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  • 1.
    Akl, Ziad
    et al.
    School of Health Sciences, Örebro University, Sweden / Youth Association for Social Awareness- YASA, Lebanon.
    Akl, Mona
    Youth Association for Social Awareness- YASA, Lebanon.
    Eriksson, Charli
    School of Health Sciences, Örebro University, Sweden.
    Gifford, Mervyn
    School of Health Sciences, Örebro University, Sweden.
    Dalal, Koustuv
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Higher School of Public Health, Al-Farabi Kazakh National University, Almaty, Kazakhstan.
    Evaluating seat belt use in Lebanon (1997-2017)2019In: Open Public Health Journal, ISSN 1874-9445, Vol. 12, no 1, p. 127-135Article in journal (Refereed)
    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.

  • 2.
    Bazargan-Hejazi, Shahrzad
    et al.
    University of California, Los Angeles.
    Medeiros, Sarah
    University of California, Los Angeles.
    Mohammadi, Reza
    Karolinska Institutet.
    Lin, Johnny
    University of Los Angeles.
    Dalal, Koustuv
    University of Skövde, School of Life Sciences.
    Patterns of Intimate Partner Violence: a study of female victims in Malawi2012In: Journal of Injury and Violence Research, ISSN 2008-2053, E-ISSN 2008-4072, Vol. 5, no 1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The term “intimate partner violence” (IPV) encompasses physical, sexual and psychological violence, or any combination of these acts, and globally is the most common type of violence against women. This study aims to examine the lifetime prevalence of different types of intimate partner violence (IPV) among Malawi women ages 15 to 49, and its association with age, education, and living in rural versus urban areas. METHODS: Data was obtained from a cross-sectional study of data as part of the 2004 Malawi Demographic and Health Survey.  Women were eligible for the study if they met the following criteria: 1) lived in one of the 15,041 households randomly selected from 522 rural and urban clusters located in 10 large districts of Malawi; 2) were married or cohabitating; and 3) were between the ages of 15 and 49 years.  Consenting, eligible women responded to a comprehensive questionnaire covering demographic factors, health issues, as well as items related to physical, emotional and sexual IPV.  To assess bivariate associations, chi-squared tests and multivariate logistic regressions were conducted. RESULTS: Among the 8291 respondents, 13% reported emotional violence; 20% reported being pushed, shaken, slapped or punched; 3% reported experiencing severe violence, such as being strangled or burned, threatened with a knife, gun or with another weapon; and 13% reported sexual violence.  Data showed women ages 15 to 19 were significantly less likely to report emotional IPV, women ages 25 to 29 were significantly more likely to report being pushed or shaken, slapped or punched (OR 1.35; CI: 1.05-1.73), and women ages 30 to 34 were significantly more likely to report sexual IPV, compared to women ages 45 to 49 (OR 1.40; CI: 1.03-1.90).  Finally, women who had no ability to read were less likely to report sexual IPV than their counterparts who could read a full sentence (OR 0.76; CI: 0.66-0.87). CONCLUSIONS: The prevalence of different types of IPV in Malawi appears slightly lower than that reported for other countries in sub-Saharan Africa.  Further studies are needed to assess the attitudes and behaviors of Malawi women towards acceptability and justification of IPV as well as their willingness to disclose it.

  • 3.
    Chang, Angela Y.
    et al.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, USA.
    Dalal, Koustuv
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Dieleman, Joseph L.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, USA / Univ Washington, Dept Hlth Metr Sci, Seattle, USA.
    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, 1995–20502019In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 393, no 10187, p. 2233-2260Article, review/survey (Refereed)
    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.

  • 4.
    Dalal, Koustuv
    et al.
    University of Skövde, School of Life Sciences.
    Andrews, Johanna
    Karolinska Institutet, Stockholm, Sweden.
    Dawad, Suraya
    Univ KwaZulu Natal, HEARD, Durban, South Africa.
    Contraception use and associations with intimate partner violence among women in Bangladesh2012In: Journal of Biosocial Science, ISSN 0021-9320, E-ISSN 1469-7599, Vol. 44, no 1, p. 83-94Article in journal (Refereed)
    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.

  • 5.
    Dalal, Koustuv
    et al.
    University of Skövde, School of Life Sciences.
    Dawad, Suraya
    University of KwaZulu Natal, Durban, South Africa.
    Economic Costs of Domestic Violence: A Community Study in South Africa2011In: HealthMed, ISSN 1840-2291, E-ISSN 1986-8103, Vol. 5, no 6/Suppl 1, p. 1931-1940Article in journal (Refereed)
    Abstract [en]

    The present study estimated economic costs of domestic violence against women who sought help from a community care centre in South Africa. It aimed to relate the victims' income and victims' family income to violence related injuries and related costs. This was a cross sectional study with face-to-face interviews in a community care center in which victims of domestic violence sought various kinds of assistance. In total, 261 women were interviewed. The average economic cost of each domestic violence incidence was 691 USD while average cost for medical expenditure was 29 USD and average loss of income due to domestic violence was 2092 USD. Larger families and higher individual and family incomes were protective factors for severity of violence related injuries. Pain and discomfort due to domestic violence emerged as expensive for both medical costs and productivity losses. Considering the average monthly income of 482 USD, domestic violence averaged a cost per incident of 691 USD during the previous month, indicating a deficit in household budget. We found that domestic violence against women resulted with expensive injuries, pain and discomforts.

  • 6.
    Dalal, Koustuv
    et al.
    Örebro University, Sweden.
    Lao, Zhinqin
    China.
    Gifford, Mervyn
    University of Skövde, School of Life Sciences.
    Wang, Shu-Mei
    Fudan University, Shanghai, China .
    Knowledge and attitudes towards childhood injury prevention: a study of parents in Shanghai, China2012In: HealthMed, ISSN 1840-2291, Vol. 6, no 11, p. 3783-3789Article in journal (Refereed)
    Abstract [en]

    Childhood injuries are a major problem worldwide. The study explored the parents' knowledge and attitudes towards childhood injury prevention in relation to theirsocioeconomic status. The study also tried to compare parents' perceptions of cause and place of child injury with actual cause and place of injury. This was a cross sectional study of 986 randomly selected parents whose children (3-6 years old) were enrolled at selected kindergartens in a 'Safe Community' in Shanghai, China. Chi-square tests and bar diagrams were used. Almost all parents (97%) thought that injury was a serious problem for their children. Around half of the parents thought that child injuries could be prevented while almost one-third (29%) of parents indicated that there were risk factors in the living environment of their children. Parental perceptions of cause of injuries and place of injuries significantly differed from that of the reality. Parents identified the most common barriers of childhood injury prevention: lack of parental attention (41.6%), environment (35.6%) and children's risky behavior (22.7%). The difference between parental opinions and reality illustrated that parents had incorrect knowledge of childhood injuries, which might lead to incorrect foci of prevention programs. Before tackling environmental modifications to prevent child injuries, policy makers should focus on rectifying parents' incorrect perceptions and on modifying their attitudes as key players. It is important to first raise awareness about childhood injury prevention among the parents for appropriate intervention strategies.

  • 7.
    Dalal, Koustuv
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Lee, Ming-Shinn
    National Dong Hwa University, Hualien, Taiwan.
    Ussatayeva, Gainel
    Kazakhstan School of Public Health, Almaty, Kazakhstan.
    Gifford, Mervyn
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Female genital mutilation: a multi-country study2015In: HealthMed, ISSN 1840-2291, E-ISSN 1986-8103, Vol. 9, no 4, p. 161-167Article in journal (Refereed)
  • 8.
    Dalal, Koustuv
    et al.
    University of Skövde, School of Life Sciences.
    Shabnam, Jahan
    Independent Researcher, Copenhagen, Denmark.
    Andrews-Chavez, Johanna
    Tufts University, Boston, USA.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Timpka, Toomas
    University of Skövde, School of Life Sciences. Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Economic empowerment of women and utilization of maternal delivery care in Bangladesh2012In: International Journal of Preventive Medicine, ISSN 2008-7802, E-ISSN 2008-8213, Vol. 3, no 9, p. 628-636Article in journal (Refereed)
    Abstract [en]

    Objective: Maternal mortality is a major public health problem in low-income countries, such as Bangladesh. Women's empowerment in relation to enhanced utilization of delivery care is underexplored. This study investigates the associations between women's economic empowerment and their utilization of maternal health care services in Bangladesh. Methods: In total, 4925 women (15-49 years of age) with at least one child from whole Bangladesh constituted the study sample. Home delivery without skilled birth attendant and use of institutional delivery services were the main outcome variables used for the analyses. Economic empowerment, neighborhood socioeconomic status, household economic status, and demographic factors were considered as explanatory variables. The chi square test and unadjusted and adjusted logistic regression analyses were applied at the collected data. Results: In the adjusted model, respondent's and husband's education, household economic status, and residency emerged as important predictors for utilization of delivery care services. In the unadjusted model, economically empowered working and microfinanced women displayed more home delivery. Conclusion: The current study shows that use of delivery care services is associated with socioeconomic development and can be enhanced by societies that focus on general issues such as schooling, economic wellbeing, and gender-based discrimination.

  • 9.
    Dalal, Koustuv
    et al.
    University of Skövde, School of Life Sciences.
    Shinn Lee, Ming
    National Dong Hwa University.
    Gifford, Mervyn
    University of Skövde, School of Life Sciences.
    Male Adolescents' Attitudes Toward Wife Beating: A Multi-Country Study in South Asia2012In: Journal of Adolescent Health, ISSN 1054-139X, E-ISSN 1879-1972, Vol. 50, no 5, p. 437-442Article in journal (Refereed)
    Abstract [en]

    Purpose: This study has aimed to address the gaps in knowledge about male adolescents and their attitudes toward wife beating in multi-country study in Bangladesh, India, and Nepal.

    Methods: The study used secondary data generated from nationally representative samples of male adolescents (aged 15–19 years) in the demographic and health surveys data in Bangladesh, India, and Nepal. These were household surveys using structured questionnaires, with 275 boys in Bangladesh, 13,078 boys in India, and 939 boys in Nepal. Chi-square tests and logistic regressions were used to assess the associations.

    Results: In Bangladesh, 42% of 275 respondents had justified wife beating; in India, 51% of 13,078 male adolescents had supported wife beating; and in Nepal, 28% of 939 respondents had supported wife abuse. Individual-level factors, such as rural residency, low educational attainment, low economic status, being unemployed, and having a history of family violence, were positively associated with the justification of wife abuse.

    Conclusions: This multi-country study indicates a general trend of male adolescents' strong supportive attitude toward wife beating, and hence may suggest that policy makers can specifically target young groups of the population for various interventions for reducing violence against women.

  • 10.
    Dalal, Koustuv
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Centre for Injury Prevention and Safety Promotion (CIPSP), School of Health & Medical Sciences, Department of Public Health Science, Örebro University, Örebro, Sweden.
    Svanström, Leif
    University of Skövde, School of Health and Education. Division of Social Medicine, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
    Economic Burden of Disability Adjusted Life Years (DALYs) of Injuries2015In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 7, no 4, p. 487-494Article in journal (Refereed)
  • 11.
    Dalal, Koustuv
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Centre for Injury Prevention and Safety Promotion (CIPSP), School of Health & Medical Sciences, Department of Public Health Science, Örebro University, Örebro, Sweden.
    Wang, Shumei
    School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.
    Svanström, Leif
    University of Skövde, School of Health and Education. WHO CC Community Safety Promotion, Karolinska Institutet, Stockholm, Sweden.
    Intimate Partner Violence against Women in Nepal: An Analysis through Individual, Empowerment, Family and Societal Level Factors2014In: Journal of Research in Health Sciences, ISSN 1682-2765, Vol. 14, no 4, p. 251-257Article in journal (Refereed)
    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.

  • 12.
    Hussain, A. H. M. Enayet
    et al.
    Directorate General of Health Services, Dhaka, Bangladesh.
    Ferdoush, Junnatul
    Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh.
    Mashreky, Saidur Rahman
    Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh / Bangladesh University of Health Sciences, Dhaka, Bangladesh / National Institute of Ophthalmology, Dhaka, Bangladesh.
    Rahman, A. K. M. Fazlur
    Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh / Bangladesh University of Health Sciences, Dhaka, Bangladesh / National Institute of Ophthalmology, Dhaka, Bangladesh.
    Ferdausi, Nahid
    National Institute of Ophthalm ology, Dhaka, Bangladesh.
    Dalal, Koustuv
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Higher School of Public Health, Al-Farabi Kazakh National University, Almaty, Kazakhstan.
    Epidemiology of childhood blindness: A community-based study in Bangladesh2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 6, article id e0211991Article in journal (Refereed)
    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.

  • 13.
    Lao, Zhiqin
    et al.
    Independent researcher, China.
    Gifford, Mervyn
    University of Skövde, School of Life Sciences.
    Dalal, Koustuv
    University of Skövde, School of Life Sciences. School of Health & Medical Sciences, Örebro University, Örebro, Sweden.
    Economic Cost of Childhood Unintentional Injuries2012In: International Journal of Preventive Medicine, ISSN 2008-7802, E-ISSN 2008-8213, Vol. 3, no 5, p. 303-312Article in journal (Refereed)
    Abstract [en]

    Aims: This study aims to review the economic cost of childhood (0-18 years) unintentional injuries (UI) and focuses upon comparing the cost burden between developing and developed countries.

    Methods: Articles were selected from PUBMED using the search words “Economic Cost”, “Unintentional injuries” and “Children”. Nine articles were selected.

    Results: Studies in China focused upon cost to hospitals, in Bangladesh they focused on personal payment in rural areas, and in Vietnam they focused upon community-based cost analysis. There was one study from Norway on UI at home. There were 5 articles from the USA focusing on submersion injury, UI insurance, unintentional traumatic brain injury, UI due to firearms and UI medical costs. The cost of childhood UI is enormous, ranging from US $516,938 to US $9,550,704 per year. This represents a large economic burden on society. Additionally, there is a large gap between lower-middle income countries (LMIC) and high income countries (HIC) in the burden of injury, injury health care and insurance systems.

    Conclusion: Different bases and contexts of studies make it difficult to draw a solid conclusion about the amount of costs of UI among children. Therefore, more studies of children’s unintentional injuries should be carried out in low and middle income countries.

  • 14.
    Naeini, Hassan Sadeghi
    et al.
    Iran University of Science and Technology, Tehran, Iran.
    Lindqvist, Kent
    Division of Social Medicine and Public Health, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Jafari, Hamid Reza
    Environmental Planning Department, Graduate Environment Faculty, University of Tehran, Tehran, Iran.
    Mirlohi, Amir Hossein
    Apadana Research Center, Isfahan, Iran.
    Dalal, Koustuv
    University of Skövde, School of Life Sciences. Division of Social Medicine and Public Health, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Playground injuries in children2011In: Open Access Journal of Sports Medicine, ISSN 1179-1543, E-ISSN 1179-1543, Vol. 2, p. 61-68Article in journal (Refereed)
    Abstract [en]

    Background: Rapid urbanization and unplanned population development can be detrimentalto the safety of citizens, with children being a particularly vulnerable social group. In this review, we assess childhood playground injuries and suggest safety mechanisms which could be incorporated into playground planning.

    Methods: Inclusion criteria were “children” as the focus group, “playground” as the main field of study, and “unintentional injury” and “safety” as the concepts of study. The keywords used for the PubMed search were “playground”, “children”, and “injury”. Initially we accessed 182 articles. After screening according to inclusion criteria, 86 articles were found, and after reading the abstracts and then the full text, 14 articles were finally included for analysis. The papers reviewed included four case-control studies, three case studies, three descriptive studies, two interventional studies, one retrospective study, one cross-sectional study, and one systematic review.

    Results: Playground-related fractures were the most common accidents among children, underscoring the importance of safety promotion and injury prevention in playgrounds, lowrisk equipment and playing hours (week days associated with higher risk), implementation of standards, preventing falls and fall-related fractures, and addressing concerns of parents about unsafe neighborhoods. With the exception of one study, all of the reviewed papers had not implemented any practical safety plan. Safe engineering approaches were also ignored.

    Conclusion: We recommend a systematic safety approach based on the “safety circle” which includes three main areas, ie, equipment, environment, and children.

  • 15.
    Pahrne, Sandra
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Chavez, Johanna Y. Andrews
    Tufts University, Boston, USA.
    Dalal, Koustuv
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Centre for Injury Prevention and Safety Promotion, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Economic Cost of Pedestrian Injuries in Stockholm City2014In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 6, no 19, p. 2736-2742Article in journal (Refereed)
  • 16.
    Sandor, Maria
    et al.
    University of Skövde, School of Life Sciences.
    Dalal, Koustuv
    University of Skövde, School of Life Sciences. School of Health and Medical Science, Örebro University, Sweden.
    Influencing factors on time of breastfeeding initiation among a national representative sample of women in India2013In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 5, no 12, p. 2169-2180Article in journal (Refereed)
  • 17. Shabnam, Jahan
    et al.
    Gifford, Mervyn
    University of Skövde, School of Life Sciences.
    Dalal, Koustuv
    University of Skövde, School of Life Sciences.
    Socioeconomic inequalities in the use of delivery care services in Bangladesh: a comparative study between 2004 and 20072012In: Health, ISSN 1949-4998, Vol. 3, no 12, p. 762-771Article in journal (Refereed)
    Abstract [en]

    The study explores inequalities in the utilization of delivery care services in different administrative divisions in Bangladesh, by key socioeconomic factors. It estimates the extent of the relationship between women’s socioeconomic inequalities and their place of delivery during 2004 and 2007. Trends in relation to place of delivery in relation to residency and education over a period of thirteen years (1993-2007) have also been measured. The study analyzed the trends and patterns in utilization of institutional delivery care among mothers, using data from the Bangladesh Demographic Health Survey (BDHS) conducted during 1993-2007. The data was disaggregated by area of residence in different divisions in Bangladesh. Bi-variate analyses, concentration curves and multivariate logistic regression were employed in the analysis of the data. The study indicated slow progress in the utilization of institutional delivery care among mothers in Bangladesh between 1993 and 2007. Large variations in outcome measures were observed among the different divisions. Multivariate analyses suggested growing inequalities in utilization of delivery care services between different economic groups and parents with different educational levels. The use of institutional delivery care remains substantially lower among poor and less educated rural mothers in Bangladesh, irrespective of age and employment. Further studies are recommended to explore the specific causes relating to the non-utilization of institutional delivery care.

  • 18.
    Wang, Shu Mei
    et al.
    Key Laboratory of Public Health Safety, School of Public Health, Fudan University, China.
    Zou, Jin Liang
    Key Laboratory of Public Health Safety, School of Public Health, Fudan University, China.
    Gifford, Mervyn
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Dalal, Koustuv
    School of Health & Medical Sciences, Department of Public Health Science, Örebro University, Sweden.
    Young students' knowledge and perception of health and fitness: A study in Shanghai, China2014In: Health Education Journal, ISSN 0017-8969, E-ISSN 1748-8176, Vol. 73, no 1, p. 20-27Article in journal (Refereed)
    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.

  • 19.
    Wang, Shu-Mei
    et al.
    Fudan Univ, Sch Publ Hlth, Key Lab Publ Hlth Safety, Minist Educ, Shanghai 200433, Peoples R China .
    Dalal, Koustuv
    University of Skövde, School of Life Sciences.
    Road Traffic Injuries in Shanghai, China2012In: HealthMed, ISSN 1840-2291, Vol. 6, no 1, p. 74-80Article in journal (Refereed)
    Abstract [en]

    Road traffic injuries are major public health social and economic problem. In China road traffic injuries are increasing rapidly. Objective of the study was to assess the risk factors for road traffic injuries and the relationship between the individual and environmental factors and the severity of injury in a designated Safe Community in Shanghai, China. Data were retrieved from a Safe Community surveillance system including hospital, police and fire brigade records. Chi-square test and multivariate logistic regression were used. Total 568 was injured due to road accidents in 2008 (43% were mild injured and 9% severely injured).Violation of traffic rule was major problem among drivers of motorized vehicles. Police has identified 15 major causes of road accidents. Age over 45 years and cloudy/rainy road conditions were major cause of accidents at the individual and environmental level factors. Findings are important for policy makers and Safe Community planning.

  • 20.
    Wu, Jie
    et al.
    IMS Health Shanghai.
    Dalal, Koustuv
    University of Skövde, School of Life Sciences.
    Tuberculosis in Asia and the Pacific: The role of socioeconomic status and health system development2012In: International Journal of Preventive Medicine, ISSN 2008-7802, E-ISSN 2008-8213, Vol. 3, no 1, p. 8-16Article in journal (Refereed)
    Abstract [en]

    Objective: To identify the relationship between socioeconomic status, health system development and the incidence, prevalence and mortality of tuberculosis in Asia and the Pacific. Methods: Incidence, prevalence and mortality rates of tuberculosis and 20 variables of  socioeconomic, health system and biological behavioral issues were included in the study involving all 46 countries of  the Asian Development Bank region (2007 data). Both univariate and multivariate linear regressions were used. Results: The worst three tuberculosis affected countries were Cambodia, India and Indonesia, while the least affected was Australia. Tuberculosis incidence, prevalence and mortality rate were higher in countries with lower human development index, corruption perception index, gross domestic product (GDP) per capita and countries with more people under minimum food supplements. Among the health system variables, total health expenditure per capita, governmental health expenditure per capita, hospital beds, and access to improved water and sanitation were strongly associated with tuberculosis. Conclusions: Socioeconomic determinants and health system development have significant effect on the control of tuberculosis in Asia and the Pacific region. The study has some policy implications by means of  lowering the corruption and improving the sanitation.

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