Tag Archives: Health Services

Sexual and Reproductive Health in Humanitarian Settings

As of today, there are 68.5 million people who have had to flee their homes, nearly 25.4 million of them being classified as refugees (UNHCR, 2018). We have reached the highest level of displacement in recorded history (UNHCR, 2018). There is a need to further discuss the unique and specific needs of displaced people and the complications surrounding effective services.

People who are affected by humanitarian crises, whether it be war, violence, or natural disasters, are particularly vulnerable to life-threatening ailments, including sexual and reproductive ill-health. The failure to effectively provide sexual and reproductive health services to this population is a leading cause of death, disease and disability and subsequently poses serious barriers in the advancement towards the Sustainable Development Goals (Foster et al., 2017). Those in a particularly vulnerable position are women and girls of reproductive age. According to the Women’s Refugee Commission, women and girls in humanitarian settings have a significantly increased risk of experiencing gender-based violence including exploitation and abuse (2019).

Improvements in sexual and reproductive health and rights is directly linked to an improvement in both social and economic development (CARE, 2013). However, in order to affectively address these issues we need to work towards not only improving direct services, we need to work towards creating real systemic change targeting gender inequality, power imbalances and policy barriers (CARE, 2013). The first step in developing meaningful health interventions is gathering reliable data and scientific evidence to support them. Unfortunately, there is a gap in this field of research done on women and girl’s health in these areas (WHO, 2016).

Due to the particular needs of this population, there is a need to encourage the unity and collaboration between different sectors to assure comprehensive sexual and reproductive health care (Foster et al., 2017). We need to be actively working towards implementing new strategies to increase prevention and response interventions as well as strengthening social and protective networks in these areas. There is a global obligation to assure that the right to sexual and reproductive health is upheld for everyone, including those living in humanitarian settings.

Despite these shortcomings, Canada is at the forefront of a feminist humanitarian movement and other countries are following in its wake. After announcing its Feminist International Assistance Policy, Canada pledged to better support women and girls’ health in developing countries and has launched 123 projects in 51 countries as of April 2019 (Government of Canada, 2017). With the investment of $650 million, the Canadian government has worked towards closing the gaps in sexual and reproductive health and rights of women and girls by providing and improving access to comprehensive health care, prevention and education (Government of Canada, 2017). The launch of this foreign policy is an important step in the advancement of a more feminist approach to humanitarian aid.

As the World Health Assembly (WHA) approaches along with the 25th Anniversary of the International Conference on Population and Development, the stage is set for the international community to implement sustainable change and uphold the rights of women and girls. It is important however that in these discussions we ensure that those who are affected by these crises are not only seen and heard within the humanitarian system but that they are main actors in leading the discussion and shaping the policies in question (CARE, 2019). The year 2019 has the potential to enact significant change in the way we carry out humanitarian aid and Canada must continue to be a leading voice in this global effort.

References

CARE. (2013, September). Sexual and Reproductive Health and Rights [Text]. Retrieved from https://www.care.org/work/health/sexual-and-reproductive-health-and-rights

Foster, A. M., Evans, D. P., Garcia, M., Knaster, S., Krause, S., McGinn, T., … Wheeler, E. (2017). The 2018 Inter-agency field manual on reproductive health in humanitarian settings: revising the global standards. Reproductive Health Matters, 25(51), 18–24. https://doi.org/10.1080/09688080.2017.1403277

Government of Canada, G. A. C. (2016). Canada’s Feminist International Assistance Policy. Retrieved from https://international.gc.ca/world-monde/issues_development-enjeux_developpement/priorities-priorites/policy-politique.aspx?lang=eng

UNHCR (2018, June). Figures at a Glance. Retrieved from  https://www.unhcr.org/figures-at-a-glance.html

WHO (2016). Sexual and reproductive health and rights of refugees and migrants. Retrieved from http://www.who.int/reproductivehealth/news/srhr-refugees-migrant/en/

CARE (2019, April). Womens and girls rights and agency in humanitarian action: A life-saving priority. Retrieved from https://care.ca/2019/04/womens-and-girls-rights-and-agency-in-humanitarian-action-a-life-saving-priority/

 

 

EXITING STREET-LEVEL PROSTITUTION IN CANADA: THE TRANSDISCIPLINARY APPROACH OF THE INTEGRATED MODEL IN POPULATION HEALTH

Author: Émilie Lessard

(The article is available in French only)

Abstract

This article examines the influence of social determinants of health on the entry into, the continuance in, and the exit out of street-level prostitution in Canada. The complexity of street-level prostitution in young women creates multiple challenges in implementing a theoretical model to identify issues affecting the health of prostituted women. Street-level prostitution, being closely linked to substance abuse and homelessness, leads to increased health risks associated with drug dependence, sexually transmitted and blood-borne infections, mental health problems, increased exposure to physical, emotional and sexual abuse, and a high mortality rate. It is imperative to establish a transdisciplinary theoretical model to understand the entry, the continuance and the exit mechanisms of prostitution to better target preventative interventions and better support women wishing to leave street-level prostitution. The transdisciplinary approach also aims to provide courses of intervention for leaving the prostitution system and for guiding future research.

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Access for All to Restricted Access: The Evolution of Assisted Procreation Services in Quebec

Author: Andréanne Chaumont

(The article is available in French only)

Que savez-vous des lois entourant la procréation assistée du Ministère de la Santé du Québec? Débuté par le projet de loi no23 en 2010, le programme de procréation assistée a été sujet de grands débats aux seins du corps médical et médiatique québécois dès sa genèse. Sa couverture médiatique est revenue en force en 2014 avec l’adoption de la Loi favorisant l’accès aux services de médecine de famille et de médecine spécialisée (loi no20) dans le cadre de la réforme du système de santé québécois (Gouvernement du Québec, 2015). Le texte ici-bas offre un survol de la couverture médiatique de l’évolution aux services de procréation assistée au Québec (SPA) jusqu’à aujourd’hui.

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The Global Burden of Surgical Disease: An Analysis of Inaccessible Surgical Care in Low and Middle Income Countries

Authors: Chau Huynh, Minh NQ Huynh

Abstract

Worldwide, 4.8 billion people do not have access to safe, adequate surgical care and anaesthetic management. Surgical care has been deemed “the neglected child of global health,” a startling reminder of the disparities in health services. The provision of surgical interventions can avert 11% of the global burden of disease and 1.5 million deaths each year. Many obstacles exist for low- and middle-income countries (LMIC) to progress towards accessible surgical care. The first challenge is delivering cost-effective surgical care despite financial constraints and political turmoil. Foreign aid was established to alleviate the financial burden and its contributions have been pivotal. However, based on the political climate in certain countries, funds are siphoned to government sectors other than health care. Moreover, the lack of infrastructure, equipment, and personnel in LMIC compound the issue. The other challenge is determining if surgery is as feasible and effective as non-surgical health interventions. Surgical care is crucial and this paper aims to assess the challenges that limit its stature in global health discussions. The paper will address the influence of financing, infrastructure, workforce, service delivery, and information management on surgical care, and the current resolutions, such as humanitarian aid missions.

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Reducing interprofessional conflicts in order to facilitate better rural care: A report from a 2016 Rural Surgical Network Invitational Meeting

Author: Hayley Pelletier

Abstract

An invitational meeting organized by the Centre for Rural Health Research convened to facilitate respectful dialogue with general surgeons in British Columbia to clearly understand concerns and address questions around rural family physicians with enhanced surgical skills (FPESS). In particular, the meeting focused on interprofessional challenges that hinder the adoption of a network model between general surgeons and FPESS. This report summarizes the findings (n=5) and recommendations (n=8) from the meeting. The meeting underscored the need for more thoughtful discussions to develop interprofessional trust and support between general surgeons and FPESS through an integrated health care system and proper networks.

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Healthcare in Cuba: Defining Features and Future Trends

In 2016, Cuba made headlines for the status of its economic embargo with the US, its increasing foreign investments through tourism, and the death of Fidel Castro. Besides these recent events, in a sense foreshadowing Cuba’s future political and economic paths, throughout the 20th century, Cuba’s healthcare system has been acclaimed as one of the best healthcare systems in the world with very good health outcomes for the Cuban people. For example, infant mortality is lower than in the US and the life expectancy is 77.5 years of age (WHO, 2016). What are the Cuban healthcare system’s defining features? Will recent events alter some of its key aspects?

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Finding Potential in Another Mother’s Breastmilk

In Canada, the primary cause of mortality in infancy and long-term disability in children is being born at very low birth weight (<1500g or <3.3lbs; Saigal & Doyle, 2008). If these infants are fed their mother’s milk in the neonatal intensive care unit (NICU) they experience fewer severe infections (Hylander, Strobino, & Dhanireddy, 1998; Patel et al., 2013), improved feeding tolerance (Schanler, Shulman, & Lau, 1999; Sisk, Lovelady, Gruber, Dillard, & O’Shea, 2008), lower colonization of pathogenic bacteria (Yoshioka, Iseki, & Fujita, 1983), and increased neurocognitive development (Anderson, Johnstone, & Remley, 1999). However, due to many reasons related to preterm birth, as many as 70% of mothers cannot provide a sufficient amount of breastmilk to meet the demands of these infants, therefore, a supplement is necessary (Callen & Pinelli, 2005). Currently in Canada, either pasteurized donor breastmilk (donor milk) or preterm formula is used as a supplement to mother’s milk.

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Planning and delivery of health services – an article review on urban aboriginal mobility in Canada: examining the association with healthcare utilization

Author: Ankit Dhawan

Abstract

An article from Social Science and Medicine, written by Snyder and Wilson (2012), examined the use of healthcare services by urban Aboriginal populations in Canada. Using the Behavioural Model of Health Services Use (BMHSU), predisposing, enabling, and need factors were organized and used for data analysis. Specifically, a comparison was made between conventional (physicians and nurses) and traditional (traditional healers) health service utilization in Toronto and Winnipeg. In addition to the geographical and educational factors, the results of the research recognized mobility as a significant predisposing complement to healthcare utilization.

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The Development of Scoring Criteria for a New Picture Naming Task

Authors: Ferzin MahavaChristine SheppardLaura MonettaVanessa Taler

Abstract

Objective: The purpose of the study was to develop a scoring system for a novel naming task suitable for assessing naming performance in younger (18-30 years) and older (65+ years) adults in monolingual English, monolingual French, and English-French bilingual groups. This novel naming task will serve as an important health service to help diagnose and assess cognitively impaired older individuals, while also serving as an educational tool for healthcare providers.

Materials and Methods: The Naming Task consists of 120 images organized in the same randomized order, and are shown on a white background displayed on a computer screen using PowerPoint. Participants are instructed to name the image displayed. Monolinguals completed the test in their native language and bilinguals completed the test in English only, French only, and a bilingual administration. Scoring criteria was established based on the responses from testing.

Results: Strict and lenient scoring criteria developed for the Naming Task are presented. Eight items were removed from the original Naming Task due to quality and/or clarity, inability to name the image, or too many alternate responses. Performance in mono-lingual English and French was similar in younger and older adults for strict and lenient scoring. Bilinguals performed better with bilingual administration and worse with French administration, where scores were the lowest of all age and language groups.

Conclusion: The Naming Task appears to be suitable for monolingual French and English individuals. Results suggest that a bilingual administration should be used when testing English-French bilinguals.

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Transmission of Human Papillomavirus Without Sexual Contact

Authors: Naweed Ahmed, Wakqas Kayani, Sahab Jamshidi, Suneil Bapat, Ahmed ImamovicPanteha Tavassol

Abstract

Human papillomavirus (HPV) is one of the most common sexually transmitted infections. There are four common HPV strains: 6, 11, 16, and 18. Strains 6 and 11 cause genital warts, while strains 16 and 18 are asymptomatic in males and may progress to cervical cancer in females. Although uncommon, a small percentage of males and females have been diagnosed with HPV without previous sexual contact. In this case report, we discuss a case conducted on a 15-year-old South Asian male who contracted an unknown low-risk strain of HPV with no history of sexual contact. HPV is highly infectious, however in the majority of cases the immune system is able to clear the infection, preventing the appearance of genital warts. In cases such as these, it is important to help control the spread of viral infections. Several determinants of health are involved in and affect the trans-mission of HPV, including income and social status, social support networks, education and literacy, culture, social and physical environments, and health services. To aid in the prevention of HPV, sexual education should be taught at early ages within schools and the Gardasil® vaccine should be administered to both females and males at an early age to reduce the burden of disease and the incidence of HPV.

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