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Sample records for african health systems

  1. Understanding global health and development partnerships: Perspectives from African and global health system professionals.

    PubMed

    Barnes, Amy; Brown, Garrett W; Harman, Sophie

    2016-06-01

    Partnership is a key idea in current debates about global health and development assistance, yet little is known about what partnership means to those who are responsible for operationalising it or how it is experienced in practice. This is particularly the case in the context of African health systems. This paper explores how health professionals working in global health hubs and the health systems of South Africa, Tanzania and Zambia understand and experience partnership. Drawing on semi-structured interviews with 101 professionals based in each country, Washington DC and Geneva between October 2012 and June 2013, the paper makes four key arguments. First, partnership has a legitimating function in global health policy processes for international development institutions, government agencies and civil society organisations alike. Second, the practice of partnership generates idiosyncratic and complicated relationships that health professionals have to manage and navigate, often informally. Third, partnership is shaped by historical legacies, critical events, and independent consultants. Fourth, despite being an accepted part of global health policy, there is little shared understanding of what good partnership is meant to include or resemble in practice. Knowing more about the specific socio-cultural and political dynamics of partnership in different health system contexts is critical to equip health professionals with the skills to build the informal relations that are essential to effective partnership engagement. PMID:27155226

  2. Institutionalization of African traditional medicine in health care systems in Africa.

    PubMed

    Kofi-Tsekpo, Mawuli

    2004-01-01

    In recent times, the phrase " traditional medicine" has become a catchword among the peoples in all countries in Africa. This has been due partly because the use of herbal remedies has gained popularity worldwide and the exploitation of these remedies has become a multimillion industry. The term "African traditional medicine" is not synonymous with "Alternative and complimentary medicine" which is a misnomer which is sometimes used. African traditional medicine is the African indigenous system of health care and therefore cannot be an alternative. In Africa, there is an important reason why African traditional medicine has become increasingly popular. The high cost of allopathic medical health care and the expensive pharmaceutical products have become unavailable to a majority of people. Naturally, the many centuries-old alternative sources of health care have become handy, often in desperate situations. In fact, the frequently quoted statement that 85 per cent of the people in Africa use traditional medicine, is an understatement because this figure is much higher and continues to increase. At the Alma Atta Declaration of 1978, it was resolved that traditional medicine had to be incorporated in the health care systems in developing countries if the objective of the "Health for All by the Year 2000" was to be realized. Notwithstanding this strategy, African countries did not come near the objective at the end of the 20th century. Therefore, the Member States of the WHO African Region adopted a resolution in 2000 called "Promoting the role of traditional medicine in health care systems: A strategy for the African Region". This strategy provides for the institutionalization of traditional medicine in health care systems of the member states of the WHO African Region. Furthermore, the OAU (African Union) Heads of State and Government declared the period 2000 - 2010 as the African Decade on African Traditional Medicine. In addition, the Director General of the World

  3. The use of modern quality improvement approaches to strengthen African health systems: a 5-year agenda.

    PubMed

    Heiby, James

    2014-04-01

    There is a growing international consensus that African health systems need to improve, but no agreement on how to accomplish this. From the perspective of modern quality improvement (QI), a central issue for low performance in these health systems is the relative neglect of health-care processes. Both health system leaders and international donors have focused their efforts elsewhere, producing noteworthy health gains. But these gains are at risk if health systems do not develop the capacity to study and improve care processes. Substantial experience with QI in Africa shows impressive potential for broad-based process improvement. But this experience also highlights the need for modifying these growing programs to incorporate a more rigorous learning component to address challenges that have emerged recently. The addition of a region-wide knowledge management program could increase the efficiency of each country's QI program by learning from the experiences of other programs. With a coordinated donor initiative, it is reasonable to project that within 5 years, evidence-based improvement will become a norm in health services, and African health systems will approach the model of a learning organization. PMID:24481053

  4. Status of national health research systems in ten countries of the WHO African Region

    PubMed Central

    Kirigia, Joses M; Wambebe, Charles

    2006-01-01

    Background The World Health Organization (WHO) Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4) which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. Methods A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country) bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. Results The key findings were as follows: the response rate was 21.7% (10/46); three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS); two countries confirmed the existence of a functional national health research management forum (NHRMF); six countries had a functional ethical review committee (ERC); five countries had a scientific review committee (SRC); five countries reported the existence of health institutions with institutional review committees (IRC); two countries had a health research programme; and three countries had a national health research institute (NHRI) and a faculty of health sciences in the national university that conducted health research. Four out of the ten

  5. Race, health, and the African Diaspora.

    PubMed

    Spigner, Clarence

    Health inequalities exist throughout the African Diaspora and are viewed in this article as largely color-coded. In developed, developing, and undeveloped nations today, "racial" stratification is consistently reflected in an inability to provide adequate health regardless of national policy or ideology. For instance, African Americans experience less than adequate health care very similar to Blacks in Britain, in spite of each nations differing health systems. Latin America's Africana Negra communities experience poorer health similar to Blacks throughout the Caribbean. The African continent itself is arguably the poorest on earth. A common history of racism correlates with health disparities across the African Diaspora. PMID:18364304

  6. An ICT-Based Diabetes Management System Tested for Health Care Delivery in the African Context

    PubMed Central

    Takenga, Claude; Berndt, Rolf-Dietrich; Musongya, Olivier; Kitero, Joël; Katoke, Remi; Molo, Kakule; Kazingufu, Basile; Meni, Malikwisha; Vikandy, Mambo; Takenga, Henri

    2014-01-01

    The demand for new healthcare services is growing rapidly. Improving accessibility of the African population to diabetes care seems to be a big challenge in most countries where the number of care centers and medical staff is reduced. Information and communication technologies (ICT) have great potential to address some of these challenges faced by several countries in providing accessible, cost-effective, and high-quality health care services. This paper presents the Mobil Diab system which is a telemedical approach proposed for the management of long-term diseases. The system applies modern mobile and web technologies which overcome geographical barriers, and increase access to health care services. The idea of the system is to involve patients in the therapy process and motivate them for an active participation. For validation of the system in African context, a trial was conducted in the Democratic Republic of Congo. 40 Subjects with diabetes divided randomly into control and intervention groups were included in the test. Results show that Mobil Diab is suitable for African countries and presents a number of benefits for the population and public health care system. It improves clinical management and delivery of diabetes care services by enhancing access, quality, motivation, reassurance, efficiency, and cost-effectiveness. PMID:25136358

  7. Improving health information systems for decision making across five sub-Saharan African countries: Implementation strategies from the African Health Initiative

    PubMed Central

    2013-01-01

    Background Weak health information systems (HIS) are a critical challenge to reaching the health-related Millennium Development Goals because health systems performance cannot be adequately assessed or monitored where HIS data are incomplete, inaccurate, or untimely. The Population Health Implementation and Training (PHIT) Partnerships were established in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze advances in strengthening district health systems. Interventions were tailored to the setting in which activities were planned. Comparisons across strategies All five PHIT Partnerships share a common feature in their goal of enhancing HIS and linking data with improved decision-making, specific strategies varied. Mozambique, Ghana, and Tanzania all focus on improving the quality and use of the existing Ministry of Health HIS, while the Zambia and Rwanda partnerships have introduced new information and communication technology systems or tools. All partnerships have adopted a flexible, iterative approach in designing and refining the development of new tools and approaches for HIS enhancement (such as routine data quality audits and automated troubleshooting), as well as improving decision making through timely feedback on health system performance (such as through summary data dashboards or routine data review meetings). The most striking differences between partnership approaches can be found in the level of emphasis of data collection (patient versus health facility), and consequently the level of decision making enhancement (community, facility, district, or provincial leadership). Discussion Design differences across PHIT Partnerships reflect differing theories of change, particularly regarding what information is needed, who will use the information to affect change, and how this change is expected to manifest. The iterative process of data use to monitor and assess the health system has been heavily communication

  8. Advancing the application of systems thinking in health: South African examples of a leadership of sensemaking for primary health care

    PubMed Central

    2014-01-01

    Background New forms of leadership are required to bring about the fundamental health system changes demanded by primary health care (PHC). Using theory about complex adaptive systems and policy implementation, this paper considers how actors’ sensemaking and the exercise of discretionary power currently combine to challenge PHC re-orientation in the South African health system; and provides examples of leadership practices that promote sensemaking and power use in support of PHC. Methods The paper draws on observational, interview, and reflective data collected as part of the District Innovation and Action Learning for Health Systems Development (DIALHS) project being implemented in Cape Town, South Africa. Undertaken collaboratively between health managers and researchers, the project is implemented through cycles of action-learning, including systematic reflection and synthesis. It includes a particular focus on how local health managers can better support front line facility managers in strengthening PHC. Results The results illuminate how the collective understandings of staff working at the primary level - of their working environment and changes within it – act as a barrier to centrally-led initiatives to strengthen PHC. Staff often fail to take ownership of such initiatives and experience them as disempowering. Local area managers, located between the centre and the service frontline, have a vital role to play in providing a leadership of sensemaking to mediate these challenges. Founded on personal values, such leadership entails, for example, efforts to nurture PHC-aligned values and mind-sets among staff; build relationships and support the development of shared meanings about change; instil a culture of collective inquiry and mutual accountability; and role-model management practices, including using language to signal meaning. Conclusions PHC will only become a lived reality within the South African health system when frontline staff are able to

  9. Ebola impact on African health systems entails a quest for more international and local resilience: the case of African Portuguese speaking countries

    PubMed Central

    Lapão, Luís Velez; Silva, Andreia; Pereira, Natália; Vasconcelos, Paula; Conceição, Cláudia

    2015-01-01

    Introduction Ebola epidemics have shown to have significant impacts on many aspects of healthcare systems. African countries have been facing many difficulties while addressing Ebola epidemics, moreover due to both lack of resources and fragmented involvement of national and international entities. The participation of multiple organizations has created serious problems of coordination of aid and the operation of that aid on the ground. This paper aims at addressing the impact of Ebola epidemics on African health systems, with a special focus on the definition of impact mitigation guidelines and the role of resilience. The example of Portuguese speaking countries is presented. Methods A combination of literature review and case study methods are used. A literature review on Ebola outbreak impact on health systems will provide information to define a set of guidelines for healthcare services response to Ebola. The role of cooperation in providing additional resilience is described. Finally a case study focusing on the Portuguese collaboration and intervention in African Portuguese Speaking Countries (PALOP) is presented, as an example how the international community can provide additional resilience. Results The existing knowledge is very helpful to guide both the preparation and the coordination of Ebola preparedness interventions. Additional resilience can be provided by international cooperation. Conclusion In addition to international concrete support in times of crisis, to have a regional strategy of creating (multi-national) teams to rapidly implement an intervention while establishing better regional capacity to have sufficient resources to support the “resilience” required of the health system. PMID:26740843

  10. Health Conditions Common in African American Women

    MedlinePlus

    ... health. Return to top Health conditions common in African-American women Asthma Breast cancer Cancer Cervical cancer Diabetes Glaucoma and cataracts Heart disease High blood pressure High cholesterol HIV/AIDS Infant death Kidney disease Lupus Mental health ...

  11. Environmental health and African Americans.

    PubMed Central

    Walker, B

    1991-01-01

    As environmental health has taken on immensely increased significance in the prevention of disease, dysfunction, and premature death, its boundaries have been anything but stable. This instability, along with a multitude of demographic, social, and economic currents, have brought into stark relief the increasing demand for scientists who have the skills and knowledge to perform environmental risk assessment and implement effective risk management policies and services. Despite this demand far too few African Americans want, or are prepared, to pursue careers in sciences. This paper describes efforts to address this problem and suggests why such initiatives may not yield the desired results. PMID:1951793

  12. Feasibility of a Web-Based Training System for Peer Community Health Advisors in Cancer Early Detection Among African Americans

    PubMed Central

    Santos, Sherie Lou Z.; Tagai, Erin K.; Wang, Min Qi; Scheirer, Mary Ann; Slade, Jimmie L.

    2014-01-01

    We describe the feasibility of a Web-based portal for training peer community health advisors (CHAs). We conducted a community-based implementation trial in African American churches between 2012 and 2014. The Web-based portal allows CHAs to log in and view 13 training videos, preparing them to deliver 3 cancer early detection workshops in their churches. Of 8 churches, 6 completed the training, each certifying 2 CHAs. These CHAs took an average of 26 days to complete the training, requiring little technical assistance. Additional technical assistance was required to implement the workshops. The Web-based system appears to be a feasible method for training lay individuals for the CHA role and has implications for increasing the reach of evidence-based interventions. PMID:25320894

  13. New data on African health professionals abroad

    PubMed Central

    Clemens, Michael A; Pettersson, Gunilla

    2008-01-01

    Background The migration of doctors and nurses from Africa to developed countries has raised fears of an African medical brain drain. But empirical research on the causes and effects of the phenomenon has been hampered by a lack of systematic data on the extent of African health workers' international movements. Methods We use destination-country census data to estimate the number of African-born doctors and professional nurses working abroad in a developed country circa 2000, and compare this to the stocks of these workers in each country of origin. Results Approximately 65,000 African-born physicians and 70,000 African-born professional nurses were working overseas in a developed country in the year 2000. This represents about one fifth of African-born physicians in the world, and about one tenth of African-born professional nurses. The fraction of health professionals abroad varies enormously across African countries, from 1% to over 70% according to the occupation and country. Conclusion These numbers are the first standardized, systematic, occupation-specific measure of skilled professionals working in developed countries and born in a large number of developing countries. PMID:18186916

  14. Institutional capacity for health systems research in East and Central African Schools of Public Health: strengthening human and financial resources

    PubMed Central

    2014-01-01

    Background Despite its importance in providing evidence for health-related policy and decision-making, an insufficient amount of health systems research (HSR) is conducted in low-income countries (LICs). Schools of public health (SPHs) are key stakeholders in HSR. This paper, one in a series of four, examines human and financial resources capacities, policies and organizational support for HSR in seven Africa Hub SPHs in East and Central Africa. Methods Capacity assessment done included document analysis to establish staff numbers, qualifications and publications; self-assessment using a tool developed to capture individual perceptions on the capacity for HSR and institutional dialogues. Key informant interviews (KIIs) were held with Deans from each SPH and Ministry of Health and non-governmental officials, focusing on perceptions on capacity of SPHs to engage in HSR, access to funding, and organizational support for HSR. Results A total of 123 people participated in the self-assessment and 73 KIIs were conducted. Except for the National University of Rwanda and the University of Nairobi SPH, most respondents expressed confidence in the adequacy of staffing levels and HSR-related skills at their SPH. However, most of the researchers operate at individual level with low outputs. The average number of HSR-related publications was only <1 to 3 per staff member over a 6-year period with most of the publications in international journals. There is dependency on external funding for HSR, except for Rwanda, where there was little government funding. We also found that officials from the Ministries of Health often formulate policy based on data generated through ad hoc technical reviews and consultancies, despite their questionable quality. Conclusions There exists adequate skilled staff for HSR in the SPHs. However, HSR conducted by individuals, fuelled by Ministries’ of Health tendency to engage individual researchers, undermines institutional capacity. This study

  15. Institutional capacity for health systems research in East and Central African schools of public health: knowledge translation and effective communication

    PubMed Central

    2014-01-01

    Background Local health systems research (HSR) provides policymakers and practitioners with contextual, evidence-based solutions to health problems. However, producers and users of HSR rarely understand the complexities of the context within which each operates, leading to the “know–do” gap. Universities are well placed to conduct knowledge translation (KT) integrating research production with uptake. The HEALTH Alliance Africa Hub, a consortium of seven schools of public health (SPHs) in East and Central Africa, was formed to build capacity in HSR. This paper presents information on the capacity of the various SPHs to conduct KT activities. Methods In 2011, each member of the Africa Hub undertook an institutional HSR capacity assessment using a context-adapted and modified self-assessment tool. KT capacity was measured by several indicators including the presence of a KT strategy, an organizational structure to support KT activities, KT skills, and institutional links with stakeholders and media. Respondents rated their opinions on the various indicators using a 5-point Likert scale. Averages across all respondents for each school were calculated. Thereafter, each school held a results validation workshop. Results A total of 123 respondents from all seven SPHs participated. Only one school had a clear KT strategy; more commonly, research was disseminated at scientific conferences and workshops. While most respondents perceived their SPH as having strong institutional ties with organizations interested in HSR as well as strong institutional leadership, the organizational structures required to support KT activities were absent. Furthermore, individual researchers indicated that they had little time or skills to conduct KT. Additionally, institutional and individual links with policymakers and media were reported as weak. Conclusions Few SPHs in Africa have a clear KT strategy. Strengthening the weak KT capacity of the SPHs requires working with institutional

  16. Health parties for African American study recruitment.

    PubMed

    Sadler, Georgia Robins; York, Crystal; Madlensky, Lisa; Gibson, Kathi; Wasserman, Linda; Rosenthal, Eric; Barbier, Leslie; Newman, Vicky A; Tso, Cindy

    2006-01-01

    Innovative strategies are needed to increase minorities' research participation. Using existing social networks within the African American community, "home health parties" were tested as a way to recruit African American women to a breast cancer control study. Parties included social, educational, and recruitment components. All women attending health parties consented, completed a survey, and received the study's preliminary breast cancer risk assessment. There were no differences in rates of participation for subsequent study components between women recruited via parties versus other methods. Health parties are viable recruitment strategies, reduce barriers to participation, provide a supportive environment, and are relatively inexpensive. PMID:17020516

  17. Assessment of capacity for Health Policy and Systems Research and Analysis in seven African universities: results from the CHEPSAA project

    PubMed Central

    Mirzoev, Tolib; Lê, Gillian; Green, Andrew; Orgill, Marsha; Komba, Adalgot; Esena, Reuben K; Nyapada, Linet; Uzochukwu, Benjamin; Amde, Woldekidan K; Nxumalo, Nonhlanhla; Gilson, Lucy

    2014-01-01

    The importance of health policy and systems research and analysis (HPSR+A) is widely recognized. Universities are central to strengthening and sustaining the HPSR+A capacity as they teach the next generation of decision-makers and health professionals. However, little is known about the capacity of universities, specifically, to develop the field. In this article, we report results of capacity self- assessments by seven universities within five African countries, conducted through the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA). The capacity assessments focused on both capacity ‘assets’ and ‘needs’, and covered the wider context, as well as organizational and individual capacity levels. Six thematic areas of capacity were examined: leadership and governance, organizations’ resources, scope of HPSR+A teaching and research, communication, networking and getting research into policy and practice (GRIPP), demand for HPRS+A and resource environment. The self-assessments by each university used combinations of document reviews, semi-structured interviews and staff surveys, followed by comparative analysis. A framework approach, guided by the six thematic areas, was used to analyse data. We found that HPSR+A is an international priority, and an existing activity in Africa, though still neglected field with challenges including its reliance on unpredictable international funding. All universities have capacity assets, such as ongoing HPSR+A teaching and research. There are, however, varying levels of assets (such as differences in staff numbers, group sizes and amount of HPSR+A teaching and research), which, combined with different capacity needs at all three levels (such as individual training, improvement in systems for quality assurance and fostering demand for HPSR+A work), can shape a future agenda for HPSR+A capacity strengthening. Capacity assets and needs at different levels appear related. Possible integrated strategies for

  18. Assessment of capacity for Health Policy and Systems Research and Analysis in seven African universities: results from the CHEPSAA project.

    PubMed

    Mirzoev, Tolib; Lê, Gillian; Green, Andrew; Orgill, Marsha; Komba, Adalgot; Esena, Reuben K; Nyapada, Linet; Uzochukwu, Benjamin; Amde, Woldekidan K; Nxumalo, Nonhlanhla; Gilson, Lucy

    2014-10-01

    The importance of health policy and systems research and analysis (HPSR+A) is widely recognized. Universities are central to strengthening and sustaining the HPSR+A capacity as they teach the next generation of decision-makers and health professionals. However, little is known about the capacity of universities, specifically, to develop the field. In this article, we report results of capacity self- assessments by seven universities within five African countries, conducted through the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA). The capacity assessments focused on both capacity 'assets' and 'needs', and covered the wider context, as well as organizational and individual capacity levels. Six thematic areas of capacity were examined: leadership and governance, organizations' resources, scope of HPSR+A teaching and research, communication, networking and getting research into policy and practice (GRIPP), demand for HPRS+A and resource environment. The self-assessments by each university used combinations of document reviews, semi-structured interviews and staff surveys, followed by comparative analysis. A framework approach, guided by the six thematic areas, was used to analyse data. We found that HPSR+A is an international priority, and an existing activity in Africa, though still neglected field with challenges including its reliance on unpredictable international funding. All universities have capacity assets, such as ongoing HPSR+A teaching and research. There are, however, varying levels of assets (such as differences in staff numbers, group sizes and amount of HPSR+A teaching and research), which, combined with different capacity needs at all three levels (such as individual training, improvement in systems for quality assurance and fostering demand for HPSR+A work), can shape a future agenda for HPSR+A capacity strengthening. Capacity assets and needs at different levels appear related. Possible integrated strategies for strengthening

  19. From placement to prison revisited: Do mental health services disrupt the delinquency pipeline among Latino, African American and Caucasian youth in the child welfare system?

    PubMed

    Garcia, Antonio R; Greeson, Johanna K P; Kim, Minseop; Thompson, Allison; DeNard, Christina

    2015-12-01

    Racial and ethnic disparities in delinquency among child welfare-involved youth are well documented. However, less is known about the mechanisms through which these disparities occur. This study explores the extent to which sets of variables predict the occurrence of juvenile delinquency and whether race/ethnicity moderates the strength of the relationships between (1) social, emotional, and behavioral (SEB) problems and delinquency and (2) mental health service use and delinquency. We used a nationally representative sample of 727 African American, Caucasian, and Latino youth between the ages of 12-17 who were referred to the child welfare system. Controlling for age, gender, placement instability, maltreatment history, poverty, and urbanicity, linear regression analyses revealed that African American and Latino youth engaged in more delinquent acts than Caucasian youth did. However, service use decreased the likelihood of engaging in more delinquent acts for African Americans. Additional efforts are needed to illuminate and address the contextual and organizational barriers to delivering effective mental health services as a strategy to reduce racial disparities in delinquent behavior. PMID:26536399

  20. Health Literacy, Smoking, and Health Indicators in African American Adults.

    PubMed

    Hoover, Diana Stewart; Vidrine, Jennifer I; Shete, Sanjay; Spears, Claire A; Cano, Miguel A; Correa-Fernández, Virmarie; Wetter, David W; McNeill, Lorna H

    2015-01-01

    We examined cross-sectional associations of health literacy (HL) with smoking and other established health indicators among 1,467 African American adults. Data emanated from a longitudinal cohort study designed to investigate cancer risk factors among church-going African American adults. We conducted linear and logistic regression analyses to assess associations between HL and health indicators. HL was assessed using an established single-item screening question. Outcomes included indicators of poor physical health (cigarette smoking, self-rated general and physical health) and mental health (self-rated mental health, depressive symptoms, perceived stress). Nearly 19% of participants had low HL. Low HL was significantly associated with current smoking, poorer self-rated general and physical health, and higher perceived stress (ps < .05) even after we controlled for demographic variables (i.e., age, gender, relationship status) and indicators of socioeconomic status (i.e., education, income, insurance status). Low HL appears to be an independent risk factor for smoking and other indicators of poor physical and mental health in a large sample of African American adults. Future directions and clinical implications are discussed. PMID:26513028

  1. Mental Health and African Americans

    MedlinePlus

    ... for Action Campaigns and Initiatives Performance Improvement and Management System Report to Congress Knowledge Center Capacity Building Information Services Events Calendar Resource Guide Reentry Resources Trauma ...

  2. Health literacy, smoking, and health indicators in African American adults

    PubMed Central

    Stewart, Diana W.; Vidrine, Jennifer I.; Shete, Sanjay; Spears, Claire A.; Cano, Miguel A.; Correa-Fernández, Virmarie; Wetter, David W.; McNeill, Lorna H.

    2015-01-01

    We examined cross-sectional associations of health literacy (HL) with smoking and other established health indicators among 1,467 African American adults. Data emanated from a longitudinal cohort study designed to investigate cancer risk factors among church-going African American adults. We conducted linear and logistic regression analyses to assess associations between HL and health indicators. HL was assessed using an established single-item screening question. Outcomes included indicators of poor physical (cigarette smoking, self-rated general and physical health) and mental health (self-rated mental health, depressive symptoms, perceived stress). Nearly 19% of participants had low HL. Low HL was significantly associated with current smoking, poorer self-rated general and physical health, and higher perceived stress (ps < .05) even after controlling for demographic variables (i.e., age, gender, relationship status) and indicators of socioeconomic status (i.e., education, income, insurance status). Low HL appears to be an independent risk factor for smoking and other indicators of poor physical and mental health in a large sample of African American adults. Future directions and clinical implications are discussed. PMID:26513028

  3. Negro, Black, Black African, African Caribbean, African American or what? Labelling African origin populations in the health arena in the 21st century.

    PubMed

    Agyemang, Charles; Bhopal, Raj; Bruijnzeels, Marc

    2005-12-01

    Broad terms such as Black, African, or Black African are entrenched in scientific writings although there is considerable diversity within African descent populations and such terms may be both offensive and inaccurate. This paper outlines the heterogeneity within African populations, and discusses the strengths and limitations of the term Black and related labels from epidemiological and public health perspectives in Europe and the USA. This paper calls for debate on appropriate terminologies for African descent populations and concludes with the proposals that (1) describing the population under consideration is of paramount importance (2) the word African origin or simply African is an appropriate and necessary prefix for an ethnic label, for example, African Caribbean or African Kenyan or African Surinamese (3) documents should define the ethnic labels (4) the label Black should be phased out except when used in political contexts. PMID:16286485

  4. The Myth of Meritocracy and African American Health

    PubMed Central

    Meyer, Ilan H.

    2010-01-01

    Recent theoretical and empirical studies of the social determinants of health inequities have shown that economic deprivation, multiple levels of racism, and neighborhood context limit African American health chances and that African Americans' poor health status is predicated on unequal opportunity to achieve the American Dream. President Obama's election has been touted as a demonstration of American meritocracy—the belief that all may obtain the American Dream—and has instilled hope in African Americans. However, we argue that in the context of racism and other barriers to success, meritocratic ideology may act as a negative health determinant for African Americans. PMID:20724679

  5. The myth of meritocracy and African American health.

    PubMed

    Kwate, Naa Oyo A; Meyer, Ilan H

    2010-10-01

    Recent theoretical and empirical studies of the social determinants of health inequities have shown that economic deprivation, multiple levels of racism, and neighborhood context limit African American health chances and that African Americans' poor health status is predicated on unequal opportunity to achieve the American Dream. President Obama's election has been touted as a demonstration of American meritocracy-the belief that all may obtain the American Dream-and has instilled hope in African Americans. However, we argue that in the context of racism and other barriers to success, meritocratic ideology may act as a negative health determinant for African Americans. PMID:20724679

  6. African Self-Consciousness and Health-Promoting Behaviors among African American College Students.

    ERIC Educational Resources Information Center

    Thompson, Shawn N.; Chambers, John W., Jr.

    2000-01-01

    Investigated three models of relationships between African self-consciousness, health consciousness, and health-promoting behaviors among African American college students. The models included the mediator model, moderator model, and independent model. Surveys of 80 students supported the independent model, suggesting that African…

  7. Exploration of Culturally Proficient Mental Health Assessment and Treatment Practices of Black/African American Clients

    ERIC Educational Resources Information Center

    Glover, Tina Marie

    2012-01-01

    Changing trends within the mental health system treatment practices demand exploration of the cultural context of assessment and treatment of Black/African Americans. Culturally competent assessments include a realistic integration of historical context. Clinicians counseling Black/African Americans must be prepared to assess and address PTSD,…

  8. Traditional African Dance: An Excellent Approach to Fitness and Health.

    ERIC Educational Resources Information Center

    Thompson, Iola

    This paper argues that traditional African dance can develop fitness and health particularly for those interested in both health and African culture. A discussion of fitness concludes that this quality enables the body to perform physical activities with greater efficiency and that all the qualities commonly found in notions of fitness are found…

  9. Exploring corruption in the South African health sector.

    PubMed

    Rispel, Laetitia C; de Jager, Pieter; Fonn, Sharon

    2016-03-01

    Recent scholarly attention has focused on weak governance and the negative effects of corruption on the provision of health services. Employing agency theory, this article discusses corruption in the South African health sector. We used a combination of research methods and triangulated data from three sources: Auditor-General of South Africa reports for each province covering a 9-year period; 13 semi-structured interviews with health sector key informants and a content analysis of print media reports covering a 3-year period. Findings from the Auditor-General reports showed a worsening trend in audit outcomes with marked variation across the nine provinces. Key-informants indicated that corruption has a negative effect on patient care and the morale of healthcare workers. The majority of the print media reports on corruption concerned the public health sector (63%) and involved provincial health departments (45%). Characteristics and complexity of the public health sector may increase its vulnerability to corruption, but the private-public binary constitutes a false dichotomy as corruption often involves agents from both sectors. Notwithstanding the lack of global validated indicators to measure corruption, our findings suggest that corruption is a problem in the South African healthcare sector. Corruption is influenced by adverse agent selection, lack of mechanisms to detect corruption and a failure to sanction those involved in corrupt activities. We conclude that appropriate legislation is a necessary, but not sufficient intervention to reduce corruption. We propose that mechanisms to reduce corruption must include the political will to run corruption-free health services, effective government to enforce laws, appropriate systems, and citizen involvement and advocacy to hold public officials accountable. Importantly, the institutionalization of a functional bureaucracy and public servants with the right skills, competencies, ethics and value systems and whose

  10. Training for health services and systems research in Sub-Saharan Africa - a case study at four East and Southern African Universities

    PubMed Central

    2013-01-01

    Background The need to develop capacity for health services and systems research (HSSR) in low and middle income countries has been highlighted in a number of international forums. However, little is known about the level of HSSR training in Sub-Saharan Africa (SSA). We conducted an assessment at four major East and Southern African universities to describe: a) the numbers of HSSR PhD trainees at these institutions, b) existing HSSR curricula and mode of delivery, and c) motivating and challenging factors for PhD training, from the trainees’ experience. Methods PhD training program managers completed a pre-designed form about trainees enrolled since 2006. A desk review of existing health curricula was also conducted to identify HSSR modules being offered; and PhD trainees completed a self-administered questionnaire on motivating and challenging factors they may have experienced during their PhD training. Results Of the 640 PhD trainees enrolled in the health sciences since 2006, only 24 (3.8%) were in an HSSR field. None of the universities had a PhD training program focusing on HSSR. The 24 HSSR PhD trainees had trained in partnership with a university outside Africa. Top motivating factors for PhD training were: commitment of supervisors (67%), availability of scholarships (63%), and training attached to a research grant (25%). Top challenging factors were: procurement delays (44%), family commitments (38%), and poor Internet connection (35%). Conclusion The number of HSSR PhD trainees is at the moment too small to enable a rapid accumulation of the required critical mass of locally trained HSSR professionals to drive the much needed health systems strengthening and innovations in this region. Curricula for advanced HSSR training are absent, exposing a serious training gap for HSSR in this region. PMID:24365482

  11. Establishing priorities for advocacy in South African Health.

    PubMed

    Mametja, D; Jinabhai, C C; Ngwane, N; Dolan, C; Twala, J; Mackenzie, A; Gear, J; Russo, R; Tollman, S; Pugh, A

    1993-01-01

    To develop an appropriate health policy agenda, the National Progressive Primary Health Care Network (NPPHC) and the South African Health and Social Services Organization (SAHSSO) conducted situational analyses in 4 areas: an informal peri-urban area within the Durban functional region in Natal, a rural area in the Mhala-Mapulaneng district in the North Eastern Transvaal, the informal settlement of Botshabelo in the Orange Free State, and a dense township dwelling in Soweto. The analyses were based on interviews with health workers and community leaders, a national survey, and a questionnaire for health service administrators. All 4 areas were characterized by poverty, unemployment, low educational levels, lack of a clean water supply or refuse removal system, housing shortages or overcrowding, and political violence. Preventable diseases, such as water-borne diarrhea and malnutrition, cause substantial morbidity, yet health services tend to be inaccessible, distributed inequitably, of poor quality, and with unclear administrative structures. Community members interviewed indicated that clinic fees were too high, especially given the low quality of care, and there was a general mistrust of the competency of doctors and nurses. There was a lack of consensus on the meaning of community participation; some viewed it as a vehicle for empowerment, while others felt the strategy would be exploited as a means to deny government assistance. Overall, respondents were supportive of a greater role for community health workers and more involvement on the part of nongovernmental organizations. A priority, at present, is attention to the many socioeconomic factors that are compromising the health of black South Africans and overshadowing the rationalization of health services. PMID:12345439

  12. African-American Grandmothers as Health Educators in the Family

    ERIC Educational Resources Information Center

    Watson, Jeffrey A.; Randolph, Suzanne M.; Lyons, James L.

    2005-01-01

    More than 18,000 adolescents die each year in the United States from bicycle, motorcycle, car, and truck accidents. This study sought to understand the role of African-American grandmothers as prevention-oriented health educators in the family. Full Model Fitted Regression Analyses were conducted on a sample of African-American grandmothers (N =…

  13. Am I My Brother's Keeper? African American Men's Health Within the Context of Equity and Policy.

    PubMed

    Enyia, Okechuku Kelechi; Watkins, Yashika J; Williams, Quintin

    2016-01-01

    African American men's health has at times been regarded as irrelevant to the health and well-being of the communities where they are born, grow, live, work, and age. The uniqueness of being male and of African descent calls for a critical examination and deeper understanding of the psycho-socio-historical context in which African American men have lived. There is a critical need for scholarship that better contextualizes African American Male Theory and cultural humility in terms of public health. Furthermore, the focus of much of the social determinants of health and health equity policy literature has been on advocacy, but few researchers have examined why health-related public policies have not been adopted and implemented from a political and theoretical policy analysis perspective. The purpose of this article will be to examine African American men's health within the context of social determinants of health status, health behavior, and health inequalities-elucidating policy implications for system change and providing recommendations from the vantage point of health equity. PMID:25424505

  14. The East African rift system

    NASA Astrophysics Data System (ADS)

    Chorowicz, Jean

    2005-10-01

    This overview paper considers the East African rift system (EARS) as an intra-continental ridge system, comprising an axial rift. It describes the structural organization in three branches, the overall morphology, lithospheric cross-sections, the morphotectonics, the main tectonic features—with emphasis on the tension fractures—and volcanism in its relationships with the tectonics. The most characteristic features in the EARS are narrow elongate zones of thinned continental lithosphere related to asthenospheric intrusions in the upper mantle. This hidden part of the rift structure is expressed on the surface by thermal uplift of the rift shoulders. The graben valleys and basins are organized over a major failure in the lithospheric mantle, and in the crust comprise a major border fault, linked in depth to a low angle detachment fault, inducing asymmetric roll-over pattern, eventually accompanied by smaller normal faulting and tilted blocks. Considering the kinematics, divergent movements caused the continent to split along lines of preexisting lithospheric weaknesses marked by ancient tectonic patterns that focus the extensional strain. The hypothesis favored here is SE-ward relative divergent drifting of a not yet well individualized Somalian plate, a model in agreement with the existence of NW-striking transform and transfer zones. The East African rift system comprises a unique succession of graben basins linked and segmented by intracontinental transform, transfer and accommodation zones. In an attempt to make a point on the rift system evolution through time and space, it is clear that the role of plume impacts is determinant. The main phenomenon is formation of domes related to plume effect, weakening the lithosphere and, long after, failure inducing focused upper mantle thinning, asthenospheric intrusion and related thermal uplift of shoulders. The plume that had formed first at around 30 Ma was not in the Afar but likely in Lake Tana region (Ethiopia

  15. Designing and Evaluating Health Systems Level Hypertension Control Interventions for African-Americans: Lessons from a Pooled Analysis of Three Cluster Randomized Trials

    PubMed Central

    Pavlik, Valory N.; Chan, Wenyaw; Hyman, David J.; Feldman, Penny; Ogedegbe, Gbenga; Schwartz, Joseph E.; McDonald, Margaret; Einhorn, Paula; Tobin, Jonathan N.

    2015-01-01

    Objectives African-Americans (AAs) have a high prevalence of hypertension and their blood pressure (BP) control on treatment still lags behind other groups. In 2004, NHLBI funded five projects that aimed to evaluate clinically feasible interventions to effect changes in medical care delivery leading to an increased proportion of AA patients with controlled BP. Three of the groups performed a pooled analysis of trial results to determine: 1) the magnitude of the combined intervention effect; and 2) how the pooled results could inform the methodology for future health-system level BP interventions. Methods Using a cluster randomized design, the trials enrolled AAs with uncontrolled hypertension to test interventions targeting a combination of patient and clinician behaviors. The 12-month Systolic BP (SBP) and Diastolic BP (DBP) effects of intervention or control cluster assignment were assessed using mixed effects longitudinal regression modeling. Results 2,015 patients representing 352 clusters participated across the three trials. Pooled BP slopes followed a quadratic pattern, with an initial decline, followed by a rise toward baseline, and did not differ significantly between intervention and control clusters: SBP linear coefficient = −2.60±0.21 mmHg per month, p<0.001; quadratic coefficient = 0.167± 0.02 mmHg/month, p<0.001; group by time interaction group by time group x linear time coefficient=0.145 ± 0.293, p=0.622; group x quadratic time coefficient= −0.017 ± 0.026, p=0.525). Results were similar for DBP. The individual sites did not have significant intervention effects when analyzed separately. Conclusion Investigators planning behavioral trials to improve BP control in health systems serving AAs should plan for small effect sizes and employ a “run-in” period in which BP can be expected to improve in both experimental and control clusters. PMID:25808682

  16. Infusing Culture into Practice: Developing and Implementing Evidence-Based Mental Health Services for African American Foster Youth

    ERIC Educational Resources Information Center

    Briggs, Harold Eugene; McBeath, Bowen

    2010-01-01

    The lack of culturally appropriate health and mental health care has contributed to the large number of African American youth and families involved in the child welfare system. This article reviews the consequences of the insufficient access to culturally sensitive, evidence-supported interventions for African American foster youth. The authors…

  17. Health insurance systems in five Sub-Saharan African countries: medicine benefits and data for decision making.

    PubMed

    Carapinha, João L; Ross-Degnan, Dennis; Desta, Abayneh Tamer; Wagner, Anita K

    2011-03-01

    Medicine benefits through health insurance programs have the potential to improve access to and promote more effective use of affordable, high quality medicines. Information is lacking about medicine benefits provided by health insurance programs in Sub-Saharan Africa. We describe the structure of medicine benefits and data routinely available for decision-making in 33 health insurance programs in Ghana, Kenya, Nigeria, Tanzania and Uganda. Most programs surveyed were private, for profit schemes covering voluntary enrollees, mostly in urban areas. Almost all provide both inpatient and outpatient medicine benefits, with members sharing the cost of medicines in all programs. Some programs use strategies that are common in high-income countries to manage the medicine benefits, such as formularies, generics policies, reimbursement limits, or price negotiation. Basic data to monitor performance in delivering medicine benefits are available in most programs, but key data elements and the resources needed to generate useful management information from the available data are typically missing. Many questions remain unanswered about the design, implementation, and effects of specific medicines policies in the emerging and expanding health insurance programs in Sub-Saharan Africa. These include questions about the most effective medicines policy choices, given different corporate and organizational structures and resources; impacts of specific benefit designs on quality and affordability of care and health outcomes; and ways to facilitate use of routine data for monitoring. Technical capacity building, strong government commitment, and international donor support will be needed to realize the benefits of medicines coverage in emerging and expanding health insurance programs in Sub-Saharan Africa. PMID:21167619

  18. Caregiver Mental Health, Neighborhood, and Social Network Influences on Mental Health Needs among African American Children

    ERIC Educational Resources Information Center

    Lindsey, Michael A.; Browne, Dorothy C.; Thompson, Richard; Hawley, Kristin M.; Graham, Christopher J.; Weisbart, Cindy; Harrington, Donna; Kotch, Jonathan B.

    2008-01-01

    In this study, the authors examined the combined effects of caregiver mental health, alcohol use, and social network support/satisfaction on child mental health needs among African American caregiver-child dyads at risk of maltreatment. The sample included 514 eight-year-old African American children and their caregivers who participated in the…

  19. The Cultural Relevance of Mindfulness Meditation as a Health Intervention for African Americans

    PubMed Central

    Woods-Giscombé, Cheryl L.; Gaylord, Susan A.

    2014-01-01

    African Americans experience a disproportionate rate of stress-related health conditions compared to European Americans. Mindfulness meditation has been shown to be effective for managing stress and various stress-related health conditions. This study explored the cultural relevance of mindfulness meditation training for African Americans adults. Fifteen African American adults with past or current experience with mindfulness meditation training were interviewed. Participants felt that mindfulness meditation helped them with enhanced stress management, direct health improvement, and enhanced self-awareness and purposefulness. They felt that they would recommend it and that other African Americans would be open to the practice but suggested that its presentation may need to be adapted. They suggested emphasizing the health benefits, connecting it to familiar spiritual ideology and cultural practices, supplementing the reading material with African American writers, increasing communication (education, instructor availability, “buddy system,” etc.), and including African Americans as instructors and participants. By implementing minor adaptations that enhance cultural relevance, mindfulness meditation can be a beneficial therapeutic intervention for this population. PMID:24442592

  20. Institutional capacity for health systems research in East and Central African schools of public health: experiences with a capacity assessment tool

    PubMed Central

    2014-01-01

    Background Despite significant investments in health systems research (HSR) capacity development, there is a dearth of information regarding how to assess HSR capacity. An alliance of schools of public health (SPHs) in East and Central Africa developed a tool for the self-assessment of HSR capacity with the aim of producing institutional capacity development plans. Methods Between June and November 2011, seven SPHs across the Democratic Republic of Congo, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda implemented this co-created tool. The objectives of the institutional assessments were to assess existing capacities for HSR and to develop capacity development plans to address prioritized gaps. A mixed-method approach was employed consisting of document analysis, self-assessment questionnaires, in-depth interviews, and institutional dialogues aimed at capturing individual perceptions of institutional leadership, collective HSR skills, knowledge translation, and faculty incentives to engage in HSR. Implementation strategies for the capacity assessment varied across the SPHs. This paper reports findings from semi-structured interviews with focal persons from each SPH, to reflect on the process used at each SPH to execute the institutional assessments as well as the perceived strengths and weaknesses of the assessment process. Results The assessment tool was robust enough to be utilized in its entirety across all seven SPHs resulting in a thorough HSR capacity assessment and a capacity development plan for each SPH. Successful implementation of the capacity assessment exercises depended on four factors: (i) support from senior leadership and collaborators, (ii) a common understanding of HSR, (iii) adequate human and financial resources for the exercise, and (iv) availability of data. Methods of extracting information from the results of the assessments, however, were tailored to the unique objectives of each SPH. Conclusions This institutional HSR capacity assessment

  1. Sexual health communication within religious African-American families.

    PubMed

    Williams, Terrinieka T; Pichon, Latrice C; Campbell, Bettina

    2015-01-01

    While research suggests youth prefer parents and family members to serve as the primary sources of sexual health information, fear and discomfort around discussing sex with their parents may leave youth misinformed and underinformed. This study explored sexual heath communication within religious African-American families. Thirty adolescents participated in four focus groups, and 19 adults and 30 adolescents participated in six focus groups, at two predominantly African-American Christian churches in Flint, MI. All data were analyzed inductively using a constant comparison approach. Nearly all participants reported attending church weekly. Three themes emerged and are described: initiating sex talks, using mistakes as teaching tools, and clarifying prevention messages. Participants highlighted the need for religious parents to offer both religious and practical guidance to adolescents about sexual health. Findings from this study may be used to inform future sexual health promotion interventions for religious African-American families. PMID:24901449

  2. Experiences of undergraduate African health sciences students: A hermeneutic inquiry.

    PubMed

    Inyama, Davis; Williams, Allison; McCauley, Kay

    2015-06-01

    While efforts have been made to understand the experiences of African students in predominantly white environments, the experiences of African students in clinical placement areas have rarely been explored. This paper is a report on a study designed to address the gap in educational research on the experiences of African health sciences students in clinical placements in predominantly white environments. Interviews adopting an open approach to conversations were conducted with nine African students from three health disciplines at one metropolitan university in Australia between 2012 and 2013. Interview transcripts were analyzed using philosophical hermeneutics, where shared meanings were arrived at by employing key Gadamerian hermeneutic components. Findings revealed a number of factors that had a direct effect on the meaning students derived from their clinical placement experiences. These, as revealed in the interlinked domains of body, space, relationships, and time included difference, acceptance, resilience, and cultural sensitivity. Insights from this study may lead to the adoption of strategies designed to improve the experiences of African students studying health sciences in predominantly white environments. PMID:24942056

  3. The Diabetic Health of African American Grandmothers Raising their Grandchildren

    PubMed Central

    Carthron, Dana L.; Busam, Maria Rivera

    2016-01-01

    PURPOSE The purpose of this study is to compare the health of primary caregiving African American grandmothers with diabetes with African American women with diabetes who were not primary caregivers. DESIGN Using a comparative, descriptive, cross-sectional design, 34 African American primary caregiving grandmothers were compared with 34 non-caregiving women with diabetes mellitus; women aged 55–75 years were recruited for this study throughout the central Arkansas. METHODS To measure the overall health, data on blood pressure, body mass index measurements, HbA1c levels, total cholesterol, and urine protein and creatinine levels were collected from all the participants. RESULTS Statistically significant differences between the caregivers and non-caregivers groups in systolic pressure (t = −3.42, P = 0.001) and diastolic pressure (t = −3.790, P = 0.000) and urine protein (W = 294.00, P = 0.000) were noted. Additionally, a clinically significant difference in HbA1c was noted between groups. CONCLUSION Differences in systolic and diastolic pressures, urine protein, and clinically significant differences in HbA1c suggest that African American primary caregiving grandmothers with diabetes mellitus may have more difficulty in maintaining their diabetic health than non-caregiving African American women. PMID:27398044

  4. A common evaluation framework for the African Health Initiative

    PubMed Central

    2013-01-01

    Background The African Health Initiative includes highly diverse partnerships in five countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia), each of which is working to improve population health by strengthening health systems and to evaluate the results. One aim of the Initiative is to generate cross-site learning that can inform implementation in the five partnerships during the project period and identify lessons that may be generalizable to other countries in the region. Collaborators in the Initiative developed a common evaluation framework as a basis for this cross-site learning. Methods This paper describes the components of the framework; this includes the conceptual model, core metrics to be measured in all sites, and standard guidelines for reporting on the implementation of partnership activities and contextual factors that may affect implementation, or the results it produces. We also describe the systems that have been put in place for data management, data quality assessments, and cross-site analysis of results. Results and conclusions The conceptual model for the Initiative highlights points in the causal chain between health system strengthening activities and health impact where evidence produced by the partnerships can contribute to learning. This model represents an important advance over its predecessors by including contextual factors and implementation strength as potential determinants, and explicitly including equity as a component of both outcomes and impact. Specific measurement challenges include the prospective documentation of program implementation and contextual factors. Methodological issues addressed in the development of the framework include the aggregation of data collected using different methods and the challenge of evaluating a complex set of interventions being improved over time based on continuous monitoring and intermediate results. PMID:23819778

  5. Religion, health and medicine in African Americans: implications for physicians.

    PubMed Central

    Levin, Jeff; Chatters, Linda M.; Taylor, Robert Joseph

    2005-01-01

    Recent years have seen a burgeoning of research and writing on the connections between religion and health. The very best of this work comes from epidemiologic studies of African Americans. This paper summarizes results of these investigations, including findings identifying effects of religious participation on both physical and mental health outcomes. Evidence mostly supports a protective religious effect on morbidity and mortality and on depressive symptoms and overall psychological distress among African Americans. This paper also carefully discusses what the results of these studies mean and do not mean, an important consideration due to frequent misinterpretations of findings on this topic. Because important distinctions between epidemiologic and clinical studies tend to get glossed over, reports of religion-health associations oftentimes draw erroneous conclusions that foster unrealistic expectations about the role of faith and spirituality in health and healing. Finally, implications are discussed for clinical practice, medical education and public health. PMID:15712787

  6. Addressing health disparities: the role of an African American health ministry committee.

    PubMed

    Austin, Sandra; Harris, Gertrude

    2011-01-01

    Healthy People 2010 identified the need to address health disparities among African Americans, Asians, American Indians, Hispanics, Alaskan American, and Pacific Islanders. These are groups disproportionately affected by cancer, cardiovascular disease, diabetes, HIV infection, and AIDSs. Despite the growing body of research on health disparities and effective interventions, there is a great need to learn more about culturally appropriate interventions. Social work professional values and ethics require that service delivery be culturally competent and effective. Social workers can collaborate with community based health promotion services, exploring new ways to ensure that health disparities can be addressed in institutions to which African Americans belong. This article presents findings of an African American health ministry committee's health promotion initiatives and probed the viability of a health ministry committee' role in addressing health disparities through education. The promising role of the Black church in addressing health disparities is explored. PMID:21213192

  7. Positioning women's and children's health in African union policy-making: a policy analysis

    PubMed Central

    2012-01-01

    Background With limited time to achieve the Millennium Development Goals, progress towards improving women's and children's health needs to be accelerated. With Africa accounting for over half of the world's maternal and child deaths, the African Union (AU) has a critical role in prioritizing related policies and catalysing required investments and action. In this paper, the authors assess the evolution of African Union policies related to women's and children's health, and analyze how these policies are prioritized and framed. Methods The main method used in this policy analysis was a document review of all African Union policies developed from 1963 to 2010, focusing specifically on policies that explicitly mention health. The findings from this document review were discussed with key actors to identify policy implications. Results With over 220 policies in total, peace and security is the most common AU policy topic. Social affairs and other development issues became more prominent in the 1990s. The number of policies that mentioned health rose steadily over the years (with 1 policy mentioning health in 1963 to 7 in 2010). This change was catalysed by factors such as: a favourable shift in AU priorities and systems towards development issues, spurred by the transition from the Organization of African Unity to the African Union; the mandate of the African Commission on Human and People's Rights; health-related advocacy initiatives, such as the Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA); action and accountability requirements arising from international human rights treaties, the Millennium Development Goals (MDGs), and new health-funding mechanisms, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Prioritization of women's and children's health issues in AU policies has been framed primarily by human rights, advocacy and accountability considerations, more by economic and health frames looking at investments and

  8. Allostatic Load and Health Status of African Americans and Whites

    ERIC Educational Resources Information Center

    Deuster, Patricia A.; Kim-Dorner, Su Jong; Remaley, Alan T.; Poth, Merrily

    2011-01-01

    Objectives: To compare health risks in 84 healthy African American and 45 white men and women after calculating allostatic load (AL) from biologic, psychosocial, and behavioral measures. Methods: Participants (18-45 years) ranging in weight from normal to obese and without hypertension or diabetes. Fitness, body fat, CRP, mood, social support,…

  9. Contextual Stress and Health Risk Behaviors among African American Adolescents

    ERIC Educational Resources Information Center

    Copeland-Linder, Nikeea; Lambert, Sharon F.; Chen, Yi-Fu; Ialongo, Nicholas S.

    2011-01-01

    This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress…

  10. Hostility, Relationship Quality, and Health among African American Couples

    ERIC Educational Resources Information Center

    Guyll, Max; Cutrona, Carolyn; Burzette, Rebecca; Russell, Daniel

    2010-01-01

    Objective: This study investigated the association between hostility and health and whether it is moderated by the quality of an individual's primary romantic relationship. Method: Longitudinal data were provided by 184 African Americans, including 166 women. Participants averaged 38 years old and were married or in long-term marriagelike…

  11. Priority Health Behaviors among South African Undergraduate Students

    ERIC Educational Resources Information Center

    Porter, Kandice; Johnson, Ping Hu; Petrillo, Jane

    2009-01-01

    This study examined the priority health behaviors of South African youth by administering a questionnaire to 635 undergraduate students enrolled in a large metropolitan university in South Africa. Results indicate that 65.5% of the participants tried cigarettes at least once during their lifetime, over 15.2% had their first cigarette and 31.2% had…

  12. Rurality and African American Perspectives on Children's Mental Health Services

    ERIC Educational Resources Information Center

    Mukolo, Abraham; Heflinger, Craig Anne

    2011-01-01

    The combined effect of race and place of residence on caregivers' perceptions of children's mental health services is underresearched. Differences in caregiver strain, barriers-to-care endorsement, and provider satisfaction are examined among 175 rural and urban African American caregivers from one Southern state whose children received Medicaid…

  13. The Role of African American-Owned Radio in Health Promotion: Community Service Projects Targeting Young African American Males.

    ERIC Educational Resources Information Center

    Johnson, Phylis; Birk, Thomas A.

    1993-01-01

    Surveys African-American-owned radio stations to determine how effective they are in addressing health issues among African Americans. Responses from more than 50 stations indicate that they serve as change agents by encouraging community partnerships and emphasizing drug awareness, nonviolent behavior, education, and other health issues. (SLD)

  14. Race consciousness and the health of African Americans.

    PubMed

    Watts, Rosalyn J

    2003-01-01

    The historical experience of African Americans in our country has been shaped by the institution of slavery, dehumanization of blacks, segregation, pursuit of civil rights, and racism in contemporary American society. Disparities in health care provide compelling evidence that issues of race or skin color for the descendants of slaves and other ethnic minorities persist in the 21st century. Nurses providing care for African Americans must bridge the racial divide and incorporate culturally relevant content in the health history. As an integral aspect of their professional growth as culturally competent health care providers, they must incorporate the idea of "race consciousness" which is described as an awareness of the historical journey of the group, knowledge of disparities in health care for the people, and a self appraisal of one's attitudes and biases toward the group. PMID:12729454

  15. Environment, Health and Climate: Impact of African aerosols

    NASA Astrophysics Data System (ADS)

    Liousse, C.; Doumbia, T.; Assamoi, E.; Galy-Lacaux, C.; Baeza, A.; Penner, J. E.; Val, S.; Cachier, H.; Xu, L.; Criqui, P.

    2012-12-01

    Fossil fuel and biofuel emissions of particles in Africa are expected to significantly increase in the near future, particularly due to rapid growth of African cities. In addition to biomass burning emissions prevailing in these areas, air quality degradation is then expected with important consequences on population health and climatic/radiative impact. In our group, we are constructing a new integrated methodology to study the relations between emissions, air quality and their impacts. This approach includes: (1) African combustion emission characterizations; (2) joint experimental determination of aerosol chemistry from ultrafine to coarse fractions and health issues (toxicology and epidemiology). (3) integrated environmental, health and radiative modeling. In this work, we show some results illustrating our first estimates of African anthropogenic emission impacts: - a new African anthropogenic emission inventory adapted to regional specificities on traffic, biofuel and industrial emissions has been constructed for the years 2005 and 2030. Biomass burning inventories were also improved in the frame of AMMA (African Monsoon) program. - carbonaceous aerosol radiative impact in Africa has been modeled with TM5 model and Penner et al. (2011) radiative code for these inventories for 2005 and 2030 and for two scenarios of emissions : a reference scenario, with no further emission controls beyond those achieved in 2003 and a ccc* scenario including planned policies in Kyoto protocol and regulations as applied to African emission specificities. In this study we will show that enhanced heating is expected with the ccc* scenarios emissions in which the OC fraction is relatively lower than in the reference scenario. - results of short term POLCA intensive campaigns in Bamako and Dakar in terms of aerosol chemical characterization linked to specific emissions sources and their inflammatory impacts on the respiratory tract through in vitro studies. In this study, organic

  16. Discussing Adolescent Sexual Health in African American Churches

    PubMed Central

    Williams, Terrinieka T.; Dodd, Darcy; Campbell, Bettina; Pichon, Latrice C.; Griffith, Derek M.

    2012-01-01

    This study describes the ways in which two African American churches discuss adolescent sexual health topics. Six focus groups were conducted in two churches in Flint, Michigan that reported no formal sexual health programming for their congregants. Three themes emerged to highlight the different perspectives about the role of churches in adolescent sexual decision-making and sexual health education 1) churches as sources of sexual information; 2) churches as complex communities; and 3) recommendations for sexual education in churches. Participant responses suggest that churches can and should serve a resource for sexual health information. Implications for practice and research are discussed. PMID:22814618

  17. Health and nutritional status of old-old African Americans.

    PubMed

    Bernard, M A; Anderson, C; Forgey, M

    1995-01-01

    This study reports the initial results of a baseline cross-sectional evaluation of the health and nutritional status of 58 old-old African Americans, 74 years of age and older, residing in low income housing complexes in metropolitan Oklahoma City. Although the population had a high overall functional status, cognitive status, and mood, there were a number of nutritional parameters suggestive of nutritional risk. In particular, 20% of subjects had relatively low serum albumin levels, 14% had serum cholesterol levels below 160 mg/dl, and a subset of the population reported low intake during 24 hour dietary recall. The National Center and Caucus on Black Aged report that 60% of African American elders live at or below the poverty level. These study findings suggest that the present cohort of African American elders may be at nutritional risk. PMID:7602459

  18. Subjective Social Status and Health Behaviors Among African Americans

    PubMed Central

    Reitzel, Lorraine R.; Nguyen, Nga; Strong, Larkin L.; Wetter, David W.; McNeill, Lorna H.

    2012-01-01

    Objectives To examine associations of the US and community subjective social status (SSS) ladders with smoking status, at-risk drinking, fruit and vegetable intake, physical activity, and body mass index among 1467 church-going African American adults from a larger cohort study. Methods Regression analyses, adjusted for sociodemographics, examined associations between SSS ladders and health behaviors. Results The SSS-US ladder was significantly associated with fruit and vegetable consumption (p = .007) and physical activity (p = .005). The SSS-community ladder was not significantly associated with any health behaviors. Conclusions Among this sample of African Americans, the SSS-US ladder is more predictive of some health behaviors than is the SSS-community ladder. PMID:22943107

  19. INTERFACING INFANT MENTAL HEALTH KNOWLEDGE SYSTEMS: REFLECTIONS ON THE NARRATIVES OF LAY HOME VISITORS' EXPERIENCES OF LEARNING AND APPLYING RELATIONAL CONCEPTS OF DEVELOPMENT IN A SOUTH AFRICAN INTERVENTION PROGRAM.

    PubMed

    Baradon, Tessa; Bain, Katherine

    2016-07-01

    The question of interfacing research and clinically generated knowledge in the field of infant mental health (IMH) with local cultural knowledge and belief systems has provoked extended discussion in recent years. This article explores convergences and divergences between current research-based, relational IMH mental health models and "community" knowledge held by a group of South African lay home visitors from a socioeconomically deprived township. These women were trained in a psychoanalytic and attachment-informed infant mental health program that promotes a relational model of infant development. They provide an intervention that supports high risk mother-infant relationships in the same locality. A two-tiered approach was taken to the analysis of the home visitor interviews and focused on the home visitors' constructed narratives of infant development posttraining as well as the personal impact of the training and work on the home visitors themselves. The study found that psychoanalytic and attachment-informed thinking about development makes sense to those operating within the local South African cultural context, but that the accommodation of this knowledge is a complex and challenging process. PMID:27186854

  20. The Offshore East African Rift System

    NASA Astrophysics Data System (ADS)

    Franke, D.; Klimke, J.; Jokat, W.; Stollhofen, H.; Mahanjane, S.

    2014-12-01

    Numerous studies have addressed various aspects of the East African Rift system but surprisingly few on the offshore continuation of the south-eastern branch of the rift into the Mozambique Channel. The most prominent article has been published almost 30 years ago by Mougenot et al. (1986) and is based on vintage seismic data. Several studies investigating earthquakes and plate motions from GPS measurements reveal recent deformation along the offshore branch of the East African Rift system. Slip vectors from earthquakes data in Mozambique's offshore basins show a consistent NE direction. Fault plane solutions reveal ~ E-W extensional failure with focal depth clustering around 19 km and 40 km, respectively. Here, we present new evidence for neotectonic deformation derived from modern seismic reflection data and supported by additional geophysical data. The modern rift system obviously reactivates structures from the disintegration of eastern Gondwana. During the Jurassic/Cretaceous opening of the Somali and Mozambique Basins, Madagascar moved southwards along a major shear zone, to its present position. Since the Miocene, parts of the shear zone became reactivated and structurally overprinted by the East African rift system. The Kerimbas Graben offshore northern Mozambique is the most prominent manifestation of recent extensional deformation. Bathymetry data shows that it deepens northwards, with approximately 700 m downthrown on the eastern shoulder. The graben can be subdivided into four subbasins by crosscutting structural lineaments with a NW-SE trend. Together with the N-S striking graben-bounding faults, this resembles a conjugate fault system. In seismic reflection data normal faulting is distinct not only at the earthquake epicenters. The faults cut through the sedimentary successions and typically reach the seafloor, indicating ongoing recent deformation. Reference: Mougenot, D., Recq, M., Virlogeux, P., and Lepvrier, C., 1986, Seaward extension of the East

  1. Pharmacogenomics Implications of Using Herbal Medicinal Plants on African Populations in Health Transition

    PubMed Central

    Thomford, Nicholas E.; Dzobo, Kevin; Chopera, Denis; Wonkam, Ambroise; Skelton, Michelle; Blackhurst, Dee; Chirikure, Shadreck; Dandara, Collet

    2015-01-01

    The most accessible points of call for most African populations with respect to primary health care are traditional health systems that include spiritual, religious, and herbal medicine. This review focusses only on the use of herbal medicines. Most African people accept herbal medicines as generally safe with no serious adverse effects. However, the overlap between conventional medicine and herbal medicine is a reality among countries in health systems transition. Patients often simultaneously seek treatment from both conventional and traditional health systems for the same condition. Commonly encountered conditions/diseases include malaria, HIV/AIDS, hypertension, tuberculosis, and bleeding disorders. It is therefore imperative to understand the modes of interaction between different drugs from conventional and traditional health care systems when used in treatment combinations. Both conventional and traditional drug entities are metabolized by the same enzyme systems in the human body, resulting in both pharmacokinetics and pharmacodynamics interactions, whose properties remain unknown/unquantified. Thus, it is important that profiles of interaction between different herbal and conventional medicines be evaluated. This review evaluates herbal and conventional drugs in a few African countries and their potential interaction at the pharmacogenomics level. PMID:26402689

  2. Pharmacogenomics Implications of Using Herbal Medicinal Plants on African Populations in Health Transition.

    PubMed

    Thomford, Nicholas E; Dzobo, Kevin; Chopera, Denis; Wonkam, Ambroise; Skelton, Michelle; Blackhurst, Dee; Chirikure, Shadreck; Dandara, Collet

    2015-01-01

    The most accessible points of call for most African populations with respect to primary health care are traditional health systems that include spiritual, religious, and herbal medicine. This review focusses only on the use of herbal medicines. Most African people accept herbal medicines as generally safe with no serious adverse effects. However, the overlap between conventional medicine and herbal medicine is a reality among countries in health systems transition. Patients often simultaneously seek treatment from both conventional and traditional health systems for the same condition. Commonly encountered conditions/diseases include malaria, HIV/AIDS, hypertension, tuberculosis, and bleeding disorders. It is therefore imperative to understand the modes of interaction between different drugs from conventional and traditional health care systems when used in treatment combinations. Both conventional and traditional drug entities are metabolized by the same enzyme systems in the human body, resulting in both pharmacokinetics and pharmacodynamics interactions, whose properties remain unknown/unquantified. Thus, it is important that profiles of interaction between different herbal and conventional medicines be evaluated. This review evaluates herbal and conventional drugs in a few African countries and their potential interaction at the pharmacogenomics level. PMID:26402689

  3. Health, Human Capital, and African American Migration Before 1910

    PubMed Central

    Logan, Trevon D.

    2009-01-01

    Using both IPUMS and the Colored Troops Sample of the Civil War Union Army Data, I estimate the effects of literacy and health on the migration propensities of African Americans from 1870 to 1910. I find that literacy and health shocks were strong predictors of migration and the stock of health was not. There were differential selection propensities based on slave status—former slaves were less likely to migrate given a specific health shock than free blacks. Counterfactuals suggest that as much as 35 percent of the difference in the mobility patterns of former slaves and free blacks is explained by differences in their human capital, and more than 20 percent of that difference is due to health alone. Overall, the selection effect of literacy on migration is reduced by one-tenth to one-third once health is controlled for. The low levels of human capital accumulation and rates of mobility for African Americans after the Civil War are partly explained by the poor health status of slaves and their immediate descendants. PMID:20161107

  4. Evidence to support church-based health promotion programmes for African Canadians at risk for cardiovascular disease.

    PubMed

    Tomlinson, Sherldine

    2011-12-01

    High quality management of cardiovascular disease is a critical health issue for people of African descent as this group is more likely than the general population to have greater coexisting cardiovascular comorbidities. The higher than average rates of cardiovascular conditions among Black populations are a cause for concern. In an effort to combat the disproportionate number of African Americans experiencing cardiovascular conditions a significant number of churches within the African American community have initiated health promotion programmes and/or services. Health organisations and agencies in the United States are keen to support and encourage these programmes for cardiovascular disease risk populations (i.e. African Americans and other minority groups, such as the Hispanic community). Indeed these health organisations and agencies recognise the need to promote healthier habits among African Americans and other minority groups as statistics continue to show health disparities among these populations within the US health care system. This paper attempts to encourage Canadian health agencies, organizations and practitioners to support similar CBHPPs initiatives for the African Canadian population. The historical significance of the church in Black Canadian communities is also examined. PMID:21773881

  5. Mental health of the African girl child: challenges for nurses.

    PubMed

    Uys, Leana

    2009-07-01

    In this paper, the ecological systems theory of child development is used as the framework for exploring research on the development of African children, especially girl children. The special problems faced by children and the challenges this raises for nurses also are described in this paper. PMID:19544126

  6. Latina and African American women: continuing disparities in health.

    PubMed

    Lillie-Blanton, M; Martinez, R M; Taylor, A K; Robinson, B G

    1993-01-01

    Women of all races have faced incredible challenges as they sought to realize the promises of America. For women of color, these challenges were compounded by the second-class citizenship of U.S. racial and ethnic minority population groups. In an effort to assess the quality of life experienced by Latina and African American women, this article provides descriptive information on racial/ethnic differences in women's social conditions, health status, exposure to occupational and environmental risks, and use of health services. When possible, indices are stratified by family income to limit the effects of social class on the comparison of racial differences. The authors provide evidence that Latina and African American women are more likely than nonminority women to encounter social environments (e.g., poverty, densely populated neighborhoods, hazardous work conditions) that place them at risk for ill-health and injury. Although persistent racial disparities in health are often attributed to the lifestyle behaviors of racial minority populations, they are undoubtedly a consequence of poorer social conditions as well as barriers in access to quality health services. To achieve further gains, public policies must reduce social inequalities (i.e., by gender, race, and social class) and assure greater equity in access to resources that facilitate healthier environments and lifestyles. Public health initiatives should be community-based, reflecting a shared partnership that actively engages minority women in decision-making about their lives. PMID:8375955

  7. Determinants of health insurance ownership among South African women

    PubMed Central

    Kirigia, Joses M; Sambo, Luis G; Nganda, Benjamin; Mwabu, Germano M; Chatora, Rufaro; Mwase, Takondwa

    2005-01-01

    Background Studies conducted in developed countries using economic models show that individual- and household- level variables are important determinants of health insurance ownership. There is however a dearth of such studies in sub-Saharan Africa. The objective of this study was to examine the relationship between health insurance ownership and the demographic, economic and educational characteristics of South African women. Methods The analysis was based on data from a cross-sectional national household sample derived from the South African Health Inequalities Survey (SANHIS). The study subjects consisted of 3,489 women, aged between 16 and 64 years. It was a non-interventional, qualitative response econometric study. The outcome measure was the probability of a respondent's ownership of a health insurance policy. Results The χ2 test for goodness of fit indicated satisfactory prediction of the estimated logit model. The coefficients of the covariates for area of residence, income, education, environment rating, age, smoking and marital status were positive, and all statistically significant at p ≤ 0.05. Women who had standard 10 education and above (secondary), high incomes and lived in affluent provinces and permanent accommodations, had a higher likelihood of being insured. Conclusion Poverty reduction programmes aimed at increasing women's incomes in poor provinces; improving living environment (e.g. potable water supplies, sanitation, electricity and housing) for women in urban informal settlements; enhancing women's access to education; reducing unemployment among women; and increasing effective coverage of family planning services, will empower South African women to reach a higher standard of living and in doing so increase their economic access to health insurance policies and the associated health services. PMID:15733326

  8. Improving health services for African migrants in China: A health diplomacy perspective

    PubMed Central

    McLaughlin, Megan M.; Lee, Margaret C.; Hall, Brian J.; Bulterys, Marc; Ling, Li; Tucker, Joseph D.

    2014-01-01

    Global health has been an increasingly prominent component of foreign policy in the last decade. The term health diplomacy has been used to describe this growing interface between foreign policy and global health, and it encompasses both the concept of using health to further foreign policy objectives, as well as the idea that diplomatic tools can be helpful for attaining public health goals. The Chinese presence in Africa has grown in the last 15 years, generating increased interest in Sino-African relations. While much has been written in recent years about the Chinese presence in Africa, the growing numbers of Africans in China have attracted considerably less attention. Many are small-scale traders and might be expected to face many of the health challenges common among foreign migrants, but their health needs have been largely unrecognised. In this paper, we consider how a health diplomacy approach could be applied to African migrants in China, and the potential advantages and limitations of this strategy. We identify areas of overlap between public health, trade, and foreign policy goals that can be emphasised to generate support for improved services for African migrants in China and to engage partners from a diversity of sectors. PMID:24807820

  9. Improving health services for African migrants in China: A health diplomacy perspective.

    PubMed

    McLaughlin, Megan M; Lee, Margaret C; Hall, Brian J; Bulterys, Marc; Ling, Li; Tucker, Joseph D

    2014-01-01

    Global health has become an increasingly prominent component of foreign policy in the last decade. The term health diplomacy has been used to describe this growing interface between foreign policy and global health, and it encompasses both the concept of using health to further foreign policy objectives as well as the idea that diplomatic tools can be helpful for attaining public health goals. The Chinese presence in Africa has grown in the last 15 years, generating increased interest in Sino-African relations. While much has been written in recent years about the Chinese presence in Africa, the growing numbers of Africans in China have attracted considerably less attention. Many are small-scale traders and might be expected to face many of the health challenges common among foreign migrants, but their health needs have been largely unrecognised. In this paper, we consider how a health diplomacy approach could be applied to African migrants in China, and the potential advantages and limitations of this strategy. We identify areas of overlap between public health, trade and foreign policy goals that can be emphasised to generate support for improved services for African migrants in China and to engage partners from a diversity of sectors. PMID:24807820

  10. Western health practitioners' view about African traditional health practitioners' treatment and care of people living with HIV/AIDS.

    PubMed

    Summerton, J V

    2006-08-01

    African traditional health practitioners are an important source of health care for many South Africans. Thus, they are a health resource in this society. However, the integration of traditional health practitioners into the mainstream of health care is a complex process. Various factors contribute to this complexity, including the skepticism and reservation with which some western health practitioners view traditional health practitioners. This paper highlights the perceived strengths and weaknesses of the traditional healing system for people living with HIV/AIDS, as perceived by western health practitioners. The use of traditional practitioners as a choice of health care is attributed to both the strengths and weaknesses of this system of health care. The strength of the traditional healing system is in its sharing of the worldview and belief system of its users, it being an alternative to an inefficient western health care system (official system), privacy and absence of time limitations per consultation, treating patients psychologically, and scientifically unexplained physiological relief of the symptoms of specific illnesses. The perceived weaknesses of the traditional healing system include harmful treatment regimens, especially for people living with HIV/AIDS; prolonging the seeking of appropriate health care when traditional remedies fail to produce the desired effect; destroying interpersonal relationships of people living with HIV/AIDS through witchcraft accusations; psychological torment caused by the belief that HIV/AIDS can be cured by traditional remedies/intervention; and increasing the workload of western practitioners who are requested by patients to conduct multiple HIV tests after undergoing various traditional treatment regimens to cure HIV/AIDS. It is recommended that traditional practitioners be encouraged to adapt harmful traditional healing practices to the benefit of their patients in a non-judgemental and non-critical manner. In addition

  11. Alcohol Dependence and Health Care Utilization in African Americans

    PubMed Central

    Marshall, Vanessa J.; Kalu, Nnenna; Kwagyan, John; Scott, Denise M.; Cain, Gloria E.; Hill, Karen; Hesselbrock, Victor; Ferguson, Clifford L.; Taylor, Robert E.

    2013-01-01

    Objective Ethnic and cultural differences in patterns of alcohol use disorders must be understood in order to address improvement in prevention of such disorders and accessibility to health care services. The purpose of this study was to evaluate factors that influence the utilization of medical and mental health services among alcohol-dependent and non alcohol–dependent African Americans. Method A cohort of 454 African Americans was evaluated. Alcohol-dependent participants were recruited from various inpatient treatment facilities in the Washington, DC, metropolitan area and through advertisement and word of mouth. Non–alcohol-dependent participants were recruited by advertisements. Each participant was administered the Semi-Structured Assessment for the Genetics of Alcoholism to assess alcohol dependency and the Family History Assessment module to access family history of alcoholism. χ2 Test and analysis of variance were used to analyze the data. Results Alcohol dependence was more prevalent among men, those with lower income, those with less education, and they utilized mental health counseling as opposed to medical-based therapy. Increased reports of medical conditions such as migraine (p < .001), loss of consciousness (p = .001), and sexually transmitted diseases (p < .001) were also associated with alcohol dependency. Other factors, including visits to inpatient treatment programs, were directly related to incidence of alcohol dependency regardless of gender status (p < .001). Conclusions This study suggests an association exists among alcohol dependence, medical conditions, health care, and mental care utilization among African Americans. Future research may benefit from investigating if an association exists between alcohol use disorders and health care utilization for other ethnic groups. PMID:23862295

  12. The Great Recession and health risks in African American youth.

    PubMed

    Chen, Edith; Miller, Gregory E; Yu, Tianyi; Brody, Gene H

    2016-03-01

    In the present study, we investigated associations of macro-economic conditions - the Great Recession - with cellular epigenetic aging, allostatic load, and self-reported health, in a group that experiences significant health disparities, African Americans. A sample of 330 African American adolescents in Georgia was followed from pre-recession (2007, M age=16.6) to post-recession (2010, M age=19.3). Economic data were collected in both 2007 and 2010. Three groups were formed to represent economic trajectories across the period of the Great Recession (stable low economic hardship, downward mobility, and stable high economic hardship). At age 19, measures of cellular epigenetic aging (derived from leukocyte DNA methylation profiles, reflecting the disparity between a person's biological and chronological age), allostatic load (composite of blood pressure, C reactive protein, cortisol, epinephrine, norepinephrine, and body mass index), and adolescent self-report of health were obtained. Linear trend analyses documented significant differences across all outcomes. The more time adolescents spent under economic hardship, the higher their epigenetic aging [estimate=1.421, SE=0.466, p=.002] and allostatic load [estimate=1.151, SE=0.375, p=.002] scores, and the worse their self-report of health [estimate=4.957, SE=1.800, p=.006]. Specific group comparisons revealed that adolescents in the downward mobility group had higher levels of allostatic load than adolescents in the stable low hardship group [p<.05]. Overall, these findings suggest that the health profiles of African American youth may in part be shaped by environmental macro-economic societal conditions, and that effects on biological markers can be detected relatively early in life. PMID:26718449

  13. African American College Students' Health Behaviors and Perceptions of Related Health Issues.

    ERIC Educational Resources Information Center

    Ford, Denyce S.; Goode, Carolyn R.

    1994-01-01

    A study of African American college students compared students' health-related behaviors with their perceptions of corresponding health issues. Students had low smoking rates but higher alcohol consumption. Most students did not practice good nutrition or daily physical activity. Over half managed stress well, and three-quarters were sexually…

  14. Health information-seeking behavior and older African American women.

    PubMed Central

    Gollop, C J

    1997-01-01

    This study explored the ways in which urban, older, African American women obtain health information and some of the factors that influence such activity. Among the possible determinants examined were self-perceived literacy, access to health information, and mobility. The findings suggest that respondents receive health information from their physicians, the mass media, and members of their social networks. The results of this research also indicated that members of this population have a highly positive perception of the public library, although only a small segment use the library regularly, and that it may be in the interest of the library to investigate the role it could play in providing health information to older adults. PMID:9160150

  15. Health information-seeking behavior and older African American women.

    PubMed

    Gollop, C J

    1997-04-01

    This study explored the ways in which urban, older, African American women obtain health information and some of the factors that influence such activity. Among the possible determinants examined were self-perceived literacy, access to health information, and mobility. The findings suggest that respondents receive health information from their physicians, the mass media, and members of their social networks. The results of this research also indicated that members of this population have a highly positive perception of the public library, although only a small segment use the library regularly, and that it may be in the interest of the library to investigate the role it could play in providing health information to older adults. PMID:9160150

  16. Venture funding for science-based African health innovation

    PubMed Central

    2010-01-01

    Background While venture funding has been applied to biotechnology and health in high-income countries, it is still nascent in these fields in developing countries, and particularly in Africa. Yet the need for implementing innovative solutions to health challenges is greatest in Africa, with its enormous burden of communicable disease. Issues such as risk, investment opportunities, return on investment requirements, and quantifying health impact are critical in assessing venture capital’s potential for supporting health innovation. This paper uses lessons learned from five venture capital firms from Kenya, South Africa, China, India, and the US to suggest design principles for African health venture funds. Discussion The case study method was used to explore relevant funds, and lessons for the African context. The health venture funds in this study included publicly-owned organizations, corporations, social enterprises, and subsidiaries of foreign venture firms. The size and type of investments varied widely. The primary investor in four funds was the International Finance Corporation. Three of the funds aimed primarily for financial returns, one aimed primarily for social and health returns, and one had mixed aims. Lessons learned include the importance of measuring and supporting both social and financial returns; the need to engage both upstream capital such as government risk-funding and downstream capital from the private sector; and the existence of many challenges including difficulty of raising capital, low human resource capacity, regulatory barriers, and risky business environments. Based on these lessons, design principles for appropriate venture funding are suggested. Summary Based on the cases studied and relevant experiences elsewhere, there is a case for venture funding as one support mechanism for science-based African health innovation, with opportunities for risk-tolerant investors to make financial as well as social returns. Such funds should

  17. A Campus-Community Partnership to Disseminate Health Internet Technology Resources among African Americans

    ERIC Educational Resources Information Center

    Littlefield, Melissa B.; Edwards, Lorece; Akers, Timothy

    2014-01-01

    The Internet is increasingly used to disseminate health information about diseases and prevention and to help in obtaining health services. Although technology can empower African Americans to adopt healthy lifestyles, the gap in usage between African Americans and Whites undermines the potential power of health Internet technology (IT) to…

  18. Mental health promotion for vulnerable African American youth.

    PubMed

    Shelton, Deborah; Lyon-Jenkins, Nina

    2006-01-01

    Fifty-six African American youth between 10-14 years of age participated in a community-based 14-week expressive arts program designed for youth at risk of involvement with the juvenile justice system. Positive and statistically significant findings for pre-post changes in self-control, protective factors, and resilience were found. Difficulty in engaging parents and the strong racial biases of the community appear to have influenced the lack of improvement in self-esteem scores. PMID:17073393

  19. Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context

    PubMed Central

    2014-01-01

    Background International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Discussion Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address

  20. Revisiting sub-Saharan African countries' drug problems: health, social, economic costs, and drug control policy.

    PubMed

    Affinnih, Yahya H

    2002-02-01

    This article takes an international perspective on the drug problem in sub-Saharan Africa. This analysis borrows ideas from physical and economic geography as a heuristic device to conceptualize the global narcoscapes in which drug trafficking occurs. Both the legitimate and the illegal drug trade operate within the same global capitalist system and draw on the same technological innovations and business processes. Central to the paper's argument is evidence that sub-Saharan African countries are now integrated into the political economy of drug consumption due to the spill-over effect. These countries are now minor markets for "hard drugs" as the result of the activities of organizations and individual traffickers that use Africa as a staging point in their trade with Europe and the United States. As a result, sub-Saharan African countries have drug consumption problems that were essentially absent prior to 1980, along with associated health, social, and economic costs. The emerging drug problem has forced African countries to develop their own drug control policy. The sub-Saharan African countries mentioned below vary to some extent in the level of drug use and misuse problems: Burundi, Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Reunion, Rwanda, Seychelles, Somalia, Tanzania, Uganda, Zambia, Angola, Cameroon, Central African Republic, Chad, Congo, Congo (Zaire), Equatorial Guinea, Gabon, Sao Tome and Principe, Botswana, Lesotho, Namibia, South Africa, Swaziland, Benin, Burkina Faso, Cape Verde, Cote d'Ivoire, Gambia, Ghana, Guinea, Guinea Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, and Togo. As part of this effort, African countries are assessing the health, social, and economic costs of drug-use-related problems to pinpoint methods which are both effective and inexpensive, since their budgets for social programs are severely constrained. Many have progressed to the point of adopting anti

  1. The Cultural Relevance of Mindfulness Meditation as a Health Intervention for African Americans: Implications for Reducing Stress-Related Health Disparities.

    PubMed

    Woods-Giscombé, Cheryl L; Gaylord, Susan A

    2014-09-01

    African Americans experience a disproportionate rate of stress-related health conditions compared to European Americans. Mindfulness meditation has been shown to be effective for managing stress and various stress-related health conditions. This study explored the cultural relevance of mindfulness meditation training for African Americans adults. Fifteen African American adults with past or current experience with mindfulness meditation training were interviewed. Participants felt that mindfulness meditation helped them with enhanced stress management, direct health improvement, and enhanced self-awareness and purposefulness. They felt that they would recommend it and that other African Americans would be open to the practice but suggested that its presentation may need to be adapted. They suggested emphasizing the health benefits, connecting it to familiar spiritual ideology and cultural practices, supplementing the reading material with African American writers, increasing communication (education, instructor availability, "buddy system," etc.), and including African Americans as instructors and participants. By implementing minor adaptations that enhance cultural relevance, mindfulness meditation can be a beneficial therapeutic intervention for this population. PMID:24442592

  2. Self-Care Among Chronically Ill African Americans: Culture, Health Disparities, and Health Insurance Status

    PubMed Central

    Becker, Gay; Gates, Rahima Jan; Newsom, Edwina

    2004-01-01

    Little is known about the self-care practices of chronically ill African Americans or how lack of access to health care affects self-care. Results from a qualitative interview study of 167 African Americans who had one or more chronic illnesses found that self-care practices were culturally based, and the insured reported more extensive programs of self-care. Those who had some form of health insurance much more frequently reported the influence of physicians and health education programs in self-care regimens than did those who were uninsured. It is concluded that the cultural components of self-care have been underemphasized, and further, that the potential to maximize chronic illness management through self-care strategies is not realized for those who lack access to health care. PMID:15569953

  3. Concepts of Healthful Food among Low-Income African American Women

    ERIC Educational Resources Information Center

    Lynch, Elizabeth B.; Holmes, Shane; Keim, Kathryn; Koneman, Sylvia A.

    2012-01-01

    Objective: Describe beliefs about what makes foods healthful among low-income African American women. Methods: In one-on-one interviews, 28 low-income African American mothers viewed 30 pairs of familiar foods and explained which food in the pair was more healthful and why. Responses were grouped into codes describing concepts of food…

  4. Health disparities and culturally specific treatment: perspectives and expectancies of African American smokers.

    PubMed

    Webb, Monica S; Francis, Joan; Hines, Bill C; Quarles, Frankie B

    2007-06-01

    Researchers suggest that culturally specific (CS) interventions are important in addressing smoking-related health disparities. Yet, little research has examined the perspectives of African American smokers regarding these efforts. This qualitative study sought to gain insight into perceptions related to (a) the smoking prevalence among African Americans, (b) smoking-related health disparities, (c) expectancies for CS interventions, (d) methods of recruiting research participants, and (e) key intervention components. Six focus groups were conducted with 41 African American smokers (aged 21-64) at a community health center. Content analyses revealed several themes, including the perception that smoking is normative among African Americans, limited knowledge of racial health disparities, mixed perceptions regarding race as a risk factor for illness, and mixed expectancies for the efficacy of CS interventions. In conclusion, individual differences, such as smoking norms, knowledge of health disparities, and intervention expectations may influence receptivity to CS treatments. Implications for tobacco interventions among African Americans are discussed. PMID:17457845

  5. Health Promotion Programs and Healthy Lifestyle: First Generation African Black Males’ Perspectives

    PubMed Central

    Asare, Matthew

    2015-01-01

    screening behaviors, most respondents stated lack of trust in the healthcare system, the fear of knowing their health status, lack of health insurance were some of the reasons that prevent them from accessing regular health screening. Conclusion Healthy lifestyle promotion programs which are based on the culture of first generation black African males stand a better chance of having a greater impact on this targeted population as opposed to a “one-size-fits-all” approach. PMID:26693184

  6. Cardiometabolic Health in African Immigrants to the United States: A Call to Re-examine Research on African-descent populations.

    PubMed

    Commodore-Mensah, Yvonne; Himmelfarb, Cheryl Dennison; Agyemang, Charles; Sumner, Anne E

    2015-01-01

    In the 20th century, Africans in Sub-Saharan Africa had lower rates of cardiometabolic disease than Africans who migrated. However, in the 21st century, beyond infectious diseases, the triple epidemics of obesity, diabetes and hypertension have taken hold in Africa. Therefore, Africans are acquiring these chronic diseases at different rates and different intensity prior to migration. To ensure optimal care and health outcomes, the United States practice of grouping all African-descent populations into the "Black/African American" category without regard to country of origin masks socioeconomic and cultural differences and needs re-evaluation. Overall, research on African-descent populations would benefit from a shift from a racial to an ethnic perspective. To demonstrate the value of disaggregating data on African-descent populations, the epidemiologic transition, social, economic, and health characteristics of African immigrants are presented. PMID:26675140

  7. The African Health Profession Regulatory Collaborative (ARC) at two years

    PubMed Central

    McCarthy, Carey F; Zuber, Alexandra; Kelley, Maureen A; Verani, Andre R; Riley, Patricia L

    2016-01-01

    Background The African Health Profession Regulatory Collaborative (ARC) for nurses and midwives was created in response to the increasing reliance on shifting HIV tasks to nurses and midwives without the necessary regulation supporting this enhanced professional role. ARC Approach The ARC initiative comprises regional meetings, technical assistance, and regulatory improvement grants which enhance HIV service delivery by nurses and midwives, and systematic evaluation of project impact. Results Eight of 11 countries funded by ARC advanced a full stage in regulatory capacity during their 1-year project period. Countries in ARC also demonstrated increased capacity in project management and proposal writing. Discussion The progress of country teams thus far suggests ARC is a successful model for regulation strengthening and capacity building, as well as presenting a novel approach for sustainability and country ownership. The ARC platform has been a successful vehicle for regional harmonisation of updated regulations and promises to help facilitate the enhancement of HIV service delivery by nurses and midwives. PMID:27066113

  8. Oral Cancer in African Americans: Addressing Health Disparities

    ERIC Educational Resources Information Center

    Dodd, Virginia J.; Watson, Jennifer M.; Choi, Youjin; Tomar, Scott L.; Logan, Henrietta L.

    2008-01-01

    Objectives: To explore factors underlying African Americans' perceptions of oral cancer and the oral cancer exam. Study findings were used to guide development of oral cancer messages designed to increase oral cancer exams among African Americans. Methods: Focus groups were conducted to understand African Americans' attitudes and expectations…

  9. Financial Hardship, Unmet Medical Need, and Health Self-Efficacy among African American Men

    ERIC Educational Resources Information Center

    Tucker-Seeley, Reginald D.; Mitchell, Jamie A.; Shires, Deirdre A.; Modlin, Charles S., Jr.

    2015-01-01

    Background: Health self-efficacy (the confidence to take care of one's health) is a key component in ensuring that individuals are active partners in their health and health care. The purpose of this study was to determine the association between financial hardship and health self-efficacy among African American men and to determine if unmet…

  10. African Americans, hypertension and the renin angiotensin system

    PubMed Central

    Williams, Sandra F; Nicholas, Susanne B; Vaziri, Nosratola D; Norris, Keith C

    2014-01-01

    African Americans have exceptionally high rates of hypertension and hypertension related complications. It is commonly reported that the blood pressure lowering efficacy of renin angiotensin system (RAS) inhibitors is attenuated in African Americans due to a greater likelihood of having a low renin profile. Therefore these agents are often not recommended as initial therapy in African Americans with hypertension. However, the high prevalence of comorbid conditions, such as diabetes, cardiovascular and chronic kidney disease makes treatment with RAS inhibitors more compelling. Despite lower circulating renin levels and a less significant fall in blood pressure in response to RAS inhibitors in African Americans, numerous clinical trials support the efficacy of RAS inhibitors to improve clinical outcomes in this population, especially in those with hypertension and risk factors for cardiovascular and related diseases. Here, we discuss the rationale of RAS blockade as part of a comprehensive approach to attenuate the high rates of premature morbidity and mortality associated with hypertension among African Americans. PMID:25276290

  11. [Sexuality, reproductive health and violence against the African Brazilian women: aspects of interest for nursing care].

    PubMed

    da Cruz, Isabel Cristina Fonseca

    2004-12-01

    Based on the referential of the critical racial theory, a review of the literature was made with the objective of searching for information that leads to an affirmative professional action against racism and sexism, based on scientific evidences and culturally competent. It was evidenced that the sexuality, reproductive health and violence against African Brazilian women are themes with scarce literature, suggesting that racism and sexism occur by the omission and negligence of State to weigh on African Brazilian women's mobilization. The study concluded that institutional discrimination in health needs to be neutralized by affirmative actions regarding to African Brazilian women that must be implemented or strengthen to promote equity in health. PMID:15689003

  12. A Phenomenological Study of African American Males Persisting in Community College Health and Public Safety Programs

    ERIC Educational Resources Information Center

    Mills-Byrd, Love

    2011-01-01

    This qualitative phenomenological study examined the lived experiences of persisting as described by ten African American men in persisting in a community college program. The primary research question was: "How do African American males describe their lived experiences of persisting in community college health and public programs?" African…

  13. Trials, Tribulations, and Celebrations: African-American Perspectives on Health, Illness, Aging, and Loss.

    ERIC Educational Resources Information Center

    Secundy, Marian Gray, Ed.; Nixon, Lois LaCivita, Ed.

    This book is an anthology of short stories, narratives, and poems exploring aspects of the life cycle (birth, illness, aging, loss and grief) from an African-American perspective. The book is intended to give health care providers and interested others insights into the African-American experience, and to encourage readers to explore the…

  14. Health Behaviors and Breast Cancer: Experiences of Urban African American Women

    ERIC Educational Resources Information Center

    Stolley, Melinda R.; Sharp, Lisa K.; Wells, Anita M.; Simon, Nolanna; Schiffer, Linda

    2006-01-01

    Breast-cancer survival rates are lower among African American women compared to White women. Obesity may contribute to this disparity. More than 77% of African American women are overweight or obese. Adopting health behaviors that promote a healthy weight status may be beneficial because obesity increases risk for recurrence. Studies among White…

  15. Marriage and Health in the Transition to Adulthood: Evidence for African Americans in the Add Health Study

    ERIC Educational Resources Information Center

    Harris, Kathleen Mullan; Lee, Hedwig; DeLeone, Felicia Yang

    2010-01-01

    This article explores the relationships among early marriage (before age 26 years), cohabitation, and health for African Americans and Whites during the transition to adulthood using the National Longitudinal Study of Adolescent Health (Add Health). The study examines three categories of health outcomes relevant to young adulthood: physical…

  16. Regional health governance: A suggested agenda for Southern African health diplomacy

    PubMed Central

    Penfold, Erica Dale; Fourie, Pieter

    2015-01-01

    Regional organisations can effectively promote regional health diplomacy and governance through engagement with regional social policy. Regional bodies make decisions about health challenges in the region, for example, the Union of South American Nations (UNASUR) and the World Health Organisation South East Asia Regional Office (WHO-SEARO). The Southern African Development Community (SADC) has a limited health presence as a regional organisation and diplomatic partner in health governance. This article identifies how SADC facilitates and coordinates health policy, arguing that SADC has the potential to promote regional health diplomacy and governance through engagement with regional social policy. The article identifies the role of global health diplomacy and niche diplomacy in health governance. The role of SADC as a regional organisation and the way it functions is then explained, focusing on how SADC engages with health issues in the region. Recommendations are made as to how SADC can play a more decisive role as a regional organisation to implement South–South management of the regional social policy, health governance and health diplomacy agenda. PMID:26635498

  17. Overcoming barriers to health-care access: A qualitative study among African migrants in Guangzhou, China.

    PubMed

    Lin, Lavinia; Brown, Katherine B; Hall, Brian J; Yu, Fan; Yang, Jingqi; Wang, Jason; Schrock, Joshua M; Bodomo, Adams B; Yang, Ligang; Yang, Bin; Nehl, Eric J; Tucker, Joseph D; Wong, Frank Y

    2016-10-01

    Guangzhou is China's third most populous city, and the region's burgeoning manufacturing economy has attracted many young African businessmen and entrepreneurs to the city. The aims of this study were to examine strategies that African migrants in Guangzhou have adopted in response to health-care barriers, and explore their perceptions of how to address their needs. Twenty-five semi-structured interviews and two focus groups were conducted among African migrants residing in Guangzhou, China. Facing multiple barriers to care, African migrants have adopted a number of suboptimal and unsustainable approaches to access health care. These included: using their Chinese friends or partners as interpreters, self-medicating, using personal connections to medical doctors, and travelling to home countries or countries that offer English-speaking doctors for health care. Health-care providers and health organisations in Guangzhou have not yet acquired sufficient cultural competence to address the needs of African migrants residing in the city. Introducing linguistically and culturally competent health-care services in communities concentrated with African migrants may better serve the population. With the growing international migration to China, it is essential to develop sustainable approaches to improving health-care access for international migrants, particularly those who are marginalised. PMID:26400191

  18. Superwoman Schema: African American Women’s Views on Stress, Strength, and Health

    PubMed Central

    Woods-Giscombé, Cheryl L.

    2011-01-01

    Researchers have suggested that health disparities in African American women, including adverse birth outcomes, lupus, obesity, and untreated depression, can be explained by stress and coping. The Strong Black Woman/Superwoman role has been highlighted as a phenomenon influencing African American women’s experiences and reports of stress. The purpose of this study was to develop a preliminary conceptual framework for Superwoman Schema (SWS) by exploring women’s descriptions of the Superwoman role; perceptions of contextual factors, benefits, and liabilities; and beliefs in how it influences health. Analysis of eight focus group discussions with demographically diverse African American women yielded themes characterizing the Superwoman role and personal or sociohistorical contextual factors. Participants reported that the Superwoman role had benefits (preservation of self and family or community) and liabilities (relationship strain, stress-related health behaviors, and stress embodiment). The SWS framework might be used to enhance future research on stress and African American women’s health. PMID:20154298

  19. The Impact of Racism on the Sexual and Reproductive Health of African American Women

    PubMed Central

    Prather, Cynthia; Fuller, Taleria R.; Marshall, Khiya J.; Jeffries, William L.

    2016-01-01

    African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women’s sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women’s sexual and reproductive health. PMID:27227533

  20. The Impact of Racism on the Sexual and Reproductive Health of African American Women.

    PubMed

    Prather, Cynthia; Fuller, Taleria R; Marshall, Khiya J; Jeffries, William L

    2016-07-01

    African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women's sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women's sexual and reproductive health. PMID:27227533

  1. The skills gap in hospital management in the South African public health sector.

    PubMed

    Pillay, Rubin

    2008-01-01

    A lack of management capacity has been identified as the key stumbling block to the transformation and reconceptualization of the public sector in South Africa into a more effective, efficient, and responsive system of health delivery. As part of the overall management development process, this research aimed to identify the skills important for public sector health management and to evaluate managers' self-assessed proficiency in each of these skills. A cross-sectional survey using a self-administered questionnaire was conducted among hospital managers in the South African public health sector. Respondents were asked to rate the level of importance that each proposed competency had in their job and to indicate their proficiency in each skill. Self-assessment of levels of competency showed that managers felt most competent in strategic planning, people management, and self-management, and relatively less competent in the task-related skills and their ability to deliver healthcare. People management, self-management, and task-related skills were rated as being most important, followed by strategic management and health delivery skills, respectively. The largest differences between mean importance rating and mean skill rating were for people management skills, task-related and self-management skills. These findings reflect the reality of the local health service environment and the needs of health managers and will be useful in the conceptualization, design, and delivery of health management programs aimed at enhancing current and future management and leadership capacity in the public health sector in South Africa. PMID:18708881

  2. A Public Health Priority: Disparities in Gynecologic Cancer Research for African-Born Women in the United States.

    PubMed

    Pinder, Leeya F; Nelson, Brett D; Eckardt, Melody; Goodman, Annekathryn

    2016-01-01

    African-born immigrants comprise one of the fastest growing populations in the U.S., nearly doubling its population size in recent years. However, it is also one of the most underrepresented groups in health-care research, especially research focused on gynecologic and breast malignancies. While the opportunity exists for access to an advanced health-care system, as immigrants migrate to the U.S., they encounter the same health-care inequalities that are faced by the native-born population based on ethnicity and social class, potentiated by limitations of health literacy and lack of familiarity with U.S. health systems. Given the continued influx of African-born immigrants in the U.S., we sought to understand the representation of this population in cervical and breast cancer research, recognizing the population's high risk for these diseases at baseline while residing in their native countries. We determined that there is limited research in these diseases that disproportionately affect them; yet, there are identifiable and potentially modifiable factors that contribute to this paucity of evidence. This clinical commentary seeks to underscore the clear lack of research available involving African-born immigrants with respect to gynecologic and breast malignancies in the existing literature, demonstrate the need for more robust research in this population, and provide fundamental insights into barriers and solutions critical to the continued health of this growing population. PMID:27499654

  3. A Public Health Priority: Disparities in Gynecologic Cancer Research for African-Born Women in the United States

    PubMed Central

    Pinder, Leeya F.; Nelson, Brett D.; Eckardt, Melody; Goodman, Annekathryn

    2016-01-01

    African-born immigrants comprise one of the fastest growing populations in the U.S., nearly doubling its population size in recent years. However, it is also one of the most underrepresented groups in health-care research, especially research focused on gynecologic and breast malignancies. While the opportunity exists for access to an advanced health-care system, as immigrants migrate to the U.S., they encounter the same health-care inequalities that are faced by the native-born population based on ethnicity and social class, potentiated by limitations of health literacy and lack of familiarity with U.S. health systems. Given the continued influx of African-born immigrants in the U.S., we sought to understand the representation of this population in cervical and breast cancer research, recognizing the population’s high risk for these diseases at baseline while residing in their native countries. We determined that there is limited research in these diseases that disproportionately affect them; yet, there are identifiable and potentially modifiable factors that contribute to this paucity of evidence. This clinical commentary seeks to underscore the clear lack of research available involving African-born immigrants with respect to gynecologic and breast malignancies in the existing literature, demonstrate the need for more robust research in this population, and provide fundamental insights into barriers and solutions critical to the continued health of this growing population. PMID:27499654

  4. Building a gateway to promote cardiovascular health research in African-American communities: lessons and findings from the field.

    PubMed

    Becker, D M; Tuggle, M B; Prentice, M F

    2001-11-01

    African American communities traditionally mistrust academic research. This forms a significant barrier to understanding cardiovascular risk factors in this population, which bears an excess risk of cardiovascular disease and stroke. A clergy/academic partnership was established to build a gateway for salient research and for improving resources for reducing cardiovascular disease risk in the community. From this partnership emanated the African American Family Heart Study. People with a family history of premature coronary heart disease (CHD) have an increased risk for the disease--as high as 12 times that of the general population, if among siblings. Considerably less is known about the actual remediable risk factors in African American families with premature CHD. We initiated the Family Heart Study with a full characterization of 161 apparently healthy, unaffected 30- to 59-year-old African Americans whose siblings were 85 African American index cases with documented premature CHD prior to 60 years of age. We compared their risk factor values to population reference norms obtained in the Third National Health and Nutrition Examination Survey (NHANES III) and the National Health Interview Survey (NHIS) for cigarette smoking. Only 13% of African American male siblings and 14% of female siblings from these families were without any major remediable risk factors. The fact that so many siblings were at extremely high risk calls into question the current applications by provider systems of national guidelines in high-risk African American families. This is an easily identifiable population that would be likely to benefit greatly from targeted screening and culturally sensitive and appropriate treatment. PMID:11721804

  5. Building a gateway to promote cardiovascular health research in African American communities: lessons and findings from the field.

    PubMed

    Becker, D M; Tuggle, M B; Prentice, M F

    2001-11-01

    African American communities traditionally mistrust academic research. This forms a significant barrier to understanding cardiovascular risk factors in this population, which bears an excess risk of cardiovascular disease and stroke. A clergy/academic partnership was established to build a gateway for salient research and for improving resources for reducing cardiovascular disease risk in the community. From this partnership emanated the African American Family Heart Study. People with a family history of premature coronary heart disease (CHD) have an increased risk for the disease--as high as 12 times that of the general population, if among siblings. Considerably less is known about the actual remediable risk factors in African American families with premature CHD. We initiated the Family Heart Study with a full characterization of 161 apparently healthy, unaffected 30- to 59-year-old African Americans whose siblings were 85 African American index cases with documented premature CHD prior to 60 years of age. We compared their risk factor values to population reference norms obtained in the Third National Health and Nutrition Examination Survey (NHANES III) and the National Health Interview Survey (NHIS) for cigarette smoking. Only 13% of African American male siblings and 14% of female siblings from these families were without any major remediable risk factors. The fact that so many siblings were at extremely high risk calls into question the current applications by provider systems of national guidelines in high-risk African American families. This is an easily identifiable population that would be likely to benefit greatly from targeted screening and culturally sensitive and appropriate treatment. PMID:11876188

  6. Psychosocial Mechanisms Linking the Social Environment to Mental Health in African Americans.

    PubMed

    Mama, Scherezade K; Li, Yisheng; Basen-Engquist, Karen; Lee, Rebecca E; Thompson, Deborah; Wetter, David W; Nguyen, Nga T; Reitzel, Lorraine R; McNeill, Lorna H

    2016-01-01

    Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African American adults. African American men and women (n = 1467) completed questionnaires on the social environment, psychosocial factors (stress, depressive symptoms, and racial discrimination), and mental health. Multiple-mediator models were used to assess direct and indirect effects of the social environment on mental health. Low social status in the community (p < .001) and U.S. (p < .001) and low social support (p < .001) were associated with poor mental health. Psychosocial factors significantly jointly mediated the relationship between the social environment and mental health in multiple-mediator models. Low social status and social support were associated with greater perceived stress, depressive symptoms, and perceived racial discrimination, which were associated with poor mental health. Results suggest the relationship between the social environment and mental health is mediated by psychosocial factors and revealed potential mechanisms through which social status and social support influence the mental health of African American men and women. Findings from this study provide insight into the differential effects of stress, depression and discrimination on mental health. Ecological approaches that aim to improve the social environment and psychosocial mediators may enhance health-related quality of life and reduce health disparities in African Americans. PMID:27119366

  7. Psychosocial Mechanisms Linking the Social Environment to Mental Health in African Americans

    PubMed Central

    Basen-Engquist, Karen; Lee, Rebecca E.; Thompson, Deborah; Wetter, David W.; Reitzel, Lorraine R.

    2016-01-01

    Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African American adults. African American men and women (n = 1467) completed questionnaires on the social environment, psychosocial factors (stress, depressive symptoms, and racial discrimination), and mental health. Multiple-mediator models were used to assess direct and indirect effects of the social environment on mental health. Low social status in the community (p < .001) and U.S. (p < .001) and low social support (p < .001) were associated with poor mental health. Psychosocial factors significantly jointly mediated the relationship between the social environment and mental health in multiple-mediator models. Low social status and social support were associated with greater perceived stress, depressive symptoms, and perceived racial discrimination, which were associated with poor mental health. Results suggest the relationship between the social environment and mental health is mediated by psychosocial factors and revealed potential mechanisms through which social status and social support influence the mental health of African American men and women. Findings from this study provide insight into the differential effects of stress, depression and discrimination on mental health. Ecological approaches that aim to improve the social environment and psychosocial mediators may enhance health-related quality of life and reduce health disparities in African Americans. PMID:27119366

  8. Henry Ford Health Systems

    Cancer.gov

    Henry Ford Health Systems evolved from a hospital into a system delivering care to 2.5 million patients and includes the Cancer Epidemiology, Prevention and Control Program, which focuses on epidemiologic and public health aspects of cancer.

  9. Engaging African American and Latino Adolescent Males through School-Based Health Centers

    ERIC Educational Resources Information Center

    Bains, Ranbir Mangat; Franzen, Carolyn W.; White-Frese', Jesse

    2014-01-01

    African American and Latino males are less likely to seek mental health services and obtain adequate care than their White counterparts. They are more likely to receive mental health services in school-based health centers (SBHCs) than in other community-based setting. The purpose of this article was to understand the issues and reasons these…

  10. Psychosocial mechanisms linking the social environment to mental health in African Americans

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African Amer...

  11. Ukraine: Health system review.

    PubMed

    Lekhan, Valery; Rudiy, Volodymyr; Richardson, Erica

    2010-01-01

    The HiT profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Ukrainian health system has preserved the fundamental features of the Soviet Semashko system against a background of other changes, which are developed on market economic principles. The transition from centralized financing to its extreme decentralization is the main difference in the health system in comparison with the classic Soviet model. Health facilities are now functionally subordinate to the Ministry of Health, but managerially and financially answerable to the regional and local self-government, which has constrained the implementation of health policy and fragmented health financing. Health care expenditure in Ukraine is low by regional standards and has not increased significantly as a proportion of gross domestic product (GDP) since the mid 1990s; expenditure cannot match the constitutional guarantees of access to unlimited care. Although prepaid schemes such as sickness funds are growing in importance, out-of-pocket payments account for 37.4% of total health expenditure. The core challenges for Ukrainian health care therefore remain the ineffective protection of the population from the risk of catastrophic health care costs and the structural inefficiency of the health system, which is caused by the inefficient system of health care financing. Health system weaknesses are highlighted by increasing rates of avoidable mortality. Recent political impasse has complicated health system reforms and policy-makers face significant challenges in overcoming popular distrust and

  12. Integration of non-communicable diseases in health care: tackling the double burden of disease in African settings

    PubMed Central

    Temu, Florence; Leonhardt, Marcus; Carter, Jane; Thiam, Sylla

    2014-01-01

    Sub-Saharan African countries now face the double burden of Non Communicable and Communicable Diseases. This situation represents a major threat to fragile health systems and emphasises the need for innovative integrative approaches to health care delivery. Health services need to be reorganised to address populations’ needs holistically and effectively leverage resources in already resource-limited settings. Access and delivery of quality health care should be reinforced and implemented at primary health care level within the framework of health system strengthening. Competencies need to be developed around services provided rather than specific diseases. New models of integration within the health sector and other sectors should be explored and further evidence generated to inform policy and practice to combat the double burden. PMID:25419329

  13. Investing in health systems for universal health coverage in Africa

    PubMed Central

    2014-01-01

    Background This study focused on the 47 Member States of the World Health Organization (WHO) African Region. The specific objectives were to prepare a synthesis on the situation of health systems¿ components, to analyse the correlation between the interventions related to the health Millennium Development Goals (MDGs) and some health systems¿ components and to provide overview of four major thrusts for progress towards universal health coverage (UHC). Methods The WHO health systems framework and the health-related MDGs were the frame of reference. The data for selected indicators were obtained from the WHO World Health Statistics 2014 and the Global Health Observatory. Results African Region¿s average densities of physicians, nursing and midwifery personnel, dentistry personnel, pharmaceutical personnel, and psychiatrists of 2.6, 12, 0.5, 0.9 and 0.05 per 10 000 population were about five-fold, two-fold, five-fold, five-fold and six-fold lower than global averages. Fifty-six percent of the reporting countries had fewer than 11 health posts per 100 000 population, 88% had fewer than 11 health centres per 100 000 population, 82% had fewer than one district hospital per 100 000 population, 74% had fewer than 0.2 provincial hospitals per 100 000 population, and 79% had fewer than 0.2 tertiary hospitals per 100 000 population. Some 83% of the countries had less than one MRI per one million people and 95% had fewer than one radiotherapy unit per million population. Forty-six percent of the countries had not adopted the recommendation of the International Taskforce on Innovative Financing to spend at least US$ 44 per person per year on health. Some of these gaps in health system components were found to be correlated to coverage gaps in interventions for maternal health (MDG 5), child health (MDG 4) and HIV/AIDS, TB and malaria (MDG 6). Conclusions Substantial gaps exist in health systems and access to MDG-related health interventions. It is imperative that countries

  14. Slovenia: Health System Review.

    PubMed

    Albreht, Tit; Pribakovic Brinovec, Radivoje; Josar, Dusan; Poldrugovac, Mircha; Kostnapfel, Tatja; Zaletel, Metka; Panteli, Dimitra; Maresso, Anna

    2016-06-01

    This analysis of the Slovene health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The health of the population has improved over the last few decades. While life expectancy for both men and women is similar to EU averages, morbidity and mortality data show persistent disparities between regions, and mortality from external causes is particularly high. Satisfaction with health care delivery is high, but recently waiting times for some outpatient specialist services have increased. Greater focus on preventive measures is also needed as well as better care coordination, particularly for those with chronic conditions. Despite having relatively high levels of co-payments for many services covered by the universal compulsory health insurance system, these expenses are counterbalanced by voluntary health insurance, which covers 95% of the population liable for co-payments. However, Slovenia is somewhat unique among social health insurance countries in that it relies almost exclusively on payroll contributions to fund its compulsory health insurance system. This makes health sector revenues very susceptible to economic and labour market fluctuations. A future challenge will be to diversify the resource base for health system funding and thus bolster sustainability in the longer term, while preserving service delivery and quality of care. Given changing demographics and morbidity patterns, further challenges include restructuring the funding and provision of long-term care and enhancing health system efficiency through reform of purchasing and provider-payment systems. PMID:27467813

  15. Fragile health and fragile wealth: mortgage strain among African American homeowners.

    PubMed

    Keene, Danya E; Lynch, Julia F; Baker, Amy Castro

    2014-10-01

    Several recent studies identify illness and disability as contributors to mortgage strain, suggesting that the disproportionate burden of poor health that African Americans experience may be an important source of housing fragility in this population. In order to understand how poor health plays out in the lived experiences of African-American homeowners and contributes to mortgage strain, we present an analysis of 28 in-depth interviews conducted with middle and working-class African-American homeowners at risk of losing their homes. Our interviews show how racial inequalities in health, which result from an ongoing history of racial discrimination, intersect with other racially stratified sources of housing fragility to put homeowners at risk of foreclosure. Many participants in this study were long-term homeowners who experienced mortgage strain as result of a health-related event that triggered the collapse of a fragile household budget. Like many middle and working-class African Americans, participants experienced poor health and disability at relatively young ages. Additionally, they often lacked access to personal and public safety nets that could buffer the consequences of illness. Understanding how poor health contributes to mortgage strain among African-American homeowners provides important insight into the downstream consequences of health inequalities. Furthermore, understanding the processes through which illness can act as a financial shock has important policy implications. PMID:25112566

  16. African-American women's perceptions of their most serious health problems.

    PubMed Central

    Sadler, Georgia Robins; Escobar, Rita Paola; Ko, Celine Marie; White, Monique; Lee, Shianti; Neal, Tiffany; Gilpin, Elizabeth A.

    2005-01-01

    African Americans experience a disproportionate burden of illness. According to the Centers for Disease Control and Prevention (CDC), heart disease, cancer, cerebrovascular disease and diabetes are the most common causes of mortality among African Americans. Data were gathered from 1,055 African-American women to gain their perspectives of the most serious health problems affecting African-American women and their related knowledge, attitudes and health promoting behaviors. Women listed CDC's top four causes of mortality as their top four most serious health threats. Cancer was reported as a serious health threat by 81% of the participants, whereas heart disease, the most common cause of mortality and a disease amenable to prevention and early intervention, was mentioned by only 31% of the women. Diabetes was reported by 59% of the women and cerebrovascular disease by 52%. As the Health Belief and other theoretical models would predict, awareness of the seriousness of these four disease groups among African-American women was associated with a greater likelihood of adherence for several of the recommended behaviors. Many opportunities exist for raising women's awareness of these four diseases and linking women's growing health awareness with those health promoting behaviors known to reduce morbidity and mortality. PMID:15719869

  17. Kazakhkstan health system review.

    PubMed

    Katsaga, Alexandr; Kulzhanov, Maksut; Karanikolos, Marina; Rechel, Bernd

    2012-01-01

    Since becoming independent, Kazakhstan has undertaken major efforts in reforming its post-Soviet health system. Two comprehensive reform programmes were developed in the 2000s: the National Programme for Health Care Reform and Development 2005-2010 and the State Health Care Development Programme for 2011-2015 Salamatty Kazakhstan. Changes in health service provision included a reduction of the hospital sector and an increased emphasis on primary health care. However, inpatient facilities continue to consume the bulk of health financing. Partly resulting from changing perspectives on decentralization, levels of pooling kept changing. After a spell of devolving health financing to the rayon level in 2000-2003, beginning in 2004 a new health financing system was set up that included pooling of funds at the oblast level, establishing the oblast health department as the single-payer of health services. Since 2010, resources for hospital services under the State Guaranteed Benefits Package have been pooled at the national level within the framework of implementing the Concept on the Unified National Health Care System. Kazakhstan has also embarked on promoting evidence-based medicine and developing and introducing new clinical practice guidelines, as well as facility-level quality improvements. However, key aspects of health system performance are still in dire need of improvement. One of the key challenges is regional inequities in health financing, health care utilization and health outcomes, although some improvements have been achieved in recent years. Despite recent investments and reforms, however, population health has not yet improved substantially. PMID:22894852

  18. Addressing health concerns of pregnant African American women using the lens of complexity theory.

    PubMed

    Sims, Traci

    2014-01-01

    Pregnant African American women are at higher risk for multiple complex health issues, including depression, than their European American counterparts (Canady, Bullen, Holzman, Broman, & Tian, 2008; Martin et al, 2011; Mathews & MacDorman, 2007; Orr, Blazer, & James, 2006; Segre, Losch, & O'Hara, 2006). Various strategies must be used to address depression through preventive care and promotion of access to appropriate mental health services. Nurses and other health care providers need to examine the relationships between the multifactorial problems to improve the health and well-being of pregnant African American women and their unborn children. This article presents a case study demonstrating the use of complexity science theory to understand and prevent poor health outcomes for pregnant African American women with depression and their unborn children. PMID:26050422

  19. Latvia: Health system review.

    PubMed

    Mitenbergs, Uldis; Taube, Maris; Misins, Janis; Mikitis, Eriks; Martinsons, Atis; Rurane, Aiga; Quentin, Wilm

    2012-01-01

    This analysis of the Latvian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health-system performance. Latvia has been constantly reforming its health system for over two decades. After independence in 1991, Latvia initially moved to create a social health insurance type system. However, problems with decentralized planning and fragmented and inefficient financing led to this being gradually reversed, and ultimately the establishment in 2011 of a National Health Service type system. These constant changes have taken place against a backdrop of relatively poor health and limited funding, with a heavy burden for individuals; Latvia has one of the highest rates of out-of-pocket expenditure on health in the European Union (EU). The lack of financial resources resulting from the financial crisis has posed an enormous challenge to the government, which struggled to ensure the availability of necessary health care services for the population and to prevent deterioration of health status. Yet this also provided momentum for reforms: previous efforts to centralise the system and to shift from hospital to outpatient care were drastically accelerated, while at the same time a social safety net strategy was implemented (with financial support from the World Bank) to protect the poor from the negative consequences of user charges. However, as in any health system, a number of challenges remain. They include: reducing smoking and cardiovascular deaths; increasing coverage of prescription pharmaceuticals; reducing the excessive reliance on out-of-pocket payments for financing the health system; reducing inequities in access and health status; improving efficiency of hospitals through implementation of DRG-based financing; and monitoring and improving quality. In the face of these challenges at a time of financial crisis, one further challenge emerges: ensuring adequate funding for the health

  20. Gender as a Moderator of the Relation between Race-Related Stress and Mental Health Symptoms for African Americans

    ERIC Educational Resources Information Center

    Greer, Tawanda M.; Laseter, Adrian; Asiamah, David

    2009-01-01

    The present study tested gender as a moderator of the relationship between race-related stress and mental health symptoms among African American adults. Because African American women are exposed to stressors associated with race and gender, we hypothesized that African American women would have higher levels of race-related stress and more severe…

  1. Germany: Health system review.

    PubMed

    Busse, Reinhard; Blümel, Miriam

    2014-01-01

    This analysis of the German health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. In the German health care system, decision-making powers are traditionally shared between national (federal) and state (Land) levels, with much power delegated to self-governing bodies. It provides universal coverage for a wide range of benefits. Since 2009, health insurance has been mandatory for all citizens and permanent residents, through either statutory or private health insurance. A total of 70 million people or 85% of the population are covered by statutory health insurance in one of 132 sickness funds in early 2014. Another 11% are covered by substitutive private health insurance. Characteristics of the system are free choice of providers and unrestricted access to all care levels. A key feature of the health care delivery system in Germany is the clear institutional separation between public health services, ambulatory care and hospital (inpatient) care. This has increasingly been perceived as a barrier to change and so provisions for integrated care are being introduced with the aim of improving cooperation between ambulatory physicians and hospitals. Germany invests a substantial amount of its resources on health care: 11.4% of gross domestic product in 2012, which is one of the highest levels in the European Union. In international terms, the German health care system has a generous benefit basket, one of the highest levels of capacity as well as relatively low cost-sharing. However, the German health care system still needs improvement in some areas, such as the quality of care. In addition, the division into statutory and private health insurance remains one of the largest challenges for the German health care system, as it leads to inequalities. PMID:25115137

  2. African Americans' perceived sociocultural determinants of suicide: afrocentric implications for public health inequalities.

    PubMed

    Borum, Valerie

    2014-01-01

    The cultural values of African Americans have not been adequately incorporated as a theoretical base to develop new public health models. The major objectives of this study were to explore, with a purposive sample, via seven focus groups, 40 African American college students, the following: How do (a) ethnic culture and (b) a "minoritized" status influence perceptions of sociocultural determinants in explaining increases in the incidence of suicide among African Americans? Thematic results of focus group discussions including the following: (a) racism, discrimination, and stereotyping; (b) U.S. individualism; (c) integration and cultural assimilation; and, (d) the prison industrial complex. PMID:25350896

  3. Health inequalities: promoting policy changes in utilizing transformation development by empowering African American communities in reducing health disparities.

    PubMed

    Kennedy, Bernice Roberts

    2013-01-01

    Social inequalities in the United States resulted in negative health outcomes for the African Americans. Their stressful living conditions of poverty, discrimination, racism, abuse and rejection from American society contribute to their negative health outcomes. The lifestyles of African Americans have been influenced by poverty and prior injustices, which have molded their worldview of health and illness. Dr. Martin Luther King, national civil rights leader, brought about social change with much prayer; however, he went a step further with collective gatherings to include the power of non-violence massive public demonstrations. This paper is an analytical review of the literature addressing social inequalities impacting on health inequalities of African Americans resulting in health disparities. Policy changes are propose by implementing transformation development and community empowerment models as frameworks for community/public health nurses in guiding African American communities with addressing health disparities. These models empower members of the community to participate in a collaborative effort in making political and social changes to improve their overall health outcomes. PMID:24575590

  4. A study of HIV positive undocumented African migrants' access to health services in the UK.

    PubMed

    Whyte, James; Whyte, Maria D; Hires, Kimberly

    2015-01-01

    Newly immigrated persons, whatever their origin, tend to fall in the lower socioeconomic levels. In fact, failure of an asylum application renders one destitute in a large proportion of cases, often resulting in a profound lack of access to basic necessities. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority. The purpose of the study was to determine the basic social processes that guide HIV positive undocumented migrant's efforts to gain health services in the UK. The study used the Grounded Theory Approach. Theoretical saturation occurred after 16 participants were included in the study. The data included reflections of the prominent factors related to the establishment of a safe and productive life and the ability of individuals to remain within the UK. The data reflected heavily upon the ability of migrants to enter the medical care system during their asylum period, and on an emerging pattern of service denial after loss on immigration appeal. The findings of this study are notable in that they have demonstrated sequence of events along a timeline related to the interaction between the asylum process and access to health-related services. The results reflect that African migrants maintain a degree of formal access to health services during the period that they possess legal access to services and informal access after the failure of their asylum claim. The purpose of this paper is to examine the basic social processes that characterize efforts to gain access to health services among HIV positive undocumented African migrants to the UK. The most recent estimates indicate that there are a total of 618,000 migrants who lack legal status within the UK. Other studies have placed the number of undocumented migrants within the UK in the range of 525,000-950,000. More than 442,000 are thought to dwell in the London metropolitan area. Even in

  5. Challenges to HIV prevention in psychiatric settings: Perceptions of South African mental health care providers

    PubMed Central

    Collins, Pamela Y.

    2009-01-01

    Mental health services in South Africa increasingly feel the brunt of the AIDS epidemic. Despite the high prevalence of infection in the psychiatric setting, HIV risk reduction interventions targeting South Africans with psychiatric illness remain few and far between. The attitudes of mental health care providers about sexual relations and HIV among people with mental illness continue to influence the extent to which these issues are addressed in care settings. This study examines these attitudes through the use of a semi-structured interview administered to 46 mental health care providers in four provinces of South Africa. I found that personal, contextual and political factors in the clinic and the hospital create barriers to integrating prevention activities. In particular, providers face at least three challenges to intervening in the epidemic among their patients: their own views of psychiatric illness, the transitions occurring in the mental health care system, and shifting social attitudes toward sexuality. Barriers operate at the individual level, the institutional level, and the societal level. At the individual level providers’ perceptions of psychiatric symptoms shape their outlook on intervention with psychiatric patients. At the institutional level disruptive transitions in service delivery relegate HIV services to lesser importance. At the societal level, personal beliefs about sexuality and mental illness have remained slow to change despite major political changes. Minimizing barriers to implementing HIV prevention services requires institutional and health care policies that ensure adequate resources for treating people with mental illness and for staff development and support. PMID:16647793

  6. A Community Health Advisor Program to Reduce Cardiovascular Risk among Rural African-American Women

    ERIC Educational Resources Information Center

    Cornell, C. E.; Littleton, M. A.; Greene, P. G.; Pulley, L.; Brownstein, J. N.; Sanderson, B. K.; Stalker, V. G.; Matson-Koffman, D.; Struempler, B.; Raczynski, J. M.

    2009-01-01

    The Uniontown, Alabama Community Health Project trained and facilitated Community Health Advisors (CHAs) in conducting a theory-based intervention designed to reduce the risk for cardiovascular disease (CVD) among rural African-American women. The multiphased project included formative evaluation and community organization, CHA recruitment and…

  7. Marriage Trajectories and Health Risk Behaviors throughout Adulthood among Urban African Americans

    ERIC Educational Resources Information Center

    Green, Kerry M.; Doherty, Elaine E.; Fothergill, Kate E.; Ensminger, Margaret E.

    2012-01-01

    Although previous studies have identified a protective effect of marriage on risky health behaviors, gaps remain in our understanding of how marriage improves health, particularly among African Americans. This study uses longitudinal data to take selection into account and examines whether marital trajectories that incorporate timing, stability,…

  8. Transformative Learning Intervention: Effect on Functional Health Literacy and Diabetes Knowledge in Older African Americans

    ERIC Educational Resources Information Center

    Ntiri, Daphne W.; Stewart, Merry

    2009-01-01

    This study evaluated the effect of a transformative learning (TL) intervention on functional health literacy and diabetes knowledge in older African Americans. Twenty participants from senior community centers completed a six-session intervention. The short-form Test of Functional Health Literacy in Adults (s-TOFHLA), Literacy Assessment for…

  9. Provision of Mental Health Services in South African Substance Abuse Treatment Facilities

    ERIC Educational Resources Information Center

    Myers, Bronwyn; Fakier, Nuraan

    2009-01-01

    To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services…

  10. Lithuania: health system review.

    PubMed

    Murauskiene, Liubove; Janoniene, Raimonda; Veniute, Marija; van Ginneken, Ewout; Karanikolos, Marina

    2013-01-01

    This analysis of the Lithuanian health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance since 2000.The Lithuanian health system is a mixed system, predominantly funded from the National Health Insurance Fund through a compulsory health insurance scheme, supplemented by substantial state contributions on behalf of the economically inactive population amounting to about half of its budget. Public financing of the health sector has gradually increased since 2004 to 5.2 per cent of GDP in 2010.Although the Lithuanian health system was tested by the recent economic crisis, Lithuanias counter-cyclical state health insurance contribution policies (ensuring coverage for the economically inactive population) helped the health system to weather the crisis, and Lithuania successfully used the crisis as a lever to reduce the prices of medicines.Yet the future impact of cuts in public health spending is a cause for concern. In addition, out-of-pocket payments remain high (in particular for pharmaceuticals) and could threaten health access for vulnerable groups.A number of challenges remain. The primary care system needs strengthening so that more patients are treated instead of being referred to a specialist, which will also require a change in attitude by patients. Transparency and accountability need to be increased in resource allocation, including financing of capital investment and in the payer provider relationship. Finally, population health,albeit improving, remains a concern, and major progress can be achieved by reducing the burden of amenable and preventable mortality. PMID:23902994

  11. Ukraine: health system review.

    PubMed

    Lekhan, Valery; Rudiy, Volodymyr; Shevchenko, Maryna; Nitzan Kaluski, Dorit; Richardson, Erica

    2015-03-01

    This analysis of the Ukrainian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Since the country gained independence from the Soviet Union in 1991, successive governments have sought to overcome funding shortfalls and modernize the health care system to meet the needs of the population's health. However, no fundamental reform of the system has yet been implemented and consequently it has preserved the main features characteristic of the Semashko model; there is a particularly high proportion of total health expenditure paid out of pocket (42.3 % in 2012), and incentives within the system do not focus on quality or outcomes. The most recent health reform programme began in 2010 and sought to strengthen primary and emergency care, rationalize hospitals and change the model of health care financing from one based on inputs to one based on outputs. Fundamental issues that hampered reform efforts in the past re-emerged, but conflict and political instability have proved the greatest barriers to reform implementation and the programme was abandoned in 2014. More recently, the focus has been on more pressing humanitarian concerns arising from the conflict in the east of Ukraine. It is hoped that greater political, social and economic stability in the future will provide a better environment for the introduction of deep reforms to address shortcomings in the Ukrainian health system. PMID:26106880

  12. Innovative tephra studies in the East African Rift System

    NASA Astrophysics Data System (ADS)

    WoldeGabriel, Giday; Hart, William K.; Heiken, Grant

    Geosciences investigations form the foundation for paleoanthropological research in the East African Rift System. However, innovative applications of tephra studies for constraining spatial and temporal relations of diverse geological processes, biostratigraphic records, and paleoenvironmental conditions within the East African Rift System were fueled by paleoanthropological investigations into the origin and evolution of hominids and material culture. Tephra is a collective, size-independent term used for any material ejected during an explosive volcanic eruption.The East African Rift System has become a magnet for paleoanthropological research ever since the discovery of the first hominids at Olduvai Gorge, in Tanzania, in the 1950s [Leakey et al., 1961]. Currently, numerous multidisciplinary scientific teams from academic institutions in the United States and Western Europe make annual pilgrimages for a couple of months to conduct paleoanthropological field research in the fossil-rich sedimentary deposits of the East African Rift System in Ethiopia, Kenya, and Tanzania. The field expedition consists of geological, paleontological, archaeological, and paleoenvironmental investigations.

  13. Iceland: health system review.

    PubMed

    Sigurgeirsdóttir, Sigurbjörg; Waagfjörð, Jónína; Maresso, Anna

    2014-01-01

    This analysis of the Icelandic health system reviews the developments in its organization and governance, health financing, health care provision, health reforms and health system performance. Life expectancy at birth is high and Icelandic men and women enjoy longer life in good health than the average European. However, Icelanders are putting on weight, more than half of adult Icelanders were overweight or obese in 2004, and total consumption of alcohol has increased considerably since 1970. The health care system is a small, state centred, publicly funded system with universal coverage, and an integrated purchaser provider relationship in which the state as payer is also the owner of most organizations providing health care services. The country's centre of clinical excellence is the University Hospital, Landspitali, in the capital Reykjavik, which alone accounts for 70 percent of the total national budget for general hospital services. However, since 1990, the health system has become increasingly characterized by a mixed economy of care and service provision, in which the number and scope of private non profit and private for profit providers has increased. While Iceland's health outcomes are some of the best among OECD countries, the health care system faces challenges involving the financial sustainability of the current system in the context of an ageing population, new public health challenges, such as obesity, and the continued impact of the country's financial collapse in 2008. The most important challenge is to change the pattern of health care utilization to steer it away from the most expensive end of the health services spectrum towards more cost efficient and effective alternatives. To a large degree, this will involve renewed attempts to prioritize primary care as the first port of call for patients, and possibly to introduce a gatekeeping function for GPs in order to moderate the use of specialist services. PMID:25720021

  14. African American Women, Hair Care, and Health Barriers

    PubMed Central

    Mahan, Meredith Grace

    2014-01-01

    Objectives: The objective of this study was to elucidate the prevalence of hair loss among African American women; explore the psychosocial impact of hair grooming difficulties; and examine both perceptions related to physician encounters in this group and the relationship between hair grooming, physical activity, and weight maintenance. Design: An anonymous retrospective and qualitative survey, the Hair Care Assessment Survey, is an 18-question novel survey instrument designed at the Henry Ford Hospital Department of Dermatology Multicultural Dermatology Center. Setting: The Hair Care Assessment Survey was distributed at church-related functions at predominantly African American metropolitan Detroit churches. Participants: Two hundred African American women from metropolitan Detroit, Michigan, aged 21 to 83. Measurements: The Hair Care Assessment Survey collected data relating to hair loss and hair care, psychosocial experiences relating to hair loss, and hair care as it relates to exercise and body weight management. Data was collected on doctor-patient hair-related medical visits and experiences with commercially available ethnic hair care products. Results: More than 50 percent reported excessive hair loss. Twenty-eight percent had visited a physician to discuss hair issues, but only 32 percent felt their physician understood African American hair. Forty-five percent reported avoiding exercise because of hair concerns, and 22 percent felt that their hair impeded maintaining healthy body weight. Conclusion: Hair loss affects a compelling number of African American women, and a significant number express dissatisfaction in hair-related physician encounters. Additionally, hair styling problems present a serious impediment to physical activity and weight management among this already high-risk population. PMID:25276273

  15. Belgium: Health system review.

    PubMed

    Gerkens, Sophie; Merkur, Sherry

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Belgian population continues to enjoy good health and long life expectancy. This is partly due to good access to health services of high quality. Financing is based mostly on proportional social security contributions and progressive direct taxation. The compulsory health insurance is combined with a mostly private system of health care delivery, based on independent medical practice, free choice of physician and predominantly fee-for-service payment. This Belgian HiT profile (2010) presents the evolution of the health system since 2007, including detailed information on new policies. While no drastic reforms were undertaken during this period, policy-makers have pursued the goals of improving access to good quality of care while making the system sustainable. Reforms to increase the accessibility of the health system include measures to reduce the out-of-pocket payments of more vulnerable populations (low-income families and individuals as well as the chronically ill). Quality of care related reforms have included incentives to better integrate different levels of care and the establishment of information systems, among others. Additionally, several measures on pharmaceutical products have aimed to reduce costs for both the National Institute for Health and Disability Insurance (NIHDI) and patients, while maintaining the quality of care. PMID:21224177

  16. Health Numeracy: Perspectives About Using Numbers in Health Management from African American Patients Receiving Dialysis

    PubMed Central

    Wright Nunes, Julie A.; Osborn, Chandra Y.; Ikizler, T. Alp; Cavanaugh, Kerri L.

    2015-01-01

    Background Health numeracy is linked to important clinical outcomes. Kidney disease management relies heavily on patient numeracy skills across the continuum of kidney disease care. Little data is available eliciting stakeholder perspectives from patients receiving dialysis about the construct of health numeracy. Methods Using focus groups we asked patients receiving hemodialysis open-ended questions to identify facilitators and barriers to their understanding, interpreting, and applying numeric information in kidney care. Transcripts were analyzed using content analysis. Results Twelve patients participated with a mean (SD) age of 56 (12) years. All were African American, 50% were female and 83% with an annual income < $20,000/year. Although patients felt numbers were critical to every aspect in life, they noted several barriers to understanding, interpreting and applying quantitative information specifically to manage their health. Low patient self-efficacy related to health numeracy and limited patient-provider communication about quantitatively based feedback, were emphasized as key barriers. Conclusions Through focus groups of key patient stakeholders we identified important modifiable barriers to effective kidney care. Additional research is needed to develop tools that support numeracy sensitive education and communication interventions in dialysis. PMID:25358522

  17. Strategic Planning for Recruitment and Retention of Older African Americans in Health Promotion Research Programs

    PubMed Central

    Dreer, Laura E.; Weston, June; Owsley, Cynthia

    2014-01-01

    The purpose of this study was to 1) describe a strategic plan for recruitment and retention used in conducting eye health education research with African-Americans living in urban and rural areas of Alabama and 2) characterize recruitment and retention patterns for this community-based project. We evaluated an eye health education program tailored specifically to older African Americans. InCHARGE© was designed to promote eye disease prevention by conveying the personal benefits of annual, dilated, comprehensive eye care and teaching strategies to minimize barriers to regular eye care. The InCHARGE© program or a social contact control program was delivered at 20 senior centers in predominately African American urban and rural communities. From pooled data across three studies, 380 African Americans completed a questionnaire about knowledge and attitudes/beliefs about eye disease and eye care before the program and by telephone at either 3 or 6 months after the presentation. The project consisted of 4 phases and a total of 10 strategic objectives for recruitment as well as retention of older African Americans that were implemented in a systematic fashion. Overall, retention rates for follow-up at either 3 or 6 months were 75% and 66% respectively. African Americans from rural areas were more likely to be lost to follow-up compared to those from urban areas. We discuss the benefits of utilizing a strategic plan that serves to address problems with underrepresentation of minorities in clinical research. PMID:25346876

  18. France: Health System Review.

    PubMed

    Chevreul, Karine; Berg Brigham, Karen; Durand-Zaleski, Isabelle; Hernandez-Quevedo, Cristina

    2015-01-01

    This analysis of the French health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The French population has a good level of health, with the second highest life expectancy in the world for women. It has a high level of choice of providers, and a high level of satisfaction with the health system. However, unhealthy habits such as smoking and harmful alcohol consumption remain significant causes of avoidable mortality. Combined with the significant burden of chronic diseases, this has underscored the need for prevention and integration of services, although these have not historically been strengths of the French system. Although the French health care system is a social insurance system, it has historically had a stronger role for the state than other Bismarckian social insurance systems. Public financing of health care expenditure is among the highest in Europe and out-of-pocket spending among the lowest. Public insurance is compulsory and covers the resident population; it is financed by employee and employer contributions as well as increasingly through taxation. Complementary insurance plays a significant role in ensuring equity in access. Provision is mixed; providers of outpatient care are largely private, and hospital beds are predominantly public or private non-profit-making. Despite health outcomes being among the best in the European Union, social and geographical health inequities remain. Inequality in the distribution of health care professionals is a considerable barrier to equity. The rising cost of health care and the increasing demand for long-term care are also of concern. Reforms are ongoing to address these issues, while striving for equity in financial access; a long-term care reform including public coverage of long-term care is still pending. PMID:26766545

  19. Austria: health system review.

    PubMed

    Hofmarcher, Maria M; Quentin, Wilm

    2013-01-01

    This analysis of the Austrian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health-system performance. The Austrian health system provides universal coverage for a wide range of benefits and high-quality care. Free choice of providers and unrestricted access to all care levels (general practitioners, specialist physicians and hospitals) are characteristic features of the system. Unsurprisingly, population satisfaction is well above EU average. Income-related inequality in health has increased since 2005, although it is still relatively low compared to other countries. The health-care system has been shaped by both the federal structure of the state and a tradition of delegating responsibilities to self-governing stakeholders. On the one hand, this enables decentralized planning and governance, adjusted to local norms and preferences. On the other hand, it also leads to fragmentation of responsibilities and frequently results in inadequate coordination. For this reason, efforts have been made for several years to achieve more joint planning, governance and financing of the health-care system at the federal and regional level. As in any health system, a number of challenges remain. The costs of the health-care system are well above the EU15 average, both in absolute terms and as a percentage of GDP. There are important structural imbalances in healthcare provision, with an oversized hospital sector and insufficient resources available for ambulatory care and preventive medicine. This is coupled with stark regional differences in utilization, both in curative services (hospital beds and specialist physicians) and preventative services such as preventive health check-ups, outpatient rehabilitation, psychosocial and psychotherapeutic care and nursing. There are clear social inequalities in the use of medical services, such as preventive health check-ups, immunization or dentistry

  20. Projections of 21st Century African Climate: Implications for African Savanna Fire Dynamics, Human Health and Food Security

    NASA Astrophysics Data System (ADS)

    Adegoke, J. O.

    2015-12-01

    Fire is a key agent of change in the African savannas, which are shaped through the complex interactions between trees, C4 grasses, rainfall, temperature, CO2 and fire. These fires and their emitted smoke can have numerous direct and indirect effects on the environment, water resources, air quality, and climate. For instance, veld fires in southern Africa cause large financial losses to agriculture, livestock production and forestry on an annual basis. This study contributes to our understanding of the implications of projected surface temperature evolution in Africa for fire risk, human health and agriculture over the coming decades. We use an ensemble of high-resolution regional climate model simulations of African climate for the 21st century. Regional dowscalings and recent global circulation model projections obtained for Africa indicate that African temperatures are likely to rise at 1.5 times the global rate of temperature increase in the tropics, and at almost twice the global rate of increase in the subtropics. Warming is projected to occur during the 21st century, with increases of 4-6 °C over the subtropics and 3-5 °C over the tropics plausible by the end of the century relative to present-day climate under the A2 (low mitigation) scenario. We explore the significance of the projected warming by documenting increases in projected high fire danger days and heat-wave days. General drying is projected across the continent, even for areas (e.g. tropical Africa) where an increase in rainfall is plausible. This is due to the drastic increases in temperature that are projected, which leads to drier soils (through enhanced evaporation) despite the rainfall increases. This will likely impact negatively on crop yield, particularly on the maize crop that is of crucial importance in terms of African food security.

  1. Marijuana Use and Its Association with Participation, Navigation, and Enrollment in Health Research among African Americans.

    PubMed

    Webb, Fern J; Striley, Catherine W; Cottler, Linda B

    2015-01-01

    This analysis examined the association between marijuana (Mj) use, willingness to participate, navigation and enrollment in health research among African Americans. Data from HealthStreet, a community-engagement model implemented in North Central Florida that reduces health disparities by engaging and linking community members to medical and social services and health research opportunities, were analyzed to determine willingness of African American Mj users to participate, be navigated to and enroll in health research studies. Among 1,496 African American community members, 8.0% were current Mj users, 30.3% were past Mj users and 61.7% reported never using Mj. Current and past Mj users were more willing to volunteer for a research study that only involved the use of medical records, required an overnight stay in a hospital or clinic, or might require use of medical equipment compared to those who never used Mj. Current Mj users were significantly less likely to be navigated (95% CI: 0.21-0.58) to health research studies while past Mj users (95% CI: 1.05-2.64) were significantly more likely to be enrolled in health research studies. Navigating and enrolling Mj users into health research studies could help decrease health disparities and increase health equity for the entire community since study findings would undoubtedly be more representative of the entire community rather than a select few. PMID:26213328

  2. Israel: Health System Review.

    PubMed

    Rosen, Bruce; Waitzberg, Ruth; Merkur, Sherry

    2015-12-01

    Israel is a small country, with just over 8 million citizens and a modern market-based economy with a comparable level of gross domestic product per capita to the average in the European Union. It has had universal health coverage since the introduction of a progressively financed statutory health insurance system in 1995. All citizens can choose from among four competing, non-profit-making health plans, which are charged with providing a broad package of benefits stipulated by the government. Overall, the Israeli health care system is quite efficient. Health status levels are comparable to those of other developed countries, even though Israel spends a relatively low proportion of its gross domestic product on health care (less than 8%) and nearly 40% of that is privately financed. Factors contributing to system efficiency include regulated competition among the health plans, tight regulatory controls on the supply of hospital beds, accessible and professional primary care and a well-developed system of electronic health records. Israeli health care has also demonstrated a remarkable capacity to innovate, improve, establish goals, be tenacious and prioritize. Israel is in the midst of numerous health reform efforts. The health insurance benefits package has been extended to include mental health care and dental care for children. A multipronged effort is underway to reduce health inequalities. National projects have been launched to measure and improve the quality of hospital care and reduce surgical waiting times, along with greater public dissemination of comparative performance data. Major steps are also being taken to address projected shortages of physicians and nurses. One of the major challenges currently facing Israeli health care is the growing reliance on private financing, with potentially deleterious effects for equity and efficiency. Efforts are currently underway to expand public financing, improve the efficiency of the public system and constrain

  3. Beyond shamanism: the relevance of African traditional medicine in global health policy.

    PubMed

    Aginam, Obijiofor

    2007-06-01

    This article explores the tension between African traditional medicine and orthodox medicine, and argues for a cosmopolitan and inclusive health policy that integrates ethnomedical therapies into the core framework of global health architecture. The paper argues that age-old traditional therapies in Africa are relegated to the peripheries of orthodox health policy. The paper briefly discusses the accelerating pace of globalization of intellectual property rights (patents) as a factor that would continue to perpetrate bio-piracy and threaten traditional herbal therapies with extinction. The search for an inclusive global health policy opens a new vista in the interaction of traditional and orthodox medicine. The paper concludes that a sustained relegation of African traditional medicine to the margins of orthodox health policy is a phenomenon that would likely project the globalization of public health as predatory, discriminatory and unfair. PMID:17639845

  4. Assessing Nutritional Diversity of Cropping Systems in African Villages

    PubMed Central

    DeClerck, Fabrice; Diru, Willy; Fanzo, Jessica; Gaynor, Kaitlyn; Lambrecht, Isabel; Mudiope, Joseph; Mutuo, Patrick K.; Nkhoma, Phelire; Siriri, David; Sullivan, Clare; Palm, Cheryl A.

    2011-01-01

    Background In Sub-Saharan Africa, 40% of children under five years in age are chronically undernourished. As new investments and attention galvanize action on African agriculture to reduce hunger, there is an urgent need for metrics that monitor agricultural progress beyond calories produced per capita and address nutritional diversity essential for human health. In this study we demonstrate how an ecological tool, functional diversity (FD), has potential to address this need and provide new insights on nutritional diversity of cropping systems in rural Africa. Methods and Findings Data on edible plant species diversity, food security and diet diversity were collected for 170 farms in three rural settings in Sub-Saharan Africa. Nutritional FD metrics were calculated based on farm species composition and species nutritional composition. Iron and vitamin A deficiency were determined from blood samples of 90 adult women. Nutritional FD metrics summarized the diversity of nutrients provided by the farm and showed variability between farms and villages. Regression of nutritional FD against species richness and expected FD enabled identification of key species that add nutrient diversity to the system and assessed the degree of redundancy for nutrient traits. Nutritional FD analysis demonstrated that depending on the original composition of species on farm or village, adding or removing individual species can have radically different outcomes for nutritional diversity. While correlations between nutritional FD, food and nutrition indicators were not significant at household level, associations between these variables were observed at village level. Conclusion This study provides novel metrics to address nutritional diversity in farming systems and examples of how these metrics can help guide agricultural interventions towards adequate nutrient diversity. New hypotheses on the link between agro-diversity, food security and human nutrition are generated and strategies for

  5. Using peer education to increase sexual health knowledge among West African refugees in Western Australia.

    PubMed

    Drummond, Peter D; Mizan, Ayse; Brocx, Katie; Wright, Bernadette

    2011-03-01

    Ten bilingual West African peer educators conducted a 3-hour workshop on sexual health for small groups of West African refugees (N = 58) who recently had settled in Perth, Western Australia. There were significant increases in the participants' knowledge of sexually transmitted infections and HIV, how these infections are spread, and how to protect against infection. In addition, attitudes toward condom use became more positive. We conclude that the peer-education approach was successful in assisting a new and emerging community to work effectively on sexual health topics generally considered "taboo" or too sensitive to discuss. PMID:21337242

  6. Psychocultural Correlates of Mental Health Service Utilization Among African American and European American Girls.

    PubMed

    Yasui, Miwa; Hipwell, Alison E; Stepp, Stephanie D; Keenan, Kate

    2015-11-01

    Structural equation modeling was used to examine the effects of cultural factors (ethnic identity, perceived discrimination), family relations, and child problem type on mental health service utilization in a community sample of 1,480 adolescent girls (860 African American, 620 European American) between ages 15 and 17 years enrolled in the Pittsburgh Girls Study. Results revealed ethnic identity, caregiver attachment, and conduct disorder were related to service use among African American girls. Among European American girls, correlate patterns differed by clinical need. Findings highlight the need for research on health disparities to examine racially specific influences on service utilization. PMID:25380787

  7. Psychocultural Correlates of Mental Health Service Utilization Among African American and European American Girls

    PubMed Central

    Hipwell, Alison E.; Stepp, Stephanie D.; Keenan, Kate

    2015-01-01

    Structural equation modeling was used to examine the effects of cultural factors (ethnic identity, perceived discrimination), family relations, and child problem type on mental health service utilization in a community sample of 1,480 adolescent girls (860 African American, 620 European American) between ages 15 and 17 years enrolled in the Pittsburgh Girls Study. Results revealed ethnic identity, caregiver attachment, and conduct disorder were related to service use among African American girls. Among European American girls, correlate patterns differed by clinical need. Findings highlight the need for research on health disparities to examine racially specific influences on service utilization. PMID:25380787

  8. Health Information Seeking Among Rural African Americans, Caucasians, and Hispanics: It Is Built, Did They Come?

    PubMed

    Powe, Barbara D

    2015-09-01

    This cross-sectional study examines health information-seeking behaviors and access to and use of technology among rural African Americans, Caucasians, and Hispanics. There was a low level of health information seeking across the sample. Few used smartphones or tablets and did not endorse receiving health information from their health care provider by e-mail. Printed materials remained a source of health information as did friends and family. Information should be shared using multiple platforms including more passive methods such as television and radio. More research is needed to ensure the health literacy, numeracy, and ability to navigate the online environment. PMID:26333608

  9. Poland health system review.

    PubMed

    Sagan, Anna; Panteli, Dimitra; Borkowski, W; Dmowski, M; Domanski, F; Czyzewski, M; Gorynski, Pawel; Karpacka, Dorota; Kiersztyn, E; Kowalska, Iwona; Ksiezak, Malgorzata; Kuszewski, K; Lesniewska, A; Lipska, I; Maciag, R; Madowicz, Jaroslaw; Madra, Anna; Marek, M; Mokrzycka, A; Poznanski, Darius; Sobczak, Alicja; Sowada, Christoph; Swiderek, Maria; Terka, A; Trzeciak, Patrycja; Wiktorzak, Katarzyna; Wlodarczyk, Cezary; Wojtyniak, B; Wrzesniewska-Wal, Iwona; Zelwianska, Dobrawa; Busse, Reinhard

    2011-01-01

    Since the successful transition to a freely elected parliament and a market economy after 1989, Poland is now a stable democracy and is well represented within political and economic organizations in Europe and worldwide. The strongly centralized health system based on the Semashko model was replaced with a decentralized system of mandatory health insurance, complemented with financing from state and territorial self-government budgets. There is a clear separation of health care financing and provision: the National Health Fund (NFZ) the sole payer in the system is in charge of health care financing and contracts with public and non-public health care providers. The Ministry of Health is the key policy-maker and regulator in the system and is supported by a number of advisory bodies, some of them recently established. Health insurance contributions, borne entirely by employees, are collected by intermediary institutions and are pooled by the NFZ and distributed between the 16 regional NFZ branches. In 2009, Poland spent 7.4% of its gross domestic product (GDP) on health. Around 70% of health expenditure came from public sources and over 83.5% of this expenditure can be attributed to the (near) universal health insurance. The relatively high share of private expenditure is mostly represented by out-of-pocket (OOP) payments, mainly in the form of co-payments and informal payments. Voluntary health insurance (VHI) does not play an important role and is largely limited to medical subscription packages offered by employers. Compulsory health insurance covers 98% of the population and guarantees access to a broad range of health services. However, the limited financial resources of the NFZ mean that broad entitlements guaranteed on paper are not always available. Health care financing is overall at most proportional: while financing from health care contributions is proportional and budgetary subsidies to system funding are progressive, high OOP expenditures

  10. Human health impacts in a changing South African climate.

    PubMed

    Wright, C Y; Garland, R M; Norval, M; Vogel, C

    2014-08-01

    Climate change is projected to lead to warmer temperatures, especially in southern Africa, where the warming is predicted to be 2°C higher than the global increase. Given the high burden of disease already associated with environmental factors in this region, this temperature increase may lead to grave challenges for human health and quality of life. HIV/AIDS, poverty, food and water insecurity together with inequality and unemployment will further complicate the manner in which we will need to address the challenges of a changing climate. The health impacts are direct, such as increased temperatures leading to heat exhaustion, and indirect, such as likely increases in infectious diseases from contaminated water and changes in the distribution and/or magnitude of vector-borne diseases. The most effective measures for adapting to climate change to ensure healthy populations are to implement basic public health systems and services. These range from a continuous supply of clean water to adequate primary healthcare services. Support for required interventions is required not only from government, but also from healthcare professionals and communities. The need for disease surveillance, data capturing and more focused research is paramount. PMID:26307804

  11. Italy: health system review.

    PubMed

    Ferre, Francesca; de Belvis, Antonio Giulio; Valerio, Luca; Longhi, Silvia; Lazzari, Agnese; Fattore, Giovanni; Ricciardi, Walter; Maresso, Anna

    2014-01-01

    Italy is the sixth largest country in Europe and has the second highest average life expectancy, reaching 79.4 years for men and 84.5 years for women in 2011. There are marked regional differences for both men and women in most health indicators, reflecting the economic and social imbalance between the north and south of the country. The main diseases affecting the population are circulatory diseases, malignant tumours and respiratory diseases. Italy's health care system is a regionally based national health service that provides universal coverage largely free of charge at the point of delivery. The main source of financing is national and regional taxes, supplemented by copayments for pharmaceuticals and outpatient care. In 2012, total health expenditure accounted for 9.2 percent of GDP (slightly below the EU average of 9.6 percent). Public sources made up 78.2 percent of total health care spending. While the central government provides a stewardship role, setting the fundamental principles and goals of the health system and determining the core benefit package of health services available to all citizens, the regions are responsible for organizing and delivering primary, secondary and tertiary health care services as well as preventive and health promotion services. Faced with the current economic constraints of having to contain or even reduce health expenditure, the largest challenge facing the health system is to achieve budgetary goals without reducing the provision of health services to patients. This is related to the other key challenge of ensuring equity across regions, where gaps in service provision and health system performance persist. Other issues include ensuring the quality of professionals managing facilities, promoting group practice and other integrated care organizational models in primary care, and ensuring that the concentration of organizational control by regions of health-care providers does not stifle innovation. PMID:25471543

  12. Development of a One Health National Capacity in Africa : the Southern African Centre for Infectious Disease Surveillance (SACIDS) One Health Virtual Centre Model.

    PubMed

    Rweyemamu, Mark; Kambarage, Dominic; Karimuribo, Esron; Wambura, Philemon; Matee, Mecky; Kayembe, Jean-Marie; Mweene, Aaron; Neves, Luis; Masumu, Justin; Kasanga, Christopher; Hang'ombe, Bernard; Kayunze, Kim; Misinzo, Gerald; Simuunza, Martin; Paweska, Janusz T

    2013-01-01

    Among the many challenges to health, infectious diseases stand out for their ability to have a profound impact on humans and animals. The recent years have witnessed an increasing number of novel infectious diseases. The numerous examples of infections which originated from animals suggest that the zoonotic pool is an important and potentially rich source of emerging diseases. Since emergence and re-emergence of pathogens, and particularly zoonotic agents, occur at unpredictable rates in animal and human populations, infectious diseases will constitute a significant challenge for the public health and animal health communities in the twenty-first century. The African continent suffers from one of the highest burdens of infectious diseases of humans and animals in the world but has the least capacity for their detection, identification and monitoring. Lessons learnt from recent zoonotic epidemics in Africa and elsewhere clearly indicate the need for coordinated research, interdisciplinary centres, response systems and infrastructures, integrated surveillance systems and workforce development strategies. More and stronger partnerships across national and international sectors (human health, animal health, environment) and disciplines (natural and social sciences) involving public, academic and private organisations and institutions will be required to meet the present and future challenges of infectious diseases. In order to strengthen the efficiency of early warning systems, monitoring trends and disease prediction and timely outbreak interventions for the benefit of the national and international community, it is essential that each nation improves its own capacity in disease recognition and laboratory competence. The SACIDS, a One Health African initiative linking southern African academic and research institutions in smart partnership with centres of science excellence in industrialised countries as well as international research centres, strives to strengthen

  13. Discrimination, mental health, and leukocyte telomere length among African American men.

    PubMed

    Chae, David H; Epel, Elissa S; Nuru-Jeter, Amani M; Lincoln, Karen D; Taylor, Robert Joseph; Lin, Jue; Blackburn, Elizabeth H; Thomas, Stephen B

    2016-01-01

    African American men in the US experience disparities across multiple health outcomes. A common mechanism underlying premature declines in health may be accelerated biological aging, as reflected by leukocyte telomere length (LTL). Racial discrimination, a qualitatively unique source of social stress reported by African American men, in tandem with poor mental health, may negatively impact LTL in this population. The current study examined cross-sectional associations between LTL, self-reported racial discrimination, and symptoms of depression and anxiety among 92 African American men 30-50 years of age. LTL was measured in kilobase pairs using quantitative polymerase chain reaction assay. Controlling for sociodemographic factors, greater anxiety symptoms were associated with shorter LTL (b=-0.029, standard error [SE]=0.014; p<0.05). There were no main effects of racial discrimination or depressive symptoms on LTL, but we found evidence for a significant interaction between the two (b=0.011, SE=0.005; p<0.05). Racial discrimination was associated with shorter LTL among those with lower levels of depressive symptoms. Findings from this study highlight the role of social stressors and individual-level psychological factors for physiologic deterioration among African American men. Consistent with research on other populations, greater anxiety may reflect elevated stress associated with shorter LTL. Racial discrimination may represent an additional source of social stress among African American men that has detrimental consequences for cellular aging among those with lower levels of depression. PMID:26398001

  14. Circumpolar Inuit health systems

    PubMed Central

    Ellsworth, Leanna; O'Keeffe, Annmaree

    2013-01-01

    Background The Inuit are an indigenous people totalling about 160,000 and living in 4 countries across the Arctic – Canada, Greenland, USA (Alaska) and Russia (Chukotka). In essence, they are one people living in 4 countries. Although there have been significant improvements in Inuit health and survival over the past 50 years, stark differences persist between the key health indicators for Inuit and those of the national populations in the United States, Canada and Russia and between Greenland and Denmark. On average, life expectancy in all 4 countries is lower for Inuit. Infant mortality rates are also markedly different with up to 3 times more infant deaths than the broader national average. Underlying these statistical differences are a range of health, social, economic and environmental factors which have affected Inuit health outcomes. Although the health challenges confronting the Inuit are in many cases similar across the Arctic, the responses to these challenges vary in accordance with the types of health systems in place in each of the 4 countries. Each of the 4 countries has a different health care system with varying degrees of accessibility and affordability for Inuit living in urban, rural and remote areas. Objective To describe funding and governance arrangements for health services to Inuit in Canada, Greenland, USA (Alaska) and Russia (Chukotka) and to determine if a particular national system leads to better outcomes than any of the other 3 systems. Study design Literature review. Results It was not possible to draw linkages between the different characteristics of the respective health systems, the corresponding financial investment and the systems’ effectiveness in adequately serving Inuit health needs for several reasons including the very limited and inadequate collection of Inuit-specific health data by Canada, Alaska and Russia; and second, the data that are available do not necessarily provide a feasible point of comparison in terms of

  15. Interactions between Oceanic Saharan Air Layer and African Easterly Jet- African Easterly Waves System

    NASA Astrophysics Data System (ADS)

    Hosseinpour, F.; Wilcox, E. M.

    2013-12-01

    Aerosols have robust influences on multi-scale climatic systems and variability. Non-linear aerosol-cloud-climate interactions depend on many parameters such as aerosol features, regional atmospheric dynamics and variability. Although there are remarkable modeling studies indicating that aerosols induce robust modifications in cloud properties, circulations and the hydrological cycle, many of the physical and dynamical processes involving in these complex interactions between aerosols and Earth's system are still poorly understood. Better understanding the contribution of aerosols with atmospheric phenomena and their transient changes are crucial for efforts to evaluate climate predictions by next generation climate models. This study provides strong evidence of mechanistic relationships between perturbations of the oceanic Saharan air layer (OSAL) and anomalies of atmospheric circulations over the eastern tropical Atlantic/Africa. These relationships are characterized using an ensemble of daily datasets including the Modern-Era Retrospective Analysis for Research and Applications (MERRA), the Moderate Resolution Imaging Spectro-radiometer (MODIS), and the Sea-viewing Wide Field-of-View Sensor (SeaWIFS) for the boreal summer season. The study is motivated by previous results suggesting that oceanic dust-induced large-scale to meso-scale climatic adjustments. Our hypothesis is that perturbations in OSAL significantly interact with regional climate variability through African Easterly Jet- African Easterly Waves (AEJ-AEW) system. Passive/ active phases of AEWs in the northern and southern-track wave packets are associated with dipole patterns of thermal/dynamical anomalies correlated with perturbations of aerosol optical depth (AOD) in OSAL. Enhanced (suppressed) dust AOD in OSAL are significantly correlated with convective re-circulation within subsidence region of Hadley cell as well as robust mid-level dipole vorticity disturbances downstream of the AEJ core

  16. Bulgaria health system review.

    PubMed

    Dimova, Antoniya; Rohova, Maria; Moutafova, Emanuela; Atanasova, Elka; Koeva, Stefka; Panteli, Dimitra; van Ginneken, Ewout

    2012-01-01

    In the last 20 years, demographic development in Bulgaria has been characterized by population decline, a low crude birth rate, a low fertility rate, a high mortality rate and an ageing population. A stabilizing political situation since the early 2000s and an economic upsurge since the mid-2000s were important factors in the slight increase of the birth and fertility rates and the slight decrease in standardized death rates. In general, Bulgaria lags behind European Union (EU) averages in most mortality and morbidity indicators. Life expectancy at birth reached 73.3 years in 2008 with the main three causes of death being diseases of the circulatory system, malignant neoplasms and diseases of the respiratory system. One of the most important risk factors overall is smoking, and the average standardized death rate for smoking-related causes in 2008 was twice as high as the EU15 average. The Bulgarian health system is characterized by limited statism. The Ministry of Health is responsible for national health policy and the overall organization and functioning of the health system and coordinates with all ministries with relevance to public health. The key players in the insurance system are the insured individuals, the health care providers and the third party payers, comprising the National Health Insurance Fund, the single payer in the social health insurance (SHI) system, and voluntary health insurance companies (VHICs). Health financing consists of a publicprivate mix. Health care is financed from compulsory health insurance contributions, taxes, outofpocket (OOP) payments, voluntary health insurance (VHI) premiums, corporate payments, donations, and external funding. Total health expenditure (THE) as a share of gross domestic product (GDP) increased from 5.3% in 1995 to 7.3% in 2008. At the latter date it consisted of 36.5% OOP payments, 34.8% SHI, 13.6% Ministry of Health expenditure, 9.4% municipality expenditure and 0.3% VHI. Informal payments in the health

  17. Switzerland: Health System Review.

    PubMed

    De Pietro, Carlo; Camenzind, Paul; Sturny, Isabelle; Crivelli, Luca; Edwards-Garavoglia, Suzanne; Spranger, Anne; Wittenbecher, Friedrich; Quentin, Wilm

    2015-01-01

    This analysis of the Swiss health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Swiss health system is highly complex, combining aspects of managed competition and corporatism (the integration of interest groups in the policy process) in a decentralized regulatory framework shaped by the influences of direct democracy. The health system performs very well with regard to a broad range of indicators. Life expectancy in Switzerland (82.8 years) is the highest in Europe after Iceland, and healthy life expectancy is several years above the European Union (EU) average. Coverage is ensured through mandatory health insurance (MHI), with subsidies for people on low incomes. The system offers a high degree of choice and direct access to all levels of care with virtually no waiting times, though managed care type insurance plans that include gatekeeping restrictions are becoming increasingly important. Public satisfaction with the system is high and quality is generally viewed to be good or very good. Reforms since the year 2000 have improved the MHI system, changed the financing of hospitals, strengthened regulations in the area of pharmaceuticals and the control of epidemics, and harmonized regulation of human resources across the country. In addition, there has been a slow (and not always linear) process towards more centralization of national health policy-making. Nevertheless, a number of challenges remain. The costs of the health care system are well above the EU average, in particular in absolute terms but also as a percentage of gross domestic product (GDP) (11.5%). MHI premiums have increased more quickly than incomes since 2003. By European standards, the share of out-of-pocket payments is exceptionally high at 26% of total health expenditure (compared to the EU average of 16%). Low and middle-income households contribute a greater share of their income to

  18. African American college students' health behaviors and perceptions of related health issues.

    PubMed

    Ford, D S; Goode, C R

    1994-03-01

    The authors identify specific health-related behaviors of African American college students and compare them with the students' perceptions of corresponding health issues. Among students surveyed, the rate of cigarette smoking (4%) was very low compared with smoking rates found in a national survey (14%); but alcohol consumption was relatively high (63%), although lower than the national average of 91%. More men than women smoked, but more women than men reported they drank alcoholic beverages. Most students (90.2%) said they did not usually eat breakfast, 73.6% reported that their diets were not nutritionally balanced, and the majority (55.4%) were not involved in daily physical activity. More than half (63%) of the students reported satisfactorily handling stress, and 74.1% indicated that they were sexually active. Respondents perceived the most important health issues facing college students as HIV/AIDS and sexually transmitted diseases (STDs), birth control, date rape, stress management, suicide, and alcohol and other drugs. PMID:8201133

  19. Utilisation and costs of nursing agencies in the South African public health sector, 2005–2010

    PubMed Central

    Rispel, Laetitia C.; Angelides, George

    2014-01-01

    Background Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals. Objective The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. Design A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6–2009/10) from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ∼ R7, 2010 prices). Results Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million) was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million) in Mpumalanga Province (mixed urban-rural) to a high of R356.43 million (US$50.92 million) in the Eastern Cape Province (mixed urban-rural). Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural) to 11.96% in the Northern Cape

  20. Estonia: health system review.

    PubMed

    Lai, Taavi; Habicht, Triin; Kahur, Kristiina; Reinap, Marge; Kiivet, Raul; van Ginneken, Ewout

    2013-01-01

    This analysis of the Estonian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health system performance. Without doubt, the main issue has been the 2008 financial crisis. Although Estonia has managed the downturn quite successfully and overall satisfaction with the system remains high, it is hard to predict the longer-term effects of the austerity package. The latter included some cuts in benefits and prices, increased cost sharing for certain services, extended waiting times, and a reduction in specialized care. In terms of health outcomes, important progress was made in life expectancy, which is nearing the European Union (EU) average, and infant mortality. Improvements are necessary in smoking and alcohol consumption, which are linked to the majority of avoidable diseases. Although the health behaviour of the population is improving, large disparities between groups exist and obesity rates, particularly among young people, are increasing. In health care, the burden of out-of-pocket payments is still distributed towards vulnerable groups. Furthermore, the number of hospitals, hospital beds and average length of stay has decreased to the EU average level, yet bed occupancy rates are still below EU averages and efficiency advances could be made. Going forwards, a number of pre-crisis challenges remain. These include ensuring sustainability of health care financing, guaranteeing a sufficient level of human resources, prioritizing patient-centred health care, integrating health and social care services, implementing intersectoral action to promote healthy behaviour, safeguarding access to health care for lower socioeconomic groups, and, lastly, improving evaluation and monitoring tools across the health system. PMID:24334730

  1. Regional Health Information Systems

    PubMed Central

    Fuller, Sherrilynne

    1997-01-01

    Abstract In general, there is agreement that robust integrated information systems are the foundation for building successful regional health care delivery systems. Integrated Advanced Information Management System (IAIMS) institutions that, over the years, have developed strategies for creating cohesive institutional information systems and services are finding that IAIMS strategies work well in the even more complex regional environment. The key elements of IAIMS planning are described and lessons learned are discussed in the context of regional health information systems developed. The challenges of aligning the various information agencies and agendas in support of a regional health information system are complex ; however, the potential rewards for health care in quality, efficacy, and cost savings are enormous. PMID:9067887

  2. Mantle support of the East African Rift System

    NASA Astrophysics Data System (ADS)

    Lin, S.; van Keken, P. E.; Brandenburg, J. P.; Furman, T.; Bryce, J.

    2007-12-01

    The African Superplume is a region of slow seismic wave velocities in the lower mantle under southern Africa. The uplift, volcanism and rifting that defines the much of eastern and southern Africa suggest a dynamic link between lower mantle dynamics and near-surface processes affecting the African plate. The dynamic link between the lower mantle and the surface, and the structure and dynamics of the upper mantle below the East African Rift System (EARS) remain unclear. As part of a comprehensive geochemical and numerical investigation of basaltic magmatism in the EARS we have modeled the interaction between putative upper mantle plumes and the rifting continental lithosphere. The modeling provides dynamically tested scenarios that explain the observed episodes of Cenozoic volcanism. Results from recent models that provided an explanation for the present day distribution of volcanism (Lin et al., EPSL, 237, 2005) suggest two plumes below Afar and Tanzania whose uplift is influenced by lithospheric topography. In new 3D modeling we provide improved quantification of the mantle involvement in generating EARS volcanism as constrained by the timing of uplift and regional volcanism. The time scales of episodicity of the volcanism observed at Turkana (related to the Tanzania-Kenya plume) since 45 Ma can be explained by deep- seated time-dependent plume activity. We suggest that this time-dependence is due to thermochemical interactions of dense recycled oceanic crust in the thermally hot regions in the African superplume region (Lin and Van Keken, Nature, 436, 2005).

  3. Promoting healthy behavior from the pulpit: clergy share their perspectives on effective health communication in the African American church.

    PubMed

    Lumpkins, Crystal Y; Greiner, K Allen; Daley, Christine; Mabachi, Natabhona M; Neuhaus, Kris

    2013-12-01

    African Americans continue to suffer disproportionately from health disparities when compared to other ethnicities (ACS 2010; CDC 2007). Research indicates that the church and the pastor in the African American community could be enlisted to increase effectiveness of health programs (Campbell et al. in Health Edu Behav 34(6):864-880, 2007; DeHaven et al. in Am J Public Health 94(6):1030-1036, 2004). The objective of this study was to investigate African American pastors' perceptions about health promotion in the church and how these perceptions could serve as a guide for improving health communication targeting African Americans. Semi-structured interviews with African American clergy revealed that pastors feel strongly about the intersection of health, religion and spirituality; they also believe that discussing health screening and other health issues more frequently from the pulpit and their own personal experiences will ultimately impact health behavior among congregants. This study suggests that African American clergy see themselves as health promoters in the church and believe this communication (i.e., pastor-endorsed health information materials) will impact health behavior among underserved and minority populations. PMID:21965057

  4. Romania: Health System Review.

    PubMed

    Vladescu, Cristian; Scintee, Silvia Gabriela; Olsavszky, Victor; Hernandez-Quevedo, Cristina; Sagan, Anna

    2016-08-01

    This analysis of the Romanian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Romanian health care system is a social health insurance system that has remained highly centralized despite recent efforts to decentralize some regulatory functions. It provides a comprehensive benefits package to the 85% of the population that is covered, with the remaining population having access to a minimum package of benefits. While every insured person has access to the same health care benefits regardless of their socioeconomic situation, there are inequities in access to health care across many dimensions, such as rural versus urban, and health outcomes also differ across these dimensions. The Romanian population has seen increasing life expectancy and declining mortality rates but both remain among the worst in the European Union. Some unfavourable trends have been observed, including increasing numbers of new HIV/AIDS diagnoses and falling immunization rates. Public sources account for over 80% of total health financing. However, that leaves considerable out-of-pocket payments covering almost a fifth of total expenditure. The share of informal payments also seems to be substantial, but precise figures are unknown. In 2014, Romania had the lowest health expenditure as a share of gross domestic product (GDP) among the EU Member States. In line with the government's objective of strengthening the role of primary care, the total number of hospital beds has been decreasing. However, health care provision remains characterized by underprovision of primary and community care and inappropriate use of inpatient and specialized outpatient care, including care in hospital emergency departments. The numbers of physicians and nurses are relatively low in Romania compared to EU averages. This has mainly been attributed to the high rates of workers emigrating abroad over the

  5. Denmark health system review.

    PubMed

    Olejaz, Maria; Juul Nielsen, Annegrete; Rudkjøbing, Andreas; Okkels Birk, Hans; Krasnik, Allan; Hernández-Quevedo, Cristina

    2012-01-01

    Denmark has a tradition of a decentralized health system. However, during recent years, reforms and policy initiatives have gradually centralized the health system in different ways. The structural reform of 2007 merged the old counties into fewer bigger regions, and the old municipalities likewise. The hospital structure is undergoing similar reforms, with fewer, bigger and more specialized hospitals. Furthermore, a more centralized approach to planning and regulation has been taking place over recent years. This is evident in the new national planning of medical specialties as well as the establishment of a nationwide accreditation system, the Danish Healthcare Quality Programme, which sets national standards for health system providers in Denmark. Efforts have also been made to ensure coherent patient pathways - at the moment for cancer and heart disease - that are similar nationwide. These efforts also aim at improving intersectoral cooperation. Financially, recent years have seen the introduction of a higher degree of activity-based financing in the public health sector, combined with the traditional global budgeting.A number of challenges remain in the Danish health care system. The consequences of the recent reforms and centralization initiatives are yet to be fully evaluated. Before this happens, a full overview of what future reforms should target is not possible. Denmark continues to lag behind the other Nordic countries in regards to some health indicators, such as life expectancy. A number of risk factors may be the cause of this: alcohol intake and obesity continue to be problems, whereas smoking habits are improving. The level of socioeconomic inequalities in health also continues to be a challenge. The organization of the Danish health care system will have to take a number of challenges into account in the future. These include changes in disease patterns, with an ageing population with chronic and long-term diseases; ensuring sufficient staffing

  6. Hungary health system review.

    PubMed

    Gaal, Peter; Szigeti, Szabolcs; Csere, Marton; Gaskins, Matthew; Panteli, Dimitra

    2011-01-01

    Hungary has achieved a successful transition from an overly centralized, integrated Semashko-style health care system to a purchaser provider split model with output-based payment methods. Although there have been substantial increases in life expectancy in recent years among both men and women, many health outcomes remain poor, placing Hungary among the countries with the worst health status and highest rate of avoidable mortality in the EU (life expectancy at birth trailed the EU27 average by 5.1 years in 2009). Lifestyle factors especially the traditionally unhealthy Hungarian diet, alcohol consumption and smoking play a very important role in shaping the overall health of the population.In the single-payer system, the recurrent expenditure on health services is funded primarily through compulsory, non-risk-related contributions made by eligible individuals or from the state budget. The central government has almost exclusive power to formulate strategic direction and to issue and enforce regulations regarding health care. In 2009 Hungary spent 7.4% of its gross domestic product (GDP) on health, with public expenditure accounting for 69.7% of total health spending, and with health expenditure per capita ranking slightly above the average for the new EU Member States, but considerably below the average for the EU27 in 2008. Health spending has been unstable over the years, with several waves of increases followed by longer periods of cost-containment and budget cuts. The share of total health expenditure attributable to private sources has been increasing, most of it accounted for by out-of-pocket (OOP) expenses. A substantial share of the latter can be attributed to informal payments, which are a deeply rooted characteristic of the Hungarian health system and a source of inefficiency and inequity. Voluntary health insurance, on the other hand, amounted to only 7.4% of private and 2.7% of total health expenditure in 2009. Revenue sources for health have been

  7. Training Trainers in health and human rights: Implementing curriculum change in South African health sciences institutions

    PubMed Central

    2011-01-01

    Background The complicity of the South African health sector in apartheid and the international relevance of human rights as a professional obligation prompted moves to include human rights competencies in the curricula of health professionals in South Africa. A Train-the-Trainers course in Health and Human Rights was established in 1998 to equip faculty members from health sciences institutions nationwide with the necessary skills, attitudes and knowledge to teach human rights to their students. This study followed up participants to determine the extent of curriculum implementation, support needed as well as barriers encountered in integrating human rights into health sciences teaching and learning. Methods A survey including both quantitative and qualitative components was distributed in 2007 to past course participants from 1998-2006 via telephone, fax and electronic communication. Results Out of 162 past participants, 46 (28%) completed the survey, the majority of whom were still employed in academic settings (67%). Twenty-two respondents (48%) implemented a total of 33 formal human rights courses into the curricula at their institutions. Respondents were nine times more likely (relative risk 9.26; 95% CI 5.14-16.66) to implement human rights education after completing the training. Seventy-two extracurricular activities were offered by 21 respondents, many of whom had successfully implemented formal curricula. Enabling factors for implementation included: prior teaching experience in human rights, general institutional support and the presence of allies - most commonly coworkers as well as deans. Frequently cited barriers to implementation included: budget restrictions, time constraints and perceived apathy of colleagues or students. Overall, respondents noted personal enrichment and optimism in teaching human rights. Conclusion This Train-the-Trainer course provides the historical context, educational tools, and collective motivation to incorporate human

  8. Health Emergency 2003: The Spread of Drug-Related AIDS and Hepatitis C among African American and Latinos. Health Emergency Series.

    ERIC Educational Resources Information Center

    Day, Dawn

    This report is the fifth in a series detailing the impact of the injection-related AIDS epidemic on African Americans and Latinos. Ten chapters include: (1) "Health Emergency: The Spread of AIDS among African Americans Who Inject Drugs"; (2) "Health Emergency: The Spread of AIDS Among Latinos Who Inject Drugs"; (3) "A Neglected Opportunity: Drug…

  9. Living Arrangements during Childrearing Years and Later Health of African American Mothers

    ERIC Educational Resources Information Center

    Fothergill, Kate E.; Ensminger, Margaret E.; Green, Kerry M.; Thorpe, Roland J.; Robertson, Judy; Kasper, Judith D.; Juon, Hee-Soon

    2009-01-01

    Using longitudinal data from the Woodlawn Project (N = 680), this study examined how patterns of living arrangements among a community cohort of African American mothers were associated with later physical and emotional health. We identified eight patterns of stability and transition in living arrangements during the childrearing years. Health…

  10. African American College Students' Perceptions of Psychosocial Factors Influencing Racial Disparities in Health

    ERIC Educational Resources Information Center

    Zekeri, Andrew A.; Habtemariam, Tsegaye

    2006-01-01

    Objective: This study examined African American college students' perceptions of psychosocial factors that influence racial disparities in health. Methods: We conducted focus groups in two Alabama Black Belt Counties from June to August 2005. Data were collected using a standardized discussion guide, augmented by prompts for clarification.…

  11. What Makes African American Health Disparities Newsworthy? An Experiment among Journalists about Story Framing

    ERIC Educational Resources Information Center

    Hinnant, Amanda; Oh, Hyun Jee; Caburnay, Charlene A.; Kreuter, Matthew W.

    2011-01-01

    News stories reporting race-specific health information commonly emphasize disparities between racial groups. But recent research suggests this focus on disparities has unintended effects on African American audiences, generating negative emotions and less interest in preventive behaviors (Nicholson RA, Kreuter MW, Lapka C "et al." Unintended…

  12. Eliminating Health Disparities in the African American Population: The Interface of Culture, Gender, and Power

    ERIC Educational Resources Information Center

    Airhihenbuwa, Collins O.; Liburd, Leandris

    2006-01-01

    Since the release of former Secretary Margaret Heckler's "Secretary's Task Force Report on Black and Minority Health" more than two decades ago, excess death from chronic diseases and other conditions between African Americans and Whites have increased. The conclusion of that report emphasized excess death and thus clinical care, paying little…

  13. Religious Orientation and Social Support on Health-Promoting Behaviors of African American College Students

    ERIC Educational Resources Information Center

    Turner-Musa, Jocelyn O.; Wilson, Shaunqula A.

    2006-01-01

    This study examined the role of religious orientation and social support in health-promoting behaviors of African American college students. Data were collected from 211 students attending a historically Black university. Results from a 4 x 2 MANOVA revealed significant main effects for both variables. No interaction effects were observed. Post…

  14. Parental Nurturance and the Mental Health and Parenting of Urban African American Adolescent Mothers

    ERIC Educational Resources Information Center

    Lewin, Amy; Mitchell, Stephanie J.; Hodgkinson, Stacy; Burrell, Lori; Beers, Lee S. A.; Duggan, Anne K.

    2011-01-01

    This study examined the relationship between a teen mother's perceptions of nurturance from her mother and father and her mental health and parenting attitudes. One-hundred and thirty-eight urban, primarily African American adolescent mothers were interviewed. Multivariate results indicate that teen mothers who felt nurtured by their mothers had…

  15. Culture and Dental Health among African Immigrant School-Aged Children in the United States

    ERIC Educational Resources Information Center

    Obeng, Cecilia S.

    2007-01-01

    Purpose: The paper examines African immigrant parents' views on dental decay and whether such views affect their decision to obtain dental insurance for their children. The paper also examines the cultural underpinnings of the immigrants' oral health care practices. Design/methodology/approach: The data for the study were collected in the states…

  16. Yo-Yo Dieting in African American Women: Weight Cycling and Health

    PubMed Central

    Osborn, Robyn L.; Forys, Kelly L.; Psota, Tricia L.; Sbrocco, Tracy

    2014-01-01

    Objective Research on the effects of weight cycling on health is mixed, strife with inconsistent definitions and the exclusion of African Americans. This study examined weight cycling prevalence among African American women prior to enrolling in a weight management program. Associations of weight cycling with physical and psychological health were conducted. Design Cross-sectional analysis. Setting Community-based weight-management program. Participants 167 overweight or obese treatment-seeking African American women. Main Outcome Measures Weight cycling was examined in relation to physiological factors, including eating pathology, mood, self esteem, and physical health, specifically current weight, ideal weight, peak weight, and blood pressure. Results Weight cycling was prevalent (63%). Cyclers had higher current and peak weights (P<.01). Blood pressure did not differ between groups. Cyclers had higher drive for thinness, less body satisfaction, and less self-esteem for appearance (P<.05). Conclusion African American women are at risk for weight cycling and it may be associated with greater weight and poorer measures of psychological health. (Ethn Dis PMID:21942158

  17. Longitudinal associations between social support and physical and mental health in African American adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    African Americans report a greater number of modifiable risk factors, such as overweight/obesity, physical inactivity and poor dietary habits, putting them at increased risk of developing and dying from chronic diseases. These risk factors are also associated with poorer health-related quality of li...

  18. Comparative Validity of MMPI-2 Scores of African American and Caucasian Mental Health Center Clients.

    ERIC Educational Resources Information Center

    McNulty, John L.; Graham, John R.; Ben-Porath, Yossef S.; Stein, L. A. R.

    1997-01-01

    The comparative validity of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scores for 123 African American and 561 Caucasian clients from a community mental health center was studied by contrasting mean MMPI-2 scores and correlations between these scores and therapists' ratings. Correlations were not significantly different for racial…

  19. Health Risk Behaviors of African American Adolescents with Mild Mental Retardation: Prevalence Depends on Measurement Method.

    ERIC Educational Resources Information Center

    Pack, Robert P.; Browne, Dorothy; Wallander, Jan L.

    1998-01-01

    Health risk behaviors (substance use, violence, suicide, and car safety) of 194 African American urban adolescents with mild mental retardation were measured using either a confidential individual interview or an anonymous group survey. The survey methodology resulted in disclosure of more risk behaviors than the interview methodology. Elevated…

  20. Family-Level Factors and African American Children's Behavioral Health Outcomes: A Systematic Review

    ERIC Educational Resources Information Center

    Washington, Tyreasa; Rose, Theda; Colombo, Gia; Hong, Jun Sung; Coard, Stephanie Irby

    2015-01-01

    Background: Considerable prior research targeting African American children has focused on the pervasiveness of problematic behavior and negative risk factors associated with their development, however the influence of family on better behavioral health outcomes has largely been ignored. Objective: The purpose of this review is to examine…

  1. Provider Types Utilized and Recency of Mental Health Service Use among African American Emerging Adults

    PubMed Central

    Williams, Sha-Lai

    2014-01-01

    Objective This study examined factors associated with mental health service utilization among African American emerging adults, specifically, when services were used (recency) and the types of providers utilized (mental health/non-mental health). Methods Guided by the Behavioral Model for Vulnerable Populations, secondary analysis of the National Survey of American Life (2001-2003) was conducted. A nationally representative sample of African American emerging adults, ages 18-29 (n=806), were assessed using the Composite International Diagnostic Interview. “Evaluated need” was determined by endorsement for one of four DSM-IV diagnosis types (mood, anxiety, substance use, impulse control). Respondents who reported a need for services for emotional/substance use problems were considered to have a “perceived need”. Those who reported voluntary use of mental health/health services to address these problems were considered to have utilized services. Results 25%of the sample utilized services in their lifetime, while 9% utilized services in the past 12 months. Females were more likely than males to utilize services in three of the four service use categories (lifetime, mental health sector, and non-mental health sector).Respondents with an evaluated need for services were 2-12 times more likely to have utilized services compared to those without a need. Conclusions Little is known about why African American emerging adults underutilize mental health services. These findings indicate that being female and having an evaluated need for services were associated with greater odds of service use among this sample. This suggests the need for additional examination of gender differences in service utilization and greater mental health outreach/education among African American males. PMID:24981778

  2. Netherlands: Health System Review.

    PubMed

    Kroneman, Madelon; Boerma, Wienke; van den Berg, Michael; Groenewegen, Peter; de Jong, Judith; van Ginneken, Ewout

    2016-03-01

    This analysis of the Dutch health system reviews recent developments in organization and governance, health financing, healthcare provision, health reforms and health system performance. Without doubt, two major reforms implemented since the mid-2000s are among the main issues today. The newly implemented long-term care reform will have to realize a transition from publicly provided care to more self-reliance on the part of the citizens and a larger role for municipalities in its organization. A particular point of attention is how the new governance arrangements and responsibilities in long-term care will work together. The 2006 reform replaced the division between public and private insurance by one universal social health insurance and introduced managed competition as a driving mechanism in the healthcare system. Although the reform was initiated almost a decade ago, its stepwise implementation continues to bring changes in the healthcare system in general and in the role of actors in particular. In terms of performance, essential healthcare services are within easy reach and waiting times have been decreasing. The basic health insurance package and compensations for lower incomes protect citizens against catastrophic spending. Out-of-pocket payments are low from an international perspective. Moreover, the Dutch rate the quality of the health system and their health as good. International comparisons show that the Netherlands has low antibiotic use, a low number of avoidable hospitalizations and a relatively low avoidable mortality. National studies show that healthcare has made major contributions to the health of the Dutch population as reflected in increasing life expectancy. Furthermore, some indicators such as the prescription of generics and length of stay reveal improvements in efficiency over the past years. Nevertheless, the Netherlands still has one of the highest per capita health expenditures in Europe, although growth has slowed considerably after

  3. Regional analysis of convective systems during the West African monsoon

    NASA Astrophysics Data System (ADS)

    Guy, Bradley Nicholas

    The West African monsoon (WAM) occurs during the boreal summer and is responsible for a majority of precipitation in the northern portion of West Africa. A distinct shift of precipitation, often driven by large propagating mesoscale convective systems, is indicated from satellite observations. Excepting the coarser satellite observations, sparse data across the continent has prevented understanding of mesoscale variability of these important systems. The interaction between synoptic and mesoscale features appears to be an important part of the WAM system. Without an understanding of the mesoscale properties of precipitating systems, improved understanding of the feedback mechanism between spatial scales cannot be attained. Convective and microphysical characteristics of West African convective systems are explored using various observational data sets. Focus is directed toward meso -alpha and -beta scale convective systems to improve our understanding of characteristics at this spatial scale and contextualize their interaction with the larger-scale. Ground-based radar observations at three distinct geographical locations in West Africa along a common latitudinal band (Niamey, Niger [continental], Kawsara, Senegal [coastal], and Praia, Republic of Cape Verde [maritime]) are analyzed to determine convective system characteristics in each domain during a 29 day period in 2006. Ancillary datasets provided by the African Monsoon Multidisciplinary Analyses (AMMA) and NASA-AMMA (NAMMA) field campaigns are also used to place the radar observations in context. Results show that the total precipitation is dominated by propagating mesoscale convective systems. Convective characteristics vary according to environmental properties, such as vertical shear, CAPE, and the degree of synoptic forcing. Data are bifurcated based on the presence or absence of African easterly waves. In general, African easterly waves appear to enhance mesoscale convective system strength

  4. Health behaviors and all-cause mortality in African American men.

    PubMed

    Thorpe, Roland J; Wilson-Frederick, Shondelle M; Bowie, Janice V; Coa, Kisha; Clay, Olivio J; LaVeist, Thomas A; Whitfield, Keith E

    2013-07-01

    Because of the excess burden of preventable chronic diseases and premature death among African American men, identifying health behaviors to enhance longevity is needed. We used data from the Third National Health and Nutrition Examination Survey 1988-1994 (NHANES III) and the NHANES III Linked Mortality Public-use File to determine the association between health behaviors and all-cause mortality and if these behaviors varied by age in 2029 African American men. Health behaviors included smoking, drinking, physical inactivity, obesity, and a healthy eating index score. Age was categorized as 25-44 years (n = 1,045), 45-64 years (n = 544), and 65 years and older (n = 440). Cox regression analyses were used to estimate the relationship between health behaviors and mortality within each age-group. All models were adjusted for marital status, education, poverty-to-income ratio, insurance status, and number of health conditions. Being a current smoker was associated with an increased risk of mortality in the 25- to 44-year age-group, whereas being physically inactive was associated with an increased risk of mortality in the 45- to 64-year age-group. For the 65 years and older age-group, being overweight or obese was associated with decreased mortality risk. Efforts to improve longevity should focus on developing age-tailored health promoting strategies and interventions aimed at smoking cessation and increasing physical activity in young and middle-aged African American men. PMID:23649171

  5. Turkey. Health system review.

    PubMed

    Tatar, Mehtap; Mollahaliloğlu, Salih; Sahin, Bayram; Aydin, Sabahattin; Maresso, Anna; Hernández-Quevedo, Cristina

    2011-01-01

    Turkey has accomplished remarkable improvements in terms of health status in the last three decades, particularly after the implementation of the Health Transformation Program (HTP (Saglikta Donus, um Programi)). Average life expectancy reached 71.8 for men and 76.8 for women in 2010. The infant mortality rate (IMR) decreased to 10.1 per 1000 live births in 2010, down from 117.5 in 1980. Despite these achievements, there are still discrepancies in terms of infant mortality between rural and urban areas and different parts of the country, although these have been diminishing over the years. The higher infant mortality rates in rural areas can be attributed to low socioeconomic conditions, low female education levels and the prevalence of infectious diseases. The main causes of death are diseases of the circulatory system followed by malignant neoplasms. Turkeys health care system has been undergoing a far-reaching reform process (HTP) since 2003 and radical changes have occurred both in the provision and the financing of health care services. Health services are now financed through a social security scheme covering the majority of the population, the General Health Insurance Scheme (GHIS (Genel Saglik Sigortasi)), and services are provided both by public and private sector facilities. The Social Security Institution (SSI (Sosyal Guvenlik Kurumu)), financed through payments by employers and employees and government contributions in cases of budget deficit, has become a monopsonic (single buyer) power on the purchasing side of health care services. On the provision side, the Ministry of Health (Saglik Bakenligi) is the main actor and provides primary, secondary and tertiary care through its facilities across the country. Universities are also major providers of tertiary care. The private sector has increased its range over recent years, particularly after arrangements paved the way for private sector provision of services to the SSI. The most important reforms since

  6. Challenges associated with tracking resources allocation for reproductive health in sub-Saharan African countries: the UNFPA/NIDI resource flows project experience.

    PubMed

    Sidze, Estelle M; Beekink, Erik; Maina, Beatrice W

    2015-01-01

    Universal access to reproductive health services entails strengthening health systems, but requires significant resource commitments as well as efficient and effective use of those resources. A number of international organizations and governments in developing countries are putting efforts into tracking the flow of health resources in order to inform resource mobilization and allocation, strategic planning, priority setting, advocacy and general policy making. The UNFPA/NIDI-led Resource Flows Project ("The UNFPA/NIDI RF Project") has conducted annual surveys since 1997 to monitor progress achieved by developing countries in implementing reproductive health financial targets. This commentary summarizes the Project experiences and challenges in gathering data on allocation of resources for reproductive health at the domestic level in sub-Saharan African countries. One key lesson learnt from the Project experience is the need for strengthening tracking mechanisms in sub-Saharan African countries and making information on reproductive health resources and expenditures available, in particular the private sector resources. PMID:26012472

  7. On the Move to Better Heart Health for African Americans

    MedlinePlus

    ... to the doctor, take all of your medicine bottles with you. Your health and your family’s health ... and bologna ■ Liver, chitterlings, and other organ meats ■ Egg yolks (no more than four per week) ■ Lard, ...

  8. Mechanisms linking the social environment to health in African Americans

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The social environment may influence health directly or indirectly through psychosocial factors, such as perceived stress, depressive symptoms and discrimination. This study explored potential psychosocial mediators of the associations between the social environment and physical and mental health in...

  9. Mediators of Discrimination and Self-rated Health among African Americans

    PubMed Central

    Cuevas, Adolfo G.; Reitzel, Lorraine R.; Cao, Yumei; Nguyen, Nga; Wetter, David W.; Adams, Claire E.; Watkins, Kellie L.; Regan, Seann D.; McNeill, Lorna H.

    2013-01-01

    Objectives To examine whether stress and depressive symptoms mediated relationships of perceived discrimination and self-rated health among African Americans. Methods A nonparametric bootstrapping procedure was used to assess mediation, controlling for sociodemographic variables, among 1406 cohort study adults (age=45.5±12.6, 25.1% male). Results Greater discrimination was associated with poorer self-rated health (β=−.010, SE=.003, p = .001). Stress and depressive symptoms were each significant mediators of this relationship in single and multiple mediator models (ps ≤ 05). Conclusions Perceived discrimination may contribute to poorer self-rated health among African Americans through heightened levels of stress and depression. Interventions addressing these mechanisms might help reduce the impact of discrimination on health. Definitive results await longitudinal study designs to assess causal pathways. PMID:24001623

  10. Struggling to survive: sexual assault, poverty, and mental health outcomes of African American women.

    PubMed

    Bryant-Davis, Thema; Ullman, Sarah E; Tsong, Yuying; Tillman, Shaquita; Smith, Kimberly

    2010-01-01

    A substantial body of research documents the mental health consequences of sexual assault including, but not limited to, depression, posttraumatic stress disorder, substance use, and suicidality. Far less attention has been given to the mental health effects of sexual assault for ethnic minority women or women living in poverty. Given African American women's increased risk for sexual assault and increased risk for persistent poverty, the current study explores the relationship between income and mental health effects within a sample of 413 African American sexual assault survivors. Hierarchical regression analyses revealed that after controlling for childhood sexual abuse there were positive relationships between poverty and mental health outcomes of depression, posttraumatic stress disorder, and illicit drug use. There was no significant relationship between poverty and suicidal ideation. Counseling and research implications are discussed. PMID:20397989

  11. African American consumers' perceptions of racial disparities in mental health services.

    PubMed

    Newhill, Christina E; Harris, Daniel

    2007-01-01

    In 2001, former Surgeon General, Dr. David Satcher, reported that minorities in the United States suffer a disproportionate burden of mental illness because of a large gap between the need for mental health services and the services actually provided. While research findings and policy analyses show that racial disparities exist, there has been little exploration of how minority recipients of mental health services perceive such disparities. This paper reports findings from a study using consumer focus groups with African Americans to explore how African American mental health consumers perceive and personally experience the impact of racial disparities in accessing and utilizing mental health services. Findings showed that the consumers voiced similar concerns to those reported by the Surgeon General; however, they also identified problems in communicating with providers as a major obstacle to seeking services and engaging in treatment. The consumers suggested a number of specific recommendations to improve services in their community. PMID:19306590

  12. Summary and Final Recommendations of the University System of Georgia's African-American Male Initiative.

    ERIC Educational Resources Information Center

    Georgia Univ. System, Atlanta. Board of Regents.

    In 2000, the University System of Georgia (USG) verified that USG institutions enrolled a low percentage of African American males in comparison with the percentage of African American males in the state's population. In 2001, the USG developed a special funding initiative to conduct a study of barriers to the participation of African American…

  13. Strengthening health systems by health sector reforms

    PubMed Central

    Senkubuge, Flavia; Modisenyane, Moeketsi; Bishaw, Tewabech

    2014-01-01

    Background The rising burden of disease and weak health systems are being compounded by the persistent economic downturn, re-emerging diseases, and violent conflicts. There is a growing recognition that the global health agenda needs to shift from an emphasis on disease-specific approaches to strengthening of health systems, including dealing with social, environmental, and economic determinants through multisectoral responses. Methods A review and analysis of data on strengthening health sector reform and health systems was conducted. Attention was paid to the goal of health and interactions between health sector reforms and the functions of health systems. Further, we explored how these interactions contribute toward delivery of health services, equity, financial protection, and improved health. Findings Health sector reforms cannot be developed from a single global or regional policy formula. Any reform will depend on the country's history, values and culture, and the population's expectations. Some of the emerging ingredients that need to be explored are infusion of a health systems agenda; development of a comprehensive policy package for health sector reforms; improving alignment of planning and coordination; use of reliable data; engaging ‘street level’ policy implementers; strengthening governance and leadership; and allowing a holistic and developmental approach to reforms. Conclusions The process of reform needs a fundamental rather than merely an incremental and evolutionary change. Without radical structural and systemic changes, existing governance structures and management systems will continue to fail to address the existing health problems. PMID:24560261

  14. Benefits of community-based education to the community in South African health science facilities

    PubMed Central

    Flack, Penny

    2013-01-01

    Abstract Background Community-based education (CBE) is utilised by health science faculties worldwide to provide a relevant primary care experience for students and a service to underserved communities and, hopefully, to affect student career choices. The benefits to training institutions and students are well documented, but it may well be that communities, too, will be able to benefit from a more balanced partnership, where they are consulted in the planning of such training programmes. Method An exploratory qualitative study was undertaken by three South African universities in the provinces of Limpopo, KwaZulu-Natal and the Western Cape. Focus group interviews were conducted in their local languages with groups of community leaders, patients and supervisors at community sites involved in CBE training. A thematic analysis of their views was undertaken with the aid of NVivo (version 9). Ethics approval was obtained from the respective universities and health care training sites. Results Benefits to the community could be categorised into short-term and long-term benefits. Short-term benefits included improved service delivery, reduction in hospital referrals, home visits and community orientated primary health care, improved communication with patients and enhanced professionalism of the health care practitioner. Long-term benefits included improved teaching through a relationship with an academic institution and student familiarity with the health care system. Students also became involved in community upliftment projects, thereby acting as agents of change in these communities. Conclusion Communities can certainly benefit from well-planned CBE programmes involving a training site - community site partnership.

  15. What makes African American health disparities newsworthy? An experiment among journalists about story framing

    PubMed Central

    Hinnant, Amanda; Oh, Hyun Jee; Caburnay, Charlene A.; Kreuter, Matthew W.

    2011-01-01

    News stories reporting race-specific health information commonly emphasize disparities between racial groups. But recent research suggests this focus on disparities has unintended effects on African American audiences, generating negative emotions and less interest in preventive behaviors (Nicholson RA, Kreuter MW, Lapka C et al. Unintended effects of emphasizing disparities in cancer communication to African-Americans. Cancer Epidemiol Biomarkers Prev 2008; 17: 2946–52). They found that black adults are more interested in cancer screening after reading about the progress African Americans have made in fighting cancer than after reading stories emphasizing disparities between blacks and whites. This study builds on past findings by (i) examining how health journalists judge the newsworthiness of stories that report race-specific health information by emphasizing disparities versus progress and (ii) determining whether these judgments can be changed by informing journalists of audience reactions to disparity versus progress framing. In a double-blind-randomized experiment, 175 health journalists read either a disparity- or progress-framed story on colon cancer, preceded by either an inoculation about audience effects of such framing or an unrelated (i.e. control) information stimuli. Journalists rated the disparity-frame story more favorably than the progress-frame story in every category of news values. However, the inoculation significantly increased positive reactions to the progress-frame story. Informing journalists of audience reactions to race-specific health information could influence how health news stories are framed. PMID:21911844

  16. A survey of African American physicians on the health effects of climate change.

    PubMed

    Sarfaty, Mona; Mitchell, Mark; Bloodhart, Brittany; Maibach, Edward W

    2014-12-01

    The U.S. National Climate Assessment concluded that climate change is harming the health of many Americans and identified people in some communities of color as particularly vulnerable to these effects. In Spring 2014, we surveyed members of the National Medical Association, a society of African American physicians who care for a disproportionate number of African American patients, to determine whether they were seeing the health effects of climate change in their practices; the response rate was 30% (n = 284). Over 86% of respondents indicated that climate change was relevant to direct patient care, and 61% that their own patients were already being harmed by climate change moderately or a great deal. The most commonly reported health effects were injuries from severe storms, floods, and wildfires (88%), increases in severity of chronic disease due to air pollution (88%), and allergic symptoms from prolonged exposure to plants or mold (80%). The majority of survey respondents support medical training, patient and public education regarding the impact of climate change on health, and advocacy by their professional society; nearly all respondents indicated that the US should invest in significant efforts to protect people from the health effects of climate change (88%), and to reduce the potential impacts of climate change (93%). These findings suggest that African American physicians are currently seeing the health impacts of climate change among their patients, and that they support a range of responses by the medical profession, and public policy makers, to prevent further harm. PMID:25464138

  17. A Survey of African American Physicians on the Health Effects of Climate Change

    PubMed Central

    Sarfaty, Mona; Mitchell, Mark; Bloodhart, Brittany; Maibach, Edward W

    2014-01-01

    The U.S. National Climate Assessment concluded that climate change is harming the health of many Americans and identified people in some communities of color as particularly vulnerable to these effects. In Spring 2014, we surveyed members of the National Medical Association, a society of African American physicians who care for a disproportionate number of African American patients, to determine whether they were seeing the health effects of climate change in their practices; the response rate was 30% (n = 284). Over 86% of respondents indicated that climate change was relevant to direct patient care, and 61% that their own patients were already being harmed by climate change moderately or a great deal. The most commonly reported health effects were injuries from severe storms, floods, and wildfires (88%), increases in severity of chronic disease due to air pollution (88%), and allergic symptoms from prolonged exposure to plants or mold (80%). The majority of survey respondents support medical training, patient and public education regarding the impact of climate change on health, and advocacy by their professional society; nearly all respondents indicated that the US should invest in significant efforts to protect people from the health effects of climate change (88%), and to reduce the potential impacts of climate change (93%). These findings suggest that African American physicians are currently seeing the health impacts of climate change among their patients, and that they support a range of responses by the medical profession, and public policy makers, to prevent further harm. PMID:25464138

  18. Belarus: health system review.

    PubMed

    Richardson, Erica; Malakhova, Irina; Novik, Irina; Famenka, Andrei

    2013-01-01

    This analysis of the Belarusian health system reviews the developments in organization and governance, health financing, healthcare provision, health reforms and health system performance since 2008. Despite considerable change since independence, Belarus retains a commitment to the principle of universal access to health care, provided free at the point of use through predominantly state-owned facilities, organized hierarchically on a territorial basis. Incremental change, rather than radical reform, has also been the hallmark of health-care policy, although capitation funding has been introduced in some areas and there have been consistent efforts to strengthen the role of primary care. Issues of high costs in the hospital sector and of weaknesses in public health demonstrate the necessity of moving forward with the reform programme. The focus for future reform is on strengthening preventive services and improving the quality and efficiency of specialist services. The key challenges in achieving this involve reducing excess hospital capacity, strengthening health-care management, use of evidence-based treatment and diagnostic procedures, and the development of more efficient financing mechanisms. Involving all stakeholders in the development of further reform planning and achieving consensus among them will be key to its success. PMID:24334702

  19. Physical Health Screenings Among African-American Church and Community Members.

    PubMed

    Moore, Erin W; Berkley-Patton, Jannette Y; Berman, Marcie; Burleson, Christine; Judah, Abigail

    2016-10-01

    This study sought to identify characteristics, including religiosity, related to having received health screenings among persons who attend African-American churches or receive church-based community outreach services. A sample of 602 was recruited during two phases as part of a larger project. Blood pressure, cholesterol, and blood glucose screenings were the most frequently reported screenings ever and in the last 12 months. Although religiosity was significantly related to several of the health screenings in bivariate analysis, it is not a predictor of health screenings in multivariate analyses. Innovative strategies are needed to promote screenings such as church-based health fairs. PMID:27272330

  20. Sexual Health Information Networks: What are Urban African American Youth Learning?

    PubMed Central

    Dolcini, M. Margaret; Catania, Joseph A.; Harper, Gary W.; Boyer, Cherrie B.; Richards, Kimberly A. M.

    2012-01-01

    This qualitative study examined sexual health information networks among urban African American youth living in low-income communities. The authors identified sources, message content, and utility of messages about sex and sexual health in a sample of 15–17-year olds (N = 81). Youth received sexual health information from a variety of sources. Messages from parents and sex education had high utility, whereas messages from the Internet and religion had low utility. Four information network patterns were identified, suggesting considerable variation in how youth are socialized regarding sex. Findings suggest that sexual information networks have the potential to affect sexual health and development. PMID:22505842

  1. Sweden health system review.

    PubMed

    Anell, Anders; Glenngård, Anna H; Merkur, Sherry

    2012-01-01

    Life expectancy in Sweden is high and the country performs well in comparisons related to disease-oriented indicators of health service outcomes and quality of care. The Swedish health system is committed to ensuring the health of all citizens and abides by the principles of human dignity, need and solidarity, and cost-effectiveness. The state is responsible for overall health policy, while the funding and provision of services lies largely with the county councils and regions. The municipalities are responsible for the care of older and disabled people. The majority of primary care centres and almost all hospitals are owned by the county councils. Health care expenditure is mainly tax funded (80%) and is equivalent to 9.9% of gross domestic product (GDP) (2009). Only about 4% of the population has voluntary health insurance (VHI). User charges fund about 17% of health expenditure and are levied on visits to professionals, hospitalization and medicines. The number of acute care hospital beds is below the European Union (EU) average and Sweden allocates more human resources to the health sector than most OECD countries. In the past, the Achilles heel of Swedish health care included long waiting times for diagnosis and treatment and, more recently, divergence in quality of care between regions and socioeconomic groups. Addressing long waiting times remains a key policy objective along with improving access to providers. Recent principal health reforms over the past decade relate to: concentrating hospital services; regionalizing health care services, including mergers; improving coordinated care; increasing choice, competition and privatization in primary care; privatization and competition in the pharmacy sector; changing co-payments; and increasing attention to public comparison of quality and efficiency indicators, the value of investments in health care and responsiveness to patients needs. Reforms are often introduced on the local level, thus the pattern of

  2. African American Women's Beliefs, Coping Behaviors, and Barriers to Seeking Mental Health Services

    PubMed Central

    Ward, Earlise C.; Clark, Le Ondra; Heidrich, Susan

    2010-01-01

    Little is known about African American women's beliefs about mental illness. In this qualitative study we employed the Common Sense Model (CSM) to examine African American women's beliefs about mental illness, coping behaviors, barriers to treatment seeking, and variations in beliefs, coping, and barriers associated with aging. Fifteen community-dwelling African American women participated in individual interviews. Dimensional analysis, guided by the CSM, showed that participants believed general, culturally specific, and age-related factors can cause mental illness. They believed mental illness is chronic, with negative health outcomes. Participants endorsed the use of prayer and counseling as coping strategies, but were ambivalent about the use of medications. Treatment-seeking barriers included poor access to care, stigma, and lack of awareness of mental illness. Few age differences were found in beliefs, coping behaviors, and barriers. Practice and research implications are discussed. PMID:19843967

  3. System health monitoring

    SciTech Connect

    Reneke, J.A.; Fryer, M.O.

    1995-08-01

    Well designed large systems include many instrument taking data. These data are used in a variety of ways. They are used to control the system and its components, to monitor system and component health, and often for historical or financial purposes. This paper discusses a new method of using data from low level instrumentation to monitor system and component health. The method uses the covariance of instrument outputs to calculate a measure of system change. The method involves no complicated modeling since it is not a parameter estimation algorithm. The method is iterative and can be implemented on a computer in real time. Examples are presented for a metal lathe and a high efficiency particulate air (HEPA) filter. It is shown that the proposed method is quite sensitive to system changes such as wear out and failure. The method is useful for low level system diagnostics and fault detection.

  4. How do African American men rate their health care? An analysis of the consumer assessment of health plans 2003-2006.

    PubMed

    Elder, Keith; Meret-Hanke, Louise; Dean, Caress; Wiltshire, Jacqueline; Gilbert, Keon L; Wang, Jing; Shacham, Enbal; Barnidge, Ellen; Baker, Elizabeth; Wray, Ricardo; Rice, Shahida; Johns, Marquisha; Moore, Tondra

    2015-05-01

    African American (AA) men remain one of the most disconnected groups from health care. This study examines the association between AA men's rating of health care and rating of their personal physician. The sample included 12,074 AA men aged 18 years or older from the 2003 to 2006 waves of the Consumer Assessment of Healthcare Providers and Systems Adult Commercial Health Plan Survey. Multilevel models were used to obtain adjusted means rating of health care systems and personal physician, and the relationship of ratings with the rating of personal physician. The adjusted means were 80 (on a 100-point scale) for most health ratings and composite health care scores: personal physician (83.9), specialist (83.66), health care (82.34), getting needed care (89.57), physician communication (83.17), medical staff courtesy (86.58), and customer service helpfulness (88.37). Physician communication was the strongest predictor for physician rating. AA men's health is understudied, and additional research is warranted to improve how they interface with the health care system. PMID:24785426

  5. Greece: Health system review.

    PubMed

    Economou, Charalambos

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The health status of the Greek population has strongly improved over the last few decades and seems to compare relatively favourably with other OECD and European Union (EU) countries. The health system is a mixture of public integrated, public contract and public reimbursement models, comprising elements from both the public and private sectors and incorporating principles of different organizational patterns. Access to services is based on citizenship as well as on occupational status.The system is financed by the state budget, social insurance contributions and private payments.The largest share of health expenditure constitutes private expenditure, mainly in the form of out of pocket payments which is also the element contributing most to the overall increase in health expenditure. The delivery of health care services is based on both public and private providers. The presence of private providers is more obvious in primary care,especially in diagnostic technologies, private physicians' practices and pharmaceuticals. Despite success in improving the health of the population, the Greek health care system faces serious structural problems concerning the organization, financing and delivery of services. It suffers from the absence of cost-containment measures and defined criteria for funding, resulting in sickness funds experiencing economic constraints and budget deficits. The high percentage of private expenditure goes against the principle of fair

  6. African American Children and Mental Health. Child Psychology and Mental Health

    ERIC Educational Resources Information Center

    Hill, Nancy E., Ed.; Mann, Tammy L., Ed.; Fitzgerald, Hiram E., Ed.

    2011-01-01

    This groundbreaking two-volume set examines the psychological, social, physical, and environmental factors that undermine or support healthy development in African American children while considering economic, historical, and public policies. African American children are at the highest risk for becoming school dropouts, for academic disengagement…

  7. [Health system of Vietnam].

    PubMed

    Matsuda, S

    1994-01-01

    Vietnam's health system consists of four levels: national, provincial/special city, prefecture/ward, and basic unit of town or village. Health care is managed by the Health Department at the national level and by the health and welfare section of the People's Committee at all other levels. Actual medical services are provided by the National Central Hospital at the national level, by general hospitals at the provincial/special city level, by general hospitals and multi-purpose health clinics at the prefecture/ward level, and by health stations at the basic unit level. Health services provide not only doctors, nurses, and pharmacists, but also paramedical staff, especially at the basic unit level. Just as with other developing countries, infectious diseases are the most important priorities in health/medical care policies; especially malaria, which is the number one priority followed by diarrhea. Because of well-established health stations at the basic unit level throughout the country and a relatively sufficient supply of medication, the mortality rate due to the above is low. The maternal/infant health care index of 1988 shows the following: low birth weight (14%); maternal mortality (1.4/1000); neonatal mortality (33.5/1000); and perinatal mortality (22.5/1000). Malnutrition of children under 3 years of age in farming areas, insufficient supply of drinking water, and lack of industrial health insurance are some of the problems yet to be solved. It is hoped that medical services can be a significant part of the comprehensive economic development program within the framework of Japan's international cooperation/assistance. PMID:8111100

  8. "Let's get moving: let's get praising:" promoting health and hope in an African American church.

    PubMed

    Williamson, Wanda; Kautz, Donald D

    2009-01-01

    Stroke and cardiovascular disease are major health problems for African Americans. This article describes challenges, strategies employed, and successes in implementing a combination "faith-based" and "faith-placed" health promotion program called the BLESS Project in a small rural church in North Carolina. The project was implemented by a congregational nurse who teaches nursing at a nearby HBCU and students with a grant from a local agency and partnerships with local health-care agencies. Despite numerous challenges in implementing the project, it was successful in increasing awareness of stroke and heart disease and the need for improving diet and increasing physical activity. Research is needed to test the efficacy of combining faith-based and faith-placed activities in preventing cardiovascular disease in African Americans. PMID:19927895

  9. Disease Messaging in Churches: Implications for Health in African-American Communities.

    PubMed

    Harmon, Brook E; Chock, Marci; Brantley, Elizabeth; Wirth, Michael D; Hébert, James R

    2016-08-01

    Using the right messaging strategies, churches can help promote behavior change. Frequencies of disease-specific messages in 21 African-American churches were compared to overall and cancer-specific mortality and morbidity rates as well as church-level variables. Disease messages were found in 1025 of 2166 items. Frequently referenced topics included cancer (n = 316), mental health conditions (n = 253), heart disease (n = 246), and infectious diseases (n = 220). Messages for lung and colorectal cancers appeared at low frequency despite high mortality rates in African-American communities. Season, church size, and denomination showed significant associations with health messages. Next steps include testing messaging strategies aimed at improving the health of churchgoing communities. PMID:26296703

  10. African Americans: Disparities in Health Care Access and Utilization

    ERIC Educational Resources Information Center

    Copeland, Valire Carr

    2005-01-01

    Despite remarkable improvements in the overall health of the nation during the past two decades, compelling evidence suggests that the nation's racial and ethnic minority Americans suffer increasing disparities in the incidence, prevalence, mortality, and burden of diseases and adverse health outcomes compared with white Americans. The 1998…

  11. Norway: health system review.

    PubMed

    Ringard, Ånen; Sagan, Anna; Sperre Saunes, Ingrid; Lindahl, Anne Karin

    2013-01-01

    Norways five million inhabitants are spread over nearly four hundred thousand square kilometres, making it one of the most sparsely populated countries in Europe. It has enjoyed several decades of high growth, following the start of oil production in early 1970s, and is now one of the richest countries per head in the world. Overall, Norways population enjoys good health status; life expectancy of 81.53 years is above the EU average of 80.14, and the gap between overall life expectancy and healthy life years is around half the of EU average. The health care system is semi decentralized. The responsibility for specialist care lies with the state (administered by four Regional Health Authorities) and the municipalities are responsible for primary care. Although health care expenditure is only 9.4% of Norways GDP (placing it on the 16th place in the WHO European region), given Norways very high value of GDP per capita, its health expenditure per head is higher than in most countries. Public sources account for over 85% of total health expenditure; the majority of private health financing comes from households out-of-pocket payments.The number of practitioners in most health personnel groups, including physicians and nurses, has been increasing in the last few decades and the number of health care personnel per 100 000 inhabitants is high compared to other EU countries. However, long waiting times for elective care continue to be a problem and are cause of dissatisfaction among the patients. The focus of health care reforms has seen shifts over the past four decades. During the 1970s the focus was on equality and increasing geographical access to health care services; during the 1980s reforms aimed at achieving cost containment and decentralizing health care services; during the 1990s the focus was on efficiency. Since the beginning of the millennium the emphasis has been given to structural changes in the delivery and organization of health care and to policies

  12. Obesity and Body Ideals in the Media: Health and Fitness Practices of Young African-American Women

    ERIC Educational Resources Information Center

    Duncan, Margaret Carlisle; Robinson, T. Tavita

    2004-01-01

    This study explores the female body ideal and its implications for health and fitness practices in African-American culture. Employing Patricia Hill Collins's (1986) notion of the "outsider-within," we analyze a focus group discussion on women's body ideals, exercise, and fitness. Our group comprises 9 young, college-educated African-American…

  13. Comparison of African American and Afro-Caribbean Older Adults' Self-Reported Health Status, Function, and Substance Use

    ERIC Educational Resources Information Center

    Keane, Florence; Tappen, Ruth M.; Williams, Christine L.; Rosselli, Monica

    2009-01-01

    African American and Afro-Caribbean elders differ in regard to ethnic group membership, place of birth, and years of residence in the United States. In this study, the authors compare self-rated health status, function, and reports of substance use in these two groups. Fifty low-income African American and fifty low-income Afro-Caribbean adults…

  14. Socioeconomic inequalities in informal payments for health care: An assessment of the 'Robin Hood' hypothesis in 33 African countries.

    PubMed

    Kankeu, Hyacinthe Tchewonpi; Ventelou, Bruno

    2016-02-01

    In almost all African countries, informal payments are frequently made when accessing health care. Some literature suggests that the informal payment system could lead to quasi-redistribution among patients, with physicians playing a 'Robin Hood' role, subsidizing the poor at the expense of the rich. We empirically tested this assumption with data from the rounds 3 and 5 of the Afrobarometer surveys conducted in 18 and 33 African countries respectively, from 2005 to 2006 for round 3 and from 2011 to 2013 for round 5. In these surveys, nationally representative samples of people aged 18 years or more were randomly selected in each country, with sizes varying between 1048 and 2400 for round 3 and between 1190 and 2407 for round 5. We used the 'normalized' concentration index, the poor/rich gap and the odds ratio to assess the level of inequality in the payment of bribes to access care at the local public health facility and implemented two decomposition techniques to identify the contributors to the observed inequalities. We obtained that: i) the socioeconomic gradient in informal payments is in favor of the rich in almost all countries, indicating a rather regressive system; ii) this is mainly due to the socioeconomic disadvantage itself, to poor/rich differences in supply side factors like lack of medicines, absence of doctors and long waiting times, as well as regional disparities. Although essentially empirical, the paper highlights the need for African health systems to undergo substantial country-specific reforms in order to better protect the worse-off from financial risk when they seek care. PMID:26808336

  15. M-Health: Emerging Mobile Health Systems

    NASA Astrophysics Data System (ADS)

    Istepanian, Robert; Laxminarayan, Swamy; Pattichis, Constantinos S.

    M-health can be defined as the "emerging mobile communications and network technologies for healthcare systems.' This book paves the path toward understanding the future of m-health technologies and services and also introducing the impact of mobility on existing e-health and commercial telemedical systems. M-Health: Emerging Mobile Health Systems presents a new and forward-looking source of information that explores the present and future trends in the applications of current and emerging wireless communication and network technologies for different healthcare scenaria.

  16. Religion and health connection: a study of African American, Protestant Christians.

    PubMed

    Gonnerman, Melvin E; Lutz, Gene M; Yehieli, Michele; Meisinger, Bruce K

    2008-02-01

    The roles religious and health promoting behaviors may play in bolstering positive physical and emotional health were assessed using structured, face-to-face interviews conducted using a non-random community sample of 105 adult African American, Protestant Christians in a small city in a rural state in the Midwest. The interview measured health promotion, health locus of control beliefs, emotional health, physical health, religious practices, and demographics. Health promotion, church attendance, or both were related to decreased prevalence of loneliness, depression, trouble sleeping, and family problems. More than 80% of those interviewed ascribed healing power to God and prayer. There was an apparent lack of connection between respondents' attitudes about faith and healing and their actual experiences. PMID:18263995

  17. African American and European American Veterans’ Perspectives on Receiving Mental Health Treatment

    PubMed Central

    Castro, Frank; AhnAllen, Christopher G.; Wiltsey-Stirman, Shannon; Lester-Williams, Kristin; Klunk-Gillis, Julie; Dick, Alexandra M.; Resick, Patricia A.

    2015-01-01

    Little is known about client attitudes, especially Veterans’, toward the types of structured interventions that are increasingly being offered in public sector and VA mental health clinics, nor is the possible impact these attitudes may have on treatment engagement well understood. Previous work indicates that attitudes of African Americans and European Americans toward treatment may differ in important ways. Attitudes toward treatment have been a proposed explanation for lower treatment engagement and higher dropout rates among African Americans compared to European Americans. Yet to date, the relationship between race and attitudes toward treatment and treatment outcomes has been understudied, and findings inconclusive. The purpose of this study was to explore African American and European American Veteran attitudes toward mental health care, especially as they relate to structured treatments. Separate focus groups were conducted with 24 African American and 37 European American military Veterans. In general, both groups reported similar reasons to seek treatment and similar thoughts regarding the purpose of therapy. Differences emerged primarily regarding therapist preferences. In both groups, some participants expressed favorable opinions of structured treatments and others expressed negative views; treatment preferences did not appear to be influenced by race. PMID:25822316

  18. Overview of the 2016 South African Health Review.

    PubMed

    Padarath, Ashnie; King, Judith; Mackie, Emma-Louise; Casciola, Julia

    2016-07-01

    The Global Report on Urban Health: Equitable, Healthier Cities for Sustainable Development, issued in March 2016 by the World Health Organization and the United Nations Human Settlements Programme (UN-Habitat), emphasises the need for enhanced governance and leadership to achieve universal health coverage and the Sustainable Development Goals. Noting that a healthy population forms the foundation for 'sustainable economic growth, social stability, and full realisation of human potential', the report presents 'practical, proven solutions for working across sectors to tackle these … health challenges', and includes examples of such successes in South Africa. PMID:27384353

  19. Uzbekistan: health system review.

    PubMed

    Ahmedov, Mohir; Azimov, Ravshan; Mutalova, Zulkhumor; Huseynov, Shahin; Tsoyi, Elena; Rechel, Bernd

    2014-01-01

    Uzbekistan is a central Asian country that became independent in 1991 with the break-up of the Soviet Union. Since then, it has embarked on several major health reforms covering health care provision, governance and financing, with the aim of improving efficiency while ensuring equitable access. Primary care in rural areas has been changed to a two-tiered system, while specialized polyclinics in urban areas are being transformed into general polyclinics covering all groups of the urban population. Secondary care is financed on the basis of past expenditure and inputs (and increasingly self-financing through user fees), while financing of primary care is increasingly based on capitation. There are also efforts to improve allocative efficiency, with a slowly increasing share of resources devoted to the reformed primary health care system. Health care provision has largely remained in public ownership but nearly half of total health care expenditure comes from private sources, mostly in the form of out-of-pocket expenditure. There is a basic benefits package, which includes primary care, emergency care and care for certain disease and population categories. Yet secondary care and outpatient pharmaceuticals are not included in the benefits package for most of the population, and the reliance on private health expenditure results in inequities and catastrophic expenditure for households. While the share of public expenditure is slowly increasing, financial protection thus remains an area of concern. Quality of care is another area that is receiving increasing attention. PMID:25689490

  20. Incarceration history relative to health, substance use, and violence in a sample of vulnerable South African women: implications for health services in criminal justice settings

    PubMed Central

    Johnson, Jennifer E; Carney, Tara; Kline, Tracy; Browne, Felicia A; Wechsberg, Wendee M

    2012-01-01

    International research has suggested that women in the criminal justice system carry a higher burden of many illnesses than women in the community, especially mental health disorders, substance use disorders, sexually transmitted infections, and a history of violent victimization. Knowledge of these health disparities is often used to advocate for relevant screening and treatment services for women passing through criminal justice custody within US and European settings. However, almost all criminal justice health research has taken place in high-income countries, with little or no research taking place in other countries, especially in South Africa. This baseline analysis compares the health, substance use, and violent victimization of women who have ever been incarcerated to those who have not, in a cross-sectional sample of 720 young, vulnerable, substance-using women in Cape Town, South Africa. Results of univariate tests indicated that women who had ever been incarcerated had worse health, mental health, and sexually transmitted infection indicators and were more likely to report use of substances and to have been victims of physical and sexual assault than women who had never been incarcerated. Passing through the criminal justice system appears to be a marker for a variety of current and/or future health service needs among vulnerable South African women, suggesting that screening, prevention, and treatment referral efforts at the time of intersection with the criminal justice system may reduce health burden for these women. PMID:24474876

  1. Can countries of the WHO African Region wean themselves off donor funding for health?

    PubMed

    Kirigia, Joses Muthuri; Diarra-Nama, Alimata J

    2008-11-01

    More than 20% of total health expenditure in 48% of the 46 countries in the WHO African Region is provided by external sources. Issues surrounding aid effectiveness suggest that these countries ought to implement strategies for weaning off aid dependency. This paper broaches the following question: what are some of the strategies that countries of the region can employ to wean off donor funding for health? Five strategies are discussed: reduction in economic inefficiencies; reprioritizing public expenditures; raising additional tax revenues; increased private sector involvement in health development; and fighting corruption. PMID:19030696

  2. “Church-Based Health Programs for Mental Disorders among African Americans: A Review

    PubMed Central

    Hankerson, Sidney H.; Weissman, Myrna M.

    2014-01-01

    Objective African Americans, compared to White Americans, underutilize traditional mental health services. A systematic review is presented of studies involving church-based health promotion programs (CBHPP) for mental disorders among African Americans to assess the feasibility of utilizing such programs to address racial disparities in mental health care. Methods A literature review of MEDLINE, PsycINFO, CINAHL, and ATLA Religion databases was conducted to identify articles published between January 1, 1980 and December 31, 2009. Inclusion criteria included the following: studies were conducted in a church; primary objective(s) involved assessment, perceptions/attitudes, education, prevention, group support, or treatment for Diagnostic and Statistical Manual-IV mental disorders or their correlates; number of participants was reported; qualitative and/or quantitative data were reported; and African Americans were the target population. Results Of 1,451 studies identified, 191 studies were eligible for formal review. Only eight studies met inclusion criteria for this review. The majority of studies focused on substance related disorders (n=5), were designed to assess the effects of a specific intervention (n=6), and targeted adults (n=6). One study focused on depression and was limited by a small sample size of seven participants. Conclusion Although CBHPP have been successful in addressing racial disparities for several chronic medical conditions, the published literature on CBHPP for mental disorders is extremely limited. More intensive research is needed to establish the feasibility and acceptability of utilizing church-based health programs as a possible resource for screening and treatment to improve disparities in mental health care for African Americans. PMID:22388529

  3. Justice and justiciability: advancing solidarity and justice through South Africans' right to health jurisprudence.

    PubMed

    Forman, Lisa

    2008-09-01

    The South African Constitutional Court's jurisprudence provides a path-breaking illustration of the social justice potential of an enforceable right to health. It challenges traditional objections to social rights by showing that their enforcement need not be democratically unsound or make zero-sum claims on limited resources. Indeed the South African experience suggests that enforcing health rights may in fact contribute to greater degrees of collective solidarity and justice as the Court has sought to ensure that the basic needs of the poor are not unreasonably restricted by competing public and private interests. This approach has seen the Court adopt a novel fights paradigm which locates individual civil and social rights within a communitarian framework drawing from the traditional African notion of'ubuntu', denoting collective solidarity, humaneness and mutual responsibilities to recognize the respect, dignity and value of all members of society. Yet this jurisprudence also illustrates the limits of litigation as a tool of social transformation, and of social rights that remain embedded in ideological baggage even where they have been constitutionally entrenched and enforced. This paper explores the Constitutional Court's unfolding jurisprudence on the right to health, providing background to the constitutional entrenchment of a justiciable right to health; exploring early Constitutional Court jurisprudence on this right; turning to the forceful application of this right in relation to government policy on AIDS treatment; and concluding with thoughts about the strengths and limits of this jurisprudence in light of subsequent case-law. PMID:19004388

  4. Life-course Financial Strain and Health in African-Americans

    PubMed Central

    Thorpe, Roland J; Whitfield, Keith E

    2010-01-01

    Differential exposure to financial strain may explain some differences in population health. However, few studies have examined the cumulative health effect of financial strain across the life-course. Studies that have are limited to self-reported health measures. Our objective was to examine the associations between childhood, adulthood, and life-course, or cumulative, financial strain with disability, lung function, cognition, and depression. In a population-based cross-sectional cohort study of adult African-American twins enrolled in the US Carolina African American Twin Study of Aging (CAATSA), we found that participants who reported financial strain as children and as adults are more likely to be physically disabled, and report more depressive symptoms than their unstrained counterparts. Participants who reported childhood financial strain had lower cognitive functioning than those with no childhood financial strain. We were unable to detect a difference in lung function beyond the effect of actual income and education in those who reported financial strain compared to those who did not. Financial strain in adulthood was more consistently associated with poor health than was childhood financial strain, a finding that suggests targeting adult financial strain could help prevent disability and depression among African-American adults. PMID:20452712

  5. Trade in Educational Services: Reflections on the African and South African Higher Education System

    ERIC Educational Resources Information Center

    Sehoole, Chika Trevor

    2004-01-01

    This article discusses and analyses the emergence of globalisation and its impact on developments within the African continent. Africa's response at a regional level through the New Partnership for Africa's Development and at a subregional level through the Southern African Development Community's "Protocol on Education" come under scrutiny. These…

  6. Wearable Health Monitoring Systems

    NASA Technical Reports Server (NTRS)

    Bell, John

    2015-01-01

    The shrinking size and weight of electronic circuitry has given rise to a new generation of smart clothing that enables biological data to be measured and transmitted. As the variation in the number and type of deployable devices and sensors increases, technology must allow their seamless integration so they can be electrically powered, operated, and recharged over a digital pathway. Nyx Illuminated Clothing Company has developed a lightweight health monitoring system that integrates medical sensors, electrodes, electrical connections, circuits, and a power supply into a single wearable assembly. The system is comfortable, bendable in three dimensions, durable, waterproof, and washable. The innovation will allow astronaut health monitoring in a variety of real-time scenarios, with data stored in digital memory for later use in a medical database. Potential commercial uses are numerous, as the technology enables medical personnel to noninvasively monitor patient vital signs in a multitude of health care settings and applications.

  7. Diaspora engagement of African migrant health workers – examples from five destination countries

    PubMed Central

    Wojczewski, Silvia; Poppe, Annelien; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Pentz, Stephen; Kutalek, Ruth

    2015-01-01

    Background Migrant health workers fill care gaps in their destination countries, but they also actively engage in improving living conditions for people of their countries of origin through expatriate professional networks. This paper aims to explore the professional links that migrant health workers from sub-Saharan African countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the United Kingdom) have to their countries of origin. Design Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan Africa (N=66). A qualitative content analysis of the material was performed using the software ATLAS.ti. Results Almost all migrant health workers have professional ties with their countries of origin supporting health, education, and social structures. They work with non-governmental organizations, universities, or hospitals and travel back and forth between their destination country and country of origin. For a few respondents, professional engagement or even maintaining private contacts in their country of origin is difficult due to the political situation at home. Conclusions The results show that African migrant health workers are actively engaged in improving living conditions not only for their family members but also for the population in general in their countries of origin. Our respondents are mediators and active networkers in a globalized and transnationally connected world. The research suggests that the governments of these countries of origin could strategically use their migrant health workforce for improving education and population health in sub-Saharan Africa. Destination countries should be reminded of their need to comply with the WHO Global Code of Practice for the international recruitment of health professionals. PMID:26652910

  8. Health workforce development: a needs assessment study in French speaking African countries.

    PubMed

    Chastonay, Philippe; Moretti, Roberto; Zesiger, Véronique; Cremaschini, Marco; Bailey, Rebecca; Pariyo, George; Kabengele, Emmanuel Mpinga

    2013-05-01

    In 2006, WHO alerted the world to a global health workforce crisis, demonstrated through critical shortages of health workers, primarily in Sub-Saharan Africa (WHO in World Health Report, 2006). The objective of our study was to assess, in a participative way, the educational needs for public health and health workforce development among potential trainees and training institutions in nine French-speaking African countries. A needs assessment was conducted in the target countries according to four approaches: (1) Review at national level of health challenges. (2) Semi-directed interviews with heads of relevant training institutions. (3) Focus group discussions with key-informants. (4) A questionnaire-based study targeting health professionals identified as potential trainees. A needs assessment showed important public health challenges in the field of health workforce development among the target countries (e.g. unequal HRH distribution in the country, ageing of HRH, lack of adequate training). It also showed a demand for education and training institutions that are able to offer a training programme in health workforce development, and identified training objectives and core competencies useful to potential employers and future trainees (e.g. leadership, planning/evaluation, management, research skill). In combining various approaches our study was able to show a general demand for health managers who are able to plan, develop and manage a nation's health workforce. It also identified specific competencies that should be developed through an education and training program in public health with a focus on health workforce development. PMID:22453358

  9. The Context for Choice: Health Implications of Targeted Food and Beverage Marketing to African Americans

    PubMed Central

    Grier, Sonya A.; Kumanyika, Shiriki K.

    2008-01-01

    Targeted marketing of high-calorie foods and beverages to ethnic minority populations, relative to more healthful foods, may contribute to ethnic disparities in obesity and other diet-related chronic conditions. We conducted a systematic review of studies published in June 1992 through 2006 (n = 20) that permitted comparison of food and beverage marketing to African Americans versus Whites and others. Eight studies reported on product promotions, 11 on retail food outlet locations, and 3 on food prices. Although the evidence base has limitations, studies indicated that African Americans are consistently exposed to food promotion and distribution patterns with relatively greater potential adverse health effects than are Whites. The limited evidence on price disparities was inconclusive. PMID:18633097

  10. Depression, Social Support, and Mental Health: A Longitudinal Mediation Analysis in African American Custodial Grandmothers.

    PubMed

    Whitley, Deborah M; Kelley, Susan J; Lamis, Dorian A

    2016-03-01

    Custodial grandparents raising grandchildren experience intense levels of stress that can lead to depression and other forms of psychological distress. Drawing on a coping model of family stress, adjustment, and adaptation, we explored the relationship between depression and mental health quality of life mediated by social support and moderated by grandparent's age. The sample consisted of 667 African American custodial grandmothers, dichotomized into two age groupings, ≤55 (n = 306) and 55 + (n = 361). All grandmothers participated in a 12-month support intervention. The prospective analysis revealed social support was a mediator in the association between depressive symptoms and mental health quality of life for older African American grandmothers; however, this same relationship did not hold for their younger counterparts. Study limitations and future research directions are discussed. PMID:26798077

  11. Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region.

    PubMed

    Ogunbodede, E O; Kida, I A; Madjapa, H S; Amedari, M; Ehizele, A; Mutave, R; Sodipo, B; Temilola, S; Okoye, L

    2015-07-01

    Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations. PMID:26101336

  12. Canada: Health system review.

    PubMed

    Marchildon, Gregory

    2013-01-01

    Canada is a high-income country with a population of 33 million people. Its economic performance has been solid despite the recession that began in 2008. Life expectancy in Canada continues to rise and is high compared with most OECD countries; however, infant and maternal mortality rates tend to be worse than in countries such as Australia, France and Sweden. About 70% of total health expenditure comes from the general tax revenues of the federal, provincial and territorial governments. Most public revenues for health are used to provide universal medicare (medically necessary hospital and physician services that are free at the point of service for residents) and to subsidise the costs of outpatient prescription drugs and long-term care. Health care costs continue to grow at a faster rate than the economy and government revenue, largely driven by spending on prescription drugs. In the last five years, however, growth rates in pharmaceutical spending have been matched by hospital spending and overtaken by physician spending, mainly due to increased provider remuneration. The governance, organization and delivery of health services is highly decentralized, with the provinces and territories responsible for administering medicare and planning health services. In the last ten years there have been no major pan-Canadian health reform initiatives but individual provinces and territories have focused on reorganizing or fine tuning their regional health systems and improving the quality, timeliness and patient experience of primary, acute and chronic care. The medicare system has been effective in providing Canadians with financial protection against hospital and physician costs. However, the narrow scope of services covered under medicare has produced important gaps in coverage and equitable access may be a challenge in these areas. PMID:23628429

  13. [People of African descent in the region of the Americas and health equity].

    PubMed

    Torres, Cristina

    2002-01-01

    The Region of the Americas and the Caribbean has a complex demographic profile from an ethnic and racial perspective. One of the largest groups is composed of persons of African descent, who in some countries, such as Brazil and the Dominican Republic, comprise 46 and 84% of the total population, respectively. Recent analyses of the statistics available in some countries of the Region show wide gaps in terms of living conditions and health in these communities, as well as gaps in access to health services. PAHO, through its Public Policy and Health Program, under the Division of Health and Human Development, supports sectorial efforts and those of civil organizations that aim to improve health conditions in this segment of the population, while taking into account their sociodemographic and cultural characteristics. This article briefly summarizes health conditions and access to health services in selected countries, as well as some aspects of the recent changes to the legislation in those countries. Finally, collaborative activities on the part of United Nations agencies and international financial institutions for the benefit of people of African descent and other ethnic minorities are described. PMID:12162849

  14. Resilience: An Entry Point for African Health Promoting Schools?

    ERIC Educational Resources Information Center

    Stewart, Donald

    2014-01-01

    Purpose: The purpose of this paper is to provide a review of an Australian health promoting schools (HPS) project to identify key features of the concept of resilience and how it can be used in a school setting to develop and strengthen protective factors in young people, as a mechanism for improving social functioning and reducing involvement in…

  15. Improving Your Health: Tips for African American Men and Women

    MedlinePlus

    ... drinking, and physical activity habits may help you control your weight, feel better, and improve your health.​​​ This fact sheet will give you ideas on how to make better food and beverage choices and add physical activity to your life. ...

  16. Health and human rights a South African perspective.

    PubMed

    Naidoo, Sudeshni

    2014-01-01

    General statements of basic entitlements are established as a guide for potential laws and regulations protecting human rights. Human rights are those claimed to belong to every individual regardless of nationality or position within society. The historical evolution of human rights relative to health in the Republic of South Africa is discussed. PMID:25080665

  17. Nutrition Advertisements in Consumer Magazines: Health Implications for African Americans.

    ERIC Educational Resources Information Center

    Pratt, Charlotte A.; Pratt, Cornelius B.

    1996-01-01

    Examines the "Ladies' Home Journal" and two popular consumer magazines that target blacks to determine the proportions of food and beverage advertisements, nutrition advertisements and their promotional messages, and the health implications they reveal. Findings reveal these magazines had a significantly higher number of alcohol ads, limited…

  18. Project Sugar: a recruitment model for successful African-American participation in health research.

    PubMed

    Spruill, Ida

    2004-12-01

    Attempts to increase the number of African-Americans participating in clinical trials, regardless of age, have been hampered by a lack of published data regarding successful recruitment and retention strategies. Successful strategies can be used as a guide for future researchers in the design of studies to recruit African-Americans, regardless of age, into clinical as well as qualitative studies to promote health among this vulnerable population. The goal of the primary study was to recruit 400 families with 2 or more family members affected with diabetes, totaling 800 participants. Project Sugar utilized the coordinated research principals known as CPR (Community, Plan, Reward) to recruit 615 African-American families totalling 1,230 people known as the Sea Island people (Gullahs) in the first five years of the study. The intention of the study was to identify markers for diabetes among these Sea Island natives who tended to be genetically homogenous. In so doing, specific strategies were identified as serendipitous findings for this study. Nonetheless, these serendipitous findings were thought to be so integral to success in the recruitment of African-Americans, mainly because of their success among this fairly close-knit, historically isolated, and significantly genetically homogenous Sea Islanders (Gullah). In recognizing the success of this model, an alternate aim was examined to devise rigorous scientific strategies to promote methods for recruitment of African-Americans into clinical trials aimed at reducing health disparities among this vulnerable population. This projects success can be attributed to the involvement of a local citizen advisory committee and rewards in the form of services, benefits, and incentives to the community. Findings from this alternative aim, which was scientifically built on the CPR model, suggest that when services are provided to the community, coupled with the use of local community advisory committees, the possibilities of

  19. Tipping the scales on obesity: church-based health promotion for African American women.

    PubMed

    Cooper, Kami C; King, Michalene A; Sarpong, Daniel F

    2015-01-01

    Research suggests that over 80% of U.S. adult African American (AA) women are at risk for hypertension, cardiovascular disease, and diabetes. In 2011-2012, 56.6% of non-Hispanic Black women were obese (BMI ≥ 30 kg/m2). Project TEACH--Transforming, Empowering, and Affecting Congregation Health was designed to determine the effectiveness of a faith-based, culturally competent, nutrition and exercise program targeting AA women in a church setting. PMID:25585468

  20. Croatia: health system review.

    PubMed

    Džakula, Aleksandar; Sagan, Anna; Pavić, Nika; Lonćčarek, Karmen; Sekelj-Kauzlarić, Katarina

    2014-01-01

    Croatia is a small central European country on the Balkan peninsula, with a population of approximately 4.3 million and a gross domestic product (GDP) of 62% of the European Union (EU) average (expressed in purchasing power parity; PPP) in 2012. On 1 July 2013, Croatia became the 28th Member State of the EU. Life expectancy at birth has been increasing steadily in Croatia (with a small decline in the years following the 1991 to 1995 War of Independence) but is still lower than the EU average. Prevalence of overweight and obesity in the population has increased during recent years and trends in physical inactivity are alarming. The Croatian Health Insurance Fund (CHIF), established in 1993, is the sole insurer in the mandatory health insurance (MHI) system that provides universal health coverage to the whole population. The ownership of secondary health care facilities is distributed between the State and the counties. The financial position of public hospitals is weak and recent reforms were aimed at improving this. The introduction of concessions in 2009 (public private partnerships whereby county governments organize tenders for the provision of specific primary health care services) allowed the counties to play a more active role in the organization, coordination and management of primary health care; most primary care practices have been privatized. The proportion of GDP spent on health by the Croatian government remains relatively low compared to western Europe, as does the per capita health expenditure. Although the share of public expenditure as a proportion of total health expenditure (THE) has been decreasing, at around 82% it is still relatively high, even by European standards. The main source of the CHIFs revenue is compulsory health insurance contributions, accounting for 76% of the total revenues of the CHIF, although only about a third of the population (active workers) is liable to pay full health care contributions. Although the breadth and scope

  1. Health status attributes of older African-American adults with hearing loss.

    PubMed

    Pugh, Kenneth C

    2004-06-01

    This article describes a study that examined hearing loss and health-related quality of life (HRQoL) attributes of 71 African-American older adults ranging in age from 60 to 89 years. Demographic profiles were used to obtain pertinent case histories, audiometric testing was used to obtain estimates of peripheral hearing sensitivity, and middle-ear integrity was assessed via tympanometry. The health status (i.e., HRQoL) attributes were determined via self-report scores on the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Results from bivariate analyses determined statistically significant correlations between hearing loss and lower SF-36 scores across subscales. Multivariate regression models revealed a statistically significant impact between hearing loss and lower SF-36 scores across subscales, even after controlling for experimental confounds. These findings suggest that hearing loss is capable of contributing to HRQoL deficits in African-American older adults. The importance of these data in terms of pre-existing attitudes of African-American older adults towards hearing healthcare services and long-term effects of untreated hearing loss are considered. PMID:15233487

  2. African Indigenous Knowledge Systems and Relevance of Higher Education in South Africa

    ERIC Educational Resources Information Center

    Kaya, Hassan O.; Seleti, Yonah N.

    2013-01-01

    The higher education system in Africa and South Africa in particular, is still too academic and distant from the developmental challenges of African local communities. The integration of African indigenous knowledge systems (AIKS) into the higher educational system could improve its relevance. This is due to the holistic, community-based nature…

  3. Inductive System Health Monitoring

    NASA Technical Reports Server (NTRS)

    Iverson, David L.

    2004-01-01

    The Inductive Monitoring System (IMS) software was developed to provide a technique to automatically produce health monitoring knowledge bases for systems that are either difficult to model (simulate) with a computer or which require computer models that are too complex to use for real time monitoring. IMS uses nominal data sets collected either directly from the system or from simulations to build a knowledge base that can be used to detect anomalous behavior in the system. Machine learning and data mining techniques are used to characterize typical system behavior by extracting general classes of nominal data from archived data sets. IMS is able to monitor the system by comparing real time operational data with these classes. We present a description of learning and monitoring method used by IMS and summarize some recent IMS results.

  4. Childhood lead exposure in an enslaved African community in Barbados: implications for birthplace and health status.

    PubMed

    Schroeder, Hannes; Shuler, Kristrina A; Chenery, Simon R

    2013-02-01

    Lead was ubiquitous on Caribbean sugar plantations, where it was used extensively in the production of sugar and rum. Previous studies suggest that skeletal lead contents can be used to identify African-born individuals (as opposed to Creoles) among slave burials found in the New World. To test this hypothesis, we measured lead concentrations in enamel samples from 26 individuals from the Newton Plantation cemetery in Barbados, which was in use from around 1660 to 1820, and compared the results with enamel (87) Sr/(86) Sr measurements that had been previously obtained for the same population. Results show a clear association between low (i.e., below 1 ppm) enamel lead concentrations and higher enamel (87) Sr/(86) Sr ratios which have previously been interpreted as being indicative of African birth, suggesting that individuals with low enamel lead levels were indeed born in Africa as opposed to the New World. Based on these results, we propose that enamel lead measurements provide an effective and inexpensive way to determine African birth from skeletal remains. Furthermore, the lead measurements can provide useful insights into the health status and childhood environment of enslaved Africans during the colonial period. PMID:23225156

  5. One Health: Past Successes and Future Challenges in Three African Contexts

    PubMed Central

    Okello, Anna L.; Bardosh, Kevin; Smith, James; Welburn, Susan C.

    2014-01-01

    Background The recent emergence of zoonotic diseases such as Highly Pathogenic Avian Influenza (HPAI) and Severe Acute Respiratory Syndrome (SARS) have contributed to dominant Global Health narratives around health securitisation and pandemic preparedness, calling for greater co-operation between the health, veterinary and environmental sectors in the ever-evolving One Health movement. A decade later, One Health advocates face increasing pressure to translate the approach from theory into action. Methodology/Principal Findings A qualitative case study methodology was used to examine the emerging relationships between international One Health dialogue and its practical implementation in the African health policy context. A series of Key Informant Interviews (n = 32) with policy makers, government officials and academics in Nigeria, Tanzania and Uganda are presented as three separate case studies. Each case examines a significant aspect of One Health operationalisation, framed around the control of both emerging and Neglected Zoonotic Diseases including HPAI, Human African Trypanosomiasis and rabies. The research found that while there is general enthusiasm and a strong affirmative argument for adoption of One Health approaches in Africa, identifying alternative contexts away from a narrow focus on pandemics will help broaden its appeal, particularly for national or regionally significant endemic and neglected diseases not usually addressed under a “global” remit. Conclusions/Significance There is no ‘one size fits all’ approach to achieving the intersectoral collaboration, significant resource mobilisation and political co-operation required to realise a One Health approach. Individual country requirements cannot be underestimated, dismissed or prescribed in a top down manner. This article contributes to the growing discussion regarding not whether One Health should be operationalised, but how this may be achieved. PMID:24851901

  6. Caucasion allied health students' attitudes towards African Americans: implications for instruction and research.

    PubMed

    Steed, Robin

    2014-01-01

    In order to determine Caucasian allied health student racial attitudes towards the African American population, students and faculty of a Southern school of allied health professions were surveyed using the Racial Argument Scale (RAS). A one way ANOVA found a significant difference between allied health programs, p = .008, and post hoc testing found the Occupational Therapy Program's scores to be significantly lower (less negative towards Blacks) than the Physical Therapy and Physician Assistant Program's scores (p = .008 and p = .041 respectively). Student scores overall were significantly higher than faculty scores on the RAS (p = .014). The Speech-Language Pathology, Physician Assistant, and Physical Therapy Programs' scores as well the overall allied health student scores were found to be significantly higher than the population mean, thus indicating a higher negativity towards African Americans. The overall results of this study indicate that negative racial bias may be a serious problem in some allied health programs. Future instruction in cultural competency in allied health programs should address racial bias specifically, taking into account cognitive-perceptual errors that may perpetuate negative racial attitudes. PMID:25181786

  7. Obesity and African Americans

    MedlinePlus

    ... Data > Minority Population Profiles > Black/African American > Obesity Obesity and African Americans African American women have the ... ss6304.pdf [PDF | 3.38MB] HEALTH IMPACT OF OBESITY More than 80 percent of people with type ...

  8. Socioeconomic disparities in the health of African-Americans with rheumatoid arthritis from the Southeastern USA

    PubMed Central

    Baldassari, Antoine R.; Cleveland, Rebecca J.; Jonas, Beth L.; Conn, Doyt L.; Moreland, Larry W.; Bridges, S. Louis; Callahan, Leigh F.

    2014-01-01

    Objective To examine cross-sectional baseline data from the Consortium for the Longitudinal Evaluation of African Americans with Early Rheumatoid Arthritis Registry (CLEAR) for the association between socioeconomic status (SES) with clinical and self-report health outcomes. Methods We analyzed data on 937 African Americans (AA) who provided comprehensive sociodemographic data in addition to self-reported health outcomes. SES measures included educational attainment, homeownership, household income and occupation. Outcomes included measures of disease activity, joint damage, autoantibody status, and self-reported measures. Multivariable linear, logistic and zero-inflated Poisson regression models were used to estimate associations of each SES measure with RA outcomes, controlling for gender, age, disease duration, comorbid conditions, BMI, smoking, methotrexate/leflunomide use and biologic agent use. Results The mean age was 54 years, 86% were female, and average RA disease duration was 7.8 years. Approximately 24% had less than a high-school degree, 56% a non-professional occupation, 75% a household income ≤$30K, and 55% were non-homeowners. In multivariable regression models, significantly increased associations of disease activity measures and self-reported health outcomes were observed with low household income (≤$30K/year) and non-homeownership. Education was primarily associated with self-reported health outcomes. Among participants with disease duration <2 years, associations of SES were confined to self-reported measures. Conclusion Our results indicate significant socioeconomic disparities in self-reported physical and mental health, clinical disease activity measures and autoantibody status among African-Americans with RA not explained by differences in demographics, medication use and health behaviors. PMID:24757034

  9. The Cost of Color: Skin Color, Discrimination, and Health among African-Americans.

    PubMed

    Monk, Ellis P

    2015-09-01

    In this study, the author uses a nationally representative survey to examine the relationship(s) between skin tone, discrimination, and health among African-Americans. He finds that skin tone is a significant predictor of multiple forms of perceived discrimination (including perceived skin color discrimination from whites and blacks) and, in turn, these forms of perceived discrimination are significant predictors of key health outcomes, such as depression and self-rated mental and physical health. Intraracial health differences related to skin tone (and discrimination) often rival or even exceed disparities between blacks and whites as a whole. The author also finds that self-reported skin tone, conceptualized as a form of embodied social status, is a stronger predictor of perceived discrimination than interviewer-rated skin tone. He discusses the implications of these findings for the study of ethnoracial health disparities and highlights the utility of cognitive and multidimensional approaches to ethnoracial and social inequality. PMID:26594713

  10. The context of collecting family health history: examining definitions of family and family communication about health among African American women.

    PubMed

    Thompson, Tess; Seo, Joann; Griffith, Julia; Baxter, Melanie; James, Aimee; Kaphingst, Kimberly A

    2015-04-01

    Public health initiatives encourage the public to discuss and record family health history information, which can inform prevention and screening for a variety of conditions. Most research on family health history discussion and collection, however, has predominantly involved White participants and has not considered lay definitions of family or family communication patterns about health. This qualitative study of 32 African American women-16 with a history of cancer-analyzed participants' definitions of family, family communication about health, and collection of family health history information. Family was defined by biological relatedness, social ties, interactions, and proximity. Several participants noted using different definitions of family for different purposes (e.g., biomedical vs. social). Health discussions took place between and within generations and were influenced by structural relationships (e.g., sister) and characteristics of family members (e.g., trustworthiness). Participants described managing tensions between sharing health information and protecting privacy, especially related to generational differences in sharing information, fear of familial conflict or gossip, and denial (sometimes described as refusal to "own" or "claim" a disease). Few participants reported that anyone in their family kept formal family health history records. Results suggest family health history initiatives should address family tensions and communication patterns that affect discussion and collection of family health history information. PMID:25730634

  11. Migration of South African health workers: the extent to which financial considerations influence internal flows and external movements

    PubMed Central

    2013-01-01

    Background The loss of human resource capacity has had a severe impact on the health system in South Africa. This study investigates the causes of migration focussing on the role of salaries and benefits. Health professionals from public, private and non-governmental (NGO) health facilities located in selected peri–urban and urban areas in KwaZulu-Natal, South Africa were surveyed about their current positions and attitudes toward migration. Methods The study uses cross-sectional data collected in 2009. A total of 694 health professionals (430 in the public sector, 133 in the NGO sector and 131 in the private sector) were surveyed. An additional 11 health professionals were purposively selected for in-depth interviews. Odds ratios with 95% confidence intervals were calculated to determine whether salaries influenced HWs decisions to migrate. Results HWs decision to move was not positively associated with lower salaries. It was found, instead, that the consideration to move was determined by other factors including age, levels of stress experienced and the extent to which they were satisfied at their current place of work. Conclusions The OSD appears to have lowered the risk of HWs migrating due to low salaries. However, the results also indicate that the South African Department of Health needs to improve working conditions for HWs within the public health sector to assist in retention. PMID:23919539

  12. Mobile health monitoring systems.

    PubMed

    Walker, William; Aroul, A L Praveen; Bhatia, Dinesh

    2009-01-01

    Advancements are being made towards a cheap and effective means for health monitoring. A mobile monitoring system is proposed for monitoring a bicycle rider using light weight, low power wireless sensors. Biometric and environmental information pertaining to the bicycle rider is captured, transmitted to, and stored in a remote database with little user interaction required. Remote users have real time access to the captured information through a web application. Possible applications for this system include the monitoring of a soldier in the battlefield and the monitoring of a patient during an ambulance ride. PMID:19965041

  13. Health Information Systems.

    PubMed

    Sirintrapun, S Joseph; Artz, David R

    2016-03-01

    This article provides surgical pathologists an overview of health information systems (HISs): what they are, what they do, and how such systems relate to the practice of surgical pathology. Much of this article is dedicated to the electronic medical record. Information, in how it is captured, transmitted, and conveyed, drives the effectiveness of such electronic medical record functionalities. So critical is information from pathology in integrated clinical care that surgical pathologists are becoming gatekeepers of not only tissue but also information. Better understanding of HISs can empower surgical pathologists to become stakeholders who have an impact on the future direction of quality integrated clinical care. PMID:26851670

  14. The 4th Bi-annual international African-Caribbean Cancer Consortium conference: building capacity to address cancer health disparities in populations of African descent.

    PubMed

    Blackman, Elizabeth; Campbell, Jasmine; Bowen, Carlene; Delmoor, Ernestine; Jean-Louis, Gilda; Noumbissi, Raphiatou; O'Garro, Yvonne; Richards-Waritay, Oni; Straughter, Stanley; Tolbert, Vera; Wilson, Barbara; Ragin, Camille

    2014-01-01

    This is a brief summary of the 4(th) International Meeting of the African-Caribbean Cancer Consortium (AC3), organized and sponsored by Fox Chase Cancer Center (FCCC), and held on July 21-22, 2012 at the Lincoln University Graduate Center, Lincoln Plaza, Philadelphia, Pennsylvania. AC3 investigators gathered in Philadelphia, PA to present the results of our ongoing collaborative research efforts throughout the African Diaspora. The general theme addressed cancer health disparities and presentations represented all cancer types. However, there was particular emphasis on women's cancers, related to human papillomavirus (HPV) and human immunodeficiency virus (HIV) infections. PMID:26422007

  15. The Role of Game Based Learning in the Health Literacy of African American Adolescent Males

    NASA Technical Reports Server (NTRS)

    Connell, Judith; Knight, Margaret

    2012-01-01

    Twenty-first century literacy is more than being able to encode for spelling ability, decode for reading comprehension, and calculate for numeric reasoning. It demands the skills to negotiate the world of technology. Health literacy is lower than general literacy, and general literacy is lower among African American males than the overall population. The authors discuss the prospects of incorporating Game Based Learning approaches into strategies for teaching health literacy. Results of a survey administered to youth to determine their level of involvement in video game playing indicate that key elements must be in place to ensure that a game will be played. These include action, strategy, and entertainment. Future investigation will examine the knowledge level of African American adolescent males of the nexus of certain concepts of climate change and health literacy. Climate change has significant implications for human health. This understanding will produce a scientifically based foundation for curricular and instructional decisions that include GBL. Results of this study will be used to design a video game concept and will contribute to the body of knowledge concerning environmental justice and empower individuals to make informed decisions about their own health and those they influence.

  16. Disability and Health: Exploring the Disablement Experience of Young Adult African Americans

    PubMed Central

    Harrison, Tracie

    2013-01-01

    Purpose The objective of this study was to examine disablement as experienced by young adult African American men and women with permanent mobility impairment. Methods This study included a sample of 5 male and 5 female participants ranging in age from 22 to 39. An exploratory descriptive design and qualitative methods, including interviews and fieldnotes, were used. Interview data was analyzed using the process of inductive qualitative content analysis. Results Basic desires for independence, shared intimacy, and psychological and physical health were not diminished by physical limitations. The disablement experience of this group is reflected in the themes of “Cumulative Losses” and “Sustained Desires.” The findings of this study describe the high level of motivation that young adult African American men and women with disabilities have to improve levels of health and well-being within the context of their impairments. Conclusion This study provides a better understanding of the contextual factors and experiences that may contribute to the development of further disability and subsequent health-related problems over time. Increased knowledge of the disablement experience of these young men and women may assist health care entities and social service providers in improving health care and rehabilitation efforts targeting this group. PMID:23745770

  17. Lactose intolerance and health disparities among African Americans and Hispanic Americans: an updated consensus statement.

    PubMed

    Bailey, Rahn K; Fileti, Cecelia Pozo; Keith, Jeanette; Tropez-Sims, Susanne; Price, Winston; Allison-Ottey, Sharon Denise

    2013-01-01

    Dairy foods contribute nine essential nutrients to the diet including calcium, potassium and vitamin D; nutrients identified by the 2010 Dietary Guidelines for Americans as being "of public health concern" within the U.S. population. Milk and milk product intake is associated with better diet quality and has been associated with a reduced risk of chronic diseases or conditions including hypertension, cardiovascular disease, metabolic syndrome, Type 2 Diabetes and osteoporosis. Some research also indicates dairy food intake may be linked to reduced body fat, when accompanied by energy-restriction. On average, both African Americans and Hispanic Americans consume less than the recommended levels of dairy foods, and perceived or actual lactose intolerance can be a primary reason for limiting or avoiding dairy intake. True lactose intolerance prevalence is not known because healthcare providers do not routinely measure for it, and no standardized assessment method exists. Avoiding dairy may lead to shortfalls of essential nutrients and increased susceptibility to chronic disease. This updated Consensus Statement aims to provide the most current information about lactose intolerance and health, with specific relevance to the African American and Hispanic American communities. Topics covered include diagnostic considerations, actual and recommended dairy food intake and levels of consumption of key dairy nutrients among African Americans and Hispanic Americans; prevalence of self-reported lactose intolerance among various racial/ethnic groups; the association between dairy food intake, lactose intolerance and chronic disease; and research-based management recommendations for those with lactose intolerance. PMID:24079212

  18. Beauty salon health intervention increases fruit and vegetable consumption in African-American women.

    PubMed

    Johnson, Latasha T; Ralston, Penny A; Jones, Ethel

    2010-06-01

    African Americans, especially women, have low fruit and vegetable consumption, which is related to higher rates of obesity, morbidity, and mortality in comparison to whites. Community-based approaches are recommended to address this problem, including beauty salons, which are conducive environments for health information dissemination. The purpose of this pilot study, conducted in 2007, was to determine the effectiveness of a 6-week beauty salon-based health intervention, Steps for a New You, in improving diet, physical activity, and water consumption behaviors in African-American women using a quasiexperimental design. A random sample of 20 African-American women was selected from a list of regular clients at two beauty salons (n=10 each for treatment and comparison salons) located in a Southern rural community. The intervention included scripted motivational sessions between the cosmetologist and clients, information packets, and a starter kit of sample items. Data were collected using pre- and posttest questionnaires. The results showed that mean intake of fruit and vegetables was significantly higher at posttest for the treatment group but not for the comparison group. These findings suggest that the intervention may have had a positive effect on fruit and vegetable consumption by treatment group participants. However, further work is needed to refine the methodology, especially strengthening the intervention to increase physical activity and water consumption. PMID:20497787

  19. Convection pattern and stress system under the African plate

    NASA Technical Reports Server (NTRS)

    Liu, H.-S.

    1977-01-01

    Studies on tectonic forces from satellite-derived gravity data have revealed a subcrustal stress system which provides a unifying mechanism for uplift, depression, rifting, plate motion and ore formation in Africa. The subcrustal stresses are due to mantle convection. Seismicity, volcanicity and kimberlite magmatism in Africa and the development of the African tectonic and magnetic features are explained in terms of this single stress system. The tensional stress fields in the crust exerted by the upwelling mantle flows are shown to be regions of structural kinship characterized by major concentration of mineral deposits. It is probable that the space techniques are capable of detecting and determining the tectonic forces in the crust of Africa.

  20. Increasing awareness in African American BSN students of the health risks of obesity.

    PubMed

    Williamson, Wanda; Kautz, Donald D

    2013-01-01

    This paper reports on the perceived effectiveness of a program to increase awareness of the health risks of obesity among African-American students. Thirty (n = 30) senior level Bachelor of Science in Nursing students attending a Historically Black College and University (HBCU) took a knowledge test, then participated in an hour-long educational session on obesity. Following the session, the students completed a 10-item post-test to evaluate the effectiveness of the program in increasing awareness of obesity as a risk for heart disease and diabetes. The findings suggested a need to further educate African-American students on the consequences of obesity as well as recommendations to advance the science of personal and family risk awareness in nursing students. PMID:23734470

  1. A brotherhood perspective: how African American male relationships may improve trust and utilization of health care.

    PubMed

    Grande, Stuart W; Sherman, Ledric; Shaw-Ridley, Mary

    2013-11-01

    The objective of this research was to explore interview data to understand and characterize the nature of brotherhood in a sample of African American men at two historically Black colleges and universities. The authors used thematic analysis on semistructured interview data, collected by an ethnically diverse research team. Recruitment and interviews were conducted at two historically Black colleges and universities in Texas. Twenty African American men, 18 to 35 years old, were randomly selected from 62 recruited participants. Five categories framed brotherhood and health care utilization: (a) trust lessens individual barriers to action, (b) identity unites men through a process of authentication, (c) generations lead by example, (d) approaching life as a shared learning experience, and (e) social pressure and ridicule uphold collective action. Findings suggest that participants trust a group view, identify with the collective, and respond to social pressure to conform; therefore, brotherhood acts as a support mechanism, and its validation influences individual-level engagement and nonengagement. PMID:23620540

  2. Barriers to prostate cancer prevention and community recommended health education strategies in an urban African American community in Jackson, Mississippi.

    PubMed

    Ekúndayò, Olúgbémiga T; Tataw, David B

    2013-01-01

    This article describes the use of survey research in collaboration with the African American urban community of Georgetown, Jackson, Mississippi to identify and understand prostate cancer knowledge, resource utilization, and health education strategies considered most effective in reaching the community with prostate cancer prevention messages. The study revealed profound needs in disease identification and resources awareness and utilization. Barriers to utilization were identified by participants to include lack of self-efficacy, low self-esteem, lack of trust in the health care system, limited knowledge of prostate pathology, and limited ability to pay. Participants' recommended strategies for reaching the community with prostate cancer education include traditional and nontraditional strategies. The list of recommendations exclude modern-day outlets such as handheld devices, Twitter, Facebook, blogs, wikis, and other Internet-based outlets. The findings provide a road map for program development and an intervention research agenda custom-tailored to the Georgetown community of Jackson, Mississippi. PMID:23805806

  3. Evaluation of Health Disparity in Bacterial Vaginosis and the Implications for HIV-1 Acquisition in African American Women.

    PubMed

    Alcendor, Donald J

    2016-08-01

    There is a health disparity for both bacterial vaginosis (BV) and human immunodeficiency virus type 1 (HIV-1) infection in African American women that may be linked. The evidence that BV predisposes women to higher risk for HIV infection is well documented. The underlying mechanisms to support the epidemiological connections will require further investigations. This review explores the risk factors for BV disease with implications for HIV-1 acquisition in the context of race as a potential driver of the 20-fold increase in HIV-1 acquisition for African American women compared to white women. Specifically, it explores (i) disparities for BV in African American women, (ii) racial disparity for HIV-1 acquisition in African American women, (iii) common factors associated with BV and HIV acquisition in African American women, and (iv) potential mechanisms of the enhancement of HIV-1 transmission by BV. PMID:26847837

  4. Differential Associations Between Partner Violence and Physical Health Symptoms Among Caucasian and African American Help-Seeking Women

    PubMed Central

    Iverson, Katherine M.; Bauer, Margret R.; Shipherd, Jillian C.; Pineles, Suzanne L.; Harrington, Ellen F.; Resick, Patricia A.

    2012-01-01

    The relationship between partner violence and physical health symptoms is well-established. Although some researchers have theorized that the physical health effects of partner violence may be worse for ethnic minority women, there is little research addressing this topic. The current study examined whether African American women demonstrate a differential association in this relationship than Caucasian women. This study included 323 women (232 African American, 91 Caucasian) who participated in a larger investigation of the psychological and psychophysiological correlates of recent partner violence among women seeking help for the abuse. Race was examined as a moderator of the relationship between partner violence frequency and physical health symptoms. Although mean levels of partner violence frequency and physical health symptoms did not significantly differ between African American and Caucasian women, linear regression analyses demonstrated a significant positive relationship between partner violence frequency and physical health symptoms for African American women; whereas there was no association observed between these variables for Caucasian women. Post hoc analyses revealed that posttraumatic stress disorder symptoms partially mediated the association between partner violence frequency and physical health symptoms for the African American women. The current findings underscore the importance of considering race when studying the effect of partner violence on women’s health. PMID:23616911

  5. Violence exposure and health related risk among African American adolescent female detainees: A strategy for reducing recidivism

    PubMed Central

    Woodson, Kamilah M.; Hives, Courtney; Sanders-Phillips, Kathy

    2010-01-01

    Juvenile crime and violent victimization continue to be significant social problems (Fitzpatrick, Piko, Wright, & LaGory, 2005); in that, adolescents, females in particular, are likely to participate in health related risk behaviors as result of having been victimized or exposed to a violent environment. Specifically, abuse, neglect, sexual molestation, poverty, and witnessing violence are well known risk factors for the development of trauma-related psychopathology and poor outcomes relative to delinquency, drug and alcohol abuse, and HIV risk behaviors (Steiner, Garcia, & Matthews, 1997). HIV infection is a common public health concern disproportionally affecting adolescent African American female detainees. This unique population has a serious history of violence exposure, which subsequently tends to lead to engaging in risky sexual behaviors, mental health problems, and abusing substances. Also, as a result of little to no intervention, this population is recidivating at an alarming rate, a problem that may further exacerbate the expression of health-related risk behaviors among African American adolescent female detainees. The authors briefly describe a pilot program to be implemented in the juvenile justice system that is based on the Model of Accumulated Risk (Garbarino, 1996), Bronfenbrenner’s Ecological Model (1994), and the Positive Youth Justice Model (Butts, Bazemore, & Meroe, 2009). The program proposes to reduce risky sexual behaviors, teach alternatives to abusing substances, treat mental health concerns, and reduce the rate of recidivism through “positive youth development”, PYD (Butts, Bazemore, & Meroe, 2009). Tying elements of wraparound services and reeducation together, this program addresses salient concerns that may have an impact on an adolescent detainees’ success following their release from prison in a holistic manner. PMID:21373205

  6. Family health advocacy: an empowerment model for pregnant and parenting African American women in rural communities.

    PubMed

    Baffour, Tiffany D; Jones, Maurine A; Contreras, Linda K

    2006-01-01

    The model of family health advocacy built firmly upon principles of empowerment theory seeks to help individuals, families, and communities to improve their circumstances by incorporating multiple levels of intervention. The goal of family health advocacy is to improve the well-being of pregnant women and mothers of children younger than 2 years by providing social support and health education about risk factors related to infant mortality and prematurity. This program primarily targets rural African American women, a group at high risk. Advocacy and referral for needed medical and social services are provided. This article presents a comprehensive model of health advocacy, including social marketing strategies, recruitment efforts, and curriculum development. PMID:16775472

  7. Solution-Focused Strategies for Effective Sexual Health Communication among African American Parents and Their Adolescents.

    PubMed

    Johnson, Sharon D; Williams, Sha-Lai

    2015-11-01

    The high rates of sexual risk behaviors, particularly among African American youths who may not be aware of their HIV status, provide indication that, unless prevention efforts are enhanced, this vulnerable group of youths will remain at greater risk for negative health status outcomes. Parents are important in efforts to reduce risk among youths and often have a willingness to be sexuality educators for their children; however, communication barriers often impede their ability to provide preventive sexual health knowledge to their youths. Social workers are often presented with opportunities to help parents develop effective sexual health communication skills in informal settings when formal interventions are not feasible. The present effort considers solution-focused strategies social workers can use to help parents overcome barriers and communicate more positively with their youths about sexual health. PMID:26638502

  8. Human resources for health through conflict and recovery: lessons from African countries.

    PubMed

    Pavignani, Enrico

    2011-10-01

    A protracted conflict affects human resources for health (HRH) in multiple ways. In most cases, the inflicted damage constitutes the main obstacle to health sector recovery. Interventions aimed at healing derelict human resources are however fraught with difficulties of a political, technical, financial and administrative order. The experience accumulated in past recovery processes has made some important players aware of the cost incurred by neglecting human resource development. Several transitions from conflict to peace have been documented, even if largely in unpublished reports. This paper presents condensed descriptions of some African HRH-related recovery processes, which provide useful lessons. The technical work demanded to resuscitate a derelict health workforce is fairly well understood. In most situations, the highest hurdles lie outside of the health domain, and are of a political and administrative nature. Success stories are rare. But useful lessons are taught by failure as well as by success. PMID:21913930

  9. An American health dilemma: a history of blacks in the health system.

    PubMed Central

    Byrd, W. M.; Clayton, L. A.

    1992-01-01

    The present black health crisis is a continuum. After 346 years of neglect, flawed efforts were made to admit black Americans to the "mainstream" health system. Gains were significant from 1965 to 1975; however, since then black health status has eroded. Since colonial times, the racial dilemma that affected America's liberal democratic system also distorted medical relationships and institutions. There are clear connections between campaigns to defeat bills that would improve the health of blacks and other disadvantaged groups and acquiescence with the present reassignment of them to the underfunded, overcrowded, inferior, public health-care sector. Physician leadership helped to establish the slaveocracy, create the racial inferiority myths, and build the segregated health subsystem for blacks and the poor. Clearly, if the history-based health disparities are to be resolved, black physician leadership will be necessary. Without justice and equity in health care, the dream of Martin Luther King will never become a reality for African Americans. PMID:1602519

  10. Health and Mental Health Policies' Role in Better Understanding and Closing African American-White American Disparities in Treatment Access and Quality of Care

    ERIC Educational Resources Information Center

    Snowden, Lonnie R.

    2012-01-01

    Since publication of the U.S. Surgeon General's report "Mental Health: Culture, Race and Ethnicity--A Supplement to Mental Health: A Report of the Surgeon General" (U.S. Department of Health and Human Services, 2001), several federal initiatives signal a sustained focus on addressing African American-White American disparities in mental health…

  11. Intimate partner violence and mental health symptoms in African American female ED patients#

    PubMed Central

    Houry, Debra; Kemball, Robin; Rhodes, Karin V.; Kaslow, Nadine J.

    2006-01-01

    Background Intimate partner violence (IPV) victims often seek care in the ED, whether for an injury from abuse or other sequelae such as mental health symptoms. Objectives The objective of the study was to assess whether depressive symptoms, posttraumatic stress disorder (PTSD), and suicidality were associated with physical, sexual, or emotional IPV in African American female ED patients and to determine if experiencing multiple types of abuse was associated with increased mental health symptoms. Methods All eligible African American female patients were approached in the ED waiting room during study periods. Patients participated in the screening process via a computer kiosk. Questions regarding IPV and mental health symptoms were asked using validated tools. Results In this prospective cohort, 569 participated and 36% of those in a relationship in the past year (n = 461) disclosed that there were victims of IPV in the past year. In the past year, 22% experienced recent physical abuse, 9% recent sexual abuse, and 32% recent emotional abuse. A Pearson correlation was conducted and showed that all mental health symptoms were positively correlated with each type of IPV and each type of mental health symptom category. Mental health symptoms increased significantly with amount of abuse: depression (odds ratio [OR], 5.9 for 3 types of abuse), PTSD (OR, 9.4 for 3), and suicidality (OR, 17.5 for 3). Conclusions Emotional, sexual, and physical IPV were significantly associated with mental health symptoms. Each type of abuse was independently associated with depression, suicidality, and PTSD. Experiencing more than 1 type of abuse was also correlated with increased mental health symptoms. PMID:16787803

  12. Experiences of racist events are associated with negative health consequences for African American women.

    PubMed Central

    Kwate, Naa Oyo A.; Valdimarsdottir, Heiddis B.; Guevarra, Josephine S.; Bovbjerg, Dana H.

    2003-01-01

    This study investigated whether experiences of racist events were related to psychological distress, negative health behaviors, and health problems. Participants were 71 African American women (mean age 44.4) who were recruited from an urban cancer-screening clinic as part of a larger longitudinal study on familial risk of breast cancer. Participants completed three study assessments, approximately one month apart, and data were collected via self-report. Correlational analyses revealed that past year and lifetime racism were both related to psychological distress. Among smokers and drinkers, past year racism was positively correlated with number of cigarettes and drinks consumed. Lifetime racism was negatively related to perceived health, and positively related to lifetime history of physical disease and frequency of recent common colds. Analyses using a general linear model revealed that these relationships were largely unaccounted for by other variables. In addition, demographic variables such as income and education were not related to experiences of racism. The results suggest that racism can be detrimental to African American's well being and should be investigated in health disparities research. PMID:12856911

  13. African-American Fathers’ Perspectives on Their Children’s Health Education: A Qualitative, Exploratory Study

    PubMed Central

    Odum, Mary; Smith, Matthew Lee; McKyer, E. Lisako J.

    2014-01-01

    Purpose: To investigate African-American fathers’ (AAF) perceptions regarding the applicability and need for their involvement as a health connection for their children and describe how participating fathers’ behavior was affected by their attitudes, knowledge, and perceptions of their influence on their children’s health. Methods: This exploratory study gathered data via semi-structured focus groups (n = 3) and thematically analyzed it utilizing a grounded theory approach. Participants included AAF (n = 20) with a mean age of 37 years (SD 11.79), with at least one child between 6 and 18 years old. Results: Four major themes were revealed: (1) appropriate health education for participants’ children (should first and foremost be delivered by parents); (2) participants’ paternal health-related guidance approach (reactive, rather than proactive); (3) participants’ perceived influences on health-related communication with their children (gender roles, efficacy constraints); and (4) paternal definitions of health (most often associated with diet). Conclusion: Understanding AAFs’ perceived and desired role in their children’s health edification can inform initiatives that actively engage these men, and nurture their level of involvement, to promote positive health behaviors among their children; this is necessary to realize their potential to actively improve the health of their children, families, and communities. PMID:25538938

  14. Capacity Building and Financing Oral Health in the African and Middle East Region.

    PubMed

    Mumghamba, E G; Joury, E; Fatusi, O; Ober-Oluoch, J; Onigbanjo, R J; Honkala, S

    2015-07-01

    Many low- and middle-income countries do not yet have policies to implement effective oral health programs. A reason is lack of human and financial resources. Gaps between resource needs and available health funding are widening. By building capacity, countries aim to improve oral health through actions by oral health care personnel and oral health care organizations and their communities. Capacity building involves achieving measurable and sustainable results in training, research, and provision of care. Actions include advancement of knowledge, attitudes and skills, expansion of support, and development of cohesiveness and partnerships. The aim of this critical review is to review existing knowledge and identify gaps and variations between and within different income levels in relation to the capacity building and financing oral health in the African and Middle East region (AMER). A second aim is to formulate research priorities and outline a research agenda for capacity building and financing to improve oral health and reduce oral health inequalities in the AMER. The article focuses on capacity building for oral health and oral health financing in the AMER of the IADR. In many communities in the AMER, there are clear and widening gaps between the dental needs and the existing capacity to meet these needs in terms of financial and human resources. Concerted efforts are required to improve access to oral health care through appropriate financing mechanisms, innovative health insurance schemes, and donor support and move toward universal oral health care coverage to reduce social inequality in the region. It is necessary to build capacity and incentivize the workforce to render evidence-based services as well as accessing funds to conduct research on equity and social determinants of oral health while promoting community engagement and a multidisciplinary approach. PMID:26101338

  15. Effective Coverage and Systems Effectiveness for Malaria Case Management in Sub-Saharan African Countries

    PubMed Central

    Galactionova, Katya; Tediosi, Fabrizio; de Savigny, Don; Smith, Thomas; Tanner, Marcel

    2015-01-01

    Scale-up of malaria preventive and control interventions over the last decade resulted in substantial declines in mortality and morbidity from the disease in sub-Saharan Africa and many other parts of the world. Sustaining these gains will depend on the health system performance. Treatment provides individual benefits by curing infection and preventing progression to severe disease as well as community-level benefits by reducing the infectious reservoir and averting emergence and spread of drug resistance. However many patients with malaria do not access care, providers do not comply with treatment guidelines, and hence, patients do not necessarily receive the correct regimen. Even when the correct regimen is administered some patients will not adhere and others will be treated with counterfeit or substandard medication leading to treatment failures and spread of drug resistance. We apply systems effectiveness concepts that explicitly consider implications of health system factors such as treatment seeking, provider compliance, adherence, and quality of medication to estimate treatment outcomes for malaria case management. We compile data for these indicators to derive estimates of effective coverage for 43 high-burden Sub-Saharan African countries. Parameters are populated from the Demographic and Health Surveys and other published sources. We assess the relative importance of these factors on the level of effective coverage and consider variation in these health systems indicators across countries. Our findings suggest that effective coverage for malaria case management ranges from 8% to 72% in the region. Different factors account for health system inefficiencies in different countries. Significant losses in effectiveness of treatment are estimated in all countries. The patterns of inter-country variation suggest that these are system failures that are amenable to change. Identifying the reasons for the poor health system performance and intervening to tackle

  16. Former migrant mineworkers with respiratory disease: the South African compensation system, and implications for neighbouring countries.

    PubMed

    Steen, T W; Mabongo, N; Moeti, T; Monare, B; Trapido, A S

    2000-01-01

    In the region of Southern Africa, substantial numbers of people, primarily males, have been employed in the South African mining industry. Migrant workers from neighbouring countries have constituted a large part of the work force. Until recently, there has been little or no attention directed toward the state of health of these individuals, despite the fact that their work involves a high health risk, especially in regard to mine-related lung diseases. In addition, the South African workers' compensation programme has seldom been utilised by the migrant worker who is a victim of occupational disease. However, recent experiences from Botswana show that compensation claims can be successfully made from the neighbouring countries where the migrant workers originate. Efforts are being made to address the problem systematically, and the government of Botswana is actively involved. The major occupational lung disorders are described briefly, and differential diagnostic problems with pulmonary TB are discussed. Furthermore, a survey of the compensation system in South Africa is presented, and practical steps for medical examinations involving compensation claims are described. PMID:14674203

  17. The Afya Bora Consortium: an African-U.S. partnership to Train Leaders in Global Health

    PubMed Central

    Farquhar, Carey; Nathanson, Neal

    2011-01-01

    Synopsis The Afya Bora Consortium is a partnership of eight academic health institutions, four in Africa and four in the United States. The Consortium members have a history of collaboration in four African-U.S. pairs: Makerere University, Kampala, Uganda, and Johns Hopkins University, Baltimore, Maryland, USA; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, and the University of California in San Francisco, California, USA; the University of Botswana, Gaborone, Botswana, and the University of Pennsylvania, Philadelphia, Pennsylvania, USA; the University of Nairobi, Nairobi, Kenya, and the University of Washington, Seattle, Washington, USA. The Consortium is developing a Global Health Leadership Fellowship for medical, nursing, and public health professionals, largely drawn from the four African partner countries. The primary purpose of the fellowship is to provide trainees with practical skills that will prepare them for future positions leading the design, implementation and evaluation of large, high impact programs in governmental agencies, non-governmental organizations, and academic health institutions in their own countries. In this overview, we describe a Pilot of the proposed program, which includes three components: a six-week Core Curriculum taught in modules that focus on foundational skills in leadership, management, evaluation and other relevant topics; a six-month assignment to two Attachment Sites, that provides hands-on experience in a programmatic, clinical, or research area; and a post-training support and mentoring phase. We believe that the Afya Bora Fellowship is an innovative model, which, when fully implemented, could contribute significantly to training future leaders in global health and reducing “brain drain” of health professionals. PMID:21628054

  18. Corruption in health-care systems and its effect on cancer care in Africa.

    PubMed

    Mostert, Saskia; Njuguna, Festus; Olbara, Gilbert; Sindano, Solomon; Sitaresmi, Mei Neni; Supriyadi, Eddy; Kaspers, Gertjan

    2015-08-01

    At the government, hospital, and health-care provider level, corruption plays a major role in health-care systems in Africa. The returns on health investments of international financial institutions, health organisations, and donors might be very low when mismanagement and dysfunctional structures of health-care systems are not addressed. More funding might even aggravate corruption. We discuss corruption and its effects on cancer care within the African health-care system in a sociocultural context. The contribution of high-income countries in stimulating corruption is also described. Corrupt African governments cannot be expected to take the initiative to eradicate corruption. Therefore, international financial institutions, health organisations, and financial donors should use their power to demand policy reforms of health-care systems in Africa troubled by the issue of corruption. These modifications will ameliorate the access and quality of cancer care for patients across the continent, and ultimately improve the outcome of health care to all patients. PMID:26248847

  19. Understanding African American Adolescents' Identity Development: A Relational Developmental Systems Perspective

    ERIC Educational Resources Information Center

    Brittian, Aerika S.

    2012-01-01

    This article examines the development of African American adolescents' identity using a relational developmental systems theory framework, which led to the expectation that identity development is linked to both the reduction of risk behaviors and the promotion of African American adolescents' healthy development. Different personological theories…

  20. Unheard and Unseen: How Housing Insecure African American Adolescents Experience the Education System

    ERIC Educational Resources Information Center

    Ellis, Addie Lucille; Geller, Kathy D.

    2016-01-01

    This narrative study is based on stories told by African American adolescents experiencing homelessness. It offers insights into their lived experiences and describes the challenges faced in negotiating the urban education system. African American youth are disproportionately represented in the adolescent homeless demographic. "Unheard and…

  1. Indigenous African Knowledge Systems and Innovation in Higher Education in South Africa

    ERIC Educational Resources Information Center

    Higgs, P.; Higgs, L. G.; Venter, E.

    2003-01-01

    The importance of innovation in higher education is recognised in South African educational discourse. The South African White Paper on Science and Technology, issued in September 1996 and entitled, "Preparing for the 21st Century", states that, "the White Paper is built upon the twin concepts of "innovation" and a "national system of innovation"…

  2. Victimization Experiences, Substance Misuse and Mental Health Problems in Relation to Risk for Lethality among African-American and African-Caribbean Women

    PubMed Central

    Sabri, Bushra; Stockman, Jamila K.; Betrand, Desiree; Campbell, Doris W.; Callwood, Gloria B.; Campbell, Jacquelyn C.

    2013-01-01

    The purpose of this study was to investigate the association of intimate partner victimization experiences, mental health, and substance misuse problems with the risk for lethality among women of African descent. Data for this cross-sectional study were derived from a large case-control study examining the relationship between abuse status and health consequences. Women were recruited from primary care, prenatal or family planning clinics in Baltimore and the US Virgin Islands. Logistic regression was used to generate the study findings. Among 543 abused women, physical and psychological abuse by intimate partners, comorbid PTSD and depression symptoms, and PTSD-only problems significantly increased the likelihood of lethality risk. However victims’ substance misuse and depression-only problems were not associated with the risk for lethality. Additionally, PTSD symptoms mediated the relationship between severe victimization experiences and risk for lethality. Practitioners should pay attention to victimization experiences and mental health issues when developing treatment and safety plans. Policies to fund integrated services for African-American and African-Caribbean women with victimization and related mental health issues, and training of providers to identify at-risk women may help reduce the risk for lethality in intimate partner relationships. PMID:23929602

  3. The impact of health insurance on an African-American population with colorectal cancer.

    PubMed Central

    Dawkins, F. W.; Laing, A. E.; Smoot, D. T.; Perlin, E.; Tuckson, W. B.

    1995-01-01

    This study evaluates the impact of health insurance as a substitute for social class on tumor location, presentation, stage, grade, and age-adjusted survival in an African-American population. Patients were stratified by insurance into two groups: group 1 (private insurance and Medicare parts A & B) and group 2 (Medicaid, Medical Charity, self-pay, uninsured, or unemployed). A total of 212 patients were evaluated. Of these, 210 patients were insured or had Medical Charity, and two were uninsured. The type of health insurance did not significantly affect age-adjusted survival. However, age and stage at presentation were positive predictors of age-adjusted survival. Higher socioeconomic status was associated with group 1 health insurance. PMID:7752284

  4. Indigenous Systems within the African-American Community

    ERIC Educational Resources Information Center

    Marbley, Aretha Faye; Rouson, Leon

    2011-01-01

    For the African-American family, life ain't been no crystal stair. The African-American family has trotted for over 400 years through a wilderness of racism, poverty, discrimination of all kinds, crossing seas of monsters and forests of demons. Yet, despite the numerous obstacles and attacks that society has mounted against it since slavery, the…

  5. [Ethnic disparities in the use of reproductive health services by indigenous and African-descendant Colombian women].

    PubMed

    Noreña-Herrera, Camilo; Leyva-Flores, René; Palacio-Mejía, Lina Sofía; Duarte-Gómez, María Beatriz

    2015-12-01

    The aim of this study in Colombia was to analyze the use of reproductive health services (prenatal care, childbirth, and postpartum) according to women's ethnicity, based on the National Demographic and Health Survey for 2010. Ethnicity was self-reported (indigenous, African-descendant, or neither), and logistic models were performed for each service. The use of reproductive health services was lower among indigenous and African-descendant Colombian women when compared to those that did not declare their ethnicity. According to the regression models, indigenous women showed lower odds of having an adequate number of prenatal visits (OR = 0.61), and the same was true for African-descendant women. The same situation prevailed for institutional childbirth care: indigenous women (OR = 0.33) and African-descendant women (OR = 0.60); and postpartum follow-up: indigenous (OR = 0.80), African-descendant (OR = 0.80). In conclusion, there are inequities in the use of reproductive health services by women belonging to ethnic groups in Colombia, who should be targeted with government strategies to guarantee their right to health. PMID:26872239

  6. Using community-based participatory mixed methods research to understand preconception health in African American communities of Arizona.

    PubMed

    Hussaini, Khaleel S; Hamm, Eric; Means, Toni

    2013-12-01

    The article discusses Arizona's strategic implementation and evaluation of the first time motherhood initiative grant (FTMI) to understand preconception health among African American men and women in Arizona. Longitudinal focus groups assessed whether African American men and women in the targeted areas comprehended and recalled the messages related to preconception health. Matched pre and posttests assessed community members' knowledge of preconception as well as physicians' perceptions on preconception health and care. Focus-group data were transcribed and coded by independent coders to conduct content analyses. Inter-rater reliability and agreement among coders, bivariate and multivariate statistics were conducted for quantitative matched pre and posttests data using SAS v9.2 (SAS Institute, Cary, NC). The social marketing campaign had limited impact in recall and comprehension of the preconception health message among African American men and women. Data from focus groups revealed that African American men and women perceived preconception health to be vital. And results from the pretest and posttests of community-based presentations, further supported this finding. Evidence from Grand Round presentations indicated that practitioners and health care providers had diverging views on preconception health. Use of community-based participatory mixed methods research can facilitate better understanding of the efficacy of strategic interventions such as FTMI and can provide valuable information on preconception health. Cost limitations often prohibit extensive evaluation of social marketing campaigns, hence, evaluators and researchers should assess the feasibility of conducting an efficacy study versus an effectiveness study in evaluating social marketing campaigns. PMID:23229170

  7. Developmental Trajectories of African American Adolescents' Family Conflict: Differences in Mental Health Problems in Young Adulthood

    ERIC Educational Resources Information Center

    Choe, Daniel Ewon; Stoddard, Sarah A.; Zimmerman, Marc A.

    2014-01-01

    Family conflict is a salient risk factor for African American adolescents' mental health problems. No study we are aware of has estimated trajectories of their family conflict and whether groups differ in internalizing and externalizing problems during the transition to young adulthood, a critical antecedent in adult mental health and…

  8. Hookah and Cigarette Smoking among African American College Students: Implications for Campus Risk Reduction and Health Promotion Efforts

    ERIC Educational Resources Information Center

    Jones, Brittni D.; Cunningham-Williams, Renee M.

    2016-01-01

    Objective: To identify individual and institutional risks and protections for hookah and cigarette smoking among African American (AA) college students. Participants: AA college students (N = 1,402; mean age = 20, range = 18-24 years; 75% female) who completed the Fall 2012 American College Health Association--National College Health Assessment…

  9. Knowledge, attitudes, perceptions and practices of African-American women toward menopausal health.

    PubMed

    Sharps, Phyllis W; Phillips, Janice; Oguntimalide, Lola; Saling, Jessica; Yun, Stephanie

    2003-12-01

    The purpose of this study was to describe and compare the knowledge, attitudes, perceptions and health practices related to menopausal health among African-American women (N= 106) from diverse SES levels, between 40 to 65 years of age. The mean age was 49 years of age, 60.7% were college graduates, 45.8% were married, 85% employed full-time and 88% had medical insurance. Two-thirds rated their health as good, and half believed their health was better than other women. Most women (58%) use hormone replacement therapy (HRT) or would consider using HRT. In general women were knowledgeable about the process of menopause. Among this diverse group of women there were significant differences (p<.05) in use of HRT and health promotion behaviors. Most women (48.5%) sought information from printed materials. Women and their physicians should be encouraged to discuss menopausal health. Culturally appropriate materials should be provided in all women's health settings, through media and places where women gather including churches, beauty parlors, community centers. PMID:15011939

  10. Integrating Oral Health with Non-Communicable Diseases as an Essential Component of General Health: WHO's Strategic Orientation for the African Region.

    PubMed

    Varenne, Benoit

    2015-05-01

    In the context of the emerging recognition of non-communicable diseases (NCDs), it has never been more timely to explore the World Health Organization (WHO) strategic orientations on oral health in the WHO African region and to raise awareness of a turning point in the search for better oral health for everyone. The global initiative against NCDs provides a unique opportunity for the oral health community to develop innovative policies for better recognition of oral health, as well as to directly contribute to the fight against NCDs and their risk factors. The WHO African region has led the way in developing the first regional oral health strategy for the prevention and control of oral diseases integrated with NCDs. The support of the international oral health community in this endeavor is urgently needed for making a success story of this initiative of integrating oral health into NCDs. PMID:25941239

  11. The College Health and Wellness Study: baseline correlates of overweight among African Americans.

    PubMed

    Gary, Tiffany L; Gross, Susan M; Browne, Dorothy C; LaVeist, Thomas A

    2006-03-01

    Overweight and obesity are epidemic in the United States, particularly among minority populations. This epidemic contributes to the development of chronic conditions that occur later in life such as type 2 diabetes and hypertension. Therefore, it is important to identify factors associated with the development of obesity during young adulthood. We conducted a cross-sectional survey among students graduating from a Historically Black College or University (HBCU) in the Mid-Atlantic region. Participants were 392 predominantly African American seniors graduating in the spring of 2003. Data were collected using a self-administered paper and pencil questionnaire which focused on weight, weight management activities, individual and familial weight history, and health status indicators. Participants were on average 24 +/- 5 years of age and 69% female; over 90% identified as African American or Black. According to NIH guidelines, about 30% of males and 28% of females were considered overweight, 12% of males and 7% of females were considered obese, and 7% of males and females were considered extremely obese. Significant correlates of being more overweight were being married, having children, lower socio-economic status, weight-loss attempts, personal and family history of overweight, and poorer health status. These data suggest that among this sample, the prevalence of overweight and obesity is similar to other populations of young African American adults. Familial factors such as socio-economic status and family weight history were important correlates of overweight. Overweight is a significant problem in this population, and these data should be useful for developing weight loss interventions aimed at young adults. PMID:16736374

  12. Lack of access to health care for African indigents: a social exclusion perspective

    PubMed Central

    2013-01-01

    Background Lack of access to health care is a persistent condition for most African indigents, to which the common technical approach of targeting initiatives is an insufficient antidote. To overcome the standstill, an integrated technical and political approach is needed. Such policy shift is dependent on political support, and on alignment of international and national actors. We explore if the analytical framework of social exclusion can contribute to the latter. Methods We produce a critical and evaluative account of the literature on three themes: social exclusion, development policy, and indigence in Africa–and their interface. First, we trace the concept of social exclusion as it evolved over time and space in policy circles. We then discuss the relevance of a social exclusion perspective in developing countries. Finally, we apply this perspective to Africa, its indigents, and their lack of access to health care. Results The concept of social exclusion as an underlying process of structural inequalities has needed two decades to find acceptance in international policy circles. Initial scepticism about the relevance of the concept in developing countries is now giving way to recognition of its universality. For a variety of reasons however, the uptake of a social exclusion perspective in Africa has been limited. Nevertheless, social exclusion as a driver of poverty and inequity in Africa is evident, and manifestly so in the case of the African indigents. Conclusion The concept of social exclusion provides a useful framework for improved understanding of origins and persistence of the access problem that African indigents face, and for generating political space for an integrated approach. PMID:24238000

  13. The Context of Collecting Family Health History: Examining Definitions of Family and Family Communication About Health Among African American Women

    PubMed Central

    THOMPSON, TESS; SEO, JOANN; GRIFFITH, JULIA; BAXTER, MELANIE; JAMES, AIMEE; KAPHINGST, KIMBERLY A.

    2015-01-01

    Public health initiatives encourage the public to discuss and record family health history (FHH) information, which can inform prevention and screening for a variety of conditions. Most research on FHH discussion and collection, however, has involved predominantly White participants and has not considered lay definitions of family or family communication patterns about health. This qualitative study of 32 African American women, 16 with a history of cancer, analyzed participants’ definitions of family, family communication about health, and collection of FHH information. “Family” was defined by biological relatedness, social ties, interactions, and proximity. Several participants noted using different definitions of family for different purposes (e.g. biomedical vs. social). Health discussions took place between and within generations and were influenced by structural relationships (e.g. sister) and characteristics of family members (e.g. trustworthiness). Participants described managing tensions between sharing health information and protecting privacy, especially related to generational differences in sharing information, fear of familial conflict or gossip, and denial (sometimes described as refusal to “own” or “claim” a disease). Few participants reported that anyone in their family kept formal FHH records. Results suggest FHH initiatives should address family tensions and communication patterns that affect discussion and collection of FHH information. PMID:25730634

  14. [The health system of Peru].

    PubMed

    Alcalde-Rabanal, Jacqueline Elizabeth; Lazo-González, Oswaldo; Nigenda, Gustavo

    2011-01-01

    This paper describes the health conditions in Peru and, with greater detail, the Peruvian health system, including its structure and coverage, its financial sources, its physical, material and human resources, and its stewardship functions. It also discusses the activities developed in the information and research areas, as well as the participation of citizens in the operation and evaluation of the health system. The article concludes with a discussion of the most recent innovations, including the Comprehensive Health Insurance, the Health Care Enterprises system, the decentralization process and the Local Committees for Health Administration. The main challenge confronted by the Peruvian health system is the extension of coverage to more than I0% of the population presently lacking access to basic health care. PMID:21877089

  15. [The health system of Colombia].

    PubMed

    Guerrero, Ramiro; Gallego, Ana Isabel; Becerril-Montekio, Victor; Vásquez, Johanna

    2011-01-01

    This document briefly describes the health conditions of the Colombian population and, in more detail, the characteristics of the Colombian health system. The description of the system includes its structure and coverage; financing sources; expenditure in health; physical material and human resources available; monitoring and evaluation procedures; and mechanisms through which the population participates in the evaluation of the system. Salient among the most recent innovations implemented in the Colombian health system are the modification of the Compulsory Health Plan and the capitation payment unit, the vertical integration of the health promotion enterprises and the institutions in charge of the provision of services and the mobilization of additional resources to meet the objectives of universal coverage and the homologation of health benefits among health regimes. PMID:21877080

  16. The Contribution of Community and Family Contexts to African American Young Adults’ Romantic Relationship Health: A Prospective Analysis

    PubMed Central

    Kogan, Steven M.; Lei, Man-Kit; Grange, Christina R.; Simons, Ronald L.; Brody, Gene H.; Gibbons, Frederick X.; Chen, Yifu

    2013-01-01

    Accumulating evidence suggests that African American men and women experience unique challenges in developing and maintaining stable, satisfying romantic relationships. Extant studies have linked relationship quality among African American couples to contemporaneous risk factors such as economic hardship and racial discrimination. Little research, however, has examined the contextual and intrapersonal processes in late childhood and adolescence that influence romantic relationship health among African American adults. We investigated competence-promoting parenting practices and exposure to community-related stressors in late childhood, and negative relational schemas in adolescence, as predictors of young adult romantic relationship health. Participants were 318 African American young adults (59.4% female) who had provided data at four time points from ages 10–22 years. Structural equation modeling indicated that exposure to community-related stressors and low levels of competence-promoting parenting contributed to negative relational schemas, which were proximal predictors of young adult relationship health. Relational schemas mediated the associations of competence-promoting parenting practices and exposure to community stressors in late childhood with romantic relationship health during young adulthood. Results suggest that enhancing caregiving practices, limiting youths’ exposure to community stressors, and modifying relational schemas are important processes to be targeted for interventions designed to enhance African American adults’ romantic relationships. PMID:23494451

  17. Health workers’ knowledge of and attitudes towards computer applications in rural African health facilities

    PubMed Central

    Sukums, Felix; Mensah, Nathan; Mpembeni, Rose; Kaltschmidt, Jens; Haefeli, Walter E.; Blank, Antje

    2014-01-01

    Background The QUALMAT (Quality of Maternal and Prenatal Care: Bridging the Know-do Gap) project has introduced an electronic clinical decision support system (CDSS) for pre-natal and maternal care services in rural primary health facilities in Burkina Faso, Ghana, and Tanzania. Objective To report an assessment of health providers’ computer knowledge, experience, and attitudes prior to the implementation of the QUALMAT electronic CDSS. Design A cross-sectional study was conducted with providers in 24 QUALMAT project sites. Information was collected using structured questionnaires. Chi-squared tests and one-way ANOVA describe the association between computer knowledge, attitudes, and other factors. Semi-structured interviews and focus groups were conducted to gain further insights. Results A total of 108 providers responded, 63% were from Tanzania and 37% from Ghana. The mean age was 37.6 years, and 79% were female. Only 40% had ever used computers, and 29% had prior computer training. About 80% were computer illiterate or beginners. Educational level, age, and years of work experience were significantly associated with computer knowledge (p<0.01). Most (95.3%) had positive attitudes towards computers – average score (±SD) of 37.2 (±4.9). Females had significantly lower scores than males. Interviews and group discussions showed that although most were lacking computer knowledge and experience, they were optimistic about overcoming challenges associated with the introduction of computers in their workplace. Conclusions Given the low levels of computer knowledge among rural health workers in Africa, it is important to provide adequate training and support to ensure the successful uptake of electronic CDSSs in these settings. The positive attitudes to computers found in this study underscore that also rural care providers are ready to use such technology. PMID:25361721

  18. Acknowledging others as 'whole beings'. Managers' perceptions of spirituality and health in the South African workplace.

    PubMed

    Honiball, George; Geldenhuys, Dirk; Mayer, Claude-Hélène

    2014-06-01

    This article explores the concept of spirituality within selected South African managerial work contexts. The aim of the study was to determine managers' perceptions of spirituality and health-related aspects in various South African workplaces. A phenomenological research paradigm was used, applying an in-depth qualitative research approach. The sample consisted of 12 senior managers from different organizations, including, for example, an international healthcare provider, an international auditing and consulting firm, a manufacturer of paint supplies and decorations and an ecclesiastical organization. Research methods included semi-structured interviews and observation. Data was analysed through content analysis, identifying themes, categories and codes. The findings indicate that spirituality promotes the development of health-related aspects of individuals, such as self-awareness, inner peace and the management of stress and depression. Managers emphasize that spirituality also has an impact on managing teams and teamwork, engaging in competitive behaviour, encouraging honesty and reducing selfishness. Based on the findings, a conclusion is given and practical as well as scientific recommendations are emphasized. In love lies the seed of our growth. The more we love, the closer we are to the spiritual experience. (Paulo Coelho, 1994). PMID:24953148

  19. Beliefs about Racism and Health among African American Women with Diabetes: A Qualitative Study

    PubMed Central

    Wagner, Julie A.; Osborn, Chandra Y.; Mendenhall, Emily A.; Budris, Lisa M.; Belay, Sophia; Tennen, Howard A.

    2011-01-01

    Exposure to racism has been linked to poor health outcomes. Little is known about the impact of racism on diabetes outcomes. This study explored African American (AA) women’s beliefs about how racism interacts with their diabetes self-management and control. Four focus groups were conducted with a convenience sample of 28 adult AA women with type 2 diabetes who were recruited from a larger quantitative study on racism and diabetes. The focus group discussions were transcribed verbatim and analyzed by the authors. Women reported that exposure to racism was a common phenomenon, and their beliefs did in fact link racism to poor health. Specifically, women reported that exposure to racism caused physiological arousal including cardiovascular and metabolic perturbations. There was consensus that physiological arousal was generally detrimental to health. Women also described limited, and in some cases maladaptive, strategies to cope with racist events including eating unhealthy food choices and portions. There was consensus that the subjective nature of perceiving racism and accompanying social prohibitions often made it impossible to address racism directly. Many women described anger in such situations, and the tendency to internalize anger and other negative emotions, only to find that the negative emotions would be reactivated repeatedly with exposure to novel racial stressors, even long after the original racist event remitted. AA women in this study believed that racism affects their diabetes self-management and control. Health beliefs can exert powerful effects on health behaviors and may provide an opportunity for health promotion interventions in diabetes. PMID:21528110

  20. Health impact of incarceration on HIV-positive African American males: a qualitative exploration.

    PubMed

    Brinkley-Rubinstein, Lauren; Turner, William L

    2013-08-01

    Previous research suggests that incarceration can have a negative effect on health. These health effects have an especially profound impact on HIV-positive individuals. As such, the current study investigates how incarceration affects the health of 12 African American HIV-positive formerly incarcerated males recruited via an AIDS Service Organization. Individuals were enrolled via purposive sampling and engaged in a series of in-depth interviews over a yearlong period (n=46). Participants ranged in age from 33 to 61 years. Most had finished high school, were not employed at time of first and last interview, and most were primarily residing at a homeless shelter. The time incarcerated ranged among participants from 3 months to 3 years. Findings suggest that health is impacted via limited and delayed access to medication, stigma, and poor quality of medical care while incarcerated. Health continues to worsen after release, largely due to incarceration's impact on individuals' social context. Macro-level policy limits opportunity to fulfill basic needs such as housing and hinders one's ability to be gainfully employed. Moreover, stigma, loss of social support, and a delay in accessing HIV-related services deleteriously impacts individuals' mental and physical health status. Implications for practice, policy and future research are also discussed. PMID:23968205

  1. Regional view of a Trans-African Drainage System

    PubMed Central

    Abdelkareem, Mohamed; El-Baz, Farouk

    2014-01-01

    Despite the arid to hyperarid climate of the Great Sahara of North Africa, pluvial climates dominated the region. Radar data shed some light on the postulated Trans-African Drainage System and its relationship to active and inactive tributaries of the Nile basin. Interpretations of recent elevation data confirm a source of the river water from the Red Sea highlands did not connect the Atlantic Ocean across Tushka basin, highlands of Uwinate and Darfur, and Chad basin, but northward to the ancestral Nile Delta. Elements of topography and climate were considered. They show that the former segments of the Nile closely mirror present-day tributaries of the Nile basin in drainage geometry, landscape, and climate. A rainfall data interpolation scenario revealed that this basin received concurrent runoff from both flanks such as Gabgaba-Allaqi to the east and Tushka basin to the west, similar to present-day Sobat and White Nile tributaries, respectively. Overall the western tributaries such as those of Tushka basin and Howar lead to the Nile, which was (and still is) the biggest river system in Africa. PMID:26257941

  2. Regional view of a Trans-African Drainage System.

    PubMed

    Abdelkareem, Mohamed; El-Baz, Farouk

    2015-05-01

    Despite the arid to hyperarid climate of the Great Sahara of North Africa, pluvial climates dominated the region. Radar data shed some light on the postulated Trans-African Drainage System and its relationship to active and inactive tributaries of the Nile basin. Interpretations of recent elevation data confirm a source of the river water from the Red Sea highlands did not connect the Atlantic Ocean across Tushka basin, highlands of Uwinate and Darfur, and Chad basin, but northward to the ancestral Nile Delta. Elements of topography and climate were considered. They show that the former segments of the Nile closely mirror present-day tributaries of the Nile basin in drainage geometry, landscape, and climate. A rainfall data interpolation scenario revealed that this basin received concurrent runoff from both flanks such as Gabgaba-Allaqi to the east and Tushka basin to the west, similar to present-day Sobat and White Nile tributaries, respectively. Overall the western tributaries such as those of Tushka basin and Howar lead to the Nile, which was (and still is) the biggest river system in Africa. PMID:26257941

  3. [The health system of Mexico].

    PubMed

    Gómez Dantés, Octavio; Sesma, Sergio; Becerril, Victor M; Knaul, Felicia M; Arreola, Héctor; Frenk, Julio

    2011-01-01

    This paper describes the Mexican health system. In part one, the health conditions of the Mexican population are discussed, with emphasis in those emerging diseases that are now the main causes of death, both in men and women: diabetes, ischaemic heart disease, cerebrovascular diseases and cancer. Part two is devoted to the description of the basic structure of the system: its main institutions, the population coverage, the health benefits of those affiliated to the different heath institutions, its financial sources, the levels of financial protection in health, the availability of physical, material and human resources for health, and the stewardship functions displayed by the Ministry of Health and other actors. This part also discusses the role of citizens in the monitorization and evaluation of the health system, as well as the levels of satisfaction with the rendered health services. In part three the most recent innovations and its impact on the performance of the health system are discussed. Salient among them are the System of Social Protection in Health and the Popular Health Insurance. The paper concludes with a brief analysis of the short- and middle-term challenges faced by the Mexican health system. PMID:21877087

  4. Using an intersectional approach to study the impact of social determinants of health for African American mothers living with HIV.

    PubMed

    Caiola, Courtney; Docherty, Sharron L; Relf, Michael; Barroso, Julie

    2014-01-01

    Heightened awareness of the social determinants of health by health scientists and clinicians has failed to translate into significant progress in the amelioration of those social determinants contributing to health inequities. The purpose of this article is to broaden the discussion about conceptual approaches nurse scientists can use to address health and health inequities. We will apply an intersectional approach to the study of the social determinants of health for African American mothers living with human immunodeficiency virus and through this explore the utility of an intersectional approach to generate knowledge in nursing. PMID:25365282

  5. [Public health and public health systems sustainability].

    PubMed

    Repullo Labrador, José R; Segura Benedicto, Andreu

    2006-01-01

    Public health and healthcare originally started out separately from one another in the past, having later further developed taking different paths in modern times. The major development the health systems underwent in the last half of the 20th century entailed a heightening of the individual standpoint and a division of these two approaches despite the attempts made to bring them together as of the WHO Alma-Ata Conference in 1978. The waning of rationalism and other social phenomena had a hand the collective or population-oriented focus being focused on to a lesser degree in Public Health, but these trends also gave rise to a growing problem of rationality in individual healthcare and sustainability in the public health systems. The debate on the current scene stands to set out the sustainability-related problems mediated by internal and external agents and to revise Public Health's possible contribution to the improvement thereof by advocating yet a further attempt at bringing together and integrating these two diverging standpoints. PMID:17193811

  6. TRICARE, Military Health System

    MedlinePlus

    ... Change My Primary Care Manager Book Appointments Getting Care When Traveling Information about Quality, Patient Safety, and Access Costs Health Plan Costs Prescription Costs Dental Costs Pay My ...

  7. Assessment of the Status of African-Americans. Volume V: Health and Medical Care of African-Americans.

    ERIC Educational Resources Information Center

    Reed, Wornie L.; Darity, William, Sr.; Roman, Stanford; Baquet, Claudia; Roberson, Norma L.

    In 1987 a project was undertaken to assess the status of African Americans in the United States in the topical areas to be addressed by the National Research Council's Study Committee on the Status of Black Americans: education, employment, income and occupations, political participation and the administration of justice, social and cultural…

  8. Using diaries to explore the work experiences of primary health care nursing managers in two South African provinces

    PubMed Central

    Munyewende, Pascalia O.; Rispel, Laetitia C.

    2014-01-01

    Background South Africa is on the brink of another wave of major health system reforms that underscore the centrality of primary health care (PHC). Nursing managers will play a critical role in these reforms. Objective The aim of the study was to explore the work experiences of PHC clinic nursing managers through the use of reflective diaries, a method hitherto under-utilised in health systems research in low- and middle-income countries. Design During 2012, a sub-set of 22 PHC nursing managers was selected randomly from a larger nurses’ survey in two South African provinces. After informed consent, participants were requested to keep individual diaries for a period of 6 weeks, using a clear set of diary entry guidelines. Reminders consisted of weekly short message service reminders and telephone calls. Diary entries were analysed using thematic content analysis. A diary feedback meeting was held with all the participants to validate the findings. Results Fifteen diaries were received, representing a 68% response rate. The majority of respondents (14/15) were female, each with between 5 and 15 years of nursing experience. Most participants made their diary entries at home. Diaries proved to be cathartic for individual nursing managers. Although inter-related and not mutually exclusive, the main themes that emerged from the diary analysis were health system deficiencies; human resource challenges; unsupportive management environment; leadership and governance; and the emotional impact of clinic management. Conclusions Diaries are an innovative method of capturing the work experiences of managers at the PHC level, as they allow for confidentiality and anonymity, often not possible with other qualitative research methods. The expressed concerns of nursing managers must be addressed to ensure the success of South Africa's health sector reforms, particularly at the PHC level. PMID:25537937

  9. Family Matters: The Role of Mental Health Stigma and Social Support on Depressive Symptoms and Subsequent Help Seeking among African American Boys

    ERIC Educational Resources Information Center

    Lindsey, Michael A.; Joe, Sean; Nebbitt, Von

    2010-01-01

    African American adolescent boys underutilize mental health service due to stigma associated with depression. Gaining an increased understanding of how depressed, African American adolescent boys perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to…

  10. Mapping of the major structures of the African rift system

    NASA Technical Reports Server (NTRS)

    Mohr, P. A. (Principal Investigator)

    1972-01-01

    The author has identified the following significant results. ERTS-1 imagery of the African rift system resolves the major Cenozoic faults, zones of warping, and the associated volcanism. It also clearly depicts the crustal grain of the Precambrian rocks where these are exposed. New structural features, or new properties of known features such as greater extent, continuity, linearity, etc., are revealed by the ERTS-1 imagery. This applies to the NE-SW fracture zones in Yemen, the Aswa mylonite zone at the northern end of the Western Rift, the Nandi fault of western Kenya, the arcuate faults of the Elgeyo escarpment in the Gregory rift, and hemi-basins of warped Tertiary lavas on the Red Sea margin of Yemen, matching those of the Ethiopian plateau-Afar margin. A tentative scheme is proposed, relating the effect on the pattern of Cenozoic faulting of the degree of obliquity to Precambrian structural trend. Some ground-mapped lithological boundaries are obscure on ERTS-1 imagery. The present approaches to mapping of Precambrian terrain in Africa may require radical revision with the input of satellite imagery.

  11. National health policies: sub-Saharan African case studies (1980-1990).

    PubMed

    Dugbatey, K

    1999-07-01

    changes in the sub-Saharan African region as a whole and in some of the case countries in particular. Political leadership has changed in Ghana and Cote d'Ivoire with some course corrections in Ghana's health plans. Health sector financing in the region has become more dependent on external donors. The World Bank leads the external donor community in promoting policy-based lending. The complexity of a number of health problems has changed while the problems themselves remain the same as before. Essentially, building viable public health infrastructures to address basic public health needs must still be high on the agenda of action for most governments in the region. Thus, notwithstanding some course corrections and reasonable shifts in priorities, all the PHC principles are still applicable, indeed, much needed in the sub-Saharan African region. This study's findings, underscoring the fact that significant improvements in health are possible even where financial resources are limited, still hold true. PMID:10414831

  12. Health Care System Accessibility

    PubMed Central

    Steinberg, Annie G; Barnett, Steven; Meador, Helen E; Wiggins, Erin A; Zazove, Philip

    2006-01-01

    BACKGROUND People who are deaf use health care services differently than the general population; little research has been carried out to understand the reasons. OBJECTIVE To better understand the health care experiences of deaf people who communicate in American Sign Language. DESIGN Qualitative analyses of focus group discussions in 3 U.S. cities. PARTICIPANTS Ninety-one deaf adults who communicate primarily in American Sign Language. MEASUREMENTS We collected information about health care communication and perceptions of clinicians' attitudes. We elicited stories of both positive and negative encounters, as well as recommendations for improving health care. RESULTS Communication difficulties were ubiquitous. Fear, mistrust, and frustration were prominent in participants' descriptions of health care encounters. Positive experiences were characterized by the presence of medically experienced certified interpreters, health care practitioners with sign language skills, and practitioners who made an effort to improve communication. Many participants acknowledged limited knowledge of their legal rights and did not advocate for themselves. Some participants believed that health care practitioners should learn more about sociocultural aspects of deafness. CONCLUSIONS Deaf people report difficulties using health care services. Physicians can facilitate change to improve this. Future research should explore the perspective of clinicians when working with deaf people, ways to improve communication, and the impact of programs that teach deaf people self-advocacy skills and about their legal rights. PMID:16499543

  13. Reducing uncertainty in nitrogen budgets for African livestock systems

    NASA Astrophysics Data System (ADS)

    Rufino, M. C.; Brandt, P.; Herrero, M.; Butterbach-Bahl, K.

    2014-10-01

    Livestock is poorly represented in N budgets for the African continent although some studies have examined livestock-related N flows at different levels. Livestock plays an important role in N cycling and therefore on N budgets including livestock-related flows. This study reviews the literature on N budgets for Africa to identify factors contributing to uncertainties. Livestock densities are usually modelled because of the lack of observational spatial data. Even though feed availability and quality varies across seasons, most studies use constant livestock excretion rates, and excreta are usually assumed to be uniformly distributed onto the land. Major uncertainties originate in the fraction of manure managed, and emission factors which may not reflect the situation of Africa. N budgets use coarse assumptions on production, availability, and use of crop residues as livestock feed. No flows between croplands-livestock and rangelands reflect the lack of data. Joint efforts are needed for spatial data collection of livestock data, crowdsourcing appears to be a promising option. The focus of the assessment of N budgets must go beyond croplands to include livestock and crop-livestock flows. We propose a nested systems definition of livestock systems to link local, regional level, and continental level and to increase the usefulness of point measurements of N losses. Scientists working at all levels should generate data to calibrate process-based models. Measurements in the field should not only concentrate on greenhouse gas emissions, but need to include crop and livestock production measurements, soil stock changes and other N loss pathways such as leaching, run-off and volatilization to assess management practices and trade-offs. Compared to the research done in other continents on N flows in livestock systems, there are few data for Africa, and therefore concerted effort will be needed to generate sufficient data for modelling.

  14. Hydrothermal vents in Lake Tanganyika, East African, Rift system

    NASA Astrophysics Data System (ADS)

    Tiercelin, Jean-Jacques; Pflumio, Catherine; Castrec, Maryse; Boulégue, Jacques; Gente, Pascal; Rolet, Joël; Coussement, Christophe; Stetter, Karl O.; Huber, Robert; Buku, Sony; Mifundu, Wafula

    1993-06-01

    Sublacustrine hydrothermal vents with associated massive sulfides were discovered during April 1987 at Pemba and Cape Banza on the Zaire side of the northern basin of Lake Tanganyika, East African Rift system. New investigations by a team of ten scuba divers during the multinational (France, Zaire, Germany, and Burundi) TANGANYDRO expedition (August-October 1991) found hydrothermal vents down to a depth of 46 m along north-trending active faults bounding the Tanganyika rift on the western side. Temperatures from 53 to 103 °C were measured in hydrothermal fluids and sediments. Veins of massive sulfides 1-10 cm thick (pyrite and marcasite banding) were found associated with vents at the Pemba site. At Cape Banza,active vents are characterized by 1-70-cm-high aragonite chimneys, and there are microcrystalline pyrite coatings on the walls of hydrothermal pipes. Hydrothermal fluid end members show distinctive compositions at the two sites. The Pemba end member is a NaHCO3-enriched fluid similar to the NaHCO3 thermal fluids from lakes Magadi and Bogoria in the eastern branch off the rift. The Cape Banza end member is a solution enriched in NaCl. Such brines may have a deep-seated basement origin, as do the Uvinza NaCl brines on the eastern flank of the Tanganyika basin. Geothermometric calculations have yielded temperatures of fluid-rock interaction off 219 and 179 °C in the Pemba and Cape Banza systems, respectively. Abundant white or reddish-brown microbial colonies resembling Beggiatoa mats were found surrounding the active vents. Thermal fluid circulation is permitted by opening of cracks related to 130 °N normal-dextral faults that intersect the north- south major rift trend. The source of heat for such hydrothermal systems may relate to the existence of magmatic bodies under the rift, which is suggested by the isotopic composition of carbon dioxide released at Pemba and Cape Banza.

  15. Using the health belief model to develop culturally appropriate weight-management materials for African-American women.

    PubMed

    James, Delores C S; Pobee, Joseph W; Oxidine, D'lauren; Brown, Latonya; Joshi, Gungeet

    2012-05-01

    African-American women have the highest prevalence of adult obesity in the United States. They are less likely to participate in weight-loss programs and tend to have a low success rate when they do so. The goal of this project was to explore the use of the Health Belief Model in developing culturally appropriate weight-management programs for African-American women. Seven focus groups were conducted with 50 African-American women. The Health Belief Model was used as the study's theoretical framework. Participants made a clear delineation between the terms healthy weight, overweight, and obese. Sexy, flirtatious words, such as thick, stacked, and curvy were often used to describe their extra weight. Participants accurately described the health risks of obesity. Most believed that culture and genetics made them more susceptible to obesity. The perceived benefits of losing weight included reduced risk for health problems, improved physical appearance, and living life to the fullest. Perceived barriers included a lack of motivation, reliable dieting information, and social support. Motivators to lose weight included being diagnosed with a health problem, physical appearance, and saving money on clothes. Self-efficacy was primarily affected by a frustrated history of dieting. The data themes suggest areas that should be addressed when developing culturally appropriate weight-loss messages, programs, and materials for African-American women. PMID:22709771

  16. Project Joy: faith based cardiovascular health promotion for African American women.

    PubMed Central

    Yanek, L. R.; Becker, D. M.; Moy, T. F.; Gittelsohn, J.; Koffman, D. M.

    2001-01-01

    OBJECTIVE: The authors tested the impact on cardiovascular risk profiles of African American women ages 40 years and older after one year of participation in one of three church-based nutrition and physical activity strategies: a standard behavioral group intervention, the standard intervention supplemented with spiritual strategies, or self-help strategies. METHODS: Women were screened at baseline and after one year of participation. The authors analyzed intention-to-treat within group and between groups using a generalized estimating equations adjustment for intra-church clustering. Because spiritual strategies were added to the standard intervention by participants themselves, the results from both active groups were similar and, thus, combined for comparisons with the self-help group. RESULTS: A total of 529 women from 16 churches enrolled. Intervention participants exhibited significant improvements in body weight (-1.1 lbs), waist circumference (-0.66 inches), systolic blood pressure (-1.6 mmHg), dietary energy (-117 kcal), dietary total fat (-8 g), and sodium intake (-145 mg). The self-help group did not. In the active intervention group, women in the top decile for weight loss at one year had even larger, clinically meaningful changes in risk outcomes (-19.8 lbs). CONCLUSIONS: Intervention participants achieved clinically important improvements in cardiovascular disease risk profiles one year after program initiation, which did not occur in the self-help group. Church-based interventions can significantly benefit the cardiovascular health of African American women. PMID:11889276

  17. Biomedical research, a tool to address the health issues that affect African populations

    PubMed Central

    2013-01-01

    Traditionally, biomedical research endeavors in low to middle resources countries have focused on communicable diseases. However, data collected over the past 20 years by the World Health Organization (WHO) show a significant increase in the number of people suffering from non-communicable diseases (e.g. heart disease, diabetes, cancer and pulmonary diseases). Within the coming years, WHO predicts significant decreases in communicable diseases while non-communicable diseases are expected to double in low and middle income countries in sub-Saharan Africa. The predicted increase in the non-communicable diseases population could be economically burdensome for the basic healthcare infrastructure of countries that lack resources to address this emerging disease burden. Biomedical research could stimulate development of healthcare and biomedical infrastructure. If this development is sustainable, it provides an opportunity to alleviate the burden of both communicable and non-communicable diseases through diagnosis, prevention and treatment. In this paper, we discuss how research using biomedical technology, especially genomics, has produced data that enhances the understanding and treatment of both communicable and non-communicable diseases in sub-Saharan Africa. We further discuss how scientific development can provide opportunities to pursue research areas responsive to the African populations. We limit our discussion to biomedical research in the areas of genomics due to its substantial impact on the scientific community in recent years however, we also recognize that targeted investments in other scientific disciplines could also foster further development in African countries. PMID:24143865

  18. Association between witnessing traumatic events and psychopathology in the South African Stress and Health Study

    PubMed Central

    Platt, Jonathan; Williams, David R.; Stein, Dan J.; Koenen, Karestan C.

    2016-01-01

    Background The high burden of witnessing traumatic events has been demonstrated in previous research in South Africa. However, previous work has focused on PTSD rather than a broader range of psychopathological outcomes. This study examined the association between witnessing trauma and multiple outcomes including mood, anxiety, and substance use disorders. Methods Regression models measured the odds of mood, anxiety, and substance use disorders among those who reported witnessing in the South African Stress and Health Study. Discrete-time survival analysis was used to examine whether witnessing was associated with earlier onset of mental disorders. Results Witnessing trauma was more commonly reported among males and those with low-average education. Posttraumatic stress disorder, mood, and anxiety disorders varied significantly with witnessing status, and witnessing was associated with exposure to a higher number of traumatic events compared to other types of traumatic events. Respondents reporting witnessing trauma had elevated odds of mood and anxiety disorders, but not substance use disorders. Conclusion Witnessing trauma is common in the South African population and results in increased risk of mood and anxiety disorders. Interventions aimed at reducing the burden of trauma and its outcomes must now increase their focus on bystanders and other observers, rather than just focusing on those directly affected. PMID:25773525

  19. Czech Republic: health system review.

    PubMed

    Alexa, Jan; Recka, Lukas; Votapkova, Jana; van Ginneken, Ewout; Spranger, Anne; Wittenbecher, Friedrich

    2015-01-01

    This analysis of the Czech health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The Czech health-care system is based on compulsory statutory health insurance providing virtually universal coverage and a broad range of benefits, and doing so at 7.7 % of GDP in 2012 - well below the EU average - of which a comparatively high 85 % was publicly funded. Some important health indicators are better than the EU averages (such as mortality due to respiratory disease) or even among the best in the world (in terms of infant mortality, for example). On the other hand, mortality rates for diseases of the circulatory system and malignant neoplasms are well above the EU average, as are a range of health-care utilization rates, such as outpatient contacts and average length of stay in acute care hospitals. In short, there is substantial potential in the Czech Republic for efficiency gains and to improve health outcomes. Furthermore, the need for reform in order to financially sustain the system became evident again after the global financial crisis, but there is as yet no consensus about how to achieve this. PMID:26106825

  20. Tobacco--its role in the economy and the health of African countries.

    PubMed

    1985-01-01

    In Africa the issue of smoking and health is complicated by the fact that in many countries tobacco is grown commercially and is relied upon to bring in foreign exchange through export, of revenue for the government if sold on the home market. Consequently, in some nations the ministries of health and of agriculture are working at cross purposes. This contradiction is recognized in the report issued recently of a World Health Organization (WHO) seminar on smoking and health organized for English-speaking Member States of the WHO African Region, and held in Zambia. In opening the seminar, the prime minister of Zambia, Mr. N. Mundia, stated that governments had an obligation to educate people on the risks involved in the use of tobacco but that this could pose a moral dilemma where tobacco production made an apparently significant contribution to the economy. Additionally, he warned that developing countries are considered valuable markets by tobacco companies and stressed that if the promotion of tobacco products by such companies represented a threat "to the health of our people, we cannot let it happen." This point was endorsed by Mr. W.C. Mwambazi, the National WHO Program Coordinator who stated that smoking was on the increase in many developing countries as a result of unscrupulous marketing practices by cigarette manufacturers and that smoking was a major threat to the realization of health for all by the year 2000. Aspects of smoking and health that have special relevance for Africa are emphasized in the report. The few studies carried out in Africa tend to confirm findings from the developed world that smoking increases the risk of cancer and coronary heart disease. Not only is tobacco smoked in Africa, but it is chewed and taken as snuff, and these uses also entail a risk to health. Case studies included in the report show that transnational tobacco companies take full advantage of the present lack of legislation in most African countries on the promotion

  1. Russian Federation. Health system review.

    PubMed

    Popovich, Larisa; Potapchik, Elena; Shishkin, Sergey; Richardson, Erica; Vacroux, Alexandra; Mathivet, Benoit

    2011-01-01

    The HiT reviews are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. At independence from the Soviet Union in 1991, the Russian health system inherited an extensive, centralized Semashko system, but was quick to reform health financing by adopting a mandatory health insurance (MHI) model in 1993. MHI was introduced in order to open up an earmarked stream of funding for health care in the face of severe fiscal constraints. While the health system has evolved and changed significantly since the early 1990 s, the legacy of having been a highly centralized system focused on universal access to basic care remains. High energy prices on world markets have ensured greater macroeconomic stability, a budget surplus and improvements in living standards for most of the Russian population. However, despite an overall reduction in the poverty rate, there is a marked urban rural split and rural populations have worse health and poorer access to health services than urban populations. The increase in budgetary resources available to policy-makers have led to a number of recent federal-level health programmes that have focused on the delivery of services and increasing funding for priority areas including primary care provision in rural areas. Nevertheless, public health spending in the Russian Federation remains relatively low given the resources available. However, it is also clear that, even with the current level of financing, the performance of the health system could be improved. Provider payment mechanisms are the main obstacle to improving technical efficiency in

  2. Let's Talk about the Needs of African American Children with Sickle Cell Disease: A Recognized "Other Health Impairment."

    ERIC Educational Resources Information Center

    Dooley, Elizabeth A.; Perkins, Nechelle

    Children who inherit sickle cell disease, primarily African Americans and Hispanics, are at risk for serious medical conditions and require special care both at home and in school. Sickle cell disease is recognized as an "Other Health Impairment" and identified students may be eligible for special education services under the Individuals with…

  3. Racial Identity as a Predictor of the Psychological Health of African American Students at a Predominantly White University

    ERIC Educational Resources Information Center

    Pillay, Yegan

    2005-01-01

    This study examined racial identity attitudes, acculturation, and gender as predictors of psychological health in a sample of African American college students. The participants were 136 undergraduate students who attended a predominantly White midwestern university. Hierarchical regression analysis indicated that gender was a significant…

  4. Health Information-Seeking Practices of African American Young Men Who Have Sex with Men: A Qualitative Study

    ERIC Educational Resources Information Center

    Rose, India D.; Friedman, Daniela B.; Spencer, S. Melinda; Annang, Lucy; Lindley, Lisa L.

    2016-01-01

    The current study used a qualitative, phenomenological approach to investigate the health information-seeking practices of African American young men who have sex with men (AAYMSM). Forty-two self-identified AAYMSM, aged 18 to 21, residing in a Southeastern U.S. city participated in a qualitative focus group or face-to-face interview to examine…

  5. YOUR Blessed Health: A Faith-Based CBPR Approach to Addressing HIV/AIDS among African Americans

    ERIC Educational Resources Information Center

    Griffith, Derek M.; Pichon, Latrice C.; Campbell, Bettina; Allen, Julie Ober

    2010-01-01

    Despite substantial federal, state, and local efforts to reduce the transmission of HIV/AIDS, African Americans experience higher rates of infection than any other ethnic or racial group in the United States. It is imperative to develop culturally and ecologically sensitive interventions to meet the sexual health needs of this population.…

  6. A Comprehensive Test of the Health Belief Model in the Prediction of Condom Use among African American College Students.

    ERIC Educational Resources Information Center

    Winfield, Evelyn B.; Whaley, Arthur L.

    2002-01-01

    Tested an expanded version of the Health Belief Model (HBM) in predicting condom use among heterosexual African American college students. Overall, only the core HBM explained a significant amount of variance in condom use. Perceived barriers and gender significantly predicted condom use. Perceived barriers mediated the correlation between gender…

  7. Promoting Sexual Health Equity in the United States: Implications from Exploratory Research with African-American Adults

    ERIC Educational Resources Information Center

    Friedman, Allison L.; Uhrig, Jennifer; Poehlman, Jon; Scales, Monica; Hogben, Matthew

    2014-01-01

    In an effort to inform communication efforts to promote sexual health equity in the United States, the Centers for Disease Control and Prevention sought to explore African-Americans' perceptions of the sexually transmitted disease (STD) problem in their communities, reactions to racially comparative STD data and opinions about dissemination…

  8. African American Women and HIV/AIDS: A National Call for Targeted Health Communication Strategies to Address a Disparity

    PubMed Central

    Arya, Monisha; Behforouz, Heidi L.; Viswanath, Kasisomayajula

    2013-01-01

    Dr Arya is assistant professor of medicine in the section of infectious diseases at the Baylor College of Medicine and a health services researcher at the Houston Center for Quality of Care and Utilization Studies in Houston. Dr Behforouz is assistant professor of medicine at Harvard Medical School, medical and executive director of the Prevention and Access to Care and Treatment Project, and associate physician in the Brigham Internal Medicine Associates at Brigham and Women’s Hospital, Boston. Dr Viswanath is associate professor of society, human development and health at the Harvard School of Public Health and director of the Health Communication Core of the Dana-Farber/Harvard Cancer Center, Boston. At the time of manuscript submission, Dr Arya was a fellow in the division of infectious diseases at Beth Israel Deaconess Medical Center and Harvard Medical School. African American women are disproportionately affected by the HIV/AIDS epidemic in the United States. To address this disparity, the CDC released a call for targeted communication campaigns in African American communities. The mass media is an HIV/AIDS information source used by African Americans, and media initiatives can be cost-effective for delivering HIV prevention messages. Needed is research in communities at risk to determine the messages needed and the preferred formats and channels with which to deliver the messages so that targeted communication campaigns can be part of the multifaceted approach to ending the HIV/AIDS disparity affecting African American women. PMID:19271331

  9. Achieving Equity through Critical Science Agency: An Ethnographic Study of African American Students in a Health Science Career Academy

    ERIC Educational Resources Information Center

    Haun-Frank, Julie

    2010-01-01

    The purpose of this study was to examine the potential of a High School Health Science Career Academy to support African American students' science career trajectories. I used three key theoretical tools---critical science agency (Basu, 2007; Calabrese Barton & Tan, 2008), power (Nespor, 1994), and cultural production (Carlone, 2004; Eisenhart &…

  10. A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment

    PubMed Central

    Johnson, Leigh F; Dorrington, Rob E; Laubscher, Ria; Hoffmann, Christopher J; Wood, Robin; Fox, Matthew P; Cornell, Morna; Schomaker, Michael; Prozesky, Hans; Tanser, Frank; Davies, Mary-Ann; Boulle, Andrew

    2015-01-01

    Introduction There is uncertainty regarding the completeness of death recording by civil registration and by health centres in South Africa. This paper aims to compare death recording by the two systems, in cohorts of South African patients receiving antiretroviral treatment (ART). Methods Completeness of death recording was estimated using a capture–recapture approach. Six ART programmes linked their patient record systems to the vital registration system using civil identity document (ID) numbers and provided data comparing the outcomes recorded in patient files and in the vital registration. Patients were excluded if they had missing/invalid IDs or had transferred to other ART programmes. Results After exclusions, 91,548 patient records were included. Of deaths recorded in patients files after 2003, 94.0% (95% CI: 93.3–94.6%) were recorded by civil registration, with completeness being significantly higher in urban areas, older adults and females. Of deaths recorded by civil registration after 2003, only 35.0% (95% CI: 34.2–35.8%) were recorded in patient files, with this proportion dropping from 60% in 2004–2005 to 30% in 2010 and subsequent years. Recording of deaths in patient files was significantly higher in children and in locations within 50 km of the health centre. When the information from the two systems was combined, an estimated 96.2% of all deaths were recorded (93.5% in children and 96.2% in adults). Conclusions South Africa's civil registration system has achieved a high level of completeness in the recording of mortality. However, the fraction of deaths recorded by health centres is low and information from patient records is insufficient by itself to evaluate levels and predictors of ART patient mortality. Previously documented improvements in ART mortality over time may be biased if based only on data from patient records. PMID:26685125

  11. Understanding African American Adolescents’ Identity Development: A Relational Developmental Systems Perspective

    PubMed Central

    Brittian, Aerika S.

    2012-01-01

    This article examines the development of African American adolescents’ identity using a relational developmental systems theory framework, which led to the expectation that identity development is linked to both the reduction of risk behaviors and the promotion of African American adolescents’ healthy development. Different personological theories of identity development were discussed, including Erikson’s theory of psychosocial development and Marcia’s theory of identity statuses. Developmental systems theory was used to further the literature on African American adolescents’ identity development, by integrating various views of identity development as they pertain to these youth. Furthermore, the formation of many aspects of identity may be an important coping and resilience process for such youth. In addition, directions for future research are discussed, including a consideration of the complexity of diversity that exists within the African American adolescent population, and a call for more longitudinal assessments of identity development is presented. PMID:23243325

  12. Evolutionary and comparative anatomical investigations of the autonomic cardiac nervous system in the African Cercopithecidae.

    PubMed

    Kawashima, Tomokazu; Akita, Keiichi; Sato, Kenji; Sasaki, Hiroshi

    2007-09-01

    The purpose of this study was to clarify the general architecture and morphological variations of the autonomic cardiac nervous system (ACNS) in the African Cercopithecidae (Old World monkeys), and to discuss the evolutionary changes between this system in African/Asian Cercopithecidae and humans. A detailed macroscopic comparative morphological investigation of the ACNS was performed by examining the left and right sides of 11 African cercopithecid specimens, including some previously unreported species (Abyssinian colobus, Angola pied colobus, Savanna monkey, and lesser white-nosed guenon). The common characteristics of the ACNS in the African Cercopithecidae are described in detail. Consequently, homologies of the ACNS between Asian (macaques) and African Cercopithecidae, and differences between the Asian/African Cercopithecidae and humans, were found. In particular, differences in the sympathetic (cardiac) systems of the Cercopithecidae and humans were recognized, despite the similar morphology of the parasympathetic vagal (cardiac) system. These differences include the composition of the cervicothoracic ganglion, the lower positions of the middle cervical and cervicothoracic ganglia, and the narrow range for the origin of the cardiac nerves in the Cercopithecidae, compared with that in humans. In conclusion, these findings are considered with regard to the morphology of the last common ancestors of the Cercopithecidae. PMID:17591730

  13. Planning health care delivery systems.

    PubMed Central

    Baum, M A; Bergwall, D F; Reeves, P N

    1975-01-01

    The increasing concern and interest in the health delivery system in the United States has placed the health system planners in a difficult position. They are inadequately prepared, in many cases, to deal with the management techniques that have been designed for use with system problems. This situation has been compounded by the failure, until recently, of educational programs to train new health professionals in these techniques. Computer simulation is a technique that allows the planners dynamic feedback on his proposed plans. This same technique provides the planning student with a better understanding of the systems planning process. PMID:1115292

  14. Exploring uncertainty in advance care planning in African Americans: does low health literacy influence decision making preference at end of life.

    PubMed

    Melhado, Lolita; Bushy, Angeline

    2011-11-01

    African Americans over 65 represent 3.5 of the 35.6 million Americans. Morbidity and mortality rates are highest among this group; associated with lack of resources and awareness of health problems. But health needs are the same at end of life, yet care is less than optimal. African Americans are less likely to have advance directives nonetheless desire communication, information, respect, and a trusting doctor-patient relationship. Low health literacy may contribute to this disparity. This scholarly review examines the health literacy in advance care planning and refines concepts of uncertainty in illness theory deriving a model for advance care planning in African Americans. PMID:21398263

  15. Hydrothermal vents is Lake Tanganyika, East African Rift system

    SciTech Connect

    Tiercelin, J.J.; Pflumio, C.; Castrec, M.

    1993-06-01

    Sublacustrine hydrothermal vents with associated massive sulfides were discovered during April 1987 at Pemba and Cape Banza on the Zaire side of the northern basin of Lake Tanganyika, East African Rift system. New investigations by a team of ten scuba divers during the multinational (France, Zaire, Germany, and Burundi) TANGANYDRO expedition (August-October 1991) found hydrothermal vents down to a depth of 46 m along north-trending active faults bounding the Tanganyika rift on the western side. Temperatures from 53 to 103 {degrees}C were measured in hydrothermal fluids and sediments. Veins of massive sulfides 1-10 cm thick (pyrite and marcasite banding) were found associated with vents at the Pemba site. At Cape Banza, active vents are characterized by 1-70-cm-high aragonite chimneys, and there are microcrystalline pyrite coatings on the walls of hydrothermal pipes. Hydrothermal fluid end members show distinctive compositions at the two sites. The Pemba end member is a NaHCO{sub 3}-enriched fluid similar to the NaHCO{sub 3} thermal fluids form lakes Magadi and Bogoria in the eastern branch of the rift. The Cape Banza end member is a solution enriched in NaCl. Such brines may have a deep-seated basement origin, as do the Uvinza NaCl brines on the eastern flank of the Tanganyika basin. Geothermometric calculations have yielded temperatures of fluid-rock interaction of 219 and 179 {degrees}C in the Pemba and Cape Banza systems, respectively. Abundant white or reddish-brown microbial colonies resembling Beggiatoa mats were found surrounding the active vents. Thermal fluid circulation is permitted by opening of cracks related to 130{degrees}N normal-dextral faults that intersect the north-south major rift trend. The sources of heat for such hydrothermal systems may relate to the existence of magmatic bodies under the rift, which is suggested by the isotopic composition of carbon dioxide released at Pemba and Cape Banza. 21 refs., 2 figs.

  16. African Educational Systems: A Comparative Approach. Edu 510.

    ERIC Educational Resources Information Center

    Watson, Rose T.

    This course of study for college students is about educational development in tropical Africa, or Africa south of the Sahara, excluding North Africa and the Republic of South Africa. The major goals of the course are to help students gain knowledge about the educational policies and practices of African countries under the rule of Belgium,…

  17. Thinking shift on health systems: from blueprint health programmes towards resilience of health systems

    PubMed Central

    Blanchet, Karl

    2015-01-01

    International health is still highly dominated by equilibrium approaches. The emergence of systems thinking in international health provides a great avenue to develop innovative health interventions adapted to changing contexts. The public health community, nevertheless, has the responsibility to translate concepts related to systems thinking and complexity into concrete research methods and interventions. One possibility is to consider the properties of systems such as resilience and adaptability as entry points to better understand how health systems react to shocks. PMID:25905481

  18. Masculinity and Race-Related Factors as Barriers to Health Help-Seeking Among African American Men.

    PubMed

    Powell, Wizdom; Adams, Leslie B; Cole-Lewis, Yasmin; Agyemang, Amma; Upton, Rachel D

    2016-01-01

    Men's tendency to delay health help-seeking is largely attributed to masculinity, but findings scarcely focus on African American men who face additional race-related, help-seeking barriers. Building principally on reactance theory, we test a hypothesized model situating racial discrimination, masculinity norms salience (MNS), everyday racism (ERD), racial identity, sense of control (SOC), and depressive symptomatology as key barriers to African American men's health help-seeking. A total of 458 African American men were recruited primarily from US barbershops in the Western and Southern regions. The primary outcome was Barriers to Help-Seeking Scale (BHSS) scores. The hypothesized model was investigated with confirmatory factor and path analysis with tests for measurement invariance. Our model fit was excellent [Formula: see text] CFI = 0.99; TLI = 1.00; RMSEA = 0.00, and 90% CI [0.00, 0.07] and operated equivalently across different age, income, and education strata. Frequent ERD and higher MNS contributed to higher BHHS scores. The relationship between ERD exposure and BHHS scores was partially mediated by diminished SOC and greater depressive symptomatology. Interventions aimed at addressing African American men's health help-seeking should not only address masculinity norms but also threats to sense of control, and negative psychological sequelae induced by everyday racism. PMID:27337619

  19. African Programme for Onchocerciasis Control 1995–2015: Model-Estimated Health Impact and Cost

    PubMed Central

    Coffeng, Luc E.; Stolk, Wilma A.; Zouré, Honorat G. M.; Veerman, J. Lennert; Agblewonu, Koffi B.; Murdoch, Michele E.; Noma, Mounkaila; Fobi, Grace; Richardus, Jan Hendrik; Bundy, Donald A. P.; Habbema, Dik; de Vlas, Sake J.; Amazigo, Uche V.

    2013-01-01

    Background Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015. Methods and Findings With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs) lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million. Conclusions Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future. PMID:23383355

  20. [Health Communication: Preventing the Spread of Ebola Virus Disease in the Portuguese Spoken African Countries--Methodology KISS & KEYWORDS].

    PubMed

    Santiago, Isabel De; Miguel, José Pereira; Antunes, Francisco

    2015-01-01

    In this work, Health Communication is considered as an important discipline in medicine and health sciences for his role as true determinant of health. We highlight their contribution to health promotion and disease prevention. Thus, the Health Communication Plan (PCS): Preventing the spread of Ebola virus disease in the Portuguese Speaking African Countries - KISS & KEYWORDS methodology is a tool that aims to minimize the risk of infection by Ebola virus in the Portuguese Speaking African Countries and also train for a general improvement of health conditions of the local populations. In the PCS design are especially considered the social and cultural contexts of the target populations, especially the customs, traditions and religion. Health Communication is considered as an Essential Function of Public Health and its main is to provide a population-based approach. The target of communication actions are population groups in addition to the individual communication, target-audiences are people without access to the media, in Guinea Bissau, Cape Verde and Sao Tome and Principe. Under the communication plan uses the methodology, models and practices both by media professionals as health. A proximity approach and cultural mediation, previously identified key facts, are defined objectives; outlines to the Plan in concrete and its implementation methodology (target-audience and following intervention, materials to be used and key-messages and partners to mobilize) following the World Health Organisation standards. PMID:26061502

  1. The Netherlands: health system review.

    PubMed

    Schäfer, Willemijn; Kroneman, Madelon; Boerma, Wienke; van den Berg, Michael; Westert, Gert; Devillé, Walter; van Ginneken, Ewout

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of health systems and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems. They also describe the institutional framework, process, content, and implementation of health and health care policies, highlighting challenges and areas that require more in-depth analysis. Undoubtedly the dominant issue in the Dutch health care system at present is the fundamental reform that came into effect in 2006. With the introduction of a single compulsory health insurance scheme, the dual system of public and private insurance for curative care became history. Managed competition for providers and insurers became a major driver in the health care system. This has meant fundamental changes in the roles of patients, insurers, providers and the government. Insurers now negotiate with providers on price and quality and patients choose the provider they prefer and join a health insurance policy which best fits their situation. To allow patients to make these choices, much effort has been made to make information on price and quality available to the public. The role of the national government has changed from directly steering the system to safeguarding the proper functioning of the health markets. With the introduction of market mechanisms in the health care sector and the privatization of former sickness funds, the Dutch system presents an innovative and unique variant of a social health insurance system. Since the stepwise realization of the blueprint of the system has not yet been completed, the health care system in The Netherlands should be characterized as being in transition. Many measures have been taken to move from the old to the new system as smoothly as possible. Financial measures intended to prevent sudden budgetary

  2. Czechoslovakia's changing health care system.

    PubMed Central

    Raffel, M W; Raffel, N K

    1992-01-01

    Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services. PMID:1454975

  3. Basement control in the development of the early cretaceous West and Central African rift system

    NASA Astrophysics Data System (ADS)

    Maurin, Jean-Christophe; Guiraud, René

    1993-12-01

    The structural framework of the Precambrian basement of the West and Central African Rift System (WCARS) is described in order to examine the role of ancient structures in the development of this Early Cretaceous rift system. Basement structures are represented in the region by large Pan-African mobile belts (built at ca. 600 Ma) surrounding the > 2 Ga West African, Congo and Sao Francisco cratons. Except for the small Gao trough (eastern Mali) located near the contact nappe of the Pan-African Iforas suture zone along the edge of the West African craton, the entire WCARS is located within the internal domains of the Pan-African mobile belts. Within these domains, two main structural features occur as the main basement control of the WCARS: (1) an extensive network of near vertical shear zones which trend north-south through the Congo, Brazil, Nigeria, Niger and Algeria, and roughly east-west through northeastern Brazil and Central Africa. The shear zones correspond to intra-continental strike-slip faults which accompanied the oblique collision between the West African, Congo, and Sao Francisco cratons during the Late Proterozoic; (2) a steep metamorphic NW-SE-trending belt which corresponds to a pre-Pan-African (ca. 730 Ma) ophiolitic suture zone along the eastern edge of the Trans-Saharian mobile belt. The post-Pan-African magmatic and tectonic evolution of the basement is also described in order to examine the state of the lithosphere prior to the break-up which occurred in the earliest Cretaceous. After the Pan-African thermo-tectonic event, the basement of the WCARS experienced a long period of intra-plate magmatic activity. This widespread magmatism in part relates to the activity of intra-plate hotspots which have controlled relative uplift, subsidence and occasionally block faulting. During the Paleozoic and the early Mesozoic, this tectonic activity was restricted to west of the Hoggar, west of Aïr and northern Cameroon. During the Late Jurassic

  4. [The health system of Venezuela].

    PubMed

    Bonvecchio, Anabelle; Becerril-Montekio, Victor; Carriedo-Lutzenkirchen, Angela; Landaeta-Jiménez, Maritza

    2011-01-01

    This paper describes the Venezuelan health system, including its structure and coverage, financial sources, human and material resources and its stewardship functions. This system comprises a public and a private sector. The public sector includes the Ministry of Popular Power for Health (MS) and several social security institutions, salient among them the Venezuelan Institute for Social Security (IVSS). The MH is financed with federal, state and county contributions. The IVSS is financed with employer, employee and government contributions. These two agencies provide services in their own facilities. The private sector includes providers offering services on an out-of-pocket basis and private insurance companies. The Venezuelan health system is undergoing a process of reform since the adoption of the 1999 Constitution which calls for the establishment of a national public health system. The reform process is now headed by the Barrio Adentro program. PMID:21877092

  5. [Corruption and health care system].

    PubMed

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions. PMID:26016214

  6. Unpacking the new proposed regulations for South African traditional health practitioners.

    PubMed

    Street, Renee Anne

    2016-04-01

    South Africa (SA) has legislation that regulates almost all of its healthcare systems. The Traditional Health Practitoners Act finally provides legitimisation of an overwhelmingly popular indigenous healthcare system. However, as a consequence of the legal acknowledgement of traditional health practitioners, traditional medicine products must now also be brought under regulatory measures. If traditional medicines are to be prescribed, marketed and sold as part of a healthcare system recognised under SA law, they must meet the same stringent standards. PMID:27032840

  7. Hypertension and Diabetes Mellitus: A Preliminary South African Health Promotion Activity Using Service-Learning Principles.

    PubMed

    Srinivas, Sunitha C; Paphitis, Sharli Anne

    2016-06-01

    A marked increase in the chronic non-communicable diseases such as hypertension and diabetes mellitus in the South African population is in concert with global trends. A health promotion activity carried out by pharmacy students for school learners during the Sasol National Festival of Science and Technology (SciFest) in South Africa was used as a service-learning opportunity. Pilot tested quizzes on hypertension and diabetes were used to determine the level of knowledge of attendees before and after taking the computer based quiz. Posters, information leaflets and interactive models on these two conditions were also used to reach out to the larger population. Of the 203 participants for the hypertension quiz, 169 completed both the pre- and post-intervention quizzes. Similarly, 86 of the 104 participants for the diabetes quiz, completed both the pre- and post-intervention quizzes. The results show that the post-intervention quiz resulted in a significant increase in the scores from 78.2 to 85.6 % in the case of Hypertension while a marginal increase from 94.2 to 95.5 % was obtained in the case of diabetes. The knowledge of the SciFest attendees with regard to both conditions is above average and improved further after the educational intervention. Health promotion activities which include interactive educational methods and culturally appropriate materials carried out by pharmacy students during service-learning courses are important for improving the awareness on the prevention of these chronic health conditions. Heath promotion service-learning courses can assist in addressing the health care gaps which arise because of a lack of co-ordinated efforts between NGO's and local Government to address the prevention and management of non-communicable diseases such as hypertension and diabetes mellitus. PMID:26659854

  8. Perceived Discrimination is Associated with Health Behaviors among African Americans in the Jackson Heart Study*

    PubMed Central

    Sims, Mario; Diez-Roux, Ana V.; Gebreab, Samson Y.; Brenner, Allison; Dubbert, Patricia; Wyatt, Sharon; Bruce, Marino; Hickson, DeMarc; Payne, Tom; Taylor, Herman

    2016-01-01

    Background Using Jackson Heart Study data, we examined associations of multiple measures of perceived discrimination with health behaviors among African Americans (AA). Methods The cross-sectional associations of everyday, lifetime, and burden of discrimination with odds of smoking and mean differences in physical activity, dietary fat, and sleep were examined among 4,939 35–84 year old participants after adjustment for age and socioeconomic status (SES). Results Men reported slightly higher levels of everyday and lifetime discrimination than women and similar levels of burden of discrimination as women. After adjustment for age and SES, everyday discrimination was associated with more smoking and a greater percentage of dietary fat in men and women (OR for smoking: 1.13, 95%CI 1.00,1.28 and 1.19, 95%CI 1.05,1.34; mean difference in dietary fat: 0.37, p<.05 and 0.43, p<.01, in men and women, respectively). Everyday and lifetime discrimination were associated with fewer hours of sleep in men and women (mean difference for everyday discrimination: −0.08, p<.05 and −0.18, p<.001, respectively; and mean difference for lifetime discrimination: −0.08, p<.05, and −0.24, p<.001, respectively). Burden of discrimination was associated with more smoking and fewer hours of sleep in women only. Conclusions Higher levels of perceived discrimination were associated with select health behaviors among men and women. Health behaviors offer a potential mechanism through which perceived discrimination affects health in AA. PMID:26417003

  9. Mortgage foreclosure and health disparities: serial displacement as asset extraction in African American populations.

    PubMed

    Saegert, Susan; Fields, Desiree; Libman, Kimberly

    2011-06-01

    In this paper we offer a conceptualization of mortgage foreclosure as serial displacement by highlighting the current crisis in the context of historically repeated extraction of capital-economic, social, and human-from communities defined at different scales: geographically, socially, and that of embodied individuals. We argue that serial displacement is the loss of capital, physical resources, social integration and collective capacity, and psycho-social resources at each of these scales, with losses at one level affecting other levels. The repeated extraction of resources has negative implications for the health of individuals and groups, within generations as well as across generations, through the accumulation of loss over time. Our analysis of the foreclosure crisis as serial displacement for African American households in the United States begins with the "housing niche" model. We focus on the foreclosure crisis as an example of the interconnectedness of structured inequality in health and housing. Then we briefly review the history of policies related to racial inequality in homeownership in the twentieth and twenty-first centuries. We end with an analysis of the scales of displacement and the human, social, and capital asset extraction that accompany them. PMID:21643884

  10. Health behavior and perceptions among African American women with metabolic syndrome

    PubMed Central

    Malayala, Srikrishna Varun; Raza, Ambreen

    2016-01-01

    Background Metabolic syndrome is a cluster of different risk factors (abdominal obesity, insulin resistance, high blood pressure, and high cholesterol) that predispose to the development of cardiovascular diseases. African American women (AAW) are easily predisposed to metabolic syndrome due to higher levels of insulin resistance. Various sociodemographic factors further contribute to higher prevalence. Aim This study evaluates the current prevalence of metabolic syndrome in AAW and identifies the related sociodemographic risk factors. Methods The study utilized 2007–11 National Health and Nutrition Examination Survey (NHANES) data sets from the Centers for Disease Control (CDC). The sample was divided into two groups: AAW with and without metabolic syndrome. Sociodemographic, physical examination, laboratory parameters, and health perceptions were compared between the two groups. Results Out of the available sample of 30,442 individuals, 1918 (6.4%) met the inclusion criteria (AAW, age>20, non-pregnant women). The prevalence of metabolic syndrome was 47%. Older age, lower education level, low socioeconomic status, unmarried status, low physical activity level, and smoking were associated with higher prevalence of metabolic syndrome (p<0.001). The prevalence of borderline hypertension, hypertension, diabetes, stroke, and cardiovascular diseases was significantly higher in AAW with metabolic syndrome (p<0.001). Conclusion In spite of the focus on prevention of cardiovascular risk factors and elimination of ethnic and gender disparities, metabolic syndrome is still widely prevalent in AAW and poses a threat to the goals of Healthy People 2020. PMID:26908390

  11. Validation of a mental health assessment in an African conflict population.

    PubMed

    Ertl, Verena; Pfeiffer, Anett; Saile, Regina; Schauer, Elisabeth; Elbert, Thomas; Neuner, Frank

    2010-06-01

    We studied the validity of the assessment of posttraumatic stress disorder (PTSD) and depression within the context of an epidemiological mental health survey among war-affected adolescents and young adults in northern Uganda. Local language versions of the Posttraumatic Diagnostic Scale (PDS) and the Depression section of the Hopkins Symptom Checklist (DHSCL) were administered by trained local interviewers. Correlations with probable predictor variables (i.e., trauma exposure), outcomes (e.g., impaired functioning), and local idioms of distress (i.e., spirit possession) were determined to estimate criterion-related construct validity. To assess convergent validity, expert clinicians reinterviewed a subsample using structured interviews (the Clinician Administered PTSD Scale [CAPS] and the Mini International Neuropsychiatric Interview [MINI]). Depression and PTSD symptoms as assessed by the local interviewers correlated with the context variables as predicted. After optimizing the scoring algorithm, we found good agreement between the PDS-based diagnoses and expert diagnoses. However, the concordance for depression diagnoses was not satisfactory. Results show that mental health assessments in African languages can produce reliable and valid data but that caution is warranted in the unevaluated transfer of cutoff scores and scoring algorithms. PMID:20528059

  12. Children's exposure to community and war violence and mental health in four African countries.

    PubMed

    Foster, Holly; Brooks-Gunn, Jeanne

    2015-12-01

    In this article we review the mental health consequences of children's exposure to community and war violence (ETV) in four African countries: South Africa, Sierra Leone, Gambia and Rwanda. A focus on Africa is particularly pressing because of children's high levels of community and war ETV in countries therein. Regions of Africa present important macro-contexts for understanding children's various types of violence exposure amidst war and economic disadvantage. Findings of the review across 20 quantitative studies from 2004 to 2015 indicate consistent associations between exposure to war and community violence and children's symptoms of Post-traumatic Stress disorder (PTSD), depression, and aggression. School climate and family support mitigate these ETV influences upon children: however, more research is needed on the buffering effects of such resources. The effects of war violence are mediated by perceived discrimination in communities post-conflict. We integrate findings across studies to synthesize knowledge on children's ETV in Africa around a model of its correlates, mediators, and moderators in relation to mental health. Emerging research points to avenues for prevention and future inquiry. PMID:26497096

  13. Intelligent Integrated System Health Management

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando

    2012-01-01

    Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems

  14. "If you do nothing about stress, the next thing you know, you're shattered": Perspectives on African American men's stress, coping and health from African American men and key women in their lives.

    PubMed

    Ellis, Katrina R; Griffith, Derek M; Allen, Julie Ober; Thorpe, Roland J; Bruce, Marino A

    2015-08-01

    Stress has been implicated as a key contributor to poor health outcomes; however, few studies have examined how African American men and women explicitly describe the relationships among stress, coping, and African American men's health. In this paper, we explore strategies men use to cope with stress, and beliefs about the consequences of stress for African American men's health behaviors, morbidity and mortality from the perspectives of African American men and women. A phenomenological analytic approach was used to examine focus group data collected from 154 African American men (18 focus groups) and 77 African American women (8 focus groups). Women's perspectives were captured because women often observe men under stress and can provide support to men during stressful times. Our findings indicate that African American men in this study responded to stress by engaging in often identified coping behaviors (i.e., consumption of calorie dense food, exercise, spiritually-related activities). Men in our study, however, did not always view their responses to stress as explicit coping mechanisms. There was also some discordance between men's and women's perceptions of men's coping behaviors as there were occasions where they seemed to interpret the same behavior differently (e.g., resting vs. avoidance). Men and women believed that stress helped to explain why African American men had worse health than other groups. They identified mental, physical and social consequences of stress. We conclude by detailing implications for conceptualizing and measuring coping and we outline key considerations for interventions and further research about stress, coping and health. PMID:26183018

  15. ‘You can't stay away from your family’: a qualitative study of the ongoing ties and future plans of South African health workers in the United Kingdom

    PubMed Central

    Taylor, Katherine; Blacklock, Claire; Hayward, Gail; Bidwell, Posy; Laxmikanth, Pallavi; Riches, Nicholas; Willcox, Merlin; Moosa, Shabir; Mant, David

    2015-01-01

    Background Migration of African-trained health workers to countries with higher health care worker densities adds to the severe shortage of health personnel in many African countries. Policy initiatives to reduce migration levels are informed by many studies exploring the reasons for the original decision to migrate. In contrast, there is little evidence to inform policies designed to facilitate health workers returning home or providing other forms of support to the health system of their home country. Objective This study explores the links that South African-trained health workers who now live and work in the United Kingdom maintain with their country of training and what their future migration plans may be. Design Semi-structured interviews were conducted with South African trained health workers who are now living in the United Kingdom. Data extracts from the interviews relating to current links with South Africa and future migration plans were studied. Results All 16 participants reported strong ongoing ties with South Africa, particularly through active communication with family and friends, both face-to-face and remotely. Being South African was a significant part of their personal identity, and many made frequent visits to South Africa. These visits sometimes incorporated professional activities such as medical work, teaching, and charitable or business ventures in South Africa. The presence and location of family and spouse were of principal importance in helping South African-trained health care workers decide whether to return permanently to work in South Africa. Professional aspirations and sense of duty were also important motivators to both returning and to being involved in initiatives remotely from the United Kingdom. Conclusions The main barrier to returning home was usually the development of stronger family ties in the United Kingdom than in South Africa. The issues that prompted the original migration decision, such as security and education

  16. Sisters Together: Move More, Eat Better: a community-based health awareness program for African-American women.

    PubMed

    Curtis, Leslie; Brown, Zaneta G; Gill, Jennifer E

    2008-12-01

    Statistics indicate that African-American women have the highest rate of obesity among all racial groups. In response, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) developed "Sisters Together: Move More, Eat Better," a national program that encourages African-American women to maintain a healthy weight by becoming more physically active and by eating healthier foods. "Sisters Together" programs are run locally by individuals or community groups in locations such as churches and health departments. The NIDDK offers culturally relevant materials and technical assistance to program leaders, including a recently updated program guide. The guide walks leaders through program planning, promotion, implementation, and evaluation. It is based on obesity, nutrition, and physical activity research; evidence-based programs for African-American women; and proven health communication strategies. The guide is consumer friendly, using clear language and real-life examples. "Sisters Together" programs encourage African-American women and their families to improve their eating habits and their physical activity habits. PMID:19397055

  17. Socioeconomic Status, Occupational Characteristics, and Sleep Duration in African/Caribbean Immigrants and US White Health Care Workers

    PubMed Central

    Ertel, Karen A.; Berkman, Lisa F.; Buxton, Orfeu M.

    2011-01-01

    Study Objectives: o advance our understanding of the interplay of socioeconomic factors, occupational exposures, and race/ethnicity as they relate to sleep duration. We hypothesize that non Hispanic African/Caribbean immigrant employees in long term health care have shorter sleep duration than non Hispanic white employees, and that low education, low income, and occupational exposures including night work and job strain account for some of the African/Caribbean immigrant–white difference in sleep duration. Design: Cross sectional Setting: Four extended care facilities in Massachusetts, United States Participants: 340 employees in extended care facilities Measurements and Results: Sleep duration was assessed with wrist actigraphy for a mean of 6.3 days. In multivariable regression modeling controlling for gender and age, African/Caribbean immigrants slept 64.4 fewer minutes (95% CI: −81.0, −47.9) per night than white participants; additional control for education and income reduced the racial gap to 50.9 minutes (−69.2, −32.5); additional control for the occupational factors of hours worked per week and working the night shift reduced the racial gap to 37.7 minutes (−57.8, −17.6). Conclusions: his study provides support for the hypothesis that socioeconomic and occupational characteristics explain some of the African/ Caribbean immigrant–white difference in sleep duration in the United States, especially among health care workers. Citation: Ertel KA; Berkman LF; Buxton OM. Socioeconomic status, occupational characteristics, and sleep duration in African/Caribbean immi grants and US white health care workers. SLEEP 2011; 34(4):509-518. PMID:21461330

  18. The World Health Organization's mechanisms for increasing the health sector budget: The South African context.

    PubMed

    Venter, Fouche Hendrik Johannes; Wolfaardt, Jaqueline Elizabeth

    2016-08-01

    South Africa (SA) has limited scope for raising income taxes, and the proposed National Health Insurance (NHI) scheme will necessitate growth in the health sector budget. The NHI White Paper suggests five funding scenarios to meet the expected shortfall. These scenarios are a mixture of a surcharge on taxable income, an increase in value-added tax and a payroll tax. Five alternative options, suggested by the World Health Organization, are interrogated as ways to decrease the general taxation proposed in the White Paper. The five mechanisms (corporate tax, financial transaction levy, and taxes on tobacco, alcohol and unhealthy foods) were chosen based on their fund-raising potential and their mandatory element. A literature review provides the information for a discussion of the potential costs of each mechanism. Within specific assumptions, potential budgetary contribution is compared with the requirement. First, raising corporate tax rates could raise enough funds, but the losses due to capital flight might be too much for the local economy to bear. Second, a levy on currency transactions is unlikely to raise the required resources, even without a probable decrease in the number of transactions. Third, the increase in the tax on tobacco and alcohol would need to be very large, even assuming that consumption patterns would remain unchanged. Lastly, a tax on unhealthy food products is a new idea and could be explored as an option - especially as the SA Treasury has announced its future implementation. Implementing only one of the mechanisms is unlikely to increase available funding sufficiently, but if they are implemented together the welfare-maximising tax rate for each mechanism may be high enough to fulfil the NHI scheme's budgetary requirement, moderating the increases in the tax burden of the SA population. PMID:27499398

  19. Integrated Systems Health Management for Intelligent Systems

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

    The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

  20. Finding what works: Predicting health or social service linkage in drug using, African American, female sex workers in Miami, FL.

    PubMed

    Levi-Minzi, Maria A; Surratt, Hilary L; O'Grady, Catherine L; Kurtz, Steven P

    2016-07-01

    Female sex workers (FSWs) encounter numerous challenges in accessing health and social services. In this study of drug using, African American FSWs, the authors examine specific factors associated with health or social service linkage among participants in a randomized intervention trial. Respondent linkage was significantly associated with individual factors (living alone, severe internal mental distress, and traumatic victimization) and project-related variables (attending five case management sessions and client engagement rating). In the multivariate model, higher client engagement and session attendance remained significant. The researchers conclude by discussing the importance of intervention attendance and engagement as key contributors to health and social service linkage among FSWs. PMID:26933839

  1. The associations between resilience, social capital and self-rated health among HIV-positive South Africans.

    PubMed

    Dageid, Wenche; Grønlie, Anette A

    2015-11-01

    This study examined the relationship between resilience, social capital and self-rated health among 263 HIV-positive South Africans living in poverty, using questionnaires. Self-rated good health was predicted by younger age, trust in community-based organizations and having contacts of different religions. The findings highlight the importance of community-based networks and resources for care and support for persons living with HIV/AIDS in poor, rural areas. Furthermore, resilience, which also related positively to education and income, contributed positively to self-rated health, drawing attention to the interplay between resources at individual and community levels. PMID:24345683

  2. Essential evidence for guiding health system priorities and policies: anticipating epidemiological transition in Africa

    PubMed Central

    Byass, Peter; de Savigny, Don; Lopez, Alan D.

    2014-01-01

    Background Despite indications that infection-related mortality in sub-Saharan Africa may be decreasing and the burden of non-communicable diseases increasing, the overwhelming reality is that health information systems across most of sub-Saharan Africa remain too weak to track epidemiological transition in a meaningful and effective way. Proposals We propose a minimum dataset as the basis of a functional health information system in countries where health information is lacking. This would involve continuous monitoring of cause-specific mortality through routine civil registration, regular documentation of exposure to leading risk factors, and monitoring effective coverage of key preventive and curative interventions in the health sector. Consideration must be given as to how these minimum data requirements can be effectively integrated within national health information systems, what methods and tools are needed, and ensuring that ethical and political issues are addressed. A more strategic approach to health information systems in sub-Saharan African countries, along these lines, is essential if epidemiological changes are to be tracked effectively for the benefit of local health planners and policy makers. Conclusion African countries have a unique opportunity to capitalize on modern information and communications technology in order to achieve this. Methodological standards need to be established and political momentum fostered so that the African continent's health status can be reliably tracked. This will greatly strengthen the evidence base for health policies and facilitate the effective delivery of services. PMID:24848653

  3. Improving Health-Related Quality of Life in Older African-Americans and non-Latino Whites

    PubMed Central

    Jimenez, Daniel E.; Begley, Amy; Bartels, Stephen J.; Alegría, Margarita; Thomas, Stephen B.; Quinn, Sandra C.; Reynolds, Charles F.

    2014-01-01

    Objective To compare the effect of problem solving therapy against a health-promotion intervention (dietary practices) on health-related quality of life (HRQOL) and examine if there is a differential effect on non-Latino Whites and African-Americans between the two interventions. This paper also explores participant characteristics (problem solving style and physical functioning) as potential predictors of HRQOL. Methods Secondary analysis of data from a randomized depression prevention trial involving 247 older adults (154 non-Latino Whites, 90 African-Americans, 3 Asians). Participants were randomly assigned to receive either problem solving therapy for primary care (PST-PC) or coaching in healthy dietary practices (DIET). Results Both PST-PC and DIET improved HRQOL over two years and did not differ significantly from each other. African-Americans in both conditions had greater improvements in mental health-related quality of life (MHRQOL) compared to non-Latino Whites. In addition, higher social problem solving and physical functioning were predictive of improved MHRQOL. Conclusions PST-PC and DIET have the potential to improve health-related quality of life in a culturally relevant manner. Both hold promise as effective and potentially scalable interventions that could be generalized to highly disadvantaged populations in which little attention to HRQOL has been paid. PMID:25171889

  4. Surveillance of Canine Rabies in the Central African Republic: Impact on Human Health and Molecular Epidemiology

    PubMed Central

    Tricou, Vianney; Bouscaillou, Julie; Kamba Mebourou, Emmanuel; Koyanongo, Fidèle Dieudonné; Nakouné, Emmanuel; Kazanji, Mirdad

    2016-01-01

    Background Although rabies represents an important public health threat, it is still a neglected disease in Asia and Africa where it causes tens of thousands of deaths annually despite available human and animal vaccines. In the Central African Republic (CAR), an endemic country for rabies, this disease remains poorly investigated. Methods To evaluate the extent of the threat that rabies poses in the CAR, we analyzed data for 2012 from the National Reference Laboratory for Rabies, where laboratory confirmation was performed by immunofluorescence and PCR for both animal and human suspected cases, and data from the only anti-rabies dispensary of the country and only place where post-exposure prophylaxis (PEP) is available. Both are located in Bangui, the capital of the CAR. For positive samples, a portion of the N gene was amplified and sequenced to determine the molecular epidemiology of circulating strains. Results In 2012, 966 exposed persons visited the anti-rabies dispensary and 632 received a post-exposure rabies vaccination. More than 90% of the exposed persons were from Bangui and its suburbs and almost 60% of them were under 15-years of age. No rabies-related human death was confirmed. Of the 82 samples from suspected rabid dogs tested, 69 were confirmed positive. Most of the rabid dogs were owned although unvaccinated. There was a strong spatiotemporal correlation within Bangui and within the country between reported human exposures and detection of rabid dogs (P<0.001). Phylogenetic analysis indicated that three variants belonging to Africa I and II lineages actively circulated in 2012. Conclusions These data indicate that canine rabies was endemic in the CAR in 2012 and had a detrimental impact on human health as shown by the hundreds of exposed persons who received PEP. Implementation of effective public health interventions including mass dog vaccination and improvement of the surveillance and the access to PEP are urgently needed in this country. PMID

  5. Introduction on health recommender systems.

    PubMed

    Sanchez-Bocanegra, C L; Sanchez-Laguna, F; Sevillano, J L

    2015-01-01

    People are looking for appropriate health information which they are concerned about. The Internet is a great resource of this kind of information, but we have to be careful if we don't want to get harmful info. Health recommender systems are becoming a new wave for apt health information as systems suggest the best data according to the patients' needs.The main goals of health recommender systems are to retrieve trusted health information from the Internet, to analyse which is suitable for the user profile and select the best that can be recommended, to adapt their selection methods according to the knowledge domain and to learn from the best recommendations.A brief definition of recommender systems will be given and an explanation of how are they incorporated in the health sector. A description of the main elementary recommender methods as well as their most important problems will also be made. And, to finish, the state of the art will be described. PMID:25417084

  6. [National public health information system].

    PubMed

    Erceg, Marijan; Stevanović, Ranko; Babić-Erceg, Andrea

    2005-01-01

    Information production and its communication being a key public health activity, developing modern information systems is a precondition for its fulfilling these assignments. A national public health information system (NPHIS) is a set of human resources combined with computing and communication technologies. It enables data linkage and data coverage as well as undertaking information production and dissemination in an effective, standardized and safe way. The Croatian Institute of Public Health LAN/WAN modules are under development. Health Safety System, Health Workers Registry, and Digital Library are among the Institute's developmental priorities. Communication between NPHIS participants would unfold over the Internet by using every relevant data protection method. Web technology-based applications would be run on special servers. Between individual applications, use would be made of the transaction module of communication through an exchange of the HL7 standard-based xml messages. In the conditions of transition, the health system must make an optimal use of the resources, which is not feasible without applying modern information and communication technologies. PMID:16095199

  7. Biogeographic Ancestry Is Associated with Higher Total Body Adiposity among African-American Females: The Boston Area Community Health Survey

    PubMed Central

    Goonesekera, Sunali D.; Fang, Shona C.; Piccolo, Rebecca S.; Florez, Jose C.; McKinlay, John B.

    2015-01-01

    Objectives The prevalence of obesity is disproportionately higher among African-Americans and Hispanics as compared to whites. We investigated the role of biogeographic ancestry (BGA) on adiposity and changes in adiposity in the Boston Area Community Health Survey. Methods We evaluated associations between BGA, assessed via Ancestry Informative Markers, and adiposity (body mass index (BMI), percent body fat (PBF), and waist-to-hip ratio (WHR)) and changes in adiposity over 7 years for BMI and WHR and 2.5 years for PBF, per 10% greater proportion of BGA using multivariable linear regression. We also examined effect-modification by demographic and socio-behavioral variables. Results We observed positive associations between West-African ancestry and cross-sectional BMI (percent difference=0.62%; 95% CI: 0.04%, 1.20%), and PBF (β=0.35; 95% CI: 0.11, 0.58). We also observed significant effect-modification of the association between West-African ancestry and BMI by gender (p-interaction: <0.002) with a substantially greater association in women. We observed no main associations between Native-American ancestry and adiposity but observed significant effect-modification of the association with BMI by diet (p-interaction: <0.003) with inverse associations among participants with higher Healthy Eating Scores. No associations were observed between BGA and changes in adiposity over time. Conclusion Findings support that West-African ancestry may contribute to high prevalence of total body adiposity among African-Americans, particularly African-American women. PMID:25875902

  8. Integrating global animal health, public health and tropical animal health issues into the veterinary curriculum: a South African/African perspective.

    PubMed

    Swan, G E; Coetzer, J A W; Terblanche, H M

    2009-08-01

    The globalisation of trade and food, the increased volume and speed of international travel, climate change, and the related escalation of emerging and re-emerging infectious diseases mean that countries are now more interconnected and interdependent than ever before. Africa is beleaguered by a range of endemic infectious and parasitic tropical diseases which, due to its diverse wildlife populations and indigenous livestock, can serve as a reservoir of high-impact or transboundary diseases and play a role in the emergence of disease, particularly at the wildlife, domestic animal and human interfaces. It is therefore essential to integrate animal and public health issues into the veterinary curriculum. Veterinary training in most parts of sub-Saharan Africa has focused on producing veterinarians to serve the livestock sector although socio-economic changes and privatisation of Veterinary Services have caused curriculum adjustments, as have globalisation and the increased risk of the spread of transboundary diseases. In South Africa, undergraduate veterinary training is more clinically oriented than in other regions. Animal and public health issues are covered in the curriculum, although their global relevance is not emphasised. The authors describe the undergraduate veterinary curriculum and summarise post-graduate programmes in South Africa. They also discuss a more comprehensive core-elective approach to the current curriculum and the need to adapt to new challenges facing the profession. Finally, they examine the potential use of innovative technology in undergraduate and post-graduate training and professional development, the importance of regional and international collaboration and the accreditation and recognition of veterinary training. PMID:20128484

  9. [The health system of Chile].

    PubMed

    Becerril-Montekio, Víctor; Reyes, Juan de Dios; Manuel, Annick

    2011-01-01

    This paper describes the Chilean health system, including its structure, financing, beneficiaries, and its physical, material and human resources. This system has two sectors, public and private. The public sector comprises all the organisms that constitute the National System of Health Services, which covers 70% of the population, including the rural and urban poor, the low middle-class, the retired, and the self-employed professionals and technicians.The private sector covers 17.5% of the population, mostly the upper middle-class and the high-income population. A small proportion of the population uses private health services and pays for them out-of-pocket. Around l0% of the population is covered by other public agencies, basically the Health Services for the Armed Forces. The system was recently reformed with the establishment of a Universal System of Explicit Entitlements, which operates through a Universal Plan of Explicit Entitlements (AUGE), which guarantees timely access to treatment for 56 health problems, including cancer in children, breast cancer, ischaemic heart disease, HIV/AIDS and diabetes. PMID:21877079

  10. A Qualitative Examination of Health Barriers and Facilitators Among African American Mothers in a Subsidized Housing Community.

    PubMed

    Cotter, Elizabeth W; Hamilton, Natia S; Kelly, Nichole R; Harney, Megan B; Greene, LaShaun; White, Kelly A; Mazzeo, Suzanne E

    2016-09-01

    Although African American families are at particular risk for obesity and its associated health comorbidities, few interventions have directly targeted low-income members of this group living in subsidized public housing. Using a consensual qualitative research approach, we conducted 11 interviews with African American mothers living in two public housing communities to enhance understanding of their perceived barriers and facilitators to health. Five primary domains emerged, including barriers (access, financial, personal, and neighborhood concerns), resources (personal and community), current behaviors (diet, physical activity, and program participation), definition of health (mental well-being, physical well-being, and health behaviors), and needs/interests in programming (health behavior-specific programs, non-health-related programs, child-focused programming, and qualities of programs and their leaders). Results demonstrate the complex interaction among social, environmental, and personal factors on health behaviors for this priority population, and highlight the need for community members' involvement in the development of community-based obesity prevention programming. PMID:27091605

  11. Health Systems Governance for health equity: critical reflections.

    PubMed

    Labonté, Ronald

    2010-01-01

    This article addresses several issues pertinent to health systems governance for health equity. It argues the importance of health systems using measures of positive health (well-being), discriminating in favour of historically less advantaged groups and weighing the costs of health care against investments in the social determinants of health. It cautions that the concept of governance could weaken the role of government, with disequalizing effects, while emphasizing the importance of two elements of good governance (transparency and participation) in health systems decision-making. It distinguishes between participation as volunteer labour and participation as exercising political rights, and questions the assumption that decentralization in health systems is necessarily empowering. It then identifies five health system roles to address issues of equity (educator/watchdog, resource broker, community developer, partnership developer and advocate/catalyst) and the implications of these roles for practice. Drawing on preliminary findings of a global research project on comprehensive primary health care, it discusses political aspects of progressive health system reform and the implications of equity-focused health system governance on health workers' roles, noting the importance of health workers claiming their identity as citizens. The article concludes with a commentary on the inherently political nature of health reforms based on equity; the necessary confrontation with power relations politics involves; and the health systems governance challenge of managing competing health discourses of efficiency and results-based financing, on the one hand, and equity and citizen empowerment, on the other. PMID:20963302

  12. Family Matters: The Role of Mental Health Stigma and Social Support on Depressive Symptoms and Subsequent Help Seeking Among African American Boys

    PubMed Central

    Lindsey, Michael A.; Joe, Sean; Nebbitt, Von

    2010-01-01

    African American adolescent boys underutilize mental health service due to stigma associated with depression. Gaining an increased understanding of how depressed, African American adolescent boys perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to care. Using a mixed-methods design, this study examined the influence of mental health stigma and social support on depressive symptoms among African American adolescent boys. Findings indicated the protective effects of social support in decreasing depressive symptoms, especially when participants experienced mental health stigma. Results also revealed the pivotal role of family social support over both professional and peer support for participants who struggled with depressive symptoms. The primacy of family support among the sample, combined with the frequent distrust of professionals and peer networks, would indicate that working with families may improve initial identification of depression among African American adolescent boys and decrease their barriers to care. PMID:20953336

  13. Association between childhood adversities and long-term suicidality among South Africans from the results of the South African Stress and Health study: a cross-sectional study

    PubMed Central

    Bruwer, Belinda; Govender, Ravi; Bishop, Melanie; Williams, David R; Stein, Dan J; Seedat, Soraya

    2014-01-01

    Objective Suicide and suicidal behaviours are significant public health problems and a leading cause of death worldwide and in South Africa. We examined the association between childhood adversities and suicidal behaviour over the life course. Methods A national probability sample of 4351 South African adult participants (aged 18 years and older) in the South African Stress and Health (SASH) study was interviewed as part of the World Mental Health Surveys initiative. Respondents provided sociodemographic and diagnostic information, as well as an account of suicide-related thoughts and behaviours. Suicidality or suicidal behaviour were defined as were defined as suicide attempts and suicidal ideation in the total sample, and suicide plans and attempts among ideators. Childhood adversities included physical abuse, sexual abuse, parental death, parental divorce, other parental loss, family violence, physical illness and financial adversity. The association between suicidality and childhood adversities was examined using discrete-time survival models. Results More than a third of the respondents with suicidal behaviour experienced at least one childhood adversity, with physical abuse, parental death and parental divorce being the most prevalent adversities. Physical abuse, sexual abuse and parental divorce were identified as significant risk markers for lifetime suicide attempts, while physical abuse and parental divorce were significantly correlated with suicidal ideation. Two or more childhood adversities were associated with a twofold higher risk of lifetime suicide attempts. Sexual abuse (OR 9.3), parental divorce (OR 3.1) and childhood physical abuse (OR 2.2) had the strongest associations with lifetime suicide attempts. The effect of childhood adversities on suicidal tendencies varied over the life course. For example, sexual abuse was significantly associated with suicide attempts during childhood and teen years, but not during young and later adulthood

  14. Adiposity and hyperglycaemia in pregnancy and related health outcomes in European ethnic minorities of Asian and African origin: a review

    PubMed Central

    Jenum, Anne Karen; Sommer, Christine; Sletner, Line; Mørkrid, Kjersti; Bærug, Anne; Mosdøl, Annhild

    2013-01-01

    Background Ethnic minorities in Europe have high susceptibility to type 2 diabetes (T2DM) and, in some groups, also cardiovascular disease (CVD). Pregnancy can be considered a stress test that predicts future morbidity patterns in women and that affects future health of the child. Objective To review ethnic differences in: 1) adiposity, hyperglycaemia, and pre-eclampsia during pregnancy; 2) future risk in the mother of obesity, T2DM and CVD; and 3) prenatal development and possible influences of maternal obesity, hyperglycaemia, and pre-eclampsia on offspring's future disease risk, as relevant for ethnic minorities in Europe of Asian and African origin. Design Literature review. Results Maternal health among ethnic minorities is still sparsely documented. Higher pre-pregnant body mass index (BMI) is found in women of African and Middle Eastern descent, and lower BMI in women from East and South Asia compared with women from the majority population. Within study populations, risk of gestational diabetes mellitus (GDM) is considerably higher in many minority groups, particularly South Asians, than in the majority population. This increased risk is apparent at lower BMI and younger ages. Women of African origin have higher risk of pre-eclampsia. A GDM pregnancy implies approximately seven-fold higher risk of T2DM than normal pregnancies, and both GDM and pre-eclampsia increase later risk of CVD. Asian neonates have lower birth weights, and mostly also African neonates. This may translate into increased risks of later obesity, T2DM, and CVD. Foetal overgrowth can promote the same conditions. Breastfeeding represents a possible strategy to reduce risk of T2DM in both the mother and the child. Conclusions Ethnic minority women in Europe with Asian and African origin and their offspring seem to be at increased risk of T2DM and CVD, both currently and in the future. Pregnancy is an important window of opportunity for short and long-term disease prevention. PMID:23467680

  15. Neighborhoods, Social Support, and African American Adolescents' Mental Health Outcomes: A Multilevel Path Analysis

    ERIC Educational Resources Information Center

    Hurd, Noelle M.; Stoddard, Sarah A.; Zimmerman, Marc A.

    2013-01-01

    This study explored how neighborhood characteristics may relate to African American adolescents' internalizing symptoms via adolescents' social support and perceptions of neighborhood cohesion. Participants included 571 urban, African American adolescents (52% female; "M" age = 17.8). A multilevel path analysis testing both direct and indirect…

  16. Social Messages, Social Context, and Sexual Health: Voices of Urban African American Youth

    ERIC Educational Resources Information Center

    Secor-Turner, Molly; Sieving, Renee; Garwick, Ann

    2011-01-01

    Objective: To describe aspects of the social context that low-income, urban African American young women articulate as having influenced social messages they received during adolescence about pregnancy timing and childbearing. Methods: Individual interviews were conducted with 20 African American young women ages 18-22. Results: Findings clustered…

  17. Breast cancer knowledge, attitudes, and screening behaviors among African American women: the Black cosmetologists promoting health program

    PubMed Central

    Sadler, Georgia R; Ko, Celine M; Cohn, Jennifer A; White, Monique; Weldon, Rai-nesha; Wu, Phillis

    2007-01-01

    Background African American women have higher rates of breast cancer mortality than their white counterparts. Studies have suggested that this is partly caused by discovery of cancer at a later stage, highlighting the importance of encouraging early detection of breast cancer in this population. To guide the creation of a breast cancer education intervention and help focus other health educators' and clinicians' health promotion efforts, this study explored whether a cohort of African American women living in San Diego would demonstrate the possession of adequate baseline knowledge about breast cancer screening and adherence to widely recommended screening guidelines. Methods African American women (N = 1,055) from San Diego, California participated in a beauty salon-based survey about breast cancer knowledge, attitudes, and screening practices. Women's ages ranged from 20 to 94 years, with average age of 42.20 (SD = 13.53) years. Thirty-four percent reported completing college and/or some graduate school training, and 52% reported having some college or post high school formal training. Seventy-five percent of the sample reported working outside their home. Participating cosmetologists and their salons were recruited to the study through word-of-mouth referral by highly respected African American community leaders. Results Salon clients reported low rates of adherence to recommended breast cancer screening guidelines. Of the 1,055 participants, 31% reporting performing breast self-exam every month. Of those participants 40 and older, 57% reported having had a clinical breast exam and 43% reported having had a mammogram in the past year. Knowledge of breast cancer was associated with adherence to screening guidelines. While women recognized the serious health threat that breast cancer poses and that early detection of breast cancer is important, only 30% of women reported feeling well informed about the disease. Many participants demonstrated a lack of basic

  18. Polio eradication in the World Health Organization African Region, 2008-2012.

    PubMed

    Kretsinger, Katrina; Gasasira, Alex; Poy, Alain; Porter, Kimberly A; Everts, Johannes; Salla, Mbaye; Brown, Kristin H; Wassilak, Steven G F; Nshimirimana, Deogratias

    2014-11-01

    A renewed commitment at the regional and the global levels led to substantial progress in the fight for polio eradication in the African Region (AFR) of the World Health Organization (WHO) during 2008-2012. In 2008, there were 912 reported cases of wild poliovirus (WPV) infection in 12 countries in the region. This number had been reduced to 128 cases in 3 countries in 2012, of which 122 were in Nigeria, the only remaining country with endemic circulation of WPV in AFR. During 2008-2012, circulation apparently ceased in the 3 AFR countries with reestablished WPV transmission-Angola, the Democratic Republic of the Congo, and Chad. Outbreaks in West Africa continued to occur in 2008-2010 but were more rapidly contained, with fewer cases than during earlier years. This progress has been attributed to better implementation of core strategies, increased accountability, and implementation of innovative approaches. During this period, routine coverage with 3 doses of oral polio vaccine in AFR, as measured by WHO-United Nations Children's Fund estimates, increased slightly, from 72% to 74%. Despite this progress, challenges persist in AFR, and 2013 was marked by new setbacks and importations. High population immunity and strong surveillance are essential to sustain progress and assure that AFR reaches its goal of eradicating WPV. PMID:25316840

  19. Cross race comparisons between SES health gradients among African-American and white women at mid-life

    PubMed Central

    Salsberry, Pamela J.

    2014-01-01

    This study explored how multiple indicators of socioeconomic status (SES) inform understanding of race differences in the magnitude of health gains associated with higher SES. The study sample, 1268 African-American women and 2066 white women, was drawn from the National Longitudinal Surveys of Youth 1979. The outcome was the Physical Components Summary from the SF-12 assessed at age 40. Ordinary least squares regressions using education, income and net worth fully interacted with race were conducted. Single measure gradients tended to be steeper for whites than African-Americans, partly because “sheepskin” effects of high school and college graduation were higher for whites and low income and low net worth whites had worse health than comparable African-Americans. Conditioning on multiple measures of SES eliminated race disparities in health benefits of education and net worth, but not income. A discussion of current public policies that affect race disparities in levels of education, income and net wealth is provided. PMID:24632052

  20. Quality of life in patients with systemic lupus erythematosus (SLE) compared with related controls within a unique African American population

    PubMed Central

    Barnado, A; Wheless, L; Meyer, AK; Gilkeson, GS; Kamen, DL

    2012-01-01

    The patient’s perspective of how their health affects their function is health-related quality of life (HRQOL). HRQOL is poorer in patients with systemic lupus erythematosus (SLE). Few HRQOL studies in SLE patients have focused on African Americans despite an increased disease burden compared with Caucasians. The African American Gullah population of South Carolina has a homogeneous genetic and environmental background and a high prevalence of multi-patient families with SLE. Demographics, medical history, and Short-Form 36 (SF-36) were measured within a cohort of Gullah SLE cases and related controls. Compared with related controls (n = 37), cases (n = 89) had a lower Physical Component Summary (PCS, 41.8 vs. 52.3, p < 0.01), but not Mental Component Summary (MCS, 55.0 vs. 56.0, p = 0.70). The difference in PCS was no longer significant upon adjustment for working status, disability, and medical conditions. None of the 11 SLE American College of Rheumatology criteria, disease duration, or Systemic Lupus International Collaborating Clinics Damage Index were associated with either PCS or MCS. Cases and controls had similar MCS scores. We hypothesize that this lack of effect of SLE on MCS may be due to disease-coping mechanisms interplaying with cultural factors unique to the Gullah. PMID:22031537

  1. [Public health and the health system. SESPAS Report 2010].

    PubMed

    Aboal-Viñas, José Luis

    2010-12-01

    Analysis of the relationship between public health and the health system requires definition of a conceptual framework and the choice of a particular context. The chosen context of this discussion is the management of public organizations. With this in mind, functions will be associated with organizational macroprocesses. From this point of view, this article identifies the functions-processes that any health system should develop and their goals. The current situation of public health in the health system is analyzed through the study of public health budgets and the place they occupy in the hierarchy of the health departments of the autonomous communities. The "public health" budget program represents an average of 1.34% of health expenditure in the autonomous communities in 2010. Over 20% of public health organizations of the autonomous communities have a rank lower than general directorate. These data indicate the low weight assigned to public health in the health systems of the Spanish state. To change this situation, consensus must be reached on the desired relationship between public health and the health system. Such a consensus would then have to be accepted and work would have to be undertaken to improve results. Three alternatives are proposed: (i) public health would be an organization that would be above or outside the health system; (ii) public health would be synonymous with the public health system; and (iii) public health would form part of the health system with a range of assigned functions. Finally, we provide some recommendations to help define the most effective and efficient relationship between public health and the health system. PMID:20970219

  2. A Survey of African American Men in Chicago Barbershops: Implications for the Effectiveness of the Barbershop Model in the Health Promotion of African American Men.

    PubMed

    Moore, Nataka; Wright, Matara; Gipson, Jessica; Jordan, Greg; Harsh, Mohit; Reed, Daniel; Murray, Marcus; Keeter, Mary Kate; Murphy, Adam

    2016-08-01

    The barbershop has been used to target African American (AA) men across age groups for health screenings, health interventions, and for research. However, few studies explore the sociodemographic characteristics of barbers and their clients. Additionally, few have evaluated the client's relative comfort with receiving health information and screenings in barbershops and other non-clinical settings. Lastly, it is unknown whether barbers feel capable of influencing health-decision making of AA men. AA male clients and barbers completed a self-administered survey in barbershops in predominantly AA neighborhoods throughout Chicago, Illinois. We assessed sociodemographic characteristics and attitudes towards receiving physical and mental health education and screenings in barbershops and other settings. Barbers were also surveyed regarding their most and least common clients by age group and their perceived ability to influence the decision-making of AA males by age group. AAs surveyed in barbershops have similar rates of high school completion, poverty and unemployment as the AA residents of their neighborhood. AA males prefer to receive health education and screening in clinician offices followed by barbershops and churches. Barbers reported serving males age 18-39 years of age most frequently while men 50 years and older were the least served group. Overall, barbers did not believe they could influence the decision-making of AA men and in the best case scenario, only 33 % felt they could influence young men 18-29 years old. Barbershops reach AA men that are representative of the demographics of the neighborhood where the barbershop is located. Barbers reach a small population of men over age 49 and feel incapable of influencing the decisions of AAs over age 39. Further studies are needed to assess other locales for accessing older AA men and to evaluate the feasibility of mental health interventions and screenings within the barbershop. PMID:26831485

  3. Allied health: untapped potential in the Australian health system.

    PubMed

    Philip, Kathleen

    2015-06-01

    Although comprising around 20 per cent ofAustralia's health care workforce, allied health and its contribution to improving health outcomes remains poorly understood and largely invisible in the Australian health policy and reform environment. There is strong evidence demonstrating the benefits of allied health in improving patient outcomes, minimising risk and harm from illness and improving health system efficiency and capacity to meet increased demand cost effectively. Despite this, the existing health model, funding and culture prevent us from effectively accessing these benefits at a system level. The untapped potential of allied health represents a major underutilised resource to address many of the challenges facing Australia's health system today. A transformational change in the Australian health system in how, where and by whom care is provided is necessary. Australia's health model and culture needs to shift, to genuinely involve the consumer and make fill use of all three pillars of the patient care workforce. PMID:26629583

  4. “If you do nothing about stress, the next thing you know, you’re shattered”: Perspectives on African American men’s stress, coping and health from African American men and key women in their lives

    PubMed Central

    Ellis, Katrina; Griffith, Derek M.; Allen, Julie Ober; Thorpe, Roland J.; Bruce, Marino A.

    2015-01-01

    Stress has been implicated as a key contributor to poor health outcomes; however, few studies have examined how African American men and women explicitly specify the relationships among stress, coping, and African American men’s health. In this paper, we explore strategies men use to cope with stress, and beliefs about the consequences of stress for African American men’s health behaviors, morbidity and mortality from the perspectives of African American men and women. A phenomenological analytic approach was used to examine focus group data collected from 154 African American men (18 focus groups) and 77 women (8 focus groups). Women’s perspectives were captured because women often observe men under stress and can provide support to men during stressful times. Our findings indicate that African American men in this study responded to stress by engaging in often identified coping behaviors (i.e., consumption of calorie dense food, exercise, spiritually-related activities). Men in our study, however, did not always view their responses to stress as explicit coping mechanisms. There was also some discordance between men’s and women’s perceptions of men’s coping behaviors as there were occasions where they seemed to interpret the same behavior differently (e.g., resting vs. avoidance). Men and women believed that stress helped to explain why African American men had worse health than other groups. They identified mental, physical and social consequences of stress. We conclude by detailing implications for conceptualizing and measuring coping and we outline key considerations for interventions and further research about stress, coping and health. PMID:26183018

  5. Health risks of energy systems.

    PubMed

    Krewitt, W; Hurley, F; Trukenmüller, A; Friedrich, R

    1998-08-01

    Health risks from fossil, renewable and nuclear reference energy systems are estimated following a detailed impact pathway approach. Using a set of appropriate air quality models and exposure-effect functions derived from the recent epidemiological literature, a methodological framework for risk assessment has been established and consistently applied across the different energy systems, including the analysis of consequences from a major nuclear accident. A wide range of health impacts resulting from increased air pollution and ionizing radiation is quantified, and the transferability of results derived from specific power plants to a more general context is discussed. PMID:9775447

  6. Screening of Imported Infectious Diseases among Asymptomatic Sub-Saharan African and Latin American Immigrants: A Public Health Challenge

    PubMed Central

    Monge-Maillo, Begoña; López-Vélez, Rogelio; Norman, Francesca F.; Ferrere-González, Federico; Martínez-Pérez, Ángela; Pérez-Molina, José Antonio

    2015-01-01

    Migrants from developing countries are usually young and healthy but several studies report they may harbor asymptomatic infections for prolonged periods. Prevalence of infections were determined for asymptomatic immigrants from Latin America and sub-Saharan Africa who ettended to a European Tropical Medicine Referral Center from 2000 to 2009. A systematic screening protocol for selected infections was used. Data from 317 sub-Saharan Africans and 383 Latin Americans were analyzed. Patients were mostly young (mean age 29 years); there were significantly more males among sub-Saharan Africans (83% versus 31.6%) and pre-consultation period was longer for Latin Americans (5 versus 42 months). Diagnoses of human immunodeficiency virus (HIV), chronic hepatitis B and C virus infection, and latent tuberculosis were significantly more frequent in sub-Saharan Africans (2.3% versus 0.3%; 14% versus 1.6%; 1.3 versus 0%; 71% versus 32.1%). There were no significant differences in prevalence for syphilis and intestinal parasites. Malaria and schistosomiasis prevalence in sub-Saharan Africans was 4.6% and 5.9%, respectively, and prevalence of Chagas disease in Latin Americans was 48.5%. Identifying and treating asymptomatic imported infectious diseases may have an impact both for the individual concerned and for public health. Based on these results, a systematic screening protocol for asymptomatic immigrants is proposed. PMID:25646257

  7. Portable Health Algorithms Test System

    NASA Technical Reports Server (NTRS)

    Melcher, Kevin J.; Wong, Edmond; Fulton, Christopher E.; Sowers, Thomas S.; Maul, William A.

    2010-01-01

    A document discusses the Portable Health Algorithms Test (PHALT) System, which has been designed as a means for evolving the maturity and credibility of algorithms developed to assess the health of aerospace systems. Comprising an integrated hardware-software environment, the PHALT system allows systems health management algorithms to be developed in a graphical programming environment, to be tested and refined using system simulation or test data playback, and to be evaluated in a real-time hardware-in-the-loop mode with a live test article. The integrated hardware and software development environment provides a seamless transition from algorithm development to real-time implementation. The portability of the hardware makes it quick and easy to transport between test facilities. This hard ware/software architecture is flexible enough to support a variety of diagnostic applications and test hardware, and the GUI-based rapid prototyping capability is sufficient to support development execution, and testing of custom diagnostic algorithms. The PHALT operating system supports execution of diagnostic algorithms under real-time constraints. PHALT can perform real-time capture and playback of test rig data with the ability to augment/ modify the data stream (e.g. inject simulated faults). It performs algorithm testing using a variety of data input sources, including real-time data acquisition, test data playback, and system simulations, and also provides system feedback to evaluate closed-loop diagnostic response and mitigation control.

  8. A pan-African medium-range ensemble flood forecast system

    NASA Astrophysics Data System (ADS)

    Thiemig, V.; Bisselink, B.; Pappenberger, F.; Thielen, J.

    2015-08-01

    The African Flood Forecasting System (AFFS) is a probabilistic flood forecast system for medium- to large-scale African river basins, with lead times of up to 15 days. The key components are the hydrological model LISFLOOD, the African GIS database, the meteorological ensemble predictions by the ECMWF (European Centre for Medium-Ranged Weather Forecasts) and critical hydrological thresholds. In this paper, the predictive capability is investigated in a hindcast mode, by reproducing hydrological predictions for the year 2003 when important floods were observed. Results were verified by ground measurements of 36 sub-catchments as well as by reports of various flood archives. Results showed that AFFS detected around 70 % of the reported flood events correctly. In particular, the system showed good performance in predicting riverine flood events of long duration (> 1 week) and large affected areas (> 10 000 km2) well in advance, whereas AFFS showed limitations for small-scale and short duration flood events. The case study for the flood event in March 2003 in the Sabi Basin (Zimbabwe) illustrated the good performance of AFFS in forecasting timing and severity of the floods, gave an example of the clear and concise output products, and showed that the system is capable of producing flood warnings even in ungauged river basins. Hence, from a technical perspective, AFFS shows a large potential as an operational pan-African flood forecasting system, although issues related to the practical implication will still need to be investigated.

  9. A photovoltaic power system in the remote African village of Tangaye, Upper Volta

    NASA Technical Reports Server (NTRS)

    Bifano, W. J.; Ratajczak, A. F.; Martz, J. E.

    1979-01-01

    A photovoltaic (PV) system powering a grain mill and a water pump was installed in the remote West African village of Tangaye, Upper Volta. Village characteristics as well as system design, hardware, installation and operation to date are described. The PV system cost is discussed. A baseline socio-economic study performed and a follow-up study is planned to determine the impact of the system on the villagers.

  10. Ideological schisms about HIV/AIDS helping systems in the African American community, with an emphasis on women.

    PubMed

    Fairfax, Colita Nichols

    2010-10-01

    This article is an initial exploration about the impact of ideological beliefs on helping services in the African American community. Newly infected HIV/AIDS cases place African Americans at 45% of such new cases, with African American women becoming infected at a rate 18 times that of Whites. Yet, helping services that are organic to African American women should be stronger through a discussion of cultural beliefs held in the community, where the genesis of helping services exists. Values and beliefs should be at the center of community partnerships, public media strategies, generalist-practice curricula in macro-level systems, and creating more space for relationship dialogue between African American men and women, which includes gender and racial distortions. Given the exponentially high numbers of HIV/AIDS cases in the African American community, a more earnest examination of values and beliefs is warranted. PMID:21082471

  11. Psychological distress in African American grandmothers raising grandchildren: the contribution of child behavior problems, physical health, and family resources.

    PubMed

    Kelley, Susan J; Whitley, Deborah M; Campos, Peter E

    2013-08-01

    Diminished psychological health has been identified among caregiving grandmothers. The intent of this investigation was to examine psychological distress levels, as well as their predictors, in a sample of 480 caregiving African American grandmothers, mean age 56 years. Almost 40% (39.8%) of participants had clinically elevated psychological distress scores. Results of hierarchical multiple regression indicated that internalizing and externalizing child behavior problems, poor grandmother physical health, younger age of grandmother, and lack of family resources predicted 31% of the variance in psychological distress. Results provide direction for nursing interventions aimed at enhancing the psychological well-being of caregiving grandmothers. PMID:23606233

  12. System Justification, Mental Health, and Behavior Among Disadvantaged Mothers and Their Children

    PubMed Central

    Godfrey, Erin B.

    2014-01-01

    Integrating social psychological research with work in child development, this study explored relationships between system justification (Jost & Banaji, 1994), maternal mental health and child externalizing behavior among low-income immigrants and racial/ethnic minorities. Dominican, Mexican and African-American families (N = 239) were assessed when children were 14-, 24- and 36-months old. SEM was used to explore longitudinal relationships between maternal system justification and mental health and associations with child behavior. Earlier mental health was negatively related to later system justification and system justification was negatively related to children’s externalizing behavior. Implications for system justification theory, child development and immigration are discussed. PMID:25035527

  13. Analysis of pan-African Centres of excellence in health innovation highlights opportunities and challenges for local innovation and financing in the continent.

    PubMed

    Nwaka, Solomon; Ochem, Alexander; Besson, Dominique; Ramirez, Bernadette; Fakorede, Foluke; Botros, Sanaa; Inyang, Uford; Mgone, Charles; Adae-Mensah, Ivan; Konde, Victor; Nyasse, Barthelemy; Okole, Blessed; Guantai, Anastasia; Loots, Glaudina; Atadja, Peter; Ndumbe, Peter; Sanou, Issa; Olesen, Ole; Ridley, Robert; Ilunga, Tshinko

    2012-01-01

    A pool of 38 pan-African Centres of Excellence (CoEs) in health innovation has been selected and recognized by the African Network for Drugs and Diagnostics Innovation (ANDI), through a competitive criteria based process. The process identified a number of opportunities and challenges for health R&D and innovation in the continent: i) it provides a direct evidence for the existence of innovation capability that can be leveraged to fill specific gaps in the continent; ii) it revealed a research and financing pattern that is largely fragmented and uncoordinated, and iii) it highlights the most frequent funders of health research in the continent. The CoEs are envisioned as an innovative network of public and private institutions with a critical mass of expertise and resources to support projects and a variety of activities for capacity building and scientific exchange, including hosting fellows, trainees, scientists on sabbaticals and exchange with other African and non-African institutions. PMID:22838941

  14. Analysis of pan-African Centres of excellence in health innovation highlights opportunities and challenges for local innovation and financing in the continent

    PubMed Central

    2012-01-01

    A pool of 38 pan-African Centres of Excellence (CoEs) in health innovation has been selected and recognized by the African Network for Drugs and Diagnostics Innovation (ANDI), through a competitive criteria based process. The process identified a number of opportunities and challenges for health R&D and innovation in the continent: i) it provides a direct evidence for the existence of innovation capability that can be leveraged to fill specific gaps in the continent; ii) it revealed a research and financing pattern that is largely fragmented and uncoordinated, and iii) it highlights the most frequent funders of health research in the continent. The CoEs are envisioned as an innovative network of public and private institutions with a critical mass of expertise and resources to support projects and a variety of activities for capacity building and scientific exchange, including hosting fellows, trainees, scientists on sabbaticals and exchange with other African and non-African institutions. PMID:22838941

  15. Late Registration and African American Males' Academic Performance in a Suburban Community College System

    ERIC Educational Resources Information Center

    McWaine, Wendell Lamar, II

    2012-01-01

    The purpose of this study was to determine if there was a relationship between registration status and the persistence, end-of-semester GPA, and course success for African American males in a suburban community college system. This study also sought to determine if there was a difference between the persistence, end-of-semester GPA, and course…

  16. Drivers of Learning Management System Use in a South African Open and Distance Learning Institution

    ERIC Educational Resources Information Center

    Venter, Peet; van Rensburg, Mari Jansen; Davis, Annemarie

    2012-01-01

    The study on which this article reports examined the determinants of usage of an online learning management system (LMS) by fourth level business students at a South African open and distance learning university using an extension of the widely used technology acceptance model (TAM) as a theoretical basis. A survey was conducted among students at…

  17. Variations in Reading Achievement across 14 Southern African School Systems: Which Factors Matter?

    ERIC Educational Resources Information Center

    Hungi, Njora; Thuku, Florence W.

    2010-01-01

    In this study the authors employed a multilevel analysis procedure in order to examine the pupil and school levels factors that contributed to variation in reading achievement among Grade 6 primary school pupils in 14 southern African school systems (Botswana, Kenya, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa,…

  18. New Controls and Accountability for South African Teachers and Schools: The Integrated Quality Management System

    ERIC Educational Resources Information Center

    Weber, Everard

    2005-01-01

    This article analyses the Integrated Quality Management System (IQMS), an agreement reached in 2003 between the South African Education Department and the major teacher organisations in the country by using discourse analysis. The IQMS was scheduled to be implemented in public schools in 2004. Three discursive tensions are identified and…

  19. External Research Report on Attitudes and Barriers Impacting the Participation of African-American Males in the University System of Georgia. The University System of Georgia's African-American Male Initiative.

    ERIC Educational Resources Information Center

    Georgia Univ. System, Atlanta. Board of Regents.

    The African-American Male Initiative, a task force of the University System of Georgia (USG) Board of Regents, commissioned a statewide study to explore African American males' attitudes toward college in general and the USG in particular. Designed and conducted by external consulting firms, the study drew on discussions in focus groups and with…

  20. Power System State of Health

    NASA Astrophysics Data System (ADS)

    Carpenter, P.

    2012-12-01

    Understanding the state of a polar station's power system can be critical to a successful long-term deployment. Knowing how the system is functioning, prior to service, is key to proper logistics, scheduling and the service performed during a visit. A full record of power system performance is key to proper analysis of the health of the power system. The design of a power system with monitoring is a balance of components to gather information while still trying to keep complexity low. To properly incorporate a system to analyze a stations power system a firm understanding of how the power components function in polar environments as well as communication to data acquisition and / or telemetry is needed. For example designers will need to know how a station's power storage system will change in colder environments then manufactures standard design criteria. This would include the reduced available capacity, change in the mean time between failure and possible new failure modes. This understanding coupled with a system that would collect key information on the state of health of the power system will provide crucial insight in to what service is needed to keep the station functioning.

  1. Negotiating markets for health: an exploration of physicians' engagement in dual practice in three African capital cities.

    PubMed

    Russo, Giuliano; McPake, Barbara; Fronteira, Inês; Ferrinho, Paulo

    2014-09-01

    Scarce evidence exists on the features, determinants and implications of physicians' dual practice, especially in resource-poor settings. This study considered dual practice patterns in three African cities and the respective markets for physician services, with the objective of understanding the influence of local determinants on the practice. Forty-eight semi-structured qualitative interviews were conducted in the three cities to understand features of the practice and the respective markets. A survey was carried out in a sample of 331 physicians to explore their characteristics and decisions to work in public and private sectors. Descriptive analysis and inferential statistics were employed to explore differences in physicians' engagement in dual practice across the three locations. Different forms of dual practice were found to exist in the three cities, with public physicians engaging in private practice outside but also inside public facilities, in regulated as well as unregulated ways. Thirty-four per cent of the respondents indicated that they worked in public practice only, and 11% that they engaged exclusively in private practice. The remaining 55% indicated that they engaged in some form of dual practice, 31% 'outside' public facilities, 8% 'inside' and 16% both 'outside' and 'inside'. Local health system governance and the structure of the markets for physician services were linked to the forms of dual practice found in each location, and to their prevalence. Our analysis suggests that physicians' decisions to engage in dual practice are influenced by supply and demand factors, but also by how clearly separated public and private markets are. Where it is possible to provide little-regulated services within public infrastructure, less incentive seems to exist to engage in the formal private sector, with equity and efficiency implications for service provision. The study shows the value of analysing health markets to understand physicians' engagement in

  2. Local public health system partnerships.

    PubMed Central

    Zahner, Susan J.

    2005-01-01

    OBJECTIVES: Interorganizational collaboration aimed at community health improvement is an expectation of local public health systems. This study assessed the extent to which such collaboration occurred within one state (Wisconsin), described the characteristics of existing partnerships, and identified factors associated with partnership effectiveness. METHODS: In Stage 1, local health department (LHD) directors in Wisconsin were surveyed (93% response rate). In Stage 2, LHDs completed self-administered mailed surveys for each partnership identified in Stage 1 (85% response rate). Two-level hierarchical logit regression methods were used to model relationships between partnership and LHD variables and partnership outcomes. Data from 924 partnerships associated with 74 LHDs were included in the analysis. RESULTS: Partnerships most frequently addressed tobacco prevention and control, maternal and child health, emergency planning, community assessment and planning, and immunizations. Partnering was most frequent with other government agencies, hospitals, medical practices or clinics, community-based organizations, and schools. Partnership effectiveness was predicted by having a budget, having more partners contributing financially, having a broader array of organizations involved, and having been in existence for a longer period of time. A government mandate to start the partnership was inversely related to successful outcomes. Characteristics of LHDs did not predict partnership effectiveness. CONCLUSIONS: Financial support, having a broader array of partners, and allowing sufficient time for partnerships to succeed contribute to partnership effectiveness. Further study-using objective outcome measures-is needed to examine the effects of organizational and community characteristics on the effectiveness of local public health system partnerships. PMID:15736335

  3. Rhythm experience and Africana culture trial (REACT!): A culturally salient intervention to promote neurocognitive health, mood, and well-being in older African Americans.

    PubMed

    Lukach, Alexis J; Jedrziewski, M Kathryn; Grove, George A; Mechanic-Hamilton, Dawn J; Williams, Shardae S; Wollam, Mariegold E; Erickson, Kirk I

    2016-05-01

    The Rhythm Experience and Africana Culture Trial (REACT!) is a multi-site randomized controlled intervention study designed to examine the efficacy of using African Dance as a form of moderate-intensity physical activity to improve cognitive function in older African Americans. African Americans are almost two times more likely than Caucasians to experience cognitive impairment in late adulthood. This increased risk may be attributed to lower level and quality of education, lower socioeconomic status, and higher prevalence of vascular diseases, type 2 diabetes, hypertension, and obesity, all of which are recognized as risk factors for dementia. Fortunately, interventions targeting cardiovascular health (i.e., physical activity) are associated with improved neurocognitive function and a reduced risk for dementia, so African Americans may be particularly suited for interventions targeting cardiovascular health and cognitive function. Here, we describe a randomized intervention protocol for increasing physical activity in older (65-75years) African Americans. Participants (n=80) at two study locations will be randomized into one of two groups. The treatment group will participate in African Dance three times per week for six months and the control group will receive educational training on Africana history and culture, as well as information about health behaviors, three times per week for six months. If successful, the REACT! study may transform community interventions and serve as a platform and model for testing other populations, age groups, and health outcomes, potentially identifying novel and creative methods for reducing or eliminating health disparities. PMID:27033674

  4. A Cluster Randomized Controlled Trial to Increase Breast Cancer Screening Among African American Women: The Black Cosmetologists Promoting Health Program

    PubMed Central

    Sadler, Georgia Robins; Ko, Celine M.; Wu, Phillis; Alisangco, Jennifer; Castañeda, Sheila F.; Kelly, Colleen

    2014-01-01

    Background African American women have disproportionately higher rates of breast cancer (BC) mortality than all other ethnic groups, thus highlighting the importance of promoting early detection. Methods African American women (N = 984) from San Diego, California participated in a randomized controlled trial testing the efficacy of BC education sessions offered in beauty salons. Cosmetologists received ongoing support, training, and additional culturally aligned educational materials to help them engage their clients in dialogues about the importance of BC early detection. Posters and literature about BC early detection were displayed throughout the salons and cosmetologists used synthetic breast models to show their clients how BC lumps might feel. Participants in the control group received a comparable diabetes education program. Baseline and six month follow-up surveys were administered to evaluate changes in women’s BC knowledge, attitudes and screening behaviors. Results This intervention was well received by the participants and their cosmetologists and did not interfere with, or prolong, the client’s salon visit. Women in the intervention group reported significantly higher rates of mammography compared to women in the control group. Training a single educator proved sufficient to permeate the entire salon with the health message and salon clients agreed that cosmetologists could become effective health educators. Conclusions Cosmetologists are in an ideal position to increase African American women’s BC knowledge and adherence to BC screening guidelines. PMID:22046851

  5. Globalization, pharmaceutical pricing, and South African health policy: managing confrontation with U.S. firms and politicians.

    PubMed

    Bond, P

    1999-01-01

    Brewing since the advent of South African democracy in 1994 and promises of health sector transformation, an extraordinary drug war between President Nelson Mandela's African National Congress government and U.S. pharmaceutical manufacturers took on global proportions in 1998-1999. Within months of the passage of South African legislation aimed at lowering drug prices, the U.S. government quickly applied powerful pressure points to repeal a clause allowing potential importation of generic substitutes and imposition of compulsory licensing. At stake were not only local interpretations of patent law and World Trade Organization rules on Trade in Intellectual Property, but international power relations between developing countries and the pharmaceutical industry. In reviewing the ongoing debate, this article considers post-apartheid public health policy, U.S. government pressure to change the law, and pharmaceutical industry interests and links to the U.S. government, and evaluates various kinds of resistance to U.S. corporate and government behavior. The case thus raises--not for the first time--concerns about contemporary imperialism ("globalization"), the role of the profit motive as an incentive in vital pharmaceutical products, and indeed the depth of "democracy" in a country where high-bidding international drug firms have sufficient clout to embarrass Vice President Al Gore by pitting him against the life-and-death interests of millions of consumers of essential drugs in South Africa and other developing countries. PMID:10615573

  6. Problem posing and cultural tailoring: developing an HIV/AIDS health literacy toolkit with the African American community.

    PubMed

    Rikard, R V; Thompson, Maxine S; Head, Rachel; McNeil, Carlotta; White, Caressa

    2012-09-01

    The rate of HIV infection among African Americans is disproportionately higher than for other racial groups in the United States. Previous research suggests that low level of health literacy (HL) is an underlying factor to explain racial disparities in the prevalence and incidence of HIV/AIDS. The present research describes a community and university project to develop a culturally tailored HIV/AIDS HL toolkit in the African American community. Paulo Freire's pedagogical philosophy and problem-posing methodology served as the guiding framework throughout the development process. Developing the HIV/AIDS HL toolkit occurred in a two-stage process. In Stage 1, a nonprofit organization and research team established a collaborative partnership to develop a culturally tailored HIV/AIDS HL toolkit. In Stage 2, African American community members participated in focus groups conducted as Freirian cultural circles to further refine the HIV/AIDS HL toolkit. In both stages, problem posing engaged participants' knowledge, experiences, and concerns to evaluate a working draft toolkit. The discussion and implications highlight how Freire's pedagogical philosophy and methodology enhances the development of culturally tailored health information. PMID:22102601

  7. African desert dust in the Caribbean atmosphere: Microbiology and public health

    USGS Publications Warehouse

    Griffin, Dale W.; Garrison, V.H.; Herman, J.R.; Shinn, E.A.

    2001-01-01

    Air samples collected on St. John in the U.S. Virgin Islands were screened for the presence of viable bacteria and fungi to determine if the number of cultivatable microbes in the atmosphere differed between "clear atmospheric conditions" and "African dust-events." Results indicate that during "African dust-events," the numbers of cultivatable airborne microorganisms can be 2 to 3 times that found during "clear atmospheric conditions." Direct microbial counts of air samples using an epifluorescent microscopy assay demonstrated that during an "African dust-event," bacteria-like and virus-like particle counts were approximately one log greater than during "clear atmospheric conditions." Bacteria-like particles exhibiting autofluoresence, a trait of phototrophs, were only detected during an "African dust-event.".

  8. Integrating homoeopathy in health systems.

    PubMed Central

    Poitevin, B.

    1999-01-01

    Homoeopathy is a therapy which involves many components and three main agents: the patient, with his or her condition and personal characteristics; the medication used, with its composition and manufacturing procedure; and the physician, with his or her approach to treatment and concepts of health. The development of research and evaluation structures, combined with a critical education in the discipline, would help to improve practices and define homoeopathy's potential role in relation to the other therapies, both conventional and unconventional, used in Western health systems. PMID:10083716

  9. Mortality of White Americans, African Americans, and Canadians: The Causes and Consequences for Health of Welfare State Institutions and Policies

    PubMed Central

    Kunitz, Stephen J; Pesis-Katz, Irena

    2005-01-01

    The life expectancy of African Americans has been substantially lower than that of white Americans for as long as records are available. The life expectancy of all Americans has been lower than that of all Canadians since the beginning of the 20th century. Until the 1970s this disparity was the result of the low life expectancy of African Americans. Since then, the life expectancy of white Americans has not improved as much as that of all Canadians. This article discusses two issues: racial disparities in the United States, and the difference in life expectancy between all Canadians and white Americans. Each country's political culture and institutions have shaped these differences, especially national health insurance in Canada and its absence in the United States. The American welfare state has contributed to and explains these differences. PMID:15787952

  10. An Exploration of the Leadership Style Preferences among African American Women Administrators of the 1890 Cooperative Extension System

    ERIC Educational Resources Information Center

    Campbell, Shelvy L.

    2010-01-01

    The purpose of this mixed-methods study was to identify and explore the leadership style preferences among current African American Administrators of the 1890 Land-Grant Cooperative Extension system. The population used in this study was African American women administrators from eighteen mostly southern states. The researcher used a "two-phase…

  11. Integrated Systems Health Management for Intelligent Systems

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

    The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. Management implies storage, distribution, sharing, maintenance, processing, reasoning, and presentation. ISHM is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this chapter, concepts, procedures, and approaches are presented as a foundation for implementing an ISHM capability relevant to intelligent systems. The capability stresses integration of DIaK from all elements of a system, emphasizing an advance toward an on-board, autonomous capability. Both ground-based and on-board ISHM capabilities are addressed. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

  12. Evaluation of a health setting-based stigma intervention in five African countries.

    PubMed

    Uys, Leana; Chirwa, Maureen; Kohi, Thecla; Greeff, Minrie; Naidoo, Joanne; Makoae, Lucia; Dlamini, Priscilla; Durrheim, Kevin; Cuca, Yvette; Holzemer, William L

    2009-12-01

    The study aim is to explore the results of an HIV stigma intervention in five African health care settings. A case study approach was used. The intervention consisted of bringing together a team of approximately 10 nurses and 10 people living with HIV or AIDS (PLHA) in each setting and facilitating a process in which they planned and implemented a stigma reduction intervention, involving both information giving and empowerment. Nurses (n = 134) completed a demographic questionnaire, the HIV/AIDS Stigma Instrument-Nurses (HASI-N), a self-efficacy scale, and a self-esteem scale, both before and after the intervention, and the team completed a similar set of instruments before and after the intervention, with the PLHA completing the HIV/AIDS Stigma Instrument for PLHA (HASI-P). The intervention as implemented in all five countries was inclusive, action-oriented, and well received. It led to understanding and mutual support between nurses and PLHA and created some momentum in all the settings for continued activity. PLHA involved in the intervention teams reported less stigma and increased self-esteem. Nurses in the intervention teams and those in the settings reported no reduction in stigma or increases in self- esteem and self-efficacy, but their HIV testing behavior increased significantly. This pilot study indicates that the stigma experience of PLHA can be decreased, but that the stigma experiences of nurses are less easy to change. Further evaluation research with control groups and larger samples and measuring change over longer periods of time is indicated. PMID:20025515

  13. Evaluation of a Health Setting-Based Stigma Intervention in Five African Countries

    PubMed Central

    Uys, Leana; Chirwa, Maureen; Kohi, Thecla; Greeff, Minrie; Makoae, Lucia; Dlamini, Priscilla; Durrheim, Kevin; Cuca, Yvette; Holzemer, William L.

    2009-01-01

    Abstract The study aim is to explore the results of an HIV stigma intervention in five African health care settings. A case study approach was used. The intervention consisted of bringing together a team of approximately 10 nurses and 10 people living with HIV or AIDS (PLHA) in each setting and facilitating a process in which they planned and implemented a stigma reduction intervention, involving both information giving and empowerment. Nurses (n = 134) completed a demographic questionnaire, the HIV/AIDS Stigma Instrument-Nurses (HASI-N), a self-efficacy scale, and a self-esteem scale, both before and after the intervention, and the team completed a similar set of instruments before and after the intervention, with the PLHA completing the HIV/AIDS Stigma Instrument for PLHA (HASI-P). The intervention as implemented in all five countries was inclusive, action-oriented, and well received. It led to understanding and mutual support between nurses and PLHA and created some momentum in all the settings for continued activity. PLHA involved in the intervention teams reported less stigma and increased self-esteem. Nurses in the intervention teams and those in the settings reported no reduction in stigma or increases in self- esteem and self-efficacy, but their HIV testing behavior increased significantly. This pilot study indicates that the stigma experience of PLHA can be decreased, but that the stigma experiences of nurses are less easy to change. Further evaluation research with control groups and larger samples and measuring change over longer periods of time is indicated. PMID:20025515

  14. Systemic diseases and oral health.

    PubMed

    Tavares, Mary; Lindefjeld Calabi, Kari A; San Martin, Laura

    2014-10-01

    The US population is at the beginning of a significant demographic shift; the American geriatric population is burgeoning, and average longevity is projected to increase in the coming years. Elder adults are affected by numerous chronic conditions, such as diabetes, hypertension, osteoarthritis, osteoporosis, cardiovascular diseases, and cerebrovascular diseases. These older adults need special dental care and an improved understanding of the complex interactions of oral disease and systemic chronic diseases that can complicate their treatment. Oral diseases have strong associations with systemic diseases, and poor oral health can worsen the impact of systemic diseases. PMID:25201543

  15. Ethnic identities, social capital and health inequalities: factors shaping African-Caribbean participation in local community networks in the UK.

    PubMed

    Campbell, Catherine; McLean, Carl

    2002-08-01

    This paper examines the impact of ethnic identity on the likelihood of peoples' participation in local community networks, in the context of recent policy emphasis on the participation of marginalised communities in such networks as a means of reducing health inequalities. Conceptually, the paper is located against the background of debates about possible links between health and social capital--defined in terms of grassroots participation in local community networks--and an interest in the way in which social exclusion impacts on social capital. The paper draws on lengthy semi-structured, open-ended interviews with 25 African-Caribbean residents of a deprived multi-ethnic area of a south England town. While African-Caribbean identity played a central role in peoples' participation in inter-personal networks, this inter-personal solidarity did not serve to unite people at the local community level beyond particular face-to-face networks. Levels of participation in voluntary organisations and community activist networks were low. Informants regarded this lack of African-Caribbean unity within the local community as a problem, saying that it placed African-Caribbean people at a distinct disadvantage--furthering their social exclusion through limiting their access to various local community resources. The paper examines the way in which the construction of ethnic identities--within a context of institutionalised racism at both the material and symbolic levels--makes it unlikely that people will view local community organisations or networks as representative of their interests or needs, or be motivated to participate in them. Our findings highlight the limitations of policies which simply call for increased community participation by socially excluded groups, in the absence of specific measures to address the obstacles that stand in the way of such participation. PMID:12188469

  16. [Professional health cards (CPS): informatic health care system in France].

    PubMed

    Fortuit, P

    2005-09-01

    The Professional Health Card Public interest group (Groupement d'Intérêt Public-Carte de professionnel de Santé (GIP-CPS)) was founded in 1993 as a joint initiative by the different parties involved in health care in France: the state, the representatives of the health care professions and the compulsory and complementary health insurance organizations. The CPS system enables safe exchange and electronic sharing of medical data. Via Intranet connections and Extranet hosting of medical files, databases, the CPS system enables health care professionals who access servers to be identified with certainty. For email exhanges, the CPS systems guarantees the sender's identity and capacity. The electronic signature gives legal value to the email. The system also enables confidential email. The health card system (CPS) contributes to making the health service efficient. Shared medical files, health care networks, health warning systems or electronic requests for reimbursement of health insurance expenses all use the CPS system. More than 300,000 health care professionals use it regularly. The freedom of movement of patients throughout Europe has led to the growth of exchanges and information sharing between health professionals in the States of the Union. More and more health professionals will be leaving their own countries to work in foreign countries in the future. It is essential that their freedom of movement is accompanied by the ability to prove their rights to practice. PMID:16385785

  17. Systemic inflammatory responses in African tick-bite fever.

    PubMed

    Jensenius, Mogens; Ueland, Thor; Fournier, Pierre-Edouard; Brosstad, Frank; Stylianou, Eva; Vene, Sirkka; Myrvang, Bjørn; Raoult, Didier; Aukrust, Pål

    2003-04-15

    Information regarding the inflammatory response in African tick-bite fever (ATBF), an emerging spotted-fever-group rickettsiosis, in international travelers to sub-Saharan Africa, is scarce. Plasma/serum levels of von Willebrand factor (vWF), soluble (s) E-selectin, tumor necrosis factor-alpha, interleukin (IL)-6, interferon-gamma, IL-10, IL-13, IL-8, RANTES, macrophage inflammatory protein-1alpha, and C-reactive protein were studied, at both first presentation and follow-up, in 15 patients with travel-associated ATBF and in 14 healthy travelers who served as control subjects. Our main and novel findings are the following: (1) patients with ATBF had increased levels of vWF and sE-selectin, with a subsequent decrease at follow-up; (2) with the exception of IFN-gamma, levels of cytokines and chemokines were also increased in these patients at the first presentation; and (3) IL-10 and IL-13 tended to increase during follow-up, whereas most of the inflammatory cytokines decreased. The induction of these mediators and the balance between them may be critical both for the regulation of inflammation and for protective immunity in ATBF. PMID:12696016

  18. [The health system of Argentina].

    PubMed

    Belló, Mariana; Becerril-Montekio, Victor M

    2011-01-01

    This paper describes the health system of Argentina.This system has three sectors: public, social security and private.The public sector includes the national and provincial ministries as well as the network of public hospitals and primary health care units which provide care to the poor and uninsured population. This sector is financed with taxes and payments made by social security beneficiaries that use public health care facilities. The social security sector or Obras Sociales (OS) covers all workers of the formal economy and their families. Most OS operate through contracts with private providers and are financed with payroll contributions of employers and employees. Finally, the private sector includes all those private providers offering services to individuals, OS beneficiaries and all those with private health insurance.This sector also includes private insurance agencies called Prepaid Medicine Enterprises, financed mostly through premiums paid by families and/or employers.This paper also discusses some of the recent innovations implemented in Argentina, including the program Remediar. PMID:21877098

  19. Energy Systems and Population Health

    SciTech Connect

    Ezzati, Majid; Bailis, Rob; Kammen, Daniel M.; Holloway, Tracey; Price, Lynn; Cifuentes, Luis A.; Barnes, Brendon; Chaurey, Akanksha; Dhanapala, Kiran N.

    2004-04-12

    It is well-documented that energy and energy systems have a central role in social and economic development and human welfare at all scales, from household and community to regional and national (41). Among its various welfare effects, energy is closely linked with people s health. Some of the effects of energy on health and welfare are direct. With abundant energy, more food or more frequent meals can be prepared; food can be refrigerated, increasing the types of food items that are consumed and reducing food contamination; water pumps can provide more water and eliminate the need for water storage leading to contamination or increased exposure to disease vectors such as mosquitoes or snails; water can be disinfected by boiling or using other technologies such as radiation. Other effects of energy on public health are mediated through more proximal determinants of health and disease. Abundant energy can lead to increased irrigation, agricultural productivity, and access to food and nutrition; access to energy can also increase small-scale income generation such as processing of agricultural commodities (e.g., producing refined oil from oil seeds, roasting coffee, drying and preserving fruits and meats) and production of crafts; ability to control lighting and heating allows education or economic activities to be shielded from daily or seasonal environmental constraints such as light, temperature, rainfall, or wind; time and other economic resources spent on collecting and/or transporting fuels can be used for other household needs if access to energy is facilitated; energy availability for transportation increases access to health and education facilities and allow increased economic activity by facilitating the transportation of goods and services to and from markets; energy for telecommunication technology (radio, television, telephone, or internet) provides increased access to information useful for health, education, or economic purposes; provision of energy

  20. The Effect of Message Framing on African American Women's Intention to Participate in Health-Related Research.

    PubMed

    Balls-Berry, Joyce E; Hayes, Sharonne; Parker, Monica; Halyard, Michele; Enders, Felicity; Albertie, Monica; Pinn, Vivian; Radecki Breitkopf, Carmen

    2016-05-01

    This study examined the effect of message framing on African American women's intention to participate in health-related research and actual registration in ResearchMatch (RM), a disease-neutral, national volunteer research registry. A community-engaged approach was used involving collaboration between an academic medical center and a volunteer service organization formed by professional women of color. A self-administered survey that contained an embedded message framing manipulation was distributed to more than 2,000 African American women attending the 2012 national assembly of The Links, Incorporated. A total of 391 surveys were completed (381 after exclusion: 187 containing the gain-framed message and 194 containing the loss-framed message). The majority (57%) of women expressed favorable intentions to participate in health-related research, and 21% subsequently enrolled in RM. The effect of message framing on intention was moderated by self-efficacy. There was no effect of message framing on RM registration; however, those with high self-efficacy were more than 2 times as likely as those with low self-efficacy to register as a potential study volunteer in RM (odds ratio = 2.62, 95% confidence interval [1.29, 5.33]). This investigation makes theoretical and practical contributions to the field of health communication and informs future strategies to meaningfully and effectively include women and minorities in health-related research. PMID:27077665

  1. Privatisation of South African health services--are the underlying assumptions correct?

    PubMed

    Naylor, C D

    1987-11-21

    Six key assumptions made by proponents of privatisation are critically appraised in the light of Canadian, US and UK studies. 'Counter' assumptions, equally credible, are: (i) the economic behaviour of the health-care market does not correspond to the idealized rules of the free market nor, given the nature of health care as a 'public good', should it do so; (ii) national health-care systems with a heavy emphasis on private insurance are as or more costly than universal public systems; (iii) private for-profit hospitals do not usually enjoy any cost-efficiency advantages over public hospitals; (iv) subsidizing individuals to purchase private care carries a risk of adding administrative costs, fueling the inflationary spiral in health care, and reducing public accountability of tax money; (v) user-fees and co-insurance will not deter over-utilisation without penalising and reducing legitimate use of health services; and (vi) savings from privatisation are unlikely except for the more affluent citizens of the RSA who will carry a slightly reduced tax burden--all others will pay more and may be deterred from seeking necessary care. PMID:3317922

  2. Bioelectrocatalytic systems for health applications.

    PubMed

    Sekretaryova, Alina N; Eriksson, Mats; Turner, Anthony P F

    2016-01-01

    We present a brief overview of bioelectrocatalytic devices for in vitro health applications, including food safety and environmental analysis, focusing on microelectrode- and microfluidic-based biosensors, paper-based point-of-care devices and wearable biosensors. The main hurdles and future perspectives are discussed. We then consider the role of electron transfer between a biocatalyst and an electrode in biosensor design. Brief descriptions of indirect, direct and mediated mechanisms are given. The principal strategies, as well as recent developments for modulation of electron transfer in biocatalytic systems are summarised. In conclusion, we highlight some of the challenges associated with improving these redox systems. PMID:26724183

  3. Health-protective effects of attachment among African American girls in psychiatric care.

    PubMed

    Emerson, Erin; Donenberg, Geri R; Wilson, Helen W

    2012-02-01

    African American girls in psychiatric care are at increased risk for HIV and sexually transmitted infection (STI) through sexual risk taking. Adolescent sexual behavior often reflects peer norms and behavior. Secure attachment patterns with mothers and peers might lessen the effects of negative peer influences and reduce sexual risk taking among African American girls. This study examined the relationships among mother-daughter and peer attachment, peer norms, and sexual-risk behaviors in African American girls seeking outpatient psychiatric care. A group of 12-16-year-old African American girls (N = 262; M age = 14.45 years) reported on their attachment to their mothers and peers, peer risk-taking and dating behaviors, peer pressure, and sexual-risk behaviors (e.g., number of partners, high-risk partners, and condom use). Structural equation modeling examined whether peer attachment and peer norms mediated the relationship between mother attachment and sexual risk. Findings supported peer norms, but not peer attachment, as a mediator of mother attachment and girls' sexual-risk behaviors. Findings revealed important family and peer factors for African American girls in psychiatric care. HIV prevention programs may be strengthened by improving mother-daughter relationships, addressing the importance of peer relationships, and emphasizing how secure mother-daughter relationships can temper the impact of peer norms. PMID:22182334

  4. Perceptions of the religion--health connection among African Americans in the southeastern United States: sex, age, and urban/rural differences.

    PubMed

    Holt, Cheryl L; Schulz, Emily; Wynn, Theresa A

    2009-02-01

    Extensive literature reviews suggest that religiousness is positively associated with health. Much less understood is the particular nature of the religion-health connection. Religion and the church play a central role in the lives of many African Americans. This study used a mixed-methods approach to examine perceptions of the religion-health connection among African Americans in urban and rural areas. Four hundred participants were randomly selected and interviewed by telephone, answering open-ended questions about their perceptions of the role of religiousness in their health. Data were analyzed using an open-coding technique. Codes were arranged into families involving the role of a higher power, health behavior, physical factors, social support, mental health, and contextual factors in determining physical health, as well as the potential negative role of religiousness. Quantitative analysis revealed the stronger presence of themes among women, older participants, and those in rural counties. Applications for theory and health promotion are discussed. PMID:17652617

  5. Assessing public and private sector contributions in reproductive health financing and utilization for six sub-Saharan African countries.

    PubMed

    Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg

    2011-05-01

    The present study provides evidence to support enhanced attention to reproductive health and comprehensive measures to increase access to quality reproductive health services. We compare and contrast the financing and utilization of reproductive health services in six sub-Saharan African countries using data from National Health Accounts and Demographic and Health Surveys. Spending on reproductive health in 2006 ranged from US$4 per woman of reproductive age in Ethiopia to US$17 in Uganda. These are below the necessary level for assuring adequate services given that an internationally recommended spending level for family planning alone was US$16 for 2006. Moreover, reproductive health spending shows signs of decline in tandem with insufficient improvement in service utilization. Public providers played a predominant role in antenatal and delivery care for institutional births, but home deliveries with unqualified attendants dominated. The private sector was a major supplier of condoms, oral pills and IUDs. Private clinics, pharmacies and drug vendors were important sources of STI treatment. The findings highlight the need to commit greatly increased funding for reproductive health services as well as more policy attention to the contribution of public, private and informal providers and the role of collaboration among them to expand access to services for under-served populations. PMID:21555087

  6. Black African Traditional Mathematics

    ERIC Educational Resources Information Center

    Zaslavsky, Claudia

    1970-01-01

    Discusses the traditional number systems and the origin of the number names used by several African peoples living south of the Sahara. Also included are limitations in African mathematical development, and possible topics for research. (RP)

  7. Randomized Trial of A Lay Health Advisor and Computer Intervention to Increase Mammography Screening in African American Women

    PubMed Central

    Russell, Kathleen M.; Champion, Victoria L.; Monahan, Patrick O.; Millon-Underwood, Sandra; Zhao, Qianqian; Spacey, Nicole; Rush, Nathan L.; Paskett, Electra D.

    2009-01-01

    Background Low-income African American women face numerous barriers to mammography screening. We tested the efficacy of a combined interactive computer program and lay health advisor (LHA) intervention to increase mammography screening. Methods In this randomized, single blind study, participants were 181 African American female health center patients ages 41-75, ≤250% of poverty level with no breast cancer history and no screening mammogram in the past 15 months. They were assigned to either (a) a low dose comparison group consisting of a culturally appropriate mammography screening pamphlet or (b) interactive, tailored computer instruction at baseline and 4 monthly LHA counseling sessions. Self-reported screening data were collected at baseline and 6 months and verified by medical record. Results For intent-to-treat analysis of primary outcome (medical-record-verified mammography screening, available on all but two participants), the intervention group had increased screening to 51% (45/89) compared to 18% (16/90) for the comparison group at 6 months. When adjusted for employment status, disability, first-degree relatives with breast cancer, health insurance, and previous breast biopsies, the intervention group was three times more likely (adjusted relative risk [RR]=2.7 [95% CI: 1.8, 3.7], p<.0001) to get screened than the low dose comparison group. Similar results were found for self-reported mammography stage of screening adoption. Conclusions The combined intervention was efficacious in improving mammography screening in low-income African American women, with an unadjusted effect size (RR = 2.84) significantly higher (p < .05) than previous studies of each intervention alone. PMID:20056639

  8. Joint trajectories of victimization and marijuana use and their health consequences among urban African American and Puerto Rican young men.

    PubMed

    Pahl, Kerstin; Brook, Judith S; Lee, Jung Yeon

    2013-06-01

    We examined the joint trajectories of violent victimization and marijuana use from emerging adulthood to the early thirties and their health consequences in the early thirties among urban African American and Puerto Rican men. Data were collected from a community sample of young men (N = 340) when they were 19, 24, 29, and 32 years old. The joint trajectories of violent victimization and marijuana use were extracted using growth mixture modeling. Three distinct joint trajectory groups of violent victimization and marijuana use were identified: high violent victimization/consistently high marijuana use; low violent victimization/increasingly high marijuana use, and low violent victimization/low marijuana use. Group comparisons using regression analyses showed that men who had experienced high levels of violent victimization and were high frequency marijuana over time users experienced the most adverse psychological and physical health outcomes, including more health problems, psychological maladjustment, and substance use disorders. PMID:22532191

  9. Joint Trajectories of Victimization and Marijuana Use and Their Health Consequences Among Urban African American and Puerto Rican Young Men

    PubMed Central

    Pahl, Kerstin; Brook, Judith S.; Lee, Jung Yeon

    2012-01-01

    We examined the joint trajectories of violent victimization and marijuana use from emerging adulthood to the early thirties and their health consequences in the early thirties among urban African American and Puerto Rican men. Data were collected from a community sample of young men (N=340) when they were 19, 24, 29, and 32 years old. The joint trajectories of violent victimization and marijuana use were extracted using growth mixture modeling. Three distinct joint trajectory groups of violent victimization and marijuana use were identified: high violent victimization/consistently high marijuana use; low violent victimization/increasingly high marijuana use, and low violent victimization/low marijuana use. Group comparisons using regression analyses showed that men who had experienced high levels of violent victimization and were high frequency marijuana over time users experienced the most adverse psychological and physical health outcomes, including more health problems, psychological maladjustment, and substance use disorders. PMID:22532191

  10. Racial and Gender Discrimination in the Stress Process: Implications for African American Women's Health and Well-Being

    PubMed Central

    Perry, Brea L.; Harp, Kathi L. H.; Oser, Carrie B.

    2013-01-01

    In recent decades, sociologists have increasingly adopted an intersectionality framework to explore and explain the complex and interconnected nature of inequalities in the areas of race, class, and gender. Using an inclusion-centered approach and a sample of 204 low-socioeconomic-status (SES) African American women, the authors theorize and explore the role of racial and gender discrimination in the stress process. Analyses examine relationships between social stressors (racial and gender discrimination) and individual stressors occurring in each of six distinct social contexts. Furthermore, the authors evaluate the effects of racial and gender discrimination as compared to individual stressors on three indicators of mental health and well-being. Findings suggest that racial and gender discrimination increases risk for poor health and low well-being, working both directly and indirectly through increased vulnerability to individual stressors. This research demonstrates the value of a more comprehensive study of stressors that influence the health of low-SES African American women and other multiply disadvantaged groups. PMID:24077024

  11. Achieving equity through critical science agency: An ethnographic study of African American students in a health science career academy

    NASA Astrophysics Data System (ADS)

    Haun-Frank, Julie

    The purpose of this study was to examine the potential of a High School Health Science Career Academy to support African American students' science career trajectories. I used three key theoretical tools---critical science agency (Basu, 2007; Calabrese Barton & Tan, 2008), power (Nespor, 1994), and cultural production (Carlone, 2004; Eisenhart & Finkel, 1998) to highlight the intersections between the career trajectory implied by the Academy (its curriculum, classroom activities, and clinical experiences) and the students' pursued career trajectories. Data was collected over five months and included individual student interviews, group interviews, parent and administrator interviews, field notes from a culminating medical course and clinical internship, and Academy recruitment documents. The results of this study suggest that participants pursued a health science career for altruistic purposes and the Academy was a resource they drew upon to do so. However, the meanings of science and science person implied by the Academy hindered the possibility for many participants' to advance their science career trajectories. While the Academy promised to expose students to a variety of high-status health care roles, they were funneled into feminine, entry-level positions. This study adds to previous underrepresentation literature by contextualizing how identity-related factors influence African American students' career attainment.

  12. Promoting healthful diets and exercise: efficacy of a 12-week after-school program in urban African Americans.

    PubMed

    Engels, Hermann-J; Gretebeck, Randall J; Gretebeck, Kimberlee A; Jiménez, Linda

    2005-03-01

    This study examined the effectiveness of a unique extracurricular after-school initiative designed to promote healthy diets and exercise in urban African Americans. The Students and Parents Actively Involved in Being Fit after-school program was offered for 12 weeks to students and their parents/guardians at an urban middle school. Specific aims of the intervention were to increase participants' vegetable and fruit intake by using established 5 A Day for Better Health educational resource materials/activities and to affect their health-related fitness through dance, games, and fitness activities. Fifty-six children and 25 parents/guardians completed a standard battery of evaluations before and after the program. Pre-post pairwise t test revealed that both children and their parents/guardians showed an increase in fruit consumption and a reduction in diastolic blood pressure (P <.05). Moreover, children showed improvements in systolic blood pressure and fruit juice, salad, and nonfried potato consumption while parents/guardians showed a decrease in body fat, body mass index, and endurance walk/run time (P <.05). Overall, findings indicate that children tended to gain more diet-related benefits while parents/guardians tended to derive more fitness-related benefits. After-school programs like the Students and Parents Actively Involved in Being Fit initiative can potentially contribute to improved health levels in urban African Americans. PMID:15746836

  13. Health without wealth? Costa Rica's health system under economic crisis.

    PubMed

    Morgan, L M

    1987-01-01

    The recent history of Costa Rica's health system is reviewed, emphasizing the health-related effects of the economic crisis of the 1980s. This economic crisis has stopped and in some instances reversed the marked health improvements Costa Rica realized during the decade of the 1970s. The effects of the economic crisis emerge in 4 areas: deterioration in health status, as poverty contributed to higher disease rates; reductions in the government's ability to maintain public health and medical services; increased reliance on foreign aid to finance the health system; and growing national debate over the role of the state in health care. The result of the economic crisis was a reduction in health services and a questioning of the Costa Rican health model. This occurred following the implementation of an expensive health infrastructure and at a time when people most needed health services. During the 1941-70 period, domestic initiative can account for much of the expansion of Costa Rica's social security system, but also at this time international agencies such as the US Agency for International Development (USAID) and the Inter-American Development began to assist in the expansion of the health system. In 1971 a plan was initiated to create a nationalized health system. By 1980 the success of the health sector reorganization was evident in the statistics: marked improvements in life expectancy, infant mortality, and infectious disease mortality had surpassed the goals set by the Pan American Health Organization (PAHO) and the Ministry of Health. Costa Rica's success was a vindication of both policy goals and funding priorities, for it has been "proved" that primary health care was capable of improving health indices, particularly where the agencies had the active and conscientious support of the national government. By 1977, foreign contracts for aid had expired, and the Ministry declared that the rural health program would be supported totally by the government. The

  14. Low-Income African-American Caregivers' Experiences of Being Referred to Mental Health Services by the School Counselor: Implications for Best Practices

    ERIC Educational Resources Information Center

    Tucker, Catherine

    2009-01-01

    Referring students for mental health care is a core job function for school counselors, and one that is often stressful for all parties involved. In this phenomenological study, six low-income African-American caregivers were interviewed about their experiences of having a son or grandson referred for mental health care by the school counselor.…

  15. Reproductive Health of Urban Adolescents: Differences in the Behaviors, Cognitions, and Social Context of African-American and Puerto Rican Females

    ERIC Educational Resources Information Center

    Milan, Stephanie; Ethier, Kathleen; Lewis, Jessica; Kershaw, Trace; Niccolai, Linda; Ickovics, Jeannette

    2006-01-01

    Although ethnic and racial disparities exist in adolescent reproductive health, few studies have examined differences between members of different minority groups. This paper describes differences in measures of reproductive health behaviors, cognitions and social context between African-American (n=170) and Puerto Rican (n=150) adolescent females…

  16. The West African monsoon: Contribution of the AMMA multidisciplinary programme to the study of a regional climate system.

    NASA Astrophysics Data System (ADS)

    Lebel, T.; Janicot, S.; Redelsperger, J. L.; Parker, D. J.; Thorncroft, C. D.

    2015-12-01

    The AMMA international project aims at improving our knowledge and understanding of the West African monsoon and its variability with an emphasis on daily-to-interannual timescales. AMMA is motivated by an interest in fundamental scientific issues and by the societal need for improved prediction of the WAM and its impacts on water resources, health and food security for West African nations. The West African monsoon (WAM) has a distinctive annual cycle in rainfall that remains a challenge to understand and predict. The location of peak rainfall, which resides in the Northern Hemisphere throughout the year, moves from the ocean to the land in boreal spring. Around the end of June there is a rapid shift in the location of peak rainfall between the coast and around 10°N where it remains until about the end of August. In September the peak rainfall returns equatorward at a relatively steady pace and is located over the ocean again by November. The fact that the peak rainfall migrates irregularly compared to the peak solar heating is due to the interactions that occur between the land, the atmosphere and the ocean. To gain a better understanding of this complex climate system, a large international research programme was launched in 2002, the biggest of its kind into environment and climate ever attempted in Africa. AMMA has involved a comprehensive field experiment bringing together ocean, land and atmospheric measurements, on timescales ranging from hourly and daily variability up to the changes in seasonal activity over a number of years. This presentation will focus on the description of the field programme and its accomplishments, and address some key questions that have been recently identified to form the core of AMMA-Phase 2.

  17. The West African monsoon: Contribution of the AMMA multidisciplinary programme to the study of a regional climate system.

    NASA Astrophysics Data System (ADS)

    Lebel, T.; Janicot, S.; Redelsperger, J. L.; Parker, D. J.; Thorncroft, C. D.

    2014-12-01

    The AMMA international project aims at improving our knowledge and understanding of the West African monsoon and its variability with an emphasis on daily-to-interannual timescales. AMMA is motivated by an interest in fundamental scientific issues and by the societal need for improved prediction of the WAM and its impacts on water resources, health and food security for West African nations. The West African monsoon (WAM) has a distinctive annual cycle in rainfall that remains a challenge to understand and predict. The location of peak rainfall, which resides in the Northern Hemisphere throughout the year, moves from the ocean to the land in boreal spring. Around the end of June there is a rapid shift in the location of peak rainfall between the coast and around 10°N where it remains until about the end of August. In September the peak rainfall returns equatorward at a relatively steady pace and is located over the ocean again by November. The fact that the peak rainfall migrates irregularly compared to the peak solar heating is due to the interactions that occur between the land, the atmosphere and the ocean. To gain a better understanding of this complex climate system, a large international research programme was launched in 2002, the biggest of its kind into environment and climate ever attempted in Africa. AMMA has involved a comprehensive field experiment bringing together ocean, land and atmospheric measurements, on timescales ranging from hourly and daily variability up to the changes in seasonal activity over a number of years. This presentation will focus on the description of the field programme and its accomplishments, and address some key questions that have been recently identified to form the core of AMMA-Phase 2.

  18. Development of the Choctaw Health Delivery System.

    ERIC Educational Resources Information Center

    Nguyen, Binh N.

    The Choctaw Tribe is the first and only tribe to develop a health delivery system to take over an existing Indian Health Service inpatient facility. The takeover was accomplished in January 1984 under the Indian Self-Determination Act through a contract with the Indian Health Service. The Choctaw Health Delivery System includes a 35-bed general…

  19. Trends in udder health and emerging mastitogenic pathogens in South African dairy herds.

    PubMed

    Petzer, I-M; Karzis, J; Watermeyer, J C; van der Schans, T J; van Reenen, R

    2009-03-01

    The aim of this study was to retrospectively analyse the results of milk samples obtained from South African dairy herds during the period 1996 to April 2007 in order to identify possible trends in isolates of microorganisms and their pathogenicity under field conditions. Milk samples were obtained from 7 of the 9 provinces in South Africa where there are low numbers of dairy cows. Although there is scientific limitation to a country wide survey, such as the variation in herd size, management skills, parity, milk yield, milking frequency and other parameters, the size of this database helps to give a fair indication of general udder health in South Africa. Cytology and routine bacteriology were performed on 379,000 milk samples of lactating cows and bacteriology on 11,946 samples from non-lactating cows. According to the results obtained, mastitis did not decrease in South Africa over the test period. The prevalence of mastitis and teat canal infection was lowest in 2002. Mastitis and teat canal infection increased from 2002 to 2006 from 8.1% and 24.1% to 15.4 and 30.0% respectively. The percentage of mastitogenic pathogens isolated from cows over these years also varied. Previously unknown or almost eradicated mastitogenic pathogens such as alphabeta haemolytic Staphylococcus aureus which is thought to be of human origin, Streptococcus agalactiae and Enterococcus canis were responsible for numerous mastitis outbreaks seen in the test samples. Coagulase-negative staphylococci were the most frequently isolated bacteria in milk samples from both lactating and dry cows, followed by Staphylococcus aureus and Streptococcus agalactiae. Although Staphylococcus aureus remained the principal mastitogenic pathogen in South Africa, owing to its chronic nature and resultant economic losses, most cases of mastitis were caused by coagulase-negative staphylococci. This finding increases the importance of coagulase-negative staphylococci (formerly described as a minor pathogen

  20. Cumulative burden of lifetime adversities: Trauma and mental health in low-SES African Americans and Latino/as.

    PubMed

    Myers, Hector F; Wyatt, Gail E; Ullman, Jodie B; Loeb, Tamra B; Chin, Dorothy; Prause, Nicole; Zhang, Muyu; Williams, John K; Slavich, George M; Liu, Honghu

    2015-05-01

    This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation modeling. A sample of 500 low-socioeconomic status African American and Latino men and women with histories of adversities and trauma were recruited and assessed with a standard battery of self-report measures of stress and mental health. Multiple-group structural equation models indicated good overall model fit. As hypothesized, experiences of discrimination, childhood family adversities, childhood sexual abuse, other childhood trauma, and chronic stresses all loaded on the latent cumulative burden of adversities and trauma construct (CBAT). The CBAT stress exposure index in turn predicted the mental health status latent variable. Although there were several significant univariate ethnic and gender differences, and ethnic and gender differences were observed on several paths, there were no significant ethnic differences in the final model fit of the data. These findings highlight the deleterious consequences of cumulative stress and trauma for mental health and underscore a need to assess these constructs in selecting appropriate clinical interventions for reducing mental health disparities and improving human health. PMID:25961869

  1. Object representations and their relationship to psychopathology and physical health status in African-American women in primary care.

    PubMed

    Porcerelli, John H; Huprich, Steven K; Binienda, Juliann; Karana, Dunia

    2006-11-01

    Object relations theories hypothesize a relationship between self/other representations and level of psychopathology. Research has lent support to this hypothesis. This study was conducted to examine the link between object representation and psychopathology, stress, physical health status, and alcohol abuse in 110 African-American women in primary care. Object representations were assessed through spontaneous descriptions of parents. Psychopathology and physical health status were assessed with the Patient Health Questionnaire and the Medical Outcomes Study Short-Form Health Survey, both of which were designed for medical settings. The results support the link between dimensions of object representations (developmental level, benevolence, punitiveness) and psychopathology and between object representations and aspects of health status. Punitive maternal and paternal representations were most robustly associated with psychopathology and health status and were the only representational variables associated with alcohol abuse. The findings provide additional support for the object representations-psychopathology link and extend the research by demonstrating associations among object representations, alcohol abuse, and health status. PMID:17102708

  2. Self-image and self-esteem in African-American preteen girls: implications for mental health.

    PubMed

    Doswell, W M; Millor, G K; Thompson, H; Braxter, B

    1998-01-01

    Current research suggests that pubertal development is occurring earlier in African-American preteen girls in response to familial contextual factors, which may make them vulnerable to low self-image and self-esteem dissatisfaction. This lowering in self-image and self-esteem may contribute to the early initiation of sexual behaviors, putting these girls at risk for pregnancy and sexually transmitted diseases. These potential risks place these girls in need of prepubertal health promotion, yet preadolescents are not frequently a focus of nursing care delivery except when summer camp and back-to-school physicals are performed. This article presents an in-depth overview of selected literature on self-esteem, discusses findings on self-image and self-esteem from a pilot study on pubertal influences on accelerated sexual behavior, and proposes health promotion strategies for pre- and peripubertal girls to promote positive mental health outcomes. More focused attention is needed on health promotion targeting the developmental transition health needs of prepubertal girls. Targeted health promotion activities may foster healthier pre- and peripubertal girls' perceptions of the meaning of their pubertal physical changes and stronger self-image and self-esteem. The goal of these health promotion activities should be to foster continuity of positive self-image and self-esteem among preteen girls, which is essential to prevent initiation of premature-for-age risk of problem behavior, such as early coitus. PMID:9479103

  3. Cumulative Burden of Lifetime Adversities: Trauma and Mental Health in Low-SES African Americans and Latino/as

    PubMed Central

    Myers, Hector F.; Wyatt, Gail E.; Ullman, Jodie B.; Loeb, Tamra B.; Chin, Dorothy; Prause, Nicole; Zhang, Muyu; Williams, John K.; Slavich, George M.; Liu, Honghu

    2015-01-01

    This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation modeling. A sample of 500 low-socioeconomic status African American and Latino men and women with histories of adversities and trauma were recruited and assessed with a standard battery of self-report measures of stress and mental health. Multiple-group structural equation models indicated good overall model fit. As hypothesized, experiences of discrimination, childhood family adversities, childhood sexual abuse, other childhood trauma, and chronic stresses all loaded on the latent cumulative burden of adversities and trauma construct (CBAT). The CBAT stress exposure index in turn predicted the mental health status latent variable. Although there were several significant univariate ethnic and gender differences, and ethnic and gender differences were observed on several paths, there were no significant ethnic differences in the final model fit of the data. These findings highlight the deleterious consequences of cumulative stress and trauma for mental health and underscore a need to assess these constructs in selecting appropriate clinical interventions for reducing mental health disparities and improving human health. PMID:25961869

  4. Software for Intelligent System Health Management

    NASA Technical Reports Server (NTRS)

    Trevino, Luis C.

    2004-01-01

    This viewgraph presentation describes the characteristics and advantages of autonomy and artificial intelligence in systems health monitoring. The presentation lists technologies relevant to Intelligent System Health Management (ISHM), and some potential applications.

  5. Modern Medical Engineering and Health Information Systems

    ERIC Educational Resources Information Center

    Davis, John F.

    1975-01-01

    Describes the impact of medical engineering and system design on hospital design and construction, health care in the home and hospital, equipment design, information systems, and health resources utilization. (GS)

  6. The Astronomy of Africa's Health Systems Literature During the MDG Era: Where Are the Systems Clusters?

    PubMed

    Phillips, James F; Sheff, Mallory; Boyer, Christopher B

    2015-09-01

    Growing international concern about the need for improved health systems in Africa has catalyzed an expansion of the health systems literature. This review applies a bibliometric procedure to analyze the acceleration of scientific writing on this theme. We focus on research published during the Millennium Development Goal (MDG) era between 1990 and 2014, reporting findings from a systematic review of a database comprised of 17,655 articles about health systems themes from sub-Saharan African countries or subregions. Using bibliometric tools for co-word textual analysis, we analyzed the incidence and associations of keywords and phrases to generate and visualize topical foci on health systems as clusters of themes, much in the manner that astronomers represent groupings of stars as galaxies of celestial entities. The association of keywords defines their relative position, with the size of images weighted by the relative frequency of terms. Sets of associated keywords are arrayed as stars that cluster as "galaxies" of concepts in the knowledge universe represented by health systems research from sub-Saharan Africa. Results show that health systems research is dominated by literature on diseases and categorical systems research topics, rather than on systems science that cuts across diseases or specific systemic themes. Systems research is highly developed in South Africa but relatively uncommon elsewhere in the region. "Black holes" are identified by searching for terms in our keyword library related to terms in widely cited reviews of health systems. Results identify several themes that are unexpectedly uncommon in the country-specific health systems literature. This includes research on the processes of achieving systems change, the health impact of systems strengthening, processes that explain the systems determinants of health outcomes, or systematic study of organizational dysfunction and ways to improve system performance. Research quantifying the relationship

  7. Appraising the quality of sub-Saharan African cancer registration systems that contributed to GLOBOCAN 2008: a review of the literature and critical appraisal

    PubMed Central

    Pollock, Allyson M

    2015-01-01

    Objective To critically appraise the quality of sub-Saharan African cancer registration systems that submitted data to GLOBOCAN 2008 with respect to population coverage using publicly available information and to show the use of GLOBOCAN statistics in determining global health priorities. Design Sources of cancer registration data for twenty-six sub-Saharan African cancer registries were identified from GLOBOCAN 2008 factsheets. Additional information was extracted from International Agency for Research on Cancer publications. A literature search was conducted to identify studies that reported additional information on data collection methods and provided 27 studies. The websites of the 10 largest funders of development assistance for health were searched for GLOBOCAN citations. Setting and participants Twenty-six sub-Saharan African cancer registration systems submitting data to GLOBOCAN 2008 in relation to 21 countries. Main outcome measures Information on 15 quality variables were extracted and compared with the international gold standard for cancer registration systems. Results Population coverage of the cancer registries ranged from from 2.3% of the population in Kenya to 100% in The Gambia, with a heavy urban bias in all countries. However, 20 countries (300 million people) had no cancer registration systems. Nineteen of the 26 registries failed to meet more than five of the 15 quality criteria and only one country met more than 10. Seven of the 10 largest funders of development assistance for health cite GLOBOCAN statistics in support of policy priorities. Conclusions GLOBOCAN 2008 estimates are based on data drawn from poor quality cancer registration systems, with limited or no population registry coverage. It is essential the GLOBOCAN 2012 estimates should provide information on the quality of the data collection and explain the limitations of the estimates. Development organisations and the World Health Organization need to take a more cautious approach

  8. Sexual Health Discussions between African-American Mothers and Mothers of Latino Descent and Their Children

    ERIC Educational Resources Information Center

    Murray, Ashley; Ellis, Monica U.; Castellanos, Ted; Gaul, Zaneta; Sutton, Madeline Y.; Sneed, Carl D.

    2014-01-01

    We examined approaches used by African-American mothers and mothers of Latino descent for informal sex-related discussions with their children to inform sexually transmitted infection (STI)/HIV intervention development efforts. We recruited mothers (of children aged 12-15) from youth service agencies and a university in southern California.…

  9. Africentric Cultural Values: Their Relation to Positive Mental Health in African American Adolescent Girls

    ERIC Educational Resources Information Center

    Constantine, Madonna G.; Alleyne, Vanessa L.; Wallace, Barbara C.; Franklin-Jackson, Deidre C.

    2006-01-01

    The primary purpose of this study was to test a path model exploring the relationships among Africentric cultural values, self-esteem, perceived social support satisfaction, and life satisfaction in a sample of 147 African American adolescent girls. This investigation also examined the possible mediating effects of self-esteem and perceived social…

  10. Health, Double Jeopardy, and Culture: The Use of Institutionalization by African-Americans.

    ERIC Educational Resources Information Center

    Belgrave, Linda Liska; And Others

    1993-01-01

    Examines theoretical approaches and nature of evidence typically brought to bear in addressing issue of elderly African Americans being admitted to nursing homes at one-half to three-quarters the rate of elderly whites. Notes that double jeopardy hypothesis effectively describes but does not explain apparent racial inequities in use of…

  11. Caregiver Experiences of Discrimination and African American Adolescents' Psychological Health over Time

    ERIC Educational Resources Information Center

    Ford, Kahlil R.; Hurd, Noelle M.; Jagers, Robert J.; Sellers, Robert M.

    2013-01-01

    The present study examined the effect of caregivers' experiences of racial discrimination on their adolescent children's psychological functioning among a sample of 264 African American dyads. Potential relations between caregiver discrimination experiences and a number of indicators of adolescents' (aged 12-17) psychological functioning over time…

  12. Cardiovascular Risk Reduction for African-American Men through Health Empowerment and Anger Management

    ERIC Educational Resources Information Center

    Stephens, Torrance; Braithwaite, Harold; Johnson, Larry; Harris, Catrell; Katkowsky, Steven; Troutman, Adewale

    2008-01-01

    Objective: To examine impact of CVD risk reduction intervention for African-American men in the Atlanta Empowerment Zone (AEZ) designed to target anger management. Design: Wilcoxon Signed-Rank Test was employed as a non-parametric alternative to the t-test for independent samples. This test was employed because the data used in this analysis…

  13. FastStats: Health of Black or African American non-Hispanic Population

    MedlinePlus

    ... Death Life Expectancy Race and Ethnicity Health of American Indian or Alaska Native Population Health of Asian or ... 1 [PDF - 993 KB] Related FastStats Health of American Indian or Alaska Native Population Health of Asian or ...

  14. Trust and health worker performance: exploring a conceptual framework using South African evidence.

    PubMed

    Gilson, Lucy; Palmer, Natasha; Schneider, Helen

    2005-10-01

    Two relationships of particular importance to health care provision are those between patient and provider, and health worker and employer. This paper presents an analytical framework that establishes the key dimensions of trust within these relationships, and suggests how they may combine in influencing health system responsiveness. The paper then explores the relevance of the framework by using it to analyse case studies of primary care providers in South Africa. The analysis suggests that respectful treatment is the central demand of primary care service users, in terms of positive attitudes/behaviours, thoroughness, and technical competence, as well as institutions that support fair treatment. It is argued that such treatment is necessary for, and integral to, patient-provider trust. The findings also suggest that the notion of workplace trust (combining trust in colleagues, supervisor and employing organisation) has relevance to provider experiences of their workplaces, and so can provide important insights for strengthening management. Nonetheless, given the limitations of this preliminary analysis, further research is needed to develop the notion of workplace trust and to test what role it has, along with that of provider-community relations, in influencing health worker performance. PMID:16005777

  15. Correlates of Bone Mineral Density among Postmenopausal Women of African Caribbean Ancestry: Tobago Women’s Health Study

    PubMed Central

    Hill, Deanna D.; Cauley, Jane A.; Bunker, Clareann H.; Baker, Carol E.; Patrick, Alan L.; Beckles, Gloria L. A.; Wheeler, Victor W.; Zmuda, Joseph M.

    2008-01-01

    Population dynamics predict a drastic growth in the number of older minority women, and resultant increases in the number of fractures. Low bone mineral density (BMD) is an important risk factor for fracture. Many studies have identified the lifestyle and health related factors that correlate with BMD in Whites. Few studies have focused on non-Whites. The objective of the current analyses is to examine the lifestyle, anthropometric and health related factors that are correlated with BMD in a population based cohort of Caribbean women of West African ancestry. We enrolled 340 postmenopausal women residing on the Caribbean Island of Tobago. Participants completed a questionnaire and had anthropometric measures taken. Hip BMD was measured by DXA. We estimated volumetric BMD by calculating bone mineral apparent density (BMAD). BMD was 10% and 20% higher across all age groups in Tobagonian women compared to US non-Hispanic Black and White women, respectively. In multiple linear regression models, 35–36% of the variability in femoral neck and total hip BMD respectively was predicted. Each 16 kilogram (one standard deviation (SD)) increase in weight was associated with 7% higher BMD; and weight explained over 10% of the variability of BMD. Each eight year (1 SD) increase in age was associated with 6% lower BMD. Current use of both thiazide diuretics and oral hypoglycemic medication were associated with 4–5% higher BMD. For femoral neck BMAD, 26% of the variability was explained by a multiple linear regression model. Current statin use was associated with 5% higher BMAD and a history of breast feeding or coronary heart disease were associated with 1–1.5% of higher BMAD. In conclusion, African Caribbean women have the highest BMD on a population level reported to date for women. This may reflect low European admixture. Correlates of BMD among Caribbean women of West African ancestry were similar to those reported for U.S. Black and White women. PMID:18448413

  16. African Breast Cancer—Disparities in Outcomes (ABC-DO): protocol of a multicountry mobile health prospective study of breast cancer survival in sub-Saharan Africa

    PubMed Central

    McKenzie, Fiona; Zietsman, Annelle; Galukande, Moses; Anele, Angelica; Adisa, Charles; Cubasch, Herbert; Parham, Groesbeck; Anderson, Benjamin O; Abedi-Ardekani, Behnoush; Schuz, Joachim; dos Santos Silva, Isabel; McCormack, Valerie

    2016-01-01

    Introduction Sub-Saharan African (SSA) women with breast cancer (BC) have low survival rates from this potentially treatable disease. An understanding of context-specific societal, health-systems and woman-level barriers to BC early detection, diagnosis and treatment are needed. Methods The African Breast Cancer—Disparities in Outcomes (ABC-DO) is a prospective hospital-based study of overall survival, impact on quality of life (QOL) and delays along the journey to diagnosis and treatment of BC in SSA. ABC-DO is currently recruiting in Namibia, Nigeria, South Africa, Uganda and Zambia. Women aged 18 years or older who present at participating secondary and tertiary hospitals with a new clinical or histocytological diagnosis of primary BC are invited to participate. For consented women, tumour characteristics, specimen and treatment data are obtained. Over a 2-year enrolment period, we aim to recruit 2000 women who, in the first instance, will be followed for between 1 and 3 years. A face-to-face baseline interview obtains information on socioeconomic, cultural and demographic factors, QOL, health and BC attitudes/knowledge, and timing of all prediagnostic contacts with caregivers in orthodox health, traditional and spiritual systems. Responses are immediately captured on mobile devices that are fed into a tailored mobile health (mHealth) study management system. This system implements the study protocol, by prompting study researchers to phone women on her mobile phone every 3 months and, failing to reach her, prompts contact with her next-of-kin. At follow-up calls, women provide updated information on QOL, care received and disease impacts on family and working life; date of death is asked of her next-of-kin when relevant. Ethics and dissemination The study was approved by ethics committees of all involved institutions. All participants provide written informed consent. The findings from the study will be published in peer-reviewed scientific journals

  17. A mixed methods study of health and social disparities among substance-using African American/Black men who have sex with men.

    PubMed

    Buttram, Mance E; Kurtz, Steven P

    2015-03-01

    African American/Black men who have sex with men (MSM) in the U.S. experience health and social disparities at greater rates than MSM of other races/ethnicities, including HIV infection and substance use. This mixed methods paper presents: 1) a quantitative examination of health and social disparities among a sample of substance-using African American/Black MSM (N=108), compared to Caucasian/White MSM (N=250), and 2) in-depth qualitative data from a subsample of African American/Black MSM (N=21) in order to contextualize the quantitative data. Findings indicate that compared to Caucasian/White MSM, African American/Black MSM experienced a wide range of health and social disparities including: substance use and dependence; buying, trading or selling sex; educational attainment; employment; homelessness; identifying as gay; HIV status; arrest history; social support; and satisfaction with one's living situation. Qualitative data suggests that structural interventions that address homophobia and the social environment would be likely to mitigate many of the health and social disparities experienced by African American/Black MSM. PMID:25960944

  18. The St. Louis African American health-heart study: methodology for the study of cardiovascular disease and depression in young-old African Americans

    PubMed Central

    2013-01-01

    Background Coronary artery disease (CAD) is a major cause of death and disability worldwide. Depression has complex bidirectional adverse associations with CAD, although the mechanisms mediating these relationships remain unclear. Compared to European Americans, African Americans (AAs) have higher rates of morbidity and mortality from CAD. Although depression is common in AAs, its role in the development and features of CAD in this group has not been well examined. This project hypothesizes that the relationships between depression and CAD can be explained by common physiological pathways and gene-environment interactions. Thus, the primary aims of this ongoing project are to: a) determine the prevalence of CAD and depression phenotypes in a population-based sample of community-dwelling older AAs; b) examine the relationships between CAD and depression phenotypes in this population; and c) evaluate genetic variants from serotoninP and inflammatory pathways to discover potential gene-depression interactions that contribute significantly to the presence of CAD in AAs. Methods/design The St. Louis African American Health (AAH) cohort is a population-based panel study of community-dwelling AAs born in 1936–1950 (inclusive) who have been followed from 2000/2001 through 2010. The AAH-Heart study group is a subset of AAH participants recruited in 2009–11 to examine the inter-relationships between depression and CAD in this population. State-of-the-art CAD phenotyping is based on cardiovascular characterizations (coronary artery calcium, carotid intima-media thickness, cardiac structure and function, and autonomic function). Depression phenotyping is based on standardized questionnaires and detailed interviews. Single nucleotide polymorphisms of selected genes in inflammatory and serotonin-signaling pathways are being examined to provide information for investigating potential gene-depression interactions as modifiers of CAD traits. Information from the parent AAH

  19. [A Maternal Health Care System Based on Mobile Health Care].

    PubMed

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals. PMID:27382731

  20. Sexual and reproductive health and rights in changing health systems.

    PubMed

    Sen, Gita; Govender, Veloshnee

    2015-01-01

    Sexual and reproductive health and rights (SRHR) are centrally important to health. However, there have been significant shortcomings in implementing SRHR to date. In the context of health systems reform and universal health coverage/care (UHC), this paper explores the following questions. What do these changes in health systems thinking mean for SRHR and gender equity in health in the context of renewed calls for increased investments in the health of women and girls? Can SRHR be integrated usefully into the call for UHC, and if so how? Can health systems reforms address the continuing sexual and reproductive ill health and violations of sexual and reproductive rights (SRR)? Conversely, can the attention to individual human rights that is intrinsic to the SRHR agenda and its continuing concerns about equality, quality and accountability provide impetus for strengthening the health system? The paper argues that achieving equity on the UHC path will require a combination of system improvements and services that benefit all, together with special attention to those whose needs are great and who are likely to fall behind in the politics of choice and voice (i.e., progressive universalism paying particular attention to gender inequalities). PMID:25536851

  1. Sexual and reproductive health and rights in changing health systems

    PubMed Central

    Sen, Gita; Govender, Veloshnee

    2015-01-01

    Sexual and reproductive health and rights (SRHR) are centrally important to health. However, there have been significant shortcomings in implementing SRHR to date. In the context of health systems reform and universal health coverage/care (UHC), this paper explores the following questions. What do these changes in health systems thinking mean for SRHR and gender equity in health in the context of renewed calls for increased investments in the health of women and girls? Can SRHR be integrated usefully into the call for UHC, and if so how? Can health systems reforms address the continuing sexual and reproductive ill health and violations of sexual and reproductive rights (SRR)? Conversely, can the attention to individual human rights that is intrinsic to the SRHR agenda and its continuing concerns about equality, quality and accountability provide impetus for strengthening the health system? The paper argues that achieving equity on the UHC path will require a combination of system improvements and services that benefit all, together with special attention to those whose needs are great and who are likely to fall behind in the politics of choice and voice (i.e., progressive universalism paying particular attention to gender inequalities). PMID:25536851

  2. Differences in psychological health and family dysfunction by sexual victimization type in a clinical sample of African American adolescent women.

    PubMed

    Cecil, Heather; Matson, Steven C

    2005-08-01

    We examined levels of sexual victimization among a sample of 249 14- to 19-year-old African American adolescent women. Victimization was common: 32.1% reported having been raped, 33.7% had experienced sexual coercion, and 10.8% reported an attempted rape. Only 23.4% had never been victimized. We investigated whether levels of psychological health and family dysfunction varied as a function of the type of sexual victimization. Girls who had been raped had lower levels of self-esteem and mastery and higher levels of depression compared to girls who reported no sexual victimization. Significantly higher levels of family cohesion and significantly lower levels of family support were reported by girls who had been raped versus girls who reported no sexual victimization. These findings are a starting point for future studies by providing evidence that levels of mental health and family dysfunction vary by the type of sexual victimization experienced. PMID:19817034

  3. Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach

    PubMed Central

    2013-01-01

    Background The impact of unmet eye care needs in sub-Saharan Africa is compounded by barriers to accessing eye care, limited engagement with communities, a shortage of appropriately skilled health personnel, and inadequate support from health systems. The renewed focus on primary health care has led to support for greater integration of eye health into national health systems. The aim of this paper is to demonstrate available evidence of integration of eye health into primary health care in sub-Saharan Africa from a health systems strengthening perspective. Methods A scoping review method was used to gather and assess information from published literature, reviews, WHO policy documents and examples of eye and health care interventions in sub-Saharan Africa. Findings were compiled using a health systems strengthening framework. Results Limited information is available about eye health from a health systems strengthening approach. Particular components of the health systems framework lacking evidence are service delivery, equipment and supplies, financing, leadership and governance. There is some information to support interventions to strengthen human resources at all levels, partnerships and community participation; but little evidence showing their successful application to improve quality of care and access to comprehensive eye health services at the primary health level, and referral to other levels for specialist eye care. Conclusion Evidence of integration of eye health into primary health care is currently weak, particularly when applying a health systems framework. A realignment of eye health in the primary health care agenda will require context specific planning and a holistic approach, with careful attention to each of the health system components and to the public health system as a whole. Documentation and evaluation of existing projects are required, as are pilot projects of systematic approaches to interventions and application of best practices

  4. [Human resources for local health systems].

    PubMed

    Linger, C

    1989-01-01

    The economic and social crises affecting Latin America have had a profound social and political effect on its structures. This paper analyzes this impact from 2 perspectives: 1) the impact on the apparatus of the state, in particular on its health infra-structures; and 2) the direction of the democratic process in the continent and the participatory processes of civil societies. The institutionalization of the Local Health Systems (SILOS) is an effort to analyze the problem from within the health sector and propose solutions. This paper discusses the issues of human resource development in health systems; training in human resource development and human resource development in local health care systems. There are 3 strategies used to change health systems: 1) The judicial-political system: The state's apparatus 2) The political-administrative system: the national health care system; and 3) the political-operative system: local health care systems. To assure implementation of SILOS there are 4 steps to be followed: 1) create political conditions that allow the transformation and development of local health systems; 2) development of high-level institutional and political initiatives to develop health care networks; 3) offer key players institutional space and social action to develop the SILOS process; 4) rapidly develop SILOS in regions to assure its integration with other development efforts. The labor force in the health sector and organized communities play critical roles in proposing and institutionalizing health programs. PMID:2766984

  5. Health Workforce Development: A Needs Assessment Study in French Speaking African Countries

    ERIC Educational Resources Information Center

    Chastonay, Philippe; Moretti, Roberto; Zesiger, Veronique; Cremaschini, Marco; Bailey, Rebecca; Pariyo, George; Kabengele, Emmanuel Mpinga

    2013-01-01

    In 2006, WHO alerted the world to a global health workforce crisis, demonstrated through critical shortages of health workers, primarily in Sub-Saharan Africa (WHO in World Health Report, 2006). The objective of our study was to assess, in a participative way, the educational needs for public health and health workforce development among potential…

  6. The South African Higher Education System: Performance and Policy

    ERIC Educational Resources Information Center

    Cloete, Nico

    2014-01-01

    Transformation in higher education in South Africa over the last 20 years has been strongly shaped by post-apartheid pressures. Recent research shows that South Africa's current higher education system can be described as medium knowledge-producing and differentiated, with low participation and high attrition. In the decade following 1994,…

  7. Health and health systems in the Commonwealth of Independent States.

    PubMed

    Rechel, Bernd; Roberts, Bayard; Richardson, Erica; Shishkin, Sergey; Shkolnikov, Vladimir M; Leon, David A; Bobak, Martin; Karanikolos, Marina; McKee, Martin

    2013-03-30

    The countries of the Commonwealth of Independent States differ substantially in their post-Soviet economic development but face many of the same challenges to health and health systems. Life expectancies dropped steeply in the 1990s, and several countries have yet to recover the levels noted before the dissolution of the Soviet Union. Cardiovascular disease is a much bigger killer in the Commonwealth of Independent States than in western Europe because of hazardous alcohol consumption and high smoking rates in men, the breakdown of social safety nets, rising social inequality, and inadequate health services. These former Soviet countries have embarked on reforms to their health systems, often aiming to strengthen primary care, scale back hospital capacities, reform mechanisms for paying providers and pooling funds, and address the overall shortage of public funding for health. However, major challenges remain, such as frequent private out-of-pocket payments for health care and underdeveloped systems for improvement of quality of care. PMID:23541055

  8. Nurturing Advocacy Inclusion to Bring Health Equity in Breast Cancer among African American Women

    PubMed Central

    Ashing, Kimlin Tam; Miller, Aria M.; Mitchell, Eudora; Martin, Virginia; McDowell, Kommah; Santifer, Rhonda; Smith, June; Brown, Shirley; Ragin, Camille; Carrington, Agatha

    2015-01-01

    Summary This paper will present the multiple roles and the impact of cancer advocates. The emerging literature provides evidence for the consideration and integration of African American BC survivors as advocates in practice, policy and research relevant to cancer prevention and control. We present a practical outline for organizational assessment for the inclusion of advocates in these arenas. This assessment can be conducted by all levels of partners, including community advocacy and scientific organizations. PMID:26913082

  9. A population-based analysis of the health experience of African Nova Scotians

    PubMed Central

    Kisely, Steve; Terashima, Mikiko; Langille, Don

    2008-01-01

    Background People of African descent living in Britain and the United States have higher rates of morbidity from chronic disease than among the general population. We investigated whether the same applied to people of African descent living in a Canadian province. Methods We used administrative data to calculate 10-year cumulative incidence rate ratios for the period 1996–2005 for treated circulatory disease, diabetes mellitus and psychiatric disorders in Preston (population 2425), a community of predominantly African Nova Scotians. We used data for the province of Nova Scotia as a whole as the population reference standard. We also calculated 10-year incidence rate ratios for visits to family physicians and specialists and for admissions to hospital. We compared these findings with those in 7 predominantly white communities in Nova Scotia with otherwise similar socio-economic characteristics. Results In the province as a whole, we identified 787 787 incident cases for the 3 disease groups over the 10-year period. Incidence rate ratios for the community of interest relative to the provincial population were significantly elevated for the 3 diseases: circulatory disease (1.19, 95% CI 1.08–1.29), diabetes (1.43, 95% CI 1.21–1.64) and psychiatric disorders (1.13, 95% CI 1.06–1.20). Incidence rate ratios in the community of interest were also higher than those in the comparison communities. Visits to family physicians and specialists for circulatory disease and diabetes were similarly elevated, but the pattern was less clear for visits for psychiatric disorders and hospital admissions. Interpretation African Nova Scotians had higher morbidity levels associated with treated disease, which could not be explained by socio-economic characteristics, recent immigration or language. Apart from psychiatric disorders, use of specialist services was consistent with morbidity. Further study is needed to investigate the relative contribution of genetic, biological

  10. Self-rated health and associated factors among older South Africans: evidence from the study on global ageing and adult health

    PubMed Central

    Phaswana-Mafuya, Nancy; Peltzer, Karl; Chirinda, Witness; Kose, Zamakayise; Hoosain, Ebrahim; Ramlagan, Shandir; Tabane, Cily; Davids, Adlai

    2013-01-01

    Background Population ageing has become significant in South African society, increasing the need to improve understandings of health and well-being among the aged. Objective To describe the self-reported ratings of overall health and functioning, and to identify factors associated with self-rated health among older South Africans. Design A national population-based cross-sectional survey, with a sample of 3,840 individuals aged 50 years and older, was completed in South Africa in 2008. Self-reported ratings of overall health and functioning were measured using a single self-reported health state covering nine health domains (used to generate the Study on Global Ageing and Adult Health (SAGE) composite health state score). Disability was measured using the World Health Organization Disability Assessment Schedule II (WHODAS-II) activities of daily living (ADLs), instrumental activities of daily living (IADLs), perceptions of well-being, and the World Health Organization Quality of Life index/metric (WHOQoL). Results Overall, more than three quarters (76.8%) of adults rated their health as moderate or good. On balance, men reported very good or good health more often than women (p<0.001). Older people (aged 70 years and above) reported significantly poorer health status than those aged 50–59 (adjusted odds ratio (AOR) 1.52; 95% confidence interval (CI) 1.00–2.30). Indians and Blacks were significantly more likely to report poorer health status at (AOR=4.01; 95% CI 1.27–12.70) and (AOR=0.42; 95% CI 0.18–0.98; 30 p <0.045), respectively, compared to Whites. Respondents with primary education (AOR=1.83; 95% CI 1.19–2.80) and less than primary education (AOR=1.94; 95% CI 1.37–2.76) were more likely to report poorer health compared to those with secondary education. In terms of wealth status, those in low wealth quintile (AOR=2.02; 95% CI 1.14–3.57) and medium wealth quintile (AOR=1.47; 95% CI 1.01–2.13) were more likely to report poorer health status than

  11. The Medical Education Partnership Initiative: PEPFAR's effort to boost health worker education to strengthen health systems.

    PubMed

    Mullan, Fitzhugh; Frehywot, Seble; Omaswa, Francis; Sewankambo, Nelson; Talib, Zohray; Chen, Candice; Kiarie, James; Kiguli-Malwadde, Elsie

    2012-07-01

    The early success of the President's Emergency Plan for AIDS Relief (PEPFAR) in delivering antiretroviral medications in poor countries unmasked the reality that many lacked sufficient health workers to dispense the drugs effectively. The 2008 reauthorization of PEPFAR embraced this challenge and committed to supporting the education and training of thousands of new health workers. In 2010 the program, with financial support from the US National Institutes of Health and administrative support from the Health Resources and Services Administration, launched the Medical Education Partnership Initiative to fund thirteen African medical schools and a US university. The US university would serve as a coordinating center to improve the quantity, quality, and retention of the schools' graduates. The program was not limited to training in the delivery of services for patients with HIV/AIDS. Rather, it was based on the principle that investment in medical education and retention would lead to health system strengthening overall. Although results are limited at this stage, this article reviews the opportunities and challenges of the first year of this major transnational medical education initiative and considers directions for future efforts and reforms, national governmental roles, and the sustainability of the program over time. PMID:22778346

  12. Charges for hospital admissions attributable to health disparities for African-American patients, 1998-2002.

    PubMed Central

    Chumney, Elinor C. G.; Mauldin, Patrick D.; Simpson, Kit N.

    2006-01-01

    OBJECTIVE: Racial disparities exist across most major disease categories, which result in a disproportionately large number of hospital admissions for many conditions. Estimates for the financial impact of the racial admission differences for the State of South Carolina are assessed. METHODS: South Carolina hospital discharge data for 1998-2002 was used for the analysis. The database includes all-payer billing data for inpatient hospital admissions as received on the UB-92 billing file for the covered episode. Charges were inflation adjusted to 2002 constant dollars. RESULTS: For 1998-2002, there were an estimated dollar 1.6 billion in total charges for hospital admissions in South Carolina that were attributed to higher age-adjusted admission rates for African-American patients. In addition, African Americans had consistently higher hospital admission rates for disease categories that are often associated with a failure to obtain ambulatory and preventive care. CONCLUSION: This simple analysis reveals that age-adjusted hospital admission rates for African Americans in South Carolina are higher than for Caucasians, and the gap appears to be widening over time. Given the magnitude of the financial implication, interventions with even a small impact on the conditions underlying the racial disparities in hospital admissions are likely to be cost effective. PMID:16749643

  13. Patient-Centered mHealth Living Donor Transplant Education Program for African Americans: Development and Analysis

    PubMed Central

    Sieverdes, John Christopher; Nemeth, Lynne S; Magwood, Gayenell S; Baliga, Prabhakar K; Chavin, Kenneth D; Brunner-Jackson, Brenda; Patel, Sachin K; Ruggiero, Kenneth J

    2015-01-01

    Background There is a critical need to expand the pool of available kidneys for African Americans who are on the transplant wait-list due to the disproportionally lower availability of deceased donor kidneys compared with other races/ethnic groups. Encouraging living donation is one method to fill this need. Incorporating mHealth strategies may be a way to deliver educational and supportive services to African American transplant-eligible patients and improve reach to those living in remote areas or unable to attend traditional group-session-based programs. Before program development, it is essential to perform formative research with target populations to determine acceptability and cultivate a patient-centered and culturally relevant approach to be used for program development. Objective The objectives of this study were to investigate African American kidney transplant recipients’ and kidney donors’/potential donors’ attitudes and perceptions toward mobile technology and its viability in an mHealth program aimed at educating patients about the process of living kidney donation. Methods Using frameworks from the technology acceptance model and self-determination theory, 9 focus groups (n=57) were administered to African Americans at a southeastern medical center, which included deceased/living donor kidney recipients and living donors/potential donors. After a demonstration of a tablet-based video education session and explanation of a group-based videoconferencing session, focus groups examined members’ perceptions about how educational messages should be presented on topics pertaining to the process of living kidney donation and the transplantation. Questionnaires were administered on technology use and perceptions of the potential program communication platform. Transcripts were coded and themes were examined using NVivo 10 software. Results Qualitative findings found 5 major themes common among all participants. These included the following: (1

  14. A multivariate comparison of elderly African Americans and Caucasians voting behavior: how do social, health, psychological, and political variables effect their voting?

    PubMed

    Bazargan, M; Kang, T S; Bazargan, S

    1991-01-01

    No study until now has examined the impact of the physical and psychological condition on voter turnout among elderly African Americans and Caucasians. Utilizing data from a national survey (Aging in the Eighties) and using multiple logistic regression, the present study examines the impact of health rating and life satisfaction as well as other socio-psychological characteristics on voting turnout among elderly Caucasian and African Americans. The results provide some empirical evidence that the pattern of election participation can be significantly influenced by the self-assessment of health and life satisfaction. For elderly Caucasians self-assessment of health is significantly related to voting behavior, whereas among elderly African Americans life satisfaction shows significant impact on turnout. Elderly African Americans who identified their personal political philosophy as "liberal" were more likely to vote, while among elderly Caucasians, those who identified their personal political philosophy as "conservative" were more likely to vote. In addition, SES, age, and organizational activity proved to have significantly independent impact on elderly Caucasian turnout, whereas among elderly African Americans, education was detected as a significant predictor. PMID:2060982

  15. Evolving African attitudes to European education: Resistance, pervert effects of the single system paradox, and the ubuntu framework for renewal

    NASA Astrophysics Data System (ADS)

    Assié-Lumumba, N'Dri Thérèse

    2016-02-01

    This paper is a reflection that critically examines the dynamics of education and the struggle by African people for freedom, control of the mind, self-definition and the right to determine their own destiny from the start of colonial rule to the present. The primary methodological approach is historical structuralism, which stipulates that social reality and facts are determined and created by social agents within structural and historical contingencies. It addresses some of the most powerful challenges and contradictions that explain the ineffectiveness of numerous post-independence reforms, and presents the arguments for relevance and use of African languages, for instance, that have been made since the 1960s. The first section of the paper deals with the colonial imperatives for setting new education systems in the colonised societies of Africa and the initial attitudes of the Africans towards colonial education. The second section critically examines the evolving meanings of Western education in Europeanising African societies, the articulation of their rationale and the mechanism for resistance. It analyses the turning point when Africans began to embrace European education and demand it in the colonial and post-independence era. The third section addresses the roots of the inadequacies of received post-colonial education and the imperative of deconstruction and re-appropriation of African education using an ubuntu framework for an African renewal.

  16. Chronic disease risk factors, healthy days and medical claims in South African employees presenting for health risk screening

    PubMed Central

    Kolbe-Alexander, Tracy L; Buckmaster, Chris; Nossel, Craig; Dreyer, Liezel; Bull, Fiona; Noakes, Timothy D; Lambert, Estelle V

    2008-01-01

    Background Non-communicable diseases (NCD) accounts for more than a third (37%) of all deaths in South Africa. However, this burden of disease can be reduced by addressing risk factors. The aim of this study was to determine the health and risk profile of South African employees presenting for health risk assessments and to measure their readiness to change and improve lifestyle behaviour. Methods Employees (n = 1954) from 18 companies were invited to take part in a wellness day, which included a health-risk assessment. Self-reported health behaviour and health status was recorded. Clinical measures included cholesterol finger-prick test, blood pressure and Body Mass Index (BMI). Health-related age was calculated using an algorithm incorporating the relative risk for all case mortality associated with smoking, physical activity, fruit and vegetable intake, BMI and cholesterol. Medical claims data were obtained from the health insurer. Results The mean percentage of participation was 26% (n = 1954) and ranged from 4% in transport to 81% in the consulting sector. Health-related age (38.5 ± 12.9 years) was significantly higher than chronological age (34.9 ± 10.3 yrs) (p < 0.001). Both chronological and risk-related age were significantly different between the sectors (P < 0.001), with the manufacturing sector being the oldest and finance having the youngest employees. Health-related age was significantly associated with number of days adversely affected by mental and physical health, days away from work and total annual medical costs (p < 0.001). Employees had higher rates of overweight, smoking among men, and physical inactivity (total sample) when compared the general SA population. Increased health-related expenditure was associated with increased number of risk factors, absenteeism and reduced physical activity. Conclusion SA employees' health and lifestyle habits are placing them at increased risk for NCD's, suggesting that they may develop NCD's earlier than

  17. Remote sensing and geographic information system-based African civet habitat mapping in Andracha, Ethiopia

    NASA Astrophysics Data System (ADS)

    Melese, Dagnachew; Suryabhagavan, Karuturi Venkata; Gelet, Melakneh; Balakrishnan, Mundanthra

    2014-01-01

    Remote sensing and geographic information systems have enormous applications in ecological studies, particularly in the habitat analysis of wild animals. The present study aimed to evaluate the habitats of the African civet in Andracha, Ethiopia, in order to generate geo-referenced ecological data on the habitats of this species. Habitat evaluation and habitat changes during 1986 to 2012 were analyzed using LANDSAT imageries. In the year 1986, 1017.56 km2 (99.75%) of the study area was covered with forest, but in 2012 only 949.61 km2 (93.09%) had forest cover. There has been a reduction of 5.97% forest cover at a rate of 0.22% per year since 1986. The study area has been classified into three suitability categories based on forest cover, water, settlement/agriculture, road and slope. Currently, 611.07 km2 (59.9%) of the area has dense forest cover, which is less preferred by the African civet, 336.75 km2 (33.01%) is moderately interfered with human activities and is suitable for civets, and 70.56 km2 (6.91%) is degraded forest around human habitats, which is highly preferred by civets. Habitat suitability analysis is useful to predict potential habitats of African civets in Ethiopia and elsewhere in Africa.

  18. A Systemic Functional Linguistic Analysis of the Utterances of Three South African Physical Sciences Teachers

    NASA Astrophysics Data System (ADS)

    Jawahar, Kavish; Dempster, Edith R.

    2013-06-01

    In this study, the sociocultural view of science as a language and some quantitative language features of the complementary theoretical framework of systemic functional linguistics are employed to analyse the utterances of three South African Physical Sciences teachers. Using a multi-case study methodology, this study provides a sophisticated description of the utterances of Pietermaritzburg Physical Sciences teachers in language contexts characterised by varying proportions of English Second Language (ESL) students in each class. The results reveal that, as expected, lexical cohesion as measured by the cohesive harmony index and proportion of repeated content words relative to total words, increased with an increasing proportion of ESL students. However, the use of nominalisation by the teachers and the lexical density of their utterances did not decrease with an increasing proportion of ESL students. Furthermore, the results reveal that each individual Physical Sciences teacher had a 'signature' talk, unrelated to the language context in which they taught. This study signals the urgent and critical need for South African science teacher training programmes to place a greater emphasis on the functional use of language for different language contexts in order to empower South African Physical Sciences teachers to adequately apprentice their students into the use of the register of scientific English.

  19. Integrated System Health Management Development Toolkit

    NASA Technical Reports Server (NTRS)

    Figueroa, Jorge; Smith, Harvey; Morris, Jon

    2009-01-01

    This software toolkit is designed to model complex systems for the implementation of embedded Integrated System Health Management (ISHM) capability, which focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, and predict future anomalies), and to provide data, information, and knowledge (DIaK) to control systems for safe and effective operation.

  20. Engaging faith-based resources to initiate and support diabetes self-management among African Americans: a collaboration of informal and formal systems of care.

    PubMed

    Johnson, Patria; Thorman Hartig, Margaret; Frazier, Renee; Clayton, Mae; Oliver, Georgia; Nelson, Belinda W; Williams-Cleaves, Beverly J

    2014-11-01

    Diabetes for Life (DFL), a project of Memphis Healthy Churches (MHC) and Common Table Health Alliance (CTHA; formerly Healthy Memphis Common Table [HMCT]), is a self-management program aimed at reducing health disparities among African Americans with type 2 Diabetes Mellitus in Memphis and Shelby County, Tennessee. This program is one of five national projects that constitute The Alliance to Reduce Disparities in Diabetes, a 5-year grant-funded initiative of The Merck Foundation. Our purpose is to describe the faith-based strategies supporting DFL made possible by linking with an established informal health system, MHC, created by Baptist Memorial Health Care. The MHC network engaged volunteer Church Health Representatives as educators and recruiters for DFL. The components of the DFL project and the effect on chronic disease management for the participants will be described. The stages of DFL recruitment and implementation from an open-access to a closed model involving six primary care practices created a formal health system. The involvement of CTHA, a regional health collaborative, created the opportunity for DFL to expand the pool of health care providers and then recognize the core of providers most engaged with DFL patients. This collaboration between MHC and HMCT led to the organization of the formal health network. PMID:25359253

  1. [Perceptions of nursing service managers in the South African Military Health Service on their level of motivation].

    PubMed

    Fischer, A; Muller, M

    2000-12-01

    The process of transformation in the South African Military Health Services, has influenced the nursing service managers' level of motivation and the following research question is applicable: what are the perceptions of the nursing service managers within the South African Military Health Services on their level of motivation? The purpose with this study was to explore and describe the perceptions of nursing service managers on their level of motivation within these health services. A qualitative research design was utilized and four focus group interviews were conducted with 33 nursing service managers country wide. The transcribed interviews were exposed to a content analysis. The results confirm that the level of motivation amongst these nursing service managers is low. The demotivators relate mainly to the following: inadequate acknowledgement, job insecurity in relation to the future, problems with the process of integration, transformation and rationalization, problems with management, many labour related issues, poor/inadequate communication, inadequate support, increased work load, poor physical environment, negative publicity and poor self motivation. Although there were a few motivators identified, they were of less importance. These results were interpreted within Herzberg's motivation theory to identify the hygiene/maintenance factors and to assess whether the important motivators were in place. During any process of change, and/or when the level of motivation amongst employees is low, it is important to adequately manage the environment (hygiene/maintenance factors within the Herzberg theory). But it is even more important to ensure that the motivators are in place or to intensify them. It is therefore recommended that a motivation strategy, based on the Herzberg theory as well as the Hackman-Oldham job enrichment model, be developed, implemented and evaluated. PMID:11949294

  2. Glucocorticoid receptor density correlates with health risk factors and insulin resistance in Caucasian and African American subjects.

    PubMed

    Islam, A; Chen, Y; Poth, M; Smith, Z P; Deuster, P A

    2012-09-01

    Activation of the hypothalamic-pituitary-adrenal axis leads to secretion of cortisol, which binds to peripheral glucocorticoid receptor and mediates a complex series of metabolic and immune effects. Cortisol also binds to receptors in the hypothalamus and pituitary, and inhibits further secretion of adrenocorticotropic hormone thus preventing an excessive response. Excess glucocorticoid effect is seen in Cushings disease, adrenal adenomas/carcinomas and in glucocorticoid resistance. Within such pathology there are health consequences of excessive glucocorticoid action, including obesity, hypertension, and glucose intolerance or diabetes. We hypothesized that increased glucocorticoid receptor in peripheral tissue might mediate an excess glucocorticoid effect in the absence of increased cortisol secretion. The objective of the study was to investigate the relationship between glucocorticoid receptor density in leukocytes and health risk indices relevant to obesity and diabetes in a sample of Caucasian and African American subjects. Comparison of glucocorticoid receptor concentration with subject body mass index, percentage body fat, waist circumference, insulin resistance, plasma cortisol levels, gender, and lipid profiles were conducted. Increased glucocorticoid receptor density significantly correlated with body mass index, percentage body fat, waist circumference, and insulin resistance. No significant correlation was observed for glucocorticoid receptor density with lipid profiles. Furthermore, no significant differences were observed in glucocorticoid receptor density between Caucasian and African American subjects or male and female participants. Our results show that high risk health conditions, such as obesity and type-2 diabetes, may be associated with a form of hypothalamic-pituitary-adrenal axis dysfunction, characterized by localized leukocyte glucocorticoid receptor over-expression. PMID:22851186

  3. Building health research systems to achieve better health

    PubMed Central

    Hanney, Stephen R; González Block, Miguel A

    2006-01-01

    Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS) provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics related to the above

  4. The systemic pathology of cerebral malaria in African children

    PubMed Central

    Milner, Danny A.; Whitten, Richard O.; Kamiza, Steve; Carr, Richard; Liomba, George; Dzamalala, Charles; Seydel, Karl B.; Molyneux, Malcolm E.; Taylor, Terrie E.

    2014-01-01

    Pediatric cerebral malaria carries a high mortality rate in sub-Saharan Africa. We present our systematic analysis of the descriptive and quantitative histopathology of all organs sampled from a series of 103 autopsies performed between 1996 and 2010 in Blantyre, Malawi on pediatric cerebral malaria patients and control patients (without coma, or without malaria infection) who were clinically well characterized prior to death. We found brain swelling in all cerebral malaria patients and the majority of controls. The histopathology in patients with sequestration of parasites in the brain demonstrated two patterns: (a) the “classic” appearance (i.e., ring hemorrhages, dense sequestration, and extra-erythrocytic pigment) which was associated with evidence of systemic activation of coagulation and (b) the “sequestration only” appearance associated with shorter duration of illness and higher total burden of parasites in all organs including the spleen. Sequestration of parasites was most intense in the gastrointestinal tract in all parasitemic patients (those with cerebral malarial and those without). PMID:25191643

  5. Benue trough and the mid-African rift system

    SciTech Connect

    Thomas, D.

    1996-01-29

    Large areas of the Anambra and Gongola basins have distinct petroleum exploration problems: a geologically persistent high geothermal gradient that promoted Cretaceous source rock maturation into the gas phase very early on; intrusive lead-zinc mineralization veins attributed to the Senonian igneous and folding event; and meteoric water-flushing along the periphery of the basins. From preliminary analysis, these basins have to be considered high risk for the discovery of commercial oil accumulations. On the other hand, the petroleum potential of the Bornu basins seems favorable. This Nigerian northernmost rift basin continues into the Kanem basin of western Chad, which has proven oil accumulations in Coniacian deltaic sands. Cretaceous paleofacies is considered to be relatively continuous throughout both basins. Paleo-geothermal history is also considered to be similar, although some igneous activity is recorded in the Bornu basin (Senonian?). There is a very real possibility of kerogen-rich non-marine basal Albo-Aptian basin fill lacustrine source rocks, as found in the Doba basin, could be present in the deepest sections of the Nigerian rift basins. Due to the depths involved, no well is expected to penetrate the incipient graben-fill stage sequences; however, possible oil migration from these tectono-stratigraphic units would certainly enhance the petroleum potential of cooler sections of the rift system. As opposed to interpreted thermogenic gas which seems to be prevalent in the Anambra basin.

  6. Quality improvement in population health systems.

    PubMed

    Inkelas, Moira; McPherson, Marianne E

    2015-12-01

    Quality improvement methods have achieved large sustainable changes in health care quality and health outcomes. Transforming health care into a population health system requires methods for innovation and improvement that can work across professions and sectors. It may be possible to replicate improvement successes in healthcare settings within and across the broader systems of social, educational, and other human services that influence health outcomes in communities. Improvement methods could translate the rhetoric of collaboration, integration and alignment into practice across the fragmented health and human service sectors in the U.S. PMID:26699349

  7. Recommendations for the Use of Online Social Support for African American Men

    PubMed Central

    Watkins, Daphne C.; Jefferson, S. Olivia

    2014-01-01

    African American men face greater psychosocial stressors than African American women and men of other racial and ethnic groups, which place them at higher risk for psychological distress. Yet, research suggests that African Americans are less likely to utilize professional mental health services because of their mistrust of the health care system and their need for more specialized and innovative services. Supplemental resources aimed at positive coping and social support for African American men may reduce the likelihood that they experience psychological distress, which could lead to more severe mental disorders. This article proposes the use of online social support for African American men who are in early, nonsevere stages of psychological distress. We examine the unique experiences of African American men, discuss distress among this underserved group, and finally, offer recommendations for achieving an online community for African American men. PMID:22924797

  8. Primary health care and public health: foundations of universal health systems.

    PubMed

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified termin