189 research outputs found
The need for improved Australian data on social determinants of health inequities.
No full textJoanne Flavel, Martin McKee, Toby Freeman, Connie Musolino, Helen van Eyk, Fisaha H Tesfay, Fran Bau
Causes of death among females-investigating beyond maternal causes: a community-based longitudinal study
No full textBACKGROUND: In developing countries, investigating mortality levels and causes of death among all age female population despite the childhood and maternal related deaths is important to design appropriate and tailored interventions and to improve survival of female residents. METHODS: Under Kilite-Awlealo Health and Demographic Surveillance System, we investigated mortality rates and causes of death in a cohort of female population from 1st of January 2010 to 31st of December 2012. At the baseline, 33,688 females were involved for the prospective follow-up study. Households under the study were updated every six months by fulltime surveillance data collectors to identify vital events, including deaths. Verbal Autopsy (VA) data were collected by separate trained data collectors for all identified deaths in the surveillance site. Trained physicians assigned underlining causes of death using the 10th edition of International Classification of Diseases (ICD). We assessed overall, age- and cause-specific mortality rates per 1000 person-years. Causes of death among all deceased females and by age groups were ranked based on cause specific mortality rates. Analysis was performed using Stata Version 11.1. RESULTS: During the follow-up period, 105,793.9 person-years of observation were generated, and 398 female deaths were recorded. This gave an overall mortality rate of 3.76 (95% confidence interval (CI): 3.41, 4.15) per 1,000 person-years. The top three broad causes of death were infectious and parasitic diseases (1.40 deaths per 1000 person-years), non-communicable diseases (0.98 deaths per 1000 person-years) and external causes (0.36 per 1000 person-years). Most deaths among reproductive age female were caused by Human Deficiency Virus/Acquired Immune Deficiency Virus (HIV/AIDS) and tuberculosis (0.14 per 1000 person-years for each cause). Pregnancy and childbirth related causes were responsible for few deaths among women of reproductive age--3 out of 73 deaths (4.1%) or 5.34 deaths per 1,000 person-years. CONCLUSIONS: Communicable diseases are continued to be the leading causes of death among all age females. HIV/AIDS and tuberculosis were major causes of death among women of reproductive age. Together with existing efforts to prevent pregnancy and childbirth related deaths, public health and curative interventions on other causes, particularly on HIV/AIDS and tuberculosis, should be strengthened.Yohannes Adama Melaku, Berhe Weldearegawi, Alemseged Aregay, Fisaha Haile Tesfay, Loko Abreha, Semaw Ferede Abera and Afework Mulugeta Bezabi
Joint-liability borrowing decisions under risk: Empirical evidence from rural microfinance in Ethiopia
No full textThis paper investigates borrowing decisions of rural households from a microfinance in Tigray, Ethiopia using household panel data on 5 years and a dynamic panel probit model. The theoretical model takes two types of risk involved in joint-liability lending explicitly into account: risk of partner failure and the risk of losing future access to credit. Empirical results show that these risks are important in explaining borrowing decisions. Another finding is that the probability of repeat-borrowing is higher than the probability of new participation, with possible implications that perceived joint-liability threats deter participation and easing stringent punishments might help poor households’ access to credit.Microfinance, risk, dynamic panel probit, Financial Economics,
RECENT DEVELOPMENTS IN LAND TENURE LAW IN ERITREA, HORN OF AFRICA
No full textAfter a historical sketch of the evolution of land tenure systems in the Eritrean highlands, this paper describes the main features of the new Eritrean land law and its operative assumption that the legislation is meant to extend state control over land. The legal devices employed by the law are widely used in sub-Saharan Africa (and were largely inspired by colonial policies). The State of Eritrea frequently asserts that its recent independence gives it the opportunity to learn from other developing countries' mistakes and to avoid them. The basic patterns of the new land law, however, are common to the rest of Africa, notwithstanding the evident poor results. The central government wants its control to be widespread and pervasive. The fight against traditional social groups controlling land, at least in the highlands, is severe. Apart from a formal repeal of customary law, the state's acquisition of the power to modify village boundaries according to a scheme already completed at higher administrative levels and to introduce equal rights on land for women entails a disruption of the villages' social identity. Mandatory state control over landed property in Eritrea is, as usual, motivated by the necessity to address higher social needs. The ultimate intent, of course, is that the evolution from communal property to state property will eventually result in the widespread introduction of individual property once a sufficient level of economic development is achieved. This unfavorable attitude toward communal property is not supported by the evidence, which shows that, in fact, efficient land management can be obtained through renovation of traditional institutions.Land tenure -- Eritrea, Land tenure -- Government policy -- Eritrea, Land tenure -- Law and legislation -- Eritrea, Customary law -- Eritrea, Tenure types, Traditional -- Eritrea, Land reform -- Eritrea, Land Economics/Use,
Causes of death among adults in northern Ethiopia: evidence from verbal autopsy data in health and demographic surveillance system
No full textBACKGROUND: In countries where registration of vital events is lacking and the proportion of people who die at home without medical care is high, verbal autopsy is used to determine and estimate causes of death. METHODS: We conducted 723 verbal autopsy interviews of adult (15 years of age and above) deaths from September 2009 to January 2013. Trained physicians interpreted the collected verbal autopsy data, and assigned causes of death according to the international classification of diseases (ICD-10). We did analysis of specific as well as broad causes of death (i.e. non-communicable diseases, communicable diseases and external causes of death) by sex and age using Stata version 11.1. We performed logistic regression to identify socio-demographic predictors using odds ratio with 95% confidence interval and a p-value of 0.05. FINDINGS: Tuberculosis, cerebrovascular diseases and accidental falls were leading specific causes of death accounting for 15.9%, 7.3% and 3.9% of all deaths. Two hundred sixty three (36.4% [95% CI: 32.9, 39.9]), 252 (34.9% [95% CI: 31.4, 38.4]) and 89 (12.3% [95% CI: 10.1, 14.9]) deaths were due to non-communicable, communicable diseases, and external causes, respectively. Females had 1.5 times (AOR = 1.53 [95% CI: 1.10, 2.15]) higher odds of dying due to communicable diseases than males. The odds of dying due to external causes were 4 times higher among 15-49 years of age (AOR = 4.02 [95% CI: 2.25, 7.18]) compared to older ages. Males also had 1.7 times (AOR = 1.70 [95% CI: 1.01, 2.85]) higher odds of dying due to external causes than females. CONCLUSION: Tuberculosis, cerebrovascular diseases and accidental falls were the top three causes of death among adults. Efforts to prevent tuberculosis and cerebrovascular diseases related deaths should be improved and safety efforts to reduce accidents should also receive attention.Yohannes Adama Melaku, Berhe Weldearegawi Sahle, Fisaha Haile Tesfay, Afework Mulugeta Bezabih, Alemseged Aregay, Semaw Ferede Abera, Loko Abreha, Gordon Alexander Zell
Conoscenza e tutela degli edifici in c.a. dei primi del Novecento come frontiera del restauro
No full textIn Italy the necessity to safeguard reinforced concrete buildings of the Twentieth century had emerged and was stabilized progressively during the second half of the last century. Since that moment numerous studies were devoted for this theme, conventions had put emphasis on the materials, technique author and other aspects. The Superintendence launched knowledge campaigns of the territory and census by inquiring into parameters of selection to adopt in order to place a restriction and then declaration of the cultural interest, according to the Code of Cultural Heritage. Therefore the historical and artistic value from time to time was recognised as well as the social meaning of the work, the correlation with the background or the innovation from the point of view of materials and the construction principles. Despite this fact, the two illustrated examples allow to highlight that reinforced concrete buildings are unrecognised as a part of the heritage to protect. It is significant the case of the ex-Multiplex Odeon in Genoa, that has not been substracted from speculative logics despite having all the features mentioned in order to be selected as part of the heritage of the Twenties of the Twentieth century to defend. The second example about ex vegetable market in Genoa, concerned the practice to safeguard some part of the buildings or complex, that seem to be selectable as exemplifying of standardized and repeatable works
Health Extension Workers' and Mothers' Attitudes to Maternal Health Service Utilization and Acceptance in Adwa Woreda, Tigray Region, Ethiopia.
No full textBACKGROUND:The maternal health system in Ethiopia links health posts in rural communities (kebeles) with district (woreda) health centres, and health centres with primary hospitals. At each health post two Health Extension Workers (HEWs) assist women with birth preparedness, complication readiness, and mobilize communities to facilitate timely referral to mid-level service providers. This study explored HEWs' and mother's attitudes to maternal health services in Adwa Woreda, Tigray Region. METHODS:In this qualitative study, we trained 16 HEWs to interview 45 women to gain a better understanding of the social context of maternal health related behaviours. Themes included barriers to health services; women's social status and mobility; and women's perceptions of skilled birth attendant's care. All data were analyzed thematically. FINDINGS:There have been substantial efforts to improve maternal health and reduce maternal mortality in Adwa Woreda. Women identified barriers to healthcare including distance and lack of transportation due to geographical factors; the absence of many husbands due to off-woreda farming; traditional factors such as zwar (some pregnant women are afraid of meeting other pregnant women), and discouragement from mothers and mothers-in-law who delivered their children at home. Some women experienced disrespectful care at the hospital. Facilitators to skilled birth attendance included: identification of pregnant women through Women's Development Groups (WDGs), and referral by ambulance to health facilities either before a woman's Expected Due Date (EDD) or if labour started at home. CONCLUSION:With the support of WDGs, HEWs have increased the rate of skilled birth attendance by calling ambulances to transfer women to health centres either before their EDD or when labour starts at home. These findings add to the growing body of evidence that health workers at the community level can work with women's groups to improve maternal health, thus reducing the need for emergency obstetric care in low-income countries
BMC Res Notes
No full textBackgroundIn developing countries, investigating mortality levels and causes of death among all age female population despite the childhood and maternal related deaths is important to design appropriate and tailored interventions and to improve survival of female residents.MethodsUnder Kilite-Awlealo Health and Demographic Surveillance System, we investigated mortality rates and causes of death in a cohort of female population from 1st of January 2010 to 31st of December 2012. At the baseline, 33,688 females were involved for the prospective follow-up study. Households under the study were updated every six months by fulltime surveillance data collectors to identify vital events, including deaths. Verbal Autopsy (VA) data were collected by separate trained data collectors for all identified deaths in the surveillance site. Trained physicians assigned underlining causes of death using the 10th edition of International Classification of Diseases (ICD). We assessed overall, age- and cause-specific mortality rates per 1000 person-years. Causes of death among all deceased females and by age groups were ranked based on cause specific mortality rates. Analysis was performed using Stata Version 11.1.ResultsDuring the follow-up period, 105,793.9 person-years of observation were generated, and 398 female deaths were recorded. This gave an overall mortality rate of 3.76 (95% confidence interval (CI): 3.41, 4.15) per 1,000 person-years. The top three broad causes of death were infectious and parasitic diseases (1.40 deaths per 1000 person-years), non-communicable diseases (0.98 deaths per 1000 person-years) and external causes (0.36 per 1000 person-years). Most deaths among reproductive age female were caused by Human Deficiency Virus/Acquired Immune Deficiency Virus (HIV/AIDS) and tuberculosis (0.14 per 1000 person-years for each cause). Pregnancy and childbirth related causes were responsible for few deaths among women of reproductive age\u20143 out of 73 deaths (4.1%) or 5.34 deaths per 1,000 person-years.ConclusionsCommunicable diseases are continued to be the leading causes of death among all age females. HIV/AIDS and tuberculosis were major causes of death among women of reproductive age. Together with existing efforts to prevent pregnancy and childbirth related deaths, public health and curative interventions on other causes, particularly on HIV/AIDS and tuberculosis, should be strengthened.20142014-09-10T00:00:00Z5U22/PS022179_10/PS/NCHHSTP CDC HHS/United States25208473PMC4174652691
Gift-giving and hospitality in Eritrean Tigrinya society
No full textIn the present study, with the help of Eritrean examples, the author discusses how objects and visits become a means of expression for relationships and social connections. In Tigrinya society, kinship and friendly relationships have great significance, their preservation is secured by frequent visits, meetings and phone calls. They are completed by gifts, the sharing of food, contributions and loans, which move between the individuals within society, in the form of objects and money. Every transaction and exchange signifies the quality of a relationship and an event.
Starting with a summary of theories that has influenced her ideas of gift-giving, the author continues with a discussion of the types of gifts she has seen in her Eritrean field, and presents the argument that the movement of objects in society signifies the intensity and quality of social bonds and the relationship between the specific individuals involved. She also attempts to map patterns of commonality. This is followed by a discussion, in which — through interpreting objects, individuals, and occasions as signifiers —, she endeavours to outline some general characteristics of Tigrinya society
Economic evaluations considering costs and outcomes of diabetic foot ulcer infections: A systematic review.
No full textBACKGROUND:Diabetic foot ulcer (DFU) is a severe complication of diabetes and particularly susceptible to infection. DFU infection intervention efficacy is declining due to antimicrobial resistance and a systematic review of economic evaluations considering their economic feasibility is timely and required. AIM:To obtain and critically appraise all available full economic evaluations jointly considering costs and outcomes of infected DFUs. METHODS:A literature search was conducted across MedLine, CINAHL, Scopus and Cochrane Database seeking evaluations published from inception to 2019 using specific key concepts. Eligibility criteria were defined to guide study selection. Articles were identified by screening of titles and abstracts, followed by a full-text review before inclusion. We identified 352 papers that report economic analysis of the costs and outcomes of interventions aimed at diabetic foot ulcer infections. Key characteristics of eligible economic evaluations were extracted, and their quality assessed against the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. RESULTS:542 records were screened and 39 full-texts assessed for eligibility. A total of 19 papers were included in the final analysis. All studies except one identified cost-saving or cost-effective interventions. The evaluations included in the final analysis were so heterogeneous that comparison of them was not possible. All studies were of "excellent", "very good" or "good" quality when assessed against the CHEERS checklist. CONCLUSIONS:Consistent identification of cost-effective and cost-saving interventions may help to reduce the DFU healthcare burden. Future research should involve clinical implementation of interventions with parallel economic evaluation rather than model-based evaluations
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