Background: Tobacco advertising in Indonesia is among the most aggressive and innovative in the world, and tobacco advertisements saturate the environment. Tobacco companies are politically and financially powerful in the country because they are one of the largest sources of government revenue. As a result, there are few restrictions on tobacco marketing and advertising. National surveys reveal that 62% of men and 1% to 3% of women are smokers.
This pilot study suggests that it is more appropriate to think of avian flu as a bio-social and bio-political challenge for Indonesia than merely an epidemiological challenge involving a disease of zoonotic origin. Our examination of popular perceptions of avian flu in Central Java reveals important differences of opinion about which types of fowl are responsible for avian flu transmission and the degree of risk H5N1 poses to humans. The opinions of backyard farmers and commercial poultry farmers are motivated by different forms of practical logic and are differentially influenced by media accounts, government education programmes, foreign aid and rumours about who stands to profit from the disease. Rumours reflect collective anxieties about globalization, the agenda of big business and the trustworthiness of the national government. We also illustrate how a commodity chain analysis can assist in the identification of different stake-holders in the informal and formal poultry industries. The position of each stake-holder needs to be considered in any comprehensive investigation of avian flu. An economic analysis of the capital investment of stake-holders provides insight into how each responds to government directives about the reporting of dead chickens, vaccinating birds etc. Finally, we call for research on avian flu preparedness attentive to Indonesia's de-centralized form of political rule and the social organization of communities so that clear lines of communication and command can be established and mutual assistance mobilized.
We found that owning land and that the highest and lowest categories of reported household income were associated with higher serum retinol levels. We also noted clustering of serum retinol levels by village and discovered that children from larger sibships and infants had significantly lower serum retinol levels. Vitamin A supplementation of lactating mothers, particularly of high parity, and/or their infants should be considered.
BackgroundThe INDEPTH Training & Research Centres of Excellence (INTREC) collaboration developed a training programme to strengthen social determinants of health (SDH) research in low- and middle-income countries (LMICs). It was piloted among health- and demographic researchers from 9 countries in Africa and Asia. The programme followed a blended learning approach and was split into three consecutive teaching blocks over a 12-month period: 1) an online course of 7 video lectures and assignments on the theory of SDH research; 2) a 2-week qualitative and quantitative methods workshop; and 3) a 1-week data analysis workshop. This report aims to summarise the student evaluations of the pilot and to suggest key lessons for future approaches to strengthen SDH research capacity in LMICs.MethodsSemi-structured interviews and questionnaires with 24 students from 9 countries in Africa and Asia were used to evaluate each teaching block. Information was collected about the students’ motivation and interest in studying SDH, any challenges they faced during the consecutive teaching blocks, and suggestions they had for future courses on SDH.ResultsOf the 24 students who began the programme, 13 (54%) completed all training activities. The students recognised the need for such a course and its potential to improve their skills as health researchers. The main challenges with the online course were time management, prior knowledge and skills required to participate in the course, and the need to get feedback from teaching staff throughout the learning process. All students found the face-to-face workshops to be of high quality and value for their work, because they offered an opportunity to clarify SDH concepts taught during the online course and to gain practical research skills. After the final teaching block, students felt they had improved their data analysis skills and were better able to develop research proposals, scientific manuscripts, and policy briefs.ConclusionsThe INTREC programme has trained a promising cadre of health researchers who live and work in LMICs, which is an essential component of efforts to identify and reduce national and local level health inequities. Time management and technological issues were the greatest challenges, which can inform future attempts to strengthen research capacity on SDH.
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