Global Health Research and Policy最新文献

{"title":"Differentiating network structures and sex differences of pain-related outcomes, analgesic opioid dosages, and psychosocial factors for postoperative management: a study of PAIN OUT registry in seven Asian regions.","authors":"Yulin Huang, Hung Chak Ho, Yuchang Bao, Ruth Zaslansky, Winfried Meißner, Chi Wai Cheung","doi":"10.1186/s41256-025-00442-w","DOIUrl":"10.1186/s41256-025-00442-w","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in global healthcare, Asia lacks a systematic framework for postoperative pain-related symptoms, particularly in addressing pain identification/prevention and reporting sex differences. This study used network analysis to unravel the complex interplay of pain-related symptoms, analgesic opioid dosages, and psychosocial factors, with a particular focus on sex differences in the Asian population.</p><p><strong>Methods: </strong>Utilizing anonymized data from 5,093 adult patients across seven Asian regions between 2018 and 2021 from the PAIN OUT registry, this study applied network analysis: 1) to map the relationships between analgesic opioid dosages and multidimensional pain-related symptoms and 2) to explore sex differences. This network analysis was performed based on information from the International Pain Outcomes Questionnaire (IPO-Q), which included pain severity, adverse events, perceptions of pain care perception, and pain treatment satisfaction within 24h of an operation. The model utilized Least Absolute Shrinkage and Selection Operator (LASSO) for regularization and edge estimation, a penalized estimation method allowing for the identification of the most relevant connections while effectively controlling for overfitting.</p><p><strong>Results: </strong>Network structures demonstrated high stability, revealing distinct sex-based patterns. Chronicity of pain (#CP) emerged as the most central node in the overall network structure (EI = 1.50) and among male patients (EI = 1.80), reflecting the profound effect of persistent pain on their functional activities and sensory-focused symptoms, such as dizziness (#AE4). In contrast, helplessness (#MH2) was a significant symptom in female patients (EI = 1.70), highlighting the emotional and psychological dimensions of their pain experience. Comparative analysis uncovered significant structural differences between males and females (M = 0.154, p = 0.023), emphasizing the unique interplay of psychological, emotional, societal, and pathophysiological symptoms in shaping postoperative pain experiences.</p><p><strong>Conclusions: </strong>This study was the first comprehensive network analysis of pain-related symptoms with sex differences. The results highlighted a significant difference in associations between analgesic opioid dosages and multidimensional pain-related symptoms among males and females, implying the necessity for region-specific, multimodal interventions to optimize postoperative care in Asian populations.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"10 1","pages":"51"},"PeriodicalIF":4.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical analysis of the liver cancer policies and programs in China: implications for international liver cancer control.","authors":"Xianwen Chen, Junnan Shi, Yan Xue, Yunfeng Lai, Menghuan Song, Carolina Oi Lam Ung, Hao Hu","doi":"10.1186/s41256-025-00450-w","DOIUrl":"10.1186/s41256-025-00450-w","url":null,"abstract":"<p><strong>Background: </strong>Liver cancer is among the top five causes of cancer death in 90 countries, with China accounting for a substantial proportion of the global burden. This study aimed to analyse the national liver cancer policies and programs in China.</p><p><strong>Methods: </strong>This study applied a documentary research method using the systematic READ approach. Six national official websites and one public policy database were searched. The document analysis was based on the WHO Health System's Six Building Blocks and the WHO's four modules of cancer control (prevention, early detection, diagnosis and treatment, and palliative care).</p><p><strong>Results: </strong>A total of 74 liver cancer-related policies and 8 programs published from 1 January 1984 to 31 March 2025 were included in this study. The analysis revealed that liver cancer management in China mainly focused on Medical products and Technologies (n = 46, 62.16%), and Service Delivery (n = 34, 45.95%) within the WHO health system building blocks. When it came to WHO cancer control four modules, most policies (n = 39, 52.70%) targeted Diagnosis and Treatment of liver cancer, followed by Prevention of liver cancer (n = 33, 44.59%). Additionally, 8 national programs were implemented to improve the prevention, diagnosis, and treatment of liver cancer. Before 2019, the emphasis of liver cancer prevention was primarily on hepatitis prevention and control. However, since 2020, the national-level programs aimed at preventing and controlling liver cancer emphasizing patient education and treatment for high-risk groups.</p><p><strong>Conclusions: </strong>China's liver cancer control mainly focused heavily on prevention, diagnosis and treatment modules with special focus on medical products and technology, as well as service delivery. Currently, less attention has been given to the detection and palliative care of survivors. The control of liver cancer in China still requires further strengthening of the health system for implementation. Considering the continual increase in the burden of liver cancer, it is imperative for future efforts to develop a comprehensive national liver cancer strategy.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"10 1","pages":"50"},"PeriodicalIF":4.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can social support improve Mpox care-seeking among men who have sex with men through stigma reduction: a chain mediation analysis from China.","authors":"Xin Ge, Yujie Liu, Shangbin Liu, Shunyu Tao, Chen Xu, Birong Wu, Ying Wang, Jiechen Zhang, Yong Cai","doi":"10.1186/s41256-025-00452-8","DOIUrl":"10.1186/s41256-025-00452-8","url":null,"abstract":"<p><strong>Background: </strong>Monkeypox (mpox) has emerged as a global public health concern, particularly among men who have sex with men (MSM). Stigma limits access to care, and the role of social support in shaping care-seeking through psychosocial mechanisms remains unclear. This study examined whether social support influences care-seeking intentions via stigma and perceived healthcare benefits among MSM in China.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from October 2023 to March 2024 across 6 provinces in China. Descriptive statistics, chi-square tests, Spearman correlations, and logistic regression were performed to explore associations between HBM-related constructs and healthcare-seeking intentions. Structural equation modeling was used to examine the direct and indirect effects of social support via stigma and perceived healthcare benefits.</p><p><strong>Results: </strong>Among participants, 83.4% expressed an intention to seek healthcare for mpox. Directly, social support was positively associated with healthcare-seeking intention (β = 0.274, p < 0.001). Indirectly, social support affected healthcare-seeking intention through two pathways: (1) by reducing stigma (β = -0.108, p < 0.001), which in turn enhanced perceived healthcare benefits (β = -0.663, p < 0.001), ultimately increasing healthcare-seeking intention (chain effect β = 0.033, p = 0.005); and (2) directly enhancing perceived healthcare benefits (β = 0.091, p < 0.001), thereby increasing healthcare-seeking intention (β = 0.231, p < 0.001; indirect effect β = 0.042, p = 0.005). The total indirect effect accounted for 22.6% of the total effect.</p><p><strong>Conclusions: </strong>Social support enhances mpox care-seeking intention among MSM in China by reducing stigma and improving perceptions of privacy, affordability, and treatment efficacy. Integrated interventions-combining peer support, stigma reduction, and privacy protection-are needed to foster early health engagement.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"10 1","pages":"49"},"PeriodicalIF":4.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioural and social drivers of routine childhood immunization in selected low coverage areas in the Philippines.","authors":"Soledad Natalia Dalisay, Madilene Landicho, Maria Margarita Lota, Yoshiki Fujimori, Paulyn Jean Acacio-Claro, Evalyn Roxas, Alvin Abeleda, Jan Zarlyn Rosuello, Micaella Dato, Florian Vogt, Margaret Danchin, Vicente Belizario, Jessica Kaufman","doi":"10.1186/s41256-025-00447-5","DOIUrl":"10.1186/s41256-025-00447-5","url":null,"abstract":"<p><strong>Background: </strong>Routine childhood vaccination coverage under the National Immunization Program of the Philippines is well below the target of 95% with a high number of zero-dose children. Declining immunization rates led to outbreaks of vaccine-preventable diseases such as measles, polio, and pertussis. This study aimed to identify the factors affecting childhood vaccine uptake by exploring the perspectives of community members, program managers, and coordinators.</p><p><strong>Methods: </strong>Three regions with low vaccine coverage in the Philippines were selected as study sites. We conducted focus groups with adult caregivers of vaccinated and unvaccinated children aged 0-11 years recruited by barangay (community) health workers. Key informant interviews were also conducted with immunization program managers and coordinators from different administrative levels. Focus group and interview guides were informed by the World Health Organization's Behavioural and Social Drivers (BeSD) of Vaccination framework. Transcripts were analysed by themes and deductive axial coding was used to categorize themes into BeSD domains and socioecological levels.</p><p><strong>Results: </strong>Twelve focus groups (n = 143) and 57 key informant interviews were done. Various behavioural and social drivers of vaccination present at different levels of the socioecological model affect vaccine decisions both positively and negatively. Under the 'Thinking and feeling' domain of the BeSD, at the intrapersonal level, the perception of benefits and negative side effects of routine vaccines were clear drivers of vaccination. In the 'Social processes' domain, factors at multiple socioecological levels such as the influence of family, barangay health workers, and community leaders were identified. Practical issues such as the availability of vaccines and accessibility of vaccination sites remain a barrier to vaccination.</p><p><strong>Conclusions: </strong>Availability of routine vaccines and accessibility to vaccination sites are major challenges in the Philippines. Acceptability of routine vaccines continue to be affected by previous controversies around the Dengue vaccine and the recent COVID-19 pandemic. Findings suggest that enhancing advocacy for immunization through continuing communication training for health care workers on health promotion and education regarding vaccination may contribute to increased vaccine uptake. Integration of immunization with other population-based health programs could be explored.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"10 1","pages":"48"},"PeriodicalIF":4.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Private sector engagement strategies with implications for NCD prevention and control: focus on ten international organisations.","authors":"Téa E Collins, Svetlana Akselrod, Daria Berlina, Amanda Karapici, Flaminia Ortenzi, Fatima Bashir, Luke N Allen","doi":"10.1186/s41256-025-00448-4","DOIUrl":"10.1186/s41256-025-00448-4","url":null,"abstract":"<p><strong>Background: </strong>International organisations and development agencies have important roles to play in addressing noncommunicable diseases (NCDs) and their risk factors at the nexus of health, socioeconomic, and environmental development challenges. Much of this work occurs through direct engagement with the private sector. We aimed to assess the types of private sector engagement (PSE) approaches and the degree of alignment across ten major international organisations whose work is critical to achieving global NCD and mental health goals.</p><p><strong>Methods: </strong>We examined the publicly available PSE strategy documents for a purposive sample of ten major international development partners. We obtained copies of each organisation's publicly available PSE policy documents and extracted data on the stated purpose, processes, and types of engagement. We used thematic analysis and triangulation to identify areas of agreement, dissonance and silence across the policy approaches.</p><p><strong>Results: </strong>Whilst all PSE documents emphasised the importance of conducting due diligence, they varied widely in their approach to the risk of engagement and the sophistication of potential conflict of interest management strategies. Many documents were silent on prohibited industries, managing reputational risks, and guidance to Member States. The proactive engagement stance in USAID and World Bank policy documents contrasted starkly with more conservative approaches advanced by UNDP, FAO, and WHO.</p><p><strong>Conclusions: </strong>The core practices of conducting due diligence and risk mitigation are common to all of the major international organizations we assessed, however, the framing, content, and PSE processes vary widely. The potential impact of these findings is that WHO and other partners can focus on adopting common approaches wherever possible for greater coherence and smoother coordination across the wider development system.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"10 1","pages":"47"},"PeriodicalIF":4.6,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why do we need a shift to the transformative paradigm if we are to decolonise global health?","authors":"Chloe Tuck, Laura Gray, Robert Akparibo, Richard Cooper","doi":"10.1186/s41256-025-00443-9","DOIUrl":"10.1186/s41256-025-00443-9","url":null,"abstract":"<p><p>There is growing recognition of the need for global health and associated research to decolonise. Yet discourse so far has overlooked the role that research paradigms play within this. Left unaddressed, this omission could further engender hierarchical approaches in global health research. The transformative paradigm articulates the relationships between evidence, power and oppression. With this acknowledgement, we can strive for positive social change through research. In this commentary, we argue the importance of considering the transformative paradigm in efforts to decolonise global health research. We provide an initial overview of key terms in this debate, before exploring what is meant by a research paradigm in more detail and then arguing that a transformative paradigm offers unique and powerful opportunities to address enduring colonial inequities in global health research; we then illustrate how this was applied in a recent mixed methods study which explored experiences and barriers to accessing cancer treatment in Ghana. We show how researcher sensitivity to historical injustices and community-based values were vital to our study design and also in specific methods like a participatory creative task and qualitative interviews. This commentary is important as part of the wider debate about decolonising global health and provides a unique critical insight into how research and how particularly research paradigms are of importance in this task, offering suggestions based on a transformative paradigm.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"10 1","pages":"46"},"PeriodicalIF":4.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of an assessment tool for public health emergency management program.","authors":"Sileshi Demelash Sasie, Getinet Ayano, Medhanit Girma, Pien Van Zuylen, Fantu Mamo Aragaw, Tadele Dana Darebo, Lorena Guerrero-Torres, Afework Mulugeta, Mark Spigt","doi":"10.1186/s41256-025-00423-z","DOIUrl":"10.1186/s41256-025-00423-z","url":null,"abstract":"<p><strong>Background: </strong>Effective public health emergency management (PHEM) is crucial for safeguarding population health and societal resilience in the face of escalating global threats. However, standardized tools for comprehensively assessing emergency readiness across diverse contexts are lacking, particularly in resource-constrained settings like Ethiopia. Existing assessment approaches have demonstrated limitations, including narrow scope focused on specific hazards or sectors, over-emphasis on implementation processes rather than programmatic outcomes, and lack of empirical grounding in tool development and validation. This study aimed to develop and validate a standardized tool to assess PHEM programs.</p><p><strong>Methods: </strong>This study employed a sequential exploratory mixed methods design. Relevant assessment domains were identified through a literature review, stakeholder consultations, and expert consultations conducted at a workshop. This study utilizes Donabedian's structure-process-outcome framework to guide the assessment of public health emergency management. A questionnaire containing 60 items was then generated and underwent translation, face validation, and content validity assessment. Construct validity was evaluated using exploratory factor analysis with responses from 260 professionals. Internal consistency reliability was assessed utilizing Cronbach's alpha.</p><p><strong>Results: </strong>A 45-item tool for assessing PHEM programs in diverse contexts in Ethiopia was developed and validated. The tool demonstrated high content validity (CVIs > 0.83), good construct validity (15-factor structure explaining 74.8% variance), and excellent reliability (overall α = 0.863, subscales > 0.70). The final tool covers domains such as multi-sectoral coordination, resource allocation, transparency/accountability, workforce capacity, and provision of essential supplies.</p><p><strong>Conclusions: </strong>This study developed a comprehensive tool to assess emergency management programs across diverse contexts. The validation revealed critical preparedness factors like multi-sector coordination, funding transparency and workforce strength. The mixed-methods approach proved effective for crafting contextually appropriate evaluation methods in low-resource settings with infrastructure barriers. By standardizing measurement of capacities and gaps, this validated tool can guide strategic policy planning to bolster resilience nationwide. Ongoing monitoring of progress using this model can help prioritize investments and direct coordinated responses to future crises.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"10 1","pages":"44"},"PeriodicalIF":4.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need to address the myopia pandemic: summary report of the global myopia public health summit 2024.","authors":"Wei Pan, Ian Morgan, Ian Flitcroft, Kathryn Rose, Lisa A Ostrin, Mark Rosenfield, Pirindhavellie Govender-Poonsamy, Dunia Siu-Villaseñor, Hakan Kaymak, Jong Mei Khew, Oliver Woo, Kazuo Tsubota, Lakshmi Shinde, Olga Prenat, Jun Ma, Jia Qu, Zhikuan Yang, Yan Wang, Kah Ooi Tan, Amanda Davis, Weizhong Lan","doi":"10.1186/s41256-025-00445-7","DOIUrl":"10.1186/s41256-025-00445-7","url":null,"abstract":"<p><p>The World Health Organization (WHO) recognizes myopia as a significant public health concern, as its prevalence has been rising at an alarming rate worldwide. In the WHO's Global Action Plan for the Prevention of Avoidable Blindness and Visual Impairment 2014-2019, myopia has already been identified as a major target for action. However, the attention paid and measures taken to treat this target is significantly diverse across the globe. This report presents the summary of the Global Myopia Public Health Summit jointly organized by the International Agency for the Prevention of Blindness (IAPB), the Asia Optometric Congress (AOC), and Aier Eye Hospital Group in September 2024. The summit centered on the public health, clinical challenges, and practical barriers faced in different regions of the world, along with strategic recommendations for myopia prevention and control. The summit has concluded: (1) although myopia prevalence is rising globally, population-based data remain limited in many regions; (2) common challenges such as limited awareness of myopia, the high cost of interventions, and the lack of continuing education for practitioners should be addressed; (3) while effective interventions are crucial for controlling myopia, their cost-effectiveness needs to be evaluated both at the individual and societal levels; (4) countries like China, where government-led initiatives have integrated school vision screening, reduction of education burden, compulsory increase of outdoor activities, and advocacy for eye health awareness, offer valuable experience and lessons for other countries or regions facing similar myopia epidemics.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"10 1","pages":"45"},"PeriodicalIF":4.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving epidemiological projections for infectious diseases in Ghana: addressing methodological challenges.","authors":"Verena Struckmann, Vincent Findeiss, Philip El-Duah, Jonathan Mawutor Gmanyami, Andrzej Jarynowski, Rexford Mawunyo Dumevi, Johanna Wildemann, Daniel Opoku, Vitaly Belik, Michael Owusu, Wilm Quentin, Christian Drosten, Johanna Hanefeld, John Amuasi, Reinhard Busse, Hanna-Tina Fischer","doi":"10.1186/s41256-025-00449-3","DOIUrl":"10.1186/s41256-025-00449-3","url":null,"abstract":"<p><p>The COVID-19 pandemic highlighted the essential role of disease modeling in shaping public health responses. However, models designed in high-resource settings often fail to capture disease dynamics accurately in lower-resource contexts like Ghana, where socio-ecological factors, infrastructure constraints, and data fragmentation complicate accurate predictions. In this Commentary, we examine the challenges of adapting global modeling approaches to Ghana's context and propose strategies to improve their accuracy, relevance, and policy utility. These challenges were further compounded during the pandemic recovery period, when Ghana simultaneously faced outbreaks of Marburg virus and Mpox. These additional pressures-against a backdrop of rapid urbanization, increased human-wildlife interaction, shifting transmission dynamics, and environmental degradation-underscore the limitations of current modeling approaches. A key limitation lies in the difficulty of collecting raw, disaggregated data, accounting for sociocultural determinants, and capturing the complex interplay between disease dynamics and adaptive behaviors. Addressing these challenges requires valid, timely, and disaggregated data on social and epidemiological dynamics for model parameterization and validation. To examine the challenges faced in adapting global models for local use, we focus on Ghana's unique context and argue for a rethinking of modeling approaches in this commentary. To mitigate potential harm, it is imperative to emphasize context-specific data, interdisciplinary input, and integration of social and economic factors, as foundational principles for future frameworks that can better support pandemic preparedness in Ghana and similar settings.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"10 1","pages":"43"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infrastructure-health nexus in Brazil: a scoping review.","authors":"Flavio Pinheiro Martins, Carol Vigurs, Mariana Matera Veras, Lusi Morhayim, Monica Lakhanpaul, Priti Parikh","doi":"10.1186/s41256-025-00441-x","DOIUrl":"10.1186/s41256-025-00441-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Health system development requires robust infrastructure systems support, particularly in countries with significant regional and socioeconomic disparities. Brazil's experience with its Unified Health System offers important insights into how the infrastructure and built environment is linked to health outcomes especially in underserved populations. This scoping review examines how different infrastructure systems such as sanitation, transportation, educational facilities, housing, influence population health in Brazil through two key pathways: (1) their role in shaping environmental conditions that affect health, and (2) their impact on healthcare service delivery among vulnerable populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Following PRISMA-ScR checklist, we conducted a systematic search of studies published between 2013-2024 across Scopus, Web of Science, and PubMed databases. Search terms included infrastructure systems (sanitation, transportation, housing, educational facilities), health outcomes (universal health coverage, infectious diseases, maternal health), and population descriptors (vulnerable, indigenous, underserved) combined with Brazil-specific terms. Inclusion criteria focused on studies examining physical infrastructure's impact on health outcomes in underserved Brazilian communities, published in English or Portuguese. After applying exclusion criteria including publication year restrictions, language filters, geographic limitations, duplicate removal, and non-article format exclusions, 68 studies met inclusion criteria following screening and quality assessment using the Critical Appraisal Skills Programme (CASP) checklist. Our analysis applied an infrastructure framework examining institutional, personal, and material infrastructure dimensions. Data extraction captured infrastructure systems, healthcare service tiers (primary, secondary, tertiary), and specific health outcomes. Synthesis involved thematic analysis to identify patterns in infrastructure-health relationships, revealing three interconnected dimensions that form the Infrastructure-Health Nexus framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study revealed three interconnected dimensions of infrastructure impact: Supporting Health & Wellbeing, Service Access and Delivery, and Community Engagement. This framework shows how sanitation, transportation, educational, housing, and waste management systems affect health outcomes, with underserved populations facing particular challenges. Healthcare workforce programs serve as interim solutions, with educational facilities simultaneously functioning as health hubs for service delivery and community engagement. The study highlights misalignment between infrastructure investment and UHC objectives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The Infrastructure-Health Nexus framework, building on Buhr's complementarity concept, shows how infrastructure shapes health outcomes through pathways requiring ","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"10 1","pages":"42"},"PeriodicalIF":4.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}