Public health challenges最新文献

{"title":"Determinants of Second Dose Measles Vaccination Coverage in Somaliland: A Binary and Multivariate Logistic Regression Analysis.","authors":"Ladna Hussein Ali, Abdiqani Muse Muhumed, Asma Siyad Dirie, Abdirahman Abdilahi Adan, Nouh Sulaiman Yousuf, Rahma Isse Bullale, Ahmed Osman Gelle, Yaser Abdirahman Abdilahi, Mohamed Said Hassan","doi":"10.1002/puh2.70212","DOIUrl":"https://doi.org/10.1002/puh2.70212","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding the predictors of second dose measles vaccination (MCV2) is essential for designing effective interventions to prevent outbreaks and reduce child mortality in Somaliland, thereby informing targeted public health strategies and policy decisions.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using a national health survey of Somaliland. The study analyzed data from mothers regarding their children, selecting one child per household to ensure statistical independence. Binary and multivariate logistic regression models were applied to identify determinants of MCV2 coverage among 1417 eligible children.</p><p><strong>Results: </strong>The sample prevalence of MCV2 coverage was low at 33.5%. Significant predictors included maternal age, region, and prior receipt of DPT and BCG vaccinations. The adjusted odds ratio (AOR) MCV2 were higher among children of older mothers compared to those aged 15-19, specifically those aged 40-44 (AOR = 4.30; 95% confidence interval [CI]: 1.84-10.04) and 45-49 (AOR = 5.31; 95% CI: 1.55-18.16). Prior vaccination with DPT (AOR = 3.87; 95% CI: 2.92-5.15) and BCG (AOR = 2.47; 95% CI: 1.86-3.29) were also powerful predictors of MCV2 completion. Urban residence and maternal education were not significantly associated with coverage in the final adjusted model.</p><p><strong>Conclusion: </strong>The findings highlight the importance of maternal experience and the strength of the routine immunization system. Addressing systemic barriers through targeted interventions may encourage stakeholders to strengthen routine immunization programs, especially by utilizing prior healthcare contacts like DPT/BCG visits to potentially improve MCV2 follow-up.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 1","pages":"e70212"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791641","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":"Biological Consequences of Declining Human Fertility.","authors":"Maciej Henneberg, Frank Rühli","doi":"10.1002/puh2.70207","DOIUrl":"https://doi.org/10.1002/puh2.70207","url":null,"abstract":"<p><p>Human fertility has been declining for over a century, especially in economically developed nations. This decline is a result of the changing socio-economic situation that triggered the \"demographic transition.\" The progress in medical sciences and in living conditions has resulted in a strong reduction of infant and child mortality, which, together with increasing family economic expectations and female economic independence, has produced a situation of a few children being born. It appears that the short time over which the fertility declined and the socioeconomic causes of this decline did not allow directional forces of evolution to affect biological determinants of human reproductive abilities. It is argued here that the alteration of the mutation/selection balance over the lifetime of a few generations is sufficient to affect human ability to produce offspring-fecundity-and thus we have already entered R.Aitken's \"post-transition trap\" that reduces \"future fecundity of our species.\" It is no longer just a hypothesis. Reduced fertility will lead to a situation in which the use of artificial reproductive technologies will become an increasingly more relied upon way to reproduce humans unless methods to remove from the gene pool deleterious mutations affecting human fecundity are developed.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 1","pages":"e70207"},"PeriodicalIF":0.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791636","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":"Leveraging the Positive Deviance Approach to Drive Behavior Change in Noncommunicable Diseases: A Scoping Review.","authors":"Oumnia Bouaddi, Imad El Badisy, Hafida Charaka, Houda E L Kirat, Mouna Boucham, Majdouline Obtel, Asmae Khattabi, Kenza Hassouni, Lahcen Belyamani, Mohamed Khalis","doi":"10.1002/puh2.70074","DOIUrl":"https://doi.org/10.1002/puh2.70074","url":null,"abstract":"<p><p>The positive deviance approach (PDA) to behavior and social change has been used to tackle child malnutrition in low-resource settings and has yielded positive health outcomes. Yet, not much is known about its application in noncommunicable disease (NCD) prevention and promotion. We did a scoping review by searching three electronic databases; PubMed (MEDLINE), Scopus (ScienceDirect), and Google Scholar and gray literature websites for primary research studies published in any language, country, and on any date, reporting on the application of the positive deviance (PD) approach to NCDs. A total of 2802 records were retrieved and 26 articles were included in the final analysis. The majority of studies were related to the application of the PDA on physical activity, obesity, weight-loss, and healthy eating, and the majority did not cover all steps of the PD approach and focused mainly on the identification of positive deviants and the identification of underlying PD behaviors and strategies, using a variety of quantitative and qualitative methods. All studies where PD behavior strategies were disseminated to nonpositively deviant communities and organizations yielded positive outcomes, such as clinically significant weight loss, and increased blood pressure control. The results of these studies suggest that positive deviants exhibiting exceptional performance exist in high-risk NCD settings, and therefore researchers and public health practitioners in the field of NCD prevention and promotion can learn from their success.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 1","pages":"e70074"},"PeriodicalIF":0.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13098055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791600","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":"Need-Based Mental Health Aid Allocation to Disadvantaged Patients Toward Universal Health Coverage in Bangladesh.","authors":"Saiful Islam Saif, Sultana Nasrin, Sayedul Ashraf Kushal, Yahia Md Amin, Woarisha Alam, Md Tajul Islam","doi":"10.1002/puh2.70197","DOIUrl":"https://doi.org/10.1002/puh2.70197","url":null,"abstract":"<p><strong>Introduction: </strong>Out-of-pocket (OOP) healthcare costs remain prohibitive in low-resource settings, often pushing families into poverty. Universal health coverage (UHC) goals emphasise protecting households from financial hardship due to medical expenses.</p><p><strong>Objectives: </strong>This study examines which socioeconomic and demographic factors predict the amount of free mental healthcare support received by applicants.</p><p><strong>Methodology: </strong>We conducted a cross-sectional analysis. Descriptive statistics summarised 286 applicant profiles (e.g., 66.8% female and 49% aged 28-48). Spearman and Pearson correlations assessed the relationship between applicants' monthly treatment-related OOP costs and aid received (log-transformed values). A multiple linear regression was then fitted with log (free care amount) as the outcome and predictors including age group, sex, occupation, marital status, income source, reason for support and log (monthly treatment-related OOP cost).</p><p><strong>Results: </strong>The applicant profile was predominantly young, unmarried, female students relying on parental support, seeking aid mainly for financial hardship. Spearman's <i>ρ</i> showed a small but significant positive correlation between treatment cost and aid amount, confirmed by Pearson's <i>r</i> after log transformation (<i>r </i>≈ 0.17, <i>p</i> < 0.01). In regression analysis, higher treatment cost strongly predicted more free aid (<i>β</i> ≈ 0.18, <i>p</i> = 0.003), indicating that donors allocate more resources to costlier cases. Households supported by a spouse's income received significantly less aid (<i>β</i> ≈ -0.93, <i>p</i> = 0.038), suggesting that more stable households needed less assistance. Parental income support was marginally associated with reduced aid (<i>p</i> ≈ 0.07), whereas student status showed a borderline positive effect (<i>p</i> ≈ 0.08).</p><p><strong>Conclusion: </strong>This study highlights that free mental healthcare support in a resource-poor setting is driven primarily by treatment cost and applicants' perceived need. Those with higher medical expenses receive more aid, aligning with the principle of need-based assistance.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 1","pages":"e70197"},"PeriodicalIF":0.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791557","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":"Real-World Pharmacological Management of Alcohol Dependence in a Nepalese Rehabilitation Center: Prospective Cohort Study.","authors":"Sanjay Singh, Nirmal Raj Marasine, Sabina Sankhi, Kabita Bhandari, Gajendra Bahadur Bhuju","doi":"10.1002/puh2.70199","DOIUrl":"https://doi.org/10.1002/puh2.70199","url":null,"abstract":"<p><strong>Background: </strong>Alcohol dependence syndrome (ADS) poses a significant public health issue in Nepal, necessitating effective pharmacological management. This study evaluated the real-world pharmacological management and short-term treatment outcomes of ADS patients in a rehabilitation center in Kathmandu, Nepal.</p><p><strong>Methods: </strong>A prospective cohort study was conducted among 96 adult ADS patients between November 2023 and April 2024. Alcohol consumption severity and withdrawal risk were assessed using validated tools (Alcohol Use Disorders Identification Test [AUDIT] and Prediction of Alcohol Withdrawal Severity Scale [PAWSS]). Treatment regimens, symptom profiles, and liver enzyme levels were documented. Statistical analysis included paired and independent <i>t</i>-tests to assess changes in withdrawal severity and clinical markers, with significance set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>The cohort had a mean age of 37.8 years; 69% were male. At baseline, 96% were identified as problematic drinkers, and all were classified as high risk for withdrawal. Lorazepam (98.8%) and thiamine (97.9%) were the most commonly prescribed agents. A significant reduction in PAWSS scores was observed from admission to follow-up (7.06 ± 0.89 vs. 3.64 ± 0.94, <i>p</i> < 0.001). Liver enzyme levels also improved significantly after treatment. Antipsychotics and benzodiazepines were associated with greater symptom control, whereas antidepressants showed limited impact on withdrawal severity.</p><p><strong>Conclusion: </strong>Structured, evidence-informed pharmacological regimens were associated with improved clinical outcomes among ADS patients in this resource-limited setting. These findings support the integration of standardized ADS protocols in Nepalese rehabilitation centers. Multicenter studies with long-term follow-up are warranted.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 1","pages":"e70199"},"PeriodicalIF":0.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791629","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":"Not Every Country Can Absorb a Shock: Unequal Capacity to Withstand World Health Organization Aid Cuts.","authors":"Animesh Ghimire","doi":"10.1002/puh2.70208","DOIUrl":"https://doi.org/10.1002/puh2.70208","url":null,"abstract":"<p><p>External health aid is contracting sharply, and this moment is often framed as a stress test of health system resilience. This perspective argues that it is equally a stress test of global health ethics and governance: When external actors withdraw from essential services, they are not merely responding to fiscal constraints-they are shaping who loses care. In 2025, the World Health Organization (WHO) projected a 30%-40% decline in external health aid to low- and middle-income countries (LMICs) and urged governments to protect essential services, integrate programs into primary healthcare, and improve efficiency. Yet recent developments show that even well-intentioned national reforms cannot fully absorb abrupt donor exits when core functions have long depended on external finance and coordination. Drawing on up-to-date evidence from Nepal and Afghanistan, this article shows how abrupt reductions in WHO and United States (US) support have simultaneously disrupted family planning, nutrition, immunization, community-based care, and disease surveillance. In Nepal, the halt of US assistance exposed profound single-donor dependence for contraceptive supply, nutrition programing, and elements of immunization financing-turning commodity gaps into system-wide operational strain. In Afghanistan, a funding shortfall placed a large share of WHO-supported facilities at risk of closure as measles and other outbreaks intensified, amplifying existing access barriers-especially for women and girls. These cases reveal a missing governance standard: There is no shared rulebook for how external actors should exit from essential services in fragile settings. This perspective proposes \"transition discipline\" as a practical global norm that links any reduction in support to (i) a time-bound grace period, (ii) a publicly specified minimum protected service package, and (iii) a transparent, joint transition plan with clear responsibility. Transition discipline cannot eliminate all risk, but it can make inevitable cuts more predictable, accountable, and less detrimental.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 1","pages":"e70208"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446270","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":"Correction to \"Anthropometric Failure and Associated Factors Among 6-59 Month Children Living in Gicumbi District\".","authors":"","doi":"10.1002/puh2.70196","DOIUrl":"10.1002/puh2.70196","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1002/puh2.70183.].</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 1","pages":"e70196"},"PeriodicalIF":0.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379927","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":"From Pledge to Practice: A Call for FIGO/WHO to Issue Harmonized, Consolidated Abortion Care Guidelines.","authors":"Abraham Fessehaye Sium, Don Eliseo-Iii Lucero-Prisno","doi":"10.1002/puh2.70206","DOIUrl":"https://doi.org/10.1002/puh2.70206","url":null,"abstract":"<p><p>October 5, 2025, saw the launch of first-ever consolidated postpartum hemorrhage (PPH) management guidelines issued by three global health agencies-World Health Organization (WHO), Federation International of Gynecologists and Obstetricians (FIGO), and International Confederation of Midwives (ICM)-at the FIGO congress in Cape Town, South Africa. This landmark XXV FIGO 2025 congress also hosted inauguration of two vital pledge walls-\"End PPH\" and \"Safe abortion saves women. Denial takes them.\" These pledge walls represent a commitment to initiatives of end two leading causes of maternal mortality at global level, which are PPH and unsafe abortion. We call on WHO and FIGO-in collaboration with Society of Family Planning (SFP) and other guideline-setting bodies-to convene a similar harmonization and process and issue a consolidated, consistent abortion care guidelines to reduce contradictory recommendations and improve uptake of evidence-based recommendations.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 1","pages":"e70206"},"PeriodicalIF":0.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12951815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349211","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":"Public Health Fallout From Transboundary Sewage Exposure in the Tijuana River Valley.","authors":"Nam T Nguyen, Jae-Hee Bae, Dhroov Pathare, Rain Wong, Kevan Shah, Vi T Nguyen","doi":"10.1002/puh2.70203","DOIUrl":"https://doi.org/10.1002/puh2.70203","url":null,"abstract":"","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 1","pages":"e70203"},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12947767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328291","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":"Repositioning Global Health: Decolonising Narratives and Practice in the African Context.","authors":"Michael Sarfo, Ruth Owusuaa","doi":"10.1002/puh2.70204","DOIUrl":"https://doi.org/10.1002/puh2.70204","url":null,"abstract":"<p><strong>Background: </strong>Global health practice in Africa remains shaped by enduring colonial legacies that privilege external expertise and undervalue indigenous knowledge systems. Despite widespread recognition of inequities in authorship, funding and representation, global health discourse often overlooks the deeper epistemic and cultural dimensions of decolonisation.</p><p><strong>Main argument: </strong>This article argues that true decolonisation of global health requires dismantling the enduring mechanisms of coloniality, specifically epistemic injustice, misrepresentation and peripheral positioning, that continue to produce knowledge hierarchies and limit African autonomy. We propose a shift from a donor-recipient logic to a partnership logic, where African institutions and scholars lead in defining priorities and generating knowledge. Examples such as the widespread use of herbal and traditional medicine, often the first line of care for rural communities, illustrate how local innovations are frequently dismissed as unscientific rather than recognised as valuable health assets. Furthermore, the routine portrayal of deprived African communities in global health imagery perpetuates stereotypes that reinforce dependency.</p><p><strong>Conclusion: </strong>Decolonising global health in Africa demands not only fair authorship and funding practices but also epistemic inclusion and representational justice. Global health must be repositioned to leverage Africa's own resources, cultural practices and institutional capacities to create contextually grounded, equitable and sustainable health systems.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 1","pages":"e70204"},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328338","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}