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‣ Health-seeking behaviour of persons with HIV/AIDS in Ghana: prospects for change

Awusabo-Asare, Kofi; Anarfi, John Kwasi
Fonte: Health Transition Centre, National Centre for Epidemiology and Population Health, The Australian National University Publicador: Health Transition Centre, National Centre for Epidemiology and Population Health, The Australian National University
Tipo: Artigo de Revista Científica Formato: 60236 bytes; application/pdf
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Historically, diseases whose aetiology could not be readily explained have been given supernatural explanations among the various ethnic groups in Ghana. Now HIV infection, with no known cure and origin, has been given a supernatural explanation. Such an explanation of disease causation influences people’s attitude to the disease and to infected persons, and influences the healthseeking behaviour of infected persons. Data from a study on the Social Dimensions of HIV/AIDS Infection in Ghana are used to examine the health-seeking behaviour of some persons with AIDS interviewed in 1992. The paper examines the health care outlets used by infected persons and the reasons for using those outlets. Some HIV-infected persons in Ghana felt that they had been bewitched and, therefore, used multiple health care outlets, either serially or simultaneously, hoping that one of them might provide a cure or relief as well as explain the source of the infection. This is in spite of the continuing educational campaign stating that the disease has no cure. Such attitudes towards the disease and health-seeking behaviour should be considered in the design of programs for infected persons.; no

‣ A health profile in adults in a Northern Territory Aboriginal community, with an emphasis on preventable morbidities

Hoy, W.; Norman, R.; Hayhurst, B.; Pugsley, D.
Fonte: PUBLIC HEALTH ASSOC AUSTRALIA INC Publicador: PUBLIC HEALTH ASSOC AUSTRALIA INC
Tipo: Artigo de Revista Científica
Publicado em //1997 Português
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We conducted a brief health survey of adults in an isolated Northern Territory Aboriginal community, whose standardised mortality rates are the second highest in Australia. The screen revealed high rates of smoking and excessive drinking, of preventable infections and their sequelae, and of hypertension, insulin resistance, diabetes and renal disease. The infectious morbidities were more pronounced and the life-style morbidities almost entirely new since a health screen in 1957. Most morbidities were strongly associated with identifiable risk factors, such as overweight, smoking, excessive drinking, skin sores and scabies, all of which which are amenable to modification. Problems with food supply and pricing, poor food choices and diversion of money to cigarettes, beer and gambling all contributed to poor nutrition. Low birthweight probably compounds the risk for serious adult disease associated with these environmental influences. This profile highlights the failure of current systems to deal with health needs. Improvements in infrastructure, education and employment, and reinvigoration of preventive and primary health care programs, assumption of responsibility for health by the community and by individuals themselves, and better management of existing morbidities are essential to rectifying this shameful situation.

‣ Dental knowledge and oral health among middle-aged adults

Brennan, D.; Spencer, A.; Roberts-Thomson, K.
Fonte: Public Health Assoc Australia Inc Publicador: Public Health Assoc Australia Inc
Tipo: Artigo de Revista Científica
Publicado em //2010 Português
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Objective: Knowledge of oral disease prevention should lead to better oral health outcomes. The aims were to assess the association of dental knowledge and oral health. Methods: A random sample of 45-54 year-olds from Adelaide, South Australia, was surveyed in 2004/05. Oral examinations provided data on caries. Results: A total of 879 persons returned questionnaires (response=43.8%) with 709 (80.7%) examined. The majority rated ‘seeing a dentist regularly’ (63.0%), ‘regular brushing of teeth’ (92.5%) and ‘using fluoride toothpaste’ (52.2%) as ‘definitely important’ in preventing tooth decay. The percentage of persons who had a high knowledge of tooth decay prevention was 59.9%. Multivariate analysis controlling for sex, place of birth, education and income showed (p<0.05) associations of high dental knowledge of tooth decay prevention with fewer decayed teeth (β=-0.19) and more filled teeth (β=1.13). Conclusions: Dental knowledge was associated with oral health status. Implications: Conveying of information should be one part of oral health promotion actions to improve oral health.; David Brennan, John Spencer and Kaye Roberts-Thomson

‣ Separation from family and its impact on the mental health of Sudanese refugees in Australia: A qualitative study

Savic, M.; Chur-Hansen, A.; Mahmood, M.; Moore, V.
Fonte: Public Health Assoc Australia Inc Publicador: Public Health Assoc Australia Inc
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
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Objective: This study explored the impact of separation from family members on the mental health and wellbeing of Sudanese refugees in Australia, and the coping strategies used. Methods: In-depth interviews were conducted with Sudanese community representatives and health workers, primary and mental health care practitioners, health service managers and policy makers. Interviews were analysed using thematic analysis. Results: Separation was perceived as having a negative impact on the mental health of Sudanese refugees in Australia, and manifested in concern about the safety of relatives abroad and in changing roles. The pressure to send money home emerged as a high priority for Sudanese refugees, often superseding local concerns. Several strategies were used to bridge the separation gap, including maintaining contact through the use of information communication technologies, and family-reunification. Conclusions: Separation from family can be an ongoing source of stress and sadness among refugees in countries such as Australia. While resettling refugees are actively taking steps to cope with the impact of separation, awareness of the issue in mainstream services appears to be low. Implications: Separation from family continues to affect refugees' lives in countries of resettlement. While it may be difficult to alter the course of the monumental circumstances that cause forced migration...

‣ Networks to strengthen health systems for chronic disease prevention

Willis, C.; Riley, B.; Herbert, C.; Best, A.
Fonte: Amer Public Health Assoc Inc Publicador: Amer Public Health Assoc Inc
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
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Interorganizational networks that harness the priorities, capacities, and skills of various agencies and individuals have emerged as useful approaches for strengthening preventive services in public health systems. We use examples from the Canadian Heart Health Initiative and Alberta's Primary Care Networks to illustrate characteristics of networks, describe the limitations of existing frameworks for assessing the performance of prevention-oriented networks, and propose a research agenda for guiding future efforts to improve the performance of these initiatives. Prevention-specific assessment strategies that capture relevant aspects of network performance need to be identified, and feedback mechanisms are needed that make better use of these data to drive change in network activities.; Cameron D. Willis, Barbara L. Riley, Carol P. Herbert, and Allan Best

‣ Utilization of maternal health-care services in Peru: the role of women's education

Elo, Irma T
Fonte: Health Transition Centre, National Centre for Epidemiology and Population Health, The Australian National University Publicador: Health Transition Centre, National Centre for Epidemiology and Population Health, The Australian National University
Tipo: Artigo de Revista Científica Formato: 66206 bytes; application/pdf
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This article explores the hypothesis that formal education of women influences the use of maternal health-care services in Peru, net of the mother’s childhood place of residence, household socioeconomic status and access to health-care services. The findings are consistent with the hypothesis; both cross-sectional and fixed-effects logit models yield quantitatively important and statistically reliable estimates of the positive effect of maternal schooling on the use of prenatal care and delivery assistance. In addition, large differentials were found in the utilization of maternal health-care services by place of residence, suggesting that much greater efforts on the part of the government are required if modern maternal health-care services are to reach women in rural areas.; yes

‣ What children value : a scale to guide health promotion programs

Foster, Kelly A.
Fonte: Brock University Publicador: Brock University
Tipo: Electronic Thesis or Dissertation
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Objective. Physical activity is important for the health of all human beings. Although it is important to develop good health promotion programs for children to increase participation in physical activity, to date there appear to be no programs based on what kids value beyond health and physical activity itself. This study proposed to create a scale with strong content and face validity that could uncover what any given population of children value in life regardless of their participation in physical activity and that experts feel could be related to physical activity. These findings will allow the development of targeted health promotion programs to increase children's participation in regular physical activity. Method In this study, a combination of qualitative and quantitative approaches was used. Data were gathered from seven experts in the field, sixty-seven children in grades three to five, five parents, and three teachers. From these data response groupings were created and sent to four experts to be given single word names. The resulting nine theme names were re-worked into "child-friendly" language. Four children were then asked to discuss theme names to see if they liked and understood them. The next step involved asking children and experts to rank order the nine themes...

‣ Racial/Ethnic Variations in Women's Health: The Social Embeddedness of Health

Williams, David R.
Fonte: © American Journal of Public Health 2002 Publicador: © American Journal of Public Health 2002
Tipo: Artigo de Revista Científica
Publicado em /04/2002 Português
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This article provides an overview of the magnitude of and trends in racial/ethnic disparities in health for women in the United States. It emphasizes the importance of attending to diversity in the health profiles and populations of minority women. Socioeconomic status is a central determinant of racial/ethnic disparities in health, but several other factors, including medical care, geographic location, migration and acculturation, racism, and exposure to stress and resources also play a role. There is a need for renewed attention to monitoring, understanding, and actively seeking to eliminate racial/ethnic disparities in health.

‣ The 1918 Influenza Epidemic in New York City: A Review of the Public Health Response

Aimone, Francesco
Fonte: Association of Schools of Public Health Publicador: Association of Schools of Public Health
Tipo: Artigo de Revista Científica
Publicado em //2010 Português
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New York City approached the 1918 influenza epidemic by making use of its existing robust public health infrastructure. Health officials worked to prevent the spread of contagion by distancing healthy New Yorkers from those infected, increasing disease surveillance capacities, and mounting a large-scale health education campaign while regulating public spaces such as schools and theaters. Control measures, such as those used for spitting, were implemented through a spectrum of mandatory and voluntary measures. Most of New York City's public health responses to influenza were adapted from its previous campaigns against tuberculosis, suggesting that a city's existing public health infrastructure plays an important role in shaping its practices and policies during an epidemic.

‣ Expenditures for Public Health: Assessing Historical and Prospective Trends

Kinner, Kyle; Pellegrini, Cindy
Fonte: American Public Health Association Publicador: American Public Health Association
Tipo: Artigo de Revista Científica
Publicado em /10/2009 Português
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We integrated publicly available fiscal and budgetary data to assess historical and prospective trends in public health system funding at the federal, state, and local levels in relation to the recommended objectives outlined in the Institute of Medicine's definitive 2002 report. Although historical growth rates for public health expenditures at all levels were competitive with other major funding objects (requested or funded budget items), outlays for health care services and medical research dwarfed public health spending in absolute amounts. Competition for scarce discretionary resources, competing policy priorities, and protracted fiscal pressures will make it difficult for public health systems to achieve the recommended objectives.

‣ Maximizing the Impact of Community-Based Practitioners in the Quest for Universal Health Coverage

Campbell, James; Admasu, Kesetebirhan; Soucat, Agnes; Tlou, Sheila
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Journal Article; Publications & Research :: Journal Article; Publications & Research
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The last decade has highlighted major gaps in the availability, accessibility, acceptability and quality of the health workforce in many countries. The quantity, skills and geographic distribution of the health workforce have long been recognized as factors that limit population health outcomes and progress towards the related Millennium Development Goals. Similarly, the even more ambitious health targets included in the Sustainable Development Goals – scheduled for adoption by the United Nations General Assembly later this month – may be undermined by the same factors.

‣ National Health Accounts Data from 1996 to 2010; A Systematic Review

Bui, Anthony L.; Lavado, Rouselle F.; Johnson, Elizabeth K.; Brooks, Benjamin P. C.; Freeman, Michael K.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Journal Article; Publications & Research :: Journal Article; Publications & Research
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We downloaded country-generated NHA reports from the World Health Organization global health expenditure database and the Organisation for Economic Co-operation and Development (OECD) StatExtract website. We also obtained reports from Abt Associates, through contacts in individual countries and through an online search. We compiled data in the four main types used in these reports: (i) financing source; (ii) financing agent; (iii) health function; and (iv) health provider. We combined and adjusted data to conform with OECD’s first edition of A system of health accounts manual, (2000).

‣ Participation in health impact assessment: objectives, methods and core values

Wright,John; Parry,Jayne; Mathers,Jonathan
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2005 Português
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Health impact assessment (HIA) is a multidisciplinary aid to decision-making that assesses the impact of policy on public health and on health inequalities. Its purpose is to assist decision-makers to maximize health gains and to reduce inequalities. The 1999 Gothenburg Consensus Paper (GCP) provides researchers with a rationale for establishing community participation as a core value of HIA. According to the GCP, participation in HIA empowers people within the decision-making process and redresses the democratic deficit between government and society. Participation in HIA generates a sense that health and decision-making is community-owned, and the personal experiences of citizens become integral to the formulation of policy. However, the participatory and empowering dimensions of HIA may prove difficult to operationalize. In this review of the participation strategies adopted in key applications of HIA in the United Kingdom, we found that HIA's aim of influencing decision-making creates tension between its participatory and knowledge-gathering dimensions. Accordingly, researchers have decreased the participatory dimension of HIA by reducing the importance attached to the community's experience of empowerment, ownership and democracy...

‣ Other patients are really in need of medical attention: the quality of health services for rape survivors in South Africa

Christofides,Nicola J.; Jewkes,Rachel K.; Webster,Naomi; Penn-Kekana,Loveday; Abrahams,Naeema; Martin,Lorna J.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/07/2005 Português
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OBJECTIVE: To investigate in the South African public health sector where the best services for rape survivors were provided, who provided them, what the providers' attitudes were towards women who had been raped and whether there were problems in delivering care for rape survivors. METHODS: A cross-sectional study of facilities was carried out. Two district hospitals, a regional hospital and a tertiary hospital (where available) were randomly sampled in each of the nine provinces in South Africa. At each hospital, senior staff identified two doctors and two nurses who regularly provided care for women who had been raped. These doctors and nurses were interviewed using a questionnaire with both open-ended and closed questions. We interviewed 124 providers in 31 hospitals. A checklist that indicated what facilities were available for rape survivors was also completed for each hospital. FINDINGS: A total of 32.6% of health workers in hospitals did not consider rape to be a serious medical condition. The mean number of rape survivors seen in the previous six months at each hospital was 27.9 (range = 9.3-46.5). A total of 30.3% of providers had received training in caring for rape survivors. More than three-quarters of regional hospitals (76.9%) had a private exam room designated for use in caring for rape survivors. Multiple regression analysis of practitioner factors associated with better quality of clinical care found these to be a practitioner being older than 40 years (parameter estimate = 2.4; 95% confidence interval (CI) = 0.7-5)...

‣ Making abortions safe: a matter of good public health policy and practice

Berer,M.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2000 Português
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Globally, abortion mortality accounts for at least 13% of all maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high mortality and morbidity from abortion tend to occur together. Preventing mortality and morbidity from abortion in countries where these remain high is a matter of good public health policy and medical practice, and constitutes an important part of safe motherhood initiatives. This article examines the changes in policy and health service provision required to make abortions safe. It is based on a wide-ranging review of published and unpublished sources. In order to be effective, public health measures must take into account the reasons why women have abortions, the kind of abortion services required and at what stages of pregnancy, the types of abortion service providers needed, and training, cost and counselling issues. The transition from unsafe to safe abortions demands the following: changes at national policy level; abortion training for service providers and the provision of services at the appropriate primary level health service delivery points; and ensuring that women access these services instead of those of untrained providers. Public awareness that abortion services are available is a crucial element of this transition...

‣ Global public-private partnerships: part II - what are the health issues for global governance?

Buse,K.; Walt,G.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2000 Português
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This is the second of a two-part review of global public-private partnerships (GPPPs) for health development. Part I was published in the April issue of the Bulletin (Vol. 78, No.4). The recent emergence of GPPPs is rapidly reconfiguring the international health landscape. While most multilateral and bilateral agencies are currently grappling with how to proceed, there is little information in the public domain concerning how individual partnerships work and to date very little consideration of the many implications of this trend. This paper differentiates between product-based, product development-based and issues/ systems-based GPPPs and describes a number of examples of each type in the health sector. The benefits of these initiatives, not least the major resources which they harness for specific health problems, are identified. The final section of the paper explores the implications and dilemmas posed by GPPPs. It discusses whether or not shared goals can transcend conflicting values and mandates and how governance of partnership arrangements may transform and undermine certain attributes of multilateral organizations. The paper concludes that the current climate of goodwill between public and private sectors offers an opportunity that should not be missed: it can be used not only to foster new partnership but to ensure that partnership is truly in the interests of international public health.

‣ Debt relief and public health spending in heavily indebted poor countries

Gupta,Sanjeev; Clements,Benedict; Guin-Siu,Maria Teresa; Leruth,Luc
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2002 Português
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The Heavily Indebted Poor Countries (HIPC) Initiative, which was launched in 1996, is the first comprehensive effort by the international community to reduce the external debt of the world's poorest countries. The Initiative will generate substantial savings relative to current and past public spending on health and education in these countries. Although there is ample scope for raising public health spending in heavily indebted poor countries, it may not be advisable to spend all the savings resulting from HIPC resources for this purpose. Any comprehensive strategy for tackling poverty should also focus on improving the efficiency of public health outlays and on reallocating funds to programmes that are most beneficial to the poor. In order to ensure that debt relief increases poverty-reducing spending and benefits the poor, all such spending, not just that financed by HIPC resources, should be tracked. This requires that countries improve all aspects of their public expenditure management. In the short run, heavily indebted poor countries can take some pragmatic tracking measures based on existing public expenditure management systems, but in the longer run they should adopt a more comprehensive approach so as to strengthen their budget formulation...

‣ Migration of health-care workers from developing countries: strategic approaches to its management

Stilwell,Barbara; Diallo,Khassoum; Zurn,Pascal; Vujicic,Marko; Adams,Orvill; Dal Poz,Mario
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2004 Português
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Of the 175 million people (2.9% of the world's population) living outside their country of birth in 2000, 65 million were economically active. The rise in the number of people migrating is significant for many developing countries because they are losing their better-educated nationals to richer countries. Medical practitioners and nurses represent a small proportion of the highly skilled workers who migrate, but the loss for developing countries of human resources in the health sector may mean that the capacity of the health system to deliver health care equitably is significantly compromised. It is unlikely that migration will stop given the advances in global communications and the development of global labour markets in some fields, which now include nursing. The aim of this paper is to examine some key issues related to the international migration of health workers and to discuss strategic approaches to managing migration.

‣ Use of business planning methods to monitor global health budgets in Turkmenistan

Ensor,Tim; Amannyazova,Bakhtigul
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2000 Português
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After undergoing many changes, the financing of health care in countries of the former Soviet Union is now showing signs of maturing. Soon after the political transition in these countries, the development of insurance systems and fee-for-service payment systems dominated the discussions on health reform. At present there is increasing emphasis on case mix adjusted payments in larger hospitals and on global budgets in smaller district hospitals. The problem is that such systems are often mistrusted for not providing sufficient financial control. At the same time, unless further planned restructuring is introduced, payment systems cannot on their own induce the fundamental change required in the health care system. As described in this article, in Tejen etrap (district), Turkmenistan, prospective business plans, which link planned objectives and activities with financial allocations, provide a framework for setting and monitoring budget expenditure. Plans can be linked to the overall objectives of the restructuring system and can be used to ensure sound financial management. The process of business planning, which calls for a major change in the way health facilities examine their activities, can be used as a vehicle to increase awareness of management issues. It also provides a way of satisfying the requirement for a rigorous...

‣ Overlooked opportunities for investing in health research and development

Fraser,David W.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2000 Português
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In 1996, an Ad Hoc Committee on Health Research Relating to Future Intervention Options (formed under the auspices of the World Health Organization) described a model for setting priorities in research funding. This model, however, as presented in the Ad Hoc Committee’s report entitled Investing in health research and development, fails in the following important situations: (i) when there is a health problem about which little is known; (ii) when current control measures are unsustainable; (iii) when there are complex risk factors, like ‘‘social factors’’, which affect many different diseases; and (iv) when the disease burden and resources for control vary greatly from one place to another. In situations of uncertainty or complexity, a method of priority-setting that emphasizes certainty and simplicity may actually mislead. A transparent, matrix-based process - illustrated with an example of priority-setting for malaria - may permit such uncertainty and complexity to be better taken into account in setting health research priorities.