Global Public Health最新文献_第2页

Vaccination coverage among migrant and refugee populations in Uganda: A narrative review of challenges and recommendations. 乌干达移民和难民人口的疫苗接种覆盖率：挑战和建议的叙述性审查。

IF 2.6 3区医学

Global Public Health Pub Date : 2026-12-31 Epub Date: 2026-09-23 DOI: 10.1080/17441692.2026.2735676

Sarah Marion Nakachwa, Pascal Mathew Okorobe, John Onama

{"title":"Vaccination coverage among migrant and refugee populations in Uganda: A narrative review of challenges and recommendations.","authors":"Sarah Marion Nakachwa, Pascal Mathew Okorobe, John Onama","doi":"10.1080/17441692.2026.2735676","DOIUrl":"10.1080/17441692.2026.2735676","url":null,"abstract":"Uganda hosts one of Africa's largest refugee populations, yet displaced and migrant communities face persistent barriers to routine immunisation. Despite commitments to vaccine equity, many remain unprotected against preventable diseases. This narrative review synthesises evidence from peer-reviewed studies, national surveys, and institutional reports up to September 2025 to assess immunisation coverage, challenges, and potential solutions among refugees and migrants in Uganda. The findings indicate that vaccination rates in refugee communities are generally lower than national averages due to administrative barriers, vaccine shortages, long distances to health facilities, language difficulties, misinformation, and challenges intensified during the COVID-19 pandemic. Economic hardship further limits healthcare access. However, several strategies show promise: integrating refugees into national immunisation systems, simplifying registration processes, strengthening mobile outreach, engaging community health workers, and improving cross-border data coordination. Addressing these inequities requires both technical and social commitment through adequate financing, inclusive policies, and meaningful community engagement. Achieving equitable immunisation for refugees in Uganda is essential for public health protection and the realisation of universal health coverage.","PeriodicalId":12735,"journal":{"name":"Global Public Health","volume":"21 1","pages":"2735676"},"PeriodicalIF":2.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Food insecurity amongst families seeking asylum in England: A qualitative study. 在英国寻求庇护的家庭中的粮食不安全：一项定性研究。

IF 2.6 3区医学

Global Public Health Pub Date : 2026-12-31 Epub Date: 2026-10-30 DOI: 10.1080/17441692.2026.2753367

R K Sharma, N Ziauddeen, R Dewar-Haggart, N A Alwan

{"title":"Food insecurity amongst families seeking asylum in England: A qualitative study.","authors":"R K Sharma, N Ziauddeen, R Dewar-Haggart, N A Alwan","doi":"10.1080/17441692.2026.2753367","DOIUrl":"https://doi.org/10.1080/17441692.2026.2753367","url":null,"abstract":"Food security is difficult to obtain for many families seeking asylum in the UK. Sufficient food and diet quality are integral to health. This study aims to explore descriptions of food insecurity amongst these families, to identify barriers to food security and consider how to mitigate them. We recruited parents or parents-to-be seeking asylum (or who had recently received refugee status) and stakeholders working or volunteering at organisations that support asylum seekers. We conducted eight semi-structured interviews; four with stakeholders, and four with mothers seeking asylum. We inductively coded the qualitative data, and iteratively derived common themes from them using thematic analysis. Five themes were constructed: lack of income, culturally inappropriate food interventions, inaccessibility due to cost of transport services, lack of support settling in and resulting poor mental and physical health. The situation is so bleak that some families are forced to choose between food or necessities like nappies. Tackling food insecurity amongst families seeking asylum is essential to enabling a healthy start in the host country. Potential interventions to consider include matching the money allowance to inflation and giving monthly rather than weekly instalments, allowing families to budget. Families seeking asylum also need more support through culturally-appropriate services.","PeriodicalId":12735,"journal":{"name":"Global Public Health","volume":"21 1","pages":"2753367"},"PeriodicalIF":2.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149296874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Increasing competition in pharmaceutical tenders: Patents, treatment guidelines, and centralised procurement of Hepatitis C drugs in Brazil. 药品招标竞争加剧：巴西丙型肝炎药物的专利、治疗指南和集中采购。

IF 2.6 3区医学

Global Public Health Pub Date : 2026-12-31 Epub Date: 2026-07-23 DOI: 10.1080/17441692.2026.2708415

Eduardo Mercadante

{"title":"Increasing competition in pharmaceutical tenders: Patents, treatment guidelines, and centralised procurement of Hepatitis C drugs in Brazil.","authors":"Eduardo Mercadante","doi":"10.1080/17441692.2026.2708415","DOIUrl":"10.1080/17441692.2026.2708415","url":null,"abstract":"This article investigates how therapeutic substitutability and patent exclusivity influence the centralised procurement of Hepatitis C drugs in Brazil. Combining data on treatment guidelines, registered products, and patent applications, this article analyses how the government can increase competition in tenders. Since 2019, the public procurement rationale has shifted from the cost-effectiveness of discrete products to simply buying the cheapest among treatment alternatives that are virtually equal in effectiveness, with originators of different patented drugs competing against each other. Moreover, rigorous examination of patent applications and robust opposition mechanisms led to limited patent exclusivity in some cases, allowing generic manufacturers to compete with the originators of their drugs and other drugs. The findings are discussed based on a matrix of competition scenarios and the literature on patent exclusivity, drug prices, and public procurement. The strategy of having both on- and off-patent competition in the same tender significantly increased the government's bargaining power and reduced drug prices. However, market concentration has limited this strategy. While helpful, local production and price control policies were less relevant than suggested. Therefore, this article provides lessons on how to combine different public policies to increase bargaining power and thereby promote access to high-quality treatments.","PeriodicalId":12735,"journal":{"name":"Global Public Health","volume":"21 1","pages":"2708415"},"PeriodicalIF":2.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561785","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}

引用次数: 0

The emergence of the adolescent subject in global health: Prioritizing epistemic justice in research and practice. 青少年主体在全球健康中的出现：在研究和实践中优先考虑认识正义。

IF 2.1 3区医学

Global Public Health Pub Date : 2026-12-31 Epub Date: 2026-01-02 DOI: 10.1080/17441692.2025.2611183

Julien Brisson

{"title":"The emergence of the adolescent subject in global health: Prioritizing epistemic justice in research and practice.","authors":"Julien Brisson","doi":"10.1080/17441692.2025.2611183","DOIUrl":"10.1080/17441692.2025.2611183","url":null,"abstract":"In 2015, the United Nations integrated adolescents as a unique category into the Sustainable Development Goals, a recognition the World Health Organization expanded in 2017 with the introduction of the Global Accelerated Action for the Health of Adolescents. This paper examines the emergence of the 'adolescent subject' in global health. Adolescence is a modern concept embedded in Western views that is not universally applicable, hence raising issues in global health practice by embodying a colonial legacy in using categories that may not align with all cultural contexts. Moreover, the paper explores a critical gap in global health research: while the majority of the world's adolescents reside in low- and middle-income countries, most adolescent health research is conducted in high-income settings. This disparity is due, in part, to a lack of funding for adolescent research and barriers like parental consent requirements that prevent adolescents from participating in research. This exclusion inadvertently silences some adolescents' voices and restricts their opportunities for research engagement, perpetuating an epistemic injustice in global health data production. The paper calls for a concerted effort to develop measures to inclusively engage adolescents in global health research, aiming for a fair and representative inclusion of adolescent perspectives.","PeriodicalId":12735,"journal":{"name":"Global Public Health","volume":"21 1","pages":"2611183"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What went wrong? A qualitative exploration of the determinants of poor adherence to antiretroviral therapy and retention in care among pregnant and postpartum women in the Uganda WiseMama trial. 出了什么问题？在乌干达WiseMama试验中，对孕妇和产后妇女抗逆转录病毒治疗依从性差和保留护理的决定因素进行定性探索。

IF 2.6 3区医学

Global Public Health Pub Date : 2026-12-31 Epub Date: 2026-09-23 DOI: 10.1080/17441692.2026.2736318

Lisa J Messersmith, Rebecca L West, Anna Larson, Jennifer Beard, Elizabeth Simmons, Nafisa Halim, Julia Gasuza, Philip Aroda, Davidson H Hamer, Allen L Gifford, Barbara Mukasa, Lora L Sabin

{"title":"What went wrong? A qualitative exploration of the determinants of poor adherence to antiretroviral therapy and retention in care among pregnant and postpartum women in the Uganda WiseMama trial.","authors":"Lisa J Messersmith, Rebecca L West, Anna Larson, Jennifer Beard, Elizabeth Simmons, Nafisa Halim, Julia Gasuza, Philip Aroda, Davidson H Hamer, Allen L Gifford, Barbara Mukasa, Lora L Sabin","doi":"10.1080/17441692.2026.2736318","DOIUrl":"10.1080/17441692.2026.2736318","url":null,"abstract":"Pregnant and postpartum women living with HIV face several challenges to antiretroviral therapy adherence and retention in care. Our WiseMama trial in Uganda assessed the effectiveness of real-time wireless pill containers that delivered text message reminders when ART doses were missed and provided data-informed counselling for women with low levels of adherence. The trial found overall poor adherence and retention and no differences between intervention and control arms. To better understand these findings, we collected qualitative data at the conclusion of the trial. Twenty women participated in in-depth interviews, and 36 women participated in focus group discussions that explored the barriers and facilitators to ART adherence and retention in HIV care. Barriers included lack of disclosure to male partners and lack of autonomy and financial independence to afford transportation to the clinic, food to be able to take their medication, and effectively use the wireless pill container. The main facilitators included desire for a healthy baby, disclosure to male partners, supportive clinic staff, and use of the wireless pill container. While WiseMama focused on individual-level determinants of adherence and retention in care, it did not address the critical interpersonal and structural barriers faced by pregnant and postpartum women in Uganda.","PeriodicalId":12735,"journal":{"name":"Global Public Health","volume":"21 1","pages":"2736318"},"PeriodicalIF":2.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Stunting in indigenous Waorani children living near the oil-extraction sites: What can the determinants of health tell us about this? 居住在石油开采地点附近的土著Waorani儿童发育迟缓：健康的决定因素能告诉我们什么？

IF 2.6 3区医学

Global Public Health Pub Date : 2026-12-31 Epub Date: 2026-10-03 DOI: 10.1080/17441692.2026.2725373

María F Rivadeneira, Andrea Bravo-Díaz, José Cóndor, Philippe Belmont, María Sol Jurado, Ana L Torres-Castillo

{"title":"Stunting in indigenous Waorani children living near the oil-extraction sites: What can the determinants of health tell us about this?","authors":"María F Rivadeneira, Andrea Bravo-Díaz, José Cóndor, Philippe Belmont, María Sol Jurado, Ana L Torres-Castillo","doi":"10.1080/17441692.2026.2725373","DOIUrl":"https://doi.org/10.1080/17441692.2026.2725373","url":null,"abstract":"The Waorani are a recently contacted indigenous group inhabiting oil extraction territories in the Amazon. This study aimed to analyse the prevalence of stunting and explore its association with health determinants in Waorani children under 5 years of age. A cross-sectional study was conducted with 102 children. Mothers were surveyed about biological, socioeconomic, environmental and health service determinants. Bivariate, multivariate and weight-adjusted logistic regression models were performed. A total of 39.2% of the children exhibited stunting. Health determinants such as male sex (OR = 2.73, 95% CI: 1.63-4.64), short maternal stature (OR = 4.96, 95% CI: 2.38-10.84), child age (OR = 1.04, 95% CI: 1.02-1.05), reduced dietary diversity (OR = 2.37, 95% CI: 1.27-4.53) were associated with a higher prevalence of stunting. Prenatal care was also associated with stunting (OR = 1.59, 95% CI: 1.16-2.21, for two or more checkups), with a potential reverse causality effect. Tall birth height (OR 0.28, 95% CI: 0.13-0.57) was associated with a lower prevalence of stunting. No socioeconomic differences were found related to stunting. The health determinants model may have limitations in socioeconomically homogeneous populations. Stunting prevention policies should take this model into account, contextualised to the specific territory.","PeriodicalId":12735,"journal":{"name":"Global Public Health","volume":"21 1","pages":"2725373"},"PeriodicalIF":2.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploring drivers of childhood vaccine hesitancy among caregivers in Brazil and South Africa: A qualitative study. 探索在巴西和南非的照顾者中儿童疫苗犹豫的驱动因素：一项定性研究。

IF 2.6 3区医学

Global Public Health Pub Date : 2026-12-31 Epub Date: 2026-01-21 DOI: 10.1080/17441692.2025.2607248

Camila C Matos, Elizabeth O Oduwole, Edina Amponsah-Dacosta, Imen Ayouni, Charles S Wiysonge, Marcia Thereza Couto

{"title":"Exploring drivers of childhood vaccine hesitancy among caregivers in Brazil and South Africa: A qualitative study.","authors":"Camila C Matos, Elizabeth O Oduwole, Edina Amponsah-Dacosta, Imen Ayouni, Charles S Wiysonge, Marcia Thereza Couto","doi":"10.1080/17441692.2025.2607248","DOIUrl":"10.1080/17441692.2025.2607248","url":null,"abstract":"This article examines the global issue of vaccine hesitancy in Brazil and South Africa, two economically unequal BRICS nations. Despite their established immunization programs, both countries are grappling with coverage decreases, leading to outbreaks. The role of vaccine hesitancy in this scenario is significant. This qualitative study aims to understand childhood vaccine hesitancy in these contexts, highlighting social and behavioral drivers. In-depth interviews were conducted in Sao Luis (Brazil), Florianopolis (Brazil), and Cape Town (South Africa), involving 42 caregivers from diverse socioeconomic backgrounds, race/color, and gender, with children up to 6 years old. Thematic analysis method was used to analyze the empirical data. The drivers of vaccine hesitancy have been arranged across three domains: 'practical issues', prevalent among lower-income non-white families; 'social processes', as informed decisions reflecting neoliberal parenting values, found among higher-income white families; and, in the 'thinking and feeling about vaccines' domain, common fears of side effects and vaccines components are presented. These findings underscore the necessity of tailored health policies, taking into account the influence of historical, cultural, and social contexts. The study also highlights the crucial role of qualitative research in comprehending the intricate interplay of social and behavioral factors in health decision-making.","PeriodicalId":12735,"journal":{"name":"Global Public Health","volume":"21 1","pages":"2607248"},"PeriodicalIF":2.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What unhealthy food and beverage advertisements appeal to- and promote obesity amongst- adolescent children in urban South Africa? 哪些不健康的食品和饮料广告吸引了南非城市的青少年儿童，并促使他们肥胖？

IF 2.6 3区医学

Global Public Health Pub Date : 2026-12-31 Epub Date: 2026-07-01 DOI: 10.1080/17441692.2026.2682032

Michelle R Brear, Bontle Mamabolo, Sameera Mahomedy, Susan Goldstein

{"title":"What unhealthy food and beverage advertisements appeal to- and promote obesity amongst- adolescent children in urban South Africa?","authors":"Michelle R Brear, Bontle Mamabolo, Sameera Mahomedy, Susan Goldstein","doi":"10.1080/17441692.2026.2682032","DOIUrl":"10.1080/17441692.2026.2682032","url":null,"abstract":"Unhealthy food and beverage marketing is harmful to all children because it generates preferences for foods associated with obesity. Our aim was to expand knowledge about the appeal of food advertising to urban-dwelling South African teenage children. We asked 49 boys and girls aged 14-16-years-old, from three Johannesburg high schools, about food advertisements that appealed to them and their peers in six same-gender focus group discussions. We conducted thematic analysis of the discussions and content analysis of 55 advertisements that participants identified as appealing. Classic features of child-directed marketing, such as cartoons, young child characters and bright colours, no longer appealed. Black, young adult (often same gender) characters doing 'grown-up' things were perceived as appealing to teenagers, as were advertisements, including misrepresentations of bigger, better-looking food, and for foods that teenagers already liked. The participants did not mention depictions of middle-class lifestyles nor gender stereotypes as appealing, although these featured prominently in specific advertisements that they identified as appealing. Because teenagers in South Africa find food advertisements that do not directly target them appealing, targeted advertising restrictions will likely be ineffective. Comprehensive bans on advertising unhealthy food are required to protect teenage children from the harms of unhealthy food marketing.","PeriodicalId":12735,"journal":{"name":"Global Public Health","volume":"21 1","pages":"2682032"},"PeriodicalIF":2.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Substance use among incarcerated male population in Freetown, Sierra Leone: Prevalence, predictors, and risk profiles using the WHO ASSIST. 塞拉利昂弗里敦被监禁男性人群中的物质使用：使用世卫组织ASSIST的流行、预测因素和风险概况

IF 2.6 3区医学

Global Public Health Pub Date : 2026-12-31 Epub Date: 2026-04-06 DOI: 10.1080/17441692.2026.2654242

Ahmed Vandy, Mohamed Ibrahim Kargbo, Michael Lahai, Onome Thomas Abiri, Alvin Turay, Eugene Conteh, Marie Ibranatu Kolipha-Kamara, Mohamed Marah, Denis E Torin, Karlotte Mae Mecaral-Paquiz, Augustus Osborne, Don Eliseo Lucero-Prisno

{"title":"Substance use among incarcerated male population in Freetown, Sierra Leone: Prevalence, predictors, and risk profiles using the WHO ASSIST.","authors":"Ahmed Vandy, Mohamed Ibrahim Kargbo, Michael Lahai, Onome Thomas Abiri, Alvin Turay, Eugene Conteh, Marie Ibranatu Kolipha-Kamara, Mohamed Marah, Denis E Torin, Karlotte Mae Mecaral-Paquiz, Augustus Osborne, Don Eliseo Lucero-Prisno","doi":"10.1080/17441692.2026.2654242","DOIUrl":"10.1080/17441692.2026.2654242","url":null,"abstract":"This cross‑sectional study assessed the prevalence, predictors, and substance use risk profile among 333 incarcerated males at the Freetown Male Correctional Centre. The WHO-ASSIST tool was used for data collection. The risk of substance-related issues was categorised as low, moderate, or high. Logistic regression was done to identify predictors of lifetime substance use (Model I) and recent use within the past three months within or outside prisons (Model II). The prevalence of lifetime substance use was 88.6% (95% CI: 0.85-0.92), recent use 73.9% (95% CI: 0.69-0.79), and polysubstance use 77.2% (95% CI: 0.73-0.82). Tobacco (80.5%), cannabis (70.0%), alcohol (68.2%), and opioids (64.0%) were the most used substances. In adjusted models, older age, unmarried status, and rural residence were significant predictors of both lifetime and recent use, while education status was specifically associated with recent use. Risk profiles revealed a high level of dependence among tobacco users and moderate risk among most cannabis and opioid users. Substance use was notably high, with tobacco, cannabis, and opioids emerging as the primary substances of concern. These findings underscore the burden of substance use and highlight the need for targeted interventions and the integration of cessation programs within the correctional centre.","PeriodicalId":12735,"journal":{"name":"Global Public Health","volume":"21 1","pages":"2654242"},"PeriodicalIF":2.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Health system response to climate-related shocks in a lower-middle-income country setting: A comparative study of floods and droughts in Pakistan. 中低收入国家卫生系统对气候相关冲击的反应：巴基斯坦洪水和干旱的比较研究

IF 2.6 3区医学

Global Public Health Pub Date : 2026-12-31 Epub Date: 2026-05-19 DOI: 10.1080/17441692.2026.2675732

Marianne Moussallem, Shehla Zaidi, Kate Gooding, Rabia Najmi, Nousheen Akber Pradhan, Ibrahim R Bou-Orm, Sophie Witter

{"title":"Health system response to climate-related shocks in a lower-middle-income country setting: A comparative study of floods and droughts in Pakistan.","authors":"Marianne Moussallem, Shehla Zaidi, Kate Gooding, Rabia Najmi, Nousheen Akber Pradhan, Ibrahim R Bou-Orm, Sophie Witter","doi":"10.1080/17441692.2026.2675732","DOIUrl":"10.1080/17441692.2026.2675732","url":null,"abstract":"Climate-related shocks in Pakistan, particularly floods and droughts, are increasingly disrupting essential health services and worsening existing vulnerabilities. Despite expanded disaster management structures, the health system's ability to anticipate, absorb, and adapt to these shocks remains poorly understood. This study explored how planning, resourcing, coordination, and service delivery function during floods and droughts, and how communities cope with these pressures across high-risk districts. Using an exploratory qualitative design, data were collected through interviews with national, provincial, district, and facility stakeholders; focus group discussions with community members and lady health workers; and documents' review. Analysis was guided by the Maintains programme's conceptual framework for shock-responsive health systems. Responses to climate shocks in Pakistan remain largely reactive and vary by shock type. Floods receive more institutional attention, yet essential services still suffer major disruptions. Droughts expose deeper systemic weaknesses, including poor infrastructure, limited outreach, chronic undernutrition, and little anticipatory planning. Coordination between disaster and health agencies is inconsistent, financing arrives late, and service packages lack standardization. While communities mobilize solidarity networks and local initiatives, these coping mechanisms remain fragile and insufficient. The study underscores the need for a shift toward integrated, proactive resilience planning to safeguard essential health services amid climate-related shocks.","PeriodicalId":12735,"journal":{"name":"Global Public Health","volume":"21 1","pages":"2675732"},"PeriodicalIF":2.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0