The aims of this present study were to explore the use and meaning of metaphors and images about ... 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.
Community-based programmes, particularly community health workers (CHWs), have been portrayed as ... 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 ...
Despite the availability of practical knowledge and effective interventions required to reduce pr... 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...
Since the 1994 International Conference on Population and Development, male involvement in reprod... 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...
This paper focuses on ‘sexual debut’ among out-of-school youth in Masaka District, Uganda, factor... 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
Abstract This chapter is based on data collected in central Malawi as part of a large multi-centr... 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 ...
The aims of this present study were to explore the use and meaning of metaphors and images about ... 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.
Community-based programmes, particularly community health workers (CHWs), have been portrayed as ... 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 ...
Despite the availability of practical knowledge and effective interventions required to reduce pr... 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...
Since the 1994 International Conference on Population and Development, male involvement in reprod... 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...
This paper focuses on ‘sexual debut’ among out-of-school youth in Masaka District, Uganda, factor... 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
Abstract This chapter is based on data collected in central Malawi as part of a large multi-centr... 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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