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Author (up) A/Rahman, S.H.; Mohamedani, A.A.; Mirgani, E.M.; Ibrahim, A.M.
Title Gender aspects and women's participation in the control and management of malaria in central Sudan Type Journal Article
Year 1996 Publication Social Science & Medicine (1982) Abbreviated Journal Soc Sci Med
Volume 42 Issue 10 Pages 1433-1446
Keywords Adolescent; Adult; Animals; Consumer Participation--methods, psychology, statistics & numerical data; Cost of Illness; Developing Countries--economics, statistics & numerical data; Diarrhea--epidemiology, prevention & control; Female; Health Education--manpower, methods; Humans; Insecticides--adverse effects; Malaria, Falciparum--economics, epidemiology, prevention & control; Male; Medicine, Traditional; Middle Aged; Mosquito Control--methods; Prevalence; Program Evaluation; Sanitation; Schistosomiasis--epidemiology, prevention & control; Sudan--epidemiology; Superstitions; Treatment Outcome; Women; Women's Health
Abstract This work was designed to study the contribution of women in central Sudan in the control and management of malaria with particular emphasis on gender-related aspects that define women's role and participation. The Blue Nile Health Project (BNHP 1980-1990) was launched in 1980 mainly for control of water associated diseases in central Sudan. The BNHP model was chosen to conduct this work. The study showed that women were actively involved in the implementation of the BNHP strategies as health instructors (murshidat) who constituted 75% of the staff of BNHP unit of health education, as members of village health committees (VHC) where they constituted 40% of the VHC members and also as recipients of the project services. All murshidat were interviewed whereas multistage random sampling for VHC members and recipient women in 40 villages was used to select a sample which was interviewed. The results showed that the murshidat and VHC women members played a major role in the motivation, organization and health education of local communities prior to campaigns of environmental sanitation and vector control. Household commitments and difficulties in communication with the public were the main gender-related factors that contributed negatively to women's activities. Cases of malaria have more considerable socio-economic impact than other common diseases, especially with regard to women's household commitments and work. Recipient women were more concerned with aspects of self protection, management of family cases of malaria and health education programmes. They were less involved in drying mosquito breeding sites and spraying activities of insecticides which had been reluctantly accepted because of allergy and bad odour. Although the majority of women considered antimalarials to be less harmful than effects of malaria itself on pregnancy, they did not realize the role of malaria chemoprophylaxis during pregnancy. This needs more health education. The study showed that the BNHP programme was very successful in recruiting women in control and management programmes. Therefore, health planners are urged to persuade the subordinated communities of women in many African countries like Sudan to play a more active role in the health programmes and welfare of their communities.
Call Number Serial 169
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Author (up) Aspinall, P.J.
Title Describing the “white” ethnic group and its composition in medical research Type Journal Article
Year 1998 Publication Social Science & Medicine (1982) Abbreviated Journal Soc Sci Med
Volume 47 Issue 11 Pages 1797-1808
Keywords Canada; Ethnic Groups/*classification; European Continental Ancestry Group/*classification; Great Britain; Humans; *Minority Groups; *Research; Social Identification; State Medicine; United States
Abstract The routine use in medical research of an ostensibly homogeneous “white” category in ethnic group classifications has meant that white minorities, such as the Irish, Turks and Cypriots, have remained hidden, even though such groups are subject to discrimination and disadvantage common to other minority groups. The terms “white” and “Caucasian” are frequently and increasingly employed in the scientific literature in spite of widespread concern about the medicalization of race. Moreover, in Great Britain ethnic monitoring of hospital inpatients has revealed negligible interest in utilising codes that subdivide the white group. Yet recent research has shown, for example, substantially elevated age standardised limiting long-term illness rates in the first generation Irish and excess mortality in the second generation living in Britain. The health needs of these white minorities can only properly be identified through the availability of census denominator data of the kind now collected in the U.S. and Canadian decennial census questions on ethnic origin. The opportunity for government to make such provision in the forthcoming Great Britain 2001 Census should be seized whilst it is still available and recommendations for subdividing the “white” group are made.
Call Number Serial 105
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Author (up) Feagin, J.; Bennefield, Z.
Title Systemic racism and U.S. health care Type Journal Article
Year 2014 Publication Social Science & Medicine (1982) Abbreviated Journal Soc Sci Med
Volume 103 Issue Pages 7-14
Abstract This article draws upon a major social science theoretical approach-systemic racism theory-to assess decades of empirical research on racial dimensions of U.S. health care and public health institutions. From the 1600s, the oppression of Americans of color has been systemic and rationalized using a white racial framing-with its constituent racist stereotypes, ideologies, images, narratives, and emotions. We review historical literature on racially exploitative medical and public health practices that helped generate and sustain this racial framing and related structural discrimination targeting Americans of color. We examine contemporary research on racial differentials in medical practices, white clinicians' racial framing, and views of patients and physicians of color to demonstrate the continuing reality of systemic racism throughout health care and public health institutions. We conclude from research that institutionalized white socioeconomic resources, discrimination, and racialized framing from centuries of slavery, segregation, and contemporary white oppression severely limit and restrict access of many Americans of color to adequate socioeconomic resources-and to adequate health care and health outcomes. Dealing justly with continuing racial “disparities” in health and health care requires a conceptual paradigm that realistically assesses U.S. society's white-racist roots and contemporary racist realities. We conclude briefly with examples of successful public policies that have brought structural changes in racial and class differentials in health care and public health in the U.S. and other countries.

Subject Headings: *African Americans; Delivery of Health Care/*organization & administration; European Continental Ancestry Group; Healthcare Disparities/*ethnology; Humans; Physician-Patient Relations; Racism/*trends; Social Justice; United States; Health care system; Medical system; Public health; Systemic racism; United States

Keywords: Systemic racism and U.S. health care
Call Number Serial 2480
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Author (up) Rashed, S.; Johnson, H.; Dongier, P.; Moreau, R.; Lee, C.; Crepeau, R.; Lambert, J.; Jefremovas, V.; Schaffer, C.
Title Determinants of the Permethrin Impregnated Bednets (PIB) in the Republic of Benin: the role of women in the acquisition and utilization of PIBs Type Journal Article
Year 1999 Publication Social Science & Medicine (1982) Abbreviated Journal Soc Sci Med
Volume 49 Issue 8 Pages 993-1005
Keywords *Bedding and Linens/utilization; Benin; Female; Health Knowledge, Attitudes, Practice; *Health Promotion; Humans; Insecticides/therapeutic use; Malaria/*prevention & control; Male; Permethrin; Pyrethrins/therapeutic use
Abstract An important aspect of malaria control strategies has been the use of prophylactic measures such as impregnated bednets; however, adoption of this strategy has been slow and uneven. This study considers the factors determining Permethrin Impregnated Bednets (PIB) use in the context of a PIB promotion project in a rural area of Benin undertaken between 1992 and 1995. Quantitative data, on socio-demographic characteristics, malaria knowledge, attitudes, and practices, were gathered from 191 households of PIB users and non-users for comparative purposes using a questionnaire format. Qualitative data were collected from 23 focus group discussion sessions and 16 semi structured interviews. Women's income, men's educational level, and women's participation in communal organizations were the principal variables distinguishing user households from non-user households. Recourse to non-western medicine and, in particular, to medicinal teas which are considered preventive or curative correlates negatively with PIB use. The qualitative data shows that informants consider exposure to the sun, especially while engaged in agriculture work, a principal cause of malaria, and that PIB adoption is not considered justified in a context where there is a quasi chronic shortage of financial resources and where confidence in the efficacy of non-western medicine prevails. Because they have primary responsibility for the health of their families and are more aware of children's vulnerability to malaria, women are more inclined than men to want to buy PIBs. However, because the household head, who is most often male, sets family consumption priorities using family income, women often have to resort to using their own income, which is often considerably lower than that of men, to buy PIBs. Support for community initiatives which are directed to women's work, linked with intensive effort to sensitize men to the mechanisms of malaria transmission and the principal groups at risk, is seen as a means to increase PIB acquisition and use.
Call Number Serial 166
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Author (up) Sterling, T.; Weinkam, J.
Title The confounding of occupation and smoking and its consequences Type Journal Article
Year 1990 Publication Social Science & Medicine (1982) Abbreviated Journal Soc Sci Med
Volume 30 Issue 4 Pages 457-467
Keywords Age Factors; Confounding Factors (Epidemiology); Environmental Exposure; Female; Healthy Worker Effect; Humans; Life Style; Male; Neoplasms/etiology; *Occupations; Prevalence; Smoking/adverse effects/*epidemiology/psychology
Abstract A strong pattern in smoking behavior can be demonstrated, in which smoking is much more prevalent among those occupational groups (and social strata) that are also more exposed to hazards in the workplace and much less prevalent among those groups less exposed to such hazards. As a consequence, comparing individuals with greater to those with lesser exposure to tobacco also compares groups that differ with respect to occupational exposure to dust, fumes and toxic substances and with respect to occupationally related lifestyle factors. Analyses of the U.S. National Health Interview Survey show that smoking and occupation are substantially confounded among individuals differing by (1) amount of smoking; (2) smoking cessation; (3) types of cigarettes smoked; (4) age of starting to smoke; and (5) exposure to more or less environmental tobacco smoke at home. This confounding between types of work and proximity to tobacco smoke may have masked relationships between type of employment and disease. But it is difficult to disentangle the effects of occupation and of smoking from each other without well planned further studies because (1) of the difficulty of estimating occupational effects and simultaneously adjusting for healthy worker effects, (2) satisfactory techniques for estimating relative effects of intertwined variables make demands on the quality and quantity of data that are not met by presently available data, and (3) there may be deeply rooted social and psychological attitudes toward effects of work versus effects of lifestyles that tend to bias investigative work.
Call Number Serial 377
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Author (up) Tanner, M.; Vlassoff, C.
Title Treatment-seeking behaviour for malaria: a typology based on endemicity and gender Type Journal Article
Year 1998 Publication Social Science & Medicine (1982) Abbreviated Journal Soc Sci Med
Volume 46 Issue 4-5 Pages 523-532
Keywords Culture; Disease Outbreaks/*prevention & control; Female; Health Behavior; Health Services Research; Humans; Malaria/epidemiology/*prevention & control; Models, Theoretical; *Patient Acceptance of Health Care
Abstract A main component of current malaria control strategies to reduce malaria-related mortality and severe morbidity is early diagnosis and treatment at peripheral health services such as village health posts and dispensaries. This strategy has been promoted mainly by sensitising the population with regard to the available service offered and by providing classical biomedical descriptions of symptoms and signs of malaria. This strategy represents important challenges for successful implementation and maintenance. Early treatment depends upon prompt recognition of symptoms and signs of malaria in the household, i.e. mainly by women. Early treatment also requires that appropriate health services and medication are accessible and used. In this paper we argue that the success of malaria control depends upon an approach that is gender-sensitive and takes into account the level of endemicity in a given setting. The level of endemicity determines which group of the population is at highest risk for infection, morbidity and mortality, and is strongly related to gender considerations. The paper develops a typology that combines the key factors of gender variables with epidemiological features. It consequently outlines an approach to community-based, effective malaria control tailored to a given endemic setting. Finally, we suggest that the proposed framework could be validated for its potential application to the control of other communicable diseases.
Call Number Serial 167
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Author (up) van den Berg, A.E.; Maas, J.; Verheij, R.A.; Groenewegen, P.P.
Title Green space as a buffer between stressful life events and health Type Journal Article
Year 2010 Publication Social Science & Medicine (1982) Abbreviated Journal Soc Sci Med
Volume 70 Issue 8 Pages 1203-1210
Keywords Adaptation, Psychological; Adult; Aged; Aged, 80 and over; *Environment; Environment Design/statistics & numerical data; Female; *Health Status; Health Surveys; Humans; *Life Change Events; Male; Mental Health; Middle Aged; Multilevel Analysis; Nature; Netherlands; Regression Analysis; *Residence Characteristics/statistics & numerical data; *Stress, Psychological; Young Adult
Abstract This study investigates whether the presence of green space can attenuate negative health impacts of stressful life events. Individual-level data on health and socio-demographic characteristics were drawn from a representative two-stage sample of 4529 Dutch respondents to the second Dutch National Survey of General Practice (DNSGP-2), conducted in 2000-2002. Health measures included: (1) the number of health complaints in the last 14 days; (2) perceived mental health (measured by the GHQ-12); and (3) a single item measure of perceived general health ranging from 'excellent' to 'poor'. Percentages of green space in a 1-km and 3-km radius around the home were derived from the 2001 National Land cover Classification database (LGN4). Data were analysed using multilevel regression analysis, with GP practices as the group-level units. All analyses were controlled for age, gender, income, education level, and level of urbanity. The results show that the relationships of stressful life events with number of health complaints and perceived general health were significantly moderated by amount of green space in a 3-km radius. Respondents with a high amount of green space in a 3-km radius were less affected by experiencing a stressful life event than respondents with a low amount of green space in this radius. The same pattern was observed for perceived mental health, although it was marginally significant. The moderating effects of green space were found only for green space within 3 km, and not for green space within 1 km of residents' homes, presumably because the 3-km indicator is more affected by the presence of larger areas of green space, that are supposed to sustain deeper forms of restoration. These results support the notion that green space can provide a buffer against the negative health impact of stressful life events.
Call Number Serial 1701
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Author (up) Williams, H.A.H.A.; Jones, C.O.H.
Title A critical review of behavioral issues related to malaria control in sub-Saharan Africa: what contributions have social scientists made? Type Journal Article
Year 2004 Publication Social Science & Medicine (1982) Abbreviated Journal Soc Sci Med
Volume 59 Issue 3 Pages 501-523
Keywords Africa South of the Sahara; Antimalarials/therapeutic use; Humans; Malaria/*prevention & control; *Patient Acceptance of Health Care; Research; *Social Medicine/organization & administration
Abstract In 1996, Social Science & Medicine published a review of treatment seeking for malaria (McCombie, 1996). Since that time, a significant amount of socio-behavioral research on the home management of malaria has been undertaken. In addition, recent initiatives such as Roll Back Malaria have emphasized the importance of social science inputs to malaria research and control. However, there has been a growing feeling that the potential contributions that social science could and should be making to malaria research and control have yet to be fully realized. To address these issues, this paper critically reviews and synthesizes the literature (published, unpublished and technical reports) pertaining to the home management of illness episodes of malaria in sub-Saharan Africa from 1996 to the end of 2000, and draws conclusions about the use of social science in malaria research and control. The results suggest that while we have amassed increasing quantities of descriptive data on treatment seeking behavior, we still have little understanding of the rationale of drug use from the patient perspective and, perhaps more importantly, barely any information on the rationale of provider behaviors. However, the results underline the dynamic and iterative nature of treatment seeking with multiple sources of care frequently being employed during a single illness episode; and highlight the importance in decision making of gender, socio-economic and cultural position of individuals within households and communities. Furthermore, the impact of political, structural and environmental factors on treatment seeking behaviors is starting to be recognised. Programs to address these issues may be beyond single sector (malaria control programme) interventions, but social science practice in malaria control needs to reflect a realistic appraisal of the complexities that govern human behavior and include critical appraisal and proposals for practical action. Major concerns arising from the review were the lack of evidence of 'social scientist' involvement (particularly few from endemic countries) in much of the published research; and concerns with methodological rigor. To increase the effective use of social science, we should focus on a new orientation for field research (including increased methodological rigor), address the gaps in research knowledge, strengthen the relationship between research, policy and practice; and concentrate on capacity strengthening and advocacy.
Call Number Serial 165
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