Teasdale-Corti Global Health Research Partnership (TC) / partenariat Teasdale-Corti de recherche en santé mondiale

Permanent URI for this collection

Browse

Recent Submissions

Now showing 1 - 20 of 79
  • Item
    Research capacity strengthening project for infectious diseases in Honduras : experience and lessons learned
    (CoAction Publishers, 2013-08) Sanchez, Ana Lourdes; Canales, Maritza; Enriquez, Lourdes; Bottazzi, Maria Elena; Zelaya, Ada Argentina; Espinoza, Vilma Esther; Fontecha, Gustavo Adolfo
    Focusing on the School of Microbiology at the National Autonomous University of Honduras (UNAH), the primary objective was establishing an infectious disease graduate program to serve as a permanent platform for continued scientific research at UNAH and the continued training of researchers. Parallel objectives include institutional strengthening and the facilitation of partnerships and networks. Biosafety and research ethics knowledge and practices were enhanced, and collaborative networks expanded. Increased research activity and improvement in performance indicators at the prime Honduran research institution signal the need for a national research system in Honduras.
  • Item
    Sponsorship of physical activity programs by the sweetened beverages industry: public health or public relations?
    (2011) Gómez, Luis; Jacoby, Enrique; Ibarra, Lorena; Lucumí, Diego; Hernandez, Alexandra
    The growing evidence on the association between consumption of sugar-sweetened beverages, obesity and other chronic diseases has highlighted the need to implement policy actions that go beyond programs exclusively focused on individual responsibility. In order to protect their commercial goals in Latin America, the sugar-sweetened beverage industry practices intense lobbying at high government levels in several countries across the region. This strategy is accompanied by corporate social responsibility programs that fund initiatives promoting physical activity. These efforts, although appearing altruistic, are intended to improve the industry’s public image and increase political influence in order to block regulations counter to their interests. If this industry wants to contribute to human well being, as it has publicly stated, it should avoid blocking legislative actions intended to regulate the marketing, advertising and sale of their products.
  • 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, Angela
    Colombia, 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
    An Institutional Account of China's HIV/AIDS Policy Process from 1985 to 2010
    (2012) Knusten, W
    China's HIV/AIDS policy progress displays a long-term stagnancy followed by a sudden revolution. This article utilizes multiple theoretical tools to interpret this policy progress. It identifies four phases of China's HIV/AIDS policy process: (1) institutional endurance interpreted by path dependence from historical institutionalism; (2) deinstitutionalization explained by Oliver's antecedents of deinstitutionalization; (3) the radical shift interpreted by Kingdon's agenda-setting theory; and (4) reinstitutionalization and diffusion of institutional theory. This study demonstrates the utility of “creative borrowing”—employing multiple theoretical tools to harness the strengths of each. Doing so reveals that a country's past experience with similar policy issues, the perceived political and moral legitimacy of existing policies, and a country's existing political interests can exert resistance to change. In the presence of multiple pressures for change, policy entrepreneurs who can identify policy windows and couple multiple streams may achieve radical policy shifts.
  • Item
    Training Clinicians in Cultural Psychiatry: A Canadian Perspective
    (2008) Kirmayer, L J; Rousseau, C; Guzder, J; Jarvis, G E
    The authors summarize the pedagogical approaches and curriculum used in the training of clinicians in cultural psychiatry at the Division of Social and Transcultural Psychiatry, McGill University. We reviewed available published and unpublished reports on the history and development of training in cultural psychiatry at McGill to identify the main orientations, teaching methods, curriculum, and course content. Student evaluations of teaching were reviewed. The training strategies and curriculum are related to the larger social context of Canadian society including the history of migration, current demography, and policies of multiculturalism. The McGill program includes core teaching, clinical rotations, an intensive summer program, and annual Advanced Study Institutes. The interdisciplinary training setting emphasizes general knowledge rather than specific ethnocultural groups, including: understanding the cultural assumptions implicit in psychiatric theory and practice; exploring the clinician’s personal and professional identity and social position; evidence-based conceptual frameworks for understanding the interaction of culture and psychopathology; learning to use an expanded version of the cultural formulation in DSM-IV for diagnostic assessment and treatment planning; and developing skills for working with interpreters and culture-brokers, who mediate and interpret the cultural meaning and assumptions of patient and clinician. An approach to cultural psychiatry grounded in basic social science perspectives and in trainees’ appreciation of their own background can prepare clinicians to respond effectively to the changing configurations of culture, ethnicity, and identity in contemporary health care settings.Abstract Teaser
  • Item
    Rethinking resilience from indigenous perspectives
    (2011) Kirmayer, L J; Dandeneau, S; Marshall, E; Phillips, M; Williamson, K J
    The notions of resilience that have emerged in developmental psychology and psychiatry in recent years require systematic rethinking to address the distinctive cultures, geographic and social settings, and histories of adversity of indigenous peoples. In Canada, the overriding social realities of indigenous peoples include their historical rootedness to a specific place (with traditional lands, communities, and transactions with the environment) and the profound displacements caused by colonization and subsequent loss of autonomy, political oppression, and bureaucratic control. We report observations from an ongoing collaborative project on resilience in Inuit, Métis, Mi'kmaq, and Mohawk communities that suggests the value of incorporating indigenous constructs in resilience research. These constructs are expressed through specific stories and metaphors grounded in local culture and language; however, they can be framed more generally in terms of processes that include: regulating emotion and supporting adaptation through relational, ecocentric, and cosmocentric concepts of self and personhood; revisioning collective history in ways that valorize collective identity; revitalizing language and culture as resources for narrative self-fashioning, social positioning, and healing; and renewing individual and collective agency through political activism, empowerment, and reconciliation. Each of these sources of resilience can be understood in dynamic terms as emerging from interactions between individuals, their communities, and the larger regional, national, and global systems that locate and sustain indigenous agency and identity. This social-ecological view of resilience has important implications for mental health promotion, policy, and clinical practice.
  • Item
    Debating war-trauma and post-traumatic stress disorder (PTSD) in an interdisciplinary arena
    (2008) Kienzler, H
    Researchers have tried to determine and verify the effects of violent conflicts on the mental health of those affected by focusing on war trauma, posttraumatic stress disorder (PTSD), and other trauma-related disorders. This, in turn, led to the development of different kinds of theories and aid programs that aim at preventing and treating the consequences of violence and mental health. Until now, there is no agreement on the public health value of the concept of PTSD and no agreement on the appropriate type of mental-health care. Instead, psychiatrists have engaged in sometimes fierce discussions over the universality of war trauma, PTSD, and other trauma-related disorders. The two most polar positions are those who try to validate PTSD as a universal and cross-culturally valid psychopathological response to traumatic distress which may be cured or ameliorated with (Western) clinical and psychosocial therapeutic measures, and those who argue that the Western discourse on trauma only makes sense in the context of a particular cultural and moral framework and, therefore, becomes problematic in the context of other cultural and social settings. Although these positions seem mutually exclusive, their debates have led to the development of less radical approaches toward war-trauma and PTSD. The purpose of this literature review is to analyse the discourses on and debates over war-trauma and PTSD in the psychiatric literature in order to establish a better understanding for the diverse conceptualizations, interpretations and proposed healing strategies. Moreover, I discuss the cultural construction and conceptualization of war-trauma and PTSD from an anthropological perspective and show how anthropologists contribute to psychiatric debates so as to ensure more sophisticated diagnoses and healing strategies in culturally diverse contexts.
  • Item
    Ressources financières des comités de gestion du Burkina Faso peuvent améliorer l'équité d'accès au sytstème de santé
    (2010) Kafando, Y; Riddie, V
    Avec l’avènement du système de recouvrement des coûts dans les années 1990 au Burkina Faso, les patients contribuent au financement des centres de sante´ (CSPS) gérés par les comités de gestion (COGES). Mais en demandant aux patients de payer, une barrière financière s’impose aux plus pauvres. L’objectif de cet article est d’étudier la manière dont les ressources financières tirées du recouvrement des coûts peuvent contribuer à améliorer l’équité´ d’accès aux soins de santé´. L’étude se déroule dans le district sanitaire de Ouargaye. La méthodologie consiste a` documenter la situation financière de 17 COGES sur une période de 12 mois au moyen des données comptables. Les résultats montrent que les COGES ont dépensé en moyenne sept millions de francs CFA (FCFA), dont 65 % pour l’achat des médicaments, 15 % pour les frais de fonctionnement, 7 % pour le salaire du personnel et les primes aux COGES et 3,4 % pour les ristournes aux agents de sante´. Les recettes moyennes par COGES sont de 7,3 millions de FCFA. La vente des médicaments essentiels génériques correspond a` 82 % des recettes, et la tarification des actes a` 10 %. Le résultat comptable moyen annuel est de 300 000 FCFA. Le taux de recouvrement des dépenses est de 104 % en moyenne. La marge bénéficiaire sur la vente des médicaments est de 31 % en moyenne. Les ristournes aux agents de sante´ correspondent a` 30 % des recettes de la tarification des actes en moyenne. La trésorerie moyenne est de 3,1 millions de FCFA. Les COGES disposent d’une bonne capacité´ financière. Ils pourraient améliorer l’accès aux soins en respectant les normes des ristournes aux agents (20 %), en supprimant la tarification des actes, en réduisant les marges sur la vente des médicaments ou en utilisant une partie des bénéfices pour exonérer du paiement les plus pauvres.
  • Item
    Study on AIDS high risk sexual behavior and its sociological factors among MSM Pudong New Area [Chinese language]
    (2012) Mao, J; Zhang, X; Li, P; Sun, Q; Xiao, S
    Objective To study the sociological characteristics about HIV/AIDS high risk behavior and its associated factors among men who sex with men, and to provide the suggestion for the intervention against MSM. Methods A cross-sectional study was applied with snowball and internet sampling in Pudong New Area. 158 MSM were visited by face to face interview, the date about demographic、sexual orientation、sexual behaviors and sexual history were collected. ‘Informed consent’ principle was applied to the all. Results There are 130 gay and 28 bisexual in 158 MSM. In the past 6 months, 97(61.4%) of them have a fixed male sexual partner, 80(50.6%) have multiple sexual partners and 82(51.9%) have an occasional sexual partner. 46(48.4%) who have a fixed male partner、31(38.8%) who have multiple sexual partners、33(40.2%) who have a occasional sexual partner have HIV/AIDS high risk sexual behaviors in the past 6 months. Single and low-income MSM is more inclinable to have HIV/AIDS high risk sexual behavior than others. Conclusion The rate of HIV/AIDS high risk sexual behavior was high and multiple sexual partners were common in MSM. It is urgent to conduct intervention against MSM.
  • Item
    Survey on KAP and impact factors of condom use among construction workers in Shanghai,China
    (2010) Ren, J; Calzavara, L; Kang, L; Fang, H; Zhuang, M
    Objective To understand the level of knowledge,attitude and practice (KAP) related to condom use and relevant impact factors among construction workers in Shanghai so as to provide evidence base for further promotion of condom use.Methods A face-to-face questionnaire survey was conducted among 1871 construction workers who were randomly selected from 18 sites in three districts of Shanghai.The collected information included demography,working experience,living conditions,KAP related condom use,etc.Results Most of the surveyed construction workers were married and male.Average age was 39±10.4 years;80.8% of them only had primary or junior middle schooling or even below.The scores of knowledge and attitude related to condom use were very low.The proportion of consistent condom use with casual sex partners was significantly higher than that with regular sex partners (53.3% vs 10.6%;P0.001).The factors related with lower frequency of condom use included older age,cohabitation,married/remarried status and long daily working time,their OR values being 0.57,0.22,0.46 and 0.71,respectively.Conclusion Construction workers play a bridge role of transmitting HIV/STI from the high risk population to the general population because they are highly floating and sexually active,with insufficient condom use knowledge and less frequency of condom use,etc.Therefore,strong promotion of condom use should be conducted among this special population group.
  • Item
    Situation and influencing factors of sexual behaviors among male construction workers in Shanghai,China
    (2011) Ren, J; Calzavara, L; Fang, H; Pan, Q; Xu, L
    Objective To understand the situation and influencing factors of sexual behaviors among male construction workers in Shanghai and to supply the evidence for implementing AIDS/sexually transmitted disease(STD) prevention and intervention effectively.Methods A face-to-face questionnaire survey was conducted among 1 757 construction workers randomly selected from 18 sites in three districts of Shanghai.The information collected included demography,age at first sexual behavior,premarital and extramarital sexual activity,commercial sex,and sex violence.Meanwhile,the construction workers from six sites were followed up for a half of year in order to observe the change of their high risk sexual behaviors.Results Most of construction workers were young/middle-aged with an average age of 39±10.6 years and with low education.Among them,21.6% had at least 2 sexual partners and 7.3% ever had commercial sexual behavior.Among the married workers,the proportions of premarital and extramarital sexual behavior were 31.2% and 10.1%,respectively.The influencing factors of high risk sexual behaviors included age,gender,age at first sexual behavior,marital situation,and income.The risk of high risk sexual behaviors in the single or separated/divorced widowed workers was twice more higher than those of recently married or remarried.Conclusion Construction workers are the key population for the AIDS/STD prevention and control.
  • Item
    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, K
    In 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
    Evaluation of the Effects on KAP for AIDS Prevention among Construction Workers in Huangpu District after Intervention with Different Health Education Measures
    (2011) Wang, H; Cao, Z; Xu, Y; Shu, W; Su, F
    [Objective] To explore the application of different levels of health education measures among construction workers,to study its intervention effect and to provide evidence for focused health education policy.[Methods] A face-to-face questionnaire survey was conducted among construction workers in 6 construction sites of Huangpu District of Shanghai by random sampling,and different levels of health education measures were applied(the higher the intervention level was,the more multiform and professionalized intervention measures were applied).After 6 months,a follow-up was conducted to analyze the variation of KAP status among construction workers.[Results] A group of 594 workers were surveyed before intervention,and 352 workers were followed-up after 6 months,with the follow-up rate of 59.3%.Among the construction workers with some pre-intervention knowledge,the variation of HIV-related knowledge showed no statistical difference,but among those with less pre-intervention knowledge,the variation showed statistical difference in construction sites with three intervention levels(P ≤ 0.001).Before intervention the awareness rate of HIV-related knowledge was as low as 62.2%,with no statistical difference among different intervention levels.After intervention the rates rose and showed statistical differences(F=20.3,P0.001),with the highest rate of 73.6% in the construction sites with high intervention level.Before intervention there was no statistical difference of the attitudes toward HIV carriers among different intervention levels.After intervention the acceptance rate of"sympathetic"view increased and that of "afraid"and"disgusting"views decreased,with statistical differences "(sympathetic": χ2=17.7,P0.05;"afraid": χ2=16.8,P 0.05;"disgusting": χ2=16.2,P0.05).The views between construction sites with high and medium intervention levels had more changes.However,the proportion of people using condoms every time they had sex did not change much.[Conclusion] It’s feasible and effective to influence the knowledge and attitude of construction workers by using multiple health education measures.We should apply strongly focused interventions,and intervene repeatedly to improve the HIV-related knowledge as well as attitude and perception,and to protect the health of construction workers.
  • Item
    Community Health Workers’ Perspectives on Their Contribution to Rural Health and Well-Being in Iran
    (2011) Javanparast, S; Baum, F; Labonte, R; Sanders, D
    Objectives. The activities of community health workers (CHWs) have been identified as key to improvements in the health of Iran's rural population. We explored the perceptions of CHWs regarding their contribution to rural health in Iran. Methods. Three research assistants familiar with the Iranian primary health care network conducted face-to-face interviews with CHWs in 18 provinces in Iran. Results. Findings showed that Iranian CHWs have an in-depth understanding of health, including its social determinants, and are responsible for a wide range of activities. Respondents reported that trust-based relationships with rural communities, an altruistic motivation to serve rural people, and sound health knowledge and skills are the most important factors facilitating successful implementation of the CHW program in Iran. By contrast, high workload and the lack of a support system were mentioned as barriers to effective performance. Conclusions. The CHW program in Iran is a compelling example of comprehensive primary health care, in that CHWs provide basic health care but also work with community members and other sectors to address the social determinants of health.
  • Item
    Policy review of the community health worker programme in Iran
    (2011) Javanparast, S.; Baum, F.; Labonte, R.; Sanders, D.; Heidari, G.
    Iran's Community Health Worker (CHW) programme survived as an integral element of the health system during a period when many other nations’ CHW programmes collapsed and therefore warrants detailed analysis of the policies supporting the programme. We draw on a wide range of information about the Iranian programme and from this analysis draw important lessons on how to improve rural population health outcomes through Primary Health Care.
  • Item
    Investigation on the Knowledge, Attitude and Practice of Condom Use among Female Entertainment Workers and its Main Obstacles
    (2011) Ling, H; Fan, H; Song, Q; Wu, J; Yuan, J
    [Objective] To understand the knowledge, attitude and practice (KAP) of condom use among the female entertainment workers (FEWs) and analyze its obstacles to provide the practice for spreading the usage of condom. [Methods] Four large entertainment venues and eighteen small venues in Luwan District of Shanghai were selected randomly, and 124 FEWs were included. Their demographic characteristics, condom-related KAP and the information source of preventing HIV/AIDS were collected using the standardized questionnaires. [Results] The mean age of FEWs was (29.44 plus or minus 7.10) years old and 80.6% of them had only an education at or below junior middle school level. The scores of knowledge and attitude, and the skills to persuade whoremaster to use condom were low. The proportion of using condom in the last three commercial sex behaviors was just 36.6%. The availability of condom was high, but the proportion of getting information about AIDS prevention from professional institutions was low. Three risk factors were statistically significant, i.e. opinion, self-efficiency of condom use and monthly income. [Conclusion] The frequency of condom use and safe sexual behaviors among FEWs are low, which is very risky for the occurrence and spreading of AIDS. The main obstacles influencing condom use among FEWs include lower education level, insufficient knowledge of condom, low skills to persuade whoremaster to use condom, the poor attitude from managers, and insufficient propaganda from society. So the propaganda about safe sexual behaviors and expanding the usage of condom should be strengthened with the simultaneous interventions to both the FEWs and the whoremaster to improve the control effects.
  • Item
    Inequities in access to health care in South Africa
    (2011) Harris, B; Goudge, J; Ataguba, John; McIntyre, D; Nxumalo, N
    Achieving equitable universal health coverage requires the provision of accessible, necessary services for the entire population without imposing an unaffordable burden on individuals or households. In South Africa, little is known about access barriers to health care for the general population. We explore affordability, availability, and acceptability of services through a nationally representative household survey (n=4668), covering utilization, health status, reasons for delaying care, perceptions and experiences of services, and health-care expenditure. Socio-economic status, race, insurance status, and urban-rural location were associated with access to care, with black Africans, poor, uninsured and rural respondents, experiencing greatest barriers. Understanding access barriers from the user perspective is important for expanding health-care coverage, both in South Africa and in other low- and middle-income countries.
  • 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
    Modernizing concepts of access and equity
    (2009) Gulliford, M
    Former UK Prime Minister Tony Blair once observed that ‘the purpose of the twentieth century welfare state was to treat citizens as equals; the purpose of the twenty-first century reforms must be to treat them as individuals as well’ (Blair, 2002). Emphasis on the individual is evident in recent UK health service policy, which identifies the aims of ‘personalizing services [by] making [them] fit for everyone’s needs. That includes those people traditionally less likely to seek help or who find themselves discriminated against in some way’ (p. 9). ‘The National Health Service needs to give patients more rights and control over their own health care’ (Department of Health, 2008: 33)...
  • Item
    Access to health care services - an English policy perspective
    (2009) Goddard, M
    International 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.