Global Health Action最新文献

{"title":"How health system failures and prevailing social norms drive mistreatment of women in maternity care in Ethiopia: a qualitative study.","authors":"Habtamu Kasaye, Vanessa Scarf, Annabel Sheehy, Kathleen Baird","doi":"10.1080/16549716.2025.2526890","DOIUrl":"10.1080/16549716.2025.2526890","url":null,"abstract":"<p><strong>Background: </strong>Mistreatment of women during maternity care is a widespread global issue, particularly in low- and middle-income countries where health disparities intersect with rigid gender norms, systemic inequality and domestic violence.</p><p><strong>Objectives: </strong>This paper aims to explore how health system failures and societal norms against women contribute to the mistreatment of women during maternity care.</p><p><strong>Methods: </strong>A qualitative study was conducted among maternal healthcare providers in the East Wollega Zone, Ethiopia. In-depth interviews with purposively selected participants in Afan Oromo, each lasting 30-60 min, were conducted until data saturation was reached at 20 interviews. The interviews were audio-recorded, transcribed, translated into English, coded using NVivo 12 and analysed through thematic analysis guided by the Socioecological and Quality of Care frameworks.</p><p><strong>Results: </strong>Health system conditions and constraints, such as under-resourcing and issues related to governance and providers' prejudices shaped by societal norms, were found to drive mistreatment of women during maternity care. These drivers manifest at various levels throughout the healthcare system, including personal, interpersonal, facility-level, health system and societal dimensions. Overcrowding, staff shortages and low pay led to burnout, which eventually resulted in mistreatment of women. The lack of recognition from administrators and professional hierarchies also added to provider frustration, which was sometimes directed at women. Societal issues, like gender-based violence, further influenced these behaviours.</p><p><strong>Conclusion: </strong>Mistreatment of women during maternity care continues to hinder the delivery of quality care. Addressing gender inequality, boosting healthcare worker motivation and ensuring fair treatment among staff are essential for promoting respectful maternity care.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2526890"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585471","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 health workers identify children requiring health center admission in Northern Uganda: prehospital risk prediction using vital signs and advanced point-of-care tests.","authors":"Daniel Ebbs, Olanya Denish, Felix Bongomin, Arjun Chandna, Fathima Haseefa, Michael Canarie, Michael Cappello","doi":"10.1080/16549716.2025.2519704","DOIUrl":"10.1080/16549716.2025.2519704","url":null,"abstract":"<p><strong>Background: </strong>Over five million children die annually from preventable and treatable illnesses. Most of these deaths occur in sub-Saharan Africa, predominantly in socioeconomically deprived regions. With nearly half of pediatric mortality occurring at the community level, serious illnesses must be detected early in the prehospital setting. The purpose of this 18-month, prospective, observational pilot study was to introduce the first use of the proinflammatory biomarker, CRP, in the prehospital setting to community health workers and to develop a prehospital predictive model to identify sick children requiring health center admission.</p><p><strong>Methods: </strong>We recruited 636 children presenting to one of four community health worker teams who completed a prehospital evaluation and referred each child to the closest health center. The primary outcome for this study was admission at the health center for more than 24 h. We used logistic regression to quantify the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>We found poor discrimination of danger signs and CRP, with AUCs of 0.55 (95% CI 0.52-0.57) and 0.52 (95% CI 0.47-0.57), respectively. A model comprising vital signs demonstrated superior discrimination, with an AUC of 0.66 (95% CI 0.62-0.71), which improved with the addition of danger signs (AUC 0.69; 95% CI 0.64-0.73), and when restricted to children who tested negative for malaria (<i>n</i> = 327; AUC 0.71; 95% CI 0.65-0.77).</p><p><strong>Conclusions: </strong>We demonstrate that performing advanced point-of-care tests is feasible in resource-limited community settings and present one of the first prehospital prediction models developed with community health workers.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2519704"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498964","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 socio-economic dimensions in HIV research: a comprehensive bibliometric analysis (1992-2024).","authors":"Lyudmila Yermukhanova, Marat Kuzembayev, Akkumis Salkhanova, Nazerke Narymbayeva, Aigul Tazhiyeva, Dinara Nurgalievna Makhanbetkulova, Alireza Afshar","doi":"10.1080/16549716.2025.2474787","DOIUrl":"10.1080/16549716.2025.2474787","url":null,"abstract":"<p><p>The socio-economic burden of HIV infection remains a critical global health concern. This study was conducted to perform a comprehensive bibliometric analysis of the socio-economic burden of HIV infection, highlighting research trends, collaboration networks, and the evolving focus on social determinants of health over the past 32 years. A systematic search was conducted in Scopus and Web of Science Core Collection databases, covering publications from 1992 to 2024. The analysis was performed using RStudio and Biblioshiny, focusing on 1,054 studies from 422 publications. This study revealed a steady annual growth rate of 16.72% in publications on the socio-economic burden of HIV from 1992 to 2024, with the USA and Canada leading in contributions. The University of Toronto emerged as the top institution, while 'social determinants of health' and 'HIV infections' were identified as pivotal research themes. Collaboration networks were predominantly among high-income countries, with limited engagement from high-burden regions like sub-Saharan Africa. Key journals, such as AIDS and Behavior, were identified as central to advancing the field. Thematic analysis highlighted a shift from biomedical to socio-economic factors, emphasizing the need for equitable global collaboration and research addressing disparities in HIV management. This comprehensive analysis provides valuable insights into the evolving landscape of HIV socio-economic burden research, emphasizing the need for increased collaboration with high-burden regions and a continued focus on addressing social determinants of health in HIV management.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2474787"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606958","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":"Feasibility and impact of a patient support group care model on diabetes and hypertension care in informal settlements in Nairobi, Kenya: a quasi-experimental study.","authors":"Richard E Sanya, Caroline H Karugu, Samuel Iddi, Peter M Kibe, Lilian Mburu, Lilian Mbau, Victor Kibe, Sloan Mahone, Naomi S Levitt, Kerstin Klipstein-Grobusch, Gershim Asiki","doi":"10.1080/16549716.2025.2482304","DOIUrl":"10.1080/16549716.2025.2482304","url":null,"abstract":"<p><strong>Background: </strong>A support group care model including self-financing is a promising strategy to improve care for patients with diabetes or hypertension in resource-constrained settings.</p><p><strong>Objectives: </strong>We investigated the uptake, feasibility, and impact of a self-financing patient support group care model on cardiometabolic parameters among adult patients with uncontrolled diabetes or hypertension in informal settlements in Nairobi, Kenya.</p><p><strong>Methods: </strong>A two-group prospective quasi-experimental study was conducted. The outcomes were changes in mean glycated haemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index, and waist-hip ratio in control versus intervention communities, assessed 6 months after intervention implementation.</p><p><strong>Results: </strong>At baseline, 118 patients with diabetes (intervention, 60; control, 58) and 176 with hypertension (intervention, 87; control, 89) were enrolled. At endline, 81 patients with diabetes and 137 with hypertension were surveyed. In the intervention arm, HbA1c decreased from 10.8% to 9.0% (mean difference [95% CI]: -1.7 [-2.4, -0.9] <i>p</i> < 0.001) and in the control arm from 10.6% to 9.9% (-0.9 [-1.5, -0.3] <i>p</i> = 0.005). Difference-in-difference analysis showed a notably greater reduction in HbA1c in the intervention arm (-0.942 [0.463] <i>p</i> < 0.05). In the intervention arm, SBP decreased from 155.0 mmHg to 148.7 mmHg (-6.3 [-11.7, -0.9] <i>p</i> = 0.022) and in the control arm, from 160.1 mmHg to 152.5 mmHg (-7.6 [-12.9, -2.3] <i>p</i> = 0.005). DBP in the intervention arm changed from 99.1 mmHg to 97.9 mmHg (-1.1 [4.2, 1.9] <i>p</i> = 0.462) and in the control arm from 99.7 mmHg to 94.8 mmHg (-4.9 [7.8, -2.0] <i>p</i> = 0.001).</p><p><strong>Conclusions: </strong>A self-financing patient support group care model is feasible, improves cardiometabolic parameters and can be a strategy to manage diabetes, hypertension, and other chronic diseases in low-resource settings.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2482304"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812772","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":"Current scenario, challenges and way forward for augmenting tobacco control policies and programs in India: a community-based qualitative study.","authors":"Muralidhar M Kulkarni, Manpreet Bains, Veena G Kamath, Shalini Bassi, Monika Arora, Kirthinath Ballala, Rohith Bhagawath, Priyanka Bantwal, Ilze Bogdanovica, John Britton","doi":"10.1080/16549716.2025.2491195","DOIUrl":"10.1080/16549716.2025.2491195","url":null,"abstract":"<p><strong>Background: </strong>Tobacco use has resulted in a staggering number of illnesses and premature deaths worldwide. India has the world's second-highest level of tobacco consumption. The study aimed to explore the reasons of initiation among adolescents and understand community stakeholders' perceptions about the current tobacco control policies and challenges faced in implementing it for youth along with future recommendations.</p><p><strong>Methods: </strong>Focus Group Discussions (FGDs) were conducted with adolescents in grades 7th-9th, teachers, parents, and police officers, along with in-depth interviews (IDI) with tobacco vendors. These were digitally audio-recorded and transcribed verbatim. Data was analyzed using inductive thematic analysis.</p><p><strong>Results: </strong>Twenty-two focus groups were conducted with adolescents, 10 with parents, 10 with teachers (<i>n</i> = 83), 5 with police (<i>n</i> = 42) and 10 tobacco vendors completed one-to-one interviews. Stakeholders identified gaps in tobacco control policy implementation and recommended stricter enforcement. Solutions such as modifying on-screen health warnings, developing novel ways like live demonstration of patients suffering from tobacco use which creates awareness about tobacco harms, countering tobacco industry marketing strategies, restricting tobacco product sales, lowering affordability, and prominently displaying tobacco-free film rules were recommended.</p><p><strong>Conclusion: </strong>The study provides a thorough understanding of factors that lead to tobacco initiation and stakeholder's opinion on youth-related tobacco legislation that provides direction for strengthening existing tobacco control efforts. There is a need for novel ways to educate the child's microenvironment, specifically in school and family environment. The findings also emphasize the importance of multi-sector involvement and better enforcement of tobacco control laws.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2491195"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081548","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 engagement to support public health: mixed-method evaluation evidence on COVID-19 attitudes and practices in Lao PDR.","authors":"Marco J Haenssgen, Elizabeth M Elliott, Sandra Bode, Ounkham Souksavanh, Thongkhoon Xayyahong, Hironori Okabayashi, Shogo Kubota","doi":"10.1080/16549716.2025.2485523","DOIUrl":"10.1080/16549716.2025.2485523","url":null,"abstract":"<p><strong>Background: </strong>Community engagement has been recognized as a key tool for supporting national health agendas, and experiences from the COVID-19 pandemic can offer important lessons for tackling future global health challenges such as antimicrobial resistance. This paper provides much-needed evaluation knowledge on relational community engagement initiatives and their impact on COVID-19-related attitudes and practices.</p><p><strong>Methods: </strong>A two-round mixed-method evaluative study to examine outcome indicators related to COVID-19-prevention and health-seeking behavior was implemented from October 2022 to December 2023 among 14 diverse case study communities in four Lao provinces. Data involved 50 semi-structured interviews with villagers, 50 key informant interviews, and two rounds of complete census surveys (3,161 survey observations incl. matched panel data from 618 individuals) to discern outcomes among villagers with different levels of activity participation in a difference-in-difference analysis.</p><p><strong>Results: </strong>Relative to non-participating villagers, villagers participating in the activities had higher COVID-19 vaccine uptake (+0.13 doses), higher public healthcare utilization for presentations consistent with COVID-19 (e.g. fever and neurological and/or respiratory symptoms; +69.4% points), and less antibiotic use per illness episode (-0.2 antibiotic use episodes). However, the activity raised worries to disclose a COVID-19-positive status and was often interpreted as a health education campaign.</p><p><strong>Conclusions: </strong>Relational community engagement offers a respectful way of addressing persistent healthcare challenges and supporting vulnerable populations - and thus holds key for ongoing global health priorities such as emerging infectious disease responses and antimicrobial resistance. We recommend that community engagement initiatives become a standard component of national health policy portfolios beyond the scope of COVID-19.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2485523"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051685","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":"Improving the quality of chronic care through purchasing arrangements in resource-constrained settings: insights from an international Delphi survey.","authors":"Bruno Meessen, Megumi Rosenberg, Grace Marie V Ku","doi":"10.1080/16549716.2025.2518667","DOIUrl":"10.1080/16549716.2025.2518667","url":null,"abstract":"<p><strong>Background: </strong>There are substantial issues with the quality of care (QoC) received by persons living with chronic conditions, particularly in low- and middle-income countries (LMICs). One possible channel to improve QoC is through financing, specifically purchasing arrangements for health services. This has been actively explored in high-income country settings, generating a growing body of scientific knowledge.</p><p><strong>Objective: </strong>To understand the potential and the constraints of using purchasing arrangements as a way to improve QoC for chronic conditions in resource-constrained settings.</p><p><strong>Methods: </strong>A Delphi survey was conducted with 49 international participants with content expertise in chronic care management, health financing, or both, and context expertise in resource-constrained settings including in Small Island Developing States or Fragile and Conflict-Affected States, to assess the possible contribution of purchasing arrangements to QoC for chronic conditions with respect to specific types of care providers (e.g. patients and relatives, community health workers, public health centres), decentralized coordination bodies and purchasing agencies in such settings.</p><p><strong>Results: </strong>There was a high level of consensus among the Delphi panel in favour of considering purchasing arrangements as one of the levers to improve QoC for people living with chronic conditions. Specific directions for action were identified along with their caveats.</p><p><strong>Conclusions: </strong>The challenge of improving the quality of chronic care in resource-constrained settings is extensive and requires immediate attention. Leveraging purchasing arrangements is one promising channel to strengthen quality chronic care in such settings.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2518667"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555521","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":"Workplace sexual harassment is associated with poor mental well-being among employees at a large Swedish university.","authors":"Frida Pilgaard, Per-Olof Östergren, Gisela Priebe, Anette Agardh","doi":"10.1080/16549716.2025.2465050","DOIUrl":"10.1080/16549716.2025.2465050","url":null,"abstract":"<p><strong>Background: </strong>Sexual harassment (SH) is a persistent problem at workplaces around the world, including academia.</p><p><strong>Objective: </strong>This study examines the association between SH and mental well-being among employees at Lund University (LU) in Sweden.</p><p><strong>Methods: </strong>Data was obtained from a cross-sectional survey targeting all LU employees in 2019. SH exposure was measured using a ten-item scale capturing SH experiences and enabling the differentiation between soliciting and non-soliciting types of SH. Validated instruments were used to measure two aspects of mental well-being; mental health (GHQ-12) and vitality (SF-36 vitality scale). Association between SH exposure and outcome variables was investigated through multivariable logistic regression analysis adjusting for confounders. Modifying effects of gender, age, background and academic position, respectively, on the relation between SH and outcomes were studied.</p><p><strong>Results: </strong>Workplace SH was associated with poor mental health (PMH) (OR 1.5 (95% CI 1.1-2.0)) and low vitality (LV) (OR 1.8 (95% CI 1.3-2.5)) among women and with LV (OR 2.0 (95% CI 1.1-3.9)) among men, after adjusting for confounders. Among women, experiences of non-soliciting and soliciting SH combined were associated with PMH and LV. Among men, experiences of non-soliciting SH behaviours exclusively were associated with LV. Indications of synergistic interaction affecting the association between SH and LV were found related to age, background and academic position, but not gender.</p><p><strong>Conclusions: </strong>Workplace SH is a significant risk factor for poor mental well-being, primarily among female, but also among male university employees. These findings can inform local policies for prevention of SH.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2465050"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450632","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":"Determinants of outpatient healthcare-seeking behaviors among the rural poor affected by chronic conditions in India: a population-based cross-sectional study in seven states.","authors":"David Grossmann, Swati Srivastava, Volker Winkler, Stephan Brenner, Keerti Jain Gupta, Amit Paliwal, Kavita Singh, Manuela De Allegri","doi":"10.1080/16549716.2025.2480413","DOIUrl":"https://doi.org/10.1080/16549716.2025.2480413","url":null,"abstract":"<p><strong>Background: </strong>A rising burden of chronic non-communicable diseases (CNCDs) increases demand for outpatient healthcare. Yet, evidence on preferences and barriers to healthcare services for India's most disadvantaged population, the target of India's largest public health insurance scheme (PM-JAY), is lacking.</p><p><strong>Objective: </strong>We explore determinants of outpatient healthcare-seeking behavior among PM-JAY eligible individuals with CNCDs in rural areas of seven states.</p><p><strong>Methods: </strong>Using cross-sectional data from a household survey (conducted between November 2019 and March 2020), we employed multilevel multinomial logistic regression to identify factors associated with seeking care from informal (home treatment, pharmacies, traditional healers), formal public, or formal private providers, compared with no care. Anderson's behavioral model informed the selection of independent variables.</p><p><strong>Results: </strong>Of 51,820 individuals, 5,061 (9.8%) reported a chronic condition. Despite their disease, 1,168 (23.1%) reported not using regular outpatient care. Another 2,421 individuals (48.0%) used formal private, 922 (18.3%) used formal public, and 535 (10.6%) used informal care. Predictors of formal private care were higher socioeconomic status (RRR = 2.441, 95% CI [1.61, 3.70]) and health insurance coverage (RRR = 1.478, 95% CI [1.12, 1.95]). Residents of Tamil Nadu, Kerala, and Gujarat were more likely to use formal public care (RRR = 23.915, 95% CI [9.01, 63.44]). Suffering from Major CNCDs or experiencing limitations in daily activities increased the probability of using healthcare across all options.</p><p><strong>Conclusion: </strong>Future research should explore the reasons for non-utilization of chronic care and the preference for private providers. Policies to enhance public healthcare utilization and expand insurance for outpatient care could improve access and reduce health inequities.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2480413"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058761","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":"'Mind the gaps': stakeholder perspectives on addressing antimicrobial resistance in the environment in the Indian context.","authors":"Anishka Cameron, John Connolly, Regina Esiovwa, Fiona L Henriquez, Andrew Hursthouse, Suparna Mukherji, Soumyo Mukherji","doi":"10.1080/16549716.2025.2491200","DOIUrl":"https://doi.org/10.1080/16549716.2025.2491200","url":null,"abstract":"<p><strong>Background: </strong>There is growing global awareness of the pivotal role environmental factors, including pharmaceutical manufacturing waste, play in the development and spread of antimicrobial resistance (AMR). India bears one of the highest burdens of AMR globally and possesses a substantial manufacturing sector, but limited insight is available on how to practically mitigate environmental AMR-related risk in this context.</p><p><strong>Objective: </strong>To understand the barriers and opportunities in managing manufacturing waste for addressing AMR in the environment from the perspectives of stakeholders in India.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with a range of stakeholders from government, industry, and civil society following a stakeholder mapping and analysis process within the Indian context. We also undertook a series of stakeholder events to inform the study.</p><p><strong>Results: </strong>Our findings indicate that 1) Policy action is fragmentary and there are economic and capacity gaps that have implications for industry behaviours; 2) A One Health approach to addressing AMR in the environment requires leadership and that means AMR prevention needs to be institutionalised within government for them to steer, facilitate and coordinate; and 3) There is a need to enhance knowledge amongst policymakers in India about AMR in the environment, and robust 'evidence' is required to foster policy change.</p><p><strong>Conclusions: </strong>The study underscores the need for a multifaceted strategy to address the contribution of pharmaceutical manufacturing waste to AMR in the environment in India. Greater prioritisation of AMR, stakeholder collaboration, and capacity building are essential to overcoming the challenges identified.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2491200"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027713","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}