Clinical Epidemiology and Global Health最新文献

{"title":"Analysis of birth defects surveillance in Urumqi from 2018 to 2023 and application of three kinds of model in prediction","authors":"Luhan Zhang ,&nbsp;Jinfang He ,&nbsp;Shuyuan Xue ,&nbsp;Rui Shi ,&nbsp;Guifeng Ding","doi":"10.1016/j.cegh.2025.102016","DOIUrl":"10.1016/j.cegh.2025.102016","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the incidence and risk factors of perinatal birth defects in Urumqi (2018–2023), and compare the predictive accuracy of Joinpoint regression, Prophet, Grey Model (GM(1,1)), and a Bayesian-optimized hybrid model.</div></div><div><h3>Methods</h3><div>Data were extracted from the Xinjiang Maternal and Child Health Cloud Platform. After quality control, we constructed the database in Excel, and analyses were performed using JMP 14.0 and R 4.4.1. Using population-based surveillance data from 36 midwifery institutions, we conducted trend analysis (Joinpoint regression) and time-series forecasting (Prophet, GM(1,1), and a Bayesian-weighted hybrid model). Model performance was evaluated by MAE, RMSE, MAPE, and R².</div></div><div><h3>Results</h3><div>The overall incidence of birth defects was 149.47 per 10,000, with a significant upward trend (χ²_trend = 25.268, <em>P</em> &lt; 0.001). Congenital heart disease (53.65 %) was the most prevalent defect. Higher incidence rates were observed in male infants, urban areas, and mothers aged≥35 years. The Grey Model showed the lowest prediction error (MAE = 21.8, MAPE = 15.86 %), while the Combined model achieved the highest R²(0.82) and lowest RMSE (29.34).</div></div><div><h3>Conclusion</h3><div>The rising incidence of perinatal birth defects in Urumqi underscores the need for enhanced monitoring. Our findings advocate a tiered public health surveillance strategy: GM(1,1) for immediate-term (0–12 months), the hybrid model for medium-term (13–24 months), and Prophet for long-term (&gt;25 months) planning, enabling resource prioritization in low-resource settings.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102016"},"PeriodicalIF":2.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A community based cross-sectional study on the magnitude of childhood injuries during the past one year among tribal children aged 1–14 Years in Dharmapuri district, Tamil Nadu","authors":"Alex Joseph ,&nbsp;Roshni Mary Peter ,&nbsp;Dhasarathi Kumar","doi":"10.1016/j.cegh.2024.101910","DOIUrl":"10.1016/j.cegh.2024.101910","url":null,"abstract":"<div><h3>Background</h3><div>Unintentional injuries are a significant public health problem among children, especially in developing nations, which is claiming millions of lives annually. They are of noteworthy concern from the age of one, which contributes both to morbidity and mortality throughout childhood and adolescence. The study aimed to assess the prevalence of childhood injuries in the past year among tribal children aged 1–14 years in Dharmapuri district, Tamil Nadu.</div></div><div><h3>Materials and method</h3><div>A community-based cross-sectional study was conducted among the parents of the selected children in the tribal region of Sitheri, Tamil Nadu. The study was conducted using a piloted, semi-structured questionnaire. Data on unintentional injuries from the past one year was collected.</div></div><div><h3>Results</h3><div>Among the 331 children, 24.2 % (95 % CI: 0.196–0.291) of the children were injured. Among those injured, the majority of them had fall-related injury (16 %), followed by bite/animal-related injury (3.6 %), burn-related injury (2.4 %) and road traffic-related injures (1.5 %). Drowning and other miscellaneous injuries contributed 0.3 % each and there was no case of poisoning reported among the tribal children. Among the injured children, 79.5 % were male, and 20.5 % were female.</div></div><div><h3>Conclusion</h3><div>Falls were the most common injury among children. To reduce the magnitude of unintentional injury among children, actions related to sensitizing the policy measures and providing education and awareness to the community must be implemented to provide a better and safer environment for the children.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 101910"},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of indoor air pollution and birth weight in rural area: A longitudinal study","authors":"Devi Prasanthi Kandula ,&nbsp;Sulakshana S. Baliga","doi":"10.1016/j.cegh.2025.101981","DOIUrl":"10.1016/j.cegh.2025.101981","url":null,"abstract":"<div><h3>Background</h3><div>Exposure to Indoor air pollution (IAP) during pregnancy can cause numerous health conditions in both the mother and new-born. Use of biomass as cooking fuel is a major factor that could lead to IAP, and low birth weight (LBW) is one of the many adverse birth outcomes. This research study measured concentrations of PM_2.5, a hazardous pollutant to determine IAP and its association with LBW.</div></div><div><h3>Objective</h3><div>To determine the association of indoor air pollution and birthweight among pregnant women in a rural area.</div></div><div><h3>Methods and materials</h3><div>Socio-demographic, household and cooking characteristics of the participants were collected using pretested questionnaire. ANOVA, <em>t</em>-test and Multiple regression analysis done. PM_2.5 concentrations for IAP were measured using an Air Quality monitor.</div></div><div><h3>Results</h3><div>The incidence of LBW in pregnant women exposed to IAP was 24.6 %. There was association of LBW among pregnant women with, history of past adverse birth outcomes [AOR: 1.9176, 95 % CI (1.0147, 4.2349)], dampness in household [AOR: 1.6837, 95 % CI (1.3284, 4.061)] and, household PM_2.5 concentrations exceeding 40 μg/m³ [AOR: 1.0692, 95 % CI: (1.0234, 1.1192)]. Every increase in 10 μg/m³ PM_2.5 concentration showed the odds of increase in low birth weight by a factor of 1.0635.</div></div><div><h3>Conclusion</h3><div>The present study concluded that birth weight in new born was affected by maternal exposure to factors causing indoor air pollution.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 101981"},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient satisfaction and perception with tele-emergency services in King Abdulaziz Medical City in Riyadh, Saudi Arabia","authors":"Manar Alomar ,&nbsp;Sara Alrowaydan ,&nbsp;Dana AlDughiman ,&nbsp;Luluh Alali ,&nbsp;Seetah Alsalman ,&nbsp;Majid Alsalamah","doi":"10.1016/j.cegh.2025.102006","DOIUrl":"10.1016/j.cegh.2025.102006","url":null,"abstract":"<div><h3>Background</h3><div>Telemedicine is an increasingly used solution for improving healthcare access, especially in emergencies. In Saudi Arabia, the National Health Information Center (NHIC) has established a telehealth network to connect healthcare facilities, focusing on underserved rural areas. This study aims to investigate patient satisfaction with tele-emergency services at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia.</div></div><div><h3>Methods</h3><div>A cross-sectional study design was conducted at (KAMC) in Riyadh, Saudi Arabia. A convenience sample of 383 patients who used the tele-emergency services between October 2023 and December 2023 were surveyed. The survey used a validated questionnaire to assess demographics and satisfaction with various aspects of the consultation, such as registration, audio quality, communication, and overall patient experience.</div></div><div><h3>Results</h3><div>The study observed high satisfaction and favorable attitude rates among the 383 participants. Time-saving and convenience were noted as advantages. However, underutilization of the video feature and concerns about communication limitations were identified as drawbacks. A statistically significant difference in mean attitude scores was observed, with healthcare professionals displaying lower attitude scores than non-healthcare professionals. Gender, age, and education level did not significantly influence satisfaction or attitudes.</div></div><div><h3>Conclusion</h3><div>Tele-emergency services at KAMC are generally well-received by patients. Telemedicine has the potential to enhance access to care and patient convenience. Implementing and evaluating tele-emergency services across various tertiary healthcare centers nationwide would provide a broader understanding of patient satisfaction with these services in Saudi Arabia. This would also allow for feedback from diverse populations, leading to more generalizable findings.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102006"},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross sectional study regarding the self medication practices and its associated factors among residents of Bhubaneswar city, Odisha","authors":"Amrita Burma ,&nbsp;Om Prakash Panigrahi ,&nbsp;Anshuman Panigrahi ,&nbsp;Deepak Kumar ,&nbsp;Anand Patankar","doi":"10.1016/j.cegh.2025.102013","DOIUrl":"10.1016/j.cegh.2025.102013","url":null,"abstract":"<div><h3>Introduction</h3><div>Self-medication, though often perceived as a convenient and cost-effective solution for minor ailments, poses significant public health risks. It can lead to inappropriate drug use, delayed medical consultation, antimicrobial resistance, and adverse drug reactions. This issue is particularly concerning in developing countries like India. The practice is influenced by various socioeconomic and cultural factors. Therefore, this study aimed to assess the prevalence and associated factors of self-medication among residents of Bhubaneswar city, Odisha.</div></div><div><h3>Materials and methods</h3><div>A cross-sectional study was conducted among 393 participants residing in Bhubaneswar City, Orissa. The association between self-medication and various influencing factors was analyzed using the Chi-square test and multiple logistic regression analysis.</div></div><div><h3>Results</h3><div>Among the participants, 79.90 % (n = 314) reported practicing self-medication. Younger individuals (p value = 0.007) and those from the upper and middle socioeconomic strata (p value = 0.01) were significantly associated in self-medication practices. Multiple logistic regression analysis identified key factors positively related to self-medication: access to health insurance benefits (adjusted OR = 5.88), participants’ perceived knowledge about self-medication (adjusted OR = 5.69), and the presence of self-medication practices among family members (adjusted OR = 2.13).</div></div><div><h3>Conclusion</h3><div>The prevalence of self-medication was high in Bhubaneswar, particularly among younger individuals and those with higher socioeconomic status. It is influenced by various factors like individuals' perception about self medications, their perceptions of pharmacists' expertise, and the presence of health insurance. It highlights the need for targeted awareness campaigns to educate the public on the risks of self-medication and promote responsible health-seeking behaviors.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102013"},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of peppermint aroma on physiological parameters of mechanically ventilated patients: Randomized placebo controlled trial","authors":"Azza Abd Elrazek Baraka","doi":"10.1016/j.cegh.2025.102009","DOIUrl":"10.1016/j.cegh.2025.102009","url":null,"abstract":"<div><h3>Background</h3><div>Mechanical ventilation increases the stress, anxiety and, the physiological parameters of critically ill patients. Peppermint inhalation reduces the stress and improves physiological parameters in many studies, but none of these studies used peppermint inhalation for mechanically ventilated patients.</div></div><div><h3>Objectives</h3><div>To assess the effect of peppermint aroma on physiological parameters of mechanically ventilated patients.</div></div><div><h3>Method</h3><div>Randomized placebo controlled trial was utilized. This study was conducted at six intensive care units. Conscious patients on mechanical ventilation via endotracheal tube were randomly assigned to two groups. The intervention group received a peppermint inhalation, and the placebo group received water inhalation. Patients in both groups were assessed for their smell ability by the Sniffin Sticks-test before starting the interventions. CONSORT checklist was used to report the study. A total of 52 patients in the intervention group and 54 patients in the placebo group completed the study.</div></div><div><h3>Results</h3><div>The pain score was significantly decreased in the intervention group after starting the intervention in comparison to the placebo group. There was a strong positive correlation between Sniffin Sticks-test score and the decrease in pain score after inhalation of peppermint. Inhalation of mechanically ventilated patients to peppermint decreases pain score.</div></div><div><h3>Conclusion</h3><div>Inhalation of peppermint by mechanically ventilated patients decreases pain scores. The effectiveness of peppermint inhalation is correlated to the smell ability of the patients. So, nurses can use peppermint inhalation to decrease pain in mechanically ventilated patients with Sniffin Sticks test score of 17 or more.</div></div><div><h3>Trial registration</h3><div>The identification number of the registered trial in the Clinical Trials Online Registry is NCT05541809.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102009"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric properties of the Bangla version of the Vaccination Fear Scale (VFS-6): A dual approach of classical and modern test theory","authors":"Md Hasanuzzaman ,&nbsp;Md Shajadul Islam ,&nbsp;Md Hafizur Rahman ,&nbsp;Fardana Binte Zaman ,&nbsp;Abdullah Al-Adib ,&nbsp;Sayoda Sadia Rahman Sara ,&nbsp;Tahmid Ahmad ,&nbsp;Md Marufur Rahman Seyam ,&nbsp;Md Shafiqul Islam Khan ,&nbsp;Md Bony Amin","doi":"10.1016/j.cegh.2025.102015","DOIUrl":"10.1016/j.cegh.2025.102015","url":null,"abstract":"<div><h3>Background</h3><div>Bangladesh has consistently prioritized vaccination to address health issues. While high hesitation continues to be a significant barrier to vaccination success, vaccination fear is a distinct psychological construct that might affect the decision to vaccinate. Despite this, no valid and reliable tool exists to assess vaccination fear in the Bangladesh population.</div></div><div><h3>Aim</h3><div>We aim to validate culturally and adapt the Vaccination Fear Scale (VFS-6) in Bangladesh.</div></div><div><h3>Method</h3><div>We conducted a cross-sectional study among 1098 participants using a non-random convenient sampling method. A total of 1089 were included in the study (mean age = 34.28 years, SD = 12.78), with the majority being female (55,5 %). Descriptive statistics were carried out to get an overall idea of the dataset, and inferential analysis including exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Rasch statistics, were employed to validate the VFS-6 Bangla version.</div></div><div><h3>Result</h3><div>The internal consistency of the overall VFS-6 scale was 0.818.I In CFA substantial loadings were observed, ranging from 0.713 to 0.935. The significant correlation between the somatic and cognitive factors of VFS-6 was 0.48, and the correlation with DASS-21 was weak but significant (<strong><em>r</em></strong> = 0.29). CFA indicated a good model fit. Rasch analysis demonstrated good item and person separation reliability (0.82 and 0.80, respectively), with a substantial relationship between scores, ability, and probability.</div></div><div><h3>Conclusion</h3><div>The Bangla version of the VFS-6 has proven to be a reliable and valid measure to assess vaccination fear.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102015"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of appetitive traits among Iraqi population","authors":"Zainab M. Al-Shammaa ,&nbsp;Mohammed I. Aladul ,&nbsp;Narmin S. Essa","doi":"10.1016/j.cegh.2025.102014","DOIUrl":"10.1016/j.cegh.2025.102014","url":null,"abstract":"<div><h3>Background</h3><div>Appetitive traits (ATs) are the possession of an overweight-promoting group of stable tendencies towards food including responsiveness to food stimuli, hunger, and satiety responsiveness which are associated with overeating and weight gain.</div></div><div><h3>Objectives</h3><div>To assess ATs profile of a sample of the Iraqi population.</div></div><div><h3>Methods</h3><div>A cross-sectional study used a self-administered, web-survey of the Adult Eating Behavior Questionnaire between the 1st and the March 30, 2023.</div></div><div><h3>Results</h3><div>1112 subjects participated in this study. Among the measured ATs, the highest median score was for enjoyment of food (22, interquartile range [IQR]: 5), while the lowest was for food fussiness (11, IQR: 4) and slow eating (11, IQR: 6). Two distinct clusters were identified: the food gourmets cluster, which tended to have higher mean scores in food approach traits, and the fuzzy eaters cluster, which had higher mean scores in food avoidance traits. Statistically significant differences in demographic characteristics were found between the two clusters, with the food gourmets cluster tending to have a higher body mass index (BMI), being younger in age, and consuming more frequent meals per day.</div></div><div><h3>Conclusions</h3><div>This study found two clusters with different ATs in a sample of Iraqi population: fuzzy eaters cluster and food gourmets cluster. Strong associations between the identified clusters and demographic variables (age, BMI, gender, and meals per day) were found.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102014"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life after stroke from Survivors perspective: A descriptive cross-sectional study","authors":"Isha Manjalamkunnel Aboobacker ,&nbsp;Namitha Subrahmanyam ,&nbsp;Kalesh M. Karun ,&nbsp;Leena Kunnath Chacko","doi":"10.1016/j.cegh.2025.102001","DOIUrl":"10.1016/j.cegh.2025.102001","url":null,"abstract":"<div><h3>Introduction</h3><div>Stroke contributes to the global disability and greatly affects the physical, cognitive and emotional wellbeing of an individual. Understanding the factors that influence recovery is crucial for developing interventions that promote independence and autonomy among stroke survivors. The present study examines the relationship between self-efficacy, functional ability, quality of life and perceived dependence on caregiver among stroke survivors.</div></div><div><h3>Materials and methods</h3><div>A Quantitative approach with descriptive-cross sectional design was adopted in the study. By using convenient sampling technique, a total of 148 stroke survivors within the age group of 35–65 years were recruited from the neuro inpatient department of a selected tertiary care hospital of Ernakulam district, Kerala. The tools used to collect the data were, The socio demographic proforma, Clinical proforma, The Stroke Self-Efficacy Questionnaire, The Barthel Index, The Stroke Specific Quality of Life Scale, and Likert scale on Perceived dependence on caregiver. Spearman's correlation and Mann-Whitney/Kruskal-Wallis test or ANOVA (p &lt; 0.05) was used for data analysis.</div></div><div><h3>Results</h3><div>The study revealed low median scores for self-efficacy 2(0,6), functional ability 35(20,40), Quality of life 58(49,67) and perceived dependence 56(55,58) among stroke survivors. Quality of life was significantly related to self-efficacy (r_s = 0.526, p &lt; 0.001) and functional ability (r_s = 0.523, p &lt; 0.001) whereas a negative correlation was observed with perceived caregiver dependence (r_s = -0.249, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Quality of life of stroke survivors was significantly related with Self-efficacy, Functional ability and Perceived dependence on caregiver. Health care professionals can improve stroke outcomes by optimizing the care requisites and by initiating Nurse-Led Rehabilitation empowerment programs.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102001"},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valuing community health workers (CHWs): Opportunity costs and out-of-pocket spending among CHWs in the Indonesian stunting prevention program","authors":"Adriana Viola Miranda ,&nbsp;Ryan Rachmad Nugraha ,&nbsp;Trio Sirmareza ,&nbsp;Maritta Rastuti ,&nbsp;Rizky Deco Praha ,&nbsp;Rindang Asmara ,&nbsp;Zack Petersen","doi":"10.1016/j.cegh.2025.101982","DOIUrl":"10.1016/j.cegh.2025.101982","url":null,"abstract":"<div><h3>Introduction</h3><div>In the Indonesian stunting prevention program, the often non-salaried community health workers (CHWs) are responsible for monthly monitoring, counseling, and home visits. Understanding the importance of their roles from an economic perspective may inform a more sustainable and improved program delivery.</div></div><div><h3>Aim</h3><div>To estimate the opportunity costs and out-of-pocket spending incurred by the CHWs in the Indonesian stunting prevention program.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted in two rural villages in Lombok, Indonesia. We interviewed 130 CHWs with a pre-validated, structured questionnaire. Opportunity costs were assessed using two valuation models: calculating their working time valuation based on regional minimum wage and the CHWs’ self-reported earnings outside of their community health work.</div></div><div><h3>Results</h3><div>We found that 52·31 % of the CHWs were not satisfied with the current incentivization scheme. Opportunity cost calculation shows that these CHWs were underpaid: reported monthly workload is valued at USD 46·54 according to the valuation model based on regional minimum wage and USD 13·81 based on CHWs self-reported income. Furthermore, out-of-pocket spending reached almost one-third of the received incentives (median USD 2.90 (IQR 0·87–4·95)).</div></div><div><h3>Conclusion</h3><div>Appropriately incentivizing CHWs working on stunting prevention programs in Indonesia is one of the main priorities to ensure better program delivery.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 101982"},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}