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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800337/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-based follow-up of very low birth weight neonates discharged from a regional hospital in Cape Town: a descriptive study.","authors":"Thandi Maya Gondwana de Wit, Tanya Doherty, Michael Hendricks","doi":"10.1080/16549716.2025.2466277","DOIUrl":"10.1080/16549716.2025.2466277","url":null,"abstract":"<p><strong>Background: </strong>Neonatal mortality remains a global health concern. In South Africa, 32% of under-five mortality consists of neonates, with 48% of neonatal deaths attributed to prematurity. The Home and Community-Based Services (HCBS) aim to reduce deaths of very low birth weight (VLBW) neonates through community health worker (CHW) home visits.</p><p><strong>Objectives: </strong>This study aimed to describe a cohort of VLBW neonates discharged from a regional hospital including their community follow-up, clinical outcomes and caregivers' perceptions of the HCBS.</p><p><strong>Methods: </strong>This was a descriptive mixed methods study. Routine hospital health information from 1 January to 31 December 2018 was analysed to describe the cohort. The referral pathway and follow-up were assessed through stakeholder meetings and analysing referral forms. Caregivers were interviewed for HCBS data.</p><p><strong>Results: </strong>There were 169 VLBW neonates. The mean (SD) gestational age was 30 (±2.21) weeks, and the median (IQR) birthweight was 1210 g (1045-1390 g). At delivery, 85% had respiratory distress and 64% had presumed sepsis. Maternal characteristics included primigravida deliveries (15%), smoking (11%), alcohol use (9%) and teenage pregnancy (5%); 14% required social worker referral. Folder reviews showed referral plans for 49 (43.4%); however, 20 (17.7%) forms were received by HCBS. All five of the interviewed caregivers had positive perceptions of the HCBS.</p><p><strong>Conclusion: </strong>This study demonstrated a high burden of medically and socially vulnerable VLBW neonates discharged from a regional hospital. Even with established HCBS systems, few VLBW neonates were followed up at home. For the HCBS to be fully effective, promotion, strengthening and monitoring of the referral system are required.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2466277"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469788","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":"Trends in the prevalence of concurrent anaemia and stunting among infants and young children in Rwanda: a cross-sectional study from 2010 to 2020.","authors":"Mathieu Nemerimana, Mojeed Akorede Gbadamosi","doi":"10.1080/16549716.2025.2466281","DOIUrl":"10.1080/16549716.2025.2466281","url":null,"abstract":"<p><strong>Background: </strong>Concurrent anaemia and stunting (CAS) pose severe public health risks in low- and middle-income countries, affecting child health and development.</p><p><strong>Objectives: </strong>To determine trends in CAS prevalence and associated factors among infants and young children aged 6-23 months in Rwanda.</p><p><strong>Methods: </strong>Analyses of nationally representative samples from the Rwanda Demographic and Health Surveys (RDHS) of 2010, 2014/15, and 2019/20 were conducted. Participants' characteristics, trends, and prevalence of CAS were analysed using frequencies and percentages. Multivariable binary logistic regression analyses were used to assess factors associated with CAS.</p><p><strong>Results: </strong>The prevalence of CAS among children aged 6-23 months in Rwanda declined from 21.3% in 2010 to 16.9% in 2019/20 (<i>p</i> = 0.005). Significant factors associated with CAS included child's age above 12 months, male sex, small/very small birth size, breastfeeding initiation 1 day post-birth, inadequate minimum acceptable diet, history of cough 2 weeks prior to the survey, multiple births, being from a mother with no or only primary education, mother aged below 20 years, mother with no iron supplementation during pregnancy, maternal anaemia, resident of an eastern province, resident of high altitude areas (>2000 m), low household wealth and unimproved toilet facilities.</p><p><strong>Conclusions: </strong>This study reveals persistent CAS among infants and young children in Rwanda. CAS was associated with various child, maternal, and household-related factors. Despite a notable decline in CAS prevalence in Rwanda over the past decade, CAS remains a significant public health issue, requiring targeted interventions.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2466281"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450627","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":"Comparing AI and human-generated health messages in an Arabic cultural context.","authors":"Syed Ali Hussain, Ralf Schmälzle, Sue Lim, Nassir Bouali","doi":"10.1080/16549716.2025.2464360","DOIUrl":"10.1080/16549716.2025.2464360","url":null,"abstract":"<p><strong>Background: </strong>AI is rapidly transforming the design of communication messages across various sectors, including health and safety. However, little is known about its effectiveness for roughly 420 million native Arabic speakers worldwide.</p><p><strong>Objective: </strong>This study examined characteristics of AI vs. human-generated road safety messages for a potential roadside billboard campaign in the United Arab Emirates.</p><p><strong>Method: </strong>The study includes a computational analysis and an online evaluation with 186 participants from the United Arab Emirates (UAE), comparing messages generated by AI with those created by humans. To achieve this, an AI model (GPT-4) was utilized to generate 15 road safety messages, while three human experts created another set of 15 messages. Computational text analysis was employed to examine these messages, followed by an online study in which human participants evaluated all messages based on message clarity and message quality.</p><p><strong>Results: </strong>The computational analysis revealed that AI-generated messages exhibited more positive sentiment with no significant differences in terms of readability/text difficulty. Participants evaluated both AI- and human-generated messages highly in terms of message quality and clarity, but human-generated messages were rated as slightly and significantly higher in terms of clarity.</p><p><strong>Conclusion: </strong>These results add to a rapidly growing body of research demonstrating that AI-generated messages can augment public communication campaigns and point towards the need to assess how diverse, international audiences respond to AI-generated content.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2464360"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442447","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":"Behaviour change interventions to promote household connectivity to sewer: a scoping review.","authors":"Mahbub-Ul Alam, Md Assaduzzaman Rahat, Shahpara Nawaz, Nishantika Neeher, Kazy Farhat Tabassum, Tasnia Alam Upoma, Abul Kamal, Barbara Evans, Paul Hutchings","doi":"10.1080/16549716.2025.2476335","DOIUrl":"10.1080/16549716.2025.2476335","url":null,"abstract":"<p><p>Households without access to a functioning and well-managed sanitation system produce untreated faecal waste. While connecting households to sewers is ideal in densely populated low-income areas, the connection rates often remain low. Most interventions to increase connectivity focused on addressing financial, social, and legal barriers; there is limited evidence on the effectiveness of behaviour change interventions in promoting sewer connections. Thus, we aim to understand the effectiveness of behaviour change interventions in increasing the uptake of sewer connections. We developed a review protocol with key search terms relating to households, sewers, behaviour change interventions, promotion, and effectiveness. We aimed to identify both the types of interventions deployed and their impact on increasing household sewer connections. Eleven articles met the eligibility criteria and were included in the review. Findings indicate that changes in rates of connection were associated with interventions that included a blend of indirect financial subsidy in the form of a free connection and community-engagement activities. There was limited evidence that behaviour change campaigns without financial incentives lead to changes in sewer connection rates. A multi-component package involving financial subsidies with community engagement is likely to improve the sewer connection rate.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2476335"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671448","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":"A multilevel analysis on the predictors of client satisfaction with family planning services in Ethiopia: evidence from the Ethiopian service provision assessment (ESPA) 2021/22.","authors":"Michael Endale Mengesha, Henrik Holmberg","doi":"10.1080/16549716.2025.2463215","DOIUrl":"10.1080/16549716.2025.2463215","url":null,"abstract":"<p><strong>Background: </strong>Ethiopia has experienced growth in the utilization of family planning services. However, there are reports of relatively low client satisfaction across the country.</p><p><strong>Objective: </strong>The objective of this study was to assess client and facility level predictors of satisfaction with family planning services in Ethiopia.</p><p><strong>Method: </strong>A multi-level mixed effects logistic regression analysis was conducted on a national survey obtained from the service provision assessment 2021-22. A total of 2071 clients (level one) and 529 facilities (level two) were included.</p><p><strong>Results: </strong>Overall, 56% of clients were highly satisfied with the family planning service they received. Findings from the random effects of the multilevel analysis show there is a significant difference in client satisfaction between facilities, with an intra-class correlation of 0.56 in the null model. At the client-level, age above 30, auditory privacy, and discussion on side effects are significantly associated with higher client satisfaction. At the facility level, having a waiting area, facilities with a quality unit and/or committee, a DHIS2 reporting system, operating for more than 20 days a month, privately owned facilities and availability of family planning guidelines are associated with higher odds of being satisfied. On the other hand, at the client level, having a primary or higher education, increasing wait time and clients asking their providers questions are associated with lower odds of being satisfied. At the facility level, having a fixed user fee significantly reduces the odds of client satisfaction.</p><p><strong>Conclusions: </strong>Human resource and professional development training and health system strengthening is recommended.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2463215"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410895","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":"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":"'Too much, too little' - heat wave impact during pregnancy and the need for adaptation measures.","authors":"Ashish Kc, Masoud Vaezghasemi","doi":"10.1080/16549716.2025.2476277","DOIUrl":"10.1080/16549716.2025.2476277","url":null,"abstract":"<p><p>The balls are rolling for climate change, with increasing vulnerability to women and children related to climate extreme events. Recent evidence has shown that acute exposure to heat wave during pregnancy can be associated with adverse health outcomes in childhood, with the risk being significantly higher among socially disadvantaged population, despite their lack of contribution to global carbon dioxide emissions and the rising global ambient temperature. This unequal impact requires utmost attention to develop tools, establish interdisciplinary teams, and to implement evidence-based interventions for the betterment of women and children in climate-vulnerable populations.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2476277"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617801","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":"Cultivating resilience and adaptability through hands-on One Health.","authors":"Phaedra Henley, Anselme Shyaka","doi":"10.1080/16549716.2025.2478694","DOIUrl":"10.1080/16549716.2025.2478694","url":null,"abstract":"<p><p>The University of Global Health Equity's (UGHE) One Health Field School (OHFS) in Rwanda exemplifies an experiential approach to education that integrates human, animal, and environmental health. This field-based program engages students in real-world settings such as abattoirs, health centers, and mining sites to confront pressing public health issues, from zoonotic diseases and antimicrobial resistance to food safety and environmental health. Following Kolb's experiential learning model, OHFS equips graduate students to observe, analyze, and apply solutions to complex health challenges, fostering adaptability, resilience, and collaborative problem-solving skills. By bridging classroom theory with practical application, OHFS cultivates leadership and a holistic understanding of health, preparing graduates to navigate the interconnected global health landscape. Through this innovative approach, UGHE aims to train a generation of health professionals capable of addressing crises such as climate change, biodiversity loss, and emerging infectious diseases at the human-animal-environment interface.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2478694"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659343","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":"Financial motivation models for community health workers in low- and middle-income countries: a scoping review.","authors":"Oumar Mallé Samb, Mariétou Niang, Emilie Gelinas, Ndeye Thiab Diouf, Titilayo Tatiana Agbadje, Abir El Haouly","doi":"10.1080/16549716.2025.2480412","DOIUrl":"https://doi.org/10.1080/16549716.2025.2480412","url":null,"abstract":"<p><p>Community health workers (CHWs) are key players in providing primary healthcare in low- and middle-income countries. However, their absence from the formal health system in many of these countries often presents a challenge to their remuneration. The objective of this scoping review is to document programs implemented at both small and large scales in low- and middle-income countries, the remuneration strategies they have established, and the effects of these strategies on the work of CHWs. In total, we included 50 articles in this review. We have identified four types of compensation: fixed compensation, performance-based compensation, compensation based on income-generating activities (IGAs), and combined compensation. We identified the strengths and weaknesses of each type of compensation. A common strength for most models was improvement in motivation and performance. A common weakness for most models was irregular payments. The results of this review highlight the need to consider the economic, social, and cultural settings of the countries or environments at hand, and to include CHWs in discussions regarding the selection of a compensation model.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2480412"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781849","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}