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Article ; Online: Making it "work": mothers' perceptions of workplace breastfeeding and pumping at Dutch universities.

Hentges, Maike / Pilot, Eva

International breastfeeding journal

2021 Volume 16, Issue 1, Page(s) 87

Abstract: Background: Dutch breastfeeding rates are below World Health Organization's recommendations and targets despite the benefits for individuals and society. Increasing the rates is complex due to multiple breastfeeding determinants, of which maternal ... ...

Abstract	Background: Dutch breastfeeding rates are below World Health Organization's recommendations and targets despite the benefits for individuals and society. Increasing the rates is complex due to multiple breastfeeding determinants, of which maternal education and employment are dominant. This study aimed to identify the perceptions and experiences of mothers employed at Dutch universities regarding barriers and enablers to workplace breastfeeding and pumping. Methods: The study adopted a descriptive, qualitative research design. Thirteen semi-structured online interviews, underpinned by the Social Ecological Model, were conducted in 2020 with three experts and ten academic employees from five universities who had breastfed or pumped at work within the past five years. Qualitative data were examined through a thematic analysis. Results: Four main themes were identified: physical work environment, social support, work culture and organisation, policies and legal rights. Most mothers had more negative than positive experiences combining breastfeeding with work. They were unable to exercise their rights as a breastfeeding employee due to inappropriate and inaccessible lactation rooms, a lack of communication and information-provision, other people's lack of awareness, inflexible working hours and unadjusted workloads, especially for teaching positions. All participants found the duration of Dutch maternity leave too short. Conclusions: Universities need to increase institutional efforts at multiple levels and meet their legal obligations to support breastfeeding employees. Workplace interventions should be combined with more political commitment to normalise breastfeeding, monitor compliance with maternity protection provisions at work and prolong parental leave to encourage breastfeeding continuation.
MeSH term(s)	Breast Feeding ; Female ; Humans ; Mothers ; Pregnancy ; Universities ; Women, Working ; Workplace
Language	English
Publishing date	2021-11-08
Publishing country	England
Document type	Journal Article
ISSN	1746-4358
ISSN (online)	1746-4358
DOI	10.1186/s13006-021-00433-w
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Making it “work”: mothers’ perceptions of workplace breastfeeding and pumping at Dutch universities

Hentges, Maike / Pilot, Eva

International breastfeeding journal. 2021 Dec., v. 16, no. 1

2021

Abstract: BACKGROUND: Dutch breastfeeding rates are below World Health Organization’s recommendations and targets despite the benefits for individuals and society. Increasing the rates is complex due to multiple breastfeeding determinants, of which maternal ... ...

Abstract	BACKGROUND: Dutch breastfeeding rates are below World Health Organization’s recommendations and targets despite the benefits for individuals and society. Increasing the rates is complex due to multiple breastfeeding determinants, of which maternal education and employment are dominant. This study aimed to identify the perceptions and experiences of mothers employed at Dutch universities regarding barriers and enablers to workplace breastfeeding and pumping. METHODS: The study adopted a descriptive, qualitative research design. Thirteen semi-structured online interviews, underpinned by the Social Ecological Model, were conducted in 2020 with three experts and ten academic employees from five universities who had breastfed or pumped at work within the past five years. Qualitative data were examined through a thematic analysis. RESULTS: Four main themes were identified: physical work environment, social support, work culture and organisation, policies and legal rights. Most mothers had more negative than positive experiences combining breastfeeding with work. They were unable to exercise their rights as a breastfeeding employee due to inappropriate and inaccessible lactation rooms, a lack of communication and information-provision, other people’s lack of awareness, inflexible working hours and unadjusted workloads, especially for teaching positions. All participants found the duration of Dutch maternity leave too short. CONCLUSIONS: Universities need to increase institutional efforts at multiple levels and meet their legal obligations to support breastfeeding employees. Workplace interventions should be combined with more political commitment to normalise breastfeeding, monitor compliance with maternity protection provisions at work and prolong parental leave to encourage breastfeeding continuation.
Keywords	World Health Organization ; breast feeding ; compliance ; ecological models ; employment ; lactation ; politics ; qualitative analysis ; social support ; working conditions
Language	English
Dates of publication	2021-12
Size	p. 87.
Publishing place	BioMed Central
Document type	Article
ZDB-ID	2227239-2
ISSN	1746-4358
ISSN	1746-4358
DOI	10.1186/s13006-021-00433-w
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: A scoping review on the impact of austerity on healthcare access in the European Union: rethinking austerity for the most vulnerable.

Doetsch, Julia Nadine / Schlösser, Clara / Barros, Henrique / Shaw, David / Krafft, Thomas / Pilot, Eva

International journal for equity in health

2023 Volume 22, Issue 1, Page(s) 3

Abstract: Background: There is consensus that the 2008 financial and economic crisis and related austerity measures adversely impacted access to healthcare. In light of the growing debt caused by the COVID-19 crisis, it is uncertain whether a period of austerity ... ...

Abstract	Background: There is consensus that the 2008 financial and economic crisis and related austerity measures adversely impacted access to healthcare. In light of the growing debt caused by the COVID-19 crisis, it is uncertain whether a period of austerity will return. Objective: This study aims to provide a structured overview of the impact of austerity policies in the EU-28 zone, applied in response to the Great Recession, on access to health care for the adult population, using the five access dimensions by Levesque et al. (2013). Methods: This study followed the PRISMA extension for Scoping Reviews guideline. Medline (PubMed) and Web of Science were searched between February 2021 and June 2021. Primary studies in the English language published after the 1st of January 2008 reporting on the possible change in access to the healthcare system for the adult population induced by austerity in an EU28 country were included. Results: The final search strategy resulted in 525 articles, of which 75 studies were reviewed for full-text analysis, and a total of 21 studies were included. Results revealed that austerity policy has been primarily associated with a reduction in access to healthcare, described through four main categories: i) Increase in rates of reported unmet needs (86%); ii) Affordability (38%); iii) Appropriateness (38%); iv) and Availability and Accommodation (19%). Vulnerable populations were more affected by austerity measures than the general population when specific safeguards were not in place. The main affected adult vulnerable population groups were: patients with chronic diseases, elderly people, (undocumented) migrants, unemployed, economically inactive people and individuals with lower levels of education or socioeconomic status. Conclusion: Austerity measures have led to a deterioration in access to healthcare in the vast majority of the countries studied in the EU-28 zone. Findings should prompt policymakers to rethink the fiscal agenda across all policies in times of economic crisis and focus on the needs of the most vulnerable populations from the health perspective.
MeSH term(s)	Adult ; Aged ; Humans ; COVID-19/epidemiology ; Economic Recession ; European Union ; Health Services Accessibility/statistics & numerical data ; Social Class ; Economics ; Vulnerable Populations/statistics & numerical data
Language	English
Publishing date	2023-01-05
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2092056-8
ISSN	1475-9276 ; 1475-9276
ISSN (online)	1475-9276
ISSN	1475-9276
DOI	10.1186/s12939-022-01806-1
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Understanding India's urban dengue surveillance: A qualitative policy analysis of Hyderabad district.

Pilot, Eva / Murthy, G V S / Nittas, Vasileios

Global public health

2020 Volume 15, Issue 11, Page(s) 1702–1717

Abstract: Dengue's re-emerging epidemiology poses a major global health threat. India contributes significantly to the global communicable disease burden has been declared highly dengue-endemic, exposing public health authorities to severe challenges. Our study ... ...

Abstract	Dengue's re-emerging epidemiology poses a major global health threat. India contributes significantly to the global communicable disease burden has been declared highly dengue-endemic, exposing public health authorities to severe challenges. Our study aims to provide a deeper understanding of India's urban dengue surveillance policies as well as to explore the organisation, functioning and integration of existing disease control pillars. We conducted a qualitative regional case study, consisting of semi-structured expert interviews and observational data, covering the urban region of Hyderabad in South India. Our findings indicate that Hyderabad's dengue surveillance system predominantly relies on public reporting units, neglecting India's large private health sector. The surveillance system requires further strengthening and additional efforts to efficiently integrate existing governmental initiatives at all geographical levels and administrative boundaries. We concluded with recommendations for improved consistency, accuracy, efficiency and reduction of system fragmentation to enhance the integration of dengue surveillance and improved health information in urban India. Finally, our study underlines India's overall need to increase investment in public health and health infrastructures. That requires coordinated and multi-level action targeting the development of a competent, effective and motivated public health cadre, as well as truly integrated surveillance and epidemic response infrastructure, for dengue and beyond.
MeSH term(s)	Dengue/epidemiology ; Humans ; India/epidemiology ; Policy Making ; Public Health Surveillance ; Qualitative Research ; Urban Health
Language	English
Publishing date	2020-05-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2234129-8
ISSN	1744-1706 ; 1744-1692
ISSN (online)	1744-1706
ISSN	1744-1692
DOI	10.1080/17441692.2020.1767674
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Spatial Access Matters: An Analysis of Policy Change and Its Effects on Avoidable Infant Mortality in Portugal.

Weiland, Morgan / Santana, Paula / Costa, Claudia / Doetsch, Julia / Pilot, Eva

International journal of environmental research and public health

2021 Volume 18, Issue 3

Abstract: In 2006, a policy reform restructured the maternal and perinatal healthcare system, including closing smaller maternity units, to further improve care in Portugal. This study aimed to investigate the effects of the 2006 National Program of Maternal and ... ...

Abstract	In 2006, a policy reform restructured the maternal and perinatal healthcare system, including closing smaller maternity units, to further improve care in Portugal. This study aimed to investigate the effects of the 2006 National Program of Maternal and Neonatal Health policy on spatial inequalities in access to care and consequently avoidable infant mortality. A thematic analysis of qualitative data including interviews and surveys and a quantitative spatial analysis using Geographic Information Systems was applied. Spatial inequalities were found which may lead to avoidable infant mortality. Inequalities exist in freedom of choice and autonomy in care, within a medicalized system. Changes in approach to and organization of care would further enhance equitable spatial access to care in maternal health and reduce avoidable infant mortality.
MeSH term(s)	Female ; Humans ; Infant ; Infant Mortality ; Maternal Health ; Policy ; Portugal/epidemiology ; Pregnancy
Language	English
Publishing date	2021-01-30
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph18031242
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The influence of the Great Recession on perinatal health-an ecological study on the trend changes and regional differences in Portugal.

Doetsch, Julia Nadine / Almendra, Ricardo / Severo, Milton / Leão, Teresa / Teixeira, Raquel / Marques, Sandra / Pilot, Eva / Krafft, Thomas / Barros, Henrique

The Lancet regional health. Europe

2023 Volume 34, Page(s) 100735

Abstract: Background: Few studies examine the relationship between socioeconomic factors and trends in mortality in high-income European countries. Due to the lack of regional-level data, most recent studies on social inequality in Portugal do not investigate ... ...

Abstract	Background: Few studies examine the relationship between socioeconomic factors and trends in mortality in high-income European countries. Due to the lack of regional-level data, most recent studies on social inequality in Portugal do not investigate regional differences. This study analyses time trends and regional disparities in the evolution of perinatal mortality (PMR) and infant mortality (IMR) associated with demographic and socioeconomic indicators following Portugal's 2008 economic and financial crisis. Methods: Associations were assessed using generalised linear models. A Poisson joinpoint regression model was applied to identify relevant PMR and IMR changes between 2000 and 2018. Country regional disparities were analysed using Mixed Effect Multilevel models. Findings: IMR and PMR significantly decreased in the pre-crisis period but not in the post-crisis period. The significant differences between regions in IMR and PMR in 2000 were followed by a different evolution of regional IMR after 2008. PMR and IMR were not significantly associated with socioeconomic indicators. A significant positive association with maternal age at first birth was identified. Interpretation: Results confirm the influence of the crisis on PMR and IMR trends in Portugal, taking into account recurring associations between macroeconomic cycles, variations in mortality trends, macroeconomic volatility, and stagnation of IMR and PMR. Regional inequalities confirm the internal variability of the crisis influence and persistent spatial inequalities affecting IMR patterns. Funding: FCT, under the Institute of Public Health of the University of Porto (ISPUP)-EPIUnit (UIDB/04750/2020) and ITR (LA/P/0064/2020), Maastricht University's external PhD programme under the Care and Public Health Research Institute (CAPHRI), and the RECAP preterm project (grant agreement no 733280).
Language	English
Publishing date	2023-09-08
Publishing country	England
Document type	Journal Article
ISSN	2666-7762
ISSN (online)	2666-7762
DOI	10.1016/j.lanepe.2023.100735
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: 2008 economic crisis impact on perinatal and infant mortality in Southern European countries.

Doetsch, Julia Nadine / Almendra, Ricardo / Severo, Milton / Leão, Teresa / Pilot, Eva / Krafft, Thomas / Barros, Henrique

Journal of epidemiology and community health

2023 Volume 77, Issue 5, Page(s) 305–314

Abstract: Introduction: The study of crisis events provides important lessons to prepare for upcoming events. The Great Recession's impact on perinatal health in Europe can provide relevant insights into the healthcare and social protection systems' response to ... ...

Abstract	Introduction: The study of crisis events provides important lessons to prepare for upcoming events. The Great Recession's impact on perinatal health in Europe can provide relevant insights into the healthcare and social protection systems' response to the protection of the health of the most vulnerable groups. Objective: To assess time trends and international disparities in perinatal mortality rates (PMR) and infant mortality rates (IMR), following the Great Recession, and their association with socioeconomic indicators in Portugal, Greece, Italy and Spain. Methods: Associations were assessed through generalised linear models for all four countries. A Poisson joinpoint regression model was applied to explore PMR and IMR trend changes between 2000 and 2018. Country disparities were analysed using mixed-effects multilevel models. Results: IMR and PMR have decreased overall in the four selected countries between 2000 and 2018. Still, whereas in Spain, Italy and Portugal the decreasing pace was attenuated after 2009, in Greece a positive trend was found after the 2008 crisis. IMR and PMR were significantly associated with socioeconomic indicators in all four countries. National disparities in the evolution of IMR and PMR were significantly associated with most socioeconomic indicators between 2000 and 2018. Conclusion: Our results confirm the impact of the Great Recession on PMR and IMR trends in all four countries, taking recurring associations between macroeconomic cycles, variations in mortality trends, macroeconomic volatility and stagnation of IMR and PMR into account. The association with socioeconomic indicators stresses the need to strengthen social protection and healthcare systems to better protect the population's health from the earliest days.
MeSH term(s)	Infant ; Pregnancy ; Female ; Humans ; Economic Recession ; Infant Mortality ; Perinatal Mortality ; Socioeconomic Factors ; Europe/epidemiology
Language	English
Publishing date	2023-02-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	391868-3
ISSN	1470-2738 ; 0142-467X ; 0141-7681 ; 0143-005X
ISSN (online)	1470-2738
ISSN	0142-467X ; 0141-7681 ; 0143-005X
DOI	10.1136/jech-2022-219639
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Article ; Online: The Organization, Implementation, and Functioning of Dengue Surveillance in India-A Systematic Scoping Review.

Pilot, Eva / Nittas, Vasileios / Murthy, Gudlavalleti Venkata S

International journal of environmental research and public health

2019 Volume 16, Issue 4

Abstract: Dengue´s re-emerging epidemiology poses a major global health threat. In India, dengue contributes significantly to the global communicable disease burden, and has been declared highly endemic. This study aims to identify and critically appraise India's ... ...

Abstract	Dengue´s re-emerging epidemiology poses a major global health threat. In India, dengue contributes significantly to the global communicable disease burden, and has been declared highly endemic. This study aims to identify and critically appraise India's dengue surveillance system. We conducted a systematic literature review, searching Medline, Web of Sciences, Global Health, and Indian Journals. We conducted a narrative synthesis and thematic analysis. Eighteen studies fulfilled eligibility. Organizationally, most studies referred to the National Vector Borne Disease Control Programme, primarily responsible for overall vector and disease control, as well as the Integrated Disease Surveillance Programme, responsible for reporting, outbreak identification, and integration. Surveillance implementation was mostly framed as passive, sentinel, and hospital-based. Reporting varies from weekly to monthly, flowing from primary healthcare centres to district and national authorities. Dengue confirmation is only recognized if conducted with government-distributed MAC-ELISA tests. The surveillance system predominantly relies on public reporting units. In terms of functioning, current surveillance seems to have improved dengue reporting as well the system's detection capacities. Emergency and outbreak responses are often described as timely; however, they are challenged by underreporting, weak data reliability, lack of private reporting, and system fragmentation. Concluding, India's dengue surveillance structure remains weak. Efforts to create an infrastructure of communication, cooperation, and integration are evident, however, not achieved yet.
MeSH term(s)	Communicable Diseases/epidemiology ; Communicable Diseases/transmission ; Dengue/epidemiology ; Dengue/transmission ; Disease Outbreaks ; Humans ; India/epidemiology ; Mosquito Vectors ; Population Surveillance ; Reproducibility of Results
Language	English
Publishing date	2019-02-24
Publishing country	Switzerland
Document type	Journal Article ; Systematic Review
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph16040661
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A Scoping Review on Air Quality Monitoring, Policy and Health in West African Cities.

Mir Alvarez, Celia / Hourcade, Renaud / Lefebvre, Bertrand / Pilot, Eva

International journal of environmental research and public health

2020 Volume 17, Issue 23

Abstract: Ambient air pollution is a global health threat that causes severe mortality and morbidity from respiratory, cardiovascular, and other diseases. Its impact is especially concerning in cities; as the urban population increases, especially in low- and ... ...

Abstract	Ambient air pollution is a global health threat that causes severe mortality and morbidity from respiratory, cardiovascular, and other diseases. Its impact is especially concerning in cities; as the urban population increases, especially in low- and middle-income countries, large populations risk suffering from these health effects. The Economic Community of West African States (ECOWAS) comprises 15 West African countries, in which many cities are currently experiencing fast growth and industrialization. However, government-led initiatives in air quality monitoring are scarce in ECOWAS countries, which makes it difficult to effectively control and regulate air quality and subsequent health issues. A scoping study was performed following the Arksey and O'Malley methodological framework in order to assess the precise status of air quality monitoring, related policy, and legislation in this region. Scientific databases and gray literature searches were conducted, and the results were contrasted through expert consultations. It was found that only two ECOWAS countries monitor air quality, and most countries have insufficient legislation in place. Public health surveillance data in relation to air quality data is largely unavailable. In order to address this, improved air quality surveillance, stricter and better-enforced regulations, regional cooperation, and further research are strongly suggested for ECOWAS.
MeSH term(s)	Africa, Western ; Air Pollution ; Cities/statistics & numerical data ; Cote d'Ivoire ; Environmental Monitoring ; Environmental Policy ; Humans ; Nigeria ; Policy ; Senegal
Language	English
Publishing date	2020-12-07
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph17239151
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The European Union and Public Health Emergencies: Expert Opinions on the Management of the First Wave of the COVID-19 Pandemic and Suggestions for Future Emergencies.

Gontariuk, Marie / Krafft, Thomas / Rehbock, Cassandra / Townend, David / Van der Auwermeulen, Loth / Pilot, Eva

Frontiers in public health

2021 Volume 9, Page(s) 698995

Abstract: Objective: ...

Abstract	Objective:
MeSH term(s)	COVID-19 ; Emergencies ; European Union ; Expert Testimony ; Humans ; Pandemics/prevention & control ; Public Health ; SARS-CoV-2
Language	English
Publishing date	2021-08-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2021.698995
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