BMJ Global Health最新文献

{"title":"Data in the time of cholera: an assessment of global data resources for optimising surveillance, response and control.","authors":"Tessa Rose Cornell, Louise A Kelly-Hope","doi":"10.1136/bmjgh-2025-019626","DOIUrl":"10.1136/bmjgh-2025-019626","url":null,"abstract":"<p><p>Cholera represents a public health threat worldwide and an indicator of poverty, inequity and lack of social development, disproportionately affecting low-income and middle-income countries. Accessible global cholera data resources are essential to support timely, data-driven disease surveillance, response and control efforts. This analysis aims to identify, collate and describe online open-access cholera resources. 31 resources associated with multilateral agencies, academic institutions and non-profit organisations were identified, encompassing dashboards (n=16/31, 51.6%), reports or bulletins (n=12/31, 38.7%) and outbreak reporting systems (n=3/31, 9.7%). The majority of resources were affiliated with the WHO (n=19/31, 61.3%). Other affiliations comprised other United Nations (UN) and multilateral agencies (n=9/31, 29.0%), a non-profit organisation (n=1/31, 3.2%) and academic institutions (n=2/31, 6.5%). Most resources had global scope (n=21/31, 67.7%), provided data to national or subnational levels (n=27/31, 87.1%) and demonstrated variable temporal resolution and reporting frequency. 11 resources affiliated with national institutions were described, reporting predominantly weekly cholera data to the subnational level. Resources comprised epidemiological reports and bulletins, infectious disease dashboards and integrated disease surveillance and response platforms. This analysis highlights cholera resources available to researchers, healthcare workers and policy-makers, which may direct disease programmes and research activities and support Global Task Force on Cholera Control roadmap 2030 targets. National resources provided detailed subnational cholera data and complemented cholera reporting by multilateral agencies. Timely review of these resources is warranted.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051572","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":"Municipal officials' perspectives on challenges and opportunities in shaping urban built environments for active living in Thailand: a qualitative study.","authors":"Thitikorn Topothai, Chompoonut Topothai, Nicholas Alexander Petrunoff, Viroj Tangcharoensathien, Rapeepong Suphanchaimat, Falk Müller-Riemenschneider","doi":"10.1136/bmjgh-2025-019383","DOIUrl":"10.1136/bmjgh-2025-019383","url":null,"abstract":"<p><strong>Introduction: </strong>Municipalities play a critical role in shaping built environments that support active living, yet little is known about how municipal officials interpret these agendas, implement them or balance them with competing policy demands. This study explores how municipal officials in urban Thailand perceive and implement built environment strategies, manage constraints and identify opportunities to promote active living.</p><p><strong>Methods: </strong>We conducted a qualitative study using semistructured interviews with 27 informants: eight elected officials, 15 senior appointed officials and four technical staff from seven municipalities across Thailand. Municipalities were purposively selected to reflect variation in geography across seven regions and administrative levels, including metropolitan, city and town contexts. Thematic analysis combined deductive coding based on policy-related topics such as roles, coordination and governance challenges with inductive coding to identify emergent themes.</p><p><strong>Results: </strong>Three themes emerged. First, municipal officials commonly viewed the built environment through a recreational lens, prioritising parks and leisure spaces for their visibility, popularity and alignment with community expectations. Planning was influenced by leadership preferences and external models. Second, implementation was hindered by institutional fragmentation, overlapping mandates, weak cross-sector coordination and contextual factors such as complex land use, unregulated street activity, motorcycle-dominated mobility and political sensitivities. These challenges were more pronounced in smaller municipalities with limited technical capacity. Third, enabling factors included strengthened decentralisation, national incentives (eg, additional floor area near transit hubs), partnerships to repurpose underused spaces, digital tools such as mobile apps for responsive service delivery, adaptive leadership for public communication and leveraging local assets to support inclusive, context-sensitive development.</p><p><strong>Conclusion: </strong>In urban Thailand, municipal strategies for active living continue to emphasise recreation over mobility. Implementation remains constrained by institutional and contextual challenges. Advancing more inclusive and responsive environments will require stronger governance, supported by decentralisation, community partnerships, digital tools, local assets and adaptive leadership.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051773","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":"Low-research settings: is there a need for specific attention from funders?","authors":"Sahani de Silva, Mike English, Paul Newton","doi":"10.1136/bmjgh-2024-017226","DOIUrl":"10.1136/bmjgh-2024-017226","url":null,"abstract":"<p><p>In order to achieve global equity in healthcare research it is important to identify countries that are less visible in this regard, to inform interventions. We performed a bibliometric analysis of the Web of Science Core Collection to identify countries with less visible medical research output, particularly in the English language. This highlighted that an important distinction needs to be made between low-resource and low-research countries, as countries of diverse World Bank income classifications and population size appeared as low-research countries in our search. We discuss potential contributors to these inequalities and implications for potential funders and collaborators. Owing to the English language bias of the database used for our search, this piece is aimed, in particular, at Anglophone institutions. It highlights potential issues of coloniality in the healthcare research landscape and provides suggestions to address research equity through more active engagement with countries.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051512","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":"Mobile phone-based surgical telemedicine in Sudan: a conflict-driven innovation with global relevance.","authors":"Alsadig Suliman","doi":"10.1136/bmjgh-2025-020184","DOIUrl":"10.1136/bmjgh-2025-020184","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039040","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 financial protection through multitiered health coverage: evidence from 667 055 low-income households in China.","authors":"Guanping Liu, Zhongliang Zhou, Yangling Ren, Xiaohui Zhai, Yan Zhuang, Zhichao Wang, Ruifeng Cui","doi":"10.1136/bmjgh-2025-019440","DOIUrl":"10.1136/bmjgh-2025-019440","url":null,"abstract":"<p><strong>Introduction: </strong>Low-income households face disproportionate out-of-pocket hardship when accessing healthcare, undermining equity and universal health coverage. To address these challenges, China implemented a three-tiered health coverage system-basic medical insurance, catastrophic medical insurance and medical assistance-but its comprehensive impact on the financial protection remains underexplored.</p><p><strong>Methods: </strong>We analysed Shaanxi Province's Medical Assistance database (2013-2016) to evaluate the impact of China's multitiered health coverage system on financial protection by: (1) estimating the incidence of catastrophic health expenditure (out-of-pocket payments> 25% of annual income) and medical impoverishment (postpayment income <US$1.90/day) before and after reimbursement-lower incidence indicating better protection and (2) assessing income-related inequality and inequity using concentration indices and horizontal inequity indices (ranging -1 to 1, where zero indicates equality/equity, negative values indicate pro-poor and positive values pro-rich distributions). All estimates accounted for household-level clustering.</p><p><strong>Results: </strong>A total of 667 055 households were included. After reimbursement, the incidence of catastrophic health expenditure fell from 58.59% (95% CI: 58.47 to 58.70) to 17.89% (95% CI: 17.79 to 17.97) and medical impoverishment from 41.43% (95% CI: 41.30 to 41.54) to 13.47% (95% CI: 13.38 to 13.55), driven mainly by basic medical insurance and medical assistance. Rural households received larger absolute declines yet remained higher than urban counterparts. Financial protection inequity worsened: the Horizontal Inequity Index for catastrophic health expenditure shifted from -0.0890 (95% CI: -0.0902 to -0.0879) to -0.1717 (95% CI: -0.1746 to -0.1689) and for medical impoverishment from -0.2653 (95% CI: -0.2669 to -0.2640) to -0.5251 (95% CI: -0.5280 to -0.5222), a pattern observed in both urban and rural areas.</p><p><strong>Conclusion: </strong>Our findings underscore the need for a three‑tiered health coverage system-including targeted, equitable reimbursement-to advance universal health coverage. Emerging tools such as big data analytics and artificial intelligence offer new ways to monitor and optimise equity; it is timely to extend equity considerations beyond funding mobilisation to reimbursement.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039098","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 effect of supporting districts to operationalise digital payments for vaccination campaign workers: a cluster randomised controlled trial during the 2022 polio vaccination campaign in Uganda.","authors":"Peter Waiswa, Margaret McConnell, Juliet Aweko, Daniel Donald Mukuye, Charles Opio, Maggie Ssekitto Ashaba, Andrew Bakainaga, Elizabeth Ekirapa-Kiracho","doi":"10.1136/bmjgh-2024-016666","DOIUrl":"10.1136/bmjgh-2024-016666","url":null,"abstract":"<p><strong>Introduction: </strong>A motivated and satisfied health workforce is critical for the success of mass vaccination campaigns targeting diseases like polio. This study examined whether supporting districts to implement electronic cash (e-cash) payments, instead of cash, increased e-cash usage and improved vaccine campaign healthcare workers' (VCHWs) motivation and satisfaction during an oral poliovirus vaccination campaign in 2022 in Uganda.</p><p><strong>Methods: </strong>In November 2022, 54 districts and 2665 VCHWs were enrolled and randomised. Intervention districts received training on navigating the government e-cash platform, user roles, beneficiary data upload and payment report generation. Control districts received standard support. Data collected included mode of payment (cash or e-cash), VCHW motivation (primary outcome) and satisfaction with the payment method. Primary analysis was on an intention-to-treat basis, with 589 (44.1%) VCHWs in control and 765 (57.5%) in intervention districts receiving e-cash.</p><p><strong>Results: </strong>E-cash payments were more common in intervention districts (765/1330, 57.5%) compared with controls (589/1335, 44.1%). VCHWs in intervention districts were more likely to be paid via e-cash (adjusted OR (AOR) 3.15; 95% CI: 0.40 to 10.70; p=0.079). Nearly all VCHWs (97.6%) received payments after campaign completion. There was no significant difference in motivation (AOR=0.82; 95% CI: 0.47 to 1.44; p=0.498) or satisfaction (AOR=1.01; 95% CI: 0.77 to 1.55; p=0.641) between groups. Participants reported e-cash as convenient, transparent, time-saving and cost-saving.</p><p><strong>Conclusion: </strong>Supporting districts to operationalise digital payments increased e-cash usage among vaccination workers, despite delays. However, it did not significantly impact motivation or satisfaction.</p><p><strong>Trial registration number: </strong>NCT05684081.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 Suppl 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039048","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 justice in fragile and shock-prone settings: from theory to practice towards building resilient health systems.","authors":"Giulia Loffreda, Shophika Regmi, Joanna Khalil, Thazin La, Ayesha Idriss, Joanna Raven, Sophie Witter, Wesam Mansour","doi":"10.1136/bmjgh-2024-017155","DOIUrl":"10.1136/bmjgh-2024-017155","url":null,"abstract":"<p><p>Health justice is an emerging imperative in global health and health policy and systems research, particularly in fragile and shock-prone settings where inequities are deepened by political instability, conflict and structural violence. This practice paper explores how the ReBUILD for Resilience consortium has sought to operationalise health justice as a guiding principle and embedded practice in four diverse contexts: Myanmar, Nepal, Lebanon and Sierra Leone. Drawing from political philosophy, public health ethics and the capability approach, we outline a framework that positions health justice not only as an aspiration but also as an actionable, community-rooted agenda that centres equity, power redistribution and inclusive governance. Through participatory action research, political economy analysis and embedded learning sites, the ReBUILD teams engaged with communities and health system actors to co-create interventions that respond to local needs while addressing entrenched exclusion and marginalisation. Country experiences demonstrate both the potential and challenges of advancing health justice: from establishing inclusive Municipal Health Committees and revitalising health facility governance to promoting leadership among marginalised groups such as people with disabilities and displaced populations. This paper reflects on tensions around facilitation, participation and positionality and acknowledges the broader political economy, subnational, national and transnational, that shapes opportunities for transformation. We argue that health justice must be pursued through politically astute, reflexive and participatory research approaches, grounded in long-term relationships and a commitment to amplifying community voices. While the road is complex and contested, the pursuit of health justice is essential for building more equitable, inclusive and resilient health systems in the face of protracted crises and global inequities.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039095","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 WHO pandemic agreement: why countries will not use compulsory licensing - and how to fix it.","authors":"WooJung Jon","doi":"10.1136/bmjgh-2025-020856","DOIUrl":"10.1136/bmjgh-2025-020856","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032747","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":"Taxes for tuberculosis: could tobacco and sugar tax revenue fund tuberculosis control interventions?","authors":"Mikaela Coleman, Anna K Coussens, Claire Jacqueline Calderwood, Ingrid Schoeman, Madhavi Bhargava, Pranay Sinha, Ben J Marais, Katharina Kranzer","doi":"10.1136/bmjgh-2025-019770","DOIUrl":"10.1136/bmjgh-2025-019770","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022875","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":"Transforming adolescent sexual reproductive health in Pakistan: a holistic and culturally sensitive strategy.","authors":"Salima Meherali, Hina Najmi, Zahid Ali Memon, Zohra S Lassi","doi":"10.1136/bmjgh-2024-017352","DOIUrl":"10.1136/bmjgh-2024-017352","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022888","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}