BMJ Global Health最新文献

{"title":"Understanding gender inequities in antimicrobial resistance: role of biology, behaviour and gender norms.","authors":"Deepshikha Batheja, Srishti Goel, Esmita Charani","doi":"10.1136/bmjgh-2024-016711","DOIUrl":"10.1136/bmjgh-2024-016711","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) poses a critical public health threat, with gendered implications that are often overlooked. Key drivers of bacterial AMR include the misuse of antibiotics, inadequate water, sanitation and hygiene infrastructure and poor infection control practices. Persistent gender discrimination exacerbates these issues, resulting in disparities in healthcare access and outcomes. This review explores how biological, sociocultural and behavioural factors contribute to the differential incidence of AMR in women. We present a conceptual framework to understand how gender norms influence antibiotic use and AMR. Differences in infection susceptibility, health-seeking behaviours, the ability to access and afford essential antibiotics and quality healthcare and appropriate diagnosis and management by healthcare providers across genders highlight the necessity for gender-sensitive approaches. Addressing gender dynamics within the health workforce and fostering inclusive policies is crucial for effectively mitigating AMR. Integrating intersectional and life course approaches into AMR mitigation strategies is essential to manage the changing health needs of women and other vulnerable groups.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 1","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000077","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 and tuberculosis systems resilience, the role of the private sector and pandemic preparedness: insights from a cross-country qualitative study with policy-makers in India, Indonesia and Nigeria.","authors":"Laura Jane Brubacher, Vijayashree Yellappa, Bony Wiem Lestari, Petra Heitkamp, Nathaly Aguilera Vasquez, Angelina Sassi, Bolanle Olusola-Faleye, Poshan Thapa, Joel Shyam Klinton, Surbhi Sheokand, Madhukar Pai, Charity Oga-Omenka","doi":"10.1136/bmjgh-2024-016180","DOIUrl":"10.1136/bmjgh-2024-016180","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic was an unprecedented challenge to health systems worldwide and had a severe impact on tuberculosis (TB) case notifications and service delivery. India, Indonesia and Nigeria are high TB-burden countries where the majority of initial care-seeking happens in the private health sector. The objectives of this study were to (1) explore policy-makers' perspectives on the impact of the COVID-19 pandemic on private sector TB service delivery in India, Indonesia and Nigeria and (2) identify cross-cutting insights for pandemic preparedness with respect to TB service delivery.</p><p><strong>Methods: </strong>From May to November 2021, 33 interviews were conducted with key policy-makers involved in health service administration, TB service delivery and/or the COVID-19 response in India, Indonesia and Nigeria (n=11 in each country). Interviews focused on the impact of COVID-19 on TB services and lessons learnt for pandemic preparedness with respect to TB in each study context. Data were analysed thematically using a hybrid inductive-deductive approach, informed by Haldane <i>et al</i>'s Determinants of Health Systems Resilience Framework.</p><p><strong>Results: </strong>Policy-makers highlighted the crucial role of intersectoral collaboration, effective governance, innovative financing strategies, health workforce reallocation and technological advancements such as virtual consultations and mHealth in strengthening TB service delivery amid the COVID-19 pandemic. India relied on patient-provider support agencies to implement a joint strategy for TB care across sectors and states. Indonesia engaged networks of private provider professional associations to facilitate coordination of the COVID-19 response. Nigeria implemented a pandemic policy for public-private referral for the continuity of TB care.</p><p><strong>Conclusions: </strong>Countries implemented varied measures to support TB service delivery during the COVID-19 pandemic. This study presents insights from three countries (India, Indonesia and Nigeria) that together offer a 'menu' of possibilities for supporting pandemic preparedness with respect to TB care vis-à-vis strengthening health systems resilience.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 1","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000016","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":"Incidence, long-term predictors and progression of chronic kidney disease among African migrants and non-migrants: the transcontinental population-based prospective RODAM cohort study.","authors":"Muhulo Muhau Mungamba, Felix P Chilunga, Eva L van der Linden, Erik Beune, Engwa A Godwill, Charles F Hayfron-Benjamin, Karlijn Meeks, Samuel N Darko, Sampson Twumasi-Ankrah, Ellis Owusu-Dabo, Liffert Vogt, Bert-Jan H van den Born, Benedicta N Chungag, Charles Agyemang","doi":"10.1136/bmjgh-2024-016786","DOIUrl":"10.1136/bmjgh-2024-016786","url":null,"abstract":"<p><strong>Background: </strong>Limited longitudinal data exist on chronic kidney disease (CKD) in African populations undergoing epidemiological transitions. We investigated incidence, long-term predictors and progression of CKD among Ghanaians residing in Ghana and Ghanaian migrants in the Netherlands (Amsterdam).</p><p><strong>Methods and findings: </strong>We analysed data from 2183 participants in the transcontinental population-based prospective Research on Obesity and Diabetes among African Migrants cohort, followed for approximately 7 years. CKD incidence and its progression to end-stage kidney disease (ESKD) were defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. CKD incidence was calculated using age- and sex standardisation for those without CKD at baseline. Long-term predictors of CKD incidence were identified using one-step robust Poisson regression. CKD progression to ESKD from baseline was also assessed using robust Poisson regressions. Overall age- and sex standardised CKD incidence was 11.0% (95% CI 9.3% to 12.3%) in the population, with Ghanaians residing in Amsterdam at (7.6%; 5.7% to 9.5%) and Ghanaians residing in Ghana at (12.9%; 10.9% to 14.9%). Within Ghana, rural Ghanaians had similar CKD incidence to urban Ghanaians (12.5%; 8.5% to 15.5% vs 12.3%; 8.2% to 15.8%). Residence in Amsterdam was associated with lower CKD incidence compared with Ghana after adjustments (incidence rate ratio=0.32; 0.13-0.77). CKD incidence predictors were advanced age, female sex, alcohol consumption, uric acid levels and hypertension. CKD progression to ESKD was 2.3% among Ghanaians residing in Ghana and 0.0% among Ghanaians residing in Amsterdam.</p><p><strong>Conclusion: </strong>One-tenth of Ghanaians developed CKD over 7 years, with higher incidence in Ghana compared with Europe. Age, female sex, alcohol use, uric acid levels and hypertension were predictive factors. CKD progression to ESKD was minimal. High CKD incidence among Ghanaians, especially those residing in Ghana, calls for in-depth assessment of contributing factors and targeted interventions.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 1","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000037","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":"Alcohol restrictions and suicide rates in South Africa during the COVID-19 pandemic: results of a natural experiment.","authors":"Anthony Fish Hodgson, Jason Bantjes, Jane Pirkis, Keith Hawton, Wisdom Basera, Richard Matzopoulos","doi":"10.1136/bmjgh-2024-017171","DOIUrl":"10.1136/bmjgh-2024-017171","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use is a well-established potentially modifiable risk factor for suicide, yet few studies have investigated the impact of alcohol restrictions on suicide rates, particularly in low- and middle-income countries.</p><p><strong>Methods: </strong>We used data from nationally representative annual surveys of postmortem investigations in 2017 (n=6117) and 2020/21 (n=6586) to estimate changes in suicide rates associated with the COVID-19 pandemic and related alcohol restrictions.</p><p><strong>Findings: </strong>Age standardised suicide mortality rates per 100 000 were 10.91 (10.64, 11.18) in 2017 and 10.82 (10.56, 11.08) in 2020/2021, with approximately 4.4 times more deaths among males than females in both periods. No significant differences were observed between overall suicide rates during the 2020/2021 pandemic period compared with 2017 (risk ratio=1.04 (1.00, 1.07)), but in the 15-24-year age group, suicide rates were 11% higher among males and 31% higher among females than in 2017. Partial alcohol restrictions during the pandemic were not associated with lower suicide risk. However, the shift from partial to full restriction on the sale of alcohol was associated with an 18% (95% CI 10% to 25%) reduction in suicides for both sexes combined and a 22% (95% CI 13% to 30%) reduction in suicides among men, but no significant reduction among women.</p><p><strong>Interpretation: </strong>Our findings offer some support for the hypothesis that restricting access to alcohol at a population level is associated with a reduction in suicide rates and suggests that restricted access to alcohol may have been one of the reasons global suicide rates did not increase during the pandemic in some countries.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 1","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999976","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":"Upscaling a regional telecardiology service to a nationwide coverage and beyond: the experience of the Telehealth Network of Minas Gerais.","authors":"Clara Rodrigues Alves Oliveira, Gabriela Miana de Mattos Paixão, Vinicius Carvalho Tostes, Paulo Rodrigues Gomes, Mayara Santos Mendes, Maria Cristina Paixão, Milena Soriano Marcolino, Antonio Luiz Pinho Ribeiro","doi":"10.1136/bmjgh-2024-016692","DOIUrl":"10.1136/bmjgh-2024-016692","url":null,"abstract":"<p><p>Cardiovascular diseases are the leading cause of death globally and in Brazil. The provision of quality healthcare faces challenges due to resource scarcity and unequal distribution, particularly affecting rural areas. Telehealth strategies have shown potential to address these challenges by improving access to specialised care. The Telehealth Network of Minas Gerais (TNMG) is a large-scale Brazilian public telehealth service, established in 2005 to provide telecardiology support to primary healthcare teams. Positive outcomes led to its expansion. Currently, the TNMG provides telecardiology support for 14 out of the 27 states and 1320 municipalities in Brazil, 72.1% of those with up to 20 000 inhabitants. Between 2006 and 2024, more than 9 million ECG reports were issued by the TNMG. Operational aspects include 24/7 availability, with elective ECG reports issued in a median of 41 min 30 s (Q1=6 min 44 s, Q3=1 h 32 min 24 s) and emergency reports in 47 s (Q1=22 s, Q3=1 min 55 s). Clinical alerts notify urgent conditions, facilitating timely interventions. Synchronous eConsults service support local primary care-based physicians, promoting collaborative care. TNMG's telecardiology system has facilitated scientific and technological advancements, including machine learning applications for ECG interpretation and prognostic implications. International collaborations have expanded, with ongoing projects in Africa and partnerships with prestigious institutions worldwide. Future directions involve integrating artificial intelligence (AI) algorithms into the telecardiology service to improve efficiency and prioritise critical cases. AI offers promising opportunities for enhancing medical ECG reporting and sustaining the effectiveness of telehealth services.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 1","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000050","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":"Beyond COVID-19, the case for collecting, analysing and using sex-disaggregated data and gendered data to inform outbreak response: a scoping review.","authors":"McKinzie Gales, Emelie Love Yonally Phillips, Leah Zilversmit Pao, Christine Dubray, Clara Rodriguez Ribas Elizalde, Shirin Heidari, Marie-Amelie Degail, Marie Meudec, M Ruby Siddiqui, Simone E Carter","doi":"10.1136/bmjgh-2024-015900","DOIUrl":"10.1136/bmjgh-2024-015900","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding sex and gender differences during outbreaks is critical to delivering an effective response. Although recommendations and minimum requirements exist, the incorporation of sex-disaggregated data and gender analysis into outbreak analytics and response for informed decision-making remains infrequent. A scoping review was conducted to provide an overview of the extent of sex-disaggregated data and gender analysis in outbreak response within low- and middle-income countries (LMICs).</p><p><strong>Methods: </strong>Five databases were searched for peer-reviewed literature examining sex- and gender-specific outcomes for communicable disease outbreaks published in English between 1 January 2012 and 12 April 2022. An adapted version of the WHO's Gender Analysis Matrix was used to synthesise evidence, which was then mapped across four phases of the outbreak timeline: prevention, detection, treatment/management and recovery.</p><p><strong>Results: </strong>71 articles met inclusion criteria and were included in this review. Sex-, gender-, and pregnancy-related disparities were identified throughout all four phases of the outbreak timeline. These disparities encompassed a wide range of risk factors for disease, vulnerability, access to and use of services, health-seeking behaviour, healthcare options, as well as experiences in healthcare settings and health and social outcomes and consequences.</p><p><strong>Conclusion: </strong>Significant gender-evidence gaps remain in outbreak response. Evidence that is available illustrates that sex and gender disparities in outbreaks vary by disease, setting and population, and these differences play significant roles in shaping outbreak dynamics. As such, failing to collect, analyse or use sex-disaggregated data and gendered data during outbreaks results in less effective responses, differential adverse health outcomes, increased vulnerability among certain groups and insufficient evidence for effective prevention and response efforts. Systematic sex- and gender-based analyses to ensure gender-responsive outbreak prevention, detection, treatment/management and recovery are urgently needed.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 1","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000015","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":"Acceptability and effectiveness of a study information video in improving the research consent process for youth: a non-inferiority trial.","authors":"Tinashe Cynthia Mwaturura, Victoria Simms, Ethel Dauya, Som Kumar Shrestha, Salmaan Ferrand, Talent Shavani, Chido Dziva Chikwari, Constance R S Mackworth-Young, Tsitsi Bandason, Constancia Mavodza, Mandikudza Tembo, Katharina Kranzer, Sarah Bernays, Rashida Abbas Ferrand","doi":"10.1136/bmjgh-2023-014481","DOIUrl":"10.1136/bmjgh-2023-014481","url":null,"abstract":"<p><strong>Introduction: </strong>Obtaining informed consent for research includes the use of information sheets, which are often long and may be difficult for participants to understand. We conducted a trial to investigate whether consent procedures using a study information video coupled with electronic consent were non-inferior to standard consent procedures using participant information sheets (PIS) among youth aged 18-24 years in Zimbabwe.</p><p><strong>Methods: </strong>The trial was nested within an endline population-based survey for a cluster-randomised trial from October 2021 to June 2022. Randomisation of participants to video or paper-based consent was at household level. We assessed non-inferiority in comprehension of the study using a questionnaire. The video method was accepted as non-inferior to standard consent procedures if the 95% CIs of the mean difference did not fall below the prespecified margin of 1.98. Thematic analysis was conducted on brief qualitative discussions with randomly selected youth to explore the acceptability of video and PIS within consent methods.</p><p><strong>Results: </strong>Overall, 921 participants were enrolled (54% female). The median age was 20 (IQR 18-24) years. The mean comprehension score was 25.4/30 in both arms. The mean difference in comprehension between arms was -0.02 (95% CI -0.51 to 0.47) showing non-inferiority of the intervention in comprehension of study information. Youth (N=90) described both consent methods as interactive and inclusive. Those in the video consent arm felt it was exciting and youth focused. The use of imagery to explain procedures strengthened the perceived trustworthiness of the research. However, the high volume of information in both arms reduced acceptability.</p><p><strong>Conclusion: </strong>Comprehension of study information using an information video is non-inferior to a paper-based consent method. Using information videos for consent processes shows promise as a person-centred and context-sensitive approach to enhance the informed consent process and should be encouraged by ethics committees.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 1","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999972","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 Linda Kizazi study: a comparison of morbidity and mortality from birth to 2 years between children who are HIV-unexposed and HIV-exposed, uninfected in the era of universal antiretroviral therapy.","authors":"Emily R Begnel, Ednah Ojee, Judy Adhiambo, Eliza Mabele, Brenda Wandika, Vincent Ogweno, Efrem S Lim, Soren Gantt, John Kinuthia, Dara A Lehman, Jennifer Slyker, Dalton Wamalwa","doi":"10.1136/bmjgh-2024-015841","DOIUrl":"10.1136/bmjgh-2024-015841","url":null,"abstract":"<p><strong>Background: </strong>Historically, children who are HIV-exposed, uninfected (CHEU) have been found to have greater morbidity and mortality than children who are HIV-unexposed, uninfected (CHUU). To assess whether this difference persists in the era of universal antiretroviral therapy (ART), we conducted a cohort study to compare the risk of acute diarrhoea, respiratory tract infections (RTI), malaria, hospitalisation, and all-cause mortality between Kenyan CHEU and CHUU from birth to 2 years.</p><p><strong>Methods: </strong>From December 2018 to March 2020 at Mathare North Health Centre in Nairobi, we recruited pregnant women living with HIV on ART for ≥6 months and pregnant women without HIV from the same community. We followed the mother-infant pairs for 2 years post partum and collected data on symptoms of illness, clinical visits and diagnoses, and infant feeding every 3 months; a self-selected subset of participants also received weekly data collection for up to 1 year. We compared the risk of each outcome between CHEU versus CHUU using HRs from Andersen-Gill (recurrent morbidity outcomes) and Cox proportional hazards (mortality) regression models adjusted for maternal age, marital status and education level.</p><p><strong>Results: </strong>Among 187 mother-infant pairs with postpartum data, 86 (46%) infants were CHEU and 101 (54%) were CHUU. All initiated breastfeeding, and 88% of CHEU and 57% of CHUU were exclusively breastfed (EBF) for ≥6 months. There was no significant difference in risk of diarrhoea (HR=0.79, 95% CI 0.52 to 1.22), malaria (HR=0.44, 95% CI 0.16 to 1.21), hospitalisation (HR=1.11, 95% CI 0.30 to 4.14), or mortality (HR=1.87, 95% CI 0.17 to 20.5). However, CHEU had lower risk of any RTI (HR=0.60, 95% CI 0.44 to 0.82) and pneumonia (HR=0.29, 95% CI 0.091 to 0.89).</p><p><strong>Conclusions: </strong>CHEU born to women on effective long-term ART experienced similar overall morbidity and mortality as CHUU. However, CHEU had substantially lower risk of pneumonia and other RTI, possibly due to longer EBF in this group.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 1","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000059","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 gross domestic product with equitable access to childhood vaccines in 195 countries: a systematic review and meta-analysis.","authors":"Jerome Nyhalah Dinga, Jones Soladoye Akinbobola, Funmilayo Ibitayo Deborah Afolayan, Andreas Ateke Njoh, Tesfaye Kassa, David Dazhia Lazarus, Yakhya Dieye, Gezahegne Mamo Kassa, Kwabena Obeng Duedu, Nefefe Tshifhiwa, Mustapha Oumouna","doi":"10.1136/bmjgh-2024-015693","DOIUrl":"10.1136/bmjgh-2024-015693","url":null,"abstract":"<p><strong>Introduction: </strong>Gross domestic product (GDP) has been shown to affect government spending on various budget heads including healthcare and the purchase and distribution of vaccines. This vulnerable situation has been exacerbated by the COVID-19 pandemic which disrupted and exposed the fragile nature of equitable access to vaccines for childhood immunisation globally. A systematic review and meta-analysis to assess the association of country income status and GDP with vaccination coverage of vaccines for childhood immunisation and other major infectious diseases around the globe will inform global and national policy on equity in living standards and vaccine uptake. This study was carried out to identify factors influenced by GDP that affect access, distribution, and uptake of childhood vaccines around the world using a systematic review and meta-analysis approach.</p><p><strong>Methods: </strong>Data were extracted for the burden of major infectious diseases of childhood immunisation programmes, factors affecting access to vaccines, vaccine procurement platforms, vaccination coverage and percentage of GDP used for the procurement of vaccines. Factors influencing the global vaccination coverage rate were also assessed. The protocol was registered on PROSPERO (ID: CRD42022350418) and carried out using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Results: </strong>Data from 195 countries showed that the following infectious diseases had the highest burden; human papillomavirus (HPV), measles, Ebola and yellow fever. Low-income and some lower-middle-income countries (LMICs) used COVAX and UNICEF for vaccine procurement while high-income countries (HICs) preferred national and regional public tenders. Global vaccination coverage for tuberculosis, diphtheria/tetanus/pertussis, hepatitis B, <i>Haemophilus influenzae</i> type b, measles, polio, meningitis and HPV had a significantly higher coverage than COVID-19. Being an HIC and having coverage data collected from 1985 to 2015 as the most current data were associated with high vaccination coverage. The percentage of GDP spent on vaccine procurement did not influence vaccination coverage.</p><p><strong>Conclusion: </strong>Low-income countries and LMICs should prioritise vaccine research and improve on development capacity. Countries worldwide should share data on vaccine expenditure, vaccination coverage, and the development and introduction of new vaccines and technologies to facilitate equitable vaccine access.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 1","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999964","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":"Advancing whose interests? Corporate strategy and risks to food systems transformation and public health nutrition through academic partnerships in Africa.","authors":"Safura Abdool Karim, Busiso Moyo, Helen Walls","doi":"10.1136/bmjgh-2024-016049","DOIUrl":"10.1136/bmjgh-2024-016049","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 1","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999974","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}