Mid Sweden University

Previous research has indicated that migrants risk facing inequities both internationally and in Sweden; integration policies are therefore important to study. How health is described in policies affects how health interventions are approached. Discourse analysis offers a way of understanding how health is framed within the integration policies affecting newly arrived migrants in Sweden. The aim was to analyse the health discourses used in Swedish and European Union (EU) integration policies. A discourse analysis, inspired by Fairclough, was performed on integration policies related to Sweden, at local, regional, national and EU levels. The policies of the Establishment Program, which focuses on newly arrived migrants (refugees, persons of subsidiary protection and their relatives who arrived through family reunification), were chosen for the analysis, and 17 documents were analysed in total. The analysis of the documents showed how the health discourses were expressed in the form of the medicalisation of health, the individualisation of health and the risk of ill health. A pathogenic approach to health was visible in the policies and individual disease prevention or rehabilitation was the main health focus. The results showed similarities to previous research highlighting how a particular understanding of health in a neoliberal context is formed.

Background: According to recent statistics from WHO, 150 million people globally have visual impairments caused by uncorrected refractive errors. This study aimed to estimate the prevalence rate of refractive error in Bangladesh's urban, rural, and marginalized populations (tea gardens). Methods: This was a cross-sectional study conducted among all school-going children (Class I-X) aged 5 to 18. The study adopted the stratified cluster sampling method to recruit study subjects. A pre-tested semi-structured questionnaire was used for face-to-face interviews. Trained optometrists carried out vision screening and refraction to identify children with vision impairment. Results: The prevalence of refractive error is 5.3 per 100 population in which myopia is the most common form of refractive error found in 125 (78.6%, 95% CI: 77.1–80.1), followed by astigmatism in 20 (12.6%, 95% CI: 11.4–13.8) and the rest of the cases are hyperopia among 14 (8.8%, 95% CI: 7.8–9.8) children. At the time of the vision screening, only 25 (15.7%) children using spectacles were found. The study findings also showed that urban areas had the highest percentage of refractive error (9.9%), and rural and tea gardens had 3.9% and 2.1% refractive error, respectively. Refractive error was relatively higher among girls’ (AOR = 1.5, p < 0.01, 95%CI: 1.07–2.11) in comparison with boys’ and the percentage of refractive error was three times higher within the secondary school-going children (AOR = 3.2, p < 0.01, 95%CI: 1.23–8.08) compared to primary school children. Conclusion: The prevalence of refractive error was higher in the above-ten-year-old age group and significantly lower in rural and tea garden populations. To resolve these challenges, an assortment of comprehensive strategies must be implemented. 

Introduction: Childhood eye morbidity is a great public health problem, especially in low-income countries. This study aimed to determine the economic burden of childhood ocular morbidity on attending tertiary hospitals in Bangladesh. This study also assessed the catastrophic health expenditure (CHE) for childhood ocular morbidity in Bangladesh. Methods: A cross-sectional mixed method was used for this study from April to October 2023 at two tertiary hospitals in Bangladesh, one government-funded and one private. Face-to-face interviews using a semi-structured quantitative questionnaire with the caregivers/parents and in-depth interviews (IDIs) were conducted among the same respondents of these two hospitals, and a workshop was conducted with the stakeholders during the study period. Results: This was the first study in Bangladesh to determine the cost of pediatric ocular morbidity. Among 335 patients, the total median direct cost at a single time was 3740 ± 18,285 BDT (34 ± 166.2 USD) at the government hospital and 7300 ± 40,630 BDT (66.36 ± 369.36 USD) at the private hospital. The disease-specific median overall cost from diagnosis of the disease was 65,000 BDT (591 USD) for squint, 50,000 BDT (454.54 USD) for cataract, and 30,000 BDT (272.72 USD) for eye injury. Almost 90% of the caregivers/parents faced CHE due to different pediatric ocular morbidity. Conclusions: These cost estimates can be used as an initial basis for financial decisions that aim to enhance access to care, management, and follow-up of children with ocular morbidity. These cost estimates also offer helpful information for organizational and financial sustainability initiatives. Policymakers can consider serious immediate interventions for securing ocular health services in Bangladesh and prevent families from CHE. 

Introduction Falls among older adults are a significant cause of disability, injury, and death worldwide. The high incidence of falls in older adults, combined with the increased susceptibility to injury of the older adult population, leads to severe global health issues. Further studies are needed to comprehensively evaluate the typical personal and environmental risk factors of falls in the Iranian elderly population. Future preventive strategies and intervention programs will be based on these findings. The study determined the risk factors associated with unintentional falls among a representative sample of older adults living in Tehran, the capital city of Iran.Methods The study design was cross-sectional. The target population was men/women aged 65 years and over from the general population living in 22 different districts of Tehran who were selected by stratified random sampling. The researchers gathered the data using validated questionnaires and observations. The informed consent was obtained from all participants before starting the interview. Multivariate logistic regression analysis examined the association between falls occurring during the past 12 months with demographics/ socioeconomics and fall-related predictor factors.Results The risk of falls was higher in women (47.0%) and those aged≥75 years (44.1%). Older adults who were married had their fall risk reduced by 36.4% compared with other types of marital status. Older adults who were illiterate (48.1%), housewives (47.0%), and always had concerns about living expenses (53.9%) tended significantly to have a higher risk of falls. Moreover, participants who live with their family were less likely to fall than those who live alone (36.5% vs. 40.4%). Persons with safe homes were less likely to experience falls than persons with unsafe homes (30.9% vs. 41.4%). The logistic regression analysis showed that the female gender, being worried about living expenses, home safety, functional behavior, and function factors, were independently associated with the risk of falls during the past 12 months.Conclusions Our findings revealed that a wide range of intrinsic and extrinsic risk factors contributed to injurious falls; based on the literature, some are preventable. The present data may be helpful as a starting point and guide future efforts for health providers and policymakers to allocate additional resources and develop proper falls prevention or intervention programs at the community level.

Globally, ocular morbidity and disability among children are major public health concerns.This study was designed to explore the health-seeking behaviours of parents in Bangladesh whose children have ocular problems. A cross-sectional mixed method was followed for this study. The method was designed to measure the eye health care-seeking practices of caregivers/parents with children with ocular morbidity in three unions (the lowest administrative geographical area comprising 30,000–50,000 population) of the Raiganj Upazila under the Sirajganj District of Bangladesh. The study period was from January to April 2017. Face-to face interviews using a semi-structured quantitative questionnaire with the caregivers and KI were conducted among the health service providers during the study period. This was the first community-based study conducted in Bangladesh to find out caregivers’ health-seeking behaviour with identified ocular morbidity. Among 198 confirmed cases of childhood ocular problems, only 87 (43.9%) parents sought health care for their children’s ocular morbidities. Better health-seeking behavior was found among the wealthier families. Proportions were 55.3% and 36% among wealthy and low-income families, respectively. Affluent families sought care from qualified service providers. Educated household heads chose qualified service providers for their children at a higher rate than illiterate household heads. Lack of knowledge, lack of awareness and financial constraints are significant barriers to seeking proper health care. More than half of the caregivers did not seek any eye care services for their children. Socio-demographic factors, and financial constraints play an essential role in the health-seeking behaviour of the parents.

Objective:

To explore how community-living people with perceived cognitive impairment or dementia and their next-of-kin perceive functioning and disability in major life domains.

Methods:

Individual interviews guided by the World Health Organization Disability Assessment Schedule (WHODAS 2.0) were  conducted with 26 people with perceived cognitive impairment or dementia (age range 38–87 years) and 26 next-of-kin. Qualitative content analysis- and International Classification of Functioning, Disability, and Health (ICF-) linking methods were used to analyse the transcripts. The perceived degree of disability in daily functioning was calculated and compared between people with perceived cognitive impairment or dementia and next-of-kin, using a Mann–Whitney U test.

Results:

A total of 38 of 47 (81%) established ICF categories corresponding to WHODAS items and 38 additional International Classification of Functioning, Disability, and Health (ICF) categories describing participants perceived cognitive and physical impairments, activity limitations and participation restrictions in interaction with the environmental factors were confirmed from the transcripts. The perceived disability of people with perceived cognitive impairment or dementia was scored higher by next-of-kin (48%) than by people with perceived cognitive impairment or dementia (16%, p < 0.0001).

Conclusion:

Interviews provided a comprehensive picture of participants’ perceived activity limitations and participation restrictions in the life domains cognition, mobility, self-care, getting along, life activities, and participation. For a better understanding of the impact of cognitive impairment on people’s daily lives, inclusion of the perspective of the next-of-kin and the factors that hinder or facilitate daily living in the community setting is necessary.

Background and aim: Early action is important for promoting newly arrived migrants’ health. Politicians are major actors in decision-making that affects health outcomes in the population. Therefore, the aim of this study was to explore local and regional politicians’ considerations of newly arrived migrants’ health in political decision-making: whether politicians reflect on or discuss the effects of decision-making specifically on newly arrived migrants’ health, whether considerations differ between municipality and regional politicians, and how knowledge and attitudes are associated with such considerations. Subject and methods: A cross-sectional quantitative study was conducted. A total of 667 municipality and regional politicians from northern Sweden responded to a questionnaire developed based on interviews with politicians. Bivariate analyses were performed using χ2 tests, the independent samples t-test, and the Wilcoxon signed-rank test. Multivariate analysis was performed using binary logistic regression. Results: Politicians considered the effects on newly arrived migrants’ health significantly less frequently than those on the total population’s health. Regional politicians discussed such effects more often than municipality politicians. Knowledge (odds ratio [OR] = 1.343), attitude (OR = 5.962), previous experience working on public health issues (OR = 1.784), and female gender (OR = 1.787) were positively associated with considering effects on newly arrived migrants’ health in decision-making. Conclusion: Politicians play important roles in health promotion, and most consider health-related effects in their decision-making. However, about a third do not consider such effects. General health-related knowledge and attitude are important factors that could be affected or changed during political assignments. 

Newly arrived migrants in Sweden risk facing ill health. Politicians at the local and regional levels are involved in many decisions regarding the social determinants of health. The aim of this study was to explore politicians’ views on different societal actors’ responsibility and possibility to promote newly arrived migrants’ health. Data were collected through online questionnaires completed by 667 politicians from municipality and regional councils in northern Sweden. Bivariate analysis was performed using the Wilcoxon signed-rank test. Multivariate analyses were performed using cluster analysis and binary logistic regression analysis. The results show that politicians generally rate societal actors’ responsibility and possibility to promote the general population’s health higher than newly arrived migrants’ health. Moreover, they consider societal actors’ responsibility to be greater than their possibility to promote health. Factors significantly contributing to politicians’ high ratings of societal responsibility and possibility are attitude (odds ratio [OR] = 2.156, 95% confidence interval [CI]: 1.306–3.558), specific knowledge of newly arrived migrants’ health status (OR = 1.528, 95% CI: 1.005–2.323), personal interest in public health (OR = 2.452, 95% CI: 1.460–4.119), being a municipality politician (OR = 1.659, 95% CI: 1.031–2.670) and being female (OR = 1.934, 95% CI: 1.333–2.806). This study shows that politicians generally rate societal responsibility and possibility to promote newly arrived migrants’ health rather high. Personal characteristics are important for politicians’ high or low ratings of responsibility and possibility, suggesting insufficient structural support for politicians in health promotion.

For newly arrived migrants, integration is important in promoting health and decreasing health inequities. In a Swedish context, civic orientation is a program to promote integration and increase the chance of employment for newly arrived migrants. The aim of this project was to explore how civic communicators view and approach health promotion in their work with newly arrived migrants in the civic orientation program in Sweden. Data were collected through interviews with eight civic communicators working with newly arrived migrants in civic orientation in the north of Sweden. The interviews followed a semi-structured interview guide and were transcribed verbatim and analyzed using thematic analysis. The analysis resulted in the main theme “To dress the participants for a (healthy) life in Sweden,” with two sub-themes “Knowledge—a key to health” and “Being a guide for participants in a new context.” In their work with civic orientation for newly arrived migrants, civic communicators are involved in health promotion by preparing their participants for a life in Sweden. They work to empower their participants to be able to make informed decisions and live healthy lives by both providing information to enhance knowledge and skills. They also work to guide them through the complexity of being in a new situation and country. 

Background: The present study was conducted to estimate the prevalence rate of domestic violence against women and examine the socio-demographic status of the victims of domestic violence in India. The study also examined the differences in the prevalence of emotional, physical, and sexual violence against ever-married women over ten years (2005 - 2015) in all member states in India.

Methods: The study used secondary data from NFHS-3 (2005-06) and NFHS-4 (2015-16). Cross-tabulation and multivariate analyses were performed. IBM SPSS V25 was used for data analysis. 

Results: The prevalence of domestic violence against married women in India in 2015 was as follows: emotional violence, 13%; physical violence, 28%; and sexual violence, 7%. Rajasthan achieved the highest decline in the prevalence of domestic violence against women over the last ten years since 2005. In addition, younger age, urban residence, lower level of education and lower socioeconomic status were essential predictors of domestic violence. 

Conclusions: There should be an improvement in female education, awareness generation regarding their rights, and better social support to reduce the prevalence of violence against women. In addition, engaging men in the fight against domestic violence could bring positive results.