Adolescent opinions on the Asking for Help Program : Assessing participant outcomes

This study examined the effectiveness of a school-based intervention, the Asking for Help Program. Participants were 50 at-risk adolescents, aged 14 to 19 years old (M = 15.98, SD = 1.30), who completed pre- and post-questionnaires to assess perceived barriers to help seeking, attitudes towards seeking professional help, and actual help seeking. Qualitative data was also collected using focus group interviews. Qualitative findings detected significant gains in participants\u27 perceptions of barriers pertaining to knowledge and social stigmas as well as suggested that participants\u27 attitudes towards seeking help improved. Findings are discussed within the context of participants\u27 perceived and actual change as well as participants\u27 suggestions for how the intervention could be improved

Factors predicting adolescents\u27 and parents\u27 help seeking behaviour

Adolescents\u27 perceptions and responses to mental health problems have been shown to have significant implications for their future competence, coping skills, well-being, and subsequent life choices; yet, as few as 25 percent of young Canadians with mental health problems seek help (Bergeron, Poirier, Fournier, Roberge, & Barrette, 2005). The purpose of this study was to examine the stages of adolescent help seeking (i.e., recognizing the problem, deciding to seek professional help, and seeking professional help ) to better understand why some adolescents seek help and others do not. Specific predisposing, enabling, and need factors were examined as predictors of adolescents\u27 and parents\u27 behaviour across the three stages of help seeking. Participants completed on-line questionnaires assessing help-seeking stages, barriers to help seeking, help-seeking attitudes, family functioning, parental stress, and symptomatology. After data screening procedures, the sample consisted of 175 adolescents and 95 parents from the Windsor-Essex community; of these participants, 21 parent-adolescent dyads were formed. Regression analyses showed that being female and perceiving mental health problems to be severe significantly improved the likelihood that an adolescent would recognize their mental health problem (Stage 1). Further, higher perceptions of problem severity and prior professional help seeking significantly improved the likelihood that an adolescent would decide to help seek (Stage 2) and actually seek professional help (Stage 3). These findings are consistent with the study\u27s hypotheses. With regards to parental help seeking, parents\u27 worry and concern for adolescents with mental health problems significantly improved the likelihood that a parent would recognize adolescent mental health problems (Stage 1) and decide to seek professional help for the adolescent (Stage 2). Finally, parent-reported prior family professional help seeking significantly improved the likelihood of parents actually seeking professional help for adolescent mental health problems (Stage 3). Given the limited number of parent-adolescent dyads, the researcher was limited with regards to statistical analyses that could be performed; however, the results lend support to the idea that an adolescent and parent from the same family are likely to be in similar stages of help seeking. The results suggest that family cohesion, flexibility, and communication may have an indirect effect on adolescent help seeking by contributing to an adolescent being more or less vulnerable to mental health problems. Implications for increasing adolescent help seeking and improving adolescents\u27 and parents\u27 access to professional resources are discussed

Building the nation's body:The contested role of abortion and family planning in post-war South Sudan

: This paper offers an ethnographic analysis of public health policies and interventions targeting unwanted pregnancy (family planning and abortion) in contemporary South Sudan as part of wider 'nation-building' after war, understood as a process of collective identity formation which projects a meaningful future by redefining existing institutions and customs as national characteristics. The paper shows how the expansion of post-conflict family planning and abortion policy and services are particularly poignant sites for the enactment of reproductive identity negotiation, policing and conflict. In addition to customary norms, these processes are shaped by two powerful institutions - ethnic movements and global humanitarian actors - who tend to take opposing stances on reproductive health. Drawing on document review, observations of the media and policy environment and interviews conducted with 54 key informants between 2013 and 2015, the paper shows that during the civil war, the Sudan People's Liberation Army and Movement mobilised customary pro-natalist ideals for military gain by entreating women to amplify reproduction to replace those lost to war and rejecting family planning and abortion. International donors and the Ministry of Health have re-conceptualised such services as among other modern developments denied by war. The tensions between these competing discourses have given rise to a range of societal responses, including disagreements that erupt in legal battles, heated debate and even violence towards women and health workers. In United Nations camps established recently as parts of South Sudan have returned to war, social groups exert a form of reproductive surveillance, policing reproductive health practices and contributing to intra-communal violence when clandestine use of contraception or abortion is discovered. In a context where modern contraceptives and abortion services are largely unfamiliar, conflict around South Sudan's nation-building project is partially manifest through tensions and violence in the domain of reproduction.<br/

Health workforce governance for compassionate and respectful care: a framework for research, policy and practice

The progressive realisation of universal health coverage requires that health services are not only available and accessible, but also that they are rendered to the population in an acceptable, compassionate and respectful manner to deliver quality of care. Health workers’ competencies play a central role in the provision of compassionate and respectful care (CRC); but health workers’ behaviour is also influenced by the policy and governance environment in which they operate. The identification of relevant policy levers to enhance CRC therefore calls for actions that enable health workers to optimise their roles and fulfil their responsibilities.This paper aims at exploring the health workforce policy and management levers to enable CRC. Through an overview of selected country experiences, concrete examples are provided to illustrate the range of available policy options. Relevant interventions may span the individual, organisational, or system-wide level. Some policies are specific to CRC and may include, among others, the inclusion of relevant competencies in preservice and in-service education, supportive supervision and accountability mechanisms. Other relevant actions depend on a broader workforce governance approach, including policies that target health workforce availability, distribution and working conditions, or wider system -level factors, including regulatory and financing aspects.The selection of the appropriate system-wide and CRC-specific interventions should be tailored to the national and operational context in relation to its policy objectives and feasibility and affordability considerations. The identification of performance metrics and the collation and analysis of required data are necessary to monitor effectiveness of the interventions adopted

Countdown to 2015 decade report (2000-10): taking stock of maternal, newborn, and child survival.

The Countdown to 2015 for Maternal, Newborn, and Child Survival monitors coverage of priority interventions to achieve the Millennium Development Goals (MDGs) for child mortality and maternal health. We reviewed progress between 1990 and 2010 in coverage of 26 key interventions in 68 Countdown priority countries accounting for more than 90% of maternal and child deaths worldwide. 19 countries studied were on track to meet MDG 4, in 47 we noted acceleration in the yearly rate of reduction in mortality of children younger than 5 years, and in 12 countries progress had decelerated since 2000. Progress towards reduction of neonatal deaths has been slow, and maternal mortality remains high in most Countdown countries, with little evidence of progress. Wide and persistent disparities exist in the coverage of interventions between and within countries, but some regions have successfully reduced longstanding inequities. Coverage of interventions delivered directly in the community on scheduled occasions was higher than for interventions relying on functional health systems. Although overseas development assistance for maternal, newborn, and child health has increased, funding for this sector accounted for only 31% of all development assistance for health in 2007. We provide evidence from several countries showing that rapid progress is possible and that focused and targeted interventions can reduce inequities related to socioeconomic status and sex. However, much more can and should be done to address maternal and newborn health and improve coverage of interventions related to family planning, care around childbirth, and case management of childhood illnesses