BMC global and public health最新文献

{"title":"Investigating causal effects of income on health using two-sample Mendelian randomisation.","authors":"Erik Igelström, Marcus R Munafò, Ben M Brumpton, Neil M Davies, George Davey Smith, Pekka Martikainen, Desmond Campbell, Peter Craig, Jim Lewsey, S Vittal Katikireddi","doi":"10.1186/s44263-025-00130-4","DOIUrl":"10.1186/s44263-025-00130-4","url":null,"abstract":"<p><strong>Background: </strong>Income is associated with many health outcomes, but it is unclear how far this reflects a causal relationship. Mendelian randomisation (MR) uses genetic variation between individuals to investigate causal effects and may overcome some of the confounding issues inherent in many observational study designs.</p><p><strong>Methods: </strong>We used two-sample MR using data from unrelated individuals to estimate the effect of log occupational income on indicators of mental health, physical health, and health-related behaviours. We investigated pleiotropy (direct effects of genotype on the outcome) using robust MR estimators, CAUSE, and multivariable MR including education as a co-exposure. We also investigated demographic factors and dynastic effects using within-family analyses, and misspecification of the primary phenotype using bidirectional MR and Steiger filtering.</p><p><strong>Results: </strong>We found that a 10% increase in income lowered the odds of depression (OR 0.92 [95% CI 0.86-0.98]), death (0.91 [0.86-0.96]), and ever-smoking (OR 0.91 [0.86-0.96]), and reduced BMI (- 0.06 SD [- 0.11, - 0.003]). We found little evidence of an effect on alcohol consumption (- 0.02 SD [- 0.01, 0.05]) or subjective wellbeing (0.02 SD [- 0.003, 0.04]), or on two negative control outcomes, childhood asthma (OR 0.99 [0.87, 1.13]) and birth weight (- 0.02 SD, [- 0.01, 0.05]). Within-family analysis and multivariable MR including education and income were imprecise, and there was substantial overlap between the genotypes associated with income and education: out of 36 genetic variants significantly associated with income, 29 were also significantly associated with education.</p><p><strong>Conclusions: </strong>MR evidence provides some limited support for causal effects of income on some mental health outcomes and health behaviours, but the lack of reliable evidence from approaches accounting for family-level confounding and potential pleiotropic effects of education places considerable caveats on this conclusion. MR may nevertheless be a useful complement to other observational study designs since its assumptions and limitations are radically different. Further research is needed using larger family-based genetic cohorts, and investigating the overlap between income and other socioeconomic measures.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-creation and application of a framework for the de-prioritization of urban communities during insecticide-treated bed net mass campaigns for malaria prevention and control in Kwara State, Nigeria.","authors":"Ifeoma D Ozodiegwu, Laurette Mhlanga, Eniola A Bamgboye, Adeniyi F Fagbamigbe, Cyril Ademu, Chukwu Okoronkwo, Joshua O Akinyemi, Akintayo O Ogunwale, IkeOluwapo O Ajayi, Beatriz Galatas","doi":"10.1186/s44263-025-00126-0","DOIUrl":"10.1186/s44263-025-00126-0","url":null,"abstract":"<p><strong>Background: </strong>Malaria continues to be a major cause of illness and death worldwide, particularly affecting children under the age of five and those living in high-burden countries like Nigeria. Long-lasting insecticidal nets (LLINs) are one of the effective interventions for malaria control and prevention. In response to funding constraints in the Global Fund Grant Cycle 7, Nigeria's National Malaria Elimination Programme (NMEP) aimed to develop an approach that maximizes the impact of limited malaria interventions by focusing on areas with the greatest need. We developed an urban LLINs distribution framework and a novel strategy, which was piloted in Ilorin, the capital of Kwara State.</p><p><strong>Methods: </strong>A participatory action research approach, combined with abductive inquiry, was employed to co-design a framework for guiding bed net distribution. The final framework consisted of three phases: planning, data review and co-decision-making, and implementation. During the framework's operationalization, malaria risk scores were computed at the ward level using four key variables, including malaria case data and environmental factors, and subsequently mapped. A multistakeholder dialogue facilitated the selection of the final malaria risk maps. Additionally, data from an ongoing study were analyzed to determine whether local definitions of formal, informal, and slum settlements could inform community-level stratification of malaria risk in cities.</p><p><strong>Results: </strong>Akanbi 4, a ward located in Ilorin South and Are 2, a ward in Ilorin East consistently had lower risk scores, a finding corroborated during the multistakeholder dialogue. A map combining malaria test positivity rates among children under five and the proportion of poor settlements was identified as the most accurate depiction of ward-level malaria risk. Malaria prevalence varied significantly across the categories of formal, informal, and slum settlements, resulting in specific definitions developed for Ilorin. Thirteen communities classified as formal settlements in Are 2 were de-prioritized during the bed net distribution campaign.</p><p><strong>Conclusions: </strong>The framework shows promise in facilitating evidence-based decision-making under resource constraints. The findings highlight the importance of stakeholder engagement in evaluating data outputs, particularly in settings with limited and uncertain data. Enhancing surveillance systems is crucial for a more comprehensive approach to intervention tailoring, in alignment with WHO's recommendations.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using positive deviance to enhance HIV care retention in South Africa: development of a compassion-focused program to improve the staff and patient experience.","authors":"Allison J Ober, Donald H Skinner, Laura M Bogart, Leletu Busakwe, Wadene Davids, Hassan Mahomed, Debbie Ling, Virginia Zweigenthal","doi":"10.1186/s44263-025-00123-3","DOIUrl":"10.1186/s44263-025-00123-3","url":null,"abstract":"<p><strong>Background: </strong>HIV burden remains high in South Africa despite intensive efforts to curtail the epidemic. Public primary care facilities, where most people with HIV (PWH) in South Africa receive treatment, face myriad challenges retaining patients on antiretroviral therapy (ART). Nevertheless, some facilities manage to consistently retain PWH in care. We used a participatory positive deviance (PD) approach to discover characteristics of primary care facilities with above-average 12-month retention rates to develop an intervention.</p><p><strong>Methods: </strong>We conducted 11 in-depth leadership interviews, 9 staff focus groups with 29 participants, 11 patient focus groups with 45 participants, 23 patient shadowing visits, and multiple facility observations in each of 3 high- and 3 low-retention public primary care facilities in Cape Town, South Africa. Using PD, an asset-based approach to behavior change that consists of discovering how high-performing outliers succeed despite sizable barriers, and then using those data to develop interventions for low performers, we analyzed data to discover dominant characteristics of higher-retention facilities that might be contributing to higher retention rates.</p><p><strong>Results: </strong>Dominant themes found in higher-retention facilities were compassionate, respectful, and patient-centered care; higher staff morale, passion for the work, and team cohesion; efficient workflow procedures; and a welcoming physical environment. From these themes, we developed the multidimensional Connect intervention, consisting of strategies within three domains: (1) engage, encourage, and support staff (e.g., a monthly staff support huddle, a compassion training); (2) expedite and augment workflow procedures (e.g., adjust folder system to lower wait times); and (3) create a welcoming physical environment (e.g., fresh paint and plants in the waiting area).</p><p><strong>Conclusions: </strong>A PD approach enabled us to identify factors that could be contributing to higher ART retention rates within low-resource public sector primary care facilities in Cape Town, South Africa, and to develop a multidimensional intervention. If effective after a future trial, the intervention could be a feasible, affordable complement to existing programs aimed at improving care for PWH.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of gestational age limits on abortion-related outcomes: a synthesis of legal and health evidence.","authors":"Fiona de Londras, Amanda Cleeve, Maria I Rodriguez, Alana Farrell, Magdalena Furgalska, Antonella F Lavelanet","doi":"10.1186/s44263-025-00124-2","DOIUrl":"10.1186/s44263-025-00124-2","url":null,"abstract":"<p><strong>Background: </strong>Gestational age limits (GLs) are common in abortion laws and policies. They restrict when lawful abortion may be accessed by reference to the gestational duration of a pregnancy, in some cases specifying that abortion is a criminal offense after, but not before, the GL. This synthesis of legal and health evidence addresses knowledge gaps on the health and non-health outcomes plausibly related to the effects of GLs on abortion-related outcomes.</p><p><strong>Methods: </strong>This paper synthesizes the results of a systemic review with the identification and application of relevant international human rights standards. A search strategy was drawn up to capture public health, international human rights law, and policy evidence related to the impacts of GLs. We limited our search to papers published in English since 2010, including quantitative studies (comparative and non-comparative), qualitative and mixed-methods studies, reports, PhD theses, and economic or legal analyses. Only studies that undertook original data collection or analysis were included. Review of treaties, opinions, interpretations, general comments, and special procedures of UN human rights bodies identified relevant human rights standards, which were then synthesized with the extracted data to create a comprehensive evidence synthesis.</p><p><strong>Results: </strong>GLs do not prevent people from seeking abortion but do operate as a regulatory barrier that can result in people seeking abortion outside of the formal health system or unwillingly continuing pregnancy. In many jurisdictions, they interact with the criminalization of abortion, with significant health and non-health impacts. GLs impact most on people who are least able to access abortion because of later detection of pregnancy, lack of access to abortion provision, and lack of access to the resources required to avail of abortion.</p><p><strong>Conclusions: </strong>Although paradigmatic in abortion law, GLs are not based on evidence of either the safety or effectiveness of abortion or the needs and preferences of pregnant people. They produce rights-limiting impacts for pregnant people and, in some cases, result in arbitrary and disproportionate violations of legally protected rights. The persistence of GLs as part of the regulatory framework for abortion provision cannot be said to ensure an enabling environment for quality abortion care.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance-based financing is not on the path towards universal health coverage and equity.","authors":"Elisabeth Paul, Garrett W Brown, Dimitri Renmans, Valéry Ridde","doi":"10.1186/s44263-025-00128-y","DOIUrl":"10.1186/s44263-025-00128-y","url":null,"abstract":"","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing PrEP for HIV prevention: innovations and the imperative to preserve comprehensive care.","authors":"Angel B Algarin, Cho Hee Shrader","doi":"10.1186/s44263-025-00125-1","DOIUrl":"10.1186/s44263-025-00125-1","url":null,"abstract":"","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal allocation of antenatal and young child nutrition interventions: an individual-based global burden of disease calibrated microsimulation.","authors":"Alison Bowman, Sylvia Lutze, James Albright, Nathaniel Blair-Stahn, Hussain Jafari, Simar Kaur, Caroline Kinuthia, Rajan Mudambi, Patrick Nast, Alix Pletcher, Abraham Flaxman","doi":"10.1186/s44263-024-00120-y","DOIUrl":"10.1186/s44263-024-00120-y","url":null,"abstract":"<p><strong>Background: </strong>Undernutrition remains a global crisis and is a focus of Sustainable Development Goals. While there are multiple known, effective interventions, complex interactions between prevention and treatment and resource constraints can lead to difficulties in allocating funding. Simulation studies that use in silico simulation can help illuminate the interactions between interventions and provide insight into the cost-effectiveness of alternative packages of options.</p><p><strong>Methods: </strong>We developed an individual-based microsimulation model based on the Global Burden of Disease (GBD) 2021 study data to test a range of nutrition interventions, including antenatal interventions (iron and folic acid, multiple micronutrients, and balanced energy protein supplementation) and child interventions (treatment for severe acute malnutrition, treatment for moderate acute malnutrition, and wasting prevention with small-quantity lipid-based nutrient supplements). We also developed an analytic approach to process the results of the microsimulation and identify the optimal intervention funding allocation for a given budget size. We use Ethiopia as an example in this paper.</p><p><strong>Results: </strong>In our illustrative example of Ethiopia, the reallocation of the baseline budget to minimize disability-adjusted life years (DALYs) resulted in first funding the antenatal multiple micronutrients to their maximum coverage and then funding treatment for severe child acute malnutrition. Relative to the baseline allocation, the reallocation optimized to minimizing DALYs resulted in 592,000 fewer annual DALYs, constituting an 8.3% reduction in total DALYs in Ethiopia. For budgets larger than the baseline, our model recommended funding first targeted moderate acute malnutrition treatment, second universal moderate acute malnutrition treatment, third wasting prevention with small-quantity lipid-based nutrient supplements, and fourth balanced energy protein supplementation.</p><p><strong>Conclusions: </strong>Our simulation is a novel model for estimating optimal allocation of spending on antenatal and child health nutrition interventions which accounts for the interaction between preventive and therapeutic approaches. Our illustrative results show that an optimized reallocation of current spending can substantially improve pregnancy-related and child health without additional funding. We hope this model can add validity and confidence to prior results to aid stakeholders in funding decisions.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and user experience of nose and throat swabbing techniques for SARS-CoV-2 detection: results from the UK COVID-19 National Testing Programme.","authors":"Matthias E Futschik, Raghavendran Kulasegaran-Shylini, Edward Blandford, Sean Harper, David Chapman, Elena Turek, Somya Agrawal, Valerie Phillips, Hannah Fordham, Lee Chan, Mike Kidd, Andrew Dodgson, Paul E Klapper, Malur Sudhanva, Richard Vipond, Susan Hopkins, Tim Peto, Sarah Tunkel, Tom Fowler","doi":"10.1186/s44263-024-00121-x","DOIUrl":"10.1186/s44263-024-00121-x","url":null,"abstract":"<p><strong>Background: </strong>The UK's National Health Service Test and Trace (NHSTT) program aimed to provide the most effective and accessible SARS-CoV-2 testing approach possible. Early user feedback indicated that there were accessibility issues associated with throat swabbing. We report the results of service evaluations performed by NHSTT to assess the effectiveness and user acceptance of swabbing approaches, as well as qualitative findings of user experiences from research reports, surveys, and incident reports. Our intent is to present and summarize our findings about the application of alternative swabbing approaches during the COVID-19 pandemic in the UK.</p><p><strong>Methods: </strong>From May 2020 to December 2021, NHSTT conducted a series of service evaluations assessing self-swabbing and assisted swabbing of the nose and throat, and nose only (anterior nares/mid-turbinate) using polymerase chain reaction (PCR) and lateral flow devices (LFDs), for diagnostic suitability within the COVID-19 National Testing Programme. Outcomes included observational user feedback on swabbing approaches and quantitative testing performance (concordance, sensitivity, and specificity). A post-hoc indirect comparison of swabbing approaches was also performed. Additionally, an analysis of existing cross-service research was conducted in April 2021 to determine user feedback regarding swabbing approaches.</p><p><strong>Results: </strong>Observational data from cross-service research indicated a user preference for nose swabbing over throat swabbing. Significantly more users reported that nose swabbing was easier to perform than throat swabbing (50% vs. 12%) and there were significantly fewer reported incidents. In the service evaluations, while there was reduced sensitivity for nose-only swabbing for PCR (88%) compared with nose and throat swabbing, similar sensitivities were observed for nose-only and nose and throat swabbing for LFDs. The sensitivity of nose-only swabbing for LFDs was higher for individuals with higher viral concentrations.</p><p><strong>Conclusions: </strong>User experience analyses supported a preference for nose-only swabbing. Nose-only swabbing for LFDs provided sufficient diagnostic accuracy, supporting its use as a viable option in the COVID-19 National Testing Programme. Less invasive swabbing approaches are important to maximize testing accessibility and alongside other behavioral interventions, increase user uptake.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women living with HIV face intersectional stigma from infection, domestic violence, and other marginalized identities: a qualitative study in West Bengal, India.","authors":"Reshmi Mukerji, David Osrin, Jenevieve Mannell","doi":"10.1186/s44263-024-00122-w","DOIUrl":"10.1186/s44263-024-00122-w","url":null,"abstract":"<p><strong>Background: </strong>Women living with HIV bear a disproportionate burden of stigma, especially in countries where gender discrimination is more common. A result is widespread domestic violence against women. This violence is itself stigmatized, but the intersectional stigma of HIV and domestic violence has not been well studied. Our work aimed to fill this research gap by exploring how domestic violence and HIV stigma intersect with other marginalized identities in women's lives.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted in Kolkata, India with 31 women living with HIV and 16 key informants to gain an understanding of intersecting stigmas. Interviewees discussed women's experiences and perceptions of stigma and discrimination around HIV, domestic violence, and other marginalized identities. The coding of data was informed by an intersectional stigma framework. Thematic Network Analysis was used to group themes originating in the data into higher-order themes connecting to a global theme.</p><p><strong>Results: </strong>The findings presented are a qualitative self-report of violence. The three main themes developed were (1) the intersectional stigma of HIV and domestic violence amplified stigma as a whole, (2) the intersection of multiple stigmas worsens domestic violence, and (3) the stigma of HIV hides domestic violence. Specifically, HIV stigma triggered domestic violence and perpetrators reinforced HIV stigma through verbal abuse. Women with other marginalized identities, such as having daughters or being a widow, experienced substantial violence. Domestic violence stigma was worsened by HIV stigma as women hid the violence for fear of revealing their status. As a result, help-seeking from formal and informal sources decreased, which increased women's isolation.</p><p><strong>Conclusions: </strong>The findings shape new understandings of how intersectional stigma of HIV, domestic violence, and marginalized social identities interact to amplify stigma and related violence. Women living with HIV who have multiple marginalized identities should be prioritized for violence reduction interventions.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel approach to expedite evidence to impact in pre-eclampsia: co-developed policy labs in Zambia and Sierra Leone.","authors":"Katy Kuhrt, Chileshe Mabula-Bwalya, Harriet Boulding, Alice Beardmore-Gray, Alexandra Ridout, Osman Koroma, Betty Sam, Prince Tommy Williams, Francis Smart, Isabel Meleki, Meek Mwila, Mubanga Chileshe, Racheal Mawere, Alice Hurrell, Christabel Mbiiza, Cristina Fernandez-Turienzo, Jane Sandall, Bellington Vwalika, Andrew Shennan, Kate Bramham","doi":"10.1186/s44263-024-00116-8","DOIUrl":"10.1186/s44263-024-00116-8","url":null,"abstract":"<p><p>Pre-eclampsia is a leading cause of maternal and neonatal mortality; 30,000 pre-eclampsia-related maternal deaths occur annually, with 70% in Sub-Saharan Africa (SSA) and 16% in South Asia. We have shown that early, accurate detection of hypertension combined with planned early delivery in women with late preterm pre-eclampsia significantly reduces stillbirth and severe maternal hypertension. We describe co-development and delivery of policy labs, working with The Policy Institute (King's College London), and local stakeholders in Sierra Leone and Zambia, to expedite integration of new knowledge into pre-eclampsia care pathways, to improve care for women and babies with the worst outcomes. Policy labs are a unique, user-centric engagement approach, bringing diverse stakeholders together in co-designing strategies for translation of evidence into policy and impact. Both labs were facilitated by local, well-respected female team members, and addressed co-developed questions: 'How can we improve timely detection and appropriate action in women with pre-eclampsia?' (Sierra Leone); 'What are enablers and barriers to offering planned early delivery between 34 and 37 weeks?'(Zambia). Participants at both labs identified lack of pre-eclampsia awareness as a key barrier, and recommended local co-design of community-based strategies to increase access to timely pre-eclampsia management. We demonstrated  policy labs as an effective approach in two low-and middle income settings to facilitate transfer of new knowledge into policy and action.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}