Situating zoonotic diseases in peacebuilding and development theories: Prioritizing zoonoses in Jordan.

Zoonotic diseases are projected to be a serious public threat in the coming decades. In 2016, the World Health Organization (WHO) recommended that Jordan prioritize their list of zoonoses, partially in response to the influx of Syrian refugees. We write this paper to expand the One Health framework by situating zoonotic diseases in peacebuilding and development theories in order to prioritize zoonotic diseases in Jordan. We employ an explanatory sequential mixed methods approach to create a modified version of the Center for Disease Control's (CDC) One Health Zoonotic Disease Prioritization (OHZDP) tool. We use an integrative literature review to develop a list of zoonoses to be prioritized. We expand the One Health framework by arguing health inequity is a form of violence, and thus promotion of health equity is a form of peacebuilding. We undertake thematic and statistical analyses to assess the 12 previously published OHZDP tools to evaluate necessity for change to the process given COVID-19 and the refugee situation in Jordan. In these analyses we use drivers of health indicators as measurements for peacebuilding and development, given these drivers are related to health inequities, to guide weighting of the criteria in our tool for Jordan. We apply our modified OHZDP tool to prioritize our disease list. We find it necessary to give socioeconomic factors greater consideration and to distribute weighting more evenly among all criteria within the tool when prioritizing zoonotic diseases in better reflect the Jordanian context and incorporate the refugee population. We find the priority zoonoses within Jordan to be bovine tuberculosis, brucellosis, and COVID-19, with most having a disproportionately negative impact on refugees. In Jordan's case, zoonotic diseases represent an area where promoting social equity for individuals is essential to the larger society. In this sense managing zoonoses is an area uniquely suited for peacebuilding.

Inequalities in catastrophic health expenditures in conflict-affected areas and the Colombian peace agreement: an oaxaca-blinder change decomposition analysis.

BACKGROUND: The present study analyzes inequalities in catastrophic health expenditures in conflict-affected regions of Meta, Colombia and socioeconomic factors contributing to the existence and changes in catastrophic expenditures before and after the sign of Colombian Peace Agreement with FARC-EP guerilla group in 2016. METHODS: The study uses the results of the survey Conflicto, Paz y Salud (CONPAS) conducted in 1309 households of Meta, Colombia, a territory historically impacted by armed conflict, for the years 2014 and 2018. We define catastrophic expenditures as health expenditures above 20% of the capacity to pay of a household. We disaggregate the changes in inequalities in catastrophic expenditures through the Oaxaca-Blinder change decomposition method. RESULTS: The incidence of catastrophic expenditures slightly increased between 2014 to 2018, from 29.3 to 30.7%. Inequalities in catastrophic expenditures, measured through concentration indexes (CI), also increased from 2014 (CI: -0.152) to 2018 (CI: -0.232). Results show that differences in catastrophic expenditures between socioeconomic groups are mostly attributed to an increased influence of specific sociodemographic variables such as living in rural zones, being a middle-aged person, living in conflict-affected territories, or presenting any type of mental and physical disability. CONCLUSIONS: Conflict-deescalation and the peace agreement may have facilitated lower-income groups to have access to health services, especially in territories highly impacted by conflict. This, consequently, may have led to higher levels of out-of-pocket expenditures and, therefore, to higher chances of experiencing catastrophic expenditures for lower-income groups in comparison to higher-income groups. Therefore, results indicate the importance of designing policies that guarantee access to health services for people in conflict -affected regions but also, that minimize health care inequalities in out-of-pocket payments that may arouse between people at different socioeconomic groups.

The political and security dimensions of the humanitarian health response to violent conflict.

The nature of armed conflict throughout the world is intensely dynamic. Consequently, the protection of non-combatants and the provision of humanitarian services must continually adapt to this changing conflict environment. Complex political affiliations, the systematic use of explosive weapons and sexual violence, and the use of new communication technology, including social media, have created new challenges for humanitarian actors in negotiating access to affected populations and security for their own personnel. The nature of combatants has also evolved as armed, non-state actors might have varying motivations, use different forms of violence, and engage in a variety of criminal activities to generate requisite funds. New health threats, such as the COVID-19 pandemic, and new capabilities, such as modern trauma care, have also created new challenges and opportunities for humanitarian health provision. In response, humanitarian policies and practices must develop negotiation and safety capabilities, informed by political and security realities on the ground, and guidance from affected communities. More fundamentally, humanitarian policies will need to confront a changing geopolitical environment, in which traditional humanitarian norms and protections might encounter wavering support in the years to come.

A light of hope? Inequalities in mental health before and after the peace agreement in Colombia: a decomposition analysis.

BACKGROUND: The present study seeks to evaluate the change in mental health inequalities in the department of Meta after the signing of Colombia's Peace Agreement in 2016 with the FARC guerrilla group. Using a validated survey instrument composed of 20 questions ('SRQ-20'), we measure changes in mental health inequalities from 2014, before the signing of the agreement, to 2018, after the signing. We then decompose the changes in inequalities to establish which socioeconomic factors explain differences in mental health inequalities over time. METHODS: Our study uses information from the Conflicto, Salud y Paz (CONPAS) survey conducted in the department of Meta, Colombia, in 1309 households in 2018, with retrospective information for 2014. To measure inequalities, we calculate the concentration indices for both years. Through the Oaxaca change decomposition method, we disaggregate changes in mental health inequalities into its underlying factors. This method allows us to explain the relationship between changes in mental health inequalities and changes in inequalities in several sociodemographic factors. It also identifies the extent to which these factors help explain the changes in mental health inequalities. RESULTS: Mental health inequalities in Meta were reduced almost by half from 2014 to 2018. In 2018, the population at the lower and middle socioeconomic levels had fewer chances of experiencing mental health disorders in comparison to 2014. The reduction in mental health differences is mostly attributed to reductions in the influence of certain sociodemographic variables, such as residence in rural zones and conflict-affected territories, working in the informal sector, or experiencing internal displacement. However, even though mental health inequalities have diminished, overall mental health outcomes have worsened in these years. CONCLUSIONS: The reduction in the contribution of conflict-related variables for explaining mental health inequalities could mean that the negative consequences of conflict on mental health have started to diminish in the short run after the peace agreement. Nevertheless, conflict and the presence of other socioeconomic inequalities still contribute to persistent adverse mental health outcomes in the overall population. Thus, public policy should be oriented towards improving mental health care services in these territories, given the post-accord context.

Mapping the role of health professionals in peace promotion within an urban complex emergency: the case of Chegutu, Zimbabwe.

The study sought to establish the role of health professionals in promoting peace through health care using a case study of Chegutu Urban District in Zimbabwe. The participants were drawn from health professionals employed in three council clinics and were interviewed on their views on programmes that promote peace and end violence. Their narratives were thematically presented. Results revealed that although the participants had ideas on how to promote peace through health care, did health education and assisted victims of violence, their programmes were inhibited by several challenges, predominantly related to the state of the Zimbabwean economy. The study recommended a systematic focus on these challenges so that the health professionals can realize their potential. The study also recommended further research into the impact of village health workers in community peace and the use of a multisectoral approach to managing artisanal violence.

Conceptual perspectives in mental health and their implications in the context of achieving peace in Colombia. / Perspectivas conceptuales en salud mental y sus implicaciones en el contexto de construcción de paz en Colombia.

This article presents a critical reflection on the conceptual perspectives in mental health, in the quest for new meanings for this concept and its implications in the context of achieving peace in Colombia. For this, an integrative review of the literature was conducted in seven bibliographic databases and search engines. As a result, five conceptual perspectives of mental health were identified: 1) biomedical and behavioral; 2) wellbeing and its potential; 3) cultural; 4) psychosocial; and 5) based on social determination, the epistemological foundations, contributions, criticisms, and limitations of which are described in each case. Finding more pertinence in the proposal of mental health from collective health/social medicine rather than from the classic public health for achieving peace in Colombia, a comprehensive view of mental health that takes into account its socio-cultural relevance from a critical and socio--historical position is proposed.

Este artículo presenta una reflexión crítica sobre las perspectivas conceptuales en salud mental, en busca de nuevos sentidos para este concepto y sus implicaciones en el contexto de construcción de paz en Colombia. Para esto se realizó una revisión integrativa de la literatura, por medio de siete bases de datos bibliográficas y motores de búsqueda. Como resultado, se identificaron cinco perspectivas conceptuales de salud mental: 1) biomédica y conductual, 2) del bienestar y las potencialidades, 3) cultural, 4) psicosocial y 5) de la determinación social, cuyos fundamentos epistemológicos, sus aportes, críticas y limitaciones se describen en cada caso. Al encontrar mayor pertinencia en la propuesta de salud mental desde la salud colectiva/medicina social que desde la salud pública clásica para la construcción de paz en Colombia, se propone una mirada integral de la salud mental que tenga en cuenta su pertinencia socio-cultural desde una posición crítica y socio-histórica.

Perspectivas conceptuales en salud mental y sus implicaciones en el contexto de construcción de paz en Colombia / Conceptual perspectives in mental health and their implications in the context of achieving peace in Colombia

Resumen Este artículo presenta una reflexión crítica sobre las perspectivas conceptuales en salud mental, en busca de nuevos sentidos para este concepto y sus implicaciones en el contexto de construcción de paz en Colombia. Para esto se realizó una revisión integrativa de la literatura, por medio de siete bases de datos bibliográficas y motores de búsqueda. Como resultado, se identificaron cinco perspectivas conceptuales de salud mental: 1) biomédica y conductual, 2) del bienestar y las potencialidades, 3) cultural, 4) psicosocial y 5) de la determinación social, cuyos fundamentos epistemológicos, sus aportes, críticas y limitaciones se describen en cada caso. Al encontrar mayor pertinencia en la propuesta de salud mental desde la salud colectiva/medicina social que desde la salud pública clásica para la construcción de paz en Colombia, se propone una mirada integral de la salud mental que tenga en cuenta su pertinencia socio-cultural desde una posición crítica y socio-histórica.

Abstract This article presents a critical reflection on the conceptual perspectives in mental health, in the quest for new meanings for this concept and its implications in the context of achieving peace in Colombia. For this, an integrative review of the literature was conducted in seven bibliographic databases and search engines. As a result, five conceptual perspectives of mental health were identified: 1) biomedical and behavioral; 2) wellbeing and its potential; 3) cultural; 4) psychosocial; and 5) based on social determination, the epistemological foundations, contributions, criticisms, and limitations of which are described in each case. Finding more pertinence in the proposal of mental health from collective health/social medicine rather than from the classic public health for achieving peace in Colombia, a comprehensive view of mental health that takes into account its socio-cultural relevance from a critical and socio-­historical position is proposed.

Demanding a bigger role: Palestinian women in politics and decision making.

The political participation1 of Palestinian women in its many forms has been significantly influenced by Palestinian history. The male-dominated society and political system have hindered women's prominence in society and in politics. Although slowly on the rise, lack of women's representation and their voices is reflected in the low number of women in higher political echelons and in policy and decision making in general. After the signing of the Oslo Accords in 1993 and 19952 in 1993, women were integrated in state building processes, yet formal female participation was weak and marginalized and their representation, despite women's political activism, remained low and not to the extent hoped for. This paper sheds light on the Palestinian women's involvement in politics and decision making firstly in the pre-Oslo era under non-indigenous Palestinian government and then in the post-Oslo era after the establishment of the Palestinian National Authority, with focus on involvement in negotiations with Israel and internal Palestinian reconciliation efforts. It also focuses on UNSCR 1325, the degree of influence it has had on women's engagement and the mechanisms established to enhance a bigger role for women in politics and decision making, leading towards a larger role in nation-state building and reconciliation and peace negotiations. Recommendations are offered for measures to increase future participation.

A vision for global heath diplomacy in the foreign policy process: using smart power to prevent and resolve international conflict.

In the twenty-first Century, the developed world attempts to provide global health assistance, to poorer countries - at least in part in the pursuit and maintenance of world order and stability. Rarely, however - and in most cases, then on an ad hoc basis - are related foreign policy tools deployed in combination with each other. Nonetheless, there is currently greater openness than ever before to such interdigitation. Not least this reflects the unprecedented challenges of modern political and security conditions - struggling to operate amidst a broader culture of global adverserialism, and conflict which conventional systems of intervention have struggled to successfully resolve. The problems presented in this regard by the Iraq and Afghanistan conflicts have evolved into, and been magnified by, the limited range and availability of effective responses to contemporary threats such as the Islamic State, international terrorism, jihadism, and the Syrian civil war. The risk of further contagion to even more severe world stability concerns that these situations present calls for an urgent restructuring of the way in which foreign policy processes and initiatives work, including systems of coordination and consultation between national and international agencies of defense, diplomacy, and development.