bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Promotion Financing With Mongolia’s Social Health Insurance
Authors: Bayarsaikhan Dorjsuren , Nakamura Keiko
Published: June 2011

Health promotion is receiving more attention in Mongolia. A survey is undertaken to examine health promotion in terms of health-related information, education, counseling, screening, and preventive and medical checkups. Almost all (97.5%) the participants feel that access to reliable and systematically organized health-related information is important. About 60% of the participants said that the amount of currently available information is inadequate. There are several factors that limit the implementation of public health programs. These include inadequate focus on promoting health at the individual level, lack of funds, and limited incentives to promote health. This article examines social health insurance as an option to address these issues. Three hypothetical benefits package options expanded to health promotion were developed and simulated by a computerized tool. The simulations show that all 3 options are financially sustainable at the existing level of contribution if Mongolia will gain near universal health insurance coverage and improve revenue collection practices.
Factors Contributing to Utilization of Health Care Services in Malaysia: A Population-Based Study
Authors: Krishnaswamy Saroja , Subramaniam Kavitha , Low Wah Yun , Aziz Jemain Abdul , Indran Tishya , Ramachandran Padma , Hamid Abdul Rahman Abdul , Patel Vikram
Published: June 2011

Objective. This paper examines the factors contributing to the under utilisation of health care services in the Malaysian population. Methodology. Using data derived from Malaysian Mental Health Survey (MMHS) information on utilisation of four basic health services in the previous three months, namely contact with health care professionals, ward admissions, having diagnostic or laboratory tests done and being on any medications were obtained. Results. A total of 2202 out of 3666 or 60% of the MMHS participants were included in this study. Thirty percent of the subjects (n = 664) had contacts with health care professionals. Those with health complications, disabilities and those aged 50 years and above utilised health services more significantly as compared to those who lacked health facilities near their homes, had little family support during illnesses and were from the Chinese ethnic group. Conclusion. Factors leading to the under utilisation of health care services need to be further studied and needs in certain groups in the population should be addressed. Healthcare providers must be prepared to fulfil these needs.
The Relationship Between Women’s Mental Health and Domestic Violence in Semirural Areas: A Study in Turkey
Authors: Savas Nazan , Agridag Gulseren
Published: June 2011

The authors examine the relationship between emotional disorders and domestic violence (DV) in 395 women of different ethnicities in Turkey. PRIME MD (Primary Care Evaluation of Mental Disorders) was used for diagnosis. This is a cross-sectional and epidemiological research. Results showed that the prevalence of emotional disorders, anxiety, and somatoform disorders was 22.8%, 24.8%, and 16.9%, respectively. The mean DV score was 2.98 ± 1.32 over 10.00. DV scores were higher when women did not want to get married or did not have their family’s blessing for marriage. Observed scores were also high for civil marriage cases, or when women had a job, had low income, or were afraid of their husbands ( P < .05). The number of comorbid diagnoses increased with increase in DV scores ( P < .001). Mean DV scores were higher for women diagnosed with major depression, partial remission or recurrence of major depression, panic disorder, and common anxiety ( P < .05). The authors recommend that if physicians suspect any emotional disorders in women in primary care, they should evaluate for DV.
Determinants of Infant and Child Mortality in Periurban Areas of Kolkata city, India
Authors: Ghosh Rohini , Bharati Premananda
Published: June 2011

Recent Indian studies indicate stagnation in decline of child mortality, though various health care interventions were introduced during the last 2 decades. This study examined the rates of infant and child mortality and associated demographic and socioeconomic factors in 2 socioeconomically vulnerable populations, comprising 195 Munda and 334 Poundrakshatriya women having similar access to health care facilities in a periurban region of Kolkata city. Higher infant mortality rate (IMR) was noted in the older and younger Munda women, in contrast to lower IMR in younger Pod women. Child mortality rate was lower in younger women in both the ethnic groups. Stagnation in IMR in younger Munda women indicates poor delivery practices whereas lower rate among the Pod reflects better adoption of safe delivery practices. Differential association of factors with infant and child deaths in the 2 populations indicate that a better understanding of determinants in culturally heterogeneous populations at the community or household level is needed to develop more effective strategies for child survival and development.
Public Awareness of Risk Factors for Cancer and Its Determinants in an Iranian Population
Authors: Feizi Awat , Kazemnejad Anoshirvan , Babaee Gholamreza , Parsayekta Zohreh , Monjamed Zahra
Published: June 2011

Cancer is increasingly being seen as a disease that is preventable and manageable. Knowledge often does constitute one element in the behavior change process. In addition, to promote the cancer prevention programs, data on level of knowledge among the target population are needed. The present research (as the first) aimed at providing information on level and correlates of awareness of cancer risk factors among the general public in Iran. The level of knowledge about 12 cancer risk factors (as a section of a multipart questionnaire) was assessed in a representative sample of 2500 adults (aged >18 years) in Tehran, Iran. The data were analyzed using latent class regression with the R statistical package. A small proportion of the respondents (12.2%) had high knowledge level and most of them had mixed (56.9%) and low level of awareness (30.9%). The most important determinants of knowledge level included level of education, gender, and family history. The results provided valuable clues and guidelines toward the formulation of relevant cancer prevention strategies, especially within the scope of health education. The applied statistical model presented a new descriptive and analytical perspective to evaluate the level of knowledge about the cancer risk factors and its determinants.
Public Health Responses to Climate Change Health Impacts in Indonesia
Authors: Ady Wirawan Made
Published: June 2011

Although climate change is a global concern, there are particular considerations for Indonesia as an archipelagic nation. These include the vulnerability of people living in small islands and coastal areas to rising sea levels; the expansion of the important mosquito-borne diseases, particularly malaria and dengue, into areas that lack of immunity; and the increase in water-borne diseases and malnutrition. This article proposes a set of public health responses to climate change health impacts in Indonesia. Some important principles and practices in public health are highlighted, to develop effective public health approaches to climate change in Indonesia.
Prevalence and Determinants of Malnutrition Among Reproductive Aged Women of Rural Bangladesh
Authors: Hasnat Milton Abul , Smith Wayne , Rahman Bayzidur , Ahmed Bashir , Shahidullah S.M. , Hossain Zakir , Hasan Ziaul , Sharmin Sabrina
Published: June 2011

Malnutrition among the rural Bangladeshi women of reproductive age is still very high. This high prevalence attributes to a range of adverse health consequences on the women and their offspring. A total of 2341 women aged between 20 and 45 years residing in the study area were interviewed in this cross-sectional study. Information on socioeconomic variables, nutritional status, and pregnancy-related history was obtained using interviewer administered questionnaire. A total of 34% of the reproductive aged rural women suffer from malnutrition. A multivariate analysis shows association between malnutrition and monthly household income, history of taking oral contraceptive, current pregnancy status, and history of breastfeeding. The final regression model shows a statistically significant decreasing trend in malnutrition status with increasing income ( P for trend <.001). The economic and health consequences of malnutrition in this group of women are enormous. National nutritional program should target this women group for any intervention with a special priority.
The Role of Health Insurance in Improving Health Services Use by Thais and Ethnic Minority Migrants
Authors: Jian Hu
Published: June 2011

In Thailand, a universal coverage health care scheme for Thai citizens and a foreign worker health insurance program for registered foreign workers have been implemented since 2001. This study uses the 2000-2004 panel data of the Kanchanaburi Demographic Surveillance System to explore the role of health insurance in influencing the use of health care for Thai, Thai ethnic minority, and ethnic minority migrants from 2000 to 2004. The results show that health insurance plays a major role in improving the use of health care for ethnic groups, especially for Thai ethnic minorities. However, a gap still existed in 2004 between health insurance and health care use by ethnic minority migrants and by Thais. The results suggest that improving health insurance status for ethnic minority migrants should be encouraged to reduce the ethnic gap in the use of health care.
Income-Related Health Inequalities in Korea
Authors: Byung Chul Ahn  , Engelhardt Katrin , Joung Hyojee
Published: June 2011

Data from the 2001 Korean National Health and Nutrition Examination Survey and the ill health concentration index (CI) were used to examine income-related health inequalities among Koreans. Participants (>19 years old) were requested to provide information regarding monthly household income, expenditures, subjective living conditions, and health status. Ill health was determined both subjectively through self-rated health (SRH) scores and objectively through the number of diseases (ND). At the individual level, the CIs for SRH and ND were -0.147 and -0.093, respectively; age—gender adjusted CIs were -0.065 and -0.071, respectively. These values remained unchanged when estimating CI for grouped data. These results indicate that ill health was more pronounced among lower income groups in Korea. However, avoidable health inequality in Korea was smaller than in the United Kingdom and the United States, larger than in Sweden, Eastern Germany, Finland, and Western Germany, and roughly equal to the Netherlands, Spain, and Switzerland.
Support for and Reported Compliance Among Smokers With Smoke-Free Policies in Air-Conditioned Hospitality Venues in Malaysia and Thailand: Findings From the International Tobacco Control Southeast Asia Survey
Authors: Yong Hua-Hie , Foong Kin , Borland Ron , Omar Maizurah , Hamann Stephen , Sirirassamee Buppha , Fong Geoffrey T. , Fotuhi Omid , Hyland Andrew
Published: June 2011

This study examined support for and reported compliance with smoke-free policy in air-conditioned restaurants and other similar places among adult smokers in Malaysia and Thailand. Baseline data (early 2005) from the International Tobacco Control Southeast Asia Survey (ITC-SEA), conducted face-to-face in Malaysia and Thailand (n = 4005), were used. Among those attending venues, reported total smoking bans in indoor air-conditioned places such as restaurants, coffee shops, and karaoke lounges were 40% and 57% in Malaysia and Thailand, respectively. Support for a total ban in air-conditioned venues was high and similar for both countries (82% Malaysian and 90% Thai smokers who believed there was a total ban), but self-reported compliance with bans in such venues was significantly higher in Thailand than in Malaysia (95% vs 51%, P < .001). As expected, reporting a ban in air-conditioned venues was associated with a greater support for a ban in such venues in both countries.
Socioeconomic and Demographic Factors Associated With Health Care Choices in Taiwan
Authors: Liu Chieh-Yu , Liu Jih-Shin
Published: June 2011

By using the data from the 2001 National Health Interview Survey and the National Heath Insurance database in Taiwan, this study aims at investigating the socioeconomic and demographic factors associated with different health care choices. This study incorporated hierarchical cluster analysis into multiple correspondent analysis to determine 5 attribute clusters of socioeconomic and demographic factors associated with different health care choices. This study found that older women with higher education levels were more likely to choose multiple sources of health care and that low- to middle-income people were more likely to use over-the-counter medications in pharmacies. In addition, people’s self-reported health care choices were inconsistent with their observed health care seeking behavior. The health policy authority may need to provide more health promotion education programs, especially for older women with higher educational levels, and funding incentives for quality of care provided rather than relying solely on reimbursements for episodic care.
Promoting Organ Donation Through an Entertainment— Education TV Program in Korea
Authors: Byoung Kwan Lee  , Hyun Soon Park  , Choi Myung-Il , Cheon Soo Kim
Published: June 2011

The purpose of this study is to investigate the effects of the characteristics of the program, Open Your Eyes, an entertainment—education TV program in Korea, on parasocial interaction and behavioral intention for organ donation. The results indicated that affective evaluation positively affected parasocial interaction with the program but cognitive evaluation negatively affected involvement with beneficiaries in the program. Also, it was found that cognitive evaluation of Open Your Eyes had a significant positive effect on behavioral intention. In addition, a significant positive effect of program engagement on the behavioral intention was found. Thus, the results indicate that individuals who feel program engagement of Open Your Eyes will be more likely to proceed with organ donation. However, no direct effect of involvement with the beneficiary and program hosts was found.
Estimation of Fatalities Due to Road Traffic Crashes in Karachi, Pakistan, Using Capture-Recapture Method
Authors: Muhammad Usman Lateef
Published: June 2011

The objective of the study was to estimate the magnitude of road traffic fatalities occurring in Karachi, Pakistan. A 2-source capture—recapture model was applied to obtain a reliable estimate of the magnitude of the problem. A conservative adjusted estimate of fatalities generated, using data from 2 sources matched by at least name, gender, age, and location. In 2008, police reported 616 fatalities whereas hospitals recorded 1092 fatalities due to road traffic crashes. The capture— recapture analysis estimated at least 1375 fatalities. Police data show 55% deficit from the estimated figure and 43.6% deficit from the observed one, whereas hospital data show 20.6% deficit from the estimation. Road traffic crashes and resulting fatalities and injuries are a much more substantial health problem than is evident from official statistics. The capture—recapture analysis can be used as a tool to provide affordable and reliable estimates in developing countries where routine official statistics suffer from underreporting.
Individual and Areal Risk Factors for Road Traffic Injury Deaths: Nationwide Study in South Korea
Authors: Park Kunhee , Hwang Seung-Sik , Lee Jin-Seok , Kim Yoon , Kwon Soonman
Published: June 2011

This study determines the individual and areal risk factors for road traffic injury deaths in South Korea. The risk factors that influence road traffic injury deaths are defined by multilevel Poisson regression analysis. It is seen that not only demographic factors but also individual educational level, which represents socioeconomic status, influences road traffic injury deaths. The material deprivation index, which represents areal socioeconomic status, and W statistics, as a measure of the quality of the emergency medical system in an area, also influence road traffic injury deaths. Based on this study, the most vulnerable group for road traffic injury deaths is elderly men with a low level of education who live in the most deprived areas.Therefore, preventive policies focusing on both these areas and this population demographic should be established.
Prevalence and Correlates of Problem Behaviors Among Adolescents in Hong Kong
Authors: Lau Maggie , Kan Ming-yue
Published: June 2011

The aims of this study were to examine the frequency and correlates of problem behaviors among Hong Kong adolescents. It is a cross-sectional survey targeting secondary forms 1 to 3 (equivalent to grades 7-9 in the United States) students (N = 1029). A self-administered questionnaire was used as the measurement tool. The study found that there are intercorrelations of problem behaviors in adolescence, such as tobacco use, alcohol use, drug abuse, and having connections with triad society. Given the intercorrelations among problem behaviors, identification of a single type of problem behavior in adolescents can help discover the likelihood of the occurrence of other problem behaviors. It can facilitate identification and intervention at an early stage. The results provide some insights for the concerned authorities to develop a syndrome approach addressing problem behaviors.
Awareness About Antiretroviral Treatment, Intentions to Use Condoms, and Decisions to Have an HIV Test Among Rural Northern Lowland Thai and Ethnic Minority Young Adults
Authors: Srithanaviboonchai Kriengkrai , Celentano David D. , Visaruratana Surasing , Kawichai Surinda , Wichajarn Monjun , Genberg Becky , Chariyalertsak Chonlisa , Kulich Michal , Chariyalertsak Suwat
Published: June 2011

Young adults aged 18 to 32 years were randomly selected from a household probability sample participating in Project Accept in the remote areas of Chiang Mai province in northern Thailand in 2005. Among 2989 respondents, 44.4% had never heard of antiretroviral treatment (ART). Lack of awareness of ART was independently associated with having had no formal education compared with some formal education and being an ethnic minority compared with being Thai. In all, 57% of the respondents who had ever heard of ART stated that if ART were easily available in their communities it would affect their intentions to be tested for HIV, whereas only 36% stated that this would affect their intentions to use condoms. Younger participants were less likely to intend to get an HIV test as compared with older individuals, and ethnic minorities were less likely to report that they would get an HIV test compared with Thai lowlanders. Single individuals and people who lived separately from their spouses were more likely to have the intention to use condoms if ART were available.
Utilization of Antenatal Care Services in Bangladesh: An Analysis of Levels, Patterns, and Trends From 1993 to 2007
Authors: Kishowar Hossain A.H.M.
Published: June 2011

Maternal mortality in Bangladesh was 320 per 100,000 live births between the years of 1998 and 2000. Utilization of maternal health services remains low in the low-resource countries like Bangladesh. This study attempts to evaluate the levels, patterns, and trends of utilization of antenatal care (ANC) services in Bangladesh. This is a descriptive study based on national surveys of Bangladesh Demographic and Health Survey (BDHS) 2007, 2004, 1999-2000, 1996-1997, and 1993-1994. Bangladeshi women reported low utilization of ANC. Approximately 52% of women received antenatal care from medically trained providers in 2007. The median number of ANC visits was 3.1 in 2007. About 63% of women were not informed about the signs of pregnancy complications. The proportion of women who received ANC services and information on the signs of pregnancy complications as well as the median number of ANC visits showed an increase in 2007 compared with 2004.
An Estimate of Patient Costs and Benefits of the New Primary Eye Care Model Utilization Through Vision Centers in Andhra Pradesh, India
Authors: Kovai Vilas , Rao Gullapalli N. , Holden Brien , Krishnaiah Sannapaneni , Bhattacharya Shubhra K. , Marmamulla Srinivas , Khanna Rohit
Published: June 2011

Little or no work has been carried out in developing countries on costs to patients and patient benefits in accessing primary eye care services. The purpose of this study was to assess the indirect, direct, and overall costs of patients accessing vision care at vision center services (New Primary Eyecare Approach) as compared with the nearest private clinic. The authors used a standardized questionnaire and a paired sample t test to check the significance of difference of costs. They considered a P value of <.05 as significant in this study. The total costs were significantly lower for patients who accessed the vision centers compared with the costs these patients may have incurred if they had sought services from the nearest town-based clinic (mean in Indian rupees [INR] of 178.4 ± 48.3, standard error of the mean = 4.2, and INR 366.2 ± 48.2, standard error of the mean = 4.2, respectively, t test P value < .001). vision centers, besides providing quality eye care services, offer substantial cost savings to rural populations compared with town-based optical clinics.
Review Paper: The Challenge of Emerging Zoonoses in Asia Pacific
Authors: Bhatia Rajesh , Narain Jai P.
Published: June 2011

Diseases transmitted from animals have assumed substantial public health importance. Avian influenza, severe acute respiratory syndrome, and Nipah virus infection are a few examples of growing number of diseases that humans can contract from animals. These diseases can cause huge economic losses in addition to mortality and morbidity. In developing countries of Asia, there is a continuous and close contact between animals and humans, especially in rural settings. The prevailing sociocultural practices and weak public health infrastructure further enhances the vulnerability of Asia as the epicenter of outbreaks due to zoonotic infections. There is a clear need of greater awareness and application of a multisectoral and multidisciplinary approach to prevent and control zoonotic infections.
Factors Related to Accelerometer-Derived Physical Activity in Pacific Children Aged 6 Years
Authors: Oliver Melody , Schluter Philip J. , Schofield Grant M. , Paterson Janis
Published: June 2011

The objective of this study was to investigate potential factors related to Pacific children’s moderate-to-vigorous physical activity (MVPA). A total of 393 Pacific children aged 6 years and their mothers were invited to participate. Participants wore accelerometers over 8 days; height, weight, and waist circumference were measured, and mothers reported on individual, social, and perceived environmental factors. Generalized estimation equation models were used to identify associates of children’s daily MVPA. In all, 135 children and 91 mothers were included in analyses. Children spent 24% of time in MVPA; 99% of days had ≥60 minutes of MVPA. Higher maternal MVPA, male sex, longer sunlight hours, and rain-free days were associated with children’s MVPA. Approaches for improving activity in Pacific children may be most efficacious if strategies for inclement weather and the encouragement of activity in mothers and, in particular, their daughters are included. Also, 60 minutes of daily MVPA may be insufficient to protect Pacific children from increased body size.
Health and Medical Research in Nepal: A Bibliometric Review
Authors: Simkhada Padam P. , Baral Yuba R. , van Teijlingen Edwin R.
Published: June 2011

This study aimed to quantify the following: (1) health research in academic journals covering Nepal, (2) location of authors, and (3) most prevalent specialties. Published health research conducted in Nepal during 1996 to May 2007 was assessed by searching from 4 electronic databases, and 631 research articles met the inclusion criteria. Only 11% was published in Nepalese journals. Most research covered urban districts. About two thirds of articles had Nepalese authors, but only 41% had a Nepalese first author. Child health and nutrition (11%), maternal health and women’s health (11%), and sexual reproductive health and HIV/AIDS, and family planning (11%) were the most common topics. Most articles (78%) reported quantitative methods. The number of research articles from Nepal is fairly small and concentrated on a limited number of topics and districts. Strategic planning is required to improve the research capacity of Nepal to achieve public health improvements using locally produced evidence.
Spatial and Gender Scenario of Literate Life Expectancy at Birth in India
Authors: Chattopadhyay Aparajita , Kumar Chiman Sinha
Published: June 2011

Measuring human quality of life is academically challenging. The human development index (HDI) substantially captures the overall country level status on human welfare. However, this index has some drawbacks. Therefore, Lutz composed a simple index in 1995 combining life expectancy and literacy, called literate life expectancy (LLE). LLE can be calculated for subpopulations depending on availability of data. This article captures the LLE in major states in India and the gender differences in LLE at rural and urban levels. The authors have tried to highlight the social development scenario in India and its major states by using this pure social indicator that intentionally does not use any economic measurement. The state scenario comprehensively depicts gender differentials in social development, and it calls for implementing development measures more seriously in states like Haryana, Bihar, Rajasthan, Madhya Pradesh, and Uttar Pradesh to reduce the gender gap. Being highly correlated with the HDI, the LLE index proves to be a very clear and simple comprehensive measure of social development for different subpopulations.
Conventional Versus Asset Approaches: Comparative Appraisal of Socioeconomic Indicators for Oral Health Research Among Adolescents in a Developing Country
Authors: Perera Irosha , Ekanayake Lilani
Published: June 2011

The aim of the study was to assess the value of different indicators of socioeconomic status for oral health research among Sri Lankan adolescents. Six indicators of socioeconomic status were assessed in terms of their relationship to 2 oral health outcomes. The sample consisted of 15-year-old students (n = 1218) selected from 48 schools in the Colombo district using a stratified cluster sampling technique. Data collection included oral examinations of students and questionnaires to both students and their parents. The correlations between the 6 indicators were low to moderate. The indicators of household material assets and parental educational status emerged as significant predictors of the 2 oral health outcomes. Therefore, it is concluded that indicators of material assets—namely, the family affluence scale and the asset index—could be used as optimal measures of socioeconomic status in oral health research among adolescents in Sri Lanka.
Uptake of Prenatal HIV Testing in Hai Phong Province, Vietnam
Authors: Nguyen Lan T. N. , Christoffersen Sarah V. , Rasch Vibeke
Published: June 2011

The objective of the study is to describe the uptake of prenatal HIV testing among Vietnamese women. Exit interviews were conducted among 300 women who had delivered at Hai Phong obstetrical hospital. Information about socioeconomic characteristics and HIV testing was obtained through structured questionnaire interviews. It was found that 45% of the women were tested for HIV before the end of 34 weeks of gestation, 5% in 35 to 40 weeks of gestation, and 55% at labor. Low educational levels, being a farmer or worker, having a low income, and living close to the hospital were associated with being tested at labor. When adjusting for possible confounders, however, living more than 15 km from the hospital was the only factor, which remained significantly associated with HIV testing during labor (odds ratio = 2.15; confidence interval = 1.14-4.04). The results suggest that many Vietnamese women are not tested for HIV during prenatal care and that a relationship exists between distance to the hospital and lack of HIV testing during pregnancy.
Adolescent Tobacco Use and Health in Southeast Asia
Authors: Al-Sadat Nabilla , Misau A.Y. , Zarihah Z. , Maznah Dahlui , Tin Tin Su
Published: June 2011

The use of tobacco by adolescents is a major public health concern worldwide. There are 1.2 billion smokers globally, of which more than 50% are young people. The Southeast Asian countries have about 600 million tobacco smokers within the global burden of tobacco users. Most smokers begin at early stage of life and persist through adulthood. Malaysia alone has about 5 million smokers, 20% of whom are younger than 18 years old. Many factors are implicated in the continuous rising trend of tobacco use among adolescents in Southeast Asia. A triad of family, environmental, and individual factors synergistically acts to motivate adolescents toward smoking. This article discusses the current trends of tobacco use and implications of increasing rise in adolescent smoking in the Southeast Asia region.
Global Public Health and the United Arab Emirates
Authors: Aw Tar-Ching
Published: June 2011

The United Arab Emirates (UAE), as a rapidly developing country in the Middle East, is in a good position to contribute to global health. It can share its experience of dealing with public health problems characteristic of a desert environment, and it can learn from the experience of other nations in tackling challenges posed by globalization. The health issues particular to the region include heat stress, the effects of consanguineous marriages on families and society, and exposure to occupational and environmental hazards. As in many other developed countries, the UAE also has public health problems associated with smoking, road traffic accidents, and obesity. The experience of other countries in dealing with infectious diseases has helped the UAE implement preventive measures to cope with infections such as the recent H1N1 pandemic. International collaboration has advantages to the UAE in managing problems pertaining to global public health.
Urban Environment and Health: Food Security
Authors: Galal Osman , Corroon Meghan , Tirado Cristina
Published: June 2011

The authors examine the impact of urbanization on food security and human health in the Middle East. Within-urban-population disparities in food security represent one of the most dramatic indicators of economic and health disparities. These disparities are reflected in a double burden of health outcomes: increasing levels of chronic disease as well as growing numbers of undernourished among the urban poor. These require further comprehensive solutions. Some of the factors leading to food insecurity are an overdependence on purchased food commodities, lack of sufficient livelihoods, rapid reductions in peripheral agricultural land, and adverse impacts of climate change. The Food and Agriculture Organization of the United Nations (FAO) Food Security Framework is used to examine and compare 2 cities in the Middle East: Amman, Jordan, and Manama, Bahrain.
Access to Diabetes Care and Medicines in the Philippines
Authors: Higuchi Michiyo
Published: June 2011

In the Philippines, diabetes is rapidly becoming a major public health issue, as in other low- and middle-income countries. Availability and affordability of care and medicines are crucial to control diabetes. This study describes the situations of diabetes patients and identifies possible barriers to diabetes care and medicines in the Philippines. Quantitative and qualitative data were collected from multilevel respondents using different semistructured questionnaires/checklists. The study revealed that many patients took intermittent medication based on their own judgment, and/ or selected certain pieces of medical advice, subjectively weighing symptoms against household budget. The current public health insurance scheme and decentralized health systems did not promote access to diabetes care. Investing in regular care is expected to be less expensive both for individuals and for society in the long-term. Insurance outpatient coverage and application of standard treatment/management guidelines will be of help to encourage providing and receiving regular care.
Global Flows in Drug Treatment: Heroin Addiction and Therapeutic Community Approaches in China
Authors: Hyde Sandra Teresa
Published: June 2011

This article focuses on one residential therapeutic community for the treatment of heroin and opiate addiction in contemporary China. It discusses 2 case vignettes and shows that although addictions are extremely difficult to treat, there are small successes being reached in China’s southwest. Residential treatment communities follow mobile global practices that link Western models of 12-step Narcotics Anonymous, self-healing, to other Chinese practices like Maoist “speak bitterness.” In China it is in the drug aid theaters where Sunlight-International traveled to do three things: (a) stave off the American drug market, (b ) reduce drug trafficking across national borders, and (c) address the psychosocial problems associated with global drug trafficking and consumption. Through the process of unraveling the on-the-ground practices of public health international humanitarian nongovernmental organizations and some of their therapeutic models, we begin to see new alliances formed across the globe around drug treatment and care that point toward important results.
Globalization and Reproductive Tourism in the United Arab Emirates
Authors: Inhorn Marcia C. , Shrivastav Pankaj
Published: June 2011

Over the past 2 decades, the discipline of anthropology has been deeply concerned with the processes and effects of globalization around the world. One of the major anthropological theorists of globalization, Arjun Appadurai, has delineated a “global cultural economy” in which global movements operate through 5 pathways, which he famously called “scapes.” This article uses the language of “scapes” to examine the global flows involved in so-called “reproductive tourism,” or the search for assisted reproductive technologies across national and international borders. Reproductive tourism entails a complex “reproscape” of moving people, technologies, finance, media, ideas, and gametes, pursued by infertile couples in their “quests for conception.” This article examines reproductive tourism to and from the United Arab Emirates, which is now the site of intense globalization and global flows, including individual and population movements for the purposes of reproductive and other forms of medical care.
Controlling Alcohol-Related Global Health Problems
Authors: Tai Hing Lam  , Chim David
Published: June 2011

Alcohol’s adverse public health impact includes disease, injury, violence, disability, social problems, psychiatric illness, drunk driving, drug use, unsafe sex, and premature death. Furthermore, alcohol is a confirmed human carcinogen. The International Agency for Research on Cancer concluded that alcohol causes cancer of the oral cavity, pharynx, larynx, esophagus, liver, colon—rectum, and breast. World Cancer Research Fund/American Institute for Cancer Research concluded that the evidence justifies recommending avoidance of consuming any alcohol, even in small quantities. Despite being responsible for 3.8% of global deaths (2 255 000 deaths) and 4.6% of global disability-adjusted life years in 2004, alcohol consumption is increasing rapidly in China and Asia. Contrary to the World Health Assembly’s call for global control action, Hong Kong has reduced wine and beer taxes to zero since 2008. An International Framework Convention on Alcohol Control is urgently needed. Increasing alcohol taxation and banning alcohol advertisement and promotion are among the most effective policies.
Methodological Considerations for Studying Diabetes: Understandings and Actions in Chennai, India
Authors: Lanthorn Heather E.
Published: June 2011

As per the World Health Organization’s global noncommunicable disease (NCD) strategy, data on health perceptions and behaviours are critical to designing and tailoring interventions to slow rising NCD prevalence and the toll on public health and economic well-being. Intervention planning, implementation, monitoring, and evaluation require understanding the relevant public’s sense of personal risk, prevention awareness, and willingness to undertake preventative measures, as well as structural barriers impeding engagement in healthy behaviours, seeking treatment, and managing illness. This article details the design features and challenges of a study focused on the aforementioned features in Chennai, India. These features and challenges have relevance across Asia. As such, communication and collaboration between Asian researchers and program planners can enrich results for all involved. Establishing such a forum should be high on Asia’s global health agenda.
Implementation of a Registry for Acute Coronary Syndrome in Resource-Limited Settings: Barriers and Opportunities
Authors: Safavi Kyan , Linnander Erika L. , Allam A.A. , Bradley Elizabeth H. , Krumholz Harlan M.
Published: June 2011

Cardiovascular disease (CVD) is the leading cause of death in Egypt and worldwide, placing great strain on the world’s health systems. High-quality treatment of CVD requires a valid, reliable measurement for ensuring evidence-based care. Clinical outcomes registries have been used to support quality improvement activities in some countries, but there are few examples of their implementation in resource-limited settings. A registry for acute coronary syndrome was piloted in 5 hospitals in Egypt, and observations regarding barriers and enabling factors related to implementation are summarized. Themes that emerged from daily observations include the importance of rapid cycles of change, the need to build a culture of applied research, the importance of modeling a blame-free culture, and key constraints encountered related to human resources and technical infrastructure. This pilot demonstrates that clinical registries may be a cost-effective investment in data infrastructure to support quality improvement in low- and middle-income countries.
Educational and Structural Interventions and Their Impact on Condom Use and STI/HIV Prevention for Filipina Women and Male Customers
Authors: Morisky Donald E. , Tiglao Teodora V.
Published: June 2011

Nearly 30 million people have died of AIDS during the past 27 years. More than 90% of people with HIV live in the developing world. The virus does not discriminate by age, race, gender, ethnicity, sexual orientation, or socioeconomic status—anyone is susceptible. HIV/AIDS has been particularly devastating on women and girls who now comprise more than 50% of people aged 15 years and older living with HIV. Successful strategies with significant impact on new HIV infections include strong governmental support, voluntary counseling and treatment, harm-reduction, community outreach, and universal access to treatment. This study presents the results of educational and social structural/environmental behavioral interventions among young women and their male partners. A 10-year study among high-risk populations (female bar workers and their male customers) in the Philippines identifies major components of a model HIV prevention program.
Building Research Evidence for Policy Advocacy: A Qualitative Evaluation of Existing Smoke-Free Policies in Lebanon
Authors: Nakkash Rima T , Khalil Joanna , Chaaya Monique , Afifi Rema A.
Published: June 2011

Secondhand smoke is harmful to smokers and nonsmokers, and smoke-free legislation worldwide improves health status. Lebanon has one of the weakest tobacco control regulatory environments in the Eastern Mediterranean region. However, several Lebanese workplaces and hospitality venues have chosen to implement such policies on their own. The objective of this study was to document their experiences. Qualitative interviews and focus group discussions were conducted with management, employees, and clients. Thematic analysis was used to identify recurrent themes. Results describe the types of bans implemented; the reasons for adopting a policy; and the barriers and facilitators to implementation, enforcement, and compliance. A main facilitator was management support, whereas a main barrier was prosmoking norms. This analysis provides insight and lessons learned that can aid in scaling up tobacco control efforts in Lebanon and the Eastern Mediterranean region.
Violence and Adolescent Mental Health in the Occupied Palestinian Territory: A Contextual Approach
Authors: Rabaia Yoke , Giacaman Rita , Nguyen-Gillham Viet
Published: June 2011

During the past decade, the Institute of Community and Public Health at Birzeit University has focused on youth psychosocial mental health research with special attention given to protective factors and forms of resilience adopted by people coping with extraordinary and violent times. The authors take a critical view of the predominantly biomedical interventions adopted by humanitarian aid agencies and question the utility of therapeutic forms of interventions introduced by Western medicine. In a context of collective exposure to violence, individual healing methods based on one-to-one counselling generally have little effect. An alternative approach is proposed that views Palestinian mental health within the historical and political context of loss and injustice, while acknowledging the lack of human security and social justice as a determining factor. In building an argument for the development of psychosocial mental health interventions that are contextually appropriate to the Palestinian situation and collective in nature, the authors present an example of an intervention designed and developed in joint cooperation between a Palestinian academic institution and a Palestinian partner in the field.
Sexual Health, Marital Sex, and Sexual Risk in Urban Poor Communities in India
Authors: Bojko Martha J. , Schensul Stephen L. , Singh Rajendra , Burleson Joseph A. , Moonzwe Lwendo S. , Saggurti Niranjan
Published: June 2011

Marital sex has been an unaddressed component of sexual risk. This article explores marital sex and its link to men’s extramarital sexual behavior in 3 economically marginal communities in Mumbai, India. Using in-depth interviews with women, men, and couples, qualitative results are presented on first night experiences, ability of women to refuse their husbands’ demands for sex, sexual communication, and sexual pleasure associated with marital sex. Using regression analysis of survey data for 260 couples, the quantitative results indicate that greater sexual satisfaction for both men and women is significantly related to men’s lesser involvement in extramarital sex. These results provide a basis for a couples’ intervention effort that can yield greater marital and sexual communication and reduction in sexual risk.
Body Image, Health, and Modernity: Women’s Perspectives and Experiences in the United Arab Emirates
Authors: Trainer Sarah S.
Published: June 2011

The countries of the Arab Gulf have experienced accelerated development and urbanization over the last 50 years. Changes in health have likewise been dramatic: Kuwait, Saudi Arabia, Bahrain, and the UAE now have some of the highest proportions of obese/overweight people in the world, with correspondingly high rates of chronic disease. In the UAE, particularly high rates of obesity/overweight have been reported among middle-aged Emirati women, but other problems relating to health and nutrition are starting to be identified in younger age groups as well. This article describes preliminary data from a project among young Emirati women in the UAE. This study examines how these women cope with the increased availability of fast food, changing work patterns, and evolving ideas about body image, “risk,” and health within a larger context of increasing chronic disease and weight gain throughout the UAE.
Opium Trade, Insurgency, and HIV/AIDS in Afghanistan: Relationships and Regional Consequences
Authors: Griffin Nevada , Khoshnood Kaveh
Published: June 2011

Global health and conflict studies share key linkages that have important research and policy implications but for which data are currently lacking. This analytical review examines the ongoing conflict in Afghanistan, using it as a basis to develop a conceptual framework that integrates security and public health concepts. The analysis draws on recent peer-reviewed and gray literature to assess the interrelationship among 3 variable clusters and their impact on the emergence of the HIV epidemic in Afghanistan. The evidence suggests that there is a complex indirect relationship linking illicit opium trade, the ongoing insurgency, and forced and spontaneous migration to the emergence of an injection drug use—driven HIV epidemic in Afghanistan. These findings demonstrate a clear need for an integrated cross-disciplinary and regional approach to the emerging threat of HIV/AIDS in Afghanistan, to inform more balanced and effective policy making in this and other regions of strategic global import.
The Bahasa Melayu Version of the Nursing Stress Scale Among Nurses: A Reliability Study in Malaysia
Authors: Muhamad Robat Rosnawati  , Moe Htay , Masilamani Retneswari , Darus A.
Published: June 2011

The Nursing Stress Scale (NSS) has been shown to be a valid and reliable instrument to assess occupational stressors among nurses. The NSS, which was previously used in the English version, was translated and back-translated into Bahasa Melayu. This study was conducted to assess the reliability of the Bahasa Melayu version of the NSS among nurses for future studies in this country. The reliability of the NSS was assessed after its readministration to 30 nurses with a 2-week interval. The Spearman coefficient was calculated to assess its stability. The internal consistency was measured through 4 measures: Cronbach’s α, Spearman—Brown, Guttman split-half, and standardized item α coefficients. The total response rate was 70%. Test—retest reliability showed remarkable stability (Spearman’s ρ exceeded .70). All 4 measures of internal consistency among items indicated a satisfactory level (coefficients in the range of .68 to .87). In conclusion, the Bahasa Melayu version of the NSS is a reliable and useful instrument for measuring the possible stressors at the workplace among nurses.
Body Mass Index Among Melanesian and Indian Fijians Aged ≥ 40 Years Living in Fiji
Authors: Brian Garry , Ramke Jacqueline , Maher Louise , Page Andrew , Fischer-Harder Konstanze , Sikivou Biu
Published: June 2011

To determine the distribution and sociodemographic associations of body mass index (BMI; kg/m2) among Melanesian and Indian Fijians aged ≥40 years living in Fiji, a population-based cross-sectional survey with multistage random sampling was conducted in 2009. Melanesians were more likely to have BMI ≥25 (odds ratio [OR] = 4.73; 95% confidence interval [CI] = 3.57-6.28; P < .001) and BMI ≥30 (OR = 3.84; 95% CI = 2.94-5.03; P < .001). Among Melanesians, gender and educational attainment were predictive of BMI ≥25 on multivariate analysis. Women were more likely to be overweight (OR = 2.03; 95% CI = 1.34-3.06) or obese (OR = 1.92; 95% CI = 1.43-2.59). Among Indians, gender and age were predictive of BMI ≥25. Again, women were more likely to be overweight (OR = 2.51; 95% CI = 1.69-3.73) or obese (OR = 3.71; 95% CI = 2.19-6.29). Gender—age—domicile-adjusted, and extrapolating across Fiji, 0.3%, 84.5%, and 51.7% of Melanesians aged ≥40 years had BMI <18.5, ≥25, and ≥30, respectively. Among Indians, these values were 5.8%, 54.2%, and 21.2%, respectively.