Public health challenges最新文献

{"title":"Childhood immunization in Ghana: Tracing the history and projecting the future","authors":"Williams Walana, Mahmoud Al‐Azab, I. Yabasin, A. Abdul-Mumin","doi":"10.1002/puh2.176","DOIUrl":"https://doi.org/10.1002/puh2.176","url":null,"abstract":"Childhood immunization has contributed significantly to child survival globally. Ghana adopted the Expanded Program on Immunization (EPI) in the year 1972, and since then Ghana's immunization program has chalked huge successes in disease prevention, particularly the drastic reduction in the incidence of the six childhood killer diseases. Despite these successes, there are shortfalls that affect childhood vaccinations in Ghana. Here, we look at the evolution of childhood vaccine adoption in Ghana, the disease burden in the pre‐vaccination era and the vaccination era, the benefits of the immunization program, and the identified shortfalls. More importantly, the impact of childhood immunization on the current state of vaccine‐preventable diseases and the prospects the future holds for vaccine development and disease prevention in Ghana were discussed. Undoubtedly, Ghana has made significant progress in vaccine adoption and expansion of immunization program, resulting in a significant reduction in vaccine‐preventable deaths particularly in children. However, challenges pertaining to vaccine coverage, periodic shortages of vaccine, untimely immunization, and logistics constraints persist, which need redress. Moreover, there is currently no continuous post‐vaccine surveillance to evaluate long‐term vaccine impact. Additionally, Ghana lacks the technology and skill to manufacture its own vaccines. Following the establishment of the National Vaccine Institute, Ghana should be in the position to start the production of established vaccines such as those covered under EPI, whereas collaborative research is needed to discover new vaccines. Finally, it is critical to network childhood immunization records across the nation to ensure enhanced data for planning.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"111 49","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to mental health service utilization among African immigrants in the United Kingdom: A systematic review","authors":"Archibong Bassey, Rachael Zaka","doi":"10.1002/puh2.181","DOIUrl":"https://doi.org/10.1002/puh2.181","url":null,"abstract":"African immigrants in the United Kingdom (UK) face unique challenges in accessing mental health services (MHSs), in contrast to their peers born in the UK, contributing to their worsening mental and physical health outcomes. This study aims to uncover barriers to MHS utilization and proffer evidence‐based recommendations toward addressing the mental health needs of African immigrants residing in the UK.A systematic literature search was conducted across six databases: Medline, PsycINFO, Web of Science, CIHNAL, Scopus, and Embase published up to September 2022. To assess methodological quality of the included studies, the Critical Appraisal Skills Program qualitative checklist and the Mixed Methods Appraisal Tool Version 2018 were used. Consecutively, a deductive thematic analysis was employed to group related barriers within overarching themes.The study selection process yielded eight studies conducted in the UK, encompassing African populations identifying as African/Afro‐Caribbean origin, Somali refugees, and ethnic minorities of Black/British descent. The findings highlight the complex interplay of key barriers such as stigma, residential instability, cultural influences, discrimination, and accessibility issues, among others, that continue to hinder African populations from accessing and utilizing MHSs. These barriers were categorized into predisposing,enabling and need factors (themes), aligning with Anderson's model of health service utilization, reflecting a comprehensive range of challenges affecting this population.This systematic review illuminates the myriad barriers faced by African immigrants in utilizing MHSs in the UK, underlining the urgent need for targeted interventions. The findings advocate for the development of culturally sensitive, affordable, and accessible MHSs and policies that address the personal, sociocultural, and structural barriers identified. Collaboration across key stakeholders is highly recommended for advancing equitable and inclusive MHSs for all.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"117 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the challenges of dementia care in Nigeria: A call for a comprehensive national strategy","authors":"Oluwagbemiga Oyinlola","doi":"10.1002/puh2.186","DOIUrl":"https://doi.org/10.1002/puh2.186","url":null,"abstract":"Despite the growing prevalence of dementia, driven by an ageing population and compounded by cultural misunderstandings and stigma, Nigeria lacks a coherent national plan to address this issue. The article points out that although Nigeria has enacted policies such as the National Aging Policy, which do not sufficiently address the specific needs of people living with dementia. It underscores the necessity of integrating a dementia strategy within the broader health and social care systems of Nigeria. The article draws on the World Health Organization's Global Dementia Action Plan to elaborates on several critical areas for action, including public health prioritization of dementia, awareness and stigma reduction, improved diagnosis, treatment, care, and support, alongside bolstering support for caregivers. It stresses the importance of a dementia‐friendly infrastructure, research and innovation, and leveraging community support to foster a more inclusive society. Furthermore, the article outlines current state of healthcare and social support systems in Nigeria, pointing to significant gaps in infrastructure, healthcare workforce, and financial mechanisms that hinder effective dementia care. Hence, elevating dementia care as a national health priority, and increasing access to quality care and support, Nigeria is well positioned to mitigate the impact of dementia on families and the person with dementia. The call to action is clear: a national dementia strategy, informed by global best practices and tailored to Nigeria's unique cultural and societal context, is essential for addressing the challenges of dementia care and improving the well‐being of affected individuals and their families in Nigeria.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140973456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVAX and COVID‐19 Vaccine Inequity: A case study of G‐20 and African Union","authors":"Anjali Pushkaran, V. Chattu, Prakash Narayanan","doi":"10.1002/puh2.185","DOIUrl":"https://doi.org/10.1002/puh2.185","url":null,"abstract":"As the world has a history of vaccine nationalism, especially during the 2009 Swine flu pandemic, the COVAX alliance, a globally collaborated mechanism, was created by World Health Organization (WHO), GAVI, and UNICEF to address the inequity of COVID‐19 vaccines. One of the primary aims of this alliance was to deliver vaccines to low‐ and middle‐income countries (LMICs), which otherwise have less or no capacity to access vaccines from the open market. It is crucial to explore the contribution of COVAX in bridging the gap in equity, accessibility, and affordability of COVID‐19 vaccines between high‐ and low‐income countries (LICs). We selected Group 20 (G20) COVAX participants and the African Union (AU) as case studies to estimate these gaps. The bilateral purchase data shows that by December 2021, the G20 countries had vaccines more than double their population, whereas the AU could procure only about one fifth (19%) of their population. Out of 52 AU countries whose data was available, only 21 of them could strike a bilateral deal with vaccine manufacturers. Even after COVAX delivery, the share of the population that could be vaccinated in AU was just 36.8%, less than the target of WHO (40%) for December 2021. It was found that the COVAX alliance worked better than the open market competition for LMICs and LICs. The cost of vaccinating 20% of the population was 0.7% of the current health expenditure for G20 countries, whereas AU countries had to spend 5.5%. COVAX bears more cost (1%–3%) for AU countries than G20 countries (less than 1%). COVAX made COVID‐19 vaccines more affordable and accessible to these countries. However, LICs were disproportionately affected even with the COVAX Facility mechanism owing to their lack of vaccine deployment infrastructure.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":" 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategic threat health response in Australia capital cities: Predicting the optimum locations for field hospitals through geospatial analysis","authors":"Mazen Baazeem, E. Kruger, M. Tennant","doi":"10.1002/puh2.177","DOIUrl":"https://doi.org/10.1002/puh2.177","url":null,"abstract":"The advent of the COVID‐19 pandemic has accentuated the critical importance of epidemic preparedness within national healthcare systems. This study presents a geospatial analysis aimed at optimising the placement of field hospitals in Australia to ensure adequate healthcare access during pandemics.The latest census data from the Australian Bureau of Statistics were integrated with the spatial locations of current emergency departments within Australian capitals. Buffer zones with a 7.5 km radius were created around the public emergency departments (EDs). Buffer zones outside the 7.5 km radius that exhibited high population densities were categorised into high‐density (red), moderate‐density (yellow) and low‐density (green) zones to prioritise and tailor healthcare responses during a pandemic. The identification of high‐density population areas outside the ED radius enabled the stratification of potential sites for ED facilities.Ninety‐one potential field hospital sites were identified across Australia's capital cities. The findings indicate that the addition of these sites would place over 95% of the population within a 7.5 km radius of an ED facility. This network of proposed sites is designed to serve a spectrum of population densities, ensuring equitable healthcare access for both densely populated urban centres and less populated areas.This study underscores the potential of field hospitals to strengthen Australia's public health system against emergencies. By advocating for the creation of 91 field hospitals within a 7.5 km reach for over 95% of urban dwellers across major cities, it demonstrates a strategic approach to ensure comprehensive ED coverage. Drawing on international examples, including China's Fangcang hospitals, the USA's post‐acute care (PAC) facilities and the United Kingdom's National Health Service (NHS) Nightingale Hospitals, it highlights the need for healthcare agility and scalability, especially during pandemic outbreaks. The research presents a blueprint for field hospital deployment, marking a significant advancement in public health logistics and protection across Australia's varied demographic and geographical landscapes.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":" 34","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141001096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indoor and outdoor NO2 and SO2 levels in 13 randomly selected preschools from 7 districts in Mpumalanga Province, South Africa","authors":"Mudau Rodney, Voyi Kuku, Shirinde Joyce","doi":"10.1002/puh2.175","DOIUrl":"https://doi.org/10.1002/puh2.175","url":null,"abstract":"Air pollution is a serious worldwide issue, where both outdoor and indoor air quality have a substantial impact on the health of children. Children are more vulnerable to the effects of air pollution due to their developing respiratory systems and higher respiration rates than adults. These children dedicate a substantial amount of time to the preschool setting. The study sought to evaluate the concentration of NO2 and SO2 in both outdoor and indoor environments of preschool facilities.Concurrently, the levels of NO2 and SO2 were measured indoors and outdoors at 13 randomly selected preschools in 7 districts in Mpumalanga Province, South Africa. Radiello passive air samplers were employed to collect gaseous samples.The mean levels of NO2 indoors and outdoors were within the recommended criteria outlined by the World Health Organization (WHO), specifically target levels 1–3. Additionally, these values were also below the air quality guides outlined by South Africa, both for yearly and 1‐h mean measurements. Nevertheless, both levels remained above the suitable threshold of 10 µg m−3 outlined by the WHO air quality guidelines.It is important to implement proactive measures such as enhancing airflow systems, employing air filters and reducing potential sources of air pollution in preschools, to aid in reducing exposure to indoor and outdoor NO2 and SO2.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":" 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140999638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new era for African health systems: Market shaping and the African Continental Free Trade Area (AfCFTA)","authors":"Jonta Kamara, Ukeme Essien, Alain B. Labrique","doi":"10.1002/puh2.172","DOIUrl":"https://doi.org/10.1002/puh2.172","url":null,"abstract":"The COVID‐19 pandemic has forced a reflection on the origins of supplies in African healthcare market and underscored the need for an increase in local manufacturing of medical supplies. Several African countries’ health markets have been heavily reliant on imports. First, this article demonstrates how the African healthcare market has had a high import dependency and the role that the African Continental Free Trade Area (AfCFTA) could play to reverse this. It is estimated that African countries import between 80% and 94% of medical supplies, 75% of testing kits, between 70% and 95% of pharmaceuticals, and 99% of vaccines. Second, during the COVID‐19 pandemic, countries imposed export restrictions which impacted the flow of medical supplies to African countries. This finding highlighted the limited production capabilities on the African continent and reiterated the need to strengthen continental value chains and local manufacturing capacity to establish the continent's New Public Health Order. Third, there was the emergence of local innovations seeking to minimize the impact of these supply chain disruptions. Using case studies on the local production of COVID‐19 testing kits and personal protective equipment, the article highlights progress made toward health market reform. It calls attention to the implementation of the AfCFTA to strengthen the supply, manufacturing, and trade of medical resources. Fourth, this article highlights countries that have African‐made pharmaceuticals and vaccinations and the importance of regional hubs to expand these products in African healthcare markets. It concludes by discussing investments made to expand local manufacturing of health products.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"67 s271","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141002359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health intervention trials involving transgender, transabled and transracial persons in Africa: A scoping review","authors":"J. Amzat, K. Kanmodi, K. Aminu, Abbas Ismail, A. Salami","doi":"10.1002/puh2.182","DOIUrl":"https://doi.org/10.1002/puh2.182","url":null,"abstract":"Health intervention trials constitute important research efforts to find appropriate solutions to health issues affecting different populations. In many cases, it involves high‐risk groups such as the trans‐communities. This scoping review aims to review the existing health intervention trials involving transgender, transabled and transracial persons in Africa.This scoping review adopted the research design by Arskey and O'Malley. Using the Population–Concept–Context framework, a robust systematic search of four research databases, including APA PsycINFO, SCOPUS, CINAHL Complete and PubMed, was conducted to retrieve literature relevant to the review's question. Duplicate copies in the retrieved literature were removed using the Rayyan web‐based application. The residual literature was screened for relevance based on the review's inclusion and exclusion criteria, and only those eligible articles were included in this review. From the included literature, data were charted, collated, summarized and presented as results.The scoping review included and reviewed only four articles, which reported studies involving transgender persons. No peer‐reviewed original research article on transabled and transracial persons in Africa was found eligible for inclusion in this review. All the reviewed articles focused on at‐risk, healthy and human immunodeficiency virus (HIV)‐uninfected adult participants ranging between the ages of 18 and 65 years. The domains investigated in those articles were on sexual health, HIV preventive drugs and vaccine trials. The reviewed findings showed the use of HIV‐inhibiting medications and HIV screening or testing as vital preventive interventions among transgender persons in Africa. The available research evidence shows sexuality reductionism about trans behaviour by neglecting other health domains.Health trial research on transracial, transgender and transabled persons is a largely underexplored research domain in Africa. More health intervention trials, beyond the domain of sexual health, are required to improve the health and well‐being of this highly marginalized population group in Africa.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141007275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The School Suicide Policy Evaluation Tool (SSPET): A proof‐of‐concept for assessing school suicide prevention policies","authors":"Douglas Wirthlin, Zeke Richards, Cody Crandall, Shad Mortensen, Jackson R. Richards, Amanda Bakian","doi":"10.1002/puh2.178","DOIUrl":"https://doi.org/10.1002/puh2.178","url":null,"abstract":"As adolescent suicide rates have increased, there has been a nationwide increase in legislation requiring schools to create suicide prevention policies. In Utah, school districts must implement a youth suicide program for grades 7–12. Currently, there have been no systematic analyses of Utah school district suicide prevention policies. Thus, we developed a new evaluation instrument, the School Suicide Policy Evaluation Tool (SSPET).The SSPET was derived from the “Model School District Policy” and evaluates criteria on prevention, intervention, re‐entry, and postvention. Four raters used the SSPET in a systematic analysis of suicide prevention policies for all school districts in the state of Utah.Analysis revealed a right‐skewed distribution of policy scores, and a median total score was 2.25/36. The mean percentage of inclusion of the four subsections in policies was less than 20% for most criteria. Median scores were totaled for the four subsections as follows: Prevention score was 1/9, intervention score was 1/14, re‐entry score was 0/4, and postvention score was 0/9.This proof‐of‐concept study demonstrates the utility of the SSPET in identifying shortcomings of school district policies on suicide while generating specific recommendations for improvement. With further validity testing, we expect this tool to be useful to school district administrators, education policymakers, and those studying suicide interventions and outcomes in school‐aged children and adolescents.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"107 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141022016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing cervical cancer prevention in Bhutan: A study on the use of loop electrosurgical excision procedures at the primary health care level","authors":"Sangay Tshering, N. Dorji, Zimba Letho, Nishal Chhetri","doi":"10.1002/puh2.180","DOIUrl":"https://doi.org/10.1002/puh2.180","url":null,"abstract":"Cervical cancer is the top and fourth leading cause of death among women in Bhutan and worldwide, respectively. The cervical cancer elimination flagship program initiated by the Ministry of Health aims to achieve the 90–70–90 goals by 2030. To achieve this, detection and treatment of pre‐cancerous lesions of the cervix through colposcopy and loop electrosurgical excision procedure (LEEP) are being carried out through the outreach health camps.This descriptive study aimed to assess the safety and tolerability of LEEP under local anesthesia and assess the margin status of high‐grade lesion (HGL). We analyzed 193 records of clients who underwent LEEP at Wangdue Phodrang Hospital from 26 September to 5 October 2022. The sociodemographic profile, intraoperative pain, complications, and histopathological reports were described using structured pro forma.The mean age of clients was 40.9 ± 8.5 years (range 25–66 years). There were 3.1% who had intraoperative and 2.6% who had postoperative bleeding. There were 18.6% who had foul‐smelling vaginal discharge, and 8.3% had moderate‐to‐severe intraoperative pain. Histopathological assessment revealed 29.5% with chronic cervicitis, 34.2% with HGL, and 1.6% with microinvasive cervical carcinoma. The margin positivity for HGL was 36.4%.Given the safety profile of LEEP under local anesthesia in our setting, the scope of providing a complete cervical cancer screening and treatment package at the primary health care level looks promising. Based on the higher rate of overtreatment and margin positivity, we recommend the practical implementation of standard colposcopy guidelines.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"116 S149","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141040861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}