Journal of Global Health最新文献

{"title":"Community-integrated noncommunicable disease service models: lessons from China.","authors":"Hongyi Xu, Min Liu, Yamin Bai, Jing Yang, Yueru Liu, Xinlei Gao, Alarcos Cieza, Jing Wu","doi":"10.7189/jogh.15.04296","DOIUrl":"10.7189/jogh.15.04296","url":null,"abstract":"<p><strong>Background: </strong>Integrated health services are advocated for primary health care to address non-communicable diseases (NCDs), especially in low- and middle-income countries (LMICs). However, evidence of care delivery models and means of scaling up is limited. This study examines community-integrated NCD service models in China, providing evidence on the steps that China took to reorient health services towards primary health care to address the NCD epidemic.</p><p><strong>Methods: </strong>A systematic review identified and included 20 studies (from 3959 records screened from five databases) conducted in various regions of China, published in English or Chinese. The evidence synthesis is narrative and thematic. Themes are built upon from the Chronic Care Model framework and issues identified in the World Health Organization package of essential noncommunicable (PEN) disease interventions. They cover priority diseases, interventions included in packages of care, delivery strategies at the community level, the roles of stakeholders, approaches to overcome health system challenges, outcomes, and gaps.</p><p><strong>Results: </strong>Despite facing common challenges like other LMICs, such as inadequate infrastructure and insufficient human resources, various community-level integrated NCD service models have been trialled and scaled up through health reform and policy implementation. Key interventions include health promotion, screening, tiered diagnosis and treatment, patient education, self-management, and digital health models. Family physicians and nurses are the main providers, supported by local governments and hospitals. The review identified creative service delivery strategies at the community, highlighting changes in patient clinical pathways, improved access to services, and positive clinical outcomes.</p><p><strong>Conclusions: </strong>China's experience with community-integrated NCD service models offers valuable insights for other LMICs. Key elements include prioritising universal health coverage, integrating public health and primary care, and optimising accessibility, efficiency, and patient-centredness. Future research should focus on long-term effects and sustainability, particularly in rural settings.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04296"},"PeriodicalIF":4.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214114","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":"A global health crisis in the making: the US withdrawal from the World Health Organization and its impact on global health equity.","authors":"Esteban Ortiz-Prado, Josh West, Jorge Vasconez-Gonzalez, Juan S Izquierdo-Condoy","doi":"10.7189/jogh.15.03043","DOIUrl":"10.7189/jogh.15.03043","url":null,"abstract":"<p><p>The USA initiated their year-long withdrawal from the World Health Organization (WHO) in January 2025, citing financial and governance concerns. This could have a significant impact on global health, as the country is the WHO's largest financial contributor, providing USD 1.284 billion in 2022-23 and funding crucial initiatives like pandemic preparedness and health equity programmes. Its exit creates uncertainty for the organisation, potentially delaying responses to global health crises and exacerbating inequities, particularly in low- and middle-income countries reliant on US-supported health programmes. Vulnerable populations in Africa, Southeast Asia, and Latin America, for example, face challenges in addressing pandemics and diseases like HIV/AIDS, malaria, and tuberculosis. The USA's move underscores the fragility of global health governance, raising concerns over the WHO's ability to lead on critical issues without its support. To mitigate these effects, the international community must adopt innovative, collaborative funding models to maintain the organisation's mission, emphasising global solidarity and political neutrality to ensure stability, health equity, and robust responses to future health threats.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"03043"},"PeriodicalIF":4.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214082","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 global, regional, and national preventable burden of depression attributable to greenness and inequalities: a scenario-based health impact analysis.","authors":"Jiayu Wu, Wenjie Di, Jidian Ruan, Senhao Li, Jiayao Ying, Jiali Zhou, Igor Rudan, Peige Song","doi":"10.7189/jogh.15.04280","DOIUrl":"10.7189/jogh.15.04280","url":null,"abstract":"<p><strong>Background: </strong>Growing evidence suggests that exposure to greenness may reduce the burden of depression. Here, we quantified the global, regional, and national preventable burden of depression attributable to greenness and examined the associated socioeconomic inequalities.</p><p><strong>Methods: </strong>We conducted a scenario-based health impact assessment using data from the Global Burden of Disease 2021 study to estimate the preventable burden of depression (measured in disability-adjusted life years (DALYs)) under three greenness expansion scenarios. We performed a random-effects meta-analysis to derive a pooled odds ratio (OR) for the association between greenness and depression, adjusting it for city-specific greenness levels to calculate the population attributable fraction for each country. We assessed temporal trends (2001-20), analysed sex differences, and quantified cross-country inequalities using the slope index of inequality and concentration index.</p><p><strong>Results: </strong>Under the best potential scenario, the global age-standardised DALY rate (ASDR) of preventable depression per 100 000 population increased from 93.60 (95% uncertainty interval (UI) = 87.79, 99.42) in 2001 to 117.67 (95% UI = 110.61, 124.72) in 2020, with an average annual percentage change (AAPC) of 1.13% (95% confidence interval (CI) = 0.52, 1.75). Regionally, the African Region exhibited the highest growth (AAPC = 1.78%), while the Americas had the highest preventable burden in 2020 of 287.83 (95% UI = 252.67, 322.99). Moreover, the burden varied across sociodemographic index regions. Females consistently exhibited a higher preventable burden than males, with an absolute sex difference in ASDR of 54.40 (95% CI = 44.67, 64.48) in 2020. Cross-country inequalities narrowed globally, with the concentration index declining from 0.160 (95% CI = 0.088, 0.232) in 2001 to 0.051 (95% CI = -0.021, 0.123) in 2020, though regional disparities persisted.</p><p><strong>Conclusions: </strong>Greenness expansion has the potential to significantly reduce the global depression burden, but inequitable access exacerbates mental health disparities. Targeted urban greening policies are needed to enhance mental well-being and health equity worldwide.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04280"},"PeriodicalIF":4.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214194","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":"Associations between upper limb flexibility and all-cause mortality in the oldest-old.","authors":"Yushan Zhang, Chi Zhang, Jia Hu, Yuting Kang, Jie Zhang, Jianliang Zhao, Hong Shi, Ji Shen","doi":"10.7189/jogh.15.04224","DOIUrl":"10.7189/jogh.15.04224","url":null,"abstract":"<p><strong>Background: </strong>Upper limb flexibility (ULF) is a simple and feasible measure of physical function in long-lived population. This study aimed to explore the association of ULF with all-cause mortality in community-dwelling oldest-old in China.</p><p><strong>Methods: </strong>A total of 21 861 older adults aged ≥80 years were enrolled from five waves of the Chinese Longitudinal Healthy Longevity Survey. The assessment of ULF at baseline involved three objective physical tasks (touching the root of the neck, touching the lower back, and raising arms vertically). All participants were followed up until 2018, during which survival information was collected. Cox proportional hazards regression model was used to analyse the association between ULF and all-cause mortality. Demographic characteristics, health behaviours, and disease history were included as covariates.</p><p><strong>Results: </strong>After 72 586.42 person years of follow-up, 18 570 people died. After adjusting for all confounding factors, both left and right ULF impairments were correlated with an increased risk of all-cause mortality, with adjusted hazard ratio (HR) of 1.06 (95% confidence interval (CI) = 1.01, 1.12) and 1.12 (95% CI = 1.05, 1.20). In the collaborative analyses, individuals exhibiting ULF impairment across both the left and right sides had the highest mortality risk with adjusted HR of 1.29 (95% CI = 1.19, 1.38). We found significant additive interaction between left and right ULF impairment on all-cause mortality (relative excess risk due to interaction = 0.10; 95% CI = 0.02, 0.18). The principal findings maintained stable across sensitivity analyses.</p><p><strong>Conclusion: </strong>Impaired ULF is associated with a higher risk of all-cause mortality among the oldest-old in China, especially when the impairment occurs on the right side. For the oldest-old, ULF may serve as a simple and effective predictor of premature death.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04224"},"PeriodicalIF":4.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214085","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 pathway to child survival in the Birhan Cohort, Ethiopia, 2018-22.","authors":"Negalign Berhanu Bayou, Tsinuel Girma Nigatu, Biruk Hailu Tesfaye, Bezawit Mesfin Hunegnaw, Clara Pons-Duran, Kassahun Alemu, Lisanu Taddesse, Delayehu Bekele, Getachew Tolera, Grace Chan","doi":"10.7189/jogh.15.04270","DOIUrl":"10.7189/jogh.15.04270","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Child mortality remains a concern in Ethiopia despite the significant achievements in the past three decades. Proper implementation of the existing low-cost interventions can prevent two-thirds of the deaths. Understanding illness recognition, care-seeking behaviours, and barriers that caregivers encounter during a child's illness along care pathways is imperative. We aimed to describe illness recognition and reactions of caregivers of children &lt;2 years, and factors associated with severe illness or death related to the care pathways, including the child, caretaker, household, and health system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a prospective cohort study using an open birth cohort of Birhan field site, from December 2018 to November 2022. The analysis included newborns followed up to two years old who had an illness episode and for whom data were available for the mother-child dyad. We extracted and linked data on community follow-up and morbidity visits, clinical signs and symptoms of illness at health facility visits, verbal autopsy of deceased children, and maternal health and healthcare. We used descriptive and logistic regression analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 3969 eligible children enrolled in the Birhan Cohort, 1397 (37.8%) had at least one episode of illness during the first two years of life. Of those, 108 (8%) experienced a severe illness or died, of which the majority (n = 76; 70.4%) were newborns. Most sick children (n/N = 714/1187) did not get treatment from a formal source; 53.1% (n/N = 684/1289) of those with mild or moderate illness and 27.8% (n/N = 30/108) of the severely ill or deceased. The mean delay in care-seeking was 5.9 (standard deviation (SD) = 10.6) days for those with mild or moderate illness, and 1.7 (SD = 0.58) for the severely ill or deceased. Only 4.8% (n/N = 27/559) of children sought care from a health post (HP), and 68.1% (n/N = 94/138) of children were referred for further care. Only 68.4% (n/N = 13/19) of the severely ill or deceased children were referred, of which 3 (4.9%) accepted the referral. Compared to a newborn, being a young infant (adjusted odds ratio (aOR) = 0.05; 95% confidence interval (CI) = 0.008-0.27) and a child (aOR = 0.03; 95% CI = 0.005-0.17) were associated with a reduction in the odds of severe illness or death. Children who sought care from an HP had a higher risk of severe illness or death than those who consulted a government hospital (aOR = 19.6; 95% CI = 2.71-142.40). Belonging to a rich family resulted in a reduction in the odds of the outcome compared to a poor household (aOR = 0.15; 95% CI = 0.02-0.94).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Illness recognition and care-seeking were low in the Birhan field site, and when care was sought, it was delayed. Care was sought from an HP in rare cases. Health workers did not refer about a third of severely ill or deceased children for further care. Being a newborn, consulting a HP rat","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04270"},"PeriodicalIF":4.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214214","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":"Association of loneliness and social isolation with excess risk of cardiovascular events in people with obesity: a prospective cohort study.","authors":"Ying Zhou, Rui Chen, Minzhi Xu, Yanhong Gong, Chengbin Liu, Mengdie Wang, Xiaoxv Yin","doi":"10.7189/jogh.15.04241","DOIUrl":"10.7189/jogh.15.04241","url":null,"abstract":"<p><strong>Background: </strong>Obese individuals face higher degrees of loneliness and social isolation, but evidence on the association between their levels of loneliness and social isolation and the excess risk of cardiovascular disease (CVD) is lacking. Our study aimed to explore the association between the level of loneliness and social isolation and the obesity-related excess risk of CVD events.</p><p><strong>Methods: </strong>We included 432 767 individuals from the UK Biobank at baseline (100 947 with obesity and 331 820 without obesity). The levels of loneliness and social isolation were defined by a two-item scale and a three-item scale at baseline, respectively. We ascertained CVD events, including coronary heart disease, stroke, heart failure, and CVD mortality, through linkage to inpatient records from primary and secondary health care settings and death registries.</p><p><strong>Results: </strong>A total of 29 767 non-obese and 14 312 obese participants developed incident CVD outcomes during a median (interquartile range (IQR)) follow-up of 12.48 (11.61, 13.22) years. The excess risk of CVD events, including CVD subtypes and CVD mortality, in obese people compared to non-obese people progressively decreased with lower baseline levels of loneliness and social isolation. Specifically, the excess risk of all CVD events decreased by 29% (for loneliness) and 15% (for social isolation). The excess risk of CVD mortality decreased by 25% (for loneliness) and 52% (for social isolation), respectively.</p><p><strong>Conclusions: </strong>Lower baseline levels of loneliness and social isolation were associated with lower obesity-related excess risk of CVD events. Our findings call for the integration of community engagement and social support networks into existing intervention programmes to provide more effective cardiovascular care for obese individuals.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04241"},"PeriodicalIF":4.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214092","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":"Global burden, quality of care, and cross-country inequalities in Alzheimer's disease and other dementias from 1990 to 2021.","authors":"Yajie Zhu, Siqing Cheng, Zeyu Luo, Jie Shen, Jin Cao, Lingzi Yao, Jiali Zhou, Shiyi Shan, Peige Song, Changzheng Yuan","doi":"10.7189/jogh.15.04269","DOIUrl":"10.7189/jogh.15.04269","url":null,"abstract":"<p><strong>Background: </strong>As global populations age, the burden of dementia increases, raising challenges for healthcare systems. Care quality is key to supporting individuals with dementia, but few studies have assessed this at a global level. We aimed to assess the burden and care quality of Alzheimer's disease and related dementias (ADRDs) and cross-country inequalities between 1990 and 2021.</p><p><strong>Methods: </strong>We conducted a secondary analysis of the Global Burden of Diseases Study (GBD) 2021, focussing on disability-adjusted life-years (DALYs) and care quality (measured by a variational autoencoder-based Quality of Care Index (QCI-v), range = 1-100) of ADRDs. We assessed trends using average annual percentage changes (AAPCs) and measured cross-country inequalities using the slope index of inequality and concentration index.</p><p><strong>Results: </strong>The global age-standardised DALY rates of ADRDs per 100 000 population slightly increased from 1331.59 (95% confidence interval (CI) = 881.57, 1781.61) in 1990 to 1347.24 (95% CI = 906.36, 1788.12) in 2021, with an AAPC of 0.04% (95% CI = 0.02, 0.05). The global age-standardised QCI-v of ADRDs increased from 51.56 (95% CI = 45.87, 57.26) to 54.27 (95% CI = 48.68, 59.86), with an AAPC of 0.16% (95% CI = 0.12, 0.21). Regions with a low-middle or low sociodemographic index (SDI), as well as the African Region and the South-East Asia Region, experienced an increasing burden, but a decreasing care quality. In 2021, high-middle SDI regions and the Western Pacific Region had the highest burden, while care quality was notably low in low SDI region. The European Region showed the greatest inequality in terms of burden, while the Eastern Mediterranean showed marked disparities in care quality.</p><p><strong>Conclusions: </strong>The disease burden and care quality of ADRDs both increased from 1990 to 2021, accompanied by significant disparities between countries. Regions with low-middle or low SDI, particularly the African and South-East Asia Regions, faced rising burdens and declining care quality.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04269"},"PeriodicalIF":4.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214173","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 future of Ukrainian healthcare: the digital opportunity.","authors":"Gilbert H Mudge, Andrii Vilenskyi, Udai Kumar, Manish Kohli","doi":"10.7189/jogh.15.03039","DOIUrl":"10.7189/jogh.15.03039","url":null,"abstract":"<p><p>Following the dissolution of the Soviet Union in 1991, Ukraine inherited a decaying healthcare system. Significant reform was under way by 2014, laying the framework for creating a robust digital healthcare system. This viewpoint describes the evolution of this digital system and the constraints imposed by the ongoing war. Ukraine's healthcare system is in a unique position to maximise its expsertise in digital healthcare, as it addresses workforce challenges and reconstructs its facilities.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"03039"},"PeriodicalIF":4.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214226","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":"Association between metabolic syndrome and risk of benign prostatic hyperplasia: a prospective cohort study of 163 975 participants.","authors":"Jiaming He, Xinkai Pan, Dingwen Liu, Jiaren Li, Youyou Li, Yichuan Wang, Jinjing Guo, Qing Zhou, Liang Zhou, Long Wang","doi":"10.7189/jogh.15.04275","DOIUrl":"10.7189/jogh.15.04275","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have identified metabolic syndrome (MetS) as a risk factor for benign prostatic hyperplasia (BPH). However, large-scale evidence remains to be established. This study aims to examine the association between MetS and the risk of incident BPH using large-scale cohort data, as well as the underlying biological mechanisms.</p><p><strong>Methods: </strong>We used prospective cohort data from the UK Biobank, including 163 975 male participants. We applied Cox proportional hazards models to estimate the risk of BPH associated with MetS, adjusting for sociodemographic and lifestyle factors. A mediation analysis was conducted to investigate the potential mediating role of various biomarkers.</p><p><strong>Results: </strong>The median follow-up period was 13.40 years, during which 6614 participants (12.03%) with MetS developed BPH. The presence of MetS was associated with an increased risk of BPH (hazard ratio = 1.07; 95% confidence interval = 1.03-1.10). Further analysis showed that longer follow-up duration, individual MetS components (elevated waist circumference, elevated triglycerides, elevated blood pressure, elevated glycated haemoglobin, and reduced high-density lipoprotein cholesterol), and the cumulative number of components were all significantly associated with an increased risk of BPH. Mediation analysis indicated that inflammation, erythrocyte-related biomarkers, liver function, and renal function partially mediated these associations.</p><p><strong>Conclusions: </strong>MetS is a significant risk factor for the incident BPH. Inflammation, erythrocyte-related biomarkers, liver and renal function partially mediate this relationship. Early detection and intervention in MetS may help reduce the risk of developing BPH.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04275"},"PeriodicalIF":4.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214125","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":"Two decades of the CHNRI method (2006-2025): Tracking its evolution and contribution to the emerging field of ideometrics.","authors":"Igor Rudan","doi":"10.7189/jogh.15.01006","DOIUrl":"10.7189/jogh.15.01006","url":null,"abstract":"&lt;p&gt;&lt;p&gt;This paper tracks the evolution of the Child Health and Nutrition Research Initiative (CHNRI) method for setting health research priorities and situates it within a much broader, emerging field of 'ideometrics' - the quantitative study of how ideas can be generated, evaluated, and prioritised. First presented in 2006, the CHNRI method tackled three key barriers to research priority setting: an infinite number of possible research ideas, uncertainty about future payoffs of investing in research, and the need for a fair, transparent, legitimate, and broadly acceptable consensus. Its proposed solutions were based on the systematic nature of idea generation, explicit context framing, transparent criteria, and expert crowdsourcing, while its scores reflected 'collective optimism' towards many ideas that could be optionally weighted by funders and stakeholders. Early demonstrations of its usefulness were followed by the establishment of a landmark World Health Organization (WHO) programme that set priorities across the leading causes of global child mortality. The resulting publications catalysed adoption of the method by major agencies and many national governments. Within a decade, the CHNRI method became the most widely used approach to health research priority setting. The review of the first 50 exercises revealed its practical advantages: its systematic scope, transparency, inclusiveness, flexibility, simplicity, low cost, and publishable outputs. Its 'natural evolution' within the global health research community led most users to sensibly adapt its standard criteria to their specific contexts. Experiments on quantitative properties of human collective knowledge and opinion demonstrated accuracy within domains of expertise. They also showed that saturation of experts' collective opinion occurs with 45-55 scorers, achieving very stable rankings. Subsequent advances introduced bootstrapped confidence intervals, an information-theory expert agreement metric, and clustering analysis to detect scorer sub-structures, strengthening the method. Consultations with funders clarified 'funding attractiveness' as a complementary criterion, improving the method's policy traction. By the year 2025, the CHNRI method underpinned major exercises led by the leading international organisations in all of the world's regions, and supported research prioritisation in many challenging national and regional settings. A pivotal recent shift is the integration of artificial intelligence (AI)-based large language models: the CHNRI method can now accommodate AI as a partner in all steps of the priority-setting process. Moreover, years of CHNRI practice motivated a broader theoretical move: viewing the brain's 'perception of ideas' as an underappreciated human sense. These advances call for a more quantitative, testable, and replicable future developments in which the CHNRI method will contribute to 'ideometrics' - an emerging scientific field devoted to generating, eva","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"01006"},"PeriodicalIF":4.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201399","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}