Southeast Asian Health Research Articles

Children and Women's Health in South East Asia: Gap Analysis and Solutions.

In response to the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs) commitment, eight selected countries in the South East Asia region have made a remarkable reduction in infant and child mortality, while a few have achieved an SDG 3.2 target of 25 and 12 for child and neonatal mortality rate, respectively, well before 2030. Across these eight countries, there is a large variation in the achievement of the nine dimensions of maternal, neonatal, and child health service coverage. The poorest wealth quintiles who reside in rural areas are the most vulnerable and left behind from access to service. The rich rural residents are better off than the poor counterparts as they have financial means for travel and access to health services in urban town. The recent 2019 global Universal Health Coverage (UHC) monitoring produced a UHC service coverage index and an incidence of catastrophic health spending, which classified countries into four quadrants using global average. Countries belonging to a high coverage index and a low incidence of catastrophic spending are good performers. Countries having high coverage but also a high incidence of catastrophic spending need to improve their financial risk protection. Countries having low coverage and a high incidence of catastrophic spending need to boost service provision capacity, as well as expand financial protection. Countries having low coverage and a low incidence of catastrophic spending are the poor performers where both coverage and financial protection need significant improvement. In these countries, poor households who cannot afford to pay for health services may forego required care and instead choose to die at home. This paper recommended countries to spend adequately in the health sector, strengthen primary health care (PHC) and safeguard the poor, mothers and children as a priority in pathways towards UHC.

Reviewing ocean governance in Asia

Oceans are the life support system for our planet and are vital to human health. It is said that half of the oxygen we breathe is generated by our oceans. However, ocean space is becoming more globalized over time. Hence, it is essential for countries to take up a more holistic approach to ending ocean exploitation on the one hand, and also to ensuring a healthy ocean future on the other. Today, maritime cooperation is key to the management of the global commons, and ocean governance is important in establishing maritime connectivity. This article is a qualitative analysis of how the Association of Southeast Asian Nations (ASEAN) will undertake such an initiative to promote diverse and collaborative ocean governance in Asia. The article will analyze whether ASEAN countries are ready to take up the great power game challenge, and simultaneously motivate each other to promote sustainable development of common ocean governance structures and principles in the region. Last but not the least, we will see how ASEAN (Way) will connect with global trends in order to realize its a vision of building a community conscious of its historical ties and cultural heritage to improve the overall ocean health in Southeast Asia.

Democracy, economic growth and government spending in public health in Southeast Asia

Purpose The purpose of this paper is to examine how political regimes and political transition affect government decisions to allocate budgets to the public health sector in Southeast Asia. Design/methodology/approach Ordinary least squares with fixed-effects model is adopted to examine the effect of political regime on public health spending. Findings Examining the allocation of public health budgets in Southeast Asian countries, the paper finds that a democratic government positively leads to an increase in public health budget allocation, while autocratic government negatively affects the allocation of public health budgets. Further, political liberalization contributes to an increase in budget allocation to the public health sector. Originality/value Democratic politics and economic development aim to distribute public resources to social policy, such as policy on public health.

Interventions to Improve Micronutrient Status of Women of Reproductive Age in Southeast Asia: A Narrative Review on What Works, What Might Work, and What Doesn't Work.

Objectives Toprovide an overview of nutrition-specific and nutrition-sensitive interventions that could improve micronutrient status of women of reproductive age. Methods This narrative review has a special focus on Southeast Asia, as the work was undertaken within the framework of the SMILING (Sustainable Micronutrient Interventions to controL deficiencies and Improve Nutrition status and General health in Southeast Asia) project. ResultsIn order for new interventions to become accepted, comprehension and interpretation of potential impact of different strategies by policymakers and non-nutritionists is needed. By presenting a wide overview of strategies, and discussing the context and current consensus on these strategies, the review aims to help with the formulation of new recommendations for national programs in Southeast Asia. ConclusionsCurrent policies in Southeast Asia to improve micronutrient status of women of reproductive age are focused too much on single micronutrient supplementation for pregnant women (iron and folic acid supplements). A more holistic approach, including both nutrition-specific and nutrition-sensitive interventions, is needed.

Geohealth Hub: Improving Agricultural Health in Southeast Asia

Forty percent of Thai people are engaged in agriculture. The CWEND GEOHealth Hub in Southeast Asia has focused on measuring occupational exposures and health impacts among agricultural workers. We have recruited farmers that use chemical pesticides and fertilizers and organic farmers to investigate whether they are significantly different in working conditions, musculoskeletal disorders, accidents, and a range of health problems, including metabolic disorders. In comparing the general health of organic and chemical use farmers, we found that the chemical use farmers had significantly higher BMI, waist circumference, body fat%, triglyceride, total cholesterol, LDL and blood pressure than the organic farmers. The organic farmers had significantly higher musculoskeletal disorders of the wrist/hands, fingers, upper back, hip and ankle/feet than the chemical farmers did. Chemical induced hearing loss was investigated among farmers exposed to both noise from agricultural machines and pesticides and compared to organic farmers exposed to only noise and to farmers with neither exposure. Audiometric testing of the high frequencies showed that as cumulative exposures to both noise and to pesticides increased, farmers had a significantly higher risk of hearing loss, suggesting an ototoxic effect of pesticides. Organophosphate pesticides (OP) and paraquat were measured in the meconium of newborn babies where we found 98.5% of samples had OP residues and 55% of the samples had paraquat residues. The incidence of kidney damage was investigated among sugarcane cutters using biomarker measurements (NGAL) pre and post shift. We found that NGAL significantly increased across the workshift, suggesting kidney damage may be occurring. Through the research training and mentoring component of the GEOHealth Hub, we are building capacity for occupational and environmental health research that will inform changes to policy and practice in agriculture in Southeast Asia.

Laurence Monnais and Harold J. Cook, eds. Global Movements, Local Concerns: Medicine and Health in Southeast Asia. Singapore: NUS Press, 2012, xxxi+290p.

Global Movements, Local Concerns: Medicine and Health in Laurence Monnais and Harold J. Cook, eds. Singapore: NUS Press, 2012, xxxi+290p.This edited volume contributes to the growing scholarly literature dealing with the history of The editors collaborated with 12 scholars of to come up with an 11-chapter compilation dealing with six countries, Indonesia, Malaysia, the Philippines, Singapore, Thailand, and Vietnam. This is difficult task to perform, as most scholarship tends to focus on one South- east Asian country or comparison between countries with similar histories, given that charac- teristic of Asian countries is their diversity.The volume begins by deconstructing the prevalent notion that the term Southeast Asia was constructed by North American scholars and its allies during the Second World War as way to group the countries into a community of nation-states. Asia, to quote Benedict Anderson, is an artificial construct and the region is remote, heterogeneous, and . . . imperially segmented (Anderson 1998, 5). Another strategy has been to group these countries according to the influences of the region's powerful neighbors, China and India. However, this proved to be insufficient with the migration of Arab, Chinese, and Indians to various countries fostering an image of plural societies. It was only with the introduction of the Braudelian view of long duree- researching one topic over an extended period of time and analyzing material culture in the context of global history-that framework for studying as whole became possible.1)The editors of the volume make clear that the chapters deal with issues of health rather than disease in the countries involved. The chapters avoid dealing with medicine, and focus on the development of medicine. Hence, instead of colonial masters imposing their policies upon the locals, the chapters examine the negotiations between colonial masters and locals and the appropriation of medical practices and policies within local context.This is welcome compilation for Asian scholars and those who study the history of medicine due to its ambition in attempting to tell the history of using micro- level narratives and social histories. However, one of the main issues that arise out of any compi- lation on the history of is the difficulty in grappling with the diversity that exists in region. This difficulty makes itself felt in the compilation and can be seen in the confusing order of the chapters from what initially seems to be chronological (chapters 1 to 8) to an abrupt transi- tion to the modern period with chapter 9, and then back to chronological order with chapters 10 and 11.Thomas B. Colvin's study deals with the expedition of Francisco Xavier Balmis, doctor to the Spanish court who proposed to bring the smallpox vaccine to all of Spain's colonies. The Balmis expedition brought the vaccine using the human chain method, which meant transporting number of healthy young boys who had not been exposed to smallpox and transferring the vaccine from one boy to another until they arrived at the final destination. The Spanish monarchy approved the expedition in order to increase the population of the colonies that had been afflicted by smallpox and stimulate economic activity in the colonies. Despite encountering problems not only with the locals, but with the Spanish as well, the expedition was successful and would have further influence within the surrounding countries.C. Michele Thompson narrates how the Nguyen Dynasty addressed the problem of smallpox and how officials transported the vaccine to Vietnam from France. The smallpox vaccination project was long-term policy; however, the methods in transporting the vaccine introduced by the French proved to be unsuccessful, since it was brought via glass vials, which failed to preserve the live virus on its journey through the summer heat of the South China Sea. …

Climate conditions, workplace heat and occupational health in South-East Asia in the context of climate change.

Occupational health is particularly affected by high heat exposures in workplaces, which will be an increasing problem as climate change progresses. People working in jobs of moderate or heavy work intensity in hot environments are at particular risk, owing to exposure to high environmental heat and internal heat production. This heat needs to be released to protect health, and such release is difficult or impossible at high temperatures and high air humidity. A range of clinical health effects can occur, and the heat-related physical exhaustion leads to a reduction of work capacity and labour productivity, which may cause substantial economic losses. Current trends in countries of the World Health Organization South-East Asia Region are towards higher ambient heat levels during large parts of each year, and modelling indicates continuing trends, which will particularly affect low-income individuals and communities. Prevention activities need to address the climate policies of each country, and to apply currently available heat-reducing technologies in workplaces whenever possible. Work activities can be adjusted to reduce exposure to daily heat peaks or seasonal heat concerns. Application of basic occupational health principles, such as supply of drinking water, enforcement of rest periods and training of workers and supervisors, is essential.

Online Health Search Experience: Sentiments from South East Asia

Performing an online health search is a popular activity conducted on the Internet. Research studies from developed countries provide information on source used, type of search performed and devices used to perform the search. However, the same cannot be said about the online health information searching scene in South East Asia. Online health information searching is gaining popularity in South East Asia. Citizens in these countries are turning to the Internet to obtain health information quickly. Current research studies pertaining to online health information searching in South East Asian is limited, particularly relating to search experiences of South East Asian health searchers. Search experience is pertinent as it could deter or encourage the possibility of conducting future health searches. In this research study, a user study was conducted to describe the online search experience of South East Asian health searchers. A face to face interview with 50 participants was conducted. The interview was audio recorded and transcribed verbatim. Results indicate participants have positive and negative search experiences. In some cases, post search outcomes influenced the search experience. Results of this research study contribute to the growing domain of knowledge in relation to online health information searching. Results of this study also provide an understanding pertaining to the search experience of South East Asian online health searchers.

Continual Professional Development (CPD): Improving Quality of Nursing Care in Nepal

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Editorial: Determinants of health in South-East Asia

Editorial: Determinants of health in South-East Asia

Coupled Aerosol-Cloud Systems over Northern Vietnam during 7-SEAS/BASELInE: A Radar and Modeling Perspective

ABSTRACTThe 2013 7-SEAS/BASELInE campaign over northern Southeast Asia (SEA) provided, for the first time ever, comprehensive ground-based W-band radar measurements of the low-level stratocumulus (Sc) systems that often exist during the spring over northern Vietnam in the presence of biomass-burning aerosols. Although spatially limited, ground-based remote sensing observations are generally free of the surface contamination and signal attenuation effects that often hinder space-borne measurements of these low-level cloud systems. Such observations permit detailed measurements of structures and lifecycles of these clouds as part of a broader effort to study potential impacts of these coupled aerosol-cloud systems on local and regional weather and air quality. Introductory analyses of the W-band radar data show these Sc systems generally follow a diurnal cycle, with peak occurrences during the nighttime and early morning hours, often accompanied by light precipitation. Preliminary results from idealized simulations of Sc development over land based on the observations reveal the familiar response of increased numbers and smaller sizes of cloud droplets, along with suppressed drizzle formation, as aerosol concentrations increase. Slight reductions in simulated W-band reflectivity values also are seen with increasing aerosol concentrations and result primarily from decreased droplet sizes. As precipitation can play a large role in removing aerosol from the atmosphere, and thereby improving air quality locally, quantifying feedbacks between aerosols and cloud systems over this region are essential, particularly given the negative impacts of biomass burning on human health in SEA. Such an endeavor should involve improved modeling capabilities along with comprehensive measurements of time-dependent aerosol and cloud profiles.

Histories of health in Southeast Asia: perspectives on the long twentieth century

Introduction / Sunil Amrith and Tim Harper Part I. The Long Duree 1. Knowledge Transition and the Transformation of Medicine in Early Modern Siam / Komatra Chuengsatiansup & Nopphanat Anuphongphat Part II. Health and Crisis 2. Pilgrim Ships and the Frontiers of Contagion: Quarantine Regimes from Southeast Asia to the Red Sea / Eric Tagliacozzo 3. The Influenza Epidemic of 1918-19 / Kirsty Walker 4. Disaster Medicine in Southeast Asia / Greg Bankoff Part III. Uneven Transitions 5. The Demographic History of Southeast Asia in the Twentieth Century / Peter Boomgaard 6. Rural Health in Modern Southeast Asia / Atsuko Naoko 7. Population Ageing and the Family: The Southeast Asian Context / Theresa W. Devasahayam 8. Epidemic Disease in Modern and Contemporary Southeast Asia / Mary Wilson Part IV. The Politics of Health 9. The Internationalization of Health in Southeast Asia / Sunil Amrith 10. Modernising yet Marginal: Hospitals and Asylums in Southeast Asia in the 20th Century / Loh Kah Seng 11. Healing the Nation: Politics, Medicine and Analogies of Health in Southeast Asia / Rachel Leow 12. Health or Tobacco: Competing Perspectives in Modern Southeast Asia / Loh Wei Leng 13. The Role of Non-governmental Organizations in the Field of Health in Modern Southeast Asia: the Philippine Experience / Teresa S Encarnacion Tadem Notes Contributors Index

Serological and molecular detection of Leptospira spp. from small wild mammals captured in Sarawak, Malaysia

Aims: Leptospirosis is endemic to tropical regions of the world and is re-emerging as a new danger to public health in Southeast Asia, including Malaysia. The purpose of this particular study was to determine the common leptospiral serovars present in small wild mammals living around wildlife reserves and disturbed forest habitats and human communities. Methodology and results: The samples of blood and kidneys of small rodents, bats and squirrels were analyzed. Antibodies to different serovars of leptospires were detected in 73 of 155 wild small mammals captured (47.0%: 95% CI 39.0-55.3%). The seroprevalence for rats (57.9%; 95% CI 44.1-70.9) was slightly higher than that for squirrels (42.9%; 95% CI 24.5-62.8) and bats (40%; 95% CI 28.5-52.4). Seropositive animals were detected in all 5 localities sampled. Antibodies to serovar Lepto 175 Sarawak were detected in 30 (24.7%) rats, 11 (9.0%) squirrels and 27 (52.9%) bats. Of 155 kidney samples from individual animals only 17 were positive for Leptospira on a molecular study (10.97%, 95% CI 6.5-17). The majority of the positive results were from plantain squirrels (53%; 95% CI 27.8, 77), Muller's rat (35%; 95% CI 14.2, 61.7) and brown spiny rats (12%; 95% CI 1.5, 36.4). Conclusion, significance and impact of study: This particular study should generate concerns and lead to the health authorities expanding disease control measures in the region as there are significant levels of human activity at all five locations where the animals were sampled. The pathogenesis of serovar Lepto 175 Sarawak also needs to be monitored closely, considering its similarities to the pathogenic Leptospira wolffii.

Occurrence of a mosquito vector in bird houses: Developmental consequences and potential epidemiological implications

Even with continuous vector control, dengue is still a growing threat to public health in Southeast Asia. Main causes comprise difficulties in identifying productive breeding sites and inappropriate targeted chemical interventions. In this region, rural families keep live birds in backyards and dengue mosquitoes have been reported in containers in the cages. To focus on this particular breeding site, we examined the capacity of bird fecal matter (BFM) from the spotted dove, to support Aedes albopictus larval growth. The impact of BFM larval uptake on some adult fitness traits influencing vectorial capacity was also investigated. In serial bioassays involving a high and low larval density (HD and LD), BFM and larval standard food (LSF) affected differently larval development. At HD, development was longer in the BFM environment. There were no appreciable mortality differences between the two treatments, which resulted in similar pupation and adult emergence successes. BFM treatment produced a better gender balance. There were comparable levels of blood uptake and egg production in BFM and LSF females at LD; that was not the case for the HD one, which resulted in bigger adults. BFM and LSF females displayed equivalent lifespans; in males, this parameter was shorter in those derived from the BFM/LD treatment. Taken together these results suggest that bird defecations successfully support the development of Ae. albopictus. Due to their cryptic aspects, containers used to supply water to encaged birds may not have been targeted by chemical interventions.

Improving communication skills in the Southeast Asian health care context.

The aim of these two PhD thesis are to develop a guideline on doctor-patient communication skills based on cultural characteristics of Southeast Asian context and to develop communication skills training for nurses to enhance their contribution to the informed consent and shared decision making process, in the same context. These studies started with qualitative methods; including grounded theory methodology, by exploring doctors’, patients’, medical students’ and nurses’ perceptions on the current and desired communication skills in which influenced by culture. Based on the results, we design communication skills training and evaluate the training with quantitative methods, using pre and post test studies. Southeast Asian desired ideal partnership style in communicating with their doctors. More emphasize on basic skills such as listening to subtle non-verbal cues are needed for doctors and nurses. A guideline on doctor-patient communication tailored to local culture was developed as well as training for nurses using 4CID design to enhance their contribution to the shared decision making process. To promote two-way interaction between doctors and patients and between health professionals require mastering basic skills in communicating with people, such as explorations on the unspoken concern. In a culturally hierarchical context of Indonesia, this two-way interaction is quite a challenge. To generalize our studies to other culture, more studies with rigorous methods should follow. To promote the use of basic skills in communicating with patients to approach the desired partnership communication style in Southeast Asian context, we need to use local evidences.

Laurence Monnais and Harold J. Cook (eds), Global Movements, Local Concerns: Medicine and Health in Southeast Asia

Laurence Monnais and Harold J. Cook (eds), Global Movements, Local Concerns: Medicine and Health in Southeast Asia

The neolithic demographic transition and oral health: The Southeast Asian experience

The purpose of this article is to present new oral health data from Neolithic An Son, southern Vietnam, in the context of (1) a reassessment of published data on other Neolithic, Bronze, and Iron Age Southeast Asian dental series, and (2) predictions of the Neolithic Demographic Transition (NDT). To this end, frequencies for three oral conditions (caries, antemortem tooth loss, and alveolar lesions) were investigated for seven Southeast Asian adult dental series from Thailand and Vietnam with respect to time period, age-at-death and sex. A clear pattern of elevated rates for oral disease in the Neolithic followed by a marked improvement in oral health during the Bronze and Iron Ages was observed. Moreover, rates of caries and antemortem tooth loss for females were almost without exception higher than that for males in all samples. The consensus view among Southeast Asian bioarchaeologists that oral health did not decline with the adoption/intensification of agriculture in Southeast Asia, can no longer be supported. In light of evidence for (1) the low cariogenicity of rice; (2) the physiological predisposition of females (particularly when pregnant) to poorer oral health; and (3) health predictions of the NDT model with respect to elevated levels of fertility, the most plausible chief explanation for the observed patterns in oral health in Southeast Asia is increased levels of fertility during the Neolithic, followed by a decline in fertility during the subsequent Bronze and Iron Ages.

Global Movements, Local Concerns: Medicine and Health in Southeast Asia , written by Monnais, Laurence and Harold J. Cook

Global Movements, Local Concerns: Medicine and Health in Southeast Asia , written by Monnais, Laurence and Harold J. Cook

Global Movements, Local Concerns: Medicine and Health in Southeast Asia

The development of medicine in Southeast Asia over the past two centuries has not been a simple imposition of European scientific medicine, but a complex and negotiated process that drew on Southeast Asian health experts, local medical traditions, and changing national and popular expectations. The contributors to this volume show how the practices of health in Southeast Asia over the past two centuries were mediated by local medical traditions, colonial interests, governments and policies, international interventions, and by a wide range of health agents and intermediaries. Their findings call into question many of the claims based on medicalisation and biopolitics that treat change as a process of rupture. While governments, both colonial and national, instituted policies that affected large numbers of people, much health care remained rooted in a more interactive and locally-mediated experience, in which tradition, adaptation and hybridisation is as important as innovation and conflict. Semi-subaltern Western-trained doctors and varied traditional healers, many of them women, were among the cultural brokers involved in the building of healthcare systems, and helped circulate mixed practices and ideas about medicine and health even as they found their place in new professional and social hierarchies in an era of globalisation.

Public Health in South-East Asia in the 21st Century?

Best practices, policy and innovations in the administration of healthcare in developing communities and countries. For administrators, academics, researchers and policy leaders. Includes peer reviewed research papers. Edited by Dr. Judith Shamian, President Emeritus, International Council of Nurses, Professor and Co-investigator with the Nursing Health Services Research Unit, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON