BMJ Global Health最新文献

{"title":"Reducing family and school-based violence at scale: a large-scale pre-post study of a parenting programme delivered to families with adolescent girls in Tanzania.","authors":"Jamie Lachman, Joyce Wamoyi, Mackenzie Martin, Qing Han, Francisco Antonio Calderón Alfaro, Samwel Mgunga, Esther Nydetabura, Nyasha Manjengenja, Mwita Wambura, Yulia Shenderovich","doi":"10.1136/bmjgh-2024-015472","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-015472","url":null,"abstract":"<p><strong>Background: </strong>Parenting programmes, including those delivered in the Global South, are effective strategies to reduce violence against children (VAC). However, there is limited evidence of their impact when implemented at scale within routine delivery systems. This study aimed to address this gap by evaluating the real-world delivery of Parenting for Lifelong Health for Teens in Tanzania.</p><p><strong>Methods: </strong>Participating parents/caregivers and their adolescent girls were recruited by local implementing partners in 2020-2021 as part of a community-based HIV prevention initiative focused on addressing drivers of female adolescent HIV-vulnerability such as VAC, caregiver-adolescent relationships and sexual reproductive health communication. The 14-session, group-based parenting programme was delivered by trained teachers and community facilitators. Quantitative surveys administered by providers measured a variety of outcomes including child maltreatment (primary outcome) and multiple secondary outcomes linked to increased risk of VAC. Multilevel models examined pre-post effects as well as variation by attendance and baseline demographic variables.</p><p><strong>Results: </strong>Pre-post data from 27 319 parent/caregiver-child dyads were analysed, of which 34.4% of parents/caregivers were male. Analyses showed large reductions in child maltreatment (parents/caregivers: IRR=0.55, (95% CI 0.54, 0.56); adolescents: IRR=0.57, (95% CI 0.56, 0.58)), reduced intimate partner violence experience, reduced school-based violence, increased communication about sexual health, reduced poor supervision, reduced financial insecurity, reduced parenting stress, reduced parent and adolescent depression, and reduced adolescent conduct problems. In contrast to these positive outcomes, parents/caregivers and adolescents also reported reduced parental positive involvement and support of education, with those experiencing greater adversity reporting less change than those with less adversity.</p><p><strong>Conclusions: </strong>This study is the first to examine the large-scale implementation of an evidence-based parenting programme in the Global South. Although additional research is necessary to examine potential negative effects on positive parenting and parent support of education, findings suggest that Furaha Teens can sustain its impact on key outcomes associated with VAC when delivered at scale.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 11","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal mortality following caesarean section in a low-resource setting: a National Malawian Surveillance Study.","authors":"Jennifer Riches, Yamikani Chimwaza, Bertha Immaculate Magreta Chakhame, Jack Milln, Hussein H Twabi, Rosemary Bilesi, Luis Gadama, Fannie Kachale, Annie Kuyere, Lumbani Makhaza, Regina Makuluni, Laura Munthali, Owen Musopole, Chifundo Ndamala, Deborah A Phiri, Louise Afran, Amie Wilson, Shakila Thangaratinam, Abi Merriel, Catriona Waitt, Maria Lisa Odland, James Jafali, David Lissauer","doi":"10.1136/bmjgh-2024-016999","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-016999","url":null,"abstract":"<p><strong>Background: </strong>Caesarean section (CS) is the most common major surgery conducted globally, with rates rising. CS also contributes to maternal morbidity and mortality, with increased risks in low-resource settings. We conducted a detailed review of maternal deaths from 2020 to 2022 in Malawi to determine the burden of deaths related to CS, avoidable health system factors, and causes of death associated with this procedure.</p><p><strong>Methods: </strong>Data were collected regarding every maternal death occurring across all district and central hospitals in Malawi, alongside facility-level aggregated birth data. Maternal deaths were reviewed by facility-based multidisciplinary teams with subsequent confirmation of cause of death by obstetricians according to international criteria. Logistic regression was applied to estimate the odds of associations of leading causes of death with CS while adjusting for potential confounders.</p><p><strong>Results: </strong>Despite a low national CS rate, most deaths occurred following CS (51.8%, 276/533). Women who delivered by CS were five times (OR 5.60, 95% CI 4.74 to 6.67) more likely to die than women who delivered vaginally. The leading causes of death following CS were postpartum haemorrhage (26.0%, 68/277), eclampsia (15.6%, 41/277) and infection (14.1%, 37/277). Deaths from pregnancy-related infection were more often associated with CS (OR 2.03, 95% CI 1.12 to 3.72). Health system factors more frequently associated with deaths following CS than vaginal birth included 'prolonged abnormal observations without action' (p=0.006), 'delay in starting treatment' (p=0.006) and 'lack of blood transfusion' (p=0.03).</p><p><strong>Conclusions: </strong>We found a high burden of maternal death following CS in this low-resource setting. Until now, international attention and many clinical trials have been focused on improving the safety of vaginal birth. Our findings highlight the need to ensure the safe and appropriate use of this potentially life-saving intervention to reduce maternal deaths. To avoid the high burden of death following CS we highlight, there is urgent need to develop and trial CS-specific interventions.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 11","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing alcohol industry penetration and government safeguards: the International Alcohol Control Study.","authors":"June Yue Yan Leung, Sally Casswell, Steve Randerson, Lathika Athauda, Arvind Banavaram, Sarah Callinan, Orfhlaith Campbell, Surasak Chaiyasong, Song Dearak, Emeka W Dumbili, Laura Romero-García, Gopalkrishna Gururaj, Romtawan Kalapat, Khem Karki, Thomas Karlsson, Mom Kong, Shiwei Liu, Norman Danilo Maldonado Vargas, Juan Felipe Gonzalez-Mejía, Timothy Naimi, Keitseope Nthomang, Opeyemi Oladunni, Kwame Owino, Juan Camilo Herrera Palacio, Phasith Phatchana, Pranil Man Singh Pradhan, Ingeborg Rossow, Gillian Shorter, Vanlounny Sibounheuang, Mindaugas Štelemėkas, Dao The Son, Kate Vallance, Wim van Dalen, Ashley Wettlaufer, Arianne Zamora, Jintana Jankhotkaew","doi":"10.1136/bmjgh-2024-016093","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-016093","url":null,"abstract":"<p><strong>Background: </strong>The alcohol industry uses many of the tobacco industry's strategies to influence policy-making, yet unlike the Framework Convention on Tobacco Control, there is no intergovernmental guidance on protecting policies from alcohol industry influence. Systematic assessment of alcohol industry penetration and government safeguards is also lacking. Here, we aimed to identify the nature and extent of industry penetration in a cross-section of jurisdictions. Using these data, we suggested ways to protect alcohol policies and policy-makers from undue industry influence.</p><p><strong>Methods: </strong>As part of the International Alcohol Control Study, researchers from 24 jurisdictions documented whether 22 indicators of alcohol industry penetration and government safeguards were present or absent in their location. Several sources of publicly available information were used, such as government or alcohol industry reports, websites, media releases, news articles and research articles. We summarised the responses quantitatively by indicator and jurisdiction. We also extracted examples provided of industry penetration and government safeguards.</p><p><strong>Results: </strong>There were high levels of alcohol industry penetration overall. Notably, all jurisdictions reported the presence of transnational alcohol corporations, and most (63%) reported government officials or politicians having held industry roles. There were multiple examples of government partnerships or agreements with the alcohol industry as corporate social responsibility activities, and government incentives for the industry in the early COVID-19 pandemic. In contrast, government safeguards against alcohol industry influence were limited, with only the Philippines reporting a policy to restrict government interactions with the alcohol industry. It was challenging to obtain publicly available information on multiple indicators of alcohol industry penetration.</p><p><strong>Conclusion: </strong>Governments need to put in place stronger measures to protect policies from alcohol industry influence, including restricting interactions and partnerships with the alcohol industry, limiting political contributions and enhancing transparency. Data collection can be improved by measuring these government safeguards in future studies.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 11","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in tobacco and alcohol consumption during the COVID-19 pandemic in India: a propensity score matching approach.","authors":"Amit Summan, Ramanan Laxminarayan","doi":"10.1136/bmjgh-2023-013295","DOIUrl":"https://doi.org/10.1136/bmjgh-2023-013295","url":null,"abstract":"<p><strong>Objectives: </strong>The COVID-19 pandemic may have influenced alcohol and tobacco consumption in low-income and middle-income countries, yet the effects are relatively unknown. In this study, we estimated the medium-term effects of the pandemic on tobacco and alcohol consumption in India.</p><p><strong>Methods: </strong>We used data from the fifth round of the National Family Health Survey 2019-2021, a nationally representative survey conducted between June 2019 and April 2021. We employed propensity score matching to evaluate the change in tobacco and alcohol consumption patterns by exploiting the gap in survey activities due to the pandemic lockdown-no data collection took place from April to October 2020. Individuals surveyed after the lockdown were considered COVID-19-affected, while those surveyed before were considered as unaffected.</p><p><strong>Results: </strong>The tobacco use rate was 1.4% lower and alcohol consumption was 0.3% lower for COVID-19-affected individuals relative to non-affected individuals. By tobacco product, there was a 0.9%, 0.6% and 0.4% decrease in the use of smokeless tobacco, cigarettes and bidi, respectively. Recent initiation decreased by 2.3%, 1.6% and 1.4%, for cigarettes, smokeless tobacco and alcohol, respectively. Tobacco use declined to a greater extent in low-wealth and rural populations, and in male and older subsamples. Alcohol use decreased in urban households, and among male and young subsamples, relative to their counterparts. Secondhand smoke exposure decreased by 4.6%.</p><p><strong>Conclusion: </strong>Tobacco and alcohol consumption, including recent initiation, decreased during the pandemic in India. Varying effects by subgroups suggest the need for targeted future control policies that support cessation and limit consumption.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 11","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Data for whom?</i> Experiences and perceptions of a perinatal eRegistry in two hospitals in Mtwara region, Tanzania.","authors":"Jil Molenaar, Amani Kikula, Yusufu Kionga, Hassan Tearish Berenge, Lenka Benova, Josefien van Olmen, Claudia Hanson, Muzdalifat Abeid, Andrea Barnabas Pembe","doi":"10.1136/bmjgh-2024-016765","DOIUrl":"10.1136/bmjgh-2024-016765","url":null,"abstract":"<p><strong>Introduction: </strong>Digital data systems have the potential to improve data quality and provide individual-level information to understand gaps in the quality of care. This study explored experiences and perceptions of a perinatal eRegistry in two hospitals in Mtwara region, Tanzania. Drawing from realist evaluation and systems thinking, we go beyond a descriptive account of stakeholders' experiences and provide insight into key structural drivers and underlying social paradigms.</p><p><strong>Methods: </strong>We carried out 6 weeks of focused ethnographic observations at the labour wards of the two hospitals and 29 semi-structured qualitative interviews with labour ward staff, as well as with administrative and managerial stakeholders at hospital, district and regional levels. Multi-stage reflexive thematic data analysis was carried out.</p><p><strong>Results: </strong>We provide an in-depth account of the day-to-day functioning of the eRegistry in the two hospitals, including both aspects of positive change and key challenges with its integration into routine documentation duties. Experiences with and perceptions of the eRegistry were inextricably linked to broader systemic constraints relating to staffing, workload and infrastructure. A key underlying theme shaping the way people engaged with the eRegistry was the notion of data ownership: the presence or absence of a feeling of being responsible, involved and in control of data.</p><p><strong>Conclusion: </strong>Some of the key systemic challenges in recording accurate, timely information about women and their babies are not solved by digital tools. Our findings also underline that when healthcare workers feel that data are not primarily for them, they document only for reporting purposes. The eRegistry increased a sense of data ownership among the nurse-midwives directly involved with data entry, but the potential for promoting and supporting data use feedback loops for improvement in care provision remained largely untapped. Our findings highlight the importance of local relevance and ownership in digitisation of routine health information systems.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 11","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global development assistance for early childhood care and education in 134 low- and middle-income countries, 2007-2021.","authors":"Yiqun Luan, Dominic Hodgkin, Jere Behrman, Alan Stein, Linda Richter, Jorge Cuartas, Chunling Lu","doi":"10.1136/bmjgh-2024-015991","DOIUrl":"10.1136/bmjgh-2024-015991","url":null,"abstract":"<p><strong>Introduction: </strong>Low- and middle-income countries (LMICs) often dedicate limited domestic funds to expand quality early childhood care and education (ECCE), making complementary international donor support potentially important. However, research on the allocation of international development assistance for ECCE has been limited.</p><p><strong>Methods: </strong>We analysed data from the Creditor Reporting System on aid projects to assess global development assistance for ECCE in 134 LMICs from 2007 to 2021. By employing keyword-searching and funding-allocation methods, we derived two estimates of ECCE aid: a lower-bound estimate comprising projects primarily focusing on ECCE and an upper-bound estimate comprising projects with both primary and partial ECCE focus, as well as those that could benefit ECCE but did not include ECCE keywords. We also assessed aid directed to conflict-affected countries and to ECCE projects integrating COVID-19-related activities.</p><p><strong>Results: </strong>Between 2007 and 2021, the lower-bound ECCE aid totaled US$3646 million, comprising 1.7% of the total US$213 279 million allocated to education. The World Bank led in ECCE aid, contributing US$1944 million (53.3% out of total ECCE aid). Low-income countries received less ECCE aid per child before 2016, then started to catch up but experienced a decrease from US$0.8 (2020) per child to US$0.6 (2021) per child. Funding for ECCE projects with COVID-19 activities decreased from a total of US$50 million in 2020 to US$37 million in 2021, representing 11.4% and 6.6% of annual total ECCE aid, respectively. Over 15 years, conflict-affected countries received an average of US$0.3 per child, a quarter of the aid received by non-conflict-affected countries (US$1.2 per child).</p><p><strong>Conclusion: </strong>Although ECCE aid increased significantly between 2007 and 2021, its proportion of total educational aid fell short of UNICEF's suggested 10% minimum. Recommendations include increasing the share of ECCE aid in total educational aid, increasing aid to low-income and conflict-affected countries, and investing more in preparing ECCE programmes for future global crises.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 11","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caught between violence: Mpox virus and the perils of neglect in Africa.","authors":"Nelson Aghogho Evaborhene, Jessica Oreoluwa Oga, Yussuf Adebisi Adebayo, Newton Runyowa, Chinonso Emmanuel Okorie, Gertrude Nakanwagi, Odianosen Ehiakhamen, Marie-Claire Wangari, Afifah Rahman-Shepherd","doi":"10.1136/bmjgh-2024-017090","DOIUrl":"10.1136/bmjgh-2024-017090","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 11","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probing the past: historical case study analysis to inform more just and sustainable global health partnerships in education.","authors":"Lucy Vorobej, Dawit Wondimagegn, Yonas Baheretibebe, Belete Bizuneh, Brian Hodges, Adane Petros, Stephane Jobin, Cynthia Ruth Whitehead","doi":"10.1136/bmjgh-2024-015415","DOIUrl":"10.1136/bmjgh-2024-015415","url":null,"abstract":"<p><strong>Introduction: </strong>Disparities of power between high-income (HICs) and low- and middle-income countries (LMICs) have long characterised the structures of global health, including knowledge production and training. Historical case study analysis is an often-overlooked tool to improve our understanding of how to mitigate inequalities.</p><p><strong>Methods: </strong>Drawing from the contemporary experience of collaborators from Canada and Ethiopia, we chose to examine the historical relationship between Ethiopian Emperor Haile Selassie and Canadian Jesuit Lucien Matte as a case study for international collaborations based on the model of an 'invited guest'. We used critical historical context and qualitative content analysis methodologies to assess written correspondence between them from the 1940s to the 1970s and drew from postcolonial theory to situate this case study in a broader context.</p><p><strong>Results: </strong>The respectful and responsive relationship that developed between Emperor Haile Selassie and Lucien Matte reveals important characteristics needed for meaningful collaborations in global health education. Matte came to Ethiopia fully cognizant of the imperial context of his work and prepared to take on the position of invited guest. As a result, many of both Matte and Haile Selassie's goals were achieved. At the same time, however, this case study also revealed how problematic constructions of authoritative power can arise even when productive partnerships among individuals occur. Matte and Haile Selassie's collaboration reinscribed belief in the superiority of western theories of intellectual and social development. In addition, their prescriptive vision for education in Ethiopia repeatedly dismissed competing local positions.</p><p><strong>Conclusion: </strong>As international partnerships in global health education continue to exist and form, historical case studies offer valuable insights to guide such work. Among the most crucial arenas of knowledge is the need to understand powerful dynamics that have and continue to shape HIC-LMIC interaction. The historical case study of Matte and Haile Selassie reveals how problematic power differentials can be reinforced or mitigated.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 11","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health impact and cost-effectiveness of vaccination using potential next-generation influenza vaccines in Thailand: a modelling study.","authors":"Simon R Procter, Naomi R Waterlow, Sreejith Radhakrishnan, Edwin van Leeuwen, Aronrag Meeyai, Ben S Cooper, Sunate Chuenkitmongkol, Yot Teerawattananon, Rosalind M Eggo, Mark Jit","doi":"10.1136/bmjgh-2024-015837","DOIUrl":"10.1136/bmjgh-2024-015837","url":null,"abstract":"<p><strong>Introduction: </strong>Thailand was one of the first low- and middle-income countries to publicly fund seasonal influenza vaccines, but the lack of predictability in the timing of epidemics and difficulty in predicting the dominant influenza subtypes present a challenge for existing vaccines. Next-generation influenza vaccines (NGIVs) are being developed with the dual aims of broadening the strain coverage and conferring longer-lasting immunity. However, there are no economic evaluations of NGIVs in Thailand.</p><p><strong>Methods: </strong>We estimated the health impact and cost-effectiveness of NGIVs in Thailand between 2005 and 2009 using a combined epidemiological and economic model. We fitted the model to data on laboratory-confirmed influenza cases and then simulated the number of influenza infections, symptomatic cases, hospitalisations and deaths under different vaccination scenarios based on WHO-preferred product characteristics for NGIVs. We used previous estimates of costs and disability adjusted life years (DALYs) for influenza health outcomes to estimate incremental net monetary benefit, vaccine threshold prices and budget impact.</p><p><strong>Results: </strong>With the current vaccine programme, there were an estimated 61 million influenza infections. Increasing coverage to 50% using improved vaccines reduced infections to between 23 and 57 million, and with universal vaccines to between 21 and 49 million, depending on the age groups targeted. Depending on the comparator, threshold prices for NGIVs ranged from US$2.80 to US$12.90 per dose for minimally improved vaccines and US$24.60 to US$69.90 for universal vaccines.</p><p><strong>Conclusion: </strong>Influenza immunisation programmes using NGIVs are anticipated to provide considerable health benefits and be cost-effective in Thailand. However, although NGIVs might even be cost-saving in the long run, there could be significant budget implications for the Thai government even if the vaccines can be procured at a substantial discount to the maximum threshold price.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 11","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seven core competencies and conditions for equitable partnerships and power sharing in community-based participatory research.","authors":"Kim Ozano, Wafa Alam, Bachera Aktar, Linet Okoth, Ivy Chumo, Jessica Amegee Quach, Nelly Muturi, Samuel Saidu, Ibrahim Gandi, Neele Wiltgen Georgi, Lilian Otiso, Abu Conteh, Sally Theobald, Laura Dean, Rachel Tolhurst, Robinson Karuga, Jiban Karki, Surekha Garimella, Vinodkumar Rao, Anthony Mwanki, Nazia Islam, Sia Morenike Tengbe, Sweta Dash, Prasanna Subramanya Saligram, Sabina Rashid, Rosie Steege","doi":"10.1136/bmjgh-2024-015497","DOIUrl":"10.1136/bmjgh-2024-015497","url":null,"abstract":"<p><p>Equitable health research requires actively engaging communities in producing new knowledge to advocate for their health needs. Community-based participatory research (CBPR) relies on the coproduction of contextual and grounded knowledge between researchers, programme implementers and community partners with the aim of catalysing action for change. Improving coproduction competencies can support research quality and validity. Yet, frameworks and guidance highlighting the ideal competencies and conditions needed for all research partners to contribute meaningfully and equitably are lacking. This paper aims to advance CBPR by laying out seven core competencies and conditions that can promote power sharing in knowledge production, application and dissemination at the individual, community, organisational and systems levels.Competencies were developed through an iterative process, that synthesised pre-existing literature and frameworks with a wide range of tacit knowledge from researchers, activists, implementation partners and community researchers from Bangladesh, India, Kenya, Sierra Leone and the UK.The seven core competencies and conditions are: (1) capacity to interpret and respond to individual and relational identity, connection, uniqueness and inequities; (2) ability of communities and partners to work in the most suitable, inclusive and synergistic way; (3) aptitude for generating safe and inclusive spaces for multidirectional knowledge and skills exchange that goes beyond the research focus; (4) expertise in democratic leadership and/or facilitation to balance competing priorities and ensure shared decision-making; (5) capacity to analyse readiness for action, successes and areas for improvements throughout the research process; (6) ability to instigate sustainable change processes within the political dimensions of systems, policies and practices using advocacy, lobbying or activism approaches and (7) skills to interpret and disseminate findings and outputs that are understandable, respectful and promote community ownership. We present core competency and condition areas, individual and collective expertise associated with competencies, likely outcomes, examples of activities and sources of evidence.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 11","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}