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While literature attempts to explain why self-reported subjective wellbeing (SWB) generally increases with age in most high-income countries based on a social determinants of a health framework, little work attempts to explain the low levels of self-report SWB among older persons in sub-Saharan Africa. Using the 2013 Uganda Study on Global Aging and Health with 470 individuals, this research examines (i) direct and indirect effects of age on SWB through social and structural determinants, and (ii) how direct and indirect effects vary by gender. Results show a significant direct and negative effect of age on SWB (&beta ; = 0.42, p = 0.01). Six indirect paths were statistically significant and their indirect effects on wellbeing varied by gender. Providing support, education, working status, asset level, financial status and financial improvement were significantly positively associated with men&rsquo ; s SWB, whereas younger age, providing community support, participating in group activities, number of close friends/relatives, government assistance and all socio-economic variables were significantly positively associated with women&rsquo ; s SWB. Strategies to address gendered economic, social and political inequalities among and between elderly populations are urgently needed.

Setting out the debates and reviewing the evidence that links health outcomes with social and physical environments, this new edition of the well-established text offers an accessible overview of the theoretical perspectives, methodologies, and research in the field of health geography Includes international examples, drawn from a broad range of countries, and extensive illustrationsUnique in its approach to health geography, as opposed to medical geographyNew chapters focus on contemporary concerns including neighborhoods and health, ageing, and emerging infectious diseaseOffers five new cas

The Sustainable Development Goals provide a global development agenda that is meant to be inclusive of all people. However, the development needs for vulnerable populations such as youth are not reflected within the policy agenda of some developing countries. One of the reasons for this is that research that explores health and wellbeing concerns for young people are sparse in the region and where they exist, the focus has been on marginalized subgroups. To address this gap, this cross-sectional study explored the health and wellbeing of youth in Kenya. We conducted 10 focus group discussions and 14 in-depth interviews with youth ages 15 to 24 years. A thematic analysis of the data revealed that structural factors are important influencers of youth perceptions and their social constructions of health and wellbeing. Kenyan youth are concerned about the health status and healthcare services in their communities, as well as issues of community trust of youths and perceived risks of political misuse and emotional suffering. Our findings suggest that youth transitioning into adulthood in resource-constrained areas experience feelings of powerlessness and inability to take charge over their own life. This impacts how they perceive and socially construct health and wellbeing.

The quality and safety of healthcare facility (HCF) services are critical to achieving universal health coverage (UHC) and yet the WHO/UNICEF joint monitoring program for water supply, sanitation and hygiene report indicates that only 51% and 23% of HCF in Sub-Saharan Africa have basic access to water and sanitation, respectively. Global commitments on improving access to water, sanitation, hygiene, waste management and environmental cleaning (WaSH) in HCF as part of implementing UHC have surged since 2015. Guided by political ecology of health theory, we explored the country level commitment to ensuring access to WaSH in HCFs as part of piloting UHC in Kisumu, Kenya. Through content analysis, 17 relevant policy documents were systematically reviewed using NVIVO. None of the national documents mentioned all the component of WaSH in healthcare facilities. Furthermore, these WaSH components are not measured as part of the universal health coverage pilot. Comprehensively incorporating WaSH measurement and monitoring in HCFs in the context of UHC policies creates a foundation for achieving SDG 6.

A decade ago, the World Health Organization declared obesity to be a global epidemic. Accordingly, there is a growing body of research examining how "obesogenic environments" contribute to the increasing prevalence of obesity. Using the ANGELO Framework, this research explores the role of municipal policies and practices in constructing obesogenic environments in two Southern Ontario cities in order to examine how socio-cultural and political environments shape excess body weight. Data was collected from municipal policy documents, public health websites, and key informants in Hamilton and Mississauga, Ontario, Canada. Results indicate that while the cities took different approaches to dealing with obesity, they both reflected the cities' overall prioritizing of health. Additionally, the findings reveal the pervasiveness of values and attitudes held in the socio-cultural environment in further shaping (and being shaped by) political as well as economic and physical environments in the cities. The importance of explicitly acknowledging the official discourse of the city, which this study demonstrates to be a significant factor in constructing obesogenic environments, is highlighted. Theoretical contributions and policy implications are also discussed.

While literature attempts to explain why self-reported subjective wellbeing (SWB) generally increases with age in most high-income countries based on a social determinants of a health framework, little work attempts to explain the low levels of self-report SWB among older persons in sub-Saharan Africa. Using the 2013 Uganda Study on Global Aging and Health with 470 individuals, this research examines (i) direct and indirect effects of age on SWB through social and structural determinants, and (ii) how direct and indirect effects vary by gender. Results show a significant direct and negative effect of age on SWB (β = 0.42, p = 0.01). Six indirect paths were statistically significant and their indirect effects on wellbeing varied by gender. Providing support, education, working status, asset level, financial status and financial improvement were significantly positively associated with men's SWB, whereas younger age, providing community support, participating in group activities, number of close friends/relatives, government assistance and all socio-economic variables were significantly positively associated with women's SWB. Strategies to address gendered economic, social and political inequalities among and between elderly populations are urgently needed.

The final publication is available at Elsevier via https://dx.doi.org/10.1016/j.socscimed.2018.03.031 © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/ ; Allergic diseases have closely followed the rise of non-communicable diseases (NCDs) especially in western societies. As prevalence of NCD is increasing in sub-Saharan Africa (SSA), researchers are hinting that the same future may hold for (food) allergic disease in this world region. Already, researchers are beginning to record prevalence, though with little attention to the social experience of individuals and parents with food allergic children. This paper presents the first qualitative analysis of the daily realities of adults and parents of children with allergies in SSA using Ghana as a case study. Drawing on political ecology of health, this study contextualizes the psychological (e.g. anxiety and fear), social (e.g. stigmatization, social exclusion), and economic (e.g. impact on work & household expenditures) wellbeing of affected persons within the broader sociocultural environment. By exploring the sociocultural environment, the results provide insights into the likely structures (e.g. the lack of familiarity, absence of local discursive repertoire on food allergy, infrastructure deficit) which interact to shape anxiety, and social exclusion of people with allergy. The case study provides evidence suggesting food allergies do have a global reach, and policy makers must heed the message to integrate food allergy into the broader chronic disease prevention agenda.

Small non-governmental organizations (NGOs) working in water-based development in low- and middle-income countries face unique challenges when it comes to evaluative practice. Few prioritize evaluation because they lack expertise and/or feel strongly about funding programs and not processes, given accountability to donors. To examine facilitators and barriers to evaluation in this context, we embarked on an organizational-level evaluation of H2O 4 ALL, a Canadian NGO with no prior evaluation experience. We first conducted an evaluability assessment, guided by Thurston and Potvin's framework for social change programs, to understand evaluation priorities and needs. By triangulating findings from three qualitative sources of data – an environmental scan, a document review, and in-depth interviews – we demonstrated evaluability assessments' applicability to water-based development and established a baseline for further research.

Purpose. This article presents findings that explore investment in organizational capacity building for chronic disease prevention. Specifically, this analysis examines variation in investment inputs, intervention outputs, and capacity changes to inform expectations of health-promotion capacity-building investment. Design/Setting. This multiple case study involving both qualitative and quantitative data is based on seven provincial dissemination projects involved in the Canadian Heart Health Initiative. Methods. Data on investment, number, and type of capacity-building activities and capacity changes come from a questionnaire, key informant interviews, and project report analysis. Quantitative data were analyzed descriptively and for trends, while qualitative data were analyzed thematically. Results. Per capita investments in capacity building ranged from a low of $0.21 in Ontario to $167.41 in Prince Edward Island. Multiple, tailored capacity-building interventions were used in each project. Mostly positive but modest changes were observed in at least five dimensions of capacity in all but one project. Conclusion. These findings reveal that capacity building for chronic disease prevention requires a long-term investment and is context specific. Even limited investment can produce interventions that appear to positively influence capacity for chronic disease prevention. The findings also suggest an urgent need to expand surveillance to include indicators of capacity-building investments and interventions to allow policy makers to make more informed decisions about investments in public health.

AbstractSmall NGOs in international development have a unique advantage when it comes to engaging communities, establishing partnerships and advocating rights. However, studies suggest that small NGOs are disadvantaged when it comes to demonstrating evidence‐based impact. Small NGOs are less likely to invest in development evaluation as they lack expertise and/or feel strongly about funding programmes and not processes, given the increased demand for accountability to donors. To explore the challenge NGOs face in moving from a single project‐based entity to a vision‐led professional entity, we have documented the creation of low‐cost evaluation tools using a case study in water‐based development. Copyright © 2017 John Wiley & Sons, Ltd.