Annals of Global Health最新文献

{"title":"From Product Availability to Population Protection: Vaccine Deployment Readiness in Sierra Leone.","authors":"Eric Nzirakaindi Ikoona, Lucy Namulemo, Rebecca Ikoona, Ronald Kaluya, Mohamed Alex Vandi, Foday Sahr","doi":"10.5334/aogh.5326","DOIUrl":"10.5334/aogh.5326","url":null,"abstract":"<p><p><i>Background:</i> The 100 Days Mission has reorganised preparedness around vaccine development speed. Modelling suggests that meeting its target during the COVID-19 pandemic could have averted more than eight million deaths, conditional on equitable distribution. Distribution depends on a national pathway from authorisation through financing, cold chain, targeting, delivery, monitoring and community trust. The Mission measures speed at only one end of this system. <i>Objective:</i> To develop and apply a country-anchored framework for the deployment-readiness layer of preparedness. <i>Methods:</i> We conducted a comparative documentary analysis of three vaccine deployment events in Sierra Leone: COVID-19 vaccination in 2021, preventive Ebola vaccination in 2024 and mpox clade IIb vaccination in 2025. Sources included regulatory records, government and partner reports, national plans and aggregate programme records. We organised 11 established immunisation and emergency vaccination functions into a Deployment Readiness Chain. We traced constraints, handoffs, time to vaccination start and dated reach. <i>Findings:</i> COVID-19 vaccination began 45 days after European Medicines Agency authorisation. Full coverage among people aged 12 years or older reached 73.2% by December 2022 and a reported 86.7% by October 2023. More than 84% of doses were delivered through surge campaigns or periodic intensification of routine immunisation. Nationwide preventive Ebola vaccination reached 17,454 of the 20,621 targeted workers, or 84.6%, in three weeks. It began 1851 days after authorisation, although a global stockpile had been in operation since 2021. Mpox vaccination began 106 days after outbreak confirmation and reached 186,053 people by 14 December through capabilities built during earlier emergencies. <i>Conclusions:</i> For Ebola, the 1851-day interval spanned product authorisation, global preventive policy, financing and national activation. Product availability alone was not sufficient. Preparedness frameworks should evaluate deployment readiness alongside development speed. They should treat the global-to-national deployment pathway as one fundable category. Deployment readiness is built between emergencies, not during them.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"91"},"PeriodicalIF":5.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Periodontal Disease Influence Tuberculosis Outcomes? Insights from a Scoping Review.","authors":"Prerna Hirkane, Ajay Kumar Verma, Umesh Pratap Verma, Arpita Singh","doi":"10.5334/aogh.5343","DOIUrl":"10.5334/aogh.5343","url":null,"abstract":"<p><p><i>Background:</i> Periodontitis and tuberculosis (TB) are common chronic infections disproportionately affecting disadvantaged groups. They share behavioural, environmental, and immunological risk factors. Emerging evidence suggests a bidirectional relationship, with TB patients often exhibiting poorer periodontal health and periodontal inflammation potentially exacerbating systemic TB. <i>Objective:</i> To comprehensively map and evaluate the existing evidence regarding the association between periodontal disease and TB outcomes, and to explore the potential influence of periodontal status on TB progression, treatment response, and overall disease outcomes through a scoping review. <i>Methods:</i> This scoping review examined human studies assessing periodontal status in TB patients, including observational studies, clinical trials, and reviews. Searches were conducted in PubMed, Scopus, and Google Scholar, complemented by reference screening. Two independent reviewers applied inclusion criteria, extracted data, and narratively synthesised the findings due to methodological diversity. <i>Results:</i> Out of 1,129 records screened, 8 studies met the inclusion criteria. The majority of observational studies demonstrated a significantly higher prevalence and severity of periodontitis in TB patients relative to controls, characterised by increased probing pocket depths and elevated bleeding on probing. Complementary evidence from recent reviews and microbiome analyses highlights shared inflammatory mediators, immune dysregulation, and alterations in oral microbial communities as potential mechanistic pathways underpinning the association between TB and periodontal tissue destruction. <i>Conclusion:</i> Current evidence supports a consistent but preliminary association between TB and deteriorated periodontal health, indicating complex bidirectional interactions rather than confirmed causality. Routine periodontal screening and oral health counselling integrated into TB management, along with heightened clinical vigilance for TB in unusual periodontal cases, may improve care. Further longitudinal and mechanistic studies are needed to clarify these relationships.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"89"},"PeriodicalIF":5.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes Burden and Healthcare Barriers Among Cataract Patients in Imo State, Nigeria.","authors":"Kamsi Oparaugo, Parker Cox, Andrey Kharlamov, Kelechi Mezu-Nnabue, Udo Ubani, Olachi J Mezu-Ndubuisi","doi":"10.5334/aogh.5168","DOIUrl":"10.5334/aogh.5168","url":null,"abstract":"<p><p><i>Background:</i> The coexistence of diabetes and cataracts increases the risk of poor surgical outcomes. Cataract patients with uncontrolled diabetes and other comorbidities were unsafe for same-day surgery, which excluded them from free cataract surgeries during a medical mission outreach in rural Imo State, Nigeria. <i>Objective:</i> This study aims to identify barriers to diabetes control among cataract patients in the community, to improve health outcomes and surgical readiness in short-term medical missions. <i>Methods:</i> A total of 45 cataract patients aged 40-94 years received point-of-care testing for fasting blood sugar, intraocular pressure (IOP), and hemoglobin levels. Structured questionnaires assessed socio-economic status (SES), diabetes burden, and barriers to care. <i>Findings:</i> Despite reported adherence to daily medications (p = 0.0007), many patients had high diabetes burden scores, which were significantly associated with frequent symptoms (p < 0.00003), and more chronic diseases (p < 0.008). Elevated IOP, a glaucoma risk factor, was linked to private drinking-water sources (p = 0.008), and herb use was associated with lower hematocrit (p = 0.040), suggesting anemia risk. Lower hematocrit further correlated with more advanced cataracts (p = 0.018). High barriers-to-care scores were associated with the absence of a caregiver (p = 0.005), limited food choices (p < 0.001), the frequency of medical checks (p < 0.001), and a patient's medication source (p = 0.030). Patients who struggled with transportation barriers reported needing help with daily tasks like going to the market or cooking meals (p = 0.004). <i>Conclusion:</i> Disease severity in cataract patients is influenced by overlapping medical, financial, and social barriers. Providing tools for effective diabetes self-monitoring and mitigating comorbidities through community-tailored interventions can improve health stability and future surgical access in this rural community.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"90"},"PeriodicalIF":5.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and Access Gaps in Infectious Disease Screening for Migrants in Europe: A Structured Review with Thematic Synthesis From the ESGITM Group.","authors":"Rosa Buonamassa, Nikolaos Markou-Pappas, Alberto Matteelli, Ferenc Balázs Farkas, Muhammad Asaduzzaman, Luisa Frallonardo, Botond Lakatos, Annalisa Saracino, Alba Cuxart-Graell, Nathan Bertelsen, Christian Wejse, Alexandre Raphael Meduri, Giacomo Guido, Irene Losada, Pietro Locantore, Roberta Iatta, Caroline Rönnberg, Francesco Di Gennaro","doi":"10.5334/aogh.5363","DOIUrl":"10.5334/aogh.5363","url":null,"abstract":"<p><p><i>Background:</i> Infectious disease screening is widely recommended for migrants in Europe, yet implementation remains inconsistent across countries and settings. While guidance has focused on which infections to screen for, less attention has been paid to how screening is delivered, accessed, and linked to care. This structured review with thematic synthesis aimed to synthesize evidence on implementation gaps, barriers, and facilitators, with particular attention to differences across the migratory cycle. <i>Methods:</i> A structured search was conducted across PubMed, Scopus, Web of Science, and Google Scholar for publications from January 2000 to February 2026, addressing infectious disease screening or related migrant health assessments in European settings. Of 49 included publications, 13 empirical studies formed the primary analytical basis and were quality-appraised using the Mixed Methods Appraisal Tool (MMAT, 2018); the remaining 36 contextualizing publications were used to interpret findings. Eligibility screening was performed independently by two reviewers. <i>Results:</i> Six interconnected thematic domains shaped screening implementation: administrative and legal barriers; communication, language, and cultural mediation; trust, stigma, and perceived coercion; organizational capacity and fragmented care pathways; the role of NGOs and community actors; and contextual differences across the migratory cycle. Barriers varied across the screening-to-care cascade: communication barriers and mistrust primarily affected uptake; legal and organizational barriers constrained linkage to diagnosis and treatment; and legal instability and fragmented services undermined continuity of care. First-arrival settings were characterized by systematic screening and high service pressure; long-term settlement contexts relied more heavily on primary care capacity, trust, and legal entitlement. <i>Conclusions:</i> Implementation gaps are driven less by the absence of clinical guidance than by structural, organizational, and relational barriers limiting access, linkage, and continuity. Screening should be embedded within integrated, migrant-centered care pathways supported by cultural mediation, trusted community actors, and separation from immigration enforcement.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"88"},"PeriodicalIF":5.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapidly Deployed Phone-Based COVID-19 Telemedicine Clinic in Lebanon: A Retrospective Analysis.","authors":"Rabih Soubra, Rim Taleb, Ibrahim Chehab, Yahya Makkieh, Alissar El Sibai, Issam Shaarani","doi":"10.5334/aogh.5463","DOIUrl":"10.5334/aogh.5463","url":null,"abstract":"<p><p><i>Background:</i> In early 2021, Lebanon's second COVID-19 wave coincided with financial collapse, health-workforce emigration, and the aftermath of the August 2020 Beirut port explosion, leaving hospitals saturated and many households unable to afford routine medical advice. <i>Objectives:</i> To describe the design, utilization, disposition outcomes, supervisory escalation, and direct operational cost of a free phone-based telemedicine clinic rapidly deployed through an academic-nongovernmental organization (NGO) partnership, and to identify transferable lessons for other crisis-affected, resource-constrained settings. <i>Methods:</i> Beirut Arab University Healthcare Center and the Federation of Businessmen for Support and Development (IRADA), a national NGO, launched a free 24-hour, 7-day-a-week phone-based telemedicine clinic staffed by 40 medical interns and residents using a standardized COVID-19 management protocol under a two-tier supervision model, with on-call family physicians reachable throughout each shift. WhatsApp voice calls were offered to provide free access, and missed calls were returned by the on-call responder. We retrospectively analyzed the de-identified records of all consultations managed during 14 weeks (February 2 to May 11, 2021); disposition categories were derived from the free-text recommendations using a rule-based classifier. <i>Findings:</i> The service managed 2953 consultations from all Lebanese governorates. After clinical assessment and safety-netting, 90.1% of consultations were managed outside hospitals at the point of consultation, 7.8% were referred to the emergency department, and 2.0% to primary care. The on-call family physician was consulted in 6.6% of consultations, concentrated on the highest-acuity calls (16.5% of emergency department referrals). The overnight window carried 3.7% of consultations but a higher emergency department referral proportion (12.8%). Direct operational cost was USD11,032 (USD3.74 per consultation), excluding non-monetary university contributions. <i>Conclusions:</i> An academic-NGO partnership, a standardized triage protocol, and tiered supervision can mobilize a trainee workforce safely, at low cost, and within days during a public health emergency.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"85"},"PeriodicalIF":5.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Perspectives on Patronage of Traditional Bone Setting: A Systematic Review.","authors":"Sarah Elizabeth Flynn, Sumner Rajaratnam, Colin Kruse, Daniel K Kisitu, Bradley A Petrisor","doi":"10.5334/aogh.5295","DOIUrl":"10.5334/aogh.5295","url":null,"abstract":"<p><p><i>Introduction:</i> Traditional bone setters (TBS) treat orthopedic injuries using natural remedies and traditional medicine. These practices can result in complications, including malunion, non-union, or gangrenous extremities. Despite these complications, communities in low- and middle-income countries trust and rely on TBS for musculoskeletal injuries and pathologies. Understanding patients' motives for patronizing TBS is necessary to work with TBS to reduce complications. <i>Objectives:</i> The objectives of this study were to assess the reasons patients patronize TBS, identify demographic trends associated with TBS usage, and evaluate how patient perspectives inform an understanding of TBS patronage. <i>Methods:</i> Four electronic databases, MEDLINE and Embase (via Ovid), Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), were searched prior to April 2025. Primary studies examining reasons and patient perspectives on visiting TBS were included. Studies not reporting patient perspectives regarding TBS use were excluded. Study quality was assessed using the Joanna Briggs Institute critical appraisal tools. A narrative synthesis was conducted, with pooled descriptive statistics where appropriate. <i>Results:</i> A total of 28 studies involving 8,147 participants were included. A total of 5 articles directly included patients' perspectives, while 24 articles reported themes among reasons for the patronage of TBS. The main reasons cited for patronizing TBS were the belief in TBS and affordability. Recommendations from family/friends and negative perspectives on allopathic medicine were both frequently cited. No consistent association between participant demographics and TBS patronage was identified. <i>Conclusions/Discussion:</i> The reasons for patronizing TBS are multifaceted, extending beyond pure affordability and accessibility. The analysis showed that the general preference for TBS over allopathic practitioners and the belief in TBS practices are strongly rooted in the individuals and communities that TBS serve. Despite differing recommendations, collaboration with TBS to improve access to care and reduce complication rates was identified as a future direction.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"86"},"PeriodicalIF":5.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal Health Coverage in Pakistan: Challenges, Reforms, and the Road to 2030.","authors":"Babar Tasneem Shaikh","doi":"10.5334/aogh.5238","DOIUrl":"10.5334/aogh.5238","url":null,"abstract":"<p><p><i>Background:</i> Universal Health Coverage (UHC) aims to ensure that all individuals have access to essential health services without financial hardship. Pakistan, despite constitutional commitments and policy reforms, faces significant hurdles in progressing toward this global goal due to systemic, structural, and socioeconomic challenges. <i>Methods:</i> This narrative review synthesizes available literature, policy documents, and programmatic evidence to examine Pakistan's preparedness for UHC. The analysis is structured around four thematic levels: policy, institutional, population, and service delivery, identifying barriers and opportunities within each domain. <i>Findings:</i> At the policy level, political instability, inadequate financing (<1% of GDP), and lack of evidence-based decision-making undermine sustained progress. Although a comprehensive UHC benefit package has been developed, its implementation is constrained by insufficient budget allocations. Institutionally weak regulation, fragmented governance, inequitable distribution of human resources, and limited stakeholder coordination impede service delivery. At the population level, low health literacy, poor awareness of insurance entitlements, and socioeconomic disparities result in low utilization of available services. Service delivery challenges include questionable quality of care, weak hospital empanelment standards, absence of standardized treatment protocols, and poor communication between public and private sectors. Out-of-pocket expenditures remain catastrophically high, pushing vulnerable populations further into poverty. <i>Conclusion:</i> Pakistan's path to UHC by 2030 requires a fundamental paradigm shift. Priorities include increasing health financing to at least 3% of GDP, strengthening primary healthcare as the platform for equity, scaling up social health protection programs nationwide, investing in workforce development and digital health infrastructure, and launching contextualized public awareness campaigns to improve health insurance literacy. A multi-sectoral, governance-focused approach is essential to translate policy intent into tangible health outcomes for all citizens.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"87"},"PeriodicalIF":5.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catching Up on Mortality, Falling Behind on Disability: A Dynamic Decomposition of the Health-Adjusted Life Expectancy Gap between Higher-Income and Lower-Income Countries.","authors":"Xue-Qi Li, Wei Hu, Bo Yan, Jie Sun, Jun-Yan Xi","doi":"10.5334/aogh.5458","DOIUrl":"10.5334/aogh.5458","url":null,"abstract":"<p><p><i>Background:</i> Global health inequalities are conventionally assessed through the mortality gap, yet the joint contribution of mortality and disability to health-adjusted life expectancy (HALE) gap and their dynamic evolution remain poorly understood. We aim to decompose the HALE gap between higher-income and lower-income countries into mortality and disability drivers, separate long-term trends from transient fluctuations, and reveal heterogeneity within the low-income group. <i>Methods:</i> Using data from the Global Burden of Disease Study for 199 countries (122 higher-income and 77 lower-income) from 2010 to 2019, we decomposed the HALE gap by age and cause via Horiuchi's method. Empirical mode decomposition separated each contribution time series into a long-term trend and residual fluctuations, enabling classification into dynamic archetypes: mortality catch-up, mortality divergence, disability catch-up, or disability divergence. Principal component analysis and partitioning around medoids clustering explored heterogeneity among lower-income countries, and generalized additive models assessed variation along the Socio-demographic Index (SDI) gradient. <i>Results:</i> The HALE gap narrowed from 9.10 to 7.93 years, with mortality contributing 6.87 years and disability 1.06 years in 2019. Mortality catch-up was concentrated in childhood infections and maternal conditions, while mortality divergence occurred for non-communicable diseases in adults. Disability divergence was driven by mental, musculoskeletal, and sense organ disorders. Low-income countries clustered into a high-mortality group (mainly sub-Saharan Africa and South Asia) and a disability-emerging group (Asia, Latin America). Along the development gradient, disability progressively dominated the HALE gap. <i>Conclusions:</i> The converging HALE gap masks a diverging disability gap. Sustainable progress in global health requires explicitly targeting the growing burden of non-fatal conditions alongside persistent mortality inequalities. The dynamic framework introduced here offers a reusable monitoring tool for health inequality.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"84"},"PeriodicalIF":5.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Survival Gap: Strengthening Post-Discharge Care for Preterm Infants in Tanzania.","authors":"Erick Mahatara, Kelvin Musa, Beatrice Jerome, Linda Paul Athman","doi":"10.5334/aogh.5442","DOIUrl":"10.5334/aogh.5442","url":null,"abstract":"<p><p><i>Background:</i> Despite notable progress in inpatient neonatal care expansion in Tanzania, expanding from 14 facilities in 2018 to 362 by 2025, a critical survival gap persists during the post-discharge transition. National policies heavily prioritize pre-discharge mortality, leaving the high-risk, 60-day post-discharge window unaddressed. This study evaluates targeted policy, financing, and digital health interventions designed to mitigate post-discharge neonatal mortality. <i>Methods:</i> We analyzed integrated implementation pathways within the Tanzanian health sector, specifically examining the institutional feasibility, scaling capacity, and clinical outcomes of the NEST360 Implementation Tracker (NEST-IT) and the Essential Coaching for Every Mother Tanzania (ECEM-TZ) mobile health framework. <i>Results:</i> Implementation data demonstrate that NEST-IT is a highly viable data-surveillance tool, achieving a 93% feasibility rate for daily clinical use and providing real-time data to drive national quality improvement targets. Concurrently, the ECEM-TZ digital platform effectively circumvents nurse-midwife resource limitations by providing a 54-message educational framework that improves caregiver knowledge and triples postnatal check-up attendance. <i>Conclusion:</i> Eliminating post-discharge mortality requires expanding longitudinal care frameworks. To achieve Tanzania's national target of 15 neonatal deaths per 1000 live births, strategic imperatives must include institutionalizing zero-rated mHealth tools, formalizing community health worker follow-up protocols, and explicitly integrating specialized outpatient neonatal services into the standard benefit package of the 2026 universal health insurance rollout.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"83"},"PeriodicalIF":5.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Collaboration between Traditional Bone Setters and Formal Care Providers in Cameroon: Bridging Gaps in Injury Care.","authors":"Arole Darwin Touko, Mark T Yost, Basile Ngassa, Sithombo Maqungo, Serge Ngekeng, Kudzai Chironga, Aminou Sadjo Salihou, Beme Saouwada Apollinaire, Christelle Maffo, Tonny Orach, Rasheedat Oke, Liza Rosenbloom, Catherine Juillard, Alain Chichom-Mefire","doi":"10.5334/aogh.5125","DOIUrl":"10.5334/aogh.5125","url":null,"abstract":"<p><p><i>Introduction:</i> In Cameroon, there are not enough formal care (FC) providers to treat the high volume of injured patients. Traditional bone setters (TBS) offer widely patronized alternatives for injury treatment; however, the integration of TBS into the healthcare system remains limited. Collaboration between TBS and FC providers could expand the reach and effectiveness of injury care. We explore perceptions of Cameroonian TBS and FC providers regarding injury care and willingness to collaborate. <i>Methodology:</i> We used snowball sampling to survey TBS and FC providers in two regions of Cameroon. Structured questionnaires were used to assess FC and TBS providers' beliefs regarding potential collaboration. Categorical variables were analyzed with the chi-squared test while Likert scale responses were analyzed with the Kruskal-Wallis test. <i>Results:</i> We surveyed 120 providers (<i>n</i>=58 TBS, <i>n</i>=62 FC). TBS providers were significantly older (TBS median age 51, IQR 39-60 years vs. FC 34, IQR 30-36 years; <i>P</i><0.001), greater percentage male (TBS 72.4% vs. FC 51.6%, <i>P</i>=0.019), and had more years of practice experience (TBS median 20, IQR 11-28 years vs. FC 5, IQR 3-8 years; <i>P</i><0.001). While the majority of TBS (93%) and FC providers (77%) indicated willingness to collaborate, they disagreed regarding specific roles. Though the TBS providers believed they could conduct post-operative follow-up care, FC providers disagreed (TBS median response \"Agree\" vs. FC \"Disagree,\" <i>P</i><0.001). FC providers also did not believe TBS could provide appropriate injury care triage (TBS \"Agree\" vs. FC \"Neutral,\" <i>P</i><0.001). TBS and FC providers agreed that TBS could rehabilitate injured patients, although TBS agreed more strongly (<i>P</i><0.001). <i>Conclusions:</i> The study demonstrates the willingness of both FC and TBS providers in Cameroon to collaborate in injury care, particularly in rehabilitation services. However, the cohorts disagree regarding the specific roles of TBS providers in injury triage and post-operative follow-up care.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"82"},"PeriodicalIF":5.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}