Child mental health has been an emerging topic in societal as well as scholar spheres. Mental health is intimately connected with wellbeing and as such their promotion by the World Health Organization(WHO) has allowed for governmental and societal structures to be aware of what is necessary to implement and change in order to achieve better child mental health and wellbeing. Through this thesis, the representations of children and how mental health and well-being are constructed are analysed using Bacchi’s “What’s the problem presented to be” (WPR) method. The aim of this studyis to critically examine how the concepts and representations described above are discursively generated in the annual reports of 2015 and 2016 from the WHO. When analyzing the representations of the child, mental health and wellbeing, two major themes are identified: The vulnerable/agentic child and the best place for a child. The first theme discursively represents children in three forms: Helplessness or victim, passive recipients and agentic.The second theme represents not only children but also their families, the institutions and the institutional staff. Here another three discourses emerge: Connection to the nuclear family discourse,the powerful and harming institutions discourse and the blaming the staff discourse. Regarding the concepts of wellbeing and mental health, the results comprising this thesis suggest that, in the reports,mental health is presented to be a question of who the caregiver is and how resources such as education are distributed. Wellbeing is connected to the presence of the parents with the child avoiding thus institutionalization as well as the children becoming victims of the malpractices of the negligent institutional staff and the possibility of children becoming agents in their own lives. Finally,the seemingly unproblematic aspects of such representations indicate that the arguments about the vulnerable/agentic child and the best place for a child, are not put in context and are about a generalized child that does not fit the specificity of children’s worlds.

A democracia sanitária exige que as normas do direito à saúde sejam derivadas de processos deliberativos que permitam a troca de argumentos que, por sua vez, conduzam à formação da vontade política, sendo que essa vontade deve ser constantemente submetida à confirmação em debates públicos para garantir a responsividade do governo e o controle do exercício do poder político. A partir dessa noção, pretendíamos verificar se, caso fosse aprovado o projeto de Marco para colaboração com os atores não estatais, no seio da reforma da Organização Mundial da Saúde, seriam criadas instituições e processos deliberativos que oportunizassem a participação democrática da sociedade civil internacional. Para tanto, realizamos uma pesquisa qualitativa, e, por meio do método da análise documental, estudamos os documentos básicos e documentos oficiais concernentes à reforma da Organização Mundial da Saúde. A conclusão alcançada foi que, embora o instrumento analisado não promovesse a democracia sanitária em conformidade com o marco teórico adotado no trabalho, ele criaria novas instâncias em que a sociedade civil internacional poderia exercer sua influência. / Health democracy requires that the norms of right to health are derived from deliberative processes that allow the exchange of arguments which, in turn, conduct to the formation of the political will, and this will must be constantly subject to confirmation in public debates to ensure the responsiveness of government and control of the exercise of political power. Based on this notion, we intended to verify whether, if it were approved the draft Framework for engagement with non-state actors, within the reform of the World Health Organization, it would create institutions and decision-making processes that would enable democratic participation of international civil society. To this end, we conducted a qualitative research, and through the method of document analysis, we studied the basic documents and official documents concerning the reform of the World Health Organization. The conclusion reached was that, although the analyzed instrument did not promote health democracy in accordance with the theoretical framework adopted at this work, it would create new instances in which the international civil society could exert their influence.

This thesis investigates the impact of international organizations on the making of international law by applying insights on how international organizations work—or fail to work—to the process of institutionalized treaty making. Specifically, I probe the relationship between the World Health Organization (“WHO”) and international infectious disease law, focusing in particular on the 2005 International Health Regulations (“2005 IHR”), which was negotiated, adopted, and is now being implemented under WHO’s auspices. The 2005 IHR is the most recent development in international infectious disease law, the history of which extends back to the beginning of international health cooperation in the mid-nineteenth century, before any international health organization was formed. Relying on secondary sources, WHO documents, archival materials, and personal interviews, I chronologically trace the evolution of international infectious disease law across changing institutional settings. I first examine the incremental growth of the older “barrier” approach to infectious disease regulation, initially developed in the absence of any international health organization and then with the aid of one of WHO’s predecessor organizations. I then analyze the decline of the barrier approach and the rise of the new “epidemiological” approach embodied by the 2005 IHR, with the aid of WHO. Based on my empirical analysis, I conclude that WHO has radically changed the process of making international infectious disease law as well as its content. On its own initiative and without member state demand, WHO’s permanent staff experimented with novel practices that subsequently became the basis for the 2005 IHR. WHO’s work reduced the length of formal negotiation needed to arrive at a new agreement and the uncertainty associated with adopting a novel regulatory system. Its influence also raises normative questions about the proper role of international organizations in making international law—questions that require further exploration.

Master of Public Health - MPH / Background:Theoutcomeofpregnanciesinmanyinstancesislargelypredicatedon availabilityofSkilledBirthAttendants(SBAs).Despitethisphenomenon,illiteracyand financialdisadvantagehavebeenvariouslycitedastwinfactorspromotingtheinterest andpatronageofTraditionalBirthAttendants(TBAs)bywomenfolk.Itistherefore expected thatwomenhavingtertiarylevelofeducationandpossessing adequate economic resources would naturally prefer to use the SBAs.However,these http://etd.uwc.ac.za/ 9 observationshavenotsignificantlyreflected therealityin thechoiceofmaternal healthcareprovidersinNigeriaandthecityofLagosinparticular.Yet,accessto maternalservicesoftheSBAshasbeenwidelyacceptedasoneoftheleadingwaysof loweringmaternalmortality.Therefore,inordertoimprovethepatronageofSBAsand correspondinglylowermaternaldeathrates,itbecomesimperativetounderstandthe rationalebehindthepreferencefortheTBAs’usebywomenwhoarenotordinarily expectedtodosobyvirtueoftheirhighlevelofeducationandgoodfinancialcapacity. Aim:Theaim ofthisstudywastoexploreandunderstandtheexperiences,perception and beliefsystems influencing well-educated,middle income women and their reasoningfortheuseofTraditionalBirthAttendantsratherthanSkilledBirthAttendants fordeliveryservicesinLagos,Nigeria. Methodology:ThisisaqualitativestudyconductedinAlimoshoLocalGovernmentArea ofLagosinNigeria.Tenwomenwithtertiarylevelofeducationandbelongingtomiddle incomeeconomiccategorieswereenrolledasparticipants.Inaddition,itinvolved3 FocusGroupDiscussionscomprising7TraditionalBirthAttendantspergroup. Results:Behaviouraland attitudinalshortcomings by the SBAs;misconceptions regardingsurgicaldeliverybywomen;bureaucraticdelaysandbottlenecksexperienced attheSBAs’centres;thebeliefbythewomenthatpregnancyisasacredandspiritual eventwhichonlytheTBAshaveabilitytomanage;women’sconfidenceintheTBAsas havingbettercapacitytomanagecertaincoexistingmedicalconditionsinpregnancy; andmisinformationonmanagementmodalitiesforcertainconditionslikeinfertilityand fibroidallcombinetoinfluencepreferenceforutilizationofTBAsbywell-educated, middleincomewomeninthestudyarea.

Since securitization processes are agued to be able to create excessive power to actors, there are arguments that claim that securitization is a negative process. By combining aspects of the original securitization theory with Juha Vuoir’s theory of illocutionary force, this thesis makes an attempt at finding what different actors claimed was threatened in their respective securitization of the issue terrorism. The motive behind the actors are also investigated and argued to be made visible through the different speech acts each actor employs when trying to securitize an issue. The thesis concludes that all three securitizing actors use some traditional notions of what is being threatened, namely the state. However, they are all found to use less traditional referent objects in addition to the state. The thesis also concludes that the motives of the different actors are found. These are showcased through the president of the USA trying to create deterrence for attackers of his state and trying to create control on the international arena. The High Representative of the EU, trying to legitimize future acts of more integration in the Union. Finally the World Health Organization’s motive is argued to have been to put the issue on the agenda.

Philosophiae Doctor - PhD / Semen analysis is the cornerstone for the investigation of male infertility. Semen quality can be influenced by geographical location, age, ejaculatory abstinence, and season. In 2010, the WHO published criteria for human semen characteristics that were markedly lower than those previously reported. Many reports have discussed the methodology used by the WHO to set the 2010 reference values. Some of the limitations of the WHO (2010) study included an undefined ejaculatory abstinence period, the limited representation of different age groups, and a limitation in geographical representation as the study did not include any data from Africa and Middle East. Therefore, the current cohort study was designed to provide retrospective data on semen quality (Africa and Middle East) and reproductive hormones (Middle East) in patients who underwent semen analysis and endocrine investigation at Andrology Laboratories in South Africa and Qatar.

A Research Report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the Degree of Master of Science in Medicine (Pharmaceutical Affairs) Johannesburg, 2016 / Background The World Health Organization (WHO) defines medicines regulation as the “promotion and protection of public health by ensuring the safety, efficacy and quality of drugs, and the appropriateness and accuracy of product information” (1). Medicines regulation is a key function in the realisation of the right to essential medicines. However, a satisfactory level of harmonization of regulatory activities has not been achieved in the Southern African Development Community (SADC) region as yet. Objectives The study evaluated the current status of medicines regulatory harmonization within the SADC region, as well as explored perceived barriers to regulatory harmonization and potential strategies to address these. Methods A cross-sectional exploratory study design with qualitative techniques, as well as an inductive approach was used. In-depth, semi-structured, face-to-face interviews with interviewees from the SADC Secretariat, the African Medicines Harmonization (AMRH) Initiative and the Southern Africa Regional Programme on Access to Medicines and Diagnostics (SARPAM) was used, involving secondary formal qualitative approaches to identify the emergent themes, was utilised initially. A questionnaire was formulated and adapted using secondary data collected from the face-to-face interviews, then piloted. Questionnaires were sent to senior members of all 15 regulatory authorities belonging to SADC, including registrars and deputy registrars. Theoretical and analytical codes were identified from repeated ideas, concepts or elements. Codes were grouped into concepts, and then into categories. Trend analysis was conducted, involving an in-depth analysis of patterns. Results Barriers to regulatory harmonization in the SADC region perceived by participants included i) deficiencies in governance and leadership within the SADC Secretariat, ii) human resource and technical capacity constraints, iii) limited financial resources, iv) lack of political will within SADC governments, v) lack of intra-SADC relationships, vi) risk-benefit analysis differences in assessment of applications and bias according to local population needs, as well as vii) different guidance documents and legal frameworks among member countries. Strategies identified to address these included i) using other harmonization initiatives as models, ii) application format harmonization and African Union (AU) Model Law adoption, iii) redirecting focus of harmonization to information sharing and technical matter rather than complex legislative frameworks, iv) regulator initiatives of harmonization instead of SADC secretariat reliance, v) World Bank Agreement adoption, vi) human resource capacity development and vii) convergence of guidelines instead of complete harmonization of all regulatory requirements. Conclusions The findings in this study suggest that it may be necessary to redirect the focus of harmonization to more readily achievable activities and aim for convergence of guidelines. Regulatory harmonization is possible if barriers to it are addressed. / MT2016

Den här studien grundar sig i en kvalitativ textanalys ur ett retoriskt och semiotiskt perspektiv. Syftet med denna undersökning var att se om det finns några skillnader i budskapen i kriskommunikationen som rör Covid-19 på World Health Organizations Instagram- och TikTokkonto samt att se om det finns några retoriska argument i dessa inlägg. Uppsatsen vill även ta reda på hur WHO förstärker budskapen som kommuniceras. De teoretiska utgångspunkterna för denna studie är kriskommunikation och krisretorik. I den tidigare forskningen som denna uppsats utgått ifrån beskrivs framgångsrik kriskommunikation ur ett retoriskt perspektiv. Ett av framgångskoncepten ur en retorisk synvinkel var att bygga sin kriskommunikation med hjälp av pathos. I resultatet för denna undersökning framkom det att budskapen skiljer sig men inte avsevärt mycket mellan plattformarna men att på Instagram byggs kommunikationen mera på logos och på TikTok mera på pathos. Resultatet visade även att WHO på Instagram använder sig av piktogram och bilder för att förstärka budskapet.

Magister Public Health - MPH / Sub Saharan Africa (SSA) single-handedly accounted for approximately two thirds (196 000) of the world maternal deaths. High maternal deaths have been attributed to high prevalence of HIV and low uptake of Antenatal Care (ANC). This made World Health Organization (WHO) to recommend integration of Prevention of Mother to Child Transmission of HIV (PMTCT) services into ANC to improve accessibility and utilization. According to Zambia Ministry of Health (MoH), every pregnant woman should have her ANC registration in the first trimester and achieve eight visits by delivery time. With the extra need of PMTCT services in the women living with HIV, early and regular ANC attendance is emphasized. However, in Zambia, there is limited information on ANC uptake and its associated factors among women living with HIV. / 2023

The World Health Organization estimates that there are 285 million people suffering from visual impairment worldwide. The top two causes of uncorrectable vision loss are glaucoma and age-related macular degeneration (AMD), with 112 million people anticipated to be impacted by glaucoma by 2040 and nearly 15% of U.S. adults aged 43-86 predicted to be diagnosed with AMD over the next 15 years. To slow the progression of these ophthalmic diseases, the most valuable preventive action is timely detection and treatment by an ophthalmologist. However, over 50% of glaucoma cases go undetected due to lack of timely assessment by a medical expert. This thesis seeks to transform artificial intelligence (AI) into a trustworthy partner to clinicians, aiding in expediting diagnostic screening for obvious cases and serving as corroboration/a ‘second opinion’ in ambiguous cases. In order to develop AI algorithms that can be trusted as team-mates in the clinic, the AI must be robust to data collected at various sites/from various patient populations, its decision-making mechanisms must be explainable, and to benefit the broadest population (for whom expensive imaging equipment and/or specialist time may not be available), it must be portable. This thesis addresses these three challenges (1) by developing and evaluating robust deep learning (DL) algorithms for detection of glaucoma and AMD from data collected at multiple sites or using multiple imaging modalities, (2) by making AI interpretable, through: (a) comparison of image concepts used by DL systems for decision-making with image regions fixated upon by human experts during glaucoma diagnosis, and (b) through odds ratio ranking of clinical biomarkers most indicative of AMD risk used by both experts and AI, and (3) by enhancing theimage quality of data collected via a portable OCT device using deep-learning based super-resolution generative adversarial network (GAN) approaches. The resulting robust deep learning algorithms achieve accuracy as high as 95% at detection of glaucoma and AMD from optical coherence tomography (OCT) and OCT angiography images/volumes. The interpretable AI-concept/expert-eye-movement comparison showed the importance of three OCT-report sub-regions used by both AI and human experts for glaucoma detection. The pipeline described here for evaluating AI robustness and validating interpretable image concepts used by deep learning systems in conjunction with expert eye movements has the potential to help standardize the acceptance of new AI tools for use in the clinic. Furthermore, the eye movement collection protocols introduced in this thesis may also help to train current medical residents and fellows regarding key features employed by expert specialists for accurate and efficient eye disease diagnosis. The odds ratio ranking of AMD biomarkers distinguished the top two clinical features (choroidal neovascularization and geographic atrophy) most indicative of AMD risk that are agreed upon by both AI and experts. Lastly, GAN-based super-resolution of portable OCT images boosted performance of downstream deep learning systems for AMD detection, facilitating future work toward embedding AI algorithms within portable OCT systems, in order for a larger population to gain access to potentially sight-saving technology. By enhancing AI robustness, interpretability, and portability, this work paves the way for ophthalmologist-AI teams to achieve augmented performance compared to human experts or AI alone, leading to expedited eye disease detection, treatment, and thus better patient outcomes.