International Journal for Equity in Health最新文献

{"title":"Addressing health inequalities and barriers to access among adolescent migrants in Chile: a mixed methods study.","authors":"Alejandra Carreño-Calderón, Alexandra Obach, Baltica Cabieses, Marcela Oyarte, Alicia Arias Schreiber","doi":"10.1186/s12939-025-02615-y","DOIUrl":"10.1186/s12939-025-02615-y","url":null,"abstract":"<p><strong>Background: </strong>The presence of adolescents in migration flows through Latin America and Caribbean (LAC) has increased in recent years. Adolescents are usually considered healthy due to their low mortality rates compared to the general population. However, existing research shows that adolescence is a phase of life in which mental health, sexual and reproductive health and other needs may increase. Migration, as a social determinant of health, can lead to experiencing compounded vulnerabilities among adolescent migrants, especially those already living in disadvantaged conditions.</p><p><strong>Objective: </strong>aims to estimate and compare social inequalities in health faced by adolescent migrants from LAC living in Chile versus locals, as well as to unveil perceptions and experiences related to additional barriers to accessing to healthcare in the country.</p><p><strong>Method: </strong>A mixed methods study was designed to socially and epidemiologically characterise the adolescent migrant population in Chile. First, two population-based surveys (CENSO 2017; CASEN 2022; REM 2021 and EH 2021) and national epidemiological records were analysed. Second, perceptions and experiences of accessing primary healthcare services were explored through 42 in-depth interviews with healthcare teams (n = 18) and parents of adolescent migrants (n = 24). Quantitative and qualitative data were analysed separately and then integrated to identify the main findings. The study was approved by the Ethics Committee of the Universidad del Desarrollo.</p><p><strong>Results: </strong>The study identified social inequalities negatively affecting adolescent migrant compared with their Chilean peers, including lower access to education, housing and higher chances of having to work. Regarding health, sexual and reproductive needs and experiences are identified, including adolescent pregnancy. Barriers to access to primary healthcare programmes dedicated to adolescent health, which are little known and underused by the migrant population, were also identified.</p><p><strong>Conclusions: </strong>Adolescent migrants in Chile face important social inequalities in health compared to locals and additional barriers to exercise their right to health, putting their current and future health at risk. Priority actions are needed for this specific group, and must focus on increasing the acceptability and coverage of preventive care, as well as strengthening their participation in the social and health decisions affecting them.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"234"},"PeriodicalIF":4.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174717","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":"Perceived inequality in women's sports: a qualitative critical discourse analysis in the Iranian context.","authors":"Neda Sarabi, Neda Shiri, Mohsen Khezeli, Nader Rajabi-Gilan, Sajjad Narimani, Mehdi Khezeli","doi":"10.1186/s12939-025-02604-1","DOIUrl":"10.1186/s12939-025-02604-1","url":null,"abstract":"","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"232"},"PeriodicalIF":4.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137376","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":"Late request for safe abortion and its determinants among reproductive age women in Ethiopia: systematic review and meta-analysis.","authors":"Tirusew Nigussie Kebede, Kidist Ayalew Abebe, Tebabere Moltot Kitaw, Moges Sisay Chekole, Assalif Beyene Haile, Toyba Ebrahim Yesuf, Mesfin Tadese, Mekuanint Terefe Kassa, Mulualem Silesh Zerihun, Birhan Tsegaw Taye, Tadesse Awoke Ayele","doi":"10.1186/s12939-025-02559-3","DOIUrl":"10.1186/s12939-025-02559-3","url":null,"abstract":"<p><strong>Introduction: </strong>Late requests for safe abortion during the second trimester are strongly associated with severe maternal complications, including infertility, preterm birth, low birth weight, and maternal mortality, especially in developing countries. These delays also contribute to adverse pregnancy outcomes beyond direct maternal deaths. Despite these serious concerns, data on the prevalence and contributing factors of late abortion requests in Ethiopia remain limited.</p><p><strong>Objective: </strong>To estimate the pooled prevalence of late requests for safe abortion and identify the determinants among Ethiopian women of reproductive age.</p><p><strong>Methods: </strong>This systematic review and meta-analysis was conducted following the PRISMA 2020 guidelines. A comprehensive search was performed across major international databases, including PubMed, Cochrane Library, Google Scholar, Hinari, Scopus, Web of Science, and African Journals Online, using the CoCoPop strategy. Study quality was assessed using the Joanna Briggs Institute (JBI) tool. Heterogeneity among studies was evaluated with the I² statistic, and publication bias was assessed using funnel plots and Egger's test. A random-effects model was employed to estimate the pooled prevalence and adjusted odds ratios (AOR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Ten studies involving a total of 5,559 women were included. The pooled prevalence of late requests for safe abortion was 35.20% (95% CI: 26.21, 44.19). Significant determinants identified were delayed pregnancy diagnosis (AOR: 3.23; 95% CI: 2.52, 4.13), irregular menstrual cycles (AOR: 2.36; 95% CI: 1.86, 3.00), rural residence (AOR: 2.89; 95% CI: 2.34, 3.58), unmarried status (AOR: 2.86; 95% CI: 2.13, 3.86), and age under 19 years (AOR: 4.01; 95% CI: 2.41, 6.67).</p><p><strong>Conclusion: </strong>Late requests for safe abortion are common in Ethiopia and are influenced by factors such as rural residence, young age, delayed recognition of pregnancy, and irregular menstrual cycles. Enhancing access to reproductive health services especially for rural and adolescent populations is essential to reduce maternal complications and promote timely care.</p><p><strong>Prospero registration number: </strong>CRD42024603467.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"230"},"PeriodicalIF":4.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953011","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":"Writing about health inequality: recommendations for accurate and impactful presentation of evidence.","authors":"Nicole Bergen, Katherine Kirkby, Aluisio J D Barros, Paula Braveman, Peter Goldblatt, Theadora Swift Koller, Oscar J Mujica, Devaki Nambiar, Owen O'Donnell, Anne Schlotheuber, Vivian Welch, Ahmad Reza Hosseinpoor","doi":"10.1186/s12939-025-02548-6","DOIUrl":"10.1186/s12939-025-02548-6","url":null,"abstract":"<p><p>Health and development agendas and programmes often prioritize the reduction of unfair and remediable health inequalities. There is a growing amount of data pertaining to health inequalities. Written outputs, including academic research papers, are key tools for describing health inequalities. Epidemiologists, data analysts, policy advisors and health equity scholars can have greater impact through accurate, concise and compelling presentation of this evidence and so assist those advocating for action to close health gaps. We make recommendations to improve the accuracy and impact of written evidence on health inequality. Focusing on the micro, macro and meta aspects of developing written reports, we drew from our varied experiences promoting health inequality monitoring to identify key strategies specific to this field, which were further expanded and explored through literature searches and consultation with experts. We recommend four general strategies: (i) using terminology deliberately and consistently; (ii) presenting statistical content accurately and with sufficient detail; (iii) adhering to guidelines and best practices for reporting; and (iv) respecting and upholding the interests of affected communities. Specifically, we address the use of terminology related to health inequality and health inequity, dimensions of inequality and determinants of health, economic inequality and economic-related inequality, sex and gender, and race and ethnicity. We present common pitfalls related to reporting statistical content, underscoring the importance of clarity when reporting association and causation. We advocate for engaged and inclusive writing processes that use affirming language and adopt strength-based messaging. This guidance is intended to increase the impact of written evidence on efforts to tackle avoidable health inequalities.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"231"},"PeriodicalIF":4.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952984","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 cream-skimming behaviors of tertiary hospitals under medical alliances: evidence from China.","authors":"Zixuan Peng, Xu Chen, Peter C Coyte","doi":"10.1186/s12939-025-02549-5","DOIUrl":"10.1186/s12939-025-02549-5","url":null,"abstract":"<p><strong>Background: </strong>While previous studies have delved into the formation and development of medical alliances in China, there has been limited focus on investigating inequity in the referral rates and the quality of care received provided to patients with experience of referral and those without under the introduction of medical alliances. This study explored: (1) inequity in the odds of being referred to healthcare institutions within medical alliances; and (2) inequity in the quality of care received between the referred and non-referred patients.</p><p><strong>Methods: </strong>This study employed a dataset comprising 440,950 individuals who had at least one outpatient visit at healthcare facilities in Hangzhou city, Zhejiang province, China from January 1, 2020 to September 24, 2021. Quality of outpatient care was measured by the odds of having seven-day all-cause follow-up encounters to any healthcare institution. Binary regression models combined with random effects were constructed to examine inequity in the referral rates and the quality of care received. A set of sensitivity analyses were conducted to check the robustness of study findings.</p><p><strong>Results: </strong>This study has three key findings. First, outpatients' insurance status, rather than their specific diseases and health conditions, was identified the most significant determinant driving healthcare institutions' referral decisions. Compared with outpatients covered by public health insurance programs, those without such coverage were more likely to be referred by tertiary hospitals to primary care facilities (coefficient = 1.33; 95% CI: 0.56-2.11) while being less likely to be referred by primary care facilities to tertiary hospitals (coefficient = -2.00; 95% CI: -3.08 - -0.92). Second, the referred outpatients received poorer quality of care, as indicated by higher odds of having all-cause follow-up encounters within seven days at any healthcare institution, compared to those non-referred outpatients. Third, outpatients with chronic diseases and public health insurance coverage not only experienced higher referral rates but poorer quality of outpatient care after being referred from tertiary hospitals to primary care facilities, compared to their counterparts.</p><p><strong>Conclusion: </strong>This study demonstrated that tertiary hospitals \"siphoned-off\" outpatients with public health insurance coverage from primary care facilities. Outpatients who were older, were male, with chronic diseases, and with public health insurance coverage were more likely to experience not only higher referral rates but poorer quality of outpatient care after being referred from tertiary hospitals to primary care facilities. Tailored policies are required to protect and compensate the most vulnerable population groups.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"229"},"PeriodicalIF":4.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953068","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":"Redefining intimacy: a qualitative study on sexual function experiences and perspectives among migrant and refugee women in South Australia.","authors":"Negin Mirzaei Damabi, Jodie C Avery, Mumtaz Begum, Salima Meherali, Zohra S Lassi","doi":"10.1186/s12939-025-02614-z","DOIUrl":"https://doi.org/10.1186/s12939-025-02614-z","url":null,"abstract":"<p><strong>Background: </strong>Sexual function is a fundamental aspect of sexual health, yet migrant and refugee women from Low- and Middle-Income Countries (LMICs) often face unique challenges in navigating intimacy and sexual function post-migration. While sociocultural norms, migration-related stressors, and healthcare access influence their experiences, yet these perspectives remain underexplored.</p><p><strong>Methods: </strong>This qualitative exploratory study explored the perspectives and experiences of sexual function among first-generation migrant and refugee women from low- and middle-income countries residing in South Australia. Semi-structured interviews were conducted with 20 reproductive-aged cisgender heterosexual women from diverse cultural backgrounds, recruited through multiple culturally appropriate approaches including community organisations supporting migrant and refugee populations and online outreach via the purpose-built RISE website. Although multilingual support and professional interpreters were available, all participants opted to be interviewed in English. Interviews were conducted by a trained qualitative researcher with shared migrant background, and reflexive, inductive thematic analysis guided by social constructivist epistemology was used to identify key influences on sexual health and intimacy.</p><p><strong>Results: </strong>Participants reported that cultural norms, sociocultural expectations, and migration-related stressors shaped their sexual experiences. Many described difficulties in navigating cultural taboos, communication barriers, and limited access to culturally sensitive healthcare services. Conversely, while migration provided opportunities for increased sexual autonomy, self-discovery, and improved partner communication, deeply ingrained cultural beliefs and emotional struggles continued to impact their sexual well-being.</p><p><strong>Conclusions: </strong>The findings highlight the need for culturally sensitive, gender-appropriate sexual health services and the removal of financial, linguistic, and systemic barriers to healthcare access. Healthcare providers, policymakers, and community organisations play a crucial role in fostering inclusive environments that support migrant and refugee women's sexual health and well-being.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"228"},"PeriodicalIF":4.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953016","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":"\"They were my anchors\" Māori with perinatal mental illness identify culturally safe and clinically excellent health care.","authors":"Cara Meredith, Tracy Haitana, Christina McKerchar, Suzanne Pitama","doi":"10.1186/s12939-025-02592-2","DOIUrl":"https://doi.org/10.1186/s12939-025-02592-2","url":null,"abstract":"<p><strong>Background: </strong>Clinicians can mitigate the impact of invalidating or traumatic clinical experiences by actively working to ensure that the clinical interface is a space that is safe, inclusive, and responsive. In Aotearoa, New Zealand (NZ) the cumulative and ongoing effects of colonisation drive significant health inequities experienced by the Indigenous Māori population. Systemic health inequities extend across the perinatal period for Māori mothers and birthing parents with mental health outcomes being particularly poor. Previous invalidating or traumatic experiences at the clinical interface may impact a person's ability to trust or feel safe with clinicians.</p><p><strong>Aim: </strong>The aim of this paper is to explore Māori mothers' and birthing parents' experiences of clinical interactions during the perinatal period to guide clinicians in providing high-quality, culturally safe perinatal mental health care.</p><p><strong>Methods: </strong>This qualitative study was guided and informed by Kaupapa Māori methodology. Semi-structured interviews were undertaken with 19 Māori mothers and birthing parents.</p><p><strong>Findings: </strong>Participants described the challenges they experienced at the clinical interface and also offered insights around positive interactions they encountered with clinicians. Three themes predominated the analysis of Māori mothers and birthing parents: whakawhanaungatanga (relationships, building connections); kaitiakitanga (guardianship and protection); and mana (prestige, dignity).</p><p><strong>Discussion: </strong>Themes from the clinical experiences of Māori mothers and birthing parents when seeking perinatal healthcare outline important dimensions of positive clinical encounters. During the perinatal period these dimensions were promoted through continuity of care and the inclusion and centring of whānau (family, wider support network).</p><p><strong>Conclusion: </strong>Quality clinical care occurs within a system, and structural components of the health system can influence practice and impact provision of care. It is systemic changes that will facilitate clinicians' contribution to equitable outcomes for Māori, through the creation of services that support clinicians to prioritise working with whānau, engage in culturally safe practice, and address the barriers that prevent Māori from accessing evidence-based healthcare. Whakawhanaungatanga, kaitiakitanga and mana are essential to enhancing clinician-patient/whānau interactions in perinatal mental health care. To facilitate these relational values and practices, healthcare organisations must adapt health system structures to support whānau-centred practices. Recommendations from participants within this study provide important directions to guide clinical practice.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"226"},"PeriodicalIF":4.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953003","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":"Advancing the human right to health in cancer care through drug repurposing strategies.","authors":"Nahida Sakis, Michelle Slone, Nadav Michaan, Shamgar Ben-Eliyahu","doi":"10.1186/s12939-025-02598-w","DOIUrl":"10.1186/s12939-025-02598-w","url":null,"abstract":"<p><p>This perspective critically evaluates the global potential of drug repurposing strategies in oncology to advance health equity and sustainable innovation. Drug repurposing, especially with off-patent medications, offers significant advantages, including reduced costs, shortened timelines for clinical implementation, and enhanced approval success rates compared to new drug development. Herein, we advocate for leveraging of repurposing as a scientifically sound and ethically responsible strategy, while acknowledging the implementation barriers in low- and middle-income countries (LMICs) due to global systemic inequities. Fostering equitable investment in research and infrastructure worldwide is essential to realizing the full potential of this approach. We also identify specific barriers to drug repurposing, including limited funding for clinical trials, inadequate support for investigator-led trials, and the lack of commercial incentives due to non-patented drug utilization. To overcome these barriers, we propose enhanced funding mechanisms, robust advocacy, targeted education initiatives, and policy prioritization for repurposing studies. Case examples illustrate the clinical potential of drug repurposing in reducing metastatic progression and improving survival outcomes. Overall, this perspective underscores drug repurposing as a viable and impactful strategy to advance both innovation and the human right to health in cancer care for all populations. By fostering a collaborative interdisciplinary effort, the benefits of this approach can pave a way for a more equitable and sustainable future in cancer care.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"227"},"PeriodicalIF":4.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953037","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":"Determinants of mistrust in digital health research and approaches to address them among Muslim ethnic minorities living in the United Kingdom: a qualitative study.","authors":"Syed Mustafa Ali, Mohammad Mahin Saiyed, Aneela McAvoy, Robert Mackin, Caroline Jay, Sabine N van der Veer","doi":"10.1186/s12939-025-02583-3","DOIUrl":"10.1186/s12939-025-02583-3","url":null,"abstract":"<p><strong>Background: </strong>Under-representation of Muslim ethnic minorities and their mistrust in health research are known barriers to achieving digital health equity. Therefore, this study aimed to understand determinants of Muslim communities' mistrust in digital health research and explore potential approaches to address this and increase their participation in health research.</p><p><strong>Methods: </strong>This study employed a constructivist grounded theory design, involving focus groups with Muslim ethnic minorities living in the United Kingdom. We conducted nine focus groups in mosques, co-moderated by a digital health researcher and an Imam.</p><p><strong>Findings: </strong>Muslim ethnic minorities had several negative perceptions about digital health research, which were mainly influenced by lack of their awareness about the purpose and conduct of research. They felt excluded from health research and did not perceive taking part as beneficial to them or their community. These were exacerbated by how research findings related to Muslim ethnic minorities in the UK were used or shared in public spaces (e.g., by media outlets or healthcare providers). Participants suggested that Imams and mosques could play a role in addressing these negative perceptions by raising awareness among their communities using digital resources (e.g., bite size videos, social media community groups) and during regular gatherings.</p><p><strong>Conclusion: </strong>Negative perceptions about health research are common among Muslim communities, which are further exacerbated by the way research findings related to South Asians are discussed in public spaces. Despite this, there is a potential of building the Muslim community's trust and improve their participation in health research if health researchers work collaboratively with mosques or Imams and leverage community-based networks and resources.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"225"},"PeriodicalIF":4.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859088","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 Gendered Well-being Assessment: addressing trauma, complex needs & social determinants of health.","authors":"Denise Ruprai, Simon Pemberton, Richard Summers","doi":"10.1186/s12939-025-02553-9","DOIUrl":"10.1186/s12939-025-02553-9","url":null,"abstract":"<p><p>Women's Centres in the UK provide crucial support to women with complex needs, who are often excluded from statutory services, frequently acting as a service of 'last resort'. A major challenge when working with this population is the lack of a holistic, validated, and gender-responsive assessment tool to measure needs comprehensively and systematically. This paper introduces the Gendered Well-being Assessment (GWA), a trauma-informed quality-of-life assessment designed for women with complex needs outside the criminal justice system. The GWA aims to support early intervention, enhance multi-agency collaboration, whilst offering a structured framework for case management. A comprehensive scoring algorithm combines contemporary research on accumulative complex trauma, complex needs, and toxic stress physiology with an overall aim to highlight unmet needs to avoid preventable harm and improve overall quality of life. The assessment takes account of the interconnectedness of needs, and across 5 key domains, and 12 sections create a comprehensive overview of the breadth and depth of needs. Unlike fragmented assessments, the GWA integrates multiple validated tools into a single framework, ensuring credibility within multi-agency partnerships. By recognising protective factors like self-efficacy and social support, the GWA moves beyond harm mitigation to promote resilience and flourishing. Its structured, algorithm-based approach informs personalised support plans, transforming service provision and policy. This innovative tool ensures that women's needs are addressed comprehensively and equitably within a broader social context.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"224"},"PeriodicalIF":4.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859089","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}