The Global Fund to Fight HIV/AIDS, Malaria and TB and U.S President’s Emergency Fund for AIDS Relief (PEPFAR) are global health initiatives (GHIs) that were established in the early 2000s with the mandates to increase global capacity to address HIV and AIDS rapidly. When the two GHIs were created, Namibia was one of the highest recipients of funding from both GHIs. A significant portion of their support to the country went to the Ministry of Health, which was the principal provider of treatment services in the country. Critics have argued, however, that the rise of financial support from the Global Fund and PEPFAR was associated with the creation of new administrative structures and procedures at the country level. This approach raises important questions about the degree to which Namibian health policymakers were able to exercise autonomy in the presence of GHI support. The aim of this thesis is to analyse the implications for institutional capacity and autonomy at the rise and fall of funding from the Global Fund and PEPFAR to the Ministry of Health concerning financial flows; human resources recruitment; and civil society engagement. With a focus on the changing relationship between the Ministry of Health and the two initiatives, the thesis examines the implications for country ownership and health systems capacity in the context of decreasing financial support from the Global Fund and PEPFAR. The field studies for this research was undertaken in 2011- 2012, when the two GHIs had indicated their intentions to scale-down the financial support made available to Namibia. This thesis uses multiple sources of data to qualitatively analyse the influences of Global Fund and PEPFAR support to Namibia from when the two initiatives were first established in 2002 and 2004, respectively, to 2012. A principal source of data was 43 semi-structured interviews conducted in Namibia during a placement with the Directorate of Special Programs in the Ministry of Health in early 2012. For financial flows, both the Global Fund and PEPFAR channelled and managed their funding through funder-specific structures and procedures that were developed and operated in parallel to existing Ministry of Health operations. Both for financial flows and human resources, initial structures and processes created difficulties for the Ministry of Health’s long-term objectives for HIV and AIDS. For civil society engagement, the thesis examined the Ministry of Health’s relationship with the Global Fund. At the rise of funding, the Global Fund required the establishment of a new multi-sector coordination structure for HIV and AIDS. This new structure operated at the same time as the existing national coordination structure and was perceived as having undermined the Ministry of Health’s role as the primary steward of Namibia's response. The Global Fund was also criticised for initially funding civil society organisations without making provisions for sustaining their capacity in the event of funding decline. The findings presented in this thesis indicate that at the rise of financing, the Ministry of Health’s engagement with the two HIV and AIDS GHIs initiatives was governed by the objectives of the two initiatives, rather than the long-term health systems goals of the Namibian Government. Their relationships with Namibia had an adverse impact on the Ministry of Health’s autonomy in making decisions on the national response to HIV and AIDS. The initial operations of the GHIs also had negative implications for Namibia's ability to sustain the health systems capacity they had helped to increase.

Submitted by admin tede (tede@pucgoias.edu.br) on 2017-06-09T14:48:55Z No. of bitstreams: 1 ISADORA SAMARIDI.pdf: 3361742 bytes, checksum: 284d16da32f7ec2a752cde1f689fd59e (MD5) / Made available in DSpace on 2017-06-09T14:48:55Z (GMT). No. of bitstreams: 1 ISADORA SAMARIDI.pdf: 3361742 bytes, checksum: 284d16da32f7ec2a752cde1f689fd59e (MD5) Previous issue date: 2017-03-31 / This dissertation discusses the understanding of General Health and Quality of Life (QL) of the fashion models in Goiânia. It focuses on identifying, describing and analyzing the perception of fashion models about the QL related to their work and their General Health, describing their sociodemographic profile, assessing the participants' QL in their physical, social, family and psychological aspects, as well as evaluating general health indicators such as: stress or psychic stress, death wish, lack of confidence in performance or self-efficacy, sleep disturbances, psychosomatic disorders, and absence of mental health or mental illness severity. Thus, being able to correlate QL and General Health of fashion models, evaluating the meaning of QL for each one in order to understand the senses produced relative to the aspects of General Health and QL of professional fashion models. This study is justified by the fact that Brazilian research on QL and General Health of fashion models is scarce, as well as the fact that information produced on workers' QL is usually made when they present health problems, with few studies of QL with population without clinical diagnosis. The dissertation is organized in two articles, the first of which is quantitative, descriptive, exploratory and transversal. The study was carried out with 45 models affiliated with a fashion agency in the city of Goiânia through the Whoqol Bref and the General Health Questionnaire (QSG). The correlations between QSG and WHOQOL Bref were significant and negative between General Health satisfaction in relation to stress and psychic stress, self efficacy and psychosomatic symptoms. The psychological domain showed a significant correlation with most of the relationships, except for the sleep disorder. The physical domain also showed a significant correlation with self-efficacy. It is concluded that when there is QL satisfaction the model is in good psychological and physical state. In article two, the qualitative methodology of content analysis of Bardin was used to understand and evaluate the meaning of QL and the senses produced related to the aspects of General Health and QL of professional fashion models, using as instrument the semi interview Structured. Eight fashion models from the city of Goiânia participated in a larger study that answered an interview conducted through a semi-structured script. There were four thematic categories produced: Quality of Life, Health, Professional Fashion Model and Coping Strategies. Through these categories, the production of several dualities was observed: to succeed in the professional area means a good QL, even if General Health, affectivity and social are not. With regard to General Health, the constructed meanings are reduced to affirmation or denial of physical illness. It is concluded that the biased view of General Health negatively impacts the Quality of Life conditions associated to the work of fashion models. / Essa dissertação discute a Saúde Geral e a Qualidade de Vida (QV) das modelos de moda em Goiânia. Tem como foco principal identificar, descrever e analisar a percepção de modelos de moda sobre a própria Saúde Geral e a QV relacionadas ao seu trabalho. Este estudo se justifica no fato de que são escassas as investigações brasileiras sobre a Saúde Geral e a QV de modelos de moda, bem como pelo fato de que informações produzidas sobre a QV do trabalhador, usualmente, são feitos quando os mesmos apresentam problemas de saúde, sendo poucos os estudos de QV com população sem diagnóstico clínico. A dissertação está organizada em formato híbrido: Introdução, capítulo de Percurso Metodológico e dois produtos em formato de artigos. No primeiro artigo a metodologia é quantitativa, descritiva, exploratória e transversal. Realizou-se o estudo com 45 modelos filiadas em uma agência de moda na cidade de Goiânia por meio do Whoqol Bref e do Questionário de Saúde Geral (QSG). As correlações entre QSG e WHOQOL Bref foram significativas e negativas entre a satisfação da Saúde Geral e a tensão e ao estresse psíquico, a autoeficácia e os sintomas psicossomáticos. O Domínio Psicológico da QV apresentou correlação significativa com a maioria dos itens do QSG, com exceção do distúrbio do sono. O Domínio Físico da QV também apresentou correlação significativa com a Autoeficácia. Conclui-se que quando existe satisfação da QV, a modelo encontra-se em bom estado Psicológico e Físico. No artigo dois, utilizou-se a metodologia qualitativa de análise de conteúdo de Bardin afim de compreender e avaliar o significado de QV e os sentidos produzidos relativos aos aspectos da Saúde Geral e da QV de modelos profissionais de moda, utilizando como instrumento a entrevista semiestruturada. Participaram oito modelos de moda, da cidade de Goiânia, componentes de um estudo mais amplo, que responderam a uma entrevista realizada por meio de um roteiro semiestruturado. Foram quatro as categorias temáticas produzidas: Qualidade de Vida, Saúde, Profissão Modelo de Moda e Estratégias de Enfrentamento. Por meio dessas categorias, observaram-se a produção de várias dualidades: terem êxito na área profissional significa uma boa QV, mesmo que a Saúde Geral, a afetividade e o social não estejam. No que refere-se à Saúde Geral, os significados construídos estão reduzidos a afirmação ou negação de doença física. Conclui-se que a visão parcializada da Saúde Geral impacta negativamente as condições de Qualidade de Vida associado ao trabalho das modelos de moda.

This dissertation examines how certain epidemic outbreaks become "global threats", that is, diseases that become the focus of international regulations and organized responses while others do not. To answer this question, this dissertation draws upon archival data collected at the World Health Organization (WHO) archives in Geneva, the Western Cape Archives in Cape Town, the British Library, British National Archives, the Wellcome Library Archives in London, and twelve qualitative interviews with senior global health actors in order to analyze five cases when disease threats were prioritized internationally as well as how these constructions patterned responses to outbreaks. I begin by exploring the formation of the first international disease controls in the 19th century, the International Sanitary Conventions, created to prevent the spread of three diseases- plague, cholera and yellow fever. I probe how these earliest conventions patterned responses to diseases covered under them and limited responses to those beyond their scope. Examining how these conventions transformed, I explore why the same disease priorities were maintained by the WHO in their International Sanitary Regulations of the 1950's. Finally, I analyze the transformation of the International Health Regulations in 2005 and its effects on the assessment of disease threat. This dissertation shows that three factors structure the construction of disease threat: epidemic orientalism, economic concerns and field dynamics. Epidemic Orientalism, a discourse motivating the construction of disease threat that first emerged in the 17th, 18th and 19th centuries, positioned the colonized world as the space from which Europe and the Imperial powers needed to be protected. This orientalist gaze prioritizes the control of diseases emanating from colonial sites that threaten international trade and commerce and has been re-inscribed in all past and present regulations. These factors explain how and why plague, cholera and yellow fever came to be maintained as the primary diseases of international concern until the 21st century. As the WHO has recently been challenged in its authority to manage disease threats, these two factors are also mediated by the WHO's manipulation of symbolic power within a new field of infectious disease management which conditions responses to outbreaks today.

Introdução O desenvolvimento das Relações Internacionais como disciplina a fez abarcar estudos de integração regional, cooperação internacional e, mais recentemente, saúde. O processo de globalização e uma maior interação entre os países culminaram na criação de blocos regionais de cooperação, sendo um exemplo expoente na América do Sul a União das Nações Sul-Americanas - UNASUL. Cooperação em saúde global por meio de convergência política dentro dos blocos é possível, e para isso é necessário o conhecimento dos sistemas de saúde de cada país. O Brasil, dentro da tradição de sua política externa e da defesa da Diplomacia da Saúde Global, busca cooperar com os países da UNASUL em questões de saúde. Objetivos - Descrever a ação de Organizações Internacionais e sua atuação em saúde; descrever ações de cooperação em saúde do Brasil; identificar aspectos contextuais dos sistemas de saúde e da cooperação internacional em saúde da Bolívia e da Venezuela. Métodos O procedimento metodológico é qualitativo. Dentro dos métodos possíveis, utilizou-se o descritivo e a pesquisa histórica. A descrição foi utilizada nos dois países estudados para caracterizar seus sistemas de saúde, e a pesquisa histórica, para entender os processos de reforma desses sistemas. Resultados Organizações Internacionais trabalham de diferentes formas a saúde, mas sempre a relacionando com o objetivo principal da instituição. OMS e Banco Mundial são as organizações que mais lidam com o tema. O Brasil, na década de 90, começou a debater sobre saúde em conferências internacionais, e desde os anos 2000 amplia sua cooperação em saúde com países africanos, asiáticos e latinoamericanos. Também estimula o debate da saúde no MERCOSUL e na UNASUL. Os sistemas de saúde da Bolívia e da Venezuela, que foram reformados nos anos 80 e 90, têm atualmente como meta a universalidade; contudo seus sistemas continuam mistos, com presença de um subsetor público, privado e previdenciário. Conclusões - Há um esforço conjunto do Brasil, da Bolívia, da Venezuela e da UNASUL para que a saúde de suas populações melhore em qualidade. Estes quatro atores, igualmente, utilizam o tema saúde como uma questão para cooperação e um propósito para integração. / Introduction The development of International Relations as a discipline embraces studies regarding regional integration, international cooperation, and more recently, health. The globalization process and a higher level of interaction amongst the countries culminated in the establishment of regional cooperation blocs. A representative example of this outcome in South America is the Union of South American Nations UNASUR. Cooperation in health via policy convergence within the blocs is possible, and this requires the knowledge of each countrys health system performance. Brazil, within its foreign policy tradition and its Global Health Diplomacy advocacy, seeks to cooperate with other UNASUR countries on health issues. Objectives To describe the work of International Organizations as well as their performance on health issues; to describe Brazilian cooperation in health; to identify contextual features of the health systems and of the international cooperation in health of Bolivia and Venezuela. Methods The methodological approach is qualitative, and both descriptive procedure and historical research were used. Description was used in the countries health systems scrutiny; and historical research was used to understand these systems reform process. Results International Organizations address health issues with different approaches, but they always relate it to the institutions main objective. WHO and World Bank are the organizations that the most deal with the topic. Brazil, in the 90s, started debating health in international conferences, and since the 2000 decade expands the countrys cooperation in health with African, Asian and Latin-American States. Moreover, Brazil encourages debates concerning health within MERCOSUR and UNASUR. The Bolivian and the Venezuelan health systems, which underwent a reform process during the 80s and the 90s decade, have currently as a goal universal access to health; however, their health systems are still of mixed types, with the presence of public, private and social security subsectors. Conclusion There is a joint effort of Brazil, Bolivia, Venezuela and UNASUR to accomplish an improvement in their populations health. These actors understand health both as a subject for cooperation and as a purpose for integration.

Tendo Pierre Bourdieu como referencial teórico principal, procuramos responder duas perguntas nesta tese: podemos afirmar a existência de um campo científico da saúde global na América Latina? Para responder esta pergunta, orientamos o levantamento do material a partir de três conceitos: capital científico - representado pelos congressos em saúde global (SG) e ciências humanas e sociais (CheS) na América Latina (AL), os agentes - representado pela Alasag, e o habitus - representado pelos programas de formação em SG na AL. Esses conceitos nos levaram ao roteiro que usamos para investigar a constituição de um possível campo científico da SG na AL. Nossa análise revelou a existência de um campo científico da SG na AL a partir do conceito de Bourdieu, marcado por fortes intervenções políticas das instituições que o integram, principalmente, aquelas que financiam as pesquisas no campo. Essas intervenções se caracterizam especialmente pelo condicionamento da liberação de verbas a agendas temáticas específicas, sendo os Objetivos de Desenvolvimento Sustentável 2030 (ODS 2030) a principal delas. Uma vez que podemos confirmar a SG na AL enquanto campo científico, podemos afirmar que as CheS integram o mesmo, o tencionando em um sentido crítico? A resposta é sim e não, porque identificamos dois momentos de entrada das CheS na área da saúde latino-americana que significaram duas formas distintas de atuação no referido campo. Concordamos com os autores que afirmam que a SG na AL é uma continuidade da saúde pública, internacional e coletiva - no caso brasileiro, e que as CheS que integraram estes campos desde os anos 70 assumiram uma posição estabelecida no campo científico da SG na AL, ditando as regras do jogo e o conformando com base nos seus interesses e assuntos que consideram relevantes. O segundo momento se caracteriza pela ampliação da área da saúde para o âmbito geográfico global, o intenso uso da internet e redes sociais pelos pesquisadores, e a entrada de novos agentes, provenientes de áreas do conhecimento não tradicionais, como a sustentabilidade, que chamamos de outsiders, e que assumiram uma posição diferenciada na constituição do campo da SG na AL. Distantes da possibilidade de moldar o campo ao seu modo, transitam em diferentes áreas e parecem importar-se menos com as classificações entre \'puros\' ou \'híbridos\' (CANESQUI, 2008). Dentre as características que os diferencia, está a tomada por temas também tratados pelos estabelecidos, mas em uma perspectiva mais autônoma pelo fato de não estarem atrelados a agendas temáticas específicas. Outro aspecto relevante é a postura crítica declarada em seus documentos em relação ao termo saúde global e todas implicações políticas que ele representa. E por último, estes agentes outsiders referem se mais ao projeto de saúde para a América Latina como um objetivo a ser perseguido por nossa região mediante uma posição crítica às ações dos países desenvolvidos. Acreditamos que o potencial do campo científico da SG na AL está longe da devida exploração que merece, uma vez que nos referimos a um campo que ainda está em construção, no entanto, verificamos a necessidade de uma postura mais audaciosa no sentido de contribuirmos mais para a constituição global do campo científico da saúde a partir da perspectiva latino-americana. / Having Pierre Bourdieu as the main theoretical reference, we try to answer two questions in this thesis: can we affirm the existence of a scientific field of global health in Latin America? To answer this question, we orient the research of the material from three concepts: scientific capital represented by the congresses in global health (GH) and humanities and social sciences (H&SC) in Latin America, agents - represented by Alasag and habitus - represented by the GH training programs in Latin America. The structure of this thesis follows the script we have constructed to answer the question of our research. The structure of this thesis follows the script we have constructed to answer the question of our research. These concepts led us to the script we use to investigate the constitution of a possible scientific field of OS in LA. Our analysis revealed the existence of a scientific field of GS in Latin America from the concept of Bourdieu, marked by strong political interventions of the institutions that integrate it, especially those that finance research in the field. These interventions are particularly characterized by the conditioning of the release of funds to specific thematic agendas, with the Sustainable Development Objectives 2030 being the main one. Since we can confirm the GH in the Latin America as scientific field, we can affirm that the H&SC integrate the same, conducting into a critical sense? The answer is yes and no, because we identified two moments of entry of H&SC into the area of Latin American health, which meant two distinct forms of action in that field. We agree with the authors that the GH in Latin America is a continuity of public, international and collective health - in the Brazilian case, and that the H&SC that have integrated these fields since the 1970s have assumed an established position in the scientific field of the GH in Latin America, dictating the rules of the game and conforming it based on their interests and subjects that they consider relevant. The second moment is marked by the expansion of the health area to the global geographic scope, the intense use of the internet and social medias by researchers, and the entry of new agents, originating from not traditional areas of knowledge as a sustainability, what we call outsiders, and that it assumed a differentiated position in the constitution of the field of the GH in the Latin America. Distant of the possibility of shaping the field in its own way, passing through different areas and seeming to care less about the classifications of \"pure\" or \"hybrids\" (CANESQUI, 2008). Between the characteristics that differentiate it, is being taken by the subjects were also conditioned, but in a more autonomous perspective because they are not tied to a specific agenda. Another relevant aspect is the critical posture outspoken in his papers on the term global health and all the political implications it represents. Finally, these outsiders refer more to the global health project for Latin America as a goal to be pursued by our region through a critical stance on the actions of developed countries. We believe that the potential of the GH scientific field in Latin America is far from the proper exploration it deserves. We are referring to a field that is still under construction, however, we note the need for a more audacious posture to contribute more for the global constitution of the scientific field of health from the Latin American perspective.

Systematic reviews of the effect of foster care on mental-health outcomes have consistently indicated a zero-sum game, which makes it unclear whether the intervention is suitable for children in need of out-of-home placements. This thesis took on a meta-analytical approach to examine sources of heterogeneity between studies evaluating the effect of foster care on adaptive functioning, cognitive functioning, externalizing behavior, internalizing behavior, and total problems behavior. The bulk of studies came from two recently published systematic reviews. The searches were replicated to cover studies published until March 31, 2018. From 2943 studies assessed for eligibility, 240 were selected for the analysis covering 25 085 children. A choice of study-related covariates was abstracted, and potential sources of heterogeneity were hypothesized and tested by means of meta-regression. The findings indicated that both the choice of study design and measurement instrument were significantly associated with the variation in effect sizes. These associations were even stronger in child protection-oriented welfare regimes while insignificant in family service-oriented regimes, which instead showed significant associations for outcome type and publication year. The results imply a need to standardize effect studies of foster care, and to further research on sources of heterogeneity in different child welfare regimes.

This thesis examines the politics of Zimbabwe's catastrophic cholera outbreak in 2008/09, which caused an unprecedented 98,000 cases and over 4,000 deaths. Epidemiologically, the outbreak can be explained by the breakdown of the country's water and sanitation systems. Such a reading, however, belies the byzantine political, economic and historical processes that precipitated the dysfunction of the water systems, that delineate the socio-spatial pattern of the outbreak and that account for the fragmented and inadequate response of the national health system. The complex causal factors and the far-reaching consequences of the outbreak indicate that cholera is a unique prism through which to view different political phenomena including the dilemmas and contradictions of political change, bureaucratic order, humanitarianism, crisis and citizenship in Zimbabwe. Drawing on extensive field research, I make three inter-locking arguments in this thesis. First, I argue that Zimbabwe's cholera outbreak was a 'man-made' disaster. It was the final stage of both path-dependent and contingent processes rooted in questions of political economy such as the collapse of public health infrastructure, failing livelihood strategies and violent repression. Second, I argue that cholera reproduced and exacerbated a multiplicity of socio-political crises pertaining to the legitimacy of the Zimbabwean state, the nature of structural inequalities in Zimbabwean society and fundamental flaws in the global humanitarian response to epidemics. Third, I look at the myriad meanings, memories and narratives the epidemic has left in its wake across public institutions and in civic life. I argue that cholera has been committed to historical memory as a health crisis, a political-economic crisis, and a social crisis as well as a crisis of expectations, history and social identity.

The impact of influenza pandemics is felt most greatly in developing states, where the close proximity between humans and disease vectors, weak public health surveillance systems, and poor sanitation make these states particularly vulnerable to influenza pandemics. A vaccine is the most effective intervention to minimise the spread and impact of influenza, and yet, developing states are the least likely to have timely access to a vaccine during a pandemic. According to 'The Committee on Economic, Social and Cultural Rights General Comment No. 14: the Right to the Highest Attainable Standard of Health' there is a clear positive obligation for states to provide access to vaccines during an influenza pandemic, and this obligation is not waived or depleted merely because developing states have resource constraints. There has been a proliferation of literature recently which has considered access to medicines in developing states and the right-to-health. However, there has been little exploration of this issue in respect of pandemic influenza vaccines. This research explores the manner in which developing states procure influenza vaccines during a pandemic, and determines if the current international legal mechanisms which are available to developing states can be successfully used to enhance procurement, and increase the amount of vaccine developing states can access during a pandemic, to a point where they can discharge their right-to-health obligations. In doing so, I argue that the WHO Pandemic Influenza Preparedness Framework, and the flexibilities of the TRIPS Agreement are not able to enhance the procurement of pandemic influenza vaccines by developing states, to the point where states right-to-health obligations can be said to be discharged. From this, I propose an international 'Knowledge Clearing House as a solution to the problems in procurement which are identified in this research.

Introdução O desenvolvimento das Relações Internacionais como disciplina a fez abarcar estudos de integração regional, cooperação internacional e, mais recentemente, saúde. O processo de globalização e uma maior interação entre os países culminaram na criação de blocos regionais de cooperação, sendo um exemplo expoente na América do Sul a União das Nações Sul-Americanas - UNASUL. Cooperação em saúde global por meio de convergência política dentro dos blocos é possível, e para isso é necessário o conhecimento dos sistemas de saúde de cada país. O Brasil, dentro da tradição de sua política externa e da defesa da Diplomacia da Saúde Global, busca cooperar com os países da UNASUL em questões de saúde. Objetivos - Descrever a ação de Organizações Internacionais e sua atuação em saúde; descrever ações de cooperação em saúde do Brasil; identificar aspectos contextuais dos sistemas de saúde e da cooperação internacional em saúde da Bolívia e da Venezuela. Métodos O procedimento metodológico é qualitativo. Dentro dos métodos possíveis, utilizou-se o descritivo e a pesquisa histórica. A descrição foi utilizada nos dois países estudados para caracterizar seus sistemas de saúde, e a pesquisa histórica, para entender os processos de reforma desses sistemas. Resultados Organizações Internacionais trabalham de diferentes formas a saúde, mas sempre a relacionando com o objetivo principal da instituição. OMS e Banco Mundial são as organizações que mais lidam com o tema. O Brasil, na década de 90, começou a debater sobre saúde em conferências internacionais, e desde os anos 2000 amplia sua cooperação em saúde com países africanos, asiáticos e latinoamericanos. Também estimula o debate da saúde no MERCOSUL e na UNASUL. Os sistemas de saúde da Bolívia e da Venezuela, que foram reformados nos anos 80 e 90, têm atualmente como meta a universalidade; contudo seus sistemas continuam mistos, com presença de um subsetor público, privado e previdenciário. Conclusões - Há um esforço conjunto do Brasil, da Bolívia, da Venezuela e da UNASUL para que a saúde de suas populações melhore em qualidade. Estes quatro atores, igualmente, utilizam o tema saúde como uma questão para cooperação e um propósito para integração. / Introduction The development of International Relations as a discipline embraces studies regarding regional integration, international cooperation, and more recently, health. The globalization process and a higher level of interaction amongst the countries culminated in the establishment of regional cooperation blocs. A representative example of this outcome in South America is the Union of South American Nations UNASUR. Cooperation in health via policy convergence within the blocs is possible, and this requires the knowledge of each countrys health system performance. Brazil, within its foreign policy tradition and its Global Health Diplomacy advocacy, seeks to cooperate with other UNASUR countries on health issues. Objectives To describe the work of International Organizations as well as their performance on health issues; to describe Brazilian cooperation in health; to identify contextual features of the health systems and of the international cooperation in health of Bolivia and Venezuela. Methods The methodological approach is qualitative, and both descriptive procedure and historical research were used. Description was used in the countries health systems scrutiny; and historical research was used to understand these systems reform process. Results International Organizations address health issues with different approaches, but they always relate it to the institutions main objective. WHO and World Bank are the organizations that the most deal with the topic. Brazil, in the 90s, started debating health in international conferences, and since the 2000 decade expands the countrys cooperation in health with African, Asian and Latin-American States. Moreover, Brazil encourages debates concerning health within MERCOSUR and UNASUR. The Bolivian and the Venezuelan health systems, which underwent a reform process during the 80s and the 90s decade, have currently as a goal universal access to health; however, their health systems are still of mixed types, with the presence of public, private and social security subsectors. Conclusion There is a joint effort of Brazil, Bolivia, Venezuela and UNASUR to accomplish an improvement in their populations health. These actors understand health both as a subject for cooperation and as a purpose for integration.

Background: Zambia has one of the highest rates of intimate partner violence (IPV) in the world. While the focus has been put on the prevalence and the consequences of physical, sexual and psychological violence, economic abuse has been a neglected area in research. Studies have shown that accepting attitudes toward IPV are the most prominent predictor of the occurrence of IPV while men’s attitudes toward IPV have not gained equal attention in research as women.  Aim: To explore women’s and men’s attitudes towards economic abuse in Livingstone, Zambia.  Methods: This study used a qualitative case study method consisting of semi-structured interviews with 17 women and men in four villages in Livingstone town. Transcripts were analyzed through a thematic analysis using the software NVivo 12 as an aid in facilitating the coding process.  Results: The husband not providing for the family was not acceptable by the respondents. As a result of this, men expressed constant feelings of societal pressure of being a good provider. Mixed and contradicting attitudes concerning preventing the wife from working or taking money without consent were shown. Preventing the wife from working or taking money were often justified as long as the husband could provide.  Conclusion: This study concludes that people’s overall attitudes towards economic abuse are strongly affected by traditional gender roles, where societal norms and expectations put on men should be questioned. Therefore, reducing the prevalence of economic abuse requires interventions targeting irresistible stereotypical norms concerning expectations on masculinities and femininities.