TB STIGMA – MEASUREMENT GUIDANCE

TB is the most deadly infectious disease in the world, and stigma continues to play a significant role in worsening the epidemic. Stigma and discrimination not only stop people from seeking care but also make it more difficult for those on treatment to continue, both of which make the disease more difficult to treat in the long-term and mean those infected are more likely to transmit the disease to those around them. TB Stigma – Measurement Guidance is a manual to help generate enough information about stigma issues to design and monitor and evaluate efforts to reduce TB stigma. It can help in planning TB stigma baseline measurements and monitoring trends to capture the outcomes of TB stigma reduction efforts. This manual is designed for health workers, professional or management staff, people who advocate for those with TB, and all who need to understand and respond to TB stigma

HIV in Japan: Epidemiologic puzzles and ethnographic explanations

AbstractJapan is widely perceived to have a low level of HIV occurrence; however, its HIV epidemics also have been the subject of considerable misunderstanding globally. I used a ground truthing conceptual framework to meet two aims: first, to determine how accurately official surveillance data represented Japan's two largest epidemics (urban Kansai and Tokyo) as understood and experienced on the ground; and second, to identify explanations for why the HIV epidemics were unfolding as officially reported. I used primarily ethnographic methods while drawing upon epidemiology, and compared government surveillance data to observations at community and institutional sites (459 pages of field notes; 175 persons observed), qualitative interviews with stakeholders in local HIV epidemics (n = 32), and document research (n = 116). This revealed seven epidemiologic puzzles involving officially reported trends and conspicuously missing information. Ethnographically grounded explanations are presented for each. These included factors driving the epidemics, which ranged from waning government and public attention to HIV, to gaps in sex education and disruptive leadership changes in public institutions approximately every two years. Factors constraining the epidemics also contributed to explanations. These ranged from subsidized medical treatment for most people living with HIV, to strong partnerships between government and a well-developed, non-governmental sector of HIV interventionists, and protective norms and built environments in the sex industry. Local and regional HIV epidemics were experienced and understood as worse than government reports indicated, and ground-level data often contradicted official knowledge. Results thus call into question epidemiologic trends, including recent stabilization of the national epidemic, and suggest the need for revisions to the surveillance system and strategies that address factors driving and constraining the epidemics. Based upon its utility in the current study, ground truthing has value as a conceptual framework for research and shows promise for future theoretical development

An Examination of the relationship between Health and Economic Growth

This paper attempts to examine the relationship between health and economic growth. The rate of growth is measured using gross national income [GNI] and health status is measured using infant mortality rate, life expectancy rate and crude health rate. The above relationships are measured using a multivariate framework controlling for other background variables. Thus we have modelled the macroeconomic impact of health. A theoretical framework has been developed to model this linkage between health and growth and this is further tested using a regression model which tests the causality between these variables of interest. These models are tested using pooled data. We have also assumed in this analysis that these variables are affected by state-specific unobservable fixed effects, since there are other cultural, political and social factors at work here.Health, Economic Growth

Fear of Relationship Collapse: A Qualitative Study on Factors Associated with HIV Status Disclosure to Sexual Partner

聖路加国際大学修士(公衆衛生学)2022thesi

Reciprocity in global mental health policy

In an attempt to address inequalities and inequities in mental health provision in low and middle-income countries the WHO commenced the Mental Health Gap Action Programme (mhGAP) in 2008. Four years on from the commencement of this programme of work, the WHO has recently adopted the Comprehensive Mental Health Action Plan 2013-2020. This article will critically appraise the strategic direction that the WHO has adopted to address mental health difficulties across the globe. This will include a consideration of the role that the biomedical model of mental health difficulties has had on global strategy. Concerns will be raised that an over-reliance on scaling up medical resources has led to a strengthening of psychiatric hospital-based care, and insufficient emphasis being placed on social and cultural determinants of human distress. We also argue that consensus scientific opinion garnered from consortia of psychiatric ‘experts’ drawn mainly from Europe and North America may not have universal relevance or applicability, and may have served to silence and subjugate local experience and expertise across the globe. In light of the criticisms that have been made of the research that has been conducted into understanding mental health problems in the global south, the article also explores ways in which the evidence-base can be made more relevant and more valid. An important issue that will be highlighted is the apparent lack of reciprocity that exists in the impetus for change in how mental health problems are understood and addressed in low and middle-income countries compared to high-income countries. Whereas there is much focus on the need for change in low and middle-income countries, there is comparatively little critical reflection on practices in high-income countries in the global mental health discourse. We advocate for the development of mental health services that are sensitive to the socio-cultural context in which the services are applied. Despite the appeal of global strategies to promote mental health, it may be that very local solutions are required. The article concludes with some reflections on the strategic objectives identified in the Comprehensive Mental Health Action Plan 2013-2020 and how this work can be progressed in the future

Stigmatization fo HIV/AIDS: A Cross-Cultural Analysis

The Human Immunodeficiency Virus (HIV) is the cause of a public health epidemic that has impacted millions of individuals worldwide. Though medical advances have decreased the number of AIDS related deaths by 42% since the peak year of 2004 (UNAIDS, 2015), many individuals with HIV/AIDS are unaware of their status and are not currently receiving antiretroviral treatment. Many experts have suggested that a significant barrier to HIV/AIDS prevention and treatment is the social stigma that has become attached to the disease. No single cause of this stigmatization has been identified, but a variety of influences may play a role. To gain a better understanding on the role of culture in this situation, this study measures cross-cultural attitudes about HIV/AIDS using a questionnaire distributed to both international and American students at Western Kentucky University. Results show that international students hold significantly more stigmatizing attitudes about HIV/AIDS than American students. Recommendations are made for methods of reducing stigmatizing attitudes globally

State of the World's Volunteerism Report: Universal Values for Global Well-being

The focus of this report is on the universal values that motivate people the world over to volunteer for the common good and on the impact of volunteer action on societies and individuals. The authors advocate the power of volunteering to promote cooperation, encourage participation and contribute to the well-being of individuals and of society as a whole

The Effect of Facilitator Gender on the Effectiveness of Adolescent Reproductive Health Education: A Literature Review

Abstract Introduction: Sex education is a prevention measure to decrease juvenile delinquency. However, the implementation of sex education runs insufficiently and it is influenced by various factors. Of those, gender is one of the factors. This study shows the results of literature reviews regarding the relationship between facilitators and the effectiveness of sex education in adolescents aged 13-19 years.Methods : This research method used a literature review, by screening literature from 4 databases; Google Scholar, Pubmed, Science Direct, and Scopus. The PRISMA flow chart was used to show each step eligibility criteria of article selection.Results: This study found 6 journals that match the inclusion criteria. There were 5 articles that show a relationship between the gender of e-facilitators and the effectiveness of sex education in adolescents aged 13-19 years, while 1 article did not show a relationship because of an imbalance in the sample between male facilitators (24.5%) and women facilitators (75.5%).Conclusion: This review highlighted that implementing class separation based on sex (single-sex education) is one of best strategies to increase the effectiveness of reproductive health education for adolescents aged 13- 19 years. Thus, it is also suggested for Health Office or NGO to adopt a separate class system based on gender

Global aging: emerging challenges

This repository item contains a single issue of The Pardee Papers, a series papers that began publishing in 2008 by the Boston University Frederick S. Pardee Center for the Study of the Longer-Range Future. The Pardee Papers series features working papers by Pardee Center Fellows and other invited authors. Papers in this series explore current and future challenges by anticipating the pathways to human progress, human development, and human well-being. This series includes papers on a wide range of topics, with a special emphasis on interdisciplinary perspectives and a development orientation.Aging policy frameworks were devised during a demographic and economic context in which population aging seemed confined to wealthy nations. These countries could afford retirement policies that supported older workers, decreased unemployment among younger workers, and decreased family pressure to provide old age care. This calculation was based in part on failure to anticipate three demographic trends: continual decline in fertility below replacement rate, continual gains in longevity, and the rise of population aging in poor and “under-developed” countries. These three trends now fuel a sense of crisis. In the global North, there is fear that increasing numbers of older adults will deplete state pension and health care systems. In the global South, the fear is that population aging coupled with family breakdown” requires such state intervention. Natural disaster metaphors, such as “agequake” and “age-tsunami,” illustrate fears of a “graying globe” in which population aging implies population decay and economic destruction. Yet, global aging trends develop over decades and are not easily reversed. Longer-range trends can be addressed through revising policy frameworks to incorporate how growing old is moving from global exception to expectation. Alexandra Crampton was a 2008–2009 Postdoctoral Fellow at the Frederick S. Pardee Center for the Study of the Longer-Range Future and is currently Assistant Professor in the Department of Social and Cultural Sciences at Marquette University. Her scholarship and teaching bring an anthropological perspective to theoretical and practical questions on aging, social welfare policy, social work practice, negotiation, and alternative dispute resolution. She has presented her work for the American Anthropological Association, the Gerontological Society of America, the Council on Social Work Education, and the Society for Social Work Research. She holds a joint PhD in Social Work and Anthropology from the University of Michigan