PLOS global public health最新文献

{"title":"\"She helped from the first minute to the last\" - Experiences of respectful maternal and newborn care during the COVID-19 pandemic in Nampula Province, Mozambique.","authors":"Megan M Lydon, Joaquim Vilanculos, Carter Crew, Américo Barata, Emily Keyes","doi":"10.1371/journal.pgph.0003089","DOIUrl":"https://doi.org/10.1371/journal.pgph.0003089","url":null,"abstract":"<p><p>Pandemic-related health service adaptations raised concerns about provision of quality, respectful maternity care globally. Despite this, little research has focused on the experiences of those using intrapartum care during this time. This study aimed to elevate the voices and document the experiences of birthing people in Nacala-Porto and Erati districts of Nampula Province, Mozambique during the COVID-19 pandemic. We conducted a longitudinal qualitative study from March-August 2021 and present an analysis of the 17 follow-up in-depth interviews conducted with participants who had a vaginal live birth. Interviews explored participants' experience of labor and delivery care. They were conducted in Makua and Portuguese, audio-recorded, transcribed and translated. We applied thematic content analysis. Overall, participants did not express major concerns about COVID-19 or related service adaptations when describing their experiences of intrapartum care. Some noted its negative effects on elements of respectful care such as restricting birth companions. Overcrowding became more concerning due to the threat of infection. While unclear if affected by the pandemic, all participants who gave birth at a health facility reported experiencing at least one form of mistreatment, some recounting threats of cesarean delivery. Most explained that they and their newborns received care without their consent, especially regarding enemas and episiotomies. At the same time, respondents described a range of intrapartum experiences that included both respectful and disrespectful care. Most recalled positive verbal communication with their providers and many described receiving continuous attentive care. Participants explained that their satisfaction with childbirth services was tied to their birth outcome and their experience of respectful care. The findings indicate that steadfast commitments to quality care are critical to ensure families benefit from high-quality, respectful care at all times. The ramifications of the COVID-19 pandemic were limited but nonetheless signal a need for tighter connections between maternal health and emergency preparedness stakeholders.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0003089"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058824","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":"Prevalence of low birth weight and associated factors in Ethiopia: An umbrella review of systematic review and meta-analyses.","authors":"Neway Ejigu, Negussie Sarbecha, Kenbon Seyoum, Degefa Gomora, Girma Geta, Chala Kene, Sheleme Mengistu, Derese Eshetu, Yaregal Admasu, Telila Mesfin, Daniel Atlaw, Girma Beressa","doi":"10.1371/journal.pgph.0004556","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004556","url":null,"abstract":"<p><p>Low birth weight (LBW) is one of the major causes of neonatal mortality and morbidity in low and middle-income countries (LMICs). Despite the goal of reducing newborn morbidity and mortality by 2030, low-income countries, including Ethiopia, still confront major challenges. Although various systematic reviews and meta-analyses (SRMA) have been conducted on LBW in Ethiopia, there is notable variation among their findings. This umbrella review aimed to consolidate inconsistent findings into a single summary estimate, providing a robust synthesis of evidence from systematic reviews and meta-analyses to bolster health policy development and planning in Ethiopia.Articles were retrieved on PubMed/Medline, Science Direct, Web of Science, HINARI, and Google Scholar. Assessments of Multiple Systematic Reviews checklist scores were used to assess the quality of the included SRMA studies. A random-effects model was used to estimate the overall effect size.A total of eleven SRMA studies (5 prevalence and 6 predictors) involving 190,492 neonates with an outcome of interest were included in the analysis. The summary estimate for the prevalence of LBW was 16% (95% CI: 13, 18%). Being prematurity [POR: 7.86; 95% CI: 5.79, 10.67], not attending antenatal care (ANC) [POR: 2.4, 95% CI: 1.49, 3.88], having pregnancy-induced hypertension (PIH) [POR: 4.2; 95% CI: 2.78, 6.36], being a rural resident [POR: 2.14, 95% CI: 1.56, 2.94], having a pregnancy interval < 24 months [POR: 2.96; 95% CI: 1.79, 4.9], not having iron-folic acid supplementation (IFAS) [POR: 0.38; 95% CI: 0.29, 0.5], and being a maternal age < 20 [POR: 2.02, 95% CI: 1.41, 2.9] were significantly associated with LBW. This umbrella review revealed more than three out of twenty neonates experienced LBW in Ethiopia. Being premature, not attending antenatal care, having pregnancy-induced hypertension, being a rural resident, having a pregnancy interval < 24 months, not having iron-folic acid supplementation and being a maternal age < 20 were significant predictors of LBW. Therefore, timely diagnosis, proper treatment, and follow-up of women at risk might combat the incidence of LBW in Ethiopia.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004556"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029934","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":"Pediatric severe TBI in South America: Healthcare resource utilization before and during the COVID-19 pandemic.","authors":"Janessa M Graves, Silvia Lujan, Julia L Velonjara, Gustavo Petroni, Nahuel Guadagnoli, Michael J Bell, Monica S Vavilala","doi":"10.1371/journal.pgph.0004318","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004318","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is a leading cause of pediatric morbidity and mortality worldwide. Understanding healthcare utilization during hospitalization for severe TBI across varied resource settings is crucial for informing improvements in clinical practice, patient outcomes, and for reducing TBI burden. We examined hospital services utilization among children with severe TBI in South America. This secondary analysis of data collected during the baseline period of a randomized controlled trial implementing severe TBI clinical management guidelines identified pediatric patients (<18 years) with severe TBI across 16 hospitals in Argentina, Chile, and Paraguay between September 1, 2019 and July 13, 2020. Demographics, injury characteristics, clinical presentation, intensive care unit (ICU) utilization, surgical interventions, and imaging data were collected, and descriptive statistics were calculated. Utilization differences were examined across two time periods based on the COVID-19 pandemic: prepandemic (September 1, 2019-March 10, 2020) and during the pandemic (March 11-July 13, 2020) using Student's t-tests and chi-square tests. One-hundred and sixteen patients (median age: 6.5 years) with severe TBI enrolled during the study (n = 80 prepandemic and n = 36 during the pandemic) period. There were no differences in demographic characteristics, injury mechanism, or discharge outcomes between time periods. Vasopressor use was less common during the pandemic (63.8% vs. 33.3%, p < 0.01) as were surgeries (p = 0.05). Other measures, including nutrition, mechanical ventilation, and central venous pressure monitoring were stable over time. Intracranial pressure (ICP) monitoring remained above 50% throughout. We failed to detect a pandemic effect resulting in pediatric severe TBI ICU care or hospital discharge outcome changes. Clinicians adapted successfully.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004318"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030696","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":"Electrolyte abnormalities and clinical outcomes in children aged one month to 13 years hospitalized with acute gastroenteritis in two large referral hospitals in Botswana.","authors":"Anita A Kinasha, Jeffrey M Pernica, Francis M Banda, David M Goldfarb, Henry D Welch, Andrew P Steenhoff, Sarah A MacLean","doi":"10.1371/journal.pgph.0004588","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004588","url":null,"abstract":"<p><p>Acute gastroenteritis (AGE) is a common childhood disease, with a median of 2.5 diarrhoea episodes per child per year in both low- and middle-income countries. Morbidity and mortality from AGE result from a number of causes, including electrolyte abnormalities. This study characterized children hospitalized for AGE in Botswana with and without electrolyte abnormalities. This was a prospective observational study of children under the age of 13 years who were admitted with AGE in Princess Marina Hospital (PMH) and Nyangabgwe Referral Hospital (NRH) between May 2011 and April 2013. All children with serum electrolyte values obtained within 48 hours of admission were included. Patient characteristics and prevalence of electrolyte abnormalities were described. Risk factors for mortality were explored using univariate and multivariate logistic regression analyses. Among 544 patients, 37% had electrolyte abnormalities, namely hyponatraemia (9%), hypernatraemia (12%) and hypokalaemia (16%). Patients with hypernatraemia were younger (median age 6 months) compared to those with normal electrolytes (median age 9 months, p < 0.001). Patients with hypokalaemia presented after a longer duration of diarrhoea (median 4 days) compared to those with normal electrolytes (median 2 days, p < 0.001). Length of stay was longer in hypokalaemic (5 days) and hyponatraemic (5 days) patients compared to patients with hypernatraemia (3 days) and those without electrolyte abnormalities (3 days, p < 0.002). Those with malnutrition were significantly more likely to have electrolyte imbalances, with 19% having hypokalaemia. In multivariate analysis, the strongest predictors of mortality were malnutrition (OR 4.3; 95% CI 1.44-12.9); hypokalaemia (OR 5.5; 95% CI 1.84-16.6) and hypernatraemia (OR 3.9; 95% CI 1.11-13.5). Given the global impact of paediatric AGE, it is important that clinicians take additional care and precautions when admitting children with AGE and hypokalaemia, hypernatraemia, or malnutrition, as these increase the length of stay and odds of mortality.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004588"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045468","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":"Does enhanced HIV prevention, diagnosis, and linkage to care reduce hospitalisation in high HIV-burden communities in Zambia and South Africa? findings from the HPTN 071 (PopART) randomised trial.","authors":"Ronelle Burger, Nomtha Bell-Mandla, Abigail Harper, Sean Richardson, Sarah Kanema, Ranjeeta Thomas, Lawrence Mwenge, Ethan Wilson, Sian Floyd, Peter Bock, Helen Ayles, Sarah Fidler, Richard Hayes, Katharina Hauck","doi":"10.1371/journal.pgph.0004373","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004373","url":null,"abstract":"<p><strong>Trial registration: </strong>ClinicalTrials.gov NCT01900977.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004373"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045613","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":"Correlates of cervical cancer awareness among women aged 30-49 in five sub-Saharan African nations: Evidence from the Demographic and Health Survey (DHS)-2017-2023.","authors":"Daniel J Olivieri, McKenna C Eastment, Noleb Mugisha, Manoj P Menon","doi":"10.1371/journal.pgph.0003344","DOIUrl":"https://doi.org/10.1371/journal.pgph.0003344","url":null,"abstract":"<p><p>Cervical cancer is the leading cause of cancer-related mortality in low- and middle-income countries (LMICs). Prior studies associate high cervical cancer awareness with reductions in cervical cancer incidence. In this study, we utilize nationally representative Demographic and Health Surveys Program (DHS) to analyze correlates of cervical cancer awareness to inform global strategies. All DHS surveys between 2017-2023 were queried for questions on cervical cancer awareness. Socio-demographic variables (e.g., age, marital status), socioeconomic variables (e.g., education, wealth, literacy) and variables pertaining to healthcare decision making, distance traveled, intimate partner violence (IPV), and female genital mutilation/circumcision (FGC/M)) were extracted. Sample weights were applied, and logistic regressions were performed. Variables with p < 0.20 were included in multivariate analysis. Data was obtained from 30,214 women aged 30-49 years old living in Benin, Cameroon, Madagascar, Mauritania, and Mozambique, 19,403 of whom were asked questions on cervical cancer awareness. Cervical cancer awareness varied from 53% in Cameroon to 12% in Benin. Literacy, frequency of watching television, mobile telephone ownership, visiting a local healthcare facility and hormonal contraceptive use were associated with increased cervical cancer awareness, while lack of healthcare decision making independence was associated with decreased awareness after multivariate adjustment. Women who experienced emotional IPV were associated with increased awareness in Cameroon. Less than 4% of all women were screened for cervical cancer. Given the known association between awareness and screening, targeted efforts to increase awareness among women without communication modalities has the potential to reduce global cervical cancer disparities. Potential strategies include co-locating cervical cancer awareness programs with public health programs and implementing large-scale telecommunication outreach programs to improve awareness.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0003344"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014175","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":"AD-AutoGPT: An autonomous GPT for Alzheimer's disease infodemiology.","authors":"Haixing Dai, Yiwei Li, Zhengliang Liu, Lin Zhao, Zihao Wu, Suhang Song, Shen Ye, Dajiang Zhu, Xiang Li, Sheng Li, Xiaobai Yao, Lu Shi, Tai-Quan Peng, Quanzheng Li, Zhuo Chen, Donglan Zhang, Tianming Liu, Gengchen Mai","doi":"10.1371/journal.pgph.0004383","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004383","url":null,"abstract":"<p><p>In this pioneering study, inspired by AutoGPT, the state-of-the-art open-source application based on the GPT-4 large language model, we develop a novel tool called AD-AutoGPT, which can conduct data collection, processing, and analysis about complex health narratives of Alzheimer's Disease in an autonomous manner via users' textual prompts. We collated comprehensive data from a variety of news sources, including the Alzheimer's Association, BBC, Mayo Clinic, and the National Institute on Aging since June 2022, leading to the autonomous execution of robust trend analyses, intertopic distance map visualization, and identification of salient terms pertinent to Alzheimer's Disease. This approach has yielded not only a quantifiable metric of relevant discourse but also valuable insights into public focus on Alzheimer's Disease. This application of AD-AutoGPT in public health signifies the transformative potential of AI in facilitating a data-rich understanding of complex health narratives like Alzheimer's Disease in an autonomous manner, setting the groundwork for future AI-driven investigations in global health landscapes. Code, a demo video, and other information are available at https://github.com/levyisthebest/AD-AutoGPT.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004383"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058004","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":"Attitudes and practices for antibiotic prescription and antimicrobial resistance among general physicians -Findings from a multi-country survey.","authors":"Nitin Maksane, Karen Langfeld, J P Bhaskar, Sanchayita Sadhu, James van Hasselt","doi":"10.1371/journal.pgph.0004558","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004558","url":null,"abstract":"<p><p>This study aimed to assess the attitudes, and practices (AP) of general physicians (GPs) regarding antibiotic prescribing and antimicrobial resistance (AMR). A cross-sectional, descriptive AP study was conducted by surveying GPs treating community acquired respiratory tract infections (RTIs) across nine countries, including India, Pakistan, Algeria, Thailand, Vietnam, Egypt, Morocco, the United Arab Emirates, and Saudi Arabia. A 29-item, web-based questionnaire was used to collect data between October-2023 and December-2023. Overall, 9249/14207 invited GPs responded, and 1008 responses were included in the analysis after quality control (3341 terminated due to eligibility, 4764 dropped out without completion, 136 excluded for quality concern). Of the included respondents, 78.8% were male and 98% were aged ≥35 years. 41% of GPs agreed, 33% disagreed, and 27% were neutral to questions regarding whether or not antibiotics are helpful in treating infectious respiratory diseases. In total, 62% of GPs agreed that AMR is a concern in their country and 63% agreed that prescribing antibiotics in primary care results in AMR. Pregnant women and patients with comorbidities were populations for whom selecting an appropriate antibiotic was most challenging; 38% of GPs found prescribing antibiotics to children was difficult. Difficulty in correlating susceptibility data (53%), limited availability of information on antibiotics (52%), and lack of availability of appropriate antibiotics (51%) were important challenges for appropriate antibiotic selection. Overall, 94% of GPs agreed that there is a need for frequent training on antibiotic therapy, with 33% and 49% recommending quarterly and biannual trainings, respectively. This study identified current practices, and possible gaps in appropriate antibiotic prescribing for RTIs. As an outcome, specific training needs could be identified to assist GPs with appropriate antibiotic prescribing in an outpatient setting.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004558"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061559","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":"Programmatic mapping and population size estimation of key population in India: Method and findings.","authors":"Pradeep Kumar, Chinmoyee Das, Bhawani Singh Khushwaha, Saiprasad P Bhavsar, Shantanu Kumar Purohit, Arvind Kumar, Subrata Biswas, Nidhi Priyam, Lalit Singh Kharayat, Shajan Mathew, Akhilesh Srivastava, Jyotsana Pal, Shreena Ramanathan, Abhina Aher, Deepika Srivastava Joshi, Rajatashuvra Adhikary, Shajy Isac, H Sanayaima Devi, P V M Lakshmi, Elangovan Arumugam, Sanjay K Rai, Sheela V Godbole, S K Singh, Himanshu K Chaturvedi, Shanta Dutta, Shashi Kant, Dandu Chandra Sekhar Reddy, Sanjay Mehendale, Shobini Rajan","doi":"10.1371/journal.pgph.0004475","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004475","url":null,"abstract":"<p><p>India has the world's second-largest HIV burden. Key populations of female sex workers (FSW), men who have sex with men (MSM), hijra/transgender (H/TG) people, and people who inject drugs (PWID), are disproportionately affected by the HIV epidemic. A community-led programmatic mapping and population size estimation (PMPSE) was carried out in 651 districts of 32 States and Union Territories of India. The goal was to identify the hotspots, network operators, and estimate the size of key population groups. This involved documenting the known hotspots, visiting them for rapid field assessment through key informants'/ network operators interviews, and identifying additional hotspots/ network operators through the snow-balling approach from the existing hotspots. For each identified hotspot, network operator, and village, size of each key population group was estimated after adjusting for the duplications and overlaps. These estimates were then aggregated to arrive at district, State, and ultimately national-level estimates. PMPSE estimated a total of 9,95,499 (9,02,277-10,88,712) FSWs, 3,51,020 (3,13,860-3,88,175) MSM, 2,88,717 (2,53,024-3,24,407) PWIDs, and 96,193 (85,206-1,07,174) H/TG individuals. The number of FSWs per 1000 adult women in different States/Union Territories (UT) varied from 0.34 to 17.25; MSM estimates ranged from 0.07 to 7.35 per 1000 adult men, H/TG persons ranged from 0.03 to 2.75 per 1000 adult men, and PWIDs ranged from 0.01 to 31.30 per 1000 adult men. Additionally, approximately 14% of FSWs, 7% of MSM, and 8% of H/TG individuals were estimated to operate exclusively through network operators. The community-led PMPSE has updated the size estimates for FSWs, MSM, PWIDs, and H/TG individuals at a granular level. This approach has emphatically quantified the presence of network operators. The methodological simplicity of the present round of PMPSE is likely to encourage and facilitate its periodic implementation for better tracking of population level changes in HIV burden based on more reliable denominators.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004475"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055102","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":"COVID-19 vaccination implementation in six lower- and middle-income countries: Successes, challenges, and lessons for pandemic preparedness.","authors":"Cara Tupps, Dora Curry, Amanda Edwards, Eva Bazant, Ann Moen, Anthony W Mounts, Joseph Bresee","doi":"10.1371/journal.pgph.0004417","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004417","url":null,"abstract":"<p><p>The COVID-19 pandemic challenged health systems in low- and middle-income countries (LMIC) to rapidly deploy vaccines, target adult populations, and integrate the COVID-19 vaccine into existing vaccination programs. This evaluation examined COVID-19 vaccination implementation and planning experiences of six LMICs. We aimed to identify common strategies and investments contributing to country-level readiness to scale up COVID-19 vaccination and gaps in pandemic preparedness. In-depth interviews were conducted with national COVID-19 vaccination program representatives from Côte d'Ivoire, Kyrgyzstan, Moldova, Pakistan, the Philippines, and Zambia. Interview questions covered activities, barriers, and facilitators related to vaccine integration; planning and financing; digital systems; vaccine infrastructure and delivery; adult immunization; the health workforce; and demand and communications. We used the framework analysis method to establish key themes from the recorded data and categorize our results. Countries with influenza vaccine platforms leveraged these to reach adults with COVID-19 vaccines. Community-based platforms were viewed to be an effective approach to vaccinate prioritized populations. Stand-alone delivery platforms and data systems for COVID-19 vaccination were viewed as inefficient and not cost-effective, and vaccine supply delays and shortages were a major issue. Participants highlighted that integrated planning, management, and financing for vaccination activities facilitated the COVID-19 vaccine roll out, and that National Immunization Technical Advisory Groups filled a gap by providing guidance on prioritizing populations for vaccination. Health workers were viewed as key influencers of vaccine uptake by patients and their vaccination was believed by participants to improve public trust in COVID-19 vaccines. These findings informed the following priority areas for targeted investment and technical support. 1. Improve vaccine procurement and supply. 2. Integrate financing and management of national vaccination programs broadly. 3. Digitize and integrate data systems. 4. Build health workforce capacity. 5. Establish and expand adult and life-course vaccination, including health workers. 6. Address hesitancy and misinformation.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004417"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054899","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}