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      Engaging ethnic minority communities through performance and arts: health education in Cambodian forest villages

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          Abstract

          Background

          In Siem Pang, northeastern Cambodia, malaria transmission persists in remote forested areas populated by ethnic minorities. Engaging affected communities in health education campaigns is challenging due to language, access and literacy constraints. During 2018, a newly established medical research station conducted a health education programme in local villages harnessing traditional songs, arts and crafts, along with theatre, comedy and health talks and quizzes. Health education topics were proposed by community leaders and focused on maternal and child health and malaria. This article describes a process evaluation of these activities, the community's response and whether this was an appropriate form of health education in this context.

          Methods

          In-depth interviews were conducted with community members, leaders and performers. Interviews were audio-recorded, transcribed and translated to English for thematic analysis.

          Results

          In total, 65 interviews were conducted; 20 of these were follow-up interviews with respondents interviewed prior to the performances. Respondents were able to recall the key health messages about malaria, antenatal care and infant vaccination. They also showed good awareness of malaria transmission and prevention and described how they enjoyed the events and appreciated the efforts of the project team.

          Conclusions

          In isolated communities in Cambodia, a health education programme harnessing performance and arts engaged the whole community and its messages were readily recalled and prompted reflection.

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          Most cited references20

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          Maternal healthcare in migrants: a systematic review.

          Pregnancy is a period of increased vulnerability for migrant women, and access to healthcare, use and quality of care provided during this period are important aspects to characterize the support provided to this population. A systematic review of the scientific literature contained in the MEDLINE and SCOPUS databases was carried out, searching for population based studies published between 1990 and 2012 and reporting on maternal healthcare in immigrant populations. A total of 854 articles were retrieved and 30 publications met the inclusion criteria, being included in the final evaluation. The majority of studies point to a higher health risk profile in immigrants, with an increased incidence of co-morbidity in some populations, reduced access to health facilities particularly in illegal immigrants, poor communication between women and caregivers, a lower rate of obstetrical interventions, a higher incidence of stillbirth and early neonatal death, an increased risk of maternal death, and a higher incidence of postpartum depression. Incidences vary widely among different population groups. Some migrant populations are at a higher risk of serious complications during pregnancy, for reasons that include reduced access and use of healthcare facilities, as well as less optimal care, resulting in a higher incidence of adverse outcomes. Tackling these problems and achieving equality of care for all is a challenging aim for public healthcare services.
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            High resolution age-structured mapping of childhood vaccination coverage in low and middle income countries

            Highlights • Geostatistical models showing strong predictive performance are used to produce maps of measles vaccination coverage at 1 × 1 km resolution. • Remoteness, measured as travel time to nearest major settlement, was consistently a key predictor of coverage. • The maps reveal heterogeneities and ‘coldspots’ of low vaccination coverage that are missed using large area summaries. • Aggregated estimates of coverage that do not account for local heterogeneities potentially over-estimate the numbers of children vaccinated by over 10%. • Relating to the WHO GVAP targets of 80% coverage, the integration of high resolution coverage and population maps shows the districts that have attained the threshold in the study countries.
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              School-based drama interventions in health promotion for children and adolescents: systematic review.

              The paper is a report of a review of the literature on the effects of school-based drama interventions in health promotion for school-aged children and adolescents. Drama, theatre and role-playing methods are commonly used in health promotion programmes, but evidence of their effectiveness is limited. The educational drama approach and social cognitive theory is share the assumption that learning is based on self-reflection and interaction between environment and person. However, educational drama also emphasizes learning through the dialectics between actual and fictional contexts. A search was carried out using 10 databases and hand searching for the period January 1990 to October 2006. A Cochrane systematic review was conducted. Nine studies met the criteria for inclusion. Their topics included health behaviour (five studies), mental health (two) and social health (two). Actor-performed drama or theatre play followed by group activities was the intervention in five studies, and classroom drama in four studies. Four of the studies were randomized controlled trials and five were non-randomized controlled studies. Four reports gave the theory on which the intervention was based, and in eight studies at least some positive effects or changes were reported, mostly concerning knowledge and attitudes related to health behaviour. The diversity of designs and instruments limited comparisons. There is a need for well-designed and theory-based studies that address drama interventions in health promotion for children and families. The challenge is to find or develop a theory, which combines educational, drama and health theories with valid and reliable measurements to examine the effects of the intervention.
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                Author and article information

                Contributors
                Journal
                Int Health
                Int Health
                inthealth
                International Health
                Oxford University Press
                1876-3413
                1876-3405
                March 2021
                10 October 2020
                10 October 2020
                : 13
                : 2
                : 188-195
                Affiliations
                Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University , Bangkok, Thailand
                Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University , Bangkok, Thailand
                University Research Company , Phnom Penh, Cambodia
                Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University , Bangkok, Thailand
                Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford , Oxford, UK
                Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University , Bangkok, Thailand
                Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University , Bangkok, Thailand
                Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford , Oxford, UK
                Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University , Bangkok, Thailand
                Amsterdam Institute for Global Health and Development , Amsterdam, The Netherlands
                Centre for Social Sciences and Global Health, University of Amsterdam , Amsterdam, The Netherlands
                Provincial Health Department of Stung Treng Province , Cambodia
                National Center for Parasitology, Entomology and Malaria Control , Phnom Penh, Cambodia
                National Center for Parasitology, Entomology and Malaria Control , Phnom Penh, Cambodia
                School of Public Health, National Institute of Public Health , Phnom Penh, Cambodia
                Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University , Bangkok, Thailand
                Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford , Oxford, UK
                Author notes
                Corresponding author: Tel: +66 (0) 2 203 6333; E-mail: james.c@ 123456tropmedres.ac
                Author information
                http://orcid.org/0000-0002-3218-2166
                Article
                ihaa076
                10.1093/inthealth/ihaa076
                7902271
                33038893
                b139b628-3c7b-4acc-a7f2-88f955e4be7b
                © The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 December 2019
                : 28 September 2020
                : 20 May 2020
                Page count
                Pages: 8
                Funding
                Funded by: Wellcome Trust, DOI 10.13039/100010269;
                Award ID: 096527
                Funded by: Mahidol Oxford Tropical Medicine Research Unit;
                Award ID: **
                Categories
                Original Article
                AcademicSubjects/MED00390

                Medicine
                cambodia,community engagement,ethnic minority,health education,malaria,performance arts
                Medicine
                cambodia, community engagement, ethnic minority, health education, malaria, performance arts

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