BMC Health Services Research最新文献

{"title":"Correction: Assessing inequality of opportunity in access to maternal healthcare services in Pakistan: A quantitative attempt.","authors":"Jawad Rahim Afridi, Sajjad Ahmad Jan, Muhammad Farhan Asif","doi":"10.1186/s12913-025-13525-8","DOIUrl":"10.1186/s12913-025-13525-8","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1280"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transitioning a large-scale HIV/AIDS treatment program from an international partner to a local Nigerian implementing partner: a before-after early outcomes assessment study.","authors":"David Ochedomi Ekele, Inichinbia Boniface, Bonaventure Michael Ukoaka, Otoyo Toyo, Uduak Akpan, Esther Nwanja, Kolawole Olatunbosun, Augustine Idemudia, Pius Nwaokoro, Onwah Ogheneuzauzo, Nkemjika Uwakwe, Hope Udokor, Dolapo Ogundehin, Ezekiel James, Abutu Inedu, Adeoye Adegboye, Okezie Onyedinachi, Andy Eyo","doi":"10.1186/s12913-025-13386-1","DOIUrl":"10.1186/s12913-025-13386-1","url":null,"abstract":"<p><strong>Background: </strong>HIV prevention, treatment, and care across the globe have been heavily dependent on donor funding and international aid, particularly across the Global South, with the highest contribution from the United States Government (USG) through PEPFAR. PEPFAR's shift towards HIV care sustainability involves transitioning HIV/AIDS treatment programs from international to local partners. Despite the increasing focus on these transitions, there is limited evidence of effective models and the outcome of such transitions, particularly in low- and middle-income countries like Nigeria. This study evaluates the transition of a large-scale HIV/AIDS program from an international implementing partner (FHI 360) to a local partner, Excellence Community Education Welfare Scheme (ECEWS) in Nigeria, highlighting the processes and early outcomes.</p><p><strong>Methods: </strong>The study used a before-after design to analyse programme data from Akwa Ibom and Cross River States, comparing indicators before, during and after the transition of HIV services from FHI 360 to the local partner ECEWS. A transition model was developed with stakeholder engagement. De-identified client data were abstracted from the Electronic Medical Records and District Health Information System (DHIS2) database for the pre-transition period (January-June 2022) and post-transition period (July-December 2022) and compared. Outcomes compared included HIV testing services, on-schedule refill appointments, and viral load testing uptake. Statistical analyses were performed using STATA version 14, with significance at p < 0.05.</p><p><strong>Results: </strong>A total of 405,702 individuals were tested for HIV between January 2022 and December 2022, with 116,138 (29%) tested before and 289,564 (71%) tested after the transition period. The average number of monthly tests increased by 149%, from 19,356 to 48,260 (p = 0.001), between the two periods. Additionally, on-schedule refill appointments improved significantly post-transition, increasing from 97.8 to 98.2% (p < 0.001), while viral load testing uptake improved from 96 to 99%. Success was attributed to comprehensive planning, strong stakeholder engagement, flexible communication strategies, and a robust monitoring and evaluation (M&E) system, which were outcomes of the transition model.</p><p><strong>Conclusion: </strong>HIV/AIDS treatment program transitions to indigenous partners can be successfully achieved without compromising service accessibility, care quality, or treatment outcomes. Our study findings highlight the importance of collaborative planning in sustaining program outcomes during transitions with the aim of sustaining service delivery during this period. A systematic approach, utilising a well-structured transition model, facilitates a seamless transfer and provides a strategic framework for Nigerian programs.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1259"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fast-tracking international health regulations in Sierra Leone through implementation of the third edition of Integrated Disease Surveillance and Response (IDSR) guidelines during COVID-19 pandemic, 2019-2021: a mixed methods study.","authors":"Charles Njuguna, Mohamed Vandi, James Sylvester Squire, Joseph Sam Kanu, Wilson Gachari, Ian Njeru, Bridget Magoba, Jane Githuku, Victor Caulker, Mugagga Malimbo, Stephen Sesay, Aminata Tigiedankay Koroma, Robert Musoke, Innocent Bright Nuwagira, Boukare Bonkoungou, Etien Luc Koua, Ambrose Otau Talisuna, Zabulon Yoti, Dick Damas Chamla, Abdou Salam Gueye","doi":"10.1186/s12913-025-13498-8","DOIUrl":"10.1186/s12913-025-13498-8","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1264"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary health care roles of community pharmacists in low- and middle-income countries: a mixed methods systematic review.","authors":"Erick Wesley Hedima, Roland Nnaemeka Okoro","doi":"10.1186/s12913-025-13387-0","DOIUrl":"10.1186/s12913-025-13387-0","url":null,"abstract":"<p><strong>Background: </strong>Community pharmacists (CPs) play vital roles in primary healthcare (PHC), yet they are not officially recognised as PHC providers, particularly in low- and middle-income countries (LMICs).</p><p><strong>Objectives: </strong>This review aims to uncover the provision of PHC services by CPs in LMICs and identify barriers to these services, as well as strategies to overcome them.</p><p><strong>Methods: </strong>Medline, CINAHL, Google Scholar, and others were searched for articles published between 2000 and 2022 that reported on CPs' provision of PHC services in LMICs. Eligible studies were evaluated, and data were extracted and assessed for quality using the mixed methods appraisal tool (MMAT).</p><p><strong>Results: </strong>Only 13 studies had a high quality rating, less than a quarter (n = 23) of the articles were of considerable quality while 34 had moderate quality. Additionally, 10 articles met the low-quality rating at the same time, four articles were considered to be of very low quality. The most common PHC services reported were health education, referral to GPs, medication review, point-of-care testing, screening, self-care for chronic illnesses (n = 41 studies), and promoting access to sexual and reproductive health as well as essential medicines (n = 16 studies). The major hindrances to PHC activities included unfriendly government policies (n = 25 studies), lack of time and effective collaboration (n = 13 studies), physical barriers and limited knowledge in patient care (n = 11 studies). The majority of studies recommended enacting pharmacy-friendly policies to designate CPs as PHC providers (n = 20 studies) and continuous professional development programmes (n = 16 studies).</p><p><strong>Conclusion: </strong>Pharmacists in LMICs play a vital role in PHC despite the presence of some barriers. Policies that recognise pharmacists as PHC providers and continuous training could improve their services.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1269"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How hospital doctors respond to contextual factors revealed by older patients with heart failure in hospital interactions: an interaction-based study.","authors":"Herman Bjørnstad, Christine Frigaard, Pål Gulbrandsen, Jennifer Gerwing, Henrik Schirmer, Julia Menichetti","doi":"10.1186/s12913-025-13505-y","DOIUrl":"10.1186/s12913-025-13505-y","url":null,"abstract":"<p><strong>Background: </strong>Patients with heart failure often face individual context-dependent challenges that affect their ability to follow a treatment plan. How hospital doctors recognize and respond to such contextual factors (CF) may influence health outcomes. This study aims to identify adherence related CF disclosed by older patients with heart failure during hospital interactions and to examine how doctors respond to them.</p><p><strong>Methods: </strong>Audio-recordings from two key hospital interactions were collected from 42 older patients with heart failure. Occurrences of CF were identified based on a previously developed coding scheme and followed during the hospital interactions. We then analysed doctor's responses to patient's CF and categorized them as: (1) Solution-oriented, (2) Exploring (3) No follow-up.</p><p><strong>Results: </strong>We identified 58 CF across 113 occurrences in 27 (64%) patients. Medication-related CF (47%) were the most frequently disclosed, followed by patient-specific (34%), condition-related (12%), and healthcare system-related factors (7%). Doctors' responses varied: 26% (n = 15) of CF received no follow-up, 21% (n = 12) were only explored, 24% (n = 14) were explored and met with a solution-oriented action, and 29% (n = 17) were met with solution-oriented actions without any exploration from the doctor.</p><p><strong>Conclusions: </strong>Older patients with heart failure often disclose important CF relevant to adherence during hospital interactions. Roughly half of these factors are not met with a solution-oriented response, with a substantial portion not being followed up by the doctors at all. Future research should explore how to better improve doctors' ability to recognize and appropriately respond to CF disclosed by patients.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1273"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disposal practices of unused and expired medications among healthcare practitioners in Ibadan, Nigeria: results from a cross-sectional survey.","authors":"Wuraola Akande-Sholabi, Iman A Abdul-Azeez, Yusuff A Adebisi, Taofik O Odukoya, Temitope Ilori","doi":"10.1186/s12913-025-13492-0","DOIUrl":"10.1186/s12913-025-13492-0","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1262"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic disparities and (non)adherence in standardized treatment: implications through an equity lens.","authors":"Nina Halberg, Mari Holen, Trine Schifter Larsen","doi":"10.1186/s12913-025-13477-z","DOIUrl":"10.1186/s12913-025-13477-z","url":null,"abstract":"<p><strong>Background: </strong>In order to achieve optimal outcomes for patients, standardized treatment has gained traction in recent years. By unifying care based on the best available evidence, standardized treatment has been described as a means to mitigate health disparities. Despite this aim, ethnic and racial disparities are well-described. Standardized treatment depends on adherence from patients. However, how staff position patients' health behavior and assess, adapt, and intervene to improve adherence is underexplored. In this article, we aim to investigate how ethnically minoritized patients' health behavior is positioned under a gaze of (non)adherence.</p><p><strong>Methods: </strong>This is an ethnographic study based on nine months of fieldwork in two orthopedic departments in Denmark. The work of both departments is based on the standardized concept of Enhanced Recovery After Surgery (ERAS). The participants include patients (n = 13), relatives (n = 6), and hospital staff (n = 79). The data were analyzed using abductive analysis.</p><p><strong>Results: </strong>The analysis shows that when ethnically minoritized patients were positioned as nonadherent, the staff drew on essentialist and stereotypical problematizations of ethnicity to accommodate perceived differences. In this manner, ethnicity was connected to ideas of cultural food habits, collectivist family structures and un-stoic and exaggerated pain behavior.</p><p><strong>Conclusions: </strong>This paper advances knowledge on how inequitable care and treatment manifests in clinical practice, illustrating how dominant understandings and conceptualizations at the intersections of health, ethnicity, and (non)adherence produce marginalization in standardized pathways. Ultimately, perceived non-adherence has important consequences for minoritized patients, as we find that it causes potential inaccessibility to standardized pathways due to ideas of ineligibility, undertreatment of pain, as well as underrepresentation of minorities in patient seminars and even same-day surgeries.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1267"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A sex- and gender-based analysis plus of frequent healthcare utilization among individuals living with chronic pain: a cohort study.","authors":"Marimée Godbout-Parent, Nancy Julien, Hermine Lore Nguena Nguefack, M Gabrielle Pagé, Line Guénette, Lucie Blais, Anaïs Lacasse","doi":"10.1186/s12913-025-13374-5","DOIUrl":"10.1186/s12913-025-13374-5","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1261"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficiency and productivity of county-level CDCs in Qingdao municipal, China: a retrospective study based on 6 years of panel data.","authors":"Chongyi Wang, Kunzheng Lyu, Dan Lin, Mile Lin, Ying Zhang, Ayan Mao, Yujie Yang, Wuqi Qiu","doi":"10.1186/s12913-025-13478-y","DOIUrl":"10.1186/s12913-025-13478-y","url":null,"abstract":"<p><strong>Background: </strong>County-level Centers for Disease Control and Prevention (CDCs) are the foundational units of China's public health system. The COVID-19 pandemic has highlighted the shortcomings of the system, making it urgent to strengthen the functions of county-level CDCs. The efficiency and equity of resource allocation are crucial for enhancing public health outcomes. Therefore, this study aimed to evaluate six-year trends (2018-2023) in equity and efficiency of resource allocation among the ten county-level CDCs in Qingdao and to identify actionable measures for optimizing grassroots public-health capacity in the post-COVID-19 era.</p><p><strong>Methods: </strong>We used Gini coefficient and Lorenz curve to assess the equity of resource allocation in the county-level CDCs in Qingdao. The efficiency of CDCs was evaluated using data envelopment analysis (DEA) and Bootstrap DEA. Efficiency change was analyzed by employing the Malmquist productivity index (MPI).</p><p><strong>Results: </strong>The health resources at the Qingdao CDCs showed an overall upward trend from 2018 to 2023. During 2018-2023, CDC personnel allocation showed good equity in demographic and economic dimensions (Gini < 0.3), but suboptimal equity in geographic distribution (Gini 0.3-0.5). The average technical efficiency was 0.940, pure technical efficiency averaged 0.995, and scale efficiency was 0.944. Among 10 CDCs, 50% achieved DEA efficiency. According to the total factor productivity (TFP) reflected by the indicator system constructed in this study, TFP grew at a rate of 6.0% between 2022 and 2023. Changes in technical efficiency change (TEC) and scale efficiency change (SEC) generally exceeded those in technological progress (TC).</p><p><strong>Conclusion: </strong>In order to enhance the equity and efficiency of resource allocation in county-level CDCs in Qingdao City. The government needs to adopt targeted policies, such as implementing flexible staffing adjustments, increasing the number of technical personnel and senior experts, and strengthening continuous training to enhance workforce capabilities. Also, fiscal efficiency should be enhanced by linking fund allocation with performance evaluation. Meanwhile, accelerating technological modernization and enhancing technological capabilities through digital tools and management innovation are crucial. Overall, these comprehensive measures aim to enhance resource utilization efficiency and strengthen the resilience of public health services.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1275"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic discharge summary design: a step towards electronic health record ophthalmology patients.","authors":"Bahare Zafarnezhad, Javad Sadeghi, Sanaz Abasi, Shamim Kiani, Marziyhe Meraji","doi":"10.1186/s12913-025-13462-6","DOIUrl":"10.1186/s12913-025-13462-6","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1250"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}