Journal of Global Health最新文献

{"title":"The prevalence of long-term neurodevelopmental outcomes in preterm-born children in low- and middle-income countries: a systematic review and meta-analysis of developmental outcomes in 72 974 preterm-born children.","authors":"Saima Sultana, Sayaka Horiuchi, Caroline Se Homer, Abdullah H Baqui, Joshua P Vogel","doi":"10.7189/jogh.15.04106","DOIUrl":"10.7189/jogh.15.04106","url":null,"abstract":"<p><strong>Background: </strong>Preterm birth is associated with an increased risk of adverse neurodevelopmental outcomes. However, prevalence estimates of adverse neurodevelopmental outcomes on preterm born children in low - and middle - income countries (LMICs) remain unclear. In this systematic review and meta-analysis, we aim to estimate the prevalence of adverse neurodevelopmental outcomes in preterm-born children in LMICs.</p><p><strong>Methods: </strong>We comprehensively searched six electronic databases - Medline, Embase, CINAHL, PsycInfo, Scopus, and Web of Science, without language and date restrictions. We included observational studies conducted in LMICs that reported prevalence of any type of neurodevelopmental outcome in children born preterm using a validated method or clinical diagnosis, and outcome measurement was performed in at least 100 eligible children at age ≥12 months. The primary outcomes of interest were a composite of any neurodevelopmental impairment, cerebral palsy, visual impairment/blindness, hearing impairment/deafness, motor impairment, developmental delays, learning difficulties, and adverse behavioural and socio-emotional outcomes. We used the JBI critical appraisal checklist to assess the quality of the included studies, and prevalence estimates were calculated using a random-effects meta-analysis model.</p><p><strong>Results: </strong>A total of 47 data sets from 12 countries involving 72 974 preterm-born children were included. The estimated pooled prevalence of overall neurodevelopmental impairment and cerebral palsy was 16% (95% confidence interval (CI) = 11-21%) and 5% (95% CI = 3-6%), respectively. The pooled prevalence of developmental delays across different domains ranged from 8 to 13%. Lower prevalence was found in hearing impairment/deafness and visual impairment/blindness (1%). Higher prevalences were observed with decreasing gestational age and birth weight.</p><p><strong>Conclusions: </strong>There is a high burden of adverse neurodevelopmental outcomes in preterm born children in LMICs. Such prevalence estimates are essential in informing clinical and public health policy, allocating scarce resources, and directing further research to improved outcomes in these settings.</p><p><strong>Registration: </strong>PROSPERO: CRD42024569564.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04106"},"PeriodicalIF":4.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do gender transformative interventions reduce adolescent pregnancy in low- and middle-income countries: a realist synthesis.","authors":"Shruti Shukla, Aishwarya Kharade, Ines Böhret, Manzura Jumaniyazova, Sarah R Meyer, Ibukun-Oluwa Omolade Abejirinde, Yulia Shenderovich, Janina Steinert","doi":"10.7189/jogh.15.04102","DOIUrl":"10.7189/jogh.15.04102","url":null,"abstract":"<p><strong>Background: </strong>Adolescent pregnancy poses a significant health challenge for girls aged 15-19 in low- and middle-income countries. While gender transformative interventions (GTIs) aim to address this issue, a substantial research gap exists concerning the underlying mechanisms contributing to their success. This study employs a realist synthesis approach to systematically investigate how, why, for whom, and in what contexts GTIs effectively reduce adolescent pregnancy.</p><p><strong>Methods: </strong>A five-step realist review examined literature from four databases and five organisational repositories, including published and grey literature. The review focused on GTIs for adolescents aged 10-19 in low- or middle-income countries. Narrative synthesis and realist analysis were used to develop context-mechanism-outcome configurations.</p><p><strong>Results: </strong>The review analysed 28 documents covering 14 interventions and proposing eight programme theories across three settings. In the school, creating a supportive environment to foster positive social norms and providing a safe space was emphasised. Comprehensive sexual health education to promote critical thinking, knowledge retention, and goal setting was one of the key strategies. Empowering boys to adopt positive gender norms for behaviour change was also identified. In the health facility, providing a safe, supportive, and confidential environment for accessing services, as well as using digital health apps to empower adolescents in sexual reproductive health, were key. In the community, empowering girls through life skills and economic support and involving community members to foster stronger interpersonal bonds and a gender-positive environment were highlighted. These interventions led to increased contraceptive use, delayed marriage, and reduced adolescent pregnancy.</p><p><strong>Conclusion: </strong>This realist synthesis proposes eight nuanced programme theories of successful GTIs, providing essential insights for developing, implementing, and improving future programmes. These findings offer a foundation for effective strategies to mitigate adolescent pregnancy in diverse socio-cultural contexts.</p><p><strong>Registration: </strong>PROSPERO: CRD42023398293.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04102"},"PeriodicalIF":4.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health service readiness and quality for sick child care: an effective coverage analysis in eight low- and middle-income countries.","authors":"Abdoulaye Maïga, Gouda Roland M Mady, Elizabeth A Hazel, Safia S Jiwani, Emily B Wilson, Assanatou Bamogo, Helen W Kiarie, Agbessi Amouzou","doi":"10.7189/jogh.15.04085","DOIUrl":"10.7189/jogh.15.04085","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Most child deaths can be averted through prompt and appropriate treatment of child illnesses such as pneumonia, diarrhoea, and malaria. However, research has suggested that increases in care seeking do not necessarily mean that quality care is being received. We assessed the service readiness and process quality of curative healthcare during childhood and determined whether children are receiving health services with sufficient quality across countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We linked data from household surveys including the standard Demographic and Health Survey and the Multiple Indicator Cluster Survey to data from facility surveys including the Service Provision Assessment and Health Facility Assessment in Bangladesh, the Democratic Republic of Congo, Haiti, Kenya, Malawi, Nepal, Senegal and Tanzania to estimate the effective coverage of child illness treatment. We assessed the gaps in service availability and coverage, lack of service readiness, missed care opportunities, and inadequate service process, where service readiness and process quality were defined according to global standards with country-specific adaptations. We analysed the service readiness, quality of care, and effective coverage by individual illness and combined illnesses accounting for equity dimensions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seven to 42% of children experienced at least one illness. An integrated management of child illnesses (IMCI) service was available in 58-85% of facilities. We found that 55-66% of health facilities in the countries were ready to deliver treatment to sick children. However, the readiness-adjusted contact suggested that child healthcare was mostly sought in facilities with low readiness score, ranging from 15% (Nepal) to 46.0% (Malawi). Health facilities had low diagnostics, supervision, and trained personnel capacity to manage child illnesses. Concerning the quality of care, only 51-60% of the procedures during clinical encounters were in line with standards. Counselling of caretakers had the lowest score, while treatment components had the highest process quality score. Hospitals had higher readiness and process quality scores compared to primary facilities and the private sector. There were, however, large gaps in service readiness and significant inadequate service processes in all countries; 35% (Haiti) to 79% (Bangladesh) of sick children sought care from a health facility, with only 7% (Nepal) to 29% (Malawi) of them actually receiving appropriate treatment. We found large inequalities in care seeking, quality of care, and effective coverage across levels of education and poverty, and places of residence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A large proportion of facilities did not meet the required capacity to provide IMCI services. The provision of health services has major quality gaps, highlighting the need for strengthening health service access, capacity and quality of care to reach unive","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04085"},"PeriodicalIF":4.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The COVID-19 pandemic in children and young people during 2022-24: what new did we learn?","authors":"Igor Rudan, Steven Kerr, Colin R Simpson, Amanj Kurdi, Davies Adeloye, Chris Robertson, Aziz Sheikh","doi":"10.7189/jogh.15.01002","DOIUrl":"10.7189/jogh.15.01002","url":null,"abstract":"<p><p>The research conducted between 2022 and 2024 has advanced our understanding of COVID-19 in children and young people (CYP), particularly with the emergence of the Omicron variant and its subvariants. The findings have reinforced that, while Omicron infections are often milder compared to earlier variants, the overall seroprevalence of SARS-CoV-2 in children has increased, with notable regional and demographic disparities. COVID-19-related hospitalisation rates in children rose during Omicron waves, especially among infants, unvaccinated individuals, and CYP at higher risk, i.e. with comorbidities such as obesity, diabetes, and neurological or cardiac conditions. Despite this, severe disease and mortality in children remained very low. The observed increases in type 1 diabetes incidence and multisystem inflammatory syndrome in children (MIS-C) have also highlighted the broader systemic effects of SARS-CoV-2 in paediatric populations. Evidence has underscored the protective effect of vaccination in preventing severe disease and MIS-C and vaccine safety, emphasising the need for targeted immunisation strategies, particularly among children who may be at higher risk. Studies have also estimated that a significant proportion of children experienced persistent post-COVID-19 infection symptoms such as fatigue, mood disturbances, sleep disorders, and respiratory difficulties, but the reported prevalence varied widely, from as low as 1.6% to as high as 70%, due to differences in study methodologies, case definitions, and populations studied. Standardised definitions and measurement tools, such as those developed through international consensus processes, are required to improve diagnosis, treatment, and research into this persisting condition. Ethnic disparities in vaccine uptake persist, implying that vaccine hesitancy and accessibility, alongside approaches to countering disinformation, are important areas for future research.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"01002"},"PeriodicalIF":4.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing human and animal health data integration and informed actions for pandemic preparedness at the primary healthcare level: a multisectoral conceptual framework.","authors":"Bach Xuan Tran, Ha Ngoc Vu, David B Duong, Laurent Boyer, Tran Hoang Long, Duy Cao Nguyen, Shenglan Tang","doi":"10.7189/jogh.15.03018","DOIUrl":"10.7189/jogh.15.03018","url":null,"abstract":"<p><p>A key priority for strengthening global health capacity for pandemic response is rapid risk assessment for timely, context-specific decision-making. However, integrating human and animal health data for preparedness remains a challenge, especially at the primary healthcare (PHC) level. Here we review Vietnam's pandemic response and propose a conceptual framework for improving data integration across sectors in low- and middle-income countries. Despite the country's progress in health information systems and telehealth, disparities in data use and coordination between human and animal health sectors hindered effective responses. Existing mechanisms between healthcare and veterinary professionals lack integrated data-sharing, delaying risk communication and crisis management, particularly in rural areas with limited IT access and infrastructure. The proposed model includes five components: data interoperability with standardised indicators for real-time synthesis; robust digital health infrastructure and telehealth expansion; capacity building in data management for health and veterinary professionals; epidemic intelligence tools for risk assessment; and evidence-driven decision-making for coordinated epidemic responses. This model offers a pathway to strengthen health systems and improve pandemic preparedness at the PHC level in Vietnam and similar settings.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"03018"},"PeriodicalIF":4.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial correlates of free Mpox vaccination intention among men who have sex with men in China: model construction and validation.","authors":"Yinghuan Zhang, Meihui Zhang, Yuxuan Wang, Chenrui Li, Huifang Xu, Gang Xu, Jiechen Zhang, Ying Wang, Fan Hu, Yong Cai","doi":"10.7189/jogh.15.04070","DOIUrl":"10.7189/jogh.15.04070","url":null,"abstract":"<p><strong>Background: </strong>The outbreak of Mpox in China has rendered the promotion of effective preventive measures among susceptible populations particularly crucial. We aimed to explore the correlates and develop a model for Mpox vaccination intention.</p><p><strong>Methods: </strong>We distributed a questionnaire to a sample of 2403 men who have sex with men to investigate whether they would get a Mpox vaccine. The participants were randomly split into a training set and a testing set in a ratio of 3:1. We screened relevant variables by the least absolute shrinkage and selection operator (LASSO) regression analysis and included them into a Mpox vaccination intention model, which used a multivariate logistic regression analysis and presented the findings as a nomogram. We used the receiver operating characteristic curve, calibration curve, Kolmogorov-Smirnov test, lift test, and population stability index to test the validity and stability of the model.</p><p><strong>Results: </strong>Of the 2403 participants in our sample, 87.1% intended to get an Mpox vaccine. Five of the thirty-one screened variables, i.e. Mpox knowledge, social support, vaccination internal rewards, vaccination external rewards, and vaccination response efficacy, were included in the vaccination intention model. The model demonstrated strong risk differentiation (Kolmogorov-Smirnov value = 0.46), moderate predictive power (training area under the curve = 0.7709), and good calibration fit, indicating robust performance.</p><p><strong>Conclusions: </strong>Our proposed model has a good performance and is highly stable, while our findings suggest that governments should design targeted public health strategies, integrating social engagement and leveraging peer and community education to promote Mpox vaccination.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04070"},"PeriodicalIF":4.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome and management of children with chest indrawing pneumonia at primary health care settings in Pakistan: an observational cohort study.","authors":"Zamir Hussain Suhag, Ashlesha Pal, Muhammad Naeem, Imran Ahmed, Noorulain Altaf Khuwaja, Shayan Khakwani, Ali Mujtaba, Shamim Ahmad Qazi, Yasir Bin Nisar","doi":"10.7189/jogh.15.04096","DOIUrl":"10.7189/jogh.15.04096","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia is a major cause of childhood mortality in Pakistan. In 2019, the Government of Pakistan revised the national Integrated Management of Childhood Illness (IMCI) chart booklet, following the World Health Organization's recommendation for outpatient management with oral antibiotics of children aged 2-59 months with chest indrawing pneumonia. We aimed to assess the outcomes of children aged 2-59 months with chest indrawing pneumonia in programme setting of Pakistan.</p><p><strong>Methods: </strong>This was a prospective observational cohort study in three primary health care facilities in Thatta district, Sindh province. We screened children aged 2-59 months who presented with cough and/or difficult breathing, and recruited those classified with chest indrawing pneumonia according to the IMCI tool. from December 2022 to March 2024. The primary outcome was to assess the case fatality ratio. The secondary outcomes were to calculate the prevalence of antibiotic use, hospital admissions and treatment adherence among these children during the current illness. We followed up on day 15 after enrolment to assess outcomes.</p><p><strong>Results: </strong>456 children with chest indrawing pneumonia met the study's enrolment criteria. Two (0.4%) died. Four (0.9%) were lost to follow-up and excluded from the analysis. According to parental/caregiver reports, among 452 children followed up on day 15, 435 (96.3%) were cured, 12 (2.7%) did not improve and two (0.4%) worsened and were hospitalised. All patients were treated with oral antibiotics. Oral amoxicillin was prescribed and used by 282 (62.4%) and 236 of those (83.7%) adhered to five or more days of oral amoxicillin treatment. Oral cefixime was prescribed and used by 114 children (25.2%).</p><p><strong>Conclusions: </strong>Our findings support using the IMCI protocol for treating chest indrawing pneumonia without danger signs in children aged 2-59 months with oral antibiotics on an outpatient basis. It can potentially reduce childhood pneumonia deaths, increase access to treatment, improve treatment coverage, reduce referrals and reduce costs for the health system and families in resource-limited settings.</p><p><strong>Registration: </strong>ISRCTN: 12687253.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04096"},"PeriodicalIF":4.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a coach-supported mHealth intervention for dementia prevention in China: a qualitative study among Chinese participants and coaches in the PRODEMOS trial.","authors":"Jinxia Zhang, Marieke P Hoevenaar-Blom, Xuening Jian, Haifeng Hou, Siqi Ge, Carol Brayne, Esmé Eggink, Melanie Hafdi, Mingyue He, Guohua Wang, Wenzhi Wang, Wei Zhang, Yueyi Yu, Yixuan Niu, Jihui Lyu, Libin Song, Wei Wang, Youxin Wang, Eric P Moll van Charante, Manshu Song","doi":"10.7189/jogh.15.04036","DOIUrl":"10.7189/jogh.15.04036","url":null,"abstract":"<p><strong>Background: </strong>Modifiable risk factors have been linked to 45% of dementia cases. Mobile health (mHealth) interventions targeting lifestyle-related risk factors with remote coaching have the potential to reach underserved high-risk populations globally. To date, little is known about the implementation of such interventions in China.</p><p><strong>Methods: </strong>Fifty semi-structured interviews were conducted with 14 participants and 11 health coaches involved in the PRODEMOS trial. This trial investigated whether a coach-supported mHealth application intervention can reduce dementia risk in people aged 55-75 years with multiple risk factors. Interviews were conducted three months and 12-18 months into the intervention, focusing on implementation outcomes among Chinese participants using thematic analysis.</p><p><strong>Results: </strong>Participants found the PRODEMOS app easy to use and remote coaching convenient, although coach responses were sometimes perceived as slow due to not logging into the mHealth platform simultaneously, thus delaying text chat communication. The intervention's appropriateness was shaped by its effectiveness in enhancing health awareness and meeting participants' needs. Feasibility depended on integration into daily routines, participant progress, partner support, coach attention, smartphone literacy, and time availability. Challenges for the coaches included remote motivational interviewing and sustained participant-coach engagement, influenced by participant-coach relationships, social environment, and the COVID-19 pandemic. Participants generally adhered to goals, but fidelity varied. Integration into primary care was endorsed.</p><p><strong>Conclusions: </strong>This first qualitative study of the Chinese arm of the PRODEMOS intervention demonstrates that it is an acceptable and implementable approach for promoting lifestyle changes in individuals at increased risk of dementia. While coaching is crucial for sustained engagement, it presents challenges when delivered remotely. Despite significant variability in participants' adherence, positive feedback underscores its potential for integration into primary care and large-scale implementation, provided issues with coaching and engagement are addressed. These findings offer valuable insights for practitioners and policymakers seeking to incorporate mHealth solutions into public health strategies for dementia prevention.</p><p><strong>Registration: </strong>PRODEMOS: ISRCTN15986016.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04036"},"PeriodicalIF":4.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling the determinants of life expectancy during and after the COVID-19 pandemic: a qualitative comparative analysis.","authors":"Xiao Li, Jialing Zhu, Jae Man Park, Jordan Mitchell","doi":"10.7189/jogh.15.04126","DOIUrl":"10.7189/jogh.15.04126","url":null,"abstract":"<p><strong>Background: </strong>Disparities in life expectancy persist across countries, despite overall improvements in recent years. The COVID-19 pandemic further exacerbated these disparities. While substantial research has investigated life expectancy determinants, the factors driving variations across countries remain insufficiently explored.</p><p><strong>Methods: </strong>This study innovatively employed Qualitative Comparative Analysis with data from 2020-2022, integrating multiple global data sources. We examined the complex causal patterns among conditions, including educational attainment, economic prosperity, environmental quality, social stability, urban development, and public health capacity within a case-oriented framework. Variables were calibrated into fuzzy sets to analyse necessary and sufficient conditions, with intermediate results tested across cases per solution, including robustness tests to validate the findings.</p><p><strong>Results: </strong>Environmental quality, represented by access to electricity, consistently emerged as a necessary and sufficient condition across seven key case scenarios for achieving high life expectancy. Each case highlights unique pathways that align with different combinations of socioeconomic and policy conditions, illustrating that diverse approaches can lead to positive outcomes. In addition to environmental quality, factors such as mean years of schooling, gross national income per capita, urban population density, and measles immunisation were found to be influential in various combinations within these cases, underscoring the complexity of life expectancy determinants.</p><p><strong>Conclusions: </strong>Our findings indicate that while core determinants like environmental quality are crucial, countries can enhance life expectancy through unique, context-dependent pathways that integrate environmental, educational, economic, and public health factors. Specifically, countries may focus on different policy areas based on their socio-economic conditions and development priorities to optimise life expectancy outcomes.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04126"},"PeriodicalIF":4.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upgrading delivery rooms in Africa's primary healthcare systems: a combination strategy of the 'staff, stuff, space, and systems' framework and emerging technologies.","authors":"Yuxuan Li, Rudong Zhang, Ruolin Zhang, Nicholas Peoples, Chunshan Zhao, Min Yang, Kun Tang","doi":"10.7189/jogh.15.03006","DOIUrl":"10.7189/jogh.15.03006","url":null,"abstract":"<p><p>Maternal health disparities in sub-Saharan Africa remain critical, with high maternal mortality ratio requiring urgent interventions. In this viewpoint, we propose an integrated strategy combining the 'staff, stuff, space, and systems' (4S) framework with emerging technologies to upgrade delivery rooms in primary health care settings. Infrastructure enhancements, point-of-care innovations like artificial intelligence-driven diagnostics and ultrasound, and workforce training through traditional training-of-trainers approach or emerging simulation-based education aim to improve maternal and neonatal health outcomes. While financial and systemic barriers persist, sustainable funding, community engagement, and policy support are crucial for success. The integrated strategy offers a scalable solution to reduce maternal mortality and advance the maternal and child health targets of the 2030 Sustainable Development Goals.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"03006"},"PeriodicalIF":4.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}