Global Health: Science and Practice最新文献

{"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 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":"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":"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}

{"title":"An Effective Health System Approach to End TB: Implementing the Double X Strategy in Vietnam.","authors":"Anh L Innes, Victoria Lebrun, Gia Linh Hoang, Andres Martinez, Nhi Dinh, Thi Thuy Ha Nguyen, Tan Phat Huynh, Van Luong Quach, Thanh Binh Nguyen, Van Chinh Trieu, Nghi Do Bao Tran, Huy Minh Pham, Van Luong Dinh, Binh Hoa Nguyen, Thi Thanh Huyen Truong, Van Cu Nguyen, Viet Nhung Nguyen, Thu Hien Mai","doi":"10.9745/GHSP-D-24-00024","DOIUrl":"10.9745/GHSP-D-24-00024","url":null,"abstract":"<p><p>Countries that are high burden for TB must reverse the COVID-19 pandemic's devastating effects to accelerate progress toward ending TB. Vietnam's Double X (2X) strategy uses chest radiography (CXR) and GeneXpert (Xpert) rapid diagnostic testing to improve early detection of TB disease. Household contacts and vulnerable populations (e.g., individuals aged 60 years and older, smokers, diabetics, those with alcohol use disorders, and those previously treated for TB) with and without TB symptoms were screened in community campaigns using CXRs, followed by Xpert for those with a positive screen. In public non-TB district facilities, diabetics, respiratory outpatients, inpatients with lung disease, and other vulnerable populations underwent 2X evaluation. During COVID-19 restrictions in Vietnam, the 2X strategy improved access to TB services by decentralization to commune health stations, the lowest level of the health system, and enabling self-screening using a quick response mobile application. The number needed to screen (NNS) with CXRs to diagnose 1 person with TB disease was calculated for all 2X models and showed the highest yield among self-screeners (11 NNS with CXR), high yield for vulnerable populations in communities (60 NNS) and facilities (19 NNS), and moderately high yield for household contacts in community campaigns (154 NNS). Computer-aided diagnosis for CXRs was incorporated into community and facility implementation and improved physicians' CXR interpretations and Xpert referral decisions. Integration of TB infection and TB disease evaluation increased eligibility for TB preventive treatment among household contacts, a major challenge during implementation. The 2X strategy increased the rational use of Xpert, employing a health system-wide approach that reached vulnerable populations with and without TB symptoms in communities and facilities for early detection of TB disease. This strategy was effectively adapted to different levels of the health system during COVID-19 restrictions and contributed to post-pandemic TB recovery in Vietnam.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":"12 3","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467484","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":"Acceptability of an Incentivized Peer Referral Intervention to Address COVID-19 Vaccine Hesitancy Among Adults in Yopougon-Est, Côte d'Ivoire.","authors":"Katherine Thanel, Brian Pedersen, Yao Kouakou Albert, Mariame Louise Ouattara, Dorgeles Gbeke, Virupax Ranebennur, Holly M Burke","doi":"10.9745/GHSP-D-23-00468","DOIUrl":"10.9745/GHSP-D-23-00468","url":null,"abstract":"<p><strong>Introduction: </strong>Vaccine hesitancy persists as a barrier to vaccine uptake among adults across geographies. We pilot-tested an incentivized peer referral intervention in Yopougon-Est, Côte d'Ivoire, to encourage adults who recently received COVID-19 vaccination to discuss their experiences and motivate family and friends to seek vaccination.<b>Implementation:</b> From May through June 2023, the intervention operated at 2 vaccination sites, where staff approached individuals immediately after receiving COVID-19 vaccination. Interested vaccine recipients received up to 9 referral coupons to distribute among their social circles, with a small financial incentive (approximately US$3) offered for each person they referred who returned to 1 of the 2 sites for COVID-19 vaccination.</p><p><strong>Methods: </strong>We collected data on numbers of people vaccinated and coupons returned. Qualitative interviews were conducted with 40 referred vaccine recipients and 7 public health officials.</p><p><strong>Results: </strong>During the 6-week intervention, 450 newly vaccinated individuals were offered the opportunity to enroll, with 197 opting to distribute coupons. Nearly half (45%) of these peer mobilizers who distributed coupons referred at least 1 person who subsequently came in for vaccination, and most of this subset had 2 or more completed referrals. Qualitative findings revealed that coupons served as effective reminders, sparking discussions within social networks and prompting vaccine-seeking behavior. According to the referred vaccine recipients, hearing about their peers' vaccination experience influenced uptake. Vaccine recipients and public health officials found the small referral incentive acceptable. Officials noted the intervention's potential utility and cost effectiveness, suggesting possible sustainability.</p><p><strong>Conclusion: </strong>This incentivized peer referral intervention, capitalizing on peer networks and social norms, holds promise for increasing vaccine uptake in Yopougon-Est and potentially in other vaccination contexts globally. Practitioners can leverage the implementation guide and training materials we developed to replicate the intervention at larger scale and assess impact on vaccination trends.</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/PMC11216699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897173","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":"Empowerment Among Adolescent Girls in Nepal: A Concept Mapping Exploratory Study.","authors":"Jessica G Burke, Sara Baumann, Jennifer Jones, Niva Joshi, Pema Lhaki","doi":"10.9745/GHSP-D-23-00010","DOIUrl":"10.9745/GHSP-D-23-00010","url":null,"abstract":"<p><strong>Background: </strong>The concept of empowerment is challenging to operationalize and measure; it is multidimensional, the outcomes are not always directly observable, and meanings of empowerment are highly contextual and socially and culturally situated. This study aimed to explore perspectives of empowerment among adolescent girls in Nepal to identify statements for inclusion in a context-specific empowerment measure.</p><p><strong>Methods: </strong>We used a participatory and mixed method research method called concept mapping in 3 districts in Nepal. Three sequential concept mapping sessions were used to solicit, organize, and process how participants responded to the prompt: \"The life of an adolescent girl improves when she has/can…\" The Concept Systems Global software was used to manage and analyze the concept mapping brainstorming, sorting, and rating data using established tools, such as multidimensional scaling and cluster analysis.</p><p><strong>Results: </strong>Concept mapping was conducted with 113 participants, including national experts, program staff, adolescents, and their mothers. They identified 105 items that fall into a 4-cluster solution: education and knowledge, decision-making, supports and skills, and physical infrastructure. Rating data uncovered there was some overlap between the top 10 most important items between the national-level experts and other stakeholder groups; however, several components associated with empowerment differed by stakeholder group in terms of importance.</p><p><strong>Conclusion: </strong>This research represents a critical step in exploring definitions of empowerment among adolescent girls in the Nepal context and with expert input. These results led to the development of a contextually specific definition of empowerment. Researchers and practitioners interested in developing context-specific understandings of complex topics that incorporate community voices and perspectives could use a similar concept mapping approach in other countries to explore various topics with diverse populations.</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/PMC11216707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184050","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}