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Hussain, A. H., Ferdoush, J., Mashreky, S. R., Rahman, A. K., Ferdausi, N. & Dalal, K. (2019). Epidemiology of childhood blindness: A community-based study in Bangladesh. PLoS ONE, 14(6), Article ID e0211991.
Open this publication in new window or tab >>Epidemiology of childhood blindness: A community-based study in Bangladesh
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 6, article id e0211991Article in journal (Refereed) Published
Abstract [en]

This study aimed to investigate the prevalence and causes of childhood blindness in a rural area of Bangladesh. We adopted a cross-sectional quantitative study design for this study, which was performed in three unions (sub-districts) located in Raiganj Upazila of the Sirajganj district in Bangladesh. Using a validated tool, a screening program was conducted at the household level. After initial screening, a team of ophthalmologists confirmed the diagnoses by clinical examinations. The prevalence of childhood blindness was observed to be 6.3 per 10,000 children, whereas the rate of uniocular blindness was 4.8 per 10,000 children. Congenital problems were the major causes of both uniocular and binocular blindness (uniocular blindness: 84% and binocular blindness: 92%). The whole globe was the site responsible for binocular blindness (28.0%, 95% confidence interval [CI]: 13.1, 47.7), whereas the cornea was responsible for uniocular blindness (57.8%, 95% CI: 35.3, 78.1). Childhood blindness is a public health problem in Bangladesh and is highly prevalent, regardless of sex. The major causes of childhood blindness are congenital.

Place, publisher, year, edition, pages
Public Library of Science, 2019
Keywords
impairment, glaucoma
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:his:diva-17226 (URN)10.1371/journal.pone.0211991 (DOI)000470658500002 ()31173584 (PubMedID)2-s2.0-85067382400 (Scopus ID)
Available from: 2019-06-20 Created: 2019-06-20 Last updated: 2019-08-06
Akl, Z., Akl, M., Eriksson, C., Gifford, M. & Dalal, K. (2019). Evaluating seat belt use in Lebanon (1997-2017). Open Public Health Journal, 12(1), 127-135
Open this publication in new window or tab >>Evaluating seat belt use in Lebanon (1997-2017)
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2019 (English)In: Open Public Health Journal, ISSN 1874-9445, Vol. 12, no 1, p. 127-135Article in journal (Refereed) Published
Abstract [en]

Introduction: The use of seat belts has made a significant contribution to the reduction of road traffic casualties, and the risk inherent with not wearing seat belts in all seats of a vehicle is now well-known worldwide. The use of seat belts has a major role in reducing fatal and nonfatal injuries in all types of motor-vehicles crashes. Aim: The aim of this study is to understand the reasons behind the variation in seat belt use over the past two decades in Lebanon. It analyzes the situation and suggests recommendations to improve seat belt use in Lebanon. Design: Nine observational studies had been conducted in Lebanon during the last two decades between 1997 and 2017, and one qualitative study was performed in 2017. Results: The results show a significant variation in the use of the seat belt. When enforcement efforts are in progress, seat belt use increases. While when there are no checkpoints and the enforcement of seat belt use is almost absent, a significant fall was noticed. Discussion: The results of this study proved the failure of the Lebanese government in saving hundreds of lives just by a simple measure of enforcing seat belt law. Although experiences from various countries prove that such laws usually have a long-lasting effect on seat belt use, Lebanon failed to pursue the successful implementation of this law due to security and political problems. Conclusion: During the past two decades, Lebanon witnessed continuous fluctuations in seat belt use. Outside few short enforcement campaigns, our observations showed lack in seat belt use. Our observations of seat belt use among drivers and front seat passengers showed a significant correlation between seat belt use and the enforcement of seat belt law. The greatest national benefits from seat belt use are obtained when wearing rates are very high. This can be achieved only through a sustained enforcement campaign alongside other seat belt wearing interventions such as publicity and education. © 2019 Open Public Health Journal. All rights reserved.

Place, publisher, year, edition, pages
Bentham Science Publishers B.V., 2019
Keywords
Injury prevention, Law enforcement, Lebanon, Media campaigns, Road Traffic Injuries (RTI), Seat belts
National Category
Public Health, Global Health, Social Medicine and Epidemiology Law and Society
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-17580 (URN)10.2174/1874944501912010127 (DOI)2-s2.0-85070240780 (Scopus ID)
Available from: 2019-08-23 Created: 2019-08-23 Last updated: 2019-11-11Bibliographically approved
Chang, A. Y., Dalal, K. & Dieleman, J. L. (2019). Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995–2050. The Lancet, 393(10187), 2233-2260
Open this publication in new window or tab >>Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995–2050
2019 (English)In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 393, no 10187, p. 2233-2260Article, review/survey (Refereed) Published
Abstract [en]

Background Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries. Methods We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories-government, out-of-pocket, and prepaid private health spending-and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more resources for health. Findings Between 1995 and 2016, health spending grew at a rate of 4.00% (95% uncertainty interval 3.89-4.12) annually, although it grew slower in per capita terms (2.72% [2.61-2.84]) and increased by less than $ 1 per capita over this period in 22 of 195 countries. The highest annual growth rates in per capita health spending were observed in upper-middle-income countries (5.55% [5.18-5.95]), mainly due to growth in government health spending, and in lower-middle-income countries (3.71% [3.10-4.34]), mainly from DAH. Health spending globally reached $ 8.0 trillion (7.8-8.1) in 2016 (comprising 8.6% [8.4-8.7] of the global economy and $ 10.3 trillion [10.1-10.6] in purchasing-power parity-adjusted dollars), with a per capita spending of US$ 5252 (5184-5319) in high-income countries, $ 491 (461-524) in upper-middle-income countries, $ 81 (74-89) in lower-middle-income countries, and $ 40 (38-43) in low-income countries. In 2016, 0.4% (0.3-0.4) of health spending globally was in low-income countries, despite these countries comprising 10.0% of the global population. In 2018, the largest proportion of DAH targeted HIV/AIDS ($ 9.5 billion, 24.3% of total DAH), although spending on other infectious diseases (excluding tuberculosis and malaria) grew fastest from 2010 to 2018 (6.27% per year). The leading sources of DAH were the USA and private philanthropy (excluding corporate donations and the Bill & Melinda Gates Foundation). For the first time, we included estimates of China's contribution to DAH ($ 644.7 million in 2018). Globally, health spending is projected to increase to $ 15.0 trillion (14.0-16.0) by 2050 (reaching 9.4% [7.6-11.3] of the global economy and $ 21.3 trillion [19.8-23.1] in purchasing-power parity-adjusted dollars), but at a lower growth rate of 1.84% (1.68-2.02) annually, and with continuing disparities in spending between countries. In 2050, we estimate that 0.6% (0.6-0.7) of health spending will occur in currently low-income countries, despite these countries comprising an estimated 15.7% of the global population by 2050. The ratio between per capita health spending in high-income and low-income countries was 130.2 (122.9-136.9) in 2016 and is projected to remain at similar levels in 2050 (125.9 [113.7-138.1]). The decomposition analysis identified governments' increased prioritisation of the health sector and economic development as the strongest factors associated with increases in government health spending globally. Future government health spending scenarios suggest that, with greater prioritisation of the health sector and increased government spending, health spending per capita could more than double, with greater impacts in countries that currently have the lowest levels of government health spending. Interpretation Financing for global health has increased steadily over the past two decades and is projected to continue increasing in the future, although at a slower pace of growth and with persistent disparities in per-capita health spending between countries. Out-of-pocket spending is projected to remain substantial outside of high-income countries. Many low-income countries are expected to remain dependent on development assistance, although with greater government spending, larger investments in health are feasible. In the absence of sustained new investments in health, increasing efficiency in health spending is essential to meet global health targets.

Place, publisher, year, edition, pages
The Lancet Publishing Group, 2019
Keywords
sex-specific mortality, systematic analysis, disease, coverage, burden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-17231 (URN)10.1016/S0140-6736(19)30841-4 (DOI)000470017100027 ()31030984 (PubMedID)2-s2.0-85065127995 (Scopus ID)
Available from: 2019-06-20 Created: 2019-06-20 Last updated: 2019-12-02
Dalal, K. & Svanström, L. (2015). Economic Burden of Disability Adjusted Life Years (DALYs) of Injuries. Health, 7(4), 487-494
Open this publication in new window or tab >>Economic Burden of Disability Adjusted Life Years (DALYs) of Injuries
2015 (English)In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 7, no 4, p. 487-494Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Scientific Research Publishing, 2015
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Woman, Child and Family (WomFam)
Identifiers
urn:nbn:se:his:diva-10881 (URN)10.4236/health.2015.74058 (DOI)
Available from: 2015-05-04 Created: 2015-05-04 Last updated: 2019-08-29Bibliographically approved
Dalal, K., Lee, M.-S., Ussatayeva, G. & Gifford, M. (2015). Female genital mutilation: a multi-country study. HealthMed, 9(4), 161-167
Open this publication in new window or tab >>Female genital mutilation: a multi-country study
2015 (English)In: HealthMed, ISSN 1840-2291, E-ISSN 1986-8103, Vol. 9, no 4, p. 161-167Article in journal (Refereed) Published
Place, publisher, year, edition, pages
DRUNPP, 2015
National Category
Other Medical Sciences not elsewhere specified
Research subject
Woman, Child and Family (WomFam)
Identifiers
urn:nbn:se:his:diva-10842 (URN)
Available from: 2015-04-16 Created: 2015-04-16 Last updated: 2019-08-29Bibliographically approved
Pahrne, S., Chavez, J. Y. A. & Dalal, K. (2014). Economic Cost of Pedestrian Injuries in Stockholm City. Health, 6(19), 2736-2742
Open this publication in new window or tab >>Economic Cost of Pedestrian Injuries in Stockholm City
2014 (English)In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 6, no 19, p. 2736-2742Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Scientific Research Publishing, 2014
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Woman, Child and Family (WomFam)
Identifiers
urn:nbn:se:his:diva-10233 (URN)10.4236/health.2014.619312 (DOI)
Available from: 2014-11-28 Created: 2014-11-28 Last updated: 2019-09-18
Dalal, K., Wang, S. & Svanström, L. (2014). Intimate Partner Violence against Women in Nepal: An Analysis through Individual, Empowerment, Family and Societal Level Factors. Journal of Research in Health Sciences, 14(4), 251-257
Open this publication in new window or tab >>Intimate Partner Violence against Women in Nepal: An Analysis through Individual, Empowerment, Family and Societal Level Factors
2014 (English)In: Journal of Research in Health Sciences, ISSN 1682-2765, Vol. 14, no 4, p. 251-257Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The current study estimated the national prevalence rate of intimate partner violence against women (IPVAW) in Nepal. Besides, the individual level, empowerment level, family and societal level factors were assessed to relate with the victims of IPAVW in Nepal.

METHODS: Nationally representative sample of 4210 women of reproductive age (15-49 yr) were included in the study. Household surveys using two stage sampling procedures, face to face interview with pre-tested questionnaires were performed. Emotional, physical and sexual violence were target variables. A violence variable was constructed from these three types of violence. Individual level factors were measured by age, residency, education, religion and husband's education. Empowerment factors included employment status and various decision making elements. Family and societal factors included economic status, neighborhood socioeconomic disadvantage index, history of family violence, husband's controlling behavior and other issues. Cross tabulation with chi-square tests and multivariate logistic regression were employed.

RESULTS: Prevalence of emotional IPVAW was 17.5%, physical IPAVW 23.4% and sexual IPAVW 14.7%. Overall the prevalence of IPVAW in Nepal was 32.4%. Joint decision making for contraception, husband's non-controlling behavior to wives and friendly feelings were emerged as less likely to be IPVAW perpetration.

CONCLUSIONS: The findings have immense policy importance as a nationally representative study and indicating necessity of more gender equality.

Place, publisher, year, edition, pages
Hamadan University of Medical Sciences, 2014
Keywords
Educational Status, Empowerment, Nepal, Risk Factors, Spouse Abuse, Women’s Health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medical sciences; Woman, Child and Family (WomFam)
Identifiers
urn:nbn:se:his:diva-10499 (URN)25503278 (PubMedID)2-s2.0-84919382717 (Scopus ID)
Available from: 2015-01-05 Created: 2015-01-05 Last updated: 2019-08-29Bibliographically approved
Wang, S. M., Zou, J. L., Gifford, M. & Dalal, K. (2014). Young students' knowledge and perception of health and fitness: A study in Shanghai, China. Health Education Journal, 73(1), 20-27
Open this publication in new window or tab >>Young students' knowledge and perception of health and fitness: A study in Shanghai, China
2014 (English)In: Health Education Journal, ISSN 0017-8969, E-ISSN 1748-8176, Vol. 73, no 1, p. 20-27Article in journal (Refereed) Published
Abstract [en]

Objective: This study investigated how young urban students conceptualize health and fitness and tried to identify their sources of information about health-related issues. The findings are intended to help make suggestions for policy makers to design and develop effective health-education strategies. Methods: Focus group discussions (FGDs) of 20 groups, each comprised of eight 10th-grade students, were carried out. In total 160 students participated in the FGDs. Results: Young students' knowledge and perceptions about health and fitness had certain limitations, although most of the students emphasized the importance of good health and felt that they knew the meaning of health and fitness. They were most concerned with physical health and failed to consider other aspects of health such as mental/psychological, behavioural and social aspects. This represents a lack of awareness of contemporary conceptions of health and illness. Conclusion: These findings are important when considering the design of effective high school health education strategies that meet state content standards and for influencing students to continue participating in health-promoting activities.

Place, publisher, year, edition, pages
Sage Publications, 2014
Keywords
China, fitness, health, high school students, qualitative
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:his:diva-16610 (URN)10.1177/0017896912469565 (DOI)000328881400003 ()2-s2.0-84891414801 (Scopus ID)
Available from: 2019-02-08 Created: 2019-02-08 Last updated: 2019-11-26Bibliographically approved
Sandor, M. & Dalal, K. (2013). Influencing factors on time of breastfeeding initiation among a national representative sample of women in India. Health, 5(12), 2169-2180
Open this publication in new window or tab >>Influencing factors on time of breastfeeding initiation among a national representative sample of women in India
2013 (English)In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 5, no 12, p. 2169-2180Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Scientific Research Publishing, 2013
Keywords
Breastfeeding, Socioeconomic, Partner Violence, India
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-9462 (URN)10.4236/health.2013.512296 (DOI)
Available from: 2014-06-13 Created: 2014-06-13 Last updated: 2017-12-05Bibliographically approved
Dalal, K., Andrews, J. & Dawad, S. (2012). Contraception use and associations with intimate partner violence among women in Bangladesh. Journal of Biosocial Science, 44(1), 83-94
Open this publication in new window or tab >>Contraception use and associations with intimate partner violence among women in Bangladesh
2012 (English)In: Journal of Biosocial Science, ISSN 0021-9320, E-ISSN 1469-7599, Vol. 44, no 1, p. 83-94Article in journal (Refereed) Published
Abstract [en]

This study examines the association between contraception use and intimate partner violence (IPV) among women of reproductive age in Bangladesh. The observational study of 10,996 women used the chi-squared test and logistic regressions to assess the associations. Almost 80% of all respondents had used contraceptives at some point in their lives. About half of the respondents (48%) were victims of physical violence, while 11% experienced sexual abuse from their husbands. Urban residents, higher educated women and women aged 20-44 were more likely to use contraceptives than their peers in rural areas, those with lower education and those in their late forties (45-49 years). Women exposed to physical violence were almost two times (OR 1.93, CI 1.55-2.41) more likely to use contraceptives compared with their non-abused peers. Sexual abuse had no significant association with contraceptive use. Physical violence is a predictor for higher levels of contraceptive use among women in Bangladesh. The findings emphasize the importance of screening for IPV at health care centres. The differences in urban and rural contraceptive use and IPV exposure identified by the study have policy implications for service delivery and planning.

Place, publisher, year, edition, pages
Cambridge University Press, 2012
Keywords
Demography, Public Environmental & Occupational Health, Biomedical Social Sciences
National Category
Medical and Health Sciences
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-5460 (URN)10.1017/S0021932011000307 (DOI)000298441100006 ()21676277 (PubMedID)2-s2.0-82155163851 (Scopus ID)
Available from: 2012-02-22 Created: 2012-02-22 Last updated: 2019-11-26Bibliographically approved
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