Journal of Global Health最新文献

{"title":"The target trial framework in global health research: barriers and opportunities.","authors":"Ali Al-Kassab-Córdova, Esteban A Alarcón-Braga, Camila Olarte Parra, Niveditha Devasenapathy, Martin Gerdin Wärnberg, Anthony A Matthews","doi":"10.7189/jogh.15.03014","DOIUrl":"10.7189/jogh.15.03014","url":null,"abstract":"<p><p>A randomised trial is the best way to make causal inferences when evaluating the effectiveness and safety of health interventions in global health research. Trials, however, are inherently expensive, unfeasible in many scenarios, and may raise ethical issues. In these scenarios, we must turn to analyses of observational data to learn what works. The target trial framework provides an organising principle for the design of observational studies that can lead to clinically interpretable results and analytic approaches that can reduce common biases. In this analysis, we describe the global distribution of data sources used in applications of the target trial framework and discuss barriers to its increased use in global health research, such as limited access to high-quality observational data. We then suggest a cost-effective solution of incorporating the collection of additional high-quality observational data into the implementation of large randomised trials in low- and middle-income countries. We found that the target trial framework is underutilised in observational studies conducted in most low- and middle-income countries. The main barriers are little available data and few trained researchers, which can be overcome by incorporating high-quality observational data collection into the data collection phase of large randomised trials, and by introducing small adjustments to the teaching curriculum.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"03014"},"PeriodicalIF":4.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671488","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":"Bidirectional associations between social isolation, loneliness, and cognitive function among Chinese older adults.","authors":"Chaoping Pan, Na Cao","doi":"10.7189/jogh.15.04077","DOIUrl":"10.7189/jogh.15.04077","url":null,"abstract":"<p><strong>Background: </strong>Social isolation (SI), loneliness, and cognitive function (CF) are increasingly acknowledged as significant public health concerns globally. In this study, we aimed to investigate the bidirectional relationships and mediating effects between SI, loneliness, and CF among older adults in China.</p><p><strong>Methods: </strong>We analysed data from six waves of the Chinese Longitudinal Healthy Longevity Survey conducted between 2002-18. The sample included individuals aged ≥65 years. We used the general cross-lagged panel model to account for confounding factors and reveal mediating effects.</p><p><strong>Results: </strong>The findings indicated that SI and loneliness can independently lower CF. Moreover, loneliness may lower CF through SI, and SI may also lower CF through loneliness. Finally, we revealed that decreased CF can increase SI and loneliness.</p><p><strong>Conclusions: </strong>SI and loneliness are significantly intertwined with CF among older adults in China. Interventions aiming at reducing SI, loneliness, and CF should consider the interplay of these factors to enhance the health and well-being of older adults.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04077"},"PeriodicalIF":4.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673664","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":"Accounting for aid: estimating the impact of United States' global health investments on mortality among women of reproductive age using synthetic control and Bayesian methods.","authors":"Karar Zunaid Ahsan, Gustavo Angeles, Allysha Choudhury, Kavita Singh, Tory M Taylor, Farhan Majid, Rachel Lucas, Robert L Cohen, Atul A Gawande, William Weiss","doi":"10.7189/jogh.15.04067","DOIUrl":"10.7189/jogh.15.04067","url":null,"abstract":"<p><strong>Background: </strong>The United States government (USG) is a key global actor in preventing mortality and supporting lifesaving health services among women and children in low- and middle-income countries (LMICs). Since the Foreign Assistance Act of 1961, USG has funded global health programmes targeting specific conditions and strengthening health systems for the delivery of essential services via the United States Agency for International Development (USAID) and other USG agencies. However, directly quantifying and attributing the impact of USG health investments is challenging due to the inability of conducting randomised control trials for such large programmes at scale. In this study, we compared two quasi-experimental impact evaluation approaches to estimate the effects of sustained USG health investments on mortality among women of reproductive age (WRA).</p><p><strong>Methods: </strong>We employed synthetic control analysis and a Bayesian alternative to synthetic control to estimate the impact of USG's global health investments on WRA mortality rate across 16 LMICs that received sustained, multifaceted, and above-average USAID global health funding levels from 2005 to 2019.</p><p><strong>Results: </strong>Countries receiving sustained, multifaceted, and above-average USAID global health funding had a reduction in the annual WRA mortality rate by 0.65 deaths per 1000 WRA throughout the post-treatment period. For the years (i.e. 2009-2019) where the effect estimates are statistically significant (P < 0.001), the reduction in WRA mortality rate was 0.80 deaths per 1000 WRA. Sensitivity analyses and Bayesian modelling supported the robustness of these findings. We conservatively estimated that about 1.0-1.3 million WRA deaths were averted in study countries between 2009 and 2019 as a result of USG health investments.</p><p><strong>Conclusions: </strong>Our results suggest that well-funded donor initiatives can substantially reduce WRA mortality rates beyond what would have been achieved without such investments. Sustained donor investments significantly reduce WRA mortality, underscoring the transformative potential of well-funded global health initiatives. Our study also demonstrates that synthetic control and Bayesian models are valuable tools for evaluating the impact of large-scale global health financing.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04067"},"PeriodicalIF":4.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674770","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 short-term exposure to fine particulate matter with ischemic stroke mortality and the role of green space: a time-series study in Zibo, China.","authors":"Sihao Song, Chuanlong Cheng, Ying Liu, Yuqi Duan, Hui Zuo, Rui Xi, Zhisong Ni, Kemeng Liang, Shufen Li, Feng Cui, Xiujun Li","doi":"10.7189/jogh.15.04068","DOIUrl":"10.7189/jogh.15.04068","url":null,"abstract":"<p><strong>Background: </strong>Previous studies on associations between short-term exposure to fine particulate matter (PM_2.5) and ischemic stroke (IS) mortality reported inconclusive results. Additionally, whether and how PM_2.5 and green space interact to precipitate IS deaths remains unclear. We aimed to examine the impacts of short-term exposure to PM_2.5 on IS mortality and the role of green space in the association.</p><p><strong>Methods: </strong>We collected data on daily IS deaths, daily PM_2.5 concentrations, and monthly normalized difference vegetation index (NDVI) in Zibo City from 2015 to 2019. Generalised additive models were adopted to investigate the short-term impacts of PM_2.5 on IS mortality, and subgroup analyses were used to examine effect modification by population characteristics. Stratified analyses by green space levels and joint effect model were conducted to test the interactions of PM_2.5 and green space on IS mortality.</p><p><strong>Results: </strong>A total of 10 799 IS deaths were included in our study. Exposure to PM_2.5 was associated with an increased risk of IS mortality, with odds ratios (ORs) of 1.0263 (95% confidence interval (CI) = 1.0017, 1.0516) for each interquartile range (IQR) increase in PM_2.5 on lag0 and 1.0317 (95% CI = 1.0016, 1.0627) on lag01. The links between PM_2.5 and IS mortality were not significantly different across genders, ages, or PM_2.5 zones. Furthermore, our results showed that the effects of PM_2.5 on IS mortality were higher in low levels of green space. Specifically, for each IQR increase in PM_2.5, the ORs (95% CIs) of IS death in the low level and the high level of NDVI were 1.0287 (95% CI = 1.0019, 1.0563) and 0.9934 (95% CI = 0.9296, 1.0615), respectively. In addition, PM_2.5 and NDVI exhibited significant interactive effects on IS mortality, with relative excess odds due to interaction (REOI) of greater than 0.</p><p><strong>Conclusions: </strong>Our findings showed that PM_2.5 was significantly associated with increasing odds of IS mortality. Furthermore, there were synergetic impacts between PM_2.5 and lack of greenness on IS mortality. Our results suggest that expanding green spaces, such as increasing park coverage and street greening, along with regulating industrial emissions to reduce PM_2.5 levels, can help prevent premature deaths from IS.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04068"},"PeriodicalIF":4.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674771","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 psychological impact of displacement and female genital mutilation/cutting.","authors":"Sargun Kaur Virk, Andrew Robert Milewski, Leslie Bull, Gunisha Kaur","doi":"10.7189/jogh.15.03011","DOIUrl":"10.7189/jogh.15.03011","url":null,"abstract":"<p><p>Although 230 million people worldwide have undergone female genital mutilation/cutting (FGM/C), its psychological consequences remain understudied. Asylum-seekers may face unique biopsychosocial burdens when migrating to countries where FGM/C is not a cultural norm. We conducted a retrospective observational study of 50 asylum seekers evaluated at the Weill Cornell Center for Human Rights between 2010 and 2020 to characterize the psychological sequelae of FGM/C. Psychological symptoms were reported in 86% of cases, with anxiety, depressed/sad mood, aversion to sexual activity and nightmare being the most common. Formal psychological diagnoses were made for 32% of cases with 30% diagnosed with posttraumatic stress disorder, 20% with major depressive disorder, and 6% with generalised anxiety disorder. Additionally, 74% of cases had experienced other forms of trauma(s), including domestic violence, sexual violence, and kidnapping signaling that violence experienced in this population is complex. Psychological disorders were diagnosed in 93% of individuals who underwent a psychological evaluation, versus 9% of those who did not, despite similar trauma history. There is a role for psychological evaluation and symptom screening for asylum-seekers who have undergone FGM/C.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"03011"},"PeriodicalIF":4.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671437","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 factors associated with caesarean delivery on maternal request and its effect on maternal and foetal outcomes in selected tertiary care hospital, Odisha, Southeastern India.","authors":"Sindhu Singh, Dharitri Swain","doi":"10.7189/jogh.15.04073","DOIUrl":"10.7189/jogh.15.04073","url":null,"abstract":"<p><strong>Background: </strong>Caesarean delivery is now predominantly performed in response to the mother's request, often without medical indications, commonly referred to as caesarean delivery on maternal request (CDMR). The rise in CDMR has become a significant issue in maternal and newborn health. We aimed to explore the factors influencing CDMR and its effect on maternal and foetal outcomes.</p><p><strong>Methods: </strong>We used a prospective cohort design approach to recruit 413 participants and a consecutive sampling technique to select the participants. Those who fulfilled the inclusion criteria were taken during the six-month data collection period from October 2023 to March 2024. We used a structured interview method for data collection. We utilised inferential statistics, such as Fisher exact and χ² tests for univariate analysis and a logistic regression model in the multivariate analysis, to investigate the relationship between factors and mode of delivery.</p><p><strong>Results: </strong>The multivariate regression analysis revealed that the CDMR rate was higher among the women who preferred caesarean delivery before giving birth (odds ratio (OR) = 6.295; 95% confidence interval (CI) = 1.468-26.995, P < 0.05). Additionally, women with a history of previous caesarean delivery were more inclined to choose CDMR in the subsequent pregnancy (OR = 25.642; 95% CI = 1.199-548.221, P < 0.05). The likelihood of experiencing wound pain (OR = 42.374; 95% CI = 14.612-122.887, P < 0.05), encountering breastfeeding difficulties (OR = 11.469; 95% CI = 2.91-45.2, P < 0.05), and neonatal intensive care unit admissions (OR = 0.268; 95% CI = 0.076-0.95, P < 0.05) was significantly higher in CDMR compared to normal vaginal delivery.</p><p><strong>Conclusions: </strong>The prevalence of CDMR was 21.35%, which was relatively higher than the World Health Organization's recommended guidelines. The previous mode of delivery and maternal preference for caesarean birth were the factors that influenced CDMR. It is necessary to make childbirth readiness counselling a regular practice to assist women in selecting the best delivery method.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04073"},"PeriodicalIF":4.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674112","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":"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":"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":"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}