Parallel session 1B: International perspectives on public health
Franshelis Garcia - Stigma towards Bariatric Surgery: Prevalence and impact in the Netherlands, France and England
Bariatric surgery is an increasingly used method to battle obesity and obesity related comorbidities. However, like obesity, bariatric surgery is highly stigmatized with patients being viewed as lazy, cheaters, and taking the easy way out. Negative attitudes towards bariatric surgery are held by both the general public and healthcare professionals and may discourage people with obesity from considering the surgery or impact well-being and everyday life post-surgery.
This project explores the perceptions, experiences and consequences of bariatric surgery from the perspective of individuals with obesity who are considering surgery, post bariatric surgery patients, the general public and healthcare professionals. The study also explores the extent to which this stigma is context and culture-dependent by comparing three European countries, the Netherlands, France, & England. Despite these countries being geographically and socioeconomically close, their approaches to tackle obesity differ significantly.
This research project will use a convergent mixed-methods research design to collect, analyze and interpret the data. In this type of design, both quantitative and qualitative data are collected, however, the results of one do not depend on the results of the other as each method is equally important for addressing the research questions and objectives.
Relevance and expected results
First this project will lead to in-depth knowledge on bariatric surgery stigmatization by studying stigma from different perspectives. Second, it will contribute to theory development by applying attribution theory and Health Stigma theories as conceptual models. Third, the research will provide insights into how bariatric surgery stigma is socially constructed and maintained by comparing three European countries. Finally, the research will be unique in combining quantitative and qualitative data to gain a full understanding of the topic.
Keyword: Stigma, Bariatric Surgery, Cross-Cultural
Zinzi Pardoel - Core health-components, contextual factors and program elements of community-based interventions in Southeast Asia – a realist synthesis regarding hypertension and diabetes
In Southeast Asia, diabetes and hypertension are the leading cause of death. Community-based interventions can achieve the required behavioural change for better prevention. The aims of this review are 1) to assess the core health-components of community-based interventions and 2) to assess which contextual factors and program elements affect their impact in Southeast Asia.
A r ealist review was conducted, combining empirical evidence with theoretical understanding. Documents published between 2009 and 2019 were systematically searched in PubMed/Medline, Web of Science, Cochrane Library, Google Scholar and PsycINFO and local databases. Documents were included if they reported on community-based interventions aimed at hypertension and/or diabetes in Southeast Asian context; and had a health-related outcome; and/or described contextual factors and/or program elements.
We retrieved 67 scientific documents and 12 grey literature documents. We identified twelve core health-components: community health workers, family support, education, comprehensiveness, physical exercise, telehealth, peer support, empowerment, self-efficacy, lifestyle advice, trust, and storytelling. In addition, we found ten contextual factors and program elements that may affect the impact: implementation problems, group-based, cultural sensitivity, synergy, access, family health/worker support, gender, involvement of stakeholders, and referral and education services when giving a lifestyle advice.
We identified a considerable number of core health-components, and contextual influences and program elements of community-based interventions to improve diabetes and hypertension prevention. Main innovative outcomes were that telehealth can substitute primary healthcare in rural areas, that storytelling is a useful context-adaptable component, and that comprehensive interventions are more effective than single target interventions. This extends the understanding of the core health-components that are most promising, including which elements and in what Southeast Asian context.
Keywords: Community-based interventions, Southeast Asia, Non-communicable diseases
Ratna Juwita - Understanding the Typology of Health Sector Corruption in Indonesia
Theoretical with secondary empirical data based on the case-law documents.
The focus of the paper is to describe the typology of health sector corruption in Indonesia. Subsequently, to analyze how the pattern of corruption impacts on the realization of the right to health in Indonesia.
This research uses an empirical legal method by obtaining data on corruption in health and education sectors through the collection of electronic case-law documents from the Indonesian Supreme Court Case Law database. The theoretical legal framework is formed by the international laws and policies concerning anti-corruption and human rights applicable to Indonesia. The typology of corruption will be formulated based on the United Nations Convention Against Corruption (UNCAC). The assessment on the impact of corruption will be conducted based on the International Covenant on Economic, Social and Cultural Rights (ICESCR), the General Comments of the Committee on Economic, Social and Cultural Rights (Comm ESCR), and relevant case law.
Corruption exists in myriad forms in the health sector at the central and regional governmental level. The perpetrators are public officials (executive, legislative and judicative organs), and some cases involve private actors. This study shows that grand corruption in state procurement of health project is the most prevalent type of corruption.
Implications: The insights derived from this study is a better understanding of the typology of corruption in the health sector. This understanding can be utilized to design a further mechanism to combat corruption in these sectors and to better implement the human right to health.
Keywords: right to health, corruption, Indonesia.
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