Suchergebnisse

AbstractHealth policies worldwide have changed dramatically in the last few decades. We reflect upon these changes, highlight current trends and identity key issues and challenges as the year 2000 approaches. The article comprises five sections: (i) comments on concepts of health and of policy; (ii) historical developments which have influenced policy; (iii) discussion of the context within which health policies in low income countries are formulated and implemented, including macropolitical and macroeconomic developments, health needs and determinants, financing, approaches to health planning and priority setting, and the key international health policy actors; (iv) an overview of the content of current health policy proposals in less developed countries which considers the financing, organization and management of health systems and (v) a concluding section which identifies key issues for the coming years. The recent World Bank Development Report,Investing in Health(1993) and other health sector reform efforts, form the backdrop for this discussion.

ABSTRACT: The COVID-19 pandemic has disrupted every sphere of life and livelihoods around the world. Many migrant workers from the Global South, such as Bangladesh, working in the Gulf countries were reported to be impacted by COVID-19, but the direct voices and views of migrant workers themselves and their households are largely unknown. This research adopts a mixed-method approach to assess the impact of the pandemic on foreign remittances to Bangladesh and the well-being of migrant households. The primary data collection involved fieldwork conducted in four migrant-dense villages, situated in Mymensingh and Meherpur districts of Bangladesh. A set of 221 household surveys was administered. In addition to the surveys, 52 semi-structured interviews were carried out, engaging with key individuals at community, district, and national levels such as heads of migrant households, returnee migrants, managers of migration financiers, owners of labor recruiting agencies, officials of the district manpower office etc. Results show that although a significant number of Bangladeshi migrant workers returned home since the COVID-19 pandemic and the outflow of Bangladeshi migrant workers shrank by 69 percent in 2020, remittance inflows at the national level witnessed a growth of 18.5 percent in 2020, which did not resonate with the negative prediction made by the World Bank. However, this research found a macro-micro mismatch, indicating a substantial decline in remittances at the household level. This might be due to the existence of a robust unofficial channel for remittance sending. Approximately 62% of migrant households in the case study sites experienced a 32% reduction in remittances during the COVID-19 pandemic compared to the pre-COVID-19 period. In response to the decline in remittance income, a majority of migrant households (77%) resorted to utilizing their accumulated savings. Additionally, approximately 20% of households sought financial support and borrowing from friends, relatives, and community members. At the community level, the local economy experienced a sharp downturn, leading to a ripple effect that affected everyone within the community. To address the unofficial remittance sending, the Government of Bangladesh should implement effective measures to curb unofficial remittance channels. Upskilling initiatives have the potential to alleviate the vulnerability of Bangladeshi migrant workers, fostering increased income stability. Policymakers should place greater emphasis on crafting savings instruments tailored to the specific needs of migrant households. It is also imperative to prioritize an income diversification policy at the community level to mitigate dependence on remittances.

Understanding the 'evidence' for policy is complicated. This article examines the relationship between evidence and policies on early childhood interventions in two states of Australia, revealing powerful insights into what constitutes the evidence for policy and the importance of 'killer facts' to decision makers. The nature of evidence in the policy environment is broad and complex, going well beyond research to incorporate policy context and processes. These findings reinforce an evidence-informed approach to health policy making and the need for researchers to develop a more sophisticated understanding of the policy context.

Abstract
Background
Post-sexual violence service utilization is often poor in humanitarian settings. Little is known about the service uptake barriers facing male survivors specifically.

Methods
To gain insights into this knowledge gap, we undertook a qualitative exploratory study to better understand the barriers to service utilization among male survivors in three refugee-hosting countries. The study sites and populations included refugees who had travelled the central Mediterranean migration route through Libya living in Rome and Sicily, Italy; Rohingya refugees in Cox's Bazar, Bangladesh; and refugees from eastern Democratic Republic of the Congo, Somalia, and South Sudan residing in urban areas of Kenya. Methods included document review, 55 semi-structured focus group discussions with 310 refugees, semi-structured key informant interviews with 148 aid workers and human rights experts, and observation of service delivery points. Data were thematically analyzed using NVivo 12.

Results
We identified eleven key barriers and situated them within a social ecological framework to describe impediments at the policy, community (inter-organizational), organizational, interpersonal, and individual levels. Barriers entailed: 1) restrictions to accessing legal protection, 2) legislative barriers such as the criminalization of same-sex sexual relations, 3) few designated entry points, 4) poor or nonexistent referral systems, 5) lack of community awareness-raising and engagement, 6) limited staff capacity, 7) negative provider attitudes and practices, 8) social stigma, 9) limited knowledge (at the individual level), 10) self-stigma, and 11) low formal help-seeking behaviors.

Conclusion
The social ecological framework allowed us to better understand the multifaceted ways that the barriers facing male survivors operate and reinforce one another, and may be useful to inform efforts promoting service uptake. Additional research is warranted in other refugee settings.

BACKGROUND: Post-sexual violence service utilization is often poor in humanitarian settings. Little is known about the service uptake barriers facing male survivors specifically. METHODS: To gain insights into this knowledge gap, we undertook a qualitative exploratory study to better understand the barriers to service utilization among male survivors in three refugee-hosting countries. The study sites and populations included refugees who had travelled the central Mediterranean migration route through Libya living in Rome and Sicily, Italy; Rohingya refugees in Cox's Bazar, Bangladesh; and refugees from eastern Democratic Republic of the Congo, Somalia, and South Sudan residing in urban areas of Kenya. Methods included document review, 55 semi-structured focus group discussions with 310 refugees, semi-structured key informant interviews with 148 aid workers and human rights experts, and observation of service delivery points. Data were thematically analyzed using NVivo 12. RESULTS: We identified eleven key barriers and situated them within a social ecological framework to describe impediments at the policy, community (inter-organizational), organizational, interpersonal, and individual levels. Barriers entailed: 1) restrictions to accessing legal protection, 2) legislative barriers such as the criminalization of same-sex sexual relations, 3) few designated entry points, 4) poor or nonexistent referral systems, 5) lack of community awareness-raising and engagement, 6) limited staff capacity, 7) negative provider attitudes and practices, 8) social stigma, 9) limited knowledge (at the individual level), 10) self-stigma, and 11) low formal help-seeking behaviors. CONCLUSION: The social ecological framework allowed us to better understand the multifaceted ways that the barriers facing male survivors operate and reinforce one another, and may be useful to inform efforts promoting service uptake. Additional research is warranted in other refugee settings.

The Republic of South Sudan continues to face considerable challenges in meeting maternal, newborn and child health (MNCH) care needs and improving health outcomes. Ongoing instability and population displacement undermine scope for development, and damaged infrastructure, low coverage of health services, and limited government capacity and a human resource base have resulted in a fragmented health system. Despite considerable attention, effort and support, the issues and challenges facing South Sudan remain deep and sustained, and urban–rural disparities are considerable. There is a need to maintain investments in MNCH care and to support developing systems, institutions, and programs. This review of the literature offers a commentary and appraisal of the current MNCH situation in South Sudan. It explores the barriers and challenges of promoting MNCH gains, and identifies priorities that will contribute to addressing the Millennium Development Goals and the emerging health priorities for the post-2015 development agenda.