Global health journal (Amsterdam, Netherlands)最新文献

{"title":"Reforming WHO to strengthen its role in the global health architecture","authors":"Minghui Ren,&nbsp;Yang Hao,&nbsp;Minmin Wang,&nbsp;Xiaofeng Liang,&nbsp;Xiaoqi Wang,&nbsp;Quanle Li,&nbsp;Yunping Wang,&nbsp;Xiaopeng Qi,&nbsp;Xiaochun Wang,&nbsp;Xiaonong Zhou,&nbsp;Yangmu Huang","doi":"10.1016/j.glohj.2026.06.001","DOIUrl":"10.1016/j.glohj.2026.06.001","url":null,"abstract":"<div><div>The World Health Organization (WHO) has shown systemic vulnerabilities in pandemic response, resource mobilization and allocation, and political coordination, prompting strong demands for reform from member states and the international community. Against the background of global health system restructuring, WHO reform should be carried out in four aspects: adapting to changes in global disease burden and demographic structure, conforming to the trend of multipolar health governance, building an agile and efficient modern governance framework, and improving sustainable financing mechanisms. This paper constructs a hierarchy-function coupling model integrating horizontal core functions and vertical organizational hierarchies (headquarters, regional offices, and country offices) to analyze the challenges of WHO in three core functions: global health leadership, norms and standards setting, and national health capacity-building and partnership promotion. It proposes targeted reform strategies at headquarters, regional, and national levels to streamline management, decentralize authority, promote the localization of norms and standards, and shift from vertical aid to sovereign empowerment. The reform of WHO is not only an institutional adjustment but also a strategic transformation to adapt to the paradigm shift of global health governance, aiming to enhance its leadership and build a more agile, equitable, and resilient global health architecture.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"10 2","pages":"Pages 89-92"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148718671","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 use and perception of expired medications among the Lebanese community","authors":"Souraya Domiati,&nbsp;Mohamad Ismail,&nbsp;Hassana Shatila,&nbsp;Asmaa Abdel Rahim,&nbsp;Nour Barbish,&nbsp;Alaa Hawari,&nbsp;Dana Faraj,&nbsp;Abdalla El Lakany,&nbsp;Hania Nakkash Chmaisse","doi":"10.1016/j.glohj.2026.06.007","DOIUrl":"10.1016/j.glohj.2026.06.007","url":null,"abstract":"<div><h3>Objectives</h3><div>While expiration date indicates the last day the drug is guaranteed its full efficacy and safety, evidence suggests that some medications remain stable beyond this date, and others may degrade posing significant risks. In Lebanon, economic crises and drug shortages have prompted interest in the potential use of expired medications raising important public health concerns, as inappropriate use of expired medications may result in therapeutic failure, adverse health outcomes, and reduced patient safety. Accordingly, this study is needed to assess the Lebanese residents’ knowledge, attitudes, and practices regarding expired medications to improve public health strategies and ensure medication safety.</div></div><div><h3>Methods</h3><div>A cross-sectional descriptive study was conducted from May to June 2023, across five Lebanese governates. Data was collected through self-administered anonymous questionnaires distributed via social media platforms that included questions on knowledge, attitudes, and practices toward using expired medications. Data was analyzed using SPSS-version-25.</div></div><div><h3>Results</h3><div>Among the 1112 participants, 66.5% correctly identified an expired medication as one that no longer guarantees safety and efficacy. Additionally, 62.3% recognized that expired medications could have harmful effects, and 82.3% understood that such medications might lose their potency. About 89% of respondents accurately noted that factors such as light, temperature, and humidity influence medication stability. Overall, the total median knowledge score of the respondents was 15.00 (<em>interquartile range</em>=5.00) out of 24. Notably, 27.2% of respondents admitted using expired medications, particularly painkillers, antacids, cough and cold preparations, with chronic medications comprising only 17.9%. The primary reasons cited for using expired drugs were cost concerns, availability, and perceived preservation of efficacy. In adjusted regression analysis, significant predictors of expired medication use included individuals aged 26‒35 years [<em>odds ratio</em>(<em>OR</em>) = 0.59, 95% confidence interval (<em>CI</em>): 0.36 to 0.98], students (<em>OR</em> = 2.36, 95% <em>CI</em>: 1.30 to 4.02), housewives (<em>OR</em> = 1.9, 95% <em>CI</em>: 1.14 to 3.17), and those with a non-medical background (<em>OR</em> = 2.52, 95% <em>CI</em>: 1.86 to 3.42).</div></div><div><h3>Conclusion</h3><div>The Lebanese community exhibits a moderate knowledge regarding expired medications, highlighting the need for pharmacist-led targeted interventions through enhanced education on safe medication practice.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"10 2","pages":"Pages 178-185"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148718677","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 physicians in training: a systematic review of career choices, professional experiences, and implications for the healthcare workforce","authors":"Pathiyil Ravi Shankar,&nbsp;Hui Meng Er,&nbsp;Siti Suriani Abd Razak,&nbsp;Norul Hidayah Binti Mamat","doi":"10.1016/j.glohj.2026.06.009","DOIUrl":"10.1016/j.glohj.2026.06.009","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review explored factors motivating women medical students and postgraduates to choose medicine, the effects of their increasing numbers, and challenges encountered. Influence on professional interactions with men physicians and other professionals, and workforce planning implications were also explored. The quality of evidence of the studies supporting different research questions was also noted.</div></div><div><h3>Methods</h3><div>Studies among medical students and postgraduates published from January 2003 to September 2024 addressing the key questions were included. Although this manuscript is being submitted in June 2026, the data included in the literature search is till September 2024. The databases PubMed, Scopus, EBSCO Host, and Google Scholar were searched for English-language studies. Two authors independently evaluated the quality of included studies using appropriate checklists (appraisal tool for cross sectional studies for quantitative cross-sectional studies, and quality appraisal checklist for qualitative studies). The studies were summarized and analysed according to the key questions.</div></div><div><h3>Results</h3><div>Fifty-six studies were included, with 29 (51.8%) published during or after 2014. Personal interest, increasing number of medical schools, increasing job availability, financial advantages, parental expectations, and stable career prospects attracted women to medicine. In developing countries, women patients often preferred women doctors, especially for gynaecological and reproductive problems. Systemic challenges included inadequate institutional support (e.g., inflexible scheduling, insufficient maternity leave), gender discrimination, a shortage of women mentors, discriminatory social norms, and underrepresentation in certain specialties.</div></div><div><h3>Conclusion</h3><div>Inclusive policies, including flexible scheduling, parental leave for all caregivers, accessible childcare, and mentorship programs are required at the institutional level. These initiatives will benefit both men and women professionals balancing caregiving, family, and career responsibilities. Increasing numbers of women in medicine will significantly impact healthcare education and service delivery. Additional research from low- and middle-income countries is needed, and the methodological quality of studies may require strengthening.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"10 2","pages":"Pages 129-141"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148718868","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":"Comparison of the 1st and 24th WHO essential medicines list (1977–2025): identification of “core essential drugs”","authors":"Lilly Josephine Bindel,&nbsp;Roland Seifert","doi":"10.1016/j.glohj.2026.06.010","DOIUrl":"10.1016/j.glohj.2026.06.010","url":null,"abstract":"<div><h3>Purpose</h3><div>The Essential Medicines List (EML), published by the World Health Organization since 1977, provides global guidance for the selection of effective, safe, and essential medicines. Following the publication of the 24th edition in 2025, this study sought to compare nearly five decades of EML development in order to identify and evaluate “core essential drugs” with long-standing use and efficacy.</div></div><div><h3>Methods</h3><div>The 1st (1977) and 24th (2025) edition of the EML were compared in regard to listed drugs. Extracted were explanations for changes and indications to summarize usage fields and generalize patterns. Changes of drug listings were categorized as additions, deletions, or modifications, while drugs retaining were defined as “core essential drugs”.</div></div><div><h3>Results</h3><div>The total number of listed drugs increased strongly from 1977 to 2025. Despite this, the proportional distribution of most usage fields remained relatively stable. Anti-infective, antineoplastic, central nervous system, cardiovascular, and immunization-related medicines experienced many changes and represent dynamic categories. In contrast, blood components, nutrition, electrolyte-correcting solutions, and respiratory system demonstrated high preservation rates and can be regarded as comparatively static. 143 medicines were identified as core essential drugs retained in both editions.</div></div><div><h3>Conclusions</h3><div>The long-term comparison highlights consistent patterns of both stability and change within the EML. Despite significant therapeutic advancements, a substantial group of core essential drugs has remained central for nearly five decades, reflecting their continued importance in global pharmacotherapy. Identifying which medicines persist and evaluating the reasons for their retention can support evidence-based updates to future EML editions and inform medicine list development.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"10 2","pages":"Pages 142-151"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148718675","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":"Development of policy recommendations on health system governance for modern elderly care: evidence from Chang Klang community, Nakhon Si Thammarat, Southern Thailand","authors":"Wittaya Sornkaew,&nbsp;Buppha Raksanam,&nbsp;Phiman Thirarattanasunthon,&nbsp;Mark Gregory Robson,&nbsp;Worayuth Nak-Ai,&nbsp;Rattana Kraikeaw,&nbsp;Sukhumaphorn Sriwisit","doi":"10.1016/j.glohj.2026.06.004","DOIUrl":"10.1016/j.glohj.2026.06.004","url":null,"abstract":"<div><h3>Background and objective</h3><div>Health system governance is a critical determinant of effective elderly care, particularly in rural settings undergoing rapid demographic aging. Despite expanded long-term care coverage in Thailand, persistent challenges—including fragmented service delivery, weak intersectoral coordination, and limited community engagement—continue to constrain system performance. This study examines governance and participation in elderly care in a rural Thai context and develops a participatory governance model to inform scalable policy responses.</div></div><div><h3>Methods</h3><div>A mixed-methods study, informed by Participatory Action Research (PAR), was conducted in Chang Klang District, Southern Thailand, between February and September 2024. Quantitative data from 482 participants were analyzed using one-sample <em>t</em>-tests against predefined performance benchmarks. Qualitative data from interviews, focus group discussions, and observations were analyzed thematically. Iterative PAR cycles were used to co-produce governance strategies and policy recommendations with stakeholders.</div></div><div><h3>Results</h3><div>Community participation exceeded benchmark levels (2.88 ± 0.80, <em>P</em> &lt; 0.001), particularly in care planning and information dissemination, but remained limited in monitoring and evaluation. Elderly care competency was marginally below benchmark (2.34 ± 0.52, <em>P</em> = 0.012), with a small effect size, suggesting limited practical significance<strong><em>.</em></strong> Health care behaviors aligned with expected levels (2.39 ± 0.60, <em>P</em> = 0.711). Qualitative findings revealed systemic governance constraints, including fragmented service integration, weak data systems, and inconsistent cross-sector collaboration, alongside strong community engagement in co-design processes. Integrated analysis informed the development of a participatory governance model based on the six building blocks plus framework.</div></div><div><h3>Conclusion</h3><div>Participatory and decentralized governance approaches are associated with improved system responsiveness and community engagement in elderly care. However, their effectiveness depends on enabling institutional and community-level capacities. The proposed model offers a context-sensitive yet potentially transferable framework for strengthening health system governance in aging rural settings.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"10 2","pages":"Pages 152-160"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148718869","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":"Factors affecting willingness to participate in hepatitis B clinical trials among diverse United States populations: mitigating missed opportunities","authors":"Yasmin Ibrahim,&nbsp;Tanya Machado,&nbsp;Fiona Borondy-Jenkins,&nbsp;Shreya Koirala,&nbsp;Mi Dong,&nbsp;Ellen Tham,&nbsp;Ibrahima Sankare,&nbsp;Mohamed Ali,&nbsp;Dung Hua,&nbsp;Ashley Che,&nbsp;Chari Cohen","doi":"10.1016/j.glohj.2026.06.003","DOIUrl":"10.1016/j.glohj.2026.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>Including diverse participants in hepatitis B clinical trials is important for accurately evaluating the safety and effectiveness of new therapies. However, certain populations are underrepresented in clinical trials. Lack of trial awareness and use of inappropriate communication channels are barriers to participation among people living with hepatitis B (PLWHB). This study aimed to identify factors influencing willingness to participate in clinical trials among PLWHB of Asian, African, and Pacific Islander descent.</div></div><div><h3>Methods</h3><div>This qualitative study involved 10 ethnically and racially diverse United States communities, representing populations impacted by the disease. In total, 36 individuals (PLWHB, ≥ 18 years old) participated in this study, with 30 participating in focus groups and six participating in interviews. Communities included Somali, West African, Black, White, Chinese, Filipino, Korean, Vietnamese, Chuukese and Marshallese. Focus groups and semi-structured interviews were conducted in participants’ preferred language. Data were analyzed using inductive content analysis.</div></div><div><h3>Results</h3><div>Barriers were identified and categorized into the Socio-Ecological Model of Health’s institutional, cultural, interpersonal, and individual-level themes. Institutional factors included researchers’ qualifications, physician trust, and access to supportive services. Cultural factors surrounded the roles of respect, distrust, and community involvement. Altruism and familial influences constituted the interpersonal level. Individual factors included anticipated treatment outcomes, knowledge gaps, and time constraints.</div></div><div><h3>Conclusion</h3><div>Challenges to clinical trial participation faced by PLWHB are multifaceted but can be effectively addressed through coordinated, multilevel approaches. Intersectional strategies can improve patient-centricity in clinical trials, enhancing participant diversity.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"10 2","pages":"Pages 161-168"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148718678","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":"Challenges of precision public health: a scoping review","authors":"Thirumurugan Nyanasegram,&nbsp;Kamal Lazi,&nbsp;Sharina Mohd Shah,&nbsp;Suhail Abdul Wali,&nbsp;Jonathan Lamit,&nbsp;Francesca Primus Chew,&nbsp;Abdul Rahman Ramdzan,&nbsp;Nor Ashikin Sopian,&nbsp;Mohd Khairul Izamil Zolkefley","doi":"10.1016/j.glohj.2026.06.005","DOIUrl":"10.1016/j.glohj.2026.06.005","url":null,"abstract":"<div><div>Precision Public Health (PPH) leverages advanced data, technology, and analytics to target public health interventions more precisely, improving population health outcomes. PPH involves the applications of artificial intelligence, machine learning, geographic information systems, and big data analytics. Despite its transformative potential, the implementation and scaling of PPH face numerous challenges that hinder its effectiveness and equity. Understanding these challenges is critical for developing strategies to address them. This scoping review aimed to identify and map the challenges associated with PPH implementation, categorize them into key domains (technical, ethical, societal, and organizational), and highlight gaps in the literature. A systematic scoping review was conducted following Arksey and O’Malley’s framework. Searches were performed in two major databases, Scopus and PubMed, using a combination of keywords. A total of 21 studies met the inclusion criteria. The findings revealed that PPH faces four major categories of challenges such as data fragmentation issues, data privacy, public mistrust and workforce limitations. PPH faces significant data-related, resource and ethical challenges. The lack of diversity in genomic databases limits the effectiveness of precision health tools for underrepresented populations, while issues of data quality, bias, and system interoperability hinder comprehensive analysis. Resource constraints, such as the shortage of qualified professionals, insufficient infrastructure, and in equitable resource distribution, exacerbate health inequalities, particularly in underserved regions. Disparities in PPH adoption were observed between high-income countries, which focused on technological advancements, and low-and middle-income countries, which faced infrastructure and resource gaps. While PPH holds promise for improving public health outcomes, addressing its challenges requires a holistic, interdisciplinary approach. Strategies must prioritize infrastructure development, ethical safeguards, equity, and public trust to ensure PPH is implemented effectively and inclusively across diverse populations.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"10 2","pages":"Pages 108-120"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148718673","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 development of a tool for measuring food safety literacy among working age population","authors":"Teerayoot Mongkolmafai,&nbsp;Worrawit Nakpan,&nbsp;Sanhawat Chaiwong,&nbsp;Araya Prasertchai","doi":"10.1016/j.glohj.2026.06.006","DOIUrl":"10.1016/j.glohj.2026.06.006","url":null,"abstract":"<div><h3>Objective</h3><div>Food safety literacy among working-age adults is increasingly recognized as a key determinant of safe food handling behaviors and, indirectly, foodborne disease risk. However, existing measurement approaches are dominated by knowledge-based or knowledge–attitude–practice instruments, which often fail to capture the broader competencies required for food safety decision-making in real-world food environments. This study aimed to develop and validate a multidimensional food safety literacy measurement tool specifically designed for working-age adults.</div></div><div><h3>Methods</h3><div>A cross-sectional instrument development study was conducted among 480 working-age adults (25–60 years) from 12 provinces in Thailand where Food Safety Mobile Units operate. The instrument was developed based on health literacy and food literacy frameworks and initially comprised five domains: basic knowledge, interactive skills, behaviors, and judgment, along with personal and contextual factors. Content validity was evaluated using the index of item–objective congruence. Internal consistency reliability, item difficulty, and discrimination indices were assessed. Construct validity was examined using exploratory factor analysis with principal component extraction and varimax rotation.</div></div><div><h3>Results</h3><div>The final instrument consisted of 31 items and demonstrated high internal consistency (Cronbach’s α = 0.902). Exploratory factor analysis identified six distinct components: (1) hygienic food storage and cooking; (2) food safety behaviors; (3) food safety communication and social interaction skills; (4) knowledge of food contamination hazards; (5) consumer rights and food safety information; and (6) food safety judgment and decision-making. These factors explained 65.15% of the total variance, with all retained items showing acceptable factor loadings and communalities.</div></div><div><h3>Conclusions</h3><div>The developed food safety literacy instrument demonstrates strong psychometric properties and captures functional, interactive, behavioral, and critical dimensions of food safety literacy relevant to working-age adults. This tool offers a comprehensive approach for assessing food safety literacy at the population level and supports intervention development, and policy evaluation aimed at improving food safety outcomes.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"10 2","pages":"Pages 169-177"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148718676","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":"Antimicrobial resistance patterns of Helicobacter pylori in Thailand: a systematic review and meta-analysis","authors":"Chonticha Romyasamit,&nbsp;Conny Turni,&nbsp;Supanut Anusuriya,&nbsp;Thitinat Duangchan","doi":"10.1016/j.glohj.2026.06.008","DOIUrl":"10.1016/j.glohj.2026.06.008","url":null,"abstract":"<div><h3>Background</h3><div>Rising antimicrobial resistance in <em>Helicobacter pylori</em> presents a significant challenge to therapy worldwide. In Thailand, success rates for treatment have decreased, and data on antimicrobial resistance remain limited. This systematic review and meta-analysis aimed to analyze the patterns and trends of <em>H. pylori</em> antimicrobial resistance in Thailand over time.</div></div><div><h3>Methods</h3><div>PubMed, Scopus, Embase, MEDLINE, Web of Science, ProQuest, Google Scholar, and the Thai-Journal Citation Index Centre were searched from database inception to 25 July 2025. Eligible studies reported antimicrobial susceptibility data for <em>H. pylori</em> isolates from Thai populations. Study selection and data extraction were conducted independently by reviewers. Study quality was assessed using the Joanna Briggs Institute checklist. Antimicrobial resistance rates with 95% confidence intervals were calculated using random-effects or fixed-effects models. Subgroups were analyzed by testing method, geographical region, publication year, study quality, and study design. Meta-regression was conducted using publication year as a moderator to explore temporal trends.</div></div><div><h3>Results</h3><div>Twenty-five studies (28 datasets) with 5202 <em>H. pylori</em> isolates were included. Antimicrobial resistance rates were highest for metronidazole (38.0%); moderate for clarithromycin (10.0%), levofloxacin (10.6%), and ciprofloxacin (10.4%); and low for amoxicillin (3.9%) and tetracycline (2.9%). Clarithromycin resistance differed by testing method and was higher in molecular-based studies. Amoxicillin resistance was higher in the Central region. Meta-regression revealed a significant increasing trend in ciprofloxacin resistance.</div></div><div><h3>Conclusions</h3><div>In Thailand, metronidazole resistance remains high, while resistance to clarithromycin and fluoroquinolones is clinically important and variable across settings and testing methods. These findings emphasize the need to strengthen nationwide surveillance with standardized susceptibility testing and the incorporation of molecular resistance diagnostics to guide therapy and sustain eradication effectiveness.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"10 2","pages":"Pages 93-107"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148718672","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":"Operational outcomes and feasibility of medical drones for healthcare delivery and vector control in emerging economies: a systematic review","authors":"Nelson McNova Bryant,&nbsp;Gift Mwonzora","doi":"10.1016/j.glohj.2026.06.002","DOIUrl":"10.1016/j.glohj.2026.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Operational inadequacies in terrestrial transport infrastructure in emerging economies create significant barriers to healthcare access. Medical drones have been proposed as a technological solution to bypass geographic bottlenecks.</div></div><div><h3>Objectives</h3><div>This review aims to evaluate the operational outcomes, feasibility and cost- effectiveness of medical drone logistics across low- and middle-income settings. It investigates the comparative advantages of drones versus traditional ground transport in reducing delivery times and facilitating vector-control surveillance.</div></div><div><h3>Methods</h3><div>The systematic literature review consisted of a comprehensive search from PubMed for published academic journal articles. Additional databases included Embase, Google Scholar, and Scopus. As inclusion and exclusion criteria, the search strings focused on medical drones and health surveillance studies in the Global South. We used keywords, such as developing countries, low- and middle-income countries. A systematic search and screening process adhering to PRISMA 2020 guidelines identified 11 eligible studies published between 2016 and 2025. Included studies encompassed randomized and non-randomized trials, economic evaluations, and mixed studies. Each included study was evaluated against the relevant Mixed Methods Appraisal Tool criteria to generate a standardized risk of bias score.</div></div><div><h3>Results</h3><div>The systematic literature review shows that drones significantly reduce travel times by 50%‒80% compared with ground transport. In vaccine supply chains, drone integration reduced stockouts by 30% and missed vaccination opportunities by 44%. While initial capital costs remain high, recurrent operational costs may be lower than those for motorcycle logistics (0.34 USD vs. 1.40 USD per trip). In vector control, drone-based multispectral imagery can achieve higher accuracy (86%–98%) in identifying larval habitats than manual surveying methods.</div></div><div><h3>Conclusions</h3><div>Medical drones represent a significant tool for healthcare delivery in emerging economies, offering higher speed and accessibility. However, their impact on improving patients’ outcomes requires further research. Their integration requires ensuring community acceptance through conditional trust frameworks, and addressing technical limitations related to battery endurance and adverse weather conditions.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"10 2","pages":"Pages 121-128"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148718674","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}