BMJ Global Health最新文献

{"title":"Extending a parallel cluster randomised trial into a stepped-wedge cluster randomised trial: implications for interpretation.","authors":"Karla Hemming, Monica Taljaard","doi":"10.1136/bmjgh-2024-018087","DOIUrl":"10.1136/bmjgh-2024-018087","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 2","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405637","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":"The economic burden of ischaemic heart diseases on health systems: a systematic review.","authors":"Thanitsara Rittiphairoj, Caroline Bulstra, Chochat Ruampatana, Maria Stavridou, Sagar Grewal, Che L Reddy, Rifat Atun","doi":"10.1136/bmjgh-2024-015043","DOIUrl":"10.1136/bmjgh-2024-015043","url":null,"abstract":"<p><strong>Introduction: </strong>There is a dearth of evidence regarding the global economic burden of ischaemic heart diseases (IHDs). This systematic review aims to synthesise national-level studies worldwide quantifying the economic burden of IHDs from a provider's perspective.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Cochrane, DARE and EconLit databases from 1 January 2000 to 29 June 2022. We included observational, cost-of-illness and economic modelling studies reporting direct healthcare cost data for IHDs at the national level. At least two reviewers independently screened titles and abstracts and full texts, extracted data and assessed quality using a seven-question assessment tool. We synthesised findings by country, focusing on three key economic estimates: total annual costs of IHDs, costs of managing acute IHD episodes and chronic IHD care. We correlated these costs with country-specific macroeconomic measures and disease burden.</p><p><strong>Results: </strong>We included 65 national-level studies conducted in 21 countries worldwide, with a majority in high-income countries. The median direct healthcare cost per episode of IHDs was 8062 Int$ 2019 (IQR: 5770-9580), and the median direct healthcare cost of IHDs per patient-year was 10 064 Int$ 2019 (IQR: 7619-14 818). These estimates positively correlated with country-specific macroeconomic and DALY measures.</p><p><strong>Conclusion: </strong>IHDs impose a substantial economic burden on health systems globally. Economic costs in countries exceed per capita public health expenditure, primarily driven by acute episodes. National-level data were available for only 21 countries, and none from low-middle-income and low-income countries. Economic costs of IHDs need to be quantified to inform resource allocation decisions at national and global levels.CRD42022337577.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 2","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405643","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":"Trends in the prevalence and factors associated with indoor smoking in 24 countries Party to the WHO FCTC: implications for equitable policy implementation.","authors":"Daniel Bogale Odo, Olalekan Ayo-Yusuf, Yonatan Dinku, Alemayehu Gonie Mekonnen, Raglan Maddox","doi":"10.1136/bmjgh-2024-017110","DOIUrl":"10.1136/bmjgh-2024-017110","url":null,"abstract":"<p><strong>Introduction: </strong>The health consequences of secondhand smoke (SHS) are a long-standing concern. The WHO Framework Convention on Tobacco Control (FCTC) is an evidence-based treaty that aims to protect people from health and environmental harms of commercial tobacco use and exposure to SHS. This study quantified the prevalence of daily smoking inside the house (indoor smoking) and change over time and examined the determinants of indoor smoking in 24 WHO FCTC Parties.</p><p><strong>Methods: </strong>We used data from the 2 most recent Demographic and Health Surveys (DHS) from 24 countries. Counties were selected if they submitted at least one FCTC implementation report and had two DHS surveys conducted after 2010. The weighted prevalence and percentage changes in daily indoor smoking in the two consecutive surveys were calculated, including rate of change, and a two-sample test of proportions was used to assess changes. Multinomial logistic regression model was employed to examine the association between socioeconomic characteristics and indoor smoking. All results were presented by country.</p><p><strong>Results: </strong>A significant decline in the prevalence of daily indoor smoking was detected in 16/24 countries, with the rate of decline ranging from -45.8% in Liberia to -15.2% in India. Jordan reported a significant increase in daily indoor smoking from 57% to 60%; p=0.002. The meta-analytical estimate showed that overall, the relative risk ratio (RRR) of daily indoor smoking was significantly lower for households in the 5th wealth quintile compared with counterparts in the 1st quintile (RRR=0.40; 95% CI: 0.30 to 0.52), and in households where head of the household attended higher education compared with no formal education (RRR=0.60; 95% CI: 0.53 to 0.69).</p><p><strong>Conclusions: </strong>This study demonstrated that prevalence of daily indoor smoking was associated with low socioeconomic status. Reducing SHS exposure is critical, including addressing inequities to help improve health outcomes. Currently, over 2.8 billion people in low-income countries are not protected by smoke-free environment laws, and only 18% of the world's population is covered by strong restrictions on tobacco marketing.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 2","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405644","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":"Feasibility, acceptability and preliminary effectiveness of the Hospital to Home discharge and follow-up programme in rural Uganda: a mixed-methods intervention study.","authors":"Beatrice Niyonshaba, Daniel Kabugo, Cornety Nakiganda, Christine Otai, Margret Seela, Joyce Nankabala, James Nyonyintono, Josephine Nakakande, Tadeo Kigozi, Madeline Vaughan, Heidi Nakamura, Mohan Paudel, Kimber Haddix-McKay, Benjamin J S Al-Haddad, Cally J Tann, Paul Mubiri, Peter Waiswa, Brooke Magnusson","doi":"10.1136/bmjgh-2024-015945","DOIUrl":"10.1136/bmjgh-2024-015945","url":null,"abstract":"<p><strong>Introduction: </strong>Over 60% of premature infants are born in Africa or South Asia. Infants born early, small or who become sick after birth have a higher risk of death, poor growth and developmental impairments. Innovative interventions tailored for low- and middle-income countries are essential to help these newborns survive and develop optimally. This study evaluated the feasibility, acceptability and preliminary effectiveness of Hospital to Home (H2H), a discharge and follow-up programme for small and sick newborns in rural Uganda.</p><p><strong>Methods: </strong>We compared two cohorts of high-risk hospitalised neonates in Uganda: a historical-comparison cohort receiving standard facility-based care and an intervention cohort that received the H2H programme, a hospital and community spanning package of interventions designed to improve neurodevelopmental outcomes. We compared 6-month corrected neurodevelopmental, growth, nutritional and vaccination outcomes between the cohorts complemented by qualitative interviews of caregivers, community health workers and health facility staff.</p><p><strong>Results: </strong>We recruited 191 participants: 91 historical-comparison cohort (born between July and September 2018), and 100 intervention cohort (born July 2019 to February 2020). No statistically significant difference was seen in neurodevelopmental outcomes (adjusted OR 0.68; 95% CI: 0.32 to 1.46). Improved vaccination completion (88.5% intervention vs 76.9% comparison, p=0.041), and exclusive breastfeeding rates (42% vs 6.6%, p<0.001) were seen. Caregivers and healthcare workers reported the intervention to be acceptable and feasible in this rural Ugandan setting.</p><p><strong>Conclusion: </strong>The H2H programme was feasible and acceptable to caregivers and healthcare providers. Improved vaccination and exclusive breastfeeding rates were seen in the intervention group when compared with a historical comparison cohort in this rural Ugandan setting. Further investigation on the short and long-term effectiveness of the H2H programme in a government health services setting is warranted.</p><p><strong>Trial registration number: </strong>ISRCTN51636372.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 2","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405638","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":"Tackling non-communicable disease risk in young adults across the Caribbean: a call to action.","authors":"Matthew J Savage, Natalie Darko, Philip J Hennis, Ruth M James, Neval Grazette, Trevor S Ferguson, Shelley McFarlane, Heather Armstrong, Horace Cox, Ian Varley","doi":"10.1136/bmjgh-2024-017010","DOIUrl":"10.1136/bmjgh-2024-017010","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 2","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405642","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 system governance for injury care in low- and middle-income countries: a survey of policymakers and policy implementors.","authors":"Leila Ghalichi","doi":"10.1136/bmjgh-2024-017890","DOIUrl":"10.1136/bmjgh-2024-017890","url":null,"abstract":"<p><strong>Introduction: </strong>Good health system governance is essential for reducing high mortality and morbidity after injury in low- and middle-income countries (LMICs). Unfortunately, the current state of governance for injury care is not known. This study evaluated governance for injury care in Ghana, Pakistan, Rwanda and South Africa, four LMICs with diverse contexts, to allow understanding of similarities or difference in the status of governance systems in different LMICs.</p><p><strong>Method: </strong>This cross-sectional study captured the perceptions of 220 respondents (31 policymakers and 189 policy implementers) on injury care governance using the framework for governance in health system developed by Siddiqi. Input was captured in 10 domains: strategic vision; participation and consensus; rule of law; transparency; responsiveness; equity and inclusion; effectiveness and efficiency; accountability; intelligence and information; and ethics.</p><p><strong>Result: </strong>The median injury care governance score across all domains and countries was 29% (IQR 17-43). The highest median score was achieved in the rule of law (50, 33-67), and the lowest scores were seen in the transparency (0, 0-33), accountability (0, 0-33), and participation and consensus (0, 0-33) domains. Median scores were higher for policymakers (33, 27-48) than for policy implementers (27, 17-42), but the difference was not statistically significant.</p><p><strong>Conclusion: </strong>The four studied countries have developed some of the foundations of good injury care governance, although many governance domains require more attention. The gap in awareness between policymakers and policy implementers might reflect a delayed or partial implementation of policies or lack of communication between sectors. Ensuring equitable access to injury care across LMICs requires investment in all domains of good injury care governance.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 2","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389989","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":"Retention in the <i>Bukhali</i> trial in Soweto, South Africa: a qualitative analysis using self-determination theory.","authors":"Catherine E Draper, Nosibusiso Tshetu, Nokuthula Nkosi, Stephen Lye, Shane A Norris","doi":"10.1136/bmjgh-2024-017729","DOIUrl":"10.1136/bmjgh-2024-017729","url":null,"abstract":"<p><strong>Introduction: </strong>There is limited research on applying theory to retention in complex intervention trials. To address this gap, this study aimed to qualitatively examine retention in the <i>Bukhali</i> randomised controlled trial, from the perspective of trial participants and staff, through the lens of self-determination theory (SDT). The <i>Bukhali</i> trial is part of the Healthy Life Trajectories Initiative in Soweto, South Africa, with young women.</p><p><strong>Methods: </strong>Nine focus group discussions were used to generate data from <i>Bukhali</i> trial staff (n=45, 23-64 years), and participants, including those currently enrolled (n=16, 25-31 years) and those who had withdrawn from the trial (n=20, 24-32 years). A codebook thematic approach was taken to data analysis; SDT was used to develop a conceptual model to analyse the data in context. The main themes identified were external influences on the trial, trial implementing environment, controlled motivation and intrinsic autonomous motivation.</p><p><strong>Results: </strong>Our findings highlighted the contextual issues influencing the trial, including participants' socioeconomic circumstances, and the presence or absence of social support, the trial complexity and participant burden. Issues related to controlled motivation comprised challenges of staying in contact, financial incentives and food, health services provided and other incentives. We also identified aspects of the trial supporting participants' psychological needs of autonomy, competence and relatedness, which in turn contributed to their intrinsic autonomous motivation. These included participants' interest in the trial and its relevance to them; participants' sense of agency, meaning and purpose through their involvement; the building of their knowledge and awareness about their health; relating to other participants and the relationships built with staff and being treated well.</p><p><strong>Conclusion: </strong>SDT provides a helpful frame for a contextualised understanding of the complexity of retention of <i>Bukhali</i> trial participants (longitudinal study and intervention). These findings have relevance for trials in under-resourced settings.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 2","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390129","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":"Effect of biannual azithromycin on respiratory pathogens among symptomatic children: results from the randomised Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) I trial.","authors":"Jie Liu, Stephanie A Brennhofer, Jixian Zhang, Suzanne Stroup, Suporn Pholwat, Ahmed M Arzika, Ramatou Maliki, Amza Abdou, Elodie Lebas, Kieran S O'Brien, Benjamin F Arnold, Jeremy D Keenan, Thomas M Lietman, James A Platts-Mills, Elizabeth T Rogawski McQuade, Eric R Houpt","doi":"10.1136/bmjgh-2024-016043","DOIUrl":"10.1136/bmjgh-2024-016043","url":null,"abstract":"<p><strong>Introduction: </strong>Biannual (ie, every 6 months) mass drug administration of azithromycin has reduced childhood mortality in Niger, but its effects on specific respiratory pathogens are not fully elucidated.</p><p><strong>Methods: </strong>Across 2 years of the Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) study in Niger, we evaluated 1468 nasopharyngeal swabs from children who presented for care with respiratory symptoms. Swabs were tested by quantitative PCR using a customised TaqMan Array Card that included assays for 19 respiratory pathogens.</p><p><strong>Results: </strong>Nasopharyngeal detection of <i>Haemophilus influenzae</i>, <i>Moraxella catarrhalis</i> and <i>Streptococcus pneumoniae</i> was common in both azithromycin and placebo communities. The prevalence was reduced in children from azithromycin communities for just two pathogens: <i>Bordetella pertussis</i> and <i>H. influenzae</i> type b (Hib). These children had a 49% and 65% reduction in the prevalence of <i>B. pertussis</i> and Hib in nasopharyngeal swabs, respectively, compared with children from the control communities (prevalence ratios 0.51, 95% CI 0.35, 0.75; and 0.35, 95% CI 0.17, 0.71).</p><p><strong>Conclusions: </strong>Biannual administration of azithromycin to communities in Niger was associated with lower prevalence of <i>B. pertussis</i> and Hib compared with placebo. These reductions may explain some of the childhood mortality benefit of azithromycin.</p><p><strong>Trial registration number: </strong>NCT02048007.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 2","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389986","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":"Impact of measles vaccination strategies on vaccination rates in low-income and middle-income countries: a systematic review and meta-analysis.","authors":"Kiddus Yitbarek, Abela Mahimbo, Firew Tekle Bobo, Mirkuzie Woldie, Meru Sheel, Jane Frawley, Andrew Hayen","doi":"10.1136/bmjgh-2024-016647","DOIUrl":"10.1136/bmjgh-2024-016647","url":null,"abstract":"<p><strong>Introduction: </strong>While many interventions aim to raise measles vaccination coverage in low-income and middle-income countries (LMICs), their overall effectiveness and cost-effectiveness are unknown. We did a review to identify and synthesise scientific research that evaluated the impact and cost-effectiveness of measles vaccination strategies on measles vaccination coverage, timeliness, hospitalisation rates, and mortality.</p><p><strong>Methods: </strong>In this review, we searched for English-language articles published between 2012 and July 2023 in eight databases, including PubMed, ProQuest, MEDLINE (Ovid), Embase (Ovid), CINAHL, Scopus, Web of Science and the Cochrane Database of Systematic Reviews. We also included relevant grey literature sources. The review focused on studies evaluating the impact of vaccination strategies on vaccination-related outcomes in children under 5. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines throughout the process, we used Covidence software to manage most review activities. Two independent reviewers screened articles, assessed their quality using the Joanna Briggs Institute guidelines and extracted data using a predefined electronic tool. We predetermined measles vaccination coverage and timeliness as the primary outcomes, with hospitalisation and mortality as secondary outcomes. A random-effects model was employed for the meta-analysis.</p><p><strong>Results: </strong>We identified 44 articles, of which 14 were included in the meta-analysis. The meta-analysis indicated that vaccination-targeting interventions such as vaccination reminders, cash incentives, community engagement and health education activities increase measles vaccination coverage (RR 1.19, 95% CI 1.10 to 1.27). Our analysis also indicated that interventions such as vaccine reminders, educational programmes and incentives improved timely vaccination. Furthermore, we identified cost-effective strategies such as geographically informed microplanning, unrestricted vial opening, supplementary immunisation activities, community engagement, outreach programmes and financial incentives.</p><p><strong>Conclusion: </strong>Most of the identified vaccination interventions significantly improve measles vaccination coverage and timeliness in LMICs while remaining cost-effective. Tailoring these interventions to local contexts is crucial for maximising their effectiveness in protecting children from measles and its adverse consequences.</p><p><strong>Prospero registration number: </strong>CRD42023433125.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 2","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390117","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":"Observational research in epidemic settings: a roadmap to reform.","authors":"Emily E Ricotta, Fausto A Bustos Carrillo, Samuel Angelli-Nichols, John Barugahare, Adia Benton, Colin J Carlson, Emma Chang-Rabley, Natalie E Dean, Stephany N Duda, Lisa Federer, Mary-Margaret A Fill, Elizabeth C LeRoy, Natalie M Linton, Marc Lipsitch, Maya B Mathur, Alexandra L Phelan, Annette Rid, Jennifer B Rosen, Lauren Sauer, Sheena G Sullivan, Mackenzie Zendt, Nicholas Evans","doi":"10.1136/bmjgh-2024-017981","DOIUrl":"10.1136/bmjgh-2024-017981","url":null,"abstract":"<p><p>Observational studies are critical tools in clinical research and public health response, but challenges arise in ensuring the data produced by these studies are scientifically robust and socially valuable. Resolving these challenges requires careful attention to prioritising the most valuable research questions, ensuring robust study design, strong data management practices, expansive community engagement, and access and benefit sharing of results and research materials. This paper opens with a discussion of how well-designed observational studies contribute to biomedical evidence and provides examples from across the clinical literature of how these methods generate hypotheses for future research and uncover otherwise unattainable insights by providing examples from across the clinical literature. Then, we present obstacles that remain in ensuring observational studies are optimally designed, conducted and communicated.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 2","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390127","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}