Community health equity research & policy最新文献

{"title":"A Community Rights and Gender Assessment of Tuberculosis Diagnosis, Treatment and Care in Lebanon.","authors":"Arabia Mohamad Ali, Marie Claire Van Hout, Lannah Kent, Isabelle Salameh, Elie Aaraj","doi":"10.1177/2752535X251355731","DOIUrl":"10.1177/2752535X251355731","url":null,"abstract":"<p><p>TB remains a significant global health challenge despite being preventable and curable. The Global Plan to End TB 2023-2030 is underpinned by a rights-based, public health and people-centred approach to ending TB. Lebanon is a low TB endemic country, where for the first time a community, rights, and gender (CRG) assessment of the national TB response was conducted in 2024. Despite the universal availability and cost-free access to TB care in Lebanon, systemic barriers continue to hinder patient accessibility. Low disease awareness, transportation costs, financial challenges, and pervasive stigma frequently compel individuals to conceal their TB diagnosis, thereby undermining contact tracing and treatment adherence. Beyond medical treatment, TB patients receive minimal psychosocial or financial support, disproportionately affecting key vulnerable groups who are already marginalized in Lebanese society. Insufficient community engagement and chronic funding shortages further weaken the Lebanese TB response. While Lebanon upholds advanced medical protocols, its outdated TB laws fail to protect crucial patient rights, including privacy, confidentiality, and informed consent. Gender disparities also persist, with a lack of gender-specific data to inform policies, and inadequate sensitization among healthcare personnel (e.g., transgender women, women with HIV, women who use drugs). There is a pressing need for accountability mechanisms for TB program implementers and labor protections to prevent workplace discrimination against TB patients. Strengthening the National TB Program and addressing the structural deficiencies in Lebanon through targeted interventions, legal reforms, and a gender-inclusive, rights-based approach is essential to ensuring available, accessible, acceptable and quality TB services in Lebanon.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"385-396"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A GP-Led health system for diabetes care: A patient-centered structure or a systemic constraint?","authors":"Charalampos Milionis","doi":"10.1177/2752535X261462989","DOIUrl":"https://doi.org/10.1177/2752535X261462989","url":null,"abstract":"<p><p>Modern diabetes care faces increasing clinical and technological complexity. While generalist-led models are widely promoted for continuity and accessibility, they may fall short in addressing the nuanced needs of patients with diabetes, particularly in complex or rapidly evolving clinical contexts. The aim of the article is to critically evaluate whether general practitioner (GP)-led models of diabetes care adequately meet patient needs and to explore the role of specialist access within contemporary health systems. A narrative and conceptual analysis of current literature was applied, focusing on patient-centered care, equity, and the organization of diabetes services. Patient-centeredness and equity should underpin diabetes care, including individualized goal setting and shared decision-making. However, overreliance on generalist-led care may contribute to delays, suboptimal care, and reduced clinical precision in complex cases. Open access to specialist care may enhance patient autonomy and enable more timely, comprehensive, and personalized management. At the same time, general practitioners remain essential for holistic care, coordination, and long-term patient engagement. Integrating specialists within primary care through hybrid or collaborative models may combine the strengths of generalists and specialists and improve outcomes, while maintaining equity. Strategic policy initiatives, workforce planning, and technological innovation are necessary to sustainably expand access.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X261462989"},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marital sexual autonomy and pleasure among Palestinian women: Negotiating religion, culture, and emotional wellbeing.","authors":"Hanan Abu Mukh","doi":"10.1177/2752535X261462991","DOIUrl":"https://doi.org/10.1177/2752535X261462991","url":null,"abstract":"<p><p>This study investigates married Palestinian women's experiences of sexual rights, autonomy, and pleasure, emphasizing the interplay of religion, culture, and marital communication. Using a qualitative phenomenological design, 20 women from urban, rural, and refugee camp settings were interviewed. Findings reveal that women perceive sexual rights and pleasure in Islam as mutually reciprocal, yet cultural norms and social expectations often constrain the enactment of sexual autonomy and enjoyment. Religious guidance serves as both empowerment and a site of negotiation, helping women interpret their rights and navigate tension with local customs. Emotional wellbeing, trust, privacy, and knowledge of sexual rights emerged as critical enablers of sexual decision-making and pleasurable experiences. The study underscores the importance of culturally and religiously sensitive education, counseling, and marital support to foster sexual autonomy and pleasure, contributing to relational equity and wellbeing in Palestinian marital contexts.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X261462991"},"PeriodicalIF":2.2,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessing perinatal education in the Australian health system: A mixed-methods exploration of the experiences of migrant and refugee women.","authors":"Dipti Zachariah, Monika Latanik, Nelma Galas, Tracy Paterson, Amina Hadi, Sarah Marshall, Kirsten McCaffery, Danielle M Muscat","doi":"10.1177/2752535X261456538","DOIUrl":"https://doi.org/10.1177/2752535X261456538","url":null,"abstract":"<p><p>Although many migrant and refugee women in Australia experience healthy pregnancies, inequities in perinatal outcomes persist. Perinatal education supports health literacy and informed decision making about pregnancy, birth and early parenting, yet little is known about how migrant and refugee women become aware of and experience these services. This study explores the experiences of migrant and refugee women in Western Sydney in navigating the Australian health system and accessing perinatal education. We adoted a mixed-methods phenomenological research approach, comprising semi-structured interviews in Arabic, Mandarin, Dari and Hindi alongside a quantitative survey. Purposive sampling was used to recruit women from culturally and linguistically diverse backgrounds through antenatal clinics and community health centres, with participants representing varying levels of engagement in perinatal education. Qualitative data was analysed using thematic analysis and quantitative data were analysed descriptively. A total of 22 participants completed interviews, and 246 participants completed the survey. Nearly all survey participants (92.3%) spoke a language other than English, representing more than 18 languages and 34 countries of birth. Quantitative findings demonstrated low uptake of perinatal education, with 86.2% (n = 212) reporting no engagement with formal programs. Qualitative analysis identified four key themes: (1) Pregnancy as a pivotal introduction to health care; (2) Mirrored barriers to engagement with care and education; (3) Care through connection - social and cultural bridges, and (4) Scrolling for solutions: the digital classroom. Across both qualitative and quantitative data, women described intersecting barriers including language, cost, cultural expectations, and limited awareness of available services alongside facilitators such as bilingual providers, community networks and digital platforms. These findings highlight the need for equity-oriented approaches to perinatal education, including community based and culturally responsive awareness and delivery methods.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X261456538"},"PeriodicalIF":1.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Community-Based Educational Program on Childhood Anemia in a Rural Amazonian Population in Peru.","authors":"Jhan Cm Fernandez-Delgado, Verónica Aguilar-Esteva, Miguel A Arce-Huamani, Adán Acosta-Banda, Francisca Edita Díaz Villanueva","doi":"10.1177/2752535X261440666","DOIUrl":"https://doi.org/10.1177/2752535X261440666","url":null,"abstract":"<p><p>Childhood anemia remains a major public health challenge in low-resource settings, particularly in rural Amazonian regions of Peru. This study evaluated the impact of a community-based educational program known as \"Compromiso 1,\" implemented through home visits by trained social agents. A quasi-experimental design was used to follow a cohort of 145 six-month-old infants diagnosed with anemia in our city. Over a 6-month period, caregivers received three structured home visits that included nutritional education, iron supplementation guidance, and the use of age-appropriate visual and written materials. Hemoglobin levels were measured at 6, 7, 9, and 12 months of age to assess the effectiveness of the intervention. Statistical analyses included descriptive measures, paired t-tests, chi-square tests, and Spearman correlations. The results showed a progressive and significant increase in hemoglobin levels over time, with higher values among infants who adhered consistently to iron supplementation. Sociodemographic variables such as maternal age, education, occupation, and income level were not significantly associated with hemoglobin outcomes, although residence in rural areas was linked to slightly higher values. These findings suggest that targeted, home-based education delivered through structured visits can effectively promote adherence and improve child health outcomes. The program offers a replicable model for anemia prevention in underserved regions with limited access to formal healthcare.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X261440666"},"PeriodicalIF":1.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies and Implementation Considerations for Preventing Suicide in Slums: A Scoping Systematic Review.","authors":"Mohammad Heidari, Jamileh Amirzadeh Iranagh, Afshar Kabiri, Saeide Alidoost","doi":"10.1177/2752535X261431087","DOIUrl":"https://doi.org/10.1177/2752535X261431087","url":null,"abstract":"<p><p>BackgroundSuicide is a critical public health issue, particularly among vulnerable populations of all ages living in slums. People residing in these environments often face unique psychosocial challenges that contribute to elevated rates of suicidal ideation and behavior. This study aims to consider the strategies and implementation considerations for suicide prevention programs in slums.MethodsA systematic scoping review was conducted according to Arksey and O'Malley's framework in 2024. Multiple electronic databases were searched systematically to identify studies focusing on suicide prevention strategies in slum populations. Studies were selected based on their relevance to suicide prevention, risk factors, and considerations for implementation. A narrative synthesis approach was applied to summarize the findings from the included studies.ResultsA total of 15 studies were included from an initial search of 3914 records screened. Synthesis of findings led to the identification of suicide control strategies for some target groups, including the general population, individuals at risk, and individuals with warning signs or previous suicide attempts. The strategies can be considered in the form of primary, secondary, and tertiary prevention. Strategies focus on enhancing mental health services access, promoting community awareness, reducing access to lethal means, and providing responsive crisis services.ConclusionAddressing suicide prevention in slum areas requires a multifaceted approach that considers the unique socio-economic contexts of these communities. Community-based interventions, enhanced healthcare access, and targeted mental health programs, adapted to the unique resource and structural constraints of slum environments, are crucial for reducing the incidence of suicidal ideation and behaviors.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X261431087"},"PeriodicalIF":1.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Between Tradition and Transformation: Visual Accounts of Menstrual Experiences in Rural Nepal Using Collaborative Filmmaking.","authors":"Sara E Baumann, Sara Parker, Korrina Gidwani, Katarina Schneiderman, Sushma Bhatta, Laxmi Dhital, Madhusudan Subedi","doi":"10.1177/2752535X261441357","DOIUrl":"10.1177/2752535X261441357","url":null,"abstract":"<p><p>BackgroundMenstruation in Nepal is shaped by intersecting factors of caste, ethnicity, religion, geography, and generational norms, with practices ranging from subtle restrictions to overt seclusion. Despite being a natural biological process, menstruation is deeply stigmatized, affecting women's dignity, safety, and daily activities. PurposeThis study explored menstrual practices and intergenerational knowledge transmission among mothers and grandmothers in a rural far-west Nepali village.Research DesignUsing Collaborative Filmmaking - a participatory visual method - women participated in the study as filmmakers, co-researchers, and storytellers. Thirteen women, aged 23-68, from diverse caste and ethnic backgrounds co-created two films, 8-Day Journey and Stay Away, which documents daily routines, restrictions, and rituals in Kanchanpur.ResultsFindings revealed persistent limitations around sacred spaces, kitchens, water sources, and interpersonal contact, and highlighted evolving practices such as greater autonomy in sleeping arrangements, nutrition practices, and menstrual product use. Religious traditions were especially enduring even as other taboos declined. Participants reported enhanced comfort, hygiene, and agency due to increased access to menstrual products and knowledge, yet intergenerational tensions persist, with younger women challenging norms while elders maintain tradition.ConclusionsThe films provide visual insight into the subtle negotiation, reinterpretation, and resistance of restrictive practices, which illustrate both tradition and adaptation. These findings underscore the importance of multi-generational engagement, culturally and religiously sensitive interventions, and creative participatory approaches to amplify local voices. Integrating these strategies can inform policy, advocacy, and programmatic efforts to reduce menstrual stigma, enhance autonomy, and promote holistic health and well-being for women and girls in Nepal.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X261441357"},"PeriodicalIF":2.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635254","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":"Violence Against Lesbian, Gay, and Bisexual Older Adults: Findings From the Brazilian Health System.","authors":"Daniel Canavese, Maurício Polidoro, Sávio Marcelino Gomes, Ariadne Ribeiro Ferreira","doi":"10.1177/2752535X251327537","DOIUrl":"10.1177/2752535X251327537","url":null,"abstract":"<p><p>The primary objective of this research was to describe the prevalence of violence against older adults according to sexual orientation as documented in the Notifiable Diseases Information System (SINAN) in Brazil. SINAN is a national database that compiles violence-related notifications reported by healthcare services. This ecological study analyzed aggregated data at the population level, focusing on violence notifications involving individuals aged 50 and above from 2017 to 2021. The data underwent descriptive and bivariate statistical analyses, adhering to a significance level of 5%. The completeness percentage of the sexual orientation variable ranged from 70% to 72%. Our analysis detected noteworthy disparities in the distribution of violence notifications based on sexual orientation. Specifically, lesbians had the highest incidence rates of physical violence compared to heterosexual and bisexual women. In a broader context, women demonstrated a higher susceptibility to psychological violence, with bisexual women experiencing a notably elevated prevalence (41.67%). Reports of physical and psychological violence differed based on contextual variables, such as race, education level, and geographic region. We hereby conclude that the disparities found in violence notifications underscore a troubling situation faced by older adults within the LGB community, with a particular emphasis on the challenges encountered by bisexual individuals. Improving cultural competence in health systems is essential to enhancing data collection and understanding the complexities of violence against this population.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"245-254"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"En Route to Midwifery Professionalisation: Contextualising Midwifery Care in the Indian Public Health System.","authors":"Sanjana Santosh","doi":"10.1177/2752535X251340760","DOIUrl":"10.1177/2752535X251340760","url":null,"abstract":"<p><p>BackgroundThe 'Guidelines on Midwifery Services Initiative, 2018' introduces the Nurse Practitioner in Midwifery (NPM) cadre to improve maternal mortality rates, quality of care, and reduce overmedicalisation in the Indian public health system. The paper examines how the NPM cadre is envisioned in the guidelines, positioned within the medical hierarchy, and aligned within the existing maternal health context. It also looks at how existing midwives and midwifery advocates perceive the changes introduced and the accompanying professionalisation process.MethodologyThe study employed two methods: (a) qualitative document analysis (QDA) of the midwifery guidelines and (b) semi-structured in-depth interviews with 14 nurse-midwifery leaders and advocates.FindingsThe QDA uncovers the underlying themes of task shifting and institutional deliveries as dominant, discussions on professional autonomy and primary health care receiving less importance and even less reflection on the history of midwifery in India. The interview findings highlight (a) tensions around carving out a separate profession, (b) the implications of midwifery at the primary healthcare level and (c) the need for an enabling environment for midwives. This paper reveals how the guidelines frame midwifery as a cost-effective, specialised nursing care within the institutional delivery framework and distanced from its traditional connotations.DiscussionIt elucidates tensions around autonomous midwifery involving professional boundaries, negotiations with medical professionals, institutional perceptions, and historical stereotypes. It builds on the broader literature on 'professions' in sociology by identifying aspects of 'professional boundary work' embedded in policy documents and experiences of participants - thereby unpacking the midwifery professionalisation process in the Indian context.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"321-336"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043844","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":"Launching the Indianapolis Health Equity, Access, outReach & Treatment (iHEART) Collaborative: A Case Study.","authors":"Erika R Cheng, Brittany Smart, Sarah E Wiehe, Karen Comer, Lisa K Staten, Aruna Manisekaran, Nichole Wilson, Jay Foster, Shadreck Kamwendo, Rachael Peters, Tatyana Roberts, Shelley Hoffman, Brownsyne Tucker Edmonds","doi":"10.1177/2752535X251342307","DOIUrl":"10.1177/2752535X251342307","url":null,"abstract":"<p><p><b>Objective:</b> To describe the creation, deployment, and initial impact of a place-based, multi-level, multi-component initiative designed to prevent cardiovascular health disparities in high-risk neighborhoods in Indianapolis, Indiana. <b>Methods:</b> The Indianapolis Health Equity Access outReach & Treatment (iHEART) Collaborative uses a community-driven, place-based approach and leverages partnerships with local organizations, businesses, and residents to implement health screenings, educational outreach, and support for social determinants of health (SDOH). <b>Results:</b> From September 2022 - September 2024, iHEART conducted 4048 blood pressure screenings; 3135 in community settings. >38% of participants were identified as having Stage 1 hypertension or being at risk. 29% of 1219 individuals with elevated CVD risk were previously undiagnosed. 94.6% of 223 individuals referred for medical care completed follow-up care. Barbershop 2.0 screened 378 patrons, with 126 returning for additional screenings. >50% of these returning participants demonstrated improvements between their initial and follow-up screenings. The Convenient Home Evaluation for Cardiovascular Health and Individual Tracking (CHECK-IT) program enrolled 1105 patients; 63.9% achieved blood pressure control, or their last recorded blood pressure reading below 140/90 mmHg, by the end of the 4-month program. <b>Conclusions:</b> iHEART's approach highlights the potential benefits of combining health and SDOH interventions, offering a promising model for addressing health inequities.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"301-310"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}