The 2014-2016 Ebola epidemic was largely restricted to the three nations of Guinea, Liberia and Sierra Leone, yet it tested the world's ability to address a potential global pandemic. This study ...provides an in-depth examination of the role of emotions in the response to the outbreak and engagement with public health measures, and the contextual factors which influenced them.
Historical research methods were utilised in the examination of primary and secondary sources. A multi-faceted SPEECH (Society and Politics, Economy, Epidemiology, Culture, Healthcare and Public Health) framework was developed to aid data synthesis and analysis.
The outbreak occurred in a region still reeling from years of civil war, where poverty was widespread and healthcare severely underfunded. Internationally, global health security had been politically neglected. After a slow start, the international response to the outbreak was strong, yet the lack of community engagement and inadequate consideration of local culture and traditional beliefs, fueled fear and hindered engagement with professionals and uptake of public health measures. Improved collaboration and communication with rural communities in the latter phases of the response was crucial in effectively addressing the outbreak.
This study illustrates the importance of effective collaboration between international crisis responders, in-country public health practitioners and local communities in addressing public emotional responses to the Ebola outbreak. It highlights how community engagement and communications tactics can effectively be utilised to soothe and educate the public, abating counterproductive extreme emotional responses, and in turn improving uptake of public health measures.
The majority of disease transmission during the 2014-16 West Africa Ebola epidemic was driven by community-based behaviors that proved difficult to change in a social paradigm of misinformation, ...denial, and deep-seated distrust of government representatives and institutions. In Liberia, perceptions and beliefs about Ebola during and since the epidemic can provide insights useful to public health strategies aimed at improving community preparedness. In this 2018 study, we conducted nine focus groups with Liberians from three communities who experienced Ebola differently, to evaluate behaviors, attitudes, and trust during and after the epidemic. Focus group participants reported that some behaviors adopted during Ebola have persisted (e.g. handwashing and caretaking practices), while others have reverted (e.g. physical proximity and funeral customs); and reported ongoing distrust of the government and denial of the Ebola epidemic. These findings suggest that a lack of trust in the biomedical paradigm and government health institutions persists in Liberia. Future public health information campaigns may benefit from community engagement addressed at understanding beliefs and sources of trust and mistrust in the community to effect behavior change and improve community-level epidemic preparedness.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Studies of United Nations (UN) peacekeeping operations (PKOs) typically give scant attention to an important aspect of host states’ development: their external affairs. This article identifies ways ...in which UN PKOs can shape the external affairs of host states, focusing on UN peacekeeping in the post-Cold War period. We present the findings of a quantitative content analysis of key UN peacekeeping documents to establish which aspects of host state external affairs have been of concern to the UN. We then provide a conceptual framework that maps three areas of external affairs in which PKOs are particularly influential: relationship-building; institution- and diplomatic capacity-building; and the shaping of policy in domains of external affairs. We identify three pathways through which PKOs shape the external affairs of host states: mandated roles, improvised actions, and unintended consequences. Drawing on documentary analysis and original interview data, we illustrate our conceptual framework through an exploration of the impact of peacekeeping on the external affairs of two countries that have hosted large-scale UN-led peacekeeping missions in recent decades: Timor-Leste (East Timor) and Liberia.
The Ebola virus disease (EVD) epidemic that has stricken thousands of people in the three West African countries of Liberia, Sierra Leone, and Guinea highlights the lack of adaptive capacity in ...post-conflict countries. The scarcity of health services in particular renders these populations vulnerable to multiple interacting stressors including food insecurity, climate change, and the cascading effects of disease epidemics such as EVD. However, the spatial distribution of vulnerable rural populations and the individual stressors contributing to their vulnerability are unknown. We developed a Social Vulnerability Classification using census indicators and mapped it at the district scale for Liberia. According to the Classification, we estimate that districts having the highest social vulnerability lie in the north and west of Liberia in Lofa, Bong, Grand Cape Mount, and Bomi Counties. Three of these counties together with the capital Monrovia and surrounding Montserrado and Margibi counties experienced the highest levels of EVD infections in Liberia. Vulnerability has multiple dimensions and a classification developed from multiple variables provides a more holistic view of vulnerability than single indicators such as food insecurity or scarcity of health care facilities. Few rural Liberians are food secure and many cannot reach a medical clinic in <80 minutes. Our results illustrate how census and household survey data, when displayed spatially at a sub-county level, may help highlight the location of the most vulnerable households and populations. Our results can be used to identify vulnerability hotspots where development strategies and allocation of resources to address the underlying causes of vulnerability in Liberia may be warranted. We demonstrate how social vulnerability index approaches can be applied in the context of disease outbreaks, and our methods are relevant elsewhere.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
As the founder of Liberia, the American Colonization Society (ACS) was instrumental in modeling the institutions of this country. Therefore, the role of this private organization is of paramount ...importance when studying the building of the U.S.-Liberia relationship. Before the U.S. recognition of Liberia in 1862, the conduct of U.S. policy towards this country was largely delegated to the ACS. The article raises the question of the evolution of the historical ACS-Liberia relationship after 1862 and sheds light on the influence of the ACS on the diplomatic relations that developed between the two countries until the mission of the first black American appointed U.S. Minister Resident and Consul General to Liberia. Despite a majority of historians having explained that the ACS lost strength in the aftermath of the U.S. Civil War, it shows that this organization maintained an active relationship with Liberia and that it remained influential in the decade that followed the abolition of slavery. The U.S.-Liberia relationship was thus marked by an institutional in-betweenness, the ACS and the U.S. diplomats representing two actors interacting with Liberia. Through an analysis of the diplomats’ official dispatches and the correspondence of the ACS, it further argues that the organization directly interfered in the diplomatic relationship.
The shocks of the unexpected outbreak of violent internal armed conflicts in post Cold War West Africa continue to linger in policy and academic circles. While considerable attention is devoted to ...explaining the civil wars, there is little understanding of the delicate and unpredictable processes of reconstruction. Post-war reconstruction programmes in Africa have become, by and large, externally driven processes; and while externalisation may not be negative per se, it is important to interrogate how such intervention recognises and interacts with local dynamics, and how it manipulates and conditions the outcomes of post-conflict reconstruction agenda. Investigating the interface between power elite, the nature of post-war regimes and the pattern which post-war reconstruction takes is important both for theory and practice. This original study, by some of West Africa's leading scholars, interrogates post-war reconstruction processes in the twin West African countries of Liberia and Sierra Leone, focusing on the effects of regime types on the nature, scope, success or failure of their post-war reconstruction efforts. Political scientists, diplomats, the international community, donor and humanitarian agencies, advocacy groups, the United Nations and its agencies, would find it an important resource in dealing with countries emerging from protracted violence and civil war.
Acquired Immune Deficiency Syndrome (AIDS) continues to be a deadly pandemic and a serious threat to public health. Globally, reproductive age women are more likely to be infected with Human ...Immunodeficiency Virus (HIV). Comprehensive knowledge about HIV/AIDS is pivotal in the fight against AIDS. However, comprehensive HIV/AIDS knowledge is low in Sub-Saharan African (SSA) nations including Liberia, which contributes to the high incidence of HIV in these nations. This study assessed the level of comprehensive knowledge about HIV/AIDS and its associated factors among reproductive age women in Liberia.
The prevalence and associated factors of comprehensive knowledge about HIV/AIDS among reproductive age women in Liberia were determined using secondary data analysis of 2019-2020 Liberia Demographic and Health Surveys (LDHS). Comprehensive knowledge about HIV/AIDS was a composite variable computed from six variables available in the Demographic and Health Survey (DHS). The study included 7,621 reproductive age women in weighted samples. A generalized linear mixed model with robust error variance was used. For the variables included in the final model, adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) were calculated.
The prevalence of comprehensive HIV/AIDS knowledge among Liberian women aged 15-49 was 33.5%. Women's age and education, and distance to health facility were positively associated with comprehensive knowledge about HIV/AIDS among Liberian reproductive age women. In contrast, community poverty level was negatively associated with comprehensive knowledge about HIV/AIDS.
This study demonstrates that the prevalence of good comprehensive HIV/AIDS knowledge was relatively low among reproductive age women in Liberia. Hence, health practitioners and policymakers should strengthen HIV/AIDS sensitization programmes to increase women's knowledge about HIV/AIDS.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Whereas suicide remains in the top 12 leading causes of death among young people aged 10-24 in sub-Saharan Africa, little is known about suicidal behaviours among adolescents in Liberia. We aimed to ...estimate the 12-month prevalence and describe some of the correlates of suicide behaviours (ideation, planning, and attempt) among school-going adolescents in Liberia.
We analysed data from the 2017 Liberia Global School-based Student Health Survey conducted nationwide among secondary school students. We performed bivariate and multivariable analyses to assess the correlates of suicidal ideation, planning, and attempt in the previous 12 months.
Of the 2744 students, 26.8% reported suicidal ideation, 36.5% made a specific plan to attempt suicide and 33.7% attempted suicide during the 12 months preceding the survey. In the final adjusted logistic models, bullying victimisation and food insecurity were associated with increased odds of ideation, planning, and attempt. Whereas no factor was uniquely associated with suicidal ideation, having many close friends, and parental monitoring were associated with the increased odds of suicidal planning only. Leisure-time sedentary behaviour was associated with increased odds of suicidal planning and attempt. Cannabis use, alcohol drunkenness, being physically attacked, and parental supervision were uniquely associated with increased odds of suicidal attempt, while parental understanding and having a smaller number of close friends were uniquely associated with reduced odds of suicidal attempt.
The relatively high prevalence estimates of suicide behaviours and the multi-contextual nature of the associated factors warrant the need for the design and implementation of universal and multi-level, collaborative targeted intervention efforts towards the prevention of the onset of ideation, planning, and attempt, and the possible transition to deaths by suicide among school-going adolescents in Liberia.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In sub-Saharan Africa, sexually transmitted infections (STIs) are a public health concern. The impact of STIs are exacerbated in post-conflict low- and middle-income countries, such as Liberia, where ...exposure to traumatic events is prevalent and access to mental health services are limited. Following a syndemics framework, this study used regression analyses to explore the independent, additive, and multiplicative effects of four psychosocial conditions (exposure to war-related traumatic events, intimate partner violence IPV, stressful life events, and depressive symptoms) on self-reported STIs. Data were collected from 379 youth aged 18–30 years (
n
= 170 women;
n
= 179 men) in Montserrado County, Liberia. Results revealed that psychosocial variables correlated with each other and STI risk. In multivariable analysis, stressful life events, depressive symptoms, and IPV were statistically significant predictors of STI risk. We found support for an additive effect between the number of psychosocial conditions reported and STI risk, as well as a multiplicative effect (interaction) between IPV and depressive symptoms on STI risk. Our results suggest a synergy between experiencing psychosocial conditions and STI risk and point to the potential benefit of multi-level sexual health approaches that simultaneously address mental health and IPV among youth in Liberia.
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