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Global Public Health

Rachel Irwin, Richard Smith
The World Health Assembly is the WHO's supreme decision-making body and consists of representatives from the 194 WHO Member States who take formal decisions on the WHO's policies, workplan and budget. The event is also attended by representatives of non-governmental organisations, the private sector, the press and even members of the public. Based on participant observation at six World Health Assemblies, in-depth interviews with 53 delegates to the WHA, and an analysis of WHA Official Records, this article examines the ritualistic aspects of WHA negotiations...
August 13, 2018: Global Public Health
Penny Vlahos, Stephen L Schensul, Nishantha Nanayakkara, Rohana Chandrajith, Lalarukh Haider, Shuchi Anand, Kalinga Tudor Silva, Jean J Schensul
Over the last two decades, a global epidemic of chronic kidney disease of unknown etiology (CKDu) has emerged in rural, arid, agricultural, lowland areas. Endemic regions have reported 15 to 20% prevalence among residents aged 30-60 years. CKDu is a progressive and irreversible disease resulting in renal failure and death in the absence of dialysis or a kidney transplant. While much of the research has focused on identifying etiology, this project seeks to ascertain factors associated with the rapidity of kidney disease progression in one of Sri Lanka's CKDu endemic areas...
August 10, 2018: Global Public Health
Carina Heckert, Timothy Wright, Estefanía Hernandez, Victoria De Anda
This article draws on two decades of media representations of HIV, ethnographic research among people living with HIV, and an analysis of global health programms in Bolivia. In doing so, we chart the evolution of media representations in relation to the global health context and the implications of these representations for people living with HIV. Our overarching argument is that media discourses on HIV in Bolivia have consistently been produced in a context of an unequal balance of power between global health bodies and local actors...
August 9, 2018: Global Public Health
Erin C Wilson, Emilia M Jalil, Cristiane Castro, Nilo Martinez Fernandez, Luciana Kamel, Beatriz Grinsztejn
Pre-exposure prophylaxis (PrEP) is an important biomedical intervention that may help reduce the risk of HIV transmission among transwomen. To date, little research is available to inform interventions to increase uptake and adherence to PrEP among transwomen, especially in places outside the U.S. We conducted a qualitative study in 2015 with 34 adult transwomen in Rio de Janeiro, Brazil and assessed awareness, interest, barriers and facilitators to PrEP uptake and adherence for transwomen. Almost one third of participants had heard of PrEP, and most were interested and thought it would be beneficial for transwomen in their community...
August 7, 2018: Global Public Health
Chris Hartmann
The concepts Vivir Bien and Buen Vivir, often translated as 'living well' or 'collective well-being,' are central to contemporary social medicine reforms in Latin America. Owing to increasing social inequalities, notably in the public healthcare sector, Vivir Bien has regional significance as it redefines the neoliberal development goals from economic improvement to so-called post-neoliberal social goals of harmonious co-existence between society and the physical environment. To examine how this abstract concept is conceptualised, is incorporated into, and shapes state-sponsored public health strategies, I analyze the 'Vivir Limpio, Vivir Sano, Vivir Bonito, Vivir Bien … !' ('Live Clean, Live Healthy, Live Beautiful, Live Well … !') national campaign in Nicaragua that began in 2013...
August 6, 2018: Global Public Health
Armando Arredondo, Emanuel Orozco, Maria Beatriz Duarte, Magali Cuadra, Ana Lucía Recaman, Alejandra Azar
The epidemiological and economic burden of diabetes poses one of the main challenges for health systems worldwide. This is particularly relevant in middle-income countries because of the constant growing trends that have been observed in recent years. In order to identify trends and challenges on epidemiological and economic burden from diabetes in a middle-income country we developed a longitudinal analysis on costs and trends in the number of cases of diabetes in Mexico. The study population included total annual cases of diabetes at national level...
August 1, 2018: Global Public Health
Oscar Javier Maldonado
This paper discusses the complexity of contemporary struggles for collective health in Colombia, by analysing the efforts of different actors to inscribe abortion as a matter of public health and as a human right. In 2006 the Colombian Constitutional Court (Sentence C 355 of 2006) partially decriminalised abortion in specific circumstances. Such a change in regulation was the result of the strategic coordination of international organisations, researchers and women's social movements. These groups produced a powerful network of international regulation and epidemiological data about abortion's mortality and burden of disease in order to move the discussion from the moral field to public health and international law...
August 1, 2018: Global Public Health
Rebecca Hodes, Beth Vale, Elona Toska, Lucie Cluver, Ros Dowse, Mikael Ashorn
The global rollout of Antiretroviral Treatment (ART) has revealed an urgent need to understand the medicines-taking practices of HIV-positive adolescents. In the last decade, the literature on the social determinants of health has broadened the evidence-base on ART adherence. Interdisciplinary studies have expanded conceptions of medicines-taking beyond clinical or health systems frameworks, recognising the importance of socio-structural conditions and of patients' beliefs and experiences. Participatory research techniques which foreground the perspectives of adolescents provide greater insights still into their adherence...
August 1, 2018: Global Public Health
Lydia Kapiriri, Lauranne Be LaRose
Priority setting (PS) and resource allocation during health emergencies are key factors influencing an effective response. However, there is limited understanding of how priorities and resource allocation during disease outbreaks occur and the extent to which these processes are successful. This paper, based on 23 in-depth interviews with policy makers and a review of policy and emergency preparedness documents, used a PS evaluation framework to evaluate PS for disease outbreaks in Uganda. With regard to PS for disease outbreaks in Uganda, we identified a conducive socio-political-economical context, credible institutions, formal participatory prioritisation processes, evidence informed the processes, demonstrated implementation capacity, institutional strengthening and positive health outcomes...
August 1, 2018: Global Public Health
Yodi Mahendradhata
The Indonesian government is set to take part in the region's growing healthcare tourism industry. However, Indonesia would need to do much more than just develop world-class hospitals at major tourist destinations to provide a thriving healthcare tourism industry that could attract patients from abroad. Moreover, the amount of resources needed to ensure the success of a healthcare tourism industry attracting foreign patients also raises the question of potential resource allocation diversion, as the country still has a long list of public health issues to address...
July 26, 2018: Global Public Health
Peter Balvanz, Thespina J Yamanis, Marta I Mulawa, Gema Mwikoko, Deusdith Kajuna, Mrema N Kilonzo, Lusajo J Kajula, Sheila Leatherman, Suzanne Maman
Poverty is associated with numerous poor health outcomes. Youth unemployment in Tanzania is approximately 13.7%, and concentrates in urban areas. These youth lack relevant job skills and access to financial capital. Microfinance continues to be implemented globally to address poverty, and increasingly has been linked to health interventions. Men less frequently are recipients of microfinance loans. We offered microcredit to young men in an area of Dar es Salaam with high poverty as part of a randomised controlled-trial to assess the efficacy of a microfinance and health leadership intervention in preventing STI acquisition...
July 20, 2018: Global Public Health
Audrey R Chapman, Samath D Dharmaratne
Sri Lanka has been lauded for providing good health coverage at a low cost despite having a modest per capita income. This article identifies the unique historical factors that enabled Sri Lanka to achieve near universal coverage, but it also discusses how this achievement is now being undermined by inadequate government investment in health services, the burdens of non-communicable diseases, and the growing privatisation of health services. In doing so, the article highlights the challenges of achieving and maintaining universal health coverage in a relatively low income country with a health system designed to treat infectious diseases and provide child and maternal health services as the country undergoes an epidemiological transition from infectious to non-communicable diseases...
July 20, 2018: Global Public Health
Nathan Paxton, Jeremy Youde
International relations theorists and global health politics scholars largely fail to communicate with one another. We argue that drawing on insights from classic and contemporary international theory more explicitly will positively augment the study of global health politics. This paper highlights four major theoretical orientations in the international relations literature (realism, neoliberal institutionalism, constructivism, and feminism) and discusses how an understanding of these perspectives can strengthen our understanding of global health policy...
July 19, 2018: Global Public Health
Constanza Jacques-Aviñó, Patricia García de Olalla, Alicia González Antelo, Manuel Fernández Quevedo, Oriol Romaní, Joan A Caylà
This study aimed to describe the methodological characteristics of publications on HIV and masculinity, to identify possible information gaps and determine the main thematic areas. A systematic review was conducted of gender, masculinity, HIV infection and other sexually-transmitted infections in original articles published between 1992 and 2015. Original studies published from Pubmed and Scopus were included. A total of 303 articles were identified, of which 187 were selected. Most of the studies were qualitative and the most widely used technique was the interview...
July 4, 2018: Global Public Health
Karin Friederic, Brian J Burke
Under President Rafael Correa (2007-2017), Ecuador's Ministry of Health established a state-centred health care regime that incorporates elements of Latin American social medicine into post-neoliberalism. These initiatives - which are part of 'The National Plan for Good Living (Buen Vivir)' - include free healthcare, greater attention to social determinants of health, a focus on equity and inclusion, and increased coordination across welfare, health, and development sectors. However, the reforms also use health services to build a sense of inclusive, participatory citizenship, with the Ecuadorean state as the central figure in service provision...
June 5, 2018: Global Public Health
Unni Gopinathan, Nick Watts, Alexandre Lefebvre, Arthur Cheung, Steven J Hoffman, John-Arne Røttingen
This comparative case study investigated how two intergovernmental organisations without formal health mandates - the United Nations Development Programme (UNDP) and the World Trade Organization (WTO) - have engaged with global health issues. Triangulating insights from key institutional documents, ten semi-structured interviews with senior officials, and scholarly books tracing the history of both organisations, the study identified an evolving and broadened engagement with global health issues in UNDP and WTO...
May 31, 2018: Global Public Health
Sebastian Kevany
In the twenty-first Century, the developed world attempts to provide global health assistance, to poorer countries - at least in part in the pursuit and maintenance of world order and stability. Rarely, however - and in most cases, then on an ad hoc basis - are related foreign policy tools deployed in combination with each other. Nonetheless, there is currently greater openness than ever before to such interdigitation. Not least this reflects the unprecedented challenges of modern political and security conditions - struggling to operate amidst a broader culture of global adverserialism, and conflict which conventional systems of intervention have struggled to successfully resolve...
May 21, 2018: Global Public Health
João Biehl, Mariana P Socal, Varun Gauri, Debora Diniz, Marcelo Medeiros, Gabriela Rondon, Joseph J Amon
Over the past two decades, debate over the whys, the hows, and the effects of the ever-expanding phenomenon of right-to-health litigation ('judicialization') throughout Latin America have been marked by polarised arguments and limited information. In contrast to claims of judicialization as a positive or negative trend, less attention has been paid to ways to better understand the phenomenon in real time. In this article, we propose a new approach-Judicialization 2.0-that recognises judicialization as an integral part of democratic life...
May 21, 2018: Global Public Health
Lesley Hoggart
This paper scrutinises the concepts of moral reasoning and personal reasoning, problematising the binary model by looking at young women's pregnancy decision-making. Data from two UK empirical studies are subjected to theoretically driven qualitative secondary analysis, and illustrative cases show how complex decision-making is characterised by an intertwining of the personal and the moral, and is thus best understood by drawing on moral relativism.
May 21, 2018: Global Public Health
Jack Wallace, Jacqueline Richmond, Jeanne Ellard, Jennifer Power, Jayne Lucke
Hepatitis C is a global public health issue affecting 150-170 million people worldwide, and over 227,000 Australians with an increasing morbidity resulting from the infection. The Australian Government funded access through the national health scheme to Direct Acting Antiviral (DAA) medication for all people with hepatitis C, regardless of disease staging or mode of transmission to eradicate hepatitis C in Australia. The availability of these drugs not only alters the end result of hepatitis C treatment from that of sustained viral response to cure, but necessitates a refocusing of the public health response to hepatitis C...
September 2018: Global Public Health
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