BMJ Global Health最新文献

{"title":"The effects of climatic and non-climatic factors on malaria mortality at different spatial scales in western Kenya, 2008-2019.","authors":"Bryan O Nyawanda, Sammy Khagayi, David Obor, Steve B Odhiambo, Anton Beloconi, Nancy A Otieno, Godfrey Bigogo, Simon Kariuki, Stephen Munga, Penelope Vounatsou","doi":"10.1136/bmjgh-2023-014614","DOIUrl":"10.1136/bmjgh-2023-014614","url":null,"abstract":"<p><strong>Background: </strong>Malaria mortality is influenced by several factors including climatic and environmental factors, interventions, socioeconomic status (SES) and access to health systems. Here, we investigated the joint effects of climatic and non-climatic factors on under-five malaria mortality at different spatial scales using data from a Health and Demographic Surveillance System (HDSS) in western Kenya.</p><p><strong>Methods: </strong>We fitted Bayesian spatiotemporal (zero-inflated) negative binomial models to monthly mortality data aggregated at the village scale and over the catchment areas of the health facilities within the HDSS, between 2008 and 2019. First order autoregressive temporal and conditional autoregressive spatial processes were included as random effects to account for temporal and spatial variation. Remotely sensed climatic and environmental variables, bed net use, SES, travel time to health facilities, proximity from water bodies/streams and altitude were included in the models to assess their association with malaria mortality.</p><p><strong>Results: </strong>Increase in rainfall (mortality rate ratio (MRR)=1.12, 95% Bayesian credible interval (BCI): 1.04-1.20), Normalized Difference Vegetation Index (MRR=1.16, 95% BCI: 1.06-1.28), crop cover (MRR=1.17, 95% BCI: 1.11-1.24) and travel time to the hospital (MRR=1.09, 95% BCI: 1.04-1.13) were associated with increased mortality, whereas increase in bed net use (MRR=0.84, 95% BCI: 0.70-1.00), distance to the nearest streams (MRR=0.89, 95% BCI: 0.83-0.96), SES (MRR=0.95, 95% BCI: 0.91-1.00) and altitude (MRR=0.86, 95% BCI: 0.81-0.90) were associated with lower mortality. The effects of travel time and SES were no longer significant when data was aggregated at the health facility catchment level.</p><p><strong>Conclusion: </strong>Despite the relatively small size of the HDSS, there was spatial variation in malaria mortality that peaked every May-June. The rapid decline in malaria mortality was associated with bed nets, and finer spatial scale analysis identified additional important variables. Time and spatially targeted control interventions may be helpful, and fine spatial scales should be considered when data are available.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 9","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145143","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":"Effective community entry: reflections on community engagement in culturally sensitive research in southwestern Nigeria.","authors":"Olubukola Omobowale, Alissa Koski, Halimat Olaniyan, Bidemi Nelson, Olayinka Egbokhare, Olayinka Omigbodun","doi":"10.1136/bmjgh-2024-015068","DOIUrl":"10.1136/bmjgh-2024-015068","url":null,"abstract":"<p><p>Effective community entry processes influence community participation and acceptance of public health interventions. Though there is a growing body of literature on the importance of community partnerships, there is a lack of pragmatic and practical documentation of the experiences involved in the community entry process as it relates to culturally sensitive topics such as child marriage which can help to support researchers working in this field. This article highlights key themes related to knowledge of the community, effective communication, cultural sensitivity, coproduction and giving feedback which help to build trust between the community members and the research team. Institutional representation, not managing expectations, and lack of clarity, along with personal opinions of community gatekeepers can create challenges for the fostering of trustworthy relationships with the community. These realities must be actively addressed right at the onset of the process between the research team and community stakeholders. Researchers can develop trust, form connections and engage different communities by working with local groups and leaders, using culturally appropriate methods, and addressing community concerns. Future projects working with communities on child marriage in Nigeria and other countries would benefit from the reflections presented in this paper.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 9","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139342","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":"Adolescent and youth-friendly health interventions in low-income and middle-income countries: a scoping review.","authors":"Cecilia Jakobsson, Rhea Sanghavi, Joseph Nyamiobo, Caitlin Maloy, Arnold Mwanzu, Katherine Venturo-Conerly, Cyprian Mostert, Stefan Peterson, Manasi Kumar","doi":"10.1136/bmjgh-2023-013393","DOIUrl":"10.1136/bmjgh-2023-013393","url":null,"abstract":"<p><strong>Background: </strong>Adolescents comprise one-sixth of the world's population, yet there is no clear understanding of the features that promote adolescent-friendly services (AFS). The lack of clarity and consistency around a definition presents a gap in health services.</p><p><strong>Methods: </strong>The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. We conducted a scoping review of peer-reviewed empirical studies to explore AFS in low-income and middle-income countries (LMICs) published between January 2000 and December 2022. The databases searched were CAB Direct (n=11), CINAHL (n=50), Cochrane Databases (n=1103), Embase (n=1164), Global Health Medicus (n=3636) and PsycINFO (n=156). The title, abstract and full text were double screened by three independent reviewers. Three independent reviewers assessed the study's quality using the Joanna Briggs Initiative Quality Appraisal and Cochrane Risk of Bias 2 tools.</p><p><strong>Results: </strong>We identified the key components, barriers and facilitators of AFS. The following emerged from our review: a non-judgmental environment, culturally appropriate and responsive interventions and a focus on supporting marginalised communities often living in high-poverty settings. Using these components, we have extended guidance around a possible framework and tool assessing quality of AFS.</p><p><strong>Interpretation: </strong>As LMICs are heterogeneous and unique, it was assumed that the operational definition of 'adolescent-friendly' might vary depending on different contexts, but there must be core components that remain consistent. Possible limitations of our review include a lack of grey literature. Potential future implications include training healthcare providers, testing these attributes for service improvement and future development and localisation of policy guidelines.</p><p><strong>Key highlights: </strong>Our review has mapped the research framing of AFS and provided a comprehensive review of barriers and facilitators to implementing a holistic outlook of AFS set-up in a tightly controlled research and real-world context. Our paper is one of the few efforts to synthesise behavioural and mental health elements underpinning AFS.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 9","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145142","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":"Integrating social behavioural insights in risk communication and community engagement approaches for better health outcomes in Africa.","authors":"Dorothy Njagi, Mary Nyikuri, Nicaise Ndembi","doi":"10.1136/bmjgh-2024-015548","DOIUrl":"10.1136/bmjgh-2024-015548","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 9","pages":""},"PeriodicalIF":7.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139343","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":"Supporting caregivers of children living with disability in a humanitarian context: realist-informed evaluation of the ‘Mighty Children’ programme in Afghanistan","authors":"Natalie Evans, Noorwhiza Ahmadi, Alice Morgan, Sadia Zalmai, Kate M Milner, Mohamed Faiz Atif, Hamish R Graham","doi":"10.1136/bmjgh-2023-012989","DOIUrl":"https://doi.org/10.1136/bmjgh-2023-012989","url":null,"abstract":"Introduction To ensure that humanitarian action is disability-inclusive, evidence is needed to understand how different strategies to support children living with disabilities and their families can work in these settings. Evidence from other contexts suggests support groups can improve caregiver quality of life (QOL). This study reports an evaluation of the ‘ Mighty Children’ programme a participatory educational support group programme for caregivers of children living with disability in Kabul province, Afghanistan. Methods We conducted a mixed-methods realist-informed before-and-after study to measure change in caregiver-reported QOL and explore how and for whom the programme worked, and in what contexts. Female caregivers of children with any disability were recruited through clinics in urban Kabul (n=3) and rural Paghman district (n=3). We collected quantitative data on QOL pre/post programme using the Paediatric Quality of Life Inventory Family Impact Module (PedsQL-FIM). Qualitative data were collected through facilitator and participant focus groups postprogramme. Results 118 caregivers participated in two cohorts (November 2020, February 2021). Caregivers expressed a significant increase in QOL from baseline to programme completion (t(125)=−10.7, p≤0.0001). Participation in cohort 2 was associated with the greatest PedsQL-FIM change. Qualitative data revealed positive changes postprogramme in five key areas: caregiver mindset, parenting practices, disability-inclusive behaviours, psychological well-being and child functioning. These changes were seen as both outcomes and mechanisms influencing the primary outcome of QOL. Mechanisms that mediated these changes included increased knowledge of disability and the core acceptance and commitment therapy components of mindfulness and acceptance. Conclusion The Mighty Children caregiver support programme for children living with disability in Afghanistan was associated with improved caregiver QOL. Further studies are warranted to explore pathways to scale, sustainability and potential application in other settings. Data are available on reasonable request.","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"67 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing collaborative research for health: why does collaboration matter?","authors":"Carla Saenz, Timothy M Krahn, Maxwell J Smith, Michelle M Haby, Sarah Carracedo, Ludovic Reveiz","doi":"10.1136/bmjgh-2024-014971","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-014971","url":null,"abstract":"The calls for health research to be collaborative are ubiquitous—even as part of a recent World Health Assembly resolution on clinical trials—yet the arguments in support of collaborative research have been taken for granted and are absent in the literature. This article provides three arguments to justify why health research ought to be collaborative and discusses trade-offs to be considered among the ethical values guiding each argument. No data are available.","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"24 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prepared for the polycrisis? The need for complexity science and systems thinking to address global and national evidence gaps","authors":"Aku Kwamie, Sara Causevic, Goran Tomson, Ali Sie, Rainer Sauerborn, Kumanan Rasanathan, Ole Petter Ottersen","doi":"10.1136/bmjgh-2023-014887","DOIUrl":"https://doi.org/10.1136/bmjgh-2023-014887","url":null,"abstract":"The Sustainable Development Goals are far off track. The convergence of global threats such as climate change, conflict and the lasting effects of the COVID-19 pandemic—among others—call for better data and research evidence that can account for the complex interactions between these threats. In the time of polycrisis, global and national-level data and research evidence must address complexity. Viewed through the lens of ‘systemic risk’, there is a need for data and research evidence that is sufficiently representative of the multiple interdependencies of global threats. Instead, current global published literature seems to be dominated by correlational, descriptive studies that are unable to account for complex interactions. The literature is geographically limited and rarely from countries facing severe polycrisis threats. As a result, country guidance fails to treat these threats interdependently. Applied systems thinking can offer more diverse research methods that are able to generate complex evidence. This is achievable through more participatory processes that will assist stakeholders in defining system boundaries and behaviours. Additionally, applied systems thinking can draw on known methods for hypothesising, modelling, visualising and testing complex system properties over time. Application is much needed for generating evidence at the global level and within national-level policy processes and structures. All data relevant to the study are included in the article.","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"7 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition remains a top priority in Ukraine despite the ongoing war: the fight against trans fats","authors":"Gerard Bryan Gonzales, Carla Motta, Clare Farrand, Jarno Habicht, Olena Kuriata, Pyi Pyi Phyo, Andrii Skipalskyi, Kremlin Wickramasinghe","doi":"10.1136/bmjgh-2024-016301","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-016301","url":null,"abstract":"### Summary box Nutrition remains a critical priority in Ukraine, even in the midst of the ongoing war. One of the specific nutrition-related concerns that many countries, including Ukraine, have been addressing is the reduction of trans fats and especially the elimination of industrially produced trans fats in the food supply. Trans fatty acids (TFA), or trans fats, are either naturally occurring or industrially synthesised type of unsaturated fatty acids with at least one double bond in the trans configuration. Industrially produced trans fats are synthesised via the partial hydrogenation of vegetable oils, which results in a semi-solid fat that is often used as a cheaper alternative to butter, has a longer shelf life and imparts desirable texture to food products. This makes trans fats more commonly found in food products that contain high amounts of partially hydrogenated oils, such as margarine, shortenings, cookies, cakes, breads and other industrially prepared foods. Developed and once widely used for their beneficial characteristics for the food industry, epidemiological evidence has since emerged on the association between regular consumption of trans fats and increased risk of non-communicable diseases (NCD), especially coronary heart disease. Approximately, 540 000 deaths each year may be attributed to intake of industrially produced TFAs.1 High TFA intake increases all-cause mortality by 34%, coronary heart disease deaths by 28% and coronary heart disease by 21%.2 This is likely due to their effect on increasing …","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"9 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training health workers and community influencers to be Vaccine Champions: a mixed-methods RE-AIM evaluation","authors":"Jessica Kaufman, Isabella Overmars, James Fong, Jemesa Tudravu, Rachel Devi, Litiana Volavola, Luisa Vodonaivalu, Kylie Jenkins, Julie Leask, Holly Seale, Yasmin Mohamed, Kshitij Joshi, Halitesh Datt, Sonya Sagan, Michelle Dynes, Monsurul Hoq, Margie Danchin","doi":"10.1136/bmjgh-2024-015433","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-015433","url":null,"abstract":"Introduction Increasing trust and confidence in vaccines is a global priority, as countries have grappled with delivering COVID-19 vaccines, maintaining routine childhood vaccination rates and introducing new vaccines. Community-based vaccine promotion interventions are commonly implemented, but effectiveness evidence is limited. In 2022, supported by the Australian Government and in partnership with Fiji’s Ministry of Health and UNICEF, we codesigned, delivered and comprehensively evaluated a vaccine education and communication training programme for health workers and community influencers to promote COVID-19 and routine immunisation. Methods The Vaccine Champions programme included three phases: (1) codesign with Fiji stakeholders; (2) vaccine education and communication training for Vaccine Champions and (3) support for Champions to deliver community vaccine discussion sessions over 6 months. The RE-AIM framework evaluation measured programme reach, effectiveness, adoption, implementation and maintenance. Mixed-methods data were collected through interviews, surveys and field notes, integrating qualitative and quantitative data to triangulate findings. Primary outcomes included Champions’ knowledge, communication self-efficacy, trust in COVID-19 vaccines, programme satisfaction and community members’ intention to vaccinate. Results We trained 35 Champions (27/35 female), including health workers, faith and community influencers. Half had a health background (17/35). Champions conducted 54 discussion sessions, reaching 1717 community members. Most Champions (22/35) conducted at least 1 session, with 16 running 3 or more. Champions who did not run sessions reported barriers like lack of confidence and competing duties. Training increased Champions’ communication self-efficacy and trust in COVID-19 vaccines. Community member intention to vaccinate increased from 41% (394/960) to 83% (822/991) before and after a session. The programme was well received with interest in continued engagement. Conclusion Training health workers and community Vaccine Champions can promote vaccine confidence. Programmes require government support and engagement for sustainability. Robust evaluation frameworks are needed to build the evidence base. Data are available on reasonable request. Deidentified individual participant data that underlie the results reported in this article, as well as the study protocol and data collection instruments, will be made available from the point of, and up to 3 years after the acceptance for publication of the main findings. Data will be shared with researchers who provide a methodologically sound proposal, for analyses that achieve the aims in the approved proposal. Proposals should be directed to jess.kaufman@mcri.edu.au. To gain access, data requesters will need to sign a data access agreement.","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"15 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A call to bridge the diagnostic gap: diagnostic solutions for neonatal sepsis in low- and middle-income countries","authors":"Birgitta Gleeson, Cecilia Ferreyra, Kara Palamountain, Shevin T Jacob, Naomi Spotswood, Niranjan Kissoon, Yasir Bin Nisar, Felicity Fitzgerald, Sarah Murless-Collins, Uduak Okomo, James H Cross, Elizabeth Molyneux, Erwan Piriou, Kenechukwu K Iloh, Data Santorino, David Goldfarb, Alex Stevenson, Rebecca Kirby, Brooke E Nichols, Benjamin Blumel, Cassandra Kelly-Cirino, Timothy Walsh, Lizel Lloyd, Sara Liaghati-Mobarhan","doi":"10.1136/bmjgh-2024-015862","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-015862","url":null,"abstract":"#### SUMMARY BOX The first month of life is the most critical period for an infant’s survival, yet the most neglected for the provision of quality care. Each year, an estimated 2.3 million neonates die in their first month of life.1 Sepsis alone is responsible for 7.3% of all neonatal deaths worldwide, with a significant burden falling on low- and middle-income countries (LMICs).2 While there remains an ongoing debate regarding the definition of neonatal sepsis, it is broadly described as a suite of non-specific signs that may include fever or hypothermia, respiratory distress, cyanosis and apnoea, feeding difficulties, lethargy or irritability, hypotonia, seizures, bulging fontanelle, poor perfusion, bleeding problems, abdominal distention, hepatomegaly, unexplained jaundice or more importantly ‘just not looking right’.3 The absence of a conclusive, easily accessible and affordable diagnostic test for sepsis, as well as the multitude of potential pathogens, allows for ambiguity. This can result in underdiagnosis or overdiagnosis, both of which can have life-altering consequences for vulnerable neonates …","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"95 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}