When female circumcision comes to the West: Attitudes toward the practice among Somali Immigrants in Oslo

Somalia is the country with the highest prevalence of female circumcision in the world, this affects Somali diaspora as well. The article investigates whether or not Somali immigrants’ attitudes in Oslo toward the practice has improved in favor of its abandonment.Soomaaliya waa dalka adduunka ugu badan gudniinka haweenka, arrintaanna waxay saamayn ku leedahay xitaa qurbajoogta soomaaliyeed. Maqaalku wuxuu baarayaa haddii qaxootiga soomaaliyeed ee Oslo uu wax iska beddelay kategidda adeegsiga gudniikaas.La Somalia è il paese con la più alta prevalenza di circoncisione femminile al mondo, e questo influisce anche sulla diaspora somala. L'articolo indaga se l'atteggiamento nei confronti di questa pratica degli immigrati somali a Oslo è migliorato a favore del suo abbandono

Caesarean Section among Referred and Self-Referred Birthing Women: A Cohort Study from a Tertiary Hospital, Northeastern Tanzania.

The inequity in emergency obstetric care access in Tanzania is unsatisfactory. Despite an existing national obstetric referral system, many birthing women bypass referring facilities and go directly to higher-level care centres. We wanted to compare Caesarean section (CS) rates among women formally referred to a tertiary care centre versus self-referred women, and to assess the effect of referral status on adverse outcomes after CS. We used data from 21,011 deliveries, drawn from the birth registry of a tertiary hospital in northeastern Tanzania, during 2000-07. Referral status was categorized as self-referred if the woman had bypassed or not accessed referral, or formally-referred if referred by a health worker. Because CS indications were insufficiently registered, we applied the Ten-Group Classification System to determine the CS rate by obstetric group and referral status. Associations between referral status and adverse outcomes after CS delivery were analysed using multiple regression models. Outcome measures were CS, maternal death, obstetric haemorrhage ≥ 750 mL, postpartum stay > 9 days, neonatal death, Apgar score < 7 at 5 min and neonatal ward transfer. Referral status contributed substantially to the CS rate, which was 55.0% in formally-referred and 26.9% in self-referred birthing women. In both groups, term nulliparous singleton cephalic pregnancies and women with previous scar(s) constituted two thirds of CS deliveries. Low Apgar score (adjusted OR 1.42, 95% CI 1.09-1.86) and neonatal ward transfer (adjusted OR 1.18, 95% CI 1.04-1.35) were significantly associated with formal referral. Early neonatal death rates after CS were 1.6% in babies of formally-referred versus 1.2% in babies of self-referred birthing women, a non-significant difference after adjusting for confounding factors (adjusted OR 1.37, 95% CI 0.87-2.16). Absolute neonatal death rates were > 2% after CS in breech, multiple gestation and preterm deliveries in both referral groups. Women referred for delivery had higher CS rates and poorer neonatal outcomes, suggesting that the formal referral system successfully identifies high-risk birth, although low volume suggests underutilization. High absolute rates of post-CS adverse outcomes among breech, multiple gestation and preterm deliveries suggest the need to target self-referred birthing women for earlier professional intrapartum care

Parenting experiences of couples living with human immunodeficiency virus: A qualitative study from rural Southern Malawi

The advent of antiretroviral therapy (ART) has allowed couples living with human immunodeficiency virus (HIV) to live longer and healthier lives. The reduction in the mother-to-child transmission of HIV has encouraged some people living with HIV (PLWH) to have children. However, little is known about the parenting experiences of couples living with HIV (CLWH). The aim of this qualitative study was to explore and describe parenting  experiences of seroconcordant couples who have a child while living with HIV in Malawi. Data were collected using in-depth interviews with 14 couples purposively sampled in matrilineal Chiradzulu and patrilineal Chikhwawa  communities from July to December 2010. The research findings shows that irrespective of kinship organization, economic hardships, food insecurity, gender-specific role expectations and conflicting information from health institutions and media about sources of support underpin their parenting roles. In addition, male spouses are directly involved in household activities, childcare and child feeding decisions, challenging the existing  stereotyped gender norms. In the absence of widow inheritance, widows from patrilineal communities are not receiving the expected support from the deceased husband relatives. Finally, the study has shown that CLWH are able to find solutions for the challenges they encounter. Contrary to existing belief that such who have children depend solely on public aid. Such claims without proper knowledge of local social cultural contexts, may contribute to stigmatizing CLWH who continue to have children. The study is also relevant to PLWH who, although not parents themselves, are confronted with a situation where they have to accept responsibility for raising children from their kin. We suggest the longer-term vision for ART wide access in Malawi to be broadened beyond provision of ART to incorporate social and economic interventions that support the rebuilding of CLWH social and economic lives. The interventions must be designed using a holistic multi-sector approach.Keywords: Malawi, couples, experiences, HIV and AIDS, parentingL’ave`nement de la the´rapie antire´trovirale a permis couples vivant avec le VIH de vivre plus longtemps et en meilleure sante´. La re´duction de la transmission du VIH de la me`re a` l’enfant a encourage´ certaines personnes vivant avec le VIH ont deux enfants. Cependant, on sait peu sur les expe´riences parentales des  couples vivant avec le VIH. Le but de cette e´tude qualitative e´tait d’explorer et de´crire des expe´riences  parentales des couples se´roconcordants qui ont un enfant tout en vivant avec le VIH au Malawi. Les donne´es  ont e´te´ collecte´es abuser des entrevues en profondeur avec des quatorze couples dessein e´chantillonne´s dans les communaute´s matriline´aires et patriline´aires Chiradzulu, Chikhwawa de Juillet jeu. De´cembre 2010.  Les re´sultats de recherche montrent que, inde´pendamment de l’organisation de la parente´, les difficulte´s  e´conomiques, l’inse´curite´ alimentaire, le roˆle des attentes spe´cifiques de genre et des informations  contradictoires des institutions de sante´ et les me´dias au sujet des sources de soutien angoisse leur roˆle  parental En outre, les conjoints de sexe masculin sont directement implique´s dans les activite´s de me´nage,  garde d’enfants et les de´cisions de l’alimentation des enfants, contestant la norme de genre ste´re´otype´s existant. En l’absence de l’he´ritage des veuves, veuves des communaute´s patriline´aires ne rec¸oivent pas le  soutien attendu de la famille du mari de´funt. Enfin, l’e´tude a montre´ que les couples vivant avec le VIH sont  a` l’aise pour trouver des solutions aux de´fis qu’ils rencontrent. Contrairement deux croyance existante que ce  qui ont des enfants de´pendent uniquement sur l’aide publique. Ces revendications sans la connaissance de  contextes socioculturels locaux, peut contribuer a` stigmatiser les couples vivant avec le VIH qui continuent deux  ont des enfants. L’e´tude est e´galement pertinent pour les personnes vivant avec le VIH qui, bien que non les  parents themelves, sont confronte´s a` une situation ou` ils doivent accepter la responsabilite´ d’e´lever les enfants de leurs parents. Nous sugge´rons la vision a` long terme de la the´rapie antire´trovirale large acce`s au Malawi a` eˆtre e´largi au-dela` de la fourniture d’un traitement antire´troviral deux interventions sociales et e´conomiques Incorporer qui soutiennent la reconstruction des couples vivant avec le VIH vie sociale et  e´conomique. Les interventions doivent eˆtre conc¸ues utilisation excessive d’une approche multi-sectorielle  globale.Mots cle´s: Malawi, les couples, les expe´riences, le VIH et le SIDA, la parentalite

Reproductive decisions of couples living with HIV in Malawi: What can we learn for future policy and research studies?

Background:  The rapid scale-up of free antiretroviral therapy has lead to decline in adult mortality at the population level and reduction of vertical transmission. Consequently, some couples living with HIV are maintaining their reproductive decisions; marrying and having children. This paper analyses policies and guidelines on HIV, AIDS and sexual and reproductive health in Malawi for content on marriage and childbearing for couples living with HIV.Methods:  A qualitative study using interpretive policy analysis approach was conducted from July to December 2010 in two phases. First, data on access to HIV, AIDS and sexual and reproductive health services were collected using in-depth interviews with twenty couples purposively sampled in matrilineal Chiradzulu and patrilineal Chikhwawa communities. Secondly,data were collected from Malawi policies and guidelines on HIV, AIDS and sexual and reproductive health. The documents were reviewed for content on marriage and childbearing for couples living with HIV. Data were analysed using framework approach for applied policy analysis.Results: Four categories emerged from each phase. From the study, we extracted health workers attitudes, weak linkage between HIV, AIDS and sexual and reproductive health services, contradictory messages between media and the hospitals and lack of information as factors directly related to guidelines and policies. Analysis of guidelines and policies showed nonprescriptiveness on issues of HIV, AIDS and reproduction: they do not reflect the social cultural experiences of couples living with HIV. In addition, there is; lack of clinical guidelines, external influence on adoption of the policies and guidelines and weak linkages between HIV and AIDS and sexual and reproductive health services.Conclusion: This synthesis along with more detailed findings which are reported in other published articles, provide a strong basis for updating the policies and development of easy-to-follow guidelines in order to effectively provide services to couples living with HIV in Malawi

Genetic research: the role of citizens, public health and international stakeholders

Background: Genetic research has become an indispensable instrument for medical research, and the subjects involved have both divergent and convergent interests. Objective: The possibility of having more detailed genetic information undoubtedly offers benefits for the health of the subject, but could also pose risks and make the subject vulnerable to discrimination. Methods: The scientific community has viewed very favorably the public health utility of family history, in which data from a family whose members suffer from chronic pathologies is collected and filed, in order to develop a sort of “stratification of family risk.” Even though in the last decade the scientific and juridical literature has contributed greatly to the topic of biobanks, the perplexities that continue to surround this theme give the idea that current ethical protocols on research are inadequate. Results: Researchers, citizens, International stakeholders, mass media, Public Health and Governments play a key role in genetic research. It is obvious that the methods used for genetic research do not present intrinsic risks; they are much less dangerous than other activities of diagnosis and research. Before authorizing a research project, it is important to reflect on the responsibility and transparency of the studies to be conducted, and on the impact they may have on the interests of public health. Conclusion: We believe that the highest priority need is to develop a common language on the theme, as is the case in the sphere of clinical experimentation where rules of good clinical practice, albeit at times conflicting, have led to uniform convergences in the scientific world on the points to be actuated

Evaluating the suitability of coupled biophysical models for fishery management

The potential role of coupled biophysical models in enhancing the conservation, management, and recovery of fish stocks is assessed, with emphasis on anchovy, cod, herring, and sprat in European waters. The assessment indicates that coupled biophysical models are currently capable of simulating transport patterns, along with temperature and prey fields within marine ecosystems; they therefore provide insight into the variability of early-life-stage dynamics and connectivity within stocks. Moreover, the influence of environmental variability on potential recruitment success may be discerned from model hindcasts. Based on case studies, biophysical modelling results are shown to be capable of shedding light on whether stock management frameworks need re-evaluation. Hence, key modelling products were identified that will contribute to the development of viable stock recovery plans and management strategies. The study also suggests that approaches combining observation, process knowledge, and numerical modelling could be a promising way forward in understanding and simulating the dynamics of marine fish populations

Spawning of bluefin tuna in the black sea: historical evidence, environmental constraints and population plasticity

<div><p>The lucrative and highly migratory Atlantic bluefin tuna, <em>Thunnus thynnus</em> (Linnaeus 1758<em>;</em> Scombridae), used to be distributed widely throughout the north Atlantic Ocean, Mediterranean Sea and Black Sea. Its migrations have supported sustainable fisheries and impacted local cultures since antiquity, but its biogeographic range has contracted since the 1950s. Most recently, the species disappeared from the Black Sea in the late 1980s and has not yet recovered. Reasons for the Black Sea disappearance, and the species-wide range contraction, are unclear. However bluefin tuna formerly foraged and possibly spawned in the Black Sea. Loss of a locally-reproducing population would represent a decline in population richness, and an increase in species vulnerability to perturbations such as exploitation and environmental change. Here we identify the main genetic and phenotypic adaptations that the population must have (had) in order to reproduce successfully in the specific hydrographic (estuarine) conditions of the Black Sea. By comparing hydrographic conditions in spawning areas of the three species of bluefin tunas, and applying a mechanistic model of egg buoyancy and sinking rate, we show that reproduction in the Black Sea must have required specific adaptations of egg buoyancy, fertilisation and development for reproductive success. Such adaptations by local populations of marine fish species spawning in estuarine areas are common as is evident from a meta-analysis of egg buoyancy data from 16 species of fish. We conclude that these adaptations would have been necessary for successful local reproduction by bluefin tuna in the Black Sea, and that a locally-adapted reproducing population may have disappeared. Recovery of bluefin tuna in the Black Sea, either for spawning or foraging, will occur fastest if any remaining locally adapted individuals are allowed to survive, and by conservation and recovery of depleted Mediterranean populations which could through time re-establish local Black Sea spawning and foraging.</p> </div

Interaction between Cape hake spawning and the circulation in the northern Benguela upwelling ecosystem

Cape hake in Namibian waters are demersal and mesopelagic spawners, spawning peaking offshore between 100 and 400 m deep, depending on local environmental conditions. The cross-shelf circulation, low-oxygen layers and mesoscale gyres are three important environmental factors influencing hake spawning behaviour and subsequent transport of the spawning products. Normally, hake spawn offshore near the bottom at depths of 150–400 m. However, during one cruise, spawning was concentrated below several subsurface mesoscale gyres, resulting in reduced dispersion of the eggs and larvae. When the low-oxygen layer above the bottom is pronounced, hake spawning has been observed close to the top of the layer at oxygen concentrations as low as 0.2–0.3 ml l-1. The relatively small size of the eggs and their high specific gravity make them ascend quite slowly from the spawning depths, 10–40 m per day. Consequently, hake eggs spawned deeper than 200 m hatch before they reach the upper mixed layer. The newly hatched larvae are relatively undeveloped, without functional eyes or mouth, and display little swimming activity during their first hours, but laboratory observations have revealed subsequent periods of downward swimming activity. Based on current field observations, on buoyancy measurements of eggs and larvae and on observed larval behaviour, it is concluded that hake eggs and larvae are transported onshore by features of the upwelling subsurface circulation that compensate for offshore movement of surface water. This may be the basic mechanism concentrating early juvenile hake nearshore. Spawning activity near the low-oxygen layer might be a behavioural adaptation to minimize egg predation, because few other species are expected to survive such low concentrations of oxygen.Keywords: buoyancy, eggs, larvae, recruitment processes, retention, vertical distributionAfrican Journal of Marine Science 2001, 23: 317–33

Attitudes toward female circumcision among Somali immigrants in Oslo: a qualitative study

Due to its negative impact on public health, female circumcision (FC) has gained increased attention from international communities and the Norwegian public in recent decades. In 1995, the Norwegian government outlawed the practice and simultaneously developed a package of measures aimed at preventing and ultimately eradicating FC in Norway. Like many other Western countries, immigrants of Somali descent constitute the largest immigrant group in Norway from countries with FC traditions. Although this immigrant group is often perceived as a cultural society that supports FC generally as a practice, there appears to be a lack of studies that explore the impact of acculturation and the Western social context on Somali immigrants’ attitudes toward the practice. Against this background, this paper explores the attitudes of Somalis living in Oslo, Norway to the practice of FC. Findings from this qualitative study indicate that Somalis in Oslo have, to a large extent, changed their attitude toward the practice. This was proven by the presence in Oslo of a large number of Somali parents who left their daughters uncut as well as Somali girls, boys, men, and women who attribute being uncircumcised a high status. This study adds to the knowledge of the process of abandonment of FC among immigrants in the Western countries. The study highlights the success that has been achieved in improving attitudes toward the practice of the Somali community in Oslo, Norway, as well as emerging challenges that need to be addressed further