International Journal for Equity in Health最新文献

{"title":"Socioeconomic trends in anxiolytic, hypnotic, and sedative use among secondary school students in Spain from 2010 to 2021: a repeated cross-sectional design.","authors":"Xabi Martinez-Mendia, Unai Martin, Anna Barbuscia, Amaia Bacigalupe","doi":"10.1186/s12939-025-02403-8","DOIUrl":"10.1186/s12939-025-02403-8","url":null,"abstract":"<p><strong>Background: </strong>The increasing use of anxiolytics, hypnotics, and sedatives (AHS) among adolescents is a growing public health concern. Social determinants such as gender or socioeconomic status have a significant influence on consumption levels. However, whether trends in adolescent AHS use show socioeconomic and gender disparities is unknown. The aim of this study is to examine the trends in gender and socioeconomic inequalities in secondary school students' AHS use in Spain from 2010 to 2021.</p><p><strong>Methods: </strong>A repeated cross-sectional analysis was conducted using data from the Survey on Drug Use in Secondary Education in Spain (n = 192,656), targeting students aged 14-18 years during 2010-2021. Gender-specific prevalences of AHS use were calculated according to the educational and occupational status of the mother, the father, and both parents. Chi-squared tests assessed statistical significance of the observed social gradients. The Relative Index of Inequality (RII) and Slope Index of Inequality (SII) with 95% confidence intervals were used to measure inequality magnitudes. Consumption trends were examined through prevalence ratios (PR) derived from age-adjusted robust variance Poisson models.</p><p><strong>Results: </strong>Statistically significant social inequalities in AHS use were identified among girls, which increased over time. These inequalities were particularly pronounced when considering maternal educational level (e.g. 2021: 21.5% vs. 16.3%; RII₂₀₂₁ = 1.37 [1.16-1.62]) and paternal occupational status (e.g. 2021: 23.2% vs. 16.5%). Trends showed a significant increase among all groups in both male and female students (e.g. both parents with primary education: PR₂₀₂₁ = 1.74 [1.23-2.47] and PR₂₀₂₁ = 1.83 [1.49-2.25], respectively).</p><p><strong>Conclusions: </strong>The findings highlight the necessity for developing equity-focused public health policies addressing adolescent AHS use, especially among disadvantaged female students. Further research is needed to explore the social determinants of adolescent AHS use, considering inequalities from an intersectional perspective.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"49"},"PeriodicalIF":4.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The people-centered care and inpatients' perceived experience in China: a nationwide cross-sectional study.","authors":"Zhixing Wang, Xueyao Wang, Herng-Chia Chiu, Xiangrong Kong, Qingfeng Li, Xu Ran, Yang Liu, Hailun Liang, Leiyu Shi","doi":"10.1186/s12939-025-02409-2","DOIUrl":"10.1186/s12939-025-02409-2","url":null,"abstract":"<p><strong>Background: </strong>The concept of People-Centered Care (PCC) is a prominent concept around the world, which is considered as an important concept and practice to promote health equity especially in China. Nevertheless, the association between PCC and the perceived experience of patients remains unclear, particularly from the perspective of the entire nation. This study examined the relationship between PCC and inpatients' perceived experience in China.</p><p><strong>Methods: </strong>The study utilized nationwide data collected from 351 healthcare facilities in 31 provinces representing all facility levels and types using proportional odds models. The five attributes of PCC encompass the following categories: continuity of care, information sharing, enhanced access, effectiveness, and respect, each contributing to improving health equity. Inpatients' perceived experience includes the following factors: inpatients' satisfaction with the hospitalization, the recognition of the hospital, and the recommendation of the hospital.</p><p><strong>Results: </strong>Concerning inpatients' overall satisfaction with the hospitalization, all PCC attributes had a positive effect on satisfaction, especially for inpatients with higher levels of care continuity and respect, contributing to health equity. Inpatients with a higher level of continuity were 3.66 times more likely to ameliorate their level of satisfaction from \"very unsatisfied\" to \"unsatisfied.\" Meanwhile, all PCC attributes had significantly positive effects on inpatients' recognition, with effectiveness and respect showing an even stronger association with health equity. Regarding inpatients' recommendation measures, all PCC attributes were positively associated, especially with higher levels of care continuity and effectiveness.</p><p><strong>Conclusion: </strong>People-centered care is positively associated with inpatients' perceived experience, and enhancing health equity through PCC attributes can further improve this experience. Further reform and practice should focus on the amelioration of continuity of care, promotion of information sharing between medical staff and patients, access and effectiveness of care, and respect for patients, all contributing to health equity.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"48"},"PeriodicalIF":4.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the qualities of a 'good doctor': family carers' and healthcare professionals' perspective on dementia healthcare in India.","authors":"Upasana Baruah, Rachita Rao, Josefine Antoniades, Santosh Loganathan, Mathew Varghese, Claudia Cooper, Mike Kent, Briony Dow, Bianca Brijnath","doi":"10.1186/s12939-025-02408-3","DOIUrl":"10.1186/s12939-025-02408-3","url":null,"abstract":"<p><strong>Background: </strong>The escalating prevalence of dementia in India highlights the need for effective dementia care, particularly in a context marked by limited specialized services and resources. In response to this growing challenge, we sought to contribute to the understanding of societal expectations of multidisciplinary dementia care by exploring the qualities that family carers and healthcare professionals value in dementia care professionals within a multidisciplinary team in India.</p><p><strong>Methods: </strong>The aim of the study was to describe the perspectives of carers and healthcare professionals regarding the attributes of a 'good doctor' in the context of accessing care for individuals with dementia in India. The research involved qualitative face-to-face interviews with 19 family carers and 25 healthcare professionals in Bengaluru, India, with data collected between March and July 2022.</p><p><strong>Results: </strong>Using a thematic analysis framework, four main themes emerged: [1] accessibility and availability [2], empathetic engagement and effective communication [3], knowledge and competency, and [4] systemic reforms and culturally competent multilevel support. Public and professionals' perceptions of 'good' care appeared to have shifted from seeking cures to prioritizing time, counselling, and information, reflecting a more holistic understanding of support needed. Interviewees valued interactions in which they perceived practitioners acting with patience, compassion, respect for dignity of the person with dementia, and professional competence. Effective communication was key. Challenges in accessing quality dementia care included inadequate infrastructure, lack of specialized services, and long waiting times. The importance of multidisciplinary approaches and the need for systemic reforms to enhance service delivery were highlighted.</p><p><strong>Conclusion: </strong>Findings highlight a need for training programs for healthcare professionals to foster the values inherent to delivery of person-centered care.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"46"},"PeriodicalIF":4.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the gendered abyss: exploring the case of women with lymphatic filariasis and the path to inclusive care in India.","authors":"Arya Rahul, Anoop C Choolayil, Dharani Govindasamy, Gnanasekaran Vijayalakshmi, Sadhasivam Anbusivam, Vijesh Sreedhar Kuttiatt","doi":"10.1186/s12939-025-02397-3","DOIUrl":"10.1186/s12939-025-02397-3","url":null,"abstract":"<p><strong>Introduction: </strong>Lymphatic filariasis (LF), a neglected tropical disease (NTD), affects tropical regions marked by poor socioeconomic conditions and often results in non-curable filarial lymphedema. The impact of LF is often disproportionate, adversely affecting women due to a multitude of intersecting disadvantages. There has been little effort to understand the unique illness experience of women with LF.</p><p><strong>Methods: </strong>To explore the interplay between gender and the illness experience of women afflicted with filarial lymphoedema, this qualitative study mapped the experience of 18 women and the perceptions of 18 men with lymphatic filariasis. Data collection involved 12 in-depth interviews and four focus group discussions, with equal gender separation. The content generated was analyzed using a hybrid thematic analysis approach.</p><p><strong>Results: </strong>The study shows that individuals with filarial lymphedema, regardless of gender, encounter numerous challenges. However, certain aspects, like cultural gender norms paired with socioeconomic disadvantages, exert a disproportionate burden on women, which adversely affects their physical health, health-seeking behavior, and mental health. While the study highlights the intersectional lived experiences of women with LF, its focus on women's experiences may limit broader generalizability across genders.</p><p><strong>Conclusions: </strong>Addressing the factors that impact the lived experiences of women with lymphatic filariasis is an essential but complex task that requires positive changes across various domains. Targeted mental health interventions and robust family support systems can play a pivotal role in improving the health outcomes of affected individuals. Also, gender-informed intersectional research on the illness experiences of women with LF can give valuable insights to tailor better morbidity management policies and practices.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"47"},"PeriodicalIF":4.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global strategies for implementing health financing equity - a state-of-the-art review of political declarations.","authors":"Alexandre Nimubona, Innocent Yandemye, Chartière Nigaba, Beatrice Abura","doi":"10.1186/s12939-025-02404-7","DOIUrl":"10.1186/s12939-025-02404-7","url":null,"abstract":"<p><strong>Background: </strong>Implementing health financing equity plays a determining role in achieving Universal Health Coverage. For this reason, the global health community stated multiple political declarations to guide health financing equity implementation in countries. The aim of this study was to investigate the global strategies for implementing health financing equity that emerged from political declarations made before 2024.</p><p><strong>Methods: </strong>Using a state-of-the-art review design, we identified the political declarations from the search of United Nations databases and the snowball search. We used textual and theoretical thematic analysis methods to extract the global strategies of health financing equity implementation that emerged from the political declarations. We grounded the global strategies in the existing practical framework - the Health Financing Progress Matrix of the World Health Organization. We employed a time-based descriptive analysis method to document the results. Quantitative information was used to shape the analysis.</p><p><strong>Results: </strong>In total, 40 political declarations were included in the review. From these declarations emerged the strategies of targeted, selective, contributive, universal, claims, proportionate, experimental, united, and aggregated financing to implement health financing equity in countries. Thirty nine of the 40 political declarations that labelled the global health community from 1944 until 2023 placed more efforts on duplicating the prevailing strategies. The declarations, categorised into nine groups (target, unity, universality, selectivity, contribution, aggregation, claims, experience, and proportionality-oriented political declarations), were insistent to press countries effectively implement the strategies.</p><p><strong>Conclusion: </strong>The political declarations proved to be the essential markers of the global health community's efforts to raise the profile of health financing equity in countries. Although some of the global strategies that emerged from the political declarations have been shown promise in different countries, any global strategy is neither effective nor optimal for providing efficient and sustainable UHC in all countries. This lays the groundwork for careful management and adaptation of the global strategies to the diverse needs of the diverse population.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"45"},"PeriodicalIF":4.5,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The bittersweet experiences of providers of Home-Based Palliative Care (HBPalC): a qualitative study on the provider perspectives of HBPalC in Kerala, India.","authors":"Resmi Madhavanpillai Indirabhai, Chithralekha Leela, Arya Rahul, Thekkumkara Surendran Anish","doi":"10.1186/s12939-024-02354-6","DOIUrl":"10.1186/s12939-024-02354-6","url":null,"abstract":"<p><strong>Background: </strong>Home-based care is a fundamental component of the Kerala model of palliative care, which has received global recognition. The study explores the experiences of palliative care providers caring for a vulnerable community of patients. Findings may assist in identifying gaps and replicating Kerala's palliative care model in other settings.</p><p><strong>Methods: </strong>This descriptive qualitative study was conducted among palliative care providers (PCPs) and other stakeholders working with the Pain and Palliative Care Project of the National Health Mission (NHM), Thiruvananthapuram District, Kerala. Three Focus Group Discussions and 21 In-Depth Interviews were conducted among a purposively sampled group of participants including palliative care providers and patients. The validity of the data was ensured by data triangulation and member checks using standard methodologies. All interviews were audio recorded and thematic analysis was done using the Braun & Clarke method.</p><p><strong>Results: </strong>PCPs experienced a multitude of positive and negative experiences and challenges. They found contentment in establishing an intimate relationship with patients and their families, getting the opportunity to deliver need-based quality care, crossing the hurdles of social acceptance and creating opportunities from challenges; giving them a feeling of satisfaction and self-worth. Challenges faced by caregivers included a lack of acceptance from patients/families, stress, burnout, and helplessness. Additionally, although the program was running efficiently in the community, palliative care providers faced administrative, organizational, and personal barriers that they felt impeded their contributions.</p><p><strong>Conclusions: </strong>The study gives an in-depth illustration of the challenges and ambivalent experiences of palliative care providers working under Kerala's home-based palliative care programme, providing care to a vulnerable section of society. The caregivers themselves represent an underprivileged community of nurses who struggle to provide the highest possible care despite the challenges and difficulties.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"44"},"PeriodicalIF":4.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the COVID-19 pandemic on urban-rural outpatient primary care utilisation in Malaysia: a retrospective time series and spatiotemporal analysis.","authors":"Izzatur Rahmi Mohd Ujang, Jabrullah Ab Hamid, Normaizira Hamidi, Asnida Anjang Ab Rahman, Rajini Sooryanarayana","doi":"10.1186/s12939-025-02406-5","DOIUrl":"10.1186/s12939-025-02406-5","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic significantly affected healthcare utilisation worldwide, underscoring the importance of monitoring it to indicate whether essential health services were maintained during crises. This study explored how the pandemic affected outpatient department (OPD) utilisation in public primary care facilities in Malaysia by analysing utilisation trends and comparing it across geographical regions, including urban-rural disparities.</p><p><strong>Methods: </strong>Monthly OPD attendance from 1,053 public primary care health clinics in Malaysia, from January 1, 2019, to June 30, 2021, was analysed. The study duration was divided into four distinct periods: pre-pandemic, pandemic with the first lockdown implementation, pandemic after the first lockdown was lifted, and pandemic with the second lockdown implementation. An interrupted time series analysis was conducted to assess the impact of different interventions at national, regional, urban-rural, and district levels. Data were then aggregated at the district level and the utilisation changes were visualised in a choropleth map. Additionally, simple linear regression (SLR) was performed to explore the association between utilisation changes and urbanisation rates of the district, for each period.</p><p><strong>Results: </strong>Nationally, OPD utilisation dropped by nearly 13% at the onset of the first lockdown and continued to decline by almost 24% monthly thereafter. In terms of urban-rural differences, urban areas in the Central and Eastern Regions showed greater fluctuations in OPD utilisation during different periods. Results from the SLR revealed that higher urbanisation rates were associated with more pronounced changes in utilisation, although the direction of these changes varied across time periods.</p><p><strong>Conclusion: </strong>The OPD utilisation was affected during the COVID-19 and sporadic urban-rural differences were observed in some areas of the country. This study offers important insights into the geographic and urban-rural patterns of healthcare utilisation during the pandemic, which are crucial in improving healthcare equity in Malaysia.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"43"},"PeriodicalIF":4.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is universal health coverage really better? Unintended consequences of the 2019 Amendment of the National Health Insurance Act for humanitarian sojourners in South Korea.","authors":"Minji Ju, Minah Kang, Eunice Y Park","doi":"10.1186/s12939-025-02396-4","DOIUrl":"10.1186/s12939-025-02396-4","url":null,"abstract":"<p><strong>Background: </strong>South Korea achieved universal health coverage (UHC) through the National Health Insurance (NHI). However, humanitarian sojourners under temporary stay permits were initially excluded. Alongside recommendations from the National Human Rights Commission of Korea (NHRCK), the 2019 Amendment of the NHI Act expanded eligibility of the NHI. While this marked significant progress toward greater universality in health care, it also led to unintended consequences for humanitarian sojourners.</p><p><strong>Methods: </strong>This study employed a two-fold approach aligned with the trajectory of the Amendment. First, we conducted semi-structured in-depth interviews to analyze diverse perspectives on the universality of health coverage, the benefits of NHI, and the limitations of policies prior to the 2019 Amendment. Participants included government officials from the Ministry of Health and Welfare, Ministry of Justice, and NHRCK, as well as humanitarian sojourners sharing real-life experiences. Second, we examined the expected and unexpected outcomes of the Amendment by reviewing legal documents, reports, and media coverage after the Amendment. Specifically, we analyzed precedents set by the Korean Constitutional Court regarding the constitutional litigation, white papers, and interviews published in the news.</p><p><strong>Results: </strong>Despite achieving UHC, Korea had limited universality of health coverage prior to the 2019 Amendment, as humanitarian sojourners were excluded from local subscription. The 2019 Amendment of NHI Act expanded eligibility, making local subscription mandatory for humanitarian sojourners. However, unintended consequences emerged from differential treatment in calculating insurance premiums, determining dependents within the same households, and enforcing penalties for missed payments. Such disparities not only continue to restrict access to care but jeopardizes visa extensions for humanitarian sojourners.</p><p><strong>Conclusions: </strong>Our findings highlight a critical gap between policy intent and policy impact, revealing the consequences that disproportionately affect the most vulnerable populations, even under the UHC. Effective implementation of UHC requires a deeper understanding of how government officials and judicial authorities perceive universality and view refugee populations. The discrepancies identified in this study underscore the urgent need for coherent policies that not only expand health coverage but also establish a robust safety net to protect marginalized groups.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"42"},"PeriodicalIF":4.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building evidences in Public Health Emergency Preparedness (\"BePHEP\" Project)-a systematic review.","authors":"Michelangelo Mercogliano, Gloria Spatari, Chiara Noviello, Francesca Di Serafino, Maria Elisabetta Mormile, Giuseppa Granvillano, Annalisa Iagnemma, Riccardo Mimmo, Irene Schenone, Eleonora Raso, Andrea Sanna, Enrica Frasson, Veronica Gallinoro, Marcello Di Pumpo, Duha Shellah, Caterina Rizzo, Nunzio Zotti","doi":"10.1186/s12939-025-02382-w","DOIUrl":"10.1186/s12939-025-02382-w","url":null,"abstract":"<p><strong>Introduction: </strong>Humanitarian crises exacerbate the vulnerability of already fragile healthcare systems and significantly increase the risk of infectious disease outbreaks in low- and middle-income countries (LMICs). This systematic review aims to evaluate strategies and interventions implemented in LMICs to prevent and manage infectious diseases outbreaks during humanitarian crises from 2018 to 2023.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across Scopus, PubMed, and Web of Science, adhering to the PRISMA guideline and the SPIDER framework to identify relevant studies. The review included studies published between 2018 and 2023 focusing on infectious disease prevention and management in LMICs during humanitarian crises. Study quality was assessed using the Joanna Briggs Institute checklist.</p><p><strong>Results: </strong>Eleven studies were identified from 1,415 unique articles. These studies addressed diverse interventions, including vaccination campaigns, epidemiologic surveillance, and integrated health services. Cholera outbreaks in Haiti and Mozambique, triggered by gang violence, internal migration, and Cyclone Kenneth, were addressed through epidemiological surveillance, case management, WASH (Water, Sanitation, and Hygiene) service improvements, and oral vaccination campaigns. Mathematical models guided cholera vaccination in Thailand's refugee camps. In India, surveillance and rapid response measures successfully prevented infectious disease outbreaks during the Kumbh Mela gathering. The Philippines improved response times to climate-related disasters using point-of-care testing and spatial care pathways. Despite challenges in Yemen, evaluating malaria surveillance systems led to recommendations for integrating multiple systems. Uganda developed a national multi-hazard emergency plan incorporating vaccination, communication, and risk management, proving useful during the refugee crisis and Ebola outbreak. In South Sudan, integrating immunisation services into nutrition centres increased vaccination coverage among children. Nigeria experienced a rise in measles cases during armed conflicts despite vaccination efforts, while visual communication strategies improved SARS-CoV-2 vaccination rates.</p><p><strong>Conclusion: </strong>These interventions highlight the importance of multimodal, targeted, and collaborative responses to address complex health crises without relying on unsustainable investments. Despite the effectiveness of these interventions, infrastructure limitations, insecurity, and logistical constraints were noted. These findings emphasize the need for adaptable and resilient healthcare systems and international collaboration to safeguard the right to health during complex humanitarian crises.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"41"},"PeriodicalIF":4.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare access barriers and utilization among the Arab Bedouin population in Israel: a cross-sectional study.","authors":"Haneen Shibli, Paula Feder-Bubis, Nihaya Daoud, Limor Aharonson-Daniel","doi":"10.1186/s12939-025-02398-2","DOIUrl":"10.1186/s12939-025-02398-2","url":null,"abstract":"<p><strong>Background: </strong>The Arab Bedouin Muslim minority in Israel, is one of the country's most vulnerable groups. They are residents of the Israeli geographical and social periphery. Bedouin's healthcare service utilization is shaped by its sociocultural and environmental characteristics. This study explores healthcare access barriers and utilization patterns among the Arab Bedouin population, focusing on two types of legal status locality: a legally recognized Bedouin town and the surrounding unrecognized villages.</p><p><strong>Methods: </strong>We conducted a cross-sectional study among Arab Bedouin adults (N = 246) residing in a Bedouin recognized town and unrecognized villages. Using an anonymous, self-administered questionnaire in Arabic. We collected information about healthcare visits, types of services accessed, access barriers and the factors influencing healthcare-seeking behavior. Multivariate linear regression was conducted to examine the predictors of healthcare services utilization.</p><p><strong>Results: </strong>Of the 246 participants, 60% resided in a recognized Bedouin town and 40% resided in unrecognized villages. Most participants were female (61%) and the mean age was 37.8 ± 13.9 years. The findings showed that barriers to seeking care differed based on the residence town's legal status. While residents of unrecognized villages face significant physical access barriers, they also show a notable reliance on cross-border healthcare providers, particularly in the Palestinian Authority. Chronic medical conditions (B = 1.147, p < 0.001), gender (B = -0.459, p < 0.01), and parental status (B = 0.667, p = 0.001) have been identified as strong predictors of healthcare service utilization.</p><p><strong>Conclusion: </strong>This study offers new insights regarding the complexity of healthcare access and utilization in the Arab Bedouin population in Israel, emphasizing that barriers are not only structural but also deeply intertwined with cultural and linguistic factors. The study highlights the universal message of addressing both physical and systemic barriers to healthcare access, ensuring that healthcare services are culturally and linguistically tailored to the specific needs of marginalized populations locally and globally. These findings provide actionable insights for policymakers emphasizing the need to improve health equity by addressing the access barriers faced by the Arab Bedouin population, including structural, cultural, and linguistic challenges, and ensuring targeted interventions for marginalized communities both locally and globally.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"40"},"PeriodicalIF":4.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}