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San Sebastian, MiguelORCID iD iconorcid.org/0000-0001-7234-3510
Alternative names
Publications (10 of 233) Show all publications
Gustafsson, P. E., Fonseca Rodriguez, O., Castel Feced, S., San Sebastian, M., Bastos, J. L. & Mosquera, P. (2024). A novel application of interrupted time series analysis to identify the impact of a primary health care reform on intersectional inequities in avoidable hospitalizations in the adult Swedish population. Social Science and Medicine, 343, Article ID 116589.
Open this publication in new window or tab >>A novel application of interrupted time series analysis to identify the impact of a primary health care reform on intersectional inequities in avoidable hospitalizations in the adult Swedish population
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2024 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 343, article id 116589Article in journal (Refereed) Published
Abstract [en]

Primary health care (PHC) systems are a crucial instrument for achieving equitable population health, but there is little evidence of how PHC reforms impact equities in population health. In 2010, Sweden implemented a reform that promoted marketization and privatization of PHC. The present study uses a novel integration of intersectionality-informed and evaluative epidemiological analytical frameworks to disentangle the impact of the 2010 Swedish PHC reform on intersectional inequities in avoidable hospitalizations. The study population comprised the total Swedish population aged 18–85 years across 2001–2017, in total 129 million annual observations, for whom register data on sociodemographics and hospitalizations due to ambulatory care sensitive conditions were retrieved. Multilevel Analysis of Individual Heterogeneity and Discriminatory Analyses (MAIHDA) were run for the pre-reform (2001–2009) and post-reform (2010–2017) periods to provide a mapping of inequities. In addition, random effects estimates reflecting the discriminatory accuracy of intersectional strata were extracted from a series MAIHDAs run per year 2001–2017. The estimates were re-analyzed by Interrupted Time Series Analysis (ITSA), in order to identify the impact of the reform on measures of intersectional inequity in avoidable hospitalizations. The results point to a complex reconfiguration of social inequities following the reform. While the post-reform period showed a reduction in overall rates of avoidable hospitalizations and in age disparities, socioeconomic inequities in avoidable hospitalizations, as well as the importance of interactions between complex social positions, both increased. Socioeconomically disadvantaged groups born in the Nordic countries seem to have benefited the least from the reform. The study supports a greater attention to the potentially complex consequences that health reforms can have on inequities in health and health care, which may not be immediate apparent in conventional evaluations of either population-average outcomes, or by simple evaluations of equity impacts. Methodological approaches for evaluation of complex inequity impacts need further development.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Discriminatory accuracy, Health inequities, Health reform, Intersectionality, Primary health care, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-220159 (URN)10.1016/j.socscimed.2024.116589 (DOI)38237285 (PubMedID)2-s2.0-85182797110 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-00236Umeå University, FS2.1.6-339-20
Available from: 2024-02-05 Created: 2024-02-05 Last updated: 2024-02-05Bibliographically approved
San Sebastian, M., Fonseca Rodriguez, O., Castel-Feced, S. & Tarupi, W. (2024). Cancer en la Amazonía del Ecuador (1990-2019): parte I. Coca, Ecuador
Open this publication in new window or tab >>Cancer en la Amazonía del Ecuador (1990-2019): parte I
2024 (Spanish)Report (Other (popular science, discussion, etc.))
Alternative title[en]
Cancer in the Amazon region of Ecuador (1990-2019) : part I
Abstract [es]

Este estudio tiene como objetivo actualizar la información sobre la incidencia del cáncer en la región amazónica (provincias de Sucumbíos, Orellana, Napo y Pastaza) del Ecuador durante el periodo 1990-2019.

Dado que no existe un registro de tumores en la región amazónica, se obtuvieron los datos del Registro Nacional de Tumores de Quito, donde se registran todos casos que se diagnostican en establecimientos de salud de esa ciudad procedentes de las provincias de estudio.

Se calcularon el número total de casos de cáncer por sexo, provincia y periodo. Se establecieron seis periodos de estudio: 1990-1994, 1995-1999, 2000-2004, 2005-2009, 2010-2014 y 2015-2019. Se estimaron también las tasas estandarizadas por edad de todos los cánceres combinados por provincia y periodo.

En total se registraron 4.881 casos (36,8% en hombres) de cáncer durante el periodo 1990-2019 en las cuatro provincias. En hombres, los cánceres de próstata, sistema hematopoyético (sangre y médula ósea), estómago, otros de piel, y el no especificado de ganglios fueron los más frecuentes. En las mujeres, los de cuello de útero, mama, tiroides, otros de piel y sistema hematopoyético fueron los cinco cánceres más comunes.

El estudio muestra un incremento acelerado de cáncer en la región en total y para cada uno de los tipos de cáncer seleccionados en los últimos tres quinquenios (2005-2019). Este aumento es probablemente un indicador del continuo aumento de esta patología junto con un posible mayor acceso al diagnóstico en la ciudad de Quito. La situación geográfica (comunidades alejadas), diferentes estilos de vida, el crecimiento de la población, sobre todo por procesos migratorios, un envejecimiento de la misma y el limitado acceso a los servicios sanitarios son probablemente los determinantes más importantes en la evolución de las tasas de cáncer en esta región. 

Especialmente preocupantes son los incrementos en los cánceres de próstata en hombres, de mama y tiroides en mujeres y la estabilidad del resto de los tumores, sobre todo teniendo en cuenta la posibilidad de implementar programas de prevención para la mayoría de estos tumores. 

En conclusión, la tendencia ascendente de casos de cáncer en la Amazonía ecuatoriana exige la necesidad urgente de contar con un Plan Nacional de Control de Cáncer como hoja de ruta para el manejo de pacientes dentro del sistema de salud.

Abstract [en]

This study aims to update information on cancer incidence in the Amazon region (provinces of Sucumbíos, Orellana, Napo and Pastaza) of Ecuador during the period 1990-2019.

Since there is no registry of tumours in the Amazon region, data were obtained from the National Cancer Registry in Quito, where all cases diagnosed in health facilities in that city from the provinces under study are registered.

The total number of cancer cases by sex, province and period was calculated. Six study periods were established: 1990-1994, 1995-1999, 2000-2004, 2005-2009, 2010-2014 and 2015-2019. Age-standardised rates for all cancers combined by province and period were also estimated.

In total, 4,881 cases (36.8% in men) of cancer were registered during the period 1990-2019 in the four provinces. In men, prostate, haematopoietic system (blood and bone marrow), stomach, other skin, and unspecified lymph node cancers were the most frequent cancers. In women, cervical, breast, thyroid, other skin and haematopoietic system were the five most common cancers.

The study shows an accelerated increase in cancer in the region in total and for each of the selected cancer types over the last three five-year periods (2005-2019). This increase is probably an indicator of the continued rise of this pathology together with a possible increased access to diagnosis in the city of Quito. Geographical location (remote communities), different lifestyles, population growth, especially due to migration, an ageing population and limited access to health services are probably the most important determinants in the evolution of cancer rates in this region. 

Of particular concern are the increases in prostate cancer in men, breast and thyroid cancer in women and the stability of the remaining tumours, especially considering the possibility of implementing prevention programmes for most of these tumours. 

In conclusion, the rising trend of cancer cases in the Ecuadorian Amazon requires the urgent need for a National Cancer Control Plan as a roadmap for patient management within the health system.

Place, publisher, year, edition, pages
Coca, Ecuador: , 2024. p. 28
Keywords
cancer, epidemiology, Amazon, Ecuador, cancer, epidemiología, Amazonía, Ecuador
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Population studies
Identifiers
urn:nbn:se:umu:diva-227741 (URN)
Available from: 2024-07-06 Created: 2024-07-06 Last updated: 2024-07-08Bibliographically approved
Arce Cardozo, R. K., Fonseca Rodriguez, O., Mamani-Ortiz, Y., San Sebastian, M. & Jonsson, F. (2024). Did the COVID-19 quarantine policies applied in Cochabamba, Bolivia mitigated cases successfully?: an interrupted time series analysis. Global Health Action, 17(1), Article ID 2371184.
Open this publication in new window or tab >>Did the COVID-19 quarantine policies applied in Cochabamba, Bolivia mitigated cases successfully?: an interrupted time series analysis
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2024 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 17, no 1, article id 2371184Article in journal (Refereed) Published
Abstract [en]

Background: The COVID-19 pandemic prompted varied policy responses globally, with LatinAmerica facing unique challenges. A detailed examination of these policies’ impacts on healthsystems is crucial, particularly in Bolivia, where information about policy implementation andoutcomes is limited.

Objective: To describe the COVID-19 testing trends and evaluate the effects of quarantinemeasures on these trends in Cochabamba, Bolivia.

Methods: Utilizing COVID-19 testing data from the Cochabamba Department Health Servicefor the 2020–2022 period. Stratified testing rates in the health system sectors were firstestimated followed by an interrupted time series analysis using a quasi-Poisson regressionmodel for assessing the quarantine effects on the mitigation of cases during surge periods.

Results: The public sector reported the larger percentage of tests (65%), followed by theprivate sector (23%) with almost double as many tests as the public-social security sector(11%). In the time series analysis, a correlation between the implementation of quarantinepolicies and a decrease in the slope of positive rates of COVID-19 cases was observedcompared to periods without or with reduced quarantine policies.

Conclusion: This research underscores the local health system disparities and the effective-ness of stringent quarantine measures in curbing COVID-19 transmission in the Cochabambaregion. The findings stress the importance of the measures’ intensity and duration, providingvaluable lessons for Bolivia and beyond. As the global community learns from the pandemic,these insights are critical for shaping resilient and effective health policy responses.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2024
Keywords
Pandemic, policy, healthservice, evaluation, LatinAmerica, time-series
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Infectious Diseases
Identifiers
urn:nbn:se:umu:diva-227635 (URN)10.1080/16549716.2024.2371184 (DOI)001259909100001 ()38949664 (PubMedID)2-s2.0-85197223681 (Scopus ID)
Funder
Sida - Swedish International Development Cooperation Agency
Available from: 2024-07-02 Created: 2024-07-02 Last updated: 2024-07-11Bibliographically approved
Healey Akearok, G. K., Chaliak, A. J., Cueva, K., Cook, D., Larsen, C. V., Jóhannsdóttir, L., . . . Lavoie, J. G. (2024). Diverse methodological approaches to a Circumpolar multi-site case study which upholds and responds to local and Indigenous community research processes in the Arctic. International Journal of Circumpolar Health, 83(1), Article ID 2336284.
Open this publication in new window or tab >>Diverse methodological approaches to a Circumpolar multi-site case study which upholds and responds to local and Indigenous community research processes in the Arctic
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2024 (English)In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 83, no 1, article id 2336284Article in journal (Refereed) Published
Abstract [en]

This paper outlines the methodological approaches to a multi-site Circumpolar case study exploring the impacts of COVID-19 on Indigenous and remote communities in 7 of 8 Arctic countries. Researchers involved with the project implemented a three-phase multi-site case study to assess the positive and negative societal outcomes associated with the COVID-19 pandemic in Arctic communities from 2020 to 2023. The goal of the multi-site case study was to identify community-driven models and evidence-based promising practices and recommendations that can help inform cohesive and coordinated public health responses and protocols related to future public health emergencies in the Arctic. Research sites included a minimum of 1 one community each from Canada (Nunavut,) United States of America (Alaska), Greenland, Iceland, Norway, Sweden, Finland. The approaches used for our multi-site case study provide a comprehensive, evidence-based account of the complex health challenges facing Arctic communities, offering insights into the effectiveness of interventions, while also privileging Indigenous local knowledge and voices. The mixed method multi-site case study approach enriched the understanding of unique regional health disparities and strengths during the pandemic. These methodological approaches serve as a valuable resource for policymakers, researchers, and healthcare professionals, informing future strategies and interventions.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2024
Keywords
arctic, arctic research, circumpolar, community-based research, Indigenous peoples, mixed methods, research methods
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-223655 (URN)10.1080/22423982.2024.2336284 (DOI)001197121200001 ()38573784 (PubMedID)2-s2.0-85190077678 (Scopus ID)
Available from: 2024-04-22 Created: 2024-04-22 Last updated: 2024-04-22Bibliographically approved
San Sebastian, M., Gustafsson, P. E. & Stoor, J. P. (2024). Embodiment of discrimination: a cross-sectional study of threats, humiliating treatment and ethnic discrimination in relation to somatic health complaints among Sámi in Sweden. Journal of Epidemiology and Community Health, 78(5), 290-295
Open this publication in new window or tab >>Embodiment of discrimination: a cross-sectional study of threats, humiliating treatment and ethnic discrimination in relation to somatic health complaints among Sámi in Sweden
2024 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 78, no 5, p. 290-295Article in journal (Refereed) Published
Abstract [en]

Background: Ethnic discrimination is acknowledged as a social determinant of health for Indigenous populations worldwide. This study aimed to investigate embodiment of perceived ethnic discrimination among the Sámi population in Sweden.

Methods: A population-based health study was conducted among the Sámi population aged 18-84 years in 2021. Perceived discrimination was assessed by three variables: exposure to threat, humiliation treatment and ethnic discrimination. To capture current physical health, complaints of headache, back pain, stomach pain, sleeping problems, dizziness and tiredness were used. An overall somatic complaints score was created by summing up the six individual symptoms. The magnitude of the association between the independent variables and the outcomes was summarised with the β coefficients and prevalence ratios using 95% credible intervals (95% CrI) for inferential purposes.

Results: Overall, 4.3% reported to have been exposed to threat, 26.1% to humiliation and 11.2% and 32.3% to ethnic discrimination in the last 12 months and beyond 12 months, respectively. After mutual adjustment, threat (β=1.25; 95% CrI=0.88 to 1.60), humiliation (β=1.29; 95% CrI: 1.14 to 1.44) and the two categories of discrimination (β=0.92; 95% CI: 0.64 to 1.21 in the last 12 months and β=0.68; 95% CI: 0.54 to 0.83 beyond) remained significantly associated to the overall somatic complaints score. Similar results were found for individual complaints.

Conclusions: This study has shown a strong relationship between different expressions of perceived ethnic discrimination and a series of somatic complaints among the Sámi in Sweden. Efforts to alleviate interpersonal and institutional discrimination against the Sámi would contribute to improve their health.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-221671 (URN)10.1136/jech-2023-221365 (DOI)001162611300001 ()38350714 (PubMedID)2-s2.0-85185486809 (Scopus ID)
Funder
Public Health Agency of Sweden , 01401-2021.2.3.2
Available from: 2024-03-01 Created: 2024-03-01 Last updated: 2024-06-25Bibliographically approved
La Parra-Casado, D., San Sebastian, M. & Stoor, J. P. (2024). Ethnic discrimination and mental health in the Sámi population in Sweden: the SámiHET study. Scandinavian Journal of Public Health, 52(4), 442-449
Open this publication in new window or tab >>Ethnic discrimination and mental health in the Sámi population in Sweden: the SámiHET study
2024 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 52, no 4, p. 442-449Article in journal (Refereed) Published
Abstract [en]

Aims: To assess the association between experiences of discrimination and mental health among the Sámi population in Sweden.

Methods: Cross-sectional study among the self-identified Sámi population living in Sweden in 2021, registered in the electoral roll of the Sámi Parliament, the reindeer mark register and the ‘Labour statistics based on administrative sources’. The analysis was based on a final sample of 3658 respondents aged between 18 and 84 years. Adjusted prevalence ratios aPRs for psychological distress (Kessler scale), self-reported anxiety and depression were estimated for four different forms of discrimination (direct experience of discrimination, offended because of ethnicity, historical trauma, and combined discrimination).

Results: Higher aPRs of psychological distress, anxiety and depression were observed in women experiencing direct discrimination because of their ethnicity, having been offended because of their ethnicity, and those with a family history of discrimination. Among men, higher aPRs for psychological distress were observed in those experiencing the four different forms of discrimination, but not for anxiety. Depression was only detected in the case of having been offended. Adding experiences of discrimination was associated with a higher prevalence of negative outcomes for all the indicators in women and for psychological distress in men.

Conclusions: The observed association between experiences of discrimination and mental health problems would support a gender approach when considering ethnic discrimination in public health policies concerning the Sámi in Sweden.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
anxiety, depression, ethnicity, Mental health, psychological distress, racism, social discrimination, Sámi
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-206208 (URN)10.1177/14034948231157571 (DOI)000945559500001 ()36883724 (PubMedID)2-s2.0-85150521555 (Scopus ID)
Funder
Swedish Research Council, 2020-01779
Available from: 2023-03-31 Created: 2023-03-31 Last updated: 2024-06-19Bibliographically approved
Castel-Feced, S., Malo, S., Aguilar-Palacio, I., Maldonado, L., Rabanaque, M. J. & San Sebastian, M. (2024). Exploring sex variations in the incidence of cardiovascular events: a counterfactual decomposition analysis. European Journal of Public Health, 34(3), 578-583
Open this publication in new window or tab >>Exploring sex variations in the incidence of cardiovascular events: a counterfactual decomposition analysis
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2024 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 34, no 3, p. 578-583Article in journal (Refereed) Published
Abstract [en]

Background: Some cardiovascular risk factors (CVRFs) that occur differently in men and women can be addressed to reduce the risk of suffering a major adverse cardiovascular event (MACE). Furthermore, the development of MACE is highly influenced by social determinants of health. Counterfactual decomposition analysis is a new methodology that has the potential to be used to disentangle the role of different factors in health inequalities. This study aimed to assess sex differences in the incidence of MACE and to estimate how much of the difference could be attributed to the prevalence of diabetes, hypertension, hypercholesterolaemia and socioeconomic status (SES).

Methods: Descriptive and counterfactual analyses were conducted in a population of 278 515 people with CVRFs. The contribution of the causal factors was estimated by comparing the observed risk ratio with the causal factor distribution that would have been observed if men had been set to have the same factor distribution as women. The study period was between 2018 and 2021.

Results: The most prevalent CVRF was hypercholesterolaemia, which was similar in both sexes, while diabetes was more prevalent in men. The incidence of MACE was higher in men than in women. The main causal mediating factors that contributed to the sex differences were diabetes and SES, the latter with an offsetting effect.

Conclusions: This result suggests that to reduce the MACE gap between sexes, diabetes prevention programmes targeting men and more gender-equal salary policies should be implemented.

Place, publisher, year, edition, pages
Oxford University Press, 2024
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-226946 (URN)10.1093/eurpub/ckad227 (DOI)001134700200001 ()38166350 (PubMedID)2-s2.0-85195621428 (Scopus ID)
Available from: 2024-06-25 Created: 2024-06-25 Last updated: 2024-06-25Bibliographically approved
San Sebastian, M., Jaakko, T., Söderberg, S., Zimmet, P., Ori, B., Heecharan, J., . . . Kowlessur, S. (2024). Prevalence and social determinants of smoking among men in Mauritius: a cross-sectional study. Global Health Action, 17(1), Article ID 2367415.
Open this publication in new window or tab >>Prevalence and social determinants of smoking among men in Mauritius: a cross-sectional study
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2024 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 17, no 1, article id 2367415Article in journal (Refereed) Published
Abstract [en]

Background: Mauritius has implemented a range of stringent policies to control smoking and promote public health. Regular monitoring focuses on the prevalence of tobacco use, yet there is a gap in understanding its socio-economic patterns. Objective: The aim of this study was to estimate the prevalence of tobacco smoking and to identify the social determinants associated with smoking among men in Mauritius in 2021.

Methods: This is a cross-sectional population-based study conducted by the Ministry of Health and Wellness during 2021. In total, 3622 individuals participated (response rate of 84.1%), of which 1663 were men (45.9%). The study mainly focused on men given the low prevalence of smoking among women. Daily smoking was the outcome and a series of sociodemographic and socioeconomic factors were included as independent variables. Prevalence ratios (PR) and their 95% confidence intervals (95% CI) were estimated to fulfill the study objective.

Results: The prevalence of smoking among men was 30.4%. People in the 25–34 age group (PR = 1.65; 95% CI: 1.12–2.41), those separated, divorced or widowed (PR = 1.57; 95% CI: 1.16–2.11), the ethnic groups Muslim-Mauritians (PR = 1.70; 95% CI: 1.00–2.89) and Creoles (PR = 1.97; 95% CI: 1.16–3.35), and those with secondary (PR = 1.29; 95% CI: 1.00–1.67) and primary education (PR = 1.47; 95% CI: 1.10–1.98) were statistically significantly associated with daily smoking.

Conclusions: Although a gradual decline in smoking prevalence was observed compared with the previous 2015 survey, the Ministry of Health and Wellness should persist in fortifying its anti-smoking measures and concentrate on crafting tailored interventions aimed at the vulnerable groups identified in this study.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
determinants, Mauritius, men, smoking, Socioeconomic
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-227336 (URN)10.1080/16549716.2024.2367415 (DOI)001251403300001 ()38899339 (PubMedID)2-s2.0-85196357769 (Scopus ID)
Available from: 2024-06-28 Created: 2024-06-28 Last updated: 2024-06-28Bibliographically approved
Aweesha, H., Hurtig, A.-K., Pulkki-Brännström, A.-M. & San Sebastian, M. (2024). Sudan's health sector partnership: from confined progression to openness and hope to uncertain demise. Development Policy Review, 42(2), Article ID e12757.
Open this publication in new window or tab >>Sudan's health sector partnership: from confined progression to openness and hope to uncertain demise
2024 (English)In: Development Policy Review, ISSN 0950-6764, E-ISSN 1467-7679, Vol. 42, no 2, article id e12757Article in journal (Refereed) Published
Abstract [en]

Motivation: Despite signature of the 2005 Paris Declaration on Aid Effectiveness and subsequent adoption of the effective development cooperation (EDC) principles for better health cooperation, there is a gap in documenting the challenges to implement these commitments at country level. Sudan represents an interesting case study: the country adopted a local health compact in 2014, but for much of the time since the regime was under sanction. Sudan witnessed a revolution in 2018, followed by a counter-coup in 2021.

Purpose: We aim to explore the evolution of Sudan health sector partners’ relationships, perspectives, and adherence to EDC principles of ownership, alignment, and harmonization, while accounting for underlying processes and context changes between 2015 and 2022.

Methods and approach: We collected data through two rounds of interviews, in 2015 (16) and 2022 (8), with stakeholders within the Sudan Health Sector Partnership. We used the framework method for data analysis where responses are coded then sorted into themes.

Findings: Prior to the 2019 revolution cooperation was progressive but restricted, with civil society marginalized and a dominating government. The principles, especially ownership, were misused and misaligned with national priorities driven by donors’ interests and conditions.

The transitional (post-revolution) period witnessed partners’ openness and influx, but unstable leadership and subsequent changes in priorities led to wasted opportunities.

Following the coup, donors adopted a no-contact policy towards the de facto government. Instead, the expectation was that civil society organizations would replace the government as the main implementers. Overall, limited coordination capacity and no sustainability measures were present throughout.

Policy implications: Much of what was observed was down to the often complicated and difficult context of the governance of Sudan. That said, general issues arose including the government's ability to coordinate policy and implementation; the need for stable, legitimate arrangements; and the need to define the role of civil society and to empower civil society organizations. Within a complex and volatile context, revisiting partners’ commitments through joint compact reviews and transparent EDC progress monitoring is crucial.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
alignment, coordination, effective development cooperation, framework analysis, harmonization, health sector, ownership, partnership, Sudan
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-216479 (URN)10.1111/dpr.12757 (DOI)001155272200001 ()2-s2.0-85184249903 (Scopus ID)
Funder
Familjen Erling-Perssons Stiftelse
Available from: 2023-11-13 Created: 2023-11-13 Last updated: 2024-07-02Bibliographically approved
Stoor, J. P., Sedholm, O., San Sebastian, M. & Nilsson, L. M. (2024). Sámi community perspectives on the COVID-19 pandemic: a mixed methods case study in Arctic Sweden. International Journal of Circumpolar Health, 83(1), Article ID 2372123.
Open this publication in new window or tab >>Sámi community perspectives on the COVID-19 pandemic: a mixed methods case study in Arctic Sweden
2024 (English)In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 83, no 1, article id 2372123Article in journal (Refereed) Published
Abstract [en]

The COVID-19 pandemic posed a grave threat not only to Indigenous people's health and well-being, but also to Indigenous communities and societies. This applies also to the Indigenous peoples of the Arctic, where unintentional effects of public health actions to mitigate the spread of virus may have long-lasting effects on vulnerable communities. This study aim was to identify and describe Sámi perspectives on how the Sámi society in Sweden was specifically affected by the pandemic and associated public health actions during 2020-2021. A mixed-method qualitative case study approach was employed, including a media scoping review and stakeholder interviews. The media scoping review included 93 articles, published online or in print, from January 2020 to 1 September 2021, in Swedish or Norwegian, regarding the pandemic-related impacts on Sámi society in Sweden. The review informed a purposeful selection of 15 stakeholder qualitative interviews. Thematic analysis of the articles and interview transcripts generated five subthemes and two main themes: "weathering the storm" and "stressing Sámi culture and society". These reflect social dynamics which highlight stressors towards, and resilience within, the Sámi society during the pandemic. The results may be useful when evaluating and developing public health crisis response plans concerning or affecting the Sámi society in Sweden.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Indigenous health, Saami, circumpolar, interview study, minority health, public health, qualitative study, social science, thematic analysis
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Epidemiology
Identifiers
urn:nbn:se:umu:diva-227223 (URN)10.1080/22423982.2024.2372123 (DOI)001253678000001 ()38917207 (PubMedID)2-s2.0-85197067716 (Scopus ID)
Available from: 2024-06-26 Created: 2024-06-26 Last updated: 2024-07-09Bibliographically approved
Projects
Applying an equity lens to cardiovascular disease prevention in northern Sweden [2014-00451_Forte]; Umeå UniversityApplying systems thinking tools to strengthen health system accountability to marginalized populations in Guatemala [2015-05898_VR]; Umeå UniversityCan mental health and health care be promoted among young prisoners in Cambodia? An intervention study [2017-05441_VR]; Umeå University; Publications
Pat, P., Edin, K., Jegannathan, B., San Sebastian, M. & Richter Sundberg, L. (2023). “Overcrowded but lonely”: exploring mental health and well-being among young prisoners in Cambodia. International Journal of Prisoner Health, 19(4), 628-640Pat, P., Richter Sundberg, L., Jegannathan, B. & San Sebastian, M. (2023). The effect of a life skills education program on mental health and social competencies among young prisoners in Cambodia: an intervention study. International Journal of Psychiatry, 8(1), 7-13Pat, P., Richter-Sundberg, L., Jegannathan, B., Edin, K. & San Sebastian, M. (2021). Mental health problems and suicidal expressions among young male prisoners in Cambodia: a cross-sectional study. Global Health Action, 14(1), Article ID 1985229.
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7234-3510

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