Portuguese-speaking African Countries Research Articles

A evidencialidade na fala dos guineenses focalizando as dificuldades da comunicação em língua portuguesa

Este estudo objetiva explicitar as marcas evidenciais que particularizam o falar dos estudantes guineenses, quando questionados sobre as dificuldades que encontram ao se comunicar em língua portuguesa, mostrando em que medida se comprometem ou se descomprometem com aquilo que é dito como algo que revela o processo de oficialidade linguística por que tem passado seu país, o qual faz parte dos países africanos de língua oficial portuguesa (os PALOPs). A metodologia adotada explicita, inicialmente, o estatuto linguístico de Guiné-Bissau, tendo como foco a situação de oficialidade da língua portuguesa nesse país, para, em seguida, apresentar uma análise linguístico-discursiva das falas de vinte acadêmicos guineenses. Este trabalho faz um recorte do questionário ALIB utilizado na coleta e analisa uma das perguntas metalinguísticas que foram reformuladas para o contexto africano.

Modelling bilateral intra-industry trade indexes with panel data: a semiparametric approach

This paper focuses on the modelling of bilateral intra-industry trade indexes with panel data, applying a semiparametric approach. This extends the work of Papke and Wooldridge (J Econom 145:121---133, 2008) for fractional responses, by introducing a nonparametric component to control for unobserved heterogeneity associated with the regressors. The proposed approach is based on the semi-mixed effects generalised linear model of Lombardia and Sperlich (Comput Stat Data Anal 56:2903---2917, 2012), introduced in the context of small area statistics, and the semiparametric gravity model of Proenca et al. (Empir Econ doi:10.1007/s00181-014-0891-x, 2014). The resulting nonlinear semiparametric model serves to explain the bilateral intra-industry trade indexes between Portugal and the European Union, the BRIC emerging economies, and the five Portuguese-speaking African countries.

Migrants and Health in Portugal

The aim of this research is to atain knowledge on immigrant´s health related problems and to identify their dificulties when acesing health care services. The article describes immigrant´s dificulties when acesing health care services that are visiting the health ofice at a National Immigrant Support Centre.Design: : A qualitative study was conducted, analysing available documentation and observing the health isues dealt with at the National Immigrant Support Centre’s (CNAI) Health Ofice. The 148 cases are mainly immigrants coming from Portuguese speaking African countries for health purposes. Immigrants from Brazil have more restricted aces, and feel discrimination on the part of the services. Immigrants from Eastern Europe come in search of information and have communication dificulties. Obstacles are related to the lack of knowledge of the law, but also to the failure of puting the law into practice. The ofice has had a great demand of users seeking information and in acesingthe health care system.Results: The cases analysed are mainly nationals from Portuguese Speaking African Countries (PSAC), Brazil and countries in Eastern Europe. The majority of the immigrants coming from PSAC are patients receiving treatment under international Cooperation Agreements requesting financial and social support. Immigrants from Brazil have more restricted aces and feel greater discrimination on the part of the services. New Labour Migrants from Eastern Europe, on the other hand, come in search of information and are known to have communication dificulties.Conclusions: Legislation in Portugal provides aces to health care to al citizens, regardles of their legal condition and origin. However, some immigrants have had significant dificulties with aces to Portugal’s National Health Service. The obstacles are not only related to the lack of legal knowledge, but also to the failure of puting the law into practice, which requires atention by the institutionresponsible for efective and comprehensive coordination. The ofice has had a great demand of users seeking information, who, above al, wish to solve their problems and dificulties in acesing the health care system.

Exogamous patterns in four immigrant groups in Portugal (2001 and 2011)

This article analyses the exogamy patterns in four groups of immigrants to Portugal — from the Portuguese-speaking African Countries (PALOPs), EU-12, Brazil, and Eastern Europe — in 2001 and 2011. In the light of earlier studies, on the one hand the authors assess the existence of both gender differences and differences in terms of educational and age homogamy in these marriages. On the other, they also analyse the factors that explain the propensity to exogamic marriage. The results point to marriage patterns that differ according to gender, as well as to differences between the older waves of immigration (PALOPs and EU-12) and the more recent ones (Brazil and Eastern Europe). These data are interpreted in the final part of the article.

The rise of medical training in Portuguese speaking African countries.

BackgroundMedical training has shown to be strategic for strengthening health systems, especially in those countries identified to have critical shortage of human resources for health. In the past few years, several studies have been conducted to characterize and identify major challenges faced by medical schools worldwide, and particularly in Africa. Nevertheless, none has previously addressed medical training issues in Portuguese Speaking African Countries (PSAC). The aim of this study was to establish baseline knowledge of the PSAC’s medical schools in terms of creation and ownership, programmes offered, applicants and registered students, barriers to increased intake of students, teaching workforce and available resources.MethodsA quantitative, observational, multicentric, cross-sectional study of all medical schools active in 2012 in the PSAC. An adapted version of the questionnaires developed by Chen et al. (2012) was sent to all medical schools electronically. Data were analyzed using descriptive statistics.ResultsA total of nine medical schools answered the questionnaire (three from Angola, two from Guinea Bissau and four from Mozambique). Since 2006 an effort has been made to increase the number of medical trainees. Besides the medical degree offered by all schools, some offered other undergraduate and postgraduate training programmes. The number of applicants to medical schools largely outnumbers the available vacancies in all countries but insufficient infrastructures and lack of teaching personnel are important constraints to increase vacancies. The teaching personnel are mainly trained abroad, employed part-time by the medical school and do not have a PhD qualification.ConclusionGovernments in the PSAC have significantly invested in training to address medical shortages. However, medical schools are still struggling to give an adequate and effective response. Developing a local postgraduate training capacity for doctors might be an important strategy to help retain medical doctors in the home country and develop local faculty capacity.

Why do some physicians in Portuguese-speaking African countries work exclusively for the private sector? Findings from a mixed-methods study.

BackgroundDespite the growing interest in the private health sector in low- and middle-income countries, little is known about physicians working outside the public sector. The present work adopts a mixed-methods approach to explore characteristics, working patterns, choices, and motivations of the physicians working exclusively for the private sector in the capital cities of Cape Verde, Guinea Bissau, and Mozambique. The paper’s objective is to contribute to the understanding of such physicians, ultimately informing the policies regulating the medical profession in low- and middle-income countries.MethodsThe qualitative part of the study involved 48 interviews with physicians and health policy-makers and aimed at understanding the practice in the three locations. The quantitative study included a survey of 329 physicians, and multivariate analysis was conducted to analyse characteristics, time allocation, earnings, and motivations of those physicians working only for the private sector, in comparison to their public sector-only and dual practice peers.ResultsOur findings showed that only a limited proportion of physicians in the three locations work exclusively for the private sector (11.2%), with members of this group being older than those practicing only in the public or in both sectors. They were found to work fewer hours per week (49 hours) than their public (56 hours) and dual practice peers (62 hours) (P <0.001 and P = 0.011, respectively). Their median earnings were USD 4,405 per month, with substantial variations across the three locations. Statistically significant differences were found with the earnings of public-only physicians (P <0.001), but not with those of the dual practice group (P = 0.340). The qualitative data from the interviews showed private-only physicians’ preference for an independent and more flexible work modality, and this was quoted as a determining factor for their choice of sector. This group appears to include those working in the more informal sector, and those who decided to leave the civil service following a disagreement with the public employer.ConclusionsThe study shows the importance of understanding the relation between health professionals’ characteristics, motivations, and their engagement with the private sector to develop effective policies to regulate the profession. This may ultimately contribute to achieving universal access to medical services in low- and middle-income countries.Electronic supplementary materialThe online version of this article (doi:10.1186/1478-4491-12-51) contains supplementary material, which is available to authorized users.

The value of grounded theory for disentangling inequalities in maternal-child healthcare in contexts of diversity: A psycho-sociopolitical approach

Adopting a psycho-sociopolitical approach, the present paper describes the results of a community-based participatory needs assessment focusing on the perceived needs of women of reproductive age as users of primary healthcare in contexts of migration-driven diversity and socioeconomic vulnerability in the Metropolitan Area of Lisbon. The investigation comprised 64 in-depth interviews with women, including natives and immigrants to Portugal from the main origin countries in the context under study (Brazil, Cape Verde, and other Portuguese-speaking African countries) and a survey of 125 women, again natives and immigrants from these countries. The central role of qualitative methodology and grounded theory, in the framework of a multi-method research, allowed understanding the needs of women as embedded in contexts characterized by asymmetrical power relations, in terms of unequal opportunities and resources, at multiple interrelated ecological levels (personal, relational, organizational, community, socioeconomic, health system/policy, cultural/migration). The priority perceived needs of women were primarily related to socioeconomic disadvantage, severely aggravated in the current contexts of crisis; and factors at the health system level, mainly unequal access to family doctors, excessive waiting lists, and increases in the direct costs of healthcare. Results allow questioning the adequacy of cultural competence approaches for the reduction of inequalities in maternal-child healthcare in the context under study, showing the critical and innovative value of qualitative methodology and grounded theory in research on social justice and health in contexts of diversity characterized by unequal power dynamics.

Assessing maternal healthcare inequities among migrants: a qualitative study

Considering pregnancy and motherhood as periods of increased vulnerability in migrant women, to characterize the healthcare provided to this collective, we sought to identify and understand patterns of satisfaction and demand of maternal and child healthcare, assessing women’s perceptions about its quality. The study followed a qualitative methodology (semi-structured interviews) for collecting and analysing data (content analysis) and was conducted in Porto, the second largest city of Portugal. Participants were 25 recent immigrant mothers from Eastern European countries, Brazil, Portuguese-speaking African countries and six native Portuguese recent mothers (for comparison), contacted through social associations and institutions. Data suggests that healthcare depends not only on accessibility but especially on social opportunities. Equitable public health action must provide individuals and groups the equal opportunity to meet their needs, which may not be achieved by providing the same standard if care to all.

(Post)-conflict Memories and Identity Narratives in the Documentary Series I Am Africa

During the last century, film and video have become important inspiring documents of collective memory; in this century, they have become an increasingly important source of evidence and historical reflection. This paper aims to analyse the documentary series I Am Africa. Consisting of ten episodes, I Am Africa gives voice to ten citizens – two from each of the Portuguese-speaking African countries: Angola, Cape Verde, Guinea-Bissau, Mozambique, and Sao Tome and Principe – with significant civic involvement in the development of the nations where they were born and currently live. Through thematic analysis of the ten stories, which make up the documentary series, were located the predominant themes in the narratives of those involved. The results of this research show the narrative organization of the ten interviewees in three central themes: the meanings of independence, which involve the representations of the people who have participated in the process of (de)colonization; the perceptions about the cultural and linguistic diversity in their countries; and, finally, the discourses associated with the (re)making of national identities.

Congenital neurosyphilis

Sónia Silva and colleagues1Silva S Henriques R Gomes JP Borrego MJ Afonso E Could we miss congenital neurosyphilis?.Lancet Infect Dis. 2012; 12: 816Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar describe a case of a Portuguese pregnant mother whose syphilis serology became positive during pregnancy. She was treated during the second trimester with 2·4 million IU of benzathine benzylpenicillin, given intramuscularly, three times at weekly intervals. The mother's serology became negative during treatment, but the newborn child was discovered to have neurosyphilis on the basis of clinical and sonographic findings, with treponemal sequences detected in the cerebrospinal fluid by PCR. The standard use of benzathine benzylpenicillin has been advocated for treatment of syphilis during pregnancy and is recommended in the local treatment protocol in Portugal, but reservations have been expressed about the use of this penicillin formulation.2Walker GJA Antibiotics for syphilis diagnosed during pregnancy.Cochrane Database Syst Rev. 2001; 3 (CD001143)PubMed Google Scholar Firstly, benzathine benzylpenicillin does not produce adequate treponemacidal concentrations of penicillin in the cerebrospinal fluid, hence the reluctance to treat neurosyphilis with this antibiotic; and secondly, when concurrent immunosuppression occurs, as in patients with HIV, syphilis is thought to resolve slowly, and even relapse, if the patient is given benzathine benzylpenicillin. The question arises as to whether the embryo or fetus is naturally in a state of immunosuppression. Certainly, when a baby is born, its cellular immunity to syphilis does not seem to be impaired,3Friedmann PS Cell-mediated immunological reactivity in neonates and infants with congenital syphilis.Clin Exp Immunol. 1977; 30: 271-276PubMed Google Scholar, 4Samson GR Beatty DW Malan AF Immune studies in infants with congenital syphilis.Clin Exp Immunol. 1990; 81: 315-318Crossref PubMed Scopus (7) Google Scholar by contrast with the cellular immunity of the placenta. Immune tolerance to paternal fetal antigens by the mother—and, inadvertently, to microbes by the placenta—depends on a reduction in T4-helper cells5Nahamias AJ Schollin J Abramowsky C Evolutionary and developmental perspectives in immune system of pregnant women, placenta and foetus, and responses to sexually transmitted infection.Ann NY Acad Sci. 2011; 1230: 25-47Crossref PubMed Scopus (23) Google Scholar (more Th2 than Th1), particularly by the peripheral regulatory T4 cells.6Williams Z Immune tolerance in pregnancy.N Engl J Med. 2012; 367: 1159-1161Crossref PubMed Scopus (86) Google Scholar Thus, in the case described by Silva and colleagues, the treponeme might not have been recognised as a foreign antigen and was allowed to cause damage to the placenta and subsequently infect the embryo. In fact, in about 70% of miscarriages associated with syphilis, syphilitic placental infection with severe restriction in fetal blood flow occurs. Therefore, the sensible option might be to restrict the use of benzathine benzylpenicillin in maternal syphilis to cases in which ultrasonic scans of the fetus and placenta are normal. One theory of how syphilis arrived in Europe is that it was imported during the Portuguese colonisation of Africa in the latter part of the 15th century. Perhaps a new neurotropic strain of Treponema pallidum is similarly being transported to Portugal from Portuguese-speaking African countries where syphilis is endemic and where a new strain could have arisen among the multiplicity of circulating treponemal strains.7Castro R Prieto E Aguas MJ Manata MJ Botas J Pereira FM Molecular subtyping of Treponema pallidum subsp. pallidum in Lisbon, Portugal.J Clin Microbiol. 2009; 47: 2510-2512Crossref PubMed Scopus (36) Google Scholar I declare that I have no conflicts of interest. Could we miss congenital neurosyphilis?Portugal has the highest incidence of congenital syphilis in Europe, and employs a screening protocol during pregnancy of serological testing in every trimester and in all newborn babies whose mothers were treated during pregnancy. Full-Text PDF Congenital neurosyphilis – Authors' replyWe agree with Fernandes and Medina-Acosta's comments regarding the lack of specificity of CNS imaging in neurosyphilis diagnosis. Nevertheless, our case study has an interesting feature: because the results of the baby's serological tests did not suggest congenital syphilis, if the neurological signs—probably due to traumatic subdural bleeding—that prompted the ultrasound had not been apparent, the diagnosis of neurosyphilis would have been missed. Therefore, we emphasise the importance of transfontanellar ultrasound, even when results show non-specific changes, to help to diagnose cases of neurosyphilis. Full-Text PDF

Valutazione dell'autostima e della motivazione al successo scolastico in studenti luso-africani della scuola secondaria del Portogallo

Given the international relevance of the Portuguese migration policies, this survey investigates the inclusion and integration processes related to secondgeneration immigrants who come from Portuguese-speaking African countries and attend the upper-school in Faro and Setubal (Portugal). To reach this goal, during the 2009-2010 school-year, we realized a quantitative survey focusing on students’ educational achievement and its influence on teaching-learning processes. For this aim, we administrated a Likert’s scale questionnaire which measures the factors that play an important role in reaching the educational goals. We found that the most relevant and significant factors which contributed to the educational achievement of students were intrinsic: motivation processes and self-esteem.

Masculinidade e colonialismo: em direção ao “homem novo” (subsídios para os estudos de gênero e para os estudos pós-coloniais no contexto de língua portuguesa)

Este estudo pretende ser a introdução a alguns problemas que se consti­tuem contemporaneamente no âmbito dos chamados estudos de gênero na medida em que se observa a constituição de identidades masculinas e de masculinidades nos contextos coloniais. A ênfase tradicionalmente dada à identidade feminina e às suas representações literárias criou o este­reótipo do “heteroeurologofalocentrismo” que homogeneiza as identida­des masculinas sem observar as contingências históricas e culturais que as pluralizam em várias possibilidades. A atenção ao conceito de “homem novo”, modelo tanto requerido pelo Estado Novo português, quanto pelos movimentos de independência dos Países Africanos de Língua Portugue­sa, demonstra que na busca pela hegemonia bélica concorriam também ideais de masculinidade, muitas vezes afastados das supostas tradições de cada lado.

Migrant Women’s Perceptions of Healthcare During Pregnancy and Early Motherhood: Addressing the Social Determinants of Health

Recent guidelines from the World Health Organization emphasize the need to monitor the social determinants of health, with particular focus on the most vulnerable groups. With this in mind, we evaluated the access, use and perceived quality of care received by migrant women during pregnancy and early motherhood, in a large urban area in northern Portugal. We performed semi-structured interviews in 25 recent mothers, contacted through welfare institutions, who had immigrated from Eastern European countries, Brazil, or Portuguese-speaking African countries. Six native-Portuguese women of equal economic status were also interviewed for comparison. Misinformation about legal rights and inadequate clarification during medical appointments frequently interacted with social determinants, such as low social-economic status, unemployment, and poor living conditions, to result in lower perceived quality of healthcare. Special attention needs to be given to the most vulnerable populations in order to improve healthcare. Challenges reside not only in assuring access, but also in promoting equity in the quality of care.

O kuduro como expressão da juventude em Portugal: estilos de vida e processos de identificação

O artigo em questão é fruto de uma pesquisa etnográfica realizada em Lisboa, no ano de 2010. O kuduro é um estilo de dança e música que surgiu em Luanda, nos anos 1990, e que chegou a Portugal logo em seguida, por meio das relações entre os imigrantes com o país de origem: a Angola. O objetivo é compreender como, ao lado de outras formas de expressão cultural juvenis, em Lisboa, o kuduro, assim como o hip-hop, o rap e o reggae, passou a fazer parte integrante do consumo e da produção cultural dos jovens da periferia. Em meio à música e à dança como formas de entretenimento, um universo de tensões sociais, étnicas e geracionais faz-se presente e faz emergir interessantes processos de identificação social. A escola, a rua e a Internet tornaram-se os principais espaços de socialização do kuduro, que perpassa um estilo de vida que parece constituir laços de afinidade entre imigrantes e descendentes, tendo como referência o país de origem ou mesmo uma África imaginada pela relação de solidariedade entre descendentes da imigração originária dos Países Africanos de Língua Portuguesa. A análise de tais questões está implicada pelas novas dinâmicas dos fluxos contemporâneos transnacionais de pessoas, de produtos culturais e de informações, em contextos metropolitanos e pós-coloniais.

Cultural struggles in the lusofonia arena: Portuguese-speaking migrant musicians in Lisbon

Approaching music as a point of social connection in the post-colonial city of Lisbon, where cultural entrepreneurs deploy the political concept of lusofonia, this study examines the ways in which local migrant musicians from Portuguese-speaking African countries (PALOPJ, as well as Brazil and East Timor, position themselves in this context. In general, the study shows that there is a lack of recognition of the contribution they make to the expressive culture of the Portuguese capital, and this is related to national preconceptions. Surprisingly, despite several existing counter- discourses regarding lusofonia, all interviewed musicians do see some future relevance in this concept. They appeal to both supranational institutions and national governments, asking for structural support in order to promote and disseminate all the expressive culture of Portuguese-speaking African countries, indicating that the contribution of migrant musicians from these countries should be considered as an integral part of Portugal's cultural expression and heritage.

Cultural struggles in the lusofonia arena: Portuguese-speaking migrant musicians in Lisbon

Approaching music as a point of social connection in the post-colonial city of Lisbon, where cultural entrepreneurs deploy the political concept of lusofonia, this study examines the ways in which local migrant musicians from Portuguese-speaking African countries (PALOP), as well as Brazil and East Timor, position themselves in this context. In general, the study shows that there is a lack of recognition of the contribution they make to the expressive culture of the Portuguese capital, and this is related to national preconceptions. Surprisingly, despite several existing coun- ter-discourses regarding lusofonia, all interviewed musicians do see some future relevance in this concept. They appeal to both supranational institutions and national governments, asking for structural support in order to promote and disseminate all the expressive culture of Portuguese-speaking African countries, indicating that the contribution of migrant musicians from these countries should be considered as an integral part of Portugal’s cultural expression and heritage. Key words: Lusofonia, Portugal, migrant musicians, cultural policy, postcolonialism

Brazil-Africa technical cooperation in health: what’s its relevance to the post-Busan debate on ‘aid effectiveness’?

BackgroundBrazil is rapidly becoming an influential player in development cooperation, also thanks to its high-visibility health projects in Africa and Latin America. The 4th High-level Forum on Aid Effectiveness held in Busan in late 2011 marked a change in the way development cooperation is conceptualised. The present paper explores the issue of emerging donors’ contribution to the post-Busan debate on aid effectiveness by looking at Brazil’s health cooperation projects in Portuguese-speaking Africa.DebateWe first consider Brazil’s health technical cooperation within the country’s wider cooperation programme, aiming to identify its key characteristics, claimed principles and values, and analysing how these translate into concrete projects in Portuguese-speaking African countries. Then we discuss the extent to which the Busan conference has changed the way development cooperation is conceptualised, and how Brazil’s technical cooperation health projects fit within the new framework.SummaryWe conclude that, by adopting new concepts on health cooperation and challenging established paradigms - in particular on health systems and HIV/AIDS fight - the Brazilian health experience has already contributed to shape the emerging consensus on development effectiveness. However, its impact on the field is still largely unscrutinised, and its projects seem to only selectively comply with some of the shared principles agreed upon in Busan. Although Brazilian cooperation is still a model in the making, not immune from contradictions and shortcomings, it should be seen as enriching the debate on development principles, thus offering alternative solutions to advance the discourse on cooperation effectiveness in health.

How students perceive medical competences: a cross-cultural study between the Medical Course in Portugal and African Portuguese Speaking Countries

BackgroundA global effort has been made in the last years to establish a set of core competences that define the essential professional competence of a physician. Regardless of the environment, culture or medical education conditions, a set of core competences is required for medical practice worldwide. Evaluation of educational program is always needed to assure the best training for medical students and ultimately best care for patients. The aim of this study was to determine in what extent medical students in Portugal and Portuguese speaking African countries, felt they have acquired the core competences to start their clinical practice. For this reason, it was created a measurement tool to evaluate self-perceived competences, in different domains, across Portuguese and Portuguese-speaking African medical schools.MethodsThe information was collected through a questionnaire that defines the knowledge, attitudes and skills that future doctors should acquire. The Cronbach's Alpha and Principal Components Analysis (PCA) were used to evaluate the reliability of the questionnaire. In order to remove possible confounding effect, individual scores were standardized by country.ResultsThe order of the domain's scores was similar between countries. After standardization, Personal Attitudes and Professional Behavior showed median scores above the country global median and Knowledge alone showed median score below the country global median. In Portugal, Clinical Skills showed score below the global median. In Angola, Clinical Skills and General Skills showed a similar result. There were only significant differences between countries in Personal Attitudes (p < 0.001) and Professional Behavior (p = 0.043).ConclusionsThe reliability of the instrument in Portuguese and Portuguese-speaking African medical schools was confirmed. Students have perceived their level of competence in personal attitudes in a high level and in opposite, knowledge and clinical skills with some weaknesses.

Portuguese-speaking African countries face shortages of doctors

It’s often problematic enough to train doctors to practise in the developing world. Add language to the equation and a chronic shortage of physicians can become a crisis. So it seems in five Portuguese-speaking nations of Africa — Angola, Cape Verde, Guinea Bissau, Mozambique, Sao Tome and

Conhecimentos sobre o uso de contraceptivos e prevenção de DST: a percepção de mulheres imigrantes

Sexual and reproductive health is a major public health concern, since it involves individual health and wellbeing and affects the socioeconomic level of societies. Socially underprivileged groups like immigrants may be more exposed to sexual and reproductive health problems. The current study examines key aspects of sexual and reproductive health among Brazilian and African immigrant women in Portugal, particularly contraceptive methods, sexually transmitted diseases, and condom use. Data were collected through focus groups with childbearing-age immigrant women living in Portugal and originally from Brazil or Portuguese-speaking African countries. The results highlight the participants' perceptions and knowledge concerning the respective issues and identify aspects to be considered in order to better meet their sexual and reproductive health needs.