The Lancet Regional Health: Western Pacific最新文献

{"title":"Progress towards the UNAIDS 2030 HIV prevention target in New South Wales, Australia: a population-based study","authors":"Phillip Keen ,&nbsp;Steven J. Nigro ,&nbsp;Curtis Chan ,&nbsp;Benjamin R. Bavinton ,&nbsp;Htein Linn Aung ,&nbsp;Martin Holt ,&nbsp;Rebecca Guy ,&nbsp;Janaki Amin ,&nbsp;Timothy R. Broady ,&nbsp;Jane Costello ,&nbsp;Anthony D. Kelleher ,&nbsp;Carla Treloar ,&nbsp;Rick Varma ,&nbsp;Matthew Vaughan ,&nbsp;Valerie Delpech ,&nbsp;Andrew E. Grulich ,&nbsp;HIV Prevention Research, Implementation Science and Monitoring (PRISM) Partnership","doi":"10.1016/j.lanwpc.2025.101535","DOIUrl":"10.1016/j.lanwpc.2025.101535","url":null,"abstract":"<div><h3>Background</h3><div>The UNAIDS ending AIDS strategy includes a 2030 prevention target of a 90% reduction in new infections from 2010. We report progress towards this goal in gay, bisexual and other men who have sex with men (GBM) in New South Wales (NSW), Australia.</div></div><div><h3>Methods</h3><div>We report HIV notification data for people newly diagnosed by exposure category, with a focus on GBM who comprised more than three-quarters of diagnoses. We report HIV testing, pre-exposure prophylaxis, HIV treatment, and undetectable viral load based on surveys of community-based GBM and data from a sentinel surveillance network of 50 clinics. We report trends between 2010 and 2022, including by geography grouped by postcodes with high-, medium- and low-prevalence of gay residents. Trends were assessed using the chi-square test for linear trend.</div></div><div><h3>Findings</h3><div>Statewide, annual notifications declined by 56% in GBM, and declines were much greater in inner-Sydney postcodes with a high percentage of gay residents compared to postcodes with a low percentage (88% and 32%). Among community-recruited GBM, annual HIV testing and PrEP uptake increased over time and by 2022 were higher in the high- (91% and 82%) than low-gay prevalence postcodes (78% and 61%). In the clinic sample, HIV testing and PrEP use increased but there was no evidence that they differed by geography. In both samples, among GBM living with HIV, the percentages on HIV treatment and with undetectable viral load increased over time, and by 2022 were greater than 95%.</div></div><div><h3>Interpretation</h3><div>HIV notifications in GBM in NSW have dropped by more than half since 2010. In inner Sydney areas with a high prevalence of gay men, prevention uptake was highest, and the decline in notifications approached 90%. Declines in HIV notifications were more modest elsewhere, and prevention uptake lower. Currently available prevention interventions, if extended population-wide, can enable a 90% reduction in new HIV infections in GBM, consistent with the ending AIDS target.</div></div><div><h3>Funding</h3><div>This project was funded by the <span>National Health and Medical Research Council</span> and the <span>NSW Ministry of Health</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101535"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Situation analysis of evidence-informed health decision-making in Lao PDR: the case of health technology assessment","authors":"Sysavanh Phommachanh ,&nbsp;Manit Sittimart ,&nbsp;Aparna Ananthakrishnan ,&nbsp;Souphaphone Vongsack ,&nbsp;Soudavanh Soysouvanh ,&nbsp;Elizabeth A. Ashley ,&nbsp;Yot Teerawattananon ,&nbsp;Saudamini Vishwanath Dabak ,&nbsp;Mayfong Mayxay","doi":"10.1016/j.lanwpc.2025.101534","DOIUrl":"10.1016/j.lanwpc.2025.101534","url":null,"abstract":"<div><h3>Background</h3><div>There is increasing interest in using evidence to inform policy in Lao PDR, which is in the process of establishing a unit for Health Technology Assessment (HTA). This situation analysis aims to explore the current landscape of evidence generation and translation into policy decisions in Lao PDR using the case of HTA.</div></div><div><h3>Methods</h3><div>A mixed methods approach was applied. Self-administered questionnaires and semi-structured interviews were conducted with different stakeholder groups. Data were analysed thematically and summarised in tabular form.</div></div><div><h3>Findings</h3><div>There were 212 responses to the survey and 38 stakeholders were interviewed between March and September 2021. The health policy decision process in Lao PDR is based on consultation meetings, influenced by external experts and/or companies, without consistent use of evidence. There remains a lack of human resource and infrastructure for health evidence to inform policy. Two-thirds of the respondents to the survey strongly agreed that HTA helps in efficient allocation of health resources and improving quality of healthcare. Half of the respondents perceived that HTA can impact the government budget and transparency, which was consistent with findings from the qualitative data. Use of economic considerations was limited in Lao PDR. HTA was seen to apply to policy areas, notably for reimbursement. Only a few organisations can supply health evidence and HTA output, and more training and multi-disciplinary collaboration is needed to conduct and produce HTA and other health evidence to inform policy in Lao PDR. Funding for HTA remains a concern.</div></div><div><h3>Interpretation</h3><div>Improvement of the health policy decision process is urgently needed in Lao PDR. Limited capacity to conduct HTA as well as institutional considerations need to be addressed. Recent efforts towards this end through the establishment of a unit focused on HTA, capacity building activities and international collaborations are promising to establish evidence-informed priority setting for health policy and can also benefit from regional efforts in this direction. This type of approach to assess the situation for evidence use will be beneficial for other countries embarking on this path.</div></div><div><h3>Funding</h3><div><span>Wellcome Trust</span>, the United Kingdom <span>Department of Health and Social Care</span> (DHSC), and the <span>Ministry of Public Health</span>, Thailand.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101534"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing age profile and incidence of injecting drug use initiation among people in Australia who inject drugs: evidence from two national repeated cross-sectional studies","authors":"Olivia Price ,&nbsp;Lisa Maher ,&nbsp;Amy Peacock ,&nbsp;Farzaneh Zolala ,&nbsp;Louisa Degenhardt ,&nbsp;Paul Dietze ,&nbsp;Sarah Larney ,&nbsp;Seraina Agramunt ,&nbsp;Samantha Colledge-Frisby ,&nbsp;Bradley Mathers ,&nbsp;Dan Lewer ,&nbsp;Rachel Sutherland","doi":"10.1016/j.lanwpc.2025.101548","DOIUrl":"10.1016/j.lanwpc.2025.101548","url":null,"abstract":"<div><h3>Background</h3><div>The age of people who inject drugs appears to be increasing in some high-income countries. We aimed to explore trends in the age of people injecting and recently starting to inject drugs in Australia, and to model incidence of initiation over time.</div></div><div><h3>Methods</h3><div>We obtained data from the Illicit Drug Reporting System (IDRS) and the Australian Needle Syringe Program Survey (ANSPS), which comprise annual cross-sectional surveys with people who inject drugs (2000–2019). Outcome measures were current age, age of initiation, and time since initiation (both surveys), and drug first injected (IDRS only). We estimated time trends in age using quantile regression. We used the relative number of people initiating injecting drug use each year and existing population size estimates to model incidence of initiation.</div></div><div><h3>Findings</h3><div>In total, 58,465 interviews with people who reported injecting drugs in the past month (33.7% women) were included. In both surveys, the median age increased over the study period (IDRS: 28–43 years; ANSPS 28–44 years). The median time since initiation also increased over the study period (IDRS: 8–22.5 years; ANSPS: 9–24 years), and the median age of initiation increased with calendar year of initiation (IDRS: 18–34 years; ANSPS: 20–30 years). Women tended to be younger and commence injecting drug use at a younger age than men. Modelling suggested that similar numbers of people injected drugs for the first time each year from 1980 (national estimates of 15,570 and 17,020 new initiates using IDRS and ANSPS data, respectively) to 1996 (IDRS: 16,360; ANSPS: 22,300 new initiates), followed by a decisive decline in incidence until 2012 (IDRS: 1110; ANSPS: 1830), whereafter it has fluctuated but remained low. Meth/amphetamine was consistently the predominant drug injected at initiation among IDRS participants, although there were peaks in heroin as the drug injected at initiation in the early 1980s and mid-1990s.</div></div><div><h3>Interpretation</h3><div>In 2019, most people who were injecting drugs in Australia were part of a cohort that began injecting in the 1980s or 1990s. Consequently, the population was older and had been injecting drugs for longer compared to those injecting drugs in 2000. This has implications for health service delivery to people who inject drugs, with increasing age likely to be accompanied by a rise in chronic health conditions and an increase in injecting duration potentially resulting in higher incidence of injecting-related injuries and diseases.</div></div><div><h3>Funding</h3><div><span>Australian Government Department of Health and Aged Care</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101548"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a best-practice model of care for cognitive impairment and dementia for first nations peoples attending primary care in Australia: a stepped-wedge cluster-randomised trial","authors":"Jo-anne Hughson ,&nbsp;Zoë Hyde ,&nbsp;Kate Bradley ,&nbsp;Roslyn Malay ,&nbsp;Harold Douglas ,&nbsp;Sadia Rind ,&nbsp;Kylie Sullivan ,&nbsp;Lauren Poulos ,&nbsp;Bridget Allen ,&nbsp;Bonnie Martin-Giles ,&nbsp;Rachel Quigley ,&nbsp;Sarah Russell ,&nbsp;Diane Cadet-James ,&nbsp;Valda Wallace ,&nbsp;Wendy Allan ,&nbsp;Dawn Bessarab ,&nbsp;Kate Smith ,&nbsp;Kylie Radford ,&nbsp;Edward Strivens ,&nbsp;Leon Flicker ,&nbsp;Dina LoGiudice","doi":"10.1016/j.lanwpc.2025.101529","DOIUrl":"10.1016/j.lanwpc.2025.101529","url":null,"abstract":"<div><h3>Background</h3><div>Dementia and cognitive impairment not dementia (CIND) are under-detected amongst First Nations peoples attending primary care. This trial implemented a culturally adapted best-practice model of care to increase detection and optimise management of CIND/dementia.</div></div><div><h3>Methods</h3><div>This closed cohort open-label, stepped-wedge, cluster-randomised trial recruited 12 Aboriginal community-controlled primary health care services (ACCHSs) across urban, regional and remote settings in Australia. ACCHSs were eligible to participate if they conducted annual health checks, engaged in continuous quality improvement processes and had ≥55 clients aged ≥50 years. After a baseline control period, four ACCHSs were scheduled to enter the intervention phase every six months. During the intervention phase, ACCHSs were supported to embed best-practice dementia care through staff education and practice change initiatives. Co-primary outcomes were: (i) documented detection of CIND/dementia and, (ii) evidence of uptake of the diagnostic pathway measured as presence of ≥2 of: use of cognitive assessment tools, relevant pathology investigations, neuroimaging, and/or referral of clients with cognitive concerns to specialist services. Data were analysed with mixed effects complementary log–log regression. This study was registered with the Australia and New Zealand Clinical Trials Registry, ACTRN12618001485224.</div></div><div><h3>Findings</h3><div>Between September 2018 and January 2019, 12 ACCHSs were recruited, comprising a sample of 1655 ACCHS clients aged ≥50 years (mean 60.3 ± 8.2 years), of whom 935 (56.5%) were female. One ACCHS withdrew during the study. After adjustment for time, the intervention did not show evidence of an effect for the first co-primary outcome (detection of CIND/dementia): HR = 1.53 (95% CI 0.64, 3.65). However, the intervention improved the second co-primary outcome (uptake of diagnostic pathway): HR = 2.34 (95% CI 1.05, 5.25). Intention-to-treat analyses yielded similar results.</div></div><div><h3>Interpretation</h3><div>The co-developed best-practice model of care for cognitive impairment and dementia for Aboriginal and Torres Strait Islander people attending primary care improved the diagnostic CIND/dementia management process.</div></div><div><h3>Funding</h3><div><span>National Health and Medical Research Council</span> (Australia) and <span>Dementia Training Australia</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101529"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closing the cancer care gap: cancer disparities among Indigenous peoples globally","authors":"Adrian E. Go ,&nbsp;Ryan C. Guinaran ,&nbsp;Edward Christopher Dee","doi":"10.1016/j.lanwpc.2025.101543","DOIUrl":"10.1016/j.lanwpc.2025.101543","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing patterns of chronic kidney disease care in Australian primary care: a retrospective cohort study of a national general practice dataset","authors":"Hannah Wallace ,&nbsp;James Wick ,&nbsp;Daniel Bekele Ketema ,&nbsp;Luke Buizen ,&nbsp;Mark Woodward ,&nbsp;David Peiris ,&nbsp;Brendon L. Neuen ,&nbsp;Charlotte Robertson ,&nbsp;Craig Nelson ,&nbsp;John Chalmers ,&nbsp;Sunil V. Badve ,&nbsp;Sradha S. Kotwal ,&nbsp;Paul Ronksley ,&nbsp;Martin Gallagher ,&nbsp;Min Jun","doi":"10.1016/j.lanwpc.2025.101541","DOIUrl":"10.1016/j.lanwpc.2025.101541","url":null,"abstract":"<div><h3>Background</h3><div>Chronic kidney disease (CKD) monitoring and cardiovascular risk management are essential in reducing disease progression and cardiovascular events. This study aimed to understand CKD monitoring and management practices in Australian primary care.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, population-based cohort study of adults who attended general practices participating in MedicineInsight between 1 January 2011 and 30 June 2020 and met diagnostic criteria for CKD. Care quality was assessed in the 18-months following identification of CKD. Core monitoring was defined as at least one assessment of all the following measurements: blood pressure, estimated glomerular filtration rate (eGFR), urine albumin creatinine ratio (UACR), lipid profile, and HbA1c in patients with diabetes. Cardiovascular risk management comprised medication prescription (ACEi/ARB and statin), blood pressure target achievement and LDL cholesterol &lt;2 mmol/L. Modified Poisson regression models adjusted for socio-demographic and clinical characteristics were used to identify patient factors associated with completion of monitoring and medication prescription.</div></div><div><h3>Findings</h3><div>CKD was identified in 140,780 patients, of which 34.2% received core monitoring within 18 months of CKD identification. Measurement of the individual components of the core monitoring outcome varied: blood pressure (88.7%), eGFR (86.0%), UACR (41.1%), lipids (70.9%) and HbA1c (85.5%). ACEi/ARB were prescribed in 65.2% of the cohort and 54.4% were prescribed a statin. Blood pressure targets of &lt;140/90 mmHg and &lt;130/80 mmHg were achieved in 57.9% and 29.3% of patients, respectively. LDL target of &lt;2 mmol/L was achieved in 38.8% of patients. Older age, comorbid diabetes and hypertension were associated with a greater likelihood of monitoring and medication prescription.</div></div><div><h3>Interpretation</h3><div>In this large, population-based study, we observed substantial variation in CKD risk monitoring and the management of cardiovascular risk in patients with CKD. We identified several priority areas for CKD management in primary care including need for improvement in albuminuria monitoring.</div></div><div><h3>Funding</h3><div><span>University of New South Wales Scientia Program</span> and <span>Boehringer Ingelheim Eli Lilly Alliance</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101541"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uplifting ethnic minority voices in the Western Pacific region: a priority for regional suicide research","authors":"Luke T. Bayliss ,&nbsp;Ingrid D. Lui ,&nbsp;Lai Fong Chan ,&nbsp;Shu-Sen Chang ,&nbsp;Tae-Yeon Hwang ,&nbsp;Vanda Scott ,&nbsp;Yasuyuki Shimizu ,&nbsp;Paul S.F. Yip","doi":"10.1016/j.lanwpc.2025.101540","DOIUrl":"10.1016/j.lanwpc.2025.101540","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101540"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and inequalities in physical fitness and nutritional status among 0.72 million Chinese adults aged 20–59 years: an analysis of five successive national surveillance surveys, 2000–2020","authors":"Chenyuan Qin ,&nbsp;Chaoqun Fan ,&nbsp;Jingjing Wang ,&nbsp;Qin Li ,&nbsp;Jue Liu ,&nbsp;Haijun Wang ,&nbsp;Qiang Feng","doi":"10.1016/j.lanwpc.2025.101542","DOIUrl":"10.1016/j.lanwpc.2025.101542","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Few comprehensive studies have assessed the long-term trends in physical fitness and nutritional status among Chinese adults, along with the socioeconomic inequalities. This study aimed to bridge this gap by examining the temporal changes and the evolution of socioeconomic disparities in physical fitness and nutritional status among Chinese adults aged 20–59, based on five successive national surveillance surveys.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We integrated data from five consecutive rounds of National Physical Fitness Surveillance (2000, 2005, 2010, 2014, and 2020) among Chinese adults aged 20–59 years. BMI was categorized into underweight (&lt;18.5 kg/m&lt;sup&gt;2&lt;/sup&gt;), overweight (24.0–27.9 kg/m&lt;sup&gt;2&lt;/sup&gt;), and obesity (≥28.0 kg/m&lt;sup&gt;2&lt;/sup&gt;). Central obesity was defined as a waist circumference ≥90 cm for males and ≥85 cm for females. A composite physical fitness indicator (PFI) was calculated by aggregating the Z-scores of all six components. Provinces were ranked by GDP per capita ($) and stratified into three socioeconomic strata from least (T1) to most developed (T3). Generalized additive models (GAMs), adjusted for age and sex, were employed to assess the associations between nutritional status, PFI, and both per capita GDP and urbanization levels.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;A total of 716,790 Chinese adults aged 20–59 were included in the analysis. The PFI score declined from 0.71 in 2000 to −0.84 in 2020, with a particularly sharp annual decline between 2014 and 2020. The underweight prevalence declined from 5.54% in 2000 to 3.51% in 2020, while the prevalence of overweight, obesity, and central obesity increased to 35.84%, 15.05%, and 32.10% in 2020, respectively. After 2005, the urban-rural disparities in physical fitness narrowed, whereas the gap between most and least developed regions widened, with urban and high-SES regions consistently showing better fitness. The prevalence of overweight, obesity, and central obesity in urban and economically developed regions was higher than in less economically developed and rural regions in earlier years, but this pattern reversed over time. The underweight prevalence showed the opposite trend. With increasing GDP per capita, PFI initially rose before declining at higher levels, and it showed a positive correlation with urbanization. Overweight prevalence increased with GDP per capita but slowed at higher levels, while obesity and central obesity exhibited an N-shaped relationship with GDP per capita. Moreover, prevalence of overweight, obesity, and central obesity were positively correlated with urbanization.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;During the first two decades of the 21st century, China experienced rapid economic growth accompanied by declining physical fitness and rising prevalence of overweight, obesity, and central obesity among adults aged 20–59 years. Inequalities in nutritional status between urban and rural areas and ","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101542"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing institutional policies for health professionals’ education reform: a case study of medical education in Viet Nam","authors":"Quang Cuong Le ,&nbsp;My Hanh Bui ,&nbsp;Quynh Long Khuong ,&nbsp;Phuong Anh Le ,&nbsp;Diep Tuan Tran ,&nbsp;Quoc Huy Nguyen Vu ,&nbsp;Nu Viet Vu","doi":"10.1016/j.lanwpc.2025.101551","DOIUrl":"10.1016/j.lanwpc.2025.101551","url":null,"abstract":"<div><div>The Lancet 2010 Commission for Health Professionals' Education highlighted both instructional and institutional reforms to improve health professionals' training. While developed countries often have well-established policies to facilitate educational reform, such policies are limited in many developing countries, including Viet Nam. In this paper, we outline the development and implementation of three key institutional policies to enhance medical education in Viet Nam: (1) Establishing competency standards for the Medical Doctor (MD) program, (2) coordinating clinical training between medical universities and hospitals, and (3) setting up a national licensing examination. These policies were also evaluated against the Lancet Commission's recommendations. Decisive factors for Viet Nam's initial success include the pioneering mindset of its governmental leaders, close collaborations between academic and governmental institutions, and support from international organizations and experts. This paper may serve as a useful reference for low- and middle-income countries seeking to improve medical education and health professionals' training.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101551"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrality or complacency? Rethinking Singapore’s place in a decolonising global health landscape","authors":"Claire Gabrielle Djuhadi ,&nbsp;Kaisin Yee ,&nbsp;Hiang Khoon Tan","doi":"10.1016/j.lanwpc.2025.101549","DOIUrl":"10.1016/j.lanwpc.2025.101549","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101549"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}