Annals of Global Health最新文献

{"title":"Assessing Colorectal Care Capacity at an Urban Tertiary Hospital in Ghana.","authors":"Kate V Panzer, Antoinette A A Bediako-Bowan, Philemon Kumassah, Andrea Orji, Nathan R Brand, Jonathan Dakubo, Pius T Agbenorku, Samuel A Debrah, Lyen Huang, Jonathan Laryea, Ann C Lowry, Gifty Kwakye","doi":"10.5334/aogh.4663","DOIUrl":"10.5334/aogh.4663","url":null,"abstract":"<p><p><i>Background:</i> The burden of colorectal diseases continues to rise in Ghana. However, building a surgical workforce to address these diseases has been hampered by the lack of a colorectal specialty training pathway. To address this gap, the first colorectal surgery fellowship in Ghana was established in July 2023. <i>Objective:</i> This study aims to identify strengths and gaps in colorectal care delivery prior to fellowship implementation by assessing relevant infrastructure, resources, and case volume at a Ghanaian teaching hospital. <i>Methods:</i> Data on surgical infrastructure and human resources were collected at Korle Bu Teaching Hospital (KBTH) in Accra, Ghana. Retrospective, de-identified data were collected on all colorectal procedures performed at KBTH from January 1, 2022, to December 31, 2022. Cases were categorized by common anorectal, abdominal, and endoscopic procedures. <i>Findings:</i> All surgical infrastructure and human resources were always available during the study period, except for immunohistochemistry services. 2,992 colorectal procedures were performed, including 173 anorectal procedures, 167 abdominal procedures, and 2,652 endoscopic procedures. The three most common colorectal surgeries performed were segmental colectomy (n = 76), excisional hemorrhoidectomy (n = 64), and stoma creation/management (n = 52). Some common colorectal services were not provided, including banding of internal hemorrhoids, seton placement for perianal fistulas, rectopexy for rectal prolapse, and pelvic floor evaluations. <i>Conclusions:</i> There is a need for colorectal-specific surgical training and infrastructure in Ghana. KBTH is well-equipped with the resources to support growth of the newly established colorectal surgery fellowship, which will expand colorectal services available for Ghanaians.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"91 1","pages":"61"},"PeriodicalIF":3.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066114","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":"Ten Recommendations for US Programs Hosting Global Health Partners.","authors":"Ana Maria Crawford, Michelle Arteaga, Rodrigo Rubio, Gaston Nyirigira, Samy Bendjemil, James C Hudspeth, Tracy L Rabin","doi":"10.5334/aogh.4699","DOIUrl":"10.5334/aogh.4699","url":null,"abstract":"<p><p><i>Background:</i> US academic institutions increasingly seek to engage in global health education through bidirectional partnerships. One innovative approach is hosting International Medical Graduates (IMGs) at US-based programs, offering short-term global health learning experiences locally while expanding professional opportunities for IMGs from both high-resource and resource-constrained settings. <i>Methods:</i> Drawing on over 15 years of collective experience, this paper brings together perspectives from global authors to identify practical strategies for hosting visiting IMGs. The recommendations address the operational, legal, and financial barriers that institutions often face when building such programs. <i>Recommendations:</i> Key challenges include securing stakeholder engagement, navigating visa limitations, and addressing funding and institutional policy gaps. The authors outline 10 actionable recommendations designed to guide US institutions in building ethical, sustainable, and mutually beneficial IMG-hosting programs. <i>Conclusion:</i> While prior literature has emphasized the ethical foundations and benefits of global partnerships, this paper offers concrete guidance to support the development of IMG-hosting initiatives. These programs advance the goals of equity, reciprocity, and long-term partnership in global health education.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"91 1","pages":"60"},"PeriodicalIF":3.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066085","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":"Intersectoral and Pro-Equity Approaches in Health Policy.","authors":"Fabiana C Saddi, Stephen Peckham, Ana Maria Nogales Vasconcelos","doi":"10.5334/aogh.4863","DOIUrl":"10.5334/aogh.4863","url":null,"abstract":"","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"91 1","pages":"58"},"PeriodicalIF":3.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066155","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 Gender Gaps in Global Health: Insights from the Gender and Health Applied Learning Institute.","authors":"Mary de Boer, Katherine Banchoff, Rosemary Morgan, Anna Kalbarczyk","doi":"10.5334/aogh.4811","DOIUrl":"10.5334/aogh.4811","url":null,"abstract":"<p><p><i>Background:</i> Gender's influence on health outcomes is well-documented, yet gaps in gender expertise persist within the global health workforce. Simultaneously, accessible and interactive gender training opportunities are limited. The Johns Hopkins Bloomberg School of Public Health Gender and Health Summer Institute (GHSI), launched in 2023, aims to address these gaps by advancing the gender integration and analysis skills of health professionals. <i>Methods:</i> Using Stake's Countenance Model for educational evaluations, we explored whether the Institute was meeting its objective of providing applied knowledge and experience of gender integration and analysis for health research, programs, and policy. The evaluation focused on intended and actual program outcomes. We examined proposal documents and held discussions with the GHSI team. All students receive pre-course surveys one week prior to each course. Post-course surveys focused on changes in knowledge, skills, and abilities and overall experience. Two focus-group discussions were held with students. Survey data were analyzed descriptively in R, and qualitative data were analyzed thematically. <i>Results:</i> The pre-course survey received 137 unique responses; the post-course survey received 78 responses. Results indicate that the GHSI successfully met many of its intended goals, for example, by increasing participants' knowledge and skills in gender analysis and integration as well as confidence in applying new skills. Learning was enhanced through creating safe and inclusive spaces. However, the courses' short duration and lack of a sustained community of practice were identified as areas for improvement. <i>Conclusion:</i> Findings underscore the importance of applied skills training and the need for ongoing support to fully equip professionals to address gender disparities in health. The GHSI's virtual format also demonstrates a scalable, innovative approach other programs may consider. Finally, recommendations are provided for enhancing the GHSI and similar programs to better serve working professionals and foster a more equitable global health landscape.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"91 1","pages":"57"},"PeriodicalIF":3.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016471","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":"The Use and Creation of Photographic Imagery in Global Health: Actionable Steps Towards Decolonization by Academic Institutions.","authors":"Meagan Harrison, Anna Kalbarczyk, Bareng Aletta Sanny Nonyane","doi":"10.5334/aogh.4847","DOIUrl":"10.5334/aogh.4847","url":null,"abstract":"<p><p><i>Background:</i> Photographic imagery holds profound power in shaping narratives, identities, and perceptions in global health education. Historically, visual representation used in global health has perpetuated colonial hierarchies, reinforcing inequities and marginalizing the voices and lived realities of the communities they depict. These images can inadvertently sustain harmful stereotypes and distort the complexity of global health challenges. <i>Findings:</i> This paper explores the ethical imperative of decolonizing photographic imagery within academic global health, proposing a comprehensive multi-level framework for change targeting institutions, faculty, and students. At the institutional level, strategies include developing formal ethical image-use policies, establishing accountability structures, and providing ongoing training to center principles of informed consent, dignity, and cultural context in image selection and use. Faculty have a critical role in modeling ethical practices by selecting imagery in research outputs and teaching materials, integrating visual ethics into curricula, and fostering classroom dialogue that encourages critical reflection on representation and power dynamics. Educators can actively engage students by empowering them to contribute their own experiences, thereby reshaping dominant visual narratives. Collaboration with community partners in co-creating authentic and respectful images is essential, alongside mechanisms for continuous evaluation and accountability to sustain ethical standards over time. <i>Recommendations:</i> We recommend that academic institutions adopt institution-wide ethical image-use policies, offer training programs for faculty and students, and develop centralized image repositories that include culturally appropriate and consented visuals. Faculty should integrate ethical image practices into research and pedagogy, while creating spaces for students to reflect on diverse perspectives. Building meaningful, ongoing partnerships with community stakeholders is crucial to ensuring that images represent the diversity and dignity of global health realities. <i>Conclusions:</i> By advancing a culture of ethical reflexivity and accountability around photographic imagery, academic institutions can dismantle colonial visual legacies and foster more equitable, inclusive, and humanizing global health education and practice.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"91 1","pages":"54"},"PeriodicalIF":3.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016414","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 Gap: Evaluating Global Health Training Needs in Pediatric Residency and Fellowship: A Program‑Wide Analysis.","authors":"Allyson Rose, Riad Rahhal, Dina Al-Zubeidi","doi":"10.5334/aogh.4734","DOIUrl":"10.5334/aogh.4734","url":null,"abstract":"<p><p><i>Background:</i> Interest in global health (GH) among pediatric trainees has grown, yet structured GH training remains limited in many programs. <i>Objective:</i> This study evaluates the GH interests, perceived barriers, and curriculum needs of pediatric residents and fellows in a Midwestern training program. <i>Methods:</i> A 23‑question anonymous survey was administered to pediatric trainees between September 2023 and September 2024. The survey assessed demographics, GH interests, barriers to participation, and curriculum gaps. Respondents were categorized by American medical graduates (AMG) vs. international medical graduates (IMG) and junior (PGY1‑2) vs. senior (PGY3‑7) trainees. Statistical analysis was conducted using SAS 9.4. <i>Results:</i> The survey response rate was 60%. Even though only 6% prioritized GH training in program selection, 56% expressed interest in GH electives. Time constraints (34%) and family responsibilities (18%) were primary barriers. IMGs (90%) were more likely than AMGs (65%) to express GH career interest. Communication skills development was identified as the highest educational need overall for all trainees, with junior trainees prioritizing it (59% vs. 32% seniors, p = 0.056) and AMGs vs. IMGs, 53% and 22% of the time (p = 0.15). <i>Conclusions:</i> Our study sheds light on differences in GH interest and trainee characteristics throughout pediatric training from residency through fellowship, considering AMG vs. IMG as a factor. Further, we were able to note how the desire for increased curriculum time in some of the ACGME's core competencies changes throughout the advanced training years, which helps guide further curriculum development. In addition, we uncovered that, despite our program's lack of GH focus, interest in GH remains high, and we call to action for further GH‑focused curriculum exposure in all pediatric training programs, regardless of size and location.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"91 1","pages":"55"},"PeriodicalIF":3.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975432","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":"Resource Allocation in the Pediatric Intensive Care Unit in Rwanda.","authors":"Tracy Kelly, Owen Selden, Dazhanae Houston, Derek Meyers, Brenna Kent, Aimable Kanyamuhunga","doi":"10.5334/aogh.4714","DOIUrl":"10.5334/aogh.4714","url":null,"abstract":"<p><p><i>Background:</i> Children born in low‑ and middle‑income countries are 14 times more likely to die before reaching the age of five compared to children in high‑income countries. Pediatric Intensive Care Units (PICUs) with specialized equipment and advanced medications managed by trained clinicians have reduced mortality of children worldwide, yet countries with limited funds and scarce resources strain to meet needs of critically ill children. <i>Objectives:</i> The aim of the study was to identify the disease burden of patients entering the PICU at the Central Hospital in Kigali, Rwanda, and the relationship between patient mortality and allocation of resources. In addition, this study focused on several factors suspected to impact the mortality rate, including the entry point into the health system, delay in admittance, and whether surgery was performed. <i>Method:</i> A retrospective, cross‑sectional review of 30 medical records per year was conducted between January 2016 and December 2022, totaling 177 encounters. Demographic and clinical data were extracted and analyzed to perform descriptive and inferential statistics, including univariable and multivariable logistic regression analyses to identify factors affecting mortality. <i>Findings:</i> The study showed an overall mortality rate of 55% for patients admitted to the PICU. Among patients who died, the most common diagnoses were sepsis, primary respiratory failure, and congenital defects. When holding age and surgery constant, patients with a noted delay in admittance to the PICU had increased odds of mortality than those without a delay. Holding the delay in admittance constant, there was an interaction effect between age and surgery on mortality, with higher odds of mortality in newborns than in children over one month of age when surgery was performed. <i>Conclusions:</i> Careful adherence to emerging pediatric sepsis guidelines, immediate recognition, and appropriate treatment may reduce mortality. Prioritizing policies that reduce delays in treating critically ill children may improve outcomes.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"91 1","pages":"48"},"PeriodicalIF":3.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975375","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":"Global Health Partnerships: A Perspective of Eye Health Initiatives from the Uganda-United Kingdom Engagements and the Global Health Agenda.","authors":"Primrose Magala, Innocent Ayesiga, Ian Yeung, Samuel Mbayo, Moses W Mulimira, Sheba G Nakacubo","doi":"10.5334/aogh.4769","DOIUrl":"https://doi.org/10.5334/aogh.4769","url":null,"abstract":"","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"91 1","pages":"47"},"PeriodicalIF":3.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975401","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":"Flooding and Cognitive Health among Middle-Aged and Older Adults in Thailand: A Case Study of Resilient City Policy in Bangkok.","authors":"Fei Sun, Jin Ke, Phatchanun Vivarkanon, Myo Nyein Aung, Qing Xia, Leiwen Jiang","doi":"10.5334/aogh.4740","DOIUrl":"https://doi.org/10.5334/aogh.4740","url":null,"abstract":"<p><p><i>Background:</i> Thailand, a developing country in Southeast Asia, faces significant challenges due to urbanization, population aging, and climate change. This case study focuses on an adaptation strategy implemented in Bangkok to address the impacts of flooding. The study aims to examine the short-, medium-, and long-term effects of flooding exposure on cognitive health among middle-aged and older adults in Thailand and to identify the role of resilient city policy (RCP) in mitigating these impacts. <i>Methods:</i> Data on cognitive health (memory, calculation, and orientation to time) were obtained from the three waves (2017, 2020, and 2022) of the Health, Aging, and Retirement (HART) surveys. Flooding data were retrieved from Thai flood hazard records in the EM-DAT database from 2017 to 2022. Panel data analyses with a fixed effects model were used to estimate the effects of flooding on cognitive health and the moderating effects of RCP. <i>Results:</i> Findings indicate that exposure to flooding negatively impacts memory and orientation to time, with these effects worsening over time. RCP was found to mitigate the negative effects of flooding on memory scores and calculation scores. Additionally, RCP was associated with reduced risks for diabetes and depressive symptoms, indirectly protecting cognitive health. <i>Discussion:</i> Flooding has long-lasting negative effects on certain cognitive health domains, specifically memory and orientation to time. This study suggests that RCP, a multi-component policy aimed at improving structural systems, community preparedness, and healthcare access, shows promise in mitigating the adverse effects of flooding on residents' cognitive health. Further research is needed to link specific policy components to cognitive health outcomes and to understand their roles in protecting cognitive health.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"91 1","pages":"49"},"PeriodicalIF":3.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975396","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":"Assessing the Effectiveness of Climate-Smart Health Facilities in Small Island Caribbean Nations.","authors":"Maureen Lichtveld, James Hospedales, Spencer Reed Davenport, Jeanine Buchanich, Judith Harvey, Firoz Abdoel Wahid, Loren De Freitas","doi":"10.5334/aogh.4755","DOIUrl":"https://doi.org/10.5334/aogh.4755","url":null,"abstract":"<p><p><i>Background:</i> The small island developing states (SIDS) in the Caribbean are particularly vulnerable to the impacts of climate change. Many SIDS' health facilities are in high-risk areas such as coastal zones and are affected by extreme weather events. It is imperative to develop climate-resilient health systems to ensure health service continuity during and after an extreme weather event. One model to achieve this is the Smart Hospital Initiative. <i>Objective:</i> This case study was designed to strengthen the evidence base for decision-making regarding investing in Smart Hospital Initiative facilities as a climate adaptation strategy. <i>Methods:</i> This case study used secondary data derived from the Smart Hospital Initiative implementation (<i>n</i> = 55) focusing on four domains: country population/population served by the facility; pre-post Smart Hospital Initiative facilities' data; disaster and severe weather events' data; and diabetes mellitus (DM) mortality data. To assess the effectiveness of the initiative, an analysis of these data domains across seven countries is presented. <i>Findings:</i> Examining population size and healthcare service resources, healthcare facilities' readiness, climate-related disasters, and a health condition of concern, represents a viable strategy to assess the impact of climate adaptation on health. The Hospital Safety Index data showed that there were statistically significant pre-post retrofitted smart improvements across all 55 retrofitted facilities. The findings revealed that the effectiveness of any adaptation strategy is influenced by local financial and human resources beyond an initial, often external, investment and the capability to maintain the initial retrofitting of health facilities' impact on DM mortality. <i>Conclusions:</i> Climate-smart hospitals are a promising initiative to support the development of climate-resilient health facilities in SIDS. However, successful implementation depends on local capacity to support implementation and maintenance. We propose a framework to assess the utility of implementing climate-smart facilities as an adaptation strategy.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"91 1","pages":"51"},"PeriodicalIF":3.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975370","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}