Medicine & Health
Medicine & Health
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(2012) Bunde-Birouste, Anne; Nathan, Sally; McCarroll, Brad; Kemp, Lynn; Shwe, Tun; Gran Ortega, MarciaReportAustralia accepts more than 13,000 refugee and humanitarian immigrants annually and young people account for a large overall percentage of the refugee population in New South Wales (NSW). There is evidence that refugee families are highly vulnerable to social isolation in their countries of resettlement. The difficulties of refugee settlement are well documented, including the need to learn new languages, negotiate differing cultural and societal values and address past emotional trauma. Development through sport refers to the use of sporting activities to provide opportunities for personal and community development with effects that go well beyond the sphere of physical activity and [elite] player and game development. In recent years there has been an increase in programs that use sport to foster social development and engagement, however little robust research has been performed to evaluate these efforts. Football United ® was developed from a vision that people’s love for Football (soccer) can be used to build opportunities for belonging, racial harmony and community cohesion. Football United ®’s six years of operations confirms the Crawford report findings, and highlights other effects of inequity in participation: • Gaps in equity of participation in both community and public education sector sport which can contribute to general disaffection within society, including leaving school, aggressive behaviour and unemployment as examples. • Lack of opportunity to interact across cultural groups which can translate to racism and the ensuing problems it provokes. Football United ® addresses these issues basing its foundations on the premise that structural variables and social processes act at multiple levels to impact on health and social behaviour. Results of the study underline Football United ®’s positive impact on participating young people’s sense of self, and appreciation for and engagement with peers from diverse backgrounds. Learning from interviews found unanticipated connections between participating in Football United ® and learning English, positive engagement with school, and building self confidence.
(2005) Stephenson, Niamh; Webb, Cammi; Carman, MarinaReportThis monograph outlines some contemporary explorations of the promises and challenges of approaching HIV through the framework of human rights. It includes an introduction and six chapters: • A public health dilemma: the vexed question of Voluntary Counselling and Testing (by Susan Kippax) • HIV testing and human rights in the era of scaling up access to treatments (by David Buchanan) • Ethical issues in trials of HIV prevention (by John Kaldor and Iona Millwood) • Power, prejudice and prevention: can research advance social justice? (by Bridge Haire) • Re-thinking human rights and the HIV epidemic: a reflection on power and goodness (by Elizabeth Reid) • HIV and human rights: through an East African prism (Michael Burke)
Developing and testing a framework for using Social Enterprise, Digital Health, and Citizen Engagement to deliver Integrated People-Centered Health Services(2022) Godinho, MyronThesisTo achieve Universal Health Coverage and the United Nations’ Sustainable Development Goals’ by 2030, the World Health Organisation recommended the use of social enterprise, digital technology, and citizen engagement in the delivery of Integrated People-Centered Health Services (IPCHS). We aimed to develop and test a framework for using social enterprise, digital health, and citizen engagement to deliver IPCHS and achieve the WHO strategic vision for 21st-century primary care. We conducted a hermeneutic review of frameworks, models, and theories on social enterprise, digital health, citizen engagement, and IPCHS. This involved multiple iterative cycles of (i) searching and acquisition, followed by (ii) critical analysis and interpretation of literature to assemble arguments and evidence for conceptual relationships. This process identified a set of constructs that we synthesized into a conceptual framework to provide theoretical grounding for an empirical inquiry into how social enterprises use digital technology to engage citizens in co-creating IPCHS. We tested this preliminary framework with two community health alliances (CHAs) in South Western Sydney (SWS), namely the Wollondilly Health Alliance and the Fairfield City Health Alliance (FCHA). Each CHA comprised the local council of the local government area (LGA), the SWS Local Health District, and the SWS Primary Health Network who collaborated to address the health challenges faced by local communities. We developed comparative case studies using a combination of documentary analysis and semi-structured interviews with stakeholders from both CHAs. The reassignment of CHA staff to address the COVID-19 pandemic limited CHA operations and prevented many CHA stakeholders from participating in the case study, possibly introducing selection bias. Nonetheless, findings from the case studies yielded evidence for several of the conceptual relationships between social enterprise, digital health citizen engagement, and IPCHS identified in our initial framework; but also suggested that greater organizational maturity was required for the CHAs to operate as social enterprises. Considering these findings, we revised our initial framework, and then used it to develop a maturity model to suggest how health organizations like CHAs can achieve greater organizational maturity to operate as social enterprises that use digital technology to engage citizens in co-creating IPCHS.
(2022) Okuba, TolesaThesisChild growth failure (CGF) is associated with high morbidity which can predispose children to impaired cognitive development. Despite decades of interventions, a high level of CGF has persisted in Ethiopia. A likely key reason for this situation is the undetermined role of water, sanitation, and hygiene (WASH) on child growth. The overarching aim of this thesis was to examine the effects of WASH on child growth in Ethiopia. Data were extensively analysed from the Ethiopia Demographic and Health Survey (EDHS) from 2000 to 2016, and a systematic review was conducted for the thesis. Logistic regression models were fitted to assess the association of access to household WASH facilities with child growth outcomes. We conducted a systematic review and meta-analysis of WASH interventions, separately, and when combined with nutrition. To estimate trends of CGF, we used adjusted margins of predicted probabilities. Socioeconomic inequalities in CGF were estimated using a concentration curve and indices. Children with access to improved household WASH facilities were 33% less likely to have stunting. Non-randomized controlled trial studies (non-RCTs) showed an effect of WASH interventions alone on height-for-age (HAZ) (Mean difference (MD)= 0.14; 95% CI: 0.08 to 0.21) while RCTs did not. WASH alone of non-RCTs and RCTs that were delivered over 18 to 60 months indicated an effect on HAZ (MD = 0.04; 95% CI: 0.01 to 0.08). RCTs showed an effect on children < 2 years (MD = 0.07; 95% CI: 0.01 to 0.13). WASH combined with nutrition showed an effect on HAZ compared with no intervention (MD = 0.13; 95% CI: 0.08 to 0.17) and on weight-for-age (WAZ) (MD = 0.09; 95% CI: 0.05 to 0.13). There was evidence of a decline in levels of CGF between 2000 and 2016 in Ethiopia. In particular, there was a greater steady decline between 2005 and 2011 compared with other periods. Access to improved household WASH facilities mainly contributed to the reduction of CGF. Between 2000 and 2016, the concentration index increased from -0.072 to -0.139 for stunting, -0.088 to -0.131 for underweight and -0.015 to -0.050 for wasting. Key socioeconomic predictors of these inequalities were identified through decomposition analyses. Socioeconomic status of the household, geographic region, antenatal care (ANC), parental education and access to household WASH facilities largely contributed to the inequalities. Access to improved household WASH facilities was strongly associated with reduced odds of stunting. WASH interventions alone improved HAZ when delivered over 18 to 60 months and in the first 1000 days of a child’s life. The effect was stronger when WASH was combined with nutrition interventions. Integrated WASH with nutrition interventions may be an effective way of improving child growth outcomes. Improving identified predictors of socioeconomic status would most likely reduce inequalities in CGF.