Journal of Global Health最新文献

{"title":"Physical activity and constipation: A systematic review of cohort studies.","authors":"Jiahe Cui, Fangfang Xie, Hongyu Yue, Chaoqun Xie, Jianwen Ma, Haotian Han, Min Fang, Fei Yao","doi":"10.7189/jogh.14.04197","DOIUrl":"10.7189/jogh.14.04197","url":null,"abstract":"<p><strong>Background: </strong>Constipation significantly impacts quality of life and is a common public health issue. For affected individuals, especially those who are inactive and experience constipation symptoms, it is recommended to engage in physical activity (PA) to improve their condition. However, the relationship between PA and improvement in constipation remains unclear. We performed this systematic review of cohort studies to evaluate this potential association.</p><p><strong>Methods: </strong>We systematically searched the Embase, Cochrane Library, PubMed, and CINAHL databases for all cohort studies examining the relationship between PA and constipation from the inception of the databases up to 5 November 2023. We calculated the reported risk ratios (RRs) and 95% confidence intervals (CIs), conducted a random effects model, and performed a subgroup analysis based on factors such as gender, geographic region, and PA intensity to comprehensively explore the link between PA and constipation. Furthermore, we used the Newcastle-Ottawa Scale to evaluate the quality of the studies included in our analysis.</p><p><strong>Results: </strong>The analysis included 13 studies with 119 426 participants and 63 713 cases. The results indicated that higher levels of PA were associated with a decreased risk of constipation compared with lower levels of PA (RR = 0.69; 95% CI = 0.88-0.83) and moderate levels of PA (RR = 0.87; 95% CI = 0.79-0.95). Furthermore, adherence to international PA guidelines was correlated with a significantly reduced risk of constipation (RR = 0.87; 95% CI = 0.81-0.93). Notably, the risk of constipation was lowered among Asian populations (RR = 0.67; 95% CI = 0.56-0.79) and Oceanian populations (RR = 0.72; 95% CI = 0.63-0.83) who engaged in regular PA. Moreover, when comparing the risk of constipation between men and women collectively, PA was associated with a 34% lower risk (RR = 0.66; 95% CI = 0.55-0.80).</p><p><strong>Conclusions: </strong>The study findings indicated that moderate to high levels of PA significantly reduced the risk of constipation, showing a negative correlation between PA and constipation.</p><p><strong>Registration: </strong>PROSPERO: CRD42023479653.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04197"},"PeriodicalIF":4.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689325","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 cost-effectiveness of a cash-based transfer, specialised nutritious food, and social and behaviour change communication intervention package to prevent undernutrition among children 6-23 months in Pakistan: A cluster randomised controlled trial.","authors":"Michael N Onah, Gul Nawaz Khan, Sumra Kureishy, Jessica Bourdaire, Saskia de Pee, Cecilia Garzon, Yasir Ihtesham, Naveed Akbar, Sajid Bashir Soofi","doi":"10.7189/jogh.14.04186","DOIUrl":"10.7189/jogh.14.04186","url":null,"abstract":"<p><strong>Background: </strong>There is mixed evidence on the cost-effectiveness of cash transfers, along with food supplements and behaviour change communication interventions in improving child nutrition outcomes. To add to existing literature, we examined the cost-effectiveness of medium-quantity lipid-based nutrient supplement (LNS) and social and behaviour change communication (SBCC) messaging, separately and combined, compared to an existing unconditional cash transfers (UCT) programme in children 6-23 months of age in the district Rahim Yar Khan, Pakistan.</p><p><strong>Methods: </strong>This was a four-arm, community-based cluster randomised controlled trial. The UCT provided a quarterly sum of USD 32, the medium-quantity LNS contained a daily ration of 50 g of LNS, and the SBCC included monthly and quarterly messaging on nutrition, health, and hygiene to eligible households. Cost data were collected from a provider perspective through the review of procurement invoices and budgets, as well as interviews with stakeholders. We examined cost-effectiveness via statistically significant differences between the intervention and control arms, and estimated as cost per case of stunting, and disability-adjusted life years (DALYs) averted at six and 18 months of intervention.</p><p><strong>Results: </strong>Costs were higher for SBCC intervention combinations (UCT + SBCC and UCT + LNS + SBCC) due to high training costs for lady health workers. UCT + LNS achieved a reduction in stunting at a per-case cost of USDS 278.74 at six months and USD 897.15 at 18 months. UCT + LNS + SBCC achieved a reduction in stunting at per case cost of USD 846.48 at six months and USD 2324.58 at 18 months. The cost per DALYs averted for preventing stunting was USD 234 to USD 557.42 at six months, and USD 787.73 to USD 1537 at 18 months without discounting and age-weights.</p><p><strong>Conclusions: </strong>Although the affordability of such interventions is arguable, combining UCTs with LNS appears to be very cost-effective for reducing undernutrition and averting DALYs, while combining cash transfers with LNS and SBCC showed limited cost-effectiveness when targeting stunting.</p><p><strong>Registration: </strong>Clinicaltrials.gov: NCT03299218.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04186"},"PeriodicalIF":4.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689327","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":"Cost-effectiveness analysis of a prediction model for community-based screening of active tuberculosis.","authors":"Chih-Chi Yang, Yun-Ju Shih, Helen Ayles, Peter Godfrey-Faussett, Mareli Claassens, Hsien-Ho Lin","doi":"10.7189/jogh.14.04226","DOIUrl":"10.7189/jogh.14.04226","url":null,"abstract":"<p><strong>Background: </strong>Active case finding could effectively detect tuberculosis (TB) patients, but it can be costly. Therefore, a feasible, cost-saving, and efficient algorithm for community-based TB screening is needed.</p><p><strong>Methods: </strong>The study population was based on a previous TB prevalence survey conducted in the Zambia/South Africa Tuberculosis and HIV/AIDS Reduction trial. We developed predictive scoring models for HIV-positive and HIV-negative/unknown populations for practical purposes. We compared the cost-effectiveness of our models with that of WHO tools through average cost-effectiveness ratio (ACER) and incremental cost-effectiveness ratio.</p><p><strong>Results: </strong>The prediction model for HIV-positive population presented higher area under the curve (AUC) = 0.652, 95% confidence interval (CI) = 0.602-0.701) than WHO-recommended four-symptom screen (AUC = 0.568, 95% CI = 0.524-0.612) among South African participants. The AUC of the model for HIV-negative/unknown population was 0.673 (95% CI = 0.648-0.697), which was higher than that of the WHO tools as well. The ACER of our model can range from 246 to 1670 USD per TB case detected in the South African communities.</p><p><strong>Conclusions: </strong>The scoring system for active TB case finding presented a better performance and showed cost-effectiveness, which can provide new strategies for active TB case finding with multiple options under budget considerations.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04226"},"PeriodicalIF":4.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689305","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":"Impact of scaling up health intervention coverage on reducing maternal mortality in 26 low- and middle-income countries: A modelling study.","authors":"Xi-Ru Guo, Yue-Long Ji, Shi-Yu Yan, Ting Shi, Kanittha Chamroonsawasdi, Jue Liu, Hai-Jun Wang","doi":"10.7189/jogh.14.04221","DOIUrl":"10.7189/jogh.14.04221","url":null,"abstract":"<p><strong>Background: </strong>Prioritising actions is urgently needed to address the stagnation of the global maternal mortality ratio (MMR). As most maternal deaths occur in low- and middle-income countries (LMICs), we aimed to assess the impact of scaling up health intervention coverage on reducing MMR under four scenarios for 26 LMICs.</p><p><strong>Methods: </strong>We conducted a modelling study to estimate the MMR and additional maternal lives saved by intervention by 2030 for 26 LMICs using the Lives Saved Tool (LiST). We used four scenarios to assess the impact of scaling up health intervention coverage by no scale-up (no change), modest scale-up (increased by 2% per year), substantial scale-up (increased by 5% per year), and universal coverage (coverage reached 95% by 2030). We divided the selected 26 countries into three groups according to their MMR levels in 2020.</p><p><strong>Results: </strong>Among 26 LMICs, six (23.1%) countries showed an increase in MMRs and 13 (50.0%) stalled on the reduction of MMR from 2015 to 2020. Under a substantial scale-up of coverage or scaling up to universal coverage, the average MMR in 2030 of 26 LMICs would be 62.8 or 52.8, reaching the Sustainable Development Goal (SDG) 3.1. Caesarean delivery, uterotonics for postpartum haemorrhage, and assisted vaginal delivery had a more important role in this reduction compared to other interventions.</p><p><strong>Conclusions: </strong>Scaling up the coverage of health interventions is critical for reducing MMRs. If a substantial scale-up or scaling up to universal coverage of continuous maternity interventions from preconception to postpartum period can be achieved, LMICs in Southeast Asia and Western Pacific regions could reach the SDG 3.1 on time.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04221"},"PeriodicalIF":4.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689311","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 divergent association of diet intake, parental education, and nutrition policy with childhood overweight and obesity from low- to high-income countries: A meta-analysis.","authors":"Xue-Ting Liu, Yi-Di Wang, Yu-Jie Xu, Xiao-Yu Wang, Shu-Fang Shan, Jing-Yuan Xiong, Guo Cheng","doi":"10.7189/jogh.14.04215","DOIUrl":"10.7189/jogh.14.04215","url":null,"abstract":"<p><strong>Background: </strong>It is unclear whether the effects of dietary intake, parental education, and nutrition policy on childhood overweight and obesity is consistent between high-income (HICs) and low- and middle-income (LMICs) countries. The objective of this meta-analysis was to investigate the association of diet, parental education and nutrition policy with childhood overweight and obesity when the economic levels were controlled.</p><p><strong>Methods: </strong>PubMed, Web of Science, Embase and Scopus were searched for observational studies published from January 1980 to October 2023 that examined the association of diet, parental education and nutrition policy with childhood overweight and obesity. Meta random effects model stratified by gross national income per capita was used to assess whether the associations were varied by economic levels.</p><p><strong>Results: </strong>From 18 191 identified studies, 154 met the inclusion criteria. Meta-analysis revealed that higher sugar-sweetened beverage intake was a risk factor for childhood overweight and obesity in both HICs and LMICs countries/regions, whereas higher intake of fruit and/or vegetable was a protective factor only in LMICs countries/regions (odds ratio (OR) = 0.77; 95% confidence interval (CI) = 0.69-0.85). Moreover, lower parental education level increased the risk (OR = 1.46; 95% CI = 1.32-1.61) and nutrition policy implementation decreased the risk (OR = 0.96; 95% CI = 0.91-0.99) of childhood overweight and obesity only in HICs.</p><p><strong>Conclusions: </strong>Fruit and/or vegetable intake, parental education and nutritional policy exert different influences on childhood overweight and obesity in countries with varied economic levels. These findings will enhance the understanding of the complex interplay between these factors and their impact on childhood health.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04215"},"PeriodicalIF":4.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710842","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":"Does work modify the relationship between violence and mental health among young people? Evidence from the Violence Against Children Surveys in Uganda, Nigeria and Colombia.","authors":"Jodie Pearlman, Harriet Morgan, Charles Opondo, Mathew Amollo, Jorge Cuartas, Amiya Bhatia","doi":"10.7189/jogh.14.04232","DOIUrl":"10.7189/jogh.14.04232","url":null,"abstract":"<p><strong>Background: </strong>Considering the well-established link between experiencing violence in childhood and poor mental health, it is important to understand the role of contextual factors in which young people live, learn, work, and play. Evidence has highlighted the importance of work as a contextual factor in the lives of young people, but it is unclear whether being in work mitigates, entrenches, or exacerbates the association between violence against children and poor mental health.</p><p><strong>Methods: </strong>This study is based on nationally representative data of males and females aged 13-24 years who completed the Violence Against Children Surveys in Nigeria, Uganda, and Colombia. We used multivariable logistic regression models to explore the association between lifetime violence and past 30-day mental distress, and explored whether working in the past year modified this association. All analyses were age- and sex-stratified and conducted separately in each country.</p><p><strong>Results: </strong>We found a high prevalence of lifetime violence among young people in all three countries and strong associations between violence and mental distress. In Colombia, there was strong evidence (P-value for interaction = 0.014) that work in the past year (adjusted odds ratio (aOR) = 0.42; 95% confidence interval (CI) = 0.07-2.57) reduced the risk of mental distress among girls who had experienced violence compared to not working in the past year (aOR = 6.12; 95% CI = 2.60-14.41). There was also evidence among boys in Nigeria (P-value for interaction = 0.045), where there was a reduction in risk of mental distress among those not in work in the past year (aOR = 0.99; 95% CI = 0.46-2.13) compared to those in work in the past year (aOR = 2.10; 95% CI = 1.32-3.33). There was also a pattern of effect modification by work in the association between childhood violence and mental health in other population groups, with variation by country, sex, and age groups.</p><p><strong>Conclusions: </strong>Our findings suggest that work can mitigate, entrench, or exacerbate risk of mental distress among young people who have experienced violence, depending on their age, sex, and country of residence. While additional research is needed to explore these mechanisms, this highlights the importance of work as a contextual factor in the lives of young people and points to the need for safe and secure workplaces and the integration of context-specific interventions into workplaces for young people.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04232"},"PeriodicalIF":4.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689307","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":"Academic vs. industry-sponsored trials: A global survey on differences, similarities, and future improvements.","authors":"Jean-Marc Hoffmann, Annina Bauer, Regina Grossmann","doi":"10.7189/jogh.14.04204","DOIUrl":"10.7189/jogh.14.04204","url":null,"abstract":"<p><strong>Background: </strong>Clinical research is marked by its multifaceted nature, presenting a multitude of different approaches, designs, and objectives that can complicate the planning, initiation, and conduct of clinical trials. The role and organisation of the sponsor institution are pivotal in this context. We aimed to investigate possible challenges and needs, including their underlying factors, for academia and industry during the set-up and conduct of clinical trials.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey-based study within an international network of highly qualified academic research institutions (ARIs). The main outcome measures were the regulatory framework for clinical trials, scope and organisation of academic and industry-sponsored trials, funding sources of academic clinical trials, submission and approval process, as well as study conduct of academic vs. industry-sponsored trials.</p><p><strong>Results: </strong>We surveyed employees of ARIs with extensive experience in phase I-IV clinical trials. All ARIs participated in academic clinical trials and 90% were involved in industry-sponsored trials. Respondents reported that academic trials faced greater challenges in communication with relevant institutional review boards/ethics committees and competent authorities compared to industry-sponsored trials. Additionally, academic trials were found to have significantly less financial support during their conduct. Specific challenges for academia vs. industry included 'insufficient personnel resources' (60% vs. 50%), 'recruitment problems' (60% vs. 78%) and 'lack of knowledge/experience' (35% vs. 11%).</p><p><strong>Conclusions: </strong>Our findings indicate that industry-sponsored trials encounter fewer issues in set-up, funding, and trial conduct compared to academic trials. Improving collaboration between academic sponsors and ARIs is essential to address these challenges. ARIs provide critical support and guidance for academic researchers, not only in planning and implementing projects, but also in assessing feasibility and securing funding.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04204"},"PeriodicalIF":4.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689303","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":"Circulating levels of blood biomarkers and risk of benign prostatic hyperplasia: Results from two large cohorts in Europe and East Asia.","authors":"Shengzhuo Liu, Xiaoyang Liu, Pan Song, Luchen Yang, Zhenghuan Liu, Jing Zhou, Linchun Wang, Xin Yan, Kai Ma, Yunfei Yu, Xianding Wang, Qiang Dong","doi":"10.7189/jogh.14.04242","DOIUrl":"10.7189/jogh.14.04242","url":null,"abstract":"<p><strong>Background: </strong>As one of the most prevalent chronic non-communicable diseases affecting aging males, the burden of benign prostatic hyperplasia is growing over the world. Our study aims at investigating the potential relationships between various blood biomarkers and benign prostatic hyperplasia (BPH) in middle-aged and older men in European and East Asian population cohorts.</p><p><strong>Methods: </strong>We included 229 022 male adults from the UK Biobank (UKB) and 20 284 male adults from the China Health and Retirement Longitudinal Study (CHARLS) in this study. Forty-four blood biomarkers in UKB cohort and 16 blood biomarkers in the CHARLS cohort were analysed to examine their association with benign prostatic hyperplasia. Cox, logistic analyses and restricted cubic spline models were used to investigate linear and nonlinear longitudinal associations.</p><p><strong>Results: </strong>In our research, elevated high-density lipoprotein cholesterol showed significant associations with a decreased risk of benign prostatic hyperplasia, and these associations remained significant after accounting for potential covariates both in UKB cohort (hazard ratio (HR) = 0.83; 95% CI = 0.79-0.88, P < 0.001) and CHARLS cohort (odds ratio (OR) = 0.992; 95% CI = 0.985-0.999, P = 0.033). Apolipoprotein A was also found to be inversely associated with BPH (HR = 0.76; 95% CI = 0.70-0.81, P < 0.001). L-shaped relationships were discovered between level of high-density lipoprotein cholesterol and apolipoprotein A with incidence of benign prostatic hyperplasia.</p><p><strong>Conclusions: </strong>This large prospective biomarker-based study highlights that high-density lipoprotein (HDL) cholesterol and apolipoprotein A are significant protective factors against the development of BPH, with L-shaped associations suggesting an optimal protective range. In contrast, biomarkers related to glucose metabolism, inflammation, and hormone levels were not found to significantly influence BPH progression. Our findings support the potential involvement of lipid biomarkers in the early stages of BPH development, suggesting that future strategies should prioritise lipid-related pathways in the prevention and management of BPH.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04242"},"PeriodicalIF":4.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710414","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":"Impact of COVID-19 on the utilisation of maternal health services in Bangladesh: A division-level analysis.","authors":"Aniqa Tasnim Hossain, Ema Akter, Ridwana Maher Manna, Tasnu Ara, Md Alamgir Hossain, K M Tanvir, Md Hafizur Rahman, Abu Sayeed, Abu Bakkar Siddique, Bibek Ahamed, M Sabbir Haider, Sabrina Jabeen, Shafiqul Ameen, Mohammad Sohel Shomik, Anisuddin Ahmed, Luis Huicho, Alicia Matijasevich, Abdoulaye Maiga, Ahmed Ehsanur Rahman, Nadia Akseer, Shams El Arifeen, Agbessi Amouzou","doi":"10.7189/jogh.14.05040","DOIUrl":"10.7189/jogh.14.05040","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic had substantially disrupted maternal health care provision and utilisation in Bangladesh. However, the extent of geographical disparities in service utilisation and how the health system withstood these challenges have not been studied. This study explores the divisional disparities in trends and disruptions in maternal health service utilisation caused by the COVID-19 pandemic.</p><p><strong>Methods: </strong>Data was extracted from the District Health Information Software of Bangladesh from January 2017 to December 2021. We assessed the trend of first antenatal care visit, institutional delivery and number of caesarean sections over these years. We explored both the yearly and monthly trends to see the variations in the number of utilisations. Segmented regression with Poisson distribution was used to assess changes in service utilisation during the COVID-19 period. We reported incidence rate ratio (IRR) of service utilisation with a 95% confidence interval (CI) in different divisions during COVID-19 (2020-2021) compared to the reference period (2017-2019).</p><p><strong>Results: </strong>Initially, a notable decline in maternal health care utilisation was observed in 2020 compared to the pre-pandemic period of 2017-2019. Divisional disparities were observed in this trend. Overall, compared to the pre-pandemic period, we observed around 30% decline in all three selected indicators of maternal health care. The lowest value was observed in Chattogram in 2020 (IRR = 0.66; 95% CI = 0.55-0.79) and Rajshahi in 2021 (IRR = 0.71; 95% CI = 0.60-0.82). For institutional delivery, Barishal division had the lowest IRR (0.64; 95% CI = 0.60-0.68) in 2020 and, in 2021 Rajshahi had the lowest IRR (0.71; 95% CI = 0.60-0.82). For caesarean section, the lowest value was observed in Barishal division (IRR = 0.48; 95% CI = 0.44-0.53) in 2020 and in Mymensingh (IRR = 0.37; 95% CI = 0.32-0.43) in 2021. By 2021, the three maternal health care utilisation indicators demonstrated recovery.</p><p><strong>Conclusions: </strong>The effect of the pandemic, including lockdown, on the selected maternal service utilisation was observed in Bangladesh though there were substantial geographic disparities. These disruptions slightly recovered after the initial shock. These results will support the government in preparing the national and regional health systems for future epidemics in Bangladesh.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"05040"},"PeriodicalIF":4.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689309","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 development and validity of the Early Learning Tool for children 0-3-year-old in rural Pakistan.","authors":"Elizabeth Hentschel, Saima Siyal, Alya Al Sager, Dana C McCoy, Aisha K Yousafzai","doi":"10.7189/jogh.14.04241","DOIUrl":"10.7189/jogh.14.04241","url":null,"abstract":"<p><strong>Background: </strong>Research has demonstrated the critical role that early learning experiences play in shaping children's cognitive, social, and emotional development. Nevertheless, tools for assessing children's exposure to early learning experiences remain scarce. This paper describes the initial validation of the Early Learning (EL) tool, which captures the levels of stimulation with playthings and people available to children 0-3-year-old in low-resource, international settings.</p><p><strong>Methods: </strong>We randomly sampled 200 mothers of children under 3-year-old in rural Sindh, Pakistan. We collected data on sociodemographic information, early learning, responsive caregiving, and child development. Psychometric analyses assessing the structural validity with confirmatory factor analysis and item response theory, criterion validity with Pearson correlation coefficients, and predictive validity with Ordinary Least Squares linear regression were conducted.</p><p><strong>Findings: </strong>We found that the EL tool is valid in this setting, capturing two factors of early learning: stimulation with playthings and stimulation with people. Stimulation with playthings and people were strongly and positively correlated with responsive caregiving, maternal education, and wealth, indicating criterion validity. Stimulation with playthings and people were also strongly associated with child development, measured by the Bayleys Scales of Infant Development.</p><p><strong>Conclusions: </strong>The EL tool is a promising instrument for measuring early learning in low- and middle-income countries, and its use can lead to more effective and inclusive monitoring and development of early learning initiatives.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04241"},"PeriodicalIF":4.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710739","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}