prof. dr. ir. H.H. (Hinke) Haisma

Current projects

2012 - present

Normative indicators of child health and nutrition - one size fits all?

 

NWO/WOTRO VIDI grant W01.70.300.002 (2012-2018)

IUNS Task Force "Toward multi-dimensional indicators of child health and development" http://www.iuns.org/taskforces/toward-multidimensional-indicators-of-child-growth-and-development/

 

Child malnutrition is an important cause of under-five mortality and morbidity around the globe. Despite national and international efforts and successes to reduce child mortality, under-five mortality rates continue to be high especially in Sub-Saharan Africa and Southern Asia. With the era of the MDGs having come to an end, and the start of the SDGs era just started, it seems appropriate to rethink current strategies for further reduction of child mortality and morbidity. In this paper, we aim to open the debate on the potential of a capability approach to child growth.

Current child growth monitoring practices are based on two assumptions: (1) anthropometric measures are the appropriate indicators; (2) child growth can be assessed using one universal standard around the world. While acknowledging the relevance of current practices, we propose a fundamentally different approach where growth will be redefined as the achievement of a capability set (of parents and children) that will allow for optimal growth, thereby taking into account contextual differences.  Similar to Amartya Sen's seminal work on a multi-dimensional approach to development and economic growth, we propose a multi-dimensional approach to child growth going beyond the current anthropometric indicators of child growth, and including for example parental care or shelter as dimensions of child growth.

Under the umbrella of Amartya Sen's Capability Approach, we suggest a multi-dimensional monitoring framework applying theories from social sciences and evolutionary biology for the identification of dimensions of child growth that could be included in an aggregated measure of child growth. Such an approach will have implications for interventions and policy, including prevention and counselling, and for making realistic comparisons between countries.

 

Staff

Sepideh Yousefzadeh - postdoc - A Capability Approach to Child Growth: Analysis of Indian DHS using fuzzy sets.

Zaina Mchome - PhD candidate - Ethnography of Child Growth in Tanzania

Shirish Darak - postdoc/ consultant - Systematic Review of Multi-dimensional Child Growth

Femke Hitzert - junior researcher - Use of deuterium for assessing body composition in adolescents in Pelotas, Brazil

2015 - present

Normative dimensions of child nutritional wellbeing in Haor areas of Bangladesh

 

PhD Candidate:

Barnali Chakraborty (Groningen University of the Netherlands and BRAC, Bangladesh)

PhD Advisors:

Prof Dr Hinke Haisma (Groningen University of the Netherlands);

Dr Sepideh Yousefzadeh(Groningen University of the Netherlands);

Dr Shrinivas Darak (PRAYAS Health Group, Pune, Adjunct Faculty, Public Health Evidence South Asia (PHESA), Manipal University, Manipal);

Dr Ahmed Mushtaque Raza Chowdhury, Vice Chairperson and Advisor to the Chairperson, BRAC, Country lead, Scaling Up Nutrition (SUN) Movement, Bangladesh

Research and funding Collaborations:

1. BRAC, Bangladesh
2. EBF (Eric Bleumink Fund), Groningen University of the Netherlands
3. LANSA (Leveraging Agriculture For Nutrition in South Asia) funded by DFID

 

Past PhD projects

2011 - 2016

Gewoon et'n

An ethnographic study of intergenerational perspectives on food practices, overweight, and obesity in Eastern Groningen, the Netherlands

PhD Candidate: Sanne (S.S.) Visser

Defended on November 17, 2016

Promotores: Prof.dr.ir. Inge Hutter, Prof.dr.ir. Hinke Haisma

Overweight and obesity are often regarded as the result of conscious choices of food and exercise. However, public information campaigns with a strong health message have thus far had little effect. Sanne Visser lived in eastern Groningen for six months to study food choices and practices with households. ‘Dietary advice often focuses strongly on medical aspects and pays too little attention to the question which food choices make household members actually happy and the role of different household members in the food choice ’, says Sanne Visser. She will be awarded a PhD on 17 November for her research on the food choices made by families in East Groningen and the role food plays in the region.

video unifocus: http://www.rug.nl/news-and-events/news/archief2016/nieuwsberichten/1109-unifocusvisser

2010 - 2016

Health-seeking behaviour among adults in the context of the epidemiological transition in Southeastern Tanzania - A focus on malaria and diabetes

PhD candidate: Emmy (E.O.) Metta

Defended on March 10, 2016

Promotor: Prof.dr.ir. Hinke Haisma

Co-promotor: Dr. Ajay Bailey and Dr. Flora Kessy

This study set out to assess cultural aspects shaping health-seeking behaviour for malaria and diabetes among adults in Tanzania, a country undergoing the epidemiological transition. The research was conducted in a rural district in which malaria has been a predominant cause of illness and which increasingly experiences diabetes as an emergent cause of ill health. The study examined how cultural aspects shape health-seeking behaviour. The theoretical insights of D’Andrade’s concept of Cultural Schemas and the Health Belief Model (HBM) were applied to guide a line of inquiry for the research.The study showed that malaria self-care is commonly practiced, which can be explained by the long-standing knowledge about the illness within this community.  Unlike malaria, however, diabetes is a relatively new condition and the knowledge about its signs and symptoms is limited. People in this setting used the prevailing cultural meaning system regarding malaria to interpret the emerging diabetes symptoms. Anti-malarial medicines were often used as initial responses to diabetes symptoms.  Failure by patients and health professionals to interpret the emerging symptoms frequently led to consultations with traditional healers and to association of the symptoms with witchcraft. Malaria services are easily accessed in the primary health facilities, whereas patients could hardly obtain diabetes services; this unavailability of services – and knowledge – proved to be an obstacle to the proper use of medication. The study shows that health-seeking behaviour for malaria and diabetes is shaped by cultural, individual, and health facility factors

2009 - 2015

Women's perceptions, knowledge and breastfeeding decision-making

Linking theory to qualitative empirical data

PhD candidate: Bettie (A.T.) Oosterhoff

date of defence: 11 June 2015

Promotores: Prof.dr.ir. Hinke Haisma, prof.dr. Inge Hutter

Het geven van borstvoeding dient te worden beschouwd als een proces en niet alleen als een product dat kan worden uitgedrukt in borstvoedingscijfers. De voorlichting over borstvoeding moet dan ook niet gescheiden worden van voorlichting over moederschap. Die aanbeveling doet Bettie Oosterhoff in haar proefschrift. Het is belangrijk dat vrouwen de mogelijkheid hebben om geïnformeerde keuzes te maken op basis van informatiebronnen vanuit verschillende sectoren, inclusief de eigen intuïtie, stelt de promovenda. Zij dienen hierin te worden ondersteund door zorgprofessionals die de vaardigheid hebben om te luisteren naar het perspectief van vrouwen zelf.

Veel vrouwen in Nederland die beginnen met het geven van borstvoeding stoppen daarmee in de eerste maand. Campagnes om de borstvoedingscijfers te laten toenemen zijn gericht op het starten met borstvoeding, evenals op het continueren ervan, bij voorkeur tot zes maanden. Er was nog weinig inzicht in de onderliggende motieven van vrouwen om borstvoeding te stoppen of te continueren.

Kennis over borstvoeding speelt een belangrijke rol in de besluitvorming van vrouwen over de manier van voeden. Vrouwen verkrijgen hun kennis over borstvoeding van zowel professionals als uit hun omgeving. De ervaringen met het uitwisselen van kennis binnen de eigen omgeving variëren sterk. Graag baseren vrouwen hun beslissingen over voeding van hun kinderen ook op hun eigen intuïtie. Oosterhoff concludeert dat wanneer de nadruk ligt op internationale richtlijnen en het meten van borstvoedingscijfers, er wordt voorbijgegaan aan de context waarin borstvoeding plaatsvindt, vanuit het perspectief van vrouwen zelf. Voorlichting en de ondersteuning door zorgverleners zouden meer gefundeerd kunnen zijn op dit perspectief.

Oosterhoff onderzocht voor en na de bevalling dertien vrouwen die hun eerste kind kregen en die van plan waren borstvoeding te geven. In de interviews werd ingegaan op de percepties van vrouwen zelf. Oosterhoff toont aan dat vrijwel alle vrouwen borstvoeding beschouwen als gezond en als iets natuurlijks. Het kan voor vrouwen die van plan zijn borstvoeding te geven een teleurstelling zijn wanneer zij ervaren dat het continueren van de borstvoeding niet lukt.

De achtergrond van het onderzoeksproject is een debat over borstvoeding zoals dat in 2008 in Nederland werd gevoerd. In dat jaar deed het Ministerie van Gezondheidszorg, Welzijn en Sport de oproep met als doelstelling dat het percentage vrouwen dat tot zes maanden borstvoeding geeft zou zijn toegenomen tot 40% in 2011. De oproep was gebaseerd op de discrepantie tussen de aanbevelingen van de Wereld Gezondheidsraad (WHO) om zuigelingen tot zes maanden exclusief borstvoeding te geven, en het hoge aantal vrouwen dat stopt met borstvoeding in de eerste maand.

Bettie Oosterhoff (1963) studeerde Cultural Anthropology aan de Radboud University Nijmegen. Ze verrichtte haar onderzoek bij het Urban and Regional Studies Institute van de Faculteit Ruimtelijke Wetenschappen. Het proefschrift is onderdeel van de onderzoekslijn Population and Wellbeing in context. Oosterhoff werkt als docent aan de Hanzehogeschool binnen het  lectoraat Healthy Ageing, Allied Health Care and Nursing.

Research valorisation projects

2010 - 2015

NICHE^[1]/TZA/005:

Expanding health research training capacity in Tanzania

 

Why has this project started ?

The Tanzanian government recognizes theimportance of capacity building as an essential tool for achieving development. Indeed, capacity for effective health research priority setting,innovation and research are crucial for the country’s progress. This project contributes to capacity building of one of the main health research institutes within Tanzania: Ifakara Health Institute (IHI).

 

Objectives

The project intends to further develop IHI into a centre of excellence that not only implements different types of health and health systems research, but also provides training on public health research and assures that the results of research are disseminated and used by policy makers, planners, managers and civil society groups. NICHE therefore aims to develop IHI’s capacities to:

- train and mentor for innovation;

- integrate and appreciate ‘soft skills’ to benefit training and research functions;

- address and integrate gender issues in the health research cycle and organizational culture;

- respond to sector and labor market priorities;

- carry out applied health research, taking in all steps in the research cycle, while putting a special emphasis on research translation capacity;

- do advanced data analysis and synthesis;

- to built a network for disseminating research results.

 

Activities

Within a four-year period (2011-2014) a number of different activities will be implemented to assure that skills are developed and that research is in line with the needs in Tanzania. These include:

- strategic analyses of regional training and research needs, as well as gender mainstreaming in IHI;

- a mentoring and soft skills development program to stimulate continuous learning and improvement;

- curriculum development on public health research, data use for decision making and research communication;

- training of trainers (ToT);

- cross-disciplinary PhD training (4 positions);

- gender mainstreaming training;

- training infrastructure development.

 

Organizations involved

The program is financed by the Dutch Ministry of Foreign Affairs and administrated by NUFFIC and implemented by IHI and two Dutch organizations: the Royal Tropical Institute (KIT, Amsterdam) and the University of Groningen (Groningen), in cooperation with ETC Crystal.

PhD candidate: Emmy Metta - Health-seeking behaviour among adults in the context of the epidemiological transition
in Southeastern Tanzania - defended on 10 March 2016 (see above)