MSc in Global Health

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7204

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Acceptability of Male circumcision for HIV prevention in Kenya
(Queen Margaret University, 2016)
Three randomized control trials in South Africa, Kenya and Uganda, demonstrated that there was a significant risk reduction of acquiring (sexually transmitted) HIV from women to men who are circumcised. Following these trials in 2007, the World Health Organization (WHO) and the Joint United Nations Programme on AIDS (UNAIDS) recommended the use of medical male circumcision (MC) for HIV prevention in eastern and southern Africa. However, the uptake of MC in countries with high HIV prevalence varies and the progress has been patchy. For example, only 3% of the targeted males in Lesotho have been reached, while 63% of the targeted males have been reached in Kenya (Gulland 2014). In this paper, the author explores the challenges and successes of MC for HIV prevention in Kenya.
Analysing the UK and the Philippines Policy Responses to Nursing Migration During Covid-19: A Source and Destination Country Perspective
(2022)
Background. The nursing workforce have been at the frontline of the global COVID-19 response, and at the same time, COVID-19 exposed vulnerabilities of nursing supply and exacerbated pre-existing nursing shortages. Reports show that, while the pandemic initially restricted the mobility of nurses around the world, it is now facilitating the movement of nurses as lockdown restrictions ease and international travel resume. However, little is known about what countries are doing to address nursing migration, specifically from the perspectives of major source and destination countries like the Philippines and the UK. The aim of this study is to analyse the policy response to nurse migration of each country during COVID-19. This study also looks at the impact of these policies on nursing supply and demand over the last two years (2020-2022), and some of the potential health system impact. Method. A descriptive health policy analysis was used to gain a comprehensive account of the policies enacted by each country with regards to nursing migration. This methodology used document review and secondary data analysis as the main methods, guided by an adapted conceptual framework drawn from both the health system and health labour market frameworks. Results. Each country adopted very distinct approaches to managing nursing migration. The UK encouraged the inflow of nurses through national regulatory mechanisms e.g., immigration policies, and bilateral labour agreements with multiple source countries. This has had a positive effect on the nursing workforce, characterised by large increases in the number of international nurses coming to the UK, majority of which are non-EU nationals. For the Philippines, findings show that they enacted policies which restricted the mobility of nurses by imposing annual limit on the number of nurses deployed abroad. While this has resulted in a significant reduction in the outflow of nurses, this did not translate into an increase in nursing supply, indicating no growth in the nursing workforce. Conclusion. This study demonstrates different responses to nursing migration which relates to the UK and the Philippines desire to address in-country nursing shortages amidst COVID-19. Monitoring policy responses as COVID-19 progresses will be essential to minimise negative impact and avoid worsening global inequities relating to the supply and demand of nurses.
Analysis of health and support services for survivors of child sexual abuse in Kenya: Lessons for Malawi
(2021)
Introduction  Child abuse is a severe and devastating issue not only in Africa but all over the world. It is an infringement of fundamental human rights and a threat to achieving Sustainable Development Goals 3 and 4. goal three, target 3.5, aims to reduce premature mortality from non-communicable diseases by one-third by 2030 through promoting mental health and well-being and prevention treatment of adverse mental effects. SDG 4. target 4,2 ensures that all girls and boys have equal access to high-quality early childhood development, care, and pre-primary education to be prepared for primary school. However, sexually abused children may not attend school due to psychological effects (shame). The consequences for mental health can be as profound as the physical impact and can last a long time. However, over the years, there is growing evidence that childhood sexual abuse survivors who experienced supportive care following disclosure of the abuse have been found to have fewer psychological symptomatology relative to those who received no support. Unfortunately, in Malawi, such services are limited, under-resourced, and challenging to access. Understanding the barriers and challenges of supportive services delivery and access will better inform efforts to improve access for survivors of child sexual abuse in Malawi.    Method  The search strategy used Online English Published peer-reviewed articles and relevant reports. The search focused only on access to psychological care or management of survivors of child sexual abuse and challenges associated with access to such services. The online search used scientific databases like PubMed, Scopus, CINAHL, Psych Info, and Google scholar to retrieve articles using controlled vocabulary and free-text terms like (a) child sexual abuse OR assault OR violence AND care OR management; (b) challenge OR barriers; and (c) Kenya and Malawi (E) mental health care, support, or services Results In Kenya, psychological care is provided through one-stop centers. There are different types of one-stop center models for survivors of child sexual abuse, namely hospital-based centers owned by a facility or run by NGOs. Malawi has mostly adopted facility-based hospital-owned services for SCSA. Challenges to access are associated with the economy, education, society and culture, and the health system. Education barriers are lack of awareness about sexual children's health, society and culture stigma, and patriarchal norms and bars SCSA access to care while the long distance to the facility has been reported as the main challenge in most studies. Therefore, multisectoral interventions should be committed to reducing the challenges at all levels in improving access to support services for survivors of child sexual abuse Conclusion  Multi-sector collaboration efforts are required for individuals, families, communities, and society. Efforts to reduce the access burden should target improving awareness of child sexual abuse and decentralizing support services at community levels.
Analysis of Successful Implementation of Oral Health Programmes in Schools in Southeast Asia
(2021)
Although the prevalence of dental caries can still be considered high in some parts of the globe, the impact of oral health programmes implemented to address caries in children is evident. This dissertation addresses learnings from the study of dental health programmes in Southeast Asia. Seventeen studies were included in this review. All studies were quantitative; six were non-experimental, five experimental, five quasiexperimental, and one comprised a cost-effective analysis. Reducing prevalence and risk of dental caries, lowering the number of decayed, missing and filled teeth, improving oral hygiene and frequency of tooth brushing, increasing knowledge, attitude, motivation as well as oral health literacy, and improving the quality of life by reducing the oral impact on daily life are observed results on school children who have attended different oral health programmes in the selected countries considered. Therefore, organized dental care and oral health education through oral health programmes can be substantiated in developing good oral health behaviour in children especially promoting brushing behaviour and prevent dental caries. In order for a programme to succeed, the following was concluded on the basis observed successes and barriers provide preventive care for screening and referral will not be enough, ensure full integration of oral health into public health promotion and school health programme, establish strategic planning of scaling up, there should be continuous training of personnel and volunteers, develop sustainable behaviour and self-efficacy and lastly, exemplary implementation and compliance to protocol is necessary.
ASSESSING THE KNOWLEDGE, ATTITUDE AND PRECEPION ON BREAST CANCER AMONG WOMEN IN GHANA
(2022)
This work has been developed to assess the extent to which women in Ghana perceive and have knowledge about breast cancer. The studies have found that breast cancer is a public health problem with incidence, morbidity and mortality rate rising in Ghana and the whole of Sub-Sahara Africa. As the number of women dying from breast cancer continue to increase, it become imperative to investigate whether the lack of knowledge has contributed to the rising rate. In this research, the background about breast cancer and the barriers and risks factors in Ghana have been explored and explained. The research has also provided the aims, objective and question that have allowed for adequate answers. A research method that outlines the procedure for conducting the research has been explained and the theoretical frame used to carry out the assessment. The research finding have noted barriers and risks factors, lack of knowledge and the perception of breast cancer, poor government initiative to increase awareness and breast cancer screening. The research strongly recommend education campaign and training to increase knowledge and awareness and how to carry screening. Finally the research conclude that the level of awareness is very low thereby significantly increasing the risks.
ASSESSING THE RELATIONSHIP OF FOOD SECURITY, CHILD MENTAL HEALTH, AND DEVELOPMENT IN RURAL NIGERIA: A NARRATIVE REVIEW
(2024-02-12) Unknown author
Aims: This narrative review aims to critically examine existing literature spanning from 2013 to 2023, focusing on unravelling the intricate connections between food security, child mental health, and development in rural Nigerian settings. Methods: Employing a narrative review methodology, this study carefully selected and analysed six key studies. Diverse research designs, including cross-sectional surveys, descriptive study, and prospective study, were utilised to investigate the relationships between food security, child mental health, and development in rural Nigeria. Results/Findings: The outcomes of the selected studies illuminate multifaceted challenges faced by children in the rural areas of Nigeria. Notable disparities in food security, psychological well-being, and dietary diversity across different regions were identified. The findings underscore the urgent need for context-specific interventions and policies tailored toward addressing the unique socio-economic, geographical, and cultural factors influencing child well-being in rural Nigeria. Discussion: The discussion center on the implications of the research findings, emphasizing the pressing need for targeted interventions to address the identified challenges. It explores the complex interplay of socio-economic, geographical, and cultural factors affecting child well-being, with a focus on how these factors contribute to disparities in food security and mental health outcomes. Conclusion: In conclusion, this review should contribute with insights to the academic discourse, providing guidance for future research endeavours and informing evidence-based strategies. The urgent recommendation is the implementation of context-specific interventions and policies to enhance the overall health and development of children in rural Nigerian settings. The discussion also emphasizes the critical importance of addressing factors such as poor road networks and infrastructure in tackling the deepening food crisis. Finally, it acknowledges the alarming rate of population growth compared to food availability, the conclusion therefore emphasizes the need for comprehensive strategies to alleviate the impact on children, who emerge as the major victims in this complex scenario.
“At that time, I couldn’t understand very well” An exploratory study of volunteering as a pathway to integration for asylum seekers and refugees in Scotland
(2024-02-12) Unknown author
Introduction: The year 2023 saw the highest number of people seeking asylum in the United Kingdom (UK) for two decades (Home Office, 2023a). Therefore, examining experiences of asylum seekers and refugees integrating into communities has become increasingly relevant. The UK government holds a particularly restrictive approach to immigration and asylum, including not allowing asylum seekers to take up employment. As such, the Home Office (2023c) encourages people who seek asylum to volunteer whilst their claim is being considered. This dissertation is concerned with the role of volunteering as a potential pathway towards the process of integration for asylum seekers and refugees in Glasgow. Methods: This dissertation adopts a qualitative study approach, based on secondary analysis of 14 interviews with refugees. Thematic analysis was guided by a conceptual framework, Indicators of Integration Framework (Ndofor-Tah et al., 2019), to understand the experiences of volunteering for asylum seekers and refugees in Glasgow and to what extent does volunteering aid or discourage integration. Findings: Based on the analysis of the interviews, factors both supporting and hindering refugee integration emerged, providing a nuanced picture of the role of volunteering towards integration. The positive pathways from volunteering to integration were: connections to people and organisations, multi-cultural learning, indirect progress towards employment and the fact that volunteering provided a purpose. The limiting pathways from volunteering to integration were: limited evidence of volunteering leading to direct employment and that it was yet another system to navigate. Conclusion: The findings of this study point to the fact that in many cases, volunteering has proved to be a valuable resource for newcomers who are from a background very different to the environment in which they find themselves. It was also noted that volunteering has the capacity to be dynamic and person specific therefore, activating different pathways to integration over the time continuum from first arrival into the country.
The Barriers and Facilitators in Contraception Access and Use among Young Adults Aged 18-24 in Scotland during COVID-19
(2021)
Background With 1.1 billion women needing family planning worldwide, ensuring the continuation of contraception is not only necessary but a right. This right has been threatened in the context of COVID-19, which has resulted in the contraction of sexual and reproductive health services. Despite the UK being affected, little is known about the experiences of young adults who have used and accessed contraception during the COVID-19 pandemic. To address this gap, this study looks at the barriers and facilitators of contraception use and access during the COVID-19 pandemic among young adults in Scotland. Methods This small scale qualitative study conducted one-to-one interviews with 12 women aged between 18-24 years old. The analysis of the in-depth information gained was guided by a socio-ecological framework, thus looking at individual, societal, health system and structural levels. Results Nine main themes have been identified as barriers and facilitators of contraception use and access during the COVDI-19 pandemic in Scotland. These include: perceptions of COVID-19 on contraception decision-making, contraception self-advocacy, stigma and shame, social support, information available, use of technology enabled care services, healthcare provider interactions, health service capacity and lockdown restrictions. Narratives revealed that many young adults adapted their contraception choices, including delaying preferred contraceptive pathways, accessing alternative healthcare services and adjusting to different means of communication with health providers. Conclusions The barriers identified have shown the potential to disrupt positive contraception practices and facilitators have demonstrated the areas where policy and practice can progress to meet the needs of young adults using and accessing contraception during the COVID-19 pandemic. To progress services, the importance of understanding experiences and working with young adults is essential.
Barriers to accessing culturally appropriate perinatal healthcare for Black migrant mothers and babies from Sub-Saharan Africa living in Scotland
(2023-03-31) Unknown author
Background: Healthcare providers and stakeholders acknowledge the increasing migration and the barriers to accessing healthcare services in high-resource countries (HRCs), including Scotland. However, delivering equitable, culturally conducive care (CCC), and good quality healthcare to those from culturally diverse ethnic groups continues to be a complex and vast issue faced by high-income countries (WHO, 2016). Methods: Snowball sampling was used in this qualitative study. Eight women voluntarily participated in semi-structured interviews (SSI) to gain a better understanding of the health disparities among black African immigrant mothers (BAIMs) from Sub-Saharan Africa. In the SSIs, open-ended questions were asked to gather insights of the lived experiences and perspectives of BAIMB-SSA, focusing on service provisions and the barriers to accessing relevant perinatal health services in Scotland. Results: The findings highlight multifaceted factors and barriers that could be mediated by a multilevel intersectoral approach. The data analysis was guided by the Levesque conceptual framework (2013). Seven themes emerged from the analysis: health system knowledge, racism, cultural norms, communication, social support networks, immigration, and financial challenges. Conclusion: Scotland's focus on migration, diversity, and equal opportunities in healthcare remains, but disparities in service delivery for minority groups persist. Research in areas such as (i) an in-depth understanding of the health needs of specific groups of black African women living in Scotland, (ii) the physical, social, and psychological barriers they face when accessing healthcare facilities, and (iii) ways to improve health outcomes by giving the women improved access to health care services are urgently needed.
Caregivers of Children with Autism: challenges of the COVID-19 lockdown.
(2021)
Little is known about the perspectives of caregivers of autistic children with regard to the challenges they have faced during the COVID-19 lockdown. This study examines these challenges by interviewing eight service providers who support caregivers of autistic children in Scotland and England. An explanatory, qualitative approach was utilised to explore the needs of caregivers, as well as the resources and support they have received from these service providers. The semi-structured interviews were conducted through digital means, and recorded, transcribed and analysed using a thematic analytic method. Findings suggest that caregivers faced behavioural challenges from the children, and a lack of respite care, as well as limited resources with which to fully cope with the COVID-19 lockdown. Recommendations from the findings of this study for improving support to caregivers of children with autism include increased coordination between government and service providers, improved financing of service providers, and enhanced technological provision for caregivers, including better training in its use.
Challenges in paediatric cancer care in the People's Republic of China - critical reflection from a socio-ecological perspective
(Queen Margaret University, 2016)
Treatment of childhood cancer is demanding and low and middle income countries struggle with provision of such care. This dissertation is a literature review and applies a socio-ecological framework as a means to identify key challenges facing children suffering from cancer in China and their families. Further, existing support services for this specific population are assessed and recommendations for additional interventions are made. Various obstacles that interfere with children's medical care are found at policy, community and institutional levels. For example, social health insurance does not cover total costs for cancer treatment, which means that many children drop out of care when parents can no longer afford it. Perceptions that cancer is not treatable may hinder some caregivers accepting medical care for their child, and China lacks both the facilities and health care professionals for childhood cancer treatment. Communication with children about their disease is a major issue at the interpersonal level, and psychological problems among family members are identified as challenges at the intrapersonal level. As of today, support at the different levels largely derives from the non-governmental sector, through organisations founded by concerned parents. A comprehensive multi-level approach from various agents is necessary to further address the identified problems, including provision of full insurance coverage for treatment, efforts to raise public awareness, and introduction of structured provider-child communication related to the disease.
CLOSING THE HEALTH GAP—INTERVENTIONS FOR ADRESSING POOR MEN’S HEALTH IN SUB-SAHARAN AFRICA: A SCOPING REVIEW
(2018)
The issue that this study addresses the poorer men’s health outcomes as compared to women in Sub-Saharan Africa (SSA). To address this problem, the purpose of this study scoping review was to take stock of health interventions conducted in SSA to engage men. A search of six electronic databases, a search of reference list of relevant systematic reviews and meta-analysis; and a search of grey literature, all reported in international languages spoken in Africa, were conducted. All studies evaluating health interventions that aimed to engage male young, adults and aged people in SSA, published between January 2000 and January 2018, were included. The electronic literature search identified 2815 original citations, full texts of 25 studies were screened and 12 studies were included. Additionally, 20 studies were retrieved from screening of reference lists of relevant articles and reviews, hence were also included. Main themes that were analysed included: geographic distribution of studies, the type of studies and main study focus, the type of gender programming, and the type of evidence gathered. This review found that Gender transformative interventions, delivered in community settings, using group discussions and workshops, were shown to be the most effective in reaching their goals. However, there is a significant literature and research bias toward HIV and SRH issues, paired with a scarcity of published studies in most SSA countries. Furthermore, the widespread use of cognitive variables to measure effectiveness of interventions may limit reliability of their findings.
The Consequences of the United Kingdoms Hostile Environment Policies on the Health & Wellbeing and Integration of Asylum Seekers escaping Violence - A Critique of the Home Office Immigration Policies guided by John Rawls “Justice as Fairness” and Intersectional Theory
(2020)
People migrate for different reasons, one such reason is to escape violence from their home country, however once reaching their country of refuge their hardships often do not come to an end. This essay focuses on the experience of asylum seekers (AS’s) trying to integrate into the United Kingdom (UK) and the effect of the Home Office policies that neg atively impact them, with particular focus on the effect of the policy that restricts their ac cess to formal work. Individuals who migrate away from violence are recognised by the 1951 UN convention as refugees. However, when they enter the UK and make a claim for political asylum, they are legally classified as AS's; they are only legally recognised as refugees in the UK once their claim has been assessed and accepted with accompanying rights. Currently, AS's have restricted rights and this essay will discuss how the restricted rights to work have cre ated problems for AS's that have a wider effect beyond themselves. This essay will use Rawls's principles in "Justice as Fairness" with Intersectional principles to examine if the Home Office has failed AS's who have escaped conflict. It will discuss health consequences of these policies. The essay concludes that the asylum policies re garding work do not satisfy Rawls's principles of Social justice, and therefore are unjust and also prevent integration. It also recognises that although the right to work benefits health and well being, those rights by themselves is only one factor to health and well be ing and that policy needs to take a more intersectional and multifaceted approach.
Contextualising health inequities and respiratory infections-associated with household air pollution among children: present and future challenges for maternal and children mortality reductions in Tanzania'
(2022)
Background: Health inequities and exposure to household air pollution from unprocessed fuel for cooking has become a significant public health concerns and threats in Tanzania. 85 percent of Tanzanian people use biomass fuel for cooking, heating, and lighting their homes, and is more frequently used in rural areas than urban areas. Exposure attributed to household air pollution is a major contribution to morbidity and health illness among young children particularly under-five children. The growing evidence shows that in 2016, the total number of adults (male and female) died in relation to air pollution from solid fuels for cooking was 8.49 percent (33,024). Of those deaths, 7.80 percent (16,221) were male while 9.28 percent (16,221) were female. While deaths related to HAP among under-five children was 8.51 percent (9,236) and 8.14 percent (792,678.1) disability-adjusted life years. This study aimed to evaluate the impacts of health inequities and household air pollution on maternal and children under-five years old and understand the consequent impact on mortality rates reduction in Tanzania. Methods: Narrative literature review study that sought to evaluate the impacts of health inequity and household air pollution on maternal and children under-five years old and understand the consequent impact on mortality rates reduction in Tanzania. Electronic database search was performed for the current studies from 2005 to 2021. The electronic search included using google scholar, BMJ open Journals, PubMed, Science Direct, and BioMed to identify relative literature reviews both qualitative and quantitative reviews and grey papers. Results, the study found that solid fuel for cooking is associated with health illness (such as respiratory infections and pneumonia) among under-five children and adverse birth outcomes (e.g. pregnancy complication, stillbirth, low birth weight, preterm birth). I found also the risk factors associated with health illness and mortality among under-five years old are strongly linked to poor housing condition, gender inequality, socioeconomic status, and geographic disparities.
Critical Appraisal of the Chronic care Model and its applicability in management of HIV and Comorbidities in Botswana clinics
(Queen Margaret University, 2015)
This study appraises the chronic care model and its application in management of HIV and comorbidity in Botswana clinics. HIV/AIDS has transformed from a deadly disease to a manageable condition as a result of scaling up ARV. At the same time, Africa is experiencing an epidemiological transition. The emergence of Non Communicable Diseases is a challenge to Health systems. That said, HIV services are still provided through vertical programs in Sub Saharan Africa. Industrialized countries have shifted from acute care delivery to chronic care models to address chronic illnesses. This study aims to analyze applicability of such a model onto an African context. A chronic care model by Wagner 2001 is used as a framework for this analysis. The model entails several components, but for the purpose of this study only one component will be discussed, that is Delivery System Design. This is to determine the strengths and limitations of the model towards service delivery. Then a discussion on the current challenges Botswana has in dealing with HIV and comorbidities will follow. The identified challenges will form bases for a further discussion on the applicability of the model. Vertical approach to HIV has been viewed to cause imbalances in care and treatment of other diseases. As a result, more research is needed on how to improve the 'status quo' to impact on health outcomes across all diseases.
Decentralization of resistant pulmonary Tuberculosis (TB) diagnosis in Pakistan: evaluation of Xpert® MTB/XDR Assay for rapid detection of fluoroquinolones and isoniazid resistant TB
(2023-08-07) Unknown author
Background: Drug resistant Tuberculosis (DR-TB) is a major threat to global health. In high burden DR-TB settings, as Pakistan, decentralization of drug susceptibility testing (DST) is one of the key strategies recommended by WHO to end the TB epidemic. The peripheral rapid DST for isoniazid and fluoroquinolones is now possible as a new molecular assay, Xpert® MTB/XDR (Cepheid, USA) was recently endorsed by WHO. Aim: This study aims to assess the performance of Xpert® MTB/XDR and to evaluate the feasibility of implementing this test in peripheral settings in Pakistan. It also proposed an updated DR-TB diagnostic algorithm tailored to the country diagnostic network needs. Methods: To establish Xpert® MTB/XDR accuracy, a secondary data analysis was performed using results from a cross sectional observational study previously conducted. A thematic literature review provided data on Pakistan TB diagnostic network. Findings: The accuracy analysis demonstrated that Xpert® MTB/XDR has the characteristics required by WHO for the detection of isoniazid resistance at the peripheral level. Regarding fluoroquinolones resistance, Xpert® MTB/XDR reaches only one of the WHO targets (i.e., sensitivity) in the RR-TB cohort (90,48%; 95%CI 80,7-95,8). Even if the standard for DST remains the phenotypic test, a faster and more reliable assay appears to be needed in this setting. Conclusion: The proposed DR-TB diagnostic algorithm, tailored to Pakistan diagnostic network needs, may reduce considerably TB diagnosis turnaround time. This strategy will contribute to ensure equitable and prompt access to DR-TB diagnosis, improving the diagnostic network effectiveness and efficacy in ensuring TB care and control.
Delivering mental health care through community health workers in South Africa: A review of the main challenges
(Queen Margaret University, 2015)
This study examines the challenges that community health workers face when delivering mental health care to people with severe mental health disorders in South Africa. Method of study This study is conducted as a desk study by firstly generalising a review of the literature to identify factors that are already known to have affected community heath workers in delivering mental health care and a further analysis to identify possible strategies that can be used to alleviate the identified challenges. A thematic approach was used for data analysis. Findings Three broad challenges; health system challenges, community related challenges and CHWs' day to day challenges are the main factors that affect community health workers in delivering mental health care. Health system challenges Resources for mental health are in short supply in South Africa given the health and social needs of the population. The health system is burdened by diseases and exacerbated by poverty, trauma due to violence and road accidents, mental health disorders and prevalent maternal deaths. Although resources for health in general are above World health Organisation's recommendations in South Africa, health outcomes are affected by the uneven distribution of resources between health sectors within different geographical areas. Community related challenges Mental health literacy remains a cause for concern in South Africa and those enduring severe mental health disorders are often stigmatised. South Africa, a multicultural society with 11 official languages, often uses interpreters from other ethnic minorities causing interpretation problems which affect health outcomes. Community health workers are mandated to diagnose, treat and refer complicated cases to specialist health workers but often lack understanding of psychiatric disorders and the referral process in South Africa. Furthermore, patient's explanatory models which influence health seeking behaviours result in western treatment options being taken when other options have failed. Community health worker day to day challenges Lack of transport is one of the factors that affect health workers to access and transport patients with severe mental health disorders to clinics and referral hospitals. Often community health workers cover large geographical areas, taking large caseloads in the background of little remuneration and support. Recommendations Training and supervision is a crucial aspect that specialised health workers should undergo for the effectiveness of programmes that involve community health workers. Identifying factors that impact community health workers' delivery of mental health care, the level of support community health workers may need and policy makers to implement policies based on service need are vital aspects for service improvement. Both traditional and western treatment options for mental illness are equally used by service users in South Africa and their collaboration with a referral system is encouraged.
DIABETES PREVENTION AND CONTROL IN NIGERIA: EXPLORING THE RESPONSE OF THE HEALTH SECTOR.
(2024-02-12) Unknown author
Introduction: Diabetes mellitus (DM) is a chronic non-communicable disease (NCD) arising from disorders in carbohydrate metabolism. It affects about 422 million people worldwide and prevalence has been shown to be on the increase in Nigeria with an estimated 4 million affected people. Besides the effect on the quality of life, the disease poses an economic burden on the individuals, families and the Nigerian health systems. Thus, necessitating a review of the response towards prevention and control by the healthcare sector, the challenges as well as the existing policies. This will help determine how to move forward with current policies as well as how to implement better best practices. Methods: A desk study is carried out to explore the responses for diabetes prevention and control, policies and challenges of the Nigerian healthcare sector. This study was guided by the 2021 framework for action on diabetes prevention and control in the WHO eastern Mediterranean region to identify challenges of diabetes prevention and control. Also guiding this review is the Non-communicable disease (NCDs) policies programme theory by Loffreda et al. (2023) to identify existing policies in Nigeria. Results: Nigeria has demonstrated commendable efforts in implementing public health education and awareness as strategies for diabetes prevention and control. Findings show that there are challenges of poor knowledge of best diabetes care practices among healthcare professionals as well as insufficient number of workers in the healthcare facilities. In addition, the healthcare institutions especially at the primary healthcare levels were noted to be poorly equipped to manage DM. Finally, it was discovered that the policies for diabetes prevention and control were poorly implemented. All these findings have been linked to challenges in healthcare financing and poor leadership. Conclusions: Despite the increase in prevalence of diabetes mellitus, Nigeria has made little progress in diabetes care as well as implementing prevention and control policies. It is suggested that the country looks into improving on human resources, health institutions and healthcare financing.
Does resilience thinking add value to food security in the context of natural disasters in developing countries- a narrative review
(2021)
The adoption of “resilience thinking” is increasing on the global agenda as a response to the unprecedented loss and damage to lives and livelihoods caused by natural disasters. Agriculture is hit hard by disasters, especially in rural areas of developing countries. This leads to increasing risk of food insecurity for subsistence farmers and those reliant on local produce. To answer the question if resilience add value to food security in the context of natural disasters, this dissertation is undergone as a narrative review to examine the emergence of resilience, its application to food security and the strengths and limitations attributed to applying the paradigm to food security. Peer-reviewed literature on resilience and food security were gathered from three databases; Web of Science, Science Direct and Scopus, in addition to grey literature from organizational websites: FAO, WFP and IFPRI. Findings indicate that resilience gained increased interest after the United Nations adopted the 2030 Sustainable Development Goals and Sendai Framework for Disaster Risk Reduction 2015-2030, which called for action towards scaling up resilience to mitigate the adverse effect of disasters on food security for the most vulnerable populations. Although this review identified hesitancy to the appropriateness of resilience to food security, scarce yet positive evidence from case studies indicates there can be an added value of resilience thinking to food security. Further, we need a unified definition of resilience and agreement on food security indicators. Literature indicates ongoing effort to the paradigm with more evidence to come.
Effects of Barriers and Facilitators of Mental Healthcare Service Use in Ghana: A Scoping Review
(2024-09-05) Unknown author
Background Mental illness is a threat to the global world. Globally, in every eight (8) people, one (1) had a mental disorder in 2019 and this is estimated to rise drastically (WHO, 2019). This, apart from the health threats to the globe, also poses economic and social dangers as it leads to low productivity, stigmatisation, discrimination, abuse and high health costs. In Ghana, one in five persons will deal with a mental health issue at some point in their lives (Badu et al., 2018). According to WHO (2011) one out of ten Ghanaians suffers from mental disorders including depression, anxiety schizophrenia, and bipolar to mention a few. Access to mental healthcare in Ghana is crippled with many challenges (Quarshie et al., 2021). This study aims to investigate enablers and barriers to mental health access in Ghana. Methods This study employed a scoping review method to analyse and synthesise articles published from 2018 to 2024 on enablers of barriers to mental health access in Ghana. A search was carried out across electronic databases spanning the years 2018–2024, including CINAHL (EBSCO) (2000–2024), EMBASE (2000–2024), Medline (2000–2024), HealthSTAR (2000–2024), Google Scholar (2000–2024), PsycINFO (2000–2024), PubMed (2000–2024), Scopus Index (2000–2024), and Web of Science (2000–2024). This was done following the guidelines recommended by the Joanna Briggs Institute (JBI) for conducting systematic reviews (Pearson et al., 2014. The eligibility criteria for the scoping review were underpinned by the population/concept/context (PCC) framework. To be included, studies had to meet the below criteria: • Studies focused on Ghana regarding barriers and enablers of access and use of mental health services from the perspective of service users were included. • Studies that target multiple participant groups, including stakeholders from government ministries, health professionals, mental health service users based in cities, rural, or remote areas of Ghana, family members/community members, and caregivers were included. • Quantitative and qualitative studies that shed light on barriers and enablers of mental health service delivery were included. Both published and unpublished papers; thesis, commentaries, and expert opinions. • Only articles published in English from 2000 to 2024 shedding light on barriers and enablers of mental health service delivery from the perspective of service users were included. • Articles that elucidated obstacles that impeded the uptake, quality, or level of mental health services being accessed or described facilitators that allowed the uptake, quality, or level of mental health services being received were included. • The review included papers that explore the treatment strategies, enablers, and barriers to accessing mental health services. It also included papers that measure the extent to which mental health service provision functions in Ghana. The exclusion criteria were: • Studies that did not target the variables of interest (i.e. enablers and barriers to access and use of mental health services, and treatment strategies) were excluded. • Also, articles published before 2000 and those published in languages other than English were excluded. • Studies on barriers and facilitators that do not focus on Ghana were excluded.