BMJ Global Health最新文献

{"title":"Regional, subregional and country-level full vaccination coverage in children aged 12-23 months for 34 countries in sub-Saharan Africa: a global analysis using Demographic and Health Survey data.","authors":"David Jean Simon, Vénunyé Claude Kondo Tokpovi, Kassoum Dianou, Osaretin Christabel Okonji, Ann Kiragu, Comfort Z Olorunsaiye, Emmanuel Juakaly Wayisovia, Adama Ouedraogo, Patrice Ngangue, Habib Tchoubou Foba, Serge Madjou","doi":"10.1136/bmjgh-2024-018333","DOIUrl":"10.1136/bmjgh-2024-018333","url":null,"abstract":"<p><strong>Objective: </strong>This study estimated the proportion of children aged 12-23 months who were fully vaccinated in sub-Saharan Africa (SSA), explored geographical disparities across subregions and countries, and identified country-level factors associated with full vaccination (FV).</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>SSA.</p><p><strong>Participants: </strong>Children aged 12-23 months.</p><p><strong>Primary outcome: </strong>FV.</p><p><strong>Methods: </strong>Data for this study were extracted from the most recent Demographic and Health Survey (DHS) conducted in 34 SSA countries between 2012 and 2023. The study included a total weighted sample of 69 218 children. Univariate analyses were performed to describe the socio-demographic profile of the participants and estimate the proportion of FV and the proportion for each of the eight vaccines (BCG, DTP1, DTP2, DPT3, Polio1, Polio2, Polio3, Measles1) at regional level. Bivariate and spatial analyses were produced to examine existing disparities at regional, subregional and countries' income levels. A multivariate logistic regression analysis was fitted for identifying country-level factors associated with FV.</p><p><strong>Results: </strong>54.1% (95% CI 53.7% to 54.5%) children aged 12-23 months in SSA were fully vaccinated. In addition, substantial inequalities emerged in FV coverage across countries ranging from 23.9% in Guinea to a high of 95.5% in Rwanda. The same pattern was observed for the eight vaccines. Findings also showed that children of birth order 3 and above, who were delivered at home, had received less than four antenatal visits, from poor households and households with more than 5 members, whose mothers were under 25, had primary education level and below, and had no income-generating activities were less likely to be fully vaccinated.</p><p><strong>Conclusion: </strong>To achieve WHO's global vaccination coverage target of 90% by 2030 in SSA, vaccination programmes must take account of regional, subregional and national inequities. Our findings also underline the need for interventions tailored to each SSA country's socio-cultural context.</p><p><strong>Ethical consideration: </strong>Ethical approval was not required as this is a secondary analysis of publicly available data.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639418","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":"Design, implementation and outcomes of a national oxygen distribution network in Lesotho.","authors":"Melino Ndayizigiye, Afom T Andom, Palesa Thabane, Mphatso Tsoka, Francis Sambani, Tumelo Monyane, Juliana Lawrence, Ninza Sheyo, Mpho Pholoanyane, Jessica Parker, William Haggerty, Emily Gingras, Tiara Calhoun, Joia Mukherjee, Paul Sonenthal","doi":"10.1136/bmjgh-2024-016607","DOIUrl":"10.1136/bmjgh-2024-016607","url":null,"abstract":"<p><strong>Background: </strong>Despite its essential and life-saving role in the treatment of many medical conditions, access to medical oxygen remains limited in many countries. In 2021, Partners In Health established an oxygen distribution network in Lesotho to increase medical oxygen access.</p><p><strong>Methods: </strong>We conducted an observational study reporting on the design, implementation, and outcomes of a national oxygen distribution network in Lesotho from November 2022 through January 2024. Oxygen delivery data were abstracted from tracking logs and analysed in Stata. Continuous and ordinal variables were summarised by medians and ranges. Categorical variables were described using frequencies and proportions.</p><p><strong>Results: </strong>Over the 15 month study period, the network expanded from one oxygen production hub serving five recipients to four hubs and 21 recipients located across nine of Lesotho's 10 districts. The network delivered 1565 filled cylinders containing 9619.23 m³ oxygen, enough to treat 601 patients. For the 13 recipients with inpatient beds, the median monthly volume of oxygen delivered per bed was 1.43 m³ (IQR: 0.57 to 2.31).</p><p><strong>Conclusion: </strong>This study demonstrates the feasibility of an oxygen distribution network in Lesotho, providing proof-of-concept for an intervention to improve oxygen access in low- and middle-income countries. By employing real-time monitoring and redundant sourcing, the network provided a reliable oxygen supply responsive to variations in demand and periods of oxygen plant downtime. This study also provides insights into facility-level oxygen consumption, which may help policymakers improve quantification and prediction of oxygen demand. Future efforts should focus on enhancing data collection, characterising oxygen usage and strengthening infrastructure to promote sustainable oxygen security.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630115","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 global partnerships for sustainable sickle cell disease care: insights from SickleInAfrica at the 77th United Nations General Assembly and the US-Africa Leaders' Summit.","authors":"Irene Kida Minja, Siana Nkya, Daima Bukini, Nesia Mahenge, Upendo Masamu, Janeth Manongi, Josephine Mgaya, Frank Mtiiye, Malula Nkanyemka, Eka Patricia Kisali, Isihaka Mwinchande Mahawi, Aisha Rifai, Agnes Jonathan, Victoria Nembaware, Mario Jonas, Nicola Mulder, Ruth Namazi, Deogratius Munube, Vivian Paintsil, Raphael Zozimus Sangeda, Hans Ackerman, Ruhl Parker, Fred Stephan Sarfo, Aldiouma Guindo, Obiageli Eunice Nnodu, Emmanuel Balandya, Sarah Kiguli, Catherine Chunda-Liyoka, Patience Kuona, Emmanuel Peprah, Appolinary Kamuhabwa, Julie Makani","doi":"10.1136/bmjgh-2024-017154","DOIUrl":"10.1136/bmjgh-2024-017154","url":null,"abstract":"<p><strong>Background: </strong>Addressing sickle cell disease (SCD) is crucial for achieving health-related Sustainable Development Goals, particularly in Africa. The region is significantly affected, with 78.7% of patients with SCD residing in sub-Saharan Africa and over 515 000 newborns diagnosed annually. Historically, African health systems have struggled to provide optimal care for patients with SCD, resulting in high under-5 mortality and severe childhood morbidity. Scientific innovations and stakeholder engagement offer hope for improving SCD outcomes.</p><p><strong>Objective: </strong>To explore the role of high-level partnerships and scientific innovation in advancing SCD care and research in Africa, focusing on the contributions and strategic engagements of the SickleInAfrica, as highlighted at the 77th United Nations General Assembly (UNGA) and the US-Africa Leaders' Summit.</p><p><strong>Approach: </strong>SickleInAfrica, comprising eight countries, leverages a robust infrastructure for SCD research and care. The consortium has established a comprehensive SCD database and a patient registry in each of the consortium sites that includes demographic details, clinical diagnosis, management details and follow-ups/visits. Currently, over 34 000 patients with SCD are enrolled, making it the largest globally. It has also contextually adapted clinical guidelines for managing SCD for all levels of care. The high-level engagements at the 77th UNGA held in September 2022 in New York and the US-Africa Leaders' Summit held in December 2022 in Washington DC promoted SCD awareness and partnerships. The UNGA session emphasised biomedical science, implementation research and partnerships in therapeutic development, while the US-Africa Leaders' Summit session focused on Global Partnerships for SCD: Advancing Science and Technology for Health in Africa.</p><p><strong>Conclusions: </strong>High-level engagements facilitate cross-border dialogues, underscoring the importance of partnerships from grassroots to global alliances. Key outcomes include increased awareness, policy advocacy and the establishment of SCD Centres of Excellence and genomics capacity-building initiatives. Sustainable efforts require robust partnerships, government involvement, community awareness and equitable access to advanced therapies.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630139","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":"Identifying health outcomes and future research directions of group antenatal care among adolescents in low and middle-income countries: a scoping review.","authors":"Theresa Norpeli Lanyo, Jody R Lori","doi":"10.1136/bmjgh-2024-017961","DOIUrl":"10.1136/bmjgh-2024-017961","url":null,"abstract":"<p><p>High maternal mortality and morbidity in low and middle-income countries (LMICs) is a significant global concern, especially among adolescents due to the high birth rates. Providing quality antenatal care, such as group antenatal care (GANC), is vital for enhancing maternal and newborn health outcomes for adolescents. Research indicates that GANC has a positive impact on maternal health outcomes for pregnant women in general. However, there is a notable gap in studies that specifically examine its effects on adolescents in LMICs. This scoping review, following Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, examines the impact of GANC versus individualised antenatal care for pregnant adolescents. After a comprehensive review of peer-reviewed literature, eight articles were included. Findings demonstrate that GANC leads to better adherence to care, increased empowerment through knowledge, enhanced social support and improved newborn health quality. However, there is a notable scarcity of research on GANC for adolescents in LMICs, highlighting the need for further studies to inform policy to create, implement and possibly scale up adolescent-friendly GANC. The insights gained from this review can be leveraged for further feasibility studies to explore cultural appropriateness, adolescent responsiveness and adolescent preferences for GANC.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630136","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 'Health-2-Go' programme's impact on all-cause mortality and clinic utilisation for children 5 and under: a retrospective cohort analysis of an iCCM intervention in Ghana's Barekese Subdistrict.","authors":"Isabella Guynn, Kristen Hassmiller Lich, Stephen Manortey, Leah Frerichs, Alyssa J Mansfield, Mohammed Shaibu, Moselle-Margaret Anum-Brown, Philip Owusu Antwi, Stephen C Alder","doi":"10.1136/bmjgh-2024-017786","DOIUrl":"10.1136/bmjgh-2024-017786","url":null,"abstract":"<p><strong>Introduction: </strong>The 'Health-2-Go' programme, which incorporates the integrated community case management strategy, aims to enhance healthcare access in rural Ghana by deploying trained and equipped community-based agents to manage the diagnosis and treatment of basic illness for children aged 5 and under. This study evaluates the intervention's impact on all-cause mortality and clinical healthcare utilisation among children 5 and under in the Barekese Subdistrict in the Atwima Nwabiagya North District of the Ashanti Region of Ghana.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from 2530 children across nine communities exposed to Health-2-Go and six comparison communities with no Health-2-Go exposure. Child mortality data were collected via a verbally administered household census, and clinical healthcare utilisation data were extracted from clinic records. We used Cox proportional hazards regression models to estimate the impact of exposure to Health-2-Go on child mortality and negative binomial regression models to assess exposure to Health-2-Go on changes in 5 and under clinic visits resulting in a malaria diagnosis.</p><p><strong>Results: </strong>Exposure to Health-2-Go was significantly associated with a 67.7% reduction in the hazard of death (<i>HR=0.323; p=0.015; 95% CI 0.130, 0.803</i>). The programme's impact on healthcare utilisation showed a significant 83% reduction in unnecessary clinic visits for uncomplicated malaria among children 5 and under (<i>IRR=0.17; p=0.027; 95% CI 0.04, 0.82</i>). No significant association was found between programme exposure and the expected number of clinic visits for severe malaria among children 5 and under.</p><p><strong>Conclusions: </strong>The Health-2-Go programme demonstrates substantial potential in reducing child mortality and improving healthcare access in low-resource and 'hard-to-reach' settings in rural Ghana. Further prospective research is recommended to confirm these findings and explore the long-term sustainability of the programme.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630141","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":"Perioperative outcomes at three rural Rwandan district hospitals: a 28-day prospective observational cohort study.","authors":"Grace Umutesi, Jocelyn Mizero, Robert Riviello, Alphonse Nshimyiryo, Marcel Nshunguyabahizi, John Kamau, Mariella Munyuzangabo, Vincent Cubaka, Egide Mpanumusingo, Jean de Dieu Gatete, Cyprien Shyirambere, Mark W Newton, Joel M Mubiligi, Fredrick Kateera, Bantayehu Sileshi","doi":"10.1136/bmjgh-2024-017354","DOIUrl":"10.1136/bmjgh-2024-017354","url":null,"abstract":"<p><strong>Introduction: </strong>The paucity of data on perioperative outcomes in low- and middle-income countries complicates the design and implementation of targeted interventions to improve the delivery of safe, affordable, accessible and timely surgical and anaesthesia care services. We assessed perioperative outcomes of patients undergoing surgical care at three Rwandan rural hospitals-Butaro District Hospital, Kirehe District Hospital and Rwinkwavu District Hospital-supported by Partners In Health/Inshuti Mu Buzima-an international non-governmental organisation.</p><p><strong>Methods: </strong>We conducted a 6-month prospective observational cohort study at the three district hospitals. A validated electronic-based perioperative assessment tool was adapted for our setting to capture demographics and clinical information. Descriptive and logistic regression analyses were performed using Stata V.15.1.</p><p><strong>Results: </strong>A total of 3289 major surgeries were performed from January to September 2020 at the three hospitals. Overall, 3204 surgeries (97.5%) were performed on women; the median age was 27 years (IQR: 23-33), and emergency cases constituted 86.8% of all cases. Cases with the American Society of Anesthesiologists (ASA) status of 3 or above had higher odds of having surgical or anaesthesia complications compared with cases with ASA status 1 (OR: 11.1, 95% CI: 2.7 to 45.8). Furthermore, emergency cases had 1.8 times higher odds of having a composite outcome (developing complications, surgical site infections or death) compared with elective cases (95% CI: 1.1 to 3.0).</p><p><strong>Conclusion: </strong>Our findings highlight the need for improving surgical capacity, reinforcing infection prevention and control measures and leveraging electronic data capture for quality improvement to ensure safer surgery and anaesthesia care in rural Rwanda.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622983","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 influence of fluid resuscitation strategy on outcomes from dengue shock syndrome: a review of the management of 691 children in 7 Southeast Asian hospitals.","authors":"Huynh Trung Trieu, Nguyen Lam Vuong, Nguyen Thanh Hung, Tuan Nguyen Minh, Vinh Chau Nguyen Van, Tu Qui Phan, Truong An Nguyen, Su Nguyen Thi Minh, An Nguyen Thi Truong, Em Jun Min, Heng Kai Voon, Shirley Chan Huey Ling, Hue Yuen Ling, Lim Eng Seng, Lucy Lum Chai See, Sharifah Faridah Syed Omar, Amnasewary Ramakrishnan, Aiu Jer Ling, Alia Zubaidah Bahtar, Nachal Nachiappan, Kyaw Zin Wai, Kyi San Thi, Yee Mon Lwin, Nick Ward, Anushka Ward, Sophie Yacoub, Hung Trinh, Phung Khanh Lam, Bridget Wills","doi":"10.1136/bmjgh-2024-017538","DOIUrl":"10.1136/bmjgh-2024-017538","url":null,"abstract":"<p><strong>Introduction: </strong>The pathognomonic feature of dengue shock syndrome (DSS) is a transient capillary leak syndrome resulting in profound intravascular volume depletion. WHO management guidelines recommend particular parenteral fluid regimens during the critical leakage phase, including synthetic colloid solutions in certain circumstances. We set out to describe the actual fluid management strategies employed in different settings and to investigate relationships with clinical outcomes.</p><p><strong>Methods: </strong>We performed a retrospective review of paediatric DSS cases managed at seven hospitals across Malaysia, Myanmar and Vietnam. We explored the effects of both initial resuscitation (crystalloid alone or mixed crystalloid/colloid in the first 2 hours) and general management: group 1 (conservative-colloid, crystalloid only), group 2 (intermediate-colloid, colloid for 1-4 hours) or group 3 (liberal-colloid, continuous colloid for more than 4 hours) categorised according to the fluid given over the first 6 hours in clinically stable patients. We incorporated an inverse probability weighting score to adjust for potential differences in baseline severity.</p><p><strong>Results: </strong>Among all 691 patients, respiratory compromise (HR 2.08, p=0.022), requirement for nasal continuous positive airway pressure (NCPAP)/ventilation (OR 2.34, p<0.045) and days in hospital after DSS onset (risk ratio, RR 1.33, p=0.032) were significantly worse for mixed crystalloid/colloid versus crystalloid-only initial resuscitation regimens, after adjusting for baseline severity. Among the 547/691 children who stabilised within 2 hours, although a liberal-colloid general management strategy (group 3) was associated with a reduction in recurrent shock episodes (RR 0.13, p=0.043) when compared with a conservative-colloid strategy (group 1), the risks for respiratory compromise (OR 8.84, p<0.001) and requirement for NCPAP/ventilation (OR 8.16, p<0.001) were markedly increased. Additionally, the respective costs for group 3 vs group 1 were significantly higher.</p><p><strong>Conclusions: </strong>The study highlights the potential benefits and risks of using colloid solutions in children with DSS. Formal randomised trials could help determine the most effective and safe parenteral fluid regimens for paediatric DSS. In the meantime, prolonged use of colloid solutions may be inappropriate, especially in settings without access to respiratory support.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603823","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":"Barriers to community engagement during the response to an Ebola virus disease outbreak in Uganda.","authors":"David Musoke, Edwinah Atusingwize, Ann Robins, Seungwoo Nam, Jesse Bonwitt, Chimwemwe Msukwa, Meddy Rutayisire, George Upenytho, Henry Kyobe, Henry Mwebesa","doi":"10.1136/bmjgh-2024-017285","DOIUrl":"10.1136/bmjgh-2024-017285","url":null,"abstract":"<p><strong>Background: </strong>Uganda reported an outbreak of Ebola virus disease (EVD) in 2022. As part of the outbreak response, government and partners promoted community engagement, which seeks to involve communities in the design, implementation and evaluation of interventions to raise awareness, build trust between communities and partners and create ownership of interventions. This study, therefore, explored barriers to community engagement during the 2022-2023 EVD outbreak response in Uganda.</p><p><strong>Methods: </strong>This qualitative study, conducted in five districts (Kampala, Kassanda, Kyegegwa, Mubende and Wakiso), involved 25 focus group discussions among community members and community health workers (CHWs). In addition, 32 key informant interviews were conducted with staff from the Uganda Ministry of Health, district health officials, local leaders, non-governmental organisation staff and other stakeholders. Data were analysed according to the thematic approach using ATLAS.ti (V.6).</p><p><strong>Results: </strong>The main barriers to community engagement identified during the EVD outbreak response are presented under four main themes: (1) delayed consultations between partners and communities; (2) poor communication and misinformation; (3) limited support to human resources; and (4) institutional and coordination challenges. Specifically, these barriers included: limited consultation due to misbelief in community roles; delayed sociocultural discussions; stigma and delayed psychosocial interventions; misinformation, rumours and political influence; poor communication mechanisms; contradictory messages and lack of transparency; language barrier and inappropriate communication media; work overload for CHWs and other community volunteers; failure to prioritise protection of community workers; lack of compensation for CHWs and other community personnel; poor logistical management; inadequate coordination and partner operations; unfavourable institutional structures; and limited funding for emergencies.</p><p><strong>Conclusion: </strong>The barriers encountered in community engagement during the 2022-2023 EVD outbreak need to be addressed through strengthening guidelines and standard operating procedures, capacity building for partners and communities, as well as adequate financing to ensure Uganda is better prepared for future health emergencies.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603735","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":"Using trauma-informed approaches: research with climate disaster affected communities.","authors":"Jo Longman, Emma Pittaway, Lisa McPhie, Scott Webster, Maddy Braddon, Petr Matous, Nader Naderpajouh, Blanche Verlie, Jodie Bailie","doi":"10.1136/bmjgh-2024-017592","DOIUrl":"10.1136/bmjgh-2024-017592","url":null,"abstract":"<p><p>Climate disasters like floods and bushfires have increased in frequency and intensity in Australia. For many, these disasters are associated with trauma. In order to further our understanding of the impacts of these disasters on individuals and communities, we need to conduct research, but the research design and implementation need to be sensitive to that trauma and support the safety of both participants and researchers. This paper provides a detailed description of the practical application of a trauma-informed research approach taken in a study exploring community-led self-organising before, during and after disasters in New South Wales, Australia. The trauma-informed approach was directed by the literature, the university's ethics committee, a trauma expert, learnings from skills training and guidelines on conducting trauma-informed research offered by Alessi and Kahn. Our team found the approach useful in preparing us for recruitment, data collection, and analysis and dissemination. A culture of care was created which maintained a focus on the well-being of participants as well as providing support for members of the team, in particular from supervision by the trauma specialist. Our paper offers reflections on our experiences, practical suggestions and considerations for planning and conducting research in communities impacted by disasters and elaborations to the Alessi and Kahn guidelines. We conclude by proposing considerations for future directions.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603884","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":"'When global health meets global goals': assessing the alignment between antimicrobial resistance and sustainable development policies in 10 African and Asian countries.","authors":"Luong Nguyen Thanh, Didier Wernli, Mats Målqvist, Peter Søgaard Jørgensen","doi":"10.1136/bmjgh-2024-017837","DOIUrl":"10.1136/bmjgh-2024-017837","url":null,"abstract":"<p><strong>Background: </strong>Sustainable development goals (SDGs) may play a pivotal role in mitigating antimicrobial resistance (AMR). This study examines how countries can integrate AMR mitigation with sustainable development strategies, providing evidence on the prioritisation of AMR-related efforts within both agendas.</p><p><strong>Methods: </strong>We conducted a comparative analysis of the international global action plan (GAP) and national action plan (NAP) on AMR and SDGs across 10 countries in Africa and Asia. We employed content analysis to map actions to AMR drivers, descriptive statistics to summarise the coverage and focus of the actions and inferential statistics to explore factors associated with the level of policy alignment.</p><p><strong>Results: </strong>Our findings highlight gaps in the current AMR policy landscape, where drivers are at risk of being redundantly addressed, narrowly focused or entirely overlooked. At the international level, over 50% of AMR drivers are addressed by both frameworks, but national-level overlap is lower (10.5%-47.4%), with Asian countries showing stronger alignment than African countries. Asian countries show a higher proportion of shared drivers than African countries. A considerable proportion of drivers are addressed solely by AMR-NAPs (23.7%-60.5%) or SDG-NAPs (13.2%-31.6%), raising concerns that actions may benefit either sustainable development or AMR at the expense of the other. Finally, 10.5%-26.3% of drivers, mostly distal, are not acknowledged by either framework, highlighting potential policy blind spots.</p><p><strong>Conclusions: </strong>The Agenda 2030 includes ambitious and cross-cutting goals with GAP-AMR, therefore it can facilitate intersectoral collaboration in addressing AMR. The effective implementation of both agendas will depend on national governments' capacity to ensure that efforts in combating AMR also contribute to sustainable development.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603885","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}