A critical account of the policy context shaping perinatal survival in Nepal: policy tension of socio-cultural versus a medical approach.

Background: Nepal formulated a range of policies related to maternal and neonatal survival, especially after the year 2000. Nevertheless, Nepal's perinatal mortality remains high, particularly in disadvantaged regions. Policy analysis can uncover the underlying values, strategies and policy formulation processes that shape the potential to reduce in-country health inequities.

Health system barriers influencing perinatal survival in mountain villages of Nepal: implications for future policies and practices.

Background: This paper aims to examine the health care contexts shaping perinatal survival in remote mountain villages of Nepal. Health care is provided through health services to a primary health care level-comprising district hospital, village health facilities and community-based health services. The paper discusses the implications for future policies and practice to improve health access and outcomes related to perinatal health.

A qualitative study about the gendered experiences of motherhood and perinatal mortality in mountain villages of Nepal: implications for improving perinatal survival.

Background: We aim to examine the gendered contexts of poor perinatal survival in the remote mountain villages of Nepal. The study setting comprised two remote mountain villages from a mid-western mountain district of Nepal that ranks lowest on the Human Development Index (0.304), and is reported as having the lowest child survival rates in the country.

"I like talking to people on the computer": Outcomes of a home-based intervention to develop social media skills in youth with disabilities living in rural communities.

Purpose: To investigate the effectiveness of a home-based social media use intervention to enhance the social networks of rural youth with disabilities.

Method: Participants were nine youth (mean age = 17.0 years) with disabilities from two rural Australian communities.

Religio-cultural factors contributing to perinatal mortality and morbidity in mountain villages of Nepal: Implications for future healthcare provision.

Objective And The Context: This paper examines the beliefs and experiences of women and their families in remote mountain villages of Nepal about perinatal sickness and death and considers the implications of these beliefs for future healthcare provision.

Methods: Two mountain villages were chosen for this qualitative study to provide diversity of context within a highly disadvantaged region. Individual in-depth interviews were conducted with 42 women of childbearing age and their family members, 15 health service providers, and 5 stakeholders.

Service providers' experiences of using a telehealth network 12 months after digitisation of a large Australian rural mental health service.

Background: Despite evidence of benefits of telehealth networks in increasing access to, or providing, previously unavailable mental health services, care providers still prefer traditional approaches. For psychiatric assessment, digital technology can offer improvements over analog systems for the technical and, subsequently, the social quality of provider-client interaction. This is in turn expected to support greater provider uptake and enhanced patient benefits.

To what extent do Australian child and youth health policies address the social determinants of health and health equity?: a document analysis study.

Background: There is a significant body of evidence that highlights the importance of addressing the social determinants of child and youth health. In order to tackle health inequities Australian governments are being called upon to take action in this area at a policy level. Recent research suggests that the health and well-being of children and youth in Australia is 'middle of the road' when compared to other OECD countries.

Intersectoral action on SDH and equity in Australian health policy.

Intersectoral action between public agencies across policy sectors, and between levels of government, is seen as essential for effective action by governments to address social determinants of health (SDH) and to reduce health inequities. The health sector has been identified as having a crucial stewardship role, to engage other policy sectors in action to address the impacts of their policies on health. This article reports on research to investigate intersectoral action on SDH and health inequities in Australian health policy.

Addressing social determinants of health inequities through settings: a rapid review.

Changing settings to be more supportive of health and healthy choices is an optimum way to improve population health and health equity. This article uses the World Health Organisation's (1998) (WHO Health Promotion Glossary. WHO Collaborating Centre for Health Promotion, Department of Public Health and Community Medicine, University of Sydney, NSW) definition of settings approaches to health promotion as those focused on modifying settings' structure and nature.

Enhancing social participation in young people with communication disabilities living in rural Australia: outcomes of a home-based intervention for using social media.

Purpose: The purpose of this study is to investigate the effectiveness of a home-based intervention using social media to enhance social networks of young people with disabilities and communication difficulties.

Method: Eight young people (M(age) = 15.4 years) with communication disabilities participated from two rural Australian towns.

Applying Health in All Policies to obesity in South Australia.

Public policy strategies impact on population health by acting on the effectiveness, availability and distribution of the social determinants of health. Reducing obesity and promoting healthy weight is a key focus of governments, health promoters and researchers, and can benefit from a systems approach with 'upstream' policy action beyond the health sector. Although the literature identifies many areas for hypothetical non-health policy action, and in particular relating to food and activity environments, few have identified practical, politically viable and relatively cost-free processes by which non-health sectors would want to commit to such action.

A longitudinal study of the mental health impacts of job loss: the role of socioeconomic, sociodemographic, and social capital factors.

Objectives: To examine the role of socioeconomic, sociodemographic, and social capital factors in buffering or exacerbating the mental health impacts of job loss.

Methods: A 2-year longitudinal cohort study of 300 workers experiencing job loss from a motoring manufacturer in Adelaide, South Australia. Data were collected on mental health (12-item version of the General Health Questionnaire) and socioeconomic, sociodemographic, and social capital factors.

An eHealth Intervention for Patients in Rural Areas: Preliminary Findings From a Pilot Feasibility Study.

Background: eHealth facilitation of chronic disease management has potential to increase engagement and effectiveness and extend access to care in rural areas.

Objective: The objective of this study was to demonstrate the feasibility and acceptability of an eHealth system for the management of chronic conditions in a rural setting.

Methods: We developed an online management program which incorporated content from the Flinders Chronic Condition Management Program (Flinders Program) and used an existing software platform (goACT), which is accessible by patients and health care workers using either Web-enabled mobile phone or Internet, enabling communication between patients and clinicians.

Dear health minister: tend the garden but make sure you fence the crocodiles.

This paper offers lessons to in-coming health ministers on how they can act to reduce inequities and take action on social determinants. It draws on an interview study of twenty former Australian State, Territory and Federal health ministers about the extent to which they were able to do these things during their tenure. In order to take effective health equity action the health ministers advised: ensure evidence is used to develop a strong party policy platform for health equity; install policy entrepreneurs for health equity and social determinants in the health ministry; build popular constituencies through processes of deliberative democracy; establish context appropriate cross-department mechanisms to co-ordinate action on social determinants; and be elected in the context of a political party which values social justice and redistribution.

The perspectives of older Greek-Australians toward changes in the nature of family support: implications for family care policies.

Internationally, public policies encourage "aging in place," and the majority of older Australians requiring care in the community receive informal care, supplemented by publicly subsidized formal services. The effect of contemporary social changes on informal care in aging migrant communities is poorly understood. This articles explores the perceptions of older Greek-Australians toward changes in the nature of family support.

Childbirth traditions and cultural perceptions of safety in Nepal: critical spaces to ensure the survival of mothers and newborns in remote mountain villages.

Objective: to uncover local beliefs regarding pregnancy and birth in remote mountainous villages of Nepal in order to understand the factors which impact on women's experiences of pregnancy and childbirth and the related interplay of tradition, spiritual beliefs, risk and safety which impact on those experiences.

Design: this study used a qualitative methodological approach with in-depth interviews framework within social constructionist and feminist critical theories.

Setting: the setting comprised two remote Nepalese mountain villages where women have high rates of illiteracy, poverty, disadvantage, maternal and newborn mortality, and low life expectancy.

"Never mind the logic, give me the numbers": former Australian health ministers' perspectives on the social determinants of health.

The articulation of strong evidence and moral arguments about the importance of social determinants of health (SDH) and health equity has not led to commensurate action to address them. Policy windows open when, simultaneously, an issue is recognised as a problem, policy formulation and refinement happens and the political will for action is present. We report on qualitative interviews with 20 former Australian Federal, State or Territory health ministers conducted between September 2011 and January 2012 concerning their views about how and why the windows of policy opportunity on the SDH did or did not open during their tenure.

Mothers' knowledge of and attitudes toward human milk banking in South Australia: a qualitative study.

Background: The beneficial effects of breastfeeding for mothers and babies are well recognized. When maternal breast milk is not available in sufficient quantity, donor breast milk is recommended as an alternate source of nutrition, particularly in preterm and other high-risk infants. Australia lags behind the rest of the developed world in establishing and promoting human milk banks; there is no human milk bank in South Australia and little is known concerning mothers' perceptions of using human milk banks in that state.

A survey of child care centers about breastfeeding support in Adelaide, South Australia.

Background: Australia has high rates of breastfeeding initiation, with a consistent decline over the first year. Furthermore, there is a growing trend of maternal employment and rising numbers of children enrolled in different types of child care services, both of which can have a negative impact on breastfeeding.

Objectives: To provide evidence to better inform implementation of breastfeeding-friendly strategies in child care settings, this study examined breastfeeding policy and practice in child care centers in metropolitan Adelaide.

The interplay between structure and agency in shaping the mental health consequences of job loss.

Background: Job loss is a discrete life event, with multiple adverse consequences for physical and mental health and implications for agency. Our research explores the consequences of job loss for retrenched workers' mental health by examining the interplay between their agency and the structures shaping their job loss experiences.

Methods: We conducted two waves of in-depth, semi-structured interviews with a sample of 33 of the more than 1000 workers who lost their jobs at Mitsubishi Motors in South Australia during 2004 and 2005 as a result of industry restructuring.

Vicious cycles: digital technologies and determinants of health in Australia.

Digital technologies are increasingly important as ways to gain access to most of the important social determinants of health including employment, housing, education and social networks. However, little is known about the impact of the new technologies on opportunities for health and well-being. This paper reports on a focus group study of the impact of these technologies on people from low socio-economic backgrounds.

Access and acceptability of community-based services for older Greek migrants in Australia: user and provider perspectives.

In most developed nations, ageing migrants represent a growing proportion of the older population. Policies that emphasise care in the community depend on older migrants having access to formal services along with informal support, yet little is known about how older migrants experience community-based formal services. By examining the views of both Greek elders in Australia and those of formal service providers, this research fills an important gap in the literature around access to and acceptability of formal community-based services for older migrants.

Digital technology use among disadvantaged Australians: implications for equitable consumer participation in digitally-mediated communication and information exchange with health services.

Objective: To present research findings on access to, and use of, digital information and communication technologies (ICTs) by Australians from lower income and disadvantaged backgrounds to determine implications for equitable consumer access to digitally-mediated health services and information.

Methods: Focus groups were held in 2008-09 with 80 residents from lower income and disadvantaged backgrounds in South Australia, predominantly of working- and family-formation age (25 to 55 years). Qualitative analysis was conducted on a-priori and emergent themes to describe dominant categories.