Traditional medicine is the main, & often the only, source of medical care for a great proportion of the population of the developing world. Systems of traditional medicine are usually rooted in long-standing cultural traditions, take a holistic approach to health, & are community based. The World Health Organization has long recognized the central role traditional systems of care can play in efforts to provide primary health care, especially in rural areas. This article provides an overview of national policies adopted by African governments following World Health Organization recommendations for the incorporation of traditional & allopathic systems of care. 12 References. [Copyright 2002 Sage Publications, Inc.]
The food riots and demonstrations that occurred in more than 50 countries in 2008 signaled the oncoming global economic recession. Skyrocketing food and fuel prices spurred on violence in poorer countries where there is no social safety net and in places impacted by food insecurity and malnutrition. Today, while the prices for some food staples have retracted a little, the deepening economic recession poses a threat in wealthier nations including the United States and members of the European Union. For example, the shuttering fall in the U.S. stock market in October 2008 resulted in the loss of billions of dollars not only to individual investors but also to states and local municipalities. In this environment, there is a potentially grave threat to the social safety net in the United States including food assistance programs. The World Food Program (WFP) has cited the increase in world food prices as the biggest challenge in its 45‐year history, calling the impact a "silent tsunami" that threatened to plunge millions into hunger. In this volume, practicing and applied anthropologists examine the current global food crisis in a variety of settings including Belize, Cuba, the Dominican Republic, Ethiopia, Lesotho, Mozambique, Tanzania, and the United States. Further, they use a variety of theoretical orientations and methodological approaches to understand the chronic nature of food insecurity and the ways in which global food policies and economic restructuring have resulted in increasing food inequities across the globe. Throughout this volume, the authors make suggestions for combating the global food crisis through the application of anthropological principles and practices.
This article outlines a biocultural approach that employs a mixed‐methods research design to the study of food insecurity in the context of economic transformations in the Monteverde Zone (MVZ), Costa Rica. Using structured survey data related to household (n = 200) and individual level variables as well as on anthropometric measurements, linear regression analyses were run in order to try to predict food insecurity based on biological and cultural data. Additionally, 100 in‐depth, qualitative interviews were carried out with heads of households in order to situate the quantitative findings ethnographically. A multiple linear regression model accounting for 36 percent of the variation in food insecurity was constructed with two predictors: an aggregate index of reported illness symptoms and a categorical variable concerning the strategies employed for the purchase of basic grocery items. Data on reported illness frequency and purchasing strategies predict a sizeable proportion of the variation of food insecurity in the study sample. This highlights the complex, biocultural nature of food insecurity processes.
Rapid economic transformations have both positive and negative consequences for nutrition and health. This article presents data from an area of rural Costa Rica that has experienced a rapid economic shift from dairy farming and coffee production to a mixed economy based increasingly on tourism and to a lesser extent on agriculture. During a one‐year period (2004–2005), sociodemographic, employment, dietary intake, food security, anthropometric, and ethnographic (food habits) data were collected from 148 households in two rural communities. The results show that 50 percent of the households are directly involved in the tourism industry, while many others rely on economic strategies that combine involvement in tourism with agricultural activities. Overall, high rates of food insecurity were documented (with over 70 percent of the households experiencing some level of food insecurity over the previous 12 months). The data also show high rates of caregiver and child overweight and obesity and a diet that varies according to food security status. Syndemics theory, which postulates that the dynamic interaction between co‐occurring conditions magnifies the effects of each one in isolation can be used to understand how malnutrition (overnutrition) related to economic insecurity and overweight and obesity together may be contributing to the rise in chronic diet‐related diseases, such as hypertension and type‐2 diabetes, in the study area. The interactions between these comorbidities point to the need for the development of multidimensional public health interventions that couple individual behavior change and community‐driven efforts that reduce economic insecurity and ameliorate food insecurity, resulting in more balanced diets and a reduction in overweight and obesity.
This article seeks to contribute to efforts toward the identification and critical analysis of sustainable community‐based initiatives that could help to ameliorate the impact of the global food crisis in developing countries. To do so, we present a discussion of a sustainable agriculture program in Lesotho, in sub‐Saharan Africa. We contextualize the discussion in the framework of both the food crisis and the HIV/AIDS pandemic, both of which are taking a major toll in Lesotho. We then present a brief discussion of some of our anthropological contributions to the work of an NGO that is implementing sustainable agriculture initiatives in periurban areas of Lesotho where households are at high risk for food insecurity.
This paper presents preliminary outcomes of a community-based AIDS prevention program for drug users called Project COPE II, the National Institute on Drug Abuse (NIDA) cooperative agreement study in Hartford, Connecticut. COPE II's efficacy study compares the NIDA standard intervention against two culturally targeted, enhanced interventions, one for African Americans and one for Puerto Ricans. A sample of 188 out-of-treatment injection drug users (IDUs) with matched baseline and 6-month follow-up interviews were compared for changes in monthly injection rates and proportionate use of new and pre-used needles and used injection supplies. Effects of injection outliers, attrition, and ethnic differences were examined for impact on outcome measures and to identify subgroups within the study population for whom the intervention had differential effects. These preliminary analyses suggest that attendance in culturally targeted enhanced interventions may increase the likelihood of positive program outcome, including drug-related risk reduction for some populations. However, subgroups of IDUs, such as extremely high injectors or individuals who drop out before initiating or completing the program, may require different intervention approaches. Further research is needed to understand the relationship between intervention and behavior change, reasons for attrition, and moderating factors affecting project outcomes.
Persistent human papillomavirus (HPV) infections can cause cancer (e.g., cervical/vaginal/penile/anal/oropharyngeal). The HPV vaccine prevents cancer, yet U.S. vaccination rates remain low. We explored sociopolitical factors in the adoption of Puerto Rico's HPV vaccine school-entry requirement. Multiple streams framework explains how the intersection of problems, policy, and politics streams influence policy adoption. Policy entrepreneurs work on joining these streams. Interviews (n = 20) were conducted with stakeholders (e.g., physicians/researchers/nonprofit organizations' leaders). Data were analyzed using applied thematic analysis. High incidence of HPV and HPV-related cancers in Puerto Rico were indicators of problems. Focusing events included Rhaiza's case and the HPV-Advisory Panel Report. During summer 2017, a policy window opened; the Department of Health (DOH) adopted the requirement in summer 2018. Stakeholders discussed policy initiatives. Political turnover positively influenced the process. Policy entrepreneurs created an extended period of intersection resulting in the adoption of the requirement. Findings can inform policy initiatives to improve HPV vaccination rates and reduce HPV-related cancers.
Syndemic Theory posits that an understanding of the HIV/AIDS pandemic can only be gained by examining the dynamic interaction of the disease with other health problems (e.g., tuberculosis, sexually transmitted infections, malnutrition, substance abuse), in the context of social and structural conditions such as poverty, unequal access to resources, violence, stigma, etc. While the theory has been extensively used to guide research, it has not been widely utilized as a training tool. This article presents a model for the use of Syndemic Theory as a framework for the training and mentorship of researchers and practitioners, particularly from underrepresented groups interested in HIV/AIDS prevention and treatment among ethnic minorities.
