Global Health Action最新文献

{"title":"Intersecting inequities: a scoping review of the gendered relationship between unpaid care work and intimate partner violence during the COVID-19 lockdown in Canada.","authors":"Alexandra Beukens, Julia Smith","doi":"10.1080/16549716.2024.2411743","DOIUrl":"10.1080/16549716.2024.2411743","url":null,"abstract":"<p><strong>Background: </strong>While there is now extensive research on how COVID-19 lockdowns negatively affected unpaid care burdens and intimate partner violence (IPV), the structural determinants shaping both experiences are less well understood.</p><p><strong>Objectives: </strong>The review seeks to answer: how did structural determinants of gender inequality shape both the experiences of increased unpaid care burdens and IPV during the COVID-19 pandemic lockdown? Which policy proposals might mitigate these effects during future pandemic preparedness and response?</p><p><strong>Methods: </strong>We conducted a scoping review of two sets of literature: on COVID-19 and unpaid care and COVID-19 on IPV. Following systematic searches of key databases and the application of inclusion/exclusion criteria, we analyzed articles using a gender matrix framework to identify common themes and policy recommendations.</p><p><strong>Results: </strong>Common themes include adherence to traditional gender norms, power dynamics featuring coercive control, narrowed pathways to formal and informal supports, and compounding emotional tolls. Policy recommendations from the literature aimed at addressing structural determinants of gender inequality common to both unpaid care and IPV, including expanded access to virtual support services, workplace policies that value the contributions of caregivers, enhanced engagement efforts to incorporate intersectional understandings, and funding for caregiver support services and the anti-violence sector which recognize the value of their contributions.</p><p><strong>Conclusions: </strong>Enhanced understanding of the structural determinants of gender inequality at play in experiences of unpaid care work and IPV highlights gaps in pandemic response, which overlooked the role of gender inequities in shaping relationship dynamics, as well as areas for more gender transformative policies.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478823","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 develop a dialogue-drama on adolescent pregnancy in a marginalised migrant population on the Thailand-Myanmar border: an ethnographic approach to participatory action research.","authors":"Saw San Soe, Saw Thwe Paw, Mu Lwel Tha Dah, Day Mu Dah, Thae Thae Naing, K Mwee Hser, Solomon Naw, Htet Khaing Lu, Kanjana Winyoorat, Primprapaporn Thongdee, Saw Win Tun, Poe Poe, Rose McGready, Poe Christ, Htee K Poung, Win Win Cho, Hser Nay Wah, Htoo Hser, Saw Phee Do, Paw Bway Shee, Bulakorn Tinoi, Prapatsorn Misa, May Myo Thwin, Ladda Kajeechiwa","doi":"10.1080/16549716.2024.2328893","DOIUrl":"https://doi.org/10.1080/16549716.2024.2328893","url":null,"abstract":"<p><strong>Background: </strong>Communities in which adolescent pregnancy and safe abortion care are taboo may benefit from culturally appropriate information, education, and communication.</p><p><strong>Objective: </strong>This ethnographic and participatory action research (PAR) elicited community members' perceptions to adolescent pregnancy: which then informed dialogue-drama development in Burmese and Karen language for undocumented migrants on the Thailand-Myanmar border.</p><p><strong>Methods: </strong>PAR was conducted in Karen and Burmese language. Interviews and discussions elicited perceptions of community members about adolescent pregnancy. These were analysed for themes and using the fishbone technique, to determine the objectives for the drama. After developing the structure and content of the drama it was piloted, revised, and performed in communities. Responses and impact of the drama were recorded. The team reflected on the drama as a method for health messaging.</p><p><strong>Results: </strong>In 2022, themes of responsibility, communication, and experiences of adolescent pregnancy emerged from 10 interviews and 6 discussions with community members. The fishbone technique established three dramatic objectives, woven into a teenage love story with an unplanned pregnancy, to raise community awareness of i) adolescent pregnancy, ii) contraception, and iii) choice in unexpected pregnancy. Post-drama feedback from 11 migrant communities (1,238 participants) was positive although some community members voiced concerns. Given the logistical challenges of conducting the drama in person, a film will be created for wider dissemination.</p><p><strong>Conclusions: </strong>Participatory action research resulted in a culturally-nuanced performance, with communities requesting further performances and awareness on adolescent pregnancy and safe abortion care. Video is likely to be a more sustainable option.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606948","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":"Two decades of research capacity strengthening and reciprocal learning on sexual and reproductive health in East Africa - a point of (no) return.","authors":"Caroline Frisendahl, Emelie Looft-Trägårdh, Amanda Cleeve, Susan Atuhairwe, Elin C Larsson, Othman Kakaire, Herbert Kayiga, Annette Aronsson, Anne Kihara, Marleen Temmerman, Marie Klingberg Allvin, Josaphat Byamugisha, Kristina Gemzell Danielsson","doi":"10.1080/16549716.2024.2353957","DOIUrl":"10.1080/16549716.2024.2353957","url":null,"abstract":"<p><p>As the world is facing challenges such as pandemics, climate change, conflicts, and changing political landscapes, the need to secure access to safe and high-quality abortion care is more urgent than ever. On 27th of June 2023, the Swedish government decided to cut funding resources available for developmental research, which has played a fundamental role in the advancement of sexual and reproductive health and rights (SRHR) globally, including abortion care. Withdrawal of this funding not only threatens the fulfilment of the United Nations sustainable development goals (SDGS) - target 3.7 on ensuring universal access to SRHR and target 5 on gender equality - but also jeopardises two decades of research capacity strengthening. In this article, we describe how the partnerships that we have built over the course of two decades have amounted to numerous publications, doctoral graduates, and important advancements within the field of SRHR in East Africa and beyond.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201071","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":"Ten years of ear, nose and throat (ENT) services in Southern Africa: a scoping review.","authors":"Lufunda Lukama, Colleen Aldous, Warren Kuhn, Charles Michelo, Chester Kalinda","doi":"10.1080/16549716.2024.2370102","DOIUrl":"10.1080/16549716.2024.2370102","url":null,"abstract":"<p><strong>Background: </strong>While ear, nose, and throat (ENT) diseases are a substantial threat to global health, comprehensive reviews of ENT services in Southern Africa remain scarce.</p><p><strong>Objective: </strong>This scoping review provides a decade-long overview of ENT services in Southern Africa and identifies gaps in healthcare provision. From the current literature, we hope to provide evidence-based recommendations to mitigate the challenges faced by the resource-limited ENT service.</p><p><strong>Data sources: </strong>PubMed, Web of Science, EBSCOhost, Cochrane Library, Cochrane Library, and Scopus.</p><p><strong>Review methods: </strong>On several databases, we conducted a comprehensive literature search on both quantitative and qualitative studies on ENT services in Southern Africa, published between 1 January 2014 and 27 February 2024. The extracted data from the analyzed studies was summarized into themes.</p><p><strong>Results: </strong>Four themes in the fourteen studies included in the final analysis described the existing ENT services in Southern Africa: 1. Workforce scarcity and knowledge inadequacies, 2. Deficiencies in ENT infrastructure, equipment, and medication, 3. Inadequate ENT disease screening, management, and rehabilitation and 4. A lack of telehealth technology.</p><p><strong>Conclusion: </strong>The Southern African ENT health service faces many disease screening, treatment, and rehabilitation challenges, including critical shortages of workforce, equipment, and medication. These challenges, impeding patient access to ENT healthcare, could be effectively addressed by implementing deliberate policies to train a larger workforce, increase ENT funding for equipment and medication, promote telehealth, and reduce the patient cost of care.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11212562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460255","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":"Barriers and pathways to environmental surveillance of antibiotic resistance in middle- and low-income settings: a qualitative exploratory key expert study.","authors":"Ann-Christin Peters, D G Joakim Larsson, Ramanan Laxminarayan, Christian Munthe","doi":"10.1080/16549716.2024.2343318","DOIUrl":"10.1080/16549716.2024.2343318","url":null,"abstract":"<p><strong>Background: </strong>Local and global surveillance of antibiotic resistance (ABR) has proven a challenge to implement effectively in low- and middleincome (LMI) settings. Environmental surveillance solutions are increasingly highlighted as a strategy to help overcome such problems, and thus to promote global health as well as the local management of ABR in LMI countries. While technical and scientific aspects of such solutions are being probed continuously, no study has investigated their practical feasibility.</p><p><strong>Objective: </strong>Explore practical barriers for environmental surveillance of ABR in LMI countries, and pathways for surveillance experts to manage these.</p><p><strong>Methods: </strong>To start charting this unknown territory, we conducted an explorative, qualitative interview study with key informants, applying a constructivist grounded theory approach to analyze the results.</p><p><strong>Results: </strong>Barriers were identified across infrastructural, institutional and social dimensions, and pathways to manage them were mostly counterproductive from an ABR management perspective, including avoiding entire regions, applying substandard methods and failing to include local collaborators.</p><p><strong>Conclusion: </strong>The research community as well as international agencies, organizations and states have key roles and responsibilities for improving the prospects of feasible environmental ABR surveillance in LMI-settings.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11141306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176705","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":"<i>Ni-kshay Poshan Yojana</i>: receipt and utilization among persons with TB notified under the National TB Elimination Program in India, 2022.","authors":"Kathiresan Jeyashree, Jeromie W V Thangaraj, Devika Shanmugasundaram, G Sri Lakshmi Priya, Sumit Pandey, Venkateshprabhu Janagaraj, Prema Shanmugasundaram, Sumitha Ts, Sabarinathan Ramasamy, Joshua Chadwick, Sivavallinathan Arunachalam, Rahul Sharma, Vaibhav Shah, Aniket Chowdhury, Swati Iyer, Raghuram Rao, Sanjay K Mattoo, Manoj V Murhekar, Npy Evaluation Group","doi":"10.1080/16549716.2024.2363300","DOIUrl":"10.1080/16549716.2024.2363300","url":null,"abstract":"<p><strong>Background: </strong><i>Ni-kshay Poshan Yojana</i> (NPY), a direct benefit transfer scheme under the National Tuberculosis Elimination Program (NTEP) in India, provides a monthly benefit of INR500 for nutritional support of persons with TB (PwTB).</p><p><strong>Objectives: </strong>To determine the proportion of PwTB receiving atleast one NPY instalment and pattern of utilisation; to ascertain factors associated with NPY non-receipt and association of NPY receipt with TB treatment outcome.</p><p><strong>Methods: </strong>In our cross-sectional study, we used multi-stage sampling to select PwTB whose treatment outcome was declared between May 2022 and February 2023. A cluster-adjusted, generalized linear model was used to identify factors associated with the non-receipt of NPY and determine association between NPY receipt and TB treatment outcome.</p><p><strong>Results: </strong>Among 3201 PwTB, 2888 (92.7%; 95% CI 89.8%, 94.8%) had received at least one NPY instalment, and 1903 (64.2%; 95% CI 58.9%, 69.2%) self-reported receipt of benefit. The median (IQR) time to receipt of first instalment was 105 (60,174) days. Non-receipt was significantly higher among PwTB from states with low TB score (aPR = 2.34; 95%CI 1.51, 3.62), who do not have bank account (aPR = 2.48; 95%CI 1.93, 3.19) and with unknown/missing diabetic status (aPR = 1.69; 95%CI 1.11, 2.55). Unfavorable treatment outcomes were associated with non-receipt of NPY (aPR 4.93; 95%CI 3.61,6.75) after adjusting for potential confounders.</p><p><strong>Conclusion: </strong>Majority of the PwTB received atleast one NPY instalment, but they experience significant delays. Most of the recipients utilised NPY for nutrition. Longitudinal follow-up studies are required to study the impact of NPY on treatment outcomes.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735448","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":"Global Financing Facility investments for vulnerable populations: content analysis regarding maternal and newborn health and stillbirths in 11 African countries, 2015 to 2019.","authors":"Mary Kinney, Meghan Bruce Kumar, Issa Kaboré, Joël Kiendrébéogo, Peter Waiswa, Joy E Lawn","doi":"10.1080/16549716.2024.2329369","DOIUrl":"10.1080/16549716.2024.2329369","url":null,"abstract":"<p><strong>Background: </strong>The Global Financing Facility (GFF) was launched in 2015 to catalyse increased domestic and external financing for reproductive, maternal, newborn, child, adolescent health, and nutrition. Half of the deaths along this continuum are neonatal deaths, stillbirths or maternal deaths; yet these topics receive the least aid financing across the continuum.</p><p><strong>Objectives: </strong>To conduct a policy content analysis of maternal and newborn health (MNH), including stillbirths, in GFF country planning documents, and assess the mortality burden related to the investment.</p><p><strong>Methods: </strong>Content analysis was conducted on 24 GFF policy documents, investment cases and project appraisal documents (PADs), from 11 African countries. We used a systematic data extraction approach and applied a framework for analysis considering mindset, measures, and money for MNH interventions and mentions of mortality outcomes. We compared PAD investments to MNH-related deaths by country.</p><p><strong>Results: </strong>For these 11 countries, USD$1,894 million of new funds were allocated through the PADs, including USD$303 million (16%) from GFF. All documents had strong content on MNH, with particular focus on pregnancy and childbirth interventions. The investment cases commonly included comprehensive results frameworks, and PADs generally had less technical content and fewer indicators. Mortality outcomes were mentioned, especially for maternal. Stillbirths were rarely included as targets. Countries had differing approaches to funding descriptions. PAD allocations are commensurate with the burden.</p><p><strong>Conclusions: </strong>The GFF country plans present a promising start in addressing MNH. Emphasising links between investments and burden, explicitly including stillbirth, and highlighting high-impact packages, as appropriate, could potentially increase impact.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535738","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":"Quality of care for chronic conditions: identifying specificities of quality aims based on scoping review and Delphi survey.","authors":"Grace Marie V Ku, Willem van de Put, Deogratias Katsuva, Mohamad Ali Ag Ahmed, Megumi Rosenberg, Bruno Meessen","doi":"10.1080/16549716.2024.2381878","DOIUrl":"10.1080/16549716.2024.2381878","url":null,"abstract":"<p><p>There is a growing need to implement high quality chronic care to address the global burden of chronic conditions. However, to our knowledge, there have been no systematic attempts to define and specify aims for chronic care quality. To address this gap, we conducted a scoping review and Delphi survey to establish and validate comprehensive specifications. The Institute of Medicine's (IOM) quality of care definition and aims were used as the foundation. We purposively selected articles from the scientific (n=48) and grey literature (n=26). We sought papers that acknowledged and unpacked the plurality of quality in chronic care and proposed or utilised frameworks, studied their implementation, or investigated at least two IOM quality care aims and implementation. Articles were analysed both deductively and inductively. The findings were validated through a Delphi survey involving 49 international chronic care experts with varied knowledge of, and experience in, low-and-middle-income countries. Considering the natural history of chronic conditions and the journey of a person with a chronic condition, we defined and identified the aims of chronic care quality. The six IOM aims apply with specific meanings. We identified a seventh aim, continuity, which relates to the issue of chronicity. The group endorsed our specifications and several participants gave contextualised interpretations and concrete examples. Chronic conditions pose specific challenges underscoring the relevance of tailoring quality of care aims. The next steps require a tailored definition and specific aims to improve, measure and assure the quality of chronic care.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989213","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":"'<i>I am happy to be listened to'</i>: co-creation of a simple tool to measure women's experiences of respectful maternity care in urban Tanzania.","authors":"Brenda Sequeira D'mello, Natasha Housseine, Hussein Lesio Kidanto, Nanna Maaløe, Jos van Roosmalen, Dan Wolf Meyrowitsch, Thomas van den Akker, Zainab Muniro, Evance Polin, Nuswe Ambokile, Charles Festo, Jane Brandt Sørensen, David Sando","doi":"10.1080/16549716.2024.2403972","DOIUrl":"10.1080/16549716.2024.2403972","url":null,"abstract":"<p><strong>Background: </strong>Rights-based Respectful Maternity Care (RMC) is crucial for quality of care and improved birth outcomes, yet RMC measurements are rarely included in facility improvement initiatives. We aimed to (i) co-create a routine RMC measurement tool (RMC-T) for congested maternity units in Dar es Salaam, Tanzania, and (ii) assess the RMC-T's acceptability among women and healthcare stakeholders.</p><p><strong>Method: </strong>We employed a participatory approach utilizing multiple mixed methods. This included a scoping review, stakeholder engagement involving postnatal women, healthcare providers, health leadership, and global researchers through interviews, focus groups, and two surveys involving 201 and 838 postnatal women. Cronbach's alpha and factor analysis were conducted for validation using Stata 15. Theories of social practice and Thematic Framework of Acceptability guided the assessment of stakeholder priorities and tool acceptability.</p><p><strong>Results: </strong>The multi-phased iterative co-creation process produced the 25-question RMC-T that measures satisfaction, communication, mistreatment (including physical, verbal, and sexual abuse; neglect; discrimination; lack of privacy; unconsented care; post-birth clean-up; informal payments; and denial of care), supportive care (such as food intake and mobility), birth companionship, post-procedure pain relief, bed-sharing, and newborn respect. The pragmatic validation process prioritized stakeholder feedback over strict statistics, lowering Cronbach's alpha from 0.70 in version 1 to 0.57 for the RMC-T. Women valued the opportunity to share their experiences.</p><p><strong>Conclusions: </strong>The RMC-T is contextualized, validated, and acceptable for measuring women's experiences of RMC. Routine use in facility-based quality improvement initiatives, along with targeted actions to address gaps, will advance rights-based RMC. Further validation and community-based studies are needed.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308890","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":"Causes of death among older children and adolescents (5-19 years) in the Magu Health and Demographic Surveillance Study, Tanzania, 1995-2022.","authors":"Sophia Kagoye, Milly Marston, Yasson Abha, Eveline T Konje, Mark Urassa, Jim Todd, Ties Boerma","doi":"10.1080/16549716.2024.2425470","DOIUrl":"10.1080/16549716.2024.2425470","url":null,"abstract":"<p><strong>Background: </strong>Population data on mortality and causes of death among 5-19-year-olds are limited.</p><p><strong>Objectives: </strong>To assess levels, trends, and risk factors of cause-specific mortality and place at death among 5-19-year-olds in Tanzania (1995-2022).</p><p><strong>Methods: </strong>Using longitudinal data from the Magu Health and Demographic Surveillance System in northwest Tanzania, we identified leading causes of death among 5-19-year-olds from verbal autopsy interviews, using physician review and a Bayesian probabilistic model (InSilicoVA). We analyzed trends in cause and place of death using three periods: 1995-2004, 2005-2014 and 2015-2022, and assessed risk factors in a Cox-proportional hazards model. We compared the results with children aged 1-4 years and global estimates for Tanzania.</p><p><strong>Results: </strong>Between 1995 and 2022, communicable disease mortality decreased by 73%, similar to the 76% decline among 1-4-year-olds. This decline in communicable disease mortality drove all-cause mortality declines of 43% and 48% among 5-14- and 15-19-year-olds, respectively. Non-communicable diseases and injuries gained importance, with their relative share of all deaths increasing from 15% in 1995-2004 to 58% in 2015-2022. Mortality risks were significantly higher among boys (particularly for injuries), those residing in rural areas (for non-communicable diseases), and those from the poorest households (for communicable diseases). By 2015-2022, 48% of 5-14 and 42% of 15-19-year-olds died in health facilities, up from 25% in 1995-2002.</p><p><strong>Conclusions: </strong>Since 1995, the decline in communicable disease mortality drove a major all-cause mortality reduction among 5-19-year-olds. Further progress will depend on continued reduction in communicable disease mortality, particularly among the poorest, and effectively addressing non-communicable and injury mortality.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591941","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}