BMJ Global Health最新文献

{"title":"Characteristics of violence, timely care-seeking and perceived barriers: a cross-sectional analysis of sexual violence among displaced and resident populations in North Kivu, Democratic Republic of the Congo.","authors":"Hanna Reinholdz, Anette Agardh, Jack Palmieri, Esther Katungu Kalere, Gérard Nteziryayo Heritier, John Muzige, Meggy Verputten, Benedict Oppong Asamoah","doi":"10.1136/bmjgh-2026-024220","DOIUrl":"10.1136/bmjgh-2026-024220","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual violence is highly prevalent in North Kivu, the Democratic Republic of the Congo and access to care for survivors remains challenging. This study aims to analyse characteristics of violence, barriers to care and timely access to care among survivors of sexual violence who accessed care in North Kivu following the increase of violence and displacement 2023-2024. Furthermore, it examines how violence characteristics differ between survivors with different residential status and factors associated with timely access to care and main barriers.</p><p><strong>Methods: </strong>This cross-sectional study uses data collected, as part of routine programme monitoring, from survivors of sexual violence who received care in three Médecins Sans Frontières programmes in North Kivu, 2023-2024. χ² tests were conducted to explore differences between residents and displaced survivors, and multivariable logistic regression models were performed to explore factors associated with timely access to care and the main perceived barriers.</p><p><strong>Results: </strong>A total of 16 712 survivors were included, of whom a majority were females (95.5%) and displaced (83.4%). Displaced survivors more commonly reported multiple assailants, violence during livelihood activities and being referred by a trained community focal point compared with residents. Lack of information and fear of social consequences were the main reported barriers to access care. Several factors, including resident status, age, assailant type and whether the assailant was armed, were significantly associated with care-seeking within 72 hours and experience of the main barriers.</p><p><strong>Conclusion: </strong>This study provides new insights regarding the impact of increased violence and displacement on sexual violence characteristics and care-seeking patterns. The main barriers, lack of knowledge and fear of social consequences, call for responses which specifically address these challenges. As changes in context impact both violence and care-seeking patterns, responses to sexual violence need to be flexible to be able to meet survivors' needs during humanitarian crises.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"11 7","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547841","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":"Making experts accountable in global health.","authors":"Valery Ridde, Elisabeth Paul, Rosina Foli, Daniel Béland","doi":"10.1136/bmjgh-2026-025094","DOIUrl":"10.1136/bmjgh-2026-025094","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"11 7","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13410693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547861","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":"Determining causes of death through an abridged verbal autopsy tool: a pilot test conducted among vulnerable communities in Kolkata, India.","authors":"Suman Kanungo, Melissa Glenda Lewis, Diplina Barman, Prantick Kumar Bhunia, Suparna Chatterjee, Sandip Samanta, Dipti Yadav, Sudipta Pati, Rounik Talukdar, Shubarna Chakraborty, Indrani Das, Amitabha Chattopadhyaya, Soumitra Ghosh, Kalpana Datta, Henry D Kalter, Debarati Guha-Sapir","doi":"10.1136/bmjgh-2025-022829","DOIUrl":"10.1136/bmjgh-2025-022829","url":null,"abstract":"<p><strong>Background: </strong>Users often regard the 2022 WHO verbal autopsy (VA) instrument as lengthy and time-consuming to implement, emphasising the need for a more concise and practical tool, particularly for use in unstable or resource-limited settings. This study aimed to develop, pilot test and validate an abridged version of the WHO VA instrument capable of identifying probable causes of neonatal (0-27 days), child (1 month-11 years) and adult (12-49 years) deaths in vulnerable populations.</p><p><strong>Methods: </strong>An abridged VA instrument based on the expert algorithm method was developed and applied to deaths recorded between 2021 and 2022 in three tertiary general hospitals and one tertiary paediatric hospital in Kolkata, West Bengal. VA interviews were conducted between July 2024 and January 2025. Causes of death were assigned using two approaches: (1) underlying medical record diagnoses and (2) a hierarchical computer-based VA algorithm. Diagnostic metrics were used to validate algorithmic causes against medical diagnoses.</p><p><strong>Results: </strong>Among 270 deaths (90 per age group), 95.5% yielded a VA diagnosis. Among neonates, the leading causes were sepsis (34.4%: 83.8% VA sensitivity, 94.9% VA specificity), IPRE (25.6%: 69.6%, 97.0%) and pneumonia (16.7%: 100%, 98.7%). Among children, the two most common medical diagnoses were pneumonia (53.3%: 100%, 50%) and other infections including sepsis without a known source (25.6%: 21.7%, 98.5%). Among adults, the two most common medical diagnostic categories were acute febrile illness (38.5%: 80.9%, 98.6%) and cardiovascular diseases (38.5%: 100%, 98.6%). The accuracy of the new VA instrument compared with the medical diagnosis was 81.1% for neonates, 71.1% for children and 87.8% for adults, with an overall accuracy of 80%.</p><p><strong>Conclusion: </strong>The abridged VA instrument demonstrated satisfactory accuracy in identifying the probable causes of death across all age groups in the study populations. This instrument holds potential for enhancing cause-of-death reporting in resource-limited settings.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"11 7","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535133","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":"Prevalence, trends and inequalities of childhood undernutrition according to a Composite Index of Anthropometric Failure (CIAF): a systematic review and meta-analysis.","authors":"Biniyam Sahiledengle, Paul Ward, Bereket Duko, Kingsley Agho, Lillian Mwanri","doi":"10.1136/bmjgh-2025-020990","DOIUrl":"10.1136/bmjgh-2025-020990","url":null,"abstract":"<p><strong>Background: </strong>The Composite Index of Anthropometric Failure (CIAF) and its extensions-the Composite Index of Severe Anthropometric Failure (CISAF) and extended CIAF (eCIAF)-capture overlapping forms of child undernutrition but remain under-reported at global and regional levels. We aimed to estimate the prevalence of CIAF, CISAF and eCIAF among children under 5 years and assess inequalities by sex, residence, household wealth and maternal education.</p><p><strong>Methods: </strong>We systematically searched major databases, including Embase, MEDLINE (PubMed), Scopus, CINAHL, ProQuest, Global Index Medicus and the Cochrane Library, without language or geographic restrictions. Random-effects meta-analyses estimated pooled prevalence. Heterogeneity was assessed using Cochran's Q and I² statistics. Subgroup analyses, meta-regression, sensitivity analyses and publication bias assessments were conducted. Inequalities were quantified using prevalence ratios (PRs), prevalence differences, the Concentration Index and the Slope Index of Inequality (SII).</p><p><strong>Results: </strong>We included 107 studies from 18 countries, predominantly low- and middle-income countries in South Asia and Africa (notably India, n=54), comprising over 2.6 million under-5 children for CIAF, 590 744 for eCIAF and 29 905 for CISAF. The pooled prevalence of CIAF was 49.07% (95% CI 46.00% to 52.14%), declining from 59.8% in 2005 to 45.9% in 2024. The pooled prevalence of CISAF and eCIAF was 12.77% and 40.41%, respectively. CIAF prevalence did not differ significantly by sex (pooled PR: 1.04, 95% CI 0.99 to 1.09) but was higher in rural than in urban settings (pooled PR: 1.18, 95% CI 1.10 to 1.27). Substantial socioeconomic inequalities were observed, with higher prevalence among children from the poorest households (pooled PR: 1.71, 95% CI 1.42 to 2.05) and among those whose mothers had no formal education (pooled PR: 1.55, 95% CI 1.26 to 1.90). Absolute inequalities were further confirmed by SII estimates for wealth (-31.28%) and maternal education (-26.60%).</p><p><strong>Conclusions: </strong>CIAF prevalence remains alarmingly high in low-income settings, disproportionately affecting children in rural areas, poorer households and those born to mothers with limited education.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"11 7","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468852","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":"Strengthening district health systems to achieve Malawi's decentralisation objectives: lessons learnt from Malawi's Blantyre Prevention Strategy.","authors":"Betha O Igbinosun, Gift Kawalazira, Darwin Pangani, Sara M Allinder, Yohane Kamgwira, Deborah Hoege, Samden Seunda, Chimwemwe Mablekisi, Stephanie Heung, Jacqueline Crowell, Charles B Holmes, Beatrice Matanje","doi":"10.1136/bmjgh-2025-019811","DOIUrl":"10.1136/bmjgh-2025-019811","url":null,"abstract":"<p><p>The Alma-Ata 'Health for All' Declaration of 1978 emphasised community participation in health systems and the need to 'bring health care as close as possible to where people live and work'. Since then, decentralised approaches that leverage the proximity of local governments to their populations have emerged as the preferred model for health systems over fully centralised structures. The district health system, particularly in low- and middle-income countries, has evolved as a key framework to advance the Alma-Ata vision and strengthen health system governance in decentralised settings. However, implementation has often been hindered by limited local capacity, raising a persistent question: how can district health systems be strengthened to achieve decentralisation objectives? Using Malawi's ongoing Blantyre Prevention Strategy (BPS), a systems-based project designed to build local capacity at district and city levels for HIV prevention, as a case study, this paper-reviews policies and frameworks guiding health sector decentralisation in Malawi and examines how BPS is contributing to strengthening the district health system and supporting broader decentralisation efforts in Malawi's health sector.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"11 7","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468888","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":"Catastrophic health expenditures associated with single admission for paediatric surgery in a low-resource setting: a multicentre study.","authors":"Tunde Talib Sholadoye, Omolara M Williams, Olumide Abiodun Elebute, Okechukwu Hyginus Ekwunife, Felix Alakaloko, Lukman Abdur-Rahman, Deirdre Kruger, Elena Libhaber, Mwayi Kachapila, Christianah Oyegbola, Omotayo Adenike Oyewande, Aneel Bhangu, Ewen Munro Harrison, Dmitri Nepogodiev, James C Glasbey, Dion Morton, Emmanuel A Ameh, Adesoji O Ademuyiwa","doi":"10.1136/bmjgh-2025-022894","DOIUrl":"10.1136/bmjgh-2025-022894","url":null,"abstract":"<p><strong>Background: </strong>Catastrophic healthcare expenditure (CHE) poses significant financial burdens on households globally, particularly in low- and middle-income countries. This study was designed to determine the prevalence of CHE among families of paediatric surgical patients admitted for surgery and to explore factors associated with it.</p><p><strong>Methods: </strong>The study was a prospective, multicentre, cross-sectional study carried out in 25 hospitals with paediatric surgery in Nigeria from July to November 2024. Consecutive patients below 16 years of age who underwent surgery were included. CHE was defined as health expenditure above 10% of the head of household annual household income. Data on demographic data, educational and employment status of parents and other related factors were collected and analysed using Stata.</p><p><strong>Results: </strong>A total of 1665 patients were recruited with ages ranging from 5 days to ≤16 years (median=4.74 years). Overall median annual income for the heads of household was US$1097.78. The median (IQR) cost of care was US$129.81 per patient and 56.3% of households spent out of pocket and only 11.7% of households had access to health insurance.A total of 981 households (58.9%; 95% CI 56.5% to 61.3%) experienced CHE. The CHE incidence rate ratio (IRR) decreased among households where the patients were male (IRR 0.92 (95% CI 0.86 to 0.98); p=0.011), the head-of-households had a graduate/postgraduate education (IRR 0.64 (95% CI 0.53 to 0.78); p<0.001), but increased when major surgery was performed (IRR 1.25 (95% CI 1.08 to 1.44); p=0.002) and with prolonged hospital stay (1.008 (95% CI 1.005 to 1.011); p<0.001).The main sources of funds for healthcare were out-of-pocket (n=936, 56.3%) and availability of health insurance was significant in preventing CHE, as three of every four households accessing health insurance did not experience it.</p><p><strong>Conclusion: </strong>Catastrophic health expenditure was highly prevalent among families of children who underwent surgery in Nigeria, particularly among those who had major and emergency surgeries.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"11 7","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468902","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 introduction of group antenatal care in northern Nigeria: an implementation research study analysing changes in service use.","authors":"Abudulhamid Abubakar, Grace Yisa, Adeola Seweje, Joseph Odu, Costa Atori, Uche Ralph Opara, Rondi Anderson","doi":"10.1136/bmjgh-2025-022038","DOIUrl":"10.1136/bmjgh-2025-022038","url":null,"abstract":"<p><strong>Introduction: </strong>With one of the highest rates of maternal mortality in the world, improving antenatal care for the poorest communities is a high priority in Nigeria. In 2022, Project HOPE partnered with the Nigerian Ministry of Health to implement group antenatal care, a WHO-recommended health system strengthening intervention for improving pregnancy outcomes in Niger State.</p><p><strong>Methods: </strong>The project trained 300 health workers and established group antenatal care in 150 health facilities. Training and initiation was staggered over September, October and November of 2022. Over 17 000 women participated in 1054 antenatal care groups from September 2022 to March 2023. We carried out an implementation research study to examine service utilisation rates and explore contributing factors within the project. Using an interrupted time series analysis, we examined project effects on antenatal contacts, facility births, live births, malaria positivity, postpartum contraception and postnatal care.</p><p><strong>Results: </strong>The analysis found statistically significant increases in first and fourth antenatal visits, facility births and live births following the intervention.</p><p><strong>Conclusion: </strong>Despite significant challenges, including a shortened implementation period, the project increased service use. We assert that health system approaches were key influencing factors, such as the use of local master trainers, broad stakeholder engagement, strong monitoring and evaluation and the inclusion of the group antenatal care model in national guidelines. Noted challenges included inadequate skilled birth attendants and lack of antenatal care commodities, though stop gap measures addressed certain supply issues such as a lack of blood pressure cuffs.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"11 7","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444316","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":"Association of surgery and economic development in low- and middle-income countries: evidence from a dynamic panel data analysis.","authors":"Martilord Ifeanyichi, Johnson Ezema Nchege, Ebikabowei Biedomo Aduku, Meskerem Aleka Kebede, Maeve Bognini, Rachel Hargest, Rocco Friebel","doi":"10.1136/bmjgh-2025-021115","DOIUrl":"10.1136/bmjgh-2025-021115","url":null,"abstract":"<p><strong>Introduction: </strong>While health improvements drive economic growth, the specific macroeconomic impact of surgery remains unknown. Previous studies have quantified economic losses from unmet need but have not established whether surgery generates economic returns. This study investigates the association between surgical activity and economic growth across low- and middle-income countries (LMICs).</p><p><strong>Methods: </strong>We analysed panel data from 95 LMICs (2000-2022) using System Generalised Method of Moments (GMM) estimation. Surgical volume was proxied by per capita suture consumption in kilograms (kg) measured by per capita suture imports (in kg), with gross domestic product (GDP) per capita adjusted for purchasing power parity as the outcome variable. We controlled for education, labour force, infrastructure, quality of governance, health expenditure, and credit availability while addressing endogeneity through internal instrumentation.</p><p><strong>Results: </strong>Each 1% increase in per capita suture consumed corresponded to a 0.0083% increase in per capita GDP (p<0.05). Associations were concentrated and larger in middle-income countries (0.013%; p<0.05) and countries with surgical activity above the 75th percentile in a piecewise spline model (0.016%; p<0.05). No significant associations were found in low-income countries (-0.0039%; p>0.05) or below the 75th percentile surgical activity settings (0.0049%; p>0.05). In a secondary (non-log-transformed) model, a 1-kg increase in per capita sutures consumption corresponded to an increase of 89 international dollars in per capita GDP (p<0.05).</p><p><strong>Conclusion: </strong>Surgical activity is positively associated with economic growth in LMICs, particularly in higher capacity settings. This provides novel empirical evidence suggesting that surgical investments may yield macroeconomic returns, supporting integration of surgical system strengthening into economic development strategies. Low-income countries may require coordinated investments to build capacity to levels where economic benefits become visible.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"11 Suppl 2","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444231","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 global SEARCH network: providing a framework for critical COVID-19 healthcare worker cohort studies transitioning from the pandemic to the interpandemic period.","authors":"Mark A Katz, Jasmin Islam, Lindsey Duca, Gili Regev-Yochay, Kim Brolin, Camelia Savulescu, Silvia Bino, Giselle Soto, Gideon O Emukule, Lia Sanodze, Liam Townsend, Nabil Seyidov, Vania Gaio, Wanitchaya Kittikraisak, Nicki L Boddington, Ana Atti, Sarah Foulkes, Iris Finci, Ashley Fowlkes, Victoria Hall","doi":"10.1136/bmjgh-2024-017704","DOIUrl":"10.1136/bmjgh-2024-017704","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"11 7","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435192","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 impact of investments in health systems: a rapid review of computational models.","authors":"Deivis Nicolas Guzman-Tordecilla, Shivam Gupta, Shunsuke Mabuchi, Olga Bornemisza, Andres I Vecino-Ortiz","doi":"10.1136/bmjgh-2025-020960","DOIUrl":"10.1136/bmjgh-2025-020960","url":null,"abstract":"<p><p>Investments in health systems are essential for achieving effective sustainable and equitable health outcomes. However, national and global level stakeholders continue to grapple with how to quantify the impact of investments, its return of investment, and how to efficiently allocate health system inputs to improve health service delivery, health outputs and outcomes.This rapid review highlights the diverse computational models used to simulate investments in health systems strengthening. Our analysis revealed a range of methodologies, from agent-based simulations and dynamic computable general equilibrium models to structural equation models and the OneHealth Tool. Each model offers unique insights and has its strengths and limitations that need to be carefully considered for every scenario.A significant limitation across all models is the lack of external validation of the inputs and assumptions. The variability in data requirements and computational complexity also presents challenges in adapting these models to different contexts.To enhance the utility of these models, future research should focus on integrating ex-post impact evaluations and improving data collection to ensure accurate, context-specific inputs. Additionally, there is a need for better alignment between modelling results and policymaking processes to enhance the adoption and legitimacy among decision-makers of these tools.Overall, while current models provide valuable insights for planning and investment in health systems, addressing these limitations will be crucial for maximising their effectiveness and ensuring better-informed decision-making in health investments.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"11 7","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435166","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}