Knowledge and perceptions of lymphatic filariasis patients in selected hotspot endemic communities in southern Ghana.

Lymphatic filariasis (LF) is a mosquito-borne neglected tropical disease that is one of the leading global causes of permanent disability. To date, LF interventions have been largely biomedical, focusing on drug treatments to disrupt parasite transmission and manage disease morbidity. Although important, these Mass Drug Administration (MDA) programs neglect the significance of socio-economic burden to the health of LF patients, which are compounded by social stigmatization, discrimination and associated depressive illnesses. The MDA program also typically fails to engage with local community beliefs and perceptions of LF, which may differ markedly from biomedical explanations and may have fueled non-compliance to treatments which is one of the major challenges of the Mass Drug Administration program. LF is not only a biomedical issue but also a social issue and LF interventions need to understand people's world views and the contexts through which they interpret bodily maladies. Hence, an effective LF intervention must bring together both the biomedical and the social components. The goal of this exploratory study was to assist in refining a large qualitative study (currently underway) that seeks to integrate culturally appropriate LF interventions into current LF control programs in Ghana. In this paper, we discuss the findings of a pre-intervention, exploratory study aimed at gaining a baseline grasp of a local culturally informed understanding of lymphatic filariasis and the knowledge gaps looking at three endemic Ghanaian communities in the Ahanta West District. A structured questionnaire was employed to assess the wellbeing, social inclusion, and cultural understanding of LF with a geographic focus within LF-endemic areas in Ghana. Interestingly, 45.8% of the 72 participants reported to have received information about LF from health care providers and the MDA program but only 5 out of the 72 (6.9%) respondents believed that LF was transmitted by mosquitos. This baseline study revealed several alternative interpretations and misconceptions about the disease, as well as the social and economic impacts, and importantly, the need to integrate qualitative research to develop culturally appropriate interventions and increase engagement with existing control programs.

Preventing Occupational Tuberculosis in Health Workers: An Analysis of State Responsibilities and Worker Rights in Mozambique.

Given the very high incidence of tuberculosis (TB) among health workers in Mozambique, a low-income country in Southern Africa, implementation of measures to protect health workers from occupational TB remains a major challenge. This study explores how Mozambique's legal framework and health system governance facilitate-or hinder-implementation of protective measures in its public (state-provided) healthcare sector. Using a mixed-methods approach, we examined international, constitutional, regulatory, and policy frameworks. We also recorded and analysed the content of a workshop and policy discussion group on the topic to elicit the perspectives of health workers and of officials responsible for implementing workplace TB policies. We found that despite a well-developed legal framework and national infection prevention and control policy, a number of implementation barrier persisted: lack of legal codification of TB as an occupational disease; absence of regulations assigning specific responsibilities to employers; failure to deal with privacy and stigma fears among health workers; and limited awareness among health workers of their legal rights, including that of collective action. While all these elements require attention to protect health workers from occupational TB, a stronger emphasis on their human and labour rights is needed alongside their perceived responsibilities as caregivers.

Court as a health intervention to advance Canada's achievement of the sustainable development goals : a multi-pronged analysis of Vancouver's Downtown Community Court.

BACKGROUND: The increase in problematic substance use is a major problem in Canada and elsewhere, placing a heavy burden on health and justice system resources given a spike in drug-related offences. Thus, achievement of Sustainable Development Goal (SDG) Target 3.5 to 'Strengthen the prevention and treatment of substance abuse' is important for Canada's overall realization of the SDGs, including SDG 3 (Good Health and Wellbeing). Since 2008, Vancouver's Downtown Community Court (DCC) has pioneered an innovative partnership among the justice, health and social service systems to address individuals' needs and circumstances leading to criminal behaviour. While researchers have examined the DCC's impact on reducing recidivism, with Canada's SDG health commitments in mind, we set out to examine the ways health and the social determinants of health (SDH) are engaged and framed externally with regard to DCC functioning, as well as internally by DCC actors. We employed a multi-pronged approach analyzing (1) publicly available DCC documents, (2) print media coverage, and (3) health-related discourse and references in DCC hearings. RESULTS: The documentary analysis showed that health and the SDH are framed by the DCC as instrumental for reducing drug-related offences and improving public safety. The observation data indicate that judges use health and SDH in providing context, understanding triggers for offences and offering rationale for sentencing and management plans that connect individuals to healthcare, social and cultural services. CONCLUSIONS: Our study contributes new insights on the effectiveness of the DCC as a means to integrate justice, health and social services for improved health and community safety. The development of such community court interventions, and their impact on health and the SDH, should be reported on by Canada and other countries as a key contribution to SDG 3 achievement, as well as the fulfillment of other targets under the SDG framework that contain the SDH. Consideration should be given by Canada as to how to capture and integrate the important data generated by the DCC and other problem-solving courts into SDG reporting metrics. Certainly, the DCC advances the SDGs' underlying Leave No One Behind principle in a high-income country context.

Expanding the Debate: Citizen Participation for the Implementation of the Right to Health in Brazil.

Brazil has established a well-known constitutional right to health. Legal scholars have focused largely on one aspect of this right: the role of the courts in enforcing health care access. Less attention has been paid to another aspect: citizens' right to participate in health planning. Participation is a constituent component of Brazil's right to health that is intended to guarantee accountability and fair resource distribution for improved population health. In this paper, drawing on constitutional analysis and interviews carried out for my doctoral research, I discuss Brazil's national-level participatory body, the National Health Council, and its potential for fostering accountability and balancing individual and societal interests in health policy. Effective participation, I contend, is a way to strengthen Brazil's health system to the benefit of the entire population, rather than only those who have access to the courts. This paper seeks to underline the constitutional requirement of participation as a core element of the realization of the right to health in Brazil and to invite other legal scholars to critically engage with the way in which Brazil's right to health is implemented.

Projeto "Um Brinde à Saúde!" - promoção, discussão e criação publicitárias de peças de incentivo ao consumo consciente do álcool / Project Toast to Health! - promotion, discussion and publicity creation of pieces of incentive to the conscious consumption of alcohol

O artigo aborda a experiência desenvolvida no projeto "Um Brinda à Saúde", de promoção da redução de danos no consumo de bebidas alcoólicas, visando também reduzir seu impacto sobre o uso de preservativos e sobre a associação de sexo não protegido e de exposição de doenças sexualmente transmissíveis e HIV / aids e à gravidez. Foram realizados debates temáticos sobre vulnerabilidade e álcool, envolvendo as principais instituições que discutem o tema e criado um concurso de confecção de peças para bares e espaços de lazer frequentado por jovens (porta-copos, porta-garrafas, jogos de mesa, cartazes, etc) para difusão em grandes universidades de São Paulo, visando a participação de estudantes de Artes, Comunicação, Propaganda e Marketing e áreas afins nesses eventos e na discussão e confecção de mensagens educativas visando o consumo consciente de bebidas. Os resultados apontaram intensa presença de jovens nos eventos e participação no concurso, criando peças publicitárias educativas que falam na linguagem jovem para seus próprios pares com uma estratégia de redução de danos.