Global Health Action最新文献

{"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":"Developing capacity in identifying cost-effective interventions to prevent and reduce obesity in China.","authors":"Angela M Jackson-Morris, Suying Chang, Christina L Meyer, Guansheng Ma","doi":"10.1080/16549716.2025.2463794","DOIUrl":"10.1080/16549716.2025.2463794","url":null,"abstract":"<p><p>Obesity is associated with multiple noncommunicable diseases and has increased rapidly worldwide. Population obesity in China grew fourfold between 1993 and 2015, increasing most rapidly among children and adolescents. Cost-effective policies and programs delivered over time and at scale are required to change this trajectory, yet application of methodologies to identify such interventions have been sparse. UNICEF China and Peking University together identified the need to strengthen the intervention evidence available to policymakers and to build stakeholders' knowledge and skills. Investment cases combine a review of intervention evidence, policy landscape assessment, and economic modelling to identify cost-effective interventions suited to a specific context. A training and mentorship program aimed to build awareness, knowledge, and skills about this methodology to encourage its use to support decision making and planning to address obesity. Program participants reported increased knowledge of analytical methods to identify contextually relevant cost-effective obesity interventions (92% of evaluation respondents), and 82% reported increased knowledge of evidence-based obesity interventions. 79% reported confidence to apply the learning in their job roles. Training and mentorship can enhance stakeholder knowledge, skills, and confidence to apply investment case methodology to develop economic evidence to strengthen the basis of obesity policy and program commissioning.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2463794"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587822","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":"Implementation matters: program impact pathway analysis of four sectoral nutrition-sensitive interventions in Anambra and Kebbi states, Nigeria.","authors":"Oluchi Ezekannagha, Scott Drimie, Dieter Von Fintel, Busie Maziya-Dixon, Xikombiso Mbhenyane","doi":"10.1080/16549716.2025.2519677","DOIUrl":"10.1080/16549716.2025.2519677","url":null,"abstract":"<p><strong>Background: </strong>Undernutrition in early childhood can be reduced when large-scale, nutrition-sensitive programs are delivered with adequate dose, reach, fidelity, and recruitment.</p><p><strong>Objectives: </strong>This study (i) investigates the implementation and impact pathways of four nutrition-sensitive programs in Kebbi and Anambra states, Nigeria: Early Childhood Development Education (ECCDE), Environmental Sanitation, Skills Acquisition, and Agricultural Transformation Support Program (ATASP-1) and (ii) identifies cross-sector factors that enable or hinder effective dose, reach, fidelity, and recruitment.</p><p><strong>Methods: </strong>The study employs qualitative methods such as document reviews, in-depth interviews, and site observations to explore the complexity of program delivery and the contextual factors that influence its outcomes.</p><p><strong>Results: </strong>All four programs showed dose-reach-fidelity-recruitment gaps in varying degrees: irregular training and equipment delayed dose; rural and low-income communities were least reached; weak quality control cut fidelity; and recruitment seldom penetrated remote areas. Barriers across sectors included insufficient infrastructure, shortages of trained personnel, and bureaucratic funding delays. Programs with robust community engagement, active multi-stakeholder collaboration, timely resource flow, and short 'reviewandadapt' cycles (ATASP1 in both states; ECCDE in Anambra) overcame many shortfalls, whereas those lacking these features underperformed (Environmental Sanitation in Anambra; Skills Acquisition in Kebbi).</p><p><strong>Conclusion: </strong>Closing Nigeria's nutrition-sensitive implementation gap demands a dual response: fix tangible barriers - staffing, infrastructure, and procurement - and institutionalize community-led planning and adaptive management to keep dose-reach-fidelity-recruitment on track. Doing so will improve program reach and quality and accelerate progress against child undernutrition.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2519677"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498966","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":"Prevalence of non-communicable disease risk factors and their association with economic status: findings from the 2021 health behaviour of population survey in Thailand.","authors":"Polathep Vichitkunakorn, Warintorn Bunyanukul, Kanarit Apiwan, Detphop Tanasanchonnakul, Monsicha Sittisombut","doi":"10.1080/16549716.2025.2485689","DOIUrl":"10.1080/16549716.2025.2485689","url":null,"abstract":"<p><strong>Background: </strong>Non-communicable diseases (NCDs) are major contributors to mortality and disease burden; however, evidence regarding NCD risk factors, particularly socioeconomic factors, remains limited.</p><p><strong>Objectives: </strong>We investigated the prevalence of five key behavioural risk factors for NCDs (smoking, alcohol consumption, physical inactivity, unhealthy diet, and overweight/obesity) within the Thai population and the influence of economic status on these risk factors.</p><p><strong>Methods: </strong>We gathered secondary data from the 2021 health Behaviour of Population Survey. Data were derived from a stratified, nationally representative household survey using two-stage sampling. Economic status was categorised into very low, low, middle, high, and very high levels.</p><p><strong>Results: </strong>Among the 207,191 participants (weighted to represent 26,600,947 participants), the most prevalent NCD risk factor was an unhealthy diet (56.93%), followed by overweight/obesity (50.03%), physical inactivity (42.70%), alcohol consumption (29.73%), and smoking (16.61%). Higher economic levels were associated with increased odds of alcohol consumption (e.g. adjusted odds ratio [AOR] = 1.13, 95% CI: 1.03-1.25 for high) and an unhealthy diet (AOR = 1.26, 95% CI: 1.15-1.38 for very high), while smoking odds decreased (AOR = 0.67, 95% CI: 0.59-0.77 for very high). Physical inactivity exhibited a U-shaped association, and overweight/obesity slightly increased at the highest economic levels (AOR = 1.10, 95% CI: 1.01-1.21).</p><p><strong>Conclusion: </strong>Unhealthy dietary patterns and overweight/obesity were the most prevalent NCD risk factors. Smoking was the least prevalent. Tailored, evidence-based interventions targeting specific economic groups are needed to effectively reduce NCD risk factors and promote health equity.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2485689"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121300","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 emotional cost of containment: a cross-sectional analysis of treatment effects among informal carers in South Asia during the COVID-19 pandemic.","authors":"Carol Troy, Anna Tjin, Anna Goodwin, Iracema Leroi, Roger O'Sullivan, Yaohua Chen","doi":"10.1080/16549716.2025.2504227","DOIUrl":"10.1080/16549716.2025.2504227","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic led to government-imposed mobility restrictions, social distancing, and lockdowns, altering the caregiving environment worldwide. In South Asia, it is unknown what aspects of these changes posed significant emotional costs to informal carers, or how such costs can be mitigated in future pandemics.</p><p><strong>Objectives: </strong>To identify environmental change aspects (dimensions) that posed distinct emotional costs for South Asian carers. To quantify the costs and classify them as persistent, transient, hidden, or insignificant. To propose ways of mitigating carer distress during future pandemics.</p><p><strong>Methods: </strong>The data came from the Coping with Loneliness, Isolation, and COVID-19 Caregiver survey. Carers (<math><mi>n</mi><mo>=</mo><mn>454</mn></math>) in Bangladesh (<math><mi>N</mi><mo>=</mo><mn>123</mn></math>), India (<math><mi>N</mi><mo>=</mo><mn>116</mn></math>), and Pakistan (<math><mi>N</mi><mo>=</mo><mn>215</mn></math>) self-reported their experiences before/during the pandemic. The dimensions were extracted from 11 change indicators. A dimension's emotional costs were its effects on (1) the change in burden frequency relative to pre-pandemic conditions and (2) the during-pandemic burden frequency.</p><p><strong>Results: </strong>Five factors emerged: social confinement, reduced/missing information on the recipient, loss of connection, restricted visitation rights, and protective clothing. Social confinement (loss of connection) increased both changes in burden frequency and during-pandemic burden frequency, indicating a persistent emotional cost to carers. Restricted visitation rights affected only pandemic burden frequency, indicating a hidden emotional impact.</p><p><strong>Conclusions: </strong>Social confinement (loss of connection, restricted visitation rights) was emotionally costly because it forced an increase (decrease) in care intensity relative to pre-pandemic levels. Through enhanced counseling and emotional support services, South Asian public health systems can alleviate carers' private suffering during normal times and future crises.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2504227"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210039","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":"Sexual and reproductive health literacy of higher education students: a scoping review of determinants, screening tools, and effective interventions.","authors":"Nour Waleed Zuhair Alhussaini, Usra Elshaikh, Khadiga Abdulrashid, Sana Elashie, Noor Ahmed Hamad, Ghadir Fakhri Al-Jayyousi","doi":"10.1080/16549716.2025.2480417","DOIUrl":"10.1080/16549716.2025.2480417","url":null,"abstract":"<p><p>Health literacy is a determinant of overall health, particularly among college students who are at increased risk for negative sexual and reproductive health outcomes. Contextualized sexual and reproductive health education serves as an important protective measure for this population. This scoping review examines sexual and reproductive health literacy among college students to identify key determinants, screening tools, and effective interventions. Following the PRISMA-ScR guidelines, a comprehensive systematic search was conducted through PubMed, Embase, and Scopus databases without restrictions to capture all publications related to health literacy of students of higher education from January 2013 to March 2023. Out of 4,526 articles identified in the initial search, 11 studies met the inclusion criteria for this review. Most studies were cross-sectional and conducted in the USA. Sexual and reproductive health literacy was examined as both an outcome, influenced by factors like age, gender, religion, study area, sexual education, birthplace/region, and race/ethnicity, and as an exposure shaping knowledge, attitudes, and behaviors regarding sexual and reproductive health. On the interpersonal level, family influence played a crucial role in shaping sexual and reproductive health literacy. The review also found correlations between health literacy and knowledge, attitudes, and practices, with technology-based interventions. Based on the findings, a conceptual model was developed. Research on sexual and reproductive health literacy remains limited, particularly in sensitive sociocultural contexts. Further studies are needed to explore the impact of sociocultural, religious, and environmental factors on young people's health literacy in order to inform more effective interventions.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2480417"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671452","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 study protocol for developing a spatial vulnerability index for infectious diseases of poverty in the Caribbean region.","authors":"Behzad Kiani, Beatris Mario Martin, Angela Cadavid Restrepo, Helen J Mayfield, Eloise Skinner, Ana Karina Maldonado Alcaíno, Eric J Nilles, Colleen L Lau, Benn Sartorius","doi":"10.1080/16549716.2025.2461867","DOIUrl":"10.1080/16549716.2025.2461867","url":null,"abstract":"<p><p>Infectious diseases of poverty (IDoP) affect disproportionately resource-limited and marginalized populations, resulting in spatial patterns of vulnerability across various geographical areas. Currently, no spatial indices exist to quantify vulnerability to IDoP at a fine geographical level within countries, such as municipalities or provinces. Without such an index, policymakers cannot effectively allocate resources or target interventions in the most vulnerable areas. This protocol aims to specify a methodological approach to measure spatial variation in vulnerability to IDoP. We will evaluate this methodological approach using surveillance and seroprevalence data from the Dominican Republic (DR) as part of a broader effort to develop a regional index for the Caribbean region. The study will consist of three main components. The first component involves identifying the relevant factors associated with IDoP in the Caribbean region through a scoping review, supplemented by expert-elicited opinion. The second component will apply a Fuzzy Analytic Hierarchy Process to weigh the aforementioned factors and develop a spatial composite index, using open data and available national surveys in the DR. In the final component, we will evaluate and validate the index by analysing the prevalence of at least three IDoPs at a fine-grained municipal level in the DR, using seroprevalence data from a 2021 national field study and other national surveillance programs. The spatial vulnerability index framework developed in this study will assess the degree of vulnerability to IDoP across different geographical scales, depending on data availability in each country.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2461867"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392324","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":"Assessing heat exposure and its effects on farmer health, harvest yields, and nutrition: a study protocol for Burkina Faso and Kenya.","authors":"Sandra Barteit, Windpanga Aristide Ouédraogo, Charlotte Müller, Pascal Zabré, Issouf Traoré, Valentin Boudo, Ali Sié, Guillaume Compaoré, Lucienne Ouèrmi, Stephen Munga, David Obor, Aditi Bunker, Hanns-Christian Gunga, Kristine Belesova, Till Bärnighausen, Jonas Franke, Maximilian Schwarz, Martina Anna Maggioni, Rainer Sauerborn","doi":"10.1080/16549716.2025.2513719","DOIUrl":"10.1080/16549716.2025.2513719","url":null,"abstract":"<p><p>Rising temperatures in Africa present an increasing threat to agricultural productivity and public health, particularly among subsistence farming communities reliant on rain-fed agriculture. Heat exposure can impair farmers' work capacity, disrupt harvests, and heighten health risks, especially for young children vulnerable to undernutrition. The Heat to Harvest (H2H) study investigates how environmental heat exposure influences farmers' physiological and behavioral responses, and how these in turn affect harvest yields and child nutrition. It also examines differences in labor performance and recovery between households with and without cool roof coatings, although this intervention is not the central focus. H2H is designed as a prospective cohort study nested within two Health and Demographic Surveillance Systems (HDSS) in Nouna, Burkina Faso, and Siaya, Kenya. The study integrates environmental monitoring (temperature and humidity sensors used to compute Wet Bulb Globe Temperature), biometric data (via wearables tracking heart rate, temperature, physical activity, energy expenditure, and sleep), and GPS tracking (capturing spatial mobility and labor duration). The study is embedded within a larger cluster-randomized controlled trial, facilitating comparative analysis under varying thermal conditions. Findings will provide evidence-based insights into how climate-related heat stress affects health and agricultural outcomes, supporting the development of targeted adaptation strategies to enhance resilience, health, and food security in vulnerable farming communities.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2513719"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627535","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":"Evaluating an internal quality assurance process for achieving national accreditation standards in midwifery education: a study protocol.","authors":"Frida Berg, Kerstin Erlandsson, Paridhi Jha, Helena Wigert, Bharati Sharma, Malin Bogren","doi":"10.1080/16549716.2025.2463234","DOIUrl":"10.1080/16549716.2025.2463234","url":null,"abstract":"<p><p>The World Health Organization and the International Confederation of Midwives emphasize the importance of accreditation to enhance quality in midwifery education. In midwifery education programmes, internal self-assessments are used to meet accreditation criteria. However, research on this topic is scarce. Therefore, this paper describes how we plan to conduct an evaluation of an internal quality assurance process in midwifery education aimed at achieving national accreditation standards in Bangladesh. This study has a longitudinal exploratory design and will be guided by the principles of process evaluation of complex interventions. An internal quality assurance self-assessment intervention will be introduced at 31 private and public education institutions in Bangladesh. To ensure a sustainable implementation, the Plan-Do-Study-Act cycle will be introduced. Data will be collected using self-administered questionnaires and focus group discussions with midwifery faculty and final-semester students. Descriptive statistics and regression models will be performed for the quantitative data, and the qualitative data will be analysed using content analysis. It is anticipated that, without internal quality assurance of midwifery education programmes, accreditation alone is unlikely to enhance quality. We aspire for this research project to illustrate a process that the midwifery institutes can implement themselves for sustainable transformation towards high-quality midwifery education in countries where such internal quality assurance processes have not yet been integrated into the education system.<b>Trial registration</b>: The study was registered retrospectively with the ISRCTN registry on 26 August 2024. The registration number is: ISRCTN14492910.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2463234"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411038","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":"Livelihood dynamics and challenges to wellbeing in the drylands of rural East Africa - the Drylands Transform study population in the Karamoja border region.","authors":"Barbara Schumann, Alice Turinawe, Kristina Lindvall, Joseph Lule Kyanjo, Derick Ansyijar Kuule, Caroline Kawira, Annrose Mwangi, Peter Mwangi, Agneta Hörnell","doi":"10.1080/16549716.2025.2490330","DOIUrl":"https://doi.org/10.1080/16549716.2025.2490330","url":null,"abstract":"<p><strong>Background: </strong>The Karamoja region in the East African drylands is a rural, impoverished setting where pastoralism is increasingly replaced by other livelihood strategies. Understanding the socioeconomic contexts as well as their local variations is key for sustainable development of communities.</p><p><strong>Objective: </strong>The aim of the present paper is to describe the baseline survey of the Drylands Transform project, its setting, methods and key findings.</p><p><strong>Methods: </strong>In June 2022, a survey was conducted with 944 randomly selected households at four study sites in the Karamoja border region of Kenya and Uganda. Data were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Main livelihood forms were pastoralism and agropastoralism, while many households also relied on other sources of income. At some study sites, livestock keeping was abandoned by many residents due to cattle raiding and droughts. Only 4% of households were rated as food secure. The proportion of malnutrition among children aged 6-59 months varied across sites between 3% and 17% and was considerably higher among women.</p><p><strong>Conclusions: </strong>Climate change, water shortage, social conflicts and marginalization pose barriers to food security and wellbeing for rural populations in the East African drylands. There are, however, opportunities for development through income diversification, the improvement of land health, the promotion of kitchen gardens and other measures of sustainable agriculture.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2490330"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12024496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055592","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}