{"title":"Community-led total sanitation (CLTS) implementation in West Mamprusi Municipal Assembly in Ghana. What do communities think eleven years on?","authors":"Elijah Adam , Emmanuel Badu","doi":"10.1016/j.glohj.2024.05.003","DOIUrl":"https://doi.org/10.1016/j.glohj.2024.05.003","url":null,"abstract":"<div><h3>Objective</h3><p>Access to improved sanitation is a fundamental human right and an important aspect of Public Health. However, an estimated thousands of people in Ghana especially, the West Mamprusi Municipal Assembly (WMMA) still have no access to adequate toilet facilities. This has brought untold health repercussions to the inhabitants, the community, and the environment at large. To address this menace, the community-led total sanitation (CLTS) was implemented. This study aimed to assess communities’ perspectives on the implementation of CLTS and to understand the factors influencing its success and failures.</p></div><div><h3>Methods</h3><p>A mixed-method approach involving sequential qualitative and quantitative methods was employed in this study. Participants for the quantitative study were randomly selected and surveyed using questionnaires. The qualitative study employed focus group discussion involving purposively sampled participants including assembly members, opinion leaders, and assembly staff.</p></div><div><h3>Results</h3><p>The CLTS program in WMMA realized an apparent use of construction and proper use of household latrines leading to a reduction of open defecation free (ODF) and two communities achieving sanitized status in the history of the study area, enabling the training of latrine artisans and natural leaders to facilitate the CLTS expansion and sustainability, improved sanitation and hygiene, strengthened the enforcement of community rules and regulations and many others.</p></div><div><h3>Conclusion</h3><p>The CLTS program has received more widespread acceptance in the study area than the previous government policy of constructing public toilets, which was greeted with massive failures due to poor implementation. To ensure that gains achieved through CLTS implementation are sustained longer, it is recommended that chiefs and opinion leaders should be involved in the CLTS programs to ensure checks and enforcement. The entrenchment of bylaws and more education to address enduring myths and misconceptions will sustain the program. Subsidies in the form of sanitation loans for latrine construction materials by the government and supporting non-governmental organizations (NGOs) will be paramount in sustaining ODF.</p></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 2","pages":"Pages 67-73"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2414644724000241/pdfft?md5=587da95365fd2d0603ca6221d55bf614&pid=1-s2.0-S2414644724000241-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483849","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":"Charting the course: India’s health expenditure projections for 2035","authors":"Pragyan Monalisa Sahoo , Himanshu Sekhar Rout","doi":"10.1016/j.glohj.2024.05.001","DOIUrl":"10.1016/j.glohj.2024.05.001","url":null,"abstract":"<div><h3>Objectives</h3><p>Understanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket (OOP) expenses. The current study analyzed health expenditure patterns in India and forecasted future trends and patterns until 2035.</p></div><div><h3>Methods</h3><p>Data on health expenditure in India from 2000 to 2019 was collected from the Organisation for Economic Co-operation and Development (OECD) iLibrary and National Health Accounts 2019 databases. Gross domestic product (GDP) data from the World Bank was also utilized. Descriptive statistics analyzed the composition and pattern, while the exponential smoothing model forecasted future health expenditures.</p></div><div><h3>Results</h3><p>The findings revealed that expenditure made by OOP is the primary health financing source, followed by government and pre-paid private spending. The percentage of GDP allocated to total health expenditure remains stable, while the per capita health expenditure fluctuates. Variations in expenditure among states are observed, with Karnataka relying heavily on pre-paid private coverage. Future projections suggest a decline in per capita and total health expenditure as a share of GDP, with a slight increase in the government’s share. Pre-paid private expenditure per capita and OOP health expenditure as a share of the total is projected to remain relatively constant but still high in absolute terms.</p></div><div><h3>Conclusion</h3><p>The study highlights variations in health spending in India, characterized by high OOP spending, limited public coverage, and a need for investments, and reforms to improve healthcare access and equity.</p></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 2","pages":"Pages 58-66"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2414644724000228/pdfft?md5=f3fd43ea7276dd00f388f8c9a116c18e&pid=1-s2.0-S2414644724000228-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141049786","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":"Knowledge and discriminatory attitudes towards HIV/AIDS among the women of reproductive age group of Pakistan using the Multiple Indicator Cluster Survey (MICS)","authors":"Remsha Hussain, Russell Kabir","doi":"10.1016/j.glohj.2024.05.004","DOIUrl":"https://doi.org/10.1016/j.glohj.2024.05.004","url":null,"abstract":"<div><h3>Background</h3><p>Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has become a major worldwide public health issue, with a focus on developing nations. Despite having a very low HIV prevalence, South Asia faces serious issues with stigma and false information because of a lack of awareness. This stigma highlights significant gaps in popular awareness while also sustaining unfavorable attitudes towards those living with HIV/AIDS. Pakistan is ranked second in South Asia for the rapidly increasing AIDS epidemic. Thorough information and optimistic outlooks are essential for successful HIV/AIDS prevention, control, and treatment. But false beliefs about how HIV/AIDS spreads lead to negative perceptions, which highlights the need to look into how women’s knowledge and attitudes about HIV/AIDS in Pakistan are influenced by sociodemographic traits and autonomy.</p></div><div><h3>Methods</h3><p>The purpose of this study is to evaluate Pakistani women’s discriminatory attitudes and level of awareness on HIV/AIDS. This study used data (the women in reproductive age 15‒49 years’ dataset) from the Pakistan Multiple Indicator Cluster Survey to conduct an analytical cross-sectional analysis. To represent the respondents’ attitudes and knowledge towards people living with HIV (PLHIV), two composite variables were developed and composite scored. Binary logistics regression was used to identify predictor variables and chi-square was used for bivariate analysis.</p></div><div><h3>Results</h3><p>The findings reveal that almost 90% of Pakistani women have poor knowledge and attitude with HIV/AIDS. In Punjab, 72.8% of rural residents have low knowledge, whereas only 20.6% of young individuals (15–< 25 years old) show the least amount of ignorance. Education is shown to be crucial, and “Higher” education is associated with superior knowledge. Urban dwellers in Khyber Pakhtunkhwa typically have more expertise. Knowledge of HIV is positively correlated with education; those with higher education levels know a lot more (odds ratio [<em>OR</em>] = 5.419). Similarly, quintiles with greater incomes show a higher likelihood of knowing about HIV (<em>OR</em> = 6.745). The study identifies age, wealth index, place of residence, educational attainment, and exposure to contemporary media as significant predictors influencing HIV knowledge and attitudes among women in these provinces.</p></div><div><h3>Conclusion</h3><p>The majority of respondents had negative opinions regarding the virus, and the majority of women in the study knew very little about HIV. Individuals who live in metropolitan areas, have higher incomes, are better educated, are exposed to contemporary media, and are generally more aware of HIV and have more positive attitudes towards HIV/AIDS, or PLHIV. The study found that, in comparison to those living in urban environments, those from rural areas with low socioeconomic level have a negative attitude and inadequate understa","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 2","pages":"Pages 74-82"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2414644724000253/pdfft?md5=fd05280f432cac9f3f346298d7c0c749&pid=1-s2.0-S2414644724000253-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483850","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}
Zecharias Fetene Anteneh , Anagaw D. Mebratie , Zemzem Shigute , Getnet Alemu , Arjun S. Bedi
{"title":"Does community-based health insurance affect lifestyle and timing of treatment seeking behavior? Evidence from Ethiopia","authors":"Zecharias Fetene Anteneh , Anagaw D. Mebratie , Zemzem Shigute , Getnet Alemu , Arjun S. Bedi","doi":"10.1016/j.glohj.2024.05.005","DOIUrl":"https://doi.org/10.1016/j.glohj.2024.05.005","url":null,"abstract":"<div><h3>Objectives</h3><p>This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance (CBHI) scheme on household preventive care activities and the timing of treatment-seeking behavior for illness symptoms. There is growing concern about the financial sustainability of CBHI schemes in developing countries. However, few empirical studies have identified potential contributors, including ex-ante and ex-post moral hazards.</p></div><div><h3>Methods</h3><p>We implement a household fixed-effect panel data regression model, drawing on three rounds of household survey data collected face to face in districts where CBHI scheme is operational and in districts where it is not operational in Ethiopia.</p></div><div><h3>Results</h3><p>The findings show that enrolment in CBHI does not significantly influence household behaviour regarding preventive care activities such as water treatment before drinking and handwashing before meals. However, CBHI significantly increases delay in treatment-seeking behaviour for diseases symptoms. Particularly, on average, we estimate about 4‒6 h delay for malaria symptoms, a little above 4 h for tetanus, and 10‒11 h for tuberculosis among the insured households.</p></div><div><h3>Conclusions</h3><p>While there is evidence that CBHI improve the utilization of outpatient or primary care services, our study suggests that insured members may wait longer before visiting health facilities. This delay could be partly due to moral hazard problems, as insured households, particularly those from rural areas, may consider the opportunity costs associated with visiting health facilities for minor symptoms. Overall, it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions to encourage insured individuals to seek early medical attention.</p></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 2","pages":"Pages 83-90"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2414644724000265/pdfft?md5=a91cab8c1b4cdf841a7b16b9ac7b989d&pid=1-s2.0-S2414644724000265-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483846","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}
Enos Moyo , Grant Murewanhema , Perseverance Moyo , Tafadzwa Dzinamarira , Andrew Ross
{"title":"The use of oral human immunodeficiency virus pre-exposure prophylaxis in pregnant and lactating women in sub-Saharan Africa: considerations, barriers, and recommendations","authors":"Enos Moyo , Grant Murewanhema , Perseverance Moyo , Tafadzwa Dzinamarira , Andrew Ross","doi":"10.1016/j.glohj.2024.04.002","DOIUrl":"https://doi.org/10.1016/j.glohj.2024.04.002","url":null,"abstract":"<div><p>In sub-Saharan Africa (SSA), 63% of new human immunodeficiency virus (HIV) infections in 2021 were among women, particularly adolescent girls, and young women. There is a high incidence of HIV among pregnant and lactating women (PLW) in SSA. It is estimated that the risk of HIV-acquisition during pregnancy and the postpartum period more than doubles. In this article, we discuss the safety and effectiveness of drugs used for oral HIV pre-exposure prophylaxis (PrEP), considerations for initiating PrEP in PLW, the barriers to initiating and adhering to PrEP among them and suggest recommendations to address these barriers. Tenofovir/emtricitabine, the most widely used combination in SSA, is safe, clinically effective, and cost-effective among PLW. Any PLW who requests PrEP and has no medical contraindications should receive it. PrEP users who are pregnant or lactating may experience barriers to starting and adhering for a variety of reasons, including personal, pill-related, and healthcare facility-related issues. To address the barriers, we recommend an increased provision of information on PrEP to the women and the communities, increasing and/or facilitating access to PrEP among the PLW, and developing strategies to increase adherence.</p></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 2","pages":"Pages 41-45"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2414644724000216/pdfft?md5=daf71420bd6b221bd667aecfa0ac64f1&pid=1-s2.0-S2414644724000216-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483847","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":"Exploring the intersection of the medical metaverse and healthcare ethics: future considerations and caveats","authors":"Colm McCourt","doi":"10.1016/j.glohj.2024.02.005","DOIUrl":"10.1016/j.glohj.2024.02.005","url":null,"abstract":"<div><p>The medical metaverse and digital twin are set to revolutionise healthcare. Like all emerging technologies their benefits must be weighed against their ethical and social, impacts. If we consider the advances of medical technology as an expression of our values, such as the pursuit of knowledge, cures and healing, an ethical study allows us to align our values and steer the technology towards an agreed goal. However, to appreciate the long-term consequents of a technology, those consequences must be considered in the context of a society already shaped by that technology. This paper identifies the technologies currently shaping society and considers the ethical, and social consequences of the medical metaverse and digital twin in that future society.</p></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 1","pages":"Pages 36-40"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S241464472400006X/pdfft?md5=be01e42b04a563852f32d16198145db4&pid=1-s2.0-S241464472400006X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139888133","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}
Nilanjana Ganguli , Anna Maria Subic , Janani Maheswaran , Byomkesh Talukder
{"title":"Planetary health risks in urban agriculture","authors":"Nilanjana Ganguli , Anna Maria Subic , Janani Maheswaran , Byomkesh Talukder","doi":"10.1016/j.glohj.2024.02.007","DOIUrl":"https://doi.org/10.1016/j.glohj.2024.02.007","url":null,"abstract":"<div><p>Urban agriculture is gaining recognition for its potential contributions to environmental resilience and climate change adaptation, providing advantages such as urban greening, reduced heat island effects, and decreased air pollution. Moreover, it indirectly supports communities during weather events and natural disasters, ensuring food security and fostering community cohesion. However, concerns about planetary health risks persist in highly urbanized and climate-affected areas. Employing electronic databases such as Web of Science and PubMed and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we identified 55 relevant papers to comprehend the planetary health risks associated with urban agriculture. The literature review identified five distinct health risks related to urban agriculture: (1) trace metal risks in urban farms; (2) health risks associated with wastewater irrigation; (3) zoonotic risks; (4) other health risks; and (5) social and economic risks. The study highlights that urban agriculture, while emphasizing environmental benefits, particularly raises concerns about trace metal bioaccumulation in soil and vegetables, posing health risks for populations. Other well studied risks included wastewater irrigation and backyard livestock farming. The main limitations in the available literature were in studying infectious diseases and antibiotic resistance associated with urban agriculture.</p></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 1","pages":"Pages 4-10"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2414644724000071/pdfft?md5=d2f636312ea515074da9c490a6a7e3fc&pid=1-s2.0-S2414644724000071-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140296486","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":"Data, digital worlds, and the avatarization of health care","authors":"Jane Thomason","doi":"10.1016/j.glohj.2024.02.003","DOIUrl":"10.1016/j.glohj.2024.02.003","url":null,"abstract":"<div><p>Significant technological trends are impacting health care, from consumerisation, datafication, circular economy, and platformization of services. Web 3.0, or the Internet of Value, enables direct peer-to-peer value exchange, opening up new business models that will impact health care. Among the many technologies that will also be part of the healthcare transformation is artificial intelligence, which shocked the world with the debut of ChatGPT in 2022. This opinion piece will explore how AI underpins the health transformation and, far from being an enemy of health, is the critical friend health care has been waiting for.</p></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 1","pages":"Pages 1-3"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2414644724000034/pdfft?md5=8e003d082a49c4ec16cf4b0e371b2313&pid=1-s2.0-S2414644724000034-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139893000","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":"Social prescribing in the metaverse: a new frontier for primary care practice","authors":"Arunpirasath Nadarasa","doi":"10.1016/j.glohj.2024.02.006","DOIUrl":"10.1016/j.glohj.2024.02.006","url":null,"abstract":"<div><p>The advent of immersive technologies such as the metaverse, extended reality, artificial intelligence, and blockchain offers novel possibilities to transform healthcare services. These innovations coincide with clinicians' aspirations to deliver more comprehensive, patient-centered care tailored to individuals' singular needs and preferences. Integration of these emerging tools may confer opportunities for providers to engage patients through new modalities and expand their role. However, responsible implementation necessitates deliberation of ethical implications and steadfast adherence to foundational principles of compassion and interpersonal connection underpinning the profession. While the metaverse introduces new channels for social prescribing, this perspective advocates that its ultimate purpose should be strengthening, not supplanting, human relationships. We propose an ethical framework centered on respect for patients' dignity to guide integration of metaverse platforms into medical practice. This framework serves both to harness their potential benefits and mitigate risks of dehumanization or uncompassionate care. Our analysis maps the developing topology of metaverse-enabled care while upholding moral imperatives for medicine to promote healing relationships and human flourishing.</p></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 1","pages":"Pages 32-35"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2414644724000058/pdfft?md5=a9443b1ed232a175ad32e1ed93e00dc1&pid=1-s2.0-S2414644724000058-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139827076","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}