Paying for reproductive health services in Bangladesh: intersections between cost, quality and culture.
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In 1997 a consortium of non-governmental organizations (NGOs) in Bangladesh began to implement health sector reform measures intended to expand access to and improve the quality of family planning and other basic health services. The new service delivery model entails higher costs for clients and requires that they take greater initiative. Clients have to travel further to get certain services, and they have to pay more for them than they did under the previous door-to-door family planning model. This paper is based on findings from a qualitative study looking at client and community reactions to the programme changes. It examines a number of barriers to access and constraints to cost recovery, including gender, class and ideas about entitlements, the role of government and obligations among people. The NGOs want to maximize cost recovery while making the basic services they offer accessible to most people. The findings suggest that this requires more than the establishment of an appropriate pricing structure. Attitudes related to charging and paying for services must also change, along with the institutional policies and practices that support them. (+info)
Teachers' perception of epilepsy in Nigeria: a community-based study.
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The social problems encountered by schoolchildren with epilepsy as a result of negative attitudes and beliefs are enormous. Varying reports on teachers' perception of epilepsy abound. Furthermore previous research has shown that urbanization and differences in socio-cultural environments could also influence teachers' perception of epilepsy. A few studies have explored the knowledge, attitude and beliefs of schoolteachers towards epilepsy in urban schools in Nigeria. This study was undertaken to examine teachers' perception of epilepsy in the rural communities with regards to knowledge, attitude and beliefs. A cross-sectional survey, using a self-administered questionnaire, was carried out among rural community primary and secondary schoolteachers in schools randomly selected from three local government areas in Enugu. One hundred and twenty five teachers correctly completed their questionnaires. Despite a fairly high level of education of the teachers, the mean overall score for correct response for knowledge was 59.2%. A majority of the teachers had negative attitudes and beliefs. None had received any form of health education on epilepsy. The level of education significantly affected various aspects of knowledge, attitudes and beliefs. This study concluded that paucity of good knowledge of epilepsy probably resulted in negative attitude and beliefs despite the teachers' high level of education. (+info)
The melting ice cellar: what native traditional knowledge is teaching us about global warming and environmental change.
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Environmental problems have often been observed by Alaska Native communities decades before they have been confirmed by scientific research. (+info)
Welsh I am.
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With developments in genetics, researchers are increasingly able to address historical issues surrounding human migration and provenance by studying present populations. Nigel Williams reports on one of the latest studies looking at a crucial period of British history. (+info)
Extending scientific horizons in the developing world - the Central American experience.
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The juxtaposition of 'oral disease' and 'developing countries' invariably evokes thoughts of how one might assist these nations in attaining 'a healthy mouth for all' according to Western standards. In this discussion, the emphasis is shifted to consider collaborations between the industrial nations and those less developed countries, in the conduct and development of research. This potentially fruitful partnership can produce scientific, educational and cultural rewards for mutual benefit. (+info)
Do beliefs of inner-city parents about disease and vaccine risks affect immunization?
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OBJECTIVE: The objective of this study was to understand how low income, inner-city parents of preschool children think about childhood diseases and prevention and the impact that this has on late receipt of vaccines. METHODS: Parents of all children born between January 1, 1991, and May 31, 1995, whose child received medical assistance and health care at one of four inner-city, primary care clinics in Pittsburgh, PA, completed a telephone interview and gave consent for a vaccine record review. The main outcome measures were lateness for first and third diphtheria and tetanus toxoids and pertussis vaccines (DTP) and not receiving at least four DTP, three polio virus containing and one measles, mumps and rubella (MMR) doses by 19 months. RESULTS: A total of 483 parents participated. Fifteen percent of children were late for the first DTP, 52% for the third DTP, and 40% had not received at least four DTP, three polio and one MMR by 19 months of age. Statistically significant factors associated with lateness at 19 months included: having three or more children, having two children, beliefs regarding the severity of immunization side effects, and being African American. CONCLUSIONS: The results of this study indicate that a combination of life circumstances, as well as cognitive factors were associated with late immunization. (+info)
Cultural context, older age and smoking in Scotland: qualitative interviews with older smokers with arterial disease.
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This paper explores how smoking among older smokers with a smoking-related illness is influenced by the wider cultural context of smoking. The paper draws upon a Scottish qualitative interview study to explore lifecourse changes in smoking-related beliefs and behaviours, in current smokers between the ages of 65 and 84 years with arterial disease. The respondents' understanding of smoking, as a socially acceptable behaviour of their youth, had undergone dramatic change over the course of their lives. While some respondents continued to associate their current smoking with their, albeit reduced, participation in social activities, others now smoked at home alone and associated smoking with increasing levels of isolation in their lives. Through an examination of how social attitudes may contribute to smoking as a solitary activity, the paper highlights the implications of cultural context for the adaptive strategies that older people use to cope with the circumstances and conditions of later life. The paper concludes that the wider cultural context of smoking is influential in shaping smoking as either an isolated 'home' activity, or as a 'social' activity for those whose opportunities to smoke in the private sphere are limited by disapproval of significant others. Within the social context, however, these 'social' smokers experience further constraints which shape and reduce their smoking behaviour. The data suggest that in order to be successful with this group of smokers, further research is needed to identify aspects of the lives of older people that sustain smoking in later life. These data will be necessary to develop appropriate health promotion measures to successfully target aspects of lives that support smoking in later life. (+info)
Evaluation of a culturally appropriate smoking cessation intervention for Latinos.
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BACKGROUND: Many believe that smoking cessation programmes for Latinos should be tailored to the values and beliefs of the culture. However, randomised studies of culturally appropriate smoking cessation interventions with Latinos are rare. METHODS: Latino smokers (n = 313) were randomised to an intervention condition or a comparison group. The intervention was a three month programme based on social cognitive constructs and delivered in the smoker's home by trained lay health advisors, or promotores. Comparison group participants were referred to the California Smoker's Helpline in Spanish. Predictors of abstinence among all participants also were examined. RESULTS: About one week post-intervention, validated (carbon monoxide) past week abstinence rates were more than twice as high in the intervention group (20.5%) than in the comparison (8.7%) (p < or = 0.005). The pattern of results held for self reported abstinence, and after recoding dropouts to non-abstinence. The primary predictor of abstinence was number of cigarettes smoked per day at baseline, a common measure of addiction. CONCLUSIONS: The culturally appropriate intervention facilitated abstinence in Latino smokers, at least in the short term. Strengths and weaknesses of the study are discussed. (+info)