Robert Pool
University of Amsterdam, Anthropology, Faculty Member
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The aims of this present study were to explore the use and meaning of metaphors and images about aging in older people with a death wish and to elucidate what these metaphors and images tell us about their self-understanding and imagined... more
The aims of this present study were to explore the use and meaning of metaphors and images about aging in older people with a death wish and to elucidate what these metaphors and images tell us about their self-understanding and imagined feared future. Twenty-five in-depth interviews with Dutch older people with a death wish (median 82 years) were analyzed by making use of a phenomenological–hermeneutical metaphor analysis approach. We found 10 central metaphorical concepts: (a) struggle, (b) victimhood, (c) void, (d) stagnation, (e) captivity, (f) breakdown, (g) redundancy, (h) subhumanization, (i) burden, and (j) childhood. It appears that the group under research does have profound negative impressions of old age and about themselves being or becoming old. The discourse used reveals a strong sense of distance, disengagement, and nonbelonging associated with their wish to die. This study empirically supports the theory of stereotype embodiment.
Research Interests: Psychology and OMEGA
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Community-based programmes, particularly community health workers (CHWs), have been portrayed as a cost-effective alternative to the shortage of health workers in low-income countries. Usually, literature emphasises how easily CHWs link... more
Community-based programmes, particularly community health workers (CHWs), have been portrayed as a cost-effective alternative to the shortage of health workers in low-income countries. Usually, literature emphasises how easily CHWs link and connect communities to formal health care services. There is little evidence in Uganda to support or dispute such claims. Drawing from linking social capital framework, this paper examines the claim that village health teams (VHTs), as an example of CHWs, link and connect communities with formal health care services. Data were collected through ethnographic fieldwork undertaken as part of a larger research program in Luwero District, Uganda, between 2012 and 2014. The main methods of data collection were participant observation in events organised by VHTs. In addition, a total of 91 in-depth interviews and 42 focus group discussions (FGD) were conducted with adult community members as part of the larger project. After preliminary analysis of the ...
Research Interests: Nursing, Focus Groups, Social Capital, Uganda, Community Health Workers, and 11 moreHumans, Human Resources for Health, Organizations, Interpersonal Relations, Psychology of Power, Government Programs, Rural Health Services, attitude to health, Health Services Accessibility, Delivery of Health Care, and Rural Population
Despite the availability of practical knowledge and effective interventions required to reduce priority health problems in low-income countries, poor and vulnerable populations are often not reached. One possible solution to this problem... more
Despite the availability of practical knowledge and effective interventions required to reduce priority health problems in low-income countries, poor and vulnerable populations are often not reached. One possible solution to this problem is the use of Community or Lay Health Workers (CLHWs). So far, however, the development of sustainability in CLHW programs has failed and high attrition rates continue to pose a challenge. We propose that the roles and interests which support community health work should emerge directly from the way in which health is organized at community level. This review explores the evidence available to assess if increased levels of integration of community health resources in CLHW programs indeed lead to higher program effectiveness and sustainability. This review includes peer-reviewed articles which meet three eligibility criteria: 1) specific focus on CLHWs or equivalent; 2) randomized, quasi-randomized, before/after methodology or substantial descriptive...
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Since the 1994 International Conference on Population and Development, male involvement in reproductive health issues has been advocated as a means to improve maternal and child health outcomes, but to date, health providers have failed... more
Since the 1994 International Conference on Population and Development, male involvement in reproductive health issues has been advocated as a means to improve maternal and child health outcomes, but to date, health providers have failed to achieve successful male involvement in pregnancy care especially in rural and remote areas where majority of the underserved populations live. In an effort to enhance community participation in maternity care, TBAs were trained and equipped to ensure better care and quick referral. In 1997, after the advent of the World Health Organization's Safe Motherhood initiative, the enthusiasm turned away from traditional birth attendants (TBAs). However, in many developing countries, and especially in rural areas, TBAs continue to play a significant role. This study explored the interaction between men and TBAs in shaping maternal healthcare in a rural Ugandan context. This study employed ethnographic methods including participant observation, which to...
Research Interests: Focus Groups, Uganda, Social Support, Midwifery, Professional Role Socialization, and 14 moreRural Health, Pregnancy, Humans, Reproductive health, Female, Male, Patient Compliance, Adult, Prenatal Care, Prenatal Education, Family Characteristics, professional patient relations, Professional Role, and Paediatrics and reproductive medicine
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This paper focuses on ‘sexual debut’ among out-of-school youth in Masaka District, Uganda, factors influencing its timing and assistance young people feel they need to delay sexual initiation. Data were drawn from a sexual health needs... more
This paper focuses on ‘sexual debut’ among out-of-school youth in Masaka District, Uganda, factors influencing its timing and assistance young people feel they need to delay sexual initiation. Data were drawn from a sexual health needs assessment using applied anthropological techniques with young people aged 13–19 years. Parents, guardians and community leaders were also consulted. All participants felt that young
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Research Interests: Nursing, Development Studies, Health Promotion, Community Engagement & Participation, Rural Development, and 14 moreUganda, Community Health, Cultural Anthropology, Community Health Workers, Humans, Human Resources for Health, Personnel Selection, Female, Male, Middle Aged, Adult, Consumer Participation, Clinical Competence, and anthropology cultural
Abstract This chapter is based on data collected in central Malawi as part of a large multi-centre acceptability study of intermittent preventive treatment of malaria in infants (IPTi). It describes women's perceptions of... more
Abstract This chapter is based on data collected in central Malawi as part of a large multi-centre acceptability study of intermittent preventive treatment of malaria in infants (IPTi). It describes women's perceptions of breast milk as being 'good'or 'bad', their beliefs about the transmission of malaria and other diseases through breastfeeding and the effect of malaria medication taken by the mother on the disease of her infant. It discusses the notion that medicines have volition and are only efficacious in the individual for whom they are ...
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Research Interests: Sociology, Anthropology, Focus Groups, Behavior, Consumer Behavior, and 15 morePublic Health, Sexual Health, Adolescent, Humans, Female, Attitude, Middle Aged, Longitudinal Studies, Adult, Public health systems and services research, Sexual Partners, Sexually Transmitted Diseases, South West, Social Science, and Truth Disclosure
d'Cruz-Grote 1 implies that there is little hope for restricting the general spread of the HIV epidemic in developing countries until major changes in the social, cultural, and structural determinants of infection have been... more
d'Cruz-Grote 1 implies that there is little hope for restricting the general spread of the HIV epidemic in developing countries until major changes in the social, cultural, and structural determinants of infection have been achieved. In other words little can be done without changing the world. Despite agreeing with the underling sentiments of d'Cruz-Grote, we find her overall approach negative in the short term. While waiting for these longer term goals of poverty reduction and widespread educati...
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Like verbal communication itself, ethnographic presentation may appear full of redundancy if measured by standards that presuppose an ideal reader, a perfect match of content and form between text and translation, and complete sets of... more
Like verbal communication itself, ethnographic presentation may appear full of redundancy if measured by standards that presuppose an ideal reader, a perfect match of content and form between text and translation, and complete sets of findings covering the, and only the, announced subject of research. Parsimony is a supreme value for those who already know; ethnographers, although some of them can say what they have to say more clearly and succinctly than others, are destined to tell baroque and tortuous tales.
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This article challenges the pervasive assumption that exchanging gifts and money in adolescent sexual relationships is transactional. Data were derived from a multi-method, qualitative sexual health needs assessment of 31 out-of-school... more
This article challenges the pervasive assumption that exchanging gifts and money in adolescent sexual relationships is transactional. Data were derived from a multi-method, qualitative sexual health needs assessment of 31 out-of-school adolescents in rural southwest Uganda. Grounded theory analysis allows contextual meanings of exchange to emerge. Adolescents have developed gendered courting and exchange models that parallel marital relationships in this cultural context. Whereas exchange is considered transactional and immoral in some types of relationships, in adolescent relationships, it is not. Young women are not ashamed of, or stigmatized by, the exchange; they are proud of it. The exchange signifies several things: self-respect and a partner's willingness to wait for the relationships to become sexual and, therefore, that they are valued and respected by their partners. This demonstrates commitment from a partner, whose role is as a provider. To expect no gift or to have sex for pleasure are the hallmarks of the worst kind of woman-a malaya. "Need" is the only acceptable rationale for extramartial sex for any woman in this sexual value system. Interventions promoting longer courting and sustained support for one partner would encourage a delay in debut for young women and encourage greater monogamy in young men.
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Research Interests: Sociology, Cultural Studies, Psychology, Contraception, Behavior, and 15 moreAfrica, Uganda, Developing Countries, Culture and Mental Health, Eastern Africa, Disease, Infection, Attitudes, Men, Attitude, Public health systems and services research, Condoms, Virus diseases, Sexually Transmitted Diseases, and HIV infections
This paper focuses on... more
This paper focuses on 'sexual debut' among out-of-school youth in Masaka District, Uganda, factors influencing its timing and assistance young people feel they need to delay sexual initiation. Data were drawn from a sexual health needs assessment using applied anthropological techniques with young people aged 13-19 years. Parents, guardians and community leaders were also consulted. All participants felt that young people begin their sexual lives too early. Young men feel under pressure from friends and older men to prove their masculinity. Most delay further activity after debut and want assistance to resist the pressure. Young women's debut after physical maturation prompts 'pestering' for sex from boys and men who offer gifts. After debut, young women remain sexually active but believe younger women need assistance to resist pressure. Programmes are needed to help young people achieve these goals. Structurally, the community needs to develop means of preventing men from pestering young women for sex and of redeveloping both the social role and pathway to marriage for young women who are marrying later than is traditional.
Research Interests: Cultural Studies, Sexual Behaviour, Sexuality, Life Style, Health, and 15 moreSexual Health, Adolescent, Humans, Needs Assessment, Sex Education, Female, Male, Sexual Behavior, Interpersonal Relations, Initiation, Questionnaires, Public health systems and services research, Sexual Activity, Sexual Abstinence, and Rural Population
This paper defines the range of sexual partners chosen by out-of-school adolescents from Masaka District in rural south-west Uganda, and implications for sexual and reproductive health discussed. Data are drawn from a sexual health needs... more
This paper defines the range of sexual partners chosen by out-of-school adolescents from Masaka District in rural south-west Uganda, and implications for sexual and reproductive health discussed. Data are drawn from a sexual health needs assessment using applied anthropological techniques with 31 adolescents, their parents, guardians and community leaders. Data were analysed using inductive thematic methods. Out-of-school adolescents are exposed to risk both stable and casual sexual relationships. Young men and women want a stable relationship with one reliable partner. Young men seek a "steady" relationship with younger schoolgirls; some also seek multiple "casual" relationships with young women easily convinced with gifts. Young women accept "permanent" partnerships with traders or transport workers one-three years older than themselves; some accept "casual" relationship with age mates, others have "casual" relationships with older men. All relationships involve the exchange of gifts and money. Older partners, or "sugar daddies", are valued, despite the knowledge they are more likely to be HIV positive, because they offer greater financial rewards than age mates. Though far less common, some older women seek relationships with younger men, but are treated with suspicion by young men, who believe they are seeking to…
Research Interests: Psychology, Health Promotion, Behavior, Evaluation, Developing Countries, and 15 moreQualitative Research, Health, Adolescent, Population, Humans, Needs Assessment, Female, Male, Condom use, Parents, Partner Selection, Older Women, Public health systems and services research, AIDS care, and HIV infections
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This paper discusses the background characteristics, sexual relationships, condom use and risk perception of bar workers in Magu district, north-west Tanzania. Bar workers in Magu are geographically mobile. They are not highly educated... more
This paper discusses the background characteristics, sexual relationships, condom use and risk perception of bar workers in Magu district, north-west Tanzania. Bar workers in Magu are geographically mobile. They are not highly educated but probably have a higher level of schooling than average. They are mostly unmarried or divorced. They choose bar work because, given the resources available, it provides them with a good balance between earning their own income and being independent. Although the women are still partially dependent on the financial support provided by sexual partners and sexual relations tend to be based on exchange, bar workers cannot simply be equated with prostitutes. Some have a regular partner and the odd casual partner while others may have large numbers of casual contacts. Regular partners are almost always married and often itinerant. The distinction between regular and casual partners is important and based on the nature and extent of financial support. It is also related to condom use and therefore to risk. Women claim to be able to demand condom use from casual partners but not from regular partners. Although women claim that regular partners can be trusted, they nonetheless admit feeling at risk of AIDS and STDs from these same partners.
Research Interests: Psychology, Perception, Behavior, Developing Countries, Risk Taking, and 15 moreAdolescent, Rural Health, Population, Humans, Risk Perception, Female, Sexual Behavior, Interpersonal Relations, Condom use, Adult, Public health systems and services research, Condoms, Occupations, AIDS care, and attitude to health
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Research Interests: Communication, Research Methodology, Behavior, Uganda, Developing Countries, and 15 moreHealth, Knowledge, Biological Sciences, Population, Transmission, Surveys, Measurement, Attitudes, AIDS, Risk factors, Prevalence, Risk Factors, Psychology and Cognitive Sciences, Medical and Health Sciences, and knowledge attitude and practice
Research Interests: Cultural Studies, Poverty, Focus Groups, Qualitative Research, Sex Work, and 15 moreSexual Health, Rwanda, Financial Crisis, Humans, Prostitution, Female, Sexual Behavior, Sex Workers, Career Choice, Adult, Public health systems and services research, Focus Group Discussion, Housekeeping, Female Sex Workers, and Economic Benefit
Few studies have described levels and determinants of perceived risk of HIV-1 among African adults for whom the sero-status is known. This study describes HIV risk perception obtained from a large rural population in south-west Uganda... more
Few studies have described levels and determinants of perceived risk of HIV-1 among African adults for whom the sero-status is known. This study describes HIV risk perception obtained from a large rural population in south-west Uganda which also underwent serological testing for HIV. Cross-sectional survey. Information on risk perception and sexual behaviour was collected by interview. Sera were obtained from all consenting adults (13 years and above) in order to assess HIV-1 prevalence. Of 14,818 adults with a definitive sero-status, 9.7% were HIV-1 positive and 51% considered themselves to be at risk of infection. Risk perception showed similar patterns as age- and sex-specific sero-prevalence and there was correspondence between risk factors for perceived risk and known HIV risk factors. Partner's sexual behaviour was the commonest reason for risk perception in women whereas men cited their own sexual behaviour. Abstinence from sex was much more commonly mentioned as a protective practice than condom use in men and women. Half of the adults we have studied already see infection with HIV as a real possibility in their lives and are aware of HIV risk behaviours. More efforts should be made to implement sustainable control measures rather than simply raising awareness. In addition to recommending abstinence, these include mutual faithfulness, condom use and better treatment for STDs.
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Translated from the Dutch publication (WYT). The author is a medical anthropologist affiliated with the Medical Research Council (UK) Programme on AIDS in Uganda. Here he reports on observations made over the course of two years at a... more
Translated from the Dutch publication (WYT). The author is a medical anthropologist affiliated with the Medical Research Council (UK) Programme on AIDS in Uganda. Here he reports on observations made over the course of two years at a Dutch hospital. He discusses why patients request euthanasia, th
PIP: The Medical Research Council's Program on AIDS assessed the acceptability of the female condom and vaginal spermicidal products in Masaka, Uganda. The interviews and focus group discussions revealed that women are more likely to... more
PIP: The Medical Research Council's Program on AIDS assessed the acceptability of the female condom and vaginal spermicidal products in Masaka, Uganda. The interviews and focus group discussions revealed that women are more likely to practice safer sex with female controlled methods that can be used secretly. The most popular formulations were the sponge and foaming tablets, followed by the female condom and foam. Age, level of education and location did not affect their choices. Expanding the range of choice among ...
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Medical anthropology is playing an increasingly important role in public health. This book provides an introduction to the basic concepts, approaches and theories used, and shows how these contribute to understanding complex health... more
Medical anthropology is playing an increasingly important role in public health. This book provides an introduction to the basic concepts, approaches and theories used, and shows how these contribute to understanding complex health related behaviour. Public health policies and interventions are more likely to be effective if the beliefs and behaviour of people are understood and taken into account. The book examines: Concepts of culture Medical systems Patient's experience of illness and treatment The use of medicines and ...
The objective of this qualitative study was to explore how clinical symptoms may affect adherence to antiretroviral therapy (ART) in HIV patients, and to explore factors, perceptions and attitudes related to adherence to therapy. A... more
The objective of this qualitative study was to explore how clinical symptoms may affect adherence to antiretroviral therapy (ART) in HIV patients, and to explore factors, perceptions and attitudes related to adherence to therapy. A qualitative study was carried out in the context of the prospective cohort study "Evaluation of Immune Reconstitution Following Initiation of Highly Active Antiretroviral Treatment in Manhiça, Mozambique". In-depth Interviews were conducted twice in a sub-sample of the study cohort (51 participants), at six-month intervals. Most participants (73%) knew that AIDS is a chronic disease and that ART does not cure it. Nine participants (18%) were non-adherent at some point and two (4%) abandoned ART. All participants but five reported having symptoms after starting ART, mainly attributed to pills needing time to act and body's reaction to the treatment. In spite of the perceived severity of the symptoms, only two people reported they discontinued...
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An estimated 2.7 million Latin Americans reside in Europe, mostly in Spain. Part of a broader project aimed at developing a research agenda on the health status and determinants of this population, this qualitative study engaged Latin... more
An estimated 2.7 million Latin Americans reside in Europe, mostly in Spain. Part of a broader project aimed at developing a research agenda on the health status and determinants of this population, this qualitative study engaged Latin American migrants in the identification of research priorities. We conducted 30 group discussions between November 2012-March 2013 with 84 participants purposively selected for maximum diversity in Madrid and Barcelona (Spain). We facilitated sequences of task-oriented visual activities to explore their views on priority health concerns. We tape-recorded and transcribed discussions and developed a coding frame based on socio-ecological frameworks, which we applied to all the data using NVIVO-10. A final round of eight group discussions allowed us to triangulate and enrich interpretations by including participants' insights. The cumulative toll of daily stresses was the major health concern perceived by a population that conceptualised ill-health as a constellation of symptoms rather than as specific diseases. Work-related factors, legislative frameworks regulating citizenship entitlements and feeling ethnically discriminated were major sources of psycho-social strain. Except for sexually transmitted infections, participants rarely referred to communicable diseases as a concern. The perception that clinicians systematically prescribed painkillers discouraged health seeking and fostered self-medication. Participants felt that the medicalised, chemicalised, sexually liberal and accelerated culture of the host society damaged their own, and the local populations' health. Health systems bear a disproportionate responsibility in addressing health problems rooted in other sectors. Occupational and migration policies should be recognised explicitly as health policies. The mismatch between researchers' emphasis on communicable infections and the health concerns of Latin American migrants highlights the need for greater interaction between different forms of knowledge. In this process, the biomedical culture of reliance on pharmacological solutions should not remain unquestioned.
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Constructively engaging male partners in women-centred health programs such as family planning and prevention of mother-to-child HIV transmission has resulted in both improved health outcomes and stronger relationships. Concerted efforts... more
Constructively engaging male partners in women-centred health programs such as family planning and prevention of mother-to-child HIV transmission has resulted in both improved health outcomes and stronger relationships. Concerted efforts to engage men in microbicide use could make it easier for women to access and use microbicides in the future. This paper synthesizes findings from studies that investigated men's role in their partners' microbicide use during clinical trials to inform recommendations for male engagement in women's microbicide use. We conducted primary and secondary analyses of data from six qualitative studies implemented in conjunction with microbicide clinical trials in South Africa, Kenya, and Tanzania. The analyses included data from 535 interviews and 107 focus groups with trial participants, male partners, and community members to answer research questions on partner communication about microbicides, men's role in women's microbicide use, a...
Research Interests: Health Education, Kenya, Tanzania, South Africa, Humans, and 6 moreFemale, Male, Young Adult, Adult, Sexual Partners, and Drug Utilization
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Research Interests: Research Methodology, Primary Health Care, Behavior, Developing Countries, Transportation, and 19 moreChild Care, Health, Adhesion, Biological Sciences, Interviews, Population, Humans, Distance, Gabon, Female, Attitudes, Patient Compliance, Vaccine, Data Collection, Mothers, Vaccination, Questionnaires, Transport Costs, and attitude to health
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Acknowledging that mothers are often the primary caregivers at the household level, malaria control efforts have emphasized educating women in its early recognition. This fails to consider the context in which knowledge will be... more
Acknowledging that mothers are often the primary caregivers at the household level, malaria control efforts have emphasized educating women in its early recognition. This fails to consider the context in which knowledge will be transformed into action, as women lack decision-making responsibility and financial resources. We examine the knowledge and power dynamics of provider-patient interactions and the implications for malaria treatment of educating mothers during consultations. We conducted in-depth interviews in Tanga, Tanzania, with 79 household participants over 2 years to explore knowledge and perceptions of febrile illness, its treatment and prevention. We also interviewed 55 clinicians at government and private healthcare facilities about their patients' knowledge and treatment-seeking behaviour. We analysed our data using a grounded theory approach. Informants had good knowledge of malaria aetiology, symptoms and treatment. Healthcare workers reported that mothers were able to give them sufficient information about their child for accurate diagnosis. However, health staff continued to see mothers who present 'late' as uneducated, intellectually incapable and lazy. Whilst evidence shows that decisions about treatment do not rest with mothers, but with male family members, it is women who continue to be blamed and targeted by health education. Aggressive didactic teaching methods used by health staff may be disempowering those already equipped with knowledge, yet unable to control treatment decisions within the household. This may lead to further delays in presentation at a healthcare facility. We propose a rethinking of health education that is context-sensitive, acknowledges class and gendered power relations, and targets men as well as women.
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Research Interests: Sociology, Anthropology, Health Promotion, Focus Groups, Health Care, and 17 moreMalaria, Mozambique, Public Health, Group Processes, Social Responsibility, Social Science & Medicine, Insecticides, Humans, Focus Group, Qualitative Study, Vector control, Mosquito Control, Public health systems and services research, Consumer Participation, Rural Area, Ministry of Health, and Family Characteristics
In 1996, a debate erupted in the Netherlands about versterven: dying as a result of abstaining from eating and drinking. This discussion initially appeared to be one of the many side-shows to the wider Dutch euthanasia debate, but it... more
In 1996, a debate erupted in the Netherlands about versterven: dying as a result of abstaining from eating and drinking. This discussion initially appeared to be one of the many side-shows to the wider Dutch euthanasia debate, but it continued to dominate the debate for the next few years, with newspaper headlines reporting "involuntary dehydration" in nursing homes. Part of the reason for this was the term itself. Introduced to refer to terminal dehydration, the word versterven had peculiar connotations and this, together with the way in which it was used, caused much confusion and controversy. Was versterven related to euthanasia? Did it denote dying naturally and peacefully or a horrible death imposed on helpless psychogeriatric patients? Was it (could it be) voluntary? Was the patient in control? Was it good death? This paper examines the discussion about, and the media representations of, versterven, focusing on its ambiguity and its relationship to good death.
Research Interests: Sociology, Anthropology, Ethics, Death, Semantics, and 16 moreThanatology, Suicide, Euthanasia, Public Health, Starvation, Social Science & Medicine, Humans, Nursing Homes, Female, Netherlands, Geriatric Psychiatry, Dehydration, Public health systems and services research, Patient Advocacy, Terminal care, and Personal autonomy
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Research Interests: Sociology, Medical Sociology, Anthropology, Ethnography, Research Ethics, and 22 moreInformed Consent, Public Sphere, Adolescent, Everyday Life, Social Science & Medicine, Humans, Face to Face, Health Services, Female, Blood, Male, Gambia, Middle Aged, Vaccinations, Social Relation, Adult, Public health systems and services research, Consumer Participation, Ethics Research, Malaria Vaccines, Clinical Trials as Topic, and Health Services Accessibility
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The objective of this study was to investigate the management of sexually transmitted diseases (STDs) in the Ugandan private sector clinics and drug shops. Men with urethral discharge who had consulted clinics (264) or drug shops (141)... more
The objective of this study was to investigate the management of sexually transmitted diseases (STDs) in the Ugandan private sector clinics and drug shops. Men with urethral discharge who had consulted clinics (264) or drug shops (141) for treatment in 5 districts were interviewed using a precoded questionnaire 1 to 3 weeks after initiation of treatment. Seventy-seven percent of patients sought treatment within 1 week of onset of symptoms but only 7% were properly managed (treated according to National Guidelines, told to use a condom or abstain, and to refer their partner). The reported cure rate was 47% and only 9% were treated according to National Guidelines. Eighteen percent of patients used condoms during treatment, 36% persuaded their partner to go for treatment, and 87% completed the recommended treatment course. Of patients not reporting cure, 56% would still recommend the treatment to a friend. Quality of STD management by private providers is poor. Improvement should occur concurrently at public and private facilities. Possible strategies include training and social marketing of prepackaged treatment for STDs.
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Globally, more than 10 million people are infected with Trypanosoma cruzi, which causes about 20 000 annual deaths. Although Chagas disease is endemic to certain regions of Latin America, migratory flows have enabled its expansion into... more
Globally, more than 10 million people are infected with Trypanosoma cruzi, which causes about 20 000 annual deaths. Although Chagas disease is endemic to certain regions of Latin America, migratory flows have enabled its expansion into areas where it was previously unknown. Economic, social and cultural factors play a significant role in its presence and perpetuation. This systematic review aims to provide a comprehensive overview of qualitative research on Chagas disease, both in endemic and non-endemic countries. Searches were carried out in ten databases, and the bibliographies of retrieved studies were examined. Data from thirty-three identified studies were extracted, and findings were analyzed and synthesized along key themes. Themes identified for endemic countries included: socio-structural determinants of Chagas disease; health practices; biomedical conceptions of Chagas disease; patient's experience; and institutional strategies adopted. Concerning non-endemic countries, identified issues related to access to health services and health seeking. The emergence and perpetuation of Chagas disease depends largely on socio-cultural aspects influencing health. As most interventions do not address the clinical, environmental, social and cultural aspects jointly, an explicitly multidimensional approach, incorporating the experiences of those affected is a potential tool for the development of long-term successful programs. Further research is needed to evaluate this approach.
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... All this is getting much too far ahead of the facts for many meteorologists. ... In the 17 November Na-ture, Robert Cava, Bertram Batlogg, and co-workers describe a group of copper-oxide compounds that become superconducting (lose... more
... All this is getting much too far ahead of the facts for many meteorologists. ... In the 17 November Na-ture, Robert Cava, Bertram Batlogg, and co-workers describe a group of copper-oxide compounds that become superconducting (lose resistance to electric currents) at tem ...
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Scientists would also like to understand the biological processes by which EMF exposure might lead to cancer. Laboratory investigations have shown that EMFs can indeed elicit some effects in cells, including changes in hormone levels, in... more
Scientists would also like to understand the biological processes by which EMF exposure might lead to cancer. Laboratory investigations have shown that EMFs can indeed elicit some effects in cells, including changes in hormone levels, in protein synthesis, and in ion flow across cell membranes. But so far this research has not produced clear laboratory evidence that EMFs either cause or promote cancer. Without such evidence, most researchers are reluctant to pin the carcinogen label on EMFs based on the somewhat ambiguous epidemiology studies. What is needed, researchers say, is more research, and that is coming. Two or three epidemiological studies, are scheduled to be released in the next couple of months, and several large projects are under way which won't be finished for 2 or 3 years. This next generation of research will include several improvements over its predecessors. The studies will in general be much larger - large enough to provide some real statistical power - and they will take into account what researchers have learned in the past few years about measuring EMF exposures.
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Research Interests: Sociology, Cultural Studies, Perception, Research Methodology, Focus Groups, and 27 moreBehavior, Sexuality, Culture, Treatment, Developing Countries, Health, Social Perception, Medicine, Knowledge, South Africa, Humans, Sex Education, Female, Male, Sexual Behavior, Focus Group, Attitudes, Data Collection, Interpersonal Relations, Questionnaires, Adult, Public health systems and services research, Microbicides, Rural Area, Focus Group Discussion, Sexual Partners, and cultural characteristics
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Microbicides are most usually conceptualised within a disease prevention framework and studies usually define acceptability in terms of product characteristics, willingness to use and risk reduction. This starting point has led to... more
Microbicides are most usually conceptualised within a disease prevention framework and studies usually define acceptability in terms of product characteristics, willingness to use and risk reduction. This starting point has led to assumptions about microbicides which, rather than being challenged by empirical studies, have tended to foreclose the data and subsequent conceptual models. Few studies take an emic ('insider') perspective or attempt to understand how microbicides fit into the broader context of women's and men's everyday lives. As part of the integrated social science component of the MDP301 Phase III microbicide trial, in-depth interviews were conducted with female trial participants in South Africa, Zambia, Tanzania and Uganda. Women's experiences of the gel challenge several assumptions that have commonly been reiterated about microbicides. Our analysis suggests that current definitions and conceptual frameworks do not adequately account for the range of meanings that women attribute to gel. Even within the context of a clinical trial, it is possible to obtain a richer, ethnographic and cross-cultural concept of acceptability based on women's practice and emic interpretations. We now need to move beyond limited notions of acceptability and consider how microbicides fit into a more holistic picture of women's and men's sexuality and sexual health.
Research Interests: Sociology, Cultural Studies, Clinical Trial, Uganda, Treatment Outcome, and 22 moreSexual Health, Adolescent, Tanzania, Zambia, Culture and Mental Health, South Africa, Humans, Female, HIV Prevention, Young Adult, Disease Prevention, Conceptual Model, Conceptual Framework, Empirical Study, Middle Aged, Adult, Risk Reduction, Public health systems and services research, Sub Saharan Africa, Sexually Transmitted Diseases, Social Science, and attitude to health
Research Interests: Sociology, Cultural Studies, Psychology, Demography, Perception, and 17 moreEducation, Behavior, Africa, Sexuality, Health Education, Uganda, Developing Countries, Virginity, Adolescent, Students, Population, Eastern Africa, Sexual Behavior, Public health systems and services research, Age Factors, Population Characteristics, and Sexual Abstinence
... Name of the Rose; buildings such as Charles Moore's Piazza d'Italia in New Orleans or Stirling and Wilford's Neue Staatsgalerie in Stuttgart; the music of John Cage and Philip Glass;... more
... Name of the Rose; buildings such as Charles Moore's Piazza d'Italia in New Orleans or Stirling and Wilford's Neue Staatsgalerie in Stuttgart; the music of John Cage and Philip Glass; the photography of Cindy Sherman and Barbara Kruger. This is not the case in ethnography. ...
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This study examined the potential of traditional ways of passing on sexual knowledge from adult to younger women (the senga institution) among the Baganda of central Uganda, as a potential tool for STI/HIV prevention today. Traditional... more
This study examined the potential of traditional ways of passing on sexual knowledge from adult to younger women (the senga institution) among the Baganda of central Uganda, as a potential tool for STI/HIV prevention today. Traditional and contemporary forms of the institution were studied, and their strengths and weaknesses assessed. Data were collected using qualitative research methods. The senga institution comprises four components: Social responsibility, moral authority, appropriate knowledge and a suitable socio- ...
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Background: Innovative prevention strategies for HIV-1 transmission are urgently needed. PRO2000 vaginal gel was efficacious against HIV-1 transmission in studies in macaques; we aimed to assess efficacy and safety of 2% and 0·5% PRO2000... more
Background: Innovative prevention strategies for HIV-1 transmission are urgently needed. PRO2000 vaginal gel was efficacious against HIV-1 transmission in studies in macaques; we aimed to assess efficacy and safety of 2% and 0·5% PRO2000 gels against vaginal HIV-1 transmission in women in sub-Saharan Africa. Methods: Microbicides Development Programme 301 was a phase 3, randomised, double-blind, parallel-group trial, undertaken at 13 clinics in South Africa, Tanzania, Uganda, and Zambia. We randomly assigned sexually active women, ...
Research Interests:
'Ethical'is: a relation between terms, in which the one and the other are not united by synthetic reasoning nor by the relationship between subject and object, and in which nevertheless the one has weight for the... more
'Ethical'is: a relation between terms, in which the one and the other are not united by synthetic reasoning nor by the relationship between subject and object, and in which nevertheless the one has weight for the other, is important for him, meaningful for him, in which they are tied by an 'intrigue'that knowledge can neither exhaust nor disentangle.(Lévinas 1999: 274)
The Wageningen UR Library Catalogue contains bibliographic data on books and periodicals held by the libraries of Wageningen University and Research Centre and some 15 associated libraries. Holding data are added to each record. ...... more
The Wageningen UR Library Catalogue contains bibliographic data on books and periodicals held by the libraries of Wageningen University and Research Centre and some 15 associated libraries. Holding data are added to each record. ... Subjects covered include Agrotechnology, Food and Food Production, Plant and Animal Sciences, Soil Science, Geo-information, Landscape and Spatial Planning, Water and Climate, Ecosystem Studies, Economics and Society. ... The joint collections of the participating libraries cover a substantial part of ...
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After a period in which the term fetishism had a central place in anthropological discourse on traditional religion (referring to a phase in the evolution of religion generallyor to a specific form of religious belief in West Africa)... more
After a period in which the term fetishism had a central place in anthropological discourse on traditional religion (referring to a phase in the evolution of religion generallyor to a specific form of religious belief in West Africa) there followed a period of embarrassment during whichit was hardly used in anthropology. Thus, in 1977 Wyatt MacGaffey could write:
SETTING: Little is known of the social and cultural issues influencing the uptake of and attitudes to tuberculosis (TB) care by people of African extraction living in the UK. OBJECTIVE: To describe the perceptions and experiences of... more
SETTING: Little is known of the social and cultural issues influencing the uptake of and attitudes to tuberculosis (TB) care by people of African extraction living in the UK. OBJECTIVE: To describe the perceptions and experiences of African patients with TB in London, focusing on issues relating to diagnosis, treatment adherence and stigma.
Research Interests: Perception, Africa, London, Humans, Female, and 6 moreStereotyping, Male, Patient Compliance, Middle Aged, Adult, and Pulmonary Tuberculosis
Although adolescent girls in Uganda are particularly vulnerable to HIV infection, providing relevant sexual health education to them is problematic. The senga (father's sister), is the traditional channel for socializing... more
Although adolescent girls in Uganda are particularly vulnerable to HIV infection, providing relevant sexual health education to them is problematic. The senga (father's sister), is the traditional channel for socializing adolescent girls into sex and marriage among many ethnic groups in Uganda. This paper discusses the implementation and community acceptability of 'modern' sengas who were trained to provide HIV-related counselling to adolescent girls. Fourteen sengas were trained in two villages and, in the course of the 1-year study, 247 individuals made a total of 403 visits to them. By including both traditional services (such as advice on and assistance with labial elongation) and modern health and sex education, the sengas provided a 'middle road' between tradition and modernity. As a result, despite initial suspicion by the community, their activities were supported by the community generally and effective as intervention.
Research Interests:
As part of the Microbicides Development Programme, we conducted formative research to explore gender relations at a site in rural KwaZulu-Natal. We were interested in gender relations and in assessing their implications for emerging... more
As part of the Microbicides Development Programme, we conducted formative research to explore gender relations at a site in rural KwaZulu-Natal. We were interested in gender relations and in assessing their implications for emerging female initiated and controlled HIV prevention methods in the form of microbicides. Eleven focus group discussions were conducted with men and women in the community. Participants were asked about decision making about sex, family planning and the use of condoms in heterosexual relationships. Findings suggest that gender relations in the context of HIV are complex. The findings suggest that both men and women feel that the final decision about child-bearing and the use of contraceptives and rests with women since they are the ones who bear the burden of child care. This implies that it is feasible for couples to use women-initiated and controlled methods of HIV prevention.
Research Interests: Psychology, Decision Making, Research Methodology, Focus Groups, Behavior, and 32 moreTreatment, Developing Countries, Qualitative Research, Child Care, Health, Public Health, Community Participation, Medicine, Prevention, Social behavior, South Africa, Humans, Virus, Female, Feasibility Studies, Gender Relations, Male, Sexual Behavior, Focus Group, HIV Prevention, Data Collection, Interpersonal Relations, Social Environment, Family Planning, Adult, Public health systems and services research, Microbicides, Social Behavior, Focus Group Discussion, Sexual Partners, Safe Sex, and AIDS care
Senga (father's sister) is a traditional channel of communication about sexual behaviour for adolescent females in rural Uganda. We evaluated a modification of this approach as an intervention for HIV and STDs in a pilot study in... more
Senga (father's sister) is a traditional channel of communication about sexual behaviour for adolescent females in rural Uganda. We evaluated a modification of this approach as an intervention for HIV and STDs in a pilot study in two intervention villages and one control village over 12 months. Eleven adult women and three adolescent girls were chosen and trained to become sengas. Adolescent girls were encouraged to visit the sengas for sexual health information. Adult sengas saw an average of 21 clients; adolescent sengas saw five. Adolescent girls made 45% of visits. The expected reasons for attending the sengas accounted for 51% of visits. Knowledge about HIV/AIDS, sexual communication skills, consistent condom use and family planning service use increased in the intervention group of girls over the study period and compared to control girls. Symptomatic STDs decreased in the intervention group. This intervention was readily accepted by the community; members of all ages and both sexes attended for a wider variety of reasons than anticipated. Adolescent girls in the intervention group showed improved knowledge, attitudes and practices related to HIV and STDs. This promising intervention warrants further testing in larger studies and other settings.
Research Interests: Psychology, Sexual Behaviour, Uganda, Sexual Health, Adolescent, and 19 moreRural Health, Humans, Child, Sex Education, Female, Male, Sexual Behavior, Communication Skill, Group Intervention, Family Planning, Condom use, Family Relations, Pilot study, Adult, Public health systems and services research, Age Factors, Pilot Projects, Sexually Transmitted Diseases, and AIDS care
Research Interests: Psychology, Domestic Violence, Focus Groups, Prejudice, Uganda, and 19 moreAdolescent, Tanzania, Counseling, Rural Health, Pregnancy, Humans, Female, Qualitative Study, Confidentiality, HIV testing, Adult, Public health systems and services research, Pregnant Women, Rural Area, Focus Group Discussion, South West, AIDS care, Nevirapine, and attitude to health
Research Interests:
Studies report substantial sexual behaviour change in Africa in response to HIV/AIDS. Generally there seems to be an increase in condom use and a reduction in partners, with men reporting more change than women. However, it is not only... more
Studies report substantial sexual behaviour change in Africa in response to HIV/AIDS. Generally there seems to be an increase in condom use and a reduction in partners, with men reporting more change than women. However, it is not only important to know whether people are changing their sexual behaviour but also their reasons for changing and the consistency and extent of change. Between 1996 and 2000 a study involving 196 respondents was carried out in rural southwest Uganda to investigate the exact nature of behaviour change and the reasons for change or lack of change since people became aware of HIV/AIDS. Data were collected from three rounds of questionnaire surveys, four rounds of open in-depth interviews, six rounds of semi-structured interviews and from informal conversations and participant observation. In order to obtain a comprehensive assessment of behaviour change the data for each participant from all sources were compared and discrepancies were then followed up by re-interviewing participants. After triangulation between all sources of data, 48% of respondents had ever used a condom. Condom use in 76% of all cases was at least partly AIDS related, while 19% was exclusively for protection against HIV. Condom use tended to be sporadic: only 13% of condom users currently used a condom regularly and most of this use was for family planning. After triangulation, 45% had reduced the number of sexual partners. Of all partner reductions, 93% was at least partly AIDS related; 29% was exclusively to avoid HIV. Half of those who had reduced the number of partners either stuck to one partner or abstained. Men reported more change than women. Of those who reported no partner reduction, 89% could not reduce the number of partners because they already had only few or a single partner or abstained; most of these were women. Most of those who could change their sexual behaviour had already changed, though the degree of change (particularly condom use) was often minimal. Not only behaviour change, but also the maintenance of safe behaviour is important. Also, understanding reasons for change and extent and consistency of change are important when planning and evaluating interventions.
Research Interests: Psychology, Research Methodology, Fear, Behavior, Uganda, and 20 moreDeveloping Countries, Qualitative Research, Adolescent, Rural Health, Population, Humans, Surveys, Female, Male, Sexual Behavior, Participant Observation, Aged, Middle Aged, Adult, Public health systems and services research, Condoms, Safe Sex, Questionnaire Survey, AIDS care, and Acquired immunodeficiency syndrome
Research Interests:
A study was carried out in south-west Uganda to assess the acceptability of the female condom and a variety of spermicidal products. Interviews were carried out with 50 men and 55 women and 25 focus group discussions (FGDs) were held with... more
A study was carried out in south-west Uganda to assess the acceptability of the female condom and a variety of spermicidal products. Interviews were carried out with 50 men and 55 women and 25 focus group discussions (FGDs) were held with 138 women and 42 men in order to investigate attitudes to the male condom and to female controlled methods of protection. The female condom, foaming tablets, sponge, foam, gel and film were demonstrated to 146 women and 35 of their male partners, who then tried out two of the ...
Research Interests:
In a recent study of the acceptability of the female condom, foaming tablets, sponge, foam, film and gel among 146 women and 35 of their male partners in south-west Uganda, we found a clear demand for, and consistent use of, these... more
In a recent study of the acceptability of the female condom, foaming tablets, sponge, foam, film and gel among 146 women and 35 of their male partners in south-west Uganda, we found a clear demand for, and consistent use of, these products. Although the participants understood that, with the exception of the female condom, there was no certainty about how much protection, if any, the products provided against HIV and sexually transmitted diseases (STD), they nonetheless said that the main reason for using the products was the partial ...
Research Interests:
... to prove that Africans have traditionally recognised a separate medical domain in which they interpret illness primarily in empirical and practical ... they were 'obsessed with native theories of magical... more
... to prove that Africans have traditionally recognised a separate medical domain in which they interpret illness primarily in empirical and practical ... they were 'obsessed with native theories of magical causality' (p. xiii) and as a result they 'reduce the study of health and disease to ...
Research Interests: Anthropology and Etiology
Research Interests: Sociology, Cultural Studies, Poverty, Focus Groups, Qualitative Research, and 18 moreSex Work, Sexual Health, Vulnerability, Rwanda, Financial Crisis, Humans, Prostitution, Female, Sexual Behavior, Follow-up studies, Sex Workers, Career Choice, Adult, Public health systems and services research, Focus Group Discussion, Housekeeping, Female Sex Workers, and Economic Benefit
Research Interests: Medical Microbiology, Malaria, Ghana, Kenya, Malawi, and 7 morePregnancy, Humans, Female, Male, Newborn Infant, Adult, and Antimalarials
Research Interests:
In order to examine the sexual behaviour of a highly mobile social group, qualitative data and quantitative data were elicited from 212 private motorbike taxi‐men, locally called bodabodamen, from two study sites in Masaka, Uganda.... more
In order to examine the sexual behaviour of a highly mobile social group, qualitative data and quantitative data were elicited from 212 private motorbike taxi‐men, locally called bodabodamen, from two study sites in Masaka, Uganda. Selection criteria were availability and willingness to participate in the study. Research techniques employed were a questionnaire, focus group discussions, in‐depth interviews and case studies.
Abstract Background: Malaria control remains a challenge in sub-Saharan Africa. In 2006, the World Health Organization (WHO) reinforced the recommendation of indoor residual spraying (IRS) with dichlorodiphenyltrichloroethane (DDT) to... more
Abstract Background: Malaria control remains a challenge in sub-Saharan Africa. In 2006, the World Health Organization (WHO) reinforced the recommendation of indoor residual spraying (IRS) with dichlorodiphenyltrichloroethane (DDT) to reduce malaria transmission. The National Malaria Control Programme has been reporting high coverage rates of IRS in Mozambique.
Abstract Randomized controlled trials and critical social theory are known not to be happy bedfellows. Such trials are embedded in a positivist view of the world, seeking definitive answers to testable questions; critical social theory... more
Abstract Randomized controlled trials and critical social theory are known not to be happy bedfellows. Such trials are embedded in a positivist view of the world, seeking definitive answers to testable questions; critical social theory questions the methods by which we deem the world knowable and may consider experiments in the biomedical sciences as social artifacts. Yet both of these epistemologically and methodologically divergent fields offer potentially important advances in HIV research.
Medische antropologie pretendeert een interdisciplinaire onderneming te zijn waarin antropologie en medische wetenschap gecombineerd worden om problemen van ziekte beter te begrijpen en vervolgens op te lossen.
Popliteal pterygium syndrome is one of the autosomal dominant limb pterygium syndromes. It has incomplete penetrance and extreme phenotypic variability that leads to difficulty in diagnosis. A case is presented to emphasize the variable... more
Popliteal pterygium syndrome is one of the autosomal dominant limb pterygium syndromes. It has incomplete penetrance and extreme phenotypic variability that leads to difficulty in diagnosis. A case is presented to emphasize the variable phenotype of this disorder. The absence of pterygia in the family members led to the misdiagnosis of van der Woude's syndrome. However, the presence of a pyramidal fold of skin over the nail of the hallux in family members suggested the diagnosis of popliteal pterygium syndrome.
Background Evidence of low end-of-life (EoL) care service use by minority ethnic groups in the UK has given rise to a body of research and a number of reviews of the literature. This article aims to review and evaluate literature reviews... more
Background Evidence of low end-of-life (EoL) care service use by minority ethnic groups in the UK has given rise to a body of research and a number of reviews of the literature. This article aims to review and evaluate literature reviews on minority ethnic groups and EoL care in the UK and assess their suitability as an evidence base for policy. Methods Systematic review. Searches were carried out in thirteen electronic databases, eight journals, reference lists, and grey literature.
Background Pneumonia is a leading cause of childhood hospitalisation and child mortality in Africa. This study explores local interpretations of Acute Respiratory Infections (ARIs), focusing on caretakers of children under five in the... more
Background Pneumonia is a leading cause of childhood hospitalisation and child mortality in Africa. This study explores local interpretations of Acute Respiratory Infections (ARIs), focusing on caretakers of children under five in the context of hospital care seeking. Methods The study took place in Manhiça, southern Mozambique and used Focused Ethnographic Study tools (FES) including field exercises and interviews. Results Understandings of terms used to describe ARIs differed between caretakers and hospital staff.
Background Antenatal care (ANC) is a key strategy to improve maternal and infant health. However, survey data from sub-Saharan Africa indicate that women often only initiate ANC after the first trimester and do not achieve the recommended... more
Background Antenatal care (ANC) is a key strategy to improve maternal and infant health. However, survey data from sub-Saharan Africa indicate that women often only initiate ANC after the first trimester and do not achieve the recommended number of ANC visits. Drawing on qualitative data, this article comparatively explores the factors that influence ANC attendance across four sub-Saharan African sites in three countries (Ghana, Kenya and Malawi) with varying levels of ANC attendance.
Background The most common form of HIV transmission in sub-Saharan Africa is heterosexual sex between two partners. While most HIV prevention interventions are aimed at the individual, there is mounting evidence of the feasibility,... more
Background The most common form of HIV transmission in sub-Saharan Africa is heterosexual sex between two partners. While most HIV prevention interventions are aimed at the individual, there is mounting evidence of the feasibility, acceptability, and efficacy of dyadic interventions. However, the mechanisms through which dyadic-level interventions achieve success remain little explored.
Background: Building on previous acceptability research undertaken in sub-Saharan Africa this article aims to investigate the acceptability of intermittent preventive treatment of malaria in infants (IPTi) in Papua New Guinea (PNG).... more
Background: Building on previous acceptability research undertaken in sub-Saharan Africa this article aims to investigate the acceptability of intermittent preventive treatment of malaria in infants (IPTi) in Papua New Guinea (PNG). Methods: A questionnaire was administered to mothers whose infants participated in the randomised placebo controlled trial of IPTi. Mothers whose infants participated and who refused to participate in the trial, health workers, community reporters and opinion leaders were interviewed.
Aim Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European... more
Aim Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries.
Background End of life (EoL) care in sub-Saharan Africa still lacks the sound evidence-base needed for the development of effective, appropriate service provision. It is essential to make evidence from all types of research available... more
Background End of life (EoL) care in sub-Saharan Africa still lacks the sound evidence-base needed for the development of effective, appropriate service provision. It is essential to make evidence from all types of research available alongside clinical and health service data, to ensure that EoL care is ethical and culturally appropriate. This article aims to synthesize qualitative research on EoL care in sub-Saharan Africa to inform policy, practice and further research.
Background HIV prevention trials conducted among disadvantaged vulnerable at-risk populations in developing countries present unique ethical dilemmas. A key concern in bioethics is the validity of informed consent for trial participation... more
Background HIV prevention trials conducted among disadvantaged vulnerable at-risk populations in developing countries present unique ethical dilemmas. A key concern in bioethics is the validity of informed consent for trial participation obtained from research subjects in such settings. The purpose of this study was to investigate the effectiveness of a continuous informed consent process adopted during the MDP301 phase III vaginal microbicide trial in Mwanza, Tanzania.
Intravaginal insertion is often associated with the concept of 'dry'sex. All HIV-prevention microbicides tested to date have been vaginally applied lubricant-based gels. In this paper, we examine whether the use of intravaginal insertions... more
Intravaginal insertion is often associated with the concept of 'dry'sex. All HIV-prevention microbicides tested to date have been vaginally applied lubricant-based gels. In this paper, we examine whether the use of intravaginal insertions could be in conflict with the introduction of vaginal microbicide gels. The Africa Centre site was part of the Microbicides Development Programme evaluating PRO2000/5 microbicide gel.
Background Malaria during pregnancy (MiP) results in adverse birth outcomes and poor maternal health. MiP-related morbidity and mortality is most pronounced in sub-Saharan Africa, where recommended MiP interventions include intermittent... more
Background Malaria during pregnancy (MiP) results in adverse birth outcomes and poor maternal health. MiP-related morbidity and mortality is most pronounced in sub-Saharan Africa, where recommended MiP interventions include intermittent preventive treatment, insecticide-treated bednets and appropriate case management.
Background Intermittent preventive treatment of malaria in infants (IPTi) reduces the incidence of clinical malaria. However, before making decisions about implementation, it is essential to ensure that IPTi is acceptable, that it does... more
Background Intermittent preventive treatment of malaria in infants (IPTi) reduces the incidence of clinical malaria. However, before making decisions about implementation, it is essential to ensure that IPTi is acceptable, that it does not adversely affect attitudes to immunization or existing health seeking behaviour. This paper reports on the reception of IPTi during the first implementation study of IPTi in southern Tanzania.
Evidence from a range of sources demonstrates that end-of-life (EoL) care practices and preferences vary across countries; culture is consistently one of the main explanations given for this. In order to understand how cultural factors... more
Evidence from a range of sources demonstrates that end-of-life (EoL) care practices and preferences vary across countries; culture is consistently one of the main explanations given for this. In order to understand how cultural factors are used to explain similarities and differences in EoL care between Spain, Italy and Portugal, database and hand searches were performed and cross-cutting core themes identified.
Abstract Background: IPTi delivered through EPI has been shown to reduce the incidence of clinical malaria by 20–59%. However, new health interventions can only be effective if they are also socially and culturally acceptable. It is also... more
Abstract Background: IPTi delivered through EPI has been shown to reduce the incidence of clinical malaria by 20–59%. However, new health interventions can only be effective if they are also socially and culturally acceptable. It is also crucial to ensure that attitudes to IPTi do not negatively influence attitudes to and uptake of immunization, or that people do not misunderstand IPTi as immunization against malaria and neglect other preventive measures or delay treatment seeking.
Abstract Adherence optimization and measurement have emerged as critically challenging issues for clinical trials of topical microbicides. Although microbicide trials have routinely collected adherence data, their utilization in trial... more
Abstract Adherence optimization and measurement have emerged as critically challenging issues for clinical trials of topical microbicides. Although microbicide trials have routinely collected adherence data, their utilization in trial design, implementation, and interpretation has been inconsistent.
Abstract Background: Intermittent preventive treatment of malaria in infants (IPTi) using sulphadoxine-pyrimethamine and linked to the expanded programme on immunization (EPI) is a promising strategy for malaria control in young children.... more
Abstract Background: Intermittent preventive treatment of malaria in infants (IPTi) using sulphadoxine-pyrimethamine and linked to the expanded programme on immunization (EPI) is a promising strategy for malaria control in young children. As evidence grows on the efficacy of IPTi as public health strategy, information is needed so that this novel control tool can be put into practice promptly, once a policy recommendation is made to implement it.
Background The collection of accurate data on adherence and sexual behaviour is crucial in microbicide (and other HIV-related) research. In the absence of a “gold standard” the collection of such data relies largely on participant... more
Background The collection of accurate data on adherence and sexual behaviour is crucial in microbicide (and other HIV-related) research. In the absence of a “gold standard” the collection of such data relies largely on participant self-reporting. After reviewing available methods, this paper describes a mixed method/triangulation model for generating more accurate data on adherence and sexual behaviour in a multi-centre vaginal microbicide clinical trial. In a companion paper some of the results from this model are presented [1].
Background Accurate data on adherence and sexual behaviour are crucial in microbicide (and other HIV-related) research. In the absence of a “gold standard” the collection of such data relies largely on participant self-reporting. The... more
Background Accurate data on adherence and sexual behaviour are crucial in microbicide (and other HIV-related) research. In the absence of a “gold standard” the collection of such data relies largely on participant self-reporting. The Microbicides Development Programme has developed a mixed method/triangulation model for generating more accurate data on adherence and sexual behaviour.
Abstract Antenatal sero-prevalence rates of 30% and more have been reported in KwaZulu-Natal since 1998 and over 50% of all adult deaths in 2000 were due to AIDS. Understanding the changing social and cultural attitudes to AIDS is... more
Abstract Antenatal sero-prevalence rates of 30% and more have been reported in KwaZulu-Natal since 1998 and over 50% of all adult deaths in 2000 were due to AIDS. Understanding the changing social and cultural attitudes to AIDS is important in providing contextual information to aid the design of interventions. This paper examines community attitudes towards individuals living with HIV. Eleven focus groups were conducted with men and women.
Vampire stories are, then, confusions and misunderstandings of the best kind: they reveal the world of power and uncertainty in which Africans have lived in this century. Their very falseness is what gives them meaning: they are a way of... more
Vampire stories are, then, confusions and misunderstandings of the best kind: they reveal the world of power and uncertainty in which Africans have lived in this century. Their very falseness is what gives them meaning: they are a way of talking that encourages a reassessment of everyday experience to address the workings of power and knowledge and how regimes use them.(White 2000)
Abstract Background: With 2.5 million new HIV infections per year, effective preventive methods against HIV are urgently needed, especially in sub-Saharan Africa. MDP301 is an ongoing trial of the vaginal microbicide PRO 2000/5 being... more
Abstract Background: With 2.5 million new HIV infections per year, effective preventive methods against HIV are urgently needed, especially in sub-Saharan Africa. MDP301 is an ongoing trial of the vaginal microbicide PRO 2000/5 being conducted by the Microbicides Development Programme. The main objective of the trial is to determine the efficacy and safety of 0.5% and 2% concentrations of PRO 2000/5 gel compared to placebo in preventing vaginally acquired HIV infection.
This article presents evidence of a substantial change in sexual behaviour among urban factory workers during the last four years; it discusses the nature of this change and the reasons for it. Fear of AIDS was the main motivating factor,... more
This article presents evidence of a substantial change in sexual behaviour among urban factory workers during the last four years; it discusses the nature of this change and the reasons for it. Fear of AIDS was the main motivating factor, followed by economic hardship: because AIDS is incurable and because sexual relationships have a substantial transactional component, workers see themselves as paying the price of promiscuity with their lives as well as their dwindling financial resources.
Abstract Microbicides are a class of substances under development that could reduce the sexual transmission of HIV and other sexually transmitted diseases when applied locally to genital mucosal surfaces. Microbicide acceptability... more
Abstract Microbicides are a class of substances under development that could reduce the sexual transmission of HIV and other sexually transmitted diseases when applied locally to genital mucosal surfaces. Microbicide acceptability research has largely focused on product characteristics, rather than processes of negotiation within relationships about use.
Research Interests: Sociology, Cultural Studies, Psychology, Contraception, Behavior, and 14 moreAfrica, Uganda, Developing Countries, Culture and Mental Health, Eastern Africa, Disease, Infection, Attitudes, Men, Attitude, Public health systems and services research, Condoms, Virus diseases, and Sexually Transmitted Diseases
Research Interests: Psychology, Culture, Uganda, Humans, Prostitution, and 16 moreFemale, Male, Sex Workers, Commercial Sex Workers, Condom use, Middle Aged, Questionnaires, Adult, Public health systems and services research, Negotiating, Occupational Diseases, South West, Long Distance, AIDS care, Acquired immunodeficiency syndrome, and Automobile driving
Research Interests:
OBJECTIVE: To examine changes in sexual behaviour among men in urban Tanzania. DESIGN: An observational cohort study among factory workers during 1991-1994. METHODS: Data from five follow-up visits with structured questionnaire-guided... more
OBJECTIVE: To examine changes in sexual behaviour among men in urban Tanzania. DESIGN: An observational cohort study among factory workers during 1991-1994. METHODS: Data from five follow-up visits with structured questionnaire-guided interviews and biomedical data were analysed to examine trends in sexual behaviour and sexually transmitted disease/HIV among 752 men. In-depth interviews were conducted to evaluate the magnitude of reporting bias. RESULTS: During the 2 years of observation, the ...
Research Interests:
This paper discusses the background characteristics, sexual relationships, condom use and risk perception of bar workers in Magu district, north-west Tanzania. Bar workers in Magu are geographically mobile. They are not highly educated... more
This paper discusses the background characteristics, sexual relationships, condom use and risk perception of bar workers in Magu district, north-west Tanzania. Bar workers in Magu are geographically mobile. They are not highly educated but probably have a higher level of schooling than average. They are mostly unmarried or divorced. They choose bar work because, given the resources available, it provides them with a good balance between earning their own income and being independent. Although the women are still partially dependent on the financial support provided by sexual partners and sexual relations tend to be based on exchange, bar workers cannot simply be equated with prostitutes. Some have a regular partner and the odd casual partner while others may have large numbers of casual contacts. Regular partners are almost always married and often itinerant. The distinction between regular and casual partners is important and based on the nature and extent of financial support. It is also related to condom use and therefore to risk. Women claim to be able to demand condom use from casual partners but not from regular partners. Although women claim that regular partners can be trusted, they nonetheless admit feeling at risk of AIDS and STDs from these same partners.
Research Interests: Psychology, Perception, Behavior, Developing Countries, Risk Taking, and 17 moreAdolescent, Tanzania, Rural Health, Population, Humans, Risk Perception, Female, Sexual Behavior, Interpersonal Relations, Condom use, Adult, Public health systems and services research, Condoms, Sexual Partners, Occupations, AIDS care, and attitude to health
Research Interests: Research Methodology, Treatment, Developing Countries, Health, Polymers, and 17 moreAdolescent, Medicine, HIV, Screening, Population, Humans, Female, Sexual Behavior, Young Adult, Lancet, Middle Aged, Adult, Microbicides, Condoms, Sexually Transmitted Diseases, Naphthalenesulfonates, and Antiviral Agents
Research Interests: Sociology, Anthropology, Focus Groups, Behavior, Uganda, and 17 moreConsumer Behavior, Public Health, Sexual Health, Adolescent, Social Science & Medicine, Humans, Female, Attitude, Middle Aged, Longitudinal Studies, Adult, Public health systems and services research, Sexual Partners, Sexually Transmitted Diseases, South West, Social Science, and Truth Disclosure
Like verbal communication itself, ethnographic presentation may appear full of redundancy if measured by standards that presuppose an ideal reader, a perfect match of content and form between text and translation, and complete sets of... more
Like verbal communication itself, ethnographic presentation may appear full of redundancy if measured by standards that presuppose an ideal reader, a perfect match of content and form between text and translation, and complete sets of findings covering the, and only the, announced subject of research. Parsimony is a supreme value for those who already know; ethnographers, although some of them can say what they have to say more clearly and succinctly than others, are destined to tell baroque and tortuous tales.
Research Interests:
Research Interests: Sociology, Anthropology, Research Methodology, Occupational Health, Behavior, and 29 moreLife Style, Life history, Uganda, Developing Countries, Risk Taking, Sex Work, Public Health, Social Science & Medicine, Commerce, Interviews, Population, Humans, Prostitution, Female, Self Disclosure, Risks, Data Collection, Commercial Sex Workers, Participant Observation, Middle Aged, Adult, Public health systems and services research, Case Histories, Personal Experience, Condoms, Working Women, Safe Sex, Acquired immunodeficiency syndrome, and cultural characteristics
Research Interests:
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our... more
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > March ...