The Lancet regional health. Southeast Asia最新文献

{"title":"Self-rated mobility, physical health, and chronic pain among women seeking abortion in a health facility in Nepal (2019–2024): a prospective cohort study","authors":"Sarah Raifman, Rachel Murro, W. John Boscardin, Mahesh C. Puri, Diana Greene Foster, Corinne H. Rocca","doi":"10.1016/j.lansea.2026.100835","DOIUrl":"10.1016/j.lansea.2026.100835","url":null,"abstract":"<div><h3>Background</h3><div>Women may have adverse physical health following abortion denial and childbirth, particularly where maternal morbidity is high. This study aims to investigate mobility, self-rated physical health, and chronic pain associated with unwanted pregnancy among women seeking facility-based abortion services in Nepal.</div></div><div>Women may have adverse physical health following abortion denial and childbirth, particularly where maternal morbidity is high. This study aims to investigate mobility, self-rated physical health, and chronic pain associated with unwanted pregnancy among women seeking facility-based abortion services in Nepal.</div><div><h3>Methods</h3><div>Women seeking abortion at 22 facilities across Nepal in 2019–2020 completed surveys every six months for five years. This longitudinal cohort study assessed limited mobility, self-rated poor health, and chronic pain using weighted linear and logistic mixed effects regression, including among those seeking abortion for health reasons. We report time-specific marginal predicted probabilities for those denied (who gave birth and did not give birth) and those who obtained abortion.</div></div><div>Women seeking abortion at 22 facilities across Nepal in 2019–2020 completed surveys every six months for five years. This longitudinal cohort study assessed limited mobility, self-rated poor health, and chronic pain using weighted linear and logistic mixed effects regression, including among those seeking abortion for health reasons. We report time-specific marginal predicted probabilities for those denied (who gave birth and did not give birth) and those who obtained abortion.</div><div><h3>Findings</h3><div>Of the sample (n = 1742), 51% obtained care (Abortions), 15% gave birth (Turnaway-Births), and 33% were denied but did not give birth (Turnaway-NoBirths). Risk of any limited mobility was 15 percentage points higher (95% CI: 7%, 22%, p = 0.0001) for Turnaway-Births (predicted probability: 47%) versus Abortions (32%), and 2.5 days longer on average (95% CI: 1.42, 3.59, p < 0.0001; 5.3 versus 2.8 days); differences were larger among those seeking abortion for health reasons. Self-rated poor health, pelvic pain, and head pain did not differ for Turnaway-Births versus Abortions overall. Among the subsample, Turnaway-Births had poorer self-rated health at 18 months (0.09, [0.01, 0.16], p = 0.026), more back pain at 24–36 months (maximum risk difference: 0.17 [0.04, 0.31], p = 0.012), and less pelvic pain at 6 months (−0.08, [−0.015, −0.01], p = 0.036) compared to the Abortions.</div></div><div>Of the sample (n = 1742), 51% obtained care (Abortions), 15% gave birth (Turnaway-Births), and 33% were denied but did not give birth (Turnaway-NoBirths). Risk of any limited mobility was 15 percentage points higher (95% CI: 7%, 22%, p = 0.0001) for Turnaway-Births (predicted probability: 47%) versus Abortions (32%), and 2.5 days longer on average (95% CI: 1.42, 3.59, p < 0.0","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"52 ","pages":"Article 100835"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951447","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":"Antenatal care, birth outcomes, health, development, maternal bonding and nutrition among children of women seeking abortion in a health facility in Nepal (2019–2024): a prospective cohort study","authors":"Diana Greene Foster, Rachel Murro, Corinne H. Rocca, Veronica Sharon Dahlkamp, Mahesh C. Puri","doi":"10.1016/j.lansea.2026.100831","DOIUrl":"10.1016/j.lansea.2026.100831","url":null,"abstract":"<div><h3>Background</h3><div>The consequences of abortion denial for women's lives are increasingly recognized, but little is known about the well-being of children born as a result of denied abortion. We compared early childhood outcomes between children born due to abortion denial (index children) and children born from a subsequent pregnancy after their mother received an abortion (subsequent children).</div></div><div>The consequences of abortion denial for women's lives are increasingly recognized, but little is known about the well-being of children born as a result of denied abortion. We compared early childhood outcomes between children born due to abortion denial (index children) and children born from a subsequent pregnancy after their mother received an abortion (subsequent children).</div><div><h3>Methods</h3><div>Longitudinal data from the five-year prospective cohort Nepal Turnaway Study (2019–2024) include index children and subsequent children. We assessed nutritional status, health, development, and household conditions through maternal report and direct anthropometric measurement. We employed mixed effects models with propensity score weighting to balance differences in maternal characteristics at time of abortion-seeking.</div></div><div>Longitudinal data from the five-year prospective cohort Nepal Turnaway Study (2019–2024) include index children and subsequent children. We assessed nutritional status, health, development, and household conditions through maternal report and direct anthropometric measurement. We employed mixed effects models with propensity score weighting to balance differences in maternal characteristics at time of abortion-seeking.</div><div><h3>Findings</h3><div>Differences between index (n = 274) and subsequent (n = 421) children are to the detriment of index children. Disadvantage starts before birth when their mothers reported more limited diets in terms of green leafy vegetables and sufficient quantity of food. Index children are more likely than subsequent children to be born at home OR = 1.91 (95% CI: 1.01–3.61), less than 24 months from an older sibling OR = 21.26 (95% CI: 4.39–102.85) and at a birthweight below 2500<em>g</em> OR = 1.92 (95% CI: 1.17–3.16). In their first years of life, index children were more likely than subsequent children to live in households with inadequate income (42.3% vs 31.8% p = 0.009), experience acute malnutrition (25.3% vs 17.4% p = 0.011); and die (0.7% vs 0.2% p = 0.038).</div></div><div>Differences between index (n = 274) and subsequent (n = 421) children are to the detriment of index children. Disadvantage starts before birth when their mothers reported more limited diets in terms of green leafy vegetables and sufficient quantity of food. Index children are more likely than subsequent children to be born at home OR = 1.91 (95% CI: 1.01–3.61), less than 24 months from an older sibling OR = 21.26 (95% CI: 4.39–102.85) and at a birthweight below 2500<em>g</em> OR = 1.","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"52 ","pages":"Article 100831"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951332","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":"The impact of abortion denial on women’s empowerment in Nepal (2019–2024): a prospective cohort study","authors":"Nadia G. Diamond-Smith, Diana Greene Foster, Mahesh C. Puri, Rachel Murro, Anupama Ale Magar, M Antonia Biggs","doi":"10.1016/j.lansea.2026.100833","DOIUrl":"10.1016/j.lansea.2026.100833","url":null,"abstract":"<div><h3>Background</h3><div>There has long been an interest in the association between family planning (contraception and abortion) and women’s empowerment, with mixed evidence as to an association and most studies relying on cross sectional data. Within this body of work, less focus has been on how family planning impacts women’s empowerment The aim of this study is to understand the impact of abortion denial resulting in having an unwanted birth on women’s empowerment, measured by education, mobility and decision-making.</div></div><div>There has long been an interest in the association between family planning (contraception and abortion) and women’s empowerment, with mixed evidence as to an association and most studies relying on cross sectional data. Within this body of work, less focus has been on how family planning impacts women’s empowerment The aim of this study is to understand the impact of abortion denial resulting in having an unwanted birth on women’s empowerment, measured by education, mobility and decision-making.</div><div><h3>Methods</h3><div>In the Nepal Turnaway Study, we followed women seeking abortions from 2019 to 2020 in Nepal and assessed whether receiving versus being denied an abortion was negatively associated with women’s empowerment over five years (longitudinal cohort). We used linear and logistic mixed effects regression models to assess the effects of obtaining an abortion compared to carrying an unwanted pregnancy to term on education, mobility outside the home and household decision-making power.</div></div><div>In the Nepal Turnaway Study, we followed women seeking abortions from 2019 to 2020 in Nepal and assessed whether receiving versus being denied an abortion was negatively associated with women’s empowerment over five years (longitudinal cohort). We used linear and logistic mixed effects regression models to assess the effects of obtaining an abortion compared to carrying an unwanted pregnancy to term on education, mobility outside the home and household decision-making power.</div><div><h3>Findings</h3><div>We followed 1742 for 5 years and find that women who did not give birth were more likely to be in school (Risk Difference (RD) = 0.2 starting 18 months post-abortion seeking) and have greater decision-making power over five years (Risk Difference (RD) = −0.2 starting 12 months post-abortion seeking) and both of these continued for the remainder of the time period. We find no evidence that giving birth affects a woman’s freedom to leave her home for shopping or connections to family and friends.</div></div><div>We followed 1742 for 5 years and find that women who did not give birth were more likely to be in school (Risk Difference (RD) = 0.2 starting 18 months post-abortion seeking) and have greater decision-making power over five years (Risk Difference (RD) = −0.2 starting 12 months post-abortion seeking) and both of these continued for the remainder of the time period. We find no evidence that giving","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"52 ","pages":"Article 100833"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951446","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":"Southeast Asia's blind spot in reproductive health: from legal measures to lived access","authors":"The Lancet Regional Health – Southeast Asia","doi":"10.1016/j.lansea.2026.100856","DOIUrl":"10.1016/j.lansea.2026.100856","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"52 ","pages":"Article 100856"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148952088","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":"Scale of unmet solid organ transplantation need in India: a projection for organ transplant need by 2040","authors":"Hari Shankar Meshram,&nbsp;Sanshriti Chauhan,&nbsp;Vivek Kute,&nbsp;Manish Balwani,&nbsp;Saurabh Puri","doi":"10.1016/j.lansea.2026.100824","DOIUrl":"10.1016/j.lansea.2026.100824","url":null,"abstract":"<div><h3>Background</h3><div>Solid organ transplantation (SOT) is the definitive therapy for end-stage organ failure. Despite the world's third-highest transplant volume, India has no systematic assessment of unmet transplant need across organs.</div></div><div><h3>Methods</h3><div>We modelled 1) Global Burden of Disease 2021 organ-specific disease incidence. 2) Global Observatory on Donation and Transplantation for SOT data, and 3) IHME demographic projections till 2040. Evidence based eligibility multipliers (kidney 5%, liver 2%, heart 1%, lung 0.3%), were applied for SOT need. We modelled four transplant supply scenarios (flat supply, pre-COVID-19 trend, moderate reform (8–10%/year growth), and aspirational expansion) to estimate coverage and unmet demand.</div></div><div><h3>Findings</h3><div>In 2021, estimated annual transplant need was 125,894 (95% uncertainty interval 115,983–136,156) kidney; 184,542 (169,563–198,686) liver; 83,841 (65,602–99,462) heart; and 11,253 (10,285–11,606) lung transplants. Actual supply met only 7.2% of kidney, 1.5% of liver, 0.2% of heart, and 1.2% of lung need. By 2040, need is projected to reach 143,722 kidney, 210,649 liver, 95,711 heart, and 12,846 lung transplants annually. Even under moderate reform, 2040 coverage reaches only 32.6% for kidney and remains below 7% for liver, heart, and lung. In 2024, five states accounted for 80–96% of SOT despite representing only 29% of the population.</div></div><div><h3>Interpretation</h3><div>Our report quantifies a large and persistent gap between transplant need and supply in India. Thus, this study provides a quantitative basis for national and state-level planning to expand organ donation programs.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"51 ","pages":"Article 100824"},"PeriodicalIF":6.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148642475","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":"Strategies for strengthening eye care in India: a consensus-based recommendations","authors":"Taraprasad Das,&nbsp;Rohit Khanna,&nbsp;Radhika Krishnan,&nbsp;Umang Mathur,&nbsp;Somasheila Murthy,&nbsp;Maneck Nicholson,&nbsp;Dhivya Ramasamy,&nbsp;Varsha Rathi,&nbsp;Thulsiraj D. Ravilla,&nbsp;Shalinder Sabherwal","doi":"10.1016/j.lansea.2026.100791","DOIUrl":"10.1016/j.lansea.2026.100791","url":null,"abstract":"<div><div>India is committed to the World Health Organization (WHO) and the International Agency for the Prevention of Blindness “2030 In Sight” recommendations to improve eye health and visual impairment. Public health experts in India were invited to discuss and recommend strategies to reduce blindness by 2030 and consolidate the gains related to quality eye care by 2047. The experts reviewed the World Report on Vision, WHO’s 2030 In Sight strategy, and the status of eye care in India, drawing on published literature and policy documents. They proposed 10 interlinked strategic pillars: universal coverage, human resources, financial sustainability, equity, partnerships, health information systems, quality care, elderly and marginalised eyecare, technology adoption, and monitoring of key indices. Using the Likert scale the experts arrived at consensus on the following recommendations: task shifting, measuring quality eyecare indicators, integrating health services, leveraging technology, expanding cashless services, and improving referral eyecare system. The recommendations also include target-oriented spending, centralised management of available resources, and interministerial commitment.</div></div><div><h3>Funding</h3><div>Hyderabad Eye Research Foundation, Hyderabad, India.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"51 ","pages":"Article 100791"},"PeriodicalIF":6.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148736966","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":"Ultra-processed and High fat-salt-sugar (HFSS) foods in India: a dual-axis framework for regulation","authors":"Sneha Chakraborty,&nbsp;SubbaRao M. Gavaravarapu,&nbsp;Samarasimha Reddy N,&nbsp;Bharati Kulkarni","doi":"10.1016/j.lansea.2026.100823","DOIUrl":"10.1016/j.lansea.2026.100823","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"51 ","pages":"Article 100823"},"PeriodicalIF":6.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586149","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":"Substance use risk among school going adolescents in India: secondary analysis of Community Based Peer-Led Intervention (CPLI) trial","authors":"U. Venkatesh,&nbsp;Mahashweta Chakrabarty,&nbsp;Palanivel Chinnakali,&nbsp;Krupal Joshi,&nbsp;Sudip Bhattacharya,&nbsp;Aravind P. Gandhi,&nbsp;Rashmi Agarwalla,&nbsp;Richa Tripathi,&nbsp;Vinoth Rajendran,&nbsp;Anand Mohan Dixit","doi":"10.1016/j.lansea.2026.100821","DOIUrl":"10.1016/j.lansea.2026.100821","url":null,"abstract":"<div><h3>Background</h3><div>Adolescent substance use is an increasing public health concern in India, yet multicentre studies are limited. In this study we aimed to understand variation in substance use risk across multiple schools in selected districts of India.</div></div><div><h3>Methods</h3><div>This study utilised cross-sectional baseline data from a multi-centre cluster randomised trial on peer-led intervention to reduce substance use, it included 6168 adolescents from 108 schools across six Indian districts (2025–2026). Substance use risk was assessed through self-reporting of participants using the WHO Alcohol, Smoking and Substance Involvement Screening Test and personality traits were assessed using the Substance Use Risk Profile Scale (SURPS). Determinants were examined using three-level multilevel ordinal logistic regression models accounting for clustering at school levels. Inter-district disparities were investigated using Fairlie decomposition.</div></div><div><h3>Findings</h3><div>Highest substance use risk was observed in selected schools of Guwahati and lowest in Nagpur and Puducherry. Higher accessibility to substances (high: aOR 1.75, 95% CI: 1.36–2.26), high digital exposure (aOR 1.44, 95% CI: 1.16–1.79), and favourable attitudes towards substance use (aOR 1.30, 95% CI: 1.01–1.69) were associated with increased risk, whereas male adolescents had lower odds than females (aOR 0.74, 95% CI: 0.62–0.88). The Guwahati–Nagpur prevalence gap was 35.1 percentage points, of which 37.9% was explained by observed characteristics, mainly school characteristics, socio-demographic and economic factors, and personality traits.</div></div><div><h3>Interpretation</h3><div>Substance use risk among adolescents in India varies substantially across settings. Context-specific strategies targeting digital exposure, and local environments may help reduce inequalities in substance use risk.</div></div><div><h3>Funding</h3><div>This study is supported by Indian Council of Medical Research, Extramural Research Grant (2024-01-00480).</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"51 ","pages":"Article 100821"},"PeriodicalIF":6.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586173","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":"Organ donation in India: a big gap to fill","authors":"The Lancet Regional Health – Southeast","doi":"10.1016/j.lansea.2026.100843","DOIUrl":"10.1016/j.lansea.2026.100843","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"51 ","pages":"Article 100843"},"PeriodicalIF":6.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148736965","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":"Beyond the numbers: interpreting the rise in student suicide deaths in India","authors":"Rakhi Dandona,&nbsp;G. Anil Kumar,&nbsp;Rajesh Sagar","doi":"10.1016/j.lansea.2026.100822","DOIUrl":"10.1016/j.lansea.2026.100822","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"51 ","pages":"Article 100822"},"PeriodicalIF":6.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586181","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}