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1.
J. Health Biol. Sci. (Online) ; 10(1): 1-12, 01/jan./2022.
Artigo em Português | LILACS | ID: biblio-1367660

RESUMO

Objetivos: contribuir para a geração de dados de avaliação econômica de estratégias de empoderamento farmacoterapêutico para pacientes com Diabetes Mellitus tipo 2 (DM tipo 2). Métodos: este estudo farmacoeconômico é aninhado a um ensaio clínico com controle não randomizado que incluiu pacientes ≥18 anos de idade, cadastrados no HIPERDIA. Os pacientes foram alocados em um modelo de Markov conforme valores de hemoglobina glicada do acompanhamento. As probabilidades do surgimento de complicações relativas ao DM, incluindo-se óbito, foram estimadas por dez anos. Cada complicação do DM tipo 2 teve seu custo estabelecido para determinação do custo anual. Resultados: entre os participantes da intervenção, não ocorrem óbitos ocasionados por DM tipo 2, e a progressão de complicações mantém-se estável durante os anos simulados, enquanto, no grupo controle, 60% dos pacientes podem evoluir para óbito nos dez anos, e a probabilidade de serem acometidos por complicações relacionadas ao DM tipo 2 é crescente. Com relação aos custos, ao final de dez anos, os pacientes que participaram da Estratégia Individual de Empoderamento Farmacoterapêutico (EIEF) tiveram um custo médio de UU$134,45 poupando a vida de 100% dos pacientes, e os pacientes do atendimento convencional um custo médio de UU$237,12 e 40% dos pacientes acompanhados chegariam ao final do ciclo com vida. Conclusão: a EIEF parece ser uma alternativa economicamente viável em longo prazo, bem como para a promoção do controle glicêmico.


Objectives: contribute to the data generation for the economic evaluation of pharmacotherapeutic empowerment strategies for type 2 diabetes mellitus patients (type 2 DM). Method: This pharmacoeconomic study is nested in a clinical trial with non-randomized control that included patients ≥18 years old, registered in HIPERDIA. The patients were allocated to a Markov model according to the follow-up glycated hemoglobin values. The probabilities of the appearance of complications related to DM, including death, have been estimated for ten years. Each complication of type 2 DM had its cost established to determine the annual cost. Results: Among the participants in the intervention, there are no deaths caused by type 2 DM, and the progression of complications remains stable during the simulated years, whereas in the control group, 60% of the patients can progress to death in ten years and the probability of being affected by complications related to type 2 DM is increasing. Regarding costs, at the end of ten years, patients who participated in Individual Pharmacotherapeutic Empowerment Strategy (IPES) had an average cost of US$ 134.45, saving 100% of patient's lives, and conventional care patients cost an average of US$ 237.12 and 40% of the patients followed would reach the end of the life cycle. Conclusion: The IPES seems like an economically viable and long-term economic alternative and promotes glycemic control.


Assuntos
Diabetes Mellitus , Análise Custo-Benefício , Custos e Análise de Custo , Empoderamento , Controle Glicêmico
3.
BMC Womens Health ; 22(1): 378, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-36114507

RESUMO

BACKGROUND: Health insurance coverage is one of the several measures being implemented to reduce the inequity in access to quality health services among vulnerable groups. Although women's empowerment has been viewed as a cost-effective strategy for the reduction of maternal and child morbidity and mortality, as it enables women to tackle the barriers to accessing healthcare, its association with health insurance usage has been barely investigated. Our study aims at examining the prevalence of health insurance utilisation and its association with women empowerment as well as other socio-demographic factors among Rwandan women. METHODS: We used Rwanda Demographic and Health Survey (RDHS) 2020 data of 14,634 women aged 15-49 years, who were selected using multistage sampling. Health insurance utilisation, the outcome variable was a binary response (yes/no), while women empowerment was assessed by four composite indicators; exposure to mass media, decision making, economic and sexual empowerment. We conducted multivariable logistic regression to explore its association with socio-demographic factors, using SPSS (version 25). RESULTS: Out of the 14,634 women, 12,095 (82.6%) (95% CI 82.0-83.2) had health insurance, and the majority (77.2%) were covered by mutual/community organization insurance. Women empowerment indicators had a negative association with health insurance utilisation; low (AOR = 0.85, 95% CI 0.73-0.98) and high (AOR = 0.66, 95% CI 0.52-0.85) exposure to mass media, high decision making (AOR = 0.78, 95% CI 0.68-0.91) and high economic empowerment (AOR = 0.63, 95% CI 0.51-0.78). Other socio-demographic factors found significant include; educational level, wealth index, and household size which had a negative association, but residence and region with a positive association. CONCLUSIONS: A high proportion of Rwandan women had health insurance, but it was negatively associated with women's empowerment. Therefore, tailoring mass-media material considering the specific knowledge gaps to addressing misinformation, as well as addressing regional imbalance by improving women's access to health facilities/services are key in increasing coverage of health insurance among women in Rwanda.


Assuntos
Empoderamento , Seguro Saúde , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Ruanda
4.
Health Promot Int ; 37(4)2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-36102476

RESUMO

There is a growing body of research examining the nature and correlates of salutogenic factors in the workplace and employee wellbeing, and the role of empowerment therewithin. A paucity of research has distinguished between structural and psychological forms of empowerment in the workplace and examined how they independently and collectively relate to employee wellbeing. Much of the existing research has examined such considerations in western samples, with limited exploration of eastern working populations. The aim of this study is to investigate the association between structural empowerment (SE) and employee self-reported work-related wellbeing (operationalized as psychological wellbeing and job satisfaction), and the postulated mediating role of psychological empowerment (PE). With a sample of 324 southeast Asian employees from a single organization, this study used a cross-sectional case study design using self-report measures to examine the relationships between SE, PE and employee job satisfaction and psychological wellbeing. PE was postulated to mediate the relationship between SE and work-related wellbeing outcomes of job satisfaction and psychological wellbeing. Mediation analyses revealed that SE was positively associated with PE which, in turn, completely mediated the positive relationships between SE, and job satisfaction and psychological wellbeing. The results of this study contribute empirically and practically in the following ways: (i) it expands upon previous research on employee empowerment, (ii) contributes to the developing field of positive occupational health psychology and (iii) highlights the crucial role of organizations in creating sources of SE and PE.


In this study, we explore two forms of empowerment at work and investigate their relationship with employee wellbeing. Workplace empowerment (WE) comes from organizational structures, policies and practices that ensure power and resources are shared across employees, and, in turn, facilitate their accomplishment and development at work. Psychological empowerment (PE) derives from the meaning, competence, perceived control and influence employees feel they have at work and on work outcomes. Limited research has investigated whether WE and PE interact with each other, and whether this, in turn, relates to employees' motivation, health and wellbeing. This is the aim of this study. We collected data from 334 employees in a large organization in southeast Asia using an online survey. Both WE and PE were observed to be important factors in relationship to employees' satisfaction at work and psychological wellbeing. We found the relationship between WE and employees' self-reported job satisfaction and psychological wellbeing was facilitated through their PE. This study contributes to the small, but growing, body of literature examining empowerment in the workplace. Our findings highlight the importance of workplace health promotion initiatives to ensure employee empowerment is cultivated both within individuals and their work environments.


Assuntos
Empoderamento , Saúde do Trabalhador , Poder Psicológico , Local de Trabalho , Estudos Transversais , Humanos , Satisfação no Emprego , Local de Trabalho/psicologia
5.
PLoS One ; 17(9): e0272909, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36103466

RESUMO

Women's empowerment is a fundamental human right but attempts to measure progress in this area have been limited. We used 142 nationally representative surveys to quantify empowerment in six domains (Intimate Partner Violence, Family Planning, Reproductive Healthcare, Employment, Education, and Decision-Making) for first-level subdivisions of all countries in Sub-Saharan Africa for three years (1995, 2005, and 2015). The possible value for each domain ranged between zero (worst) and one (best). The median value for employment decreased by 0.02, but it increased between 0.09 and 0.16 for the other domains. The average empowerment score increased from 0.44 to 0.53, but it remained low for Education (0.34). While progress was clear and consistent, it was uneven within and between countries, and Sahelian West Africa fell further behind. The expanded understanding of geographic variation and trends in women's empowerment that we provide should be instrumental in efforts to improve women's lives.


Assuntos
Poder Psicológico , Direitos da Mulher , África ao Sul do Saara , Empoderamento , Serviços de Planejamento Familiar , Feminino , Humanos
6.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-49134

RESUMO

Tema do podcast da revista Residência Pediátrica (RP) é “Pai empoderado compartilha amamentação”. No programa, a dra. Rossiclei Pinheiro, do Departamento Científico de Aleitamento Materno da Sociedade Brasileira de Pediatria (SBP), explica como o pediatra pode atuar para fortalecer o vínculo e apoio paterno na prática da amamentação.


Assuntos
Aleitamento Materno , Relações Pai-Filho , Paternidade , Empoderamento
7.
Artigo em Inglês | MEDLINE | ID: mdl-36011964

RESUMO

The number of community-dwelling people with dementia (PwD) is rising, and the role of their relatives is crucial in addressing and mitigating the implications of dementia on health care systems and on society. We developed a new conceptual framework to promote the collaboration of the community in supporting relatives who are caring for a PwD as well as a range of stakeholders in embracing dementia. A qualitatively driven, multi-method study divided into three phases was performed from 2019 to 2021. A qualitative descriptive study, a mixed-method systematic review and three consensus workshops were conducted, and their results were triangulated. The final version of the Community Collaboration Concept Framework is composed of three main domains based upon seven components: (1) embracing dementia; (2) creating empowerment and a sense of community; (3) collaborating through cocreation and design thinking. The new framework is based on the literature, the synthesis of empirical data and the consensus of a panel of international experts, supporting the global goal of improving community inclusiveness and collaboration. Further studies are needed to confirm its validity, how it should be implemented in practice in various settings and to propose improvements when designing projects based upon it.


Assuntos
Apoio Comunitário , Demência , Vida Independente , Cuidadores , Empoderamento , Humanos , Pesquisa Qualitativa
8.
BMC Nephrol ; 23(1): 282, 2022 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-35962338

RESUMO

BACKGROUND: Community engagement is essential for effective research when addressing issues important to both the community and researchers. Despite its effectiveness, there is limited published evidence concerning the evaluation of community engagement in research projects, especially in the area of nephrology. METHODS: We developed a community engagement program in Guatemala to address the role of hydration in chronic kidney disease of unknown origin, using five key engagement principles: 1. Local relevance and determinants of health. 2. Acknowledgment of the community. 3. Dissemination of findings and knowledge gained to all partners. 4. Usage of community partners' input. 5. Involvement of a cyclical and iterative process in the pursuit of goals. The effectiveness of community engagement was measured by a structured questionnaire on a 5-point likert scale. This measure determined how well and how often the research team adhered to the five engagement principles. We assessed internal consistency for each set of the engagement items through Omega coefficient. RESULTS: Sixty-two community leaders completed the questionnaire. Seventy-five percent were female, with a mean age of 37 years. All 5 engagement principles scored highly on the 5-point likert scale. Every item set corresponding to an engagement principles evaluation had a Omega coefficient > 0.80, indicating a firm internal consistency for all question groups on both qualitative and quantitative scales. CONCLUSION: Engagement of the community in the kidney research provides sustainability of the efforts and facilitates the achievements of the goals. Community leaders and researchers became a team and develop a relationship in which commitment and empowerment facilitated the participation in all aspects of the research process. This initiative could be a useful tool for researchers, especially in low-middle income countries, to start research in a community, achieve objectives in a viable form, and open opportunities to further studies.


Assuntos
Empoderamento , Hispânico ou Latino , Adulto , Feminino , Guatemala , Humanos , Rim , Masculino , Inquéritos e Questionários
9.
PLoS One ; 17(8): e0272708, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35980968

RESUMO

BACKGROUND: Central and western Africa struggle with the world's lowest regional proportion of facility birth at 57%. The aim of the current study was to compare beliefs related to maternal health care services, science/technology, gender norms, and empowerment in states with high vs. low proportions of facility birth in Nigeria. METHODS: Face-to-face interviews were performed as part of a nationally representative survey in Nigeria using a new module to measure values and beliefs related to gender and sexual and reproductive health and rights collected as part the 2018 World Values Survey. We compared beliefs related to maternal health care services, science/technology, gender norms, and empowerment between Nigerian states with facility birth proportions > 50% vs. < 25% as presented in the 2018 Nigerian Demographic Health Survey report. Pearson's chi-squared test, the independent t-test, and univariable and multivariable logistic and linear regression were used for analyses. Results were also stratified by gender. RESULTS: Among the 1,273 participants interviewed, 653 resided in states with high and 360 resided in states with low proportions of facility birth. There were no significant differences between the groups in perceived safety of facility birth (96% vs. 94%) and confidence in antenatal care (91% vs 94%). However, in states with low proportions of facility birth, participants had higher confidence in traditional birth attendants (61% vs. 39%, adjusted odds ratio [aOR] 2.1, [1.5-2.8]), men were more often perceived as the ones deciding whether a woman should give birth at a clinic (56% vs. 29%, aOR 2.4 [1.8-3.3]), and participants experienced less freedom over their own lives (56% vs. 72%, aOR 0.56 [0.41-0.76]). Most differences in responses between men and women were not statistically significant. CONCLUSIONS: In order to increase facility births in Nigeria and other similar contexts, transforming gender norms and increasing women's empowerment is key.


Assuntos
Serviços de Saúde Materna , Parto , Estudos Transversais , Empoderamento , Feminino , Humanos , Masculino , Nigéria , Gravidez
10.
Artigo em Inglês | MEDLINE | ID: mdl-35954883

RESUMO

To study the impacts of implementing a gender-sensitive value chain development (VCD) initiative in the agri-food sector, we conducted a mixed-methods study of a woman-owned food processing business and its associated value chain in Touba, Senegal. As a result of partnering with a USAID-funded project, the business began producing instant fortified flours, an innovative, higher-value product compared to traditional porridge, using extrusion and fortification techniques. Drawing on Senegalese women's association networks, the business connected with local women who could work as processors and retailers. Our study's goal was to explore how the project's support of this food processing value chain has affected the lives of women processors and retailers, farmers, and medical personnel along the value chain. Particularly relevant to our study is the general lack of opportunities for women to earn their own incomes in the study region, especially outside of the home, and provide for their families. Through surveys, interviews, observations, and novel participatory focus group activities, our study provides qualitative and quantitative evidence of the perceived impacts of value chain development on women's empowerment, income, and nutrition by key stakeholders in the value chain. We find an often cited barrier to women's empowerment is the husband's lack of understanding and limitations placed on women's mobility, yet we also find perceptions of women's empowerment in this conservative religious context. Our findings and discussion highlight the need for more research into VCD projects on the complex and, at times, contradictory processes of women's empowerment. The women in our study expressed a desire for freedom to work outside of the home, and they expressed a need for childcare and contraception. Notably, the women discussed positive community changes, such as infrastructure and the creation of a childcare center, that implicate women's collective empowerment. We also highlight a promising research opportunity in Senegal to explore the subnational variation in women's empowerment through VCD.


Assuntos
Empoderamento , Renda , Criança , Feminino , Manipulação de Alimentos , Humanos , Estado Nutricional , Senegal , Direitos da Mulher
11.
Rev. psicol. (Fortaleza, Online) ; 13(2): 168-183, jul./dez. 2022.
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1379088

RESUMO

Propostas de promoção de empoderamento, que visam maximizar as possibilidades de ação no ambiente de vida, podem contribuir para a mudança dessa realidade ao aumentar as chances de alcançar acesso mais igualitário a recursos que favorecem condições dignas de vida, garantias de direitos, bem-estar e saúde. Nesse sentido, o objetivo deste estudo foi investigar, a partir da visão das participantes, elementos que podem funcionar como mecanismos favorecedores de empoderamento para as mulheres negras. Participaram do estudo 23 mulheres de três estados brasileiros. A coleta de dados foi realizada por meio de entrevistas e a análise do material se deu por meio de Análise Temática, baseada em uma compreensão multidimensional de empoderamento. Os resultados apontam os mecanismos de empoderamento de mulheres negras localizados em três níveis de análise micro/pessoal, meso/comunitário e macro/social. Isso vai ao encontro de abordagens que compreendem o conceito a partir de uma perspectiva multidimensional e ressalta a importância de não se adotar apenas um foco individual. Os achados do estudo apontam ainda elementos que remetem a vivências interseccionadas por raça, gênero e classe.


Proposals to foster empowerment, aiming to increase people's possibilities of taking action in their living environment, may contribute to change this reality by increasing the chances for more equalitarian access to resources favoring more dignifying living conditions, the guarantee of rights, health and welfare. Thus, the goal of this study was to investigate, beginning from the participants' point of view, elements that could work as black women empowerment mechanisms. 23 women from three Brazilian states took part in the study. Data was collected through interviews with an open question and a sociodemographic questionnaire. The material analysis was performed using Thematic Analysis based on a multidimensional understanding of empowerment. The results point to black women empowerment mechanisms in three levels of analysis: micro/personal, meso/community, and macro/social levels. This is in accordance with approaches which understand the aforementioned concept by means of a multidimensional perspective, also emphasizing the importance of not using an individual focus, solely. The study findings also indicate elements which refer to intersectional experiences of race, gender and class.


Assuntos
Mulheres , Empoderamento , Grupos Raciais , Enquadramento Interseccional
12.
BMC Health Serv Res ; 22(1): 969, 2022 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-35906642

RESUMO

BACKGROUND: Traditional antenatal care (ANC) models often do not meet women's needs for information, counseling, and support, resulting in gaps in quality and coverage. Group ANC (GANC) provides an alternative, person-centered approach where pregnant women of similar gestational age meet with the same health provider for facilitated discussion. F studies show associations between GANC and various outcomes. METHODS: We employed a pre-post quasi-experimental design using mixed methods to assess a GANC model (Lea Mimba Pregnancy Clubs) at six health facilities in Kakamega County, Kenya. Between April 2018 and January 2019, we tracked 1652 women assigned to 162 GANC cohorts. Using an intention-to-treat approach, we conducted baseline (N = 112) and endline surveys (N = 360) with women attending immunization visits to assess outcomes including experience of care, empowerment and self-efficacy, knowledge of healthy practices and danger signs, and practice of healthy behaviors, including ANC retention. At endline, we conducted 29 in-depth interviews (IDIs) and three focus group discussions with women who were currently and previously participating in GANC, and 15 IDIs with stakeholders. RESULTS: The proportion of survey respondents with knowledge of three or more danger signs during pregnancy more than tripled, from 7.1% at baseline to 26.4% at endline (OR: 4.58; 95% CI: 2.26-10.61). We also found improvements in women's reports about their experience of care between baseline and endline, particularly in their assessment of knowledge and competence of health workers (OR: 2.52 95% CI: 1.57-4.02), respect shown by ANC providers (OR: 1.82, 95% CI: 1.16-2.85), and women's satisfaction with overall quality of care (OR: 1.62, 95% CI: 1.03-2.53). We saw an increase from 58.9% at baseline to 71.7% at endline of women who strongly agreed that they shared their feelings and experiences with other women (OR: 1.73, 95% CI: 1.1-2.7). The mean number of ANC visits increased by 0.89 visits (95% CI: 0.47-1.42) between baseline (4.21) and endline (5.08). No changes were seen in knowledge of positive behaviors, empowerment, self-efficacy, and several aspects related to women's experience of care and adoption of healthy behavior constructs. Qualitatively, women and stakeholders noted improved interactions between health providers and women, improved counseling, increased feelings of empowerment to ask questions and speak freely and strengthened social networks and enhanced social cohesion among women. CONCLUSIONS: GANC offers promise for enhancing women's experience of care by providing improved counseling and social support. Additional research is needed to develop and test measures for empowerment, self-efficacy, and experience of care, and to understand the pathways whereby GANC effects changes in specific outcomes.


Assuntos
Gestantes , Cuidado Pré-Natal , Aconselhamento , Empoderamento , Feminino , Humanos , Quênia , Gravidez , Gestantes/psicologia
13.
PLoS One ; 17(7): e0271123, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35877669

RESUMO

Just a decade ago Vision and Change in Undergraduate Biology Education: A Call to Action was released, catalyzing several initiatives to transform undergraduate life sciences education. Among these was the Partnership for Undergraduate Life Sciences Education (PULSE), a national organization commissioned to increase the adoption of Vision and Change recommendations within academic life sciences departments. PULSE activities have been designed based on the recognition that life sciences departments and faculty are embedded within institutions of higher education which, similar to other large organizations, are complex systems composed of multiple, interconnected subsystems. The organizational change research suggests that effecting large-scale changes (e.g., undergraduate STEM education transformation) may be facilitated by applying systems thinking to change efforts. In this paper we introduce the approach of systems thinking as a professional development tool to empower individual STEM faculty to effect department-level transformation. We briefly describe a professional development experience designed to increase life sciences faculty members' understanding of systems thinking, present evidence that faculty applied a systems thinking approach to initiate department-level change, and discuss the degree to which transformation efforts were perceived to be successful. Though focused on faculty in the life sciences, our findings are broadly transferable to other efforts seeking to effect change in undergraduate STEM education.


Assuntos
Disciplinas das Ciências Biológicas , Docentes , Disciplinas das Ciências Biológicas/educação , Empoderamento , Docentes/psicologia , Humanos , Análise de Sistemas , Universidades
14.
Health Expect ; 25(4): 1882-1891, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35644908

RESUMO

INTRODUCTION: Empowerment of families raising children with developmental disabilities (DDs) is essential to achieving rights-based service development. METHODS: In this qualitative study, we investigated stakeholder perceptions on the role of advocacy and empowerment in developing caregiver interventions for families of children with DDs in a global context. Participants had experience with at least one intervention, namely the Caregiver Skills Training developed by the World Health Organization (WHO). Participants were clinicians, caregivers and researchers representing five continents, and representatives of WHO and Autism Speaks. Two focus group discussions and 25 individual interviews were conducted. Data were analysed thematically. RESULTS: Three themes were developed: empowerment as independence and as a right; the role and practices of advocacy; and using evidence to drive advocacy. Many professional participants defined empowerment within the realms of their expertise, focusing on caregivers' individual skills and self-confidence. Caregivers expressed that this expert-oriented view fails to acknowledge their intuitive knowledge and the need for community-level empowerment. Participants discussed the challenges of advocacy in light of competing health priorities. The gap between the rights of caregivers and the availability of services, for example, evidence-based interventions, was highlighted as problematic. Scientific evidence was identified as a key for advocacy. CONCLUSION: Rights-orientated empowerment of caregivers and advocacy may make vital contributions to service development for children with DDs in contexts worldwide. PATIENT AND PUBLIC CONTRIBUTION: Research questions were revised based on views presented during focus group discussions. Participant feedback on preliminary themes informed the development of the interview guides.


Assuntos
Defesa da Criança e do Adolescente , Atenção à Saúde , Deficiências do Desenvolvimento , Empoderamento , Cuidadores/educação , Criança , Atenção à Saúde/normas , Deficiências do Desenvolvimento/terapia , Família , Grupos Focais , Humanos , Internacionalidade , Defesa do Paciente , Pesquisa Qualitativa
15.
Proc Natl Acad Sci U S A ; 119(25): e2117155119, 2022 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-35714290

RESUMO

This paper provides a picture of how societies in the G7 countries have responded to the COVID-19 pandemic. Our point of departure is to examine the effects of the pandemic in terms of four fundamental normative sources for well-being: Solidarity (S; willingness for social cooperation), Agency (A; empowerment to shape one's prospects through one's own efforts), GDP (G), and Environmental Performance (E)-SAGE for short. The normative foundations of SAGE are communitarianism, classical liberalism, materialistic utilitarianism, and ecoethics. We find that although G and E responded predictably and uniformly to the pandemic (such as G declining and carbon emissions improving), the societal responses were strikingly different. Societies that are cohesive and empowered (high S and A) may be expected to cope with the pandemic better than those that are fragmented and disempowered (low S and A). Furthermore, the pandemic has had diverse effects on S and A; while some societies became cohering and empowering (rising S and A), others became fragmenting and disempowering (falling S and A), and yet others became fragmenting and empowering. We also show that most G7 countries experienced greater tribalization (measured as the difference between inward S and outward S) during the pandemic. These trends are a matter of concern since they suggest that the willingness and perceived ability to address collective challenges collectively have waned. The analysis also suggests that governments' social policies may have an important role to play alongside economic and health policies in coping with the pandemic.


Assuntos
COVID-19 , Pandemias , Política Pública , Comportamento Social , Adaptação Psicológica , COVID-19/economia , COVID-19/psicologia , Comportamento Cooperativo , Empoderamento , Produto Interno Bruto , Humanos , Responsabilidade Social
17.
Int J Qual Health Care ; 34(2)2022 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-35445256

RESUMO

BACKGROUND: The context related to maternal mortality has improved over the past decade in Cameroon. However, the demand for reproductive health care use remains insufficient with regard to public health policy targets, and women's empowerment is identified as a catalyst with a great potential. OBJECTIVE: This study aims to analyse the association between the dimensions of women's empowerment and the utilization of adequate reproductive health care. METHOD: The data comes from the fifth demographic and health survey of Cameroon carried out in 2018. Women's empowerment is measured through two indices: the economic status index and the decision-making index. Given the dichotomous nature of reproductive health outcomes, namely the use of at least four antenatal visits during pregnancy, the timing from the first antenatal visit and the place of delivery, a logistic regression model is adopted. RESULTS: The results suggest that an increase in the decision-making index was significantly associated with higher chances of having at least four antenatal visits during pregnancy (odds ratio [OR]: 1.25; 95% confidence interval [CI]: 1.20, 1.29), of making the first prenatal visit during the first 3 months of pregnancy (OR: 1.03; 95% CI: 1.01, 1.07) and delivery in a hospital (OR: 1.34; 95% CI: 1.29, 1.39). However, a better economic status of the woman in the household was associated with lower chances of making the first prenatal visit during the first 3 months of pregnancy (OR: 0.65; 95% CI: 0.60, 0.71) and giving birth in a hospital (OR: 0.92; 95% CI: 0.83, 1.01); but no significant association was found with the number of antenatal visits. These different associations do not remain the same when mother and household characteristics are controlled. In addition, the results illustrate the key role that education, household wealth and media exposure played in the use of reproductive health care. CONCLUSION: One of the strategic objectives of the Health Sector Strategy 2016-2027, the framework document for the public health policy in force, is to reduce maternal mortality rates by improving access to reproductive health care. To achieve this objective, this study suggests that policymakers should emphasize social policies favourable to women's empowerment in Cameroon by pointing out access to income-generating activities and decision-making within the household.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Cuidado Pré-Natal , Camarões , Empoderamento , Feminino , Humanos , Gravidez , Fatores Socioeconômicos
18.
J Prev Med Public Health ; 55(2): 193-204, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35391531

RESUMO

OBJECTIVES: The primary objective of this study was to examine the effect of women's empowerment on the immunization of Indonesian children. The secondary objective was to examine the effect of wealth as a factor modifying this association. METHODS: We utilized data from the 2017 Indonesian Demographic and Health Survey (IDHS). The subjects were married women with children aged 12-23 months (n=3532). Complete immunization was defined using the 2017 IDHS definition. Multiple components of women's empowerment were measured: enabling resources, decision-making involvement, and attitude toward intimate partner violence. The primary analysis was conducted using binomial logistic regression. Model 1 represented only the indicators of women's empowerment and model 2 controlled for socio-demographic variables. Subgroup analyses were conducted for each wealth group. RESULTS: The primary analysis using model 1 identified several empowerment indicators that facilitated complete immunization. The analysis using model 2 found that maternal education and involvement in decision-making processes facilitated complete immunization in children. Subgroup analyses identified that wealth had a modifying effect. The indicators of women's empowerment were strong determinants of complete immunization in lower wealth quintiles but insignificant in middle-income and higher-income quintiles. CONCLUSIONS: To our knowledge, this study is the first to explore women's empowerment as a determinant of child immunization in Indonesia. The results indicate that women's empowerment must be considered in Indonesia's child immunization program. Women's empowerment was not found to be a determinant in higher wealth quintiles, which led us to rethink the conceptual framework of the effect of women's empowerment on health outcomes.


Assuntos
Tomada de Decisões , Empoderamento , Criança , Estudos Transversais , Feminino , Humanos , Imunização , Indonésia
19.
AIDS Behav ; 26(10): 3337-3344, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35429307

RESUMO

150/150 words.We examined the 5-year impact of an economic empowerment (EE) intervention on: adherence, viral suppression, sexual risk-taking intentions (primary); and physical health, educational and economic (secondary) outcomes among adolescents living with HIV in Uganda. The Suubi + Adherence study (2012-2018) randomized clinics to: (1) Control group, n = 19 clinics, n = 344 participants; (2) intervention group which received matched savings accounts, mentorship, financial management and, business development training, n = 20 clinics, n = 358 participants. Participants completed post-baseline assessments at 12-, 24-, 36-, and 48-months. No significant differences in viral load, sexual risk-intentions and physical health perception were observed. The intervention group had better adherence (at 24-months) (Contrast=-0.28; 95% CI: -0.55, -0.004), higher school enrolment (OR = 2.18; 95% CI:1.30, 3.66); reported savings OR = 2.03 (1.29, 3.18) and higher savings (Contrast = 0.40; 95% CI:0.10, 0.70) than controls at 48-months. The EE intervention was efficacious in improving adherence, school enrolment, and economic outcomes creating opportunities for improved overall health among adolescents living with HIV.


Assuntos
Infecções por HIV , Adolescente , Empoderamento , Infecções por HIV/prevenção & controle , Humanos , Comportamento Sexual , Uganda/epidemiologia , Carga Viral
20.
BMC Womens Health ; 22(1): 115, 2022 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-35413906

RESUMO

BACKGROUND: Sub-Saharan Africa (SSA) bears the highest burden of Human Immunodeficiency Virus (HIV) in the world. Even though the prevention of mother to child transmission (PMTCT) programmme is one of the strategies to control the HIV pandemic, the uptake in SSA countries is low. Women's decision-making power has a positive influence on health seeking behavior and uptake of several maternal health services. However, its relationship with knowledge of PMTCT services is understudied in SSA. Therefore, this study aimed to examine the association between women's decision-making power and knowledge of PMTCT in 24 countries in SSA. METHODS: Analysis of this study included data on 158,812 married women from the Demographic and Health Surveys of 24 sub-Saharan African countries conducted between 2010 and 2020. Using Stata version-14 software, bivariate and multivariable logistic regression analyses were conducted. The results were presented using adjusted odd ratios (aOR) with the corresponding 95% confidence intervals (CI). RESULTS: In the pooled results, 69.5% (95% CI; 66.7-72.1%) of married women in the studied countries had knowledge of PMTCT, ranging from 13.9% (95% CI; 11.9-16.2%) in Comoros to 75.4% (95% CI; 73.7-76.9%) in Zimbabwe. Higher odds of PMTCT knowledge were seen among married women who had decision-making power compared to married women who had no decision-making power. Moreover, we found higher odds of PMTCT knowledge among married women with manual occupation, those in the richest households and those with 1-2 children compared to married women who were not working, from the poorest households, and those with no children, respectively. CONCLUSION: Women's decision-making power had positive influence on PMTCT knowledge. To increase the coverage of PMTCT knowledge, policy makers and other stakeholders need to target ways to empower women through increasing women's decision-making power. Moreover, creating employment opportunities and economic empowerment for women need to be considered, especially in countries with very low coverage of PMTCT knowledge.


Assuntos
Infecções por HIV , Transmissão Vertical de Doenças Infecciosas , Criança , Empoderamento , Características da Família , Feminino , Infecções por HIV/prevenção & controle , Humanos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Casamento
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