Health Sciences - Theses, Dissertations, and other Required Graduate Degree Essays

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Indigenous knowledge and health: exploring and comparing mainstream academic and Indigenous community perspectives

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

There is a global priority to protect and revitalize Indigenous knowledge (IK) and increasing evidence suggests that IK is critical to restoring health and well-being in indigenous communities. How do the dominant cultural perceptions of health-related IK (HRIK) compare with those of an indigenous community whose culture has been eroded? A systematic review of the literature and a brief ethnographic pilot study in a Secwepemc community in British Columbia revealed that mainstream academic perceptions of HRIK often fail to recognize the potential applications of IK in connections between the well-being of the individual, the community, and all aspects of the ecosystem. Culturally-rooted community priorities such as language, stories, and ceremony are absent in mainstream academic depictions of HRIK. Research that incorporates the community’s perceptions of HRIK, validated in terms accepted by mainstream academicians and policy-makers as well as indigenous groups themselves, may help communities restore their cultures and health.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Craig Janes
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.Sc.)

Opportunities for action to improve the mental health of young children

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Infant-child mental health promotion and mental disorder prevention strategies are effective in reducing risk factors associated with poor mental health outcomes in adulthood. The purpose of this paper is to inform the policy development process as it relates to infant-child mental health programming in British Columbia. Key informants from early childhood development sectors across BC were interviewed and provided their perspectives on challenges and opportunities for improvement in this area. Findings suggest a need to reorient the health system away from a focus on treatment, to services aimed at promotion and prevention. Barriers to such activities include lack of understanding about the importance of early childhood social-emotional development in the life course, lack of access to research that identifies ‘what works’, and lack of outcome evaluation data. Increased collaboration within systems of service delivery was also identified as a necessary component to support healthy social-emotional development in early childhood.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Craig Janes
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Women’s nutritional and hygienic knowledge in Madagascar: a qualitative health needs assessment of the Anosy region

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Poor nutritional and hygienic practises continue to fuel high morbidity and mortality rates related to malnutrition in Madagascar. This study investigates women’s nutritional and hygienic knowledge in order to characterize health needs in the Anosy region of Madagascar. Here, women govern nutritional and hygienic practises, including meal preparation and child care, and thus are in a position to provide invaluable input in qualifying local needs. Eight focus groups of 13-60 women each were conducted in the seven most impoverished communes of the Anosy, and a qualitative analysis was done. Participants were recruited with the aid of a local NGO, Azafady. An important finding of the study was that women demonstrated a basic understanding of nutrition and hygiene and outlined the need to reduce nutritional and hygienic practise barriers. These findings should be used to prioritize projects and research seeking to improve nutrition and hygiene in the Anosy region.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Susan Erikson
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Beyond the pilot project: a review of the diffusion of ecological sanitation toilets

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Over 2.6 billion people lack safe sanitation. EcoSan toilets are an affordable technology that, used appropriately, minimize environmental and health problems associated with waterborne sewerage and pit latrines. A challenge for population health is how to encourage widespread adoption, known as diffusion or scale-up. This paper employs Diffusion of Innovations constructs to illuminate EcoSan toilet adoption factors in diverse settings. EcoSan toilets were found in 55 countries. Experiences in seven countries are compared. Findings include: a tendency for greater proliferation in federally-driven sanitation programs; successes in surmounting traditional disgust with excreta; a relationship between utilization and follow-up; and the importance of user acceptance before attempting to routinize construction. Included is a theoretical framework of EcoSan diffusion as a two-tiered, parallel innovation-decision making process, where the decisions of implementers and administrators and intended beneficiaries overlap and interact. Maximizing adoption from both groups is key for scaling up pilots to nations.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Kitty Corbett
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Diseases of affluence no longer: non-communicable disease mortality as a policy priority in South Asia

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Non-communicable diseases (NCD), historically considered to be associated with affluent regions, now comprise the greatest burden of disease in nearly every region of the world. Cardiovascular disease (CVD) mortality is foremost among these with approximately 80% of CVD deaths occurring in the developing world. Disease burden comparisons are infrequent in developing regions since the respective health infrastructures often lack the capacity to collect comprehensive mortality data. Sri Lanka and Maldives are two South Asian countries with such capacity and have recently begun keeping mortality data with electronic records. This descriptive study is the first to have made use of the data in order to gauge these nations’ NCD burdens relative to selected developed nations and identify priority areas for further investigation and policy discussion. Results show that Sri Lanka and Maldives display the highest age-standardized mortality rates for overall NCDs, CVD, hypertension and COPD.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Michel Joffres
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Evaluating food security in Nunavut: preliminary results from the Inuit Health Survey

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

This research paper reports on the food security status, general household and country food (CF) characteristics of the Kivalliq and Qikiqtaaluk regions in Nunavut. A community-participatory, cross-sectional Inuit Health Survey was conducted among self-identified Inuit adults in the Canadian north in the summer and fall of 2007 and 2008. A total of 1,038 randomly selected households completed a household questionnaire. Food insecurity affected 70.5% of participating Inuit households; 32.2% of households were moderately food insecure and 38.3% were severely food insecure. Households with children reported significantly higher rates of food insecurity (p=0.0056) and severe food insecurity (p=0.0001) compared to households without children. Approximately 65% of Inuit households reported an active hunter, 79% would prefer to eat more CF than they can get, and 54% of households relied on family and friends for CF. Inuit-specific data for Nunavut will inform future monitoring activities and help guide future policies and programs.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Lorraine Halinka Malcoe
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Moving From paradigm to practice: the Ashodaya sex worker empowerment project in Mysore India and its promise for HIV/AIDS prevention

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Empowerment has gained prominence in the field of public health as creating enabling environments is increasingly being conceptualized as fundamental to marginalized populations’ ability to enact public health messages. Yet empowerment’s application requires further investigation in order to comprehend how successful strategies can be applied in future contexts. Ashodaya Samithi, a sex worker collective in India produced positive health advances through empowerment processes. It has reported a reduction in sexually transmitted infections and increased condom use. As the HIV prevalence rate in India is 0.36 percent, and 11 percent to 90 percent amongst sex workers, their engagement in HIV prevention is instrumental. However, sex worker interventions have been widely criticized for their stigmatizing influence and ineffectiveness. Qualitative research with the Ashodaya collective demonstrates the promise empowerment-based projects hold for subverting vulnerabilities, transforming risk, and preventing the spread of HIV.

Document type: 
Thesis
File(s): 
Supervisor(s): 
S
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

HIV/TB co-infection:perspectives of TB patients and providers on the integrated HIV/TB pilot program in Tamilnadu, India

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

The WHO recommends routine HIV testing among TB patients as a key strategy to combat the dual HIV/TB epidemic. India has integrated its HIV and TB control programs and is offering provider initiated HIV testing for all TB patients since 2007. Using a mixed methods approach, this study aims to understand the perspectives of TB patients and providers on the integrated HIV/TB pilot program in Tamilnadu, India. A survey conducted by the Tuberculosis Research Center, India on 300 TB patients is the source for quantitative data and in-depth interviews conducted by the researcher with ten health care providers constitute the qualitative data. Findings of this study show that HIV testing among TB patients is feasible and acceptable in this setting. However, as identified by the providers, barriers like social stigma for HIV/AIDS and lack of adequate counseling services exist, which when addressed appropriately, could maximize uptake of the continuing program.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Arun Chockalingam
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Towards obesity prevention in British Columbia: A critical discourse analysis of key policy reports.

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

The government of British Columbia has made a commitment to applying population health and inequalities lenses to intervention strategies to ensure that vulnerable populations are of high priority. This study uses critical discourse analysis to examine two key policy reports to determine the types of public health frameworks used to guide obesity prevention and intervention strategies in British Columbia. The study found that a number of public health frameworks were being applied to obesity prevention and intervention strategies; however, risk factor epidemiology emerged as the dominant approach. The dominant use of this approach in public health intervention strategies can have negative consequences for vulnerable populations as it may overlook underlying social and structural determinants of health. The study discusses the repercussions of using this approach and makes recommendations to the provincial government for strategies that can be used to reduce inequalities experienced by vulnerable populations in British Columbia.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Lorraine Halinka Malcoe
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

The Cedar Project: Surviving the Streets Without Shelter, Trauma and HIV vulnerability among Aboriginal young people who use drugs in two Canadian cities

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Aboriginal scholars suggest that the legacy of colonialism is a key contributing factor to rising rates of homelessness among Aboriginal young people. This analysis examined factors related to sleeping on the streets for 3 nights or more and HIV vulnerability among Aboriginal young people who use drugs. A profile of these young people was created using data from the Cedar Project. Young people who reported sleeping on the streets for 3 nights or more were significantly more likely to reside in Vancouver, report HIV or HCV positive antibody status, have a diagnosed mental illness, and report being sexually abused or sexually exploited. Aboriginal females were more likely than males to report HIV or HCV positive antibody status, previous sexual abuse and previous sexual exploitation. Having a stable place to sleep is critically important to enhancing health promotion efforts and resiliency for Aboriginal young people who use drugs.

Document type: 
Thesis
File(s): 
Supervisor(s): 
M
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)