Journal of Global Health最新文献

{"title":"Addressing non-communicable diseases and injuries through an equity lens: insights from the Cameroon non-communicable disease and injury (NCDI) Poverty Commission.","authors":"Yauba Saidu, Michael Budzi, Hassan Ben Bachire, Diaby Ousmane, Farida Haoua, Mapa Clarisse, Vaissaba Emmanuel, Marie Solange Ndom, Clarence Mbanga, Ismaila Karimu, Mbiydzenyuy Ferdinant Sonyuy, Emmanuel Mensah, Gene Bukhman, Neil Gupta, Basile Njei, Yazan A Al Ajlouni, Olufunke Fasawe, Suzanne Sap, Eugene Sobngwi, Paul Ndom, Samuel Kingue","doi":"10.7189/jogh.16.04266","DOIUrl":"10.7189/jogh.16.04266","url":null,"abstract":"<p><strong>Background: </strong>Non-communicable diseases and injuries (NCDIs) constitute a leading cause of premature mortality globally, disproportionately affecting low- and middle-income countries (LMICs). To curb the rising burden of NCDIs in Cameroon, the Ministry of Public Health established the National NCDI Poverty Commission to assess the burden of NCDIs, evaluate investments and expenditures related to NCDI services, and generate evidence to guide national policy formulation and resource prioritisation.</p><p><strong>Methods: </strong>We synthesised data from the Global Burden of Disease (GBD) 2019 database and conducted a comprehensive literature review of peer-reviewed and grey literature (2005-2022) to characterise the burden and risk factors of NCDIs in Cameroon. Investments and expenditures related to NCDIs were extracted from the World Health Organization Global Health Expenditure Database and national planning documents. A two-phase priority-setting process was applied to rank NCDI conditions and identify cost-effective, context-appropriate interventions through quantitative scoring and expert consensus.</p><p><strong>Results: </strong>NCDIs accounted for 43% of all deaths in 2019, with nearly 29% occurring among individuals aged <40 years. Disability-adjusted life years (DALYs) from NCDIs have risen steadily since 1990, with almost two-thirds (61%) attributable to conditions beyond the 'big four' disease categories of diabetes, neoplasms, chronic respiratory diseases, and cardiovascular diseases. Over half (51%) of NCDI-related DALYs in Cameroon were not attributable to quantified behavioural or metabolic risk factors in the GBD framework. Despite this high burden, only 6% of disease prevention funding was directed to NCDIs between 2016 and 2020. The Commission identified 49 priority NCDI conditions and 123 interventions for phased implementation across community, primary, and hospital platforms.</p><p><strong>Conclusions: </strong>NCDIs are a major public health burden in Cameroon, heavily impacting the 'economically productive' age group. Rebalancing financing and integrating a prioritised package of NCDI services into Universal Health Coverage (UHC) would be essential to reduce premature mortality and financial hardship.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04266"},"PeriodicalIF":5.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138836","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 long-term depressive burden with incident cardiometabolic multimorbidity: a prospective study in middle-aged and older adults across three continents.","authors":"Menghan Yao, Ziliang Zhang, Jiali Zhang, Meihao Wu, Dongyao Zhao, Fuyuan Wang, Yongxin Han, Yudong Miao, Guoguo Jin, Tao Li, Hao Li, Zhiping Guo","doi":"10.7189/jogh.16.04306","DOIUrl":"https://doi.org/10.7189/jogh.16.04306","url":null,"abstract":"<p><strong>Background: </strong>Cardiometabolic multimorbidity (CMM) is a growing concern as global population ages. Although baseline depression is a recognised risk factor for chronic diseases, the dynamic and cumulative effect of depression on CMM remains unclear. We aimed to evaluate the longitudinal association between long-term depressive burden and the risk of incident CMM.</p><p><strong>Methods: </strong>This study included 51,416 participants from three large prospective cohorts conducted in China, the USA, and Europe. Incident CMM was defined as co-occurrence of two or more of heart disease, stroke, and diabetes. Long-term depressive burden was assessed by changes in depression and cumulative depressive scores during baseline and first follow-up assessments. Cox proportional hazards model, adjusted for sociodemographic, health status, and lifestyle behaviour factors, was performed to assess incident CMM associated with long-term depressive burden. Subgroup analyses by age and sex were further conducted to evaluate potential effect modification.</p><p><strong>Results: </strong>During the follow-up period, a total of 2,689 incident CMM cases were documented: 238 in China (average follow-up = 7.61 ± 2.18 years), 829 in the USA (6.81 ± 1.89 years), and 1,622 in Europe (6.00 ± 2.20 years). Depression progression was associated with elevated risks of incident CMM in China (hazard ratio (HR) = 1.474; 95% confidence interval (CI) = 1.002-2.168), the USA (HR = 1.325; 95% CI = 1.006-1.744), and Europe (HR = 1.456; 95% CI = 1.258-1.686). Conversely, depression remission correlated with a reduced risk in China (HR = 0.558; 95% CI = 0.357-0.874) and Europe (HR = 0.764; 95% CI = 0.633-0.923). The CMM risk increased with each SD increase in cumulative depressive scores. Sex was found to modify these associations in the USA and Europe, with a more pronounced impact in females.</p><p><strong>Conclusions: </strong>Severe long-term depressive burden is associated with a higher risk of incident CMM, whereas remission from depression correlates with a relatively lower risk. These findings suggest that tracking the longitudinal dynamics of depression may serve as a valuable indicator for identifying individuals at an elevated risk of incident CMM.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04306"},"PeriodicalIF":5.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117037","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":"Postnatal interventions to support newborn survival: updates for the Lives Saved Tool.","authors":"Tyler Vaivada, Yvonne Tam, Georgia Dominguez, Li Jiang, Rachel Lee Him, Oviya Muralidharan, Davneet Sihota, Leila Harrison, Robert E Black, Zulfiqar A Bhutta","doi":"10.7189/jogh.16.04272","DOIUrl":"https://doi.org/10.7189/jogh.16.04272","url":null,"abstract":"<p><strong>Background: </strong>The period immediately after birth represents a highly vulnerable time for newborns, particularly in contexts without access to high-quality secondary care for small and/or sick newborns. Scaling up existing evidence-based interventions can avert much of the mortality and morbidity that occurs during the neonatal period. We summarise the evidence for interventions delivered postnatally and propose a set of effect estimates for inclusion in the Lives Saved Tool (LiST).</p><p><strong>Methods: </strong>We first conducted a set of systematic reviews and updates on the most recent evidence from randomised controlled trials on the effectiveness of interventions for reducing neonatal mortality and associated risk factors. We then assessed the evidence using standardised set of considerations alongside an iterative consultation process with newborn care experts to determine whether and how new meta-analysed effect estimates could be incorporated into the LiST model, as well as which of these estimates should be updated and which should be retained.</p><p><strong>Results: </strong>We proposed a new set of interventions that involve three packages of newborn care: a basic package (i.e. primary/community, secondary hospital care), a referral care package (i.e. tertiary care), and a package of promising innovative interventions whose evidence base is still developing. We included five new interventions within the updated LiST model's basic and referral packages: nasal continuous positive airway pressure coupled with preterm supportive care, newborn referral and transportation, animal-derived surfactant, prophylactic antifungals, and antibiotic stewardship. Three new interventions were proposed for the innovation package: magnesium sulphate for neuroprotection in asphyxiated newborns, topical emollient therapy, and probiotics/synbiotics for hospitalised preterm newborns.</p><p><strong>Conclusions: </strong>We synthesised the evidence base for the impact of a package of effective postnatal interventions for neonates for an updated LiST model. The new interventions and updated effect estimates can provide more accurate projections of potential impacts on neonatal survival for different intervention coverage scale-up scenarios in low- and middle-income countries.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04272"},"PeriodicalIF":5.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117045","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":"Influence of environmental, economic, dietary, and behavioural factors on high myopia onset in children: a 4-year large-scale cohort study.","authors":"Zixun Wang, Jingtao Yu, Desheng Song, Jinghui Wang, Hua Yan, Bei Du, Ruihua Wei","doi":"10.7189/jogh.16.04298","DOIUrl":"https://doi.org/10.7189/jogh.16.04298","url":null,"abstract":"<p><strong>Background: </strong>High myopia (HM) has become a major global public health concern, leading to irreversible vision loss and a growing socioeconomic burden. Despite rapid urbanisation and education-driven lifestyle changes, few large-scale longitudinal studies have examined how social and environmental factors interact with children's daily behaviours to influence the progression from myopia to HM.</p><p><strong>Methods: </strong>This 4-year population-based cohort study (2021-2024) included 204,238 students (grades 1-9) with baseline myopia from the TCARE programme. Exposures included area-level socioeconomic status (SES), school-based greenness (1 km normalised difference vegetation index (NDVI)), and behavioural factors (daily outdoor activity > two vs.≤2 hours and three dietary patterns: energy-dense, plant-based, and traditional nutrient-rich).</p><p><strong>Results: </strong>Among 204,238 participants (mean age 10.8 ± 4.7 years), 26,879 (13.2%) developed HMs. Children living in low-SES areas had a 54% greater risk than those living in high-SES areas did (hazard ratio (HR) = 1.54; 95% confidence interval (CI) = 1.49-1.59). Protective factors included outdoor activity >2 hours/d (HR = 0.92; 95% CI = 0.90-0.95) and plant-based diets (HR = 0.97; 95% CI = 0.94-1.00). A higher NDVI was associated with a generally lower risk across outdoor activity levels (HR = 0.90 vs. 0.94 in low-NDVI areas, P = 0.01), whereas low SES was associated with a weaker protective association of outdoor activity (HR = 0.96 vs. 0.89 in high-SES areas, P = 0.03). The strongest protective association was observed among children aged 6-12 years (HR = 0.88; 95% CI = 0.82-0.95).</p><p><strong>Conclusions: </strong>High myopia progression among children is driven primarily by socioeconomic inequities, whereas environmental greenness and outdoor behaviour provide measurable protective effects. Integrating SES-targeted resource allocation, urban greening, and early-life behavioural interventions is crucial for mitigating the paediatric HM epidemic.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04298"},"PeriodicalIF":5.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117063","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 of abnormal spirometry and correlates of lung function decline among a population in rural Uganda.","authors":"Marvah Hill Pierre-Louis, Yiqi Qian, Emily N Satinsky, Edwin Nuwagira, Charles Baguma, Patience Ayebare, Patrick Gumisiriza, Megan Lam, Mi-Sun Lee, David C Christiani, Stephen Asiimwe, Bernard Kakuhikire, Alexander C Tsai, Mark J Siedner, Crystal M North","doi":"10.7189/jogh.16.04267","DOIUrl":"https://doi.org/10.7189/jogh.16.04267","url":null,"abstract":"<p><strong>Background: </strong>Chronic lung disease, which is the third leading cause of death globally, places a disproportionate burden of morbidity and mortality on sub-Saharan Africa, where limited infrastructure results in a lack of understanding of how lung function changes over time, whether it varies among susceptible populations, or whether at-risk individuals could be identified before abnormal lung function develops. To address this gap, we aimed to characterise lung function patterns and identify correlates of lung function decline in rural Uganda.</p><p><strong>Methods: </strong>Adults completed health questionnaires and American Thoracic Society/European Respiratory Society-acceptable spirometry up to three times over four years (2015-2019). Our primary outcome was lung function (forced expiratory volume in 1 second (EV₁) and FEV₁/forced vital capacity (FVC)); our secondary outcome was spirometry patterns. We characterised baseline patterns using Global Lung Initiative (GLI)-Global prediction equations and identified correlates of decline using generalised mixed effects linear regression. We then explored effect modification by sex, smoking, and socioeconomic status using interaction terms, with inverse probability of treatment weights balancing baseline characteristics.</p><p><strong>Results: </strong>A total of 902 participants completed 1,471 ATS/ERS-acceptable spirometry tests. Their median age was 35 years, 56% were women, 75% were never-smokers, and 31% experienced chronic respiratory symptoms. Abnormal lung function affected 14% of the cohort, more commonly women and those with respiratory symptoms. FEV₁ declined by 10mL/year (95% CI = -17, -2), and FEV₁/FVC declined by 0.006/year (95% CI = -0.008, -0.005) or 0.53% predicted/year (95% CI = -0.68, -0.37). Among those with normal baseline lung function, FEV₁ and FEV₁/FVC declined more rapidly (FEV₁ -18mL/year; FEV₁/FVC -0.66% predicted). There was no effect modification by sex, smoking, or SES.</p><p><strong>Conclusions: </strong>Lung function decline may be more rapid in this young, mostly non-smoking population. Our findings extend the understanding of non-obstructive lung disease in sub-Saharan Africa and emphasise that risk persists despite normal spirometry. These data can inform regional public health strategies for risk mitigation, early disease detection, and building healthcare infrastructure for the growing population at risk for or living with chronic lung disease.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04267"},"PeriodicalIF":5.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117039","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":"From hope to health: improving sexual and reproductive health knowledge among adolescent orphan girls through the 'HopeBox' intervention in Bangladesh.","authors":"Fariya Rahman, Rokaiya Rokaiya, Samina Naznin, Mohammad Hridoy Patwary, Syed Moshfiqur Rahman, Lubna Hossain, Yeashir Arafath, Zara Munir, Abu Sayeed, Shanjida Momtaz, Saraban Tahura Ether, Abu Bakkar Siddique, Nusaibah Munir, Md Manjur Hossain, Md Shamsul Hoque, Maliha Mohsin, Quamrun Nahar, Shams El Arifeen, Ahmed Ehsanur Rahman, Anisuddin Ahmed","doi":"10.7189/jogh.16.04312","DOIUrl":"https://doi.org/10.7189/jogh.16.04312","url":null,"abstract":"<p><strong>Background: </strong>Orphaned adolescent girls face critical barriers to accessing accurate sexual and reproductive health (SRH) knowledge, which predisposes them to risky sexual behaviours and their consequences. We aimed to evaluate the effectiveness of the 'HopeBox' intervention in improving SRH knowledge among orphaned adolescent girls living in orphanages in Bangladesh.</p><p><strong>Methods: </strong>We adopted a pre- and post-test design to conduct the study from January 2022 to September 2025 among orphaned adolescent girls in three government-run orphanages in Dhaka, Faridpur, and Chuadanga, Bangladesh. We enrolled 173 eligible participants. We performed descriptive analyses to explore the distribution of sociodemographic variables and SRH indicators. We used McNemar's tests to assess significant changes before and after the intervention. Generalised estimating equations with Firth penalisation were used to evaluate intervention effects after adjusting for relevant covariates and addressing data separation issues.</p><p><strong>Results: </strong>All five SRH knowledge indicators improved significantly: menstruation (34.73%), pregnancy avoidance (36.42%), contraceptive methods (37%), correct contraceptive use (32.92%), and sexually transmitted diseases (STDs) prevention (12.71%). After adjusting for covariates, participants in the post-intervention phase had substantially higher odds of demonstrating knowledge across all indicators, including menstruation (adjusted odds ratio (aOR) = 17.77; 95% confidence interval (CI) = 7.75-40.75), pregnancy avoidance (aOR = 21.86; 95% CI = 9.73-49.14), contraceptive methods (aOR = 41.73; 95% CI = 15.74-110.65), correct contraceptive use (aOR = 165.40; 95% CI = 28.42-962.79), and STDs prevention (aOR = 26.28; 95% CI = 5.65-122.23).</p><p><strong>Conclusions: </strong>The 'HopeBox' intervention improved SRH knowledge among orphaned adolescent girls, highlighting the need to scale up 'HopeBox' for orphan and vulnerable adolescents in Bangladesh to ensure equitable, appropriate, and accurate SRH knowledge.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04312"},"PeriodicalIF":5.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117106","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":"Multi-omics Mendelian randomisation reveals distinct molecular drivers of pathological myopia complications vs simple myopia.","authors":"Tong Wang, Aoxiang Wang, Zhongping Chen, Xiaofeng Lin","doi":"10.7189/jogh.16.04259","DOIUrl":"https://doi.org/10.7189/jogh.16.04259","url":null,"abstract":"<p><strong>Background: </strong>Pathological myopia complications are leading causes of irreversible blindness, yet the molecular mechanisms distinguishing them from simple myopia remain poorly understood. We aimed to compare the molecular profiles associated with pathological myopia complications and simple myopia using a multi-omics Mendelian randomisation (MR) framework.</p><p><strong>Methods: </strong>Using circulating protein quantitative trait loci data from the INTERVAL study, plasma metabolite genome-wide association study (GWAS) data from the Nightingale Health - UK Biobank initiative and outcome GWAS data for four complication endpoints and myopia from FinnGen R12, together with self-reported myopia from UK Biobank, we performed a two-sample multi-omics MR study. Molecules were classified as complication-specific, myopia-specific, or shared. We performed sensitivity analyses using MR-Egger, weighted median, Steiger directionality, and reverse MR, and assessed classification robustness through threshold-sensitivity and instrument-stratification analyses.</p><p><strong>Results: </strong>We identified 872 reliable associations (712 protein and 160 metabolite pairs). Complication-specific proteins (n = 387) outnumbered shared ones (n = 55) by seven to one; similarly, 51 metabolites were complication-specific vs. 9 shared. Six lipoprotein lipid ratio-myopia associations survived false discovery rate (FDR) correction (FDR<0.05), all exclusive to simple myopia. Complication-specific proteins were enriched in axon guidance (adjusted P = 2.0 × 10^-6), proteoglycan biosynthesis, and cytokine-cytokine receptor interaction pathways. No robust reverse causation was detected. Top complication-specific targets included endothelin-converting enzyme 1 (odds ratio (OR) = 0.796; P = 4.87 × 10^-5) for retinal detachment with break, vascular endothelial growth factor receptor 2 (OR = 1.441; P = 4.94 × 10^-4) for retinoschisis, and secreted frizzled-related protein 2 (OR = 1.347; P = 1.41 × 10^-4).</p><p><strong>Conclusions: </strong>Our analysis indicates that molecular drivers of pathological myopia complications are largely distinct from those of simple myopia, with complication-specific targets enriched in neuronal guidance, extracellular matrix metabolism, and inflammatory signalling. These findings may inform therapeutic strategies aimed at preventing the sight-threatening consequences of myopia.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04259"},"PeriodicalIF":5.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117026","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":"Antenatal interventions to support newborn survival: updates for the Lives Saved Tool.","authors":"Rahima Yasin, Yvonne Tam, Arjumand Rizvi, Tyler Vaivada, Ayesha Arshad Ali, Robert E Black, Jai K Das, Zulfiqar A Bhutta","doi":"10.7189/jogh.16.04303","DOIUrl":"https://doi.org/10.7189/jogh.16.04303","url":null,"abstract":"<p><strong>Background: </strong>Antenatal care strategies encompass a series of interventions delivered to expectant mothers to optimise both their health outcomes and those of their neonate. We summarise the most recent effect estimates for maternal immunisation, screening and management of infections, pre-existing chronic diseases such as hypertension and diabetes, nutrition, psychosocial interventions for smoking cessation, pre-term pre-labour rupture of membranes, administration of corticosteroids for foetal lung maturation, and induction of post-term labour.</p><p><strong>Methods: </strong>We synthesised effect estimates for antenatal and intrapartum interventions using PubMed and CENTRAL searches (2022-2023) and in consultation with a technical advisory group to determine whether and how new meta-analysed effect estimates could be incorporated into the Lives Saved Tool (LiST) model, as well as which of these estimates should be updated and which should be retained.</p><p><strong>Results: </strong>Tetanus toxoid vaccination during the antenatal period lead to a significant reduction in neonatal mortality. Antibiotics for pre-term pre-labour rupture of membranes and administration of corticosteroids for foetal lung maturation lead to significant reductions in neonatal mortality due to sepsis and prematurity, respectively. Nutritional interventions including balanced protein and energy supplementation and multiple micronutrient supplementation reduced the risks of small-for-gestational-age babies. Insecticide-treated bed-nets for malaria, antibiotic treatment of syphilis, and post-term induction of labour demonstrated significant reductions in the risks of stillbirth. The effect estimates for preterm births contributed to the LiST model for interventions including treatment of asymptomatic bacteriuria, omega-3 fatty acid supplementation, calcium supplementation, and provision of low-dose aspirin for pre-eclampsia, which projected significant reductions in the risks of small-for-gestational-age babies.</p><p><strong>Conclusions: </strong>The evidence described here highlights the potential impact of implementing high-yield healthcare packages in context-specific settings to effectively improve neonatal survival. These estimates can be used as inputs to model the impact of antenatal care interventions using the LiST.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04303"},"PeriodicalIF":5.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117090","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":"Distinguishing task shifting from task sharing through the delegating provider's presence or absence: proposed operational definitions.","authors":"Shukanto Das, Liz Grant","doi":"10.7189/jogh.16.03034","DOIUrl":"https://doi.org/10.7189/jogh.16.03034","url":null,"abstract":"<p><p>Task shifting and task sharing are strategies for redistributing healthcare responsibilities to optimise healthcare services. The World Health Organization (2008) framed 'shifting' as the delegation of tasks from higher- to lower-qualified workers, while subsequent scholarship characterised 'sharing' as collaborative, team-based redistribution. However, the two approaches are often used interchangeably in literature and by practitioners. Drawing on interviews and observations across 16 Indian organisations working in primary healthcare, mental health, and emergency medical services, we identified two types of operational ambiguities: organisations simultaneously employed both strategies for different tasks within the same service and also demonstrated practices that did not match their design intent or initial appearances. Based on these, we reiterate the importance of classifying task redistribution (Shifting OR Sharing) at individual task levels, consistent with the task-specific wording of conventional definitions, and additionally propose a new operational criterion: whether the delegating provider is functionally present or absent during task execution. We suggest revised working definitions incorporating this criterion as a hypothesis for prospective testing, and invite the global health community to validate these for clearer implementation, evaluation, and policy.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"03034"},"PeriodicalIF":5.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117041","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":"Tracking the impact of maternal health service coverage on maternal mortality across 137 low- and middle-income countries in the progress toward Sustainable Development Goals.","authors":"Francis Sarial Ganancial, Vivian Chia-Rong Hsieh","doi":"10.7189/jogh.16.04324","DOIUrl":"https://doi.org/10.7189/jogh.16.04324","url":null,"abstract":"<p><strong>Background: </strong>Achieving Sustainable Development Goal (SDG) 3, particularly targets 3.1 (reducing the global maternal mortality ratio (MMR) to less than 70 per 100,000 live births) and 3.8 (universal health coverage), requires sustained reductions in maternal mortality and equitable access to essential maternal health services (MHS). Despite global progress, large disparities persist. Low- and middle-income countries (LMICs) account for more than 90% of maternal deaths worldwide, largely reflecting gaps in access to essential MHS. However, multi-country evidence examining how improvements in MHS during the SDG period translate to reductions in MMR remains limited. This study assessed disparities in MHS coverage and their associations with MMR across LMICs.</p><p><strong>Methods: </strong>We conducted a longitudinal panel analysis of 137 LMICs, using country-level data from the World Health Organization Global Health Observatory and the World Bank from 2015 to 2023. Indicators included coverage of at least four antenatal care visits (ANC4+), facility-based delivery (FBD), and skilled birth attendance (SBA). We estimated associations between MHS coverage and MMR using generalised linear mixed models with a gamma-log link, with analyses stratified by country income group and maternal education.</p><p><strong>Results: </strong>The median MMR of the 137 LMICs declined from 109.3 to 85.5 deaths per 100,000 live births from 2015 to 2023. Coverage of FBD and SBA increased by 5.6% and 5.0%, respectively. Higher coverage of ANC4+ (β = -0.01, P = 0.02) and FBD (β = -0.01, P = 0.03) was significantly associated with lower MMR. These associations were stronger in lower-middle-income and upper-middle-income countries than in low-income countries. Stratified analyses showed larger reductions in MMR among women with moderate-to-high levels of maternal education.</p><p><strong>Conclusions: </strong>Although maternal mortality decreased during the SDG period, progress remains insufficient and inequitable. Strengthening equitable access to essential MHS is critical to accelerating MMR reductions and supporting progress toward SDG targets in LMICs.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04324"},"PeriodicalIF":5.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117100","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}