Community Views of Determinants of Men's Wellbeing in Guatemala: A Study Using Fuzzy Cognitive Mapping.

Background: In post-conflict Guatemala, Indigenous men's psychological distress has been linked to violence exposure, disrupted social support systems, and structural inequities.

Purpose: We aimed to document how communities themselves understand men's wellbeing and the factors that influence men's wellbeing.

Research Design And Study Sample: Fuzzy Cognitive Mapping with 20 stakeholder groups in Santiago Atitlán and Cuilco, Guatemala defined men's wellbeing in local terms and identified the influences community groups understood to promote and detract from men's wellbeing.

How beneficiaries see complex health interventions: a practice review of the Most Significant Change in ten countries.

Background: The Most Significant Change is a story-based evaluation approach used in many international development programs. This practice review summarises practical experience with the approach in complex health interventions in ten countries, with the objective of making it more accessible in evaluation of other complex health interventions.

Results: Participatory research practitioners and trainees discussed five themes following brief presentations by each of the seven attendees who led the exercise: (i) sampling and recruitment; (ii) phrasing the questions to elicit stories; (iii) story collection strategies; (iv) quality assurance; and (v) analysis.

Bridging Western and Indigenous knowledge through intercultural dialogue: lessons from participatory research in Mexico.

Indigenous communities in Latin America and elsewhere have complex bodies of knowledge, but Western health services generally approach them as vulnerable people in need of external solutions. Intercultural dialogue recognises the validity and value of Indigenous standpoints, and participatory research promotes reciprocal respect for stakeholder input in knowledge creation.As part of their decades-long community-based work in Mexico's Guerrero State, researchers at the responded to the request from Indigenous communities to help them address poor maternal health.

Women's circles as a culturally safe psychosocial intervention in Guatemalan indigenous communities: a community-led pilot randomised trial.

Background: Indigenous Maya women in Guatemala show some of the worst maternal health indicators worldwide. Our objective was to test acceptability, feasibility and impact of a co-designed group psychosocial intervention (Women's Circles) in a population with significant need but no access to mental health services.

Methods: A parallel group pilot randomised study was undertaken in five rural Mam and three periurban K'iche' communities.

Quantitative Methodologies Reveal a Diversity of Nutrition, Infection/Illness, and Psychosocial Stressors During Pregnancy and Lactation in Rural Mam-Mayan Mother-Infant Dyads From the Western Highlands of Guatemala.

Background: The nature and severity of 3 categories of maternal stressors (nutritional, infectious, and psychosocial) that may impact maternal health and early infant growth are not often considered together.

Objectives: To describe quantitative methodologies; assess construct validity of questionnaires; report variability in sociodemographic, obstetric, nutritional, infectious, and psychosocial characteristics; and compare characteristics between pregnancy and lactation and between study cohorts of Mam-Mayan mother-infant dyads.

Methods: Grounded in participatory action research and a socioecological framework, this observational study enrolled a longitudinal cohort of 155 women, followed during pregnancy (6-9 months), early (0-6 weeks), and later (4-6 months) postpartum, and 2 cross-sectional cohorts (60 early and 56 later postpartum).

Cultural determinants of optimal breastfeeding practices among indigenous Mam-Mayan women in the Western Highlands of Guatemala.

Background: Among indigenous Mam-Mayan women, breastfeeding practices may be intertwined with cultural influences during the early postpartum period.

Objectives: Our study explored whether beliefs regarding transmission of emotions through breast milk, the feeding of agüitas or temascal (traditional sauna) use were associated with achievement of the World Health Organization infant feeding recommendations and if these cultural practices served as moderators of the relationship between optimal breastfeeding practices and infant anthropometry.

Methods: We recruited 190 mother-infant dyads at infant age < 46 days.

Maternal health and health-seeking behaviors among indigenous Mam mothers from Quetzaltenango, Guatemala.

Objective: To obtain background information about maternal health and health-seeking behaviors among indigenous mothers living in rural Mam-Mayan communities of Quetzaltenango, Guatemala.

Methods: A cross-sectional analysis of 100 pregnant and breastfeeding women in four communities was performed to determine prevalence and determinants of service utilization.

Results: Extreme poverty, poor education, and poor access to basic resources were prevalent.

Improving average health and persisting health inequities--towards a justice and fairness platform for health policy making in Asia.

Background: Following a period of rapid economic and social change across Asia in the 1980s and 1990s, there have been persisting reports of public sector health systems decline and worsening health inequities within countries. Many studies and analyses in the region have indicated that these inequities are socially determined, leading to questions regarding the adequacy of current health policy approaches towards addressing the challenge of persisting health inequities.

Methods: Utilizing published data from Demographic Health Surveys (DHS) and case studies and reviews on health inequity in the Asian region, this article aims to describe the existing patterns of inequity of health access both within and between countries, focusing on immunization, maternal health access, nutritional outcomes and child mortality, with a view to recommending health policy options for addressing these health inequities.

Determinants of utilisation of intrapartum obstetric care services in Cambodia, and gaps in coverage.

Background: Facility delivery and skilled birth attendance are two of the most effective strategies for decreasing maternal mortality. The objectives of this study were to further define utilisation of these services in Cambodia and to uncover socio-economic or location-specific coverage gaps that may exist.

Methods: We performed a cross-sectional analysis of the 2005 Cambodia Demographic Health Survey (CDHS) to determine prevalence, and determinants, of service utilisation.

Knowledge, beliefs, and health care practices relating to treatment of HIV in Vellore, India.

In India, little is known about health care-seeking behavior among HIV-infected individuals. Similarly, little is known about how HIV is being treated in the community, in particular by Indian Systems of Medicine (ISM) providers. Therefore, while ART implementation programs continue to expand, it is important to determine whether the knowledge, attitudes, and treatment practices of HIV-infected individuals and their health care providers are aligned with current treatment recommendations.