Journal of Global Health最新文献

{"title":"Estimating the economic burden of respiratory syncytial virus infection among children <2 years old receiving care in Maputo, Mozambique.","authors":"Neele Rave, Tufária Mussá, An Nguyen, Clint Pecenka, Farina L Shaaban, Louis J Bont","doi":"10.7189/jogh.15.04076","DOIUrl":"https://doi.org/10.7189/jogh.15.04076","url":null,"abstract":"<p><strong>Background: </strong>Data on costs of respiratory syncytial virus (RSV) in low- and lower-middle-income countries are urgently needed to inform the introduction of recently developed vaccines. We estimated the costs of lower respiratory tract infections associated with RSV infection in Mozambique.</p><p><strong>Methods: </strong>We conducted a prospective cohort study to assess household and societal costs of RSV infection in children <2 years old who sought care in a referral hospital or a primary health centre in Mozambique during one local RSV season (February to August 2023). We used molecular point-of-care testing to confirm RSV status. We collected direct medical and non-medical costs and indirect cost data from hospital records and patient-level questionnaires at the initial visit and 2-4 weeks post-discharge.</p><p><strong>Results: </strong>We recruited 544 children; 52.6% were girls and the median age was 9.3 months. From the sample, 286 children from the outpatient department, 233 from the paediatric wards, and 25 from the intensive care unit (ICU). RSV was confirmed in 42 (14.7%) outpatients, 111 (47.6%) inpatients, and 6 (24.0%) ICU cases. The mean total costs associated with RSV were USD 43 (95% confidence interval (CI) = 11-76) for outpatients, USD 612 (95% CI = 544-680) for inpatients, and USD 1161 (95% CI = 837-1485) for ICU cases. The government covered 16.9%, 89.9%, and 80.0% of overall societal costs for outpatients, inpatients, and ICU patients, respectively. The average household out-of-pocket costs for life-threatened RSV cases were more than 1.5 times the monthly minimum wage of USD 91, causing a high financial burden on families in Mozambique.</p><p><strong>Conclusions: </strong>RSV infection represents a significant healthcare and economic burden in children <2 years old. Our results provide input for cost-effectiveness analyses and informed decision-making when considering RSV immunisation in Mozambique.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04076"},"PeriodicalIF":4.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993691","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 qualitative study of abortion decision-making trajectories among pregnant women at their first antenatal care visit in Kampala, Uganda.","authors":"Blake Erhardt-Ohren, Alison M El Ayadi, Hadija Nalubwama, Carol S Camlin, Dilys Walker, Josaphat Byamugisha, Alexander C Tsai, Umar Senoga, Paul J Krezanoski, Cynthia C Harper, Alison B Comfort","doi":"10.7189/jogh.15.04125","DOIUrl":"https://doi.org/10.7189/jogh.15.04125","url":null,"abstract":"<p><strong>Background: </strong>In Uganda, only about half of women who want to avoid pregnancy are using modern contraceptives, leading to high numbers of unintended pregnancies and elevated maternal and neonatal morbidity and mortality. In this study, we aimed to learn more about women's abortion decision-making before continuing to carry a pregnancy.</p><p><strong>Methods: </strong>We utilised a qualitative study design and interviewed 31 purposively selected single and partnered pregnant women aged ≥18 years at their first antenatal care visit at Kawempe National Referral Hospital in Kampala, Uganda. We conducted the interviews in Luganda or English, transcribed them, and then translated them into English, as needed, for analysis. We analysed the data using thematic analysis. Deductive codes were based on social networks, social support, and health behaviour theories, and inductive codes were derived from interview transcripts.</p><p><strong>Results: </strong>Almost half of the study participants (n = 13) considered an induced abortion before deciding to continue carrying their pregnancy. The most commonly stated reasons they considered abortion included anticipated interruptions to work and education, exhaustion related to child-rearing, and lack of social support. Other participants (n = 9) reported not considering abortion due to anticipated social support for their pregnancy, concerns about abortion-related morbidity and mortality, late confirmation of pregnancy, and religious beliefs. No participants discussed Uganda's restrictive abortion policies as a reason not to consider abortion.</p><p><strong>Conclusions: </strong>Our results point to opportunities for continued reproductive health education and improved access to reproductive health services to allow pregnant women to meet their reproductive needs, seek out family planning, antenatal care, and safe abortion services when desired, and create support networks for pregnant women.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04125"},"PeriodicalIF":4.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020499","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 nonlinear impact of air pollutants and solar radiation exposure on the risk of hospitalisation for pterygium among adults in Shanghai, China: a time series analysis.","authors":"Hongya Zeng, Yue Tan, Tong Lin, Lan Gong","doi":"10.7189/jogh.15.04110","DOIUrl":"https://doi.org/10.7189/jogh.15.04110","url":null,"abstract":"<p><strong>Background: </strong>In recent years, many studies have focused on the effects of air pollution on ocular surface health. However, there is currently little research on the relationship between pterygium and air pollution. We aimed to investigate the effects of air pollutants and solar radiation on the progression of pterygium in adults through a 5-year time series analysis.</p><p><strong>Methods: </strong>After collecting the meteorological data and clinical visits for pterygium in Shanghai, China from 2017 to 2023, we established a distributed lag nonlinear model (DLNM) for statistical analysis. We also conducted subgroup analysis according to age and sex to investigate the impact of risk factors on different populations.</p><p><strong>Results: </strong>This cohort included a total of 57 211 cases. We found that solar radiation, particulate matter less than 2.5 micrometre (μm) (PM_2.5), ozone (O₃) and nitrogen dioxide (NO₂) all increased the risk of outpatient treatment of pterygium within a certain concentration range. Among them, PM_2.5 and solar radiation have the most significant lag effects. The relative risk (RR) value was highest when the concentration of PM_2.5 reach the peak value at a lag time of 13 days. Subgroup analysis showed that women and people aged 55 to 65 years were more susceptible to extremely high concentrations of PM_2.5.</p><p><strong>Conclusions: </strong>Our results suggested that in addition to solar radiation, which is recognized as a risk factor for pterygium, PM_2.5 exposure also seems to be related with an increase in the risk of pterygium. More targeted prevention and early interventions strategies remain to be studied.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04110"},"PeriodicalIF":4.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042581","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":"Infectious disease forecasting to support public health: use of readily available methods to predict malaria and diarrhoeal diseases in Mozambique.","authors":"Rami Yaari, Marta Galanti, Rodrigo Zepeda-Tello, Sergio Chicumbe, Ilesh Jani, Annette Cassy, Ivalda Macicame, Naisa Manafe, Shannon M Farley, Wafaa M El-Sadr, Jeffrey Shaman","doi":"10.7189/jogh.15.04114","DOIUrl":"https://doi.org/10.7189/jogh.15.04114","url":null,"abstract":"<p><strong>Background: </strong>Mozambique faces a high burden of infectious diseases but currently has limited capacity for forecasting disease incidence. Recent improvements in disease surveillance through the National Monitoring and Evaluation System now provide weekly reports of disease incidence across the country's districts. This study focuses on using these records, specifically for malaria and diarrhoeal diseases, which together account for approximately 40% of deaths among children under five, to develop statistical forecasts and evaluate their accuracy.</p><p><strong>Methods: </strong>We utilised a Python library for time series forecasting called Darts, which includes a variety of statistical forecasting models. Three models were selected for this analysis: Exponential Smoothing (a classical statistical model), Light Gradient Boosting Machine (a machine-learning model), and Neural Hierarchical Interpolation for Time Series (a neural network-based model). Retrospective forecasts were generated and compared across multiple forecast horizons. We evaluated both point and probabilistic forecast accuracy for individual models and two types of model ensembles, comparing the results to forecasts based on historical expectance.</p><p><strong>Results: </strong>All models consistently outperformed forecasts based on historical expectance for both malaria and diarrhoeal disease across forecast horizons of up to eight weeks, with comparable or better performance at 16 weeks. The most accurate forecasts were achieved using a weighted ensemble of the models.</p><p><strong>Conclusions: </strong>This study highlights the potential of using a readily available tool for generating accurate disease forecasts. It represents a step toward scalable and accessible forecasting solutions that can enhance disease surveillance and public health responses, not only in Mozambique but also in other low- and middle-income countries with similar challenges.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04114"},"PeriodicalIF":4.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065011","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 landscape of early-onset thyroid cancer: current burden, temporal trend and future projections on the basis of GLOBOCAN 2022.","authors":"Qianyun Jin, Jie Wu, Caiyun Huang, Jingjing Li, Yunmeng Zhang, Yuting Ji, Xiaomin Liu, Hongyuan Duan, Zhuowei Feng, Ya Liu, Yacong Zhang, Zhangyan Lyu, Lei Yang, Yubei Huang","doi":"10.7189/jogh.15.04113","DOIUrl":"https://doi.org/10.7189/jogh.15.04113","url":null,"abstract":"<p><strong>Background: </strong>With rapid social-economic development and widespread screening, the surge in incidence and overdiagnosis of thyroid cancer is more worrying among the young than the general population. This problem, however, still lacks adequate attention.</p><p><strong>Methods: </strong>We retrieved the original data of current, past and future burden of thyroid cancer from the Global Cancer Observatory (GLOBOCAN) 2022. We calculated the age-specific mortality-to-incidence ratio (MIR) by dividing age-specific mortality rates by incidence rates to quantify potential overdiagnosis, and used Segi's world standard population to calculate the age-standardised incidence rate (ASIR) and age-standardised mortality rate (ASMR). We then assessed the correlation between the human development index (HDI) and ASIR/ASMR using the linear correlation coefficient (r). Lastly, we characterised the temporal trend with the estimated annual percentage change (EAPC) and project the early-onset thyroid cancer burdens to 2050.</p><p><strong>Results: </strong>Globally, there were an estimated 239 362 (ASIR = 4.00 per 100 000 population) cases and 2409 (ASMR = 0.04 per 100 000 population) deaths from thyroid cancer among individuals aged <40 years in 2022. Compared to its ranking as the 7th most common cancer in the overall population, thyroid cancer rose to become the 2nd most common cancer among individuals <40 years. Nearly 99% of thyroid cancer cases in individuals <40 years of age (MIR = 0.01) may be potentially overdiagnosed, whereas 34% of cases in those >80 years (MIR = 0.66) were overdiagnosed. The ASIR of early-onset thyroid cancer varied widely (from 0.13 to 13.17 per 100 000 population), while the ASMR remains relatively similar and low across different regions. The ASIR of early-onset thyroid cancer increased with HDI (r = 0.69), while the ASMR decreased (r = -0.22). The ASIR of early-onset thyroid cancer had the fastest upward trend (EAPC in males vs. females: 9.88 vs. 9.28%) compared to early-onset cancers at other sites, while ASMR showed a downward trend (EAPC in males vs. females: -0.38% vs. -1.33%). The Republic of Korea experienced the highest EAPC for early-onset thyroid cancer ASIR (males vs. females: 29.95% vs. 23.04%). If national rates from 2022 remain stable, projected cases of early-onset thyroid cancer would decrease in high (-13.3%) and very high (-10.9%) HDI countries, but increase in low (96.5%) and medium HDI countries (11.7%).</p><p><strong>Conclusions: </strong>The trend of early-onset thyroid cancer at the global level is more alarming than that of thyroid cancer overall. The younger age at diagnosis of thyroid cancer, the higher risk of potential overdiagnosis. Without timely interventions, the thyroid cancer burden will inevitably become a serious global public health issue, especially for the young population.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04113"},"PeriodicalIF":4.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035247","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":"Paper-based death record-keeping in Bangladeshi cemeteries: a qualitative exploration of practices and expectations.","authors":"Hossain Md Alamgir, Rahman Md Hafizur, Akter Ema, Islam Sm Hasibul, Akter Tahmina, Islam Md Shahidul, Ara Tasnu, Maher Manna Ridwana, Tippett Barr Beth A, El Arifeen Shams, Rahman Ahmed Ehsanur, Hossain Aniqa Tasnim, Perkins Janet E","doi":"10.7189/jogh.15.04093","DOIUrl":"https://doi.org/10.7189/jogh.15.04093","url":null,"abstract":"<p><strong>Background: </strong>Countries like Bangladesh face significant challenges in effectively registering and tracking deaths within their civil registration systems, which are essential for public health. To improve data collection for public health policy, death record-keeping at burial sites should be enhanced, particularly in areas where burial certificates are issued. With this in mind, we examined the traditional paper-based practices for recording deaths, the perceived significance of these practices, and the associated challenges, expectations, and concerns related to death record-keeping in Bangladeshi cemeteries.</p><p><strong>Methods: </strong>In 2021, we conducted an exploratory qualitative study involving 25 in-depth interviews with individuals who had lost relatives during the COVID-19 pandemic and key informant interviews with service providers at cemeteries. We complemented these interviews with non-participant observations of burial registration practices in seven cemeteries across urban, peri-urban, and rural settings. We used thematic analysis to interpret the data.</p><p><strong>Results: </strong>Our findings reveal diverse death record-keeping practices influenced by sociocultural and administrative dynamics, emphasising the necessity of accurate documentation for securing legal rights and social benefits, such as inheritance and welfare. Notable tensions exist between bureaucratic demands and the emotional realities of grieving families, particularly in non-standardised cemeteries, where acquiring death certificates poses challenges. Stakeholders view the anticipated digitalisation of death record-keeping as a transformative opportunity to streamline processes and improve access to information. However, this transition also highlights existing generational and educational disparities in technological skills, alongside ethical concerns regarding data security and user confidentiality.</p><p><strong>Conclusions: </strong>Our findings showcase the complex interaction between cultural practices, bureaucratic frameworks, and emerging digital technologies in managing death records in Bangladesh. They also emphasise the challenges of modernising traditional documentation methods, as well as the importance of maintaining death records for enhancing civil registration and vital statistics, asserting property rights, and monitoring mortality. A digital system could provide innovative and reliable mortality surveillance from cemeteries.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04093"},"PeriodicalIF":4.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033501","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":"Reshaping the hierarchical medical system for rare diseases: a two-tier structure and one-stop referral network.","authors":"Chaoyu Lei, Ying Zuo, Fanyi Kong, Hao Chen, Haoxuan Cheng, Xuefei Song, Lufa Zhang, Huifang Zhou","doi":"10.7189/jogh.15.03005","DOIUrl":"https://doi.org/10.7189/jogh.15.03005","url":null,"abstract":"","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"03005"},"PeriodicalIF":4.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003939","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 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}