Global Health Action最新文献

{"title":"Applying the photovoice method with adolescents in mining areas in rural Mozambique: critical reflections and lessons learned.","authors":"Olga Cambaco, Hermínio Cossa, Andrea Farnham, Eusébio Macete, Mirko S Winkler, Karin Gross, Khátia Munguambe","doi":"10.1080/16549716.2024.2305506","DOIUrl":"10.1080/16549716.2024.2305506","url":null,"abstract":"<p><p>There is a recognised need for innovative methods to elicit the perspective of adolescents on public health issues, particularly when addressing sensitive topics such as the impact of mining projects on their health. Participatory approaches such as \"photovoice\" allow for deep engagement of vulnerable and marginalised populations, including adolescents. However, few existing studies have used the photovoice method to reflect on issues related to the environment and its impact on public health. To date, no studies have been found that have used photovoice to gain insight into adolescents' perspectives in mining areas. In this paper, we discuss the application of the photovoice method to understand adolescents' perceptions about the impact of mining on their health and well-being in rural areas in Mozambique. The study was conducted in northern and central Mozambique. Photovoice was successfully integrated into eight focus group discussions with adolescent girls and boys aged 15 to 17 years. Several lessons for guiding future research were learned. First, it provided an understanding of the perceived impacts of mining on their health and well-being. Second, photovoice promoted active engagement and interest in the study by the adolescents. Finally, compared to its ability to capture perceptions of physical and environmental aspects affecting adolescents' well-being, the method was less straightforward in revealing their concerns regarding social, relational and community aspects that are less tangible. Programs can make use of photovoice to address health issues without setting adolescents' views and priorities aside, allowing them to influence health decisions on issues that are meaningful to them. Future studies should explore strategies to minimise the role of the power dynamics that affect the engagement and contribution of adolescents in advocating for necessary and meaningful changes. Additionally, it is important to investigate how health programs and policies can help to reduce the impact of existing inequalities.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2305506"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698648","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":"\"Arming half-baked people with weapons!\" Information enclaving among professionals and the need for a care-centred model for antibiotic use information in Uganda, Tanzania and Malawi.","authors":"Susan Nayiga, Eleanor E MacPherson, John Mankhomwa, Fortunata Nasuwa, Raymond Pongolani, Rita Kabuleta, Mike Kesby, Russell Dacombe, Shona Hilton, Delia Grace, Nicholas Feasey, Clare I R Chandler","doi":"10.1080/16549716.2024.2322839","DOIUrl":"10.1080/16549716.2024.2322839","url":null,"abstract":"<p><strong>Background: </strong>The overuse of antimicrobial medicines is a global health concern, including as a major driver of antimicrobial resistance. In many low- and middle-income countries, a substantial proportion of antibiotics are purchased over-the-counter without a prescription. But while antibiotics are widely available, information on when and how to use them is not.</p><p><strong>Objective: </strong>We aimed to understand the acceptability among experts and professionals of sharing information on antibiotic use with end users - patients, carers and farmers - in Uganda, Tanzania and Malawi.</p><p><strong>Methods: </strong>Building on extended periods of fieldwork amongst end-users and antibiotic providers in the three countries, we conducted two workshops in each, with a total of 44 medical and veterinary professionals, policy makers and drug regulators, in December 2021. We carried out extensive documentary and literature reviews to characterise antibiotic information systems in each setting.</p><p><strong>Results: </strong>Participants reported that the general public had been provided information on medicine use in all three countries by national drug authorities, health care providers and in package inserts. Participants expressed concern over the danger of sharing detailed information on antibiotic use, particularly that end-users are not equipped to determine appropriate use of medicines. Sharing of general instructions to encourage professionally-prescribed practices was preferred.</p><p><strong>Conclusions: </strong>Without good access to prescribers, the tension between enclaving and sharing of knowledge presents an equity issue. Transitioning to a client care-centred model that begins with the needs of the patient, carer or farmer will require sharing unbiased antibiotic information at the point of care.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2322839"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029384","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":"Facility capacity and provider knowledge for cholera surveillance and diarrhoea case management in cholera hotspots in the Democratic Republic of Congo - a mixed-methods study.","authors":"Mattias Schedwin, Aurélie Bisumba Furaha, Kelly Elimian, Carina King, Espoir Bwenge Malembaka, Marc K Yambayamba, Thorkild Tylleskär, Tobias Alfvén, Simone E Carter, Placide Welo Okitayemba, Mala Ali Mapatano, Helena Hildenwall","doi":"10.1080/16549716.2024.2317774","DOIUrl":"10.1080/16549716.2024.2317774","url":null,"abstract":"<p><strong>Background: </strong>Wider healthcare-strengthening interventions are recommended in cholera hotspots and could benefit other types of diarrhoeal diseases which contribute to greater mortality than cholera.</p><p><strong>Objective: </strong>Describe facility capacity and provider knowledge for case management of diarrhoea and cholera surveillance in cholera hotspots in the Democratic Republic of Congo (DRC) among health facilities, drug shops, and traditional health practitioners.</p><p><strong>Methods: </strong>We conducted a sequential exploratory mixed-method study, using focus group discussions, facility audits, and provider knowledge questionnaires during September and October 2022 in North Kivu and Tanganyika provinces, Eastern DRC. Content analysis was used for qualitative data. Quantitative data were summarised by facility level and healthcare provider type. Audit and knowledge scores (range 0-100) were generated. Multivariable linear regression estimated association between scores and explanatory factors. Qualitative and quantitative data were triangulated during interpretation.</p><p><strong>Results: </strong>Overall, 244 facilities and 308 providers were included. The mean audit score for health facilities was 51/100 (SD: 17). Private facilities had an -11.6 (95% CI, -16.7 to -6.6) lower adjusted mean score compared to public. Mean knowledge score was 59/100 (95% CI, 57 to 60) for health facility personnel, 46/100 (95% CI, 43 to 48) for drug shop vendors and 37/100 (95% CI, 34 to 39) for traditional health practitioners. Providers had particularly low knowledge concerning when to check for low blood sugar, use of nasogastric tubes, and dosing schedules. Knowledge about case definitions for cholera was similar between groups (range 41-58%) except for traditional health practitioners for the definition during an outbreak 15/73 (21%).</p><p><strong>Conclusions: </strong>Increasing awareness of cholera case definitions in this context could help improve cholera surveillance and control. Increased support and supervision, especially for private providers, could help ensure facilities are equipped to provide safe care. More nuanced aspects of case management should be emphasised in provider training.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2317774"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029385","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":"Four analysis moments for fuzzy cognitive mapping in participatory research.","authors":"Iván Sarmiento, Anna Dion, Mateja Šajna, Neil Andersson","doi":"10.1080/16549716.2024.2430024","DOIUrl":"10.1080/16549716.2024.2430024","url":null,"abstract":"<p><p>Fuzzy cognitive mapping (FCM) is a practical tool in participatory research. Its main use is clarifying causal understandings from several knowledge sources. It provides a shared substrate or language for sharing views of causality. This makes it easier for different interest groups to agree what to do next. Each map is a collection of causal relationships with three elements: factors (cause and outcome), arrows linking factors, and weights indicating the perceived influence of each cause on its outcome. Stakeholder maps are soft models of how they see causes of an outcome, such as access to services or systemic racism. Based on a standardized FCM protocol, we present four moments in FCM analysis. (1) Agree shared meaning across maps. (2) Calculate the maximum influence of perceived causes. (3) Simplify the maps for communication. (4) Identify priorities for action. We provide explanations of the four moments in FCM analysis, with examples from five countries. FCM offers a practical means to guide health action. It incorporates local perspectives with transparent and traceable procedures.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2430024"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774089","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":"Perspectives on delivering sexual and reproductive health and rights information and services to young people: focus group discussions with civil society organizations in the Democratic Republic of Congo.","authors":"Landry Egbende, Viviane Mayala, Branly Mbunga, Nina Viberg, Mala Ali Mapatano, Tobias Alfvén, Eva Åkerman","doi":"10.1080/16549716.2024.2429631","DOIUrl":"10.1080/16549716.2024.2429631","url":null,"abstract":"<p><strong>Background: </strong>Universal access to sexual and reproductive health and rights (SRHR) is fundamental to achieving the Sustainable Development Goals due to its impact on gender equality as well as women's health and survival. In the Democratic Republic of Congo, there are many civil society organizations (CSOs) that are involved in raising awareness of SRHR issues and providing SRHR services to young people. Objective: The aim of this study was to explore the challenges and enabling factors CSOs experience regarding the delivery of SRHR services to young people.</p><p><strong>Methods: </strong>We conducted a qualitative study via focus group discussions with CSOs in Kinshasa. Two focus groups comprising women and two comprising men, with approximately 10 participants in each group, were held. The interview transcripts were subjected to an inductive thematic analysis.</p><p><strong>Results: </strong>Young people's barriers to SRHR information and services were described as multi-layered, linked to individual, community, societal, institutional, and health system levels. The most common barrier in delivering SRHR information was the widespread view of sexuality as a taboo subject in communities and churches as well as in young people's families. Despite the obstacles that CSOs faced, the results also demonstrate that CSOs have found creative ways to reach out and offer SRHR information to young people.</p><p><strong>Conclusion: </strong>It is essential to acknowledge the role of CSOs in the advancement of gender equality, and it is important to put policies into place that can overcome cultural, religious, and familial barriers to young people's access to SRHR information.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2429631"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014757","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":"Alcohol consumption and allergic diseases: Mendelian randomization evidence from China.","authors":"Chen Zhu, Timothy Beatty, Yingxiang Li, Gang Chen, Qiran Zhao, Qihui Chen","doi":"10.1080/16549716.2024.2442788","DOIUrl":"10.1080/16549716.2024.2442788","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of allergic diseases in China has risen significantly over the past decades, affecting the quality of life for approximately 40% of the population.</p><p><strong>Objectives: </strong>This study aimed to integrate survey and genomic data to explore the potential causal relationship between alcohol consumption and allergic diseases.</p><p><strong>Method: </strong>In collaboration with a leading genetic testing company in China, we collected data on 3,041 participants via an online survey between December 2018 and October 2019. A Mendelian Randomization (MR) design was employed in data analysis, leveraging the random allocation of genes at meiosis in humans to create instrumental variables for alcohol intake. This method was used to estimate the causal effect of alcohol consumption on the incidence of allergic diseases.</p><p><strong>Results: </strong>While ordinary least-squares estimates showed a negative association between alcohol drinking and the risk of self-reported allergic diseases, MR estimates suggest that higher alcohol consumption increased the risks of allergy in certain subgroups. Specifically, predicted drinking [b = 0.445, <i>p</i> = 0.032] and the number of drinking times during the past 30 days [b = 0.031, <i>p</i> < 0.01] were associated with higher risks of allergic diseases among females. We found little evidence of a causal impact of alcohol intake on allergic diseases in men.</p><p><strong>Conclusion: </strong>Higher alcohol intake is causally associated with a higher risk of allergic diseases in Chinese women but not men.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2442788"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014830","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":"Factors associated with essential newborn care practices among non-institutional births in urban Bangladesh: evidence from Bangladesh Urban Health Survey 2021.","authors":"Shimlin Jahan Khanam, Mst Fatema Begum, Md Badsha Alam, Md Awal Kabir, Md Nuruzzaman Khan","doi":"10.1080/16549716.2024.2412152","DOIUrl":"10.1080/16549716.2024.2412152","url":null,"abstract":"<p><strong>Background: </strong>Non-institutional births remain prevalent in low- and middle-income countries, associated with a majority of adverse maternal and child health outcomes, including maternal and child mortality. Ensuring essential newborn care (ENC) practices for these non-institutional births is crucial for reducing these adverse outcomes. This study aimed to identify the prevalence, and factors associated with the adoption of ENC practices among non-institutional births in urban Bangladesh.</p><p><strong>Methods: </strong>A total of 2,165 children's data were analyzed, extracted from the 35,186 ever-married women interviewed in the 2021 Bangladesh Urban Health Survey. Six ENC components and their level (lowest/none, moderate, and highest) were considered as the outcome variables. Several socio-demographic factors were considered as the explanatory variables. Multivariate binary and multinomial logistic regression model were used to explore the association between outcome and explanatory variables.</p><p><strong>Results: </strong>Approximately 49% of all mothers reported practicing the highest level of ENC. Among the individual components, the highest adherence was observed for the use of a disinfected instrument to cut the umbilical cord (90%). The likelihood of adopting the highest level of ENC practices was higher among mothers with relatively higher education and wealth quintiles and lower among those residing in slum and other urban areas of city corporations compared to non-slum areas. Mothers living in the Khulna and Sylhet divisions had a lower likelihood of adopting the highest level of ENC practices.</p><p><strong>Conclusion: </strong>Awareness building programs are needed to educate the population, particularly mothers, about the importance of practicing ENC for improving maternal and child health outcomes.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2412152"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11463011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394645","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":"Changes in the menstrual hygiene management facilities and usage among Bangladeshi school girls and its effect on school absenteeism from 2014 to 2018.","authors":"Farjana Jahan, Noshin Sayiara Shuchi, Abul Kasham Shoab, Mahbub-Ul Alam, Sk Md Kamrul Bashar, Khairul Islam, Hasin Jahan, Mahadi Hasan, Md Masud Alam, Mahbubur Rahman","doi":"10.1080/16549716.2023.2297512","DOIUrl":"10.1080/16549716.2023.2297512","url":null,"abstract":"<p><strong>Background: </strong>The lack of menstrual hygiene management (MHM) information and facilities in schools is a major contributor to adolescent girls' school absenteeism in low- and middle-income countries like Bangladesh.</p><p><strong>Objectives: </strong>This paper examines the changes over time in school MHM facilities, knowledge and perceptions among adolescent girls, in relation to school absenteeism between 2014 and 2018 in Bangladesh.</p><p><strong>Methods: </strong>We examined changes in MHM and school absenteeism among schoolgirls using nationally representative data from the Bangladesh National Hygiene Baseline Survey 2014 and National Hygiene Survey 2018. Given the repetitive nature of our data and its clustering within participants, our method included performing descriptive analysis, bivariate analysis, and multivariate Generalised Estimating Equation (GEE) modelling to analyse these changes.</p><p><strong>Results: </strong>Results showed that adolescent girls' menstruation-related absenteeism decreased between 2014 and 2018. Percentage of adolescents who missed school decreased from 25% to 14% (PD: -11; CI: -16 to -6.1), while the average number of missed days reduced from 2.8 to 2.5 (PD: -0.33; CI: -0.57 to -0.10). In the GEE model, we found that living in rural areas (coef: -5.6; CI: -10.06 to -1.14), parental restrictions on going outside (coef: 4.47; CI: 0.75 to 8.2), education levels of girls (coef: -9.48; CI: -14.17 to -4.79), girl's belief that menstruation affects school performance (coef: 23.32; CI: 19.71 to 26.93), and using old cloths (coef: -4.2; CI: -7.6 to -0.79) were significantly associated with higher absenteeism. However, participant's age, type of school, knowledge of menstruation before menarche, receiving information regarding MHM, separate place for changing absorbents, and separate latrine and urine facility were not significantly associated with the changes in absenteeism over time.</p><p><strong>Conclusion: </strong>This paper emphasised the associations between changes in school absenteeism, parental restrictions on students, students' education levels, and menstruation-related misperceptions. Ongoing research, policy reviews, and targeted interventions to improve MHM perceptions among girls are required to provide long-term benefits for adolescent girls in Bangladesh.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2297512"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10795776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479303","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":"Rwanda's success in advancing midwifery education: a blueprint of a sustainable, nationally driven curriculum standardization.","authors":"Malin Bogren, Menelas Nkeshimana, Innocent Nzabahimana, Frida Temple, Marie Claire Iryanyawera, Jean de Dieu Uwimana, Renata Tallarico, Olugbemiga Adelakin, Kerstin Erlandsson","doi":"10.1080/16549716.2024.2427467","DOIUrl":"10.1080/16549716.2024.2427467","url":null,"abstract":"<p><p>The International Confederation of Midwives (ICM) defines and sets the Essential Competencies for Midwifery Practice and provides a framework for developing and reviewing midwifery curricula. This framework ensures that pre-service midwifery education designed for students leads to the demonstration of the required midwifery specific competencies. The development of the ICM competencies in 2024 confirms the timeliness of the effort of Rwanda to update its national curricula. This commentary showcases the blueprint followed by Rwanda to standardize and culturally adapt its midwifery curricula at diploma, bachelor and master's level to be competency-based and aligned with ICM. National ownership played a pivotal role in the standardization process, as the direction, priorities, and implementation of the curricula review initiative were driven by the country's own government, higher learning institutes, national midwifery association and other national organizations. Rwanda's experience in aligning its national curricula with international standards could serve as a model for south-south cooperation.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2427467"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142636186","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":"Adaptive adjustment to the needs of families caring for children and adolescents with physical disabilities in north-eastern Tanzania: a grounded-theory study.","authors":"Elia Asanterabi Swai, Haleluya Imanueli Moshi, Sia Emmanueli Msuya, Marie Lindkvist, Ann Sörlin, Klas Göran Sahlen","doi":"10.1080/16549716.2024.2354009","DOIUrl":"10.1080/16549716.2024.2354009","url":null,"abstract":"<p><strong>Background: </strong>Family interactions, which are always multi-faceted, are complicated further by family members with disabilities. In resource-poor settings, policies and programmes that address the needs of and challenges faced by families are often inaccessible or unavailable. Approximately 13% of the families in Tanzania have at least one member with a disability, yet family-centred research on caring for disabled children and adolescents is scarce in this context.</p><p><strong>Objective: </strong>The aim is to explore the needs and challenges faced by families that care for children and adolescents with physical disabilities in the Kilimanjaro Region of north-eastern Tanzania.</p><p><strong>Methods: </strong>This qualitative study had a constructivist grounded-theory design. In-depth interviews, using a semi-structured interview guide based on the social-capital framework, were conducted with 12 female participants aged between 24 and 80. A conceptual model of family needs, inspired by Maslow's hierarchy of needs, informed the analysis.</p><p><strong>Results: </strong>Challenging needs were grouped into five categories, which were linked to Maslow's hierarchy of needs and related to the central concept of 'adaptive adjustment': (1) 'barely surviving'; (2) 'safety needs in jeopardy'; (3) 'sociocultural protection'; (4) 'self-esteem far beyond reach', and (5) 'dreaming of self-actualisation'.</p><p><strong>Conclusion: </strong>Families caring for children and adolescents with physical disabilities in north-eastern Tanzania have needs that extend beyond the available and accessible resources. Families can adjust and adapt by avoiding certain situations, accepting the reality of their circumstances and exploring alternative ways of coping. A sustainable support system, including social networks, is essential for meeting basic needs and ensuring safety.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2354009"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238609","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}