Access to health services

Au plus fort de la pandémie de SARS-CoV-2, un slogan s’est imposé: "faisons confiance à la science". Cette formule a nourri une mémoire collective idéalisée de la communauté scientifique, perçue comme homogène, rationnelle et protectrice. Pourtant, la suite des événements a révélé une fausse conscience: loin de constituer un bloc unifié, la science s’est montrée traversée de tensions, d’incertitudes et de fractures sociales. Ce texte interroge donc la mémoire collective de la science telle qu’elle s’est formée durant la crise, et les conditions de sa reconstruction.

L’argumentation s’articule en quatre étapes. D’abord, l’analyse empirique d’Étienne Klein met en lumière l’échec de la vulgarisation scientifique et l’effondrement de la confiance publique. Ensuite, la réflexion théorique de Fernand Dumont, dans le sillage de Durkheim, permet de saisir la mémoire comme enjeu stratégique de la conscience collective, ressource lucide mais toujours menacée de dérive. Une troisième partie explore l’historiographie critique à travers Louis-Étienne Villeneuve, Hasok Chang et Matteo Vagelli, qui éclairent les opérations de construction des récits scientifiques, entre cohérence, pluralisme et styles. Enfin, plusieurs études de cas empiriques (racisme, misogynie, âgisme, fractures vaccinales, surmortalité persistante des jeunes) illustrent concrètement comment la mémoire collective scientifique a occulté les vulnérabilités.

La thèse défendue est que la pandémie a bouleversé la mémoire collective de la communauté scientifique en révélant ses biais stratégiques. Rebâtir cette mémoire exige de l’ancrer à la fois dans la sociologie de la conscience collective (Dumont), l’historiographie critique (Villeneuve, Chang, Vagelli) et l’expérience empirique des crises, afin de la rendre réaliste, pluraliste et protectrice.

Coastal communities often face unique health challenges, particularly limited access to health services and sanitation problems. In the coastal area of Penang District, Malaysia. Coastal environments are often exposed to higher health risks due to their proximity to the sea, low access to basic infrastructure, and people's lifestyles that depend on nature. The research aims to analyze the self-awareness of the community in Penang District, Malaysia. This type of research is descriptive observational with a qualitative approach, as well as a phenomenological design to understand in depth the self-awareness of coastal communities in Penang District, Malaysia. This research involved 15 respondents with the criteria selected proportionally. The data collection method used structured interviews and the data analysis used was thematic, namely identifying, analyzing and reporting themes in qualitative data. The results of the study showed that access to medical services was 40% for traditional healers, the distance from home to health services was 40% at a distance of >10 KM, the means of transportation used by health services had the same presentation at 33.33%, health insurance was 80% at insurance/health fund contributions, place of delivery was 33.33% at hospitals, health workers who assisted in childbirth were 26.67% for health workers, diseases that often suffered from 46.66% were diarrhea, feces. 46.67% have sewage disposal facilities, 73.33% distance to the water absorption source > 10 meters, 46.67% provide clean water in wells, 40% clean water quality is free from pollution, 46.67% have rubbish disposal available and 53.33% have wastewater disposal where facilities are not available and are dumped openly. In conclusion, this research highlights the need to improve access to health services, infrastructure, and sanitation in coastal communities to improve overall community health.

ObjectiveData on COVID-19 vaccine hesitancy is limited in Ethiopia and other parts of Africa. Therefore, the aim of this study was to determine the level of COVID-19 vaccine hesitancy and its associated factors in Addis Ababa, Ethiopia.DesignA community-based concurrent mixed-method study.SettingIn a community setting.ParticipantsAdult residents (n=422) of Akaki Kality subcity who were recruited by a two stage sampling technique and 24 adults who were selected purposively were included for the quantitative and qualitative part of the study respectively.Outcome measuresData were collected by face-to-face interview using a semistructured questionnaire. Factors associated with COVID-19 vaccine hesitancy were identified by multivariable binary logistic regression model.ResultsOne out five (19.1%, 95% CI 15.3% to 24.6%) participants were not willing to get vaccinated. In the multivariable analysis, vaccine hesitancy was significantly associated with being female (aOR=1.97; 95% CI 1.10 to...

PurposeSUPER-Finland is a large Finnish collection of psychosis cases. This cohort also represents the Finnish contribution to the Stanley Global Neuropsychiatric Genetics Initiative, which seeks to diversify genetic sample collection to include Asian, Latin American and African populations in addition to known population isolates, such as Finland.Participants10 474 individuals aged 18 years or older were recruited throughout the country. The subjects have been genotyped with a genome-wide genotyping chip and exome sequenced. A subset of 897 individuals selected from known population sub-isolates were selected for whole-genome sequencing. Recruitment was done between November 2015 and December 2018.Findings to date5757 (55.2%) had a diagnosis of schizophrenia, 944 (9.1%) schizoaffective disorder, 1612 (15.5%) type I or type II bipolar disorder, 532 (5.1 %) psychotic depression, 1047 (10.0%) other psychosis and for 530 (5.1%) self-reported psychosis at recruitment could not be confir...

The cost of the Covid-19 pandemic remains unknown. Lives directly lost to the disease continue to mount, while related health, livelihood and wellbeing impacts are still being felt, and the wider ramifications across society, politics and the economy are yet to fully materialise. What is known about these costs though, is that they have been unequally distributed both within and between countries. Preparedness plans proved inadequate in many settings – especially when it came to protecting those most vulnerable, including those marginalised by geography, poverty, or exclusion along the lines of religion, ethnicity or gender. The top-down, surge-style, biomedically dominated and technologically driven preparedness approach that has dominated global health thinking and which was propelled into action with Covid-19 was found wanting not only on the grounds of effectiveness, but also of social justice. This presents both a challenge and an opportunity for a convergence of the preparedne...

The public’s need for timely and trusted COVID-19 information remains high. Governments and global health agencies such as the WHO have sought to disseminate accurate and timely information to counteract misinformation and disinformation that has arisen as part of an ‘infodemic’—the overabundance of information on COVID-19—some accurate and some not. In early 2020, WHO began a collaboration with Google to run online public service announcements on COVID-19, in the form of search ads displayed above results of Google Search queries. Web-based text ads can drive online searchers of COVID-19 information to authoritative COVID-19 content but determining what message is most effective is a challenge. WHO wanted to understand which message framing, that is, the way in which ad information is worded for the public, leads searchers to click through to WHO content. WHO tested 71 text ads in English across four COVID-19 topics using a mix of message frames: descriptive, collective, gain, loss...

This study investigates the socio-economic impact of the COVID-19 andemic on the residents of a municipality in the Region of Central Macedonia in Greece. Conducted during 2021-2022, the field research focused on how the citizens perceive, approach, and evaluate their socio-economic situation (quality of life), access to health and social services, facilities for persons with disabilities, environmental challenges, and other factors, in light of the effects of the recent financial and health crises. To achieve this, a customised questionnaire was developed, a telephonebased opinion survey was conducted, and responses from a sample of about 3000 residents were collected and analysed.

Background: Support for patient self-management is an accepted role for health professionals. Little evidence exists on the appropriate basis for the role of health professionals in achieving optimum self-management outcomes. This study explores the perceptions of people with type 2 diabetes about their self-management strategies and how relationships with health professionals may support this. Methods: Four focus groups were conducted with people with type 2 diabetes: two with Englishspeaking and one each with Turkish and Arabic-speaking. Transcripts from the groups were analysed drawing on grounded hermeneutics and interpretive description. We describe three conceptually linked categories of text from the focus groups based on emotional context of self management, dominant approaches to self management and support from health professionals for self management. All groups described important emotional contexts to living with and self-managing diabetes and these linked closely with how they approached their diabetes management and what they looked for from health professionals. Culture seemed an important influence in shaping these linkages. Our findings suggest people construct their own individual self-management and selfcare program, springing from an important emotional base. This is shaped in part by culture and in turn determines the aims each person has in pursuing self-management strategies and the role they make available to health professionals to support them. While health professionals' support for selfcare strategies will be more congruent with patients' expectations if they explore each person's social, emotional and cultural circumstances, pursuit of improved health outcomes may involve a careful balance between supporting as well as helping shift the emotional constructs surrounding a patient life with diabetes.

What is the experience of migrant healthcare workers? How might this change following Brexit? This editorial explores the vital contributions of the migrant healthcare workers as the Architects of the NHS and recommends that it is critical to acknowledge their contribution and enhance their experience in post-Brexit Britain, for the survival of NHS as an exemplar healthcare service. 

IntroductionIn Mali, healthcare systems are severely affected by conflict. However, several studies suggest a lack of knowledge about its impact on maternal healthcare. Frequent and repeated attacks increase insecurity, limit access to maternal care, and thus represent a barrier to accessing care. The objective of this study is to understand how assisted deliveries are being reorganised at the health centre level, and how they are adapting to the security crisis.MethodThis is a mixed sequential and explanatory study. The quantitative approaches combine a spatial scan analysis of assisted deliveries by health centres, an analysis of health centre performance using an ascending hierarchical classification, and a spatial analysis of violent events in two health districts in central Mali: Mopti and Bandiagara. The qualitative phase analyses semidirective and targeted interviews with managers (n=22) of primary healthcare centres (CsCOM) and two agents of international institutions.Result...

I st World Congress of Children and Youth Health Behaviors / 4 th National Congress on Health Education Methods: An ethnographic approach with observations and interviews will be used. Encounters will be observed to identify culture in the interaction between nurses and families. Interviews with nurses and families will help to identify feelings, attitudes, and perceptions towards the HP and HE activities carried out. Data analysis will be done following ethnographic principles. The literature shows that health professionals often felt frustrated when interacting with people from other cultures and did not respond adequately to their health needs. Families from other cultures felt that their views on health and health care, their lifestyles, behaviors and education of children were not taken into account. Carrying out this research will allow to better understand what happened during the cultural encounters and what can be done to improve nurses' work. Conclusions: This study will allow the design of interventions aiming at increasing the cultural competence of nurses.

Public Health Wales is an NHS organisation providing professionally independent public health advice and services to protect and improve the health and well-being of the population of Wales. Public Health Wales funded this study and report, and collaborated on the research design, analysis, authorship and review of this report.

The Patient Protection and Affordable Care Act (ACA) mandates ongoing research on postpartum depression; however, very little research has been published in social work journals and in advanced-level textbooks on this topic. This article describes the problem of postpartum depression and argues that social work educators and researchers must pay greater attention to this issue in light of the ACA mandates, so that social workers can provide effective services to postpartum mothers and their children. The Council on Social Work Education’s recently published Educational Policy and Accreditation Standards are considered while making curriculum recommendations on postpartum depression for social work educators.

This paper aims to analyze the perspectives and meanings of social participation for the participants in a health program. A qualitative evaluation was conducted on the Andalusian Program against HIV/Aids and other sexually transmitted infections. The participants were selected through a theoretic sample: 20 HIV carriers, 19 representatives and volunteers from anti HIV associations and six administrative representatives. The information was obtained through semi-structured interviews and triangle groups; content analysis was performed. Participation has different meanings to the participant groups. HIV carriers consider it should be accomplished by communication mechanisms, support and prevention; association members consider it a right and a tool to change health policies, while two conceptions coexist among administrative representatives. The encouragement of participatory designs is proposed that respect the theoretical diversity and favor interaction based on distinct attitudes.

Special thanks go to MSF_ France for their support and cooperation. I would especially like to thank the data collectors who helped me. I would also like to thank all my family members, my father, my mother, my brothers, and sisters and the one who cares about me. All of you supported me when I faced difficult times. Words cannot express how grateful I am all of the sacrifices that you have made on my behalf. You provided me with the facilities being required and conductive conditions for my thesis.

Introduction Patient companions (PCs) can have an ambiguous impact on the quality of communication during multilingual medical consultations and therefore on health outcomes. Studies of multilingual medical consultations have focused mainly on PCs' role as interpreters, with less regard to other roles they may take up. This paper uses mixed methods to investigate PC role dynamics in multilingual PC-mediated consultations and how they affect the management of a patient's Lifeworld, a crucial element for history taking and rapport building. Methods Nine recordings of multilingual PC-mediated consultations from a Brussels emergency department, complemented with ethnographic notes and clinician interviews, were subjected to linguistic-ethnographic analysis and a codification of communication patterns and PC roles to explore the link between PC roles and Lifeworld management. PC roles were grouped into four stances (Linguistic agent, Lifeworld agent, System agent, and Principal). The communication patterns were grouped into three categories ("strictly medicine", "Lifeworld heard/included", and "Lifeworld interrupted"). Results In ED consultations, patients' Lifeworld frequently remains inadequately addressed, primarily due to physician interruptions. Significant associations are observed between roles taken up by PCs and the way patients' Lifeworld is managed. Successful integration of Lifeworld aspects is best supported by PCs taking up the role of System agent, possibly because it allows them to link the Lifeworld directly to medical issues. Linguistic-ethnographic analysis reveals how language barriers, PC role changes and Lifeworld management strategies are taking shape organically (often implicitly) determined by a wide range of situational factors, such as the complexity of the topic, the available (non)verbal linguistic repertoire, the level of meta-communication, explicit role negotiation and timing. Conclusion Since poor Lifeworld management negatively impacts care, clinicians should be trained to detect and manage role dynamics and relevant situational factors in PC-mediated multilingual consultations to protect patients' right to high-quality communication and healthcare.

Background: Black, Indigenous, and people of color (BIPOC) families comprise a disproportionately low percentage of home and freestanding birth center births in New Mexico (NM), despite NM Medicaid coverage of care by Licensed Midwives (LMs) in these settings. The purpose of this study was to examine why low income BIPOC seek out LM care, how they benefit from this model of care, and which factors facilitate and obstruct access. Methods: We conducted 7 focus groups with 55 low income BIPOC individuals who had birthed in New Mexico in the past 5 years. Participants in four of the groups intended to birth with an LM in the community setting; participants in three of the groups intended to birth in a hospital. Results: Prior negative birthing experiences at hospitals were the most-often discussed reason for choosing LM care. The aspects of LM care most commonly described as beneficial were: (1) the high quality of one-to-one individualized and holistic care offered by LMs, as well as (2) the respectfulness of care received. Medicaid coverage of LM care and special payment allowances made by LMs were cited as two important facilitators of access to LM care. Barriers to care included the lack of general awareness of LM care, the persisting stigma against community birth, the small number of LMs, and payment and insurance coverage challenges. Conclusion: LM care is beneficial for many families seeking respectful and accessible care, especially in underserved areas. BIPOC birthing individuals' reflections on their experiences with LM care provide valuable information that should be considered when designing and revising perinatal care systems and policies with the intent of increasing access to high-quality maternal and newborn care in New Mexico and, more generally, the United States.

El documento presenta un diagnóstico regional sobre la capacidad de respuesta institucional en puntos de entrada fronterizos. Analiza la articulación entre salud y migración en siete países, identificando brechas en infraestructura, protocolos, formación y coordinación interinstitucional, con el fin de fortalecer la atención a personas migrantes y responder a emergencias sanitarias como la COVID-19.

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Nuestros estudios en Nueva Orleans para analizar la raza subjetivamente asignada versus la raza auto reportada por el paciente en el cuidado de la salud en EU, arrojaron diferencias significativas entre los resultados agregados (monorracial) versus desagregados (multirracial/multiétnico). 3 Por lo tanto, en este artículo se analizan las implicaciones históricas, clínicas, estadísticas y de derechos humanos para la raza asignada (“etiquetado racial” o “perfil racial médico”) en el cuidado de la salud.

Municipal Services Project 1 (e.g., pit latrines in new low-income residential developments instead of flush toilets) and unprecedented cutoffs of services (including water and electricity) to those residents not able to pay their municipal bills. The desperate need to resolve massive backlogs of basic municipal services-water, sanitation, electricity, housing, roads and stormwater drainage, streetlights, rubbish removal, recreational facilities, even clinics (sometimes the responsibility of a municipality)-was sacrificed on the altar of fiscal discipline. (As many as half the municipalities were officially anticipated to be so fiscally unviable that by 2002 they would be declared bankrupt and merged into larger rural district councils.) This condition, in turn, led to a fascination, beginning in the early 1990s under late-apartheid municipal managers but intensifying under the new government, with municipal privatization. This was an important moment, for at the same time a relatively new phenomenon was maturing: Transnational Corporations (TNCs) in the fields of water and other municipal services were scanning the globe for sites of municipal investment and management opportunities, where takeover of municipal waterworks would allow dramatic retrenchments of civil servants, dramatic increases in water tariffs, and the opportunity for healthy profits (typically 30 percent in US$ terms, according to the World Bank's International Finance Corporation) (Bond 2000b: chapter 4). Thus the late-apartheid regime as well as a conservative bloc from the new ANC government (largely located in national government's Department of Constitutional Development), working closely with TNCs and their international boosters (especially the World Bank, as well as international merchant banks), began introducing municipal privatization by stealth. Small towns in the impoverished Eastern Cape Province were the first targets (1992-96), followed by medium-sized towns like the Mpumalanga Province capital city of Nelspruit (1996-99), and then the country's largest metropolis, Johannesburg (1999). All faced commercialization and privatization of key functions. However, arrayed against the TNCs, the conservative forces in government, and key municipal bureaucrats are new alliances of unions and communities that have fought the commodification and privatization of municipal services to, so far, a standstill. Indeed, the privatizers have been surprised at the depth and resilience of opposition. In even small Eastern Cape towns, and certainly in Nelspruit and Contradictions in Municipal Transformation from Apartheid to Democracy

Agricultural marketing, being the only sustentation source for the farmers, possess the potential to unlock new world of perquisites. In developing countries like india, where smallholder constitutes lion's share of the farmers, they confronts copious constraints which impedes their marketing entry and thereby restrains them from taking advantages out of commercialization. Coconut is one of the major crops cultivated in India and especially in Kerala with higher market value. In this context, this study analyses the major factors which influences the producers of coconut to participate in marketing of coconut. A multi-stage random sampling technique was used for selection of 158 farmers for data collection. Logistic regression model is employed to identify the factors influencing market paricipation of smallholder coconut farmers. The results of the study revealed that size of land holdings, monthly income, experience in farming, distance to market, ownership of vehicle and information regarding price of the product has significant influence on the market paricipation decision of farmers. Hence, improving market participation is indispensable to improve the conditions of smallholder farmers which can only be made possible through proper market-oriented policy implementations.

In 2004, the Department of Health carried out a public consultation exploring proposals to deny access to primary healthcare to failed asylum seekers and undocumented migrants. The results of this consultation were never published and the department have resisted our attempts to bring them into the public domain. They now claim submissions to the consultation will be made public in October 2008. This document, which has been written by medical students and doctors working with the Global Health Advocacy Project, summarises the content of submissions we have been able to obtain. It is regrettable that this important body of opinion has not been available to guide and inform public debate on this issue over the last four years. Submissions were received from doctors, primary care trusts and non-governmental organisations working with migrant communities. Ninety seven percent raised at least one concern about the proposals with eighty two percent raising three or more. Only thirteen pe...

This paper presents a collective research project in which several scholars at the universities of Amsterdam and Maastricht are involved. Its aim is to study the twentieth-century history of psychiatry and mental health care in the Netherlands from a social and cultural perspective and to situate it in an international context. Some particular features of the history of Dutch psychiatry in the twentieth century are highlighted: the expansion of its domain through the development a mental health care network outside of the psychiatric institutions and clinics; the increasing diversity of the professional groups involved; the widening of the domain of mental health care (apart from medical psychiatry and psychotherapy also (moral) education, pastoral care, and social work); the major role of religious incentives and sociopolitical values, such as ideals of democratic citizenship; the anti-psychiatric movement which ironically strengthened rather than weakened the expansion of mental health care in Dutch society; and the link between mental health care and the psychologization of the personal lives of and the social relations between the Dutch.

According to the NorthernTunisia Cancer Registry (Hsairi, 2021), this cancer ranked first among womenwith an estimated ASIR of 51.7 per 100,000 inhabitants in 2020 with a significant increasing trend in terms of incidence. Despite the considerable progress in the fight against BC, delayed diagnosis (DD) remains problematic in Tunisia with an advanced tumor stage at diagnosis (12.7%

According to the NorthernTunisia Cancer Registry (Hsairi, 2021), this cancer ranked first among womenwith an estimated ASIR of 51.7 per 100,000 inhabitants in 2020 with a significant increasing trend in terms of incidence. Despite the considerable progress in the fight against BC, delayed diagnosis (DD) remains problematic in Tunisia with an advanced tumor stage at diagnosis (12.7%

This volume addresses the complexities of service delivery to migrants in irregular or marginalized situations, to persons with diverse linguistic, cultural or religious backgrounds, and to those who need navigational assistance to reach the services they need. Barriers in service access are generated in the interaction between organizations and their most disadvantaged groups of users. Healthcare services that are accessible to migrating populations reinforce their autonomy and are in the best interest of all.
The case study, which was conducted from 2017 to 2020, is based at the San Maurizio hospital of Bozen-Bolzano, the largest hospital in South Tyrol, a multilingual and autonomous province in Northern Italy bordering Austria and Switzerland. It explores the agency of healthcare practitioners in shaping accessible services when attentive to patient needs, connected to national advocacy networks, and supported by hospital administration. With this study the author hopes to provide a broad view of this transdisciplinary field of study and practice and to offer a roadmap for practitioners who may play a role as brokers of accessible services in healthcare organizations.

per cent of the island's 68,000 inhabitants live (Instituto Nacional de Estatística 2000a). 1 Santo Antão on the other hand, has a predominately rural population of 47,000. Due to the close links between the two islands, they can be thought of as a single region with a city (São Vicente) and a rural hinterland (Santo Antão). Together, they account for slightly more than a quarter of the country's population. 1 Although the city's official name is Mindelo, this is rarely used. Instead, São Vicente refers to the urban centre as well as the island itself. When I use 'São Vicente' in this thesis, it can be thought of as an urban environment. The next chapter addresses the misfit between the contemporary international migration order and existing migration theory. It first discusses the central tendencies behind what we might call 'the age of involuntary immobility'. This provides a wider context for the Cape Verdean experience with migration that I have just described. In the second part of the chapter, I discuss the weaknesses and potential of migration theory to explain contemporary migration and non-migration. Chapter three presents the aspiration/ability model in detail. This is my own theoretical contribution, which is inspired by the theories discussed in chapter two. The aspiration/ability model is reflected in the research questions as well as in the organization of the analytical chapters. (unskilled) Employed (unskilled) Remittance receiver No No No Yes No No No Yes Close family abroad 1 No No No Yes No No No Yes Other emigrant relatives No No No Yes No No No Yes Wish to emigrate Predicted probability 2 74 % 10 % 33 % 91 % 38 % 2 % 10 % 68 % Best guess about wish 3 Yes No No Yes No No No Yes Note: All the women are born in São Vicente. 1 Defined as parents, children, siblings or spouse. 2 The formula for this calculation is given in chapter four. 3 Reflecting a probability above or below 50 %.

Background: Systems to exempt the indigent from user fees have been put in place to prevent the worst-off from being excluded from health care services for lack of funds. Yet the implementation of these mechanisms is as rare as the operational research on this topic. This article analyzes an action research project aimed at finding an appropriate solution to make health care accessible to the indigent in a rural district of Burkina Faso. Research: This action research project was initiated in 2007 to study the feasibility and effectiveness of a community-based, participative and financially sustainable process for exempting the indigent from user fees. A interdisciplinary team of researchers from Burkina Faso and Canada was mobilized to document this action research project. Results and knowledge sharing: The action process was very well received. Indigent selection was effective and strengthened local solidarity, but coverage was reduced by the lack of local financial resources. Furthermore, the indigent have many other needs that cannot be addressed by exemption from user fees. Several knowledge transfer strategies were implemented to share research findings with residents and with local and national decision-makers. Partnership achievements and difficulties: Using a mixed and interdisciplinary research approach was critical to grasping the complexity of this community-based process. The adoption of the process and the partnership with local decision-makers were very effective. Therefore, at the instigation of an NGO, four other districts in Burkina Faso and Niger reproduced this experiment. However, national decision-makers showed no interest in this action and still seem unconcerned about finding solutions that promote access to health care for the indigent. Lessons learned: The lessons learned with regard to knowledge transfer and partnerships between researchers and associated decision-makers are: i) involve potential users of the research results from the research planning stage; ii) establish an ongoing partnership between researchers and users; iii) ensure that users can participate in certain research activities; iv) use a variety of strategies to disseminate results; and v) involve users in dissemination activities.

Pre-exposure prophylaxis (PrEP) for HIV is a strategy that has been recently engineered to prevent individuals who are human immunodeficiency virus (HIV)-negative but are at high risk of being infected with HIV. Sex workers are one of the vulnerable groups that are targeted by PrEP, however effectiveness of PrEP is realised when there is maximum adherence. Empirical evidence from Mutare Urban district revealed that for the period April to November 2019, the adherence rate was 22 % (NAC, 2019).Therefore, this study sought to unearth the reasons why sex workers were not adhering to PrEP. A 1:1 unmatched casecontrol study was carried out in Mutare urban. The source population of this study was all female sex workers registered under NAC key population programs in two sites namely Forbes and Sakubva residing in Mutare urban. A total sample size of 64 participants calculated using Epi info 7 was used for this study. Participants were identified from records at the study sites and systematic sampling was done for both controls and cases. Proportional selection of participants was done for the two centres. Data was collected using an interviewer administered structured questionnaire and a key informant interview guide was used to interview health service providers. Data was analysed using Epi info version 7. A multivariate analysis showed age [

Medact is a charity that brings together health workers to fight for health justice. We recognise that health injustice is driven by political, social and economic conditions, and we mobilise the health community to take action to change the system. Medact and our member groups carry out research that helps us to understand health inequalities and offers solid evidence for effective campaigning and advocacy.

Background: Contact tracing as an epidemiological strategy has repeatedly contributed to the containment of various past epidemics and succeeded in controlling the spread of disease in the community. Systematic training of contact tracers is crucial in ensuring the effectiveness of epidemic containment. Methods: An intensive training course was offered to 216 health and other professionals who work with vulnerable population groups, such as Roma, refugees, and migrants in Greece, by the scientific team of the postgraduate programme “Global Health-Disaster Medicine” of the Medical School, National and Kapodistrian University of Athens, with the support of the Swiss embassy in Greece. The course was delivered online due to the pandemic restriction measures and was comprised of 16 h over 2 days. The course curriculum was adapted in Greek using, upon agreement, a similar training course to what was developed by the Johns Hopkins University Bloomberg School of Public Health. Evaluation o...

Nel suo “L’innocenza dei dinosauri”, pubblicato postumo il 21 novembre 2024, Giovanna Ferrara ha raccontato la sua malattia. La lotta per la giustizia nella sanità pubblica è stato il suo orizzonte politico e morale che ha accompagnato l’ingiustizia per la sofferenza e il deterioramento del corpo.

■ More than 1 billion people do not have any proof of identity (ID). Many countries use paper-based, decentralized systems that are often incomplete. ■ Identification is a critical factor for gender equality and the empowerment of women. In low-income countries, poor women are less likely to have ID documents, which deprives them of the ability to claim their political, social, and economic rights. ■ Linking national ID registers with data from civil registration and vital statistics (CRVS) systems can help create a universal, inclusive ID system. Most countries have established a CRVS system, which registers vital events occurring in its territory on a continuous and permanent basis. ■ A robust and complete national ID system can be built and sustained only with a modern, efficient CRVS system. The national ID system must be supported by appropriate legal and institutional frameworks. ■ National ID systems should provide coverage rates disaggregated by gender to help understand the gender differentials in identity registration. This will provide insights into the use of the national ID system by women compared to men. Photo: Dominic Chavez / World Bank ■ Close to 40% of the eligible population in low-income countries has no ID document. ■ 45% of women surveyed in low-income countries do not have an ID document, compared to 30% of men.

Cet article propose une réinterprétation critique du concept de ‘asabiyya (solidarité sociale), tel que formulé par Ibn Khaldoun, en l’examinant à l’aune
des dynamiques contemporaines entre solidarité communautaire et individualisme croissant dans le monde arabe. Il explore la manière dont la ‘asabiyya peut être modernisée et adaptée pour répondre aux défis actuels, en tenant compte des mutations sociales, des aspirations individuelles et des impératifs de l’économie globalisée. Cette modernisation, conceptualisée ici à travers la notion d’ahlia (entrepreneuriat communautaire), s’articule autour d’une trilogie entrepreneuriale impliquant les sphères publique, communautaire et privée. L’article analyse des exemples concrets, tels que Misk City et les coopératives marocaines, afin d’illustrer une approche pratique du développement communautaire et durable. Il examine également les tensions inhérentes à l’émergence d’un individualisme économique dans des sociétés historiquement caractérisées par des structures communautaires fortes.

Drug policy affects the health of queer people and communities. The health of queer people who use drugs must not be overlooked in our fight for sensible drug policy. And 2SLGBTQ+ rights organizations must not ignore the rights and health of queer people who use drugs.

Complementing an earlier Summary Report, this Agenda for Action, presents nearly 30 recommendations for action in multiple areas. including: improving data collection; challenging stigma through public education; making services more accessible; ensuring 2SLGBTQ+ communities are more inclusive and strengthen their advocacy for sensible drug policy; enhancing funding for the health of GBT2Q people who use drugs; and enacting key legal and policy reforms.

Drug policy affects the health of queer people and communities. The health of queer people who use drugs must not be overlooked in our fight for sensible drug policy. And 2SLGBTQ+ rights organizations must not ignore the rights and health of queer people who use drugs.

This Summary Report by the HIV Legal Network reviews the evidence about substance use — including problematic use — among GBT2Q people and includes insights from queer people working in the field of harm reduction.

A key challenge in meeting the palliative care needs of people in advanced age is the multiple healthcare and social service agencies typically involved in their care. The 'patient navigator' model, originally developed in cancer care, is the professional solution most often recommended to address this challenge. However, little attention has been paid, or is known, about the role that family carers play in enabling their dying relatives to negotiate service gaps. To explore the role family caregivers play in helping people dying in advanced old age navigate health services at the end of life. Qualitative study using semi-structured interviews and analysed via thematic analysis. A total of 58 interviews were conducted in New Zealand with the family caregivers of 52 deceased older relatives who had been participants in Life and Living in Advanced Age: a Cohort Study in New Zealand. Fragmentation of services was the key concern, causing distress both for the older person and t...

Internally displaced persons (IDP) are increasing in Nigeria. Women of reproductive age are vulnerable to sexual and reproductive health (SRH) challenges. Little is known about the utilized SRH services, and their associated factors in North-central, Nigeria. Quantitative data was collected using a structured questionnaire. Data were analyzed and descriptive analysis and Logistic regression were performed at p-value < 0.05 to identify significant factors associated with SRH utilization. The finding revealed that the utilized SRH services at the IDP camps were family planning, antenatal care, and HIV testing/voluntary counseling, and 82.40% of the displaced women have used at least one SRH service, while antenatal care was the most utilized (74.60%). At the individual level, the age, marital status, and education of respondents are significantly associated with the utilization of SRH services. At the household level, spousal employment status, age, and education determine the utilization of SRH services. In conclusion, the overall utilization of SRH services among displaced women in the IDP camps is high. Individual and household factors are associated with SRH uptake. Community awareness and addressing the issue of empowerment among women in the IDP camps can help augment the issue of financial incapacity, hence encouraging utilization.

Precision of human resources for health planning prognoses in large part is influenced by the accuracy, quality and recency of data, which is used. This article reviews available data sources, their advantages and disadvantages and presents data linkage schemes as well as practical examples. Major human resources for health planning indicators from recent research studies are also reviewed.

Tele-rehabilitation is a viable method to address healthcare access difficulties in rural parts of Africa. It involves offering remote rehabilitation services using digital technologies. This systematic review assesses the efficacy, implementation obstacles, and technological prerequisites of tele-rehabilitation programs in various environments. Evidence suggests that tele-rehabilitation has a substantial positive impact on patient outcomes, such as enhancing functional recovery and improving quality of life. Additionally, it provides cost-saving advantages by reducing the necessity for travel. Nevertheless, it is important to tackle obstacles such as technological constraints, digital literacy, and data security in order to guarantee the effective execution of the plan. It is essential to have culturally sensitive techniques and comprehensive training for healthcare providers in order to optimize the effectiveness and acceptance of these services. Future studies should prioritize investigating the long-term effects, optimizing the technology used, and integrating tele-rehabilitation programs with current healthcare systems in order to improve their sustainability.