affected by podoconiosis. The findings demonstrate the significant social and financial pressures placed on podoconiosis-affected families which are exacerbated during acute attacks. This study also highlighted the emotional burden experienced by caregivers, the range of care activities placed on them and the limited support available. Conclusions: This study found a significant impact on the caregivers of those with podoconiosis, especially during acute attacks, in in Wayu Tuka woreda. It also highlighted the limited support available to caregivers. Further research is needed to understand whether this impact applies to podoconiosis caregivers across Ethiopia, and beyond, and to establish if there are wider implications of this important consequence of podoconiosis, for example on the economy and caregivers’ mental and physical health. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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20. SMS nudges as a tool to reduce tuberculosis treatment delay and pretreatment loss to follow-up. A randomized controlled trial.
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Wagstaff, Adam, van Doorslaer, Eddy, and Burger, Ronelle
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RANDOMIZED controlled trials ,HEALTH care reminder systems ,TUBERCULOSIS treatment ,FOLLOW-up studies (Medicine) ,TREATMENT delay (Medicine) ,THERAPEUTICS ,STATISTICAL power analysis - Abstract
Background: TB persists despite being relatively easy to detect and cure because the journey from the onset of symptoms to cure involves a series of steps, with patients being lost to follow-up at each stage and delays occurring among patients not lost to follow-up. One cause of drop-off and delay occurs when patients delay or avoid returning to clinic to get their test results and start treatment. Methods: We fielded two SMS interventions in three Cape Town clinics to see their effects on whether people returned to clinic, and how quickly. One was a simple reminder; the other aimed to overcome “optimism bias” by reminding people TB is curable and many millions die unnecessarily from it. Recruits were randomly assigned at the clinic level to a control group or one of the two SMS groups (1:2:2). In addition to estimating effects on the full sample, we also estimated effects on HIV-positive patients. Results: SMS recipients were more likely to return to clinic in the requested two days than the control group. The effect was smaller in the intent-to-treat analysis (52/101 or 51.5% vs. 251/405 or 62.0%, p = 0.05) than in the per-protocol analysis (50/97 or 51.5% vs. 204/318 or 64.2%, p = 0.03). The effect was larger among HIV-positives (10/35 or 28.6% vs. 97/149 or 65.1%, p<0.01). The effects of SMS messages diminished as the interval increased: significant effects at the 5% level were found at five and 10 days only among HIV-positives. The second SMS message had larger effects, albeit not significantly larger, likely due in part to lack of statistical power. Conclusions: At 2 U.S. cents per message, SMS reminders are an inexpensive option to encourage TB testers to return to clinic, especially when worded to counter optimism bias. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
21. The explanatory power of silent comics: An assessment in the context of knowledge transfer and agricultural extension to rural communities in southwestern Madagascar.
- Author
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Stenchly, Kathrin, Feldt, Tobias, Weiss, David, Andriamparany, Jessica N., and Buerkert, Andreas
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AGRICULTURAL extension work ,KNOWLEDGE transfer ,SCIENTIFIC communication ,COMIC books, strips, etc. ,COMMUNITIES ,COMPOSTING - Abstract
The distribution of silent comic illustrations can facilitate the communication and transfer of scientific recommendations about sustainable land management (SLM) to local communities in countries where many people are illiterate. However, since there are cross-cultural differences in "visual languages", visualization styles need to be carefully selected as well as locals' comprehension of the illustrated recommendation evaluated systematically. Three agricultural recommendations were chosen for comic-style illustrations, distributed to six communities in the Mahafaly region of southwestern Madagascar and evaluated using a three-step, interdependent approach. The silent comics illustrated (i) composting of manure and its application to improve soil fertility; (ii) cautious utilization of succulent silver thicket as supplementary forage; and (iii) sustainable harvesting practices of wild yam. Results revealed that general understandability strongly depended on the community that was surveyed and on the environmental subject that was illustrated. We found a strong relationship between the general understandability of comics and the divergence that exist in communities' socio-economic structure. Education level was an important factor that explained a better understanding of respondents for the comic illustrating compost production, but not for comics that illustrated sustainable usage of silver thicket and wild yam harvest. Willingness to follow the recommended practice was impaired when respondents valued no change to the improved technique compared to the common one. Effects of respondents' socio-economic characteristics on the implementation of the recommended practice could not be clarified within this study due to the small subset of data. Based on the evaluation of recurring comments made by respondents and interviewers, we conclude that comics can be a useful communication tool to increase locals' awareness and comprehension for SLM practices. This, however, requires that drawing details used to facilitate farmers' ability to adopt a point-of-view inside the comic story are used thoughtfully as they might interfere with the central message. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
22. Substance use and its effect on antiretroviral treatment adherence among male fisherfolk living with HIV/AIDS in Uganda.
- Author
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Sileo, Katelyn M., Kizito, Williams, Wanyenze, Rhoda K., Chemusto, Harriet, Reed, Elizabeth, Stockman, Jamila K., Musoke, William, Mukasa, Barbara, and Kiene, Susan M.
- Subjects
THERAPEUTICS ,PILLS ,ALCOHOL ,AIDS ,ALCOHOL drinking ,HIV ,BINOMIAL distribution - Abstract
Background: Fisherfolk are a most-at-risk population for HIV being prioritized for the scale up of HIV treatment in Uganda. Heavy alcohol use and potential drug use may be a major barrier to treatment adherence for men in this setting. Objective: This study examines the prevalence of substance use, and its influence on antiretroviral treatment (ART) adherence, among male fisherfolk on ART in Wakiso District, Uganda. Methods: This cross-sectional study included structured questionnaires (N = 300) with men attending HIV clinics near Lake Victoria. Using generalized logistic modeling analyses with a binomial distribution and logit link, we conducted multivariate models to test the association between each alcohol variable (quantity and frequency index, hazardous drinking) and missed pills, adjusting for covariates, and tested for interactions between number of pills prescribed and alcohol variables. Results: Thirty-one percent of men reported sub-optimal adherence. Half (46.7%) reported drinking, of which 64.8% met criteria for hazardous drinking. Illicit drug use was low (6%). In the multivariate model, men with greater scores on the alcohol frequency and quantity index were more likely to report missed pills compared to those reporting no drinking (AOR: 1.60, 95% CI: 1.29–1.97). Hazardous drinking had a greater effect on missed ARV doses among men taking twice daily regimens compared to once daily (AOR: 4.91, 95% CI: 1.68–14.37). Conclusions: Our findings highlight the need for targeted alcohol-reduction interventions for male fisherfolk on ART who drink at high quantities to improve ART adherence and to prevent the known negative health effects of alcohol for HIV-infected individuals. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
23. Linking human behaviours and malaria vector biting risk in south-eastern Tanzania.
- Author
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Finda, Marceline F., Moshi, Irene R., Monroe, April, Limwagu, Alex J., Nyoni, Anna P., Swai, Johnson K., Ngowo, Halfan S., Minja, Elihaika G., Toe, Lea P., Kaindoa, Emmanuel W., Coetzee, Maureen, Manderson, Lenore, and Okumu, Fredros O.
- Subjects
INSECTICIDE-treated mosquito nets ,MALARIA ,BEHAVIOR ,PARASITIC diseases ,ANOPHELES - Abstract
To accelerate malaria elimination in areas where core interventions such as insecticide-treated nets (ITNs) are already widely used, it is crucial to consider additional factors associated with persistent transmission. Qualitative data on human behaviours and perceptions regarding malaria risk was triangulated with quantitative data on Anopheles mosquito bites occurring indoors and outdoors in south-eastern Tanzania communities where ITNS are already used but lower level malaria transmission persists. Each night (18:00h-07:00h), trained residents recorded human activities indoors, in peri-domestic outdoor areas, and in communal gatherings. Host-seeking mosquitoes were repeatedly collected indoors and outdoors hourly, using miniaturized exposure-free double net traps (DN-Mini) occupied by volunteers. In-depth interviews were conducted with household representatives to explore perceptions on persistent malaria and its control. Higher proportions of people stayed outdoors than indoors in early-evening and early-morning hours, resulting in higher exposures outdoors than indoors during these times. However, exposure during late-night hours (22:00h–05:00h) occurred mostly indoors. Some of the popular activities that kept people outdoors included cooking, eating, relaxing and playing. All households had at least one bed net, and 83.9% of people had access to ITNs. Average ITN use was 96.3%, preventing most indoor exposure. Participants recorgnized the importance of ITNs but also noted that the nets were not perfect. No complementary interventions were reported being used widely. Most people believed transmission happens after midnight. We conclude that insecticide-treated nets, where properly used, can still prevent most indoor exposures, but significant risk continues unabated before bedtime, outdoors and at communal gatherings. Such exposure is greatest for rural and low-income households. There is therefore an urgent need for complementary interventions, particularly those targeting outdoor-biting and are applicable for all people including the marginalised populations such as migratory farmers and fishermen. Besides, the differences in community understanding of ongoing transmission, and feedback on imperfections of ITNs should be considered when updating malaria-related communication and interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
24. Born captive: A survey of the lion breeding, keeping and hunting industries in South Africa.
- Author
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Williams, Vivienne L. and ‘t Sas-Rolfes, Michael J.
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LIONS ,ANIMAL behavior ,INTERNATIONAL trade ,COMMERCIAL policy ,INTERDISCIPLINARY research ,CARNIVOROUS animals - Abstract
Commercial captive breeding and trade in body parts of threatened wild carnivores is an issue of significant concern to conservation scientists and policy-makers. Following a 2016 decision by Parties to the Convention on International Trade in Endangered Species of Wild Fauna and Flora, South Africa must establish an annual export quota for lion skeletons from captive sources, such that threats to wild lions are mitigated. As input to the quota-setting process, South Africa’s Scientific Authority initiated interdisciplinary collaborative research on the captive lion industry and its potential links to wild lion conservation. A National Captive Lion Survey was conducted as one of the inputs to this research; the survey was launched in August 2017 and completed in May 2018. The structured semi-quantitative questionnaire elicited 117 usable responses, representing a substantial proportion of the industry. The survey results clearly illustrate the impact of a USA suspension on trophy imports from captive-bred South African lions, which affected 82% of respondents and economically destabilised the industry. Respondents are adapting in various ways, with many euthanizing lions and becoming increasingly reliant on income from skeleton export sales. With rising consumer demand for lion body parts, notably skulls, the export quota presents a further challenge to the industry, regulators and conservationists alike, with 52% of respondents indicating they would adapt by seeking ‘alternative markets’ for lion bones if the export quota allocation restricted their business. Recognizing that trade policy toward large carnivores represents a ‘wicked problem’, we anticipate that these results will inform future deliberations, which must nonetheless also be informed by challenging inclusive engagements with all relevant stakeholders. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
25. Utilization of decentralized health facilities and factors influencing women’s choice of a delivery site in Gida Ayana Woreda, western Ethiopia.
- Author
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Tolera, Habtamu, Gebre-Egziabher, Tegegne, and Kloos, Helmut
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HEALTH facilities ,DELIVERY (Obstetrics) ,CHILDBIRTH at home ,HEALTH facilities utilization ,MEDICAL care ,BIRTHING centers ,LOGISTIC regression analysis ,WOMEN'S health - Abstract
Introduction: Despite the government’s efforts to decentralize and expand health institutions to promote facility-based child delivery, home delivery and maternal mortality are still widespread problems in Ethiopia. Most mothers continue to give birth at home. This study aims at identifying the socio-cultural practices, perceived benefit or need, and accessibility factors influencing women’s choice of health facilities for delivery services in Gida Ayana Woreda, western Ethiopia. Methods: We conducted a cross-sectional survey to assess women’s use of delivery care services in Gida Ayana Woreda, from November 2016 to January 2017; 459 women who were selected randomly participated in the study. We evaluated the socio-cultural, perceived benefit or need, and economic and physical accessibility factors in women’s choice of delivery care and used adjusted logistic regression analysis to examine significant predictors of delivery site use decisions. Results: Over half (56.6%) of the women self-reported using institutional delivery care; 80.9% gave birth at a health center. A socio-cultural variable, maternal education, significantly influenced women’s choice of health facility for delivery care services (AOR 3.4; 95% CI 2.0–5.9). Mothers’ knowledge level of obstetric complications and experience of complications during the last birth were the two perceived benefits or need factors associated with higher odds of receiving delivery care from decentralized local facilities. Utilization of health centers for maternal delivery care was significantly higher than of health posts (AOR 5.0; 95% CI 2.4–10.2). Availability of motorized transportation during labor to nearby delivery site was a significant predictor of institutional delivery. Conclusion: This study demonstrates the under-utilization of decentralized health facilities for maternal delivery care services in Gida Ayana Woreda, which was significantly influenced by socio-cultural, perceived need, and accessibility factors of women during childbirth. This suggests the need for tailored intervention to improve childbirth services use for mothers in this kind of rural settings. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
26. Applying a deviance framework to understand modern contraceptive use in sub-Saharan Africa.
- Author
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Goldenberg, Tamar and Stephenson, Rob
- Subjects
CONTRACEPTIVES ,DEMOGRAPHIC surveys ,HEALTH programs ,CHILDREN'S health - Abstract
Increasing modern contraceptive use is important for improving maternal and child health and achieving economic growth and development goals. However, pervasive high unmet need for modern contraceptives in sub-Saharan Africa warrants new understandings of the drivers of modern contraceptive use. A deviance approach (i.e., examining how women’s experiences/characteristics differ from other women in their community) provides an innovative framework for capturing heterogeneity among women in a community. This framework can inform public health programming by both exploring how women avoid adverse health outcomes and understanding the needs of harder-to-reach populations who may experience health risks, despite living in communities where others do not experience vulnerability. Using data from Demographic and Health Surveys from 29 sub-Saharan African countries, we examine how a woman’s deviation from community norms around socioeconomic characteristics and gender and fertility norms and behaviors is associated with modern contraceptive use. Random-effects logistic regression models were fitted for each country to examine relationships between modern contraceptive use and deviance. Some deviance factors were associated with modern contraceptive use in only a few countries, while others were significant across many countries. Cross-country consistency in the direction of the relationship between deviance and modern contraceptive use varied by the specific deviance factor, with some relationships being consistent across countries, and other relationships being more varied. For example, having more education than the community norm was associated with increased modern contraceptive use across countries; however, marrying older than other women in the community was associated with an increase in modern contraceptive use in some countries and a decrease in others. More work is needed to understand the role of deviance on modern contraceptive use; however, this study suggests that using context-specific deviance approaches may be important for further elucidating experiences of modern contraceptive use. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
27. Patient and health-care worker experiences of an HIV viral load intervention using SMS: A qualitative study.
- Author
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Venables, Emilie, Ndlovu, Zibusiso, Munyaradzi, Dhodho, Martínez-Pérez, Guillermo, Mbofana, Elton, Nyika, Ponesai, Chidawanyika, Henry, Garone, Daniela B., and Bygrave, Helen
- Subjects
MOBILE health ,HEALTH care reminder systems ,VIRAL load ,HEALTH facilities ,PATIENT compliance ,HIV ,MEDICAL care - Abstract
Background: Mobile Health or mHealth interventions, including Short Message Service (SMS), can help increase access to care, enhance the efficiency of health service delivery and improve diagnosis and treatment for HIV. Text messaging, or SMS, allows for the low cost transmission of information, and has been used to send appointment reminders, information about HIV counselling and treatment, messages to encourage adherence and information on nutrition and side-effects. HIV Viral Load (VL) monitoring is recommended by the WHO and has been progressively adopted in many settings. In Zimbabwe, implementation of VL is routine and has been rolled out with support of Médecins Sans Frontières (MSF) since 2012. An SMS intervention to assist with the management of VL results was introduced in two rural districts of Zimbabwe. After completion of the HIV VL testing at the National Microbiology Reference Laboratory in Harare, results were sent to health facilities via SMS. Consenting patients were also sent an SMS informing them that their viral load results were ready for collection at their nearest health facilities. No actual VL results were sent to patients. Methods: A qualitative study was conducted in seven health-care facilities using in-depth interviews (n = 32) and focus group discussions (n = 5) to explore patient and health-care worker experiences of the SMS intervention. Purposive sampling was used to select participants to ensure that male and female patients, as well as those with differing VL results and who lived differing distances from the clinics were included. Data were transcribed, translated from Shona into English, coded and thematically analysed using NVivo software. Results: The VL SMS intervention was considered acceptable to patients and health-care workers despite some challenges in implementation. The intervention was perceived by health-care workers as improving adherence and well-being of patients as well as improving the management of VL results at health facilities. However, there were some concerns from participants about the intervention, including challenges in understanding the purpose and language of the messages and patients coming to their health facility unnecessarily. Health-care workers were more concerned than patients about unintentional HIV disclosure relating to the content of the messages or phone-sharing. Conclusion: This was an innovative intervention in Zimbabwe, in which SMS was used to send VL results to health-care facilities, and notifications of the availability of VL results to patients. Interventions such as this have the potential to reduce unnecessary clinic visits and ensure patients with high VL results receive timely support, but they need to be properly explained, alongside routine counselling, for patients to fully benefit. The findings of this study also have potential policy implications, as if implemented well, such an SMS intervention has the potential to help patients adopt a more active role in the self-management of their HIV disease, become more aware of the importance of adherence and VL monitoring and seek follow-up at clinics when results are high. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
28. The influence of raw milk exposures on Rift Valley fever virus transmission.
- Author
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Grossi-Soyster, Elysse N., Lee, Justin, King, Charles H., and LaBeaud, A. Desiree
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RIFT Valley fever ,RAW milk ,VIRAL transmission ,ANIMAL handling ,ANIMAL species - Abstract
Rift Valley fever virus (RVFV) is a zoonotic phlebovirus that can be transmitted to humans or livestock by mosquitoes or through direct contact with contaminated bodily fluids and tissues. Exposure to bodily fluids and tissues varies by types of behaviors engaged for occupational tasks, homestead responsibilities, or use in dietary or therapeutic capacities. While previous studies have included milk exposures in their analyses, their primary focus on livestock exposures has been on animal handling, breeding, and slaughter. We analyzed data from multiple field surveys in Kenya with the aim of associating RVFV infection to raw milk exposures from common animal species. Of those with evidence of prior RVFV infection by serology (n = 267), 77.2% engaged in milking livestock compared to 32.0% for 3,956 co-local seronegative individuals (p < 0.001), and 86.5% of seropositive individuals consumed raw milk compared to 33.4% seronegative individuals (p < 0.001). Individuals who milked and also consumed raw milk had greater odds of RVFV exposure than individuals whose only contact to raw milk was through milking. Increased risks were associated with exposure to milk sourced from cows (p < 0.001), sheep (p < 0.001), and goats (p < 0.001), but not camels (p = 0.98 for consuming, p = 0.21 for milking). Our data suggest that exposure to raw milk may contribute to a significant number of cases of RVFV, especially during outbreaks and in endemic areas, and that some animal species may be associated with a higher risk for RVFV exposure. Livestock trade is regulated to limit RVFV spread from endemic areas, yet further interventions designed to fully understand the risk of RVFV exposure from raw milk are imperative. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
29. The feasibility of a training course for clubfoot treatment in Africa: A mixed methods study.
- Author
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Smythe, Tracey, Owen, Rosalind, Le, Grace, Uwizeye, Esperance, Hansen, Linda, and Lavy, Christopher
- Subjects
CLUBFOOT ,PUBLIC health ,MIXED methods research ,QUESTIONNAIRES ,FEASIBILITY studies ,THERAPEUTICS - Abstract
Background: There is no available training programme with standard elements for health workers treating clubfoot in Africa. Standardised training with continued mentorship has the potential to improve management of clubfoot. We aimed to evaluate the feasibility of such a training programme among clubfoot providers in Africa, and assess implications for training effectiveness and scale up. Method: We used participatory research with trainers from 18 countries in Africa over two years to devise, pilot and refine a 2-day basic and a 2-day advanced clubfoot treatment course. (The Africa Clubfoot Training or ‘ACT’ Course.) The pilots involved training 113 participants. Mixed methods (both qualitative and quantitative) were used for evaluation. We describe and synthesise the results using the eight elements proposed by Bowen et al (2010) to assess feasibility. All participants completed feedback questionnaires, and interviews were conducted with a subset of participants. We undertook a narrative description of themes raised in the participant questionnaires and interviews. Descriptive statistics were used to compare pre- and post-course scores for confidence and knowledge. Results: 113 participants completed pre and post-course measures (response rate = 100%). Mean participant confidence increased from 64% (95%CI: 59–69%) to 88% (95%CI: 86–91%) post course. Mean participant knowledge increased from 55% (95%CI: 51–60%) to 78% (95%CI: 76–81%) post course. No difference was found in mean for either subscale of cadre or sex. The qualitative analysis generated themes under four domains: ‘practical learning in groups’, ‘interactive learning’, ‘relationship with the trainer’ and ‘ongoing supervision and mentorship’ Conclusion: The Africa Clubfoot Training package to teach health care workers to manage clubfoot is likely to be feasible in Africa. Future work should evaluate its impact on short and long term treatment outcomes and a process evaluation of implementation is required. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
30. Long term trends in behaviour to protect against adverse reproductive and sexual health outcomes among young single African women.
- Author
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Ali, Mohamed M. and Cleland, John
- Subjects
HIV infection risk factors ,PREVENTION of teenage pregnancy ,WOMEN'S health ,CONDOMS ,CONTRACEPTION ,HEALTH attitudes ,HEALTH promotion ,SEXUAL health ,INTERVIEWING ,ORAL contraceptives ,RISK-taking behavior ,SEXUAL abstinence ,SEXUAL intercourse ,SURVEYS ,REPRODUCTIVE health ,SECONDARY analysis ,FAMILY planning ,ATTITUDES toward sex ,PSYCHOLOGY - Abstract
Background: HIV and unintended pregnancy are major interrelated concerns in sub-Saharan Africa. Focussing on single women aged 15-24 years we assess trends in key behaviours that affect both outcomes. Methods: We performed a secondary analysis of public-access data sets from 112 surveys from 36 countries in the region, conducted between 1991 and 2015. We examined trends over 20 years in primary abstinence (virginity), secondary abstinence (no sex in past 3 months) among sexually experienced women, current use of modern contraception and condom use at most recent coitus among sexually active women. Results: Little change occurred in primary or secondary abstinence. Over the 20 year period, contraceptive use in the region rose from 14.7 to 33.4%, with significant increases observed in 18 of 30 countries with multiple surveys. Since 2001–2005, the proportion of contraceptive users reporting condoms as their method fell from 61.1 to 51.3%, while use of oral contraceptives or injectables rose from 19.9 to 24.0%. Between 1996 and 2000 and 2006–2010, condom use at last coitus rose from 21.3 to 40.5% but then plateaued. A strong correlation between condom use and national HIV prevalence was found. About half of condom users at last sex had earlier in interviews reported this method for pregnancy-prevention. Conclusions: Though condoms tend to be overlooked by both HIV and family planning agencies, their contribution to the health of single women remains central. Current efforts to promote non-barrier contraceptive methods may inadvertently increase HIV risk. Condom promotion for pregnancy-prevention should be re-invigorated by social marketing campaigns and other means. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
31. Barriers to and facilitators of employment for people with psychiatric disabilities in Africa: a scoping review.
- Author
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Ebuenyi, I. D., Syurina, E. V., Bunders, J. F. G., and Regeer, B. J.
- Subjects
EMPLOYMENT of people with disabilities ,CINAHL database ,DISCRIMINATION (Sociology) ,MEDICAL information storage & retrieval systems ,PSYCHOLOGY information storage & retrieval systems ,INTERPERSONAL relations ,MATHEMATICAL models ,MEDLINE ,MENTAL illness ,ONLINE information services ,PSYCHOLOGY ,PSYCHOTHERAPY patients ,SELF-perception ,SOCIAL stigma ,SYSTEMATIC reviews ,LITERATURE reviews ,MIDDLE-income countries ,LOW-income countries - Abstract
Background: Despite the importance of inclusive employment, described in Goal 8 of the Sustainable Development Goals (SDGs), employment of persons with psychiatric disabilities in Africa is lower than among the general population. Objective: The aim of this scoping review is to explore evidence related to the barriers to and facilitators of employment of persons with psychiatric disabilities in Africa. Methods: A literature search was conducted using six relevant electronic databases of articles published between 1990 and 2017. Results: Eight studies were identified and analysed regarding barriers and facilitators of employment of persons with psychiatric disabilities. The dynamic adaptation of the bio-psycho-social model was used as an analytical framework. Identified barriers include ill health, (anticipated) psychiatric illness, social stigma and discrimination, negative attitudes among employers and the lack of social support and government welfare. Facilitators of employment include stability of mental illness, heightened self-esteem, a personal decision to work despite stigma, competitive and supported employment, reduction in social barriers/stigma and workplace accommodations. Conclusion: Employment of persons with psychiatric disabilities is essential, yet there is dearth of scientific evidence to identify contextual models that might be useful in African countries and other low-and middle countries (LMICs). This gap in information would benefit from further research to improve the employment rates of persons with psychiatric disabilities in Africa. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
32. Childhood traumas as a risk factor for HIV-risk behaviours amongst young women and men living in urban informal settlements in South Africa: A cross-sectional study.
- Author
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Gibbs, Andrew, Dunkle, Kristin, Washington, Laura, Willan, Samantha, Shai, Nwabisa, and Jewkes, Rachel
- Subjects
HIV infection risk factors ,PUBLIC health ,HEALTH outcome assessment ,LOGISTIC regression analysis ,TRAUMATOLOGY - Abstract
Childhood traumas, in the form of physical, sexual, and emotional abuse and neglect, are globally widespread and highly prevalent, and associated with a range of subsequent poor health outcomes. This study sought to understand the relationship between physical, sexual and emotional childhood abuse and subsequent HIV-risk behaviours amongst young people (18–30) living in urban informal settlements in Durban, South Africa. Data came from self-completed questionnaires amongst 680 women and 677 men comprising the baseline of the Stepping Stones and Creating Futures intervention trial. Men and women were analysed separately. Logistic regression models assessed the relationship between six HIV-risk behaviours and four measures of trauma: the form of trauma, the severity of each trauma, the range of traumas, and overall severity of childhood trauma. Childhood traumas were incredibly prevalent in this population. All childhood traumas were associated with a range of HIV-risk behaviours. This was for the ever/never trauma, as well as the severity of each type of trauma, the range of trauma, and overall severity of childhood trauma. Despite the wider harsh contexts of urban informal settlements, childhood traumas still play a significant role in shaping subsequent HIV-risk behaviours amongst young people. Interventions to reduce childhood traumas for populations in informal settlements need to be developed. In addition, trauma focused therapies need to be considered as part of wider HIV-prevention interventions for young adults. Trial registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
33. Delivery fee exemption and subsidy policies: how have they affected health staff? Findings from a four-country evaluation.
- Author
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Witter, Sophie, Ilboudo, Patrick G., Cunden, Nadia, Boukhalfa, Chakib, Makoutode, Patrick, and Daou, Zoumana
- Subjects
HEALTH insurance subsidies ,OBSTETRICAL emergencies ,HEALTH policy ,MEDICAL personnel ,EMPLOYEES' workload ,CESAREAN section ,DELIVERY (Obstetrics) ,COMPARATIVE studies ,JOB satisfaction ,RESEARCH methodology ,MEDICAL cooperation ,MOTIVATION (Psychology) ,OBSTETRICS ,RESEARCH ,EVALUATION research ,ECONOMICS ,PSYCHOLOGY - Abstract
Many countries, especially in Africa, have in recent years introduced fee exemptions or subsidies targeting deliveries and emergency obstetric care. A number of aspects of these policies have been studied but there are few studies which look at how staff have been affected and how they have responded. This article focuses on this question, comparing data from Benin, Burkina Faso, Mali and Morocco. It is nested in wider evaluation of the policies. The article analyses responses to a health worker survey, carried out in 2012 on 683 health staff (doctors, nurses, midwives and others such as auxiliaries) across the four countries. The survey focused on working hours, workloads, pay, motivation and perceptions of the policies, as well as reported changes in workload and remuneration over the period of policy introduction. Self-reported staff output ratios suggest that midwives are over-worked across all settings, but facility data presents lower estimates, making it hard to judge the adequacy of workforces. Staff are generally positive about the policies’ effects on the health system (increasing supervised delivery rates, benefiting the poor, improving access to medicines and supplies and improving quality of care). In personal terms, staff in Mali and Burkina Faso report increased satisfaction with work as a result of the policies, while in Benin, there is little change and in Morocco a deterioration (which correlated with recommendations about extending exemption policies in future). Awareness of policies was high amongst staff but only a small minority had received any written guides or training on policy implementation. It is crucial that planned health financing changes engage with their implications for staffing—estimating whether specific cadres can absorb increase demand, for example, as well as how to engage them in the policy implementation such that their personal needs are met and their professionalism enhanced. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
34. Ethnic minority women prefer strong recommendations to be screened for cancer.
- Author
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Marlow, Laura A. V., Meisel, Susanne F., and Wardle, Jane
- Subjects
EARLY detection of cancer ,MINORITIES ,SOCIODEMOGRAPHIC factors ,NATIONAL health services ,FACE-to-face communication ,TUMOR diagnosis ,TUMORS & psychology ,ACCULTURATION ,ETHNOPSYCHOLOGY ,PSYCHOLOGY of Minorities ,RESEARCH funding ,TRUST ,TUMORS ,QUALITATIVE research ,PATIENTS' attitudes ,PSYCHOLOGY - Abstract
Background: Cancer screening invitations can explicitly recommend attendance or encourage individuals to consider the risks and benefits before deciding for themselves. Public preferences for these approaches might vary. We explored ethnic minority women's preferences for a strong recommendation to be screened.Methods: Women aged 30-60 years from Indian, Pakistani, Bangladeshi, Caribbean, African and white British backgrounds (n = 120 per group) completed face-to-face interviews with a multi-lingual interviewer. The interview included a question on which approach to screening invitations they would prefer: i) A strong recommendation from the National Health Service (NHS) to go for screening, ii) A statement that the NHS thinks you should go for screening, but it's up to you to decide, iii) No recommendation. Analyses examined predictors of preference for a strong recommendation.Results: Preferences varied by ethnicity (χ 2(5) = 98.20, p <.001). All ethnic minority groups had a preference for a strong recommendation to be screened (53-86% across ethnic groups vs 31% white British). Socio-demographic factors (marital status, education and employment), and indicators of acculturation (main language and migration status), contributed to explaining recommendation preferences (χ 2(5) = 35.95 and χ 2(3) = 11.59, respectively, both p <.001), but did not mediate the ethnicity effect entirely. Self-rated comprehension of written health information did not contribute to the model.Conclusions: A strong recommendation to participate in cancer screening appears to be important for ethnic minority women, particularly non-English speakers. Future research could explore how to best arrive at a consensus that respects patient autonomy while also accommodating those that would prefer to be guided by a trusted source. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
35. Bibliometric analysis of literature on female genital mutilation: (1930 - 2015).
- Author
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Sweileh, Waleed M.
- Subjects
ASSOCIATIONS, institutions, etc. ,AUTHORS ,BIBLIOMETRICS ,FEMALE genital mutilation ,INFORMATION retrieval ,LABOR productivity ,LITERATURE ,POPULATION geography ,SERIAL publications ,BIBLIOGRAPHIC databases ,DATA analysis software ,PSYCHOLOGY - Abstract
Background: Female genital mutilation/cutting (FGM/C) is a common harmful traditional practice in many communities in Africa and to a lesser extent in Middle East and other regions in the world. In order to better understand publishing on this topic, we conducted a bibliometric study on FGM/C. Bibliometric analyses can be used as an indicator of the extent of interaction of researchers, health authorities, and communities with a particular health issue. Methods: Scopus database was used to retrieve data on FGM/C. Keywords used were "female genital mutilation", "female genital circumcision", "female genital cutting" and "female circumcision". Specifically, the number of publications, top productive countries and institutions, highly cited articles, citation analysis, co-authorships, international collaboration, role of African countries, top active authors, and journals involved in publishing articles on FGM/C were reviewed and analyzed. We indirectly assessed the impact of publications using total number of citations received, average number of citations per article, Hirsch-index, percentage of highly cited articles, and journal's impact factor. Results: One thousand and thirty-five publications on FGM/C were retrieved. The h-index of retrieved articles was 37. A steep rise in number of publications was noticed in mid-1990s and again in 2012. More than half of retrieved articles were published from 2006 - 2015. A total of 65 countries contributed. The top ten productive countries included ones from Northern America, Europe and Africa. Nigeria and Egypt were the most active African countries in FGM/C publications. At least nine African academic institutions were actively involved on FGM/C publications. Articles on FGM/C that received the highest number of citations were those that focused on negative physical and psychosexual consequences of FGM/C. Journal topic areas were obstetrics/gynecology, public health, and psychological sociology. Collaboration between African and European countries on FGM/C research was evident. Conclusion: Bibliometric analysis reveals that research publications on FGM/C have been increasing since the l970s, with collaboration between African and Western countries, and articles are being published in higher impact journals, not only obstetrics, but also public health and social sciences. FGM/C research can be helpful to international health agencies and governments not only to document negative outcomes, but also to identify best practices, and to note gaps in implementation and practice. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
36. Roles and challenges of the multidisciplinary team involved in prosthetic rehabilitation, in a rural district in South Africa.
- Author
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Ennion, Liezel and Rhoda, Anthea
- Subjects
MULTIDISCIPLINARY practices ,MEDICAL rehabilitation ,LEG amputation ,QUALITY of life ,MEDICAL care ,PSYCHOLOGY - Abstract
Background: Major lower limb amputations result in a significant sense of loss, psychological stress, and decrease in function and overall quality of life for the amputee. The holistic, patient-centered prosthetic rehabilitation of an amputee requires input from a team of dedicated health professionals from different disciplines commonly referred to as a multidisciplinary team (MDT). MDT rehabilitation is considered crucial in the reintegration of the amputee into the community, as well as for providing psychological support after limb loss. Multidisciplinary and interdisciplinary rehabilitation has been proven to be more successful than therapy provided by individual therapists in a number of different populations, regardless of the population studied. However, in most developing countries, there is a significant lack of multidisciplinary rehabilitation. Aim: To explore the roles and challenges of the members of the MDT involved in trans-tibial amputation rehabilitation in a rural community in South Africa (SA). Design: An explorative sequential qualitative descriptive study. Setting: A rural district in the KwaZulu Natal province in SA. Participants: Nine prosthetic users, three surgeons, three traditional healers, 17 therapists, four prosthetists, and four community health workers. Instruments for data collection: Semistructured interviews and focus group discussions. Results: The roles of the members of the MDT were clarified, and various members of the MDT highlighted specific challenges relating to their experiences and roles in the rehabilitation team. Lack of interdisciplinary rehabilitation and communication among team members, as well as lack of resources, and patient education negatively impact the rehabilitation of trans-tibial amputees. Conclusion: Aiming to address the limited resources available to health care professionals, as well as improved communication and interdisciplinary rehabilitation, could potentially improve the overall rehabilitation of persons with a lower limb amputation in the rural setting. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
37. Attitudes towards human papillomavirus vaccination among African parents in a city in the north of England: a qualitative study.
- Author
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Mupandawana, Edith T. and Cross, Ruth
- Subjects
PATIENT refusal of treatment ,CERVIX uteri tumors ,TUMOR prevention ,ETHNIC groups ,CULTURE ,INTERVIEWING ,RESEARCH methodology ,HUMAN sexuality ,SPIRITUALITY ,HUMAN papillomavirus vaccines ,PSYCHOLOGY of Black people ,QUALITATIVE research ,THEMATIC analysis ,PARENT attitudes ,ADOLESCENCE ,CHILDREN ,PSYCHOLOGY - Abstract
Background: Human papillomavirus (HPV) is sexually transmitted and has been conclusively linked to cervical cancer and genital warts. Cervical cancer is attributed to approximately 1100 deaths annually in UK, and is the second most common female cancer globally. It has been suggested that black African women are more predisposed to HPV infection and cervical cancer. A vaccine has been developed to reduce HPV infection, and in the UK, has been offered to 12-13 year old adolescent girls through schools as part of their childhood immunization programme since 2008. Upon programme initiation, it was noted that vaccine uptake was lower in schools where girls from ethnic minority groups were proportionately higher. The study's objectives were to explore factors influencing UK based African parents' acceptance or decline of the HPV vaccine, whether fathers and mothers share similar views pertaining to vaccination and any interfamily tensions resulting from differing views. Methods: A qualitative study was conducted with five African couples residing in north England. Face to face semi- structured interviews were carried out. Participants were parents to at least one daughter aged between 8 and 14 years. Recruitment was done through purposive sampling using snowballing. Results: HPV and cervical cancer awareness was generally low, with awareness lower in fathers. HPV vaccination was generally unacceptable among the participants, with fear of promiscuity, infertility and concerns that it'ss t i l lan e w vaccine with yet unknown side effects cited as reasons for vaccine decline. There was HPV risk denial as religion and good cultural upbringing seemed to result in low risk perceptions, with HPV and cervical cancer generally perceived as a white person's disease. Religious values and cultural norms influenced vaccine decision-making, with fathers acting as the ultimate decision makers. Current information about why the vaccine is necessary was generally misunderstood. Conclusion: Tailored information addressing religious and cultural concerns may improve vaccine acceptability in African parents. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
38. Perspectives and experiences of new migrants on health screening in Sweden.
- Author
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Faustine Kyungu Nkulu Kalengayi, Hurtig, Anna-Karin, Nordstrand, Annika, Ahlm, Clas, Ahlberg, Beth Maina, and Nkulu Kalengayi, Faustine Kyungu
- Subjects
COMMUNICATION barriers ,MEDICAL screening ,MEDICAL care of immigrants ,CLINICAL trials ,MEDICAL care ,PSYCHOLOGY of caregivers ,COMMUNICABLE diseases ,PREVENTION of communicable diseases ,COOPERATIVENESS ,HEALTH attitudes ,LANGUAGE & languages ,PATIENT-professional relations ,HEALTH policy ,SENSORY perception ,NOMADS ,PSYCHOLOGY - Abstract
Background: In Sweden, migrants from countries considered to have a high burden of certain infectious diseases are offered health screening to prevent the spread of these diseases, but also identify their health needs. However, very little is known about their experiences and perceptions about the screening process. This study aimed at exploring these perceptions and experiences in order to inform policy and clinical practice.Method: Using an interpretive description framework, 26 new migrants were interviewed between April and June 2013 in four Swedish counties. Thematic analysis was used to analyze data.Results: The three themes developed include: new country, new practices; new requirements in the new country; and unmet needs and expectations. Participants described what it meant for them to come to a new country with a foreign language, new ways of communicating with caregivers/authorities and being offered health screening without clarification. Participants perceived health screening as a requirement from the authorities to be fulfilled by all newcomers but conceded that it benefits equally the host society and themselves. However, they also expressed concern over the involvement of the Migration Board staff and feared possible collaboration with health service to their detriment. They further stated that the screening program fell short of their expectations as it mainly focused on identifying infectious diseases and overlooked their actual health needs. Finally, they expressed frustration over delay in screening, poor living conditions in reception centers and the restrictive entitlement to care.Conclusions: Migrants are aware of their vulnerability and the need to undergo health screening though they view it as an official requirement. Thus, those who underwent the screening were more concerned about residency rather than the actual benefits of screening. The issues highlighted in this study may limit access to and uptake of the screening service, and compromise its effectiveness. To maximize the uptake: (1) linguistically and culturally adapted information is needed, (2) other screening approaches should be tried, (3) trained medical interpreters should be used, (4) a holistic and human right approach should be applied, (5) the involvement of migration staff should be reconsidered to avoid confusion and worries. Finally, to improve the effectiveness, (6) all migrants from targeted countries should be offered screening and efforts should be taken to improve the health literacy of migrants and the living conditions in reception centers. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
39. Can Warm Glow Alleviate Credit Market Failures? Evidence from Online Peer-to-Peer Lenders.
- Author
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Chemin, Matthieu and de Laat, Joost
- Subjects
ELECTRONIC trading of securities ,ALTRUISM ,ECONOMIC development finance ,INVESTORS ,CREDIT -- Social aspects ,INTEREST rates ,ENTREPRENEURSHIP ,ECONOMICS ,PSYCHOLOGY - Abstract
This article looks at an institutional innovation in which Western investors lend peer-to-peer to poor country enterprises. Using a unique data set from an online lending platform called MYC4, we find that MYC4's Western lenders grant lower interest rates to pro-poor, socially responsible, and pro-female African projects. Using a novel instrumental variable to account for interest rates' endogeneity, we find that these lower interest rates substantially improve the repayment performance of borrowers and do not reflect profit-maximizing behavior. This new way to organize finance improves credit market efficiency and the success rate of poor country enterprises. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
40. The Shadow of Indebtedness: Bridewealth and Norms Constraining Female Reproductive Autonomy.
- Author
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Horne, Christine, Dodoo, F. Nii-Amoo, and Dodoo, Naa Dodua
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BRIDE price ,SOCIAL norms ,WOMEN'S rights ,REPRODUCTIVE rights ,SOCIOLOGICAL research ,SOCIAL history ,HUMAN reproduction ,MARRIAGE & economics ,STATISTICS on women ,MARRIAGE ,AUTONOMY (Psychology) ,CASE studies ,RESEARCH funding ,STATISTICAL hypothesis testing ,FIELD research ,CULTURAL values ,DATA analysis software ,DESCRIPTIVE statistics ,PSYCHOLOGY - Abstract
Bridewealth is fundamental to marriage in Africa. Anthropological research provides substantial information regarding characteristics of the bridewealth transaction, but scholars and policymakers know little about its consequences for women in contemporary Africa. We argue that the payment of bridewealth strengthens normative constraints on women’s autonomy in the reproductive domain. We test and find support for our argument using a unique vignette experiment conducted with rural women in the Volta Region of Ghana. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
- View/download PDF
41. Mental health of failed asylum seekers as compared with pending and temporarily accepted asylum seekers.
- Author
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Mueller, Julia, Schmidt, Martina, Staeheli, Andrea, and Maier, Thomas
- Subjects
MENTAL illness risk factors ,POST-traumatic stress disorder ,ANALYSIS of variance ,COMPUTER software ,HEALTH services accessibility ,INTERVIEWING ,RESEARCH methodology ,MENTAL health ,RESEARCH funding ,STATISTICS ,T-test (Statistics) ,DATA analysis ,UNDOCUMENTED immigrants ,PSYCHOLOGY - Abstract
Background: Asylum seekers (AS) and refugees often suffer from severe psychopathology in the form of post-traumatic stress disorder (PTSD). As PTSD impacts memory functions, and as asylum applications rely on personal accounts, AS with PTSD are at more risk of being rejected than refugees. Methods: We studied the mental health of failed asylum seekers (FAS, N = 40) and a matched sample of AS (N = 40). Participants were administered structured interviews on sociodemographics, flight, exile and standardized questionnaires on PTSD, anxiety, depression and pain. Results: Both samples were severely affected; >80% exhibited at least one clinically significant condition. Conclusion: Given the great vulnerability of these individuals, long and unsettling asylum processes as practised in Western host countries seem problematic, as does the withdrawal of health and social welfare benefits. Finally, high rates of psychopathology amongst FAS indicate that refugee and humanitarian decision-making procedures may be failing to identify those most in need of protection. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
42. Uncertainties Associated with Quantifying Climate Change Impacts on Human Health: A Case Study for Diarrhea.
- Author
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Kolstad, Erik W. and Johansson, Kjell Arne
- Subjects
ANALYSIS of variance ,CLIMATOLOGY ,STATISTICAL correlation ,DIARRHEA ,FORECASTING ,HEALTH status indicators ,CASE studies ,POPULATION geography ,REGRESSION analysis ,TEMPERATURE ,RELATIVE medical risk ,DISEASE incidence ,PSYCHOLOGY - Abstract
BACKGROUND: Climate change is expected to have large impacts on health at low latitudes where droughts and malnutrition, diarrhea, and malaria are projected to increase OBJECTIVES: The main objective of this study was to indicate a method to assess a range of plausible health impacts of climate change while handling uncertainties in a unambiguous manner. We illustrate this method by quantifying the impacts of projected regional warming on diarrhea in this century. METHODS: We combined a range of linear regression coefficients to compute projections of future climate change-induced increases in diarrhea using the results from five empirical studies and a 19-member climate model ensemble for which future greenhouse gas emissions were prescribed. Six geographical regions were analyzed. RESULTS: The model ensemble projected temperature increases of up to 4°C over land in the tropics and subtropics by the end of this century. The associated mean projected increases of relative risk of diarrhea in the six study regions were 8-11% (with SDs of 3-5%) by 2010-2039 and 22-29% (SDs of 9-12%) by 2070-2099. CONCLUSIONS: Even our most conservative estimates indicate substantial impacts from climate change on the incidence of diarrhea. Nevertheless, our main conclusion is that large uncertainties are associated with future projections of diarrhea and climate change. We believe that these uncertainties can be attributed primarily to the sparsity of empirical climate-health data. Our results therefore highlight the need for empirical data in the cross section between climate and human health. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
43. The estimation of unwanted fertility.
- Author
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Casterline, John B. and El-Zeini, Laila O.
- Subjects
SOCIAL policy ,DEMOGRAPHIC surveys ,POPULATION policy ,FERTILITY ,RESEARCH methodology ,DEVELOPING countries -- Social aspects ,PSYCHOLOGY ,CHILDREN ,COMPARATIVE studies ,DEMOGRAPHY ,DEVELOPING countries ,MEDICAL cooperation ,RESEARCH ,EVALUATION research ,RESEARCH bias ,PARITY (Obstetrics) ,STATISTICAL models - Abstract
The estimation of unwanted fertility is a major objective of demographic surveys, including DHS surveys conducted in Asia, Africa, and Latin America. Levels and trends in unwanted fertility are important input to the formulation of population policy and the evaluation of family planning programs. Yet existing methods for estimating unwanted fertility are known to be defective, among other reasons because they rely on subjective data whose validity and reliability are questionable. In this article, we propose a new estimator of unwanted fertility-the "aggregate prospective estimator"--so named because it depends on the stated preference for another child at the time of the survey, the fertility-desires item consistently shown to possess the highest validity and reliability. Under reasonable assumptions, the aggregate prospective estimator produces less biased estimates of unwanted fertility than the most widely used existing methods. The new estimator has the limitation of generating only aggregate-level estimates, but such estimates are the primary data for policy formulation and program evaluation. The new estimator is presented in this article, along with an evaluation of its underlying assumptions and its sensitivity to several sources of error. In an illustrative application to recent DHS data from six countries, the new estimator yields substantially higher estimates of unwanted fertility than existing methods in all six countries. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
44. All the Men Are Fighting for Freedom, All the Women Are Mourning Their Men, but Some of Us Carried Guns: A Raced-Gendered Analysis of Fanon's Psychological Perspectives on War.
- Author
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White, Aaronette M.
- Subjects
WOMEN & war ,WAR ,VIOLENCE & psychology ,AFRICANS ,GENDER studies ,PATRIARCHY ,NATIONALISM ,POSTCOLONIALISM ,PSYCHOLOGY - Abstract
The author, citing anticolonial revolutionary Frantz Fanon's rationalization for revolutionary war, explores the psychological effects of war and military combat in African women. The author feels that Fanon was too confident in his views of the psychological potential of war and violence, saying that his confidence originated in his disregard for gendered aspects of anticolonial violence. The author discusses Fanon's theories of colonial oppression, the Algerian nationalist movement, and the psychological transformation rooted in revolutionary violence for men and women. The author then goes on to discuss Fanon's lack of consideration for the gendered and patriarchal elements of nationalism, war, and torture as they relate to African women.
- Published
- 2007
- Full Text
- View/download PDF
45. THE BONDSMAN'S NEW CLOTHES: THE CONTRADICTORY CONSCIOUSNESS OF SLAVE RESISTANCE ON THE SWAHILI COAST.
- Author
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Glassman, Jonathan
- Subjects
SLAVERY ,ENSLAVED persons ,INSURGENCY ,SWAHILI-speaking peoples ,PSYCHOLOGY - Abstract
Examines the consciousness that motivated African slaves to resist their masters. Changes in the nature of slavery and slave resistance on a part of the Swahili coast known as the Mrima; Understanding of the process of absorption as a process of conflict; Conflicts that ultimately determined the nature of the slave system; Slave resistance that took the form of struggle for fuller rights of social inclusion or for fuller access to local community institutions.
- Published
- 1991
- Full Text
- View/download PDF
46. Designing a course model for distance-based online bioinformatics training in Africa: The H3ABioNet experience.
- Author
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Gurwitz, Kim T., Aron, Shaun, Panji, Sumir, Maslamoney, Suresh, Fernandes, Pedro L., Judge, David P., Ghouila, Amel, Domelevo Entfellner, Jean-Baka, Guerfali, Fatma Z., Saunders, Colleen, Mansour Alzohairy, Ahmed, Salifu, Samson P., Ahmed, Rehab, Cloete, Ruben, Kayondo, Jonathan, Ssemwanga, Deogratius, Mulder, Nicola, and Null, Null
- Subjects
BIOINFORMATICS ,ONLINE education ,DISTANCE education ,EDUCATION - Abstract
Africa is not unique in its need for basic bioinformatics training for individuals from a diverse range of academic backgrounds. However, particular logistical challenges in Africa, most notably access to bioinformatics expertise and internet stability, must be addressed in order to meet this need on the continent. H3ABioNet (), the Pan African Bioinformatics Network for H3Africa, has therefore developed an innovative, free-of-charge “Introduction to Bioinformatics” course, taking these challenges into account as part of its educational efforts to provide on-site training and develop local expertise inside its network. A multiple-delivery–mode learning model was selected for this 3-month course in order to increase access to (mostly) African, expert bioinformatics trainers. The content of the course was developed to include a range of fundamental bioinformatics topics at the introductory level. For the first iteration of the course (2016), classrooms with a total of 364 enrolled participants were hosted at 20 institutions across 10 African countries. To ensure that classroom success did not depend on stable internet, trainers pre-recorded their lectures, and classrooms downloaded and watched these locally during biweekly contact sessions. The trainers were available via video conferencing to take questions during contact sessions, as well as via online “question and discussion” forums outside of contact session time. This learning model, developed for a resource-limited setting, could easily be adapted to other settings. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
47. Maternal and Neonatal and Child Health Priorities in Africa and Asia.
- Author
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Vermund, Sten H., Garg, Renu, Lo, Ying-Ru, Sheldon, Emily K., and Mwinga, Kasonde
- Subjects
EDUCATION of mothers ,PREVENTION of sexually transmitted diseases ,SEXUALLY transmitted diseases ,CHRONIC diseases ,CONTRACEPTION ,HEALTH services accessibility ,INFANT health services ,LITERACY ,QUALITY assurance ,SERIAL publications ,DEVELOPING countries ,PSYCHOLOGY - Published
- 2016
- Full Text
- View/download PDF
48. 5. Consumer Behavior.
- Author
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Penn Jr., William S., Smith, G. C., and Wotruba, Thomas R.
- Subjects
CONSUMER behavior ,PSYCHOLOGY of color ,TECHNOLOGY & civilization ,INCOME accounting ,CONSUMER preferences ,PSYCHOLOGY - Abstract
The article presents marketing abstracts relative to consumer behavior. They include "Color and the Consumer," by John E. Mertes, "Optimistic Prognosis for Cultural Technology," by Robert Fulford, and "Household Expenditure in Nairobi: A Statistical Analysis of Consumer Behavior," by Benton E. Massell and Judith Heyer.
- Published
- 1969
49. 'You can't stay away from your family': a qualitative study of the ongoing ties and future plans of South African health workers in the United Kingdom.
- Author
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Taylor, Katherine, Blacklock, Claire, Hayward, Gail, Bidwell, Posy, Laxmikanth, Pallavi, Riches, Nicholas, Willcox, Merlin, Moosa, Shabir, and Mant, David
- Subjects
MEDICAL education ,EMIGRATION & immigration ,FAMILIES ,BUSINESS management of health facilities ,IDENTITY (Psychology) ,INTERVIEWING ,RESEARCH methodology ,MEDICAL personnel ,SOCIAL security ,SPOUSES ,TEACHING ,QUALITATIVE research ,NOMADS ,PSYCHOLOGY - Abstract
Migration of African-trained health workers to countries with higher health care worker densities adds to the severe shortage of health personnel in many African countries. Policy initiatives to reduce migration levels are informed by many studies exploring the reasons for the original decision to migrate. In contrast, there is little evidence to inform policies designed to facilitate health workers returning home or providing other forms of support to the health system of their home country. This study explores the links that South African-trained health workers who now live and work in the United Kingdom maintain with their country of training and what their future migration plans may be. Semi-structured interviews were conducted with South African trained health workers who are now living in the United Kingdom. Data extracts from the interviews relating to current links with South Africa and future migration plans were studied. All 16 participants reported strong ongoing ties with South Africa, particularly through active communication with family and friends, both face-to-face and remotely. Being South African was a significant part of their personal identity, and many made frequent visits to South Africa. These visits sometimes incorporated professional activities such as medical work, teaching, and charitable or business ventures in South Africa. The presence and location of family and spouse were of principal importance in helping South African-trained health care workers decide whether to return permanently to work in South Africa. Professional aspirations and sense of duty were also important motivators to both returning and to being involved in initiatives remotely from the United Kingdom. The main barrier to returning home was usually the development of stronger family ties in the United Kingdom than in South Africa. The issues that prompted the original migration decision, such as security and education, also remained important reasons to remain in the United Kingdom as long as they were perceived as unresolved at home. However, the strong residual feeling of identity and regular ongoing communication meant that most participants expressed a sense of duty to their home country, even if they were unlikely to return to live there full-time. This is a resource for training and short-term support that could be utilised to the benefit of African health care systems. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
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