While the impact of remittances upon the economic conditions of the sending communities has received much attention, the effects of international migration on women's position in society among the leftbehind have not been adequately explored. This paper examines the changes in the leftbehind women's position at the family level as a result of the migration of adult men overseas. Data came from a demographic surveillance system covering 70 villages in Bangladesh. All migrant families having at least one male member working abroad for more than six months were identi®ed in the study villages in 1996. A comparable number of non-migrant families were selected at random from the same villages to yield a total sample of 1030 families. In-depth interviews were conducted with adult women of the sample families. Findings reveal that the overseas migration of adult males has a signi®cant positive association with women's decision-making capacity and education of girls in the migrant families. The remittances as well as the in¯uence of secular values have reduced the practice of dowry in marriages. Multivariate analysis suggests not only that remittances have increased the ®nancial capacity of the migrant families, but also that secular in¯uences from overseas might have modi®ed the position of women when the role of other socio-economic factors is controlled. The study concludes that the overseas migration of adult men can create a context for change of the women's position in traditional communities.
Sexual violence against women has never been new in history. What is new in the developmental literature is the discovery that this kind of act is wrong and has direct impact on women's health. Using data from a nationally representative sample, this article attempts to improve our understanding about the prevalence and determinants of sexual violence within marriage in Bangladesh. Findings reveal that the probability of a woman to be sexually abused increases if she is young and illiterate and hails from a landless, poor family. The risk of sexual abuse is less among women who participate in credit programs and financially contribute to their families. The article concludes that the context of sexual violence can be changed by involving vulnerable women in productive activities.
BackgroundThe major chronic non-communicable diseases (NCDs) operate through a cluster of common risk factors, whose presence or absence determines not only the occurrence and severity of the disease, but also informs treatment approaches. Primary prevention based on mitigation of these common risk factors through population-based programmes is the most cost-effective approach to contain the emerging epidemic of chronic NCDs.ObjectivesThis study was conducted to explore the extent of risk factors clustering for the major chronic NCDs and its determinants in nine INDEPTH Health and Demographic Surveillance System (HDSS) sites of five Asian countries.DesignData originated from a multi-site chronic NCD risk factor prevalence survey conducted in 2005. This cross-sectional survey used a standardised questionnaire developed by the WHO to collect core data on common risk factors such as tobacco use, intake of fruits and vegetables, physical inactivity, blood pressure levels, and body mass index. Respondents included randomly selected sample of adults (25–64 years) living in nine rural HDSS sites in Bangladesh, India, Indonesia, Thailand, and Vietnam.ResultsFindings revealed a substantial proportion (>70%) of these largely rural populations having three or more risk factors for chronic NCDs. Chronic NCD risk factors clustering was associated with increasing age, being male, and higher educational achievements. Differences were noted among the different sites, both between and within country.ConclusionsSince there is an extensive clustering of risk factors for the chronic NCDs in the populations studied, the interventions also need to be based on a comprehensive approach rather than on a single factor to forestall its cumulative effects which occur over time. This can work best if it is integrated within the primary health care system and the HDSS can be an invaluable epidemiological resource in this endeavor.
BackgroundRecognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs.MethodsA working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes) for Canadian Family Medicine training.ResultsThe main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS) competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies.ConclusionsThe shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the framework. The process used to develop this framework can be applied to other aspects of residency curriculum development.
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