Journal Article > ReviewAbstract
Glob Public Health. 2015 March 2; Volume 10 (Issue 5-6); DOI:10.1080/17441692.2015.1014826
Martinez Perez G, Duran LT, Gasch A, Desmond N
Glob Public Health. 2015 March 2; Volume 10 (Issue 5-6); DOI:10.1080/17441692.2015.1014826
Journal Article > ResearchFull Text
Glob Public Health. 2019 January 11; Volume 14 (Issue 8); 1112-1124.; DOI:10.1080/17441692.2018.1561921
Burns R, Borges J, Blasco P, Vandenbulcke A, Mukui I, et al.
Glob Public Health. 2019 January 11; Volume 14 (Issue 8); 1112-1124.; DOI:10.1080/17441692.2018.1561921
Increasing numbers of people living with HIV (PLHIV) in sub-Saharan Africa are experiencing failure of first-line antiretroviral therapy and transitioning onto second-line regimens. However, there is a dearth of research on their treatment experiences. We conducted in-depth interviews with 43 PLHIV on second- or third-line antiretroviral therapy and 15 HIV health workers in Kenya, Malawi and Mozambique to explore patients' and health workers' perspectives on these transitions. Interviews were audio-recorded, transcribed and translated into English. Data were coded inductively and analysed thematically. In all settings, experiences of treatment failure and associated episodes of ill-health disrupted daily social and economic activities, and recalled earlier fears of dying from HIV. Transitioning onto more effective regimens often represented a second (or third) chance to (re-)engage with HIV care, with patients prioritising their health over other aspects of their lives. However, many patients struggled to maintain these transformations, particularly when faced with persistent social challenges to pill-taking, alongside the burden of more complex regimens and an inability to mobilise sufficient resources to accommodate change. Efforts to identify treatment failure and support regimen change must account for these patients' unique illness and treatment histories, and interventions should incorporate tailored counselling and social and economic support.
Journal Article > ResearchFull Text
Glob Public Health. 2022 June 1; Volume 11 (Issue 1); 1-10.
Pasquero L, Staderini N, Duroch F
Glob Public Health. 2022 June 1; Volume 11 (Issue 1); 1-10.
BACKGROUND
This article shares the learnings of Médecins Sans Frontières (MSF)’s experience of adapting its sexual violence care training for its staff and missions in the Middle East and North Africa (MENA) region in 2019. It explores some of the implications of MENA operational and sociocultural specificities for MSF’s training approach, as well as theoretical and practical aspects of working in sexual violence response in specific settings and addressing contextual structural barriers to survivors’ accessing such services. It contributes to sharing knowledge among practitioners about adapting a sexual violence training approach for different contexts.
METHODS
Methods employed included a scoping review of literature; qualitative data collection via consultations with MENA organisations and interviews with MSF experts and staff working in Yemen, Palestine, Syria, Lebanon, Jordan, Turkey and Greece; collaborative content adaptation and issue integration; translation in Arabic and proofreading; testing of training modules in different settings; and feedback integration.
RESULTS
The adaptation work shows the importance of context and suggests that culturally and contextually adapted training bears potential for effectively strengthening staff members’ survivor-centered skills and attitudes, as well as technical knowledge and skills in care provision. The revision process shows that the overall approach of the training is constitutive to its effectiveness since the approach to – in addition to the substance of – most core principles and elements bears the potential to make training more acceptable and effective in encouraging staff reflectivity on local existing social and gender norms and their own beliefs and attitudes.
CONCLUSIONS
The article concludes that capacity-building efforts alone must not be overestimated in their ability to mobilize change in complex settings but highlights their potential to catalyze change if embedded in institutional longstanding efforts involving operational strategies, political advocacy and organizational culture. The process represents a first step which needs to be further tested, evaluated and continuously fed by MSF practice-based knowledge and dialogue with other organizations around response and training approaches and practices
This article shares the learnings of Médecins Sans Frontières (MSF)’s experience of adapting its sexual violence care training for its staff and missions in the Middle East and North Africa (MENA) region in 2019. It explores some of the implications of MENA operational and sociocultural specificities for MSF’s training approach, as well as theoretical and practical aspects of working in sexual violence response in specific settings and addressing contextual structural barriers to survivors’ accessing such services. It contributes to sharing knowledge among practitioners about adapting a sexual violence training approach for different contexts.
METHODS
Methods employed included a scoping review of literature; qualitative data collection via consultations with MENA organisations and interviews with MSF experts and staff working in Yemen, Palestine, Syria, Lebanon, Jordan, Turkey and Greece; collaborative content adaptation and issue integration; translation in Arabic and proofreading; testing of training modules in different settings; and feedback integration.
RESULTS
The adaptation work shows the importance of context and suggests that culturally and contextually adapted training bears potential for effectively strengthening staff members’ survivor-centered skills and attitudes, as well as technical knowledge and skills in care provision. The revision process shows that the overall approach of the training is constitutive to its effectiveness since the approach to – in addition to the substance of – most core principles and elements bears the potential to make training more acceptable and effective in encouraging staff reflectivity on local existing social and gender norms and their own beliefs and attitudes.
CONCLUSIONS
The article concludes that capacity-building efforts alone must not be overestimated in their ability to mobilize change in complex settings but highlights their potential to catalyze change if embedded in institutional longstanding efforts involving operational strategies, political advocacy and organizational culture. The process represents a first step which needs to be further tested, evaluated and continuously fed by MSF practice-based knowledge and dialogue with other organizations around response and training approaches and practices
Journal Article > ResearchFull Text
Glob Public Health. 2020 August 20; Volume 16 (Issue 6); DOI:10.1080/17441692.2020.1808039
Burtscher D, Bjertrup PJ, Vambe D, Dlamini V, Mmema N, et al.
Glob Public Health. 2020 August 20; Volume 16 (Issue 6); DOI:10.1080/17441692.2020.1808039
Patients with drug-resistant tuberculosis (DR-TB) have received community-based care in Eswatini since 2009. Trained and compensated community treatment supporters (CTSs) provide directly observed therapy (DOT), injectables and psychological support. We examined the acceptability of this model of care among DR-TB patients, including the perspective of family members of DR-TB patients and their CTSs in relation to the patient's experience of care and quality of life. This qualitative research was conducted in rural Eswatini in February 2018. DR-TB patients, CTSs and family members participated in in-depth interviews, paired interviews, focus group discussions and PhotoVoice. Data were thematically analysed and coded, and themes were extracted. Methodological triangulation enhanced the interpretation. All patients and CTSs and most family members considered community-based DR-TB care to be supportive. Positive aspects were emotional support, trust and dedicated individual care, including enabling practical, financial and social factors. Concerns were related to social and economic problems within the family and fears about infection risks for the family and the CTSs. Community-based DR-TB care was acceptable to patients, family members and CTSs. To reduce family members' fears of TB infection, information and sensitisation within the family and constant follow-up appear crucial.
Journal Article > ResearchAbstract Only
Glob Public Health. 2017 September 16; Volume 13 (Issue 10); 1422-1429.; DOI:10.1080/17441692.2017.1372504
Crane JT, Andia Biraro I, Fouad TM, Boum Y II, R Bangsberg D
Glob Public Health. 2017 September 16; Volume 13 (Issue 10); 1422-1429.; DOI:10.1080/17441692.2017.1372504
This study of a global health research partnership assesses how U.S. fiscal administrative policies impact capacity building at foreign partner institutions. We conducted a case study of a research collaboration between Mbarara University of Science and Technology (MUST) in Mbarara, Uganda, and originally the University of California San Francisco (UCSF), but now Massachusetts General Hospital (MGH). Our case study is based on three of the authors' experiences directing and working with this partnership from its inception in 2003 through 2015. The collaboration established an independent Ugandan non-profit to act as a local fiscal agent and grants administrator and to assure compliance with the Ugandan labour and tax law. This structure, combined with low indirect cost reimbursements from U.S. federal grants, failed to strengthen institutional capacity at MUST. In response to problems with this model, the collaboration established a contracts and grants office at MUST. This office has built administrative capacity at MUST but has also generated new risks and expenses for MGH. We argue that U.S. fiscal administrative practices may drain rather than build capacity at African universities by underfunding the administrative costs of global health research, circumventing host country institutions, and externalising legal and financial risks associated with international work.
Journal Article > ResearchFull Text
Glob Public Health. 2023 January 1; Volume 18 (Issue 1); 2058047.; DOI:10.1080/17441692.2022.2058047
Sitali N, Briskin E, Foday J, Walker C, Keus K, et al.
Glob Public Health. 2023 January 1; Volume 18 (Issue 1); 2058047.; DOI:10.1080/17441692.2022.2058047
Since 2015 Médecins Sans Frontières (MSF) has been supporting the Ministry of Health (MoH) in Tonkolili district, Sierra Leone, with an integrated health care approach at the community, primary health centre (PHC), and hospital level. This programme is planned to be handed over to MoH. To prepare for this handover, a qualitative study exploring elements of a successful handover was undertaken in 2019. Focus group discussions (FGD) with the community members (n-48) and in-depth interviews (IDI) with MSF staff, community leaders, and MoH staff in Sierra Leone (n-15) were conducted. Data were audio-recorded, transcribed verbatim from English, Creole, and Themne, coded, and thematically analysed. Participants expressed that an optimal project handover and exit strategy should be a continuous, long-term, the staggered process included from the inception of the programme design. It requires clear communication and relationship building by all relevant stakeholders and demands efficient resources and management capacity. Associated policy implications are applicable across humanitarian settings on the handover of programmes where the government is functional and willing to accept responsibilities.