Annals of Global Health最新文献

{"title":"The Architecture of Decolonial Partnerships in University Global Health Program Development.","authors":"Stephanie Crane, Alfredo Hernandez Moralez, Wendys Filpo Diaz, Babs Waldman, David Ansell, Ernhis Montero Hernandez, Jessica Vlaming, Kelly Dressel, Sophie Young, Zoe Kusinitz","doi":"10.5334/aogh.4952","DOIUrl":"10.5334/aogh.4952","url":null,"abstract":"<p><p><i>Background:</i> Processes and best practices for initiating and growing university global health programs in high-income countries (HICs) synchronously and symbiotically with partners in low- and middle-income countries (LMICs) are not abundantly described in the medical literature. In particular, programs that do not have university partners in LMICs may struggle to develop sustainable, ethical, and anticolonial community and governmental partnerships. <i>Methods:</i> This article reviews existing literature and describes the challenges in the contemporaneous development of university global health programs and community/governmental partners. The paper goes on to describe the creation of the Office of Global Health at Rush University in conjunction with the inception and development of its partner non-governmental organization (NGO), Community Empowerment in the Dominican Republic. The success and opportunities in the evolution of this ongoing relationship are described. Guiding principles for others attempting similar work are provided. <i>Results:</i> Creating these entities simultaneously promotes the establishment of relationships with equal power and authority from the inception, facilitates the creation of customized programs that capitalize on the strengths of the university and infrastructure of the partner country/community, and allows both entities to grow together in scope and impact. Challenges include identifying and nurturing like-minded university, NGO, and community/government partners; securing bilateral sustainable funding; ensuring quality of clinical services and educational/scholarly activities; and consistently promoting anticolonial practices. <i>Conclusion:</i> Developing university global health programs in HICs simultaneously with a partner NGO can result in mutual and commensurate growth and outcomes as well as strong and equitable relationships. This paper describes the author's own experience at Rush University building connections with community partners and colleagues in the Dominican Republic and outlines strategies to achieve these results.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"17"},"PeriodicalIF":5.1,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272600","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":"Maternal Cancer Mortality and Orphanhood: A Neglected Global Health and Equity Challenge.","authors":"Delfin Lovelina Francis","doi":"10.5334/aogh.5136","DOIUrl":"10.5334/aogh.5136","url":null,"abstract":"<p><p><i>Background:</i> Maternal cancer mortality represents a growing but under-recognized global public health issue with profound consequences for surviving children. Breast cancer, cervical cancer, and other common malignancies disproportionately affect women in their reproductive years, leading to substantial psychosocial, health, and socioeconomic impacts for their children. <i>Objective:</i> To synthesize current evidence on the global burden, determinants and consequences of maternal orphanhood due to cancer, and to identify prevention and policy opportunities aligned with existing health system goals and global cancer initiatives. <i>Methods:</i> A structured literature search (2010-2025) was conducted across four databases using predefined keywords, with eligibility screening based on relevance to maternal cancer mortality and orphanhood outcomes. Evidence was analyzed under four thematic domains and interpreted comparatively using World Bank income classifications. <i>Results:</i> An estimated 1.05 million children became orphans due to maternal cancer in 2020. The burden was greatest in Low and Middle Income Countries (LMICs) (83%), particularly in Asia and Africa (>80%), with the highest numbers in India, China, Nigeria, and Ethiopia. Breast, cervical, and upper gastrointestinal cancers are the leading causes. The majority of the affected children were ≥ 10 years old (69%). Maternal orphanhood was linked to poorer survival, mental health, education, and socioeconomic outcomes. <i>Conclusions:</i> Maternal orphanhood from cancer highlights preventable inequities in women's health, cancer control, and child support systems. Despite global initiatives, the burden remains largely unaddressed. Prioritizing equitable access to vaccination, screening, treatment, and social protection within national cancer policies is essential to reduce avoidable maternal deaths and protect affected children.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"18"},"PeriodicalIF":5.1,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272602","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 Case for Local AI Development: Lessons From Computer‑Aided Detection of Tuberculosis and Silicosis in Southern Africa's Ex‑Miners.","authors":"Sean Terespolsky, Annalee Yassi, Rodney Ehrlich, Joshua Bruton, Karen Lockhart, Hairong Wang, Richard Klein, Warrick Sive, John Statheros, Jerry M Spiegel","doi":"10.5334/aogh.5064","DOIUrl":"10.5334/aogh.5064","url":null,"abstract":"<p><p>The co‑epidemic of silicosis and tuberculosis (TB) in South Africa's mining industry affects a large number of migrant workers and is compounded by limited access to chest X‑ray (CXR) screening. Although artificial intelligence (AI)‑based computer‑aided detection (CAD) systems for TB have demonstrated impressive accuracy against microbiological standards, validation among silica‑exposed populations has been limited. Moreover, well‑documented biases hinder CAD utility in diverse patient populations, potentially exacerbating existing healthcare inequities. In this article, we describe the challenges in developing CAD systems for TB and silicosis and present the potential benefits local public‑sector development initiatives can bring. Using a local dataset of 2000 CXRs from silica‑exposed Southern African mineworkers, alongside publicly available international datasets and pretrained CAD models, we present empirical evidence of CAD biases. Dimensionality reduction analysis produced visual mappings that demonstrate how local CXRs form a distinct cluster, separate from international images. We also found that, relative to TB, reducing image resolution disproportionately degraded silicosis detection. Further visualizations proved that accuracy metrics alone are insufficient measures of clinical reliability, possibly obscuring deployment failures. We conclude that local public‑sector CAD development offers a viable alternative to reliance on externally developed systems that likely exclude underserved populations. Addressing CAD deficiencies requires curating population‑representative datasets that capture local epidemiology and transparent, open‑source development practices that enable peer review and bias correction. Embedding technical and clinical expertise locally can transform AI‑based CAD from a potential instrument of digital colonialism into a mechanism that produces contextually appropriate diagnostics while advancing knowledge for equitable AI deployment worldwide.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"16"},"PeriodicalIF":5.1,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203462","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":"Transforming Healthcare: Mozambique's Pioneering Integrative Medicine Course.","authors":"Delfina Hlashwayo, Filomena Barbosa, Angelina Martins, Tufária Mussá, Amélia Furvela, Telma Magaia, Felda Langa, Natércia Madeira, Esperança Rafael, Eliette Munezero, Nurah Virahsawmy, Marta Maculuve, Alice Massingue","doi":"10.5334/aogh.4785","DOIUrl":"10.5334/aogh.4785","url":null,"abstract":"<p><p><i>Introduction:</i> This manuscript evaluates the outcomes of a pioneering Integrative Medicine Course implemented at Eduardo Mondlane University, aiming to strengthen medical and health students' knowledge and skills while fostering a holistic approach to patient care. Delivered in two editions-an intensive in‑person program and an extended online format-the course sought to improve understanding of integrative medicine. <i>Methods:</i> A mixed‑methods approach was adopted, combining data from participatory observation, pre‑ and post‑course surveys, focus group discussions, and final course evaluations. Self‑assessments of knowledge and skills were collected before and after the course. Final exam results were analyzed to assess knowledge acquisition. The in‑person edition was conducted over 1 week (September 16-20, 2024), and the online edition spanned 8 weeks (January-February 2025). Both formats included weekly lectures, practical sessions, and interactive discussions. The Wilcoxon signed‑rank test was used to evaluate changes in knowledge and skills. <i>Results and discussion:</i> A total of 164 students enrolled, with 134 completing the course (completion rate of 82%). Most participants were female (81%), with an average age of 23 years (SD ± 3.7); 61% were medical students, and three were postgraduate students. Satisfaction was high, with 66% awarding the highest rating. The most highly rated aspects included instructors (78%), course organization (77%), and resources provided (75%). Phytotherapy emerged as the most relevant topic, followed by traditional medicine, mental well‑being, and nutrition. The participatory teaching approach was preferred, accounting for 63% of mentions. Post‑course evaluations showed significant improvements in knowledge, interest, attitudes, and competencies (<i>p</i> < 0.05). All students passed the final exam, with an average score of 18/20. <i>Conclusions:</i> The course successfully enhanced students' understanding and application of integrative medicine. Both delivery formats proved effective in engaging learners and fostering critical skills. This initiative establishes a foundation for advancing integrative medicine education and research in Mozambique.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"15"},"PeriodicalIF":5.1,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203408","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":"Beyond Incidence and Mortality: Socioeconomic Mediation of Gastric Cancer Disparities in the United States, 1990-2021.","authors":"Yun Seo Kim, Sarah Soyeon Oh, Sung Hwi Hong, Minseo Kim, Dong Keon Yon, Jae Il Shin, Chul S Hyun","doi":"10.5334/aogh.5015","DOIUrl":"10.5334/aogh.5015","url":null,"abstract":"<p><p><i>Background:</i> Gastric cancer (GC) remains a major global health burden, yet US trends often obscure disparities hidden within national averages. Although incidence and mortality have declined overall, profound geographic, racial, and socioeconomic differences persist. Few studies have systematically examined how demographic composition and social determinants jointly shape GC burden across states. <i>Methods:</i> We analyzed Global Burden of Disease 2021 estimates for GC incidence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021 across 50 US states and the District of Columbia. Outcomes were stratified by age, sex, race/ethnicity, and sociodemographic index. Multivariable and mediation models assessed how income and education modified racial and ethnic disparities. <i>Results:</i> While national GC rates declined over three decades, the burden remained concentrated in states with large immigrant and low-income populations, including Hawaii, the District of Columbia, Mississippi, and New Mexico. States with higher Asian populations exhibited roughly fourfold greater incidence than those with larger Hispanic populations. Income and education together mediated 22%-31% of racial and ethnic disparities, demonstrating that socioeconomic position-not race alone-drives much of the observed heterogeneity. <i>Conclusions:</i> This state-level sociodemographic analysis reveals the structural underpinnings of US GC inequities within a broader global context of uneven early-life risk and population diversity. By linking racial composition, income, and education to disease burden, it identifies modifiable pathways for prevention and policy action. Viewed as a case study for migrant-receiving countries, these findings underscore the importance of equity-informed strategies-such as <i>Helicobacter pylori</i> screening, nutrition interventions, and targeted resource allocation-to address persistent GC disparities globally.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"14"},"PeriodicalIF":5.1,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12880004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144279","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":"Parental Knowledge and Acceptance of HPV Vaccine in Rabigh's School, Saudi Arabia.","authors":"Raneem Alghanmi, Eman Alkhalawi, Roaa Albeladi, Shahad Albeladi, Munirah Alghamdi, Abdlkareem Fayoumi, Rawan Nassif","doi":"10.5334/aogh.4866","DOIUrl":"10.5334/aogh.4866","url":null,"abstract":"<p><p><i>Background:</i> Human papillomavirus (HPV) is a common sexually transmitted infection associated with cervical cancer. Since 2008, HPV vaccines have been available in Saudi Arabia, and in 2022, a nationwide school-based vaccination program was launched to improve coverage and reduce HPV-related diseases. <i>Objectives:</i> This study evaluated parental knowledge and acceptance of the HPV vaccine during a school-based vaccination campaign in Rabigh, Saudi Arabia. It also examined associations between demographic factors, parental knowledge, and vaccine acceptance. <i>Methods:</i> A cross-sectional study involved 261 guardians of girls attending intermediate schools in Rabigh during the academic years 2022/2023, 2023/2024, and 2024/2025. Data were collected through an online questionnaire assessing HPV vaccine knowledge, acceptance, and influencing factors. Chi-square tests were used for analysis. <i>Findings:</i> Vaccine acceptance increased with guardians' educational qualification, from 46.7% among those with primary or middle school to 89.3% among those with higher education (<i>P</i> = 0.007). Acceptance also increased with family income, from 45.2% (income < 5000 SR) to 77.7% (income ≥ 10,000 SR) (<i>P</i> = 0.002), and was higher when information was obtained from health practitioners (90.4%) or the Internet (80.4%) compared to relatives or social media (47%) (<i>P</i> < 0.001). Respondents with a knowledge score ≥80% were more likely to accept the vaccine (84.2% versus 67.3%, <i>P</i> = 0.04). Recommendations from the Ministry of Health (MOH) or physicians were key motivators for vaccination. Concerns about vaccine safety were the primary reason for refusal (48.1%). Among non-accepting parents, 59.5% reported that more information on benefits and safety would encourage acceptance, while 22.8% remained unwilling to vaccinate. <i>Conclusion:</i> Parental knowledge, education, and income significantly influenced HPV vaccine acceptance. Parents informed by healthcare professionals or the Internet were more likely to vaccinate their daughters. Targeted efforts raising awareness of vaccine benefits and safety from trusted sources like physicians and the MOH are essential.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"13"},"PeriodicalIF":5.1,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12880011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144297","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":"Host Country Views of Short-Term Medical Missions: Community-Based Research in Ghana, Uganda, and Guatemala.","authors":"Efua Esaaba Mantey, Emilly Maractho, Erwin Calgua-Guerra, Daniel Doh, Guillermo Zea-Flores, Carolina López, Sirry Alang, Peter Donkor, Judith N Lasker","doi":"10.5334/aogh.4951","DOIUrl":"10.5334/aogh.4951","url":null,"abstract":"<p><p><i>Background:</i> Growing attention to the proliferation of short-term medical missions (STMMs) in the Global South has increasingly taken the form of critiques of inadequately prepared volunteers, lack of community control and continuity. In response, scholars and practitioners in high-income countries have created guidelines for best practices. These have rarely incorporated the views of host community members and leaders. While research has begun to address what host countries want from STMMs, these projects have also been carried out almost exclusively by scholars from the Global North. <i>Objectives:</i> The aims were to provide additional insights into host views in three countries that are frequent destinations for STMMs and to explore the possibility that design and direction by host country researchers would yield new perspectives. <i>Methods:</i> Scholars from Ghana, Uganda, and Guatemala designed and directed studies of medical staff, public officials, and patients from multiple locations around each country. Interviews and focus groups were carried out with a total of 129 people. <i>Findings:</i> All three studies found widespread appreciation of STMMs for providing needed medical services. In Ghana and Guatemala, language differences were cited as a major barrier, while Ugandan participants criticized volunteers' lack of skills and mismatch between their expertise and community needs. Ghanaian and Ugandan participants voiced resentment of patients' preference for white volunteers and the arrogance of some visitors. The amount of time and effort required to host was a common theme. <i>Conclusion:</i> The findings confirm the importance for STMMs of understanding the local health context and language and working collaboratively and respectfully with hosts. Direction by host country researchers enhanced the value in several ways, including access to officials and establishment of trust with interviewees.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"12"},"PeriodicalIF":5.1,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107680","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":"Validation of the 60-Item Brief COPE for Assessing Coping Mechanisms Among Informal Caregivers of Patients with Cancer in Uganda.","authors":"Rachel Kansiime, Jackson Oryem, Nixon Niyonzima, Milton Mutto, Godfrey Zari Rukundo, Simon Kizito, Joyeeta Talukdar","doi":"10.5334/aogh.4948","DOIUrl":"10.5334/aogh.4948","url":null,"abstract":"<p><p>The psychological and emotional burdens experienced by informal caregivers of cancer patients highlight the need for effective coping strategies to maintain their well-being. The Brief COPE is a validated questionnaire consisting of 60 items, aimed at evaluating an individual's coping strategies and is effective in providing a comprehensive profile of responses to stress. This study examined the psychometric properties of the 60-item Brief COPE among informal caregivers of cancer patients in Uganda. A cross-sectional survey involving 200 caregivers was conducted, during which participants completed the Brief COPE alongside measures of psychological distress. Internal consistency was evaluated using Cronbach's α, while test-retest reliability was assessed to determine temporal stability. Construct validity was examined through confirmatory factor analysis (CFA) and correlational analysis with related constructs. The Brief COPE demonstrated excellent internal consistency (Cronbach's α = 0.92) and strong test-retest reliability (<i>r</i> = 0.89). The anticipated factor structure was validated through CFA, and significant correlational analysis corroborated its construct validity. These results affirm that the 60-item Brief COPE is a reliable and valid tool for assessing the coping strategies of informal caregivers of cancer patients in Uganda.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"11"},"PeriodicalIF":5.1,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107653","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":"Particulate Air Pollution, Disease, and Death in the Cities and Towns of Southwestern Pennsylvania.","authors":"Ella M Whitman, Luke Bryan, Sancia Sehdev, Philip J Landrigan","doi":"10.5334/aogh.5145","DOIUrl":"10.5334/aogh.5145","url":null,"abstract":"<p><p><i>Background:</i> PM_2.5 air pollution is a leading cause of disease and death. US air pollutant emissions have declined by 75% since passage of the Clean Air Act in 1970, but the Pittsburgh Metropolitan Statistical Area (MSA) continues to have elevated pollution levels and, in 2025, had the US's 12^th highest PM_2.5 concentration. Steel mills and coke ovens are major point sources. <i>Objective:</i> To quantify deaths, adverse birth outcomes, and children's IQ loss in the Pittsburgh MSA attributable to PM_2.5 air pollution. <i>Methods:</i> Mean annual PM_2.5 air pollution concentrations were obtained for each census tract in the Pittsburgh MSA from NASA's satellite-based Socioeconomic Data and Applications Center map layers and linked with vital records obtained from the Pennsylvania Department of Health. Exposure-response functions from peer-reviewed literature and EPA's BenMAP software were used to quantify deaths, adverse birth outcomes, and IQ loss attributable to PM_2.5 pollution. <i>Results:</i> The mean annual PM_2.5 concentration in the Pittsburgh MSA was 8.54 μg/m³. Concentrations across census tracts ranged from 5.74 to 15.90 μg/m³. Of 27,224 adult deaths in the Pittsburgh MSA in 2019, we estimate that between 3,085 and 3,467 (11.1%-12.5%) were attributable to PM_2.5 pollution. We estimate that 229 premature births, 177 low-weight births, and 12 stillbirths could be attributed to prenatal PM_2.5 exposure. Among the 24,604 children born in the Pittsburgh MSA in 2019, PM_2.5 pollution was linked to the loss of 60,668 full-scale IQ points, resulting in estimated lifetime economic losses of $2.7 billion. <i>Conclusion:</i> In 2019, 11.1%-12.5% of adult deaths in the Pittsburgh MSA, more than 400 adverse birth outcomes, and widespread reductions in children's IQ were attributable to PM_2.5 air pollution. Public policies and strict enforcement that reduce pollutant emissions and improve air quality will improve the health of southwestern Pennsylvania residents, save lives, and be highly cost-effective.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"10"},"PeriodicalIF":5.1,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114810","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":"Building India's Low-Carbon Healthcare System: A Comprehensive Review of National Policies, Operational Frameworks, and Decarbonization Strategies.","authors":"Harshini Thirumoorthi, Saravanan Sampoornam Pape Reddy","doi":"10.5334/aogh.5096","DOIUrl":"10.5334/aogh.5096","url":null,"abstract":"<p><p><i>Background:</i> Climate change poses a profound threat to public health globally and in India, but ironically healthcare activities themselves contribute significantly to greenhouse gas emissions. The healthcare sector produces about 4-5% of global carbon emissions. India's healthcare system is estimated to be the world's seventh-largest carbon emitter in absolute terms. To align with climate goals and protect health, India has begun instituting policies to foster a low-carbon, climate-resilient healthcare system. <i>Objective:</i> To comprehensively review India's national policies, operational frameworks, and strategies aimed at reducing healthcare-related carbon emissions (decarbonization) while strengthening health system sustainability. <i>Methods:</i> We conducted a narrative review of policy documents and PubMed-indexed literature from 2018 to 2025 focusing on climate change mitigation in the Indian health sector. <i>Findings:</i> India has mainstreamed health into national climate planning with the release of the National Action Plan on Climate Change and Human Health (2018) and the launch of the National Programme on Climate Change and Human Health (2019). These set targets for climate-health surveillance and low-carbon, climate-resilient medical health facilities. Climate action and sustainability are being included in accreditation standards. Early benefits include: greater energy reliability and lower cost energy services for healthcare centers with solar energy and higher health facility performance during extreme weather events. However, implementation remains nascent. Gaps remain in data, funding, and capacity to scale low-carbon practices across India's sprawling health system. <i>Conclusions:</i> India has made initial strides in aligning its health sector with climate mitigation imperatives through policies and guidelines for sustainable, low-carbon healthcare. Strengthening governance, financing, and technical support will be critical to fully implement decarbonization strategies. A low-carbon healthcare system in India can not only reduce emissions but also improve public health, resilience, and healthcare quality, setting an example for sustainable healthcare development in low- and middle-income countries.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"9"},"PeriodicalIF":5.1,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107668","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}