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The Institute for Global Health and Development

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/9

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    Influences of community engagement and health system strengthening for cholera control in cholera reporting countries
    (BMJ Publishing Group, 2023-12-06) Baličević, Stephanie Ayres; Elimian, Kelly Osezele; King, Carina; Diaconu, Karin; Akande, Oluwatosin Wuraola; Ihekweazu, Vivianne; Trolle, Hanna; Gaudenzi, Giulia; Forsberg, Birger; Alfven, Tobias
    The 2030 Global Task Force on Cholera Control Roadmap hinges on strengthening the implementation of multistranded cholera interventions, including community engagement and health system strengthening. However, a composite picture of specific facilitators and barriers for these interventions and any overlapping factors existing between the two, is lacking. Therefore, this study aims to address this shortcoming, focusing on cholera-reporting countries, which are disproportionately affected by cholera and may be cholera endemic. A scoping methodology was chosen to allow for iterative mapping, synthesis of the available research and to pinpoint research activity for global and local cholera policy-makers and shareholders. Using the Arksey and O’Malley framework for scoping reviews, we searched PubMed, Web of Science and CINAHL. Inclusion criteria included publication in English between 1990 and 2021 and cholera as the primary document focus in an epidemic or endemic setting. Data charting was completed through narrative descriptive and thematic analysis. Forty-four documents were included, with half relating to sub-Saharan African countries, 68% (30/44) to cholera endemic settings and 21% (9/44) to insecure settings. We identified four themes of facilitators and barriers to health systems strengthening: health system cooperation and agreement with external actors; maintaining functional capacity in the face of change; good governance, focused political will and sociopolitical influences on the cholera response and insecurity and targeted destruction. Community engagement had two themes: trust building in the health system and growing social cohesion. Insecurity and the community; cooperation and agreement; and sociopolitical influences on trust building were themes of factors acting at the interface between community engagement and health system. Given the decisive role of the community–health system interface for both sustained health system strengthening and community engagement, there is a need to advocate for conflict resolution, trust building and good governance for long-term cholera prevention and control in cholera reporting countries.
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    Changing men or changing health systems? A scoping review of interventions, services and programmes targeting men’s health in sub-Saharan Africa
    (BMC, 2021-03-31) Beia, Thierry; Kielmann, Karina; Diaconu, Karin
    Background: Sex and gender have been shown to influence health literacy, health seeking behaviour, and health outcomes. However, research examining the links between gender and health has mainly focused on women’s health, which is a long-standing global health priority. We examine literature focused on the ‘missing men’ in global health research, in particular empirical studies that document interventions, programmes, and services targeting men’s health issues in Sub-Saharan Africa. Within these studies, we identify dominant conceptualisations of men and men’s health and how these have influenced the design of men’s health interventions and services. Methods: This is a scoping review of published and grey literature. Following comprehensive searches, we included 56 studies in the review. We conducted a bibliographic analysis of all studies and used inductive methods to analyse textual excerpts referring to conceptualizations of men and service design. An existing framework to categorise services, interventions, or programs according to their gender-responsiveness was adapted and used for the latter analysis. Results: From the included studies, we distinguished four principal ways in which men were conceptualized in programs and interventions: men are variously depicted as ‘gatekeepers’; ‘masculine’ men, ‘marginal’ men and as ‘clients. Additionally, we classified the gender-responsiveness of interventions, services or programmes described in the studies within the following categories: gender-neutral, −partnering, −sensitive and -transformative. Interventions described are predominantly gender-neutral or gender-partnering, with limited data available on transformative interventions. Health systems design features – focused mainly on achieving women’s access to, and uptake of services – may contribute to the latter gap leading to poor access and engagement of men with health services. Conclusion: This review highlights the need for transformation in sub-Saharan African health systems towards greater consideration of men’s health issues and health-seeking patterns.
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    Implementing the Agenda for Global Action on human resources for health: analysis from an international tracking survey
    (Sciedu Press, 2013-02) Witter, Sophie; Cometto, G.; Zaman, R.; Sheikh, M.; Wibulpolprasert, S.
    Objective: A survey was conducted to analyse the governance and policy environment for human resources for health (HRH) development in 57 priority countries, with the objective of understanding the linkages between policy and context factors. Methods: Responses to a questionnaire tracking proxy indicators were received from 51 (89%) countries. Findings are presented by frequency; correlations were investigated through cross tabulations and multiple regression analysis. Results: The results indicate uneven performance among countries and across different domains of health workforce development. The only indicator showing a significant correlation with other areas of performance was implementing an HRH plan. No significant correlation with contextual factors was found. Discussion: Progress in addressing HRH challenges appears to be independent of contextual factors, suggesting that countries can improve their performance through concerted action by stakeholders. Having and implementing an HRH plan appears to be a key factor in galvanising that action.