International Health最新文献

{"title":"Essential dataset features in a successful obesity registry: a systematic review.","authors":"Mina Nosrati, Najmeh Seifi, Nafiseh Hosseini, Gordon A Ferns, Khalil Kimiafar, Majid Ghayour-Mobarhan","doi":"10.1093/inthealth/ihae017","DOIUrl":"10.1093/inthealth/ihae017","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of obesity and the diversity of available treatments makes the development of a national obesity registry desirable. To do this, it is essential to design a minimal dataset to meet the needs of a registry. This review aims to identify the essential elements of a successful obesity registry.</p><p><strong>Methods: </strong>We conducted a systematic literature review adhering to the Preferred Reporting Items for Systematic Review and Meta-Analysis recommendations. Google Scholar, Scopus and PubMed databases and Google sites were searched to identify articles containing obesity or overweight registries or datasets of obesity. We included English articles up to January 2023.</p><p><strong>Results: </strong>A total of 82 articles were identified. Data collection of all registries was carried out via a web-based system. According to the included datasets, the important features were as follows: demographics, anthropometrics, medical history, lifestyle assessment, nutritional assessment, weight history, clinical information, medication history, family medical history, prenatal history, quality-of-life assessment and eating disorders.</p><p><strong>Conclusions: </strong>In this study, the essential features in the obesity registry dataset were demographics, anthropometrics, medical history, lifestyle assessment, nutritional assessment, weight history and clinical analysis items.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"8-22"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747656","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":"Covid-19 vaccination coverage and associated factors among older hypertensive patients in Hangzhou, China.","authors":"Shijun Liu, Caixia Jiang, Yan Liu, Xin Qiu, Jun Luo, Jing Wang, Yuyang Xu","doi":"10.1093/inthealth/ihae019","DOIUrl":"10.1093/inthealth/ihae019","url":null,"abstract":"<p><strong>Background: </strong>Vaccination could provide effective protection against coronavirus disease 2019 (COVID-19). This study aims to describe the COVID-19 vaccination coverage and influential factors in Chinese older hypertensive patients.</p><p><strong>Methods: </strong>Using a cross-sectional design, participants were randomly selected from the electronic health records system during the pandemic era in Hangzhou, China. Logistic regression models were employed to compute the OR and 95% CI in order to assess the relationships between variables and the extent of COVID-19 vaccination coverage.</p><p><strong>Results: </strong>As of 3 August 2022, among a sample of 77 970 individuals, 75.11% had completed the full COVID-19 vaccination, while 57.66% had received a booster dose. Disparities in coverage were observed across genders, regions and age groups. Unhealthy lifestyles, cardiovascular disease, cancer, uncontrolled blood pressure, abnormal fasting plasma glucose, dyslipidemia and renal dysfunction were risk factors for COVID-19 vaccination coverage. The coverage rates continuously declined along with the number of risk factors. The ORs for full and booster vaccination in subjects with ≥4 risk factors were 2.55 (2.12∼3.07) and 2.60 (2.16∼3.13), compared to individuals without risk factors.</p><p><strong>Conclusion: </strong>The COVID-19 vaccination program for older hypertensive patients must be strengthened further. Emphasis should be placed on patients who reside in urban areas, have comorbidities or multiple risk factors.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"62-70"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747655","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":"Mediating effects of hypertension in association between household wealth disparities and diabetes among women of reproductive age: analysis of eight countries in sub-Saharan Africa.","authors":"Samuel H Nyarko, Isaac Y Addo, Castro Ayebeng, Kwamena S Dickson, Evelyn Acquah","doi":"10.1093/inthealth/ihae013","DOIUrl":"10.1093/inthealth/ihae013","url":null,"abstract":"<p><strong>Background: </strong>Diabetes prevalence appears to be increasing in low- and middle-income countries, yet little is known about how hypertension status mediates the association between household wealth and diabetes. This study examined the mediation effects of hypertension in associations between household wealth and diabetes in eight sub-Saharan African (SSA) countries.</p><p><strong>Methods: </strong>This is a cross-sectional study of 71 577 women from recent Demographic and Health Surveys for eight SSA countries. Sample-weighted logistic regression and causal mediation analyses were conducted.</p><p><strong>Results: </strong>Of the 71 577 women, 1.1% (782) reported ever being diagnosed with diabetes. Women with diabetes were more likely to have hypertension compared with those without diabetes (54.9% vs 9.9%). The odds of diabetes were significantly higher among women with hypertension (adjusted odds ratio [OR] 5.71 [95% confidence interval {CI} 4.62 to 7.05]) and women from rich households (adjusted OR 1.65 [95% CI 1.23 to 2.22]) compared with their respective counterparts. Hypertension status mediated 27.4% of the association between household wealth and diabetes status.</p><p><strong>Conclusions: </strong>Hypertension status partly contributes to the associations between household wealth disparities and diabetes status among women in the selected countries. Further research and targeted interventions are needed to explore specific mechanisms and confounding factors related to household wealth disparities, hypertension status and diabetes prevalence in this population.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"41-48"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698690","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":"Health literacy and household financial loss on malaria treatment for children under five in Ghana: a patients' perspective.","authors":"Millicent Ofori Boateng, Derek Asuman, Nuworza Kugbey, Padmore Adusei Amoah, Peter Agyei-Baffour, Ulrika Enemark","doi":"10.1093/inthealth/ihae022","DOIUrl":"10.1093/inthealth/ihae022","url":null,"abstract":"<p><strong>Background: </strong>Inadequate health literacy increases medical costs and leads to poor health outcomes. However, there is a paucity of empirical evidence of such associations in sub-Saharan Africa. This study investigates how the household cost of malaria in children under five in Ghana varies based on different levels of health literacy.</p><p><strong>Methods: </strong>A cross-sectional survey involving 1270 caregivers of children under five was conducted. The survey included health literacy questionnaire and several pieces of sociodemographic and behavioural variables.</p><p><strong>Results: </strong>We created seven caregiver health literacy profiles by scoring nine dimensions. The mean total cost for managing malaria among respondents was US$20.29 per episode. The total household cost for caregivers with high health literacy (Profile 1) (US$24.77) was higher than all other profiles, with the lowest cost (US$17.93) among the low health literacy profile (Profile 6). Compared with Profile 4, caregivers with high health literacy (Profile 1) spent more on managing malaria in children, while those with the lowest health literacy (Profile 7) spent less.</p><p><strong>Conclusion: </strong>The current study presents a snapshot of malaria treatment costs, and argues that low health literacy may lead to increased costs due to possible reinfections from delayed healthcare use. There is a need for longitudinal studies to understand causal relationship between health literacy and household expenses on malaria treatment to inform policy development and interventions.</p><p><strong>Lay summary: </strong>This study explores the impact of caregiver health literacy levels on the cost of managing malaria incidents in children under five in Ghana. High health-literate caregivers incurred the highest total household cost at US$24.77, with US$17.93 incurred by lower health-literate caregivers per malaria episode.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"77-83"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337415","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":"Metabolic syndrome burden, determinants and treatment status in an urban slum resettlement colony in Delhi, India.","authors":"Shivani Rao, Saurav Basu, Kajal Nandi, M M Singh, Heena Lalwani, Vansh Maheshwari, Amod Borle, Nandini Sharma","doi":"10.1093/inthealth/ihae024","DOIUrl":"10.1093/inthealth/ihae024","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS) in low-resource settings contributes to accentuated risk of cardiovascular disease, including stroke. The study objective was to estimate the prevalence, determinants and treatment status of MetS in an urban slum resettlement population in Delhi, India.</p><p><strong>Methods: </strong>This study was conducted from February to May 2023. Multiphase sampling was conducted with 1910 individuals screened for abdominal obesity (AO), with 996 detected as having AO, of which, 400 were selected by simple random sampling and further evaluated for triglycerides (TGs), high-density lipoprotein (HDL) and fasting glucose levels.</p><p><strong>Results: </strong>Among the 400 participants detected as having AO, 211 had evidence of MetS (52.75% [95% confidence interval 47.83 to 57.62]). The most prevalent combination of MetS clustering was for all five components (AO, diabetes mellitus [DM], hypertension [HTN], low HDL and high TGs; 14.69%), followed by AO, DM and HTN (12.32%). On adjusted analysis, the odds of having MetS was found to be independently associated with increasing age (≥40 y) but not sex.</p><p><strong>Conclusions: </strong>A high burden of MetS and suboptimal treatment status is prevalent in urban slum populations. Screening of individuals with AO, especially in those >40 y of age, can be an effective programmatic strategy for early diagnosis and management of MetS and its underlying components.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"84-93"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186120","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":"Antibiotic prescription sources and use among under-5 children with fever/cough in sub-Saharan Africa.","authors":"Getayeneh A Tesema, Godness K Biney, Vicky Q Wang, Edward K Ameyaw, Sanni Yaya","doi":"10.1093/inthealth/ihae026","DOIUrl":"10.1093/inthealth/ihae026","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Childhood febrile illness is among the leading causes of hospital admission for children &lt;5 y of age in sub-Saharan Africa (SSA). Antibiotics have played a pivotal role in enhancing health outcomes, especially for children &lt;5 y of age. Antibiotics prescription pattern evidence exists for SSA, however, prescription sources (either from qualified or unqualified sources) and use among children with fever or cough have not been explored. Thus the present study assessed antibiotic prescription sources and use among children &lt;5 y of age with fever and cough in SSA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used Demographic and Health Survey data from 37 countries with a total of 18 866 children &lt;5 y of age who had fever/cough. The surveys span from 2006 to 2021. The dependent variable was antibiotics taken for fever/cough based on prescriptions from qualified sources. The data were weighted using sampling weight, primary sampling unit and strata. A mixed-effects logistic regression model (both fixed and random effects) was fitted since the outcome variable was binary. Model comparison was made based on deviance (-2 log likelihood) and likelihood ratio tests were used for model comparison. Variables with p≤0.2 in the bivariable analysis were considered for the multivariable mixed-effects binary logistic regression model. In the final model, the adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p&lt;0.05 in the multivariable model were used to declare a significant association with taking antibiotics for fever/cough prescribed from qualified sources.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The percentage of unqualified antibiotic prescriptions among children &lt;5 y of age who had a fever/cough and took antibiotics was 67.19% (95% CI 66.51 to 67.85), ranging from 40.34% in Chad to 92.67% in Sao Tome. The odds of taking antibiotics prescribed from unqualified sources for fever/cough among children &lt;5 y of age living in rural areas were 1.23 times higher (AOR 1.23 [95% CI 1.13 to 1.33]) compared with urban children. The odds of taking antibiotics prescribed from qualified sources for fever/cough among children &lt;5 y of age whose mothers had primary, secondary and higher education decreased by 14% (AOR=0.86 [95% CI 0.79 to 0.93]), 21% (AOR 0.79 [95% CI 0.72 to 0.86]) and 21% (AOR 0.79 [95% CI 0.65 to 0.95]) compared with those whose mother had no formal education, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The study showed that the majority of the children who received antibiotics obtained them from unqualified sources in the 37 SSA countries. Our findings underscore the significance of addressing healthcare disparities, improving access to qualified healthcare providers, promoting maternal education and empowering mothers in healthcare decision-making to ensure appropriate antibiotic use in this vulnerable population. Further research and interventions targeted at these factors are warranted to optimize antibiotic prescribi","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"94-104"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307548","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":"Online health information-seeking behaviours for low back pain in the United Kingdom: analysis of data from Google trends and the Global Burden of Disease Study, 2004-2019.","authors":"Harpal Patel, Thomas A Shepherd","doi":"10.1093/inthealth/ihae020","DOIUrl":"10.1093/inthealth/ihae020","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) is a leading cause of global disability. Timely health-seeking is crucial for early diagnosis and management of pathologies. Despite increases in internet usage, there is sparse literature regarding online health information-seeking behaviours (OHISBs) for LBP and how they correlate with the LBP disease burden in the UK.</p><p><strong>Methods: </strong>To examine OHISB trends, we conducted Prais-Winsten analyses on monthly search volume data from Google Trends in the UK between 1 January 2004 and 1 December 2019. Cross-correlation analyses assessed the relationship between annual LBP search volume and LBP morbidity and mortality data from the Global Burden of Disease study (2004-2019).</p><p><strong>Results: </strong>From 2004 to 2019, the trend in LBP search volume was curvilinear (β=1.27, t=5.00, p<0.001), with a slope change around the end of 2006. There was a negative linear trend (β=-0.25, t35=-1.52, p<0.14) from 2004 to 2006 and a positive linear trend (β=0.67, t108=9.17, p<0.001) from 2007 to 2019. Cross-correlations revealed positive associations between search volume and disease burden indicators for LBP such as prevalence and incidence at lags 4 and 5.</p><p><strong>Conclusions: </strong>A rising trend in OHISBs for LBP was noted between 2004 and 2019. This trend positively correlates with incidence, prevalence and burden measures. These findings emphasise the importance of high-quality online resources to increase awareness around LBP, facilitating early diagnosis and management.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"71-76"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933693","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":"Tropical Data: supporting health ministries worldwide to conduct high-quality trachoma surveys.","authors":"E M Harding-Esch, A Bakhtiari, S Boyd, C Burgert-Brucker, R Butcher, M Dejene, A Harte, P J Hooper, C Jimenez, E M Taylor, T Millar, C Mpyet, J M Ngondi, L A Rotondo, A W Solomon","doi":"10.1093/inthealth/ihae036","DOIUrl":"10.1093/inthealth/ihae036","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"1-3"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181394","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":"Uptake and challenges with daily oral pre-exposure prophylaxis among men who have sex with men and transgender women, suburban Yangon, Myanmar.","authors":"Ni Ni Tun, Frank Smithuis, Nyan Lynn Tun, Myo Min Min Hteik, Myat Ko Ko, Lutgarde Lynen, Tom Decroo, Eric Florence, Tinne Gils","doi":"10.1093/inthealth/ihae025","DOIUrl":"10.1093/inthealth/ihae025","url":null,"abstract":"<p><strong>Background: </strong>Pre-exposure prophylaxis (PrEP) is effective for human immunodeficiency virus (HIV) prevention in risk groups. We assessed PrEP uptake and 12-month retention among men who have sex with men (MSM) and transgender women (TGW) in Myanmar during the coronavirus disease 2019 pandemic and a political crisis.</p><p><strong>Methods: </strong>Using prospectively collected data, we assessed the proportion of persons eligible, initiated and retained 12 months on PrEP. We calculated HIV and syphilis incidence among those initiated on PrEP. Predictors of compliance to scheduled visits were assessed with fractional logistic regression.</p><p><strong>Results: </strong>Among 652 persons screened between July and December 2020, 85.3% were eligible and 38.8% initiated PrEP. The daily pill burden was the main reason (86.5%) for refusing PrEP. A history of HIV post-exposure prophylaxis (PEP) and having an HIV-positive partner not on anti-retroviral therapy (ART) was associated with PrEP uptake (p<0.05). The 12-month retention among those initiating PrEP was 43.0%. Age ≥25 y, a history of PEP and having an HIV-positive partner not on ART predicted better compliance with scheduled visits (p<0.05). HIV incidence among PrEP initiators was 3.1 per 100 person-years (95% confidence interval [CI] 1.3 to 7.4) and syphilis incidence was 17.6 per 100 person-years (95% CI 12.3 to 25.1).</p><p><strong>Conclusions: </strong>A PrEP program for MSM and TGW in Myanmar was implemented successfully under difficult circumstances. Alternative strategies are needed addressing PrEP uptake and retention.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"23-32"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319575","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":"Deployment of vaccine cold chain equipment in resource-limited settings: lessons from the Gavi Cold Chain Optimization Platform in Cameroon.","authors":"Jude Nkwain, Vouking Marius Zambou, Sangwe Clovis Nchinjoh, Valirie Ndip Agbor, Amani Adidja, Clarence Mbanga, Nnang Nadege Edwidge, Shalom Tchokfe Ndoula, Andreas Ateke Njoh, Demba Diack, Pietro Di Mattei, Owens Wiwa, Ousmane Diaby, Yauba Saidu","doi":"10.1093/inthealth/ihae010","DOIUrl":"10.1093/inthealth/ihae010","url":null,"abstract":"<p><strong>Background: </strong>Lack of or use of suboptimal cold chain equipment (CCE) is a major barrier to optimal immunization coverage and equity. Gavi established the CCE optimization platform (CCEOP) in 2015 to help eligible countries modernize their cold chain systems. However, there are limited data on CCE deployment at country level. We present lessons learnt from deploying CCE from the Gavi CCEOP in Cameroon.</p><p><strong>Methods: </strong>This cross-sectional study collected data on the number of days items of CCE spent at each point on their trajectory from the entry port to 62 randomly selected health facilities in Cameroon.</p><p><strong>Results: </strong>Once equipment arrived at the entry port, it took 10 d for customs clearance, 2 d from customs clearance to warehousing and 257 d (>9 mo) from the warehouse to facilities. Upon arrival at the facilities, it took a median of 53 (range 0-395) d from installation to final commissioning: most of the days (median=210) were spent between installation and final commissioning. The major causes of delays included insufficient coordination and communication across all levels, poor documentation and final commissioning.</p><p><strong>Conclusion: </strong>Early engagement on customs clearance, strengthening coordination and communication, ensuring proper documentation, as well as eliminating final commissioning, could significantly improve implementation of the program.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"33-40"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708304","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}