World Health & Population
From the Editor-in-Chief
This issue of World Health & Population presents an interesting and varied set of papers that have been published online by WHP during the last quarter. They are selected here as representative of recent outstanding contributions to the journal and include five papers and a commentary.
The first two papers are qualitative studies, the first on HIV infection and fertility desires in Uganda, and the second a study of primary healthcare in Iraq. In "Infection with the Human Immunodeficiency Virus and Fertility Desires: Results from a Qualitative Study in Rural Uganda," Jennifer Heys et al. report focus group results indicating that nearly all HIV-positive participants do not wish more children. Moreover, there was reinforcement of this attitude by the HIV-negative focus group participants, who stated community norms dictating that HIV-positive mothers should not have further children. Both groups seemed relatively unaware of the advances of highly active antiretroviral therapy (HAART) that greatly reduce the risk of mother-to-child transmission of the virus. The focus groups also revealed a number of other misconceptions about the infection and the need for ongoing education and delivery of HIV healthcare and family planning programs.
The second qualitative paper in this issue, "A Qualitative Assessment of the Iraqi Primary Healthcare System" by Nazar Shabila, Namir Al-Tawil et al., presents results from an open-ended questionnaire of policy makers, academic researchers and primary healthcare providers in a district of Kurdistan. Not surprisingly, the survey revealed a primary healthcare system in considerable disarray from the near constant impacts of war and civil unrest over the last 25 years in that country. The authors did uncover several agreed-upon positive aspects of the primary healthcare system, including immunizations and antenatal care. The qualitative study conducted by Shabila et al. provides good background for the design of more definitive quantitative studies in Iraq.
In an explicitly quantitative study, "Breastfeeding as a Time-Varying–Time Dependent Factor for Birth Spacing: Multivariate Models with Validations and Predictions," Rajvir Singh, Vrijesh Tripathi et al. use the 1992–93 Indian National Family Health Survey data to examine the impact of breastfeeding and socio-demographic covariates on birth spacing. Although widely acknowledged that breastfeeding positively impacts birth spacing, Singh et al. found that the role of covariates is critical, but varies by covariate from first to subsequent births. Only breastfeeding is consistently significant in all the models, perhaps reflecting in part its physiological component. It is important to understand, however, the socio-demographic moderators to this component, which the authors of this paper also found to vary from locale to locale.
The fourth paper in this issue, "The Saudi Healthcare System: A View from the Minaret" by WHP Associate Editor Amir Khaliq, provides an excellent overview of Saudi healthcare from its earliest design (not all that old!) to its current challenges in evolving to a more privatized system. Michael Landry and Jacqueline Schleifer Taylor provide a helpful commentary on Khaliq's article, entitled "The Saudi Healthcare System: More Similarities Than Differences," pointing out that structural changes in healthcare are occurring broadly – not just in the stressed or under-resourced economies of the world but also in relatively well-off economies in the Middle East.
The final paper in this issue is an open access reprint, "Perceptions and Utilization of Primary Healthcare Services in Iraq: Findings from a National Household Survey" by Gilbert Burnham, Connie Hoe et al. This paper complements the Shabila et al. paper well, through presenting more quantitative results of a nationwide survey on primary healthcare services. Burnham is a regular contributor of manuscripts to WHP, and we are happy to reprint his open access article.
In conclusion, we hope that you find the papers in this issue interesting and worthwhile, and that you will also consult others recently released online at www.longwoods.com/publications/world-health-population. WHP remains committed to its mission to provide a forum for researchers and policy makers worldwide to publish and disseminate health- and population-related research, and to encourage applied research and policy analysis from diverse global and resource-constrained settings. WHP is indexed on MEDLINE and is accessible through PubMed.
We look forward to continued enthusiastic submission of manuscripts for consideration, peer review and publication. Finally, the editors and publishers of WHP are always interested in any comments or suggestions you might have on the papers or about the journal and our mission. Please feel free to write or e-mail us.
John E. Paul, PhD
Editor-in-Chief, World Health & Population
About the Author(s)
John E. Paul, PhD
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