International Public Health Research Papers (original) (raw)

2025, Ochsner Journal

Background: Child marriage represents a grave violence against children and deprives them of their rights to health, education, and a livelihood. Because child marriage should be recognized as a social and medical emergency, the social determinants of child marriage in India need to be mapped. The aim of this qualitative case study was to document social determinants of child marriage identified by the authors while providing community mobile health services in rural Mewat District, India. Case Report: We present qualitative participatory medical histories and assessments of two clinical cases: an adolescent who is waiting to get married and a young woman who was married as an adolescent but developed multiple health complications after her husband abandoned her. Conclusion: Patriarchy, coercion, social customs, and norms were identified as major social determinants. The two cases demonstrate that social norms influence intergenerational norms and lead to uninformed decision-making and child marriage. In low-and middle-income countries, medical professionals should urgently address child marriage as a major public health problem. Primary care physicians and medical professionals should implement preventive measures and provide anticipatory guidance to prevent child marriage.

2025

programme for the past two years and this has meant being away from home. To my husband Mandlenkosi Mpofu, thank you so much my love for being there for me and believing in me even when I was at my lowest point. To my daughter Bongeka Vuyisile Mpofu, I appreciate so much your understanding that I had to be away from you for so long. I love you so much and promise to be there for you always. To my father Obert Moyo, thank you for making me believe that I can do anything I set my sights on. I would not have managed without your support. To my lovely sisters Silethemba and Senelisiwe, I do not have the words to say how thankful I am to you for being there for me. Inkosi ma ilibusise ngokuphindiweyo. I am also thankful to the Canon Collins Educational and Legal Assistance Trust, the Hewlett Foundation, JC Carstens Scholarship as well the Financial Aid Scheme for their financial support during my studies. Thank you so much for affording me the opportunity to pursue my studies. Above all, I thank God almighty for his grace!

2025, The Lancet Infectious Diseases

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2025, The Lancet

Background Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10-54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10-14 years and 50-54 years was estimated from data on fertility in women aged 15-19 years and 45-49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings From 1950 to 2017, TFRs decreased by 49•4% (95% uncertainty interval [UI] 46•4-52•0). The TFR decreased from 4•7 livebirths (4•5-4•9) to 2•4 livebirths (2•2-2•5), and the ASFR of mothers aged 10-19 years decreased from 37 livebirths (34-40) to 22 livebirths (19-24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83•8 million people per year since 1985. The global population increased by 197•2% (193•3-200•8) since 1950, from 2•6 billion (2•5-2•6) to 7•6 billion (7•4-7•9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2•0%; this rate then remained nearly constant until 1970 and then decreased to 1•1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2•5% in 1963 to 0•7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2•7%. The global average age increased from 26•6 years in 1950 to 32•1 years in 2017, and the proportion of the population that is of working age (age 15-64 years) increased from 59•9% to 65•3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1•0 livebirths (95% UI 0•9-1•2) in Cyprus to a high of 7•1 livebirths (6•8-7•4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0•08 livebirths (0•07-0•09) in South Korea to 2•4 livebirths (2•2-2•6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0•3 livebirths (0•3-0•4) in Puerto Rico to a high of 3•1 livebirths (3•0-3•2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2•0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger.

2025, BMJ Open

BackgroundRandomised controlled trials can provide evidence relevant to assessing the equity impact of an intervention, but such information is often poorly reported. We describe a conceptual framework to identify health equity-relevant randomised trials with the aim of improving the design and reporting of such trials.MethodsAn interdisciplinary and international research team engaged in an iterative consensus building process to develop and refine the conceptual framework via face-to-face meetings, teleconferences and email correspondence, including findings from a validation exercise whereby two independent reviewers used the emerging framework to classify a sample of randomised trials.ResultsA randomised trial can usefully be classified as ‘health equity relevant’ if it assesses the effects of an intervention on the health or its determinants of either individuals or a population who experience ill health due to disadvantage defined across one or more social determinants of heal...

2025

The authors are especially appreciative of the young men and women from Bangu, Maré, and Morro dos Macacos who were willing to participate in the study. Special thanks to the community-based associations who assisted with the project: Associação de Moradores de Nova Aliança (Bangu), Associação de Moradores do Conjunto Esperança (Maré), CIEP Professor César Pernetta (Maré), and Centro Educacional de Ação Comunitária Criança e Adolescente (Morro dos Macacos).

2025, Universidade da Paz, Dili, Timor-Leste

Introduction Timor-Leste, a Southeast Asian nation, has made significant advancements in healthcare since its independence in 2002. However, it still faces critical challenges, including inadequate infrastructure, an uneven distribution of healthcare professionals, and high maternal and child mortality rates. Content This document outlines a comprehensive framework established by the Ministry of Health to enhance healthcare services, with a focus on access to primary, secondary, and tertiary care. Key challenges identified include financial constraints, social and cultural barriers, and the impacts of climate change. Discussion The proposed strategies emphasize strengthening governance, enhancing the healthcare workforce, upgrading medical infrastructure, securing sustainable financing, and ensuring access to essential medicines. Collaborative efforts among government entities, healthcare providers, and community organizations are essential for adapting to the evolving healthcare needs of the population. Conclusion Achieving Universal Health Coverage is a critical objective to ensure equitable access to essential health services. By implementing the proposed strategies, Timor-Leste can establish a more resilient healthcare system, ultimately enhancing health outcomes for all its citizens.

2025, Universidade da Paz, Dili, Timor-Leste

2025, PLOS ONE

Anemia in women of reproductive age is highly prevalent globally and remains a public health problem. In Ethiopia, despite efforts to minimize the burden of anemia, it is still a moderate public health problem. Anemia has various etiologies including nutritional deficiency, parasitic infection, and inflammation. The aim of this study was to examine contributing factors to anemia in lactating women. Following ethical approval, and six months after delivery, all lactating women (n = 150) were recruited to participate in this study from eight randomly selected rural villages. Anthropometric and socio-economic factors were assessed. From each, a blood sample was collected for measuring hemoglobin, iron biomarkers, zinc, selenium, and inflammation markers. The median (IQR) hemoglobin (Hb) was 132 (123, 139) g/ L. Of the women, 19% were anemic and 7% had iron deficiency anemia; 31% were iron deficient and 2% had iron overload. Also, 8% had functional iron deficit, 6% had acute inflammation, 13% had chronic inflammation, and 16% had tissue iron deficiency. The majority (78%) of the women had low plasma zinc out of which more than 16% were anemic. Hb was positively associated with plasma iron and plasma zinc and negatively associated with transferrin receptor (TfR) and α-1-acid glycoprotein (AGP). Plasma iron, AGP, TfR, hepcidin and plasma zinc were significant predictors of maternal anemia. Additionally MUAC and level of education were associated positively with maternal hemoglobin. This study showed that maternal anemia was associated with multiple factors including nutritional deficiencies, inflammation and limited education.

2025, Journal of Nutritional Science

Despite global efforts made to address anaemia, the prevalence remains high in most Sub-Saharan African countries. In Ethiopia, anaemia poses a very strong public health concern. The purpose of the present study was to examine the key risk factors related to anaemia among children aged 6–24 months (younger age group) and 25–59 months (older age group). We used the 2016 Ethiopian Demographic and Health Survey data, collected from 11 023 mothers with under five children. Ordered logistic regression modelling was used for assessing risk factors of childhood anaemia. The results suggest that the prevalence of anaemia was 72 % in the younger and 49 % in the older age groups. The risk factors for anaemia in the younger age group were morbidity (odds ratio (OR) 1⋅77; CI 1⋅21, 2⋅60), having no piped water source (OR 1⋅76; CI 1⋅07, 3⋅01) and no toilet facility (OR 1⋅60; CI 1⋅07, 2⋅38). The key risk factors for anaemia in the older age group were no micronutrient intake (OR 1⋅69; CI 1⋅23, 2⋅3...

2025, African Journal of Food, Agriculture, Nutrition and Development

Iodine is essential for the synthesis of thyroid hormones which regulate the metabolic processes of most cells and play important roles in human growth and development. Iodine deficiency has long been one of the most common nutritional problems in the world. Ethiopia, particularly the study population (Sidama) has a history of severe iodine deficiency. The purpose of the study was to assess urinary iodine concentration, level of goiter in mothers and school-age children and household salt iodine concentration in households 10 months after launch of the national salt iodization program. A crosssectional study was conducted on a randomly selected sample of women and schoolchildren. Goiter was assessed by palpation. Concentrations of iodine in salt, urine and water were analyzed by inductively coupled plasma mass spectrometry (ICP-MS). The study included 193 mothers and 76 children. The median (IQR) urinary iodine concentration (UIC) was 143 (84, 202) µg/L in the mothers and 187 (102, 278) µg/L in the children. Mothers' UIC ranged from 17 to 767.2 µg/L and children's UIC ranged from 19 to 739 µg/L. Goiter prevalence was high in both mothers (76%) and children (79%). The median household salt iodine concentration (SIC) was 8.1 (4.3, 13.4) ppm (mg/kg) with a range of 0 to 42 ppm. None of the water samples contained iodine above the detection limit of 1 µg/L. Despite the launch of the salt iodization program in Ethiopia, 94% of the study participants were not aware that they used iodized salt and 88% did not know the benefits of iodized salt. The major source of iodine for this population was iodized salt; however, the salt at household level contained minimal but variable amounts of iodine. Low concentration of iodine in salt may be further compounded by storage, handling and cooking techniques. The high variability of salt iodine concentration (SIC) was also reflected in the UIC of the mothers and children.

2025, Ethiop J Health Sci.

BACKGROUND: The availability of emergency care contributes to half of the total mortality burden in a low and middle income countries. The significant proportion of emergency departments in LMICs are understaffed and poorly equipped. The purpose of this study is to examine the status of emergency units and to describe the facilitators and barriers to the provision of facility-based emergency care at selected Ethiopian public hospitals. METHODS: A mixed-methods explanatory design was used. Ten hospitals were purposively selected due to their high number of patients and referral service. A WHO facility assessment tool was used to quantitatively assess the facilities, and an in-depth interview with hospital and emergency room leadership was conducted. The quantitative results were descriptively analyzed, and the qualitative data was thematically analyzed. RESULT: This survey included a total of ten hospitals. Three of the facilities were general hospitals, and seven were tertiary level hospitals. They all were equipped with an emergency room. All of the studied hospitals serve a population of over one million people. In terms of infrastructure, only 3/10 (30%) have adequate water supply, and alf (5/10) have telephone access in their ED. The qualitative resultshowedthat the most common barriers to emergency care delivery were prolonged patient stays in the emergency room, inadequate equipment, and a shortage of trained professionals. CONCLUSION: The status of emergency care in Ethiopia is still developing, and hospital care as a whole should improve to alleviate the high burden of care in emergency rooms and reduce morbidity and mortality.

2025, Revista Brasileira De Educacao E Saude

Fábio Alexandre dos Santos Lira Mestre em Ciências da Nutrição, especialista em Fisiologia e Biomecânica do Movimento, graduado em Educação Física, docente do curso de Bacharelado em Educação Física, das Faculdades Integradas de Patos-FIP e membro do Comitê de Ética e Pesquisa da referida instituição Resumo. Este estudo tem como foco analisar os benefícios da atividade física na redução da hipertensão arterial em um grupo de idosos, relatando seus benefícios para uma melhor qualidade de vida da pessoa idosa. O presente estudo tratou-se de uma pesquisa de campo, com caráter exploratório com abordagem quanti/qualitativa com classificação de quase experimental. Foi realizado numa Unidade de Saúde da Família com uma amostra de 30 idosos. Como resultados, foram encontradas diferenças estatisticamente significantes nas melhoras das pressões sistólicas e diastólicas, além de todos os domínios envolvidos na qualidade de vida. O melhor resultado foi associado ao domínio limitação por aspectos emocionais, seguido da saúde mental e aspectos sociais. O domínio que apresentou as piores notas foi a vitalidade. Foi também observado que a pressão arterial apresenta melhoras significativas durante a realização dos exercícios mas, para manter a melhora, a atividade física precisa ser regular, não sendo interrompida, tendo em vista que a interrupção da atividade leva à perda das vantagens associadas ao exercício físico não apenas para a pressão arterial, mas também para a qualidade de vida. Como limitação do estudo apresenta-se a dificuldade em organizar e manter os idosos nas atividades, tendo em vista a sua tendência à dispersão. Recomenda-se novos estudos relacionados ao assunto para avaliar a manutenção dos limiares pressóricos em longo prazo.

2025

The Population Council confronts critical health and developmental issues, from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs, and technologies that improve lives around the world. Established In 1952 and headquartered in New York, the Council is a nongovernmental, non-profit organization governed by an international board of trustees. www.popcouncil.org

2025

The Ubuntu Institute is a registered non-profit organisation in South Africa looking at the role of culture, heritage and indigenous knowledge systems in achieving the Millennium Development Goals in Africa. The Institute works in the... more

2025, Annals of general psychiatry

It is well known that suicidal rates vary considerably among European countries and the reasons for this are unknown, although several theories have been proposed. The effect of economic variables has been extensively studied but not that of climate. Data from 29 European countries covering the years 2000-2012 and concerning male and female standardized suicidal rates (according to WHO), economic variables (according World Bank) and climate variables were gathered. The statistical analysis included cluster and principal component analysis and categorical regression. The derived models explained 62.4 % of the variability of male suicidal rates. Economic variables alone explained 26.9 % and climate variables 37.6 %. For females, the respective figures were 41.7, 11.5 and 28.1 %. Male suicides correlated with high unemployment rate in the frame of high growth rate and high inflation and low GDP per capita, while female suicides correlated negatively with inflation. Both male and female...

2025

Council Islamabad Office who provided invaluable guidance and support right from the inception of the project to its completion. We would like to thank the external reviewer for having painstakingly reviewed the report and for providing valuable suggestions. Apart from the contribution of the authors, several individuals have also played a major role in the conduct of this study and in the preparation of this report. We gratefully acknowledge the help and support of the Director Generals of Health Punjab, Sindh, KP, Balochistan, KP, GB and the respective Executive District Health Officers of our sampled districts in undertaking this national study. Their valuable suggestions have helped in formulating the recommendations of the report.

2025

2025, Journal of Respiratory Infections

Pneumonia remains a common cause of morbidity and mortality in the US. Although, communityacquired pneumonia (CAP) has traditionally been considered an acute process, more recently, data have emerged showing that patients surviving an episode of CAP are at increased risk of death long after hospital discharged. In this descriptive review, we examine the current knowledge of long-term mortality and propose a hypothesis explaining the pathogenesis of long-term mortality in patients with CAP.

2025, ST. MARY’S UNIVERSITY

The study assesses the youth employees' utilization of sexual and reproductive health services and associated factors at Kombolcha Industrial Park. An institution-based descriptive cross-sectional design along with a quantitative research approach was employed. A random sampling technique was used to select 415 study respondents. Data were collected from June to November 2021 using questionnaires, observation and document analysis. The behavioral model developed by Andersen served as the guide for a set of questions that were adopted from related previous studies. SPSS version 21 was used to analyze the collected data. According to the finding of the study, current Reproductive Health (RH) service usage among youth employees at Kombolcha Industrial Park was low. Only 37.1% of the youth employees used reproductive health (RH) services as of the time of the study's conclusion. The main cause of this was ignorance of the services in reproductive health being offered. The study, therefore, advised that Youth and RH centers close to the industry park be strengthened with the required resources and trained personnel, and that the youth's understanding of SRH issues should be addressed. Peer educators should be prepared with the knowledge and tools necessary to raise the youth employees' understanding of SRH concerns and how to use them, as well as to assist the development of a supportive peer culture. Obstacles in the service providers should be focused to make the services youth-friendly.

2025, The University of Louisville journal of respiratory infections

Proposed mechanisms of systemic inflammation in COPD include systemic oxidative stress, activation of circulating inflammatory cells and increased levels of circulating inflammatory cytokines . Inflammation in COPD involves both innate immunity (neutrophils, macrophages, eosinophils, mast cells, natural killer cells, gamma delta T cells, and dendritic cells) and adaptive immunity (T and B lymphocytes),

2025, Trials

Background: In Cambodia, HIV prevalence is concentrated in key populations including among female entertainment workers (FEWs) who may engage in direct or indirect sex work. Reaching FEWs with sexual and reproductive health (SRH) services has been difficult because of their hidden and stigmatized nature. Mobile-phonebased interventions may be an effective way to reach this population and connect them with the existing services. This article describes study design and implementation of a randomized controlled trial (RCT) of a mobile health intervention (the Mobile Link) aiming to improve SRH and related outcomes among FEWs in Cambodia. Methods: A two-arm RCT will be used to determine the effectiveness of a mobile-phone-based text/voice messaging intervention. The intervention will be developed through a participatory process. Focus group discussions and in-depth interviews have been conducted to inform and tailor behavior change theory-based text and voice messages. During the implementation phase, 600 FEWs will be recruited and randomly assigned into one of the two arms: (1) a control group and (2) a mobile phone message group (either text messages [SMS] or voice messages [VM], a delivery method chosen by participants). Participants in the control group will also receive a weekly monitoring survey, which will provide real-time information to implementing partners to streamline outreach efforts and be able to quickly identify geographic trends. The primary outcome measures will include self-reported HIV and sexually transmitted infections (STI) testing and treatment, condom use, contraceptive use, and gender-based violence (GBV). Discussion: If the Mobile Link trial is successful, participants will report an increase in condom use, linkages to screening and treatment for HIV and STI, and contraception use as well as a reduction in GBV. This trial is unique in a number of ways. First, the option of participation mode (SMS or VM) allows participants to choose the message medium that best links them to services. Second, this is the first RCT of a mobile-phone-based behavior change intervention using SMS/VMs to support linkage to SRH services in Cambodia. Lastly, we are working with a hidden, hard-to-reach, and dynamic population with which existing methods of outreach have not been fully successful. Trial registration: Clinical trials.gov, NCT03117842. Registered on 31 March 2017.

2025, PloS one

In Cambodian context, female entertainment workers (FEWs) are young women working at establishments such as karaoke bars, restaurants, beer gardens or massage parlors. FEWs may sell sex to male patrons and are considered a high-risk group for HIV. This study aimed to identify factors associated with recent HIV testing among FEWs in Cambodia to inform future prevention activities. Data were collected in 2014 as part of the evaluation of a larger HIV prevention project. A two-stage cluster sampling method was used to select participants from Phnom Penh and Siem Reap for face-to-face interviews using a structured questionnaire. A logistic regression model was constructed to identify independent factors associated with recent HIV testing. Data were collected from 667 FEWs with a mean age of 25.6 (SD = 5.5). Of total, 81.7% reported ever having had an HIV test, and 52.8% had at least one test in the past six months. After adjustment for other covariates, factors independently associated ...

2025, BMC public health

At-risk male youth in Cambodia who purchase sex are at greater risk for HIV compared to the general population. Factors associated with paying for sex among youth are poorly studied, both globally and in Cambodia. This study aimed to identify specific factors associated with transactional sex with women among most-at-risk male youth in Cambodia. This cross-sectional questionnaire survey was conducted with 405 sexually active male youth aged 16-24 recruited at 'hotspots' in the capital city of Phnom Penh and seven provinces. We collected data on demographic factors, sexual behaviors, HIV testing and other potential factors. Multivariable logistic regression analysis was used to identify factors associated with transactional sex. In total, this study included 405 male youth with a mean age of 21.3 (SD = 2.2). Of the total respondents, 82.5% (n = 334) have ever paid for sex. After controlling for potential confounding, participants who purchased sex in the last 12 months remain...

2025, BMC Health Services Research

Background: The prevalence of HIV and sexually transmitted infections (STIs) among key populations in Cambodia continues to rise. To address this issue, KHANA, the largest national HIV organization in the country developed and implemented the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project. This study aims to determine the impacts of the SAHACOM on sexual behaviors and the uptake of HIV/STI services among men who have sex with men (MSM) in Cambodia. We compared outcome indicators at midterm (n = 352) and endline (n = 394). Surveys were conducted in 2012 and 2014 in Battambang and Siem Reap provinces. A two-stage cluster sampling method was employed to select the study sample for structured interviews. The midterm and endline samples were similar. The average number of sexual partners in the past three months decreased significantly from 6.2 to 4.0 (p = 0.03). The proportion of MSM who reported paying for sex with men in the past three months also decreased significantly from 19.0 % to 9.7 % (OR = 2.0, 95 % CI = 1.3-3.0). No significant change was found in condom and lubricant use in all types of relationships. Regarding STIs, 28.1 % of MSM at midterm reported having at least one STI symptom in the past three months compared to 6.1 % at endline (OR = 4.6, 95 % CI = 2. 9-7.4); out of them, 14.1 % of MSM at midterm sought treatment compared to 20.7 % at endline (OR = 2.6, 95 % CI = 1.1-6.9). The proportion of MSM who reported using illicit drugs in the past three months also decreased significantly from 12.2 % to 5.1 % (OR = 2.4, 95 % CI = 1.4-4.2). However, the proportion of MSM who reported having been tested for HIV in the past six months decreased significantly from 94.1 % to 77.1 % (OR = 2.9, 95 % CI = 1.8-3.6). Conclusions: Findings from this study indicate that the SAHACOM was effective in improving sexual behaviors and related health outcomes among MSM under the project. However, it could not increase condom use and HIV testing rates among this key population. Tailored intervention programs are needed to improve condom use and HIV testing among MSM in Cambodia.

2025, JMIR mHealth and uHealth

Despite great achievements in reducing the prevalence of HIV, eliminating new HIV infections remains a challenge in Cambodia. Entertainment venues such as restaurants, karaoke bars, beer gardens, cafes, pubs, and massage parlors are now considered important venues for HIV prevention efforts and other health outreach interventions. The purpose of this study was to explore phone use and texting practices of female entertainment workers (FEWs) in order to determine if text messaging is a feasible and acceptable way to link FEWs to health services. This cross-sectional phone survey was conducted in May 2015 with 97 FEWs aged 18-35 years and currently working at an entertainment venue in Phnom Penh. Of the 96 respondents, 51% reported sending text messages daily; of them, 47% used Khmer script and 45% used Romanized Khmer. Younger FEWs were more likely to report daily texting (P<.001). Most FEWs (98%) in this study reported feeling comfortable receiving private health messages despite...

2025, BMC Infectious Diseases

Background: In Cambodia, despite great successes in the fight against HIV, challenges remain to eliminating new HIV infections and addressing sexual reproductive health (SRH) issues in key populations including female entertainment workers (FEWs). To address these issues, the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project has been implemented since late 2009 using a community-based approach to integrate HIV and SRH services. This study evaluates the impact of the SAHACOM on sexual and healthcare-seeking behaviors among FEWs in Cambodia. Methods: A midterm and endpoint comparison design was utilized. Midterm data were collected in early 2012, and endpoint data were collected in early 2014. A two-stage cluster sampling method was used to randomly select 450 women at midterm and 556 women at endpoint for face-to-face interviews. Results: Compared to women at midterm, women at endpoint were significantly less likely to report having sexual intercourse in exchange for money or gifts in the past three months (OR = 2.1, 95 % CI = 1.6-2.7). The average number of commercial sexual partners in the past three months also decreased significantly from 5.5 (SD = 13.3) at midterm to 3.6 (SD = 13.9) at endpoint (p = 0.03). However, women at endpoint were significantly less likely to report always using condom when having sexual intercourse with clients in exchange for money or gifts (OR = 2.6, 95 % CI = 1.5-4.5). Regarding sexually transmitted infections (STIs), women at endpoint were significantly less likely to report having an STI symptom in the past three months (OR = 1.8, 95 % CI = 1.4-2.3) and more likely to seek treatment for the most recent STI symptom (OR = 1.6, 95 % CI = 1.1-1.9). Furthermore, women at endpoint were significantly more likely to be currently using a contraceptive method (OR = 1.4, 95 % CI = 1.1-1.8) and less likely to report having an induced abortion (OR = 1.4, 95 % CI = 1.1-1.7) during the time working as a FEW. Conclusions: The overall findings of the study indicate that the SAHACOM is effective in reducing sexual risk behaviors and improving the access to SRH care services among FEWs in Cambodia. However, several unfavorable findings merit attention.

2025, BMC International Health and Human Rights

Background: One approach to delivering healthcare in developing countries is through voucher programs, where vouchers are distributed to a specific population for free or subsidized health care. Recent evaluations suggest that vouchers have the potential to extend coverage of priority health services to the poor in developing countries. In Cambodia, a reproductive health voucher program was implemented in January 2011. This study aims to explore women's early experiences accessing health services with their vouchers at accredited clinics. Methods: This qualitative exploratory study used focus group methodology to gather information from five groups of older (>25 years) and four groups of younger (18-25 years) women who were eligible for the voucher program in three rural provinces. Focus groups were digitally recorded, transcribed and translated from Khmer into English. Data analysis was an iterative process, which comprised of open coding to find commonalities that reflected categories or themes and axial coding to relate initial themes to each other. Next, a basic framework for analysis was formed by integrating the themes into the framework. Results: Two overarching themes were identified in the data: 1) factors that facilitate voucher use and 2) factors that inhibit voucher use. Within each of these themes, three subthemes were identified: 1) pre-existing factors, 2) distribution factors, and 3) redemption factors. Overall, women expressed positive feelings towards the voucher program, while several areas for program improvement were identified including the importance of addressing preexisting demand-side barriers to using reproductive health services, the need for more comprehensive counselling during voucher distribution, and the persistent cost of unofficial payments expected by midwives after delivery irrespective of voucher use. Conclusions: Early information from program beneficiaries can lead to timely and responsive changes that can help to maximize program success. This study highlights the importance of tailoring voucher programs to specific community needs, a strategy that can lead to better program uptake.

2025

The Population Council confronts critical health and development issuesfrom stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs, and technologies that improve lives around the world. Established in 1952 and headquartered in New York, the Council is a nongovernmental, nonprofit organization governed by an international board of trustees. This publication has been made possible with the generous support of the American people through USAID/Kenya, under the APHIA II Operations Research Project, a cooperative agreement No. 623-A-00-09-00001-00 between the Kenya Mission and the Population Council. The opinions expressed herein are those of the authors and do not necessarily reflect the views of USAID Cover image courtesy of the Population Council.

2025, Journal of Infectious Diseases and Therapy

Background: Influenza viruses, respiratory-syncytial virus (RSV), metapneumovirus (hMPV), parainfluenza viruses (hPIV) type 1, 2 and 3 are leading causes of acute respiratory tract infections (ARTI) in infants and young children. The aim of this study was to determine the contribution of these viruses in medically attended ARTI among children aged <4 years during the 2012/13, 2013/14 and 2014/2015 winter seasons in Bulgaria. Methods: A total of 555 nasopharyngeal swabs of children aged <4 years diagnosed with ARTI were collected and tested for influenza A/B viruses by Real Time RT-PCR. Influenza virus negative samples were examined by individual Real Time RT-PCR using specific primers/probes for RSV, hMPV, hPIV1/2/3. Of the 555 specimens tested 152 (27%) were influenza virus positive. Influenza A (H1N1) pdm09, A(H3N2) and type B viruses were found in 64 (12%), 33 (6%) and 50 (9%) of samples, respectively. Among the 403 influenza virus negative specimens, paramyxoviruses RSV, hMPV, hPIV1/2/3 were detected in 86 (21%), 28 (7%), 23 (5, 7%), 7 (1, 7%) and 20 (5%) samples, respectively. RSV was the most frequently identified paramyxovirus. Overall, 33 (6%) patients were co-infected with two viruses. The contribution of 8 examined respiratory viruses in cases of bronchiolitis, pneumonia and neurological complications was analyzed. Conclusions: During the last three winter seasons, influenza viruses and RSV were the most frequent viral pathogens causing medically attended ARTI among children <4 years of age. Rapid diagnostics by Real Time RT-PCR is decisive in terms of adequate treatment and taking prompt anti-epidemic measures.

2025

The Population Council confronts critical health and development issues-from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs, and technologies that improve lives around the world. Established in 1952 and headquartered in New York, the Council is a nongovernmental, nonprofit organization governed by an international board of trustees. House 12, Road 25/30 Gulshan, Dhaka 1212 Bangladesh popcouncil.org This study has been funded by UNFPA.

2025, Journal of Public Health Policy

2025, KALANGAALO SS ALUMNI ASSOCIATION (KSSAA) 2025

Kalangaalo Secondary School Alumni Association (KSSAA) is a collective of former students committed to fostering lifelong connections, supporting our alma mater's development, and creating value for all members. Established to harness the power of our shared educational heritage, the association serves as a bridge between past and present students while contributing to the school's continuous improvement.

2025, Madising Foundation

Undang-Undang Nomor 33 Tahun 2014 tentang Jaminan Produk Halal (UU JPH) hadir sebagai respons atas kebutuhan mayoritas penduduk Indonesia yang beragama Islam terhadap kepastian hukum kehalalan produk yang dikonsumsi atau digunakan. Kajian... more

2025, Brazilian Journal of Physical Therapy

2025, Library Philosophy and Practice

The most recent MERS outbreak has raised questions about prevention and symptoms since there is currently no vaccine to prevent MERS. People can help protect themselves from this illness by taking everyday preventive actions. To do so, it is helpful to get medical information on the Internet about this illness. Regarding the importance of ensuring the provision of accurate online information, the aim of this study was to assess the credibility of health websites about MERS by using HONcode tool. The term "MERS" was searched in Google, Yahoo, and Bing and the first three pages reported by each search engine were selected for evaluation. After excluding 26 websites, 64 unique websites were eligible for examination. Subsequently, the trustworthiness of the websites was then evaluated by using the HONcode of conducts quality rating tool. Our findings indicate that most of the retrieved websites were commercial and governmental (37.5%). Furthermore, only 7 out of 64 websites were officially HONcode certified. In general, the health websites regarding MERS were of poor credibility and while searching for MERS information people will encounter websites which include more commercial content rather than educational. The internet is a place to educate individuals on their health condition and possible treatment options. Nevertheless, the internet cannot replace the role of health professionals in patient education. Regarding the poor credibility of MERS related websites, directing patients to reliable sources of online health information is important, mainly because search engine rank does not assure the trustworthiness of websites.

2025, Journal of Respiratory Infections

This was a longitudinal, prospective observational study of adult patients with BPP evaluated at the Santamarina Hospital in the city of Tandil. The hospital is a 130-bed primary care community hospital. Tandil is a city with a population... more

2025, Anthropology and Ethnology Open Access Journal

Community development is about placing individuals at the centre of the development process and helping them realize their potential. Community Development Workers (CDWs) are community-based resource persons who collaborate with other community activists to help fellow community members. The objective of this study is to assess factors that challenge the roles of CDWs. The study used both quantitative and qualitative study designs. Data were gathered through questionnaires, in-depth interviews and personal observation. The collected data was analyzed using mixed method of analysis of both quantitative and qualitative data. The study revealed that CDWs have proved to be key and important local actors and facilitators in bringing about attitudinal change among the communities they work with, are attracting the trust and confidence of the people they work with, have revitalized local social organizations as instruments of development, have tabled the agendas of the socially marginalized community groups, working on the principle of matching community inputs with resources, and their role approved to be well aligned with Development Policy as it fosters 'community participation, promotes self-reliance, and is strategically fasten at the grass roots level. The study concludes that CDWs are facing challenges in contextualizing their role and institutional factors are discovered to be impeding the roles of CDWs. The study recommends a multidisciplinary research involving educationalists, and social anthropologists could perhaps develop a more thorough of investigation and be more conclusive on the factors that influence CDWs performance initiated by this research.

2025

This article discussed Vietnam’s ongoing efforts to decentralize the health system and its fitness to respond to global health crises as presented through the Covid-19 pandemic. We used a general review and expert’s perspective to explore the topic. We found that the healthcare system in Vietnam continued to decentralize from a pyramid to a wheel model. This system shifts away from a stratified technical hierarchy of higher- and lower-level health units (pyramid model) to a system in which quality healthcare is equally expected among all health units (wheel model). This decentralization has delivered more quality healthcare facilities, greater freedom for patients to choose services at any level, a more competitive environment among hospitals to improve quality, and reductions in excess capacity burden at higher levels. It has also enabled the transformation from a patient-based traditional healthcare model into a patient-centered care system. However, this decentralization takes ti...

2025, The International Journal of Health Planning and Management

In responding to the COVID‐19 pandemic, each country is presented with both opportunities and challenges, some unique and some shared with the global community. It is important to not only recognize, but to embrace them as drivers of the public to the current pandemic success. In this commentary, we discuss the opportunities and challenges that may affect ongoing public health programming in Australia within the current context of epidemiology. COVID‐19 within Australia has to date been effectively suppressed through the implementation of nationally coordinated, in which the state delivered public policy, guidelines and practice, and successful establishment of a comprehensive testing, contact tracing, patient isolation and contact quarantine regime combined with national and state social distancing, hygiene etiquette and movement restrictions. However, despite its success to date great challenges lay ahead for future public health policy with the threat of a second wave, or more li...

2025, Journal of Community Health

Refugees and new immigrants arriving in the United States (U.S.) often encounter a multitude of stressors adjusting to a new country and potentially coping with past traumas. Community gardens have been celebrated for their role in improving physical and emotional health, and in the Twin Cities of Minnesota, have been offered as a resource to immigrants and refugees. The purpose of this study is to present a mixed method evaluation of a refugee gardening project hosted by area churches serving primarily Karen and Bhutanese populations. Quantitative data were obtained from early and late season surveys (44 and 45 % response rates, respectively), and seven focus groups conducted at the end of the season provided qualitative data. Although few gardeners (4 %) identified food insecurity as a problem, 86 % indicated that they received some food subsidy, and 78 % reported vegetable intake increased between the early and late season surveys. Twelve percent of gardeners indicated possible depression using the PHQ-2 scale; in focus groups numerous respondents identified the gardens as a healing space for their depression or anxiety. Refugee gardeners expressed receiving physical and emotional benefits from gardening, including a sense of identity with their former selves. Gardens may serve as a meaningful health promotion intervention for refugees and immigrants adjusting to the complexity of their new lives in the U.S. and coping with past traumas.

2025, Pakistan Journal of Public Health

Background: Pakistan ranks as one of the most poorest and most populous in the world with poor reproductive health indicators. This study helps in understanding barriers and perceptions regarding Family Planning (FP), modern contraception, quality of care and free of charge FP services amongst men and women in rural Pakistan. Methods: Employing purposive sampling and Focus Group Discussion (FGD) technique, this qualitative study was conducted with men and women of reproductive age in Pakistan. A total of eight FG Ds were conducted in Sindh and Punjab provinces. Being descriptive in nature, the study provided a thematic analysis of the relevant health issues by using an adapted constant comparison analysis process. Results: The contraceptive knowledge and uptake was low and misinformation was prevalent. Men thought of vasectomy as against men' pride and both males and females viewed removal of uterus as a permanent method. The women claimed neighbors, mother-in-law, friends and sister in-law and husband as main sources of information. Women seemed to have a greater exposure since they regularly come into contact with lady health workers and lady doctors but that information is not passed on to their husbands or discussed openly. There were many misconceptions prevalent among the participants, most of which were spread by untrained providers, such as the undesirable impact contraception can have on a woman's ability to conceive children. In addition, restrictions on female mobility and side effects were seen as barriers to contraception by majority of women whereas, most of the men perceived religio-cultural factors as barriers and considered FP as an additional expenditure. Conclusions: Though importance of family planning was recognized by the participants for the well being of the children and financial benefits of raising fewer children but the wellbeing of the woman was not considered a meaningful goal to pursue FP. Besides access, barriers towards use included money, where frequency of use and choice of method was affected by financial limitation. A gendered perspective also prevailed with reference to provider seeking behavior. Spousal communication is a topic mostly neglected by family planning programs, yet many of the barriers are linked to it. There is a need to design health interventions that devise counseling techniques to improve spousal communication, debunk the myths and misinformation in the community, and link the health of the child and mother with birth spacing and smaller family size.

2025, Obstetrics & Gynecology

OBJECTIVE: To assess the feasibility of ultrasonographic task shifting by estimating the accuracy at which primary-level health care workers can perform community-based third-trimester ultrasound diagnosis for selected obstetric risk factors in rural Nepal. METHODS: Three auxiliary nurse–midwives received two 1-week ultrasound trainings at Tribhuvan University Teaching Hospital in Kathmandu. At a study site in rural Nepal, pregnant women who were 32 weeks of gestation or greater were enrolled and received ultrasound examinations from the auxiliary nurse–midwives during home visits. Each auxiliary nurse–midwife screened for noncephalic presentation, multiple gestation, and placenta previa. Deidentified digital ultrasonograms were stored and uploaded onto an online server, where certified sonologists and ultrasonographers reviewed the images and made their own diagnoses for the three conditions. Accuracy of auxiliary nurse–midwife diagnoses was then calculated. RESULTS: A total of 804...

2025, International quarterly of community health education

To test a statistically significant change in delivery by medically trained providers following introduction of a demand-side financing voucher, a population-based quasi-experimental study was undertaken, with 3,300 mothers in 2010 and 3,334 mothers at follow-up in 2012 in government-implemented voucher program and control areas. Results found that voucher program was significantly associated with increased public health facility use (difference-in-differences (DID) 13.9) and significantly increased delivery complication management care (DID 13.2) at facility although a null effect was found in facility-based delivery increase. A subset analysis of the five well-functioning facilities showed that facility deliveries increased DID 5.3 percentage points. Quintile-based analysis of all facilities showed that facility delivery increased more than threefold in lower quintile households comparing to twofold in control sites. The program needs better targeting to the beneficiaries, ensurin...