Global Health Action最新文献

{"title":"Irrational medicine use and its associated factors in conflict-affected areas in Mali: a cross-sectional study.","authors":"Mohamed Ali Ag Ahmed, Alassane Seydou, Issa Coulibaly, Karina Kielmann, Raffaella Ravinetto","doi":"10.1080/16549716.2025.2458935","DOIUrl":"10.1080/16549716.2025.2458935","url":null,"abstract":"<p><strong>Background: </strong>Rational use of essential medicines is a critical step towards prevention and treatment of many illnesses. However, it represents a significant challenge worldwide, and particularly for under-resourced health systems in conflict-affected areas.</p><p><strong>Objective: </strong>To assess barriers to rational use of essential medicines at primary healthcare level in conflict-affected areas of Mali.</p><p><strong>Methods: </strong>We conducted a cross-sectional study in twenty randomly selected community health centres (CHCs) in four health districts, by applying the World Health Organisation and International Network on Rational Use of Drugs core forms for the rational use of medicines. Seven hundred eighty-nine (789) prescriptions were retrospectively selected and analysed; four hundred forty-three (443) patients were interviewed: and health facility-related indicators were collected prospectively from the 20 CHCs.</p><p><strong>Results: </strong>The average number of medicines per prescription was 3.89 ± 1.83; out of these, 94.0% were prescribed by generic name, and 91.0% belonged to Mali's National List of Essential Medicines. Overall, 68% of the assessed prescriptions included antibiotics; 58% included injectables; and 75.79% were characterized by polypharmacy, i.e. more than two medicines per prescription. In multivariate analysis, the study area and prescriber's sex were significantly associated with polypharmacy; prescriber's seniority and training were associated with antibiotic overprescription; the study area, prescriber's sex and seniority were associated with overprescription of injectables. Moreover, the average price of prescriptions was high in relation to average local income, likely making these unaffordable for many households.</p><p><strong>Conclusion: </strong>Excessive polypharmacy and overprescription of antibiotics and injectables undermine the performance of the local health system and the achievement of intended therapeutic outcomes. Our findings provide a solid basis for more targeted and multidisciplinary research, to further inform relevant stakeholders on how best to mitigate the impact of conflict on the rational use of medicines.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2458935"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A twinning initiative between midwife associations in Ghana and Sweden -A process evaluation study.","authors":"Hanna Fjellström, Emelie Sandberg, Johanna Blomgren, Malin Grahn, Fredrica Hanson, Netta Ackon, Gifty Baidoo, Louise Nordström, Malin Bogren","doi":"10.1080/16549716.2025.2457824","DOIUrl":"10.1080/16549716.2025.2457824","url":null,"abstract":"<p><strong>Background: </strong>This study describes the evaluation of a twinning initiative between the Ghana Register Midwives Association and the Swedish Association of Midwives. Recognising the importance of midwives being supported by a national midwife association, the initiative was to strengthen the professional association in Ghana as a labour union and to inspire Swedish midwives to involve themselves in international work.</p><p><strong>Objective: </strong>The study aimed to evaluate a twinning initiative between the Ghana Registered Midwives Association and the Swedish Association of Midwives.</p><p><strong>Method: </strong>Two focus group discussions and four individual interviews were held with nine midwives from the Ghana Registered Midwives Association (<i>n</i> = 6) and the Swedish Association of Midwives (<i>n</i> = 3). The interviews and analysis were guided by a process evaluation framework using content analysis.</p><p><strong>Results: </strong>The twinning initiative was successfully implemented regarding fidelity, dose, and reach, despite adaptations to the original project plan. Both associations gained visibility, with the Ghana Registered Midwives Association growing its paid membership by 97%, from 631 to 1,245 members during the twinning initiative. The results suggest that the Swedish Association of Midwives enhanced its understanding of international midwifery, promoted knowledge exchange, and raised awareness of midwives' global roles in improving care.</p><p><strong>Conclusion: </strong>The Ghana Registered Midwives Association and the Swedish Association of Midwives had a positive experience with the twinning initiative, despite deviations from the original plan. Midwives from both associations benefitted from sharing best practices and mutual support in their roles as newly formed labour trade unions. These findings could benefit other midwife associations in future twinning initiatives.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2457824"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Term stillbirths in Eastern Uganda: a community-based prospective cohort study.","authors":"Martin Chebet, Peter Olupot-Olupot, Andrew D Weeks, Ingunn Marie S Engebretsen, Noela Regina Akwi Okalany, Francis Okello, Thorkild Tylleskär, Kathy Burgoine, David Mukunya","doi":"10.1080/16549716.2024.2448895","DOIUrl":"10.1080/16549716.2024.2448895","url":null,"abstract":"<p><strong>Background: </strong>Every year, 1.9 million stillbirths occur worldwide, of whom 1.5 million occur in sub-Saharan Africa (SSA) and Southeast Asia.</p><p><strong>Objectives: </strong>This study aims to determine the incidence and risk factors and to describe underlying causes for term stillbirths in Eastern Uganda.</p><p><strong>Methods: </strong>This was a cohort study of pregnant women enrolled at 34 weeks of gestation or more and followed to birth between January 2021 and January 2024. Enrolment and follow-up were done in the community by trained midwives. Using structured questionnaires, details of maternal health, pregnancy and birth were captured.</p><p><strong>Results: </strong>We enrolled 6101 participants and analysed 5496 for incidence of term stillbirth and 5296 for risk factors. Of the participants, 4913/5296 (92.8%) were between 14 and 35 years, and 4456/5296 (84.1%) had a health facility birth. There were 101 term stillbirths (61 were intrapartum and 40 antepartum). The incidence of term stillbirth was 18.4 per 1000 births (95% CI 14.8 to 22.9). The most common underlying causes of stillbirth were prolonged or obstructed labour 32/101 (31.7%) and malaria 20/101 (19.8%). The factors associated with term stillbirths were caesarean birth (aRR 3.3; 95% CI 2.00 to 5.4), intimate partner violence (aRR 1.8; 95% CI 1.1 to 2.8) and maternal age above 35 years (aRR 2.2; 95% CI 1.2 to 3.9).</p><p><strong>Conclusion: </strong>Eastern Uganda has a high rate of term stillbirths with more than half occurring during labour. Efforts are needed to improve the quality of birth care and to prevent intimate partner violence.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2448895"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of HARP (The Health Access for Refugees' Project) on vaccine hesitancy in people seeking asylum and refugees in Northern England.","authors":"Marie-Clare Balaam, Melanie Haith-Cooper","doi":"10.1080/16549716.2025.2457808","DOIUrl":"10.1080/16549716.2025.2457808","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that people who are asylum seekers and refugees experience poorer physical and mental health compared to the general UK population and poor outcomes from COVID-19 if unvaccinated. However, this population can experience vaccine hesitancy and other barriers inhibiting their up-take of the COVID-19 vaccine.</p><p><strong>Objectives: </strong>This study explored the influence of HARP (Health Access for Refugees' Project) workshops on the intention to have the vaccine in people who are asylum-seekers and refugees.</p><p><strong>Methods: </strong>A qualitative study including clients (asylum-seekers and refugees), volunteers and HARP staff was undertaken to explore perceptions of HARP workshops and their influence on the barriers to the uptake of the COVID-19 vaccine including vaccine hesitancy. Semi-structured telephone interviews were undertaken with 10 participants, HARP clients (<i>n</i> = 1), HARP volunteers (<i>n</i> = 6, of whom 4 had been clients) and staff (<i>n</i> = 3). Data were thematically analysed.</p><p><strong>Results: </strong>Intention to have the vaccine was influenced by trusted sources including peers and health professionals. Tailoring evidence-based information to individuals and challenging misinformation were important influencers on vaccine uptake. HARP activity increased the uptake of vaccines in large accommodation centres and hotels. Grassroots-level interventions such as HARP workshops appear to increase intention to take up the COVID-19 vaccine in asylum seeking and refugee communities.</p><p><strong>Conclusion: </strong>This model could be adopted for health screening such as breast cancer and other vaccinations within asylum seeking and refugee communities.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2457808"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening teamwork and respect (STAR) in maternity units: developing a health system intervention in South Africa.","authors":"Tanya Doherty, Ruwayda Petrus, Sandra Land, Christiane Horwood, Veronique Filippi, Lyn Haskins, Cleo Phewa, Sphindile Mapumulo, Silondile Luthuli, Vaughn M John","doi":"10.1080/16549716.2024.2440982","DOIUrl":"10.1080/16549716.2024.2440982","url":null,"abstract":"<p><p>Disrespect and abuse in maternity services in South Africa has been described over several decades and are rooted in the country's complex socio-political landscape and unequal health system which places strain on public sector health professionals. Strategies to improve the quality of health care typically involve once-off didactic teaching or outside technical consultants focused on improving specific health programmes. These approaches fail to encourage self-reflection or to establish learning cultures. Participatory learning processes, embedded in routine service delivery, are a potentially powerful way to improve ownership and accountability for health system performance. We describe the process followed to develop the Strengthening Teamwork and Respect (STAR) intervention which is being implemented in nine district hospitals in two rural districts of KwaZulu-Natal. The intervention approach draws on a conceptual framework for learning health systems, with intervention strategies informed by participatory learning and action theory. The intervention design was an iterative process informed by literature reviews, formative data collection, consultation with provincial, district and hospital management stakeholders, expert reviewer inputs and piloting of proposed activities. This process produced the STAR intervention approach and toolkit, consisting of: identification and training of champions, creation of STAR teams, convening of learning sessions to work through STAR toolkit activities, identification, implementation and monitoring of change projects, and onsite and virtual mentorship from the STAR development team. Endline cross-sectional surveys and a parallel process evaluation will advance the evidence base for interventions to improve respectful care and cultures of teamwork and learning within maternity units in rural low- and middle-income settings.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2440982"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of care and clinical outcomes after the implementation of an electronic medical record system for type 1 diabetes management in Rwanda.","authors":"Nathalie Bille, Dirk Lund Christensen, Knut Borch-Johnsen, Crispin Gishoma, Stine Byberg","doi":"10.1080/16549716.2025.2457826","DOIUrl":"10.1080/16549716.2025.2457826","url":null,"abstract":"<p><strong>Background: </strong>Electronic medical record (EMR) systems are increasingly used to improve disease management. However, the impact on data quality, quality of care and clinical outcomes for type 1 diabetes (T1D) in sub-Saharan Africa (SSA) has not yet been explored.</p><p><strong>Objective: </strong>The aim was to evaluate the effect of implementing an EMR system on the quality of care and clinical outcomes for T1D individuals in Rwanda.</p><p><strong>Methods: </strong>The Rwanda Diabetes Association collected data during quarterly district hospital visits. We evaluated the effect of a newly developed and implemented EMR system by assessing differences in clinical attendance and outcomes 2 years before (pre-EMR: February 2020-February 2022) and after (post-EMR: February 2022-February 2024) the deployment of the EMR system.</p><p><strong>Results: </strong>We found an increase in the number of individuals examined and the number of consultations conducted post-EMR. There was an increase in data completeness on all parameters; however, we also found that more people did not monitor their blood glucose post-EMR. We found a significant increase in clinical attendance, and a reduction in median HbA_1c levels from 81.4 mmol/mol pre-EMR to 63.9 mmol/mol post-EMR (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Several quality and clinical indicators improved after the integration of the EMR system in T1D management. To the best of our knowledge, this is the first study evaluating the impact of using an EMR system on the quality of care and clinical outcomes for T1D individuals in an SSA context. The long-term effect and implications are yet to be explored.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2457826"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drivers of food acquisition practices among adolescents in suburban food environments of Lao People's Democratic Republic.","authors":"Thidatheb Kounnavong, Miho Sato, Christopher Turner, Elaine Ferguson, Hongkham Xayavong, Manithong Vonglokham, Sharon E Cox, Junko Okumura, Kazuhiko Moji","doi":"10.1080/16549716.2025.2451475","DOIUrl":"10.1080/16549716.2025.2451475","url":null,"abstract":"<p><strong>Background: </strong>Dietary shifts among adolescents in low- and middle-income countries are exacerbating the double burden of malnutrition. Understanding the drivers of adolescent food acquisition and consumption practices and their lived experiences of the food environment is crucial for the effective development of targeted interventions and policies.</p><p><strong>Objective: </strong>To explore drivers of food acquisition and consumption practices among adolescents from two suburban schools in the food environments of Phonhong District, Lao People's Democratic Republic.</p><p><strong>Methods: </strong>We implemented a Qualitative-Geographical Information System methodology, featuring participatory photography, follow-up photo-elicitation interviews and focus group discussions with 30 adolescents from April to July 2022. Thematic analysis triangulated key themes from photos, maps, and transcripts.</p><p><strong>Results: </strong>Drivers of food acquisition and consumption included interactions across external, interpersonal, and intrapersonal domains. The six key themes were food availability and accessibility, product properties and convenience, peers and social media, caregivers and household practices, affordability, desirability, and autonomy, and perceptions, beliefs, and social norms. Consumption of ultra-processed foods was driven by the availability and accessibility of these affordable products in schools. By contrast, consumption of fruits and vegetables was driven by parental food practices at home.</p><p><strong>Conclusion: </strong>A comprehensive multi-scalar approach is required to improve adolescent diets and nutrition in the suburban food environment of Lao PDR. This includes restricting the sale of ultra-processed foods in schools, promoting home gardening, increasing caregivers' awareness and engagement with adolescents about the benefits of healthy food choices, and leveraging social media to encourage healthy eating behaviors.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2451475"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring parental knowledge, care-seeking, and support strategies for neonatal illness: an integrative review of the African Great Lakes region.","authors":"Sarah Farrell, Tracey A Mills, Dame Tina Lavender","doi":"10.1080/16549716.2025.2450137","DOIUrl":"10.1080/16549716.2025.2450137","url":null,"abstract":"<p><strong>Background: </strong>Sub-Saharan Africa shoulders much of the global burden of neonatal mortality. Quality postnatal care is often lacking due to availability, accessibility, mistrust of health systems, and socio-economic barriers, yet delays in care-seeking contribute to avoidable neonatal deaths. Research highlights the urgent need for improved health education about neonatal illness; however, contextual factors are rarely considered, and few interventions have been implemented.</p><p><strong>Objectives: </strong>To critically examine the literature on parents' knowledge of neonatal illness and care-seeking behaviour and evaluate interventions supporting parental understanding in sub-Saharan African Great Lakes countries.</p><p><strong>Methods: </strong>Systematic searches were conducted in CINAHL, MEDLINE, Global Health, the Cochrane Library, and thesis repositories. Studies meeting inclusion criteria were critically analysed using Whittemore and Knafl's framework, and quality was assessed with Hawker et al.'s tool, following PRISMA guidelines.</p><p><strong>Results: </strong>Seventy studies (48 quantitative, 14 qualitative, eight mixed methods) were reviewed. The first theme, \"poor knowledge of neonatal illness\", showed parents struggled to recognise illness, with knowledge affected by maternity and socio-economic factors. The second theme, \"sub-optimal healthcare-seeking behaviour\", highlighted delayed care-seeking due to cultural, social, and economic factors. Finally, \"strategies to support parents' understanding\" emphasised the roles of community workers, health education phone calls, SMS, and videos, and neonatal monitoring systems.</p><p><strong>Conclusions: </strong>Parental knowledge of neonatal illness is generally low, and care-seeking is influenced by beliefs, trust in healthcare, and logistical challenges. While community health workers and multi-media interventions appear effective, health education efforts must address contextual barriers and beliefs to improve recognition and care-seeking for neonatal illness.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2450137"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating moral distress by enhancing healthcare workers' understanding of challenges faced by carers of children with disabilities in low-resource settings in Kenya.","authors":"Anne Geniets, Jarim Omogi, Laura Hakimi, Alice Lakati, Niall Winters","doi":"10.1080/16549716.2025.2452159","DOIUrl":"10.1080/16549716.2025.2452159","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the psychological wellbeing and the potential moral distress faced by female carers of children with disabilities living in low-resource settings in East Africa. In such environments, caregiving often requires resilience and resourcefulness, yet can also increase the vulnerability of caregivers and their children.</p><p><strong>Objective: </strong>The objective of this study is to identify factors affecting female caregivers' psychological well-being, and to suggest ways healthcare workers can support these caregivers' psychological well-being to alleviate moral distress.</p><p><strong>Methods: </strong>Employing an intersectional convergent parallel mixed-methods approach, the research explores the factors affecting the psychological wellbeing of caregivers in one urban and one rural low-resource setting in Kenya.</p><p><strong>Results: </strong>The study identifies strengthening and inhibiting factors, across three dimensions, that moderate caregivers' experiences of moral distress, and puts forward suggestions for healthcare workers on how to support caregivers' psychological wellbeing.</p><p><strong>Conclusions: </strong>Female carers of children with disabilities in low-resource settings in Kenya face numerous psychological, social and systemic challenges which jeopardize their caregiving, leading to moral distress. Paediatricians and nurses can contribute to enhance the caregivers' coping-strategies and psychological well-being through simple changes, like explaining a child's condition in non-technical language. Community health workers can help strengthen the caregivers' already existing resources by accompanying them in the day-to-day care of their children and by helping them establish self-support groups. Consequently, improved training of healthcare- and community health workers in the field of childhood disability is needed to strengthen health systems, and to support these caregivers and their children.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2452159"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a resilience, gender equity and mental health group intervention for young people living in informal urban communities in North India: a cluster randomized controlled trial.","authors":"Varadharajan Srinivasan, Miguel San Sebastián, Samson Rana, Pooja Bhatt, Greg Armstrong, Smita Deshpande, Kaaren Mathias","doi":"10.1080/16549716.2025.2455236","DOIUrl":"10.1080/16549716.2025.2455236","url":null,"abstract":"<p><strong>Background: </strong>Mental health problems are the leading cause of disease burden among young people in India. While evidence shows that youth mental health and resilience can be improved with group interventions in school settings, such an intervention has not been robustly evaluated in informal urban settings.</p><p><strong>Objective: </strong>This study aimed to evaluate whether the Nae Disha 3 group intervention could improve youth resilience, mental health and gender equal attitudes among disadvantaged young people from low-income urban communities in India.</p><p><strong>Methods: </strong>This cluster randomised controlled trial used an analytic sample of 476 adolescents and young adults aged 11-25 years from randomised clusters in urban Dehradun, India. The 251 intervention group participants were 112 boys and 139 girls, and the 225 young people in the wait-control group were 101 boys and 124 girls. Five validated tools measuring resilience gender equity and mental health were filled by participants at three different points in time.</p><p><strong>Results: </strong>Difference in difference (DiD) analysis at T2 showed that scores improved among girls in intervention group, for adjusted model, resilience (DiD = 4.12; 95% CI: 2.14, 6.09) and among boys, for resilience (DiD = 5.82; 95% CI: 1.57, 9.74).</p><p><strong>Conclusions: </strong>The Nae Disha 3 intervention among disadvantaged urban youth moderately improved resilience for both young men and women, though it did not significantly impact mental health, self-efficacy, or gender-equal attitudes. We establish potential merit for this approach to youth mental health but recommend further research to examine active ingredients and the ideal duration of such group interventions.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2455236"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}