PLOS global public health最新文献

{"title":"Prevalence of pre-clinical and clinical obesity in adults: Pooled analysis of 56 population-based national health surveys.","authors":"Rodrigo M Carrillo-Larco, Wilmer Cristobal Guzman-Vilca, Carla Tarazona-Meza, Xiaolin Xu, Antonio Bernabe-Ortiz","doi":"10.1371/journal.pgph.0004838","DOIUrl":"10.1371/journal.pgph.0004838","url":null,"abstract":"<p><p>Obesity is commonly defined using body mass index (BMI), but BMI alone does not capture the metabolic and functional consequences of excess weight. We examined the prevalence of clinical obesity, a new definition that incorporates BMI alongside metabolic and functional impairments. We analyzed nationally representative surveys. Clinical obesity was defined as BMI ≥ 30 kg/m2 and waist-to-height ratio ≥0.5 or BMI ≥ 40 kg/m2 with at least: self-reported diabetes, fasting plasma glucose ≥126 mg/dl, self-reported hypertension, blood pressure ≥140/90 mmHg, or total cholesterol ≥200 mg/dl. We estimated the survey-weighted and age-standardized prevalence of clinical obesity and BMI-only obesity by country and sex. Data from 56 countries were included (n = 142,250). The prevalence of clinical obesity ranged between 0% and 29%. The prevalence of clinical obesity was < 10% in 41 countries for men and 30 for women. In men, the largest shift in prevalence of BMI-only obesity and clinical obesity was observed in Malawi (0.7% vs 0.2%, relative change: -68%); in women, the largest shifts in prevalence were seen in Malawi (5.6% vs. 2.6%, relative change: -53%) and Rwanda (2.7% vs. 1.3%, relative change: -52%). The adoption of clinical obesity criteria revises obesity prevalence estimates and highlights metabolic and functional impairments beyond BMI. Our results emphasize the need to carefully consider how obesity is defined in population surveillance to ensure its relevance to health outcomes.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004838"},"PeriodicalIF":2.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710172","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 practices of birth preparedness and complication readiness among pregnant women in Eastern Province, Zambia: A qualitative study.","authors":"Muyereka Nyirenda, Choolwe Jacobs, Mpundu Makasa, Alice Ngoma Hazemba","doi":"10.1371/journal.pgph.0004975","DOIUrl":"10.1371/journal.pgph.0004975","url":null,"abstract":"<p><p>Birth preparedness and complication readiness are key strategies for reducing maternal and neonatal mortality. This study aimed to explore the knowledge and practices of birth preparedness and complication readiness among pregnant women attending antenatal care in selected health facilities, using qualitative insights to identify barriers, facilitators and cultural factors. A phenomenological qualitative approach was used to explore pregnant women's knowledge and experiences of birth preparedness and complication readiness. Participants were recruited through convenience sampling, and a total of seven focus group discussions (FGDs) were conducted across seven health facilities, involving 53 participants. Data collection took place in July 2023, and the transcripts were systematically analyzed using NVivo software to identify key themes and patterns emerging from participants' narratives. Four identified themes were knowledge of birth preparedness and complication readiness; knowledge of danger signs of pregnancy; practices of birth preparedness and major delays to seek care. Participants listed common labour and delivery requirements. However, for complication readiness, most of them knew the types of complications but had little knowledge about preparation for such complications. Challenges such as lack of money to buy birth requirements and inadequate partner support led to poor preparations for pregnancy and childbirth. The use of traditional medication to hasten labour negatively influenced early care seeking. Distance to health facilities and lack of transport delayed access to healthcare. We found that pregnant women understood labour requirements but lacked knowledge on complication readiness. Financial constraints, insufficient partner support, reliance on traditional medicine, and long distances to health facilities hindered preparedness. This highlights the need for education, partner support and accessible healthcare.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004975"},"PeriodicalIF":2.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710169","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":"Mortality from sickle cell disease in Brazil.","authors":"Paula Fraiman Blatyta Caselli, Claudia Di Lorenzo Oliveira, Isabel Gomes, Tassila Salomon, Ester Cerdeira Sabino, Ligia Capuani, Dahra Teles Cruz, Claudia Maximo, Miriam Veronica Flor-Park, Rosimere Afonso Mota, Daniela de Oliveira Werneck Rodrigues, Carla Luana Dinardo, Cesar de Almeida Neto, Brian Custer, Shannon Kelly","doi":"10.1371/journal.pgph.0002066","DOIUrl":"10.1371/journal.pgph.0002066","url":null,"abstract":"<p><p>Despite early diagnosis through neonatal screening and improved access to vaccines, antibiotics, and disease-modifying therapies, many individuals with sickle cell disease (SCD) die before age 60. This study evaluated causes and independent predictors of mortality in a Brazilian SCD population using data from the multicenter REDS-III cohort [2013-2018], which included six centers. Eligible patients were randomly enrolled during routine visits. Clinical and laboratory data were abstracted from medical records, and deaths were confirmed via chart review and linkage to the national death certificate database. Key variables were compared between deceased and surviving adults using Chi-square and Mann-Whitney tests. A multivariable Cox regression model identified independent predictors of mortality. Children were excluded from regression analysis due to low pediatric mortality. Among 2,793 participants, 1,558 (55.8%) were under 18. By the end of follow-up, 159 (5.7%) had died-142 adults and 17 children. Median life expectancy was 65.7 years. Infection was the leading cause of death (33.3%), followed by non-infectious pulmonary conditions (25.2%) and neurologic disease (14.5%). Cause of death was unknown in 3.1% of cases. In adults, independent predictors of mortality were older age [HR 1.03; 95% CI 1.01-1.04], iron overload [HR 1.68; 95% CI 1.09-2.60], and prior hospital admissions [HR 1.68; 95% CI 1.10-2.56]. The mortality burden in SCD is shifting toward adults, particularly in the third and fourth decades of life. Individuals with SCD in Brazil die about 10 years earlier than the general population. The main causes of death in our cohort were infections, acute chest syndrome and stroke, highlighting the need for prompt recognition and treatment of these complications. Screening and treatment for iron overload and closer monitoring and consideration of disease modifying therapies for patients with frequent hospital admissions are important as both were identified as independent predictors of mortality.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0002066"},"PeriodicalIF":2.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710171","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":"Consanguinity among individuals with diabetes in Pakistan: A cross-sectional study.","authors":"Anaya Abdul Samad, Safwat Irshad Qureshi, Ayesha Mukhtar Rathore, Azhan Ahmed, Warda Rasool, Samim Noori, Sardar Noman Qayyum, Muhammad Talha Kakar","doi":"10.1371/journal.pgph.0004964","DOIUrl":"10.1371/journal.pgph.0004964","url":null,"abstract":"<p><p>To determine the frequency of consanguinity among individuals with diabetes in Pakistan and to investigate the effect of consanguinity on the occurrence of diabetes at different familial levels, we also aimed to report public perceptions on the matter. This cross-sectional study was conducted between August 2023 and January 2024, targeting individuals with diabetes across Pakistan. Data were collected through an online questionnaire, which included questions on participants' demographics, family history, diabetes diagnosis, and awareness levels. Participants were classified based on their diabetes type. Data were analyzed using SPSS. Descriptive statistics were used to determine frequencies, and chi-square tests were applied to assess associations. Of the 404 participants, 52% reported having consanguineous parents, with 22.3% being first cousins. Type 2 diabetes was the most prevalent (70.5%), followed by Type 1 (26.5%) and gestational diabetes (3%). A strong family history of diabetes was reported by 80.4% of participants, with 41.1% having diabetic siblings. Around 64.8% demonstrated general knowledge about diabetes, and 63.1% agreed that consanguinity increases the risk of diabetes. The study reveals a high frequency of consanguineous parental relationships among individuals with diabetes in Pakistan. Public health interventions, including genetic counseling and awareness campaigns, are essential to address the risks associated with consanguineous marriages and reduce the diabetes burden in Pakistan.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004964"},"PeriodicalIF":2.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710165","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":"Enhancing sexual and reproductive health decision-making skills in underserved communities in Ghana: A quasi-experimental study.","authors":"Jacqueline Nkrumah, Aaron Asibi Abuosi, Lily Yarney, Gordon Abekah-Nkrumah, Anita Asiwome Adzo Baku","doi":"10.1371/journal.pgph.0004733","DOIUrl":"10.1371/journal.pgph.0004733","url":null,"abstract":"<p><p>Adolescent sexual and reproductive health (SRH) decision-making is crucial for long-term well-being. It plays a significant role in public health efforts, including reducing sexually transmitted infections (STIs) and teenage pregnancies. While cultural and socio-political influences on adolescent sexual and reproductive health (SRH) decision-making are well-documented, less is known about the effect of SRH educational materials' difficulty levels on decision-making, particularly in Ghana and Sub-Saharan Africa. This study used a quasi-experimental design to assess the effectiveness of SRH educational materials of varying difficulty levels on decision-making skills using 317 adolescents, ages 11-15. Participants were assigned to a control group or one of the three intervention arms: difficult text, simplified text-only, or picture-enhanced text. Over six weeks, weekly sessions were conducted, followed by an end-line assessment with 249 participants and an 8-week post-intervention evaluation. Data analysis employed SPSS (version 26.0) and STATA (version 15.0), utilizing difference-in-difference and high-dimension fixed-effects models, paired sample t-test, and Kendall's coefficient of concordance. Results show participants (66%) were females and were 7th graders (56%). All three treatments, difficult text (10.808 points; CI = 1.2-20.36; P = 0.027), simplified text (11.60 points; CI = 4.68-18.52; P = 0.001), and picture-enhanced text (11.145 points; CI = 3.96-18.32; P = 0.002) significantly improved adolescents' decision-making scores. After controlling for time-invariant characteristics within groups, the difficult-text material's effect on decision-making scores declined (β3 = -6.442 points; CI = -13.908 to 1.096; P = 0.094) while that of the simplified and picture-enhanced materials was maintained. The study highlights the need for well-designed materials and effective pedagogy in SRH education to enhance learning and retention. Incorporating structured reading and discussion-based sessions into the school health program is recommended to promote the real-world application of SRH information and improve long-term SRH outcomes in adolescents.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004733"},"PeriodicalIF":2.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710166","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, attitudes and acceptance of COVID-19 vaccine among pregnant women in Mbeya Region.","authors":"Revocatus Lawrence Kabanga, Vincent John Chambo, Rebecca Mokeha","doi":"10.1371/journal.pgph.0004408","DOIUrl":"10.1371/journal.pgph.0004408","url":null,"abstract":"<p><p>COVID-19 has caused about 580 million cases and 6.4 million deaths worldwide by August 8th, 2022, including 8.7 million cases (173,063 deaths) in Africa. East Africa reported 1.39 million cases on July, 2022. Tanzania confirmed 37,865 cases and 841 deaths by 8th August 2022. Although billions of vaccine doses administered globally, just 17.6% of Tanzanians are fully vaccinated. Symptomatic pregnant women face a mortality risk that is 70% higher than in non-pregnant women.. Therefore, this study aimed at assessing knowledge, attitude, and acceptance of COVID-19 vaccine among pregnant women in the Mbeya region. A descriptive cross-sectional study was conducted in the Obstetrics and Gynecology department of MZRH. Three scores were calculated for participants' knowledge, attitude, and acceptance to COVID-19 vaccination. These scores were compared to many sample factors using binary logistic regression and the chi-square test. The study recruited 233 participants. Most participants (31.3%) relied on social media for Covid-19 vaccine information. Poor Covid-19 vaccine knowledge (71.2%), negative attitudes (76.8%), and low acceptance rate (38.6%) were observed. Multivariate analysis showed that greater acceptance was positively associated with having a chronic illness (AOR = 3.21, CI 1.448-7.123, P = 0.004), stronger vaccine attitudes (AOR = 1.26, CI 1.149-1.368, P = 0.015), better vaccine knowledge (AOR = 2.70, CI 2.587-2.810, P = 0.005), and prior vaccination history (AOR = 0.13, CI 0.068-0.183, P = 0.000). Conversely, preference for natural immunity (AOR = 0.42, CI 0.341-0.498, P = 0.018), and not yet being vaccinated (AOR = 0.67, CI 0.594-0.755, P = 0.000) were all linked to lower acceptance. Pregnant women exhibited low knowledge, attitude, and acceptance to COVID-19 vaccines. Misinformation about the COVID-19 vaccine causes pause. Education on COVID-19 vaccination is needed to enhance vaccine uptake among pregnant women. This group must comprehend COVID-19 immunization importance, safety, and efficacy.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004408"},"PeriodicalIF":2.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710170","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":"Community health workers' counseling is based on a deficit model of behavior change.","authors":"Micah B Goldwater, Faiz A Hashmi, Sudipta Mondal, Cristine H Legare","doi":"10.1371/journal.pgph.0004167","DOIUrl":"10.1371/journal.pgph.0004167","url":null,"abstract":"<p><p>In 2005, India launched the Accredited Social Health Activist (ASHA) program, which has augmented access to medical services and health education in marginalized rural communities. Despite notable progress in health delivery, uptake of medical services remains below target levels. The current research asked ASHAs and their clients why people reject medical advice and what the ASHAs could do to convince them otherwise. Our results identify a consistent mismatch between reasons to reject advice versus how to persuade clients to follow the advice. Two reasons were primarily cited for rejecting the uptake of medical services: insufficient or inaccurate understanding of the medical benefits of these services and the dynamics of the social situation, such as pressure from family members. In contrast, the predominant solutions addressed these knowledge gaps; ASHAs and their clients felt that highlighting the health advantages would be the most effective persuasion technique. ASHAs and their clients infrequently mentioned strategies addressing societal dynamics and norms. This mismatch between barriers to uptake and solutions suggests that the ASHA program inadvertently operates with a \"deficit model\" of decision-making and persuasion. The deficit model is the belief that the way to convince people to comply with health recommendations is to address their knowledge deficit by educating them on the medical benefits. The current research suggests that ASHAs should be trained in the science of belief revision and behavior change, which requires directly addressing the concerns and motivations of others, not just providing information.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004167"},"PeriodicalIF":2.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700634","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 contributing to neonatal mortality in a tertiary center in south West Bank: A single-center retrospective cohort study.","authors":"Ahmad Abu Sharkh, Farah Ighneimat, Yazan F Khdour, Noor Y Aladam, Inad Nawajaa, Alaa Al Janazerah, Insaf Najajrah, Beesan Maraqa","doi":"10.1371/journal.pgph.0004885","DOIUrl":"10.1371/journal.pgph.0004885","url":null,"abstract":"<p><p>Neonatal mortality remains a critical public health issue, particularly in low- and middle-income countries, where factors such as preterm birth, low birth weight, congenital anomalies, infections, and limited access to quality healthcare contribute significantly to neonatal deaths. This study examines neonatal mortality outcomes in the Neonatal Intensive Care Unit (NICU) at the Palestine Red Crescent Society (PRCS) Hospital in Hebron, Palestine for newborns that was transferred to PRCS from other hospitals. An institutional-based cohort study was conducted on 606 neonates admitted \"transferred from other hospitals\" to the NICU at PRCS Hospital from 2019 to 2024. Data were collected from the hospital's electronic registry, capturing clinical parameters and potential risk factors. Statistical analysis, including bivariate and multivariable logistic regressions, was performed using SPSS version 25 to evaluate neonatal mortality risk variables. Of the 606 neonates admitted \"transferred from other hospitals\" to the NICU over five years, 21.5% died, reflecting a substantial neonatal mortality rate. The study identified significant associations between neonatal mortality and sepsis (p = 0.001, aOR=2.34), intraventricular hemorrhage (p < 0.001, aOR=4.67), and necrotizing enterocolitis (p = 0.001, aOR=3.58). Transfer process, Sepsis, intraventricular hemorrhage, necrotizing enterocolitis, prematurity, low birth weight, and hypothermia were key factors associated with neonatal mortality in this NICU setting. Prioritizing early management of sepsis, NEC, and low birth weight is crucial to reducing neonatal deaths in institutional settings. These findings can guide interventions to improve neonatal outcomes and support healthcare facilities in transfer process training for high-risk newborns to reduce preventable deaths.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004885"},"PeriodicalIF":2.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700636","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":"Dismantling colonial legacies: Decolonising research and teaching at the Health in Humanitarian Crises Centre, London school of hygiene and tropical medicine.","authors":"Sali Hafez, Amber Clarke, Katharina Richter, Michelle Lokot, Althea-Maria Rivas, Neha S Singh","doi":"10.1371/journal.pgph.0004833","DOIUrl":"10.1371/journal.pgph.0004833","url":null,"abstract":"<p><p>Despite a burgeoning discourse within the humanitarian health community regarding decolonisation, there remains lack of practical guidance for researchers seeking to decolonise their work. We conducted a qualitative study which aimed to explore the perceptions of research and teaching staff at the Health in Humanitarian Crisis Centre (HHCC) and their external partners -including humanitarian health researchers, practitioners, and donors- regarding how to decolonise research, teaching and partnerships at a leading global health Higher Education institution in the UK. We conducted 20 semi-structured interviews and 3 focus group discussions with HHCC members and external partners, including donors, academic institutions in conflict-affected and humanitarian settings, and practitioners from local and international humanitarian organisations. The first theme explored the concept of decolonisation itself, examining the disparate definitions and understandings held by HHCC members and partners, along with examining the institutional appetite and the role of leadership in driving decolonisation efforts. The second theme focused on sectoral and structural barriers to decolonising HHCC's work, including the dominance of Western-defined knowledge models, inequitable funding policies and practices, and epistemic injustice. Finally, the third theme explored HHCC's experiences in decolonising teaching and curriculum. The study identifies good practices within the HHCC community including knowledge co-production, equitable authorship arrangements, co-dissemination of findings, assigning co-principal investigators from conflict-affected countries, and centring and building on the experiences of researchers with relevant lived experience. However, these individual efforts contrast with a lack of appetite at the institutional level to address the underlying structural barriers. Our study provides the foundations for humanitarian health researchers and educators based in the Global North to begin to practically decolonise their work in the sphere of global/humanitarian health.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004833"},"PeriodicalIF":2.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700635","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":"Management capacity of primary healthcare facilities in low- and middle-income countries: A scoping review.","authors":"Harrison Ochieng, Anita Musiega, Benjamin Tsofa, Jacinta Nzinga, Edwine Barasa","doi":"10.1371/journal.pgph.0004445","DOIUrl":"10.1371/journal.pgph.0004445","url":null,"abstract":"<p><p>How health facilities are managed determines their performance and health service delivery. Management capacity of health facilities comprises the competency of managers at the individual level and the management support and work environment in their institutions. Evidence shows this management capacity influences service delivery and performance of the facility. For LMICs, there are evidence gaps as existing evidence is scarce, varied in the assessment of management capacity of PHC facilities and report a measurement gap due to the scarcity of assessment tools contextualised to the LMIC PHC setting. Our review aims to address these gaps by mapping and summarising the existing literature on management capacity of PHC facilities in LMICs, its components and performance across these components, providing evidence on what needs to be improved for better service delivery. We used Arksey and O`Malley`s scoping review methodology. We searched PubMed, Scopus, Web of Science and Google Scholar and hand-checked reference lists. We synthesized findings using a thematic approach. We included 21 articles out of the 3867 articles gotten. Individual capacity consisted of managerial competencies grouped into seven groups: (1) communication and information management, (2) financial management and planning, (3) human resource, supportive and performance management, (4) community stakeholder and engagement, (5) target setting and problem solving, (6) leadership and (7) situational analysis. Institutional capacity included functional support systems grouped into; (1) availability of resources, (2) support to undertake duties and (3) clear roles and responsibilities. Gaps were prevalent across individual and institutional capacities. There were deficiencies in the managerial competencies of the managers and the functional support systems were not adequate. These negatively affected facility service delivery and performance. There is still a scarcity of studies hence more research is needed. Furthermore, interventions such as training and supportive supervision should be considered in improving the managerial competencies of managers.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004445"},"PeriodicalIF":2.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700637","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}