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  • 1.
    Höjer, Bengt
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Another childhood narrative - to be a shoe shiner boy in Hanoi2005In: Health and Human Rights: An International Journal, ISSN 1079-0969, E-ISSN 2150-4113, Vol. 8, no 1, p. 137-56Article in journal (Refereed)
  • 2.
    Höjer, Bengt
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Can biomedical and and traditional health care providers work together?: Zambian practitioners´experiences and attitudes to collaboration in relation to care of STIs and HIV/AIDS2006In: Human Resources for Health, ISSN 1478-4491, E-ISSN 1478-4491, Vol. 4, no 16Article in journal (Refereed)
    Abstract [en]

    Background The World Health Organization's World health report 2006: Working together for health underscores the importance of human resources for health. The shortage of trained health professionals is among the main obstacles to strengthening low-income countries' health systems and to scaling up HIV/AIDS control efforts. Traditional health practitioners are increasingly depicted as key resources to HIV/AIDS prevention and care. An appropriate and effective response to the HIV/AIDS crisis requires reconsideration of the collaboration between traditional and biomedical health providers (THPs and BHPs). The aim of this paper is to explore biomedical and traditional health practitioners' experiences of and attitudes towards collaboration and to identify obstacles and potential opportunities for them to collaborate regarding care for patients with sexually transmitted infections (STIs) and HIV/AIDS. Methods We conducted a cross-sectional study in two Zambian urban sites, using structured questionnaires. We interviewed 152 biomedical health practitioners (BHPs) and 144 traditional health practitioners (THPs) who reported attending to patients with STIs and HIV/AIDS. Results The study showed a very low level of experience of collaboration, predominated by BHPs training THPs (mostly traditional birth attendants) on issues of safe delivery. Intersectoral contacts addressing STIs and HIV/AIDS care issues were less common. However, both groups of providers overwhelmingly acknowledged the potential role of THPs in the fight against HIV/AIDS. Obstacles to collaboration were identified at the policy level in terms of legislation and logistics. Lack of trust in THPs by individual BHPs was also found to inhibit collaboration. Nevertheless, as many as 40% of BHPs expressed an interest in working more closely with THPs. Conclusion There is indication that practitioners from both sectors seem willing to strengthen collaboration with each other. However, there are missed opportunities. The lack of collaborative framework integrating maternal health with STIs and HIV/AIDS care is at odds with the needed comprehensive approach to HIV/AIDS control. Also, considering the current human resources crisis in Zambia, substantial policy commitment is called for to address the legislative obstacles and the stigma reported by THPs and to provide an adequate distribution of roles between all partners, including traditional health practitioners, in the struggle against HIV/AIDS.

  • 3.
    Höjer, Bengt
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Young sex workers telling their life histories2005In: Childhood, ISSN 0907-5682, E-ISSN 1461-7013, Vol. 12, no 3, p. 391-411Article in journal (Refereed)
  • 4. Kabir, Z
    et al.
    Tischelman, C
    Aguero-Torres, H
    Chowdury, AMR
    Höjer, Bengt
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Gender and rural-urban differences in reported health status by older people in Bangladesh2003In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, no 37, p. 77-91Article in journal (Refereed)
  • 5. Kaboru, Berthollet Bwira
    et al.
    Muchimba, Maureen
    Falkenberg, Torkel
    Höjer, Bengt
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faxelid, Elisabeth
    Quality of STIs and HIV/AIDS care as perceived by biomedical and traditional health care providers in Zambia: are there common grounds for collaboration?2008In: Complementary Therapies in Medicine, ISSN 0965-2299, E-ISSN 1873-6963, Vol. 16, no 3, p. 155-162Article in journal (Refereed)
    Abstract [en]

    Objective: To explore biomedical and traditional health care providers' (BHPs and THPs, respectively) perceptions of good quality of care and opinions on weaknesses in the services they provide to patients with STIs and HIV/AIDS.

    Methods: Using data from a cross-sectional survey, we post-coded two open-ended questions related to THPs' and BHPs' perceptions on good quality of care and on provided care. The post-coding was done following Donabedian's framework of assessment of quality of care, and allowed transformation of qualitative data into quantitative. The analysis is based on comparison of frequencies, proportions and subsequent chi-square tests and odds ratios.

    Setting: Ndola and Kabwe, Zambia Main measures: Proportions of responses from 152 BHPs and 144 THPs.

    Results: Substantial proportions of providers from both sectors perceived drugs availability (63% of BHPs and 70% of THPs) and welcoming attitude (73% of BHPs and 64% of THPs) as important components of good quality care. BHPs were more likely than THPs to mention proper examination, medical management (provider's technical ability) and explanation of causes and prognosis of the disease as important. More THPs than BHPs cited short waiting time and cost of care. A majority of BHPs (87%) and of THPs (80%) reported deficiencies in their STIs and HIV/AIDS-related services. Both groups regarded training of providers and nutritional support and health education to patients as lacking. None of the THPs alluded to voluntary counselling and testing (VCT) or supportive/home-based care as aspects needing improvement.

    Conclusion: Drugs availability and Welcoming attitude were two aspects of quality highly valued by THPs and BHPs. Future collaborative interventions need to respond to aspects of joint concern including training of providers, nutritional support and health education to patients. Further, there is an imperative of expanding and adapting VCT, home-based care and palliative care to THPs for better care of STIs and HIV/AIDS.

  • 6. Khe, ND
    et al.
    Eriksson, B
    Phuong, DN
    Höjer, Bengt
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Diwan, V
    Faces of poverty: sensitivity and specificity of economic classification in rural Vietnam2003In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 31(Suppl. 62), p. 70-75Article in journal (Refereed)
  • 7.
    Klingberg-Allvin, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    Graner, Sophie
    Phuc, Ho Dang
    Höjer, Bengt
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johansson, Annika
    Pregnancies and births among adolescents: a population based prospective study in rural Vietnam2010In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 1, no 1, p. 15-19Article in journal (Refereed)
    Abstract [en]

    Objective. To describe birth rates and pregnancy outcomes, specifically stillbirth, preterm delivery and low birth weight (LBW) in relation to socio-demographic characteristics, among adolescent women in a rural district in northern Vietnam.

    Material and method. Within an epidemiological field laboratory, quarterly surveillance of 7767 adolescent women in the ages 15–19 during the period January 1999 to December 2005 was conducted. Birth rates were calculated and pregnancy outcomes were described in relation to background factors.

    Result. A total of 1021 pregnancies were reported by 926 adolescent women during the period of whom 17% were below 18years. The estimated adolescent birth rate during 1999–2005 was 27/1000 women-years. The incidence of stillbirth among all births was 19/1000 births. These were more likely to be delivered preterm. The incidence of preterm deliveries and LBW infants was 193 and 75 per 1000 live births, respectively. There were no differences in socio-demographic background for stillbirth, preterm delivery or LBW.

    Conclusion. Adolescent birth rates were similar to those found in the recent Vietnamese DHS and considerably lower than the average for South-East Asia. Higher rates of stillbirth and preterm delivery were found than those previously reported for Vietnam, indicating the need for careful monitoring of adolescent pregnancies and their infants. Further research is needed to explore if and how much socio-demographic variables influence pregnancy outcome, comparing more differentiated groups, as a basis for interventions to assure access to adequate reproductive health care services for all women.

  • 8. Rubenson, B
    et al.
    van Anh, NT
    Höjer, Bengt
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Child domestic servants in Hanoi. Who are they and how do they fare?2004In: The International Journal of Children's Rights, ISSN 0927-5568, E-ISSN 1571-8182, Vol. 11, no 4, p. 391-408Article in journal (Refereed)
  • 9. Warenius, Linnea
    et al.
    Pettersson, Karen O.
    Nissen, Eva
    Höjer, Bengt
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Chishimba, Petronella
    Faxelid, Elisabeth
    Vulnerability and sexual and reproductive health among Zambian secondary school students2007In: Culture, Health and Sexuality, ISSN 1369-1058, E-ISSN 1464-5351, Vol. 9, no 5, p. 533-544Article in journal (Refereed)
    Abstract [en]

    The present study aimed to explore secondary school students' needs in relation to sexual and reproductive health in order to inform efforts to improve the quality of health services available to young people. The study involved data collection from 716 11-22-year-old students in four secondary schools in an urban area in Zambia. Students completed a questionnaire and were invited to write down any inquiries they had regarding sexuality and reproduction. Findings revealed that boys and girls lack adequate information about human reproduction and STIs, including HIV. To avoid misconceptions and myths, they also need clear information on contraceptives and masturbation. Responses indicate that young people would welcome guidance and support related to contraception, pregnancy, abortion and STIs/HIV, but also on love and relationships. Culture, religion and gender are important factors influencing sexuality and sexual abuse. These issues need to be taken into consideration when developing youth-friendly programmes for young people.

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