Dissertations / Theses on the topic 'Global health'
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1
Wood, David. "Framework for Global Health and Global Health Electives Opportunities at Quillen COM." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7680.
2
Shah, Rebecca Sonul. "Global health inequality : Justice and public health ethics." Thesis, Keele University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.535801.
Abstract:
This thesis is motivated by the intuition that current extremes of global health inequality and deprivation constitute moral problems of the utmost importance. It aims to advance our understanding of how we should think about and be morally guided in our responses to global health inequality by engaging critically with literature and arguments at the intersection of global health, public health and social justice. Part I addresses the more conceptual question of how we should think about global health inequality. I suggest that we reject international empirical, operational and normative accounts of global health inequality in favour of genuinely global approaches. I suggest five core features of public health practice and ask whether they are meaningful at the global level. I find no argument for why the features of public health may not relate to the global sphere convincing and therefore tentatively conclude that we might think of global health inequality as a matter of public health. Part II addresses the more normative question of how we should be morally guided in our responses to global health inequality. Through engagement with the public health ethics literature I propose two roles for justice as a core public health value. First, justice may be an ethical principle guiding how public health is practiced, and second justice may provide the normative justification for why public health is practiced. I identify existing accounts of public health ethics and theories of justice reflecting these twin justice roles and evaluate how well they can morally guide our responses to global health inequality. I conclude by suggesting that public health may be a social institution governed by the principles ofjustice at the global level and that public health may be a human right which should be globally fulfilled as requirement of justice.
3
Kiddell-Monroe, Rachel. "Global governance for health: a proposal." Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=117209.
Abstract:
Global health governance structures today are failing to address the global health crises either of communicable or non-communicable diseases (NCDs). I demonstrate that global health governance is characterised by a market justice approach to health and a lack of global health leadership, as evidenced by the negotiation of global intellectual property regulations and recent debates on access to NCD medicines. This raises three challenges for global health: (i) addressing broad participation, (ii) the dilution of the meaning of global health, and (iii) the co-optation of the global health agenda by corporate interests. Analysing the existing proposals from scholars in global health governance, I demonstrate that features of a policentric model of constitutional interpretation could be adapted to the global health context. I suggest that the three challenges can be addressed by establishing the respective roles and authority of the multiple global health actors under a post-Westphalian 'multicentric global governance for health' model. By tackling the trend of market justice in health and the absence of leadership in global health, multicentric global governance for health offers a framework in which WHO, States and non-State actors can collectively govern global health so as to promote equity and social justice.Les structures de gouvernance de la santé mondiale n'ont pas su répondre à la crise sanitaire mondiale à l'égard des maladies soient transmissibles ou non transmissibles. Je démontre que la gouvernance de la santé mondiale se caractérise par une approche à la santé de justice de marché et un manque de leadership en santé mondiale, comme en témoigne la négociation de règlements mondiaux sur la propriété intellectuelle et l'accès aux médicaments pour les maladies non transmissibles. Ceci soulève trois défis pour la santé mondiale: (i) aborder la question d'une large participation, (ii) l'affaiblissement du sens à donner à la santé mondiale, et (iii) la cooptation du programme sanitaire mondiale par des intérêts corporatifs.Suivant l'analyse des propositions de spécialistes en matière de gouvernance de la santé mondiale, je propose que des caractéristiques d'un modèle policentrique d'interprétation constitutionnelle pourraient être adaptées à un contexte sanitaire mondial. Je soutiens que les trois défis pourraient être traités en établissant les rôles respectifs des multiples acteurs en santé globale dans un modèle post-Westphalien de « gouvernance mondiale multicentrique pour la santé ». En attaquant la tendance de justice de marché en santé ainsi que le manque de leadership en santé mondiale, la gouvernance multicentrique pour la santé offre un cadre dans lequel l'Organisme mondiale de la santé, les États et les acteurs non Étatiques peuvent collectivement gouverner la santé mondiale afin de promouvoir l'équité et la justice sociale.
4
Kniess, Johannes. "Justice in health : social and global." Thesis, University of Oxford, 2017. https://ora.ox.ac.uk/objects/uuid:c1b36ded-85da-4888-91ce-83c164252f93.
Abstract:
Within and across all societies, some people live longer and healthier lives than others. Although many of us intuitively think of health as a very important good, general theories of justice have hitherto paid little attention to its distribution. This is a thesis about what we owe to one another, as a matter of justice, in view of our unequal levels of health. The first part of the thesis addresses the problem of social justice in health. I argue that the basic institutional framework of society must be arranged so as to ensure an egalitarian distribution of the 'social bases of health,' that is, the socioeconomic conditions that shape our opportunities for a healthy life. Inequalities in health, including those caused by differences in individual lifestyles, are only fair when people have been given fair opportunities. This egalitarian approach to the social bases of health must be complemented by a sufficientarian concern for meeting all basic health needs, regardless of whether these originate in unfair social arrangements. The second part of the thesis takes up the problem of global justice in health. Although I argue against the idea that domestic principles of justice can be simply replicated on a global scale, I emphasise the fact that there are a number of international institutions and practices that shape people's opportunities for health. One of these is the state system - the division of the world into sovereign states - which I argue grounds the idea of the human right to health. I also examine two more specific examples of global practices that contribute to global inequalities in health, namely global trade in tobacco and the global labour market for healthcare workers. Both of these, I suggest, must be restricted in light of their impact on health levels worldwide.
5
Li, Julia Fan. "Innovation management by global health entrepreneurs." Thesis, University of Cambridge, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.608021.
6
de, Campos Thana Cristina. "Responsibilities for the global health crisis." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:3e22ef01-09ec-435c-8264-ae05d6a371ba.
Abstract:
This thesis aims to provide a framework for analyzing the moral responsibilities of global agents in what I call the Global Health Crisis (GHC), with special attention devoted to the moral responsibilities of pharmaceutical companies. The main contribution of this thesis is to provide a general account of the moral responsibilities of different global players, mapping the different kinds of duties they have, their content and force, and their relation to the responsibilities of other relevant actors in the GHC. I also apply this account to current debates surrounding the need for reforms to the international legal rules addressing the GHC, notably the TRIPs regime. In doing so, this thesis will discuss the allocation of responsibilities for the GHC among different global players, such as state and non-state actors, the latter including pharmaceutical companies. In order to investigate the allocation of duties, I will first analyze the object of such allocation which constitutes the object of the current GHC (Part A); then the agents responsible for addressing this crisis (Part B); and finally, existing institutional alternatives to reform the international legal rules addressing the GHC, such as the TRIPs regime (Part C).
7
D'Ambruoso, Lucia. "Global health post-2015 : the case for universal health equity." Umeå universitet, Epidemiologi och global hälsa, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-71419.
Abstract:
Set in 2000, with a completion date of 2015, the deadline for the Millennium Development Goals is approaching, at which time a new global development infrastructure will become operational. Unsurprisingly, the discussions on goals, topics, priorities and monitoring and evaluation are gaining momentum. But this is a critical juncture. Over a decade of development programming offers a unique opportunity to reflect on its structure, function and purpose in a contemporary global context. This article examines the topic from an analytical health perspective and identifies universal health equity as an operational and analytical priority to encourage attention to the root causes of unnecessary and unfair illness and disease from the perspectives of those for whom the issues have most direct relevance.
8
Aceves, Martins Magaly. "Health promotion in youth as a global public health challenge: effective strategies to encourage healthy lifestyles." Doctoral thesis, Universitat Rovira i Virgili, 2016. http://hdl.handle.net/10803/396152.
Abstract:
La combinació de més d'un strategia metodològica (com el màrqueting social, la participació de la joventut, l'educació dirigida per iguals i l'ús dels mitjans de comunicació social) i strategias de cambio de antorn (intervenció basada en l'escola, basada en la intervenció restaurant, basat en la família de la intervenció) pot augmentar l'eficàcia de involucrar els joves en les intervencions de salut destinades a fomentar hàbits i estils de vida saludables. Aquesta tesi té com a objectiu comprendre els factors que intervenen en l'epidèmia de l'obesitat juvenil a tot el món i com influeixen en l'obesitat. En resposta a aquest desafiament global, aquest treball proporciona estratègies basades en proves científiques innovadores, eficaces i de qualitat per millorar els estils de vida saludables entre els joves. Aquestes estratègies podrien donar lloc a un enfocament d'investigació més fort que podrien beneficiar tant a la comunitat científica i el coneixement general de les parts interessades i els responsables polítics, fomentant així un enfocament multidisciplinari participatiu i inclusiu per obtenir resultats duradors i eficaçosLa combinación de más de una estrategía metodológica (como el marketing social, la participación de la juventud, la educación dirigida por pares y el uso de los medios de comunicación social) y/o de una estrategia de cambio de entorno (intervención basada en la escuela, basada en la intervención restaurante, basado en la familia de la intervención) puede aumentar la eficacia de involucrar a los jóvenes en las intervenciones de salud destinadas a fomentar hábitos y estilos de vida saludables. Esta tesis tiene como objetivo comprender los factores que intervienen en la epidemia de la obesidad juvenil en todo el mundo. En respuesta a este desafío global, este trabajo proporciona estrategias basadas en pruebas científicas innovadoras, eficaces y de calidad para mejorar los estilos de vida saludables entre los jóvenes. Estas estrategias podrían dar lugar a un enfoque de investigaciónque podrían beneficiar tanto a la comunidad científica y el conocimiento general de las partes interesadas en prevenir este problema así como a responsables políticos, fomentando así un enfoque multidisciplinario participativo e inclusivo para obtener resultados duraderos y eficaces.
The combination of more than one methodological (such as social marketing, youth involvement, peer-led education and social media usage) and environmental (school-based intervention, restaurant-based intervention, family-based-intervention) strategy may increase the effectiveness of engaging young people in health interventions aimed at encouraging healthy habits and lifestyles. This thesis aims to understand the factors involved in the worldwide youth obesity epidemic and how they influence obesity. In response to this global challenge, this work provides innovative, effective and quality scientific evidence-based strategies for improving healthy lifestyles among young people. These strategies could lead to a stronger research approach that could benefit both the scientific community and the general knowledge of relevant stakeholders and policy makers, thus fostering a participatory and inclusive multidisciplinary approach for long-lasting and effective results.
9
Wood, David L. "ETSU and Timmy Global Health in Ecuador." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/5164.
10
Johnson, Karin Elena. "Bordering on health : origins and outcomes of the idea of global health /." Thesis, Connect to this title online; UW restricted, 2003. http://hdl.handle.net/1773/15461.
11
Hoffman, Steven Justin. "Reimagining international law to address global health challenges." Thesis, Paris, Institut d'études politiques, 2016. http://www.theses.fr/2016IEPP0024/document.
Abstract:
Cette thèse présente trois études qui imaginent à nouveaux frais la définition et le rôle du droit international dans la réponse que l’on peut apporter aux menaces transnationales contre la santé et aux inégalités sociales. Le premier chapitre évalue les capacités qu’ont les lois internationales traditionnelles de promouvoir la santé mondiale, en étudiant en particulier quand et pourquoi des traités internationaux sur la santé peuvent être utiles. Une synthèse de 90 évaluations d’impact quantitatif de traités passés a été réalisée et un cadre analytique a été développé. Le deuxième chapitre s’appuie sur ce travail pour évaluer une large gamme de possibilités de travailler en vue d’une action mondiale collective portant sur la résistance aux antimicrobiens, dont celles qui impliquent la construction d’institutions, la conception d’incitations et la mobilisation d’intérêts. Ce chapitre soutient que leur impact sur le monde réel dépend de relations d’imputabilité fortes. Le troisième chapitre porte cette thèse au-delà des notions westphaliennes traditionnelles d’action collective en s’intéressant à la question de savoir si de nouvelles technologies perturbatrices peuvent théoriquement produire les mêmes effets de régulation sur les questions de santé au niveau mondial que des lois internationales négociées par les États. Dans un premier temps, ce chapitre présente un modèle relativement simple d’apprentissage automatique qui quantifie automatiquement la pertinence, la qualité scientifique et le sensationnalisme des articles et valide ce modèle à partir d’un corpus de 163 433 articles de presse mentionnant les pandémies récentes de SARS et de H1N1This dissertation presents three studies that reimagine the definition and role of international law to address transnational health threats and social inequalities. The first chapter assesses opportunities for traditional international laws to promote global health, specifically examining when and why global health treaties may be helpful. Evidence from 90 quantitative impact evaluations of past treaties was synthesized and an analytic framework was developed. The second chapter builds on this work by evaluating a broad range of opportunities for working towards global collective action on antimicrobial resistance, including those that involve building institutions, crafting incentives and mobilizing interests. This chapter argues that their real-world impact will depend on strong accountability relationships. The third chapter takes this dissertation beyond traditional Westphalian notions of collective action by exploring whether new disruptive technologies can theoretically provide the same global regulatory effects on health matters as state-negotiated international laws. As a first move, this chapter presents a relatively simple machine-learning model that automatically quantifies the relevance, scientific quality and sensationalism of news media records, and validates the model on a corpus of 163,433 news records mentioning the recent SARS and H1N1 pandemics
12
Gagnon, Michelle L. "Global Health Diplomacy: Understanding How and Why Health is Integrated into Foreign Policy." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23141.
Abstract:
This study explores the global health diplomacy phenomenon by focusing on how and why health is integrated into foreign policy. Over the last decade or so, precipitated primarily by a growing concern about the need to strengthen global health security and deliver on the Millennium Development Goals, foreign policymakers have been paying more attention to health as a foreign policy concern and several countries have adopted formal global health policy positions and/or strategies. To elucidate a deeper and clearer understanding of how and why health is integrated into foreign policy, this thesis used a case study research design that incorporated literature and document review and interviews with twenty informants to conduct an in-depth analysis of the United Kingdom’s (UK) Health is Global: A UK Government Strategy 2008-13. Health is Global represents the first example of a formal national global health strategy developed using a multi-stakeholder process. Briefer background case reviews of three nations that are leaders in global health diplomacy - Brazil, Norway and Switzerland, were also conducted to inform the analysis of the in-depth case. Policy analysis included categorizing data into five areas: context (why?), content (what?), actors (who?), process (how?) and impact (so what?). The Multiple Streams Model of Policymaking and Fidler’s health and foreign policy conceptualizations - revolution, remediation and regression - were used to analyze the findings. Based on this analysis, the primary reason that the countries examined have decided to focus more on global health is self-interest - to protect national and international security and their economic interests. Investing in global health was also seen as a way to enhance a state’s international reputation. In terms of self-interest, Brazil was an outlier, however. International solidarity and health as a human right have been the driving forces behind its long-term investment in development cooperation to date. Investing in health for normative reasons was also a prevalent through weaker theme in the UK, Swiss and Norwegian cases. The study highlighted the critical role that policy entrepreneurs who cross the domains of international relations and health play in the global health policymaking process. In regards to advancing a conceptual understanding of global health diplomacy, the findings propose that the whole-of-government global health policymaking process is a form of global health diplomacy. The thesis elucidated factors that underpin this process as well as lessons for other nations, in particular, Canada. While ascertaining the impact of national global health strategies was not the main objective of this thesis, the study provided an initial look at the impact of these policy instruments and processes. Such impacts include better collaboration across government actors leading to enhanced policy coherence and a more strategic focus on global health. Finally, some have argued of late that the global health revolution is over due to the current world economic crisis. Considering the level of interest in whole-of-government global health strategies and the ever growing and sophisticated world-wide global health policy community, based on this thesis, the global health revolution is alive and well.
13
Magill, Elizabeth. "The Myth of Integration: Diffusion of Health Systems Strengthening Norm in Global Health." Thesis, Boston College, 2017. http://hdl.handle.net/2345/bc-ir:107443.
Abstract:
Thesis advisor: Sarah BabbSince 2000, the global health management approach of health systems strengthening (HSS) has gained support from many local and international stakeholders. This thesis investigates the diffusion of the HSS norm in the global health community and within two disease programs of malaria and tuberculosis. I show how strong support for HSS by the global health community has been overwhelmed by coercive pressure from resourcewielding funding and governance structures. Drawing on organizational theory, I argue that global health organizations and experts have engaged in strategic social reconstruction and avoidance tactics to rationalize hypocrisy towards the HSS norm
Thesis (BA) — Boston College, 2017
Submitted to: Boston College. College of Arts and Sciences
Discipline: Scholar of the College
Discipline: International Studies
14
Sherrod, Rebecca J. "The Politics of Operationalizing the World Health Organization Activities: Global Politics, health security and the Global Outbreak Alert and Response Network." Thesis, Virginia Tech, 2018. http://hdl.handle.net/10919/88823.
Abstract:
Infectious diseases attract a lot of mediatic, cultural and political attention. But are those diseases like Ebola, or ‘disease x’ actually what kills us? Since 1946, the WHO is the most authoritative figure in the fights against infectious disease outbreaks. So how does the WHO maintain this power and authority after tremendous budget cuts, competition for authority, and a shift to non-communicable disease epidemiology? This thesis uses a mixed-methods approach of quantitative analysis of ‘Disease Outbreak News’ reports, and qualitative analysis of key WHO literature, to develop the alternative narrative answering those questions. This thesis found that the WHO activities surrounding the collection and distribution of data create a political and institutional environment in which the WHO seems to be the only logical solution to prevent them. Additionally, the narrative put forth by the WHO prioritizes the ‘alert and response’ and operational capabilities of the organization to further expand authority in outbreak response. This study concludes that the WHO, through the collection and distribution of knowledge, and efforts to increase operational capability as seen through the Global Outbreak Alert and Response Network (GOARN), seeks to maintain normative authority and power as an international organization.M.A.
Globalization of trade and travel has only increased the fear of infectious disease transmission. There is a great demand for a global health security system that is alert and capable. Based on this ‘threat’ the WHO justifies their role as global health leader. The Global Outbreak Alert and Response Network (GOARN) is the system that currently acts as the operational arm of the WHO, monitoring and coordinating response to infectious disease outbreaks globally. Despite the critical role of GOARN, its day-to-day endeavors remain unexplored by the public health field. This thesis analyzes how the WHO uses GOARN and its surveillance capabilities to collect and transform data as a method to maintain normative authority, and projects a powerful narrative as the leader of ‘alert and response’. In a competitive environment with limited financial resources, the WHO has adapted in terms of surveillance and operational capability to maintain its leadership and authority in the global public health field.
15
Bryson, Maggie. "Global immunization policy making processes." Thesis, University of Ottawa (Canada), 2009. http://hdl.handle.net/10393/28146.
Abstract:
Despite national immunization programs existing in each country, the national immunization policy development processes are not well described. One approach used to facilitate the process is that of national immunization technical advisory groups (ITAGs) which make technical recommendations to the national government to guide immunization policies and programs. To better understand the current policy making processes of countries across the globe, a systematic review as well as a global level survey were conducted. This thesis summarizes the characteristics of national immunization policy development processes in all countries as well as the existence of national ITAGs and their characteristics and modes of operation. In conclusion, ITAGs are considered a useful tool by countries for immunization policy development but many countries lack this tool and many of the existing groups need strengthening. Additional evaluation of these groups and further research is needed.
16
Sawleshwarkar, Shailendra Nagorao. "Analysing a Global Health Education Framework for Public Health Education Programs in India." Thesis, The University of Sydney, 2021. https://hdl.handle.net/2123/25089.
Abstract:
Academic global health is of increasing interest to educators and students in public health but competency domains as well as education pathways that deliver this training, are still being identified and refined.
This thesis was undertaken using an education program development paradigm and aimed to analyse the factors shaping global health education in India by examining multistakeholder perspectives. The research framework consisted of four components: curriculum and content, students, faculty and key experts, and employers. Studies captured the perspectives of students through a survey and focus group discussions, faculty and other key experts through semi-structured interviews, and employers through job advertisement analysis.
We identified eleven global health competency domains focussed on three aspects: foundational competencies, core public health skills and soft skills. Global health and public health were seen as interconnected, with global health having transnational context and public health having a more national focus. Global health was seen as a nascent concept in India and although integration of global health education into the public health curriculum was supported, there were concerns given that public health is still too new a discipline in India. Global health competencies were seen as a ‘step up’ from the public health competencies.
Based on the results, a two-level approach to global health education is proposed for Indian public health institutions. The first approach, targeted at recent graduates, focuses on a ‘foundational global health education’ within public health programs such as an MPH. The second approach is an ‘Executive Global Health Certificate Program’, aimed at experienced public health professionals planning to enter the global health workforce.
This thesis has outlined a framework for Indian and other LMIC institutions looking to expand the scope of public health education and intend to develop global health education programs.
17
Havemann, Matthias [Verfasser], and Stefan [Akademischer Betreuer] Bösner. "Global Health als Themenfeld in der medizinischen Ausbildung – eine qualitative Studie unter Global Health-Lehrenden in Deutschland / Matthias Havemann ; Betreuer: Stefan Bösner." Marburg : Philipps-Universität Marburg, 2021. http://d-nb.info/1229620001/34.
18
Rodriguez, Eduardo Xavier. "Redirecting treatment paradigms in global and regional health policy." Honors in the Major Thesis, University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1487.
Abstract:
This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Office of Undergraduate Studies
Undergraduate Studies
19
Karlsson, Anders. "Green technology patents : TRIPS, compulsory licensing and global health." Thesis, Stockholms universitet, Juridiska institutionen, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-109424.
20
Storeng, Katerini T. "Safe motherhood : the making of a global health initiative." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2010. http://researchonline.lshtm.ac.uk/1487656/.
21
Modayil, Maria I. "Global Health Experiences in the Development of Healthcare Professionals." Ohio University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1597416179932742.
22
Leon, Joshua K. "The Rise of Global Health: Consensus, Expansion and Specialization." Diss., Temple University Libraries, 2010. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/72941.
Abstract:
Political SciencePh.D.
This dissertation examines the rise of global health assistance among states, multilateral institutions and NGOs. Resources devoted to global public health expanded rapidly in the 1990s and 2000s, outpacing other areas of development. New agencies have emerged to address public health issues, and existing organizations such as the UNDP, World Bank and EU have expanded their global health operations. Critics fear that the global health regime will become inefficient as it grows, duplicating tasks and skewing resources. The regime complex literature predicts similar suboptimal outcomes. These fears are overblown. While certain inefficiencies are likely as any regime expands, data shows that the allocation of resources generally reflects global health needs. Increased competition, thought to lessen efficiency, has actually pressured multilateral actors to specialize. Specialization offsets the problem of overlapping tasks. The modern global health regime is characterized by increased size, competition, specialization, and a prevailing consensus that emphasizes health as a central component of international development. This consensus holds that societal health prefigures economic growth. The international community, moreover, should cost effectively use increased aid to address the worst disease burdens in the poorest countries. In the cases of states, domestic interests play a role in shaping specialization patterns. Pressure from increased international competition has pressed multilateral institutions to reform and adapt to changing conditions in order to remain relevant in a denser global environment. The diverse cases explored in this dissertation (US, Japan, Sweden, Canada, World Bank, WHO, UNDP and EU) show high degrees of specialization and a surprisingly similar adherence to the consensus.
Temple University--Theses
23
Pearson, Georgina. "Global health, local realities : neglected diseases in northwestern Uganda." Thesis, London School of Economics and Political Science (University of London), 2015. http://etheses.lse.ac.uk/3303/.
Abstract:
This thesis explores the everyday realities of neglected diseases among people living and working along the River Nile in Moyo and Adjumani Districts, northwestern Uganda. It is based on ethnographic-epidemiological fieldwork carried out over sixteen months during 2013 and 2014. The fieldwork included participant-observation, in-depth interviews and a parasitological survey with structured questionnaire. This thesis takes an interdisciplinary approach in studying global health, contributing to literature at the intersection between medicine and anthropology. The neglected tropical diseases are a group of diverse diseases framed in global health around common socio-economic-political features, persisting in poverty. They affect neglected populations, neglected by public health policy. Current approaches to their management are largely a collection of technical, diseasefocused programmes that disregard the politics of poverty. Contemporary debates surround the side-lining of social science literature, and the evidence behind the biomedically focussed disease control programmes. Fisherfolk are said to be vulnerable to a number of these diseases. Diseases such as intestinal schistosomiasis (one of the neglected tropical diseases) persist in fishing areas despite a global public health programme. However, as this study demonstrates, in northwestern Uganda levels of schistosomiasis infection appear to have reduced. This study situates the success of the global health control programme within the local biosocial context. Furthermore, it shows that while one neglected tropical disease is controlled, other diseases persist and emerge. These other diseases explored in this research were Buruli ulcer and Hepatitis B, diseases that challenged the global health concept of neglected tropical diseases. This thesis contributes methodologically to the growing interdisciplinary field of global health. It provides empirically-based biosocial evidence of the local realities of neglected diseases. In taking this approach, it argues that this concept is misleading. While it has illuminated particular problems in global health, the restrictive gaze disregards local public health concerns.
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Wesley, Brad A. "Connecting the dots: how U.S. global health programs can improve international health regulation compliance." Thesis, Monterey, California: Naval Postgraduate School, 2014. http://hdl.handle.net/10945/44687.
Abstract:
Approved for public release; distribution is unlimitedWith a 2012 deadline, the majority of the World Health Organization (WHO) member states failed to achieve the legal obligations mandated under the International Health Regulations (IHR) of 2005. This lack of compliance coincides with the increased recognition of the threats posed by pandemics and infectious diseases. As the largest contributor of foreign global health assistance, the United States can serve an instrumental role in supporting global IHR compliance. This thesis analyzes, by U.S. government agency, which current global health programs and efforts align to the core capacities WHO member states are required to develop per the IHR. The agencies analyzed are the United States Agency for International Development, the U.S. Department of Defense, and the Centers for Disease Control and Prevention. As indicated in this thesis, all three agencies have cross-cutting efforts to assist WHO member states; however, four key programs align greatly to specific IHR core capacities. Moving forward, decision makers can utilize these key U.S. global health programs to address WHO member states’ core capacity deficiencies in surveillance, response, laboratory, and human resources. Finally, recommendations are given to address IHR monitoring and reporting, as well as gaps in critical core capacities and U.S. global health programs.
25
Boundy, Ellen O'Neal. "Determinants of Global Maternal and Neonatal Morbidity and Mortality." Thesis, Harvard University, 2015. http://nrs.harvard.edu/urn-3:HUL.InstRepos:16121139.
Abstract:
In 2013, approximately 289,000 women died from pregnancy-related causes and 2.8 million newborns died within the first 28 days of life. The vast majority of these deaths occur in resource-limited settings. This work examines risk and protective factors for the development of several perinatal complications that put mothers and their infants at risk for adverse health outcomes. We explored determinants of preeclampsia and gestational hypertension among women in Dar es Salaam, Tanzania. We also examined the effects of pregnancy spacing intervals on perinatal outcomes in that group of women. We used log binomial regression to obtain risk ratios and 95% confidence intervals for the development of the adverse pregnancy outcomes of interest. We also looked at the efficacy of an intervention aimed at improving neonatal outcomes by conducting a systematic review and meta-analysis of the effects of kangaroo mother care on neonatal morbidity and mortality.
We found that nulliparity, history of hypertension, urinary tract infection, low calcium intake, history of preeclampsia, and history of preterm birth were associated with an increased risk of developing preeclampsia among women in Dar es Salaam. Risk factors for gestational hypertension included a history of diabetes, elevated blood pressure at study enrollment, increased mid-upper arm circumference, high hematocrit, low mean corpuscular volume, a history of miscarriage or stillbirth, and older age at first pregnancy. Twin gestation and increased body mass index were risk factors for both types of hypertensive disorders of pregnancy among women in Tanzania. After a live birth, inter-pregnancy intervals less than six months were associated with an increased the risk of having a low birth weight baby in the next pregnancy; while after a stillbirth, short inter-pregnancy intervals were associated with increased risk of stillbirth and perinatal death. Providing kangaroo mother care to infants after birth was associated with decreased neonatal morbidity and mortality and increased likelihood of exclusive breastfeeding when compared to conventional care.
These findings can help identify women and infants at increased risk for developing pregnancy-related complications and contribute to informing development of evidence-based maternal, newborn, and family planning programs and policies.Epidemiology
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Chan, Lai-Ha, and na. "China Engages Global Health Governance: A Stakeholder or System-Transformer?" Griffith University. Department of International Business and Asian Studies, 2009. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20100616.084909.
Abstract:
Through the lens of public health, in particular HIV/AIDS, this research first scrutinises Chinas compliance with and resistance to the norms and rules embedded in the global health regime, and second, illustrates Chinas evolving global role and its intentions for global governance. Chinas response to its HIV/AIDS epidemic and its active engagement with the multilateral institutions of global health governance are attributable to both necessity and conscious design. While calling for and welcoming the involvement of multiple actors, a sine qua non for Chinas continued engagement with global governance and global health governance is that they should be conducted in accordance with the principles of national sovereignty, non-intervention and territorial integrity. Overall, while China does not seek any radical transformation of the prevailing world order, its vision for the global order is not compatible with that espoused by the West which attaches much weight to liberal democratic values thereby justifying the notion and practice of humanitarian intervention. With a preference for a Westphalian model of governance, China is not a responsible stakeholder in the liberal democratic order. Beijing advocates multilateral cooperation in a pluralist harmonious world and argues that there is no fixed universal blueprint for development. China adopts a twin strategy in its relations with the outside world. On the one hand, it seeks to defend itself from the encroachment of liberal values while maintaining friendly relations with the leading powers of the West; and on the other, to shore up the principles of national sovereignty and non-intervention as well as strengthen ties with Third World countries so as to consolidate a normative and political bulwark against liberal democratic values on the world stage.
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Chan, Lai-Ha. "China Engages Global Health Governance: A Stakeholder or System-Transformer?" Thesis, Griffith University, 2009. http://hdl.handle.net/10072/365278.
Abstract:
Through the lens of public health, in particular HIV/AIDS, this research first scrutinises China’s compliance with and resistance to the norms and rules embedded in the global health regime, and second, illustrates China’s evolving global role and its intentions for global governance. China’s response to its HIV/AIDS epidemic and its active engagement with the multilateral institutions of global health governance are attributable to both necessity and conscious design. While calling for and welcoming the involvement of multiple actors, a sine qua non for China’s continued engagement with global governance and global health governance is that they should be conducted in accordance with the principles of national sovereignty, non-intervention and territorial integrity. Overall, while China does not seek any radical transformation of the prevailing world order, its vision for the global order is not compatible with that espoused by the West which attaches much weight to liberal democratic values thereby justifying the notion and practice of humanitarian intervention. With a preference for a Westphalian model of governance, China is not a ‘responsible stakeholder’ in the liberal democratic order. Beijing advocates multilateral cooperation in a pluralist ‘harmonious world’ and argues that there is no fixed universal blueprint for development. China adopts a twin strategy in its relations with the outside world. On the one hand, it seeks to defend itself from the encroachment of liberal values while maintaining friendly relations with the leading powers of the West; and on the other, to shore up the principles of national sovereignty and non-intervention as well as strengthen ties with Third World countries so as to consolidate a normative and political bulwark against liberal democratic values on the world stage.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Department of International Business and Asian Studies
Griffith Business School
Full Text
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Ahmed, Hassim Sameea. "Salient Issues on the Global Health Agenda: How Science/Policy Boundary-Work Builds Confidence in Global Governance." Doctoral thesis, Universite Libre de Bruxelles, 2017. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/249167.
Abstract:
This study examines the science/policy interactions in global health science and technology governance. It focuses on the institutional design of organizations that sit at the interface of science and policy, conceptualizing them as Boundary Organizations (BOs). The analysis considers how the institutional design of BOs affect boundary-work. The study examines two case studies, UNESCO’s International Bioethics Committee and the WHO’s Strategic Advisory Group of Experts on Immunization. The study examines the ways in which boundary-work is carried out and finds that the concept of a BO demonstrates an institutionalization of science/policy interactions and the analysis of these two cases show that there are different ways that boundary-work is practiced as a function of the design of BOs.Doctorat en Sciences politiques et sociales
info:eu-repo/semantics/nonPublished
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Augustincic, Polec Lana. "Global Health Competency Skills: A Self-assessment for Medical Students." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23275.
Abstract:
Global health is an emerging concern in a rapidly changing world in which health issues transcend international borders. This study developed and validated a new self-report questionnaire to assess self-perceived global health competencies among international medical students and how they are influenced by international clinical experiences. A tool consisted of two scales and four subscales with moderate internal consistency. Comparisons between participants who completed retrospective pretest (after the intervention retrospectively) and those who completed traditional pretest (before the intervention) revealed that those participants who completed the questionnaires retrospectively provided lower pretest scores, suggesting that response-shift bias had occurred. Significant increases in scores after international clinical experience were reported for the majority of global health competency measures in IFMSA group. Linear regression identified participant’s age, gross national income (GNI) of country of medical studies, GNI of the country visited, duration of international clinical experience and years of medical school completed, as significant predictors of global health scores. This study contributes valuable information about the newly developed global health competencies measurement tool.
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Collins, Anna L. "Inequalities in global health: a world-system analysis, 1945-present." Diss., Kansas State University, 2013. http://hdl.handle.net/2097/15934.
Abstract:
Doctor of PhilosophyDepartment of Sociology, Anthropology, and Social Work
Robert Schaeffer
World-system theorist Immanuel Wallerstein made two theoretical assertions in Historical Capitalism that (a) significant inequalities in the “margin of safety against…endemic dangers and erratic violence” for people in different zones of the world economy persisted over long periods of time and (b) that the “margin of safety” for people in the periphery has actually deteriorated. This study set out to test this theory by examining mortality data for countries in different zones of the world-economy. It identified a set of health-related proxies for “endemic dangers and erratic violence”, infectious diseases (malaria, polio, tuberculosis, and influenza), chronic diseases (cancer, diabetes, and cardiovascular), erratic violence (homicide, suicide, and motor vehicle accidents), and also infant mortality and life expectancy for women and men. It gathered data from the United Nations Statistical Division’s Demographic Yearbook for a select sample of countries in different zones of the world-economy (core, semiperiphery, and periphery) from 1950 to 2010, and examined how mortality from these dangers changed during this period. This study found that mortality data for infectious diseases did not provide much support for Wallerstein’s theoretical assertions. But the mortality data for chronic disease and erratic violence provided strong support for Wallerstein’s assertions. The data on life span provided some support for Wallerstein’s first assertion, but not for his second. Overall, the findings generally support Wallerstein’s theories and suggest ways that health-related inequalities might be addressed.
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Pigott, David Michael. "Mapping the global distribution of zoonoses of public health importance." Thesis, University of Oxford, 2015. https://ora.ox.ac.uk/objects/uuid:962dc1a7-c6c1-4878-ab6f-94dcebf7b1e1.
Abstract:
Medical cartography can provide valuable insights into the epidemiology and ecology of infectious diseases, providing a quantitative representation of the distribution of these pathogens. Such methods therefore provide a key step in informing public health policy decisions ranging from prioritising sites for further investigation to identifying targets for interventions. By increasing the resolution at which risk is defined, policymakers are provided with an increasingly informed approach for considering next steps as well as evaluating past progress. In spite of their benefits however, global maps of infectious disease are lacking in both quality and comprehensiveness. This thesis sets out to investigate the next steps for medical cartography and details the use of species distribution models in evaluating global distributions of a variety of zoonotic diseases of public health importance. Chapter 2 defines a methodology by which global targets for infectious disease mapping can be quantitatively assessed by comparing the global burden of each disease with the demand from national policymakers, non-governmental organisations and academic communities for global assessments of disease distribution. Chapter 3 introduces the use of boosted regression trees for mapping the distribution of a group of vector-borne diseases identified as being a high priority target, the leishmaniases. Chapter 4 adapts these approaches to consider Ebola virus disease. This technique shows that the West African outbreak was ecologically consistent with past infections and suggests a much wider area of risk than previously considered. Chapter 5 investigates Marburg virus disease and considers the variety of different factors relating to all aspects of the transmission cycle that must be considered in these analyses. Chapters 6 and 7 complete the mapping of the suite of viral haemorrhagic fevers by assessing the distribution of Crimean-Congo haemorrhagic fever and Lassa fever. Finally, Chapter 8 considers the risk that these viral haemorrhagic fevers present to the wider African continent, quantifying potential risk of spillover infections, local outbreaks and more widespread infection. This thesis addresses important information gaps in global knowledge of a number of pathogens of public health importance. In doing so, this work provides a template for considering the global distribution of a number of other zoonotic diseases.
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Sundseth, Inger Beate Måren. "Global Mobility and the Right to Health : An assessment of migrant health care in Norway." Thesis, Norwegian University of Science and Technology, Department of Geography, 2009. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-5510.
Abstract:
In this Master‟s thesis I have studied to what degree primary- and moral duty bearers in Norway maintain accountability and fulfil their obligations towards migrants and the right to health, as stated in the International Convention on Economic, Social and Cultural Rights (ICESCR) of 1966.
Theoretical perspectives on global mobility and Rights-based approaches, an outline of the HIV/AIDS epidemic, as well as empirical data provides a basis for the discussion addressing how the Norwegian Government maintain accountability with regards to health care of migrants, and seeking to identify the role of other duty bearers in offering health care services to migrants.
The research methods applied in order to generate data are analysis of text and interviews. I have studied legislation, treaties and official publications. In addition, I have performed two key informant interviews; one with Siv Limstrand, project manager of the Church City Mission in Trondheim‟s project „Living with HIV‟ („Leve med hiv‟), and another with nurse Tove Buchmann in Trondheim Municipality‟s refugee health team (flyktningehelseteamet).
The thesis concludes that there appears to be an embedded contradiction between legislation, policy and practice. Norway has stated a clear goal to protect, respect and fulfil human rights, both internationally and through the ratification and implementation of human rights treaties into Norwegian legislation. Based on this, they should to a larger extent fulfil their obligations and not restrict the access to medical attention on the part of asylum seekers and irregular migrants. On the part of the other duty bearers included in this thesis, namely the Church City Mission in Trondheim‟s project „Living with HIV‟ and Trondheim Municipality‟s refugee health team, the thesis finds that they play a vital role in guiding and informing, as well as in administering health care services to migrants in Trondheim
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Brisbois, Benjamin Wesley. "Discursive and practical challenges in global health : pesticide-related health impacts in Ecuadorian banana production." Thesis, University of British Columbia, 2014. http://hdl.handle.net/2429/50749.
Abstract:
This dissertation aims to inform more equitable and effective practice in the emerging field of global health. To address this overriding question of how principles of equity and effectiveness can best be implemented, I critically analyze discursive and practical challenges facing Northern researchers as they approach health problems in the global South, and explore solutions to these challenges. This exploration employs a case study on the articulation of a specific problem in a specific, nominally ‘Southern’, setting: pesticide-related health effects in Ecuador's banana-producing El Oro province. I employ three methodological approaches, in three substantive chapters. Chapter 2 uses discourse analysis to understand how Latin American research sites are framed in peer-reviewed pesticide epidemiology articles. These articles often employ geographic representations of Latin America as inexplicably underdeveloped to demonstrate the need for pesticide research and health sector interventions, typically exhibiting ‘mainstream’ (Northern) public health institutional dynamics. I also show how some epidemiologists are pursuing more politically engaged approaches, in an uneasy negotiation with epidemiology's disciplinary norms. Chapter 3 reports on ethnographic pesticide risk perception work in El Oro, drawing on theories from anthropology and human geography. I document how pesticide risk perception narratives reflect El Oro's position in unstable global commodity chains. Scalar elements of these narratives combine individual and structural explanations for health problems in complex ways. In Chapter 4, I describe a political ecology of health explanation of pesticide exposure in El Oro. I employ a modified meta-narrative methodology, complemented by ethnographic fieldwork, to synthesize literature relevant to the pathways – biological, political economic, environmental and cultural – leading to pesticide-related impacts in El Oro. This analysis complements Chapters 2 and 3 in making the case for empowerment-based participatory approaches to pesticide exposure problems (and, by extension, to global health more generally), with special attention to international linkages, environmental complexity and political economy. The introduction, conclusion and 'linking' material between chapters serve to enhance the coherence of the dissertation by providing additional material not appropriate for inclusion in the three chapters, including elements of reflexivity.Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
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Valeix, Sophie Françoise. "Integrating professionals to address complex global health challenges : veterinarians, zoonoses and One Health in Ghana." Thesis, University of Sussex, 2018. http://sro.sussex.ac.uk/id/eprint/80593/.
Abstract:
This thesis explores the integration of public veterinarians in zoonosis management policy and action in Ghana with regard to the implementation of the internationally-led policy ideal: 'One Health' (OH). Drawing on theoretical contributions that examine professionalism, integration mechanisms and social processes, I researched vets' potential for OH in a context of new public health imperatives, limited resources and absence of targeted national strategy. During eight months of ethnography in Southern Ghana, I investigated veterinary professional characteristics using participant observation, interviews, document collection and a network survey. I analysed how veterinary perspectives, practices and relationships influenced the scope for integration of vets and their activities in zoonosis management, from the district-level clinics and offices to national-level institutions and international organisations. This work questioned whether and why Ghanaian vets would want to engage in OH integration with regard to their professional values and interests. It also sought to understand which practitioners and practices were professionally promoted or repressed and what were the main dilemmas or opportunities for local vets taking part in local zoonosis surveillance, prevention and control. Furthermore, it studied interactions in networks around zoonoses between Ghanaian vets and other actors, and their potential to create and maintain relationships that favour integration. This research contributes to critical knowledge on global health policy implementation by highlighting the importance of relationships and power dynamics both within and between professionals in relation to integration. This, I argue, can be done through more consideration of their professional values, interests and status, and the heterogeneity of all of these in a national context. The thesis also adds to the scarce literature on veterinary professionalism in low- and middle-income countries by providing 'thick descriptions' of veterinary perspectives, practices and network relationships.
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Bates, Nicole K. Ricketts Thomas C. "Health policy networks bridging interests and augmenting influence in the changing global health policy environment /." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2008. http://dc.lib.unc.edu/u?/etd,2165.
Abstract:
Thesis (DrPH)--University of North Carolina at Chapel Hill, 2008.Title from electronic title page (viewed Feb. 26, 2009). "... in partial fulfillment of the requirements for the degree of Doctorate of Public Health DrPH in the Department of Health Policy and Administration." Discipline: Health Policy and Administration; Department/School: Public Health.
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Foran, Brenda J. "Medical pluralism and global health policy : the integration of traditional medicine in health care systems." Thesis, View thesis, 2007. http://handle.uws.edu.au:8081/1959.7/25358.
Abstract:
This research explores the international evolution of the policy of integration (formalisation) of traditional medicine in health care systems. This concept first arose on the policy agenda of the World Health Organisation in the 1970s and then re-emerged in 2002 (with alternative and complementary medicines). The history of this policy at the global level and its transfer to national levels over this period is analysed, via the content, scope and outcomes of policy and programme documents. This analysis emphasises the roles of context and stakeholders (specifically interest groups). The context in terms of the economic, political and social environment surrounding the development of the policy is considered, and held to offer a potential explanation as to how and why the policy agenda on integration was set and the manner in which programmes were formulated and implemented. Interest group interaction (competition for resources) is concluded to play a key role in explaining the development of this policy on an international level, and its problematic transfer to national levels. A case study of Sri Lanka explores national level implementation in greater detail. An analytical framework to analyse the development and implementation of this policy has been created, from a synthesis of anthropological and political science tools. The combination of several theories into an analytical framework allows this policy issue to be understood as an intrinsically political exercise that has been stimulated by global social and economic forces. The analytical framework developed offers another tool for the analysis and consequent understanding of the health policy process and thus may have relevance beyond the health policy issue of integration.
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Foran, Brenda J. "Medical pluralism and global health policy the integration of traditional medicine in health care systems /." View thesis, 2007. http://handle.uws.edu.au:8081/1959.7/25358.
Abstract:
Thesis (Ph.D.)--University of Western Sydney, 2007.A thesis presented to the University of Western Sydney, College of Arts, Social Justice and Social Change Research Centre in fulfilment of the requirements for the degree of Doctor of Philosophy (Social Policy). Includes bibliographies.
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Lassa, Samuel. "Exploring the interactions between medical professionals and Global Health Initiatives in the Nigerian health system : a case study of the Global Fund grant in Nigeria." Thesis, University of Sheffield, 2016. http://etheses.whiterose.ac.uk/16041/.
Abstract:
Recently, increasing attention has been given to behavioural and relational aspects of health systems, placing actors at the core. Indeed, health systems comprise of numerous actors, and one of the most important and influential is the medical doctor, playing a vital role in policy transfer at the national level (Benson 2013). The influence of medical professionals stems beyond shaping the implementation of health policies, to also potentially altering the policy content and process (Koon & Mayhew 2013). In lowand middle-income countries (LMICs) the health system is a dynamic mix of multiple stakeholders, including supra-national organizations, Global Health Initiatives and NonGovernmental Organizations (Samb et al. 2009), resulting in an environment where contesting interests and values are competing for relevance and authority. This study examined the power dynamics of medical professionals in the Nigerian health system through an in-depth case study of the interactions between the Global Fund grant and Nigerian medical professionals. Results are based on an in-depth qualitative study involving 34 semi-structured key informant interviews with policy makers, board-meeting observations, and documentary analysis. Data was analysed iteratively in order to gain insight into the power dynamics of medical professionals in policy processes and to analytically identify structural and agential factors within the health system that encourage or discourage professional dominance. Medical professionals maintained dominance and professional monopoly, thereby controlling policy spaces. Global actors and the local government were challenging interest groups, with a preference for rapid biomedical models that focus on medications and test kits, and the supply of health services, while neglecting social science narratives and demand creation. This work explores such issues in detail and presents contextual factors of relevance to the Nigerian setting, thereby adding to existing literature on health systems and the sociology of medical professionals.
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Courtney, Claire. "The Pleasure Gap: Harnessing Pleasure to Increase Global Condom Use." Scholarship @ Claremont, 2014. http://scholarship.claremont.edu/scripps_theses/354.
Abstract:
The state of global health and wellbeing is threatened by the pervasive and dangerous decision to engage in unprotected sex. Only male or female condoms can prevent the spread of both sexually transmitted infections and unintended pregnancies. Despite this, condoms remain dangerously underused because of the perception that they diminish sexual pleasure. The pleasure gap in the design and promotion of condoms cripples sexual health outcomes. Acknowledging and harnessing the power of pleasure in sexual-decision making is key to increasing condom use.
40
Heffield, Rachel. "The Experience of Thriving Among Global Workers in Asia." Thesis, Regent University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10247927.
Abstract:
International nonprofit workers follow a sense of purpose or calling to serve humanity in the far corners of the world. This study is a phenomenology of thriving in this population. Parallel to the broader mental health field, there is a shift in focus from diagnosing pathology and reason for failure to promoting optimal functioning of this population. Positive psychology increased attention to optimal human function and the field of counseling has focused on wellness and development of people rather than treating pathology. This study has identified nine themes common to global workers who are thriving. Application is made to how workers and organizations can promote the well-being of global workers. Results are compared with established constructs of well-being.
41
Magnusson, Nabila. "Enhancing health literacy through civil engagement A qualitative study." Thesis, Mittuniversitetet, Avdelningen för hälsovetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-31004.
42
Lundström, Tomas. "The impact of Global Health Initiatives and HIV and AIDS Programs on the Zambian Health System." Thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-16554.
Abstract:
Background: The Human immunodeficiency virus infection (HIV) and Acquired immunodeficiency syndrome (AIDS) epidemic peaked in 1999, which led to an increase in funding by donors and Global Health Initiatives (GHI) to combat the epidemic. This literature review examined how the substantial influx of funding for GHI’s and HIV and AIDS since early 2000 has impacted the health system in Zambia. Method: The method used for the study was a systematic literature review. Results: There is conflicting views and mixed evidence about whether GHIs and HIV and AIDS initiatives have benefitted the general health system. It is clear that GHIs and HIV and AIDS initiatives have added substantially to the increase in funding for health in Zambia. Furthermore, it seems likely that the special attention put on HIV and AIDS created an exclusive and skewed environment with increased capacity to tackle HIV and AIDS, but with less capacity built for health services in general. In-coming support from Global Health Initiatives and funding for HIV and AIDS in Zambia has to some extent been controlled by and led by the contributing donor, giving the Zambian authorities limited oversight of the resources. Conclusions: The influx of funding for HIV and AIDS has led to increased support for a specific disease, but it has not generated support to the health sector in general. It has also led to a fragmented approach, where HIV and AIDS have fallen outside of the regular coordination of the health sector. Keywords: Zambia, HIV and AIDS, Health systems, vertical initiatives, strengthening, impact.Bakgrund: The Human Immunodeficiency Virus Infection (HIV) och Acquired Immunodeficiency Syndrome (AIDS) epidemin var på sin högsta nivå 1999, vilket ledde till en kraftig ökning av resurser från givare och globala hälsoinitiativ för att bekämpa epidemin. Denna genomgång av litteraturen undersökte hur denna tillväxt av resurser sedan början av 2000-talet påverkade hälsosystemet i Zambia. Metod: Den metod som användes för studien var en systematisk litteraturgenomgång. Det finns olika slutsatser och bevis för om insatser för HIV och AIDS och globala hälsoinsatser har gynnat hälsosystemet. Resultat: Det är klart att insatser för HIV och AIDS och globala hälsoinsatser har bidragit substantiellt till finansiering av hälsosektorn i Zambia. Studien visade att det är troligt att det särskilda fokus som HIV och AIDS fick skapade en exklusiv och snedvriden miljö, med ökad kapacitet för att hantera HIV och AIDS, men med mindre kapacitet för hälsosektorn generellt. Det stöd och resurser från globala hälsoinitiativ och för HIV och AIDS som Zambia fick del av, har till en del varit kontrollerat av och letts av bidragsgivaren, vilket ledde till att Zambiska myndigheter hade begränsad kontroll över dessa resurser. Slutsats: De ökade resurser som tillkom för att bekämpa HIV och AIDS innebar en ökad satsning på dessa sjukdomar men det har bevisats att detta inte genererade tillräckligt stöd till hälsosystemet. Detta ledde också till en fragmenterad satsning, där HIV och AIDS har hanterats utanför den vanliga samordningen av hälsosektorn. Nyckelord: Zambia, HIV och AIDS, Hälsosystem, vertikala initiativ, stärkande, effekt.
43
West-Oram, Peter George Negus. "Global health care injustice : an analysis of the demands of the basic right to health care." Thesis, University of Birmingham, 2015. http://etheses.bham.ac.uk//id/eprint/5559/.
Abstract:
Henry Shue’s model of basic rights and their correlative duties provides an excellent framework for analysing the requirements of global distributive justice, and for theorising about the minimum acceptable standards of human entitlement and wellbeing. Shue bases his model on the claim that certain ‘basic’ rights are of universal instrumental value, and are necessary for the enjoyment of any other rights, and of any ‘decent life’. Shue’s model provides a comprehensive argument about the importance of certain fundamental goods for all human lives, though he does not consider health or health care in any significant detail. Adopting Shue’s model, I argue that access to health care is of sufficient importance to the enjoyment of any other rights that it qualifies as what Shue describes as a ‘basic’ right. I also argue that the basic right to health care is compatible with the basic rights model, and is required by it in order to for it to achieve its goal of enabling right holders to enjoy any decent life. In making this claim I also explore the requirements of the basic right to health care in terms of Shue’s triumvirate of duties and with reference to several key examples.
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Wolfe, Ingrid. "Child Health, Health Services and Systems in UK and other European countries." Doctoral thesis, Karlstads universitet, Institutionen för hälsovetenskaper, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-35856.
Abstract:
Background This work in child population medicine describes child health problems, increases knowledge of health services, systems, and wider determinants, and makes recommendations for improvements. Aims To explore trends in UK child health and health service quality and highlight policy lessons from the UK and other European countries To study child health and health services in western Europe and derive lessons from different approaches to common challenges To enhance knowledge on child to adult transition care To describe trends in UK and EU15+ child and adolescent mortality and seek explanations for deteriorating UK health system performance, and make recommendations for improving survival Methods Population level measures of health status and system performance; primary and secondary research on policies and practice for health system assessments. Quantitative: mortality rate trends, excess deaths, DALYs, healthcare processes Qualitative: case reports, system descriptions, analyses Results European child survival has improved, but variably between countries. The UK has not matched recent EU mortality gains. There are 6,000 excess deaths annually in children under 15 years in EU14 countries. There are child survival inequities; countries investing in social protection have lower mortality. Children in the UK, compared with other EU countries, are more likely to be poor than adults. Non-communicable diseases are now dominant causes of child death, disease, and disability. Mortality, processes, and outcomes of healthcare amenable conditions varies between countries. Better outcomes seem to be associated with flexible health care models promoting cooperation, team working, and transition. Conclusions Child health in Europe is improving, but unevenly. Child health systems are not adapting sufficiently to meet needs. Recommendations are made for improving health systems and services.How do European countries compare when it comes to child health statistics? How do different child health services, systems, and wider determinants impact long term influences for good or harm? Why do some countries seem to do better than others in safeguarding their children’s and young people’s health and wellbeing? And what can we do to make things better for children? This thesis explores some of these difficult but important issues, and despite describing some serious signals of concern about child health, offers recommendations and clear ways forward for countries to ensure healthier futures for children.
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Wazny, Kerri Ann. "Crowdsourcing and global health : strengthening current applications and identification of future uses." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/29622.
Abstract:
Introduction: Despite the method existing for centuries, uses of crowdsourcing have been rising rapidly since the term was coined a decade ago. Crowdsourcing refers to ‘outsourcing’ a problem or task to a large group of people (i.e., a crowd) rapidly and cheaply. Researchers debate over definitions of crowdsourcing, and it is often conflated with mHealth, web 2.0, or data mining. Due to the inexpensive and rapid nature of crowdsourcing, it may be particularly amenable to health research and practice, especially in a global health context, where health systems, human resources, and finances are often scarce. Indeed, one of the dominant methods of health research prioritization uses crowdsourcing, and in particular, wisdom of the crowds. This method, called the Child Health and Nutrition Research Initiative (CHNRI) method, employs researchers to generate and rank research options which are scored against pre-set criteria. Their scores are combined with weights for each criterion, set by a larger, diverse group of stakeholders, to create a ranked list of research options. Unfortunately, due to difficulties in defining and assembling a group of stakeholders that would be appropriate to each exercise, 75% of CHNRI exercises to-date did not involve stakeholders, and therefore presented unweighted ranks. Methods: First, a crowdsourcing was defined through a literature review. Benefits and challenges of crowdsourcing were explored, in addition to ethical issues with crowdsourcing. A second literature review was conducted to explore ways in which crowdsourcing has been already used in health and global health. As crowdsourcing could be a potential solution to data scarcity or act as a platform for intervention in global health settings, but its potential has never been systematically assessed, a CHNRI exercise was conducted to explore potential uses of crowdsourcing in global health and conflict. Experts from both global health and crowdsourcing participated in generation and scoring ideas. This CHNRI exercise was conducted in-line with previously described steps of the CHNRI method for setting health research priorities. As three quarters of CHNRI exercises have not utilized a larger reference group (LRG) of stakeholders, and the public was cited as the most difficult stakeholder group to involve, we conducted a survey using Amazon Mechanical Turk, an online crowdsourcing platform, that involved an international group of predominantly laypersons who, in essence, formed a public stakeholder group, scoring the most common CHNRI criteria using a 5-point Likert scale. The resulting means were converted to weights that can be used in upcoming exercises. Differences in geographic location, and whether the respondents were health stakeholders were assessed through the Fisher exact test and Wilcoxon rank-sum test, respectively. The influence of other demographic characteristics was explored through random-intercept modelling and logistic regression. Finally, an example of a national-level CHNRI exercise, which is the largest CHNRI conducted to-date, exploring research priorities in child health in India is described. Results: A comprehensive definition of crowdsourcing is given, along with its benefits, challenges, and ethical considerations for using crowdsourcing, based on a literature review. An overview of uses of crowdsourcing in health are discussed, and potential challenges and techniques for improving accuracy, such as introducing thresholds, qualifiers, introducing modular tasks and gamification. Crowdsourcing was frequently used as a diagnostics or surveillance tool. The CHNRI method was not identified in the second literature review. In re-weighting the CHNRI criteria using a public stakeholder group, we identified differences in relative importance of the criteria driven by geographic location and health status. When using random-intercept modelling to control for geographic location, we found differences due to health status in many criteria (n = 11), followed by gender (n = 10), ethnicity (n = 9), and religion (n = 8). We used the CHNRI method to explore potential uses of crowdsourcing in global health, and found that the majority of ideas were problem solving or data generation in nature. The top-ranked idea was to use crowdsourcing to generate more timely reports of future epidemics (such as in the case of Ebola), and other ideas relating to using crowdsourcing for the surveillance or control of communicable disease scored highly. Many ideas were related to the United Nations’ Sustainable Development Goals (SDGs). Finally, a national-level exercise to set research priorities in child health in India identified differential priorities for three regions (Empowered Action Group and North Eastern States, Northern States and Union Territories, and the Southern and Western States). The results will be very useful in developing targeted programmes for each region, enabling India to make progress towards SDG 3.2. Conclusion: Crowdsourcing has grown exponentially in the past decade. Integrating gamification, machine learning, simplifying tasks and introducing thresholds or trustworthiness scores increases accuracy of results. This research provides recommendations for improvements in the CHNRI method itself, and for crowdsourcing, generally. Crowdsourcing is a rapid, inexpensive tool for research, and thus, is a promising data collection method or intervention for health and global health.
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Molino, Luisa. "Global health and policy translation: women's embodied experience of breastfeeding in Quebec." Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=114531.
Abstract:
Over the last few decades breastfeeding (BF) has become a World Health Organization (WHO) sanctioned public health priority due to its positive health outcomes, both for the mother and her child. In 2001, the province of Quebec issued a BF policy L'Allaitement maternel au Québec: Lignes directrices, (thereafter LD), aimed at implementing global health recommendations on infant feeding (WHO/UNICEF). Although this policy action has resulted in tremendous increase of BF initiation rate, BF duration remains below WHO standards, particularly among specific sociodemographic groups. Drawing on data from a large, multi-site qualitative study in Quebec, this study analyzes women's experience of BF, and seeks to investigate the gap between policy and its implementation, and in turn how women interpret, negotiate and/or resist current recommendations in their infant feeding practices. The focus of the study is the comparison of women's narratives (52 women participated in 11 Focus Groups) and lived experience of varying health care settings with differing degrees of compliance to LD (high and low implementation of the Baby-Friendly Initiative). This work examines BF beyond its biological dimension, and it tackles how public health policies and quality of delivery services influence women's choices and practices of infant feeding, and concur to women's experience and self-perception of motherhood and womanhood.Given that this policy evaluation study draws from women's narratives from various life contexts (rural and urban settings), my findings will contribute significantly to future BF policies in Québec as well as to give valuable insight on a global level.Depuis plusieurs décennies, l'allaitement est une question de santé publique prioritaire pour l'Organisation mondiale de la Santé (OMS) en raison de ses effets positifs pour la mère et pour son enfant. En 2001, la province de Québec a émis une politique d'allaitement, L'allaitement maternel au Québec : lignes directrices, (ci-après LD) qui visait à mettre en œuvre les recommandations internationales en matière d'alimentation du nourrisson (OMS/UNICEF). Bien que l'introduction de cette politique ait entraîné une forte augmentation du nombre de mères amorçant l'allaitement, la durée de l'allaitement reste en-deçà des standards préconisés par l'OMS, et particulièrement parmi certains groupes sociodémographiques. S'appuyant sur des données recueillies dans le cadre d'une large étude qualitative multicentrique réalisée au Québec, la présente analyse examine l'expérience de mères au regard de l'allaitement et cherche à appréhender le décalage existant entre la politique promue et sa mise en œuvre effective. Elle tente en même temps de mettre au jour la façon dont les mères interprètent et négocient les recommandations en matière d'alimentation infantile, voire comment elles y résistent. Le point central de cette analyse se situe dans la comparaison de témoignages de femmes (52 femmes ont pris part à 11 groupes de discussion focale) et de leur expérience à l'égard des services offerts par des établissements de santé ayant différents degrés de conformité aux LD (mise en œuvre de l'Initiative des amis des bébés [IAB] faible ou élevée). Ce travail examine la question de l'allaitement au-delà de sa dimension biologique et s'attache à apprécier dans quelle mesure les politiques de santé publique et la qualité des services influencent les choix des femmes et leurs pratiques d'alimentation infantile, et comment, au final, cela agit sur leur expérience et sur leur perception propre de la maternité et de la féminité.Étant donné que l'évaluation de cette politique publique repose sur des témoignages de femmes aux contextes de vie variés (milieux urbains et ruraux), mes conclusions contribueront d'une manière significative à la mise en place de futures politiques d'allaitement au Québec tout en apportant un éclairage précieux à un niveau plus global.
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Lasker, Judith N., Myron Aldrink, Ramaswami Balasubramaniam, Paul Caldron, Bruce Compton, Jessica Evert, Lawrence C. Loh, Shailendra Prasad, and Shira Siegel. "Guidelines for responsible short-term global health activities: developing common principles." BIOMED CENTRAL LTD, 2018. http://hdl.handle.net/10150/627194.
Abstract:
Background: Growing concerns about the value and effectiveness of short-term volunteer trips intending to improve health in underserved Global South communities has driven the development of guidelines by multiple organizations and individuals. These are intended to mitigate potential harms and maximize benefits associated with such efforts. Method: This paper analyzes 27 guidelines derived from a scoping review of the literature available in early 2017, describing their authorship, intended audiences, the aspects of short term medical missions (STMMs) they address, and their attention to guideline implementation. It further considers how these guidelines relate to the desires of host communities, as seen in studies of host country staff who work with volunteers. Results: Existing guidelines are almost entirely written by and addressed to educators and practitioners in the Global North. There is broad consensus on key principles for responsible, effective, and ethical programs-need for host partners, proper preparation and supervision of visitors, needs assessment and evaluation, sustainability, and adherence to pertinent legal and ethical standards. Host country staff studies suggest agreement with the main elements of this guideline consensus, but they add the importance of mutual learning and respect for hosts. Conclusions: Guidelines must be informed by research and policy directives from host countries that is now mostly absent. Also, a comprehensive strategy to support adherence to best practice guidelines is needed, given limited regulation and enforcement capacity in host country contexts and strong incentives for involved stakeholders to undertake or host STMMs that do not respect key principles.
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Roberts, Stephen L. "Catching the flu : syndromic surveillance, algorithmic governmentality and global health security." Thesis, University of Sussex, 2018. http://sro.sussex.ac.uk/id/eprint/73582/.
Abstract:
This thesis offers a critical analysis of the rise of syndromic surveillance systems for the advanced detection of pandemic threats within contemporary global health security frameworks. The thesis traces the iterative evolution and ascendancy of three such novel syndromic surveillance systems for the strengthening of health security initiatives over the past two decades: 1) The Program for Monitoring Emerging Diseases (ProMED-mail); 2) The Global Public Health Intelligence Network (GPHIN); and 3) HealthMap. This thesis demonstrates how each newly introduced syndromic surveillance system has become increasingly oriented towards the integration of digital algorithms into core surveillance capacities to continually harness and forecast upon infinitely generating sets of digital, open-source data, potentially indicative of forthcoming pandemic threats. This thesis argues that the increased centrality of the algorithm within these next-generation syndromic surveillance systems produces a new and distinct form of infectious disease surveillance for the governing of emergent pathogenic contingencies. Conceptually, the thesis also shows how the rise of this algorithmic mode of infectious disease surveillance produces divergences in the governmental rationalities of global health security, leading to the rise of an algorithmic governmentality within contemporary contexts of Big Data and these surveillance systems. Empirically, this thesis demonstrates how this new form of algorithmic infectious disease surveillance has been rapidly integrated into diplomatic, legal, and political frameworks to strengthen the practice global health security – producing subtle, yet distinct shifts in the outbreak notification and reporting transparency of states, increasingly scrutinized by the algorithmic gaze of syndromic surveillance.
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Ricciuti, E. "Grant-making foundations for global health : what drives their decision-making?" Thesis, London School of Hygiene and Tropical Medicine (University of London), 2016. http://researchonline.lshtm.ac.uk/2997229/.
Abstract:
In recent years, private foundations have gained considerable relevance in global health due to their increasing presence in both financing and policy-making. Despite this, the question of how these actors make decisions on their funding priorities is under researched. The aim of this study is to understand and assess the relative importance of different factors in foundations’ decision-making. This question is important not only for actors in the global health arena, but for foundations that are under increasing pressure to be legitimate, effective and accountable players. This is a qualitative research study on the decision-making of foundations investing in global health. It applies a multiple case study methodology in the study of three foundations: the Bill & Melinda Gates Foundation, the Rockefeller Foundation and the Wellcome Trust. In-depth interviews with forty-six informants represented the main method for data collection. A qualitative thematic content analysis has been applied to both documentary sources and interviewees’ accounts. A strategic management approach has been used to de-construct the decision-making process into strategic planning and grant-making. As a first area of inquiry, this study sought to understand how foundations’ origins, governance structure and funding ethos are relevant in influencing their decision-making behavior. Second, this study sought to assess the relative importance of different factors (e.g., private partnerships or foundations’ networks) in influencing foundations’ decisions. Findings suggest influence is an overt objective of foundations' strategies. Leaders and networks are extremely important in both strategic planning and grant-making. By discussing findings through the perspective of major strategic management schools of thought, the study provides an in-depth understanding of foundations’ strategic planning and grant-making processes and recommendations to increase accountability, legitimacy and effectiveness. The analysis also introduces a re-conceptualization of foundations’ decision-making, and offers implications on the role of philanthropy in global health.
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Softic, Nejira. "Is there an Obligation to Share? : Pharmaceuticals in Global Health Law." Thesis, Örebro universitet, Institutionen för juridik, psykologi och socialt arbete, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-86528.