1
|
Doherty T, Engebretsen IMS, Tylleskär T, Burgoine K, Baerug A, Mercer R, Baker P, Clark D, Pereira-Kotze CJ, Kroon M. Questioning the ethics of international research on formula milk supplementation in low-income African countries. BMJ Glob Health 2022; 7:bmjgh-2022-009181. [PMID: 35523452 PMCID: PMC9083380 DOI: 10.1136/bmjgh-2022-009181] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 04/25/2022] [Indexed: 01/04/2023] Open
Affiliation(s)
- Tanya Doherty
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa .,School of Public Health, University of the Western Cape Faculty of Community and Health Sciences, Cape Town, South Africa.,Department of Paediatrics and Child Health, University of Cape Town, Faculty of Health Sciences, Observatory, Western Cape, South Africa
| | - Ingunn Marie S Engebretsen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Thorkild Tylleskär
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Centre for Intervention Science in Maternal and Child Health, University of Bergen, Bergen, Norway
| | - Kathy Burgoine
- Neonatal Unit, Mbale Regional Referral Hospital, Mbale, Uganda
| | - Anne Baerug
- Unit on Breastfeeding, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Raul Mercer
- Program of Social Sciences and Health, Latin American School of Social Sciences (FLACSO), Buenos Aires, Argentina
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - David Clark
- Giovine-Clark Consultancy, Independent, New York, New York, USA
| | - Catherine Jane Pereira-Kotze
- School of Public Health, University of the Western Cape Faculty of Community and Health Sciences, Cape Town, South Africa
| | - Max Kroon
- Department of Paediatrics and Child Health, University of Cape Town, Faculty of Health Sciences, Observatory, Western Cape, South Africa.,Neonatal Service, Mowbray Maternity Hospital, Mowbray, South Africa
| |
Collapse
|
2
|
Miller C. Maternal Mortality from Induced Abortion in Malawi: What Does the Latest Evidence Suggest? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910506. [PMID: 34639806 PMCID: PMC8507663 DOI: 10.3390/ijerph181910506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/18/2021] [Accepted: 09/20/2021] [Indexed: 11/15/2022]
Abstract
It is commonly claimed that thousands of women die every year from unsafe abortion in Malawi. This commentary critically assesses those claims, demonstrating that these estimates are not supported by the evidence. On the contrary, the latest evidence—itself from 15 to 20 years ago—suggests that 6–7% of maternal deaths in Malawi are attributable to induced and spontaneous abortion combined, totalling approximately 70–150 deaths per year. I then offer some evidence suggesting that a substantial proportion of these are attributable to spontaneous abortion. To reduce maternal mortality by large margins, emergency obstetric care should be prioritised, which will also save women from complications of induced and spontaneous abortion.
Collapse
Affiliation(s)
- Calum Miller
- St. Benet's Hall, University of Oxford, Oxford OX1 3LN, UK
| |
Collapse
|
3
|
Lohne K. Ethical capacity and its challenges in the academy of science: historical continuities and contemporary violence. Biol Futur 2021; 72:155-160. [PMID: 34554466 DOI: 10.1007/s42977-020-00021-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Abstract
This reflective essay is inspired by a roundtable discussion at the World Science Forum on the question 'Are there ethical limits to what science can achieve and should pursue?' I argue that, amid the conflicting trends of 'technological utopianism'-extreme faith in technological solutions; and 'post-truth' politics-the populist pushback against the universality of science, the conditions for ethical knowledge production are significantly challenged. Drawing on insights gleaned from my work on political violence, law, and technology, I point to historical continuities in the way the application and pursuit of science relates to violence-especially state violence. Conscious of the fact that science exercises no restraint on violence-and indeed, may be put to work for violent purposes-the paper calls for more attention to the social, structural, and political conditions of scientific production. The final part of this essay, therefore, examines three developments challenging the ethical capacity of scholars and scientists today. These are (1) the bureaucratization of ethics (2), 'ethics washing,' and (3) co-optation. Like other policy domains in our society, informed normative assessments around scientific pursuits-value judgments and ethical evaluation-ought to be based on sound empirical knowledge of the contingencies of science.
Collapse
Affiliation(s)
- Kjersti Lohne
- Department of Public and International Law, Faculty of Law, University of Oslo, Oslo, Norway.
| |
Collapse
|
4
|
Closser S, Mendenhall E, Brown P, Neill R, Justice J. The anthropology of health systems: A history and review. Soc Sci Med 2021; 300:114314. [PMID: 34400012 DOI: 10.1016/j.socscimed.2021.114314] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 08/04/2021] [Accepted: 08/11/2021] [Indexed: 12/17/2022]
Abstract
Ethnographies of health systems are a theoretically rich and rapidly growing area within medical anthropology. Critical ethnographic work dating back to the 1950s has taken policymakers and health staff as points of entry into the power structures that run through the global health enterprise. In the last decade, there has been a surge of ethnographic work on health systems. We conceptualize the anthropology of health systems as a field; review the history of this body of knowledge; and outline emergent literatures on policymaking, HIV, hospitals, Community Health Workers, health markets, pharmaceuticals, and metrics. High-quality ethnographic work is an excellent way to understand the complex systems that shape health outcomes, and provides a critical vantage point for thinking about global health policy and systems. As theory in this space develops and deepens, we argue that anthropologists should look beyond the discipline to think through what their work does and why it matters.
Collapse
Affiliation(s)
- Svea Closser
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Rm E5545, Baltimore, MD, 21205, USA.
| | - Emily Mendenhall
- Science, Technology and International Affairs Program, Edmund A. Walsh School of Foreign Service, Georgetown University, USA
| | - Peter Brown
- Department of Anthropology, Emory University, USA
| | - Rachel Neill
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, USA
| | - Judith Justice
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, USA
| |
Collapse
|
5
|
Eboreime EA, Abimbola S. A priori registration of global health research-necessity or absurdity? BMJ Glob Health 2021; 6:e006199. [PMID: 34001522 PMCID: PMC8130736 DOI: 10.1136/bmjgh-2021-006199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 01/10/2023] Open
Affiliation(s)
- Ejemai Amaize Eboreime
- Department of Planning, Research & Statistics, National Primary Health Care Development Agency, Abuja, FCT, Nigeria
- Global Mental Health Research Group, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Seye Abimbola
- School of Public Health, University of Sydney, Sydney, NSW, Australia
- Julius Global Health, University Medical Center, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
6
|
Henriques P, Burlandy L, Dias PC, O'Dwyer G. [Competing ideas on the State's roles in the prevention and control of childhood obesity in Brazil]. CAD SAUDE PUBLICA 2020; 36:e00016920. [PMID: 33331589 DOI: 10.1590/0102-311x00016920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/06/2020] [Indexed: 11/22/2022] Open
Abstract
The study analyzed competing ideas on the State's roles in the prevention and control of childhood obesity in Brazil, with cognitive analysis of public policies as the frame of reference. The study included document analysis and semi-structured interviews with 20 individuals from government, organized civil society, and the commercial private sector. The State was viewed as the main party responsible for dealing with childhood obesity, but the definitions of its roles varied according to the narratives on the factors that condition obesity and the proposed solutions. Members of the commercial private sector criticized the regulatory State in the name of parents' freedom of choice. Civil society representatives and part of the government defended regulatory measures, which they considered essential. They contended that agreements between government and the food industry to reduce unhealthy ingredients are ineffective. However, some government representatives defended such agreements. These tensions and contradictions were also expressed in the policy documents acknowledging that practices by the commercial private sector favor obesity, even while considering the private sector a partner in this process. The arguments against the regulatory State were based on individual factors conditioning obesity, but the object of regulation is institutional practices by the commercial private sector, not individual behaviors. However, this kind of argument is part of corporate policy activity, since it overlooks the conflicts of interests that have contributed to delaying the reduction in obesity prevalence.
Collapse
Affiliation(s)
| | | | | | - Gisele O'Dwyer
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| |
Collapse
|
7
|
Soma DD, Zogo BM, Somé A, Tchiekoi BN, Hien DFDS, Pooda HS, Coulibaly S, Gnambani JE, Ouari A, Mouline K, Dahounto A, Ouédraogo GA, Fournet F, Koffi AA, Pennetier C, Moiroux N, Dabiré RK. Anopheles bionomics, insecticide resistance and malaria transmission in southwest Burkina Faso: A pre-intervention study. PLoS One 2020; 15:e0236920. [PMID: 32745085 PMCID: PMC7398507 DOI: 10.1371/journal.pone.0236920] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/17/2020] [Indexed: 11/21/2022] Open
Abstract
Background Twenty-seven villages were selected in southwest Burkina Faso to implement new vector control strategies in addition to long lasting insecticidal nets (LLINs) through a Randomized Controlled Trial (RCT). We conducted entomological surveys in the villages during the dry cold season (January 2017), dry hot season (March 2017) and rainy season (June 2017) to describe malaria vectors bionomics, insecticide resistance and transmission prior to this trial. Methods We carried out hourly catches (from 17:00 to 09:00) inside and outside 4 houses in each village using the Human Landing Catch technique. Mosquitoes were identified using morphological taxonomic keys. Specimens belonging to the Anopheles gambiae complex and Anopheles funestus group were identified using molecular techniques as well as detection of Plasmodium falciparum infection and insecticide resistance target-site mutations. Results Eight Anopheles species were detected in the area. Anopheles funestus s.s was the main vector during the dry cold season. It was replaced by Anopheles coluzzii during the dry hot season whereas An. coluzzii and An. gambiae s.s. were the dominant species during the rainy season. Species composition of the Anopheles population varied significantly among seasons. All insecticide resistance mechanisms (kdr-w, kdr-e and ace-1 target site mutations) investigated were found in each members of the An. gambiae complex but at different frequencies. We observed early and late biting phenotypes in the main malaria vector species. Entomological inoculation rates were 2.61, 2.67 and 11.25 infected bites per human per month during dry cold season, dry hot season and rainy season, respectively. Conclusion The entomological indicators of malaria transmission were high despite the universal coverage with LLINs. We detected early and late biting phenotypes in the main malaria vector species as well as physiological insecticide resistance mechanisms. These data will be used to evaluate the impact of complementary tools to LLINs in an upcoming RCT.
Collapse
Affiliation(s)
- Dieudonné Diloma Soma
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
- Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
- * E-mail:
| | - Barnabas Mahugnon Zogo
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
- Institut Pierre Richet (IPR), Bouaké, Côte d’Ivoire
- Université d’Abomey Calavi, Abomey-Calavi, Benin
| | - Anthony Somé
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
| | - Bertin N’Cho Tchiekoi
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
- Institut Pierre Richet (IPR), Bouaké, Côte d’Ivoire
| | | | - Hermann Sié Pooda
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
- Université de Dédougou, Dédougou, Burkina Faso
| | - Sanata Coulibaly
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
| | | | - Ali Ouari
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
| | - Karine Mouline
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
| | - Amal Dahounto
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
| | | | - Florence Fournet
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
| | | | - Cédric Pennetier
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
- Institut Pierre Richet (IPR), Bouaké, Côte d’Ivoire
| | - Nicolas Moiroux
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
| | - Roch Kounbobr Dabiré
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
| |
Collapse
|
8
|
Warin M, Moore V. Epistemic conflicts and Achilles’ heels: constraints of a university and public sector partnership to research obesity in Australia. CRITICAL PUBLIC HEALTH 2020. [DOI: 10.1080/09581596.2020.1761944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Megan Warin
- School of Social Sciences, University of Adelaide, Adelaide, Australia
- Life Course & Intergenerational Health Research Group, Adelaide, Australia
- Robinson Research Institute, Adelaide, Australia
- The Fay Gale Centre for Research on Gender, University of Adelaide, Adelaide, Australia
| | - Vivienne Moore
- Life Course & Intergenerational Health Research Group, Adelaide, Australia
- Robinson Research Institute, Adelaide, Australia
- The Fay Gale Centre for Research on Gender, University of Adelaide, Adelaide, Australia
- School of Public Health, University of Adelaide, Adelaide, Australia
| |
Collapse
|
9
|
Lazarus JV, Roel E, Elsharkawy AM. Hepatitis C Virus Epidemiology and the Impact of Interferon-Free Hepatitis C Virus Therapy. Cold Spring Harb Perspect Med 2020; 10:cshperspect.a036913. [PMID: 31570385 DOI: 10.1101/cshperspect.a036913] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The public health impact of hepatitis C virus (HCV) infection has been realized only recently. Globally, 71 million people are living with HCV chronic infection. HCV prevalence is higher in some regions and countries, as well as in some subpopulations such as people who inject drugs, prisoners, or people living with HIV. In 2017, an estimated 580,000 people died from HCV, largely because of long-term complications of the disease. The advent of direct-acting antivirals (DAAs), which are highly effective in treating the infection and are well tolerated, led the World Health Organization (WHO) in 2016 to call for the elimination of HCV by 2030, which would be possible by meeting the numerical targets laid down by the organization. However, at present, only 12 countries are on track. Overall, only 20% of people with HCV have been diagnosed and only 7% of people diagnosed have initiated treatment, with major differences among countries. Underdiagnoses, a general lack of awareness, poor surveillance, and the prices of diagnostics and treatment remain major barriers to achieving the elimination goals. Comprehensive strategies, which include innovative models of care and the removal of reimbursement restrictions for treatment, are needed to overcome these public health and health system obstacles.
Collapse
Affiliation(s)
- Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain
| | - Elena Roel
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain.,Preventive Medicine and Epidemiology, Hospital Clínic, 08036 Barcelona, Spain
| | - Ahmed M Elsharkawy
- Liver Unit, University Hospitals Birmingham, Edgbaston, Birmingham B15 2TH, United Kingdom
| |
Collapse
|
10
|
Ackers L, Ackers-Johnson G, Welsh J, Kibombo D, Opio S. Autonomy, Evidence and Methods in Global Health. ANTI-MICROBIAL RESISTANCE IN GLOBAL PERSPECTIVE 2020. [PMCID: PMC7682584 DOI: 10.1007/978-3-030-62662-4_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This chapter discusses the growing impact that funding bodies have on the design, delivery and evaluation of global health interventions with specific emphasis on the UK’s Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) funding programme. It explains the reasons for focusing the antimicrobial resistance intervention on maternal sepsis and describes the context within which the Maternal Sepsis Intervention took place; in a Regional Referral Hospital in Western Uganda.
Collapse
Affiliation(s)
- Louise Ackers
- Global Social Justice, University of Salford, Salford, UK
| | | | | | | | - Samuel Opio
- Pharmaceutical Society of Uganda, Kampala, Uganda
| |
Collapse
|
11
|
George A, Olivier J, Glandon D, Kapilashrami A, Gilson L. Health systems for all in the SDG era: key reflections based on the Liverpool statement for the fifth global symposium on health systems research. Health Policy Plan 2019; 34:ii135-ii138. [PMID: 31723972 DOI: 10.1093/heapol/czz115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2019] [Indexed: 12/16/2022] Open
Affiliation(s)
- Asha George
- School of Public Health, University of the Western Cape, Robert Sobukwe Road, Bellville, Cape Town, South Africa
| | - Jill Olivier
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa
| | - Douglas Glandon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, USA
| | | | - Lucy Gilson
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa.,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| |
Collapse
|
12
|
Storeng KT, Abimbola S, Balabanova D, McCoy D, Ridde V, Filippi V, Roalkvam S, Akello G, Parker M, Palmer J. Action to protect the independence and integrity of global health research. BMJ Glob Health 2019; 4:e001746. [PMID: 31297249 PMCID: PMC6590965 DOI: 10.1136/bmjgh-2019-001746] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 05/30/2019] [Indexed: 12/19/2022] Open
Affiliation(s)
- Katerini T Storeng
- Centre for Development and the Environment, University of Oslo, Oslo, Norway
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Seye Abimbola
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Dina Balabanova
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - David McCoy
- Centre for Primary Care and Public Health, Queen Mary University London, London, UK
| | - Valery Ridde
- Institute for Research on Sustainable Development (IRD), CEPED (IRD-Université deParis), Université de Paris, ERL INSERM SAGESUD, Paris, France
| | - Veronique Filippi
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Sidsel Roalkvam
- Centre for Development and the Environment, University of Oslo, Oslo, Norway
| | - Grace Akello
- Department of Mental Health, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Melissa Parker
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Jennifer Palmer
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|