Medical Gas ResearchPub Date : 2027-01-01Epub Date: 2026-09-12DOI: 10.4103/mgr.MEDGASRES-D-26-00088
Keyu Lu, Yao Chen, Zihao Liu, Shurui Zhu, Biyun Li, Yan Jin, Hongyun Xuan, Zao Dai, Huihua Yuan, Min Mao
{"title":"Multifunctional natural polysaccharide peach gum-encapsulated selenium quantum dot nanocrystals monitor and scavenge reactive oxygen species in living cells.","authors":"Keyu Lu, Yao Chen, Zihao Liu, Shurui Zhu, Biyun Li, Yan Jin, Hongyun Xuan, Zao Dai, Huihua Yuan, Min Mao","doi":"10.4103/mgr.MEDGASRES-D-26-00088","DOIUrl":"10.4103/mgr.MEDGASRES-D-26-00088","url":null,"abstract":"<p><p>Reactive oxygen species act as essential mediators in physiological processes, yet excess reactive oxygen species cause cellular damage and inflammation. Current strategies for reactive oxygen species monitoring and intervention remain limited in clinical practice. Here, we report selenium quantum dots (SeQDs) coated with peach gum (PG@SeQDs), a fluorescent nanocomposite for simultaneous reactive oxygen species detection and scavenging. SeQDs serve as fluorescent emitters and reactive oxygen species-active centers encapsulated by peach gum as a stabilizing matrix. Transmission electron microscopy and dynamic light scattering show SeQDs ~5 nm (hydrodynamic ~47 nm) and PG@SeQDs ~170 nm (hydrodynamic ~204 nm), with a zeta potential shift from -2.1 to -7.4 mV after peach gum coating, indicating enhanced colloidal stability. PG@SeQDs exhibit excitation-dependent emission, with a maximum intensity near 260 nm. Biocompatibility assays in Schwann cells show markedly higher viability for PG@SeQDs versus SeQDs and minimal hemolysis (0.24-0.32%). Antioxidant activity by 1,1-diphenyl-2-picrylhydrazyl shows concentration-dependent scavenging (56% at 40 μg/mL after 24 hours). In RSC96 cells, PG@SeQDs most effectively suppress hydrogen peroxide-induced reactive oxygen species and demonstrate time-dependent uptake with lysosomal localization and partial mitochondrial association; uptake is enhanced under inflammatory conditions (lipopolysaccharide). Collectively, PG@SeQDs represent a promising theragnostic platform for real-time reactive oxygen species imaging and management of reactive oxygen species-related inflammatory diseases, with potential for spinal cord inflammation.</p>","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"17 1","pages":"1-6"},"PeriodicalIF":4.2,"publicationDate":"2027-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13667839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health systems and reformPub Date : 2026-12-31Epub Date: 2026-07-06DOI: 10.1080/23288604.2026.2688285
Michael R Reich
{"title":"Mexico's New Health Reform: El Servicio Universal de Salud.","authors":"Michael R Reich","doi":"10.1080/23288604.2026.2688285","DOIUrl":"https://doi.org/10.1080/23288604.2026.2688285","url":null,"abstract":"","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"12 1","pages":"2688285"},"PeriodicalIF":1.9,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health systems and reformPub Date : 2026-12-31Epub Date: 2026-03-19DOI: 10.1080/23288604.2026.2630426
Prince Agwu, Charles Orjiakor, Aloysius Odii, Pamela Ogbozor, Eleanor Hutchinson, Martin McKee, Obinna Onwujekwe, Dina Balabanova
{"title":"Poor Accountability and Corruption in Primary Healthcare in Nigeria: Subnational Governance Deficiencies Matter.","authors":"Prince Agwu, Charles Orjiakor, Aloysius Odii, Pamela Ogbozor, Eleanor Hutchinson, Martin McKee, Obinna Onwujekwe, Dina Balabanova","doi":"10.1080/23288604.2026.2630426","DOIUrl":"10.1080/23288604.2026.2630426","url":null,"abstract":"<p><p>The formal structures in a health system, characterized by the enforcement of rules and regulations, effective human resource management, and adequate funding, are critical contributors to effective governance and optimal health service delivery. Conversely, shortcomings in these domains could lead to poor accountability and corruption within the system. Therefore, this study assesses the state of Nigeria's subnational governance structures that are conventionally and increasingly responsible for primary healthcare (PHC) delivery. In this qualitative phenomenological study, we conducted and analyzed interviews with senior managers within the PHC system. We found significant informalities and deficiencies in four areas: (a) absence of local interest in strengthening PHC, (b) weak documentation and enforcement of written rules, (c) poor practices and processes of human resource management, and (d) erratic financing of PHC. These deficiencies are seen to encourage the continuation of corruption and weaken institutional capacity to provide effective PHC. We argue that investing in PHC without first addressing these deficiencies as key aspects of subnational governance may result in wasted resources. Based on our findings, we present critical areas to consider for a well-governed PHC system to enhance accountability and address corruption at the healthcare level. The findings of this study are now more important than ever, particularly in light of a Supreme Court ruling on the autonomy of Local Government Areas (LGAs) in Nigeria and the push for state governments to ensure effective PHC services. The study demonstrates critical areas for strengthening the subnational administration of primary healthcare institutions across low- and middle-income countries (LMICs).</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"12 1","pages":"2630426"},"PeriodicalIF":1.9,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"<i>DHQS</i> regulates pollen-pistil interaction via the shikimic acid pathway in <i>Arabidopsis thaliana</i>.","authors":"Xiu Wang, Xiongbo Peng","doi":"10.1080/15592324.2026.2670874","DOIUrl":"10.1080/15592324.2026.2670874","url":null,"abstract":"<p><p>The normal production of pollen and proper pollen-pistil interaction are critical for double fertilization in <i>Arabidopsis</i>. Previous studies have demonstrated that DHQS affects female gametophyte development and pollen tube funicular guidance during fertilization. However, whether DHQS influences pollen development and pollen-pistil interaction remains unknown. In this study, we analyzed pollen and sperm cell morphology in <i>dhqs-1</i>/+ mutant. Results showed that DHQS does not affect sperm cell formation but significantly reduces pollen grain size. Pollen germination assays revealed no impairment in <i>dhqs-1</i> pollen germination. However, semi-in vitro experiments demonstrated that <i>dhqs-1</i> pollen tubes exhibited delayed growth through stigmas compared to wild-type. Notably, supplementation of shikimic acid in the medium significantly alleviated the growth inhibition of <i>dhqs-1</i> pollen tubes in wild-type stylar tissue, underscoring the essential role of shikimic acid in mediating pollen-pistil interaction. These findings suggest that DHQS regulates pollen-pistil interaction through the shikimic acid pathway, providing novel insights into the molecular mechanisms underlying fertilization in plants.</p>","PeriodicalId":94172,"journal":{"name":"Plant signaling & behavior","volume":"21 1","pages":"2670874"},"PeriodicalIF":3.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rendra Adhitya, Mia Miranti, Thomas Argyarich Jefferson, Malvin Albert, Ravindra Chandra Joshi, Muhamad Shakirin Mispan, Dedat Prismantoro, Nur Syafikah Abdullah, Mehrdad Alizadeh, Wawan Hermawan, Febri Doni
{"title":"<i>Trichoderma</i> as a biological control agent against <i>Colletotrichum</i>-associated plant diseases: current insights and future perspectives.","authors":"Rendra Adhitya, Mia Miranti, Thomas Argyarich Jefferson, Malvin Albert, Ravindra Chandra Joshi, Muhamad Shakirin Mispan, Dedat Prismantoro, Nur Syafikah Abdullah, Mehrdad Alizadeh, Wawan Hermawan, Febri Doni","doi":"10.1080/15592324.2026.2691464","DOIUrl":"10.1080/15592324.2026.2691464","url":null,"abstract":"<p><p><i>Colletotrichum</i> species are a taxonomically complex group of hemibiotrophic fungi that cause anthracnose diseases, posing a major constraint to global crop productivity. Their broad host range, high genetic diversity, and ability to shift between biotrophic and necrotrophic phases complicate effective disease management. Although synthetic fungicides are widely used, their prolonged application has raised concerns regarding pathogen resistance, environmental contamination, and food safety, driving the search for sustainable approaches. Unlike previous reviews that mainly discuss <i>Colletotrichum</i> biology or <i>Trichoderma</i> biocontrol mechanisms separately, this review integrates pathogen taxonomy and infection biology with mechanistic, applied, and future-oriented perspectives on <i>Trichoderma</i>-based anthracnose management. Evidence from laboratory, greenhouse, field, and postharvest studies indicates that <i>Trichoderma</i> has promising potential for suppressing <i>Colletotrichum</i>, particularly under controlled conditions, although its efficacy remains influenced by environmental factors, strain specificity, formulation stability, and application method. Integrating <i>Trichoderma</i>-based products into disease management systems offers a promising strategy to reduce chemical inputs and enhance crop resilience. Future research should focus on multi-omics approaches, strain optimization, formulation development, and field validation to ensure consistent performance across diverse agroecosystems.</p>","PeriodicalId":94172,"journal":{"name":"Plant signaling & behavior","volume":"21 1","pages":"2691464"},"PeriodicalIF":3.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ghulam Murtaza, Muhammad Usman, Sajid Ullah, Wael Elmenofy, Mohamed Mohamed El-Mogy, Ahmad Mahmoud Ismail, Lamy Mamdoh Mohamed Hamed, Rashid Iqbal
{"title":"24-Epibrassinolide enhances aluminum tolerance in tobacco through Ca²⁺-dependent signaling, antioxidant regulation, and metal homeostasis.","authors":"Ghulam Murtaza, Muhammad Usman, Sajid Ullah, Wael Elmenofy, Mohamed Mohamed El-Mogy, Ahmad Mahmoud Ismail, Lamy Mamdoh Mohamed Hamed, Rashid Iqbal","doi":"10.1080/15592324.2026.2639157","DOIUrl":"10.1080/15592324.2026.2639157","url":null,"abstract":"<p><p>Aluminum (Al³⁺) toxicity is a major limitation to plant productivity in acidic soils, disrupting cellular homeostasis, redox balance, and nutrient uptake. Brassinosteroids are key regulators of plant stress signaling, yet their role in Al³⁺ tolerance remains insufficiently understood. Here, we investigated the signaling functions of 24-epibrassinolide (24-EBL) in mediating aluminum stress responses in <i>Nicotiana tabacum</i> grown under soilless culture conditions. Exogenous 24-EBL significantly alleviated Al³⁺-induced photosynthetic inhibition, as reflected by increased transpiration rate (Tr), stomatal conductance (Gs), net photosynthetic rate (Pn), electron transport rate (ETR), and effective quantum yield of PSII (ΦPSII). Enhanced non-photochemical quenching (NPQ) indicated improved dissipation of excess excitation energy, suggesting photoprotective regulation. At the molecular level, 24-EBL treatment upregulated the antioxidant defense genes CAT1, NtPOD1, and NtSOD3, leading to increased enzymatic activities and reduced reactive oxygen species (ROS) accumulation, thereby preserving membrane stability. Notably, 24-EBL modulated metal detoxification pathways by inducing the expression of the phytochelatin-related genes Pr8 and Pr2, along with Al-ATPase transporters associated with vacuolar sequestration. This was accompanied by altered ion homeostasis, where enhanced Ca²⁺ and K⁺ uptake antagonized Al³⁺ accumulation and restricted its translocation to shoots. The marked upregulation of calmodulin (CaM) suggests that Ca²⁺-dependent signaling plays a central role in 24-EBL-mediated aluminum tolerance. Correlation analysis revealed strong associations between CaM expression, photosynthetic efficiency, antioxidant capacity, and metal detoxification markers. Together, these findings indicate that 24-EBL enhances aluminum tolerance in tobacco through a coordinated signaling network involving Ca²⁺-mediated signal transduction, redox regulation, and metal homeostasis. This study highlights brassinosteroid-calcium crosstalk as a key regulatory module in plant adaptation to aluminum stress.</p>","PeriodicalId":94172,"journal":{"name":"Plant signaling & behavior","volume":"21 1","pages":"2639157"},"PeriodicalIF":3.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"MicroRNA858a antagonistically regulates plant response to concurrent biotic and abiotic stresses.","authors":"Zheng Zhou, Peiwu Li, Daguang Cai","doi":"10.1080/15592324.2026.2670872","DOIUrl":"10.1080/15592324.2026.2670872","url":null,"abstract":"<p><p>Plants face various environmental stresses and have developed sophisticated adaptive mechanisms to cope with constraints. miR858a targets transcription factor (TF) MYB111 and has proven to be a key regulator in modulating plant responses to biotic and abiotic stresses. However, its transcriptional regulation and the underlying mechanisms remain unresolved. To this end, we performed the yeast one-hybrid (Y1H) assay using the miR858a promoter against an Arabidopsis transcription factor library. In this way, we identified 32 TFs that specifically interact with the miR858a promoter. By analysing expression profiles of candidate TFs under different stress conditions, mimicked by flg22, UV-B, and co-treatment of flg22/UV-B treatments, we prioritized candidate TFs, including five flg22-responsive TFs (ERF73, bZIP63, NF-YC6, AL7, and AIN1) and one UV-B-responsive TF, MYBD. Our data show that miR858a is antagonistically regulated by distinct stress-responsive TFs and by their interplay, thus highlighting, for the first time, a crucial role of miRNAs and their expression regulation in plant responses to diverse stress factors. These findings provide deeper insights into the mechanisms by which plants adapt to changing environments and offer valuable traits and approaches for breeding crops resistant to various concurrent stress factors.</p>","PeriodicalId":94172,"journal":{"name":"Plant signaling & behavior","volume":"21 1","pages":"2670872"},"PeriodicalIF":3.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13170379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Blair Moses Kamanga, Paul Barrett, Donita L Cartmill, Craig McGill, Andrea Clavijo McCormick
{"title":"Root-derived allelochemicals from <i>Moringa oleifera</i> regulate germination and early seedling growth in New Zealand pasture, native, and weed species.","authors":"Blair Moses Kamanga, Paul Barrett, Donita L Cartmill, Craig McGill, Andrea Clavijo McCormick","doi":"10.1080/15592324.2026.2644120","DOIUrl":"10.1080/15592324.2026.2644120","url":null,"abstract":"<p><p><i>Moringa oleifera</i> L. (moringa) is not currently commercially cultivated in New Zealand, but there is growing interest in its integration into farming systems. However, there are questions regarding its ecological impacts. One area of interest is its allelopathic traits, which may affect native and other introduced plant species. Hence, this study evauated the effects of root-derived moringa allelochemicals on the germination and seedling growth of pasture, weed an native species and employed untargeted metabolomics to identify potential bioactive compounds responsible for the observed effects, and their biosynthetic pathways. . Root extracts from two moringa provenances were assessed across concentration gradients (1-100%) in laboratory bioassays, while potted plant experiments were conducted under semi-controlled conditions to evaluate <b>allelochemical-mediated plant-plant interactions</b>.. Metabolomics analysis revealed several bioactive compounds with potential allelopathic activities dominated by phenylpropanoids and benzenoids, with relatively small contributions from organoheterocyclics, oxygenated compounds, and organic acids. Statistical analyses demonstrated a dose-dependent and species-specific response to moringa root allelochemicals, with white clover, a key pasture species in New Zealand, being the most adversely affected. Therefore, the utilisation of moringa within white clover pastoral systems may not be advised. Isolating and testing individual compounds will be essential for determining how moringa may influence plant growth and population dynamics in New Zealand pastoral and native ecosystems.</p>","PeriodicalId":94172,"journal":{"name":"Plant signaling & behavior","volume":"21 1","pages":"2644120"},"PeriodicalIF":3.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Role of callose accumulation in the suppression of calcium-deficiency-induced necrosis in <i>Arabidopsis thaliana</i> cotyledons.","authors":"Yusuke Shikanai, Takehiro Kamiya, Akihiro Saito, Kyoko Higuchi, Toru Fujiwara","doi":"10.1080/15592324.2025.2607237","DOIUrl":"10.1080/15592324.2025.2607237","url":null,"abstract":"<p><p>Calcium (Ca) deficiency symptoms, such as blossom end rot in tomato and tip burn in lettuce, are among the most serious physiological disorders in agriculture. A common feature of this disorder is the expansion of necrosis. However, mechanisms underlying Ca-deficiency-induced necrosis remain poorly understood. We previously identified callose synthase genes (<i>GSL1</i>, <i>GSL8</i>, <i>GSL10</i>) as the causal genes of low-Ca-sensitive <i>Arabidopsis thaliana</i> mutants, which exhibit severe cell death in true leaves and reduced callose accumulation in cotyledons under low-Ca conditions. This raises the question of whether callose accumulation suppresses the spread of cell death. To clarify their relationship within the same organ, we examined callose deposition and cell death in the cotyledons of the <i>gsl10</i> mutant. Although the <i>gsl10</i> mutant showed a comparable level of total cell death to wild-type plants, the necrotic spots were larger. Furthermore, the largest necrotic spots were typically found at the cotyledon tip, but this tendency was weaker in <i>gsl10</i> mutant. Collectively, our results suggest that callose does not suppress the initiation of cell death but rather limits its propagation, thereby leading to the formation of a characteristic necrotic pattern preferentially occurring at the cotyledon tip.</p>","PeriodicalId":94172,"journal":{"name":"Plant signaling & behavior","volume":"21 1","pages":"2607237"},"PeriodicalIF":3.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12785192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health systems and reformPub Date : 2026-12-31Epub Date: 2026-09-15DOI: 10.1080/23288604.2026.2720979
Peter Binyaruka, Douglas Ndeki, Raymond Kiwesa, Regina Joseph, Bakari Salum
{"title":"Effects, Challenges, and Preconditions for Implementing Direct Health Facility Financing and the Prime Vendor Model in Low-Resource Settings: The Experience from Tanzania.","authors":"Peter Binyaruka, Douglas Ndeki, Raymond Kiwesa, Regina Joseph, Bakari Salum","doi":"10.1080/23288604.2026.2720979","DOIUrl":"https://doi.org/10.1080/23288604.2026.2720979","url":null,"abstract":"<p><p>Primary health care (PHC), while critical to achieving universal health coverage, remains underfunded and often delivers poor-quality care. In response, Tanzania introduced two innovative and complementary reforms-Direct Health Facility Financing (DHFF) and the Prime Vendor Model-to improve PHC financing and commodity availability by decentralizing financial management and granting greater autonomy to align financing with local needs. DHFF involves direct transfer of funds to PHC facility bank accounts, enabling timely access to resources and strengthening local decision-making. The Prime Vendor Model reduces stock-outs of essential drugs by allowing facilities to use available funds in their bank accounts to procure commodities from accredited private vendors when the central medical store is out of stock. This paper presents a critical reflection on the effects of these reforms on PHC autonomy, quality of care, and strategic healthcare purchasing. This analysis draws on a targeted review of the literature and the authors' implementation experience as researchers and ministry officials overseeing the reforms. It also highlights key implementation challenges, including delays in disbursement, rigid financial regulations, and limited facility-level capacity. This paper concludes by outlining key enabling conditions and implementation lessons for other LMICs considering similar reforms, emphasizing the importance of policy integration, strong public financial management systems, capacity building, and navigating political dynamics to ensure successful implementation.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"12 1","pages":"2720979"},"PeriodicalIF":1.9,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}