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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.
Davis, Alicia; Lembo, Tiziana; Laurie, Emma; Mutua, Edna; 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.
  • Davis A; School of Social and Political Sciences/Institute of Health and Wellbeing, University of Glasgow, 27 Bute Gardens-Rm 221, Glasgow, G12 8RS, UK. alicia.davis@glasgow.ac.uk.
  • Lembo T; The Boyd Orr Centre for Population & Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK.
  • Laurie E; School of Geographical and Earth Sciences, University of Glasgow, Glasgow, UK.
  • Mutua E; School of Social and Political Sciences/Institute of Health and Wellbeing, University of Glasgow, 27 Bute Gardens-Rm 221, Glasgow, G12 8RS, UK.
  • Loosli K; The Boyd Orr Centre for Population & Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK.
  • Nthambi M; The Boyd Orr Centre for Population & Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK.
  • Nimegeer A; Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
  • Mnzava K; Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences/Bugando Medical Centre, Mwanza, Tanzania.
  • Msoka EF; Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
  • Nasuwa F; Kilimanjaro Christian Medical University College, Moshi, Tanzania.
  • Melubo M; Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
  • Shirima G; Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
  • Matthews L; Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania.
  • Hilton S; The Boyd Orr Centre for Population & Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK.
  • Mshana SE; Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
  • Mmbaga BT; Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences/Bugando Medical Centre, Mwanza, Tanzania.
Antimicrob Resist Infect Control ; 11(1): 34, 2022 02 14.
Article in English | MEDLINE | ID: covidwho-1679967
ABSTRACT

BACKGROUND:

The current Coronavirus disease pandemic reveals political and structural inequities of the world's poorest people who have little or no access to health care and yet the largest burdens of poor health. This is in parallel to a more persistent but silent global health crisis, antimicrobial resistance (AMR). We explore the fundamental challenges of health care in humans and animals in relation to AMR in Tanzania.

METHODS:

We conducted 57 individual interviews and focus groups with providers and patients in high, middle and lower tier health care facilities and communities across three regions of Tanzania between April 2019 and February 2020. We covered topics from health infrastructure and prescribing practices to health communication and patient experiences.

RESULTS:

Three interconnected themes emerged about systemic issues impacting health. First, there are challenges around infrastructure and availability of vital resources such as healthcare staff and supplies. Second, health outcomes are predicated on patient and provider access to services as well as social determinants of health. Third, health communication is critical in defining trusted sources of information, and narratives of blame emerge around health outcomes with the onus of responsibility for action falling on individuals.

CONCLUSION:

Entanglements between infrastructure, access and communication exist while constraints in the health system lead to poor health outcomes even in 'normal' circumstances. These are likely to be relevant across the globe and highly topical for addressing pressing global health challenges. Redressing structural health inequities can better equip countries and their citizens to not only face pandemics but also day-to-day health challenges.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Poverty / Public Health / Social Determinants of Health / Health Services Accessibility Type of study: Experimental Studies / Observational study / Qualitative research / Randomized controlled trials Limits: Animals / Humans Country/Region as subject: Africa Language: English Journal: Antimicrob Resist Infect Control Year: 2022 Document Type: Article Affiliation country: S13756-022-01071-5

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Poverty / Public Health / Social Determinants of Health / Health Services Accessibility Type of study: Experimental Studies / Observational study / Qualitative research / Randomized controlled trials Limits: Animals / Humans Country/Region as subject: Africa Language: English Journal: Antimicrob Resist Infect Control Year: 2022 Document Type: Article Affiliation country: S13756-022-01071-5