BMJ Global Health最新文献

{"title":"Operationalising health in the humanitarian-development-peace nexus (HDPN) in Africa: a new framework for building resilience in countries with fragile, conflict and violence-affected settings.","authors":"Ambrose Talisuna, Sohel Saikat, Redda Seifeldin, Sam Tweed, Francis Chisaka Kasolo, Yu Zhang, Gerard Schmets, Agnes Wenu Midi, Hiba Boujnah, Georges Alfred Kizerbo, Alex Ntale Gasasira, Joseph Waogodo Cabore, Ali Ardalan, Awad Mataria, Ahmed Zouiten, Bruce Aylward, Hanan H Balkhy, Matshidiso R Moeti","doi":"10.1136/bmjgh-2025-019929","DOIUrl":"https://doi.org/10.1136/bmjgh-2025-019929","url":null,"abstract":"<p><p>Humanitarian needs are escalating globally, with around 300 million people requiring assistance-over half in Africa. These crises are increasingly driven by conflict, climate-related disasters and emergencies and economic instability, all severely impacting public health and disrupting health systems. A new approach is essential to address root causes of humanitarian crises and develop durable solutions. In response to this need, the WHO developed a framework for health in the humanitarian-development-peace nexus (HDPN) in Africa. This framework was informed by literature reviews and consultations with key stakeholders across UN and wider humanitarian sector (including the African Union bodies, WHO offices and relevant non-governmental organisations). The framework presents a structured method for countries to integrate health across the HDPN, emphasising policy alignment, the need for sustainable financing, strong monitoring systems and adaptable governance. It defines clear roles for WHO, the African Union Commission, regional economic communities and authorities in countries as applicable. Key areas for operationalising the framework include health sector development planning, budgeting, financing, intersectoral coordination, services delivery and monitoring and evaluation. It also recommends integrated strategic actions focusing on health across humanitarian, development and peacebuilding efforts, emphasising synergy and co-benefits from this nexus approach. With a growing number of countries facing humanitarian crises, fragility and conflict, urgent implementation of this framework is vital to build resilience and improve health outcomes across Africa and beyond.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942734","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 secondary prevention of rheumatic heart disease into the primary healthcare system in Northern Uganda.","authors":"Neema W Minja, Jafesi Pulle, Joselyn Rwebembera, Nicholas J Ollberding, Ndate Fall, Jenifer Atala, Jenipher Kamarembo, Linda Oyella, Francis Odong, Sarah R de Loizaga, Doreen Nakagaayi, Rachel Sarnacki, Judith W Dexheimer, Craig Sable, Chris T Longenecker, Emmy Okello, Andrea Z Beaton, David A Watkins, Kristen M Danforth","doi":"10.1136/bmjgh-2024-018835","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-018835","url":null,"abstract":"<p><strong>Introduction: </strong>Over 46 million people are living with rheumatic heart disease (RHD) globally, resulting in 380 000 premature deaths each year. Effective RHD prevention strategies are known but their implementation in low-resource settings has lagged. This study evaluated the feasibility and effectiveness of integrating secondary antibiotic prophylaxis into primary health centres to improve access and adherence to RHD care.</p><p><strong>Methods: </strong>We conducted a hybrid type III study using a mixed-method, pre-post design to evaluate a package of implementation strategies centred on decentralised RHD care and use of an electronic medical record in Gulu and Lira, Uganda. We combined clinical and programmatic data with provider and patient interviews to assess effectiveness, adoption and acceptability. The mean difference in the annualised percentage of days adherent to benzathine penicillin G (BPG) monthly injections predecentralisation and postdecentralisation was calculated using linear mixed effect regression. Thematic analysis was used to analyse qualitative data.</p><p><strong>Results: </strong>We decentralised 151 patients (median age 17.9 years, 64% female) from district hospitals to eight primary health centres. The percentage of days adherent to BPG was 77.2% predecentralisation and 80.5% postdecentralisation (mean difference 3.25, (95% CI -0.72 to 6.86), p=0.081), which was statistically non-inferior at the -10% non-inferiority margin. Interview data identified knowledge, confidence and intrinsic motivation as major determinants of provider adoption. Patients expressed mixed feelings towards pain control and provider services, but convenience and financial savings resulted in a high level of acceptability. The electronic registry presented challenges in a naive environment but showed a strong potential as an oversight tool at the district level.</p><p><strong>Discussion: </strong>This study is the first to demonstrate that decentralised RHD care is effective in sub-Saharan Africa. Lessons learnt provide a platform for future integration of RHD services countrywide, with implications for increasing access to and scale-up of secondary prevention measures for RHD care in Uganda.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942769","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":"Socioeconomic inequalities in infant mortality in Colombia: a nationwide cohort study during 10 years.","authors":"Giancarlo Buitrago, Carol Guarnizo-Herreño, Javier Eslava-Schmalbach","doi":"10.1136/bmjgh-2024-018526","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-018526","url":null,"abstract":"<p><strong>Background: </strong>Although socioeconomic inequalities in infant mortality are well-documented globally, there is limited evidence from longitudinal studies, particularly in low-income and middle-income countries. This study investigates the association between maternal socioeconomic conditions, health system affiliation and infant mortality, and it measures the related socioeconomic inequalities in Colombia over a decade.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from the Unified Affiliation Registry on all singleton live births in Colombia from 1 January 2011 to 31 December 2020. Birth and death records were linked using anonymised maternal IDs. The primary outcome was 1-year survival. Key exposures included maternal educational level, health system enrolment scheme and area of residence. Cox regression models were used to estimate HRs, adjusting for relevant covariates. The Relative Index of Inequality (RII) and the Slope Index of Inequality (SII) were also calculated.</p><p><strong>Findings: </strong>Among the 5 951 953 live births recorded, 5 605 111 were analysed. Significant inequalities were noted based on maternal education, health system affiliation and area of residence. Children of mothers with primary or lower education had a 50% higher risk of dying in the first year (adjusted HR (aHR) 1.50; 95% CI 1.44 to 1.56). Those with uninsured mothers had a 61% higher risk compared with those with mothers in the contributory health scheme (aHR 1.61; 95% CI 1.54 to 1.68). Additionally, children of mothers in dispersed rural areas had an 8% higher risk of first-year mortality compared with those in urban municipal centres (aHR 1.08; 95% CI 1.05 to 1.11). There was a clear pattern of social gradients in infant mortality (educational level: RII 1.55, 95% CI 1.49 to 1.62, and SII 4.12, 95% CI 3.76 to 4.48; health insurance scheme: RII 1.67, 95% CI 1.60 to 1.73 and SII 4.78, 95% CI 4.42 to 5.14; residence's zone: RII 1.12, 95% CI 1.07 to 1.17 and 1.04, 95% CI 0.63 to 1.44) and a notable increasing trend in educational inequalities (The RII and SII revealed increasing from 2011 to 2020 (RII from 1.18 to 1.92; SII from 1.59 to 5.74)).</p><p><strong>Interpretation: </strong>Despite Colombia's economic growth, the persistence and increase of socioeconomic inequalities in infant mortality found in this analysis highlight the need for comprehensive policy reforms targeting healthcare access and socioeconomic conditions.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942767","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":"Sovereignty, equity, solidarity: progress on the Global Health Emergency Corps.","authors":"Scott F Dowell, Christophe Schmachtel, Abdi Mahamud, Abdou Salam Gueye, Andrew Lee, Armand Bejtullahu, Carita Davis, Ciro Ugarte, Didier K Ekouevi, Eduardo S Gudo, Flavio Salio, Gail Carson, Gina Samaan, Johanna Hanefeld, Linda Doull, Melkamu Abte, Michel Yao, Mohannad Al Nsour, Nedret Emiroglu, Nikki Romanik, Renee Christensen, Sadaf Lynes, Samar Al-Mutawakel, Shi Guoqing, Soha Shawqi Ahmed Albayat, Sugi Perera, Thebeyame Macheke, Valerie Nkamgang Bemo, Chikwe Ihekweazu, Michael J Ryan","doi":"10.1136/bmjgh-2025-019424","DOIUrl":"https://doi.org/10.1136/bmjgh-2025-019424","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942689","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":"Refugees and asylum seekers in Europe need a rights-based approach to the issue of return: insights from the case of the Syrian displacement.","authors":"Saleh Aljadeeah, Sali Hafez, Aula Abbara, Dawn Chatty","doi":"10.1136/bmjgh-2025-019809","DOIUrl":"https://doi.org/10.1136/bmjgh-2025-019809","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942732","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":"Valuing health across groups: a cross-sectional population-based willingness-to-pay survey in Bhutan.","authors":"Ying Yao, Md Mizanur Rahman, Pempa, Yot Teerawattananon, Ryota Nakamura","doi":"10.1136/bmjgh-2025-019098","DOIUrl":"https://doi.org/10.1136/bmjgh-2025-019098","url":null,"abstract":"<p><strong>Introduction: </strong>Context-specific cost-effectiveness thresholds (CETs) informed by societal willingness to pay (WTP) are crucial for healthcare resource allocation in low- and middle-income countries. This study investigated WTP for health per quality-adjusted life year (QALY) in Bhutan.</p><p><strong>Methods: </strong>A WTP survey was conducted alongside the 2023 National Health Survey in Bhutan, sampling 1869 households. Using contingent valuation, respondents assigned monetary values to three hypothetical scenarios: 1 year of cancer symptom-free life, 1 year of perfect health and 5 years of perfect health. We used generalised linear regression to estimate WTP, controlling for demographic, socioeconomic and health-related factors, as well as elicitation methods. Multilevel analyses examined WTP variations within and between districts.</p><p><strong>Results: </strong>WTP estimates were 76 836 Bhutanese ngultrum (BTN) (0.26 times gross domestic product (GDP) per capita; 95% CI: 71 397 to 82 275) for a year without cancer symptoms, 104 381 BTN (0.35 times GDP per capita; 95% CI: 96 405 to 112 357) for 1 QALY and 235 237 BTN (0.78 times GDP per capita; 95% CI: 218 674 to 251 800) for 5 QALYs. WTP variations were driven by within-district individual characteristics, particularly income and education, rather than between-district differences.</p><p><strong>Conclusion: </strong>Minimal between-district WTP variations support a national-level CET for Bhutan. However, WTP-based CETs would be biased upward by wealthier and more educated groups. This bias could justify expensive technologies that strain public resources in Bhutan's government-funded healthcare system.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942783","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":"'Knowing how the machine works': a novel framework for engaging with the political determinants of health.","authors":"Fritz Brugger, Joschka J Proksik, Olga Cambaço, Isaac Lyatuu, Philip Adongo, Martin Amogre Ayanore, Mirko S Winkler","doi":"10.1136/bmjgh-2025-019640","DOIUrl":"https://doi.org/10.1136/bmjgh-2025-019640","url":null,"abstract":"<p><p>It is well established that <i>social</i> determinants influence people's health and well-being. Yet, limited attention is given to the fact that social determinants are, in turn, the result of <i>political</i> determinants. The political struggle between different ideas, interests and power over public policies, that is, how societies shall function, results in formal and informal structures that work as a 'sorting machine': they determine how societies (re)distribute material resources and opportunities among their members, creating societal classes that face disparate health outcomes. Their visible and measurable characteristics are then labelled 'social determinants'. Improving public health, therefore, needs engaging with the political determinants.We contribute to this broader vision with a process-oriented, interdisciplinary framework. It first operationalises the analysis of political determinants of health to understand how, in a specific public health concern, politics shapes policy processes and causes differential health outcomes. Building on these insights, the framework then supports strategic engagement with the politics of policy processes, using agile methods to identify and promote more equitable and politically feasible policy options.We illustrate our approach by reporting on an interdisciplinary 6-year research project in Burkina Faso, Ghana, Mozambique and Tanzania, examining how structural determinants contribute to unequal public health outcomes in industrial mining areas. Trade-offs between attracting mining firms and safeguarding public health have led to a patchwork of national legislation, global governance regimes and voluntary commitments, inviting an eclectic consideration of public health industrial mining. For instance, among over 560 mining projects across Africa, more than 90% of impact assessments were inaccessible. In the few that were, public health is only marginally considered, disproportionately harming vulnerable populations.To strengthen the 'structural competence' and policy relevance of the public health discipline, our results suggest an institutionalised cooperation with political science in curricula, training and applied research.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942694","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 sputum and tongue swab specimens for in-home point-of-care targeted universal testing for tuberculosis of household contacts: an acceptability and feasibility analysis.","authors":"Charl Bezuidenhout, Lawrence Long, Brooke Nichols, Gesine Meyer-Rath, Matthew P Fox, Sharon Olifant, Grant Theron, Kuhle Fiphaza, Maria Pieruccini, Morten Ruhwald, Adam Penn-Nicholson, Bernard Fourie, Andrew Medina-Marino","doi":"10.1136/bmjgh-2024-018131","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-018131","url":null,"abstract":"<p><strong>Introduction: </strong>Effective strategies are essential for early tuberculosis (TB) detection. Reliance on passive case detection, symptom screening and collection of sputum results in delayed or undiagnosed TB, contributing to on-going TB transmission. This study assessed the acceptability of in-home targeted universal TB testing (TUTT) using GeneXpert MTB/RIF Ultra at point-of-care (POC) during household contact investigations (HCIs) and the feasibility of using sputum and tongue swab specimens.</p><p><strong>Methods: </strong>The TB Home Study sought to evaluate the predictive value of different specimen types for use as a household-level triage test for TB. Household contacts of people with TB residing in the Buffalo City Metro Health District (Eastern Cape Province, South Africa) who received in-home POC TUTT through the TB Home Study were asked to complete a post-test acceptability survey. The survey assessed the level of comfort, confidence in the test results and perceived appropriateness of in-home POC TUTT. A feasibility framework was used to assess the feasibility of using sputum and tongue swab specimens for testing.</p><p><strong>Results: </strong>Of the 325 eligible household contacts, 281/325 (86.5%) provided consent. Of those contacts, 278/281 (98.9%) provided a tongue swab, and 50/281 (17.8%) could expectorate sputum. All specimens were successfully prepared for immediate in-home testing. Of the 172 tongue swab-based tests performed, 169 (98.3%) produced a valid result, whereas 47 of 49 (95.9%) sputum-based tests had a valid result. An immediate tongue swab-based test result was available for 274/278 (98.6%) clients compared with 47/49 (95.9%) sputum-based test results. The mean in-home POC TUTT acceptability score (5=highly acceptable) was 4.2/5 (SD=0.4).</p><p><strong>Conclusion: </strong>In-homePOC TUTT using sputum and tongue swab specimens was highly acceptable and feasible. Tongue swabs greatly increased the testing rates owing to the high sample collection yield. Combining sputum and tongue swabs for in-home POC testing offers a promising strategy to improve TB case detection and reduce diagnostic delays.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942809","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":"Proof-of-concept evaluation at Cox's Bazar of the Safe Water Optimization Tool: water quality modelling for safe water supply in humanitarian emergencies.","authors":"Syed Imran Ali, Michael De Santi, Matt Arnold, Usman T Khan, Tarra L Penney, Syed Saad Ali, Jean-François Fesselet, James Orbinski","doi":"10.1136/bmjgh-2024-018631","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-018631","url":null,"abstract":"<p><strong>Introduction: </strong>Waterborne diseases are leading concerns in emergencies. Humanitarian guidelines stipulate universal water chlorination targets, but these fail to reliably protect water as postdistribution chlorine decay can leave water vulnerable to pathogenic recontamination. The Safe Water Optimization Tool (SWOT) models chlorine decay to generate context-specific chlorination targets that ensure water remains protected up to point-of-consumption. The SWOT has not been tested in an active humanitarian response, so we conducted a proof-of-concept evaluation at a Cox's Bazar refugee settlement to validate its modelling and assess its efficacy and effectiveness.</p><p><strong>Methods: </strong>We trained the SWOT using data collected from July to September 2019 and evaluated using data from October to December 2019 (n=2221). We validated the SWOT's modelling by comparing performance using training and testing data sets. We assessed efficacy using binary logistic regression comparing household free residual chlorine (FRC) when the SWOT target was delivered at tapstands versus the status quo target, and effectiveness using interrupted time series analysis of the proportion of households with protective FRC before and after SWOT implementation.</p><p><strong>Results: </strong>The SWOT generated a context-specific FRC target of 0.85-1.05 mg/L for 15-hours protection. Validation of the SWOT's process-based model showed R² decreased from 0.50 to 0.23 between training and testing data sets, indicating periodic retraining is required. The SWOT's machine-learning model predicted a 1%-9% probability of household FRC<0.2 mg/L at 15 hours, close to the observed 12% and in line with the observed 7% risk during baseline and endline, respectively. Households that collected water meeting the SWOT target were more likely to have sufficient protection after 15 hours compared with the status quo target (90% vs 35%, p<0.01), demonstrating the SWOT's efficacy. The SWOT target was not fully implemented at tapstands, so we did not observe change in household FRC during endline.</p><p><strong>Conclusion: </strong>The SWOT can generate context-specific chlorination targets that protect water against pathogenic recontamination. Improving feedback between monitoring and treatment would help system operators unlock the SWOT's full water safety potential.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942726","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":"Ethnicity and religion as determinants of health in Afghanistan: the case of Hazaras.","authors":"Frishta Nafeh","doi":"10.1136/bmjgh-2025-019503","DOIUrl":"https://doi.org/10.1136/bmjgh-2025-019503","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942773","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}