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Khalid OB, Qazi M, Khattak AF, Khattak M, Wazir MNK, Gilani H. COVID-19 Pandemic Lessons for Creating Effective Mental Health Safety Nets in Lower Middle-Income Countries. Cureus 2023; 15:e45980. [PMID: 37900459 PMCID: PMC10600952 DOI: 10.7759/cureus.45980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to mental health globally, particularly in low- and middle-income countries (LMICs) such as Pakistan. This narrative review aims to synthesize the literature on the impact of the pandemic on mental health in LMICs, the challenges and opportunities for mental health system reform, and the role of safety nets in promoting mental health. A comprehensive search was conducted in several electronic databases, resulting in 35 articles being included for review. Data were extracted and analyzed to identify key themes and trends. The COVID-19 pandemic has led to a significant increase in the prevalence of mental health problems in LMICs, particularly anxiety and depression. This burden is disproportionately borne by vulnerable populations, including women, front-line workers, and those living in poverty. The pandemic has highlighted pre-existing weaknesses in mental health systems in LMICs, including inadequate funding, lack of trained mental health professionals, and stigmatization of mental illness. However, it has also presented opportunities for reform, such as increased awareness and political will, and the use of technology to expand access to mental health services. Building effective safety nets, including social protection programs and community-based interventions, can promote mental health and address social determinants of mental illness. The COVID-19 pandemic has underscored the urgent need for mental health system reform and the development of effective safety nets in LMICs. Policymakers should prioritize investment in mental health and address the social determinants of mental illness to build more resilient societies.
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Affiliation(s)
- Osama Bin Khalid
- Medicine and Surgery, Northwest School of Medicine, Peshawar, PAK
| | - Mustafa Qazi
- Medicine and Surgery, Northwest School of Medicine, Peshawar, PAK
- Medicine and Surgery, Northwest General Hospital and Research Center, Peshawar, PAK
| | - Almas F Khattak
- Community Medicine and Research, Northwest School of Medicine, Peshawar, PAK
| | | | | | - Humaira Gilani
- Dermatology, Northwest General Hospital and Research Center, Peshawar, PAK
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Kenworthy N, Jung JK, Hops E. Struggling, helping and adapting: Crowdfunding motivations and outcomes during the early US COVID-19 pandemic. Sociol Health Illn 2023; 45:298-316. [PMID: 36239580 PMCID: PMC10072127 DOI: 10.1111/1467-9566.13568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
During the early months of COVID-19, many people in the US turned to charitable crowdfunding to seek and provide assistance. Little is known about the needs, hopes or experiences that motivated US pandemic crowdfunding and how these were correlated with campaign success. This study uses a mixed-methods data analysis of a randomised cluster sample of 919 US GoFundMe campaigns during the first 7 months of the pandemic. Overall, most campaigns performed poorly, and 38% got no donations at all. The largest proportion of campaigns aimed to address individual, acute financial struggles, often arising from considerable challenges accessing or qualifying for government assistance. These campaigns, as well as those involving campaigners and beneficiaries of colour, tended to be least successful. Qualitative thematic analysis revealed three key crowdfunding motivations that reflect individualistic, agentive responses to the pandemic: struggling, helping and adapting. These motivations reveal a shift away from social suffering and collective mobilisation and towards largely individualised efforts of survival as digital crowdfunding becomes a key domain of crisis response. Crowdfunding platforms are playing an increasingly important role in mediating and influencing individual and collective responses to crisis, which has important political ramifications for how societies perceive and address health emergencies.
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Affiliation(s)
- Nora Kenworthy
- School of Nursing and Health Studies, University of Washington Bothell, Bothell, Washington, USA
| | - Jin-Kyu Jung
- School of Interdisciplinary Arts and Sciences, University of Washington Bothell, Bothell, Washington, USA
| | - Emily Hops
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Dawson MK, Ivey A, Buggs S. Relationships, resources, and political empowerment: community violence intervention strategies that contest the logics of policing and incarceration. Front Public Health 2023; 11:1143516. [PMID: 37139383 PMCID: PMC10149693 DOI: 10.3389/fpubh.2023.1143516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Abstract
Community violence-defined as unsanctioned violence between unrelated individuals in public places-has devastating physical, psychological, and emotional consequences on individuals, families, and communities. Immense investments in policing and incarceration in the United States have neither prevented community violence nor systemically served those who have been impacted by it, instead often inflicting further harm. However, the logics that uphold policing and incarceration as suitable or preventative responses to community violence are deeply ingrained in societal discourse, limiting our ability to respond differently. In this perspective, we draw from interviews with leading voices in the field of outreach-based community violence intervention and prevention to consider alternative ways to address community violence. We begin by demonstrating that policing and incarceration are distinguished by practices of retribution, isolation, and counterinsurgency that are counterproductive to the prevention of community violence. Then, we identify alternative practices of outreach-based community violence intervention and prevention that include (1) fostering safety nets through relationships among individuals, families, and neighborhoods, (2) fighting poverty and increasing access to resources, and (3) building political capacity among organizations to transform the broader systems in which they are embedded. They also include accountability practices that are preventative and responsive to the needs of those who are harmed. We conclude that elevating the language, narratives, and values of outreach-based community violence intervention and prevention can transform our responses to violence, interrupt cycles of harm, and foster safer communities.
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Affiliation(s)
- Mia Karisa Dawson
- Geography, University of California, Davis, Davis, CA, United States
- *Correspondence: Mia Karisa Dawson
| | - Asia Ivey
- Sociology, University of California, Davis, Davis, CA, United States
| | - Shani Buggs
- Health, University of California, Davis, Davis, CA, United States
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Abstract
Similar to other developing countries, population aging in Mexico has accelerated, raising concerns that economic disparities will widen even more. We use data from the Mexican Health and Aging Study for 2001 and 2012 to derive measures of economic security ─ income and its sources, and wealth and its components ─ and describe how they changed over time and varied across key characteristics. The database is unique for a developing country: longitudinal and spanning a relatively long time period, and nationally representative of older persons (n=12,400; ages 50+). We conduct descriptive analysis for the full sample, and for sub-samples defined by 'safety net' indicators, health status, and demographic characteristics. Given that this time period included crucial economic and social changes in Mexico, we derive period results, measuring differences across time in two cross-sections; and longitudinal results, capturing changes among individuals as they age. In-depth examination of income and wealth identifies important contributors to old-age economic security in Mexico; we confirm several expected patterns and provide first evidence about others. Older adults with low income and asset values in Mexico have less diverse income sources and asset types; real incomes of older persons decreased substantially, and their income and asset portfolios became less diverse over the period. With older age, Mexicans relied more heavily on transfers and family help, and less on earnings. Overall, limited safety net options and worse health conditions were associated with less robust and deteriorating economic profiles.
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Affiliation(s)
- Deborah S DeGraff
- Department of Economics, Bowdoin College, 9700 College Station, Brunswick, Maine 04011 USA
| | - Rebeca Wong
- Sealy Center on Aging, University of Texas Medical Branch, 301 University Boulevard, Galveston, Texas 77555 USA
| | - Karina Orozco-Rocha
- Research Consultant, Cisnes #111, Col. Santa Bárbara, Colima, Colima, México C.P. 28017
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Steenkamp L, Goosen A, Venter D, Beeforth M. Food insecurity among students living with HIV: Strengthening safety nets at the Nelson Mandela Metropolitan University, South Africa. SAHARA J 2016; 13:106-112. [PMID: 27687153 PMCID: PMC5642430 DOI: 10.1080/17290376.2016.1218791] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The HIV prevalence in South Africa among students at higher education institutions (HEIs) in 2008 was reported to be 3.4%, with the highest HIV prevalence found in the Eastern Cape Province. Students at these facilities are also increasingly affected by socio-economic constraints that may impact on food security. Little is known about the impact of food insecurity on HIV-infected students in HEIs in South Africa. The purpose of this paper is to describe food insecurity and the nutritional status among HIV-infected students on the Nelson Mandela Metropolitan University campuses in South Africa, as well as current initiatives to strengthen the safety nets for food-insecure students. This descriptive, cross-sectional survey was conducted among a convenience sample of known HIV-infected, registered students (n = 63), older than 18 years of age and managed as part of the Campus Health Service antiretroviral therapy (ART) programme. Ethical approval for the study was obtained from the Research Ethics Committee (NMMU) and participants were included in the sample after providing written, informed consent. Findings indicate that food insecurity was common with more than 60% of the sample reporting food insecurity at the household level during the previous month. Of the sample, 51% were classified as being either overweight or obese. Although food insecurity did not contribute to weight loss in our sample, food-insecure students were more likely to consume inadequate amounts of vitamins and minerals, especially antioxidants that are important in supporting the immune system. Food insecurity has been identified as affecting the majority of HIV-infected students in this study, especially regarding their difficulty in accessing nutritious foods. As overweight and obesity also seem to threaten the health and future well-being of the students, appropriate management of the overweight individuals and those with obesity should be instituted in order to prevent the development of chronic diseases of lifestyle, thus allowing for a healthier more productive life. Current intervention strategies to strengthen food security have made inroads to improve access to healthier food options.
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Affiliation(s)
- L. Steenkamp
- PhD (Dietetics), is a Research Associate at the HIV&AIDS Research Unit, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa
| | - A. Goosen
- MCur (Advanced Primary Health Care), is a Head of Department at the Campus Health Service, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa
| | - D. Venter
- PhD, is a Statistical Consultant at the Unit for Statistical Consultation at the Nelson Mandela Metropolitan University, Port Elizabeth, South Africa
| | - M. Beeforth
- BSc Dietetics, is a Postgraduate Student at the Department of Dietetics, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa
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Tonguet-Papucci A, Huybregts L, Ait Aissa M, Huneau JF, Kolsteren P. The MAM'Out project: a randomized controlled trial to assess multiannual and seasonal cash transfers for the prevention of acute malnutrition in children under 36 months in Burkina Faso. BMC Public Health 2015; 15:762. [PMID: 26253152 PMCID: PMC4529713 DOI: 10.1186/s12889-015-2060-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 07/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Wasting is a public health issue but evidence gaps remain concerning preventive strategies not primarily based on food products. Cash transfers, as part of safety net approach, have potential to prevent under-nutrition. However, most of the cash transfer programs implemented and scientifically evaluated do not have a clear nutritional objective, which leads to a lack of evidence regarding their nutritional benefits. METHODS/DESIGN The MAM'Out research project aims at evaluating a seasonal and multiannual cash transfer program to prevent acute malnutrition in children under 36 months, in terms of effectiveness and cost-effectiveness in the Tapoa province (Eastern region of Burkina Faso, Africa). The program is targeted to economically vulnerable households with children less than 1 year old at the time of inclusion. Cash is distributed to mothers and the transfers are unconditional, leading to beneficiaries' self-determination on the use of cash. The study is designed as a two-arm cluster randomized intervention trial, based on the randomization of rural villages. One group receives cash transfers via mobile phones and one is a control group. The main outcomes are the cumulative incidence of acute malnutrition and the cost-effectiveness. Child anthropometry (height, weight and MUAC) is followed, as well as indicators related to dietary diversity, food security, health center utilization, families' expenses, women empowerment and morbidities. 24 h-food recalls are also carried out. Individual interviews and focus group discussions allow collecting qualitative data. Finally, based on a theory framework built a priori, the pathways used by the cash to have an effect on the prevention of under-nutrition will be assessed. DISCUSSION The design chosen will lead to a robust assessment of the effectiveness of the proposed intervention. Several challenges appeared while implementing the study and discrepancies with the research protocol, mainly due to unforeseen events, can be highlighted, such as delay in project implementation, switch to e-data collection and implementation of a supervision process. TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT01866124, registered May 7, 2013.
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Affiliation(s)
- Audrey Tonguet-Papucci
- Research and Analyses Department, Action Contre la Faim, Paris, France.
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium.
- AgroParisTech, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, Paris, France.
- NRA, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, Paris, France.
| | - Lieven Huybregts
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium.
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA.
| | - Myriam Ait Aissa
- Research and Analyses Department, Action Contre la Faim, Paris, France.
| | - Jean-François Huneau
- AgroParisTech, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, Paris, France.
- NRA, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, Paris, France.
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium.
- Child Health and Nutrition Unit, Institute of Tropical Medicine, Antwerp, Belgium.
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Abstract
PURPOSE We sought to compare and contrast patterns of change toward patient-centered medical homes (PCMHs) in 5 New Orleans primary care safety net clinics in the aftermath of Hurricane Katrina. We assessed the general direction of change in practice to discover possible reasons for differences in patterns of change, and to identify impediments to change. METHODS Data collection consisted of 5 semiannual telephone interviews with clinic leadership over 2.5 years supplemented by administrative audits. We used standard survey indexes of PCMH to monitor practice change. We conducted site visits and unstructured in-person interviews with clinicians and staff of the 5 clinics. RESULTS PCMH index scores improved during the observation period with variations in rates of change and initial levels of PCMH. Qualitative analysis suggested possible explanations for this differential success: (1) early vs later starts in practice change, (2) funding based on patient outcomes, (3) demands that compete with practice change, (4) qualities of clinic leadership, and (5) relations with the communities where patients live. Barriers to practice change included high demand for services, deficient linkages between hospital and specialty care, lack of staff resources, and a need to focus on clinic finances. CONCLUSIONS The PCMH model can successfully address the needs of safety net populations. Stable leadership committed to serving safety net patients via the PCMH model is important for successful practice transformation. Beyond clinic walls, cultivating deep ties to the communities that clinics serve also supports the PCMH model.
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Affiliation(s)
- Diane R Rittenhouse
- Department of Family and Community Medicine, Philip R. Lee Institute for Health, Policy Studies, University of California, San Francisco, San Francisco, California 94143, USA.
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