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  • 1.
    Colombini, Manuela
    et al.
    London Sch Hyg & Trop Med, UK.
    Mayhew, Susannah H.
    London Sch Hyg & Trop Med, UK.
    Lund, Ragnhild
    Norwegian Univ Sci & Technol, Norway.
    Singh, Navpreet
    AstraZeneca PLC, UK.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Infanti, Jennifer
    Norwegian Univ Sci & Technol, Norway.
    Schei, Berit
    Norwegian Univ Sci & Technol, Norway.
    Wijewardene, Kumudu
    Univ Sri Jayewardenepura, Sri Lanka.
    Factors shaping political priorities for violence against women-mitigation policies in Sri Lanka2018In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 18, article id 22Article in journal (Refereed)
    Abstract [en]

    Background: Although violence against women (VAW) is a global public health issue, its importance as a health issue is often unrecognized in legal and health policy documents. This paper uses Sri Lanka as a case study to explore the factors influencing the national policy response to VAW, particularly by the health sector. Methods: A document based health policy analysis was conducted to examine current policy responses to VAW in Sri Lanka using the Shiffman and Smith (2007) policy analysis framework. Results: The findings suggest that the networks and influences of various actors in Sri Lanka, and their ideas used to frame the issue of VAW, have been particularly important in shaping the nature of the policy response to date. The Ministry of Women and Child Affairs led the national response on VAW, but suffered from limited financial and political support. Results also suggest that there was low engagement by the health sector in the initial policy response to VAW in Sri Lanka, which focused primarily on criminal legislation, following global influences. Furthermore, a lack of empirical data on VAW has impeded its promotion as a health policy issue, despite financial support from international organisations enabling an initial health systems response by the Ministry of Health. Until a legal framework was established (2005), the political context provided limited opportunities for VAW to also be construed as a health issue. It was only then that the Ministry of Health got legitimacy to institutionalise VAW services. Conclusion: Nearly a decade later, a change in government has led to a new national plan on VAW, giving a clear role to the health sector in the fight against VAW. High-level political will, criminalisation of violence, coalesced women's groups advocating for legislative change, prevalence data, and financial support from influential institutions are all critical elements helping frame violence as a national public health issue.

  • 2.
    Hjelm, Katarina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Atwine, Fortunate
    Nbarara University of Science and Technology (MUST), Uganda.
    Health-care seeking behaviour among persons with diabetes in Uganda study: an interview study2011In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 26, article id 11Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to explore healthcare-seeking behaviour, including use of complementary alternative medicine (CAM) and traditional healers, in Ugandans diagnosed with DM. Further, to study whether gender influenced healthcare-seeking behaviour. A descriptive study with a snowball sample from a community in Uganda was implemented. Semi-structured interviews were held with 16 women and 8 men, aged 25-70. Data were analysed by qualitative content analysis. The results showed that healthcare was mainly sought among doctors and nurses in the professional sector because of severe symptoms related to DM and/or glycaemic control. Females more often focused on follow-up of DM and chronic pain in joints, while males described fewer problems. Among those who felt that healthcare had failed, most had turned to traditional healers in the folk sector for prescription of herbs or food supplements, more so in women than men. Males more often turned to private for-profit clinics while females more often used free governmental institutions. In conclusion, healthcare was mainly sought from nurses and physicians in the professional sector and females used more free-of-charge governmental institutions. Perceived failure in health care to manage DM or related complications led many, particularly women, to seek alternative treatment from CAM practitioners in the folk sector. Living conditions, including healthcare organisation and gender, seemed to influence healthcare seeking, but further studies are needed.

  • 3.
    Hjelm, Katarina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Mufunda, Esther
    Zimbabwe Open University, Zimbabwe.
    Zimbabwean diabetics' beliefs about health and illness: an interview study2010In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 10, article id 7Article in journal (Refereed)
    Abstract [en]

    Aim: to explore beliefs about health and illness that might affect self-care practice and health-care seeking behaviour in persons diagnosed with DM, living in Zimbabwe.

    Methods: consecutive sample from diabetes clinic. Semistructured interviews with 21 persons aged 19-65 yrs. Data analysis with qualitative content analysis.

    Results: Health expressed as freedom from disease and well-being. Individual factors such as compliance with advice and drugs were considered important to promote health. A mixture of causes of DM stated, mainly individual factors as heredity, overweight and wrong diet combined with supernatural factors as fate, punishment from God and witchcraft were mentioned. Most did not recognize DM symptoms when falling ill but related health problems to other diseases. Limited knowledge about the disease and body was indicated. Poor economy was claimed harmful to health and a consequence of DM due to the need of buying expensive drugs, food, attending check-ups etc.

    Conclusions: Limited knowledge about DM, based on beliefs about health and illness including biomedical and traditional explanations related to influence of supernatural forces were found, these affected self-care and care-seeking behaviour. Strained economy was claimed as of utmost importance affecting management of the disease and health. Systemic and structural conditions need to be considered toghether with educational efforts to promote health and prevent DM-complications. 

  • 4.
    Lundin, Christina
    et al.
    Linköping university.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping university.
    Hjelm, Katarina
    Linköping university;Uppsala University.
    Language interpretation conditions and boundaries in multilingual and multicultural emergency healthcare2018In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 18, article id 23Article in journal (Refereed)
    Abstract [en]

    Background: With an increasing migrant population globally the need to organize interpreting service arises in emergency healthcare to deliver equitable high-quality care. The aims of this study were to describe interpretation practices in multilingual emergency health service institutions and to explore the impact of the organizational and institutional context and possible consequences of different approaches to interpretation. No previous studies on these issues in multilingual emergency care have been found. Methods: A qualitative descriptive study was used. Forty-six healthcare professionals were purposively recruited from different organizational levels in ambulance service and psychiatric and somatic emergency care units. Data were collected between December 2014 and April 2015 through focus-group and individual interviews, and analyzed by qualitative content analysis. Results: Organization of interpreters was based on patients' health status, context of emergency care, and access to interpreter service. Differences existed between workplaces regarding the use of interpreters: in somatic emergency care bilingual healthcare staff and family members were used to a limited extent; in psychiatric emergency care the norm was to use professional interpreters on the spot; and in ambulance service persons available at the time, e.g. family and friends were used. Similarities were found in: procuring a professional interpreter, mainly based on informal workplace routines, sometimes on formal guidelines and national laws, but knowledge of existing laws was limited; the ideal was a linguistically competent interpreter with a professional attitude, and organizational aspects such as appropriate time, technical and social environment; and wishes for development of better procedures for prompt access to professional interpreters at the workplace, regardless of organizational context, and education of interpreters and users. Conclusion: Use of interpreters was determined by health professionals, based on the patients' health status, striving to deliver as fast and individualized care as possible based on humanistic values. Defects in organizational routines need to be rectified and transcultural awareness is needed to achieve the aim of person-centered and equal healthcare. Clear formal guidelines for the use of interpreters in emergency healthcare need to be developed and it is important to fulfill health professionals' wishes for future development of prompt access to interpreters and education of interpreters and users.

1 - 4 of 4
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