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  • 1.
    Okenwa Emegwa, Leah
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Determinants of sick leave duration following occupational injuries among workers in the county of Gävleborg, Sweden2014In: Occupational Medicine & Health Affairs, ISSN 1463-502X, E-ISSN 2329-6879, Vol. 2, no 4, article id 176Article in journal (Refereed)
    Abstract [en]

    Background: Occupational injuries continue to add to the global burden of injuries. Recent global estimates show that up 317 million workers were injured in accidents at work that resulted in absence from work of four days or more. Whereas sick leave is important for rehabilitation and recovery, the duration of sick leave and consequent return to work is of concern in order to prevent negative outcomes. There is therefore a need to examine factors associated with sick leave duration among injured workers for effective rehabilitation. This study aimed to investigate the determinants of leave sick duration following occupational injuries. Method: The Swedish National Working Environment Agency keeps a record of all cases of occupational injuries requiring at least one day sick leave day and reported to Swedish Social Welfare Security Agency. The present study is register based using data from a total of 5291 cases of occupational injuries that occurred in the county of Gävleborg, Sweden between 2007 and 2012. Result: Sick leave longer than two weeks was highest for the self-employed and temporary workers although injury frequency was low for both groups. Fall injuries and injuries involving slip, trip and snapping or breaking of an object were more likely to lead to sick leave longer than two weeks. Shorter sick duration was observed among injured workers in the health and manufacturing sectors. Conclusions: Possible reasons for the observed results and the need for individual based rehabilitation process for effective and more meaningful return to work are discussed.

  • 2.
    Okenwa Emegwa, Leah
    Institutionen för folkhälsovetenskap, Karolinska institutet, Stockholm.
    Intimate Partner Violence Among Women of Reproductive Age in Nigeria: Magnitude, Nature and Consequences For Reproductive Health2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Intimate Partner Violence (IPV) against women is now recognised as a problem of global magnitude, owing to its detrimental consequences on the health, social and economic welfare of women and their children. This scenario has prompted increased research to understand its risk factors and data has indicated contextual variation in this regard, warranting an assessment in each unique setting. A major constraint, however, on the detection and potential management of IPV lies in the poor disclosure of abuse by many women and their submission to abuse, particularly in Sub- Saharan Africa.

    Objective: We studied the magnitude and risk factors for IPV exposure among women in a community of Nigeria (paper 1), extent of and factors associated with the disclosure of IPV in the community sample (paper 2), the association between IPV and reproductive health outcomes in a nationally representative sample of Nigerian women (paper 3) and women and men‟s attitudes towards IPV in a nationally representative sample (paper 4).

    Methods: Structured interviews were conducted in a sample of over 900 women selected systematically from among visitors to a community health facility (papers 1 and 2). Women were probed on exposure to and disclosure of IPV, as well as demographic, social and empowerment measures. Secondary data was retrieved from the demographic and health surveys of Nigeria 2008, which utilised multi-stage sampling to gather demographic and health data on over 45,000 men and women, which was used to study the reproductive health outcomes in relation to IPV (paper 3) as well as model attitudes towards IPV using demographic, social and empowerment indicators (paper 4). Statistical analyses used included Chi-square tests and Logistic regressions.

    Results: The 1 year prevalence of IPV was 29%, with significant proportions reporting psychological (23%), physical (9%) and sexual (8%) abuse. Independent predictors of IPV included in-access to information, women‟s autonomy in decision making and contribution to household expenses (paper 1). Fifty four percent of the participating women would not disclose IPV on the hypothetical situation of exposure. Among those willing to disclose, 37% (n=103) would disclose to some form of institutions (i.e. religious leaders, law enforcement officers (only 1% would actually disclose to the police). This institutional disclosure is in contrast to 68% who opted to disclose to close family and relatives. Ethnicity, woman‟s own use of alcohol and autonomy in household decision (e.g. having a say on household purchases), increased the likelihood of disclose IPV (paper 2). Exposure to IPV was associated with using modern forms of contraception; have a history of miscarriages, induced abortions, stillbirths, or infant mortality; and having many children. These associations remained even after adjustment for potential confounders including demographic and socioeconomic factors (paper 3). Although justification of IPV was common among men and women, a higher proportion of women justified IPV compared to men. For both men and women, justification of wife beating was associated with low education, rural residency and ethnicity. Access to information was associated with justification of abuse, sometimes in the unexpected manner. While in-access to newspaper was associated with an increased likelihood of justifying abuse among women, in-access to radio/tv decreased the likelihood of endorsing wife abuse among the women. The direct opposite was observed among men. Finally, having a shared autonomy in household decisions was associated with a reduced likelihood of justifying wife abuse among both women and men (paper 4).

    Conclusion: IPV is rampant and is associated with detrimental reproductive health outcomes and contraception use among Nigerian women. Nigerian women justify IPV to a higher degree than men, with variations in gender regarding the determinants of such justification. Though many of the predictors of IPV exposure, disclosure and attitudes tend to corroborate previous work and theories, the association between empowerment indicator and these outcomes are sometimes contradictory to previous work, suggesting possible contextual differences. The thesis has important implications for prevention of IPV in Nigeria and further research.

  • 3.
    Okenwa Emegwa, Leah
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Trends in Work Place Injury and Consequent Absence from Work in the County of Gävleborg, Sweden2014In: / [ed] Massimo Cecaro, 2014Conference paper (Refereed)
    Abstract [en]

    Work related injuries continue to contribute to the global burden of disease and injuries. According to recent global estimates, about a million workers are injured and a thousand die per day due to work injuries. In Sweden, trends in reporting work place injuries have varied over time with various peaks and troughs.Differences have been observed between the reporting ofinjuries requiring sick leaves and those requiring no sick leaves, the so called ‘zero’ accidents.There are however few studies exploring the specific trends and patterns of occupational injuries in Sweden. Even problematic is the fact that available studies are very industry specific. Aim: To explore trends in workplace injuries and associated socio-demographic risk factors in the county of Gävleborg, Sweden.The study also aims to look at sick leave patterns in terms of total number of days absent from week and their determinants. Method: The study is based on retrospective longitudinal data comprising of all cases of work place accidents between 1992 and 2012 which were reported to the Swedish social insurance agency. A total of 24129 cases were reported across different industries. Data was analyzed using SPSS. Results: Preliminary results show that work place injuries vary by social demographic factors (such as age, sex, type of employment status) and industry.Results also show that age and sex are major determinants of total number of sick leave days. Conclusion: The implication for interventions and further research are discussed.

  • 4.
    Okenwa Emegwa, Leah
    et al.
    Department of Public Health Sciences Stockholm, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden .
    Lawoko, S.
    Department of Public Health Sciences Stockholm, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden .
    Jansson, B.
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Exposure to intimate partner violence amongst women of reproductive age in lagos,nigeria : Prevalence and predictors.2009In: Journal of family Violence, ISSN 0885-7482, E-ISSN 1573-2851, Vol. 24, no 7, p. 517-530Article in journal (Refereed)
    Abstract [en]

    Research on predictors of Intimate Partner Violence (IPV) in Sub-Saharan Africa is contradictory, necessitating further investigation. This study sought the prevalence and predictors of IPV among women in Lagos, Nigeria. Questionnaire data from 934 women visiting an obstetrics and gynecology clinic in Lagos were analyzed using multivariable methods. The 1 year prevalence of IPV was 29%, with significant proportions reporting psychological (23%), physical (9%) and sexual (8%) abuse. In-access to information, women's autonomy and contribution to household expenses independently predicted IPV. The findings provide new incites for IPV prevention in Lagos with implications for further research.

  • 5.
    Okenwa-Emegwa, Leah
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science. Department of Medicine and Public Health, The Swedish Red Cross University College, Stockholm, Sweden.
    Doctoral theses as a source of knowledge production for IPV prevention: A literature review of doctoral theses at a swedish university2019In: Open Public Health Journal, ISSN 1874-9445, Vol. 12, no 1, p. 145-154Article in journal (Refereed)
    Abstract [en]

    Background: Intimate Partner Violence (IPV) is a pervasive form of Violence Against Women (VAW). IPV has been acknowledged as a human rights violation and a public health problem. Years of research and advocacy have led to a better understanding of the problem including the development of the ecological model for explaining IPV. Although diverse international policies and global advances in women’s rights have contributed to addressing IPV, the problem still persists. IPV is associated with adverse health outcomes, therefore, its prevention is an important aspect of population health promotion. Objective: Considering that doctoral research and theses form an integral aspect of knowledge production, the present study aims to provide a review of doctoral theses on IPV at a Swedish university in order to identify areas of unmet need for future IPV prevention studies. Methods: A search was conducted to identify IPV related thesis stored in the Karolinska Institutet (KI), which is a database where all publications produced at KI are stored. A total of thirteen PhD theses (the earliest published in 2004 and the latest in 2017) met the inclusion criteria and were reviewed. Results: Through their wide range of contexts and contents, these theses provide a global insight into IPV. Findings show that prevalence estimates and risk factors at the individual and relationship levels are well researched. Potential areas of unmet needs include the under-researched nature of risk factors and interventions at the community and societal level as well as underlying issues preventing the healthcare sector from actively playing its role in addressing IPV. Conclusion: Capacity building for the health sector and addressing community and societal level risk factors of IPV are modifiable factors to address IPV and improve population health. 

  • 6.
    Okenwa-Emegwa, Leah
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Lawoko, Stephen
    Karolinska Institutet, Stockholm, Sweden.
    Jansson, Bjarne
    Karolinska Institutet, Stockholm, Sweden.
    Attitudes Toward Physical Intimate Partner Violence Against Women in Nigeria2016In: SAGE Open, ISSN 2158-2440, E-ISSN 2158-2440, Vol. 6, no 4, article id 2158244016667993Article in journal (Refereed)
    Abstract [en]

    Attitudes toward intimate partner violence (IPV) are known predictors of IPV victimization and perpetration with more women generally believed to justify IPV than men. An understanding of the determinants of justification of IPV may provide information necessary for holistic interventions. This study sought to examine the magnitude, extent, and predictors of justification of physical IPV against women among men and women in Nigeria. Data from 33,385 women and 15,486 men from the 2008 Nigerian demographic and health surveys were analyzed using chi-square test and multiple logistic regressions. Results show that although larger proportions of women justified physical IPV, certain categories of men such as poor, illiterate men, and men with secondary education justified abuse more than women. Contrary to expectations, access to radio/TV increased the odds of justifying abuse among women thus casting doubts on program content. The gender differences observed for predictors of attitudes to physical IPV suggest a need for gender-tailored interventions to change attitudes toward partner violence in Nigeria.

  • 7.
    Okenwa-Emegwa, Leah
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Swedish Red Cross University College, Stockholm, Sweden.
    Saboonchi, F.
    Swedish Red Cross University College, Stockholm, Sweden.
    Tinghög, P.
    Swedish RedCross University; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Depression and Low Labour Market and Social Expectations among Resettled Syrian Refugees in Sweden2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no Suppl. 3, p. 377-377Article in journal (Refereed)
    Abstract [en]

    Background

    Large numbers of refugees have come to Europe in search of safety. For non-refugee migrants, expectations and the extent to which they are met are shown to be integral components of adaptation and wellbeing. This study aims to explore the prevalence of low expectations for labour market, economic and social integration among Syrian refugees recently resettled in Sweden and whether depression is associated with these expectations.

    Methods

    Arandomsampleof1215Syrianrefugesofworkingage recently resettled in Sweden responded to a questionnaire in Arabic. Expectations were asse ssed by three items developed for this study. Average item score of >1.80 on the depressive symptoms  in  Hopkins  Symptom  Checklist  indicated depression. Logistic regressions adjusted for demographic factors and social support were conducted. Weighted data was used to produce socio-demographically representative prevalence rates and odds ratios (ORs). Robust standard errors were used to obtain 95% confidence intervals for all estimates.

    Results

    Prevalence  of  low  economic,  social  and  labour  market expectations were 14.1% (95% CI 12.0-16.1), 13.4% (11.3- 15.4) and 10.9% (9.1-12.6) respectively. Approximately 40.2% (36.9-43.3) of the participants had depression. Those with depression were about four times more likely to have low economic expectations (OR 3.89, 95% CI 2.66-5.92), three times more likely to have low social (OR 3.1, 2.30-5.24), and labour market (OR 2.83, 1.90-4.47) expectations.

    Conclusions

    Low expectations, while not widespread, exist among Syrian refugees in Sweden. Notable proportions had depression which was also significantly associated with low expectations. The association between depression and low expectations in keys areas necessary for adaptation and wellbeing in a new land, indicates the need to address mental health issues in current societal  level  efforts  aimed  at  boosting  labour  market participation and social inclusion.

    Key messages:

    • Notable proportions of Syrian refugees in Sweden have low expectations in domains vital for adaptation and wellbeing in a new land. Depression is significantly associated with low expectations.
    • Low expectation among Syrian refugees in domains vital for adaptation and wellbeing and the association with depres- sion indicate need to address mental health in social and labour market interventions.
  • 8.
    Okenwa-Emegwa, Leah
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. epartment of Health Sciences, The Swedish Red Cross University College, Stockholm, Sweden.
    von Strauss, Eva
    Department of Health Sciences, The Swedish Red Cross University College, Stockholm, Sweden.
    Higher education as a platform for capacity building to address violence against women and promote gender equality: the Swedish example2018In: Public Health Reviews, ISSN 0301-0422, E-ISSN 2107-6952, Vol. 39, article id 31Article in journal (Refereed)
    Abstract [en]

    Violence against women is an acknowledged public and global health problem which has adverse consequences for women's health. Education, especially higher education, has long been identified as an important arena for addressing the problem and promoting gender equality. Two measures recently put in place in the Swedish higher education have brought the role of the sector into focus. The first is the inclusion of gender equality as a measurable outcome in quality assurance in higher education. The second measure is the amendment of the Swedish Higher Education Ordinance to include mandatory knowledge of VAW in the degree programme of seven selected relevant professional groups. The potentials of both measures to positively contribute to the gender equality discourse, as well as improving capacity building for the public health workforce who encounter VAW, are discussed.

  • 9.
    Salima, N.
    et al.
    Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
    Okenwa-Emegwa, Leah
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Department of Health Sciences, The Swedish Red Cross University College, Stockholm, Sweden.
    Stephen, L.
    Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden; Department of Public of Health Sciences, Faculty of Health Sciences, Victoria University, Kampala, Uganda .
    HIV testing among women of reproductive age exposed to intimate partner violence in Uganda2018In: Open Public Health Journal, ISSN 1874-9445, Vol. 11, no 1, p. 275-287Article in journal (Refereed)
    Abstract [en]

    Background: Intimate Partner Violence (IPV) and Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) occur as dual epidemics with gender dimensions. IPV sometimes result in lack of decision making autonomy over one’s own health and this may negatively affect uptake HIV testing services. Objective: The study aimed to examine the association between exposure to IPV and HIV testing among women of reproductive age in Uganda. Method: The study is based on cross-sectional data from 2011 Uganda Demographic and Health Survey (UDHS). A sub-sample of 1705 ever-partnered women aged 15-49 who responded to the domestic violence module was examined in the study. Bivariate and multivariable (logistic regression) analyses were used to determine the association between exposure to IPV and HIV testing. Results: Up to 82.3% and 61.5% of the respondents were tested for HIV ever and in the past year, respectively. The prevalence of physical IPV and IPV of any form in the past year was 25.6% and 44% respectively. Exposure to physical IPV and emotional IPV in the past year was associated with HIV testing within the past year. In the multivariate analysis, exposure to physical IPV remained significantly associated with HIV testing within the past year (OR: 1.34; 95% CI: 1.03-1.73). Frequent access to newspapers remained a significant predictor of HIV testing uptake. Conclusion: HIV testing in the past year is associated with exposure to IPV among women of reproductive age in Uganda. There is a need to include IPV as a part of global strategy to address HIV/AIDS. © 2018 Salima et al.

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