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Midwives' experiences of providing maternity care to women and families during the COVID-19 pandemic in Northern Italy. Women Birth 2023; 36:e57-e64. [PMID: 35490090 PMCID: PMC9015962 DOI: 10.1016/j.wombi.2022.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 01/26/2023]
Abstract
PROBLEM The COVID-19 pandemic has significantly challenged maternity provision internationally. Rapid and radical changes were implemented, with midwives facing anxiety and moral distress if not able to provide optimal and woman-centred care in line with professional values. BACKGROUND Healthcare professionals' stress and burnout are commonly reported during other global emergencies, which may eventually contribute to reduced quality of care. There is lack of evidence of the challenges faced by midwives in Italy during the COVID-19 pandemic. AIM To explore midwives' experiences of providing care to women and families during the COVID-19 pandemic. METHODS Qualitative interpretive phenomenological approach, using semi-structured interviews and thematic analysis. The sample included 15 midwives. Ethical approval was obtained. FINDINGS Four themes were identified: 1) adjusting to the ever-evolving organisation of care; 2) physical, psychological and relational challenges; 3) support network; 4) deferred sense of awareness. DISCUSSION Midwives faced professional and personal challenges during the pandemic, displaying feelings of fear, anxiety, uncertainty, discomfort, lack of support and knowledge with potential long-term effects. Adjusting to the continuous, rapid and drastic re-organisation of maternity services was particularly challenging. Factors facilitating a safe, supportive and empowering workplace included support from colleagues and managers, access to appropriate PPE, reliable guidelines, good communication and emotional support. Positive aspects of personal and professional development included communication skills, establishment of trusting relationships, sense of empowerment and teamwork. CONCLUSION In the context of a pandemic, optimisation of midwives' physical, emotional and psychological wellbeing should be considered. Timely and comprehensive guidelines and appropriate resources should be provided to assist midwives in facilitating family-centred respectful maternity care and preserving childbirth as a bio-psychosocial event.
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Cristea F, Weishaar H, Geurts B, Delamou A, Tan MMJ, Legido-Quigley H, Aminu K, Mari-Sáez A, Rocha C, Camara B, Barry L, Thea P, Boucsein J, Bahr T, Al-Awlaqi S, Pozo-Martin F, Boklage E, Jegede AS, Bcheraoui CE. A comparative analysis of experienced uncertainties in relation to risk communication during COVID19: a four-country study. Global Health 2022; 18:66. [PMID: 35761365 PMCID: PMC9235152 DOI: 10.1186/s12992-022-00857-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background During outbreaks, uncertainties experienced by affected communities can influence their compliance to government guidance on public health. Communicators and authorities are, hence, encouraged to acknowledge and address such uncertainties. However, in the midst of public health crises, it can become difficult to define and identify uncertainties that are most relevant to address. We analyzed data on COVID-19-related uncertainties from four socio-economic contexts to explore how uncertainties can influence people’s perception of, and response to Risk Communication and Community Engagement (RCCE) strategies. Results This qualitative study, which adopts an interpretative approach, is based on data from a documentary review, key informant interviews (KII), and focus group discussions (FGD) with members of the general public and people with barriers to information from Germany, Guinea, Nigeria, and Singapore. Transcripts from the KII and FGD were coded and analyzed thematically. We interviewed a total of 155 KIs and conducted 73 FGD. Our analysis uncovered a divergence between uncertainties deemed relevant by stakeholders involved in policy making and uncertainties that people reportedly had to navigate in their everyday lives and which they considered relevant during the pandemic. We identified four types of uncertainties that seemed to have influenced people’s assessment of the disease risk and their trust in the pandemic control strategies including RCCE efforts: epidemiological uncertainties (related to the nature and severity of the virus), information uncertainties (related to access to reliable information), social uncertainties (related to social behavior in times of heightened risk), and economic uncertainties (related to financial insecurities). Conclusion We suggest that in future outbreaks, communicators and policy makers could improve the way in which affected communities assess their risk, and increase the trust of these communities in response efforts by addressing non-epidemiological uncertainties in RCCE strategies.
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Affiliation(s)
- Florin Cristea
- Evidence-Based Public Health Unit, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Heide Weishaar
- Evidence-Based Public Health Unit, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Brogan Geurts
- Evidence-Based Public Health Unit, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Alexandre Delamou
- African Center of Excellence for the Prevention and Control of Communicable Diseases & Centre de Formation et de Recherche en Santé Rurale de Maferinyah, PoBox 1017, Dixinn, Conakry, Guinea
| | - Melisa Mei Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Kafayat Aminu
- Department of Sociology, Faculty of the Social Sciences, University of Ibadan, 1, Oyo Road, Agbowo, Ibadan, Nigeria
| | - Almudena Mari-Sáez
- Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Carlos Rocha
- Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Bienvenu Camara
- Centre de Formation et de Recherche en Santé Rurale de Maferinyah, Département de Recherche, Unité de Socio-Anthropologie, Conakry, Guinea
| | - Lansana Barry
- African Center of Excellence for the Prevention and Control of Communicable Diseases, PoBox 1017, Dixinn, Conakry, Guinea
| | - Paul Thea
- African Center of Excellence for the Prevention and Control of Communicable Diseases, PoBox 1017, Dixinn, Conakry, Guinea
| | - Johannes Boucsein
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany.,Postgraduate Training for Applied Epidemiology (PAE), Robert Koch Institute, Berlin, Germany.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Thurid Bahr
- Evidence-Based Public Health Unit, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Sameh Al-Awlaqi
- Evidence-Based Public Health Unit, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Francisco Pozo-Martin
- Evidence-Based Public Health Unit, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Evgeniya Boklage
- Health Information Centre for International Health Protection unit, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Ayodele Samuel Jegede
- Department of Sociology, Faculty of the Social Sciences, University of Ibadan, 1, Oyo Road, Agbowo, Ibadan, Nigeria
| | - Charbel El Bcheraoui
- Evidence-Based Public Health Unit, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany.
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Lee F. Detecting the unknown in a sea of knowns: Health surveillance, knowledge infrastructures, and the quest for classification egress. SCIENCE IN CONTEXT 2022; 35:153-172. [PMID: 37994507 DOI: 10.1017/s0269889723000133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
The sociological study of knowledge infrastructures and classification has traditionally focused on the politics and practices of classifying things or people. However, actors' work to escape dominant infrastructures and pre-established classification systems has received little attention. In response to this, this article argues that it is crucial to analyze, not only the practices and politics of classification, but also actors' work to escape dominant classification systems. The article has two aims: First, to make a theoretical contribution to the study of classification by proposing to pay analytical attention to practices of escaping classification, what the article dubs classification egress. This concept directs our attention not only to the practices and politics of classifying things, but also to how actors work to escape or resist classification systems in practice. Second, the article aims to increase our understanding of the history of quantified and statistical health surveillance. In this, the article investigates how actors in health surveillance assembled a knowledge infrastructure for surveilling, quantifying, and detecting unknown patterns of congenital malformations in the wake of the thalidomide disaster in the early 1960s. The empirical account centers on the actors' work to detect congenital malformations and escape the dominant nosological classification of diseases, the International Classification of Diseases (ICD), by replacing it with a procedural standard for reporting of symptoms. Thus, the article investigates how actors deal with the tension between the-already-known-and-classified and the unknown-unclassified-phenomenon in health surveillance practice.
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Affiliation(s)
- Francis Lee
- Chalmers University of Technology, Gothenburg, Sweden
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4
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Costa CBDC, Freitas D. Ocular findings of congenital Zika virus infection with microcephaly. Int Ophthalmol 2022; 42:3117-3127. [DOI: 10.1007/s10792-022-02311-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
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5
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Eachempati P, Büchter RB, Ks KK, Hanks S, Martin J, Nasser M. Developing an integrated multilevel model of uncertainty in health care: a qualitative systematic review and thematic synthesis. BMJ Glob Health 2022; 7:bmjgh-2021-008113. [PMID: 35501069 PMCID: PMC9062775 DOI: 10.1136/bmjgh-2021-008113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/07/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Uncertainty is an inevitable part of healthcare and a source of confusion and challenge to decision-making. Several taxonomies of uncertainty have been developed, but mainly focus on decisions in clinical settings. Our goal was to develop a holistic model of uncertainty that can be applied to both clinical as well as public and global health scenarios. Methods We searched Medline, Embase, CINAHL, Scopus and Google scholar in March 2021 for literature reviews, qualitative studies and case studies related to classifications or models of uncertainty in healthcare. Empirical articles were assessed for study limitations using the Critical Appraisal Skills Programme (CASP) checklist. We synthesised the literature using a thematic analysis and developed a dynamic multilevel model of uncertainty. We sought patient input to assess relatability of the model and applied it to two case examples. Results We screened 4125 studies and included 15 empirical studies, 13 literature reviews and 5 case studies. We identified 77 codes and organised these into 26 descriptive and 11 analytical themes of uncertainty. The themes identified are global, public health, healthcare system, clinical, ethical, relational, personal, knowledge exchange, epistemic, aleatoric and parameter uncertainty. The themes were included in a model, which captures the macro, meso and microlevels and the inter-relatedness of uncertainty. We successfully piloted the model on one public health example and an environmental topic. The main limitations are that the research input into our model predominantly came from North America and Europe, and that we have not yet tested the model in a real-life setting. Conclusion We developed a model that can comprehensively capture uncertainty in public and global health scenarios. It builds on models that focus solely on clinical settings by including social and political contexts and emphasising the dynamic interplay between different areas of uncertainty.
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Affiliation(s)
- Prashanti Eachempati
- Department of Prosthodontics, Faculty of Dentistry, Manipal University College Malaysia, Bukit Baru, Malaysia
| | - Roland Brian Büchter
- Institute for Research in Operative Medicine (IFOM), Faculty of Health-School of Medicine, Witten/Herdecke University, Cologne, Nordrhein-Westfalen, Germany
| | - Kiran Kumar Ks
- Department of Prosthodontics, Faculty of Dentistry, Manipal University College Malaysia, Bukit Baru, Malaysia
| | - Sally Hanks
- Peninsula Dental School, Faculty of Health, University of Plymouth, Plymouth, UK
| | - John Martin
- Sustainable Earth Institute, University of Plymouth, Plymouth, UK
| | - Mona Nasser
- Peninsula Dental School, Faculty of Health, University of Plymouth, Plymouth, UK
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Marbán-Castro E, Enguita-Fernàndez C, Romero-Acosta KC, Arrieta GJ, Marín-Cos A, Mattar S, Menéndez C, Maixenchs M, Bardají A. “One feels anger to know there is no one to help us!”. Perceptions of mothers of children with Zika virus-associated microcephaly in Caribbean Colombia: A qualitative study. PLoS Negl Trop Dis 2022; 16:e0010328. [PMID: 35436298 PMCID: PMC9015150 DOI: 10.1371/journal.pntd.0010328] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 03/14/2022] [Indexed: 01/07/2023] Open
Abstract
Background
The epidemic of Zika virus (ZIKV) was associated with a sudden and unprecedented increase in infants born with microcephaly. Colombia was the second most affected country by the epidemic in the Americas. Primary caregivers of children with ZIKV-associated microcephaly, their mothers mainly, were at higher risk of suffering anxiety and depression. Often, these women were stigmatized and abandoned by their partners, relatives, and communities.
Methodology/Principal findings
This study aimed to understand the perceptions about ZIKV infection among mothers of children born with microcephaly during the ZIKV epidemic in Caribbean Colombia, and the barriers and facilitators affecting child health follow-up. An exploratory qualitative study, based on Phenomenology and Grounded Theory, was conducted in Caribbean Colombia. Data were collected through In-Depth Interviews (IDI) from women who delivered a baby with microcephaly during the ZIKV epidemic at Clínica Salud Social, Sincelejo, Sucre District (N = 11). The themes that emerged during the interviews included experiences from their lives before pregnancy; knowledge about ZIKV; experiences and perceptions when diagnosed; considering a possible termination of pregnancy, and children’s clinical follow-up. In some cases, women reported having been told they were having a baby with microcephaly but decided not to terminate the pregnancy; while in other cases, women found out about their newborn’s microcephaly condition only at birth. The main barriers encountered by participants during children’s follow-up included the lack of psychosocial and economic support, the stigmatization and abandonment by some partners and relatives, and the frustration of seeing the impaired development of their children.
Conclusions
This study contributed to identifying the social, medical, psychological, and economic needs of families with children affected by the ZIKV epidemic. Commitment and action by local and national governments, and international bodies, is required to ensure sustained and quality health services by affected children and their families.
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Affiliation(s)
- Elena Marbán-Castro
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- * E-mail:
| | | | | | - Germán J. Arrieta
- Corporación Universitaria del Caribe (CECAR), Group of Public Health, Sincelejo, Sucre, Colombia
- Clínica Salud Social, Sincelejo, Sucre, Colombia
- Universidad de Córdoba—Instituto de investigaciones biológicas del Trópico, Montería, Córdoba, Colombia
| | - Anna Marín-Cos
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Salim Mattar
- Clínica Salud Social, Sincelejo, Sucre, Colombia
- Universidad de Córdoba—Instituto de investigaciones biológicas del Trópico, Montería, Córdoba, Colombia
| | - Clara Menéndez
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Maria Maixenchs
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Azucena Bardají
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
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7
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Andrade GKSD, Teston EF, Marcon SS, Giacon-Arruda BCC, Amorim MD, Sato DM, Werle JE, Silva JLD. Congenital Zika Virus Syndrome: care in light of the Brazilian Unified Health System principles. Rev Bras Enferm 2021; 75:e20210146. [PMID: 34614105 DOI: 10.1590/0034-7167-2021-0146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 05/09/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE to know health professionals' perceptions about care actions provided to children with Congenital Zika Virus Syndrome and their families. METHODS this is a qualitative study, carried out in a capital of center-western Brazil, based on the Unified Health System theoretical precepts. Data were collected in September and October 2020, through audio-recorded interviews with 12 health professionals from a specialized service and submitted to analysis of content, thematic modality. RESULTS the implementation of care actions with these children occurs through multidimensional assessment of children and their families, use of the Unique Therapeutic Project, therapeutic interventions for the development of children and the communication and exchange of interprofessional and family experiences, in addition to considering professionals' prior knowledge and their search for it. FINAL CONSIDERATIONS children with CZS and their families need individualized, frequent, integrated and continuous care.
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Affiliation(s)
| | - Elen Ferraz Teston
- Universidade Federal de Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | | | - Daniela Miyuki Sato
- Universidade Federal de Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
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8
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Kameda K, Kelly AH, Lezaun J, Löwy I. Imperfect diagnosis: The truncated legacies of Zika testing. SOCIAL STUDIES OF SCIENCE 2021; 51:683-706. [PMID: 34461777 PMCID: PMC8474320 DOI: 10.1177/03063127211035492] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
When the Zika virus burst onto the international scene in the second half of 2015, the development of diagnostic tools was seen as an urgent global health priority. Diagnostic capacity was restricted to a small number of reference laboratories, and none of the few available molecular or serological tests had been validated for extensive use in an outbreak setting. In the early weeks of the crisis, key funders stepped in to accelerate research and development efforts, and the WHO took responsibility for steering diagnostic standardization, a role it had successfully played during the West Africa Ebola virus outbreak. Yet when the WHO declared the end of the Zika Public Health Emergency of International Concern in November 2016, diagnostic capacity remained patchy, and few tools were available at the scale required in the countries that bore the brunt of the epidemic, particularly Brazil. This article analyses the limited impact of global R&D efforts on the availability of Zika diagnostic options where they were most needed and for those most vulnerable: women who might have been exposed to the virus during their pregnancy and children born with suspected congenital Zika syndrome. The truncated legacies of testing during the Zika crisis reveal some of the fault lines in the global health enterprise, particularly the limits of 'emergency R&D' to operate in geopolitical contexts that do not conform to the ideal type of a humanitarian crisis, or to tackle technical issues that are inextricably linked to domestic struggles over the scope and distribution of biological citizenship. Diagnostic shortcomings, we argue, lie at the heart of the stunning transformation, in less than two years, in the status of Zika: from international public health emergency to neglected disease.
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Affiliation(s)
- Koichi Kameda
- Institute for Research and
Innovation in Society (IFRIS), Paris, France
| | - Ann H Kelly
- Department of Global Health and
Social Medicine, King’s College London, London, UK
| | - Javier Lezaun
- Institute for Science, Innovation
and Society, University of Oxford, Oxford, UK
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9
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Osorio-de-Castro CGS, Du Bocage Santos-Pinto C, Antunes de Lima C, Silva Miranda E. Knowledge and risk perception of vulnerable women on Zika virus infection at primary health care level in Brazil. Glob Public Health 2021; 17:1525-1539. [PMID: 34488553 DOI: 10.1080/17441692.2021.1953106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Vulnerable low-income groups were most affected by Zika virus (ZIKV)-related neurologic syndrome during the 2014-2016 outbreak in Brazil. Major ZIKV infection response took place in Primary Health Care (PHC), including prevention strategies and risk communication. We aimed to detect knowledge and beliefs, as well as knowledge gaps among vulnerable women at the PHC level. A cross-sectional study was carried out in two low-income urban community settings: a small municipality with few ZIKV infection cases and a large municipality hard-hit by the epidemic. An open-ended data collection instrument centred on ZIKV infection knowledge, sources of information, possible causes, symptoms, risk perception, consequences for pregnant women and PHC point-of-care communication was developed. Interviews were recorded, transcribed and content coded for thematic analysis. Most of the seventy-nine respondents had some knowledge of the disease, acknowledging the vector as the source of infection and associating microcephaly with the disease, but distanced themselves from possible ZIKV infection and related risk. PHC services in both communities did not adequately communicate risk for women and children. In an uncertain future scenario as to disease re-emergence, awareness may be diminished and acquired knowledge lost, configuring a public health challenge that must be overcome.
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10
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Sun Y, Hu Q, Grossman S, Basnyat I, Wang P. Comparison of COVID-19 Information Seeking, Trust of Information Sources, and Protective Behaviors in China and the US. JOURNAL OF HEALTH COMMUNICATION 2021; 26:657-666. [PMID: 34702136 DOI: 10.1080/10810730.2021.1987590] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Due to the increasing amount of new information that is emerging about COVID-19, traditional and web-based information sources are commonly used to spread and seek information. This study compared differences in information seeking, trust of information sources, and use of protective behaviors (e.g., mask wearing) among individuals in the US and China during the COVID-19 pandemic. A total of 722 valid responses in the US and 493 valid responses in China were collected via online surveys in May 2020. Pearson's Chi-square tests, independent samples t-tests, and multiple linear regressions were used to conduct the analyses. Results showed that US respondents accessed significantly fewer COVID-19 information sources, rated significantly lower levels of trust in these sources, and reported significantly lower levels of protective behaviors than the Chinese respondents. In both countries, trust in newspapers, radio/community broadcasting, and news portals were significantly positively correlated with protective behaviors. While trust of TV was significant in both populations, in China it was positively correlated, whereas in the US was negatively correlated, with protective behaviors. Findings from this study showed that coordinated and consistent messages from governmental officials, health authorities, and media platforms are important to promote and encourage protective behaviors.
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Affiliation(s)
- Yingying Sun
- School of Public Administration and Policy, Renmin University of China, Beijing, P.R. China
- Research Center for Social Development and Social Risk Control, Sichuan University, Chengdu, P.R. China
| | - Qixi Hu
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, P.R. China
| | - Suzanne Grossman
- College of Health and Behavioral Studies, James Madison University, Harrisonburg, Virginia, United States
| | - Iccha Basnyat
- Global Affairs & Department of Communication, George Mason University, Fairfax, Virginia, United States
| | - Ping Wang
- College of Business, James Madison University, Harrisonburg, Virginia, United States
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11
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Cousins T, Pentecost M, Alvergne A, Chandler C, Chigudu S, Herrick C, Kelly A, Leonelli S, Lezaun J, Lorimer J, Reubi D, Sekalala S. The changing climates of global health. BMJ Glob Health 2021; 6:e005442. [PMID: 33758015 PMCID: PMC7993205 DOI: 10.1136/bmjgh-2021-005442] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 12/12/2022] Open
Affiliation(s)
- Thomas Cousins
- Institute of Social and Cultural Anthropology, University of Oxford School of Anthropology and Museum Ethnography, Oxford, Oxfordshire, UK
- Department of Sociology and Social Anthropology, University of Stellenbosch, Stellenbosch, South Africa
| | - Michelle Pentecost
- Global Health and Social Medicine, King's College London, London, UK
- SAMRC-Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
| | - Alexandra Alvergne
- Montpellier Institute of Evolutionary Sciences, University of Montpellier, Montpellier, Languedoc-Roussillon, France
- Institute of Human Sciences, University of Oxford School of Anthropology and Museum Ethnography, Oxford, Oxfordshire, UK
| | - Clare Chandler
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Simukai Chigudu
- Oxford Department of International Development, University of Oxford, Oxford, UK
| | - Clare Herrick
- Geography, King's College London School of Social Science and Public Policy, London, UK
| | - Ann Kelly
- Global Health and Social Medicine, King's College London, London, UK
| | - Sabina Leonelli
- Sociology, Philosophy and Anthropology, University of Exeter College of Social Sciences and International Studies, Exeter, Devon, UK
| | - Javier Lezaun
- Institute for Science, Innovation and Society, University of Oxford School of Anthropology and Museum Ethnography, Oxford, Oxfordshire, UK
| | - Jamie Lorimer
- School of Geography and the Environment, University of Oxford Social Sciences Division, Oxford, Oxfordshire, UK
| | - David Reubi
- Global Health and Social Medicine, King's College London School of Social Science and Public Policy, London, UK
| | - Sharifah Sekalala
- School of Law, University of Warwick Faculty of Social Sciences, Coventry, West Midlands, UK
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12
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Heyerdahl LW, Vray M, Leger V, Le Fouler L, Antouly J, Troit V, Giles-Vernick T. Evaluating the motivation of Red Cross Health volunteers in the COVID-19 pandemic: a mixed-methods study protocol. BMJ Open 2021; 11:e042579. [PMID: 33500285 PMCID: PMC7839304 DOI: 10.1136/bmjopen-2020-042579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Voluntary organisations provide essential support to vulnerable populations and front-line health responders to the COVID-19 pandemic. The French Red Cross (FRC) is prominent among organisations offering health and support services in the current crisis. Comprised primarily of lay volunteers and some trained health workers, FRC volunteers in the Paris (France) region have faced challenges in adapting to pandemic conditions, working with sick and vulnerable populations, managing limited resources and coping with high demand for their services. Existing studies of volunteers focus on individual, social and organisational determinants of motivation, but attend less to contextual ones. Public health incertitude about the COVID-19 pandemic is an important feature of this pandemic. Whether and how uncertainty interacts with volunteer understandings and experiences of their work and organisational relations to contribute to Red Cross worker motivation is the focus of this investigation. METHODS AND ANALYSIS This mixed-methods study will investigate volunteer motivation using ethnographic methods and social network listening. Semi-structured interviews and observations will illuminate FRC volunteer work relations, experiences and concerns during the pandemic. A questionnaire targeting a sample of Paris region volunteers will allow quantification of motivation. These findings will iteratively shape and be influenced by a social media (Twitter) analysis of biomedical and public health uncertainties and debates around COVID-19. These tweets provide insight into a French lay public's interpretations of these debates. We evaluate whether and how socio-political conditions and discourses concerning COVID-19 interact with volunteer experiences, working conditions and organisational relations to influence volunteer motivation. Data collection began on 15 June 2020 and will continue until 15 April 2021. ETHICS AND DISSEMINATION The protocol has received ethical approval from the Institut Pasteur Institutional Review Board (no 2020-03). We will disseminate findings through peer-reviewed articles, conference presentations and recommendations to the FRC.
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Affiliation(s)
- Leonardo W Heyerdahl
- Anthropology & Ecology of Disease Emergence Unit/Global Health, Institut Pasteur, Paris, France
| | - Muriel Vray
- Emerging Diseases Epidemiology Unit/Global Health, Institut Pasteur, Paris, France
| | - Vincent Leger
- Fondation de la Croix-Rouge francaise, Croix-Rouge francaise, Paris, France
| | | | - Julien Antouly
- Fondation de la Croix-Rouge francaise, Croix-Rouge francaise, Paris, France
| | - Virginie Troit
- Fondation de la Croix-Rouge francaise, Croix-Rouge francaise, Paris, France
| | - Tamara Giles-Vernick
- Anthropology & Ecology of Disease Emergence Unit/Global Health, Institut Pasteur, Paris, France
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13
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Analysing the intersection between health emergencies and abortion during Zika in Brazil, El Salvador and Colombia. Soc Sci Med 2021; 270:113671. [PMID: 33486425 PMCID: PMC7895814 DOI: 10.1016/j.socscimed.2021.113671] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 01/19/2023]
Abstract
The Zika outbreak of 2015-7 is a lens to analyse the positioning of abortion within in global health security. The sequelae of the virus almost exclusively affected newborn children, manifested through Congenital Zika Syndrome (CZS), and a focus on women at risk of, planning or being pregnant. At the global level, debate considered whether Zika would provide impetus for regulatory change for reproductive rights in Latin America, a region with some of the most restrictive abortion regulation in the world. However, regulatory change for abortion did not occur. We analyse why the Zika health emergency did not lead to any changes in abortion regulation through multi-method analysis of the intersection between Zika, health emergencies and abortion in Brazil, Colombia and El Salvador. These case study countries were purposefully selected; each had Zika infected women (albeit with differing incidence) yet represent diverse regulatory environments for abortion. Our comparative research is multi-method: framework analysis of key informant interviews (n = 49); content analysis of women's enquiries to a medical abortion telemedicine provider; and, policy analysis of (inter)national-level Zika response and abortion policies. We consider this within literature on global health security, and the prioritisation of a particular approach to epidemic control. Within this securitized landscape, despite increased public debate about abortion regulatory change, no meaningful change occurred, due to a dominant epidemiological approach to the Zika health emergency in all three countries and prominent conservative forces in government and within anti-abortion rights movements. Simultaneously, we demonstrate that regulation did not deter all women from seeking such service clandestinely. Zika affected reproductive decision making, but did not impact abortion regulation. Epidemiological framing ignored reproductive dimensions of emergency responses. Conservative forces instrumentalized disability concerns to oppose abortion rights. Women sought abortions clandestinely, citing Zika as a justification. Abortion provision must form part of health emergency planning and response.
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Preis H, Mahaffey B, Heiselman C, Lobel M. Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic. Soc Sci Med 2020; 266:113348. [PMID: 32927382 PMCID: PMC7474815 DOI: 10.1016/j.socscimed.2020.113348] [Citation(s) in RCA: 163] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/31/2020] [Accepted: 09/02/2020] [Indexed: 01/27/2023]
Abstract
RATIONALE Women pregnant during the COVID-19 pandemic are experiencing moderate to high levels of emotional distress, which has previously been shown to be attributable to two types of pandemic-related pregnancy stress: stress associated with feeling unprepared for birth due to the pandemic (Preparedness Stress) and stress related to fears of perinatal COVID-19 infection (Perinatal Infection Stress). OBJECTIVE Given the well-documented harms associated with elevated prenatal stress and the critical importance of developing appropriately targeted interventions, we investigated factors predictive of pandemic-related pregnancy stress. METHOD Between April 25 and May 15, 2020, 4,451 pregnant women in the U.S. were recruited via social media to complete an online questionnaire that included sociodemographic, medical, and COVID-19 situational factors, as well as the Pandemic-Related Pregnancy Stress Scale (PREPS). Binary logistic regression was used to calculate odds ratios for high stress. RESULTS Nearly 30% of participants reported high Preparedness Stress; a similar proportion reported high Perinatal Infection Stress. Abuse history, chronic illness, income loss due to the pandemic, perceived risk of having had COVID-19, alterations to prenatal appointments, high-risk pregnancy, and being a woman of color were associated with greater levels of one or both types of stress. Access to outdoor space, older age, and engagement in healthy behaviors were protective against stress. CONCLUSIONS Practices that may alleviate pandemic-related stress such as minimizing disruptions to prenatal care, ensuring access to outdoor space, and motivating engagement in health behaviors are of vital importance. Particular attention is needed for more vulnerable populations including women of color, women with a history of abuse, and those with high-risk pregnancy. Research focused on the short and longer-term impact of pandemic-related pregnancy stress on maternal mental and physical health, perinatal outcomes, and child development is critical to identify these effects and marshal appropriate resources to reduce them.
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Affiliation(s)
- Heidi Preis
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794, USA; Department of Pediatrics, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11794, USA.
| | - Brittain Mahaffey
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11794, USA.
| | - Cassandra Heiselman
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11794, USA.
| | - Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794, USA.
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15
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Marbán-Castro E, Villén-Gonzalvo A, Enguita-Fernàndez C, Romero-Acosta KC, Marín-Cos A, Arrieta GJ, Mattar S, Menéndez C, Maixenchs M, Bardají A. Acceptability of a Hypothetical Zika Vaccine among Women from Colombia and Spain Exposed to ZIKV: A Qualitative Study. Vaccines (Basel) 2020; 8:vaccines8040580. [PMID: 33022907 PMCID: PMC7711833 DOI: 10.3390/vaccines8040580] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 12/20/2022] Open
Abstract
Zika virus (ZIKV) can cause pregnancy loss and congenital Zika syndrome, among other poor health outcomes. The ZIKV epidemic in 2015-2017 disproportionately affected pregnant women in poor-resource settings. We aimed to understand perceptions and attitudes towards a hypothetical ZIKV vaccine, women's willingness to be vaccinated, and potential barriers and facilitators for vaccine acceptance in 1) migrant women living in Spain who travelled to their countries of origin and were diagnosed with ZIKV infection during pregnancy, and their healthcare providers, and 2) women living in Colombia who delivered a child with microcephaly. An exploratory qualitative study based on phenomenology and grounded theory was conducted. Data were collected through in-depth, paired and semi-structured interviews. Overall, women from both sites were willing to receive a hypothetical ZIKV vaccine. However, some expressed concerns of being vaccinated during pregnancy, yet they would accept it if the vaccine was recommended by a healthcare professional they trust. Main fears towards vaccination were related to vaccine safety and potential adverse effects on child's health. Women reported feeling hesitant to participate in a ZIKV vaccine trial. These results may contribute to guiding the effective delivery of future ZIKV vaccines among populations most at risk and particularly vulnerable.
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Affiliation(s)
- Elena Marbán-Castro
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-93-227-1851
| | - Ana Villén-Gonzalvo
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
| | - Cristina Enguita-Fernàndez
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Kelly Carolina Romero-Acosta
- Faculty of Humanities and Education, Corporación Universitaria del Caribe (CECAR), Sincelejo, Sucre 700001, Colombia; (K.C.R.-A.); (G.J.A.)
| | - Anna Marín-Cos
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
| | - Germán J. Arrieta
- Faculty of Humanities and Education, Corporación Universitaria del Caribe (CECAR), Sincelejo, Sucre 700001, Colombia; (K.C.R.-A.); (G.J.A.)
- Clínica Salud Social, Sincelejo, Sucre 700001, Colombia;
| | - Salim Mattar
- Clínica Salud Social, Sincelejo, Sucre 700001, Colombia;
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería 230002, Córdoba, Colombia
| | - Clara Menéndez
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
| | - Maria Maixenchs
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Azucena Bardají
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
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Hodges S, Garnett E. The ghost in the data: Evidence gaps and the problem of fake drugs in global health research. Glob Public Health 2020; 15:1103-1118. [PMID: 32228359 PMCID: PMC7446034 DOI: 10.1080/17441692.2020.1744678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 02/09/2020] [Indexed: 10/31/2022]
Abstract
For the past several decades, global health research and policy have raised the alarm about the growing threat of counterfeit and low-quality drugs (henceforth 'fakes'). These high-profile and regularly-repeated claims about 'fake drugs' pepper scholarly publications, grey literature, and popular writing. We reviewed much of this work and found that it shares two characteristics that sit awkwardly alongside one another. First, it asserts that fake drugs constitute an urgent threat to lives. Second, it reports trouble with 'gaps' in the evidence on which their claims are based; that data is weaker and less conclusive than anticipated. Given the ubiquity of and urgency with these claims are made, we found this juxtaposition perplexing. To understand this juxtaposition better, we undertook a close reading of the strategies authors employed to negotiate and overcome data and evidence 'gaps' and asked questions about the cultures of scholarly publishing in global health research. We argue that a scholarly commitment to studying fakes despite--rather than because of-the evidence functions to support the continuation of similar research. It also works against asking different questions-for instance regarding the lack of easy access to pharmacological data that might make it possible to know fakes differently.
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Affiliation(s)
- Sarah Hodges
- Department of History, University of Warwick, Coventry, UK
| | - Emma Garnett
- School of Population Health and Environmental Sciences, King’s College London, London, UK
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17
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Ma R, Deng Z, Wu M. Effects of Health Information Dissemination on User Follows and Likes during COVID-19 Outbreak in China: Data and Content Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145081. [PMID: 32674510 PMCID: PMC7399940 DOI: 10.3390/ijerph17145081] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 06/30/2020] [Accepted: 07/10/2020] [Indexed: 12/16/2022]
Abstract
Background: COVID-19 has greatly attacked China, spreading in the whole world. Articles were posted on many official WeChat accounts to transmit health information about this pandemic. The public also sought related information via social media more frequently. However, little is known about what kinds of information satisfy them better. This study aimed to explore the characteristics of health information dissemination that affected users’ information behavior on WeChat. Methods: Two-wave data were collected from the top 200 WeChat official accounts on the Xigua website. The data included the change in the number of followers and the total number of likes on each account in a 7-day period, as well as the number of each type of article and headlines about coronavirus. It was used to developed regression models and conduct content analysis to figure out information characteristics in quantity and content. Results: For nonmedical institution accounts in the model, report and story types of articles had positive effects on users’ following behaviors. The number of headlines on coronavirus positively impacts liking behaviors. For medical institution accounts, report and science types had a positive effect, too. In the content analysis, several common characteristics were identified. Conclusions: Characteristics in terms of the quantity and content in health information dissemination contribute to users’ information behavior. In terms of the content in the headlines, via coding and word frequency analysis, organizational structure, multimedia applications, and instructions—the common dimension in different articles—composed the common features in information that impacted users’ liking behaviors.
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Affiliation(s)
- Rongyang Ma
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China;
| | - Zhaohua Deng
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China;
- Correspondence:
| | - Manli Wu
- School of Journalism and Information Communication, Huazhong University of Science and Technology, Wuhan 430074, China;
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18
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"Too Much to Ask, Too Much to Handle": Women's Coping in Times of Zika. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124613. [PMID: 32604943 PMCID: PMC7344537 DOI: 10.3390/ijerph17124613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 12/13/2022]
Abstract
Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences for pregnancies have made governments and both national and international agencies issue advice and recommendations to women. This study was designed to understand the impacts of Zika on women who were less directly affected and less vulnerable to Zika. Women were recruited from various locations in Brazil, Puerto Rico, and the United States. Data were collected through semi-structured interviews and analyzed using thematic analysis. Women perceived that public health systems placed an unfair responsibility for preventing health complications from Zika onto women who had limited ability to do so. They also stated that the measures recommended to them were invasive, while creating the perception that women were the sole determinant of whether they contracted Zika. The results indicate that women with higher levels of education understood the limitations of the information, government actions, and medical care they received, which ended up producing higher levels of anguish and worry. Gender inequality and discrimination must be recognized and rendered visible in the public health emergency response. The social effects of the epidemic affected women more than had been thought before and at deeper emotional levels.
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