The Columbia University Journal of Global Health最新文献

{"title":"Persistent Child Malnutrition in Dhaka: Integrating Political Considerations and Multisectoral Interventions for Solutions Moving Forward","authors":"Shafkat Meraj, Shaheem Nuraj","doi":"10.52214/cujgh.v14i1.12398","DOIUrl":"https://doi.org/10.52214/cujgh.v14i1.12398","url":null,"abstract":"One of the world’s most densely populated cities in the World, Dhaka continues to grapple with its persisting challenge of child malnutrition. While food shortages, food insecurity, and inadequate feeding practices contribute to child malnutrition, various social and economic determinants, including maternal education, family household income, and geographic residence further exacerbate the problem. While existing interventions like the Health Sector Support Project and National Nutrition Programme have made strides in reducing short-term and long-term child malnutrition, challenges such as insufficient coverage hamper its overall scope and effectiveness. In order to address issues hampering funding capacity and the breadth and quality of nutrition-related services, it is necessary to understand the factors affecting them, including political commitment toward child nutrition, policy alignment, program design and implementation, monitoring and evaluation, and intervention strategies and service delivery. Moving forward, comprehensive strategies taking into account political prioritization, multisectoral coordination, and targeted primary intervention strategies are crucial for tackling child malnutrition effectively in LMICs and cities like Dhaka and beyond.","PeriodicalId":128122,"journal":{"name":"The Columbia University Journal of Global Health","volume":"24 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141272932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitudes and Behaviors Around Preventative Measures Against Malaria During Pregnancy in The Luwero District of Uganda","authors":"Alyssa Robb, Michelle Cathorall","doi":"10.52214/cujgh.v14i1.12404","DOIUrl":"https://doi.org/10.52214/cujgh.v14i1.12404","url":null,"abstract":"Background: In Uganda, the rate of malaria in pregnancy ranges from 8.9-50% depending on the level of transmission within the region. It is estimated that malaria may contribute to 8-14% of low birth weight, 3-8% of infant mortality, and 3-15% of maternal anemia. There is limited information on the attitudes and behaviors of pregnant women related to malaria prevention-health impacts for the child, including infant and maternal death.  \u0000Methods: A cross-sectional study was conducted in June of 2023. A structured interview was used to collect data on demographics, attitudes, and preventative behaviors related to malaria during pregnancy. Interviews conducted in participants’ homes took approximately 50 minutes. Descriptive statistics were run for demographic data. Chi-squared test and Pearson Product Moment Correlation with a significance level set at p < 0.05 were conducted to test relationships between variables of interest.  \u0000Results: Data were collected from 63 women with a mean age of 37. All women had at least one pregnancy resulting in a live birth. Almost one-third of women (31.7%, n = 20) reported getting malaria during their most recent pregnancy. Most respondents (82%, n = 52) received prenatal care and 87.3% (n = 55) used at least one prevention measure against malaria during their last pregnancy. For the participants that reported not protecting themselves (12.7%, n = 8) it was found to be statistically significant in preventing malaria (χ2 = 9.744, p = .008). Bed net use was found significant in preventing malaria during pregnancy (χ2 = 7.113, p = .029) and SP/Fansidar (χ2 = 46.534, p = < .001) during their most recent pregnancy. Receiving prenatal care was found to be significant (χ2 = 24.186, p = <.001). Education level was also found to be significant in to whether women received prenatal care (χ2 = 14.634, p = .023) and in the attitudes that pregnant women should receive malaria treatment during pregnancy (χ2 = 17.084, p = .009).  \u0000Conclusion: This study sheds light on the attitudes and behaviors surrounding preventative measures against malaria during pregnancy among a sample of women in rural Uganda. The study emphasizes the need for targeted health campaigns to promote bed net use, addressing barriers to IPTp implementation, and advocacy for improved policy change and antenatal care attendance. Improving access to prenatal care services, particularly in rural communities, is needed to keep women and children healthy.  \u0000Implications for Practice: Recognizing the challenges related to policy implementation, there is a pressing need to advocate for policies that support effective prevention strategies during pregnancy. Advocacy efforts should be directed towards improved policy implementation and encouraging regular antenatal care visits.  ","PeriodicalId":128122,"journal":{"name":"The Columbia University Journal of Global Health","volume":"25 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141272778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One Health: The Future of Ecosystem Health and Where to Start","authors":"Alyssa Persano","doi":"10.52214/cujgh.v14i1.12311","DOIUrl":"https://doi.org/10.52214/cujgh.v14i1.12311","url":null,"abstract":"Highly relevant to our current and future global state is the need for ecosystem conservation. Rewilding, the process of introducing wildlife to degraded areas, is one such method of conservation. Rewilding is primarily applied from an ecological point of view and largely fails to consider the public health and systemic implications of habitat restoration. As such, a new conservation paradigm is warranted. One Health is a global health approach that considers the complex interplay between humans, animals, and their shared environment. While One Health examines the social, political, and economic context of degraded areas to prioritize systemic advancement and disease prevention in conjunction with conservation, the large scope and transdisciplinary nature of One Health make it challenging to implement. Rewilding efforts conducted by the Conservation Landscape Institute (CLI) in South Africa’s Eastern Cape is an ideal candidate for a One Health approach. With stable funding, infrastructure, and institutional support, CLI is prime for a transition to a One Health framework that can serve as a model for One Health implementation worldwide. As concerns about systemic inequality, disease prevalence, and ecosystem degradation increase, it is necessary to take advantage of the opportunity provided at CLI to establish the new global health paradigm that is One Health.","PeriodicalId":128122,"journal":{"name":"The Columbia University Journal of Global Health","volume":"43 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141273821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary analysis of the disability landscape on Roatán, Honduras","authors":"Julia Lin, Catherine Purnell, Shanzeh Sheikh, Hishi Ulak, Kallie Vallecillo, Dennis Clements","doi":"10.52214/cujgh.v14i1.11978","DOIUrl":"https://doi.org/10.52214/cujgh.v14i1.11978","url":null,"abstract":"Understanding the needs of persons with disabilities (PWDs) is vital to improving targeted healthcare and resources. The project seeks to assess the prevalence of disabilities, resources used, and care and treatment needs for PWDs on Roatán, Honduras. There is little to no prior research about disabilities on the island of Roatán, and few disability studies available in the country of Honduras. We surveyed 581 community members on the island of Roatán over a period of 6 weeks, on questions surrounding the disability status of themselves and their family members, and resources used by PWDs. Interviews were conducted with physicians, promotoras (community health promoters), and staff at the local Rehabilitation Clinic to assess the social experiences and resource needs of PWDs on the island. Of the 613 subjects obtained from our surveys, 258 (42%) had one or more disabilities. The most common disabilities were vision impairment, mobility impairment, and diabetes. 44.98% reported that the PWD did not visit any medical care facility to receive treatment. We found that there was a lack of disability-specific resources on Roatán, and no consistent definition of disability among community members and healthcare providers. Barriers to care include discrimination; caretaker burden; lack of medications, assistive devices, and specialists; and transportation. Our research highlights the need for more education on disabilities within communities, as well as increasing the amount and depth of disability-specific resources accessible on the island. This study was conducted at the request of Clinica Esperanza to determine how it could better support PWDs on Roatán, and the potential benefit of developing a day home for PWDs.","PeriodicalId":128122,"journal":{"name":"The Columbia University Journal of Global Health","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141273346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The COVID-19 Pandemic and the Health of Incarcerated People","authors":"Sebastian Acevedo, Pamela Valera","doi":"10.52214/cujgh.v13i2.10683","DOIUrl":"https://doi.org/10.52214/cujgh.v13i2.10683","url":null,"abstract":"COVID-19 has upended the daily operations of the criminal justice system. Correctional COVID-19 policies have altered how incarcerated people navigate legal proceedings, receive visitors, procure healthcare services, and maintain mental well-being and physical health. Although some of these changes have been positive (e.g., increased access to tablets, and de-incarceration policies), other strategies have exposed societal inequities that fail to meet the needs of people who are incarcerated. Lockdown orders may have unintended consequences for incarcerated people, particularly among those with mental disorders. This commentary examines the barriers and facilitators of healthcare access in our correctional system that has been made more acute due to COVID-19.","PeriodicalId":128122,"journal":{"name":"The Columbia University Journal of Global Health","volume":"24 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140426136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Capacity Building in Northwest Syria: Challenges, Successes, and Lessons Learned","authors":"Fahad Ahmed, Basem Zouhair Shaher, Nazih Mohammad Saeed Al Tueni, Fares Mohammad Amin Alshadidi, Natasha Mussa, Nimetcan Mehmet, S. Mollahaliloğlu","doi":"10.52214/cujgh.v13i2.11738","DOIUrl":"https://doi.org/10.52214/cujgh.v13i2.11738","url":null,"abstract":"The conflict in Syria has caused significant loss of life and widespread displacement. Northwest Syria (NWS) has been heavily impacted, leading to challenges in providing healthcare services. Attacks on healthcare workers and facilities have worsened the situation. Healthcare students and professionals have been specifically targeted, disrupting their education and resulting in migration and a shortage of skilled healthcare workers. To address these challenges, local and international organizations and institutions have supported long-term projects to improve healthcare facilities and provide a trained healthcare workforce. Collaborations with multiple stakeholders have been established to ensure comprehensive and effective training opportunities, enabling healthcare workers to better serve the population's healthcare needs. A range of undergraduate, postgraduate, and research programs have been developed to enhance healthcare capacity building. These programs aim to strengthen the knowledge and skills of healthcare professionals in NWS. Efforts have been made to strengthen the health system and build the capacity of policy makers in utilizing evidence-based knowledge for informed policy decisions. Global and regional partnerships, along with adequate funding, have played a significant role in the successful enhancement of capacity building activities at all levels. \u0000Building healthcare and health research capacity in underdeveloped and conflict-affected parts of NWS presents numerous challenges. Underdeveloped infrastructure, inadequate teaching and service delivery tools, gender disparities, and the sustainability of funding create obstacles to effective capacity building. The political context, coupled with security concerns further complicate efforts. The accreditation of education, and the brain drain of skilled healthcare professionals, add to the difficulties in strengthening the healthcare system in NWS. Addressing these challenges requires comprehensive and collaborative approaches that prioritize stability, security, gender equity, sustainable funding, and improved coordination and resources for education and service delivery. The lessons learned from capacity-building efforts in the Syrian conflict have broader implications for other regions facing similar challenges.","PeriodicalId":128122,"journal":{"name":"The Columbia University Journal of Global Health","volume":"10 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140426039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Impact of Living in an Asylum on the Mental Health of Middle Eastern Refugees","authors":"Maariyah Kharal","doi":"10.52214/cujgh.v13i2.11727","DOIUrl":"https://doi.org/10.52214/cujgh.v13i2.11727","url":null,"abstract":"Refugee aid is seldom a topic of American political conversations despite rising global refugee populations (American Immigration Council, 2020). Refugees who have fled or been forced out of their native country seek asylum, or protection from persecution, in a host country (U.S. Citizenship and Immigration Services, 2015). Thus, an asylum country is one in which refugees can live without fear of persecution or deportation to their native country, while they apply for permanent residence or resettlement (U.S. Citizenship and Immigration Services, 2015). Many Middle Eastern nations including Syria, Libya, Yemen, and Palestine are currently experiencing war and subsequently, hundreds of thousands of individuals from these nations have been forced to seek asylum elsewhere (International Institute for Strategic Studies, 2022). Adjusting to asylum countries may affect mental health, which is an individual’s state of psychological wellness (Centers for Disease Control and Prevention, 2023; United Nations High Commissioner for Refugees, 2022). Thus, this paper will examine how relocation to an asylum country impacts the mental health of Middle Eastern refugees.","PeriodicalId":128122,"journal":{"name":"The Columbia University Journal of Global Health","volume":"57 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140425681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Silent Suffering: Obstetric Fistula in Ethiopia","authors":"Emma Germano","doi":"10.52214/cujgh.v13i2.11986","DOIUrl":"https://doi.org/10.52214/cujgh.v13i2.11986","url":null,"abstract":"Obstetric fistula is a maternal morbidity that accounts for 6% of all maternal deaths worldwide. This condition occurs most commonly in areas of sub-Saharan Africa and rural south Asia where access to medical care and maternal education is not readily available. During prolonged or obstructed labor, a fistula can form connecting the rectum or urinary tract with the vagina. The condition is more common in young mothers who are pressured by their community, culture, or partner to have children early. This has severe and devastating potentially lifelong consequences. Women living with obstetric fistula experience chronic incontinence and associated odors, social and psychological isolation, and severe pain. Despite the condition being preventable and treatable with surgery, there is still a high prevalence in low-income countries. Although the incidences of obstetric fistula are difficult to document due to the lack of medical reporting, this analysis will focus on the effects of the disease in Ethiopia, one of the poorest countries in the world.","PeriodicalId":128122,"journal":{"name":"The Columbia University Journal of Global Health","volume":"48 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140427489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioids and Covid-19: Perfect Storm, or Perfect Opportunity?","authors":"A. Jain, Annika Dhingra, Aditya Sivakumar","doi":"10.52214/cujgh.v13i1.10687","DOIUrl":"https://doi.org/10.52214/cujgh.v13i1.10687","url":null,"abstract":"The opioid epidemic in the United States has been made worse by the COVID-19 pandemic, due to increased stress and isolation, reduced access to addiction treatment services, and a disruption in the supply chain for conventional opioids, resulting in more dangerous and potent drugs entering the market. This has led to a spike in overdose deaths, particularly from fentanyl and other synthetic opioids. The availability of Naloxone, the opioid overdose reversal medication, has also been affected by the pandemic, with shortages in some areas due to supply chain disruptions. Access to buprenorphine and methadone, drugs used in opioid use disorder (OUD) therapy, has also been limited due to social distancing guidelines, however government policy has gradually adapted to loosen regulations surrounding their access.","PeriodicalId":128122,"journal":{"name":"The Columbia University Journal of Global Health","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125168911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes for a Better Health and a Better Nation","authors":"Samantha Strelzer","doi":"10.52214/cujgh.v13i1.10654","DOIUrl":"https://doi.org/10.52214/cujgh.v13i1.10654","url":null,"abstract":"Since decentralization of Spanish government, questions have remained as to developing policy that effectively impacts both regional and national population. Spain has developed an efficient socialized healthcare program. Due to the decentralization process, however, certain regions of Spain have developed far more advanced policy mechanisms. In particular, Catalonia steps outside the traditional rolls of government oversight to forecast visionary policy and policy-making techniques. Amidst the tug of war between willingness and resistance to implement healthcare policies that have a dedicated impact on improving the population health and healthcare, Catalonia employs original thinking and innovation in policy using the Health in All Policies (HiAP) model to create comprehensive strategies. By integrating health into every policy put forth, Catalonia ensures decision-making that prioritizes citizen health first and foremost. When all shareholders are on the same plane, better conversations can be facilitated to better avoid potential issues. Health, as this policy paper explains, is aspect of life that interweaves all other socioeconomic factors. Policy changes must be introduced to improve communication and coordination amongst regions and on a national level, thereby introducing horizontal, collaborative partnerships. The accountability that exists as a main tenet of HiAP limits the presence of the free rider issue in government at all levels. This paper demonstrates the needed nuanced conversations that compel policy-makers to work together to further advance effective efficiency in socialized medicine.","PeriodicalId":128122,"journal":{"name":"The Columbia University Journal of Global Health","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133675309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}