Global Health: Science and Practice最新文献

{"title":"Interventions to Address the Health and Well-Being of Married Adolescents: A Systematic Review.","authors":"Manahil Siddiqi, Margaret E Greene, Alexandra Stoppel, Charles Allegar","doi":"10.9745/GHSP-D-23-00425","DOIUrl":"10.9745/GHSP-D-23-00425","url":null,"abstract":"<p><p>Child marriage, defined by the United Nations as marriage before the age of 18 years, is a widespread practice with serious health and social consequences. We systematically reviewed academic and gray literature to learn what is known about the current state of the evidence for interventions to respond to the needs of married adolescents. Our analysis of the 29 included intervention studies identified variability across sectors, with most programs focusing on sexual and reproductive health (SRH) and maternal health. We found that interventions occur mostly at a small scale, are geographically concentrated, and focus on SRH to the neglect of other sectors. There is a need for programs to focus on improving educational and economic outcomes among married girls, as well as increased efforts to support equitable marital relations and engage men and boys. The emphasis on preventing child marriage must be matched by efforts to mitigate and respond to the practice.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Acceptability of Biodegradable Contraceptive Implants in Kenya and Senegal.","authors":"Alice F Cartwright, Rebecca L Callahan, Anna Lawton, Christina Wong, Oliver Muchiri, Samira Matan","doi":"10.9745/GHSP-D-23-00503","DOIUrl":"10.9745/GHSP-D-23-00503","url":null,"abstract":"<p><strong>Background: </strong>Contraceptive implants are popular in Africa, but barriers to removal exist. Biodegradable implants (BDIs) offer an alternative to the need for removal. This study explored potential user, provider, and other stakeholder perspectives on 2 BDI prototypes, revealing opportunities and challenges for introduction.</p><p><strong>Methods: </strong>We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) with women, men, family planning (FP) providers, community influencers, and FP policymakers and program staff in Kenya and Senegal. Characteristics of the 2 BDI prototypes were shared, and participants held and interacted with placebo prototypes. Structural coding was used to analyze the data focused on key product attributes, including biodegradation, removal potential, size, material, insertion site, and duration of effectiveness.</p><p><strong>Results: </strong>We conducted 16 FGDs and 35 IDIs with 106 participants in Kenya and 15 FGDs and 43 IDIs with 102 participants in Senegal. Overall, respondents liked the idea of a BDI, noting the avoidance of pain and scarring and reduced transport and costs as benefits of no removal requirement. Kenyan respondents expressed greater understanding of the biodegradation process than those in Senegal, though potential users in both countries expressed concerns about possible side effects associated with the process. In Senegal, mention of cholesterol in a BDI caused concern, while Kenyan participants responded positively to the same BDI being composed of organic materials. The second BDI product was viewed as more similar to existing implants, which providers preferred. Participants suggested increasing the pregnancy protection duration beyond 18 months. No clear preference between products emerged, and participants liked and disliked some characteristics of both.</p><p><strong>Conclusions: </strong>Kenyan and Senegalese participants expressed interest in the BDI concept but expressed some reservations related to biodegradation, material, and side effects. BDIs offer the opportunity to expand contraceptive choice. However, messaging around product characteristics will be required for successful introduction and uptake.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Oxygen Supply Is Not Enough: A Qualitative Analysis of a Pressure Swing Adsorption Oxygen Plant Program in Ethiopian Hospitals.","authors":"Victoria Smith, Alana Changoor, Sarah Rummage, Haileab Fekadu Wolde, Ejigu Gebeye Zeleke, Getahun Mekonnen Belay, David Barash, James Stunkel, Cheri Reynolds","doi":"10.9745/GHSP-D-23-00515","DOIUrl":"10.9745/GHSP-D-23-00515","url":null,"abstract":"<p><strong>Background: </strong>In response to critical gaps in medical oxygen access, 2 pressure swing adsorption (PSA) oxygen production centers were established using an ecosystem-strengthening strategy in Amhara, Ethiopia, in 2019. A qualitative study was conducted to assess enablers and bottlenecks to oxygen access at the hospital level after installation.</p><p><strong>Methods: </strong>A variety of hospital staff (clinicians, biomedical professionals, hospital administrators, and procurement teams) across 13 hospitals procuring oxygen from the plants participated in comprehensive, semistructured focus group discussions. A thematic framework analysis approach was used to identify key themes.</p><p><strong>Findings: </strong>A total of 101 individuals participated in 26 focus groups in 2021, 2 years after plants were installed. Primary themes were accessibility of supply, affordability, and hospital readiness. Respondents indicated a substantial increase in their hospital's ability to access lower-cost oxygen, with many attributing this to the locality of plants and reduced transportation barriers. However, other challenges persisted, and the emergence of COVID-19 1 year after plant installation and a civil conflict exacerbated supply shortages. Investments in equipment, supplies, and training optimized clinical utilization of oxygen and were highlighted as a need for ongoing investment.</p><p><strong>Conclusion: </strong>To achieve maximum impact, investments in large-scale oxygen systems must be accompanied by strategic plans to transport oxygen, reduce costs to hospitals, and provide support to clinical teams through equipment, supply procurement, and clinical training. These findings support comprehensive ecosystem approaches to strengthening oxygen access for sustainable impact.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indicators and Implementation Guidance to Advance Value-Based HIV Care Through People-Centered Metrics.","authors":"Emily Harris, Sameera Ali, Josephine Mungurere-Baker, Atlang Mompe, Chintan Maru, Balkrishna Korgaonkar, Shipra Srihari, Yordanos Molla","doi":"10.9745/GHSP-D-23-00220","DOIUrl":"10.9745/GHSP-D-23-00220","url":null,"abstract":"","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and Barriers for Private Health Sector Engagement for TB Care in India: A Systematic Review and Meta-Synthesis of Qualitative Research.","authors":"Rakesh Ps, Mohd Shannawaz, Manu E Mathew, Kuldeep Singh Sachdeva","doi":"10.9745/GHSP-D-24-00034","DOIUrl":"10.9745/GHSP-D-24-00034","url":null,"abstract":"<p><strong>Introduction: </strong>Private sector engagement is recognized as one of the most critical interventions to achieve the End TB goals in India. We conducted a systematic review and a meta-synthesis of qualitative studies to identify the barriers and facilitators for private sector engagement in TB care in India.</p><p><strong>Methods: </strong>A systematic search in electronic databases was done. We assessed the methodological limitations of individual studies, synthesized the evidence using thematic analysis, and assessed our confidence in each finding.</p><p><strong>Results: </strong>Of the 19 eligible articles included for the qualitative synthesis, 31.5% (6/19) were conducted in northern states of India. Included studies had details from 31 focus group discussions and 303 in-depth interviews conducted among various stakeholders. The synthesis revealed that barriers to engaging the private sector were lack of coordination mechanisms, lack of the National TB Elimination Program (NTEP) staff capacity to deal with the private sector, lack of private practitioners' knowledge on various programmatic aspects, and perceived complexity of the data exchange mechanism. The private sector felt that NTEP was not sensitive to the patient's confidentiality and demanded too much patient data. The private sector considered nonfinancial incentives like recognition, feedback, involving them in planning, and giving them equal status in partnership as powerful enablers for their engagement in TB care.</p><p><strong>Conclusion: </strong>Factors related to the context in which the engagement occurs, the architecture of the engagement, and interaction among the actors contribute to barriers to engaging the private sector for TB care in India. Strengthening policies to protect patient confidentiality, using behavior change communication to NTEP program managers, providing managerial and soft-skill training to NTEP staff, promoting nonfinancial incentives to private providers, establishing a coordination mechanism between the sectors, and simplifying the data exchange mechanisms need to be done to further strengthen the private-sector engagement.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and Implementation of Brief Interventions to Address Noncommunicable Diseases in Uzbekistan.","authors":"Olakunle Alonge, Maysam Homsi, Mahnoor Syeda Rizvi, Regina Malykh, Karin Geffert, Nazokat Kasymova, Nurshaim Tilenbaeva, Lola Isakova, Maria Kushubakova, Dilbar Mavlyanova, Tursun Mamyrbaeva, Marina Duishenkulova, Adriana Pinedo, Olga Andreeva, Kremlin Wickramasinghe","doi":"10.9745/GHSP-D-23-00443","DOIUrl":"10.9745/GHSP-D-23-00443","url":null,"abstract":"<p><p>In Uzbekistan, NCDs, including cardiovascular diseases, cancer, and diabetes, accounted for over 80% of mortality in 2019. In 2021, national stakeholders, in conjunction with the World Health Organization, identified brief interventions (BIs) to implement in primary health care settings to change unhealthy behaviors and reduce the burden of NCDs in the country. BIs consist of a validated set of questions to identify and measure NCD behavioral risk factors and a short conversation with patients/clients about their behavior, as well as the provision of a referral opportunity for further in-depth counseling or treatment if needed. We used a multimethod approach of document review, participatory workshops, and key informant interviews to describe how BIs were designed and implemented in Uzbekistan and generated a theory of change for its large-scale implementation. BIs in Uzbekistan targeted 4 risk factors (alcohol use, tobacco use, unhealthy diet, and physical inactivity) and entailed training clinicians on how to conduct behavioral change counseling using the 5As and 5Rs toolkit, conducting supportive supervision, and using feedback to improve service delivery. The program was collaboratively designed by multiple stakeholders across sectors, including the Ministries of Health, Higher Education, Science, and Innovations, with buy-in from key political leaders. The potential impact of the program (i.e., reducing the incidence of NCDs) was mediated by several intermediate and implementation outcomes at the individual, primary care, and community levels operating along multiple pathways. Significant health system challenges remain to the program, such as limited human resources, lack of incentives for clinicians, outdated systems and data collection processes for performance monitoring, and coordination among different relevant sectors. These and other challenges will need to be addressed to ensure the effective large-scale implementation of BIs in Uzbekistan and similar LMICs.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of School Nutrition Policies to Address Noncommunicable Diseases in Uzbekistan and Kyrgyzstan.","authors":"Olakunle Alonge, Maysam Homsi, Mahnoor Syeda Rizvi, Regina Malykh, Karin Geffert, Nazokat Kasymova, Nurshaim Tilenbaeva, Lola Isakova, Maria Kushubakova, Dilbar Mavlyanova, Tursun Mamyrbaeva, Marina Duishenkulova, Adriana Pinedo, Olga Andreeva, Kremlin Wickramasinghe","doi":"10.9745/GHSP-D-23-00442","DOIUrl":"10.9745/GHSP-D-23-00442","url":null,"abstract":"<p><p>Noncommunicable diseases (NCDs), including cardiovascular diseases, cancer, and diabetes, account for over 80% of mortality in Uzbekistan and Kyrgyzstan in 2019, and unhealthy dietary behaviors are a major risk factor for NCDs in both countries. In 2021, national stakeholders, in consultation with the World Health Organization, identified school nutrition policies (SNPs) as a major approach to reducing the burden of NCDs in both countries. The SNPs included interventions implemented through a multistakeholder and multisectoral arrangement that aimed to improve the health and nutrition status of children and young people by providing healthy food/beverages and restricting unhealthy foods or beverages in schools. We used a multimethod approach of document review, participatory workshops, and key informant interviews to generate theories of change for the large-scale implementation of SNPs and describe the implementation processes to date, including key implementation and health system challenges, salient implementation strategies, and implementation outcomes in both countries. Multiple pathways for enacting and implementing SNPs successfully were identified. However, significant health system challenges, such as the lack of accountability for contracting and tender processes and coordination among different sectors, continue to hamper the large-scale implementation of these policies in both countries. The pathways, theories, and implementation outcomes identified will facilitate the development of implementation strategies and systematic learning and evaluation around SNPs for NCD prevention and control programs in the Central Asian region and other low- and middle-income countries more broadly.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons Learned From a Peer-Supported Differentiated Care and Nutritional Supplementation for People With TB in a Southern Indian State.","authors":"Hemant Deepak Shewade, A James Jeyakumar Jaisingh, Prabhadevi Ravichandran, S Kiran Pradeep, Sripriya Pandurangan, Subrat Mohanty, T Daniel Rajasekar, R Vijayaprabha, G Kiruthika, K V Suma, Delphina Peter Pathinathan, Deiveegan Chidambaram, K Sivagami, Anupama Srinivasan, Reuben Swamickan, Amrita Goswami, D Sivaranjani, Ramya Ananthakrishnan, Asha Frederick, Manoj V Murhekar","doi":"10.9745/GHSP-D-23-00504","DOIUrl":"10.9745/GHSP-D-23-00504","url":null,"abstract":"<p><p>Two critical components of patient support systems for people with TB are regular counseling and locally managed nutritional support. As part of an ongoing differentiated TB care initiative called Tamil Nadu Kasanoi Erappila Thittam (meaning TB death-free initiative in Tamil, TN-KET) to reduce TB deaths, adults with TB with very severe undernutrition, respiratory insufficiency, or poor performance status are identified at diagnosis (triage-positive) and prioritized for referral, comprehensive clinical assessment, and inpatient care. Between January and June 2023, in 6 districts, a pilot exercise was conducted in which trained TB survivors, known as TB champions, provided baseline counseling and additional counseling (if required) to triage-positive people with TB at diagnosis. Additionally, people with TB with severe undernutrition were prioritized for nutritional supplementation for at least 3 months. Among 652 people with TB who were triage-positive at diagnosis, the program staff shared details of 145 (22%), and all were counseled by TB champions (baseline counseling). Program staff identified 74 (11%) triage-positive people with TB who required additional counseling (i.e., those refusing referral or admission or continued admission), and 71 (96%) were counseled by TB champions. Among these, 54 (76%) were admitted or readmitted and successfully discharged. In addition, among 1,042 people with TB with severe undernutrition, program staff shared details of 390 (38%), of which 60% received nutritional supplementation through the efforts of TB champions. We conclude that TB champions were able to provide quality and timely peer support through direct counseling and by mobilizing local resources for nutritional support. The engagement of TB champions can be further strengthened by establishing robust coordination mechanisms with the TB program. Lessons from this pilot will contribute to the Tamil Nadu State TB Cell's plans to expand the role of TB champions and enhance community participation to end TB in India.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of Maternal and Newborn Health Mobile Phone E-Cohorts to Track Longitudinal Care Quality in Low- and Middle-Income Countries.","authors":"Katherine Wright, Irene Mugenya, Emma Clarke-Deelder, Laura Baensch, Tefera Taddele, Anagaw Derseh Mebratie, Monica Chaudhry, Prashant Jarhyan, Nompumelelo Gloria Mfeka-Nkabinde, Jacinta Nzinga, Sailesh Mohan, Theodros Getachew, Margaret E Kruk, Catherine Arsenault","doi":"10.9745/GHSP-D-23-00506","DOIUrl":"10.9745/GHSP-D-23-00506","url":null,"abstract":"<p><strong>Background: </strong>The maternal and newborn health (MNH) eCohort is a new mixed-mode (in-person and phone) longitudinal survey aiming to provide data on novel and undermeasured dimensions of quality along the MNH continuum of care. We describe implementation experiences and lessons learned in Ethiopia, India, Kenya, and South Africa to inform future longitudinal mobile phone-based studies on health system quality.</p><p><strong>Methods: </strong>To document the implementation approach and lesson learned, we engaged numerous stakeholders and conducted data reviews, debriefs, and a workshop with participants from all collaborative research organizations.</p><p><strong>Results: </strong>The MNH eCohorts enrolled women during their first antenatal care visit in 2 sentinel sites in Ethiopia, India, Kenya, and South Africa. In India, a site with better health outcomes and a site with poorer outcomes were chosen. In the remaining countries, an urban site and a rural site were chosen. Enrollment facilities reflect care-seeking patterns according to local health information data across public and private facilities and primary and secondary levels. Data collectors had a range of educational and experience profiles, and phone data collection was completed by the same enumerators in some countries and outsourced to data collection firms in others. Adequate infrastructure (including Internet and mobile phone coverage) was essential to implementation. Although follow-up is ongoing in India and South Africa, the eCohort retained 89%-90% of participants throughout the entire pregnancy and 78%-81% until 3 months postpartum in Ethiopia and Kenya, respectively.</p><p><strong>Conclusions: </strong>The MNH eCohort is a complex and long survey. Careful and thoughtful implementation demonstrates that it is a useful tool to gather data on health system quality and continuity and on changes in user experience over the continuum of care. Findings from the eCohort related to care and system competence and user experience will be valuable to program managers and policymakers alike.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Public Sector Availability and Supply Chain Management Practices for Malaria Commodities: Findings From Northern Nigeria.","authors":"Kunle Rotimi, Ademola Joshua Itiola, Babatunde Ariyo Fagbemi, Jimmy Aiden, Taiwo Ibinaiye, Chrysantus Dabes, Andrew Okwulu, Daniel Oguche, Adaeze Aidenagbon, Umar Babuga Abubakar, Rose Tukura, Danladi Chonoko Mohammad, Christopher Bewa, Ahmad Muhammad Danzaki, Olusola Oresanya","doi":"10.9745/GHSP-D-22-00547","DOIUrl":"10.9745/GHSP-D-22-00547","url":null,"abstract":"<p><strong>Background: </strong>Nigeria accounts for substantial proportions of global malaria infections and deaths, with children aged younger than 5 years being the most affected group. This suggests that access to lifesaving malaria interventions could be suboptimal, especially at public health facilities where most rural dwellers seek health care. We conducted this study to ascertain if public health facilities have the commodities and the robust supply chain management (SCM) system required to deliver malaria interventions to children younger than 5 years.</p><p><strong>Method: </strong>We conducted a cross-sectional survey in 1,858 health facilities across 7 states in Nigeria. Using structured questionnaires, we assessed the availability of selected malaria commodities required by children aged younger than 5 years. We also interviewed health workers to evaluate other core SCM activities.</p><p><strong>Result: </strong>More than 50% of health facilities in 5 states were stocked out of malaria rapid diagnostic tests (mRDTs), and stock-out rates for artemisinin-based combination therapies (ACTs) were over 50% for almost all assessed ACTs across all states. The percentage of health facilities that received malaria commodities within the recommended lead time was below average across most states (71%). States with a higher percentage of health workers who were aware of and placed orders following the national reporting timeline and those that delivered commodities to the last mile predominantly through third-party logistics service providers tended to have higher availability of mRDTs and artemether/lumefantrine combinations. The top 2 logistics challenges were insecurity and inadequate funding.</p><p><strong>Conclusion: </strong>The availability of lifesaving malaria commodities across the health facilities visited was suboptimal, possibly due to several SCM challenges. The results from this study underscore the urgent need to implement effective interventions to address the observed gaps. This will contribute to reducing malaria morbidity and mortality among children aged younger than 5 years in Nigeria.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}