Global public health
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Global public health · Aug 2020
In the shadow of HIV & TB: A commentary on the COVID epidemic in South Africa.
While COVID-19 has become a global pandemic that has spread to all regions of the globe, local historic, health, and socio-environmental factors shape the epidemiological contours, response, and social challenges present within each affected nation. Thus, while countries like China, Italy, Iran, Brazil, and the United States have all been hard hit by the pandemic, there are critical differences across these nations in a number of variables (e.g. demographic features, health histories, healthcare systems, infection case rates, case fatality rates, national responses). In other words, within the global pandemic there are multiple importantly distinct national epidemics. ⋯ Already concerns are being expressed among health officials about how COVID-19 might be devastating in Africa. Currently, South Africa has the highest number of diagnosed COVID-19 cases on the continent and has been identified as being at high risk in the pandemic. This paper examines the public health response to the COVID-19 threat, how the prior and ongoing HIV and TB epidemics shape the COVID-19 epidemic and influence the response, and the potential ramifications of the response.
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Global public health · Aug 2020
Health system's response to the COVID-19 pandemic in conflict settings: Policy reflections from Palestine.
As the COVID-19 pandemic spreads, concerns are particularly serious in conflict and humanitarian settings. Tackling the pandemic in those countries is challenging due to the fragility of socioeconomic and health systems. Palestine is one of those countries that is facing compounding challenges, instability, fragility, living conditions, poverty, and mobility, all of which are caused by multifactorial etiology. ⋯ A little collaboration and inter-agency task forces in preparedness and response was observed, and the mechanisms and governance remain ambiguous. A consolidated and evidence-based nation-wide plan is required, whereby state and non-state actors have a clear and transparent exit strategy. A new thinking approach to promote the public health system and evidence-informed policies in Palestine is an urgent national priority.
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Global public health · Aug 2020
Structural barriers to adhering to health behaviours in the context of the COVID-19 crisis: Considerations for low- and middle-income countries.
In seeking to limit the number of new infections of COVID-19, governments around the world have implemented national lockdowns and guidelines about safe behaviours. Lockdown requires people to stay home and only leave when essential such as to purchase groceries and medication. In low- and middle-income countries, many of which have large proportions of the population living in precarity, lockdown forces millions of people to spend prolonged periods of time together in close proximity to one another and with limited resources. ⋯ In this paper, we explore the barriers to implementation of lockdown rules in conditions of precarity. We conceptualise the structural barriers by drawing on the Theoretical Domains Framework to explain how these barriers influence adherence to lockdown rules. We argue that without sufficient support or intervention to help poor communities mitigate these structural barriers, adhering to lockdown rules is difficult, resulting in continued COVID-19 infections.