Global public health
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Global public health · Jan 2013
Marriage as a risk factor for HIV: learning from the experiences of HIV-infected women in Malawi.
The gender inequalities that characterise intimate partner relationships in Malawi, a country with one of the highest HIV prevalence rates in the world, arguably place marriage as an important risk factor for HIV infection among women, yet few studies detail the complex interactions of marriage and risk. In order to develop HIV-prevention interventions that have lasting impacts in such communities, we need a deeper understanding of the intricacies of women's lives, how and why they are involved in marital relationships, and the implications of these relationships for HIV transmission or prevention. ⋯ Based on their narratives, we describe women's lives after separation, abandonment or widowhood, and report their reflections on marriage after being married two or three times. We then review women's narratives in light of published work on HIV, and provide recommendations that would minimise the risks of HIV attendant on marriage.
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Global public health · Jan 2013
ReviewCervical cancer and the global health agenda: Insights from multiple policy-analysis frameworks.
Cervical cancer is the second leading cause of cancer deaths for women globally, with an estimated 88% of deaths occurring in the developing world. Available technologies have dramatically reduced mortality in high-income settings, yet cervical cancer receives considerably little attention on the global health policy landscape. ⋯ Each framework explores the process of agenda setting and discerns factors that either facilitate or hinder policy change in cases where there is both a clear problem and a potential effective solution. In combination, these frameworks highlight a number of crucial elements that may be needed to raise the profile of cervical cancer on global health agendas, including improving local (national or sub-national) information on the condition; increasing mobilisation of affected civil society groups; framing cervical cancer debates in ways that build upon its classification as a non-communicable disease (NCD) and an issue of women's rights; linking cervical cancer screening to well-funded services such as those for HIV treatment in some countries; and identifying key global policy windows of opportunity to promote the cervical cancer agenda, including emerging NCD global health discussions and post-2015 reviews of the Millennium Development Goals.
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Global public health · Jan 2013
Deciphering Rashomon: an approach to verbal autopsies of maternal deaths.
The paper discusses an approach to verbal autopsies that engages with the Rashomon phenomenon affecting ex post facto constructions of death and responds to the call for maternal safety. This method differs from other verbal autopsies in its approach to data collection and its framework of analysis. ⋯ This framework assesses the behavioural responses of health providers, as well as community and family members at each opportunity for death prevention and categorises them into four groups: non-actions, inadequate actions, inappropriate actions and unavoidably delayed actions. We demonstrate the application of this approach to show how verbal autopsies can delve beneath multiple narratives and rigorously identify health system, behavioural and cultural factors that contribute to avoidable maternal mortality.
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The World Trade Organization (WTO) and Trade-Related Aspects of Intellectual Property Rights (TRIPS), which made product patents compulsory for countries to follow, meant that the entire market for generic drugs was out of bounds for manufacturing till the time the products went off-patent. The TRIPS has generated widespread discussions and debates around the costs and benefits of new patent regimes on countries such as India. ⋯ It is a first-of-its-kind effort in which the data on pharmaceutical patents applications were collected, collated, cleaned and classified according to IPC codes, to enable preliminary understanding of the nature and type of the applications. The patent applications that are filed in India are not found to be consistent with the disease burden of the country.
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Global public health · Jan 2013
Religious leaders as potential advocates for HIV/AIDS prevention among the general population in Sri Lanka.
Religious leaders in Sri Lanka may have a high potential of contributing to HIV/AIDS prevention among the general public because of their social status. In order to assess their current HIV/AIDS-related knowledge and attitude and the possibility of becoming community advocates of HIV/AIDS prevention, we conducted a questionnaire survey among Buddhist, Hindu, Muslim and Christian leaders in Sri Lanka in 2009. ⋯ Their experiences, preparedness and willingness of HIV prevention activities were associated with age, knowledge and/or religious background. In conclusion, intensive and systematic learning opportunities should be provided to equip the religious leaders with overall HIV/AIDS knowledge to become key players for HIV/AIDS prevention in their communities.