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Sample records for african health systems

  1. An informatics system to support knowledge management in the health sector--the South African National Health Knowledge Network.

    PubMed

    Louw, J A; Seebregts, C J; Makgoba, W M; Fouché, B

    2001-01-01

    This paper discusses the planning and development of a South African national health knowledge network. The methodology is in essence based on the principles of knowledge management and the drivers of a system of innovation. The knowledge network, SA HealthInfo, aims to provide a one-stop interactive forum/resource, for quality-controlled and evidence-based health research information, to a wide spectrum of users, at various levels of aggregation, with the necessary security arrangements and facilities for interaction among users to promote explicit (codified) and tacit knowledge flow. It will therefore stimulate the process of innovation within the South African health system.

  2. Mental Health and African Americans

    MedlinePlus

    ... Minority Population Profiles > Black/African American > Mental Health Mental Health and African Americans Poverty level affects mental health ... compared to 120% of non-Hispanic whites. 1 MENTAL HEALTH STATUS Serious psychological distress among adults 18 years ...

  3. 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.

  4. 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

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

    PubMed

    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.

  6. 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

  7. 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

  8. Do health beliefs, health care system distrust, and racial pride influence HPV vaccine acceptability among African American college females?

    PubMed

    Bynum, Shalanda A; Brandt, Heather M; Annang, Lucy; Friedman, Daniela B; Tanner, Andrea; Sharpe, Patricia A

    2012-03-01

    The promise of human papillomavirus (HPV) vaccines rests with the ability to promote widespread uptake especially among populations at high risk of cervical cancer and other associated disease outcomes. The purpose of this study was to examine health beliefs and culturally specific influences of HPV vaccine acceptability among African American college females. Approximately 76 percent of participants reported HPV vaccine acceptability. Predictors of acceptability included: higher perceived benefit and lower racial pride. Findings can be used to inform development of campus-based HPV educational approaches to promote widespread HPV vaccine acceptability and safer sex practices among African American college females.

  9. A qualitative study of relationships among parenting strategies, social capital, the juvenile justice system, and mental health care for at-risk African American male youth.

    PubMed

    Richardson, Joseph B; Brakle, Mischelle Van

    2011-10-01

    For many poor, African American families living in the inner city, the juvenile justice system has become a de facto mental health service provider. In this article, longitudinal, ethnographic study methods were used to examine how resource-deprived, inner-city parents in a New York City community relied on the juvenile justice system to provide their African American male children with mental health care resources. The results of three case studies indicate that this strategy actually contributed to an escalation in delinquency among the youth.

  10. The World Health Organization African region laboratory accreditation process: improving the quality of laboratory systems in the African region.

    PubMed

    Gershy-Damet, Guy-Michel; Rotz, Philip; Cross, David; Belabbes, El Hadj; Cham, Fatim; Ndihokubwayo, Jean-Bosco; Fine, Glen; Zeh, Clement; Njukeng, Patrick A; Mboup, Souleymane; Sesse, Daniel E; Messele, Tsehaynesh; Birx, Deborah L; Nkengasong, John N

    2010-09-01

    Few developing countries have established laboratory quality standards that are affordable and easy to implement and monitor. To address this challenge, the World Health Organization Regional Office for Africa (WHO AFRO) established a stepwise approach, using a 0- to 5-star scale, to the recognition of evolving fulfillment of the ISO 15189 standard rather than pass-fail grading. Laboratories that fail to achieve an assessment score of at least 55% will not be awarded a star ranking. Laboratories that achieve 95% or more will receive a 5-star rating. This stepwise approach acknowledges to laboratories where they stand, supports them with a series of evaluations to use to demonstrate improvement, and recognizes and rewards their progress. WHO AFRO's accreditation process is not intended to replace established ISO 15189 accreditation schemes, but rather to provide an interim pathway to the realization of international laboratory standards. Laboratories that demonstrate outstanding performance in the WHO-AFRO process will be strongly encouraged to enroll in an established ISO 15189 accreditation scheme. We believe that the WHO-AFRO approach for laboratory accreditation is affordable, sustainable, effective, and scalable.

  11. Feasibility of a web-based training system for peer community health advisors in cancer early detection among african americans.

    PubMed

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

    2014-12-01

    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.

  12. The African diaspora: history, adaptation and health.

    PubMed

    Rotimi, Charles N; Tekola-Ayele, Fasil; Baker, Jennifer L; Shriner, Daniel

    2016-12-01

    The trans-Atlantic slave trade brought millions of Africans to the New World. Advances in genomics are providing novel insights into the history and health of Africans and the diasporan populations. Recent examples reviewed here include the unraveling of substantial hunter-gatherer and 'Eurasian' admixtures across sub-Saharan Africa, expanding our understanding of ancestral African genetics; the global ubiquity of mixed ancestry; the revealing of African ancestry in Latin Americans that likely derived from the slave trade; and understanding of the ancestral backgrounds of APOL1 and LPL found to influence kidney disease and lipid levels, respectively, providing specific insights into disease etiology and health disparities.

  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. 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

  16. African-American Males' Health Perceptions and Knowledge

    ERIC Educational Resources Information Center

    McNeal, CoSandra; Perkins, Isaac; Lyons, Shenia

    2006-01-01

    Research on African American men's health is limited. Perception and knowledge of health may have a significant effect on health seeking behavior and self care. This study was designed to examine factors that may influence health perception and knowledge among African American males. This is a cross-sectional study of 343 African American males…

  17. Health seeking behaviors of African Americans: implications for health administration.

    PubMed

    Hewins-Maroney, Barbara; Schumaker, Alice; Williams, Ethel

    2005-01-01

    Disparities in health care and good health between African Americans and other populations while established in the literature are traditionally based on socioeconomic measures of race, income, age, and education (Bailey, 2000; Lillie-Blanton, Brodie, Rowland, Altman and McIntosh, 2000; Ren and Amick, 1996; Watson, 2001; Weinick, Zuvekas, and Cohen, 2000). This study broadens the scope by exploring how sociocultural (poverty, racism, prejudice, and discrimination) and psychosocial factors (perceived health status, the lack of personal efficacy in contributing to decisions about health care. feelings of helplessness, and the lack of trust in the health care providers) relate to health-seeking behaviors of African Americans (Bailey, 1991; Ren and Amick, 1996, Watson, 2001). Interviews were conducted with 111 African American adult patients at a community health center, focusing on health-seeking behaviors, and sociocultural and psychosocial factors. Results suggest that when these negative factors are removed, the health seeking behaviors of African Americans closely mirror the behaviors of the majority population. Subjects did not view themselves in poorer health, fail to seek medical attention when needed, or distrust their primary health care providers. In general, fears associated with health care were attributed to illness rather than health care providers, although a weak linkage was found between patient self-esteem and fear or dislike of future treatment by physicians (adj R2= .362, S.E. =15, F=21, sig. <.001). The study highlights the need for further study in two areas: cultural competency of health care providers, especially those from Asia and Africa who are often assigned to community health centers, and the impact of an accessible community health center on the health seeking behaviors and health status of predominately African American communities.

  18. 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.

  19. 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.

  20. 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,…

  1. Poverty, safety net programs, and African Americans' mental health.

    PubMed

    Snowden, Lonnie R

    2014-11-01

    African Americans' poverty and deep-poverty rates are higher than those of Whites, and African Americans' poverty spells last longer. Furthermore, nonpoor African Americans are especially likely to slip into poverty, and over the course of a lifetime, very many African Americans will experience poverty. Accordingly, African Americans are disproportionately likely to be assisted by safety net programs providing income support and health and social assistance. When mental health-related outcomes are assessed, U.S.-focused and international studies of safety net programs sometimes find that adults and children show a decline in symptoms of mental illness after participating. All things being equal, these improvements can disproportionately benefit African Americans' mental health. Safety net programs' mental health-related impact should be routinely assessed when evaluating the programs' economic and social outcomes and the impact they have on African Americans' mental health. Policy research of this kind can help us to understand whether these very large interventions show society-wide mental health-related improvement in the disproportionately large number of African Americans who participate in them.

  2. 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

  3. 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

  4. Transgenerational Consequences of Racial Discrimination for African American Health

    PubMed Central

    Goosby, Bridget J.; Heidbrink, Chelsea

    2014-01-01

    Disparities in African American health remain pervasive and persist transgenerationally. There is a growing consensus that both structural and interpersonal racial discrimination are key mechanisms affecting African American health. The Biopsychosocial Model of Racism as a Stressor posits that the persistent stress of experiencing discrimination take a physical toll on the health of African Americans and is ultimately manifested in the onset of illness. However, the degree to which the health consequences of racism and discrimination can be passed down from one generation to the next is an important avenue of exploration. In this review, we discuss and link literature across disciplines demonstrating the harmful impact of racism on African American physical health and the health of their offspring. PMID:24855488

  5. South African National Cancer Registry: Effect of withheld data from private health systems on cancer incidence estimates

    PubMed Central

    Singh, E; Underwood, J M; Nattey, C; Babb, C; Sengayi, M; Kellett, P

    2015-01-01

    Background The National Cancer Registry (NCR) was established as a pathology-based cancer reporting system. From 2005 to 2007, private health laboratories withheld cancer reports owing to concerns regarding voluntary sharing of patient data. Objectives To estimate the impact of under-reported cancer data from private health laboratories. Methods A linear regression analysis was conducted to project expected cancer cases for 2005 – 2007. Differences between actual and projected figures were calculated to estimate percentage under-reporting. Results The projected NCR case total varied from 53 407 (3.8% net increase from actual cases reported) in 2005 to 54 823 (3.7% net increase) in 2007. The projected number of reported cases from private laboratories in 2005 was 26 359 (19.7% net increase from actual cases reported), 27 012 (18.8% net increase) in 2006 and 27 666 (28.4% net increase) in 2007. Conclusion While private healthcare reporting decreased by 28% from 2005 to 2007, this represented a minimal impact on overall cancer reporting (net decrease of <4%). PMID:26242527

  6. 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 =…

  7. 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.

  8. Integration of HIV/AIDS services into African primary health care: lessons learned for health system strengthening in Mozambique - a case study

    PubMed Central

    2010-01-01

    Introduction In 2004, Mozambique, supported by large increases in international disease-specific funding, initiated a national rapid scale-up of antiretroviral treatment (ART) and HIV care through a vertical "Day Hospital" approach. Though this model showed substantial increases in people receiving treatment, it diverted scarce resources away from the primary health care (PHC) system. In 2005, the Ministry of Health (MOH) began an effort to use HIV/AIDS treatment and care resources as a means to strengthen their PHC system. The MOH worked closely with a number of NGOs to integrate HIV programs more effectively into existing public-sector PHC services. Case Description In 2005, the Ministry of Health and Health Alliance International initiated an effort in two provinces to integrate ART into the existing primary health care system through health units distributed across 23 districts. Integration included: a) placing ART services in existing units; b) retraining existing workers; c) strengthening laboratories, testing, and referral linkages; e) expanding testing in TB wards; f) integrating HIV and antenatal services; and g) improving district-level management. Discussion: By 2008, treatment was available in nearly 67 health facilities in 23 districts. Nearly 30,000 adults were on ART. Over 80,000 enrolled in the HIV/AIDS program. Loss to follow-up from antenatal and TB testing to ART services has declined from 70% to less than 10% in many integrated sites. Average time from HIV testing to ART initiation is significantly faster and adherence to ART is better in smaller peripheral clinics than in vertical day hospitals. Integration has also improved other non-HIV aspects of primary health care. Conclusion The integration approach enables the public sector PHC system to test more patients for HIV, place more patients on ART more quickly and efficiently, reduce loss-to-follow-up, and achieve greater geographic HIV care coverage compared to the vertical model. Through the

  9. African-American Solo Grandparents Raising Grandchildren: A Representative Profile of Their Health Status.

    PubMed

    Whitley, Deborah M; Fuller-Thomson, Esme

    2017-04-01

    The objective of this study is to document the health profile of 252 African-American grandparents raising their grandchildren solo, compared with 1552 African-American single parents. The 2012 Behavior Risk Factor Surveillance System is used to compare the specific physical and mental health profiles of these two family groups. The findings suggest solo grandparents have prevalence of many health conditions, including arthritis (50.3 %), diabetes (20.1 %), heart attack (16.6 %) and coronary heart disease (16.6 %). Logistic regression analyses suggest that solo grandparents have much higher odds of several chronic health disorders in comparison with single parents, but this difference is largely explained by age. Although solo grandparents have good access to health care insurance and primary care providers, a substantial percentage (44 %) rate their health as fair or poor. Practice interventions to address African American solo grandparents' health needs are discussed.

  10. 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…

  11. Under the shadow of Tuskegee: African Americans and health care.

    PubMed Central

    Gamble, V N

    1997-01-01

    The Tuskegee Syphilis Study continues to cast its long shadow on the contemporary relationship between African Americans and the biomedical community. Numerous reports have argued that the Tuskegee Syphilis Study is the most important reason why many African Americans distrust the institutions of medicine and public health. Such an interpretation neglects a critical historical point: the mistrust predated public revelations about the Tuskegee study. This paper places the syphilis study within a broader historical and social context to demonstrate that several factors have influenced--and continue to influence--African American's attitudes toward the biomedical community. PMID:9366634

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

    PubMed

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

    2010-08-01

    This paper examines the relationship between early marriage (before age 26), cohabitation, and health for African Americans and whites during the transition to adulthood using the National Longitudinal Study of Adolescent Health (Add Health). We examine three categories of health outcomes relevant to young adulthood: physical health, mental health, and health risk behaviors. Lagged dependent variable models are used to examine the health effects of early marriage and cohabitation accounting for potential health selection into unions. Our results indicate that early marriage by young adults does not have protective effects for African Americans, and finds more negative effects for African American men than women. There are mixed results for whites with some protective effects of marriage for binge drinking. Early marriage for both African Americans and whites is associated with increased Body Mass Index (BMI). Cohabitation is uniformly associated with negative health outcomes for all race and sex groups.

  13. Diabetes and adverse mental health among African Americans.

    PubMed

    Mount, David L; Hairston, Kristen G; Charles, Shelton M

    2011-01-01

    This article reviews the connection between diabetes and adverse mental health among African Americans. Concern about safe insulin prescribing and administration is raised, and the importance of integrated physical and mental health care in the prevention and control of diabetes is highlighted.

  14. 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

  15. 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…

  16. 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

  17. 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.

  18. An exploration of mental health literacy among older African Americans.

    PubMed

    Stansbury, Kim L; Peterson, Tina L; Beecher, Blake

    2013-01-01

    The intent of this exploratory descriptive study was to examine mental health literacy (MHL) with 28 African American elders who reside in Kentucky. Collectively, all elders were partially literate of mental disorders and familiar with self-help and professional interventions and Alzheimer's and depression were the most recognized mental disorders. An awareness of MHL is an essential first step to understanding African American elders' views about mental health which then can facilitate the design and development of culturally relevant psychoeducational programs geared to this subset of the aging population.

  19. African American families' expectations and intentions for mental health services.

    PubMed

    Thompson, Richard; Dancy, Barbara L; Wiley, Tisha R A; Najdowski, Cynthia J; Perry, Sylvia P; Wallis, Jason; Mekawi, Yara; Knafl, Kathleen A

    2013-09-01

    A cross-sectional qualitative descriptive design was used to examine the links among expectations about, experiences with, and intentions toward mental health services. Individual face-to-face interviews were conducted with a purposive sample of 32 African American youth/mothers dyads. Content analysis revealed that positive expectations were linked to positive experiences and intentions, that negative expectations were not consistently linked to negative experiences or intentions, nor were ambivalent expectations linked to ambivalent experiences or intentions. Youth were concerned about privacy breeches and mothers about the harmfulness of psychotropic medication. Addressing these concerns may promote African Americans' engagement in mental health services.

  20. African American Families’ Expectations and Intentions for Mental Health Services

    PubMed Central

    Thompson, Richard; Dancy, Barbara L.; Wiley, Tisha R.A.; Najdowski, Cynthia J.; Perry, Sylvia P.; Wallis, Jason; Mekawi, Yara; Knafl, Kathleen

    2012-01-01

    A cross-sectional qualitative descriptive design was used to examine the links among expectations about, experiences with, and intentions toward mental health services. Individual face-to-face interviews were conducted with a purposive sample of 32 African American youth/mothers dyads. Content analysis revealed that positive expectations were linked to positive experiences and intentions, that negative expectations were not consistently linked to negative experiences or intentions, nor were ambivalent expectations linked to ambivalent experiences or intentions. Youth were concerned about privacy breeches and mothers about the harmfulness of psychotropic medication. Addressing these concerns may promote African Americans’ engagement in mental health services. PMID:22791083

  1. 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

  2. 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

  3. 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…

  4. 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…

  5. 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,…

  6. 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…

  7. Strategies in Instructional Materials Development for African Health Professionals.

    ERIC Educational Resources Information Center

    Lea, James W.; Murphy, Catherine

    1980-01-01

    An international program in health professions training has involved the development of a teaching materials library by teams of African faculty authors and U.S. instructional materials specialists. Communications difficulties and differences in culture and technology have made necessary the development of ten new production and management…

  8. Factors influencing the migration of West African health professionals

    PubMed Central

    Lowe, Mat; Chen, Duan-Rung

    2016-01-01

    Introduction The West African health sector is characterized by a human resource base lacking in numbers and specialized skills. Among the contributory factors to this lack of human resource for health workforce include but not limited to the migration of health professionals. Methods This cross-sectional survey targeted 118 young professionals who have participated in the Young Professional Internship Program (YPIP) of the West African Health Organization (WAHO), from (2005-2013). It inquired about their socio-demographic characteristics associated with migration and reasons for going to their preferred or most likely destinations through online survey. Results Of the 118 young professionals, 100 responded to the online survey, of which (28%) have migrated and (72%) did not migrate. Migration was more common among males and those (age≤31 years old), single with high dependency level and no previous work experience. Having a medical profession and being posted to urban or semi-urban area was also associated with their emigration. Their most important reasons for going to preferred or most likely destinations were to have fair level of workload, job promotion and limited occupational risks. Conclusion This finding suggests that the migration of health professionals is situation dependent, mediated by basic socio-demographic variables and work related conditions. These issues have implications for curbing the brain drain potential of health professionals in the West African health sector. PMID:27800092

  9. 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.

  10. 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

  11. 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

  12. 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.

  13. Overview of African petroleum systems

    SciTech Connect

    Perrodon, A. )

    1993-07-12

    Bordered by two large, still spreading oceans and subjected to tensional forces for more than 200 million years, continental Africa has now reached its largest surface expression ever. With a total sedimentary area of 15 million sq km distributed in about 80 basins, Africa possesses and produces circa 10% of the world's oil and 7% of the gas. More than 95% of these hydrocarbons are concentrated in seven petroleum provinces, ruled by three great petroleum systems that in turn are tightly controlled and determined by the geodynamic characteristics of the basins. From a stratigraphic standpoint, these three petroleum systems belong to three geological time periods: Silurian, Cretaceous, and Oligo-Miocene. Generally the Silurian system occurs in Saharan sag basins, the Cretaceous-Eocene systems in a continental rift complex of western and equatorial Africa, and the Cenozoic in two deltaic basins. The Upper Paleozoic and Jurassic, so rich in other continents, here play but a very minor part. The paper describes the Silurian system, the Cretaceous-Eocene system, and the Tertiary system.

  14. 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

  15. Beauty salons: a promising health promotion setting for reaching and promoting health among African American women.

    PubMed

    Linnan, Laura A; Ferguson, Yvonne Owens

    2007-06-01

    African American women suffer disproportionately from a wide range of health disparities. This article clarifies how beauty salons can be mobilized at all levels of the social-ecological framework to address disparities in health among African American women. The North Carolina BEAUTY and Health Project is a randomized, controlled intervention trial that takes into account the unique and multilevel features of the beauty salon setting with interventions that address owners, customers, stylists; interactions between customers and stylists; and the salon environment. The authors make explicit the role of the political economy of health theoretical perspective for understanding important factors (social, political, historical, and economic) that should be considered if the goal is to create successful, beauty-salon-based interventions. Despite some important challenges, the authors contend that beauty salons represent a promising setting for maximizing reach, reinforcement, and the impact of public health interventions aimed at addressing health disparities among African American women.

  16. The African Pediatric Fellowship Training Program in Pediatric Pulmonology: A Model for Growing African Capacity in Child Lung Health.

    PubMed

    Zar, Heather J; Vanker, Aneesa; Gray, Diane; Zampoli, Marco

    2017-01-26

    Childhood respiratory diseases are the major cause of mortality and morbidity in African children. However, there is limited expertise in pediatric pulmonology in Africa. The African Pediatric Fellowship Program (APFP) was developed in the Department of Pediatrics and Child Health at the University of Cape Town in partnership with African academic institutions beyond South Africa to promote training of African child health professionals and build capacity. From 2008 to 2016, 11 fellows have completed APFP training in pediatric pulmonology. Fellows have come from Kenya, Nigeria, Ghana and Uganda. All but one returned to his or her home institution, where they are building academic departments, improving clinical service delivery, growing research, and advancing advocacy and policies to improve child lung health. In parallel, training of South African pediatric pulmonologists has been strengthened with a further 9 South African fellows trained during this period. The African Pediatric Pulmonology program provides a highly successful model, with high retention of graduates in their home countries. The long-term goal is to grow African clinical capacity and strengthen services, research, training and advocacy for child lung health in Africa.

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

    PubMed

    Logan, Trevon D

    2009-04-01

    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.

  18. 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

  19. Exploring the interaction of activity limitations with context, systems, community and personal factors in accessing public health care services: A presentation of South African case studies

    PubMed Central

    Vergunst, Richard; Kritzinger, Janis; Visagie, Surona

    2017-01-01

    Background There are many factors that influence access to public health services, such as the context people live in, the existing health services, and personal, cultural and community factors. People with disabilities (activity limitations), through their experience of health services, may offer a particular understanding of the performance of the health services, thus exposing health system limitations more clearly than perhaps any other health service user. Aim This article explores how activity limitations interact with factors related to context, systems, community and personal factors in accessing public health care services in South Africa. Setting We present four case studies of people with disabilities from four low-resource diverse contexts in South Africa (rural, semi-rural, farming community and peri-urban) to highlight challenges of access to health services experienced by people with activity limitations in a variety of contexts. Methods One case study of a person with disabilities was chosen from each study setting to build evidence using an intensive qualitative case study methodology to elucidate individual and household experiences of challenges experienced by people with activity limitations when attempting to access public health services. In-depth interviews were used to collect data, using an interview guide. The analysis was conducted in the form of a thematic analysis using the interview topics as a starting point. Results First, these four case studies demonstrate that equitable access to health services for people with activity limitations is influenced by a complex interplay of a variety of factors for a single individual in a particular context. Secondly, that while problems with access to public health services are experienced by everyone, people with activity limitations are affected in particular ways making them particularly vulnerable in using public health services. Conclusion The revitalisation of primary health care and the

  20. Diet and long-term health: an African Diaspora perspective.

    PubMed

    Solomons, Noel W

    2003-01-01

    The life-stage approach, which views the behaviours and exposures of an individual from the preconceptual situation of the parent through pregnancy, infancy, childhood and adolescence, and into the advancing years through adulthood, is the basis of analysis of strategies to improve long-term health. Among the behaviours of note is the dietary selection pattern, conditioning our exposure to nutrients and dietary constituents that influences growth, nutriture, cognitive and physical performance, and disease resistance and susceptibility. The African Diaspora created a population displaced from Africa to the Western Hemisphere as part of the African slave trade from the 16th to 18th centuries. It continues to manifest distinct dietary and lifestyle practices in the context of a health experience that is different both from the population in their African countries of origin and from the other ethnicities in their countries of displacement and current residence. Afro-Americans are more susceptible to a series of diseases and conditions including low birth weight, violence, and HIV/AIDS, as well as the non-communicable diseases: obesity, diabetes mellitus, cardiovascular disease, hypertension, stroke, renal failure, breast cancer, prostate cancer and lead poisoning. The differential nature of dietary practices are conditioned at times by the poverty and marginalisation of the populace, resulting in either disadvantageous or beneficial outcomes relative to others' eating habits. Serious consideration must be given to the possibility that ethnic difference give rise to different requirements and tolerances for essential nutrients and distinct protective or adverse responses to foods and dietary substances. The major challenges to health improvement for the African Diaspora is coming to grips with the policy and programmatic nuances of differential treatment and the effecting the behavioural changes that would be needed in a population skeptical of the motives of media and

  1. Breast health teaching in predominantly African American rural Mississippi Delta.

    PubMed

    Wilson-Anderson, Kaye; Williams, P Renee; Beacham, Tracilia; McDonald, Naekhia

    2013-01-01

    This study's primary focus was breast health education to rural African American women in Mississippi and training of community members. Through practice in this area, women were found to lack knowledge of breast health which is the third leading cause of death in Mississippi Black women. They were open to education: N = 130, t = -16.6, df = 126, p < .001; 1 year, N = 35; 2-3 year N = 16 and 3 trained. Data suggest knowledge increased, a small percentage continued practices and community members would become trainers. One participant was diagnosed with breast cancer, received treatment and remained cancer-free after two years.

  2. It’s a Matter of Trust: Older African Americans Speak About Their Health Care Encounters

    PubMed Central

    Hansen, Bryan R.; Hodgson, Nancy A.; Gitlin, Laura N.

    2015-01-01

    Purpose To examine perceptions of older African Americans’ encounters with health care providers and ways to enhance trust. Method Transcribed semi-structured interviews with African American senior center members were analyzed, using Pattern Coding method. Results Four themes emerged: “Added Insult of Ageism,” “Alternative Remedies,” “Good Providers in a ‘Broken’ System,” and “The Foundation of Trust Is Person Recognition.” Provider behaviors leading to mistrust included erroneously assuming stereotypical preferences and competence, spending inadequate time listening to patients, disregarding patient preferences, and insufficiently explaining treatments. Discussion Of importance to improving trust among older African American patients is valuing individual histories and preferences by reallocating scarce time to person-centered listening, individualizing treatments, more completely explaining interventions, and assuring that patients understand and agree with treatment plans. PMID:25669876

  3. 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

  4. 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.

  5. Health Conditions Common in African American Women

    MedlinePlus

    ... prevent or delay diabetes is lost. Generations of racism and poverty also play a part. So do lack of trust in the medical system, cultural differences, problems accessing care, and a lack of knowledge about the importance ...

  6. The Great Recession and Health Risks in African American Youth

    PubMed Central

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

    2016-01-01

    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

  7. [On the development of health insurance in low-income countries: the case of African countries].

    PubMed

    Letourmy, Alain

    2008-12-01

    Health financing reforms in most low-income countries promote social and micro health insurance, in order to reduce direct spending by patients. Three phases of development can be distinguished in African countries: at first, schemes were developed only for the formal sector, then micro health insurance targeted the informal sector, and finally, health insurance was included in larger plans to reach universal coverage. The impact of health insurance is, as yet, difficult to assess. If beneficiaries have a better access to health services, the financing of health sector is not significantly improved, and there is no change in professional behaviour, in particular, in public facilities. In spite of their limits, social health insurance schemes continue to be implemented, but as a part of hybrid financing system, fitting with the abilities of low-income countries.

  8. Monitoring diseases across borders: African regional integrative information systems.

    PubMed

    Simbini, Tungamirirai; Foster, Rosemary; Nesara, Paul; Hullin Lucay Cossio, Carola

    2010-01-01

    In African countries, communicable diseases remain the chief cause of a heavy disease burden. Regional economic, political and social integration bring new challenges in the management of these diseases, many of which are treatable. Information Communication Technology (ICT) applied through electronic health systems has the potential to strengthen healthcare service delivery and disease surveillance within these countries. This paper discusses the importance of well-defined e-Health strategies within countries and, in addition, proposes that countries within regions collaborate in planning for health information exchange across borders. It is suggested that particular attention be paid to technical and data standards enabling interoperability, and also to issues of security, patient privacy and governance.

  9. 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.

  10. 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

  11. FastStats: Health of Black or African American non-Hispanic Population

    MedlinePlus

    ... Health of Black or African American non-Hispanic Population Recommend on Facebook Tweet Share Compartir Data are ... Source: Summary Health Statistics Tables for the U.S. Population: National Health Interview Survey, 2015, Table P-1c [ ...

  12. 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…

  13. 'We are doing our best': African and African-Caribbean fatherhood, health and preventive primary care services, in England.

    PubMed

    Williams, Robert; Hewison, Alistair; Stewart, Mel; Liles, Clive; Wildman, Stuart

    2012-03-01

    Recent policy pronouncements emphasise the importance of engaging fathers with preventive primary care services. However, in England, there is a paucity of literature which examines African and African-Caribbean fathers' experiences of service provision. This paper reports a study that investigated African and African-Caribbean fathers' beliefs about fatherhood, health and preventive primary care services, with the aim of addressing the deficit in the literature. Nine focus groups involving 46 African and African-Caribbean fathers, recruited using purposive sampling, were undertaken between October 2008-January 2009. Fatherhood was seen as a core aspect of the participants' identities. The fathers enacted these identities in a number of ways, such as caring for and protecting children, which were influenced by spirituality, relationships with women, paid work and racism. The fathers had concerns about their bodies, medical conditions, physical activity and forms of consumption. However, their primary focus was on maintaining and improving the well-being of their children. This resulted in them neglecting their own health needs as they had to meet the obligations of family life and paid work. The fathers reported limited contact with preventive primary care services and were unaware of their purpose, function and availability. They identified ethnicity as a positive asset, and felt their families and communities had particular strengths. However they acknowledged that structural constraints, including racism, influenced their perceptions of and access to local health services. The engagement of African and African-Caribbean fathers needs to be addressed more specifically in policy as part of a broader programme of action to tackle health inequalities. In addition, child health services could build on fathers' commitment to children's well-being through practice that addresses fathers' as well as mothers' needs in families.

  14. 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

  15. The core determinants of health expenditure in the African context: some econometric evidence for policy.

    PubMed

    Murthy, Vasudeva N R; Okunade, Albert A

    2009-06-01

    This paper, using cross-sectional data from 44 (83% of all) African countries for year 2001, presents econometric model estimates linking real per-capita health expenditure (HEXP) to a host of economic and non-economic factors. The empirical results of OLS and robust LAE estimators indicate that real per-capita GDP (PRGDP) and real per-capita foreign aid (FAID) resources are both core and statistically significant correlates of HEXP. Our empirical results suggest that health care in the African context is technically, a necessity rather than a luxury good (for the OECD countries). This suggests that the goal of health system in Africa is primarily 'physiological' or 'curative' rather than 'caring' or 'pampering'. The positive association of HEXP with FAID hints that external resource inflows targeting health could be instrumental for spurring economic progress in good policy environments. Most African countries until the late 1990s experienced economic and political instability, and faced stringent structural adjustment mandates of the major international financial institution lenders for economic development. Therefore, our finding a positive effect of FAID on HEXP could suggest that external resource inflows softened some of the macroeconomic fiscal deficit impacts on HEXP in the 2000s. Policy implications of country-specific elasticity estimates are given.

  16. Disparities in health-related Internet use among African American men, 2010.

    PubMed

    Mitchell, Jamie A; Thompson, Hayley S; Watkins, Daphne C; Shires, Deirdre; Modlin, Charles S

    2014-03-20

    Given the benefits of health-related Internet use, we examined whether sociodemographic, medical, and access-related factors predicted this outcome among African American men, a population burdened with health disparities. African American men (n = 329) completed an anonymous survey at a community health fair in 2010; logistic regression was used to identify predictors. Only education (having attended some college or more) predicted health-related Internet use (P < .001). African American men may vary in how they prefer to receive health information; those with less education may need support to engage effectively with health-related Internet use.

  17. 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

  18. Health financing in the African Region: 2000–2009 data analysis

    PubMed Central

    2013-01-01

    Background In order to raise African countries probability of achieving the United Nations Millennium Development Goals by 2015, there is need to increase and more efficiently use domestic and external funding to strengthen health systems infrastructure in order to ensure universal access to quality health care. The objective of this paper is to examine the changes that have occurred in African countries on health financing, taking into account the main sources of funding over the period 2000 to 2009. Methods Our analysis is based on the National Health Accounts (NHA) data for the 46 countries of the WHO African Region. The data were obtained from the WHO World Health Statistics Report 2012. Data for Zimbabwe was not available. The analysis was done using Excel software. Results Between 2000 and 2009, number of countries spending less than 5% of their GDP on health decreased from 24 to 17; government spending on health as a percentage of total health expenditure increased in 31 countries and decreased in 13 countries; number of countries allocating at least 15% of national budgets on health increased from 2 to 4; number of countries partially financing health through social security increased from 19 to 21; number of countries where private spending was 50% and above of total health expenditure decreased from 29 (64%) to 23 (51%); over 70% of private expenditure on health came from household out-of-pocket payments (OOPS) in 32 (71%) countries and in 27 (60%) countries; number of countries with private prepaid plans increased from 29 to 31; number of countries financing more than 20% of their total health expenditure from external sources increased from 14 to 19; number of countries achieving the Commission for Macroeconomics and Health recommendation of spending at least US$34 per person per year increased from 11 to 29; number of countries achieving the International Taskforce on Innovative Financing recommendation of spending at least US$44 per person per year

  19. 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.

  20. The income-climate trap of health development: a comparative analysis of African and Non-African countries.

    PubMed

    Tang, Kam Ki; Petrie, Dennis; Rao, D S Prasada

    2009-10-01

    This article conducts a comparative analysis of the interrelationship between climate, life expectancy and income between African and non-African countries. To put the analysis in a broader context of development, the paper develops an income-climate trap model that explains the multi-directional interaction between income, climate and life expectancy. It is suggested that the interaction can give rise to either a virtuous cycle of prosperity or a vicious cycle of poverty. Applying the model to a data set of 158 countries, we find that climate is a more important determinant of life expectancy in African countries than in non-African countries. We provide further empirical evidence that while climate is important in determining both life expectancy and income, income can in turn moderate the adverse effects of climate on life expectancy. In the past two decades, the income level of non-African countries has grown significantly while that of African countries has largely been stagnant, implying that the future development of African countries remains highly vulnerable to adverse climatic conditions. These findings have important implications in the context of climate change, as global warming is likely to create worsening climatic conditions that could see many less developed countries sinking deeper into an income-climate trap of underdevelopment in health.

  1. 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…

  2. Faith-Based Mental Health Interventions with African Americans: A Review

    ERIC Educational Resources Information Center

    Hays, Krystal; Aranda, Maria P.

    2016-01-01

    Faith-based interventions have emerged culturally sensitive way to address mental health issues among African Americans. This systematic review explores the scope and efficacy of faith-based mental health intervention outcomes among African Americans. Extracted data included the study population, setting, study design, intervention, adaptations,…

  3. 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

  4. Fibroblast growth factor 23, vitamin D and health disparities among African Americans with chronic kidney disease

    PubMed Central

    Saxena, Nakshatra; Gutiérrez, Orlando M.

    2013-01-01

    Compared to Caucasians, African Americans have lower circulating concentrations of 25-hydroxyvitamin D (25(OH)D), the major storage form of vitamin D, leading to the widespread assumption that African Americans are at higher risk of vitamin D deficiency. However, the finding that African Americans maintain better indices of musculoskeletal health than Caucasians throughout their lifespan despite having lower circulating 25(OH)D concentrations suggests that the relationship between vitamin D deficiency and racial health disparities may not be so straight forward. The fairly recent emergence of fibroblast growth factor 23 (FGF23) may help resolve some of this uncertainty. FGF23 strongly modulates both systemic and local activation of 25(OH)D, playing a potentially important role in the degree to which lower 25(OH)D concentrations impact health outcomes, including differences in the incidence and rate of progression of chronic kidney disease by race. The focus of this review will be to critically assess ongoing controversies surrounding the relationship between vitamin D and racial disparities in chronic kidney disease outcomes, and how FGF23 may help to clarify the picture. PMID:24119850

  5. African American teens and the neo-juvenile justice system.

    PubMed

    Rozie-Battle, Judith L

    2002-01-01

    African American youth continue to be overrepresented in the juvenile justice system. As a result of the current political environment and the perceived increase in crime among young people, the nation has moved away from rehabilitation and toward harsher treatment of delinquents. The African American community must encourage policy makers and community leaders to continue to address the disproportionate representation of African American youth in the system. Current policing and prosecutorial policies must also be examined and challenged to end the perception of an unjust system.

  6. Is the Role of Physicians Really Evolving Due to Non-physician Clinicians Predominance in Staff Makeup in Sub-Saharan African Health Systems?

    PubMed Central

    Sidat, Mohsin M.

    2016-01-01

    Health workforce shortages in Sub-Saharan Africa are widely recognized, particularly of physicians, leading the training and deployment of Non-physician clinicians (NPCs). The paper by Eyal et al provides interesting and legitimate viewpoints on evolving role of physicians in context of decisive increase of NPCss in Sub-Saharan Africa. Certainly, in short or mid-term, NPCs will continue to be a proxy solution and a valuable alternative to overcome physicians’ shortages in sub-Saharan Africa. Indeed, NPCs have an important role at primary healthcare (PHC) level. Physicians at PHC level can certainly have all different roles that were suggested by Eyal et al, including those not directly related to healthcare provision. However, at secondary and higher levels of healthcare, physicians would assume other roles that are mainly related to patient clinical care. Thus, attempting to generalize the role of physicians without taking into account the context where they will work would be not entirely appropriate. It is true that often physicians start the professional carriers at PHC level and progress to other levels of healthcare particularly after clinical post-graduation training. Nevertheless, the training programs offered by medical institutions in sub-Saharan Africa need to be periodically reviewed and take into account professional and occupational roles physicians would take in context of evolving health systems in sub-Saharan Africa. PMID:28005553

  7. 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

  8. 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

  9. 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…

  10. 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…

  11. The experience of mental health service use for African American mothers and youth.

    PubMed

    Thompson, Richard; Dancy, Barbara L; Wiley, Tisha R A; Perry, Sylvia P; Najdowski, Cynthia J

    2011-01-01

    Little is known about African American families' experiences with mental health services. A purposive sample of 40 dyads of African American youth (aged 13 to 19) and their mothers participated in a cross-sectional qualitative research design using semi-structured interviews that elicited information about their past experiences and satisfaction with mental health services. Though rarely received, group and family therapy were perceived favorably. However, both mothers and youth reported dissatisfaction centered on medication and lack of professionalism, confidentiality, and concern by providers. The failure of mental health services providers to meet basic standards of quality and professionalism may explain the low rate of service use by African Americans.

  12. 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…

  13. The Psychological Structure of African Americans Who Terminate Mental Health Treatment Services after Their Initial Sessions

    ERIC Educational Resources Information Center

    Dossman, Craig Arthur, Sr.

    2012-01-01

    The purpose of the qualitative phenomenological research study was to describe and explain the experiences of African Americans who terminated mental health treatment services after their initial sessions. The goal of the study was to expand the available knowledge by scientifically illuminating the lived experiences of African Americans who used…

  14. 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…

  15. 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…

  16. 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…

  17. Peer Training of Community Health Workers to Improve Heart Health Among African American Women

    PubMed Central

    Willock, Robina Josiah; Mayberry, Robert M.; Yan, Fengxia; Daniels, Pamela

    2015-01-01

    Introduction Training community health workers (CHWs) builds a workforce that is essential to addressing the chronic disease crisis. This article describes a highly replicable CHW training program that targets heart disease risk among African American women. Background African American women suffer disproportionately from heart disease mortality and morbidity. Well-trained CHWs are uniquely positioned to close this disparity gap. Method We used a Learning Circle approach to train CHWs in heart health education. The curriculum blended web-based, self-directed learning and in-person peer coaching. CHWs learned through (a) peer-to-peer sharing, (b) problem solving and brainstorming, and (c) leadership and experiential activities. Training evaluation measures were CHWs' (a) self-confidence, (b) heart health knowledge, (c) satisfaction with training, (d) training retention, and (e) replication of training within 90 days after training. Results This training resulted in appreciable effects on four of five outcome measures. Heart health knowledge increased significantly among experienced CHWs (p = .011). CHWs were satisfied with training and retention was 100%. CHWs initiated and subsequently delivered 122 person hours of community heart health education and CHW training in their communities. Discussion/Conclusion CHW heart health training using Learning Circles is a practical and replicable method of training CHWs and holds significant potential for building capacity in resource-poor community organizations. PMID:24891525

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

    PubMed

    Penfold, Erica Dale; Fourie, Pieter

    2015-12-01

    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.

  19. 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

  20. Social Ecology, Genomics, and African American Health: A Nonlinear Dynamical Perspective

    PubMed Central

    Madhere, Serge; Harrell, Jules; Royal, Charmaine D. M.

    2009-01-01

    This article offers a model that clarifies the degree of interdependence between social ecology and genomic processes. Drawing on principles from nonlinear dynamics, the model delineates major lines of bifurcation involving people's habitat, their family health history, and collective catastrophes experienced by their community. It shows how mechanisms of resource acquisition, depletion, and preservation can lead to disruptions in basic metabolism and in the activity of cytokines, neurotransmitters, and protein kinases, thus giving impetus to epigenetic changes. The hypotheses generated from the model are discussed throughout the article for their relevance to health problems among African Americans. Where appropriate, they are examined in light of data from the National Vital Statistics System. Multiple health outcomes are considered. For any one of them, the model makes clear the unique and converging contributions of multiple antecedent factors. PMID:19672481

  1. Ethical review of health-related biotechnology research in Africa: a role for the Pan African Bioethics Initiative (PABIN).

    PubMed

    Petros, B

    2007-01-01

    The paper reviews the status of nature and functions of the Pan African Bioethics Initiative (PABIN) a voluntary organization, founded in 2001 by leading members of the African health research and bioethics communities, with the aim of enhancing ethical awareness in Africa, in general, and building ethical clearance capacity in all African countries in particular. PABIN, with a membership drawn from more than 20 African countries is a member of the forum of the WHO/TDR Strategic Initiative for Developing Capacity in Ethical Review (SIDCER). PABIN works closely with its sister forums in Asia, Latin America, Eastern Europe, and North America as well as other continental and international organizations that promote bioethics in health research. PABIN has conducted three conferences and several seminars in collaboration with continental and international partners on subjects of ethical concerns in Africa. Strategically, PABIN aims at assisting in the development of competent in-country bioethics review systems in all African countries. Notable among the contemporary issues that is on the PABIN agenda is addressing the repercussions of the active pursuit by pharmaceutical and other commercial interests from the Western developed countries to conduct all sorts of clinical biomedical trials on African populations before marketing such biotechnological products and services. This drive has brought with it highly controversial ethical issues at a time when both technical and organizational capacity are lacking in much of Africa to address the ethical concerns that are arising from some health-related researches. PABIN seeks to assure that the expected health and social benefits derivable from biotechnology are reaped in accordance with internationally accepted norms.

  2. 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

  3. Genomic Basis of Prostate Cancer Health Disparity Among African-American Men

    DTIC Science & Technology

    2014-07-01

    Cancer Health Disparity Among African-American Men PRINCIPAL INVESTIGATOR: Harry Ostrer, M.D. RECIPIENT: Albert Einstein College of...ORGANIZATION REPORT NUMBER Albert Einstein College of Medicine Of Yeshiva University Bronx, NY 10461 9. SPONSORING

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. The interdependence of African American men's definitions of manhood and health

    PubMed Central

    Griffith, Derek M; Brinkley-Rubinstein, Lauren; Bruce, Marino A; Thorpe, Roland J; Metzl, Jonathan M

    2015-01-01

    In this paper we explore themes that cut across how 24-77 year old African American men define manhood and health. Utilizing a thematic approach, we analyzed data from nine focus groups (N=73). We found that manhood and health were relational constructs that are interrelated in men's minds and experiences. Manhood and health were defined by the characteristics men embody, the behaviors men engage in and the goals and values men had to positively influence their families and communities. Thus, manhood and health are interdependent constructs and their interrelationship should be considered in efforts to promote African American men's health. PMID:26291189

  9. Everyday Racial Discrimination, Everyday Non-racial Discrimination, and Physical Health Among African Americans.

    PubMed

    Mouzon, Dawne M; Taylor, Robert Joseph; Woodward, Amanda; Chatters, Linda M

    2017-01-01

    Past research has identified a link between discrimination and health outcomes among people of color. Perceptions of the cause of discrimination (racial vs. other) seem to be important for mental health; however, this relationship has not been fully examined for physical health. Using data from the National Survey of American Life, we find that, among African Americans, racial discrimination and overall discrimination regardless of attribution are associated with negative health outcomes while non-racial discrimination is not. The results suggest that racial discrimination has a unique adverse effect on physical health for African Americans that practitioners need to better understand.

  10. Powerlessness, anger, and stress in African American women: implications for physical and emotional health.

    PubMed

    Thomas, Shirley A; González-Prendes, A Antonio

    2009-01-01

    African American women find themselves at a high risk of experiencing feelings of powerlessness associated with socioeconomic disparities rooted in a history of racism and sexism. The authors present a conceptual model that discusses powerlessness as a significant variable that contributes to the experience of anger and stress in African American women, and consequently to the adverse health consequences of such anger and stress. The authors review the current literature as well as census and health statistics to discern critical historical, social, and cognitive aspects of powerlessness and anger in African American women. Implications for practitioners are addressed.

  11. The FDI African Strategy for Oral Health: addressing the specific needs of the continent.

    PubMed

    Hescot, Patrick; China, Emile; Bourgeois, Denis; Maina, Susan; Monteiro da Silva, Orlando; Luc Eiselé, Jean; Simpson, Christopher; Horn, Virginie

    2013-06-01

    The FDI World Dental Federation has defined a strategy for the development of oral health in Africa during the "African Summit" held in Cape Town, South Africa. The summit gathered presidents from 16 African National Dental Associations, FDI stakeholders, the World Health Organisation and government delegates. The outcomes of this summit were stated in a Declaration, defining the functional principles of the African strategy as three priorities: To establish and reinforce the credibility of NDAs To acquire and develop leadership and management skills Effective peer-to-peer exchange of information.

  12. Comorbid Diabetes and Depression in African Americans: Implications for the Health Care Provider.

    PubMed

    Chlebowy, Diane Orr; Coty, Mary-Beth; Fu, Liyan; Hines-Martin, Vicki

    2017-03-09

    Health care providers (HCPs) face many obstacles as they undertake efforts to meet the challenges of caring for African American patients with comorbid diabetes and depression. This review article discusses the incidence of comorbid diabetes and depression in African Americans, cultural factors affecting diabetes self-management, and clinical practice implications for the HCP. The role of patient-centered care, engagement, and best-practice strategies are discussed to provide the HCP with guidelines regarding the minimal standards that support improved health care outcomes for African Americans with comorbid diabetes and depression.

  13. 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.

  14. 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

  15. Narratives of Stress in Health Meanings of African Americans in Lake County, Indiana.

    PubMed

    Dutta, Mohan; Sastry, Shaunak; Dillard, Sydney; Kumar, Rati; Anaele, Agaptus; Collins, William; Roberson, Calvin; Dutta, Uttaran; Jones, Christina; Gillespie, Tony; Spinetta, Christine

    2016-08-02

    Across the life course, African Americans bear an unequal burden of disease compared to other racial groups. In spite of the widespread acknowledgment of racial health disparities, the voices of African Americans, their articulations of health and their local etiologies of health disparities are limited. In this article, we highlight the important role of communication scholarship to understand the everyday enactment of health disparities. Drawing upon the culture-centered approach (CCA) to co-construct narratives of health with African Americans residents of Lake County, Indiana, we explore the presence of stress in the everyday narratives of health. These narratives voice the social and structural sources of stress, and articulate resistive coping strategies embedded in relationship to structures.

  16. Training lay volunteers to promote health in central-city African American churches.

    PubMed

    Ellis, Julie L; Morzinski, Jeffrey A

    2013-01-01

    In a nation plagued by skyrocketing healthcare costs, is there an affordable way to address health needs of older African Americans in medically underserved areas? The Milwaukee, Wisconsin's Elder Community Health Upholder (ECHU) project indicates yes, we can. The key: A partnership that guides committed volunteers focused on establishing and sustaining health initiatives in faith-based settings.

  17. 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...

  18. The Fundamentals of an African American Value System.

    ERIC Educational Resources Information Center

    Alexander, E. Curtis

    The Nguzo Saba or "Seven Principles of Blackness" provide the fundamental basis for the development of an African America value system that is based on the cultural and historical particularisms of being Black in an American society that devalues Black efficacy and Black people. The fundamentals of this value system, foundational to the Kwanzaa…

  19. Welfare Systems and African-Americans: Historical Notes

    ERIC Educational Resources Information Center

    Nicholson, Rosetta

    1975-01-01

    An historical discussion of the relationship of American welfare systems to African-Americans, stating that Europeans, primarily from England, reluctantly established meagre, inhumane welfare systems based on seventeenth century English philosophy and tradition for members of their own nationality group after more than two centuries of poverty in…

  20. 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

  1. 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.

  2. Racial discrimination and health-promoting vs damaging behaviors among African-American adults.

    PubMed

    Corral, Irma; Landrine, Hope

    2012-11-01

    Studies have found relationships between racial discrimination and increased health-damaging behaviors among African-Americans, but have not examined possible concomitant decreased health-promoting behaviors. We explored the role of discrimination in two health-promoting behaviors, consuming ≥ 5 fruits/vegetables daily (FVC) and physical activity (PA), for the first time, and likewise examined discrimination's contribution to cigarette smoking, among a sample of N = 2118 African-American adults. Results revealed that discrimination contributed positively to smoking and to PA but was unrelated to FVC. These findings suggest that both adaptive and maladaptive health behaviors might be used to cope with the stress of discrimination.

  3. Mental health advocacy and African and Caribbean men: good practice principles and organizational models for delivery

    PubMed Central

    Newbigging, Karen; McKeown, Mick; French, Beverley

    2011-01-01

    Abstract Background  Advocacy has a critical role to play in addressing concerns about access to appropriate mental health care and treatment for African and Caribbean men. Aim  To investigate good practice principles and organizational models for mental health advocacy provision for African and Caribbean men. Study design  The study consisted of: (i) A systematic literature review. Bibliographic and internet searching was undertaken from 1994 to 2006. The inclusion criteria related to mental health, advocacy provision for African and Caribbean men. (ii) Four focus groups with African and Caribbean men to explore needs for and experiences of mental health advocacy. (iii) An investigation into current advocacy provision through a survey of advocacy provision in England, Wales and Northern Ireland. (iv) Twenty‐two qualitative stakeholder interviews to investigate the operation of mental health advocacy for this client group. The study was undertaken in partnership with two service user‐led organizations and an African Caribbean mental health service. Results  Primary research in this area is scant. Mainstream mental health advocacy services are often poor at providing appropriate services. Services developed by the Black Community and voluntary sector are grounded in different conceptualizations of advocacy and sharper understanding of the needs of African and Caribbean men. The lack of sustainable funding for these organizations is a major barrier to the development of high‐quality advocacy for this group, reflecting a lack of understanding about their distinctive role. Conclusions  The commissioning and provision of mental health advocacy needs to recognize the distinct experiences of African and Caribbean men and develop capacity in the range of organizations to ensure equitable access. PMID:21645185

  4. 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

  5. "There wasn't a lot of comforts in those days:" African Americans, public health, and the 1918 influenza epidemic.

    PubMed

    Gamble, Vanessa Northington

    2010-04-01

    When the 1918 influenza epidemic began, African American communities were already beset by many public health, medical, and social problems, including racist theories of black biological inferiority, racial barriers in medicine and public health, and poor health status. To address these problems, African Americans mounted efforts such as establishing separate hospitals and professional organizations and repudiating racist scientific theories. Contradicting prevailing theories about African Americans' increased susceptibility to disease, it appears that during the 1918 epidemic the incidence of influenza was lower in African Americans. Although the epidemic had a less devastating impact on African American communities, it still overwhelmed their medical and public health resources. Observations about the lower rates of influenza in African Americans did not derail racist theories about the biological inferiority of black people or overturn conceptualizations of black people as disease threats to white people. When the epidemic ended, the major problems that African Americans faced still remained.

  6. The Effect of Racial Socialization on Urban African American Use of Child Mental Health Services.

    PubMed

    Bannon, William M; Cavaleri, Mary A; Rodriguez, James; McKay, Mary M

    2008-04-01

    OBJECTIVE: To examine how parental endorsement of racial socialization parenting practices relates to child mental health service use among an urban sample of African American families. METHODS: A cross-sectional sample of urban African American parents (n = 96) provided ratings of their beliefs concerning various dimensions of racial socialization constructs, i.e., spiritual or religious coping (SRC), extended family caring (EFC), cultural pride reinforcement (CPR), and assessed regarding their use of child mental health services. RESULTS: At the multivariate level, the use of child mental health services was significantly positively associated with moderate levels of endorsement of SRC and EFC. Inversely, scores in the moderate range of CPR were associated with a reduced likelihood of child mental health service use. CONCLUSION: Parental endorsement of racial socialization parenting practices appear to play a salient role in child mental health service use among an urban African American families. Further research with larger and more representative samples should be pursued.

  7. Health Behavior Decision-making in African-American Adults Diagnosed with Schizophrenia.

    PubMed

    Findlay, Lillian J; El-Mallakh, Peggy; Howard, Patricia B; Hatcher, Jennifer; Clark, James J

    2015-07-01

    Little is known about the factors that influence health behavior decision-making among people with schizophrenia. The purpose of this qualitative study was to describe the processes used by 10 African-American adults with schizophrenia when making health behavior decisions and identification of perceived barriers and facilitators to health. Three phases of health behavior decision-making were identified: Recognizing Complex Components of Health, Personalizing Components of Health, and Tracking Health Status. Findings may guide clinicians' efforts to improve the health status of patients, as well as influence future research in understanding health behavior decision-making among vulnerable populations.

  8. Unemployment, depression, and health: a look at the African-American community

    PubMed Central

    Rodriguez, E.; Allen, J. A.; Frongillo, E. A.; Chandra, P.

    1999-01-01

    OBJECTIVES: While the unemployment rate of African-American people is more than twice that of the white population, the research on the impact of unemployment on the health of this population is scarce. This study analysed the impact of unemployment on depression and well being among African-American people, and the factors associated with well being. METHODS: Logistic and multiple regression models were used to analyse panel data collected in the National Survey of Families and Households 1987-1992. African-American (1369) and white (6660) respondents were analysed separately. Outcome variables included an index of depression and self reported health status. MAIN FINDINGS: Differences between employment and unemployment groups were less significant for African-Americans than for the white population in predicting depression and well being. Health enhancing factors such as education and wealth were significantly associated with better health and lower depression indices among the white population but not consistently so among African-Americans. Satisfaction with personal relationships was the strongest predictor of well being for both groups. CONCLUSION: Research should focus on the special needs and circumstances of African-Americans, because protective factors may not have the same impact in different groups of the population.   PMID:10396479

  9. 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…

  10. Armenia: health system review.

    PubMed

    Richardson, Erica

    2013-01-01

    This analysis of the Armenian health system reviews the developments in organization and governance, health financing, healthcare provision, health reforms and health system performance since 2006. Armenia inherited a Semashko style health system on independence from the Soviet Union in 1991. Initial severe economic and sociopolitical difficulties during the 1990s affected the population health, though strong economic growth from 2000 benefited the populations health. Nevertheless, the Armenian health system remains unduly tilted towards inpatient care concentrated in the capital city despite overall reductions in hospital beds and concerted efforts to reform primary care provision. Changes in health system financing since independence have been more profound, as out-of-pocket (OOP) payments now account for over half of total health expenditure. This reduces access to essential services for the poorest households - particularly for inpatient care and pharmaceuticals - and many households face catastrophic health expenditure. Improving health system performance and financial equity are therefore the key challenges for health system reform. The scaling up of some successful recent programmes for maternal and child health may offer solutions, but require sustained financial resources that will be challenging in the context of financial austerity and the low base of public financing.

  11. 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.

  12. The impact of IMF conditionality on government health expenditure: A cross-national analysis of 16 West African nations.

    PubMed

    Stubbs, Thomas; Kentikelenis, Alexander; Stuckler, David; McKee, Martin; King, Lawrence

    2017-02-01

    How do International Monetary Fund (IMF) policy reforms-so-called 'conditionalities'-affect government health expenditures? We collected archival documents on IMF programmes from 1995 to 2014 to identify the pathways and impact of conditionality on government health spending in 16 West African countries. Based on a qualitative analysis of the data, we find that IMF policy reforms reduce fiscal space for investment in health, limit staff expansion of doctors and nurses, and lead to budget execution challenges in health systems. Further, we use cross-national fixed effects models to evaluate the relationship between IMF-mandated policy reforms and government health spending, adjusting for confounding economic and demographic factors and for selection bias. Each additional binding IMF policy reform reduces government health expenditure per capita by 0.248 percent (95% CI -0.435 to -0.060). Overall, our findings suggest that IMF conditionality impedes progress toward the attainment of universal health coverage.

  13. Anxiety symptomatology and perceived health in African American adults: Moderating role of emotion regulation

    PubMed Central

    Carter, Sierra E.; Walker, Rheeda L.

    2014-01-01

    Though emotional health has been theoretically and empirically linked to physical health, the anxiety-physical health association in particular is not well understood for African American adults. This study examined anxiety as a specific correlate of perceived health in addition to testing the potential moderating role of emotion regulation, an index of how and when individuals modulate emotions, in the association for anxiety to perceived health. Study participants were 151 community-based African American adults who completed measures of anxiety symptomatology and emotion regulation in addition to responding to a self-report question of perceived health. Results showed that higher levels of anxiety symptomatology were associated with poorer health ratings for those who reported more limited access to emotion regulation strategies but not those who reported having more emotion regulation strategies. The findings suggest that anxiety-related distress and health problems may be interrelated when emotion regulation strategies are limited. PMID:25045943

  14. 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

  15. Economic pressure and health and weight management behaviors in African American couples: A family stress perspective.

    PubMed

    O'Neal, Catherine W; Arnold, Amy Laura; Lucier-Greer, Mallory; Wickrama, K A S; Bryant, Chalandra M

    2015-05-01

    This study extends the family stress model by examining the influence of economic pressure on health and weight management behaviors mediated by depressive symptoms and spousal support among 506 African American married couples. The actor-partner interdependence model accounted for the interdependent nature of relationships. Findings support the family stress model; yet pathways differed slightly for husbands and wives. Economic pressure directly influenced depressive symptoms and spousal support. Spousal support was a buffer against poor health and weight management behaviors for husbands, while depressive symptoms exacerbated poor health and weight management behaviors for wives. These mechanisms have implications for practitioners who promote African American couples' well-being.

  16. Clues to the Blues: Predictors of Self-Reported Mental and Emotional Health Among Older African American Men.

    PubMed

    Mitchell, Jamie A; Watkins, Daphne C; Shires, Deirdre; Chapman, Robert A; Burnett, Janice

    2015-09-07

    The mental health needs of aging African American men have been overlooked and few studies have distinguished between more severe clinically diagnosable mental health challenges and less severe emotional states for this population. African American men may not identify with or internalize the terminology of "depression" despite exhibiting the symptom criteria. This exploratory cross-sectional study examined correlates of "downheartedness" as an alternative indicator of emotional health. The authors examined the self-reported responses of 1,666 older African American men on a baseline questionnaire from a larger longitudinal study. Demographic, physical, mental and emotional health, and health system factors were examined as possible correlates of downheartedness. The mean age of participants was 73.6 years and 74.8% of men described themselves as "downhearted and blue" most or all of the time while only 18.5% of them reported feeling moderate to severe anxiety or depression. When other factors were controlled, mobility problems (odds ratio [OR] = 2.36), problems getting health care (OR = 2.69), having a doctor who never listens (OR = 2.18), physical or mental problems that interfere with social activities (OR = 1.34), accomplishing less due to physical health (OR = 1.35), and accomplishing less due to mental/emotional health (OR = 1.57) were all associated with greater odds of being downhearted. The current findings indicate that this sample more closely identified with language accurately describing their emotional health state (i.e., downhearted) and not with clinical mental health terminology (i.e., depression) that may be culturally stigmatized.

  17. 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.

  18. African-American Fathers' Perspectives on Facilitators and Barriers to Father-Son Sexual Health Communication.

    PubMed

    Randolph, Schenita D; Coakley, Tanya; Shears, Jeffrey; Thorpe, Roland J

    2017-02-21

    African-American males ages 13 through 24 are disproportionately affected by sexually transmitted infections (STIs) and human immunodeficiency virus (HIV), accounting for over half of all HIV infections in this age group in the United States. Clear communication between African-American parents and their youth about sexual health is associated with higher rates of sexual abstinence, condom use, and intent to delay initiation of sexual intercourse. However, little is known about African-American fathers' perceptions of what facilitates and inhibits sexual health communication with their preadolescent and adolescent sons. We conducted focus groups with 29 African-American fathers of sons ages 10-15 to explore perceived facilitators and barriers for father-son communication about sexual health. Participants were recruited from barbershops in metropolitan and rural North Carolina communities highly affected by STIs and HIV, and data were analyzed using content analysis. Three factors facilitated father-son communication: (a) fathers' acceptance of their roles and responsibilities; (b) a positive father-son relationship; and (c) fathers' ability to speak directly to their sons about sex. We also identified three barriers: (a) fathers' difficulty in initiating sexual health discussions with their sons; (b) sons' developmental readiness for sexual health information; and (c) fathers' lack of experience in talking with their own fathers about sex. These findings have implications for father-focused prevention interventions aimed at reducing risky sexual behaviors in adolescent African-American males. © 2017 Wiley Periodicals, Inc.

  19. 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,…

  20. 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…

  1. 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…

  2. Health Promotion and African-Americans: From Personal Empowerment to Community Action.

    ERIC Educational Resources Information Center

    Neighbors, Harold W.; And Others

    1995-01-01

    A research review discusses individual versus societal responsibility as it relates to health promotion among African Americans. The paper suggests that blacks should hold themselves more personally responsible for solving their own problems while rejecting debilitating forms of extreme self-blame. Recommendations for improving the health of…

  3. 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…

  4. Health systems in India

    PubMed Central

    Chokshi, M; Patil, B; Khanna, R; Neogi, S B; Sharma, J; Paul, V K; Zodpey, S

    2016-01-01

    Health systems and polices have a critical role in determining the manner in which health services are delivered, utilized and affect health outcomes. ‘Health' being a state subject, despite the issuance of the guidelines by the central government, the final prerogative on implementation of the initiatives on newborn care lies with the states. This article briefly describes the public health structure in the country and traces the evolution of the major health programs and initiatives with a particular focus on newborn health. PMID:27924110

  5. The relationship of language acculturation (English proficiency) to current self-rated health among African immigrant adults.

    PubMed

    Okafor, Maria-Theresa C; Carter-Pokras, Olivia D; Picot, Sandra J; Zhan, Min

    2013-06-01

    Although over 1.5 million African immigrants live in the US, few studies have examined the relationship of language acculturation to health outcomes among African immigrant adults. The primary objective of this research was to investigate the relationship between English proficiency and current self-rated health among African immigrant adults. Using a cross-sectional design, a secondary data analysis was performed on baseline data from the African immigrant adult subsample (n = 763) of the 2003 New Immigrant Survey, a longitudinal study of lawful permanent residents. Limited English proficiency (LEP), increased duration of US residence, older age at immigration, being male, less than 12 years of education, poor pre-migration health, and chronic disease were associated with good/fair/poor current self-rated health. Findings support consideration of pre-migration health and chronic disease in future acculturation and health studies, and provision of linguistically competent interventions for LEP African immigrants at risk for poor health outcomes.

  6. Tajikistan: health system review.

    PubMed

    Khodjamurodov, Ghafur; Rechel, Bernd

    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. Tajikistan is undergoing a complex transition from a health system inherited from the Soviet period to new forms of management, financing and health care provision. Following independence and the consequences of the civil war, health funding collapsed and informal out-of-pocket payments became the main source of revenue, with particularly severe consequences for the poor. With the aim of ensuring equitable access to health care and formalizing out-of-pocket payments, the Ministry of Health developed a programme that encompassed a basic benefit package (also known as the guaranteed benefit package) for people in need and formal co-payments for other groups of the population. One of the main challenges for the future will be to reorient the health system towards primary care and public health rather than hospital-based secondary and tertiary care. Pilots of primary care reform, introducing per capita financing, are under way in three of the country's oblasts. There are marked geographical imbalances in health care resources and financing, favouring the capital and regional centres over rural areas. There are also significant inequities in health care expenditures across regions. The quality of care is another major concern, owing to the lack of investment in health facilities and technologies, an insufficient supply of pharmaceuticals, poorly trained health care workers, and a lack of medical protocols and systems for quality improvement.

  7. Health and Healthcare Perspectives of African American Residents of an Unincorporated Community: A Qualitative Assessment

    PubMed Central

    King, Denae W.; Snipes, S. Amy; Herrera, Angelica P.; Jones, Lovell A.

    2009-01-01

    Residential perspectives about health in unincorporated communities are virtually unexplored. In this study, we conducted focus groups to assess individual and community health status, environmental health mediators, and systematic barriers to healthcare among African American residents of the unincorporated town, Fresno, Texas. Residents described their individual health status as excellent, but depicted the community’s health status as fair. Unaffordable healthcare, limited access to healthcare, and environmental mediators were perceived to impact the Fresno community’s health status. Our findings suggest a need to begin to examine health outcomes for minority residents in other unincorporated communities. PMID:18835739

  8. New directions in African bioethics: ways of including public health concerns in the bioethics agenda.

    PubMed

    Azetsop, Jacquineau

    2011-04-01

    Research ethics is the most developed aspect of bioethics in Africa. Most African countries have set up Institutional Review Boards (IRBs) to provide guidelines for research and to comply with international norms. However, bioethics has not been responsive to local needs and values in the rest of the continent. A new direction is needed in African bioethics. This new direction promotes the development of a locally-grounded bioethics, shaped by a dynamic understanding of local cultures and informed by structural and institutional problems that impact the public's health, as well as cognisant of the salient contribution of social sciences and social epidemiology which can bring a lasting impact on African local communities. In today's post-Structural Adjustment Africa, where healthcare has been liberalized and its cost increased, a bioethics agenda that focuses essentially on disease management and clinical work remains blind in the face of a structural marginalization of the masses of poor. Instead, the multidimensional public health crisis, with which most African countries are confronted, calls for a bioethics agenda that focuses primarily, but not exclusively, on health promotion and advocacy. Such an approach to bioethics reckons with the macro-determinants of health and well-being and places clinical and research ethics in the broader context of population's health. The same approach underscores the need to become political, not only by addressing health policymaking processes and procedures, but also by becoming an advocacy forum that includes other constituencies equipped with the potentialities to impact the population's health.

  9. Capacity development for health research in Africa: experiences managing the African Doctoral Dissertation Research Fellowship Program

    PubMed Central

    2010-01-01

    Africa's progress depends on her capacity to generate, adapt, and use scientific knowledge to meet regional health and development needs. Yet, Africa's higher education institutions that are mandated to foster this capacity lack adequate resources to generate and apply knowledge, raising the need for innovative approaches to enhance research capacity. In this paper, we describe a newly-developed program to support PhD research in health and population sciences at African universities, the African Doctoral Dissertation Research Fellowship (ADDRF) Program. We also share our experiences implementing the program. As health research capacity-strengthening in Africa continues to attract attention and as the need for such programs to be African-led is emphasized, our experiences in developing and implementing the ADDRF offer invaluable lessons to other institutions undertaking similar initiatives. PMID:20587016

  10. 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.

  11. Sick certificates issued by South African traditional health practitioners: current legislation, challenges and the way forward.

    PubMed

    Mbatha, Nompumelelo; Street, Renee Anne; Ngcobo, Mlungisi; Gqaleni, Nceba

    2012-02-23

    Traditional health practitioners (THPs) play a significant role in South African healthcare. However, the Basic Conditions of Employment Act (BCEA) does not consider sick notes issued by THPs to be valid. This creates a dilemma for employees, whose right to consult a practitioner of their choice is protected by the Constitution. We assessed the current legislation and highlight the challenges that employees face in selecting a healthcare system of their choice. The services of THPs represent an untapped capacity that can complement and strengthen healthcare services, especially in the workforce. The BCEA legislative technicality, coupled with the delayed establishment of the Interim THP Council, does not relieve the employer's burden of 'illegitimate' medical certificates issued by THPs. While seen as a dilemma for some employers, others have accommodated African cultural beliefs and accept THP-issued sick notes. Finalising the Interim THP Council will allow THP registration and oblige employers to honour sick notes issued by THPs. The empowerment of THPs to play a meaningful role in healthcare delivery is of national importance.

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

    PubMed

    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.

  13. 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

  14. 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.

  15. Polio eradication in the African Region on course despite public health emergencies.

    PubMed

    Okeibunor, Joseph C; Ota, Martin C; Akanmori, Bartholomew D; Gumede, Nicksy; Shaba, Keith; Kouadio, Koffi I; Poy, Alain; Mihigo, Richard; Salla, Mbaye; Moeti, Matshidiso R

    2017-03-01

    The World Health Organization, African Region is heading toward eradication of the three types of wild polio virus, from the Region. Cases of wild poliovirus (WPV) types 2 and 3 (WPV2 and WPV3) were last reported in 1998 and 2012, respectively, and WPV1 reported in Nigeria since July 2014 has been the last in the entire Region. This scenario in Nigeria, the only endemic country, marks a remarkable progress. This significant progress is as a result of commitment of key partners in providing the much needed resources, better implementation of strategies, accountability, and innovative approaches. This is taking place in the face of public emergencies and challenges, which overburden health systems of countries and threaten sustainability of health programmes. Outbreak of Ebola and other diseases, insecurity, civil strife and political instability led to displacement of populations and severely affected health service delivery. The goal of eradication is now within reach more than ever before and countries of the region should not relent in their efforts on polio eradication. WHO and partners will redouble their efforts and introduce better approaches to sustain the current momentum and to complete the job. The carefully planned withdrawal of oral polio vaccine type II (OPV2) with an earlier introduction of one dose of inactivated poliovirus vaccine (IPV), in routine immunization, will boost immunity of populations and stop cVDPVs. Environmental surveillance for polio viruses will supplement surveillance for AFP and improve sensitivity of detection of polio viruses.

  16. Health numeracy: perspectives about using numbers in health management from African American patients receiving dialysis.

    PubMed

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

    2015-04-01

    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 are available eliciting stakeholder perspectives from patients receiving dialysis about the construct of health numeracy. Using focus groups, we asked patients receiving hemodialysis open-ended questions to identify facilitators and barriers to their understanding, interpretation, and application of numeric information in kidney care. Transcripts were analyzed using content analysis. Twelve patients participated with a mean (standard deviation) age of 56 (12) years. All were African American, 50% were women, and 83% had 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. 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.

  17. Patterns of family health history communication among older African American adults.

    PubMed

    Hovick, Shelly R; Yamasaki, Jill S; Burton-Chase, Allison M; Peterson, Susan K

    2015-01-01

    This qualitative study examined patterns of communication regarding family health history among older African American adults. The authors conducted 5 focus groups and 6 semi-structured interviews with African Americans aged 60 years and older (N = 28). The authors identified 4 distinct patterns of family health history communication: noncommunication, open communication, selective communication (communication restricted to certain people or topics), and one-way communication (communication not reciprocated by younger family members). In general, participants favored open family health history communication, often resulting from desires to change patterns of noncommunication in previous generations regarding personal and family health history. Some participants indicated that they were selective about what and with whom they shared health information in order to protect their privacy and not worry others. Others described family health history communication as one-way or unreciprocated by younger family members who appeared uninterested or unwilling to share personal and family health information. The communication patterns that the authors identified are consistent with communication privacy management theory and with findings from studies focused on genetic testing results for hereditary conditions, suggesting that individuals are consistent in their communication of health and genetic risk information. Findings may guide the development of health message strategies for African Americans to increase family health history communication.

  18. Researching health inequities among African Americans: the imperative to understand social class.

    PubMed

    Oliver, M Norman; Muntaner, Carles

    2005-01-01

    Racial and ethnic inequities in health abound in many disease categories. African-American communities suffer from an increased burden of illness, with higher incidence and mortality rates and more severe morbidity in cerebrovascular disease, heart disease, several cancers, diabetes, and many other ailments. Healthy People 2010, the federal government's health plan, calls for eliminating health disparities by race, ethnicity, gender, education, income, disability, geographic location, or sexual orientation. Research aimed at increasing our understanding of these health disparities and designing and evaluating interventions to improve African-American health is hampered by a liberal, classless approach. The authors argue for a theoretical framework in this research that recognizes that class exploitation sets the stage for and interacts with racial discrimination to determine racial inequities in health.

  19. Joy of living: a community-based mental health promotion program for African American elders.

    PubMed

    Crewe, Sandra Edmonds

    2007-01-01

    African American elders are often acknowledged for their resilience in overcoming discrimination. Because of their unique historical experience, many have relied upon family support and spirituality to address mental health problems and have shunned professional mental health services. Despite the strengths of African American elders, there are mental health needs that require professional intervention. This article specifically discusses a mental health promotion program sponsored by the Mental Health Association of the District of Columbia. It provides a description of the program and an evaluation of its outcomes. An analysis of pre and post intervention evaluations (n = 228) shows success of the intervention in raising participant awareness of normal and abnormal mental health as well as resources available to them.

  20. 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.

  1. 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

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. The Use of Quality Improvement and Health Information Technology Approaches to Improve Diabetes Outcomes in African-American and Hispanic Patients

    PubMed Central

    Baig, Arshiya A.; Wilkes, Abigail E.; Davis, Andrew M.; Peek, Monica E.; Huang, Elbert S.; Bell, Douglas S.; Chin, Marshall H.

    2011-01-01

    Differences in rates of diabetes-related lower extremity amputations represent one of the largest and most persistent health disparities found for African-Americans and Hispanics compared to whites in the United States. Since many minority patients receive care in under-resourced settings, quality improvement (QI) initiatives in these settings may offer a targeted approach to improve diabetes outcomes in these patient populations. Health information technology (health IT) is widely viewed as an essential component of health care QI and may be useful in decreasing diabetes disparities in under-resourced settings. This article reviews the effectiveness of health care interventions utilizing health IT to improve diabetes process of care and intermediate diabetes outcomes in African-American and Hispanic patients. Health IT interventions have addressed patient, provider, and system challenges in the provision of diabetes care but require further testing in minority patient populations to evaluate their effectiveness in improving diabetes outcomes and reducing diabetes-related complications. PMID:20675350

  7. 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.

  8. Examining Perceptions about Mental Health Care and Help-Seeking among Rural African American Families of Adolescents

    ERIC Educational Resources Information Center

    Murry, Velma McBride; Heflinger, Craig Anne; Suiter, Sarah V.; Brody, Gene H.

    2011-01-01

    Rural African American children living in poverty have a higher prevalence rate of mental health disorders than their urban counterparts. While access to mental health services is lacking in resource scarce rural communities, African American rural residents may also be the most likely to confront significant barriers to care and help-seeking.…

  9. Engaging African and Caribbean Immigrants in HIV Testing and Care in a Large US City: Lessons Learned from the African Diaspora Health Initiative.

    PubMed

    Kwakwa, Helena A; Wahome, Rahab; Goines, Djalika S; Jabateh, Voffee; Green, Arraina; Bessias, Sophia; Flanigan, Timothy P

    2016-05-19

    The lifting in 2010 of the HIV entry ban eliminated an access point for HIV testing of the foreign-born. The African Diaspora Health Initiative (ADHI) was developed to examine alternative pathways to testing for African and Caribbean persons. The ADHI consists of Clinics Without Walls (CWW) held in community settings. HIV testing is offered to participants along with hypertension and diabetes screening. A survey is administered to participants. Descriptive data were analyzed using SAS 9.2. Between 2011 and 2015, 4152 African and Caribbean individuals participated in 352 CWW. Participants were mostly (67.7 %) African. HIV rates were lowest in Caribbean women (0.4 %) and highest in Caribbean men (8.4 %). Efforts to engage African and Caribbean communities in HIV testing are important given the elimination of the HIV entry ban and continued immigration to the US from areas of higher prevalence. The ADHI offers a successful model of engagement.

  10. People-centred health systems: building more resilient health systems in the wake of the Ebola crisis.

    PubMed

    Martineau, Fred P

    2016-09-01

    The 2014-2016 West African Ebola outbreak demonstrated the extent to which local social and political dynamics shape health system responses to crises such as epidemics. Many post-Ebola health system strengthening programmes are framed around a notion of health system 'resilience' that focuses on global rather than local priorities and fails to account for key local social dynamics that shape crisis responses. Post-crisis health system strengthening efforts require a shift towards a more 'people-centred' understanding of resilience that attends to the people, relationships and local contexts that constitute health systems and the practices that produce crisis responses.

  11. 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

  12. Health Care Expenditure and GDP in African Countries: Evidence from Semiparametric Estimation with Panel Data

    PubMed Central

    Lv, Zhike; Zhu, Huiming

    2014-01-01

    A large body of literature studies on the relationship between health care expenditure (HCE) and GDP have been analyzed using data intensively from developed countries, but little is known for other regions. This paper considers a semiparametric panel data analysis for the study of the relationship between per capita HCE and per capita GDP for 42 African countries over the period 1995–2009. We found that infant mortality rate per 1,000 live births has a negative effect on per capita HCE, while the proportion of the population aged 65 is statistically insignificant in African countries. Furthermore, we found that the income elasticity is not constant but varies with income level, and health care is a necessity rather than a luxury for African countries. PMID:24741366

  13. 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…

  14. Malta: Health system review.

    PubMed

    Azzopardi Muscat, Natasha; Calleja, Neville; Calleja, Antoinette; Cylus, Jonathan

    2014-01-01

    This analysis of the Maltese health system reviews the developments in its organization and governance, health financing, health-care provision, health reforms and health system performance. The health system in Malta consists of a public sector, which is free at the point of service and provides a comprehensive basket of health services for all its citizens, and a private sector, which accounts for a third of total health expenditure and provides the majority of primary care. Maltese citizens enjoy one of the highest life expectancies in Europe. Nevertheless, non-communicable diseases pose a major concern with obesity being increasingly prevalent among both adults and children. The health system faces important challenges including a steadily ageing population, which impacts the sustainability of public finances. Other supply constraints stem from financial and infrastructural limitations. Nonetheless, there exists a strong political commitment to ensure the provision of a healthcare system that is accessible, of high quality, safe and also sustainable. This calls for strategic investments to underpin a revision of existing processes whilst shifting the focus of care away from hospital into the community.

  15. Health Care Experiences and Perceived Barriers to Health Care Access: A Qualitative Study Among African Migrants in Guangzhou, Guangdong Province, China

    PubMed Central

    Brown, Katherine B.; 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.

    2014-01-01

    Guangzhou, one of China's largest cities and a main trading port in South China, has attracted many African businessmen and traders migrating to the city for financial gains. Previous research has explored the cultural and economic roles of this newly emerging population; however, little is known about their health care experiences while in China. Semi-structured interviews and focus groups were used to assess health care experiences and perceived barriers to health care access among African migrants in Guangzhou, China. Overall, African migrants experienced various barriers to accessing health care and were dissatisfied with local health services. The principal barriers to care reported included affordability, legal issues, language barriers, and cultural differences. Facing multiple barriers, African migrants have limited access to care in Guangzhou. Local health settings are not accustomed to the African migrant population, suggesting that providing linguistically and culturally appropriate services may improve access to care for the migrants. PMID:25294415

  16. Health Care Experiences and Perceived Barriers to Health Care Access: A Qualitative Study Among African Migrants in Guangzhou, Guangdong Province, China.

    PubMed

    Lin, Lavinia; Brown, Katherine B; 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

    2015-10-01

    Guangzhou, one of China's largest cities and a main trading port in South China, has attracted many African businessmen and traders migrating to the city for financial gains. Previous research has explored the cultural and economic roles of this newly emerging population; however, little is known about their health care experiences while in China. Semi-structured interviews and focus groups were used to assess health care experiences and perceived barriers to health care access among African migrants in Guangzhou, China. Overall, African migrants experienced various barriers to accessing health care and were dissatisfied with local health services. The principal barriers to care reported included affordability, legal issues, language barriers, and cultural differences. Facing multiple barriers, African migrants have limited access to care in Guangzhou. Local health settings are not accustomed to the African migrant population, suggesting that providing linguistically and culturally appropriate services may improve access to care for the migrants.

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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.

  2. 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…

  3. The Psychological Effects of Apartheid on the Mental Health of Black South African Women Domestics.

    ERIC Educational Resources Information Center

    Mohutsioa-Makhudu, Yvonne Nono K.

    1989-01-01

    Claims ideology of apartheid creates circumstances for feelings of incompleteness and inferiority among Black domestics in South Africa. Contends that apartheid has been created by the White racist minority to oppress and psychologically devastate the mental health of Black South Africans, particularly Black women domestics. (ABL)

  4. 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…

  5. 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.…

  6. The Effect of Mental Health Practioners' Racial Sensitivity on African Americans' Perceptions of Service.

    ERIC Educational Resources Information Center

    Singleton-Bowie, Sharron M.

    1995-01-01

    Client-case manager matches (n=75) from the outpatient services of an urban mental health department were selected to examine case managers' perceived racial sensitivity and its effect on African American clients. Findings demonstrated that case managers were more likely to be perceived as sensitive if they were a minority, female, and a degreed…

  7. 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…

  8. 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…

  9. Mental Health Services for African Americans: A Cultural/Racial Perspective.

    ERIC Educational Resources Information Center

    Dana, Richard H.

    2002-01-01

    Mental health services for minorities have remained biased and deficient. A discussion is included on some racial differences that affect assessment, diagnosis, and intervention of counseling services. A model is proposed that illustrates how cultural information can improve service delivery to African Americans. (JDM)

  10. 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...

  11. 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…

  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…

  13. 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…

  14. Religion and Health in African Americans: The Role of Religious Coping

    PubMed Central

    Holt, Cheryl L.; Clark, Eddie M.; Debnam, Katrina J.; Roth, David L.

    2014-01-01

    Objectives To test a model of the religion-health connection to determine whether religious coping plays a mediating role in health behaviors in a national sample of African Americans. Methods Participants completed a telephone survey (N = 2370) assessing religious involvement, religious coping, health behaviors, and demographics. Results Religious beliefs were associated with greater vegetable consumption, which may be due to the role of positive and negative religious coping. Negative religious coping played a role in the relationship between religious beliefs and alcohol consumption. There was no evidence of mediation for fruit consumption, alcohol use in the past 30 days, or smoking. Conclusions Findings have implications for theory and health promotion activities for African Americans. PMID:24629548

  15. Marriage Trajectories and Health Risk Behaviors Throughout Adulthood Among Urban African Americans

    PubMed Central

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

    2015-01-01

    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, and duration of marriage affect health risk behaviors among a community cohort of urban African Americans followed for 35 years (N = 1,049). For both men and women, we find six marital trajectories. Men and women in consistently married trajectories are less likely to smoke, drink heavily (women only), and use illegal drugs than those in unmarried or previously married trajectories. Late marrying men do not fare worse in midlife than men in earlier marrying trajectories, but late marrying women show increased risk of midlife drug use. Results suggest policies supporting marriage may have an impact on health but only if stable unions are achieved. PMID:26136611

  16. Marriage Trajectories and Health Risk Behaviors Throughout Adulthood Among Urban African Americans.

    PubMed

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

    2012-12-01

    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, and duration of marriage affect health risk behaviors among a community cohort of urban African Americans followed for 35 years (N = 1,049). For both men and women, we find six marital trajectories. Men and women in consistently married trajectories are less likely to smoke, drink heavily (women only), and use illegal drugs than those in unmarried or previously married trajectories. Late marrying men do not fare worse in midlife than men in earlier marrying trajectories, but late marrying women show increased risk of midlife drug use. Results suggest policies supporting marriage may have an impact on health but only if stable unions are achieved.

  17. Struggling to Survive: Sexual Assault, Poverty, and Mental Health Outcomes of African American women

    PubMed Central

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

    2013-01-01

    A substantial body of research documents the mental health consequences of sexual assault including, but not limited to, depression, posttraumatic stress disorder (PTSD), 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, PTSD, and illicit drug use. There was no significant relationship between poverty and suicidal ideation. Counseling and research implications are discussed. PMID:20397989

  18. 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.

  19. Race, Race-Based Discrimination, and Health Outcomes Among African Americans

    PubMed Central

    Mays, Vickie M.; Cochran, Susan D.; Barnes, Namdi W.

    2014-01-01

    Persistent and vexing health disadvantages accrue to African Americans despite decades of work to erase the effects of race discrimination in this country. Participating in these efforts, psychologists and other social scientists have hypothesized that African Americans’ continuing experiences with racism and discrimination may lie at the root of the many well-documented race-based physical health disparities that affect this population. With newly emerging methodologies in both measurement of contextual factors and functional neuroscience, an opportunity now exists to cleave together a comprehensive understanding of the ways in which discrimination has harmful effects on health. In this article, we review emerging work that locates the cause of race-based health disparities in the external effects of the contextual social space on the internal world of brain functioning and physiologic response. These approaches reflect the growing interdisciplinary nature of psychology in general, and the field of race relations in particular. PMID:16953796

  20. Race, race-based discrimination, and health outcomes among African Americans.

    PubMed

    Mays, Vickie M; Cochran, Susan D; Barnes, Namdi W

    2007-01-01

    Persistent and vexing health disadvantages accrue to African Americans despite decades of work to erase the effects of race discrimination in this country. Participating in these efforts, psychologists and other social scientists have hypothesized that African Americans' continuing experiences with racism and discrimination may lie at the root of the many well-documented race-based physical health disparities that affect this population. With newly emerging methodologies in both measurement of contextual factors and functional neuroscience, an opportunity now exists to cleave together a comprehensive understanding of the ways in which discrimination has harmful effects on health. In this article, we review emerging work that locates the cause of race-based health disparities in the external effects of the contextual social space on the internal world of brain functioning and physiologic response. These approaches reflect the growing interdisciplinary nature of psychology in general, and the field of race relations in particular.

  1. Role of mobile phone technology in health education in Asian and African countries: a systematic review.

    PubMed

    Sahu, Madhusmita; Grover, Ashoo; Joshi, Ashish

    2014-01-01

    The objective of this systematic review was to explore the role of mobile phone technologies in delivering health education programs in Asian and African countries. The search engine used was Pubmed during 2008-2011. Randomised controlled trials or controlled studies that improved health outcomes through delivery of health educational interventions using cell phone or text messaging were included in the review. Results showed studies from six Asian and African countries including Philippines, China, Kenya, South Korea, Taiwan and India. Mobile phone technology has shown to improve health outcomes for chronic disease conditions such as diabetes, heart disease and hypertension. Additional conditions include obesity and cardiopulmonary resuscitation guidance. Other studies have shown improvement in self management of breast cancer and post-hospitalisation HIV and pharmaceutical care. Overall results of the present review showed that mobile phone technologies can be a possible solution to improve healthcare outcome.

  2. 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...

  3. 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

  4. 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

  5. Public Health Risks from Illegally Imported African Bushmeat and Smoked Fish : Public Health Risks from African Bushmeat and Smoked Fish.

    PubMed

    Chaber, Anne-Lise; Cunningham, Andrew

    2016-03-01

    Large-scale importation of bushmeat from West and Central Africa into Europe was reported in 2010. We sampled 18 illegal African bushmeat consignments seized at Charles de Gaulle airport, Paris, France and tested for the presence of bacteria. Additionally, five smuggled smoked fish were analysed for polycyclic aromatic hydrocarbons, which are known carcinogens. All bushmeat samples had viable counts of aerobic bacteria above levels considered safe for human consumption. We also identified zoonotic bacterial pathogens in bushmeat and unsafe levels of carcinogens in fish. The illegal importation of meat is a potential risk for the introduction of pathogens.

  6. Beliefs about racism and health among African American women with diabetes: a qualitative study.

    PubMed

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

    2011-03-01

    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 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 African American 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. African American 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.

  7. 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

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

    PubMed

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

    2014-11-28

    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.

  9. Onboard System Health Assessment

    NASA Technical Reports Server (NTRS)

    Barry, Tom; Cunningham, Harry

    1990-01-01

    Viewgraphs and discussion of onboard system health assessment are presented. Success of the space station program will be measured by how well it addresses the basic requirements for (1) maintaining the orbiting Space Station Freedom fully operational for its projected life of thirty years, and (2) the cost-effective execution of the overall space station program. Onboard system health assessment must provide complete and thorough testing capabilities along with effective associated redundancy/fault management.

  10. France: Health system review.

    PubMed

    Chevreul, Karine; Durand-Zaleski, Isabelle; Bahrami, Stéphane Bahrami; Hernández-Quevedo, Cristina; Mladovsky, Philipa

    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 French health care system is a mix of public and private providers and insurers. Public insurance, financed by both employees and employer contributions and earmarked taxes, is compulsory and covers almost the whole population, while private insurance is of a complementary type and voluntary. Providers of outpatient care are largely private. Hospital beds are predominantly public or private non-profit-making. The French population enjoys good health and a high level of choice of providers. It is relatively satisfied with the health care system. However, as in many other countries, the rising cost of health care is of concern with regards to the objectives of the health care system. Many measures were or are being implemented in order to contain costs and increase efficiency. These include, for example, developing pay-for-performance for both hospitals and self-employed providers and increasing quality of professional practice; refining patient pathways; raising additional revenue for statutory health insurance (SHI); and increasing the role of voluntary health insurance (VHI). Meanwhile, socioeconomic disparities and geographic inequality in the density of health care professionals remain considerable challenges to providing a good level of equity in access to health care. Organizational changes at the regional level are important in attempting to tackle both equity and efficiency-related challenges. While the organizational structure of the system

  11. 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

  12. Neighborhoods, Social Support, and African American Adolescents’ Mental Health Outcomes: A Multilevel Path Analysis

    PubMed Central

    Hurd, Noelle M; Stoddard, Sarah A; Zimmerman, Marc A

    2012-01-01

    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 effects of neighborhood characteristics on adolescents’ mental health outcomes was conducted. Higher neighborhood poverty and unemployment rates predicted greater internalizing symptoms via lower cumulative social support and perceptions of neighborhood cohesion. In contrast, higher concentrations of African American and residentially stable residents in one’s neighborhood related to fewer internalizing symptoms among adolescent residents via greater cumulative social support and perceptions of neighborhood cohesion. Implications of these findings are discussed. PMID:23199188

  13. The future (history) of socioeconomic measurement and implications for improving health outcomes among African Americans.

    PubMed

    Andresen, Elena M; Miller, Douglas K

    2005-10-01

    Socioeconomic status (SES) has powerful and complex impacts on health, and understanding the relationship between SES and health is essential for long-term improvements in the health of populations. In addition, in the United States, the impact of SES on health is inextricably intertwined with racial and ethnicity status and the historical development and maintenance of health disparities. Most of the literature documenting this relationship has focused on individual-level socioeconomic factors. There are sound theoretical reasons and some empirical support to suggest that socioeconomic resources at both individual and neighborhood levels have strong influences on health outcomes such as disease, disability, and mortality. However, these relationships have been inadequately examined to date. In this article, the term "ecological SES" will be used to denote SES at geographic group levels. As the United States attempts to achieve the goals of the Department of Health and Human Services' Healthy People 2010 program, understanding ecological SES and its impacts on health will be crucial. We review the theory, some of the empirical evidence, and likely future for the measurement and use of a broader approach to SES and offer a specific research paradigm for examining these issues. We focus in particular on one racial-ethnic group that experiences health disparity, that is, African Americans. We use our ongoing project investigating physical frailty in urban African Americans to illustrate the importance of a multilevel approach to understanding the impacts of socioeconomic resources on health and the potential implications for efforts to prevent or reverse frailty.

  14. 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

  15. Effects of global financial crisis on funding for health development in nineteen countries of the WHO African Region

    PubMed Central

    2011-01-01

    Background There is ample evidence in Asia and Latin America showing that past economic crises resulted in cuts in expenditures on health, lower utilization of health services, and deterioration of child and maternal nutrition and health outcomes. Evidence on the impact of past economic crises on health sector in Africa is lacking. The objectives of this article are to present the findings of a quick survey conducted among countries of the WHO African Region to monitor the effects of global financial crisis on funding for health development; and to discuss the way forward. Methods This is a descriptive study. A questionnaire was prepared and sent by email to all the 46 Member States in the WHO African Region through the WHO Country Office for facilitation and follow up. The questionnaires were completed by directors of policy and planning in ministries of health. The data were entered and analyzed in Excel spreadsheet. The main limitations of this study were that authors did not ask whether other relevant sectors were consulted in the process of completing the survey questionnaire; and that the overall response rate was low. Results The main findings were as follows: the response rate was 41.3% (19/46 countries); 36.8% (7/19) indicated they had been notified by the Ministry of Finance that the budget for health would be cut; 15.8% (3/19) had been notified by partners of their intention to cut health funding; 61.1% (11/18) indicated that the prices of medicines had increased recently; 83.3% (15/18) indicated that the prices of basic food stuffs had increased recently; 38.8% (7/18) indicated that their local currency had been devalued against the US dollar; 47.1% (8/17) affirmed that the levels of unemployment had increased since the onset of global financial crisis; and 64.7% (11/17) indicated that the ministry of health had taken some measures already, either in reaction to the global financing crisis, or in anticipation. Conclusion A rapid assessment, like the one

  16. China-Africa Health Development Initiatives: Benefits and Implications for Shaping Innovative and Evidence-informed National Health Policies and Programs in Sub-saharan African Countries

    PubMed Central

    Tambo, Ernest; Ugwu, Chidiebere E.; Guan, Yayi; Wei, Ding; Xiao-Ning; Xiao-Nong, Zhou

    2016-01-01

    Background and Introduction: This review paper examines the growing implications of China’s engagement in shaping innovative national initiatives against infectious diseases and poverty control and elimination in African countries. It seeks to understand the factors and enhancers that can promote mutual and innovative health development initiatives, and those that are necessary in generating reliable and quality data for evidence-based contextual policy, priorities and programs. Methods: We examined the China-Africa health cooperation in supporting global health agenda on infectious diseases such as malaria, schistosomiasis, Ebola, TB, HIV/AIDS, neglected tropical diseases (NTDs) prevention, control and elimination spanning a period of 10 years. We reviewed referenced publications, global support data, and extensive sources related to and other emerging epidemics and infectious diseases of poverty, programs and interventions, health systems development issues, challenges, opportunities and investments. Published literature in PubMed, Scopus, Google Scholar, Books and web-based peer-reviewed journal articles, government annual reports were assessed from the first Forum on China-Africa Cooperation (FOCAC) in November 2006 to December 2015 Third Ministerial conferences. Results: Our findings highlight current shared public health challenges and emphasize the need to nurture, develop and establish effective, functional and sustainable health systems capacity to detect and respond to all public health threats and epidemic burdens, evidence-based programs and quality care outcomes. China’s significant health diplomacy emphasizes the importance of health financing in establishing health development commitment and investment in improving the gains and opportunities, importantly efficiency and value health priorities and planning. Conclusions and Global Health Implications: Strengthening China-Africa health development agenda towards collective commitment and investment

  17. 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.

  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.

  19. 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…

  20. 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…

  1. 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.

  2. 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…

  3. 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…

  4. Differences in mental health outcomes among Whites, African Americans, and Hispanics following a community disaster.

    PubMed

    Adams, Richard E; Boscarino, Joseph A

    2005-01-01

    A number of studies have assessed the association between race and ethnicity and psychological health status following exposure to a stressful event. However, some of these studies indicate racial and ethnic minorities have poorer mental health relative to Whites, while others show no differences or that minorities may actually have better psychological health. One year after the terrorist attacks on the World Trade Center, we collected data on a random sample of city residents (N = 2368). The dependent variables were posttraumatic stress disorder (PTSD), PTSD symptom severity, major depression, panic attack, and general physical and mental well-being. We categorized our respondents as Non-Hispanic White, Non-Hispanic African American, Dominican, Puerto Rican, and Other Hispanics. Bivariate results indicated racial/ethnic differences for PTSD symptom severity, depression, general physical and mental health, and panic attack. Using logistic regression and controlling for possible confounding factors, most of these associations were rendered non-significant. That is, we found no post-disaster racial/ethnic differences for PTSD, PTSD symptom severity, or physical health. African Americans and Other Hispanics were less likely to meet criteria for major depression or to be classified as unhealthy on the self-report SF-12 mental health scale compared to Whites. Only for panic attack were African Americans and Puerto Ricans more likely to meet criteria for this outcome. Thus, our study found little support for the hypothesis that Latinos or African Americans consistently suffered from poorer psychological and physical well-being in the aftermath of traumatic events, relative to Whites.

  5. '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

    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

  6. 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

  7. Teaching lesbian, gay, bisexual and transgender health in a South African health sciences faculty: addressing the gap

    PubMed Central

    2013-01-01

    Background People who identity as lesbian, gay, bisexual and transgender (LGBT) have specific health needs. Sexual orientation and gender identity are social determinants of health, as homophobia and heteronormativity persist as prejudices in society. LGBT patients often experience discrimination and prejudice in health care settings. While recent South African policies recognise the need for providing LGBT specific health care, no curricula for teaching about LGBT health related issues exist in South African health sciences faculties. This study aimed to determine the extent to which LGBT health related content is taught in the University of Cape Town’s medical curriculum. Methods A curriculum mapping exercise was conducted through an online survey of all academic staff at the UCT health sciences faculty, determining LGBT health related content, pedagogical methodology and assessment. Results 127 academics, across 31 divisions and research units in the Faculty of Health Sciences, responded to the survey, of which 93 completed the questionnaire. Ten taught some content related to LGBT health in the MBChB curriculum. No LGBT health related content was taught in the allied health sciences curricula. The MBChB curriculum provided no opportunity for students to challenge their own attitudes towards LGBT patients, and key LGBT health topics such as safer sex, mental health, substance abuse and adolescent health were not addressed. Conclusion At present, UCTs health sciences curricula do not adequately address LGBT specific health issues. Where LGBT health related content is taught in the MBChB curriculum, it is largely discretionary, unsystematic and not incorporated into the overarching structure. Coordinated initiatives to integrate LGBT health related content into all health sciences curricula should be supported, and follow an approach that challenges students to develop professional attitudes and behaviour concerning care for patients from LGBT backgrounds, as

  8. Health empowerment technologies (HET): building a web-based tool to empower older African American patient-doctor relationships.

    PubMed

    Winbush, Greta Berry; McDougle, Leon; Labranche, Lynda; Khan, Sidra; Tolliver, Sophia

    2013-11-01

    Responding to health and digital inequities among older African Americans, a customized web-based mobile health information intervention is being developed for this vulnerable group and their doctors as part of the Health Empowerment Technologies (HET) Project. The belief is an empowered patient-doctor relationship leads to more improved health outcomes than patient empowerment alone. Using health information technology to empower both older African Americans and their doctors by increasing health literacy and computer capacities of both is the major HET study aim. A focus group of older African American patients and one of their doctors yielded data to help build the HET. Thematic analysis of opinions and preferences about the content and structure of the HET revealed concordance and asymmetry among the patients and doctors. While challenges prevail in its construction, building this ethnicity-specific web-based health information technology presents the opportunity to integrate health information technology in clinical encounters for every patient.

  9. 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

  10. 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

    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.

  11. Anxiety symptomatology and perceived health in African American adults: moderating role of emotion regulation.

    PubMed

    Carter, Sierra E; Walker, Rheeda L

    2014-07-01

    Although emotional health has been theoretically and empirically linked to physical health, the anxiety-physical health association in particular is not well understood for African American adults. This study examined anxiety as a specific correlate of perceived health in addition to testing the potential moderating role of emotion regulation, an index of how and when individuals modulate emotions, in the association for anxiety to perceived health. Study participants were 151 community-based African American adults who completed measures of anxiety symptomatology and emotion regulation in addition to responding to a self-report question of perceived health. Results showed that higher levels of anxiety symptomatology were associated with poorer health ratings for those who reported more limited access to emotion regulation strategies but not those who reported having more emotion regulation strategies. The findings suggest that anxiety-related distress and health problems may be interrelated when emotion regulation strategies are limited. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  12. “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

  13. 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.

  14. 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.

  15. 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

  16. 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…

  17. 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.

  18. Diaspora engagement of African migrant health workers - examples from five destination countries.

    PubMed

    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.

  19. 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

  20. African traditional healers: what health care professionals need to know.

    PubMed

    Puckree, Threethambal; Mkhize, Melody; Mgobhozi, Zama; Lin, Johnson

    2002-12-01

    Traditional healing has always been a component of health care. In South Africa, traditional healers can obtain licences to practise but very little groundwork has been done to integrate Westernized medicine with traditional healing. The actual contribution of traditional healers to health care in the province of Kwa-Zulu Natal or South Africa is not known. This study determined the role of traditional healers in Durban, Kwa-Zulu Natal, the number of patients who consulted traditional healers, the types of conditions treated and the frequency of consultations. The opinions about physiotherapy of the patients who frequently consult traditional healers were also explored. Data were collected from 30 traditional healers and their 300 patients by means of questionnaires and interviews. The results show 70% of the patients would consult traditional healers as a first choice. Sangomas were the most popular type of healers and had as many as 20 patients per day. A significantly large number of patients consulted traditional healers for potentially life-threatening conditions. The patients knew very little or nothing about physiotherapy. We conclude that traditional healing is an integral component of health care in South Africa. Health care professionals need to be proactive in integrating traditional healing with Westernized practices to promote health for all.

  1. The context for choice: health implications of targeted food and beverage marketing to African Americans.

    PubMed

    Grier, Sonya A; Kumanyika, Shiriki K

    2008-09-01

    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.

  2. 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

  3. 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.

  4. [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.

  5. Perceived Cognitive Impairment among African American elders: health and functional impairments in daily life

    PubMed Central

    Ficker, Lisa J.; Lysack, Cathy L.; Hanna, Mena; Lichtenberg, Peter A.

    2014-01-01

    Objectives The Center for Disease Control began to assess Perceived Cognitive Impairment in 2009, yet there has been no in-depth study of how perceived decline in thinking or memory skills may be associated to the health and lifestyle of an independent community-dwelling older person. Among urban-dwelling older African Americans who are at elevated risk for cognitive impairment and dementia, we know even less regarding the interaction of these risk factors. Method Five hundred and one African American elders (n = 501) between the ages of 55 and 95 with an average age of 70.73 years (SD = 8.6 years) participated in telephone interviews. Results Approximately one-third of the elders reported that their memory, thinking skills, or ability to reason was worse than a year ago (n = 150; 29.9%) and 25% of this group (n = 38) reported that this Perceived Cognitive Impairment impacted their daily activities and/or warranted a consultation with their doctor. Bivariate analyses indicated that Perceived Cognitive Impairment was associated with increased health problems, mobility limitations, depressed mood, and lower social functioning. Conclusion Elders who reported that cognitive problems impacted their daily functioning reported the greatest health and mental health problems. Perceived Cognitive Impairment is an important health variable with implications for an older adult’s overall health, mobility, and mental health. PMID:24328435

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

    PubMed

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

    2009-11-01

    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 outcomes include SF-36 Physical Functioning, SF-36 Bodily Pain, depressed mood, and anxious mood. Specific patterns of living arrangements were related to later health, controlling for age, earlier health, education, and poverty. Poverty explained many, but not all, of the relationships between living arrangements and health. Findings underscored the benefits of social support and social integration and highlighted the negative effects of marital dissolution on health.

  7. Spain: Health system review.

    PubMed

    García-Armesto, Sandra; Begoña Abadía-Taira, María; Durán, Antonio; Hernández-Quevedo, Cristina; Bernal-Delgado, Enrique

    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. This edition of the Spanish HiT focuses on the consequences of the totally devolved status, consolidated in 2002, and the implementation of the road map established by the 2003 SNS Cohesion and Quality Act. Many of the steps already taken underline the improvement path chosen: the SNS Inter-territorial Council (CISNS) comprising the national and regional health ministries was upgraded to the highest SNS authority, paving the way for a brand new consensus-based policy-making process grounded in knowledge management; its effects are progressively starting to be evident. It led the way to the SNS common benefits basket or the SNS human resources policy framework, laying the cornerstones for coordination and the enactment of the SNS Quality Plan. The Plan includes the work in progress to implement the national health information system, the development of a single electronic clinical record (eCR) containing relevant clinical information guaranteeing to patients continuity of care outside their Autonomous Community (AC) of residence or a single patient ID to be used across the country, thus creating the basis for the SNS functional single insurer. It has also become one of the main drivers for the design, implementation and monitoring of quality standards across the SNS, developing national health strategies to tackle both most prevalent chronic diseases (e.g. cancer, cardiovascular diseases, diabetes) and rare diseases, as well as the National Strategy on

  8. 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,…

  9. 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…

  10. Contemporary African food habits and their nutritional and health implications.

    PubMed

    Oniang'o, Ruth K; Mutuku, Joseph M; Malaba, Serah J

    2003-01-01

    Food is fundamental to human survival, in more than just one way. First, food is basic for averting hunger and maintaining health for every human being. Secondly, food satisfies our palate and makes us happy and emotionally and socially content. Third, food constitutes a form of cultural expression. The food we eat should be safe, palatable, affordable, and of the quality that can maintain mental, emotional, physiologic and physical health. Even with globalization that has seen food movements to and from different parts of the world, for most populations in Africa, food is still very locale-specific, especially in the rural farming areas where it is produced. Many locally produced foods have both nutritional and intrinsic value. The types of foods produced in Western Africa are very different from those produced in Eastern Africa. The staple foods, vegetables and the drinks that go with these foods are different. The way food is prepared is also very different in the two parts of Africa. Cultural specificity appears to be more pronounced in Western Africa, involving more secondary processing in the home and more spicing. Data linking food to health, as something that is understood by traditional communities is not easily available. This paper will collate information that discusses people's perceptions in both Western and Eastern Africa, and try to draw comparisons between the two. The paper presents a community picture of food, nutrition and health.

  11. 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.

  12. 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.

  13. Alternative Locales for the Health Promotion of African American Men: A Survey of African American Men in Chicago Barbershops.

    PubMed

    Murphy, A B; Moore, N J; Wright, M; Gipson, J; Keeter, M; Cornelious, T; Reed, D; Russell, J; Watson, K S; Murray, M

    2017-02-01

    African American men (AA) carry unequal burdens of several conditions including cancer, diabetes, hypertension, and HIV. Engagement of diverse populations including AA men in research and health promotion practice is vital to examining the health disparities that continue to plague many racially and ethnically diverse communities. To date, there is little research on best practices that indicate locations, community areas and settings to engage AA men in research and health promotion. Traditionally, the AA church has been a key area to engage AA men and women. However, changing tides in attendance of AA parishioners require additional information to identify areas where AAs, particularly, AA men congregate. The AA barbershop has been identified as a place of social cohesion, cultural immersion and solidarity for AA men but specific sub-populations of AA men may be underrepresented. To further investigate additional locales where AA men congregate, this study engaged AA barbers and clients in several urban community barbershops in Chicago, Illinois. 127 AA men over age 18y/o receiving grooming services in 25 Chicago area barbershops across 14 predominantly AA communities were consented and recruited for a quantitative survey study. The self-administered surveys were completed in ~15 min and $10 compensation was provided to men. Descriptive statistics were reported for demographic variables and for frequency of responses for locations to find AA men of specific age ranges for health promotion and screening activities. Outside of the traditionally used churches or barbershops, the top recommended recruitment sites by age were: 18-29y/o- city park or a recreational center; 30-39y/o- gym, bars or the street; 40-49y/o- various stores, especially home improvement stores, and the mall; and 50y/o+- fast food restaurants in the mornings, such as McDonalds, and individual's homes. The study participants also reported that locations where AA men congregate vary by age

  14. 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.

  15. Volumetric analysis of the African elephant ventricular system.

    PubMed

    Maskeo, Busisiwe C; Spocter, Muhammed A; Haagensen, Mark; Manger, Paul R

    2011-08-01

    This study used magnetic resonance imaging (MRI) to determine the volume of the ventricular system in the brain of three adult male African elephants (Loxodonta africana). The ventricular system of the elephant has a volume of ∼240 mL, an order of magnitude larger than that seen in the adult human. Despite this large size, allometric analysis indicates that the volume of the ventricles in the elephant is what one would expect for a mammal with an ∼5 kg brain. Interestingly, our comparison with other mammals revealed that primates appear to have small relative ventricular volumes, and that megachiropterans and microchiropterans follow different scaling rules when comparing ventricular volume to brain mass indicating separate phylogenetic histories. The current study provides context for one aspect of the elephant brain in the broader picture of mammalian brain evolution.

  16. 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

  17. 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

  18. mHealth to promote pregnancy and interconception health among African-American women at risk for adverse birth outcomes: a pilot study

    PubMed Central

    Miller, Lindsey; Isbell, Sheila; Shields, Tekesia; Worthy, Natasha; Dunlop, Anne Lang

    2015-01-01

    Background The use of mobile phone applications (mHealth) to provide health education and behavioral prompts is 1 of the 12 common mHealth functions identified by the World Health Organization as innovations to strengthen health systems. Among low-income pregnant and parenting women, health education is widely recognized as a way to improve maternal and infant health outcomes, but the efficacy of written health education materials to change knowledge and behavior for this population is questionable. mHealth prompts, in contrast, is a promising alternative. Methods A team of researchers in medicine/epidemiology, anthropology/midwifery, computer science/sensors, and community-based case management created and pilot tested a mHealth application (mHealth app) for African-American women at high risk for adverse birth outcomes. We tested the acceptability and feasibility of the interactive application among women during the reproductive stages of early and late pregnancy, postpartum, and interconception. Results Interview data from 14 women in the various reproductive stages revealed that most women found the mHealth messages helpful. Also, 62 Ob-Gyn physicians and nurses and 19 Family Medicine residents provided feedback. Women’s responses to specific messages trended down over time. Women in the postpartum phase had the highest response rate to particular text messages, followed by those in the pregnancy phase. Responses dropped off dramatically during the interconception period. About 21% of women lost their phones. Unexpected findings were that all participants already had smartphones, women wanted messages about depression, and clinicians wanted the app to link to case management for individualized medical care. Conclusions Logistical challenges to app management were limitations but are useful for consideration before scale-up. This study corroborates findings in the health literacy literature that women most at risk for adverse birth outcomes need additional

  19. 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.

  20. African American patients' intent to screen for colorectal cancer: Do cultural factors, health literacy, knowledge, age and gender matter?

    PubMed

    Brittain, Kelly; Christy, Shannon M; Rawl, Susan M

    2016-02-01

    African Americans have higher colorectal cancer (CRC) mortality rates. Research suggests that CRC screening interventions targeting African Americans be based upon cultural dimensions. Secondary analysis of data from African-Americans who were not up-to-date with CRC screening (n=817) was conducted to examine: 1) relationships among cultural factors (i.e., provider trust, cancer fatalism, health temporal orientation (HTO)), health literacy, and CRC knowledge; 2) age and gender differences; and 3) relationships among the variables and CRC screening intention. Provider trust, fatalism, HTO, health literacy and CRC knowledge had significant relationships among study variables. The FOBT intention model explained 43% of the variance with age and gender being significant predictors. The colonoscopy intention model explained 41% of the variance with gender being a significant predictor. Results suggest that when developing CRC interventions for African Americans, addressing cultural factors remain important, but particular attention should be given to the age and gender of the patient.

  1. African American patients’ intent to screen for colorectal cancer: Do cultural factors, health literacy, knowledge, age and gender matter?

    PubMed Central

    Brittain, Kelly; Christy, Shannon M.; Rawl, Susan M.

    2016-01-01

    African Americans have higher colorectal cancer (CRC) mortality rates. Research suggests that CRC screening interventions targeting African Americans be based upon cultural dimensions. Secondary analysis of data from African-Americans who were not up-to-date with CRC screening (n=817) was conducted to examine: 1) relationships among cultural factors (i.e., provider trust, cancer fatalism, health temporal orientation (HTO)), health literacy, and CRC knowledge; 2) age and gender differences; and 3) relationships among the variables and CRC screening intention. Provider trust, fatalism, HTO, health literacy and CRC knowledge had significant relationships among study variables. The FOBT intention model explained 43% of the variance with age and gender being significant predictors. The colonoscopy intention model explained 41% of the variance with gender being a significant predictor. Results suggest that when developing CRC interventions for African Americans, addressing cultural factors remain important, but particular attention should be given to the age and gender of the patient. PMID:27182187

  2. 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

  3. [The health system of Uruguay].

    PubMed

    Aran, Daniel; Laca, Hernán

    2011-01-01

    This paper describes the Uruguayan health system, including its structure and coverage, its financial sources, the level and distribution of its health expenditure, the physical, material and human resources available, its stewardship functions, the institutions in charge of information and research, and the level and type of citizen's participation in the operation and evaluation of the system. The most recent policy innovations are also discussed, including the creation of the National Comprehensive Health System, the National Health Insurance, the National Health Fund and the Comprehensive Health Care Program. Finally, the impact of these innovations in health expenditure, fairness of health financing, coverage levels and main health indicators is analyzed.

  4. 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.

  5. Pilgrimage to wellness: an exploratory report of rural African American clergy perceptions of church health promotion capacity.

    PubMed

    Carter-Edwards, Lori; Hooten, Elizabeth Gerken; Bruce, Marino A; Toms, Forrest; Lloyd, Cheryl Lemay; Ellison, Calvin

    2012-01-01

    Churches serve vital roles in African American communities, where disease burden is disproportionately greater and healthcare access is more limited. Although church leadership often must approve programs and activities conducted within churches, little is known about their perception of churches as health promotion organizations, or the impact of church-based health promotion on their own health. This exploratory study assessed perceptions of church capacity to promote health among 27 rural, African American clergy leaders and report the relationship between their own health and that of their congregation. Results indicate a perceived need to increase the capacity of their churches to promote health. Most common were conducting health programs, displaying health information, kitchen committee working with the health ministry, partnerships outside of the church, and funding. Findings lay the foundation for the development of future studies of key factors associated with organizational change and health promotion in these rural church settings.

  6. Stress as an idiom for resilience: health and migration among sub-Saharan Africans in Switzerland.

    PubMed

    Obrist, Brigit; Büchi, Silvia

    2008-12-01

    Most research on migrants examines what makes them ill. Inspired by Antonovsky's salutogenic approach, this study shifts the perspective and asks why migrants stay healthy. At the centre of interest are sub-Saharan Africans living in Switzerland who consider themselves and/or are considered by others as mastering problems affecting their health. The mixed Swiss-African research team explored meanings of health and resilience in 20 case studies in Zurich and Basel and five group discussions in Bern, Biel and Geneva. The data show that migrants with resilient trajectories have a dynamic and multi-dimensional understanding of health. Moreover, they have learnt to interpret difficulties as 'stress': a popular illness concept in Switzerland and Europe but less known in their home countries. The paper argues that resilience is closely related with the appropriation of 'stress' as an illness concept: it not only gives meaning and helps to explain diffuse symptoms of ill-health, it also offers an agenda for action and contributes to their feeling of social belonging in the host country. These findings have important implications for policy and practice in the rapidly changing field of migration and health.

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. Health risk and inequitable distribution of liquor stores in African American neighborhood.

    PubMed

    LaVeist, T A; Wallace, J M

    2000-08-01

    In this paper we examine whether the physical availability of alcohol is greater in predominantly African American communities compared to predominantly white communities as indicated by the presence of off premises liquor stores. We investigate the extent to which the income status of the residents of a community mediates the relationship between community racial composition and alcohol availability; and explore whether the intersection of race and class places low income African American communities at increased risk to have such stores located in their communities. Multivariate analytic techniques are used to examine the relationship between community racial composition, median income of neighborhood residents and per capita number of alcohol outlets in 194 census tracts in Baltimore, Maryland. The analysis found that liquor stores are disproportionately located in predominantly black census tracts, even after controlling for census tract socioeconomic status. Census tracts that are both low income and predominantly African American have substantially more liquor stores per capita than other census tracts. Although it is beyond the scope of the present study, our data reveal significant associations between the presence of liquor stores and the risk of health-related social problems in low income neighborhoods. More research needs to be done on the impact of alcohol on the social, psychological, and physiological health of low income urban populations.

  12. Dance for health: improving fitness in African American and Hispanic adolescents.

    PubMed Central

    Flores, R

    1995-01-01

    Cardiovascular disease begins early in life but might be prevented or delayed by primary prevention programs designed for children and adolescents. Regular physical activity is an important part of primary prevention programs, and school physical education programs have potential for the promotion of regular physical activity. Cardiovascular disease is the major cause of death among Hispanics and African Americans in the United States. Low levels of fitness and increased body mass index are common in African American and Hispanic adolescents. Increased physical activity and the adoption of healthy eating habits would increase fitness and reduce body mass index among these adolescents. The purpose of the study was to undertake a small-scale controlled trial to determine if Dance for Health, an intervention program designed to provide an enjoyable aerobic program for African American and Hispanic adolescents, has a significant effect on improving aerobic capacity, helping students maintain or decrease weight, and on improving attitudes toward physical activity and physical fitness. In the first year of the program (1990-91), approximately 110 boys and girls ages 10-13 years participated in an aerobic dance pilot program three times per week for 12 weeks. Dance for Health was revised and continued in the 1992-93 school year with seventh grade students and an added culturally sensitive health curriculum. Forty-three students were randomized to Dance for Health and 38 to usual physical activity. Those in the intervention class received a health education curriculum twice a week and a dance oriented physical education class three times a week. The usual physical activity consisted mostly of playground activities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7630998

  13. Multiple Roles, Multiple Lives: The Protective Effects of Role Responsibilities on the Health Functioning of African American Mothers

    PubMed Central

    Black, Angela Rose; Murry, Velma McBride; Cutrona, Carolyn E.; Chen, Yi-fu

    2009-01-01

    Using data from 747 rural African American mothers, this study incorporated Role Accumulation theory to test direct and indirect effects of stressors, coping behaviors, and role responsibilities on health functioning. Results indicated that demands emerging from financial strain were related to compromised mental health and decreases in mothers' use of effective coping strategies and role responsibility engagement. Conversely, mothers who effectively responded to stressors and fulfilled responsibilities to their children and communities experienced enhanced mental health, which in turn promoted optimal physical health. The results can inform research and intervention with African American women. PMID:19533507

  14. 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.

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

    PubMed

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

    2010-11-01

    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.

  16. African-American clergy's perceptions of the leading health problems in their communities and their role in supporting parishioners' health.

    PubMed

    Watson, Donnie W; West, Donnie W; Bisesi, Lorrie; Tanamly, Susie; Branch, Cheryl A; Novgrod, Judith; Sim, Tiffanie; Williams, Eugene

    2006-01-01

    This article is a report on a survey of Southern California pastors to learn of their perceptions of the leading health problems in their congregations. Participants (N=41) identified stress, overweight, and obesity as the top three health indicators that effect the health of their congregations. Tobacco use and substance abuse were listed among the top five. From a list of health problems, pastors felt that from the pulpit they could impact parishioners responsible sexual behavior most. Pastors expressed their opinions about the reasons for certain maladies and addictions. The findings indicate room for improvement in building clergy's understanding of the nature of illness and addiction and in empowering them in their role of supporting healthy behaviors in the African-American community.

  17. Health Information Systems.

    PubMed

    Sirintrapun, S Joseph; Artz, David R

    2015-06-01

    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.

  18. 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.

  19. Effective coverage and systems effectiveness for malaria case management in sub-Saharan African countries.

    PubMed

    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

  20. African Americans with cancer: the relationships among self-esteem, locus of control, and health perception.

    PubMed

    Swinney, Jean E

    2002-10-01

    The purpose of this study was to describe and examine the relationships among self-esteem, locus of control, and perceived health status in African Americans with cancer and to identify predictors of perceived health status. A convenience sample of 95 oncology outpatients at two large medical facilities completed the Tennessee Self-Concept Scale, the Multidimensional Health Locus of Control Scale, and the Cantril Ladder, a measurement of perceived health. In an audiotaped interview two open-ended questions were used to clarify participants' Cantril Ladder scores. A significant positive relationship was discovered between self-esteem and powerful others health locus of control (p <.05). Participants tended to view God as the Powerful Other capable of influencing their health and well-being. Self-esteem and an internal health locus of control were found to account for 23% of the perceived variance in health status. In addition, interview data indicated that participants with normal to high levels of self-esteem and an internal health locus of control perceived their state of health and well-being positively.

  1. 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.

  2. 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.

  3. 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…

  4. 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…

  5. 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…

  6. 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

  7. 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

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

    PubMed

    Byrd, W M; Clayton, L A

    1992-02-01

    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.

  9. 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…

  10. 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

  11. 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

  12. Adherence to Exercise Prescription and Improvements in the Clinical and Vascular Health of African Americans

    PubMed Central

    BABBITT, DIANNE M.; PERKINS, AMANDA M.; DIAZ, KEITH M.; FEAIRHELLER, DEBORAH L.; STURGEON, KATHLEEN M.; VEERABHADRAPPA, PRAVEEN; WILLIAMSON, SHEARA T.; KRETZSCHMAR, JAN; LING, CHENYI; LEE, HOJUN; GRIM, HEATHER; BROWN, MICHAEL D.

    2017-01-01

    Improvements in indices of vascular health and endothelial function have been inversely associated with hypertension, a risk factor for cardiovascular disease (e.g., myocardial infarction, stroke, and heart failure), renal failure, and mortality. Aerobic exercise training (AEXT) has been positively associated with improvements in clinical health values, as well as vascular health biomarkers, and endothelial function. The purpose of this study was to evaluate whether measures of exercise adherence were related to clinical outcome measures and indices of vascular health subsequent to a 6-month AEXT intervention in a middle-to-older aged African American cohort. Following dietary stabilization, sedentary, apparently healthy, African American adults (40 – 71 y/o) underwent baseline testing including blood pressure, flow-mediated dilation (FMD) studies, fasting blood sampling, and graded exercise testing. Upon completion of a supervised 6-month AEXT intervention, participants repeated all baseline tests. Exercise adherence was measured three ways: exercise percentage, exercise volume, and exercise score. There were no significant correlations between the changes in the vascular health biomarkers of the participants and any of the adherence measures. In addition, there were no significant correlations between any of the adherence measures and the clinical values of the participants that had been significantly changed pre-post-AEXT. Participants improved their clinical and vascular health and decreased risk factors for hypertension and cardiovascular disease regardless of their level of adherence to AEXT. Future studies should continue to accurately quantify adherence in order to assess the exercise dose for improvements in vascular and clinical health. PMID:28344738

  13. Distinct age and self-rated health crossover mortality effects for African Americans: Evidence from a national cohort study.

    PubMed

    Roth, David L; Skarupski, Kimberly A; Crews, Deidra C; Howard, Virginia J; Locher, Julie L

    2016-05-01

    The predictive effects of age and self-rated health (SRH) on all-cause mortality are known to differ across race and ethnic groups. African American adults have higher mortality rates than Whites at younger ages, but this mortality disparity diminishes with advancing age and may "crossover" at about 75-80 years of age, when African Americans may show lower mortality rates. This pattern of findings reflects a lower overall association between age and mortality for African Americans than for Whites, and health-related mechanisms are typically cited as the reason for this age-based crossover mortality effect. However, a lower association between poor SRH and mortality has also been found for African Americans than for Whites, and it is not known if the reduced age and SRH associations with mortality for African Americans reflect independent or overlapping mechanisms. This study examined these two mortality predictors simultaneously in a large epidemiological study of 12,181 African Americans and 17,436 Whites. Participants were 45 or more years of age when they enrolled in the national REasons for Geographic and Racial Differences in Stroke (REGARDS) study between 2003 and 2007. Consistent with previous studies, African Americans had poorer SRH than Whites even after adjusting for demographic and health history covariates. Survival analysis models indicated statistically significant and independent race*age, race*SRH, and age*SRH interaction effects on all-cause mortality over an average 9-year follow-up period. Advanced age and poorer SRH were both weaker mortality risk factors for African Americans than for Whites. These two effects were distinct and presumably tapped different causal mechanisms. This calls into question the health-related explanation for the age-based mortality crossover effect and suggests that other mechanisms, including behavioral, social, and cultural factors, should be considered in efforts to better understand the age-based mortality

  14. [The health system of Nicaragua].

    PubMed

    Muiser, Jorine; Sáenz, María del Rocío; Bermúdez, Juan Luis

    2011-01-01

    This paper describes the health conditions in Nicaragua and discusses the characteristics of its national health system including its structure and coverage, its financial sources its physical, material and human resources the stewardship functions developed by the Ministry of Health the participation of citizens in the operation and evaluation of the system and the level of satisfaction of health care users. It also discusses the most recent policy innovations, including the new General Health Law, the decentralization of the regulation of health facilities and the design and implementation of a new health care model known as Family and Community Health Model.

  15. Change in Motor Function and Adverse Health Outcomes in Older African Americas

    PubMed Central

    Buchman, Aron S.; Wilson, Robert S.; Leurgans, Sue E.; Bennett, David A.; Barnes, Lisa L.

    2015-01-01

    Objective We tested whether declining motor function accelerates with age in older African Americans. Methods Eleven motor performances were assessed annually in 513 older African Americans. Results During follow-up of 5 years, linear mixed-effect models showed that motor function declined by about 0.03 units/yr (Estimate, −0.026, p<0.001); about 4% more rapidly for each additional year of age at baseline. A proportional hazard model showed that both baseline motor function level and its rate of change were independent predictors of death and incident disability (all p’s <0.001). These models showed that the additional annual amount of motor decline in 85 year old persons at baseline versus 65 year old persons was associated with a 1.5-fold higher rate of death and a 3-fold higher rate of developing Katz disability. Conclusions The rate of declining motor function accelerates with increasing age and its rate of decline predicts adverse health outcomes in older African Americans. PMID:26209439

  16. Health evaluation of African penguins (Spheniscus demersus) in southern Africa.

    PubMed

    Parsons, Nola J; Gous, Tertius A; Schaefer, Adam M; Vanstreels, Ralph E T

    2016-09-20

    The African penguin (Spheniscus demersus) is an endangered seabird that breeds along the coast of Namibia and South Africa, and disease surveillance was identified as a priority for its conservation. Aiming for the establishment of baseline data on the presence of potential pathogens in this species, a comprehensive health assessment (blood smear examination, haematology, biochemistry and serology) was conducted on samples obtained from 578 African penguins at 11 breeding colonies and a rehabilitation centre. There were 68 penguins that were seropositive for at least one of seven pathogens tested: avian encephalomyelitis virus, avian infectious bronchitis virus, avian reovirus, infectious bursal disease virus, Newcastle disease virus, Mycoplasma gallisepticum and Mycoplasma synoviae. All samples were seronegative for avian influenza virus subtypes H5 and H7 and infectious laryngotracheitis virus. The apparent prevalence of Babesia sp. and Borrelia sp. in blood smears was consistent with previous studies. Babesia-infected individuals had a regenerative response of the erythrocytic lineage, an active inflammatory response and hepatic function impairment. These findings indicate that African penguins may be exposed to conservation-significant pathogens in the wild and encourage further studies aiming for the direct detection and/or isolation of these microorganisms.

  17. 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.

  18. 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

  19. Sexual health information seeking on the Internet: comparisons between White and African American college students.

    PubMed

    Fogel, Joshua; Fajiram, Sandra; Morgan, Phyllis D

    2010-01-01

    College students are often interested in information about sexual health topics. A study of 149 college students and their use of the Internet for sexual health information was conducted. The study findings indicated that African American college students, as compared to White college students, and women, as compared to men, had greater odds for searching on the Internet for birth control information. Among male college students, a higher internal locus of control was associated with lower odds for looking at birth control information on the Internet. Nurses and healthcare providers working in college settings can use these findings to develop strategies for identifying those who are more likely to reference the Internet to obtain birth control and sexual health information.

  20. Health Messaging and African-American Infant Sleep Location: A Randomized Controlled Trial.

    PubMed

    Moon, Rachel Y; Mathews, Anita; Joyner, Brandi L; Oden, Rosalind P; He, Jianping; McCarter, Robert

    2017-02-01

    Infant-parent bedsharing increases the risk of SIDS and other sleep-related deaths. Despite AAP recommendations to avoid bedsharing, public health efforts have been unsuccessful in changing behaviors. African-American infants are more than twice as likely to die from SIDS and other sleep-related deaths, and are also twice as likely to bedshare with their parents. Further, African-American parents have a high degree of self-efficacy with regards to preventing infant suffocation, but low self-efficacy with regards to SIDS risk reduction. It is unclear whether messages emphasizing suffocation prevention will decrease bedsharing. To evaluate the impact of specific health messages on African-American parental decisions regarding infant sleep location. We conducted a randomized, controlled trial of African-American mothers of infants. The control group received standard messaging emphasizing AAP-recommended safe sleep practices, including avoidance of bedsharing, for the purposes of SIDS risk reduction. The intervention group received enhanced messaging emphasizing safe sleep practices, including avoidance of bedsharing, for both SIDS risk reduction and suffocation prevention. Participants completed interviews at 2-3 weeks, 2-3 months, and 5-6 months after the infant's birth. 1194 mothers were enrolled in the study, and 637 completed all interviews. Bedsharing, both usually (aOR 1.005 [95 % CI 1.003, 1.006]) and last night (aOR 1.004 [95 % CI 1.002, 1.007]) increased slightly but statistically significantly with infant age (p < 0.001). Receipt of the enhanced message did not impact on sleep location. Maternal belief that bedsharing increased the risk of SIDS or suffocation declined over 6 months (p < 0.001) and did not differ by group assignment. African-American mothers who received an enhanced message about SIDS risk reduction and suffocation prevention were no less likely to bedshare with their infants.

  1. The impact of mental health problems and religiosity on African-American girls’ HIV-risk

    PubMed Central

    Udell, Wadiya; Donenberg, Geri; Emerson, Erin

    2011-01-01

    We investigated the relationship between religiosity, mental health problems, and two sexual risk behaviors – condom use and number of partners. Participants were 80 sexually active African American girls in psychiatric care and their caregivers. Results indicated differential relationships, depending on parent versus youth report. Mother’s religiosity, was positively related to girls’ condom use and not to girls’ number of partners. Controlling for other predictors in the models, mother’s religiosity explained as much as 15% of the variance in girls’ condom use. Whereas, parent and adolescent reports of girls’ depression/anxiety and rule-breaking were positively associated with number of partners, reports of aggression was associated with having fewer partners. Neither parent nor youth report of girls’ mental health problems were associated with condom use. Controlling for other predictors in the models, girls’ mental health problems accounted for as much as 31% of the variance in number of partners. Findings underscore of the importance of adopting an ecological framework to understand both the risk and promotive factors for sexual risk taking among troubled girls. The roles of specific aspects of psychopathology and religiosity in relation to sexual risk behavior among African American girls in psychiatric care are discussed. PMID:21604846

  2. 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…

  3. 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…

  4. The Effects of Mother's Marital Status on Adolescent and Young Adult Health and Economic Well-Being among African Americans

    ERIC Educational Resources Information Center

    LaVeist, Thomas A.; Zeno, Tia L.; Fesahazion, Ruth G.

    2010-01-01

    This article explores the effects of being raised by married parents during childhood on health and well-being in adolescence and young adulthood in a longitudinal sample of African Americans. This study aims to address the following three questions: Does childhood with married parents lead to better health and well-being during adolescence? Does…

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

    NASA Technical Reports Server (NTRS)

    Mohr, P. A. (Principal Investigator)

    1973-01-01

    The author has identified the following significant results. ERTS-1 imagery of the African rift system has already proved of great value in structural geological studies. One of the interesting megastructures expressed on the imagery occurs some 40 km east of the eastern margin of the main Ethiopian rift, in Arussi province, and extending between latitude 71/2 and 81/4 deg N. The Badda-Encuolo ridge proves to have been a line of major Tertiary volcanism and probably supplied the thick Trap Series flood basalt sequence exposed farther east in the canyons of the Webi Shebeli drainage system. The ridge itself was built up by the waning activity of the Sagatu line of volcanism. Serendipitious has been the discovery on Mt. Badda of several deeply glaciated valleys, many of which show clearly on the ERTS-1 imagery. It seems that Mt. Badda was one of the most important glacial centers in eastern Africa during the Pleistocene. Three major late-Tertiary trachytic centers lie between the Badda-Encuolo ridge and the rift valley. The relationships of these three volcanoes to each other and to the rift faulting is revealed for the first time by the ERTS-1 imagery, as is the form of the cladera of Baltata and the crater of Chilalo.

  6. 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

  7. 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.

  8. Costs of maternal health care services in three anglophone African countries.

    PubMed

    Levin, Ann; Dmytraczenko, Tania; McEuen, Mark; Ssengooba, Freddie; Mangani, Ronald; Van Dyck, Gerry

    2003-01-01

    This paper is a synthesis of a case study of provider and consumer costs, along with selected quality indicators, for six maternal health services provided at one public hospital, one mission hospital, one public health centre and one mission centre, in Uganda, Malawi and Ghana. The study examines the costs of providing the services in a selected number of facilities in order to examine the reasons behind cost differences, assess the efficiency of service delivery, and determine whether management improvements might achieve cost savings without hurting quality. This assessment is important to African countries with ambitious goals for improving maternal health but scarce public health resources and limited government budgets. The study also evaluates the costs that consumers pay to use the maternal health services, along with the contribution that revenues from fees for services make to recovering health facility costs. The authors find that costs differ between hospitals and health centres as well as among mission and public facilities in the study sample. The variation is explained by differences in the role of the facility, use and availability of materials and equipment, number and level of personnel delivering services, and utilization levels of services. The report concludes with several policy implications for improvements in efficiency, financing options and consumer costs.

  9. Cancer statistics for African Americans.

    PubMed

    Ghafoor, Asma; Jemal, Ahmedin; Cokkinides, Vilma; Cardinez, Cheryll; Murray, Taylor; Samuels, Alicia; Thun, Michael J

    2002-01-01

    The American Cancer Society provides estimates on the number of new cancer cases and deaths, and compiles health statistics on African Americans in a biennial publication, Cancer Facts and Figures for African Americans. The compiled statistics include cancer incidence, mortality, survival, and lifestyle behaviors using the most recent data on incidence and survival from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) program, mortality data from the National Center for Health Statistics (NCHS), and behavioral information from the Behavior Risk Factor Surveillance System (BRFSS), Youth Risk Behavior Surveillance System (YRBSS), and National Health Interview Survey (NHIS). It is estimated that 132,700 new cases of cancer and 63,100 deaths will occur among African Americans in the year 2003. Although African Americans have experienced higher incidence and mortality rates of cancer than whites for many years, incidence rates have declined by 2.7 percent per year in African-American males since 1992, while stabilizing in African-American females. During the same period, death rates declined by 2.1 percent and 0.4 percent per year among African-American males and females, respectively. The decrease in both incidence and death rates from cancer among African-American males was the largest of any racial or ethnic group. Nonetheless, African Americans still carry the highest cancer burden among US racial and ethnic groups. Most cancers detectable by screening are diagnosed at a later stage and survival rates are lower within each stage of disease in African Americans than in whites. The extent to which these disparities reflect unequal access to health care versus other factors is an active area of research.

  10. Engaging Gatekeeper-Stakeholders in Development of a Mobile Health Intervention to Improve Medication Adherence Among African American and Pacific Islander Elderly Patients With Hypertension

    PubMed Central

    Bazargan, Mohsen; Jones, Loretta; Vawer, May; Seto, Todd B; Farooq, Summer; Taira, Deborah A

    2016-01-01

    design of a mHealth intervention to improve adherence to antihypertensives among the elderly could be very similar for African Americans and Native Hawaiian and Pacific Islanders. The main difference might be in the way in which the program is initiated (possibly through church-based workshops for African Americans and by individual providers for Native Hawaiian and Pacific Islanders). Another difference might be who sends the messages with African Americans wanting someone outside the health care system, but Native Hawaiian and Pacific Islanders preferring a provider. PMID:27784651

  11. "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.

  12. I too, am America: a review of research on systemic lupus erythematosus in African-Americans

    PubMed Central

    Williams, Edith M; Bruner, Larisa; Adkins, Alyssa; Vrana, Caroline; Logan, Ayaba; Kamen, Diane; Oates, James C

    2016-01-01

    Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disorder that can cause significant morbidity and mortality. A large body of evidence has shown that African-Americans experience the disease more severely than other racial-ethnic groups. Relevant literature for the years 2000 to August 2015 were obtained from systematic searches of PubMed, Scopus, and the EBSCOHost platform that includes MEDLINE, CINAHL, etc. to evaluate research focused on SLE in African-Americans. Thirty-six of the 1502 articles were classified according to their level of evidence. The systematic review of the literature reported a wide range of adverse outcomes in African-American SLE patients and risk factors observed in other mono and multi-ethnic investigations. Studies limited to African-Americans with SLE identified novel methods for more precise ascertainment of risk and observed novel findings that hadn't been previously reported in African-Americans with SLE. Both environmental and genetic studies included in this review have highlighted unique African-American populations in an attempt to isolate risk attributable to African ancestry and observed increased genetic influence on overall disease in this cohort. The review also revealed emerging research in areas of quality of life, race-tailored interventions, and self-management. This review reemphasizes the importance of additional studies to better elucidate the natural history of SLE in African-Americans and optimize therapeutic strategies for those who are identified as being at high risk. PMID:27651918

  13. I too, am America: a review of research on systemic lupus erythematosus in African-Americans.

    PubMed

    Williams, Edith M; Bruner, Larisa; Adkins, Alyssa; Vrana, Caroline; Logan, Ayaba; Kamen, Diane; Oates, James C

    2016-01-01

    Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disorder that can cause significant morbidity and mortality. A large body of evidence has shown that African-Americans experience the disease more severely than other racial-ethnic groups. Relevant literature for the years 2000 to August 2015 were obtained from systematic searches of PubMed, Scopus, and the EBSCOHost platform that includes MEDLINE, CINAHL, etc. to evaluate research focused on SLE in African-Americans. Thirty-six of the 1502 articles were classified according to their level of evidence. The systematic review of the literature reported a wide range of adverse outcomes in African-American SLE patients and risk factors observed in other mono and multi-ethnic investigations. Studies limited to African-Americans with SLE identified novel methods for more precise ascertainment of risk and observed novel findings that hadn't been previously reported in African-Americans with SLE. Both environmental and genetic studies included in this review have highlighted unique African-American populations in an attempt to isolate risk attributable to African ancestry and observed increased genetic influence on overall disease in this cohort. The review also revealed emerging research in areas of quality of life, race-tailored interventions, and self-management. This review reemphasizes the importance of additional studies to better elucidate the natural history of SLE in African-Americans and optimize therapeutic strategies for those who are identified as being at high risk.

  14. eHealth Literacy, Online Help-Seeking Behavior, and Willingness to Participate in mHealth Chronic Disease Research Among African Americans, Florida, 2014–2015

    PubMed Central

    Harville, Cedric

    2016-01-01

    Introduction The high rate of ownership of smartphones among African Americans provides researchers with opportunities to use digital technologies to reduce the prevalence of chronic diseases in this population. This study aimed to assess the association between eHealth literacy (EHL) and access to technology, health information–seeking behavior, and willingness to participate in mHealth (mobile health) research among African Americans. Methods A self-administered questionnaire was completed by 881 African American adults from April 2014 to January 2015 in north central Florida. EHL was assessed by using the eHealth Literacy Scale (eHEALS) with higher scores (range, 8–40) indicating greater perceived skills at using online health information to help solve health problems. Results Overall eHEALS scores ranged from 8 to 40, with a mean of 30.4 (standard deviation, 7.8). The highest score was for the item “I know how to find helpful health resources on the Internet,” and the lowest score was for “I can tell high quality from low quality health resources on the Internet.” Most respondents owned smartphones (71%) and searched online for health information (60%). Most were also willing to participate in health research that used text messages (67%), smartwatches/health tracking devices (62%), and health apps (57%). We found significantly higher eHEALS scores among women, smartphone owners, those who use the Internet to seek health information, and those willing to participate in mHealth research (P < .01 for all). Conclusion Most participants owned smartphones, used the Internet as a source of information, and were willing to participate in mHealth research. Opportunities exist for improving EHL and conducting mHealth research among African Americans to reduce the prevalence of chronic diseases. PMID:27854421

  15. 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

  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. Getting mad but ending up sad: the mental health consequences for African Americans using anger to cope with racism.

    PubMed

    Pittman, Chavella T

    2011-01-01

    Anger is a common reaction to stressful life events. However, little is known about anger’s use and efficacy as a coping strategy for racism. Is anger a coping strategy for racism that improves mental health? Or does anger operate in an opposing way, deteriorating mental health? The analyses for this research focused on a probability sample of African Americans who reported experiences of acute (n = 246) or chronic (n = 120) racial discrimination in a survey interview. General linear model results revealed that using anger to cope with racial discrimination negatively affected the general well-being and psychological distress of African Americans. These findings raise concerns about the effectiveness (or lack therefore of) of anger as a common coping mechanism for racism, given the deleterious effects it may have on African Americans’ mental health.

  18. Variations in mental health problems, substance use, and delinquency between African American and Caucasian juvenile offenders: implications for reentry services.

    PubMed

    Vaughn, Michael G; Wallace, John M; Davis, Larry E; Fernandes, Giselle T; Howard, Matthew O

    2008-06-01

    The incarceration of young people is a growing national problem. Key correlates of incarceration among American youth include mental health problems, substance use, and delinquency. The present study uses a statewide sample of incarcerated youth to examine racial differences in African American and Caucasian juvenile offenders' outcomes related to mental health, substance use, and delinquency. The data indicate that relative to Caucasian offenders, African American offenders report lower levels of mental health problems and substance use but higher levels of delinquent behavior such as violence, weapon carrying, and gang fighting. The data further reveal that African American offenders are more likely than Caucasian offenders to be victims of violence and to experience traumatic events such as witnessing injury and death. Recognition of these patterns may help to improve postrelease services by tailoring or adapting preexisting programs to patterns of risk factors and their relative magnitudes of effect.

  19. 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

  20. 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).

  1. Simple reverse genetics systems for Asian and African Zika viruses

    PubMed Central

    Atieh, Thérèse; Baronti, Cécile; de Lamballerie, Xavier; Nougairède, Antoine

    2016-01-01

    Zika virus (ZIKV), a typical example of a re‐emerging pathogen, recently caused large outbreaks in Pacific islands and the Americas, associated with congenital diseases and neurological complications. Deciphering the natural history, ecology and pathophysiology of this mosquito-borne pathogen requires effective reverse genetics tools. In the current study, using the bacterium-free ‘Infectious Subgenomic Amplicons’ (ISA) method, we generated and made available to the scientific community via the non-profit European Virus Archive collection, two simple and performing reverse genetics systems for ZIKV. One is based on an Asian ZIKV strain belonging to the outbreak lineage (French Polynesia 2013). The second was designed from the sequence of a low-passaged ZIKV African strain (Dakar 1984). Using the ISA procedure, we derived wild-type and a variety of specifically engineered ZIKVs in days (intra- and inter-lineage chimeras). Since they are based on low-passaged ZIKV strains, these engineered viruses provide ideal tools to study the effect of genetic changes observed in different evolutionary time-scales of ZIKV as well as pathophysiology of ZIKV infections. PMID:27991555

  2. 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

  3. 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.

  4. Health promotion and disease prevention through sanitation education in South African Zulu and Xhosa women.

    PubMed

    Smith, Maria A; Garbharran, Hari; Edwards, M Jo; O'Hara-Murdock, Peggy

    2004-01-01

    Poor sanitation and hygiene facilitate transmission of environmental diseases and pose a threat to the health of South African residents. This study focused on identifying sanitation needs from the perspective of informal community residents, addressing need related issues, and empowering Zulu and Xhosa women. The study used a multistep approach to identify and access communities of interest, reflexive critique during data collection from 300 heads of households, and a reiterative process to identify major themes. A process, which impacted 1,467 residents, was developed; it included culturally sensitive presentation styles and educational materials that facilitated understanding of sanitation concepts. Main sanitation themes were health knowledge and community role models. Educational sessions incorporated women. Using women as educators elevated their status and validated their community importance. Project participation added to the educational background of the Zulu and Xhosa women. It empowered them and provided an opportunity for them to articulate community needs.

  5. [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.

  6. [The health system of Ecuador].

    PubMed

    Lucio, Ruth; Villacrés, Nilhda; Henríquez, Rodrigo

    2011-01-01

    This paper describes the health conditions in Ecuador and, in more detail, the characteristics of the Ecuadorian health system, including its structure and coverage, its financial sources, the physical, material and human resources available, and the stewardship activities developed by the Ministry of Public Health. It also describes the structure and content of its health information system, and the participation of citizens in the operation and evaluation of the health system. The paper ends with a discussion of the most recent policy innovations implemented in the Ecuadorian system, including the incorporation of a chapter on health into the new Constitution which recognizes the protection of health as a human right, and the construction of the Comprehensive Public Health Network.

  7. [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.

  8. Post-Pan-African tectonic evolution of South Malawi in relation to the Karroo and recent East African rift systems

    NASA Astrophysics Data System (ADS)

    Castaing, C.

    1991-05-01

    Structural studies conducted in the Lengwe and Mwabvi Karroo basins and in the basement in South Malawi, using regional maps and published data extended to cover Southeast Africa, serve to propose a series of geodynamic reconstructions which reveal the persistence of an extensional tectonic regime, the minimum stress σ3 of which has varied through time. The period of Karroo rifting and the tholeiitic and alkaline magmatism which terminated it, were controlled by NW-SE extension, which resulted in the creation of roughly NE-SW troughs articulated by the Tanganyika-Malawi and Zambesi pre-transform systems. These were NW-SE sinistral-slip systems with directions of movement dipping slightly to the Southeast, which enabled the Mwanza fault to play an important role in the evolution of the Karroo basins of the Shire Valley. The Cretaceous was a transition period between the Karroo rifting and the formation of the Recent East African Rift System. Extension was NE-SW, with some evidence for a local compressional episode in the Lengwe basin. Beginning in the Cenozoic, the extension once more became NW-SE and controlled the evolution in transtension of the Recent East African Rift System. This history highlights the major role of transverse faults systems dominated by strike-slip motion in the evolution and perpetuation of the continental rift systems. These faults are of a greater geological persistence than the normal faults bounding the grabens, especially when they are located on major basement anisotropies.

  9. Positive practice environments influence job satisfaction of primary health care clinic nursing managers in two South African provinces

    PubMed Central

    2014-01-01

    Background Nurses constitute the majority of the health workforce in South Africa and they play a major role in providing primary health care (PHC) services. Job satisfaction influences nurse retention and successful implementation of health system reforms. This study was conducted in light of renewed government commitment to reforms at the PHC level, and to contribute to the development of solutions to the challenges faced by the South African nursing workforce. The objective of the study was to determine overall job satisfaction of PHC clinic nursing managers and the predictors of their job satisfaction in two South African provinces. Methods During 2012, a cross-sectional study was conducted in two South African provinces. Stratified random sampling was used to survey a total of 111 nursing managers working in PHC clinics. These managers completed a pre-tested Measure of Job Satisfaction questionnaire with subscales on personal satisfaction, workload, professional support, training, pay, career prospects and standards of care. Mean scores were used to measure overall job satisfaction and various subscales. Predictors of job satisfaction were determined through multiple logistic regression analysis. Results A total of 108 nursing managers completed the survey representing a 97% response rate. The mean age of respondents was 49 years (SD = 7.9) and the majority of them (92%) were female. Seventy-six percent had a PHC clinical training qualification. Overall mean job satisfaction scores were 142.80 (SD = 24.3) and 143.41 (SD = 25.6) for Gauteng and Free State provinces respectively out of a maximum possible score of 215. Predictors of job satisfaction were: working in a clinic of choice (RRR = 3.10 (95% CI: 1.11 to 8.62, P = 0.030)), being tired at work (RRR = 0.19 (95% CI: 0.08 to 0.50, P = 0.001)) and experience of verbal abuse (RRR = 0.18 (95% CI: 0.06 to 0.55, P = 0.001). Conclusion Allowing nurses greater choice of clinic

  10. 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…

  11. [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.

  12. A Multivariate Comparison of Elderly African Americans and Caucasians Voting Behavior: How Do Social, Health, Psychological, and Political Variables Effect Their Voting?

    ERIC Educational Resources Information Center

    Bazargan, Mohsen; And Others

    1991-01-01

    Used data from Aging in the Eighties national survey to examine impact of health rating and life satisfaction as well as other socio-psychological characteristics on voting turnout among elderly Caucasian and African Americans. For Caucasians, self-assessment of health was significantly related to voting behavior; whereas among African Americans,…

  13. 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

  14. United Kingdom: Health System Review.

    PubMed

    Cylus, Jonathan; Richardson, Erica; Findley, Lisa; Longley, Marcus; O'Neill, Ciaran; Steel, David

    2015-01-01

    This analysis of the United Kingdom health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. It provides an overview of how the national health services operate in the four nations that make up the United Kingdom, as responsibility for organizing health financing and services was devolved from 1997. With devolution, the health systems in the United Kingdom have diverged in the details of how services are organized and paid for, but all have maintained national health services which provide universal access to a comprehensive package of services that are mostly free at the point of use. These health services are predominantly financed from general taxation and 83.5% of total health expenditure in the United Kingdom came from public sources in 2013. Life expectancy has increased steadily across the United Kingdom, but health inequalities have proved stubbornly resistant to improvement, and the gap between the most deprived and the most privileged continues to widen, rather than close. The United Kingdom faces challenges going forward, including how to cope with the needs of an ageing population, how to manage populations with poor health behaviours and associated chronic conditions, how to meet patient expectations of access to the latest available medicines and technologies, and how to adapt a system that has limited resources to expand its workforce and infrastructural capacity so it can rise to these challenges.

  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.

  16. An Introduction to Parenting and Mental Health Services Utilization Among African American Families: The Role of Racial Socialization.

    PubMed

    Rodriguez, James; Cavaleri, Mary A; Bannon, William M; McKay, Mary M

    2008-05-01

    The articles in this special issue are a significant contribution to the literature pertaining to racial socialization, which is defined as messages parents communicate about race and culture, how African Americans are perceived societally, and how to cope with discrimination due to their skin color. More specifically, these articles examine the relationship between racial socialization and parental mental health status, child socio-behavioral functioning, and the utilization of mental health and prevention services for both parent and child. Overall, the results of these articles indicate that various racial socialization practices do indeed influence key variables such as the child's behavioral functioning and decision-making, parental mental health status, and the receipt of prevention and mental health services. Implications of these findings suggest that racial socialization beliefs and practices may in fact influence the health and functioning of African American youth and families.

  17. 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

  18. 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

  19. Cancer perceptions of South African mothers and daughters: implications for health promotion programs.

    PubMed

    Mosavel, Maghboeba; Simon, Christian; Ahmed, Rashid

    2010-09-01

    Cancer is one of the leading causes of death worldwide. A major reason why women do not obtain cancer screening procedures relates to the high levels of fear associated with cancer. In this study, we explored South African mothers' and daughters' reaction to the word "cancer" specifically. The study sample included 157 randomly selected mother and adolescent daughter pairs from an urban community in Cape Town, South Africa. Mothers and their adolescent daughters had very similar responses to the term "cancer." We found that most South African mothers and daughters had a fear-based attitude toward the illness. When we asked mothers what they immediately thought of upon hearing "cancer," a majority of women (69%) thought of death, and another 43% thought of suffering and the detrimental consequences of the illness. Similarly, 50% of the daughters also thought of death, and 42% thought of the detrimental aspects of cancer. Fatalistic attitudes and negative emotional reactions have important implications in cancer prevention and need to be addressed within a public health context.

  20. Distrust in the healthcare system and organ donation intentions among African Americans.

    PubMed

    Russell, Emily; Robinson, Dana H Z; Thompson, Nancy J; Perryman, Jennie P; Arriola, Kimberly R Jacob

    2012-02-01

    The purpose of this study is to further understanding of the association between distrust in the healthcare system and written and verbal expressions of donation intentions among African Americans. We hypothesize that distrust in the healthcare system will be significantly, positively associated with both verbal and written donation intentions. Five hundred and eighty five participants completed a 98-item survey that included scales on distrust in the healthcare system and donation intentions. Bivariate analyses (t-tests, ANOVA, chi-square tests and odds ratios) were used to explore the extent to which donation intentions and distrust in the healthcare system varied by demographic characteristics and the association between the distrust in the healthcare system scale and verbal and written donation intentions. Separate logistic regressions were performed with each of the dependent variables to see if significant associations remained while controlling for confounders. Findings based on the multiple regression indicate that when controlling the participant's education level, distrust in the healthcare system was not significantly related to written donation intentions (OR = 1.04; P = .12). When controlling for education level, health insurance status, Community Health Advocates group and marital status, distrust in the healthcare system was significantly associated with verbal donation intentions (OR = 1.08; P < 0.05). Our results suggest that distrust in the healthcare system varies in the way that it is associated with donation intentions. Future organ donation studies should be conducted to determine the pathways through which distrust in the healthcare system impacts different types of organ donation intentions.

  1. Health disparities experienced by black or African Americans--United States.

    PubMed

    2005-01-14

    In the 2000 census, 36.4 million persons, approximately 12.9% of the U.S. population, identified themselves as Black or African American; 35.4 million of these persons identified themselves as non-Hispanic. For many health conditions, non-Hispanic blacks bear a disproportionate burden of disease, injury, death, and disability. Although the top three causes and seven of the 10 leading causes of death are the same for non-Hispanic blacks and non-Hispanic whites (the largest racial/ethnic population in the United States), the risk factors and incidence, morbidity, and mortality rates for these diseases and injuries often are greater among blacks than whites. In addition, three of the 10 leading causes of death for non-Hispanic blacks are not among the leading causes of death for non-Hispanic whites: homicide (sixth), human immunodeficiency virus (HIV) disease (seventh), and septicemia (ninth). This week's MMWR is the third in a series focusing on racial/ethnic health disparities. Eliminating these disparities will require culturally appropriate public health initiatives, community support, and equitable access to quality health care.

  2. A Community Health Advisor Program to reduce cardiovascular risk among rural African-American women.

    PubMed

    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

    2009-08-01

    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 training, community intervention and maintenance. Formative data collected to develop the training, intervention and evaluation methods and materials indicated the need for programs to increase knowledge, skills and resources for changing behaviors that increase the risk of CVD. CHAs worked in partnership with staff to develop, implement, evaluate and maintain strategies to reduce risk for CVD in women and to influence city officials, business owners and community coalitions to facilitate project activities. Process data documented sustained increases in social capital and community capacity to address health-related issues, as well as improvements in the community's physical infrastructure. This project is unique in that it documents that a comprehensive CHA-based intervention for CVD can facilitate wide-reaching changes in capacity to address health issues in a rural community that include improvements in community infrastructure and are sustained beyond the scope of the originally funded intervention.

  3. A Community Health Advisor Program to reduce cardiovascular risk among rural African-American women

    PubMed Central

    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 training, community intervention and maintenance. Formative data collected to develop the training, intervention and evaluation methods and materials indicated the need for programs to increase knowledge, skills and resources for changing behaviors that increase the risk of CVD. CHAs worked in partnership with staff to develop, implement, evaluate and maintain strategies to reduce risk for CVD in women and to influence city officials, business owners and community coalitions to facilitate project activities. Process data documented sustained increases in social capital and community capacity to address health-related issues, as well as improvements in the community’s physical infrastructure. This project is unique in that it documents that a comprehensive CHA-based intervention for CVD can facilitate wide-reaching changes in capacity to address health issues in a rural community that include improvements in community infrastructure and are sustained beyond the scope of the originally funded intervention. PMID:19047648

  4. Genome-Wide Association Study in African-Americans with Systemic Lupus Erythematosus

    DTIC Science & Technology

    2013-09-01

    Americans with Systemic Lupus Erythematosus PRINCIPAL INVESTIGATOR: John Harley, M.D., Ph.D...September 2012 – 31 August 2013 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Genome-Wide Association Study in African-Americans with Systemic Lupus ...SUPPLEMENTARY NOTES 14. ABSTRACT Systemic lupus erythematosus ( lupus ) is a potentially deadly systemic autoimmune disease that disproportionately

  5. 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.

  6. [Economics of health system transformation].

    PubMed

    González Pier, Eduardo

    2012-01-01

    Health conditions in Mexico have evolved along with socioeconomic conditions. As a result, today's health system faces several problems characterized by four overlapping transitions: demand, expectations, funding and health resources. These transitions engender significant pressures on the system itself. Additionally, fragmentation of the health system creates disparities in access to services and generates problems in terms of efficiency and use of available resources. To address these complications and to improve equity in access and efficiency, thorough analysis is required in how the right to access health care should be established at a constitutional level without differentiating across population groups. This should be followed by careful discussion about what rules of health care financing should exist, which set of interventions ought to be covered and how services must be organized to meet the health needs of the population.

  7. African communalism and public health policies: the relevance ofindigenous concepts of personal identity to HIV/AIDS policies in Botswana.

    PubMed

    Jensen, Kipton; Gaie, Joseph Br

    2010-09-01

    This article explores the possible relevance of African communalism to HIV/AIDS policies in Botswana and other parts of sub-Saharan Africa. We examine various interpretations of African communalism, which many consider to be the cardinal insight of African thought. We suggest several applications of this indigenous notion of personhood to HIV prevention in general and to routine HIV-testing policies in particular. This analysis demonstrates some of the ethical dilemmas and cultural complexities inherent in designing as well as implementing effective HIV-prevention programmes that strike a conscientious balance between protecting individual freedoms and securing public health. Recovering past traditions (such as African conceptions of personal identity) is valuable not only for the purpose of self-identification but also for helping us meet the challenges and problems of today in Africa. We also suggest that the human-rights-based approach to HIV prevention, which strives to protect individuals, is possibly incompatible with the socio-ethical ideals espoused by African communalism. We conclude that public health programmes in Botswana and other parts of sub-Saharan Africa would be more effective if those who designed and implemented them possessed a better understanding of indigenous conceptions of personhood or human agency as well as existing ethno-medical beliefs and cultural practices.

  8. 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,…

  9. 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

  10. The roles of spirituality in the relationship between traumatic life events, mental health, and drug use among African American women

    PubMed Central

    Staton-Tindall, Michele; Duvall, Jamieson; Stevens-Watkins, Danelle; Oser, Carrie B.

    2013-01-01

    This study examines the role of spirituality as a moderator of the relationship between traumatic life experiences, mental health, and drug use in a sample of African American women. It was hypothesized that there would be an inverse relationship overall between spirituality and mental health and drug use among this sample of African American women. Secondly, was expected that spirituality would moderate the relationship between traumatic life events and mental health and drug use. African American women (n=206) were recruited from the community and from probation officers in three urban areas of a southern state, and face-to-face interviews were completed. Findings indicated that there was a main effect for spirituality (as measured by existential well-being on the Spiritual Well-Being Scale) and traumatic life events, mental health, and alcohol use. In addition, spirituality was a significant moderator of the relationship between traumatic life events and cocaine use. Discussion and implications for African American women are included. PMID:24041186

  11. Factors that Adversely Affect the Health and Well-Being of African-American Adolescent Mothers and Their Infants.

    ERIC Educational Resources Information Center

    Barnett, Alva P.

    1989-01-01

    Describes the negative impact of the following factors on African-American adolescent pregnancy and motherhood: (1) age; (2) nutrition; (2) family income; and (3) availability and accessibility of health care services. Briefly discusses socio-culturally relevant intervention strategies. (FMW)

  12. Differences in African American and White College Students' Drinking Behaviors: Consequences, Harm Reduction Strategies, and Health Information Sources

    ERIC Educational Resources Information Center

    Siebert, Darcy Clay; Wilke, Dina J.; Delva, Jorge; Smith, Michael P.; Howell, Richard L.

    2003-01-01

    The authors explored the differences between African American and White college students' drinking behaviors and their attitudes toward consequences, harm-reduction strategies, and health information sources. They collected data from a randomly selected sample of 1,110 students in a large public university to examine the effects of a high-risk…

  13. 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…

  14. 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…

  15. 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…

  16. 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…

  17. 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 &…

  18. 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 of…

  19. 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.…

  20. Ugba, the fermented African oilbean seeds; its production, chemical composition, preservation, safety and health benefits.

    PubMed

    Ogueke, C C; Nwosu, J N; Owuamanam, C I; Iwouno, J N

    2010-05-15

    Ugba is the Ibo name of the fermented African Oilbean seeds (Pentaclethra macrophylla, Benth). It is a traditional food condiment generally produced by natural (local) fermentation in homes as a small family business. It is an important and cheap source of protein for people whose staple foods are deficient in proteins. It is also eaten as a delicacy and used as flavouring for soup. This write up aims to review all published studies on ugba in the direction of the various methods used in the production, the chemical composition of the seeds, the microorganisms involved and the biochemical changes that occur during fermentation and optimization of the fermentation. The nutritional and food values, toxicological properties, health promoting potentials, microbiological safety as well as the storage and preservation have also been highlighted.

  1. "They read [the truth] in your blood": African American women and perceptions of HIV health.

    PubMed

    O'Daniel, Alyson J

    2014-01-01

    In this article I examine variations in the ways in which low-income HIV-positive African American women in Midway, North Carolina engaged with and made meaningful laboratory-based knowledge of HIV disease. I highlight how women's engagement with "blood-work," as it was popularly called, reflected perceptions of survival with HIV disease and the material conditions and social relations in which these perceptions were embedded. Focusing less on the diagnostics themselves and more on the social contexts in which they became socially significant for study participants, I assert that "blood-work" provided a multiply constituted lens through which women expressed their subject positions and attendant material conditions within the context of a public health care program shaped by values associated with global neoliberalism.

  2. 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.

  3. 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.

  4. Relationship between symptoms of depression, functional health status, and chronic disease among a residential sample of African Americans.

    PubMed

    Larson, Celia; Belue, Rhonda; Schlundt, David G; McClellan, Linda

    2006-01-01

    Depression and psychological distress often go unrecognized and untreated in primary care settings. The association between depression, socioeconomic status, and chronic disease underscore the importance of incorporating mental health education and screening into community-based health initiatives. This is particularly critical for African Americans who bear a disproportionate burden of poverty and chronic disease. This descriptive study assessed associations between symptoms of depression, socioeconomic status, healthcare utilization, physical and mental health functioning, and reactions to race among a sample of low-income African Americans. Consistent with the findings of previous research, respondents with symptoms of depression reported lower levels of physical and mental health functioning, and perceived that they had been treated worse by others at work, and had worse healthcare experiences than those of other races. Community-based programs for reducing disparities in physical illness may need to address the burden of undiagnosed and untreated depression in order to become optimally effective.

  5. Depression: the 'invisible grey fog' influencing the midlife health of African Canadian women.

    PubMed

    Etowa, Josephine; Keddy, Barbara; Egbeyemi, Julius; Eghan, Felicia

    2007-06-01

    Depression is a topic that is often avoided in discussions among Black women for a myriad of reasons. The purpose of this study was to investigate the midlife health of Black women living in the province of Nova Scotia, Canada. This paper will present one of the key findings of this research; midlife depression. It will examine the factors associated with depression among mid-life African Canadian women and how these women deal with depression. A triangulation of qualitative and quantitative methods guided by the principles of participatory action research (PAR) was used in the study. Data collection methods included 50 in-depth interviews of mid-life African Canadian women aged 40-65, focus groups, and workshops as well as the CES-D structured instrument. Purposive sampling method was the primary recruitment strategy and 113 people participated in the study. Although the women rarely openly discussed depression, they described depression as emotional feelings that range from "feeling blue" to being clinically depressed. Women viewed midlife depression as the consequence of a complex set of circumstances and stressors that they face. At midlife, Black women frequently recognize the importance of greater self-care and the need to pay more attention to their health, but they are reluctant to do so because they have to be "strong" in order to deal with their daily experiences of racism. Racism, among other things, leads to accumulated stress and undermines Black women's ability to cope and make healthy life choices. This signifies the implications of these research findings for clinical practice.

  6. TRICARE, Military Health System

    MedlinePlus

    ... Preventive Services Healthy Living Enter Profile Get My Plan Info Service Status Countries Zip Code Enter valid ... My Military Health Record Less Find a TRICARE Plan Answer some questions to find the right TRICARE ...

  7. Barriers and Motivators to Participating in mHealth Research Among African American Men.

    PubMed

    James, Delores C S; Harville, Cedric

    2015-12-03

    Most African American (AA) men own a smartphone, which positions them to be targeted for a variety of programs, services, and health interventions using mobile devices (mHealth). The goal of this study was to assess AA men's use of technology and the barriers and motivators to participating in mHealth research. A self-administered survey was completed by 311 men. Multinomial logistic regression examined associations between three age groups (18-29 years, 30-50 years, and 51+ years), technology access, and motivators and barriers to participating in mHealth research. Sixty-five percent of men owned a smartphone and a laptop. Men aged 18 to 29 years were more likely willing to use a health app and smartwatch/wristband monitor than older men (p < .01). Men aged 18 to 29 years were also more likely than older men to be motivated to participate for a free cell phone/upgraded data plan and contribution to the greater good (p < .05). Older men were more likely than younger ones to be motivated to become more educated about the topic (p < .05). Younger men were more likely than older ones to report lack of interest in the topic as a barrier to participating (p < .01), while older men were more likely than younger ones to cite lack of research targeted to minority communities as a barrier (p < .05). This study suggests that culturally tailored mHealth research using smartphones may be of interest to AA men interested in risk reduction and chronic disease self-management. Opportunities also exist to educate AA men about the topic at hand and why minority men are being targeted for the programs and interventions.

  8. Actor interfaces and practices of power in a community health worker programme: a South African study of unintended policy outcomes.

    PubMed

    Lehmann, Uta; Gilson, Lucy

    2013-07-01

    This paper makes a contribution to a much-neglected aspect of policy analysis: the practice of power in implementation. Practices of power are at the heart of every policy process, yet are rarely explicitly explored in the health policy literature. This paper provides a detailed study of micro-practices of power by those at the frontline of service delivery in the implementation of a national community health worker policy in one rural South African sub-district. The paper is based on a small-scale qualitative study which collected data through observations, interviews and focus group discussions with health services and facility managers, community health workers and community members. Practices of power were analysed using VeneKlasen and Miller's categorization of multiple dimensions of power, as power over, power with, power to and power within. Furthermore, the concept of 'actor interface analysis' allowed exploration of different actors' experience, interests and their specific location in the landscape of local health system governance. The study revealed that almost all policy actors exercised some form of power, from authoritative power, derived from hierarchy and budget control, to the discretionary power of those working at lower levels to withhold labour or organize in-service training. Each of these practices of power had their rationale in different actors' efforts to make the intervention 'fit' their understandings of local reality. While each had a limited impact on policy outcomes, their cumulative effect produced a significant thinning down of the policy's intent. However, discretionary power was not always used to undermine policy. One manager's use of discretionary power in fact led to a partial reconstruction of the original policy intent. The paper concludes that understanding and being responsive to the complexity of local realities, interests and contexts and the multi-layered practices of power may allow managers to adopt more appropriate

  9. The Southern African Centre for Infectious Disease Surveillance: A One Health Consortium

    PubMed Central

    Rweyemamu, Mark M.; Mmbuji, Peter; Karimuribo, Esron; Paweska, Janusz; Kambarage, Dominic; Neves, Luis; Kayembe, Jean-Marie; Mweene, Aaron; Matee, Mecky

    2013-01-01

    Formed in 2008, the Southern African Centre for Infectious Disease Surveillance (SACIDS) is a One Health consortium of academic and research institutions involved with infectious diseases of humans and animals. Operating in partnership with world-renowned centres of research in industrialised countries, its mission is to harness innovations in science and technology for improving southern Africa's capacity to detect, identify, monitor (DIM) and manage the risk posed by infectious diseases of humans, animals, and ecosystems. The consortium's major capacity development activities include a series of One Health-based Master of Science (MSc) courses and a five-year DIM-driven research program. Additionally, SACIDS organized Africa's first One Health conference, in July 2011. This paper describes these and other major activities that SACIDS has undertaken to improve infectious disease surveillance across southern Africa. The paper also describes the role and collaboration of SACIDS with other national, regional and international consortia/networks that share a vision and interest in promoting novel approaches to infectious disease surveillance and outbreak response. PMID:23362417

  10. The Southern African Centre for infectious disease surveillance: a one health consortium.

    PubMed

    Rweyemamu, Mark M; Mmbuji, Peter; Karimuribo, Esron; Paweska, Janusz; Kambarage, Dominic; Neves, Luis; Kayembe, Jean-Marie; Mweene, Aaron; Matee, Mecky

    2013-01-01

    Formed in 2008, the Southern African Centre for Infectious Disease Surveillance (SACIDS) is a One Health consortium of academic and research institutions involved with infectious diseases of humans and animals. Operating in partnership with world-renowned centres of research in industrialised countries, its mission is to harness innovations in science and technology for improving southern Africa's capacity to detect, identify, monitor (DIM) and manage the risk posed by infectious diseases of humans, animals, and ecosystems. The consortium's major capacity development activities include a series of One Health-based Master of Science (MSc) courses and a five-year DIM-driven research program. Additionally, SACIDS organized Africa's first One Health conference, in July 2011. This paper describes these and other major activities that SACIDS has undertaken to improve infectious disease surveillance across southern Africa. The paper also describes the role and collaboration of SACIDS with other national, regional and international consortia/networks that share a vision and interest in promoting novel approaches to infectious disease surveillance and outbreak response.

  11. Contextual factors influencing health-related quality of life in African American and Latina breast cancer survivors

    PubMed Central

    Miller, Aria M.; Ashing, Kimlin Tam; Modeste, Naomi N.; Herring, R. Patti; Sealy, Diadrey-Anne T.

    2015-01-01

    Purpose This study explored the relationships between systemic and individual-level contextual factors and health-related quality of life (HRQOL) in a cohort of African American and Latina breast cancer survivors (BCS). Methods Baseline questionnaire data of 320 BCS who participated in a HRQOL psycho-educational intervention were abstracted from the parent study. Hierarchical regression analysis tested the independent effects of contextual factors on HRQOL. Results HRQOL was higher in BCS who: were diagnosed at health care (b=0.20, p<0.001), had fewer comorbidities (b=−0.60, p<0.001) and depressive symptoms (b=−0.30, p<0.001), and practiced healthy diet and exercise habits (b=0.02, p<0.05). Demographic and cancer-related factors accounted for 14 % of the variance in HRQOL (F[6, 274]= 7.25, p<0.001). The socio-cultural context (i.e., ethnicity, life stress, perceived social support) explained 20% of the variance in HRQOL (FΔ[3, 271]=27.32, p<0.001). The health care system context contributed an additional 8 % to explaining HRQOL (FΔ[1, 270]=34.88, p<0.001). Health status and behavioral factors accounted for 18 % of the variance (FΔ[4, 266]=29.55, p<0.001). The full model explained 59 % of the variance in HRQOL (F[14, 266]=27.76, p<0.001). Conclusions HRQOL in ethnic minority BCS is multifaceted and is significantly influenced by cancer-related, socio-cultural, health care system, health status, and behavioral contextual factors. Therefore, survivorship research and practice must address broad multi-level domains to achieve equitable and optimal breast cancer outcomes. Implications for cancer survivors To enhance HRQOL, survivors must be provided the know-how and support to maintain healthy lifestyle and self-management practices. Advocates must engage the care team to consider systemic factors, including life stress and community resources, to be more patient-centered. PMID:25576214

  12. [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.

  13. 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

  14. Adiponectin pathway polymorphisms and risk of breast cancer in African Americans and Hispanics in the Women's Health Initiative.

    PubMed

    Kaklamani, Virginia G; Hoffmann, Thomas J; Thornton, Timothy A; Hayes, Geoffrey; Chlebowski, Rowan; Van Horn, Linda; Mantzoros, Christos

    2013-06-01

    Adiponectin, a protein secreted by the adipose tissue, is an endogenous insulin sensitizer with circulating levels that are decreased in obese and diabetic subjects. Recently, circulating levels of adiponectin have been correlated with breast cancer risk. Our previous work showed that polymorphisms of the adiponectin pathway are associated with breast cancer risk. We conducted the first study of adiponectin pathways in African Americans and Hispanics in the Women's Health Initiative SNP Health Association Resource cohort of 3,642 self-identified Hispanic women and 8,515 self-identified African American women who provided consent for DNA analysis. Single nucleotide polymorphisms (SNPs) from three genes were included in this analysis: ADIPOQ, ADIPOR1, and ADIPOR2. The genome-wide human SNP array 6.0 (909,622 SNPs) ( www.affymetrix.com ) was used. We found that rs1501299, a functional SNP of ADIPOQ that we previously reported was associated with breast cancer risk in a mostly Caucasian population, was also significantly associated with breast cancer incidence (HR for the GG/TG genotype: 1.23; 95 % CI 1.059-1.43) in African American women. We did not find any other SNPs in these genes to be associated with breast cancer incidence. This is the first study assessing the role of adiponectin pathway SNPs in breast cancer risk in African Americans and Hispanics. RS1501299 is significantly associated with breast cancer risk in African American women. As the rates of obesity and diabetes increase in African Americans and Hispanics, adiponectin and its functional SNPs may aid in breast cancer risk assessment.

  15. The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems

    PubMed Central

    Welcome, Menizibeya Osain

    2011-01-01

    Objectives: As an important element of national security, public health not only functions to provide adequate and timely medical care but also track, monitor, and control disease outbreak. The Nigerian health care had suffered several infectious disease outbreaks year after year. Hence, there is need to tackle the problem. This study aims to review the state of the Nigerian health care system and to provide possible recommendations to the worsening state of health care in the country. To give up-to-date recommendations for the Nigerian health care system, this study also aims at reviewing the dynamics of health care in the United States, Britain, and Europe with regards to methods of medical intelligence/surveillance. Materials and Methods: Databases were searched for relevant literatures using the following keywords: Nigerian health care, Nigerian health care system, and Nigerian primary health care system. Additional keywords used in the search were as follows: United States (OR Europe) health care dynamics, Medical Intelligence, Medical Intelligence systems, Public health surveillance systems, Nigerian medical intelligence, Nigerian surveillance systems, and Nigerian health information system. Literatures were searched in scientific databases Pubmed and African Journals OnLine. Internet searches were based on Google and Search Nigeria. Results: Medical intelligence and surveillance represent a very useful component in the health care system and control diseases outbreak, bioattack, etc. There is increasing role of automated-based medical intelligence and surveillance systems, in addition to the traditional manual pattern of document retrieval in advanced medical setting such as those in western and European countries. Conclusion: The Nigerian health care system is poorly developed. No adequate and functional surveillance systems are developed. To achieve success in health care in this modern era, a system well grounded in routine surveillance and medical

  16. Experiences of African immigrant women living with HIV in the U.K.: implications for health professionals.

    PubMed

    Ndirangu, Eunice W; Evans, Catrin

    2009-04-01

    In the U.K. immigrant women from Africa constitute an increasingly large proportion of newly diagnosed cases of HIV. A significant minority of these are refugees and asylum seekers. Very little is known about their experiences of living with HIV/AIDS, their psychosocial needs or their views of health care provision. This paper reports the results of a qualitative study that explored these issues by interviewing eight African women living with HIV in the British city of Nottingham. Women's ability to live positively with HIV was found to be strongly shaped by their migration history, their legal status, their experience of AIDS-related stigma and their Christian faith. Significantly, health services were represented as a safe social space, and were highly valued as a source of advice and support. The findings indicate that non-judgemental, personalised health care plays a key role in encouraging migrant African women to access psychosocial support and appropriate HIV services.

  17. Maternal & Newborn Health Road Maps: a review of progress in 33 sub-Saharan African countries, 2008-2009.

    PubMed

    Ekechi, Christine; Wolman, Yaron; de Bernis, Luc

    2012-06-01

    The 2006 Maputo Plan of Action aimed to help African nations to achieve the Millennium Development Goals related to reducing maternal mortality, combatting HIV and AIDS, and reducing infant and child mortality within integrated sexual and reproductive health care plans. In 2008 and 2009, UNFPA worked with senior Ministry of Health officials and national UNFPA, UNICEF and WHO teams in 33 African countries to review their development of national Maternal and Newborn Health strategies and plans through a self-assessment survey. The survey showed that many key components were missing, in particular there was poor integration of family planning; lack of budgetary, infrastructure and human resources plans; and weak monitoring and evaluation provisions. The maternal and newborn health Road Map initiative has been the single most important factor for the initiation and development of the national maternal and newborn health plans for many African countries. However the deficiencies within these national plans need to be addressed before a significant reduction in maternal and newborn mortality can realistically be achieved.

  18. [The health system of Cuba].

    PubMed

    Domínguez-Alonso, Emma; Zacea, Eduardo

    2011-01-01

    This paper describes the health conditions in Cuba and the general characteristics of the Cuban health system, including its structure and coverage, its financial sources, its health expenditure, its physical, material and human resources, and its stewardship functions. It also discusses the increasing importance of its research institutions and the role played by its users in the operation and evaluation of the system. Salient among the social actors involved in the health sector are the Cuban Women Federation and the Committees for the Defense of the Revolution. The paper concludes with the discussion of the most recent innovations implemented in the Cuban health system, including the cardiology networks, the Miracle Mission (Misión Milagro) and the Battle of Ideas (Batalla de Ideas).

  19. 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

  20. An evaluation of the competencies of primary health care clinic nursing managers in two South African provinces

    PubMed Central

    Munyewende, Pascalia O.; Levin, Jonathan; Rispel, Laetitia C.

    2016-01-01

    Background Managerial competencies to enhance individual and organisational performance have gained currency in global efforts to strengthen health systems. Competent managers are essential in the implementation of primary health care (PHC) reforms that aim to achieve universal health coverage. Objective To evaluate the competencies of PHC clinic nursing managers in two South African provinces. Design A cross-sectional study was conducted in two South African provinces. Using stratified random sampling, 111 PHC clinic nursing managers were selected. All supervisors (n=104) and subordinate nurses (n=383) were invited to participate in the survey on the day of data collection. Following informed consent, the nursing managers, their supervisors, and subordinate nurses completed a 40-item, 360-degree competency assessment questionnaire, with six domains: communication, leadership and management, staff management, financial management, planning and priority setting, and problem-solving. Standard deviations, medians, and inter-quartile ranges (IQRs) were computed separately for PHC nursing managers, supervisors, and subordinate nurses for competencies in the six domains. The Tinsley and Weiss index was used to assess agreement between each of the three possible pairs of raters. Results A 95.4% response rate was obtained, with 105 nursing managers in Gauteng and Free State completing the questionnaires. There was a lack of agreement about nursing managers’ competencies among the three groups of raters. Overall, clinic nursing managers rated themselves high on the five domains of communication (8.6), leadership and management (8.67), staff management (8.75), planning and priority setting (8.6), and problem-solving (8.83). The exception was financial management with a median score of 7.94 (IQR 6.33–9.11). Compared to the PHC clinic managers, the supervisors and subordinate nurses gave PHC nursing managers lower ratings on all six competency domains, with the lowest

  1. An evaluation of the competencies of primary health care clinic nursing managers in two South African provinces.

    PubMed

    Munyewende, Pascalia O; Levin, Jonathan; Rispel, Laetitia C

    2016-01-01

    Background Managerial competencies to enhance individual and organisational performance have gained currency in global efforts to strengthen health systems. Competent managers are essential in the implementation of primary health care (PHC) reforms that aim to achieve universal health coverage. Objective To evaluate the competencies of PHC clinic nursing managers in two South African provinces. Design A cross-sectional study was conducted in two South African provinces. Using stratified random sampling, 111 PHC clinic nursing managers were selected. All supervisors (n=104) and subordinate nurses (n=383) were invited to participate in the survey on the day of data collection. Following informed consent, the nursing managers, their supervisors, and subordinate nurses completed a 40-item, 360-degree competency assessment questionnaire, with six domains: communication, leadership and management, staff management, financial management, planning and priority setting, and problem-solving. Standard deviations, medians, and inter-quartile ranges (IQRs) were computed separately for PHC nursing managers, supervisors, and subordinate nurses for competencies in the six domains. The Tinsley and Weiss index was used to assess agreement between each of the three possible pairs of raters. Results A 95.4% response rate was obtained, with 105 nursing managers in Gauteng and Free State completing the questionnaires. There was a lack of agreement about nursing managers' competencies among the three groups of raters. Overall, clinic nursing managers rated themselves high on the five domains of communication (8.6), leadership and management (8.67), staff management (8.75), planning and priority setting (8.6), and problem-solving (8.83). The exception was financial management with a median score of 7.94 (IQR 6.33-9.11). Compared to the PHC clinic managers, the supervisors and subordinate nurses gave PHC nursing managers lower ratings on all six competency domains, with the lowest rating

  2. 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.

  3. Adverse events and placebo effects: African scientists, HIV, and ethics in the 'global health sciences'.

    PubMed

    Crane, Johanna

    2010-12-01

    This paper builds on the growing literature in 'postcolonial technoscience' by examining how science and ethics travel in transnational HIV research. I use examples of two controversial US-funded studies of mother-to-child transmission in Africa as case studies through which to explore quandaries of difference and inequality in global health research. My aim is not to adjudicate the debates over these studies, but rather to raise some questions about transnational research, science, and ethics that often get lost in public controversies over the moral status of such trials. Using interviews conducted with American and Ugandan HIV researchers as well as relevant material published in the popular and medical press, I argue that debates over research practice and the conditions under which practices are deemed ethically legitimate or questionable reflect the challenges faced by African researchers seeking to participate in global health science. In doing so, I show how questions of scientific legitimacy and authority are played out in debates over who decides what constitutes 'the normal' in human biological research and who can legitimately 'speak for Africa' regarding the ethics of research design and practice. I conclude that researchers from'resource-poor settings' must often walk a tightrope between claims of difference from the global North and assertions of sameness, in which a claim too forceful in either direction can undermine the ethical--and thus scientific--legitimacy of their research.

  4. 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.

  5. Digital divide and stability of access in African American women visiting urban public health centers.

    PubMed

    Haughton, Lorna Tanya; Kreuter, Matthew; Hall, Jasmine; Holt, Cheryl L; Wheetley, Eric

    2005-05-01

    This exploratory study examines access to communication technologies, its association with health-related variables and study attrition, and its stability over time in a study of lower income African American women visiting urban public health centers. Participants (n = 1,227) provided information about cancer-related behaviors in a baseline questionnaire that also assessed their e-mail and cell phone/pager access. Interviews conducted at 1-, 6-, and 18-month follow up determined attrition, and an e-mail message sent to participants at 6-month follow up determined stability of access. Fewer than 10% of women reported e-mail access; 26% reported cell/phone pager access. At 6-month follow up, 45% of e-mail accounts were inactive; accounts from pay access providers were more likely to be inactive than work- or school-based accounts (58% versus 25%). Cell phone/pager access was positively associated with mammography knowledge. Attrition rates were lower among women with access than among those without access. Priorities for future research based on these preliminary findings are discussed.

  6. Systemic Intervention for Public Health

    PubMed Central

    Midgley, Gerald

    2006-01-01

    Many calls have been made for a systems approach to public health. My response is to offer a methodology for systemic intervention that (1) emphasizes the need to explore stakeholder values and boundaries for analysis, (2) challenges marginalization, and (3) draws upon a wide range of methods (from the systems literature and beyond) to create a flexible and responsive systems practice. I present and discuss several well-tested methods with a view to identifying their potential for supporting systemic intervention for public health. PMID:16449577

  7. ‘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

  8. Systems of Social Support in Families Who Care for Dependent African American Elders

    ERIC Educational Resources Information Center

    Williams, Sharon Wallace; Dilworth-Anderson, Peggye

    2002-01-01

    Purpose: This study examined connections (linking, compensatory, or none) between three systems of social support (informal, church, and formal). Predictors of each system were also examined. Design and Methods: A community sample of 187 caregivers who provided care to older African American participants in the Duke Established Populations for…

  9. 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.

  10. Advancing understanding of the sustainability of lay health advisor (LHA) programs for African-American women in community settings.

    PubMed

    Shelton, Rachel C; Charles, Thana-Ashley; Dunston, Sheba King; Jandorf, Lina; Erwin, Deborah O

    2017-03-23

    Lay health advisor (LHA) programs have made strong contributions towards the elimination of health disparities and are increasingly being implemented to promote health and prevent disease. Developed in collaboration with African-American survivors, the National Witness Project (NWP) is an evidence-based, community-led LHA program that improves cancer screening among African-American women. NWP has been successfully disseminated, replicated, and implemented nationally in over 40 sites in 22 states in diverse community settings, reaching over 15,000 women annually. We sought to advance understanding of barriers and facilitators to the long-term implementation and sustainability of LHA programs in community settings from the viewpoint of the LHAs, as well as the broader impact of the program on African-American communities and LHAs. In the context of a mixed-methods study, in-depth telephone interviews were conducted among 76 African-American LHAs at eight NWP sites at baseline and 12-18 months later, between 2010 and 2013. Qualitative data provides insight into inner and outer contextual factors (e.g., community partnerships, site leadership, funding), implementation processes (e.g., training), as well as characteristics of the intervention (e.g., perceived need and fit in African-American community) and LHAs (e.g., motivations, burnout) that are perceived to impact the continued implementation and sustainability of NWP. Factors at the contextual levels and related to motivations of LHAs are critical to the sustainability of LHA programs. We discuss how findings are used to inform (1) the development of the LHA Sustainability Framework and (2) strategies to support the continued implementation and sustainability of evidence-based LHA interventions in community settings.

  11. [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.

  12. [The health system of Bolivia].

    PubMed

    Ledo, Carmen; Soria, René

    2011-01-01

    This paper describes the Bolivian health system, including its structure and organization, its financing sources, its health expenditure, its physical, material and humans resources, its stewardship activities and the its health research institutions. It also discusses the most recent policy innovations developed in Bolivia: the Maternal and Child Universal Insurance, the Program for the Extension of Coverage to Rural Areas, the Family, Community and Inter-Cultural Health Model and the cash-transfer program Juana Azurduy intended to strengthen maternal and child care.

  13. Conceptualizing perceived racism and its effect on the health of African-Americans: implications for practice and research.

    PubMed

    Dailey, Dawn E

    2008-07-01

    The focus on racial health inequities has resurged. Although the reasons are complex, the consequences of racism are potentially contributing factors. This article aims to advance the concept of perceived racism as an area of focus for health inequity research by describing a framework within which to examine health outcomes that are associated with perceived racism. Perceived racism is defined as the subjective interpretation by the effected individual of an event, situation, or experience as negative, unjust, or undignified and one that solely occurs due to one's racial background. The framework establishes race as a determinant in health outcomes and it depicts the multidimensional contexts of racism. The model identifies physical, psychological, and behavioral pathways affecting health outcomes and personal, cultural, and social resources as mediating factors. Perceived racism can potentially permeate the lives of African-Americans and can profoundly impact their health and well being. The principles of concept clarification were applied to explore the association between perceived racism and health.

  14. Fatalistic Cancer Beliefs and Information Seeking in Formerly Incarcerated African-American and Hispanic Men: Implications for Cancer Health Communication and Research.

    PubMed

    Valera, Pamela; Lian, Zi; Brotzman, Laura; Reid, Andrea

    2017-03-03

    African-American and Hispanic men are disproportionately affected by cancer experiencing higher rates of cancer-related morbidity and mortality for many cancers (but not all). These challenges may be magnified for a subpopulation of African-American and Hispanic men who have been incarcerated. A survey assessing demographics, incarceration experience, psychosocial, behavioral, and cancer health information seeking was administered to 230 previously incarcerated men aged 35 years and older. Data analysis was performed to assess the association between fatalism, perceived susceptibility, and health information seeking in this population. This study revealed the following: the majority of the participants (68.7%) held the fatalistic belief: "When I think of cancer, I automatically think of death." Second, the fatalistic belief, "There's not much you can do to lower your chances of getting cancer," is more prevalent among those who perceived a higher risk of developing cancer. Third, older participants (those between 55 and 70 years old) and widowed are less likely to think of death when they think of cancer. In addition, those who use the Internet to look for health or medical information (i.e., engaging in health information seeking) are less likely to agree with the fatalistic belief: "It seems like everything causes cancer." Given the high incidence of certain cancers among African-American and Hispanic men and the vulnerability of those involved in the criminal justice system, our findings highlight the importance of understanding perceived susceptibility to cancer, fatalistic beliefs about cancer, and information seeking in formerly incarcerated men.

  15. Associations of government health expenditures, the supply of health care professionals, and country literacy with prenatal care use in ten West African countries.

    PubMed

    Taylor, Yhenneko J; Laditka, Sarah B; Laditka, James N; Brunner Huber, Larissa R; Racine, Elizabeth F

    2017-03-01

    Social and health care context may influence prenatal care use. We studied associations of government health expenditures, supply of health care professionals, and country literacy rates with prenatal care use in ten West African countries, controlling for individual factors. We used data from Demographic and Health Surveys (n = 58,512) and random effect logistic regression models to estimate the likelihood of having any prenatal care and adequate prenatal care. Each percentage increase in the literacy rate was associated with 4% higher odds of having adequate prenatal care (p = .029). Higher literacy rates among women may help to promote adequate prenatal care.

  16. [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.

  17. [The health system of Guatemala].

    PubMed

    Becerril-Montekio, Víctor; López-Dávila, Luis

    2011-01-01

    This paper describes the health conditions in Guatemala and, in more detail, the characteristics of the Guatemalan health system, including its structure en coverage, its financial sources, the stewardship functions developed by the Ministry of Health, as well as the generation of health information and the development of research activities. It also discusses the recent efforts to extend coverage of essential health services, mostly to poor rural areas.The most recent innovations also discussed in this paper include the Program for the Expansion of Coverage of Essential Services, the Program to Expand Access to Essential Drugs and the agreements between the Ministry of Health and several non-governmental organizations to provide essential services in rural settings.

  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

    2016-07-04

    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.

  19. 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

  20. Reducing Low Birth Weight among African Americans in the Midwest: A Look at How Faith-Based Organizations Are Poised to Inform and Influence Health Communication on the Developmental Origins of Health and Disease (DOHaD)

    PubMed Central

    Lumpkins, Crystal Y.; Saint Onge, Jarron M.

    2017-01-01

    Low birth weight (LBW) rates remain the highest among African Americans despite public health efforts to address these disparities; with some of the highest racial disparities in the Midwest (Kansas). The Developmental Origins of Health and Disease (DOHaD) perspective offers an explanation for how LBW contributes to racial health disparities among African Americans and informs a community directed health communication framework for creating sustainable programs to address these disparities. Trusted community organizations such as faith-based organizations are well situated to explain health communication gaps that may occur over the life course. These entities are underutilized in core health promotion programming targeting underserved populations and can prove essential for addressing developmental origins of LBW among African Americans. Extrapolating from focus group data collected from African American church populations as part of a social marketing health promotion project on cancer prevention, we theoretically consider how a similar communication framework and approach may apply to address LBW disparities. Stratified focus groups (n = 9) were used to discover emergent themes about disease prevention, and subsequently applied to explore how faith-based organizations (FBOs) inform strategic health care (media) advocacy and health promotion that potentially apply to address LBW among African Americans. We argue that FBOs are poised to meet health promotion and health communication needs among African American women who face social barriers in health. PMID:28165368

  1. Reducing Low Birth Weight among African Americans in the Midwest: A Look at How Faith-Based Organizations Are Poised to Inform and Influence Health Communication on the Developmental Origins of Health and Disease (DOHaD).

    PubMed

    Lumpkins, Crystal Y; Saint Onge, Jarron M

    2017-02-04

    Low birth weight (LBW) rates remain the highest among African Americans despite public health efforts to address these disparities; with some of the highest racial disparities in the Midwest (Kansas). The Developmental Origins of Health and Disease (DOHaD) perspective offers an explanation for how LBW contributes to racial health disparities among African Americans and informs a community directed health communication framework for creating sustainable programs to address these disparities. Trusted community organizations such as faith-based organizations are well situated to explain health communication gaps that may occur over the life course. These entities are underutilized in core health promotion programming targeting underserved populations and can prove essential for addressing developmental origins of LBW among African Americans. Extrapolating from focus group data collected from African American church populations as part of a social marketing health promotion project on cancer prevention, we theoretically consider how a similar communication framework and approach may apply to address LBW disparities. Stratified focus groups (n = 9) were used to discover emergent themes about disease prevention, and subsequently applied to explore how faith-based organizations (FBOs) inform strategic health care (media) advocacy and health promotion that potentially apply to address LBW among African Americans. We argue that FBOs are poised to meet health promotion and health communication needs among African American women who face social barriers in health.

  2. Challenge!: A Mentorship Model of Health Promotion and Obesity Prevention Among Urban, African American Adolescents

    PubMed Central

    Black, Maureen M.; Hager, Erin; Le, Katherine; Anliker, Jean; Arteaga, S. Sonia; DiClemente, Carlo; Gittelsohn, Joel; Levy, Lauren; Magder, Laurence; Papas, Mia; Shebl, Fatma; Snitker, Soren; Treuth, Margarita S.; Wang, Yan

    2014-01-01

    Objective To evaluate a 12-session home and community-based health promotion/obesity prevention program (Challenge!) on changes in BMI, body composition, physical activity (PA), and diet. Methods 235 African-American adolescents (11–16 yrs, 38% overweight/obese) were recruited from low-income urban communities. Baseline measures included weight, height, body composition (dual-energy x-ray absorptiometry (DEXA) and bioelectrical impedance), physical activity (PA) (accelerometry), and diet (food frequency). PA was measured by time in play-equivalent physical activity (PEPA≥1800 activity counts/min). Participants were randomized into a home- and community-based health promotion/obesity prevention controlled trial, anchored in social cognitive theory and involving motivational interviewing techniques, and delivered by college-enrolled, African-American mentors. Control adolescents did not receive the intervention or a mentor. Post-intervention (10 mos) and delayed follow-up (24 mos) evaluations were conducted. Longitudinal analyses using random mixed effects models and generalized estimating equations (GEE) examined direct and moderated effects of time, gender, and baseline BMI category on changes at both follow-ups. Results Retention was 76% (178/235) over 2 years; overweight/obese status declined 5.3% among intervention adolescents and increased 11.3% among control adolescents (χ2=5.8, p=0.02, GEE). Among males, but not females, fat free mass was significantly higher among intervention members at both follow-up evaluations. PA effects were moderated by baseline BMI category; among adolescents ≥ 85th percentile, control adolescents averaged 25.5 min less daily activity than intervention adolescents (p=0.018) at the 10-mo, but not the 24-mo follow-up. Intervention adolescents declined significantly more in snack and dessert consumption than control adolescents (p=0.045). Conclusion A 12-session, home-and community-based intervention, based on social cognitive

  3. 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.

  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. [The health system of Honduras].

    PubMed

    Bermúdez-Madriz, Juan Luis; Sáenz, María del Rocío; Muiser, Jorine; Acosta, Mónica

    2011-01-01

    This paper describes the health system of Honduras, including its challenges, structure coverage, sources of financing, resources and stewardship activities. This system counts with a public and a private sector. The public sector includes the Ministry of Health (MH) and the Honduran Social Security Institute (HSSI). The private sector is dominated by a set of providers offering services payed mostly out-of-pocket. The National Health Plan 2010-2014 includes a set of reforms oriented towards the creation of an integrated and plural system headed by the MH in its stewardship role. It also anticipates the creation of a public health insurance for the poor population and the transformation of the HSSI into a public insurance agency which contracts services for its affiliates with public and private providers under a family medicine model.

  6. The effects of changes in racial identity and self-esteem on changes in african american adolescents' mental health.

    PubMed

    Mandara, Jelani; Gaylord-Harden, Noni K; Richards, Maryse H; Ragsdale, Brian L

    2009-01-01

    This study assessed the unique effects of racial identity and self-esteem on 259 African American adolescents' depressive and anxiety symptoms as they transitioned from the 7th to 8th grades (ages 12-14). Racial identity and self-esteem were strongly correlated with each other for males but not for females. For both males and females, an increase in racial identity over the 1 year was associated with a decrease in the prevalence of depressive symptoms over the same period, even with self-esteem controlled. It was concluded that racial identity may be as important as self-esteem to the mental health of African American adolescents, and it explains variance in their mental health not associated with feelings of oneself as an individual.

  7. 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

  8. The roles of spirituality in the relationship between traumatic life events, mental health, and drug use among African American women from one southern state.

    PubMed

    Staton-Tindall, Michele; Duvall, Jamieson; Stevens-Watkins, Danelle; Oser, Carrie B

    2013-09-01

    This study examines the role of spirituality as a moderator of the relationship between traumatic life experiences, mental health, and drug use in a sample of African American women. It was hypothesized that there would be an inverse relationship overall between spirituality and mental health and drug use among this sample of African American women. Secondly, was expected that spirituality would moderate the relationship between traumatic life events and mental health and drug use. African American women (n = 206) were recruited from the community and from probation officers in three urban areas of a southern state, and face-to-face interviews were completed. Findings indicated that there was a main effect for spirituality (as measured by existential well-being on the Spiritual Well-Being Scale) and traumatic life events, mental health, and alcohol use. In addition, spirituality was a significant moderator of the relationship between traumatic life events and cocaine use. Discussion and implications for African American women are included.

  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. 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.

  11. 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

  12. 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…

  13. Perceptions and Beliefs about Exercise, Rest, and Health among African-Americans.

    ERIC Educational Resources Information Center

    Airhihenbuwa, Collins O.; And Others

    1995-01-01

    Focus group interviews assessed African American teens' and adults' (ages 13 to 65-plus) perceptions and beliefs about exercise. Many subjects believed that African Americans performed physical labor at work and needed rest rather than exercise during free time. Many considered exercise a physical stressor and believed friends had the greatest…

  14. Chronic Systemic Immune Dysfunction in African-Americans with Small Vessel-Type Ischemic Stroke.

    PubMed

    Brown, Candice M; Bushnell, Cheryl D; Samsa, Gregory P; Goldstein, Larry B; Colton, Carol A

    2015-12-01

    The incidence of small vessel-type (lacunar) ischemic strokes is greater in African-Americans compared to whites. The chronic inflammatory changes that result from lacunar stroke are poorly understood. To elucidate these changes, we measured serum inflammatory and thrombotic biomarkers in African-Americans at least 6 weeks post-stroke compared to control individuals. Cases were African-Americans with lacunar stroke (n = 30), and controls were age-matched African-Americans with no history of stroke or other major neurologic disease (n = 37). Blood was obtained >6 weeks post-stroke and was analyzed for inflammatory biomarkers. Freshly isolated peripheral blood mononuclear cells were stimulated with lipopolysaccharide (LPS) to assess immune responsiveness in a subset of cases (n = 5) and controls (n = 4). After adjustment for covariates, the pro-inflammatory biomarkers, soluble vascular cadherin adhesion molecule-1 (sVCAM-1) and thrombin anti-thrombin (TAT), were independently associated with lacunar stroke. Immune responsiveness to LPS challenge was abnormal in cases compared to controls. African-Americans with lacunar stroke had elevated blood levels of VCAM-1 and TAT and an abnormal response to acute immune challenge >6 weeks post-stroke, suggesting a chronically compromised systemic inflammatory response.

  15. Cryocooler Prognostic Health Management System

    NASA Astrophysics Data System (ADS)

    Shah, A.; Penswick, L.; Dodson, C.; Roberts, T.

    2008-03-01

    High performance sensors are playing an increasingly important role in all aspects of all critical DoD missions. There is a family of sensors that operate with improved sensitivities if cooled to very low (cryogenic) temperatures. For these sensors, a healthy and reliable mechanical refrigeration system (cryocooler) is required. The ability to accurately predict the "health" or remaining useful life of the cryocooler has significant benefits from the viewpoint of ensuring that mission critical functions can be carried out with a high probability of success. The paper provides an overview and approaches used for the development of a Cryocooler Prognostic Health Management System (CPHMS) capable of assessing the cryocooler "health" from the viewpoint of the level of performance degradation and/or the potential for near term failure. Additionally, it quantifies the reliable remaining useful life of the cryocooler. While the proposed system is focused on the specific application to linear drive cryocoolers, especially for DoD, many of the attributes of the system can be applied to other specialized system hardware in both commercial and U.S. Government agency for situations where it is critical that all aspects of the hardware "health" and "remaining useful life" be fully understood. Several benefits of the health monitoring system are also described in the paper.

  16. 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.

  17. 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.

  18. Portable plant health measurement system

    NASA Astrophysics Data System (ADS)

    Aksoy, Nejat

    1999-01-01

    This system is designed to assist diagnosis of the plant health globally. The system is formed by portable plant health measurement devices connected to a diagnosis and analysis center through a flexible information network. A flexible network is formed so that users from the remote areas as well as internet are able to use the system. The hardware and software is designed in an open technology for easier upgrades. Portable plant health measurement instrument is a networkable leaf flash spectrophotometer capable of measuring Qa, Electrochromy, P700, Fluorescence, S Fluorescence, reflectance spectra, temperature, humidity and image of the leaf with GPS information. The network and intelligent user interface options of the system can be used by any commercially or user designed instrument.

  19. A study on ten short tandem repeat systems: African immigrant and Spanish population data.

    PubMed

    Gamero, J J; Romero, J L; Gonzalez, J L; Arufe, M I; Cuesta, M I; Corte-Real, F; Carvalho, M; Anjos, M J; Vieira, D N; Vide, M C

    2000-06-05

    This work presents the results obtained from a genetic-population study for the D1S1656 system in the population of Southwest Spain (Huelva, Cádiz and Sevilla), Spaniards of Caucasian origin from North Africa (Ceuta), as well as in the black Central West African and Moroccan immigrant populations in Spain. The results of a study of the autochtonous population of the Canary Islands (n=138), and immigrant Central West African populations in Spain (n=132), obtained for nine short tandem repeat (STR) loci (D3S1358, VWA, FGA, D8S1179, D21S11, D18S51, D5S818, D13S317, D7S820), as well as the amelogenin locus, all contained in Profiler Plus (Perkin-Elmer) PCR amplification kits, are also presented. Except for the FGA and VWA data on immigrant Central West African populations in Spain, no deviations from the Hardy-Weinberg equilibrium were detected.

  20. Engaging an Urban African American Community to Deliver Cognitive Health Education to Breast Cancer Survivors.

    PubMed

    Bail, Jennifer; Nolan, Timiya S; Vo, Jacqueline B; Gisiger-Camata, Silvia; Meneses, Karen

    2016-12-28

    Little is known about cognitive changes among African American (AA) breast cancer survivors (BCS). Here, we report our experience with engagement of leaders of urban AA churches in Birmingham, Alabama to deliver and evaluate Think Well: Healthy Living to Improve Cognitive Function, an educational cognitive health program for BCS. The Think Well team engaged leaders of urban AA churches using a 7-step process: 1) identify leaders, 2) develop connection with leaders, 3) assess AA community preferences, 4) tailor for cultural relevance, 5) plan seminars, 6) deliver seminars, and 7) evaluate cultural relevance and overall program quality. Program evaluation was via a 22-item survey and sociodemographic questionnaire. Data from AA participants were analyzed using SPSS. The engagement process resulted in sustained partnerships with three urban AA churches and delivery of three Think Well seminars to 172 participants. Of the 172 participants, 138 (80%) AA participants (40 BCS, 98 co-survivors) returned the program survey. Respondents reported Think Well to be culturally relevant (90%) and of high quality (94%). Think Well was developed and evaluated with the collaboration of urban AA church leaders. Engaging church leaders facilitated reach of AA BCS. Partnership facilitated a culturally relevant, high quality program for AA BCS and co-survivors.

  1. “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

  2. Harvest Health: Translation of the Chronic Disease Self-Management Program for Older African Americans in a Senior Setting

    PubMed Central

    Gitlin, Laura N.; Chernett, Nancy L.; Harris, Lynn Fields; Palmer, Delores; Hopkins, Paul; Dennis, Marie P.

    2014-01-01

    Purpose We describe the translation of K. R. Lorig and colleagues’ Chronic Disease Self-Management Program (CDSMP) for delivery in a senior center and evaluate pre–post benefits for African American participants. Design and Methods Modifications to the CDSMP included a name change; an additional introductory session; and course augmentations involving culturally relevant foods, stress reduction techniques, and communicating with racially/ethnically diverse physicians. We recruited participants from senior center members, area churches, and word of mouth. We conducted baseline and 4-month post-interviews. Results A total of 569 African American elders attended an introductory session, with 519 (91%) enrolling in the 6-session program. Of the 519, 444 (86%) completed ≥4 sessions and 414 (79%) completed pre–post interviews. We found small but statistically significant improvements for exercise (p = .001), use of cognitive management strategies (p = .001), energy/fatigue (p = .001), self-efficacy (p = .001), health distress (p = .001), and illness intrusiveness in different life domains (probabilities from .001–.021). We found no changes for health utilization. Outcomes did not differ by gender, number of sessions attended, number and type of chronic conditions, facilitator, leader, or recruitment site. Implications The CDSMP can be translated for delivery by trained senior center personnel to African American elders. Participant benefits compare favorably to original trial outcomes. The translated program is replicable and may help to address health disparities. PMID:18981286

  3. Interpretative repertoires that shape low-income African American women's reproductive health care seeking: "don't want to know" and "taking charge of your health".

    PubMed

    Golden, Annis G; Pomerantz, Anita

    2015-01-01

    In the context of reproductive and sexual health, African American women have higher incidence of disease and poorer outcomes on key indicators when compared with White women. In this study, we used discourse analysis to identify and examine the workings of two clusters of interpretive resources ("interpretative repertoires") associated with reproductive/sexual health care seeking among low-income African American women who participated in semistructured interviews as part of a health promotion initiative. Interpretative repertoires are ways of accounting for engaging in or refraining from engaging in actions, which are shared by people in a community. We labeled the two interpretative repertoires "Don't Want to Know," and "Take Charge of Your Health." Within the "Don't Want to Know" repertoire, that testing would lead to threatening findings was assumed, a chain of devastating consequences was imagined, and a preference for uncertainty over certain knowledge was expressed. Conversely, the "Take Charge of Your Health" repertoire valued certainty over uncertainty, though in both interpretive frameworks, knowledge-based and emotion-based decision-making were intertwined. We conclude that health promotion initiatives--if they are to succeed in encouraging women to obtain valuable preventive health care services--must respond, in their choices of language and outreach strategies, to the expressed dilemma of wishing for reassurance but fearing bad news, to the intertwining of emotional reasoning and technorationality in health decision making, and to the particular relational experiences of African American women. Failure to do so will contribute to the continuation of reproductive and sexual health disparities.

  4. 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.

  5. 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,…

  6. The Effects of Systemic Reform on Urban, African American Fifth Grade Students' Attitudes toward Science.

    ERIC Educational Resources Information Center

    Weinburgh, Molly H.

    2003-01-01

    Investigates the effectiveness of a local systemic change grant on 5th grade urban African American students' attitudes toward science. Measures students' attitudes by using the modified Attitude Toward Science Inventory (mATSI). Indicates a significant main effect for the program and for school but not for gender. Examines school characteristics…

  7. 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…

  8. 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…

  9. 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…

  10. [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.

  11. 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

  12. African Ancestry Gradient Is Associated with Lower Systemic F2-Isoprostane Levels

    PubMed Central

    Annor, Francis; Okosun, Ike; Gower, Barbara A.

    2017-01-01

    Context. Low levels of systemic F2-isoprostanes (F2-IsoP) increase the risk of diabetes and weight gain and were found in African Americans. Low F2-IsoPs could reflect an unfavorable metabolic characteristic, namely, slow mitochondrial metabolism in individuals with African ancestry. Objective. To examine differences in plasma F2-IsoPs in three groups with a priori different proportion of African ancestry: non-Hispanic Whites (NHWs), US-born African Americans (AAs), and West African immigrants (WAI). Design. Cross-sectional study. Setting. Georgia residents recruited from church communities. Participants. 218 males and females 25–74 years of age, who are self-identified as NHW (n = 83), AA (n = 56), or WAI (n = 79). Main Outcome Measure(s). Plasma F2-IsoPs quantified by gas chromatography-mass spectrometry. Results. After adjustment for age, gender, obesity, and other comorbidities, WAI had lower levels of plasma F2-IsoP than AA (beta-coefficient = −9.8, p < 0.001) and AA had lower levels than NHW (beta-coefficient = −30.3, p < 0.001). Similarly, among healthy nonobese participants, F2-IsoP levels were lowest among WAI, followed by AA, and the highest levels were among NHW. Conclusion. Plasma F2-IsoPs are inversely associated with African ancestry gradient. Additional studies are required to test whether optimization of systemic F2-IsoP levels can serve as means to improve race-specific lifestyle and pharmacological intervention targeted to obesity prevention and treatment. PMID:28250893

  13. 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.

  14. [Health: an adaptive complex system].

    PubMed

    Toro-Palacio, Luis Fernando; Ochoa-Jaramillo, Francisco Luis

    2012-02-01

    This article points out the enormous gap that exists between complex thinking of an intellectual nature currently present in our environment, and complex experimental thinking that has facilitated the scientific and technological advances that have radically changed the world. The article suggests that life, human beings, global society, and all that constitutes health be considered as adaptive complex systems. This idea, in turn, prioritizes the adoption of a different approach that seeks to expand understanding. When this rationale is recognized, the principal characteristics and emerging properties of health as an adaptive complex system are sustained, following a care and services delivery model. Finally, some pertinent questions from this perspective are put forward in terms of research, and a series of appraisals are expressed that will hopefully serve to help us understand all that we have become as individuals and as a species. The article proposes that the delivery of health care services be regarded as an adaptive complex system.

  15. 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…

  16. Advancing Understanding of the Characteristics and Capacity of African American Women Who Serve as Lay Health Advisors in Community-Based Settings

    ERIC Educational Resources Information Center

    Shelton, Rachel C.; Dunston, Sheba King; Leoce, Nicole; Jandorf, Lina; Thompson, Hayley S.; Erwin, Deborah O.

    2017-01-01

    Lay Health Advisor (LHA) programs hold tremendous promise for reducing health disparities and addressing social determinants of health in medically underserved communities, including African American populations. Very little is understood about the capacity of LHAs in these roles and the broader contributions they make to their communities. This…

  17. 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.

  18. 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

    2012-07-27

    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.

  19. 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

  20. Should health systems agencies be involved in environmental health planning?

    PubMed Central

    Higgins, C W; Philips, B U; Bruhn, J G; Aker, L T

    1980-01-01

    Public Law 93-641 provides health systems agencies (HSAs) with a broad planning preview which has enabled a number of agencies to address environmental health issues in their health systems plans. Opponents of HSA involvement in environmental health planning charge that these activities overextend agency resources, duplicate efforts of other government agencies and involve HSAs in "issues of public policy." Closer examination of these charges finds them lacking in validity. The planning activities of health systems agencies are cooperative in nature, drawing upon the planning efforts of other institutions and agencies. It is illogical to exclude environmental concerns from general health planning in light of the impact of the environment upon health. Charges that issues of public policy are inappropriate topics for health planning are seen as attempts to avoid scrutiny of inconsistant legislative policies. Cooperative planning between health systems agencies and environmental health agencies is considered both desirable and essential for the development of effective health planning. PMID:7428743

  1. 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.

  2. Access, use and completion of a brief disaster mental health intervention among Hispanics, African-Americans and Whites affected by Hurricane Ike

    PubMed Central

    Price, Matthew; Davidson, Tatiana M; Andrews, Jeannette O; Ruggiero, Kenneth J

    2013-01-01

    Summary African-Americans and Hispanics are disproportionally affected by disasters. We evaluated differences in the use and completion of a web-based mental health intervention, Disaster Recovery Web (DRW), by White, African-American and Hispanic adults in the aftermath of Hurricane Ike. Approximately one year after the hurricane, a telephone survey was carried out with adults from Galveston and Chambers counties. A total of 1249 adults participated in the survey (80% White, 14% African-American and 6% Hispanic). Mental health and mental health service utilization were assessed. Whites were more likely to have previously used the Internet to obtain general health information than African-Americans or Hispanics (P < 0.001). A logistic regression was used to identify differences in the use of the Internet intervention after controlling for covariates. There were no differences in rates of non-use and dropout attrition between Whites, African-Americans and Hispanics. Thus the findings suggest that web-based mental health interventions can be used to reach African-American, Hispanic and White adults at similar rates after a disaster. PMID:23514936

  3. Access, use and completion of a brief disaster mental health intervention among Hispanics, African-Americans and Whites affected by Hurricane Ike.

    PubMed

    Price, Matthew; Davidson, Tatiana M; Andrews, Jeannette O; Ruggiero, Kenneth J

    2013-02-01

    African-Americans and Hispanics are disproportionally affected by disasters. We evaluated differences in the use and completion of a web-based mental health intervention, Disaster Recovery Web (DRW), by White, African-American and Hispanic adults in the aftermath of Hurricane Ike. Approximately one year after the hurricane, a telephone survey was carried out with adults from Galveston and Chambers counties. A total of 1249 adults participated in the survey (80% White, 14% African-American and 6% Hispanic). Mental health and mental health service utilization were assessed. Whites were more likely to have previously used the Internet to obtain general health information than African-Americans or Hispanics (P < 0.001). A logistic regression was used to identify differences in the use of the Internet intervention after controlling for covariates. There were no differences in rates of non-use and dropout attrition between Whites, African-Americans and Hispanics. Thus the findings suggest that web-based mental health interventions can be used to reach African-American, Hispanic and White adults at similar rates after a disaster.

  4. [The health system of Brazil].

    PubMed

    Montekio, Víctor Becerril; Medina, Guadalupe; Aquino, Rosana

    2011-01-01

    This paper describes the Brazilian health system, which includes a public sector covering almost 75% of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Único de Saúde (SUS) and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal). SUS provides health care through a decentralized network of clinics, hospitals and other establishments, as well as through contracts with private providers. SUS is also responsible for the coordination of the public sector. The private sector includes a system of insurance schemes known as Supplementary Health which is financed by employers and/or households: group medicine (companies and households), medical cooperatives, the so called Self-Administered Plans (companies) and individual insurance plans.The private sector also includes clinics, hospitals and laboratories offering services on out-of-pocket basis mostly used by the high-income population. This paper also describes the resources of the system, the stewardship activities developed by the Ministry of Health and other actors, and the most recent policy innovations implemented in Brazil, including the programs saúde da Familia and Mais Saúde.

  5. THE CHALLENGES OF SCHOOL-BASED YOUTH SUICIDE PREVENTION: EXPERIENCES AND PERCEPTIONS OF MENTAL HEALTH PROFESSIONALS IN SOUTH AFRICAN SCHOOLS

    PubMed Central

    Woolf, Maryke; Bantjes, Jason; Kagee, Ashraf

    2016-01-01

    Youth suicidal behaviour poses a significant public health concern. Mental health care professionals working in schools have an important role to play in youth suicide prevention initiatives, although little is known of the experiences of this group of professionals in the developing world. The aim of this study was to explore the experiences of mental health professionals working in South African schools and document their insights, attitudes and beliefs regarding youth suicidal behaviour. In-depth semi-structured interviews were conducted with seven school-based mental health care professionals and data were analysed using Thematic Analysis. Participants reported that they relied on a reactive strategy by responding to youths who were in crisis. They were challenged by a lack of support from faculty staff, lack of access to resources, and heavy caseloads. Findings highlight the need for a proactive and collaborative approach to suicide prevention among mental health care professionals, teachers and parents in South African schools and improved training and supervision. PMID:27990493

  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.

  7. 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.

  8. Orbital forcing on West African monsoon system revealed by KZai 02 pollen record spectral analysis

    NASA Astrophysics Data System (ADS)

    Dalibard, Mathieu; Popescu, Speranta-Maria; Pittet, Bernard; Fernandez, Vincent; Marsset, Tania; Droz, Laurence; Suc, Jean-Pierre

    2013-04-01

    The present-day intertropical climate is forced by yearly fluctuations of insolation reorganizing pressure cells. They control, via the wind system, the variations of the precipitation front known as the InterTropical Convergence Zone (ITCZ). Its latitudinal oscillation drives a strong seasonality of rainfalls over Africa. However, connections between African climate during Pleistocene and orbital forcing are blurred by high-latitudes and local direct influence of insolation and need further investigations. The study of KZai 02 core pollen content provides a high-resolution record of changes in West African plant ecosystems during the last 160 kyrs. Spectral analyses were performed on pollen signals to identify periodicity in vegetation dynamics related to environmental fluctuations. The large range of frequencies detected testifies for the sensibility of African biotopes to past climate fluctuations. Milankovitch parameters, especially precession, are identified within variations of the ecological groups of KZai 02 pollen record and interpreted in terms of West African monsoon system variability. Asynchrony in the different plant ecosystem fluctuations suggests the out of step influence of several climatic parameters (precipitation, CO2, temperature) involving local insolation and high-latitude influence. Spectral analysis also reveals sub-Milankovitch periods related to (1) Heinrich and Dansgaard/Oeschger glacial pulsation events and (2) East Asian monsoon oscillations controlled by ice sheet pulses testifying for the strong relationship between low- and high-latitude climate changes.

  9. 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.".

  10. 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.

  11. 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

  12. A Review and Critique of Teledermatology in the South African Public Health Sector.

    PubMed

    Walters, Laticha E M; Mars, Maurice; Scott, Richard E

    2016-01-01

    Nearly 80% of the world's population live in developing countries in Asia, Africa, and Latin America. Many of these countries must face a triple or quadruple burden of disease with severely limited resources and health systems. South Africa (SA) is one such country, and recognises the potential for e-health to moderate these limitations. Dermatological issues remain a concern in SA and globally. Indeed, the World Health Organisation (WHO) has recognised that a number of diseases are most likely to manifest themselves through a dermatological problem before becoming full-blown. However, there is an acute shortage of dermatologists in SA. Teledermatology has promise as a service delivery intervention. This study reports on the current status of teledermatology services in the public health sector of SA.

  13. 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.

  14. 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

  15. 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.

  16. 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

  17. African Americans Seeking Nonmedical Health Care: A Study in Belief Change and Maintenance.

    ERIC Educational Resources Information Center

    Semmes, Clovis E.

    1981-01-01

    Discusses a study of Blacks who shifted from exclusive use of modern orthodox medical care to use of an alternative natural system of health care known as naprapathy. Suggests that conversion to regular use of naprapathy involves a sequential, dynamic, and reflective experiential process. (Author/MJL)

  18. 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)

  19. 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.

  20. Public health law research: exploring law in public health systems.

    PubMed

    Ibrahim, Jennifer K; Burris, Scott; Hays, Scott

    2012-11-01

    The importance of law in the organization and operation of public health systems has long been a matter of interest to public health lawyers and practitioners, but empirical research on law as a factor in health system performance has been limited in quantity and sophistication. The emergence of Public Health Law Research and Public Health Systems and Services Research within a coordinated effort to strengthen public health research and practice has dramatically changed matters. This article introduces Public Health Law Research as an integral part of Public Health Systems and Services Research, discusses the challenges of integrating the 2 fields, and highlights 2 examples of current research that demonstrate the benefits of an integrated approach to improve the use of law in public health practice.

  1. Tomography of the East African Rift System in Mozambique

    NASA Astrophysics Data System (ADS)

    Domingues, A.; Silveira, G. M.; Custodio, S.; Chamussa, J.; Lebedev, S.; Chang, S. J.; Ferreira, A. M. G.; Fonseca, J. F. B. D.

    2014-12-01

    Unlike the majority of the East African Rift, the Mozambique region has not been deeply studied, not only due to political instabilities but also because of the difficult access to its most interior regions. An earthquake with M7 occurred in Machaze in 2006, which triggered the investigation of this particular region. The MOZART project (funded by FCT, Lisbon) installed a temporary seismic network, with a total of 30 broadband stations from the SEIS-UK pool, from April 2011 to July 2013. Preliminary locations of the seismicity were estimated with the data recorded from April 2011 to July 2012. A total of 307 earthquakes were located, with ML magnitudes ranging from 0.9 to 3.9. We observe a linear northeast-southwest distribution of the seismicity that seems associated to the Inhaminga fault. The seismicity has an extension of ~300km reaching the Machaze earthquake area. The northeast sector of the seismicity shows a good correlation with the topography, tracing the Urema rift valley. In order to obtain an initial velocity model of the region, the ambient noise method is used. This method is applied to the entire data set available and two additional stations of the AfricaARRAY project. Ambient noise surface wave tomography is possible by computing cross-correlations between all pairs of stations and measuring the group velocities for all interstation paths. With this approach we obtain Rayleigh wave group velocity dispersion curves in the period range from 3 to 50 seconds. Group velocity maps are calculated for several periods and allowing a geological and tectonic interpretation. In order to extend the investigation to longer wave periods and thus probe both the crust and upper mantle, we apply a recent implementation of the surface-wave two-station method (teleseismic interferometry - Meier el al 2004) to augment our dataset with Rayleigh wave phase velocities curves in a broad period range. Using this method we expect to be able to explore the lithosphere

  2. 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.

  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.

  4. Urban-rural differences in excess mortality among high-poverty populations: evidence from the Harlem Household Survey and the Pitt County, North Carolina Study of African American Health.

    PubMed

    Geronimus, Arline T; Colen, Cynthia G; Shochet, Tara; Ingber, Lori Barer; James, Sherman A

    2006-08-01

    Black youth residing in high-poverty areas have dramatically lower probabilities of surviving to age 65 if they are urban than if they are rural. Chronic disease deaths contribute heavily. We begin to probe the reasons using the Harlem Household Survey (HHS) and the Pitt County, North Carolina Study of African American Health (PCS). We compare HHS and PCS respondents on chronic disease rates, health behaviors, social support, employment, indicators of health care access, and health insurance. Chronic disease profiles do not favor Pitt County. Smoking uptake is similar across samples, but PCS respondents are more likely to quit. Indicators of access to health care and private health insurance are more favorable in Pitt County. Findings suggest rural mortality is averted through secondary or tertiary prevention, not primary. Macroeconomic and health system changes of the past 20 years may have left poor urban Blacks as medically underserved as poor rural Blacks.

  5. [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.

  6. [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.

  7. 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

  8. 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.

  9. Multipurpose Health Care Telemedicine System

    DTIC Science & Technology

    2007-11-02

    place to the base unit (consultation site). The transmission is performed through GSM, Satellite links or POTS . Using this device a specialist...standardized medical protocol. Keywords – Emergency Health Care Telemedicine, GSM, Satellite, POTS I. INTRODUCTION The availability of prompt and expert...of communication means (Satellite, GSM and Plain Old Telephony System - POTS ). The base unit is comprised of a set of user-friendly software

  10. 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.

  11. 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.

  12. 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.

  13. YOUR Blessed Health: a faith-based CBPR approach to addressing HIV/AIDS among African Americans.

    PubMed

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

    2010-06-01

    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. Capitalizing on the assets, resources, and strengths of faith-based organizations, YOUR Blessed Health (YBH) is a community-based participatory research project developed to increase HIV/AIDS awareness and reduce HIV-related stigma among the African American faith community in Flint, Michigan. This article describes the historical context and development of YBH, discusses the results of the pilot study, and illustrates how YBH grew into a community mobilization effort led by faith leaders and their congregations to address HIV/AIDS. YBH highlights the importance of developing and testing intervention models that originate from community-based organizations to address complex and sensitive health issues among marginalized populations.

  14. An Evaluation of Research Ethics in Undergraduate Health Science Research Methodology Programs at a South African University.

    PubMed

    Coetzee, Tanya; Hoffmann, Willem A; de Roubaix, Malcolm

    2015-10-01

    The amended research ethics policy at a South African University required the ethics review of undergraduate research projects, prompting the need to explore the content and teaching approach of research ethics education in health science undergraduate programs. Two qualitative data collection strategies were used: document analysis (syllabi and study guides) and semi-structured interviews with research methodology coordinators. Five main themes emerged: (a) timing of research ethics courses, (b) research ethics course content, (c) sub-optimal use of creative classroom activities to facilitate research ethics lectures, (d) understanding the need for undergraduate project research ethics review, and (e) research ethics capacity training for research methodology lecturers and undergraduate project supervisors.

  15. Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries

    PubMed Central

    Williams, Jason; Umaru, Farouk; Edgil, Dianna; Kuritsky, Joel

    2016-01-01

    ABSTRACT In 2014, the Joint United Nations Programme on HIV/AIDS released its 90-90-90 targets, which make laboratory diagnostics a cornerstone for measuring efforts toward the epidemic control of HIV. A data-driven laboratory harmonization and standardization approach is one way to create efficiencies and ensure optimal laboratory procurements. Following the 2008 “Maputo Declaration on Strengthening of Laboratory Systems”—a call for government leadership in harmonizing tiered laboratory networks and standardizing testing services—several national ministries of health requested that the United States Government and in-country partners help implement the recommendations by facilitating laboratory harmonization and standardization workshops, with a primary focus on improving HIV laboratory service delivery. Between 2007 and 2015, harmonization and standardization workshops were held in 8 African countries. This article reviews progress in the harmonization of laboratory systems in these 8 countries. We examined agreed-upon instrument lists established at the workshops and compared them against instrument data from laboratory quantification exercises over time. We used this measure as an indicator of adherence to national procurement policies. We found high levels of diversity across laboratories’ diagnostic instruments, equipment, and services. This diversity contributes to different levels of compliance with expected service delivery standards. We believe the following challenges to be the most important to address: (1) lack of adherence to procurement policies, (2) absence or limited influence of a coordinating body to fully implement harmonization proposals, and (3) misalignment of laboratory policies with minimum packages of care and with national HIV care and treatment guidelines. Overall, the effort to implement the recommendations from the Maputo Declaration has had mixed success and is a work in progress. Program managers should continue efforts to

  16. 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.

  17. Perceptions of the Religion--Health Connection among African Americans in the Southeastern United States: Sex, Age, and Urban/Rural Differences

    ERIC Educational Resources Information Center

    Holt, Cheryl L.; Schulz, Emily; Wynn, Theresa A.

    2009-01-01

    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…

  18. 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…

  19. [Need for health and human rights training: survey in six French-speaking African countries].

    PubMed

    Mpinga, E K; Klohn, A M; Zesiger, V; Freigburghaus, F; Jeannot, E; Chastonay, P

    2010-12-01

    The purpose of this study was to assess the need of healthcare and non-healthcare professionals for training in the field of health and human rights as a basis for developing relevant education programs. In 2007 a self-administered survey questionnaire was sent to 360 health professionals and human rights activists in Chad, the Democratic Republic of the Congo, the Republic of the Congo, Mali, Burkina-Faso, and Ivory Coast. The response rate was 67% (242/360). The most common training needs involved planning tools (87%), types of human rights violations in health systems (85%), risk factors for human rights violations (80%), and human rights monitoring tools (74%). The preferred training approaches were mixed and participative methods (60%) and practical applications as a means of validation (65%). There was a high degree of homogeneity between the needs expressed by the healthcare and non-healthcare professionals. The findings of this survey indicate that healthcare and non-healthcare professionals wish to obtain the knowledge and skills necessary to prevent and/or identify human rights issues in healthcare systems and to provide adequate responses. Training programs dealing with human rights in healthcare systems should reflect these needs.

  20. 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.

  1. 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…

  2. 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…

  3. 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.…

  4. 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…

  5. African American Youth Encounters with Violence: Results from the Community Mental Health Council Violence Screening Project.

    ERIC Educational Resources Information Center

    Uehara, Edwina S.; And Others

    1996-01-01

    Examines African American youth's encounters with three forms of violence--eyewitnessing, victimization, and participation--to determine its spread in urban schools, the types of violence encountered, the sociodemographic factors associated with the encounter types, and whether there is any overlap among those who witness, are victims of, and…

  6. 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…

  7. 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

  8. Alcohol consumption amongst South African farm workers: a challenge for post-apartheid health sector transformation.

    PubMed

    London, L

    2000-05-01

    A cross-sectional analytical study was conducted amongst farm workers in the deciduous fruit industry in South Africa to assess levels of alcohol consumption and abuse, and to explore the impact of the DOP system, whereby farm workers are paid in part with alcohol, on indicators of alcohol consumption. High levels of alcohol consumption were found. On the CAGE and a shortened version of the MAST questionnaires, 87 and 65%, respectively, had responses indicating problem drinking. Close to half of the sample consumed more grams of alcohol per week than considered safe drinking (210 g) and 9.3% consumed amounts in excess of dangerous drinking (>490 g/week). Almost one-fifth (19.4%) of workers interviewed reported current use of the DOP system, and 47.8% of workers had experience of one or more farms in the past where the DOP system had been used. Workers with past experience of the DOP system were 9.8 times less likely to be asbstainers than colleagues without exposure to the DOP system. The pervasive effects of excessive alcohol consumption, and its relationship to past and current DOP practices pose substantial public health challenges to the transformation of health services currently underway in South Africa.

  9. Glucose absorption kinetics in Zambian African patients with and without systemic bacterial infections

    PubMed Central

    Cook, G. C.

    1971-01-01

    Using a double-lumen tube perfusion system, solutions of glucose (1·0, 2·5, and 5·0 g 100ml−1) have been perfused into the upper jejunum of 22 Zambian African subjects in order to study their glucose absorption kinetics. None of them had clinical evidence of malnutrition or intestinal disease. In 10 there was no evidence of an infective disease (`normal' group); seven had tuberculosis; five had acute bacterial infections. The mean serum albumin concentration was significantly lower in those with infections; the mean total and γ-globulin concentrations were significantly higher in the tuberculosis group. There was good reproducibility in triplicate assessments of glucose and water absorption rates in the individual subjects. Despite a wide scatter, the mean glucose kinetic curves were significantly flatter in those with infections than in the normal group (p<0·02). There was a significant association between glucose and water absorption rates in the individuals. D-xylose absorption was estimated in 11 subjects and there was a significant correlation between that and the glucose absorption rate. Jejunal morphology (n=9) and disaccharidase concentrations (n=6) were normal for African subjects and there were no significant associations between either of those and the absorption rates. Galactose absorption kinetics have been studied in an additional four relatively normal Zambian Africans. This study suggests that systemic bacterial infections can produce malabsorption. This may be relevant to the weight loss in patients with pulmonary tuberculosis and also to the aetiology of kwashiorkor. PMID:4110099

  10. Tracing health system challenges in post-conflict Côte d'Ivoire from 1893 to 2013.

    PubMed

    Gaber, Sabrina; Patel, Preeti

    2013-07-01

    While scholarship on health in conflict-affected countries is growing, there has been relatively little analysis of how armed conflict affects health systems in specific African countries, especially former French colonies. There is even less literature on the role of history in shaping health systems and how historical factors such as inequity may influence health impacts of armed conflict. Based on Côte d'Ivoire, this article argues that historical multidisciplinary analysis can provide valuable insight into the macro-level political, economic and social determinants of the health system over time. It explores how armed conflict has affected health services and exacerbates historically inherited challenges to the health system including unequal distribution of health services, bias towards curative care in urban areas, inadequate human resources and weak health governance. In the post-conflict period, this understanding may assist governments and other stakeholders to develop more appropriate health policies that address both urgent and long-term health needs.

  11. How do we measure up? A comparison of lifestyle-related health risk factors among sampled employees in South African and UK companies.

    PubMed

    Milner, Karen; da Silva, Roseanne; Patel, Deepak; Salau, Sulaiman

    2016-07-12

    The need to address the growing prevalence of non-communicable diseases through changing the lifestyle behaviours that contribute to them has become a global priority. Settings-based health promotion strategies such as workplace health promotion programmes are growing in an attempt to start meeting this need. In order for settings-based health promotion programmes to be successful, they need to be based on the specific risk profiles of the population for whom they are designed. Workplace health promotion programmes are becoming popular in South Africa, but there are currently few data available about the health risks and lifestyle behaviours of the South African employed population. In order to obtain such data and reward workplace health promotion initiatives, Discovery Health initiated healthy company campaigns in South Africa and the UK. These campaigns took the form of a competition to assess the healthiest companies in each country. Through these campaigns, an extensive data set was collected encompassing UK and South African employees' lifestyle behaviours and health risks. In this article, we used these data to compare self-reported physical activity levels, self-reported fruit and vegetable consumption, calculated BMI, self-reported smoking, mental health indicators, and health screening status of the UK and South African employee samples. We found significant differences across all measures, with the exception of self-reported fruit and vegetable consumption. The findings emphasise the importance of using local data to tailor workplace health promotion programmes for the population for which the programmes have been designed.

  12. 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

  13. Benefits of a self-management program in low-income African-American women with systemic lupus erythematosus: results of a pilot test.