Research Results (GHRI) / Résultats de recherches (IRSM)
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Item À la recherche de pistes pour améliorer les conditions des jeunes migrantes en centre urbain : rapport de recherche(Centre d'appui à la recherche et à la formation CAREF, 2010) Konaté, Mamadou Kani; De Koninck, Maria; Yaro, YacoubaLes petites filles migrantes dans les grandes villes de l’Afrique de l’Ouest constituent une population particulièrement exposée à des risques pour leur développement et leur santé. Des recherches ont déjà permis de connaître certaines de leurs motivations et des conditions dans lesquelles elles travaillent en ville. Afin d’améliorer la compréhension du phénomène dans une perspective d’intervention visant à réduire les risques et améliorer leurs conditions, une recherche a été menée au Mali et au Burkina Faso. Des jeunes migrantes ont été rencontrées à Bamako et à Ouagadougou. Des jeunes en âges de migrer l’ont été également dans des zones de départ. L’enquête a également permis de rencontrer des adultes dans ces mêmes zones. Les résultats confirment ce qui a déjà été documenté. C’est la pauvreté qui conduit les petites filles vers la ville. Elles y vont pour se préparer un meilleur avenir et pas nécessairement pour rester en ville puisque plusieurs souhaitent revenir au village. Elles y vont aussi pour soulager la misère de leur famille. Mais la ville ne leur offre que peu de possibilités d’acquérir des habiletés ou des savoirs qui leur permettraient de s’inscrire dans un cheminement d’amélioration de leurs conditions qui serait durable. De plus elles y souvent exploitées et encourent des risques, entre autres, parce qu’elles ne sont pas informées et ignorent comment se protéger. Des actions sont possibles et pourraient être mises en place afin d’améliorer la situation de ces jeunes. Quelques pistes sont ici suggérées selon une perspective de développement des communautés et de développement durable.Item Access as a policy-relevant concept in low- and middle-income countries(2009) McIntyre, D; Thiede, M; Birch, SAlthough access to health care is frequently identified as a goal for health care policy, the precise meaning of access to health care often remains unclear. We present a conceptual framework that defines access to health care as the empowerment of an individual to use health care and as a multidimensional concept based on the interaction (or degree of fit) between health care systems and individuals, households, and communities. Three dimensions of access are identified: availability, affordability, and acceptability, through which access can be evaluated directly instead of focusing on utilisation of care as a proxy for access. We present the case for the comprehensive evaluation of health care systems as well as the dimensions of access, and the factors underlying each dimension. Such systemic analyses can inform policy-makers about the ‘fit’ between needs for health care and receipt of care, and provide the basis for developing policies that promote improvements in the empowerment to use care.Item Access to health care services - an English policy perspective(2009) Goddard, MInternational trends highlight the confluence of economics, politics and legal considerations in the health policy process. Health Economics, Policy and Law serves as a forum for scholarship on health policy issues from these perspectives, and is of use to academics, policy makers and health care managers and professionals. HEPL is international in scope, publishes both theoretical and applied work, and contains articles on all aspects of health policy. Considerable emphasis is placed on rigorous conceptual development and analysis, and on the presentation of empirical evidence that is relevant to the policy process.Item Achieving Universal Health Coverage: State of Community Empowerment in Bangladesh(2012) Joarder, T; Uddin, A; Islam, AItem Action Research for the Health and Safety of Domestic Workers in Montreal: Using Numbers to Tell Stories and Effect Change(2010) Hanley, J; Premji, S; Messing, K; Lippel, KIn 2007, a Filipina organization in Quebec (PINAY) sought the help of university researchers to document the workplace health and safety experiences of domestic workers. Together, they surveyed 150 domestic workers and produced a report that generated interest from community groups, policy-makers, and the media. In this article, we—the university researchers—offer a case study of community-university action research. We share the story of how one project contributed to academic knowledge of domestic workers' health and safety experiences and also to a related policy campaign. We describe how Quebec workers' compensation legislation excludes domestic workers, and we analyze the occupational health literature related to domestic work. Striking data related to workplace accidents and illnesses emerged from the survey, and interesting lessons were learned about how occupational health questions should be posed. We conclude with a description of the successful policy advocacy that was possible as an outcome of this project.Item AIDS-Related Discrimination and its Effects on Prevention Service Adherence among Female Entertainment Workers(2011) Shi, G; Yin, F; Wu, J; Guo, L; Remis, R S[Objective] To investigate AIDS-related discrimination among female entertainment workers (FEWs) and its effect on prevention service adherence. [Methods] A total of 126 FEWs were randomly selected from Juyuan New Area as the study subjects, interviewed with an unified questionnaire for socio-demographic, behavioral, cognition and AIDS-related discrimination status, and tested for HIV, HSV-2, syphilis, gonorrhea and Chlamydia trachomatis with blood and urine samples. [Results] Among the 126 FEWs investigated, 31.75% came from large KTVs, 62.70% from small hair salons, 2.38% from small foot care stores, and 3.17% from small bathrooms. None was HIV-positive and 22.22% was infected with sexually transmitted diseases (STD). The mean score of AIDS-related discrimination was 4.19 plus or minus 1.61. AIDS-related discrimination had a statistical relationship with the level of AIDS knowledge ( chi super(2)=5.184, P=0.023). Only 23.81% had HIV tests ever, and "don't know where to go to get a test" and "chance of having AIDS is low" were the main reasons for not to get a test. Those having STD-related symptoms in the past one month accounted for 61.90%, and 70.51% saw a doctor. Those who went for routine STD check-ups in the past one year taken 50.00%, and the mean of STD checkups were 1.79 plus or minus 0.99. In their last sexual encounter, 96.83% used condoms when having sex with clients, but 45.74% did so when with regular sexual partners. The proportion of having a miscarriage ever was 11.11%, and 65.87% for an abortion ever. The times of miscarriage and abortion varied from 1 to 7, with the median of 1. Those using contraceptives accounted for 97.62%, among which 66.67% chose condoms. chi super(2) test showed AIDS-related discrimination had a statistical relationship with HIV test ( chi super(2)=5.936, P=0.015) and sexually transmitted infection rate ( chi super(2)=4.829, P=0.028). [Conclusion] AIDS-related discrimination is common among FEWs. HIV prevention service adherence is far from being satisfactory, and AIDS-related discrimination has an effect on some HIV prevention service adherence.Item Alimentación no saludable, inactividad física y obesidad en la población infantil colombiana: un llamado urgente al estado y la sociedad civil para emprender acciones efectivas(2012) Gómez, Luis Fernando; Ibarra, Marian Lorena; Lucumí, Diego Iván; Arango, Carlos Mario; Parra, AngelaColombia, al igual que la mayoría de los países de América Latina, ha experimentado una rápida transición nutricional, la cual se ha dado en un contexto caracterizado por altos niveles de pobreza, inequidad y exclusión social; sumado a acelerados procesos de globalización y una creciente influencia política y mediática de las grandes corporaciones de bebidas y alimentos ultra-procesados. Esta situación tiene un impacto potencialmente negativo en la salud infantil, al afectar sus patrones de actividad física y alimentación. Existen acciones poblacionales efectivas para la promoción de la actividad física y la alimentación saludable en niños, niñas y adolescentes, que podrían implementarse en Colombia si se contara con la voluntad política del gobierno y la participación activa de la sociedad civil. (Global Health Promotion, 2012; 19(3): 87–92)Item Almost universal coverage: HIV testing among TB patients in a rural public programme(2012) Chimbindi, N; Bärnighausen, T; Newell, M LItem Analyse des représentations sociales des agriculteurs et des agriculteurs-pêcheurs familiaux, hommes et femmes de la région de la Rivière Tapajós (Pará, Brésil) concernant l'usage de la coupe et du brûlis et les pratiques agricoles alternatives(Université du Québec à Montréal (UQAM), Montréal, QC, CA, 2010) Guentert, AngélaDepuis plusieurs années, l’Amazonie brésilienne subit d’importantes pressions anthropiques. On note entre autres celle des agriculteurs familiaux qui pratiquent une agriculture de subsistance basée principalement sur l’usage de la coupe et du brûlis. Cette recherche s’est déroulée dans trois communautés rurales de l’Amazonie brésilienne, dans l’État du Pará. Elle comporte deux volets intrinsèquement liés. D’une part, elle vise à connaître les représentations des agriculteurs et des agriculteurs-pêcheurs familiaux, hommes et femmes, concernant l’usage de la coupe et du brûlis et les alternatives agricoles sans feu, afin de mieux comprendre les pratiques actuelles et faciliter l’éventuelle mise en place d’alternatives plus respectueuses de l’environnement et moins nocives pour la santé humaine. La présente étude investigue également les aspects négatifs et positifs pouvant expliquer le recours à cette pratique. D’autre part, elle vise à obtenir le portrait le plus complet possible des connaissances (et leurs sources), des désirs et des besoins présents au sein des populations étudiées en lien avec les alternatives agricoles et de connaître les facteurs et les variables qui constituent des leviers et des obstacles à leur possible adoption. La collecte de données a été effectuée principalement à l’aide d’entrevues semi-dirigées. L’analyse des données, pour sa part, s’est basée sur la réduction quasi-phénoménologique, l’analyse thématique et le questionnement analytique...Item Analysing the trend of illicit tobacco in the Philippines from 1998 to 2018(BMJ, 2020-12-23) Lavares, Monica Paula; Ross, Hana; Francisco, Ariza; Doytch, NadiaThis study provides an estimate of the size of the illicit tobacco market, comparing the survey-based adult cigarette consumption with legally sold cigarettes in the Philippines. Illicit trade estimates are contrasted with the evolution of tax changes. Findings show that although the illicit market dropped substantially, and during the same time as large tax increases were implemented, the illicit share in 2018 remains similar to the 1998 level at 16% of the total market.Item Analysis of Helicobacter pylori isolates from Chile: occurrence of selective type 1 Lewis b antigen expression in lipopolysaccharide(2008) Altman, Eleonora; Fernandez, H; Chandan, V; Harrison, B A; Schuster, M WPrevious studies have shown that the LPS of Helicobacter pylori isolated from North American and European hosts predominantly expresses type 2 Lewis x (Lex) and Ley epitopes, whilst the LPS from Asian strains has the capacity to express type 1 Lea and Leb structures. The aim of this study was to evaluate the expression of Le antigens and the cytotoxin-associated antigen (CagA) by H. pylori isolates from Chile. A total of 38 isolates were screened. The expression of Le antigens and CagA was determined by whole-cell indirect ELISA, using commercially available monoclonal anti-Le and polyclonal anti-CagA antibodies. LPS profiles of H. pylori isolates were assessed by gel electrophoresis and Western blotting. Expression of Lex and/or Ley epitopes was confirmed in 32/38 isolates (84 %), whilst 9/38 isolates (24 %) expressed type 1 Leb blood group determinants, in addition to type 2 Lex and Ley structures. Six strains (16 %) were non-typeable. The majority of H. pylori strains examined were CagA-positive (83.3 %).Item Analysis on knowledge and practice of AIDS/STDs among female sex workers in Minhang district of Shanghai(2012) Yu, F; Zhang, J; Feng, Y; Huang, A; Fan, YTo investigate the living features and the knowledge and practice of AIDS/STDs among female entertainment workers(FEWs),so as to provide evidence to design,implement and assess AIDS/STDs prevention and invention.[Methods] A total of 125 FEWs,who were selected from 28 commercial entertainment locales(7 large and 21 small locales) in 2 communities by multistage cluster sampling method,were recruited for a questionnaire survey.[Results] There were significant differences in age,education,marital status and monthly income between FEWs working in large locales and those in small locales(P 0.01).Logistic regression analysis indicated that less condom use in married groups than in single groups(P 0.01).People who had higher scores in condom use knowledge and self-efficiency test revealed a higher rate of condom use in each sexual behavior.[Conclusion] FEWs,who are at the risk of infection at all times,are still the key population for AIDS/STDs prevention and control.Item Aplicación, efectividad y contexto político de la atención primaria integral de salud: resultados preliminares de una revisión de la literatura mundial(2009) Labonté, Ronald; Sanders, David; Baum, Fran; Schaay, Nikki; Packer, CorinneItem Applying social network analysis to understand the knowledge sharing behaviour of practitioners in a clinical discussion forum(PubMed, 2012-12) Stewart, S.A.; Abidi, S.S.Background: KT plays a vital role in the modern health care community, facilitating the incorporation of new evidence into practice. Web 2.0 tools provide a useful mechanism for establishing an online KT environment in which health practitioners share their practice-related knowledge and experiences with an online community of practice. We have implemented a Web 2.0 based KT environment—i.e. an online discussion forum—for pediatric pain practitioners across seven different hospitals in Thailand. The online discussion forum enabled the pediatric pain practitioners to share and translate their experiential knowledge to help improve the management of pediatric pain in hospitals. Objective: The goal of this research is to investigate the knowledge sharing dynamics of a community of practice through an online discussion forum. We evaluate the communication patterns of the community members using statistical and social network analysis methods in order to better understand how the online community engages to share experiential knowledge. Methods: Statistical analyses and visualizations provide a broad overview of the communication patterns within the discussion forum. Social network analysis provides the tools to delve deeper into the social network, identifying the most active members of the community, reporting the overall health of the social network , isolating the potential core members of the social network, and exploring the inter-group relationships that exist across institutions and professions. Results: The statistical analyses revealed a network dominated by a single institution and a single profession, and found a varied relationship between reading and posting content to the discussion forum. The social network analysis discovered a healthy network with strong communication patterns, while identifying which users are at the centre of the community in terms of facilitating communication. The group-level analysis suggests that there is strong inter-professional and interregional communication, but a dearth of non-nurse participants has been identified as a shortcoming. Conclusion: The results of the analysis suggest that the discussion forum is active and healthy, and that, though few, the inter-professional and inter-institutional ties are strong. Future work should be on connecting more analytic techniques.Item Assessing the impact of HIV/AIDS on health service capacity at primary care level, with specific focus on human resource capacity(2007) Lehmann, Uta; Schaay, Nikki; Zulu, Jabu; Matwa, Princess; Mathews, Verona; Daviaud, Emmanuelle; Scott, Vera; Dayile, NomvuyoThe project investigates how HIV/AIDS is impacting primary health care (PHC) services, especially human resources. It also reveals community participation components that can mitigate impacts. An assessment and management (audit) tool for managers was developed during the study. While research is needed to support and advance service development, the capacity to accommodate and absorb research is often very limited. The audit tool developed in Cape Town is now a well-established management tool which has national support. Leadership was found to be a crucial ingredient in capacity for change.Item Assessment of factors associated with complete immunization coverage in children aged 12-23 months : a cross-sectional study in Nouna district, Burkina Faso(BioMed Central, London, GB, 2009) Sanou, Aboubakary; Simboro, Seraphin; Kouyaté, Bocar; Dugas, Marylène; Graham, Janice; Bibeau, GillesThis study identifies specific factors associated with immunization status in Nouna health district (Burkina Faso) in order to advance improved intervention strategies in this district and in those with similar environmental and social contexts. While comprehensive communication may improve understanding about immunization, local interventions should also take into account religious specificities and critical economic periods. Communication problems need to be examined; for instance, many respondents did not understand what the health workers wanted; and or they assumed their child was already totally immunized. Particular approaches that take into consideration local distinctions need to be applied.Item Boletín de Vigilancia de Enfermedades No Transmisibles y Factores de Riesgo, Julio 2010, nro. 2(Ministerio de Salud de la Naci�n, Buenos Aires, AR, 2010) Fernández de Kirchner, Cristina; Manzur, Juan Luis; Diosque, Máximo; Kosacoff, Marina; Laspiur, SebastiánItem Boosting research for health in the new Arab world at the Bellagio Center : 26th February - 1st March 2013(2013-01-16) Council on Health Research for Development (COHRED)This is a two-page introduction for a meeting that focuses on the improvement of evidence-based culture after the events of the Arab Spring, and moving towards the advancement of health equity, along with development through research and innovation for health.Item Building and evaluating research capacity in healthcare systems : case studies and innovative models(IDRC, Ottawa, ON, CA, 2016) Mortley, Natasha; Teasdale-Corti Project Teams; Edwards, Nancy; Owino Kaseje, Dan C.; Kokuangisa Kahwa, EulaliaIn many lower- and middle-income countries (LMICs) research capacity remains fragmented, uneven and fragile. This book addresses these gaps, capturing insights from 13 teams working on the Global Health Research Initiative, co-led by Canadians and LMIC researchers in several regions of the world, including Sub-Saharan Africa, the Caribbean, Latin America and Asia. As well as enhancing skills of individual scientists, research capacity must aim towards strengthening institutional systems that can enable sustained scientific productivity, and extend understanding and development of useful indicators that can capture the impacts of initiatives that have capacity building as their focus.