Francis Sarial Ganancial, Roditt Cruz-Delfino, Vivian Chia-Rong Hsieh
{"title":"Geographical disparities in maternal healthcare and mortality in the Philippines: a 10-year comparison.","authors":"Francis Sarial Ganancial, Roditt Cruz-Delfino, Vivian Chia-Rong Hsieh","doi":"10.1093/inthealth/ihaf059","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf059","url":null,"abstract":"<p><strong>Background: </strong>Although the Philippines launched its Maternal, Neonatal, and Child Health and Nutrition strategy in 2008 to reduce maternal mortality, its impact on maternal health services (MHS) utilization and maternal mortality ratio (MMR) remains unclear. This study examines MHS utilization trends and their association with MMR across the Philippines from 2010 to 2019.</p><p><strong>Methods: </strong>We conducted an ecological study using panel data in the Philippines during 2010-2019. Secondary analyses took place on datasets from the Department of Health and the Philippine Statistics Authority. Multivariate analyses were performed to investigate the association between MHS utilization and MMR.</p><p><strong>Results: </strong>From 2010 to 2019, national mean MMR declined from 74.85 to 57.19 deaths per 100 000 live births. Facility-based deliveries increased by 39.57% and births attended by medical doctors by 19.01%. Results from fixed-effects models revealed no significant association between MHS utilization and change in MMR over the 10-y period. However, utilization of antenatal care in Luzon (β=-1.528, p=0.005) and postpartum care in Mindanao (β=-1.604, p=0.020) was attributable to MMR reduction in 2019.</p><p><strong>Conclusions: </strong>While a national decline in MMR was observed from 2010 to 2019, significant regional disparities in MMR existed. The impact of MHS utilization varied over time and location.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emmanuel Ekpor, Samuel Sanaa Brobbey, Cynthia Yaba Kumah, Samuel Akyirem
{"title":"Experience of infertility-related stigma in Africa: a systematic review and mixed methods meta-synthesis.","authors":"Emmanuel Ekpor, Samuel Sanaa Brobbey, Cynthia Yaba Kumah, Samuel Akyirem","doi":"10.1093/inthealth/ihaf060","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf060","url":null,"abstract":"<p><p>Infertility is a significant reproductive health issue with high prevalence rates in Africa, where it is often stigmatized. This systematic review characterizes the experience of infertility stigma in Africa. A systematic search of relevant studies was conducted across PubMed, MEDLINE, CINAHL, PsycINFO, Global Health, Scopus and Web of Science, covering publications from their inception to March 2025. The search incorporated subject headings and keywords related to 'infertility' and 'stigma' in combination with terms specifying all African countries. A mixed methods approach was employed for data analysis, using the convergent thematic QUAL synthesis method. A total of 1987 records were identified, with 48 studies ultimately meeting the inclusion criteria. The analysis revealed four overarching themes in the experience of infertility stigma: mechanisms of stigma-factors that drive or perpetuate stigma surrounding infertility; stigma marking-the social markers and identifiers that distinguish individuals as stigmatized; manifestations of stigma-the varied forms through which stigma is expressed; and consequences-the psychological, behavioural, relational and health-related repercussions for individuals experiencing infertility stigma. Infertility stigma was widespread, with a prevalence as high as 64%. However, no interventions were developed and implemented to mitigate this issue. Infertility stigma in Africa is deeply embedded within cultural norms and social structures, significantly impacting the lives of those affected. This review emphasizes the critical need for culturally tailored interventions to alleviate stigma and enhance access to reproductive health services.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medical insurance coverage and its associated factors among children in urban and rural Chongqing, China.","authors":"Caihui Hu, Jingyu Chen, Lanling Chen, Xinyuan Yao, Shunqing Luo, Xiaoping Jiang, Lan Chen, Fengming Wang, Jie Li, Jian Liu, Shihai Zheng, Xiaohua Liang","doi":"10.1093/inthealth/ihaf057","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf057","url":null,"abstract":"<p><strong>Background: </strong>Children face a heavy disease burden, while healthcare utilization remains low. This study seeks to assess the proportions of children in Chongqing covered by medical insurance and identify associated factors.</p><p><strong>Methods: </strong>From March to June 2019, a stratified cluster sampling was employed to cover 4705 participants in Chongqing's urban and rural districts. In a cross-sectional survey, univariate and multivariate mixed logistic regression analysis were performed to explore the determinants of medical insurance enrolment.</p><p><strong>Results: </strong>The participation rates of basic medical insurance (BMI) were 83.29%, 85.29% and 81.11% in total, urban areas and rural areas, respectively. For commercial medical insurance (CMI), the corresponding rates were 29.78%, 34.95% and 24.11%, respectively. After adjusting for covariates, younger child age, better quality of life and higher annual household income were associated with a higher BMI participation rate. Conversely, children with asthma had lower odds of BMI coverage. For CMI, childhood obesity was a risk factor for being uninsured, while higher parental education, rhinitis, annual family income >150 000 RMB, caesarean section history and maternal gestational diabetes significantly increased the likelihood of CMI enrolment.</p><p><strong>Conclusions: </strong>In summary, universal health insurance coverage for children in Chongqing remains unfulfilled. To ameliorate the gaps and inequalities in children's insurance, sustained efforts are necessary, including improving household economic conditions, enhancing parental education levels and focusing on children's physical health. Therefore, policy supports should be enhanced, especially for economically disadvantaged rural areas in southwestern China.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A qualitative risk assessment of Crimean-Congo haemorrhagic fever in Nigeria: implications for One Health response.","authors":"Abiodun Egwuenu, Sunday Makama, Nasir Ahmed, Olanrewaju Igah, Gloria Nwiyi, Yetunde Abioye, Damilola Kolade, Chika Okpala, Chinenye Emelife, Oyeladun Okunromade, Elsie Ilori, Jerry Pantuvo, Emmanuel Agogo, Olusola Aruna, Chinwe Lucia Ochu, Ifedayo M O Adetifa","doi":"10.1093/inthealth/ihaf056","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf056","url":null,"abstract":"<p><strong>Background: </strong>Crimean-Congo Haemorrhagic Fever (CCHF) is a severe tick-borne viral disease. Increasing cases in West Africa suggest potential undetected circulation in Nigeria.</p><p><strong>Methods: </strong>A One Health Joint Risk Assessment was conducted to identify transmission pathways and assess the likelihood and impact of human CCHF infections at the human-animal-environment interface in Nigeria. Risk framing involved developing structured questions for potential Crimean-Congo Haemorrhagic Fever virus (CCHFV) transmission scenarios. A scoping review was conducted and median seroprevalence values were reported. The likelihood, impact and data uncertainty for human infection scenarios were used for a qualitative estimation of risk.</p><p><strong>Results: </strong>Human contact with infected livestock during farming, veterinary practices and exposure to ticks was identified as a key infection route. Most cases in Nigeria (66.7%) were identified via serology, with a median human seroprevalence of 6.1% and cattle seroprevalence of 30.2%. CCHFV has been isolated from Rhipicephalus ticks. Four risk assessment questions were defined and focused on veterinarians, abattoir workers, herders, wildlife rangers and healthcare workers. Animal-related professions had a moderate likelihood of infection.</p><p><strong>Conclusion: </strong>Strengthening One Health surveillance, vector control and multisector infection prevention is crucial to reducing the risk of CCHF and averting future outbreaks.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Richard Gyan Aboagye, Mainprice Akuoko Essuman, Tarif Salihu, Abdul-Aziz Seidu, John Elvis Hagan, Frank Baiden, Bright Opoku Ahinkorah
{"title":"Association between the Survey-based Women's Empowerment (SWPER) index and barriers to healthcare in sub-Saharan Africa.","authors":"Richard Gyan Aboagye, Mainprice Akuoko Essuman, Tarif Salihu, Abdul-Aziz Seidu, John Elvis Hagan, Frank Baiden, Bright Opoku Ahinkorah","doi":"10.1093/inthealth/ihaf023","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf023","url":null,"abstract":"<p><strong>Background: </strong>Women's health is an essential component of the Sustainable Development Goals. We examined how women's empowerment influences barriers to healthcare access in sub-Saharan Africa.</p><p><strong>Methods: </strong>The study included a weighted sample of 188 572 women's data from the Demographic and Health Surveys of 21 countries. A multilevel binary logistic regression analysis was used to examine the association between women's empowerment and barriers to accessing healthcare.</p><p><strong>Results: </strong>Women in the medium and high categories of attitude towards violence, social independence and autonomy were less likely to experience problems in getting permission to go for treatment. Women who had high attitudes towards violence were less likely to experience problems in getting money for treatment. Women with high social independence were less likely to face problems getting money for treatment. Women with high scores for attitudes towards violence, social independence and decision-making had the lowest likelihood of experiencing difficulty with distance to a health facility. Similarly, those in the high categories for attitude towards violence, social independence and decision-making had the lowest odds of experiencing problems not wanting to go alone.</p><p><strong>Conclusions: </strong>Women's empowerment decreases the barriers to accessing healthcare in sub-Saharan Africa. Designing healthcare intervention programs for women should consider the contribution that women make to household decision-making, social independence and attitudes towards violence.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alex Bawuah, Jacob Oppong Nkansah, Godness Biney, Edward Kwabena Ameyaw, Sanni Yaya
{"title":"Understanding contraception-use intentions among women of reproductive age not currently using contraceptives in sub-Saharan Africa: key insights from Demographic and Health Surveys.","authors":"Alex Bawuah, Jacob Oppong Nkansah, Godness Biney, Edward Kwabena Ameyaw, Sanni Yaya","doi":"10.1093/inthealth/ihaf053","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf053","url":null,"abstract":"<p><strong>Background: </strong>This study assesses the prevalence of contraception-use intentions and evaluates the associated factors among non-users in sub-Saharan Africa (SSA).</p><p><strong>Methods: </strong>Data from 2014-2023 Demographic and Health Surveys of 30 countries in SSA consisting of 332 986 women aged 15-49 y not already using contraception were used.</p><p><strong>Results: </strong>The overall prevalence was 41.18% (95% CI 41.01 to 41.34%). Zimbabwe had the highest prevalence (72.34%; 95% CI 71.11 to 73.57%), whereas Ethiopia had the lowest (15.96%; 95% CI 15.40 to 16.51%). Women aged 25-49 y had lower odds of intending to use contraception compared with those aged 15-19 y, and this was striking among those aged 45-49 y (adjusted OR [AOR]=0.06, 95% CI 0.06 to 0.07). Those with a higher level of education displayed a greater likelihood of intending to use contraception (AOR=1.93, 95% CI 1.82 to 2.05) compared with those with no education. The odds increased with the number of children born, particularly for those with ≥4 children (AOR=1.59, 95% CI 1.52 to 1.67) compared with those with no children.</p><p><strong>Conclusions: </strong>Promoting the use of contraception requires tailored, multi-pronged interventions that account for the diverse sociodemographic, fertility and informational needs of women in this population.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter A M Ntenda, Mfundi P S Motsa, Jane K Ntenda, Rex B Mbewe, Fentanesh N Tiruneh
{"title":"Predictors of iron status among preschool-age children in Malawi: insights from a micronutrient survey.","authors":"Peter A M Ntenda, Mfundi P S Motsa, Jane K Ntenda, Rex B Mbewe, Fentanesh N Tiruneh","doi":"10.1093/inthealth/ihaf054","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf054","url":null,"abstract":"<p><strong>Background: </strong>Poor iron status is a common nutritional condition affecting preschool-age children (PSC) in low-income countries like Malawi. This study aimed to examine the determinants of iron deficiency (ID), functional iron deficiency (FID) and iron deficiency anaemia (IDA) among Malawian PSC.</p><p><strong>Methods: </strong>The study analysed data from the 2015-2016 Malawi Micronutrients Survey, which collected information from a nationally representative sample of PSC across Malawi. Iron status was evaluated through biochemical markers, including serum ferritin, soluble transferrin receptors and haemoglobin levels. Logistic regression analyses were performed to identify independent factors associated with iron status.</p><p><strong>Results: </strong>The prevalence of ID was 19.6%, FID was 50.3% and IDA was 4.7%. Males had higher odds of both ID and FID compared with females. Children <36 months of age were at significantly greater risk for ID, FID and IDA compared with children ages 48-59 months. Additionally, children referred for clinical malaria or those with inflammation were more likely to have ID and FID compared with those children who did not. Underweight children had a higher risk of both ID and IDA compared with children who were well nourished. Living in rural areas or the southern region of Malawi further increased the likelihood of developing ID compared with children from urban areas and the northern region.</p><p><strong>Conclusions: </strong>The study emphasizes the need for comprehensive healthcare initiatives addressing nutritional deficiencies and malaria prevention in vulnerable groups, particularly young children in rural areas.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kamran Abbasi, Parveen Ali, Virginia Barbour, Marion Birch, Inga Blum, Peter Doherty, Andy Haines, Ira Helfand, Richard Horton, Kati Juva, Jose F Lapena, Robert Mash, Olga Mironova, Arun Mitra, Carlos Monteiro, Elena N Naumova, David Onazi, Tilman Ruff, Peush Sahni, James Tumwine, Carlos Umaña, Paul Yonga, Chris Zielinski
{"title":"Ending nuclear weapons, before they end us†.","authors":"Kamran Abbasi, Parveen Ali, Virginia Barbour, Marion Birch, Inga Blum, Peter Doherty, Andy Haines, Ira Helfand, Richard Horton, Kati Juva, Jose F Lapena, Robert Mash, Olga Mironova, Arun Mitra, Carlos Monteiro, Elena N Naumova, David Onazi, Tilman Ruff, Peush Sahni, James Tumwine, Carlos Umaña, Paul Yonga, Chris Zielinski","doi":"10.1093/inthealth/ihaf052","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf052","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Basil H Aboul-Enein, Suha Ballout, Patricia J Kelly
{"title":"Family planning interventions across the League of Arab States: a regional scoping review.","authors":"Basil H Aboul-Enein, Suha Ballout, Patricia J Kelly","doi":"10.1093/inthealth/ihaf055","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf055","url":null,"abstract":"<p><p>Family planning is crucial in improving maternal and child health, reducing fertility rates and promoting gender equity. Despite global advancements in contraceptive access, disparities persist across the League of Arab States due to sociocultural, economic and policy barriers. Understanding the effectiveness of existing family planning interventions in this region is essential for addressing unmet needs and guiding policy improvements. This scoping review aims to identify and appraise family planning interventions conducted across the League of Arab States. A comprehensive search of 14 databases was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, focusing on studies published between 2010 and December 2024. The review included intervention-based studies that assessed family planning outcomes in Arabic-speaking countries. Data were extracted and tabulated. Seventeen intervention studies were identified, with the majority conducted in Jordan and Egypt. Effective interventions included pharmacist-led education, multisectoral collaborations, behavioural economics approaches and crisis-responsive strategies. While most studies reported positive effects on contraceptive uptake and knowledge, challenges such as low male engagement, provider resistance and sustainability concerns persisted. Interventions in crisis-affected settings demonstrated adaptability, but scalability remains a key issue. Future efforts should focus on culturally tailored strategies, long-term intervention sustainability and integrating family planning with broader health and economic empowerment programs.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Trends in lifestyle and mental health among 0.1 million Chinese: a longitudinal study pre- and post-COVID-19.","authors":"Yanhui Lin, Tao Wang, Ting Peng, Limo Gao","doi":"10.1093/inthealth/ihaf046","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf046","url":null,"abstract":"<p><strong>Background: </strong>To investigate the changes in lifestyle and mental conditions during the COVID-19 lockdown pre- and post-COVID-19 epidemic by analysing 0.1 million in the general population.</p><p><strong>Methods: </strong>A questionnaire was used to collect demographic, lifestyle and mental condition information. Descriptive and χ2 tests were utilized to analyse the differences among the three groups. Multiple linear regression models were used to assess the impact of mental status.</p><p><strong>Results: </strong>This study involved a total of 141 250 participants, with 68 533 individuals in 2019 (pre-COVID-19), 53 956 in 2021 (lockdown period) and 18 761 in 2023 (post-COVID-19). During the period of lockdown and post-COVID-19, there was a significant decrease in the proportion of male smokers, decreasing from 39.2% before the epidemic to 36.6% during the lockdown period and to 34.8% after the epidemic. The proportion of people with good dietary habits increased slightly during the lockdown period (71.2% vs 68.4%) and remained at 71.8% after the epidemic. The 30- to 39-y age group had the greatest increase in engaging in physical activity. Multiple regression analysis showed that mental health status is associated with age, gender, dietary habits, physical activity and sleeping condition.</p><p><strong>Conclusions: </strong>The general population is well adapted to the COVID-19 epidemic and can actively face the impact of the epidemic. Furthermore, the alarm triggered by the outbreak has cause people pay more attention to a healthy lifestyle.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}