Journal of Global Health最新文献

{"title":"Associations of genetic factors with vascular diabetes complications: an umbrella review.","authors":"Xuan Zhou, Nan Yang, Wei Xu, Xue Li, Athina Spiliopoulou, Evropi Theodoratou","doi":"10.7189/jogh.15.04081","DOIUrl":"10.7189/jogh.15.04081","url":null,"abstract":"<p><strong>Background: </strong>To comprehensively assess evidence from published systematic review and meta-analyses (SRMAs) on the genetics of vascular diabetes complications.</p><p><strong>Methods: </strong>A systematic literature search conducted in Medline and Embase identified 63 non-overlapping SRMAs. We re-conducted meta-analyses to compare diabetes with and without complications using multiple genetic models; evaluated associations using Venice criteria and Bayesian false-discovery probability (BFDP); and graded as highly credible, credible, and not credible. We also contrasted highly credible and credible associations to recent genome-wide association studies (GWASs).</p><p><strong>Results: </strong>Highly credible evidence was discovered for single nucleotide polymorphisms (SNPs) rs1024611 at MCP-1 gene and SNP rs3025039 at VEGF gene with diabetic retinopathy (DR) in type 2 diabetes; SNP rs2268388 at ACACB gene, insertion/deletion (Ins/Del) variant at ACE gene, SNP rs1801133 at MTHFR gene, and SNP rs7903146 at TCF7L2 gene with diabetic kidney disease (DKD) in type 2 diabetes; and SNP rs4880 at SOD2 gene with diabetic peripheral neuropathy (DPN) in type 1 diabetes. Combining type 1 and 2 diabetes, highly credible evidence was discovered for insertion/deletion variant at ACE gene, SNP rs759853 at AKR1B1 gene, SNP rs1044498 at ENPP1 gene and DKD, and SNP rs1617640 at EPO gene for the combined endpoint of DR and DKD. None of these associations was directly replicated in the latest GWASs for DR and DKD, however, another SNP, rs55853916 at TCF7L2 gene had been detected as a GWAS hit for DKD.</p><p><strong>Conclusions: </strong>This umbrella review rigorously assessed evidence on the genetics of vascular diabetes complications, complemented findings in recent GWASs and yielded insight into the optimal selection of genetic models for the design of GWASs on vascular diabetes complications. Mechanistic or bioinformatic studies are warranted to further assess the role of these genes in the pathology of vascular diabetes complications and their potential as drug targets.</p><p><strong>Registration: </strong>PROSPERO: CRD42022384423.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04081"},"PeriodicalIF":4.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674772","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 distribution of prognostically significant pulmonary pressure indicative of pulmonary hypertension.","authors":"Geoff A Strange, Bradley A Maron, Katarina Zeder, Yih-Kai Chan, Alexander Chen, David Playford, Marc Humbert, Ana O Mocumbi, Simon Stewart","doi":"10.7189/jogh.15.04098","DOIUrl":"10.7189/jogh.15.04098","url":null,"abstract":"<p><strong>Background: </strong>There remains a paucity of data to describe how many people worldwide are affected by pulmonary hypertension (PH), an insidious condition associated with adverse vascular remodelling, progressive heart failure, and death without proactive diagnosis and management.</p><p><strong>Methods: </strong>We combined data on the population rate of echocardiographic investigations with tricuspid regurgitant velocity (TRV) levels observed within a clinical cohort of >500 000 people, to conservatively estimate the number of adults with mild (TRV 2.5-2.8 m/s), moderate (TRV 2.9-3.4 m/s) and severe (>3.4 m/s) PH in Australia. We then applied the estimated number of PH cases (age- and sex-specific) to World Bank population estimates for 2021.</p><p><strong>Results: </strong>We conservatively estimate that 16.01 (95% confidence interval (CI) = 15.31-16.71) million men and 15.53 (95% CI = 14.79-16.27) million women, representing 0.616% (95% CI = 0.589-0.643%) and 0.589% (95% CI = 0.561-0.617%) of those aged 20-79 years worldwide, are affected by mild to severe forms of PH. The highest to lowest proportion of cases occur in Southern/Western Europe ( ~ 0.84% men and ~ 0.76% women) and sub-Saharan Africa ( ~ 0.40% both sexes), respectively. In absolute terms, the greatest number of PH cases reside in Eastern ( ~ 9.0 million) and Southern ( ~ 6.5 million) Asia. PH associated with left heart disease is predominant globally, with an estimated 8.7 (0.33%) and 7.5 (0.28%) million male and female cases worldwide. However, in sub-Saharan Africa, those aged <45 years and without left heart disease account for 11.7% of all PH cases compared to <4.0% of cases in Europe/North America.</p><p><strong>Conclusions: </strong>For the first-time, we provide conservative estimates of the global pattern of PH (affecting ~ 31.5 million people). These findings provide a rationale for more definitive burden-of-disease studies focusing on likely regional differences in causality and how PH might be successfully prevented/treated.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04098"},"PeriodicalIF":4.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671396","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":"Identifying potential drug targets for sepsis-related adult respiratory distress syndrome through comprehensive genetic analysis and druggability assessment.","authors":"Jinsen Weng, Xiaojing Wang, Jingping Lin, Yong Ye, Junjie Wei, Rongguo Yu, Xiuling Shang","doi":"10.7189/jogh.15.04117","DOIUrl":"10.7189/jogh.15.04117","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-related adult respiratory distress syndrome (ARDS) is a life-threatening condition characterised by a high mortality rate. This underscores the pressing requirement to identify and develop potential therapeutic targets for the severe condition. This study investigated the genetic predisposition to sepsis-related ARDS in this study.</p><p><strong>Methods: </strong>We utilised summary-based Mendelian randomisation (SMR), two-sample MR (TSMR), mediating MR, and multivariate MR (MVMR) analysis to explore the genetic susceptibility of sepsis-related ARDS by integrating over 10 000 cis-expression quantitative trait loci (cis-eQTLs) and over 100 000 participants. Subsequently, we performed drug target analysis to identify potentially druggable cis-eQTL genes.</p><p><strong>Results: </strong>The SMR analysis identified 677 cis-eQTL genes associated with sepsis. Further TSMR validation filtered 72 cis-eQTL genes causally associated with sepsis. Sepsis was causally associated with ARDS (beta = 1.80, standard error (SE) = 0.36, P < 0.001). After conducting the mediating MR and MVMR analysis, 50 cis-eQTL genes were reported to be causally associated with sepsis-related ARDS. Subsequent drug target analysis confirmed the role of four targets (PSMA4, PDK2, RPS18, and NDUFV3) as druggable genes for sepsis-related ARDS.</p><p><strong>Conclusions: </strong>Through an extensive analysis, we identified potential drug targets for sepsis-related ARDS. Additional research is imperative to substantiate our discoveries and to pave the way for the development of novel pharmaceuticals aimed at these specific targets.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04117"},"PeriodicalIF":4.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674160","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 strength and weakness of Mongolian healthcare: from nomadic Gobi to Ulaanbaatar.","authors":"Wei-Ti Chen, Otgonchimeg Mangal, Khulan Munkhbaatar, Enkhtuya Vankhuu, Rachel Ha Arbing, Yae Yoshino","doi":"10.7189/jogh.15.03015","DOIUrl":"10.7189/jogh.15.03015","url":null,"abstract":"<p><p>Mongolia, the world's second-largest landlocked country, has a healthcare system shaped by Soviet and Chinese influences. While its capital, Ulaanbaatar, houses nearly half of the population with well-developed medical facilities, rural and remote areas, including the Gobi region, face significant disparities in healthcare access. Urban migration to Ulaanbaatar is driven by better economic opportunities, healthcare services, and infrastructure. Traditional Mongolian medicine (TMM) remains an integral part of healthcare, particularly in rural areas, where it is often the primary form of treatment. Despite the adoption of universal healthcare coverage, rural healthcare struggles with workforce shortages, outdated infrastructure, and limited resources. Nurses and midwives lack professional autonomy, and preventive care remains underdeveloped. To address these challenges, Mongolia can strengthen global collaborations through its 'third neighbour policy', expanding partnerships with countries like the USA and Japan to improve healthcare education and workforce capacity. Enhancing online training, telemedicine, and disease prevention programmes, particularly in rural areas, would further support healthcare development. Expanding nursing and midwifery roles, integrating health screenings into community events, and leveraging digital health technologies can bridge healthcare gaps. A holistic approach integrating modern and traditional medicine can lead to a more resilient, accessible, and culturally appropriate healthcare system.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"03015"},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626532","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 epidemiology of unintentional falls among older people in the Middle East and North Africa: a systematic review and meta-analysis.","authors":"Karima Chaabna, Anupama Jithesh, Salina Khawaja, Jasmine Aboughanem, Ravinder Mamtani, Sohaila Cheema","doi":"10.7189/jogh.15.04072","DOIUrl":"10.7189/jogh.15.04072","url":null,"abstract":"<p><strong>Background: </strong>Falls epidemiology in the Middle East and North Africa (MENA) remains underexplored despite being a major cause of morbidity and mortality. We synthesised the data on unintentional falls among older adults in MENA countries.</p><p><strong>Methods: </strong>We conducted a systematic review, meta-analysis, and meta-regression, searching MEDLINE/PubMed, Web of Science, and Google Scholar up to 5 May 2024, without language or time restriction. We included records on fall prevalence, frequency, location, self-reported reasons, consequences, and health care utilisation. Two reviewers independently conducted multi-stage screening, data extraction, and quality assessment. We estimated the pooled-average prevalence using random-effect models and calculated MENA population-size weighted-averages.</p><p><strong>Results: </strong>We identified 7392 records, finding 90 eligible studies covering 99 588 older adults from 14 countries. The MENA population-size weighted-average prevalence of older adults with ≥1 fall was 17.6% (95% confidence interval (CI) = 9.8-36.3), with higher prevalence in older age (P = 0.001). Among fallers, 59.0% (95% CI = 40.0-76.0) reported ≥2 falls. The pooled prevalence of fallers was 60.1% (95% CI = 42.2-75.7) among older trauma unit patients, while 49.3% (95% CI = 33.9-64.8) of older outpatients reported falling in the past year. Falls occurred primarily at home (pooled-average proportion of fallers = 66.1%; 95% CI = 46.6-81.3), with fewer at work (10.1%; 95% CI = 1.6-44.2), and in hospitals (6.0%; 95% CI = 2.5-13.8). On average, post-fall, 45.6% (95% CI = 37.8-53.5) sought medical care, 36.8% (95% CI = 21.9-54.8) had fractures, and 17.3% (95% CI = 8.0-33.2) experienced anxiety or depression. The in-hospital death rate following a fall was 7.5% (95% CI = 1.5-29.8). Self-reported reasons for falls included medical conditions, balance problems, and environmental factors. We observed substantial heterogeneity and some publication bias (LFK index = 7.34).</p><p><strong>Conclusions: </strong>The prevalence of older adults in MENA reporting ≥1 fall is lower than global estimates. However, substantial fracture proportions, mental health issues, and in-hospital deaths following a fall underscore the need for region-specific fall prevention strategies.</p><p><strong>Registration: </strong>This review is registered on the Open Science Framework (https://osf.io/3cu4q; https://doi.org/10.17605/OSF.IO/3CU4Q).</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04072"},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626588","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":"Prevalence and socioeconomic factors of diabetes: a population-based cross-sectional analysis from Jordan.","authors":"Ghaith M Al-Taani, Austen El-Osta, Saja A Alnahar","doi":"10.7189/jogh.15.04095","DOIUrl":"10.7189/jogh.15.04095","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) is a significant public health issue in Jordan. While several studies have investigated the biological and behavioural determinants' influence on diabetes mellitus incidence, prevalence and outcomes, few studies investigated socioeconomic factors. Moreover, the available Jordan-based literature lacks an investigation of the influence of socioeconomic factors on diabetes outcomes. This research seeks to evaluate the incidence of DM among the adult population of Jordan and examine the influence of significant socioeconomic variables.</p><p><strong>Methods: </strong>The research team used the 2017-2018 Jordanian Demographic and Health Survey of individuals aged 40 and older. We used self-reported data to assess the prevalence and onset of diabetes. Descriptive and inferential analyses assessed the association between diabetes and the extracted socioeconomic variables.</p><p><strong>Results: </strong>Of the 21 860 extracted records, 3443 (15.8%) were related to diabetic patients. Approximately, 60% of those who were diagnosed with DM were in the 40-59 years age range. Statistically significant associations were found between the prevalence of DM and socioeconomic factors. Older age and low educational attainment were significantly associated with a higher prevalence of DM. The wealth index and residential location were also significantly associated with DM prevalence.</p><p><strong>Conclusion: </strong>The study findings emphasise the need for specifically tailored and delivered public health interventions targeting individuals with challenging socioeconomic factors such as older age and low educational attainment. Healthcare providers and policymakers should focus on delivering and sponsoring educational and awareness programmes to promote self-care and the adoption of health-seeking lifestyle behaviours and practices among unprivileged and at-risk local communities. Healthcare authorities could initiate community-based diabetes screening programmes targeting marginalised and at-risk groups.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04095"},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626575","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":"Poly-crisis and global health: how can we improve human health and equity while protecting the planet? The 30th Canadian Conference on Global Health in 2024.","authors":"Michelle Amri, Margaret J Mutumba-Nakalembe, Johanna C Manga, Colleen M Davison, Fawad Akbari","doi":"10.7189/jogh.15.02001","DOIUrl":"10.7189/jogh.15.02001","url":null,"abstract":"","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"02001"},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626573","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":"Incidence and costs of hospitalisation due to acute respiratory infection in adults aged over 50 years in Jiangsu, China in 2019-23: a real-world medical database analysis of 0.2 million episodes.","authors":"Xiaoyu Xu, Ling Guo, Xiao Li, Xin Wang, You Li","doi":"10.7189/jogh.15.04116","DOIUrl":"10.7189/jogh.15.04116","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory infection (ARI) poses a significant public health challenge worldwide, particularly among older adults. However, the disease and economic burden of ARI among older adults in China remained sparse. We aimed to estimate the incidence rate and medical cost of hospitalisation due to ARI among adults aged ≥50 years in Jiangsu Province, China.</p><p><strong>Methods: </strong>We analysed medical records of hospitalised episodes due to ARI from January 2019 to May 2023 from a regionally representative medical database. We estimated hospitalisation rates and the proportion of severe cases (intensive care unit admission, mechanical ventilation, or death) by sex, age group, and time period. Total direct medical cost and out-of-pocket cost were estimated in CNY. We analysed factors influencing total costs using a multivariate linear regression model. We further compared the proportion of severe cases and medical cost between those with and without selected comorbidities.</p><p><strong>Results: </strong>A total of 209 632 episodes of ARI hospitalisation were included. Over the study period, annualised ARI hospitalisation rate ranged from 1.07 to 1.83 per 1000 person-years, and varied by age, sex and region. Severe cases accounted for 6.5-10.3%. The median total direct medical cost was CNY 9027 (interquartile range (IQR) = 6118-14 886), of which 22% (IQR = 7-41) was out-of-pocket. Rural residents born a substantial out-of-pocket cost, which was even higher than their average monthly disposable income. Patients with certain comorbidities had higher medical costs despite having a similar or even lower proportion of severe cases.</p><p><strong>Conclusions: </strong>By analysing a large regionally representative medical database, we helped address the knowledge gap in the burden and cost of ARI hospitalisation in China. While highlighting the overall substantial disease burden and cost of ARI, we identified important factors such as age, sex, region, and comorbidity that influence the disease burden and cost of ARI.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04116"},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626571","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 impact of physical activity on inhibitory control of adult ADHD: a systematic review and meta-analysis.","authors":"Yi Yang, Chang-Hong Wu, Liang Sun, Ting-Ran Zhang, Jiong Luo","doi":"10.7189/jogh.15.04025","DOIUrl":"10.7189/jogh.15.04025","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to Investigate physical activity's effects on inhibitory control in adult attention deficit hyperactivity disorder (ADHD).The benefits of physical activity on the inhibitory control of adult ADHD were explored in the hope of providing some suggestions for approaches to treating adult ADHD.</p><p><strong>Methods: </strong>We searched the databases PubMed, Web of Science, CNKI and Wanfang for randomised controlled trials (RCTs) of the effect of physical activity on inhibitory control in adults with ADHD, using PRISMA guidelines. We used used the Cochrane Bias Risk Assessment Criteria to assess the methodological quality of the included studies. Finally, we performed a heterogeneity analysis and a potential publication bias analysis using Revman 5.4.</p><p><strong>Results: </strong>A total of eight articles, 14 studies, and 373 experimental subjects were included in the systematic review and meta-analysis. The meta-analysis results showed that both acute exercise (standard mean deviation (SMD) = -0.65, 95% confidence interval (CI) = -1.10,-0.2, P = 0.005) and chronic exercise (SMD = -1.77, 95% CI = -2.84, -0.69, P = 0.0001) have a positive effect on the inhibitory control of adult ADHD. Pilates (SMD = -2.22, 95% CI = -2.97, -1.47, P < 0.0001), Tai Chi (SMD = -2.20, 95% CI = -6.25, -1.8, P = 0.25), cycling (SMD = -0.67, 95% CI = -1.27, -0.08, P = 0.03), vibration training (SMD = -0.67, 95% CI = -1.39, -0.05, P = 0.07), yoga (SMD = 0.01, 95% CI = -0.50, -0.48, P = 0.97), and other different exercise styles have significant differences in their effects on adult ADHD inhibitory control.</p><p><strong>Conclusions: </strong>Physical activity has a beneficial effect on inhibitory control in adults with ADHD. However, more research is needed to examine the beneficial effects of different types of physical activity, intervention modalities, and dose-response effects of intensity.</p><p><strong>Registration: </strong>This review was registered with INPLASY (registration number: 202490109).</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04025"},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626599","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":"Enhanced quality of nutrition services during antenatal care through interventions to improve maternal nutrition in Bangladesh, Burkina Faso, Ethiopia, and India.","authors":"Phuong H Nguyen, Lan M Tran, Shivani Kachwaha, Tina Sanghvi, Zeba Mahmud, Maurice G Zafimanjaka, Tamirat Walissa, Sebanti Ghosh, Sunny S Kim","doi":"10.7189/jogh.15.04054","DOIUrl":"10.7189/jogh.15.04054","url":null,"abstract":"<p><strong>Background: </strong>Quality antenatal care (ANC) services are critical for maternal health and nutrition. Information on the quality of nutrition interventions during ANC is scarce in low- and middle-income countries. We examined the effects of intensified maternal nutrition interventions during ANC on service readiness, provision of care, and experience of care and assessed the inter-relationships between the dimensions of quality.</p><p><strong>Methods: </strong>We used data from impact evaluations of maternal nutrition interventions in Bangladesh, Burkina Faso, Ethiopia, and India. We calculated the quality of nutrition services during ANC using information from health facility assessments, health care provider interviews, ANC observations, and client exit interviews. We used structural equation models to examine relationships between the dimensions of quality.</p><p><strong>Results: </strong>Health facilities in all four countries had a high service readiness component in terms of basic amenities, equipment and supplies, medicines and commodities, and guidelines (mean (x̄) = 8-10 in Bangladesh and Burkina Faso, x̄ = 7-9 in Ethiopia, and x̄ = 6-8 in India). Scores for provision of care were low across the countries but higher in intervention compared to control areas in Bangladesh (5.2 vs. 2.9) and Burkina Faso (5.6 vs. 4.8), but not significantly different in Ethiopia (range = 4.7-5.0) and India (range = 2.6-3.5). For experience of care, client satisfaction scores were high and similar between intervention and control areas in all countries (range = 8.3-9.7), but client experience scores were lower with statistically significant differences observed only in Bangladesh (x̄ = 8.2 in intervention vs. x̄ = 7.1 in control areas). The interventions had significant direct effects on service readiness in Bangladesh (β = 0.07), Burkina Faso (β = 1.20), and Ethiopia (β = 1.0), on the provision of care in Bangladesh (β = 2.27), Burkina Faso (β = 1.27), and India (β = 0.96), and experience of care in Bangladesh (β = 0.21).</p><p><strong>Conclusions: </strong>In this study, we provided evidence on various dimensions of service quality that may be improved by interventions to strengthen nutrition services during ANC in diverse low- and middle-income countries.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04054"},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626566","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}