How Public Health Crises Expose Systemic, Day-to-Day Health Inequalities in Low- and-Middle Income Countries - An Example From East Africa

Davis, Alicia; Lembo, Tiziana; Laurie, Emma; Mutua, E.; Loosli, Kathrin; Nthambi, Mary; Nimegeer, Amy; Mnzava, Kunda; Msoka, Elizabeth F.; Nasuwa, Fortunata; Melubo, Matayo; Shirima, Gabriel; Matthews, Louise; Hilton, Shona; Mshana, Stephen E.; Mmbaga, Blandina T

doi:10.2139/ssrn.3772756

Cited by 2 publications

(2 citation statements)

References 2 publications

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“…The historical shift from a socialist to a neoliberal public health system in Tanzania impacted inequities in healthcare access 85. Factors important for Maasai participants to trust and access care are similar to those reported since this transition to more recently in Tanzania including availalbility of diagnostics and medicines, competent health workers and respectful communication 86–88. Trust among indigenous groups is further complicated by historical experiences of being misled and marginalised.…”

Section: Discussionmentioning

confidence: 77%

The role of cultural safety and ethical space within postcolonial healthcare for Maasai in Tanzania

Mtuy

Mepukori²,

Seeley³

et al. 2022

BMJ Glob Health

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The history of the Maasai tribe in northern Tanzania is characterised by marginalisation, discrimination and political subjugation. Inequities, enacted through power relations, influence healthcare access, practices and outcomes among the Maasai. Cultural safety and ethical space provide lenses into social, political and historical influences on access to care, helping to understand the realities of historically marginalised populations such as the Maasai, and responses to health services. This study aims to examine Maasai experiences of accessing and uptake of health services within a postcolonial discourse in Tanzania. In an ethnographic study examining access and perceptions of healthcare services in Maasai communities, lead authors conducted participant observations and at health facilities to document experiences. Household interviews, a group oral history and interviews with NGOs working with Maasai communities, contributed to the data analysed. Inductive thematic analysis was used to understand healthcare experiences within a framework of cultural safety and ethical space. Despite trust in biomedicine, Maasai people have a strong desire for health services with particular characteristics. Quality of care, including facilities and diagnostics available and used, was important. A sense of fairness was a determinant in respecting services including ‘first come first serve’ system and transparency when unable to treat a condition. Trust in health services was also influenced by personal interactions with health workers, including provision of health information provided to patients and instances of being mistreated. These findings offer an understanding of ways in which spaces of healthcare can be more approachable and trusted by Maasai. Incorporating cultural safety and ethical spaces to understand healthcare access can help to reduce the power imbalance possibly resulting from a history of marginalisation. This can inform development of culturally appropriate programmes, used to educate healthcare professionals and advocate for improved healthcare services for marginalised groups.

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Section: Discussionmentioning

confidence: 77%

The role of cultural safety and ethical space within postcolonial healthcare for Maasai in Tanzania

Mtuy

Mepukori²,

Seeley³

et al. 2022

BMJ Glob Health

View full text Add to dashboard Cite

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“…The fear of mortality due to the pandemic has been high, 2 while health care services focus on the pandemic. The availability of staff and accessible quality medications play an essential role in responding to the outbreak and are considered critical bodies of health infrastructure 3 . On the contrary, the understaffing and the lack of drug supply pose a challenge to the health systems, thus impelling poor health outcomes 3 …”

Section: Introductionmentioning

confidence: 99%

Curbing antimicrobial resistance in post‐COVID Africa: Challenges, actions and recommendations

Shomuyiwa

Lucero‐Prisno

Manirambona

et al. 2022

Health Science Reports

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Background Antimicrobial self‐medication and use have significantly increased in the COVID‐19 era—increasing antibiotic consumption and resulting in a high prevalence of antimicrobial resistance in Africa (AMR). We conducted a narrative review to investigate challenges associated with curbing AMR in a post‐COVID‐19 setting in Africa, suggesting practical measures applicable for policy‐informed implementation. Method A narrative review was performed to pinpoint AMR challenges and actions on the African continent. A comprehensive search was conducted in the scientific databases that include PubMed, PubMed Central and Google Scholar using predetermined search terms. Results The emergence of the COVID‐19 outbreak has added to the challenges of tackling AMR on the continent, which has jeopardized AMR interventions' hard‐won gains. Identified challenges have been Health systems disruption, Irrational Antimicrobial Use, Weak Antimicrobials Regulatory Ecosystem, Inefficient Population Infection Prevention, and Control Practices, Inadequate access to Health Services and data challenge on AMR surveillance. Conclusion The COVID‐19 pandemic fueled AMR in Africa. There is a need for AMR control post‐COVID, such as measures for ongoing antimicrobial stewardship and good infection control practices. Further, curbing AMR requires rigorous regulatory enforcement and efficient AMR Surveillance. There should be a body to raise AMR awareness among the population. Research, Innovation and Technology could play an essential role supported by capacity building and global partnership.

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How Public Health Crises Expose Systemic, Day-to-Day Health Inequalities in Low- and-Middle Income Countries - An Example From East Africa

Cited by 2 publications

References 2 publications

The role of cultural safety and ethical space within postcolonial healthcare for Maasai in Tanzania

The role of cultural safety and ethical space within postcolonial healthcare for Maasai in Tanzania

Curbing antimicrobial resistance in post‐COVID Africa: Challenges, actions and recommendations

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