Global Public Health最新文献

Antimicrobial resistance (AMR) is a critical global health issue, especially in low-resource settings. A One Health-based community engagement approach, such as the Antibiotic-Wise Village (SAJAKA) model, offers a potential solution. This study assessed SAJAKA's implementation in four Bali villages, evaluating its impact on knowledge and antibiotic use behavior. The intervention included workshops, school programs, poultry feed/water analysis, and medical audits. Using a pre-test/post-test design, 769 participants including household mothers, schoolchildren, farmers, healthcare workers were surveyed. Results showed significant knowledge improvements, particularly among farmers (30.69%) and household mothers (26.65%). Behaviorally, household antibiotic storage declined (3.39%), and addition antibiotics in poultry feed were eliminated. However, irrational prescribing by healthcare workers persisted. Water tests revealed faecal contamination but no resistant E. coli to third-generation cephalosporins was detected. Of the four villages, Buwit achieved 'Antibiotic-Wise Village' status (score = 7). The SAJAKA model successfully boosted AMR awareness and promoted responsible antibiotic use. To expand impact, healthcare workers engagement and sustained community efforts are crucial for AMR containment.

Adequate nutrition plays a vital role in maintaining women's health and ensuring the healthy growth and development of infants and children. However, during emergencies and displacement, multiple factors can disrupt adequate maternal and child nutrition. The aim of this study was to explore the available literature reporting the prevalence and associated risk factors of undernutrition among displaced pregnant and lactating women. This review follows the PRISMA guidelines for Scoping Reviews. An electronic search was conducted in the PubMed, Web of Science, and Google Scholar databases. The Emergency Nutrition Network and ReliefWeb websites were also explored for grey literature. The prevalence of wasting among pregnant and lactating women varied widely, reaching 77% in Tigray internally displaced person (IDP) camps. The underweight prevalence ranged from 9.3% in a Nigerian IDP camp to 26.7% in a refugee camp in Bangladesh. Anemia was common, affecting up to 44.7% of pregnant Syrian refugees in Jordan. Maternal age, family size, childbirth interval, family income, and lack of education were the main factors associated with undernutrition among displaced pregnant and lactating women. Acknowledging the burden of undernutrition and identifying the most frequent risk factors, should inform the development of relevant nutrition interventions in different displacement settings.

The United States is experiencing a resurgence of measles, a highly contagious disease previously declared eliminated in 2000. This article examines the current trends of this resurgence, focusing on the increasing number of cases and outbreaks, the factors contributing to low vaccination rates, and the critical role of vaccine hesitancy. Data from the Centers for Disease Control and Prevention (CDC) as of May 15, 2025, are presented, highlighting the significant increase in measles activity and the concentration of cases within outbreaks. The analysis explores the epidemiological characteristics of these outbreaks, including severity and transmission dynamics, and examines the decline in national MMR vaccine coverage. Finally, the article discusses evidence-based strategies to enhance vaccine accessibility, combat misinformation, and improve outbreak response, emphasizing the urgent need for a coordinated public health approach to mitigate future outbreaks and protect vulnerable populations.

This paper introduces the concept of collateral stigma to analyze how queer people in Dar es Salaam navigate HIV prevention through Pre-Exposure Prophylaxis (PrEP). Drawing on 11 months of ethnographic fieldwork (2021-2022), we show how PrEP use exposes individuals to unintended and misattributed stigmatization: being perceived as HIV-positive, queer, or a sex worker despite efforts to conceal these identities. Through case studies, we illustrate how stigma materializes in pills, spaces, and institutional practices, shaping strategies of concealment and avoidance. While PrEP aims to reduce HIV risk, fear of collateral stigma often deters uptake or leads to unsafe practices, paradoxically increasing vulnerability to HIV. We situate these findings within Goffman's notion of concealable stigma and extend it by considering structural power relations that produce stigma as a social process. The paper argues that collateral stigma complicates global health interventions by creating unpredictable barriers to care. We conclude by recommending stigma-sensitive programming, including discreet medication packaging and flexible service delivery, to ensure that HIV prevention does not require risking social exclusion. By conceptualizing collateral stigma, this study advances theoretical debates on stigma and offers practical insights for designing inclusive, stigma-free HIV prevention strategies.

Uncorrected refractive error - a condition affecting nearly 1 billion people globally - is a potentially significant constraint to economic productivity. Despite its prevalence, limited research has explored productivity impacts from refractive error correction in low-and middle-income countries where 90% of avoidable sight loss occurs. This study estimates the effect of refractive error correction on productivity by providing glasses to 332 seasonal harvesters across 12 Guatemalan coffee operations during the 2023-2024 season. Daily harvest weights were recorded and compared to a non-intervention group without visual impairment. We used an ANCOVA model as the primary specification with alternative difference-in-differences specifications as robustness checks. A financial benefit-cost analysis assessed whether returns exceeded costs for workers and farm owners. Results show a significant average daily harvest increase of 12.2 lbs (95% CI 3.5-20.8, p = 0.004), corresponding with a 7.9% relative productivity gain (95% CI 1.0%-14.8%, p = 0.02). Providing glasses costs $29.4 per worker, yielding returns of $10.9 to $1 to harvesters if they make this investment directly and $2.6 to $1 to the farm owners if they provide the glasses. Findings indicate substantial productivity gains and financial incentives for vision correction. This simple, cost-effective intervention has the potential to benefit millions in agriculture.

For decades, Palestinians have faced significant barriers to developing and accessing basic health services, leading to poor health outcomes. These issues are often characterized as mere 'humanitarian issues,' ignoring the broader sociopolitical context. This study aims to explore the discourse surrounding the structural and sociopolitical determinants shaping Palestinian health. We conducted in-depth interviews with experts (N = 15) on Palestine and/or regional health, coded transcripts via an inductive coding process in Dedoose software, and analyzed transcripts by identifying key patterns, developing themes and sub-themes, and collectively discussing their validity. We identified five main themes, which are: 1) tools of state violence that degrade Palestinian health; 2) health systems and barriers to care, such as movement restrictions; 3) the role of humanitarianism in Palestinian health, which hinders Palestinian sovereignty; 4) the temporalities of erasure throughout history and present; and 5) Palestinian resistance to elimination and erasure. This study underscores the importance of considering the historical and political factors that have shaped Palestinian health in future research, practice, and advocacy efforts.

This article examines how internationally educated health professionals contribute to health system change on return to their countries of origin. Rather than treating return as reintegration or skill application, this study approaches it as interpretive, constrained engagement within health systems. Drawing on interviews with 52 returnees from 43 countries and a comparison group of 14 nationally educated peers, and using an abductive realist thematic analysis, the study identifies four pathways: policy influence, community engagement, infrastructural innovation, and medical education, through which returnees engaged systems. These are underpinned by three mechanisms: reflexive agency, knowledge translation, and civic understanding. What distinguishes returnees is not exclusive access to insight, but the configuration of stance, tempo, scope, and resources. Non-mobile peers contributed through equally committed, often slower and more embedded strategies. The findings challenge instrumental framings of return as skill deployment. International education is understood as a catalytic influence that interacts with home-grown formation to shape how professionals interpret structural conditions, navigate constraints, and assume responsibility.

Breast cancer is the most common type of cancer among Saudi women. Despite this prominence, the lack of data on the association between intimate partner violence (IPV) and breast cancer among Saudi women has presented significant obstacles for both academics and practitioners. This study sought to determine the prevalence, consequences, and types of IPV-including physical, emotional, and verbal abuse as well as controlling behavior-among Saudi breast cancer patients and survivors (BCPS). A cross-sectional study was conducted in Saudi Arabia (SA) among 146 BCPS. The frequency of IPV among BCPS varied by IPV type. The most prevalent forms of IPV were verbal and emotional (26%). All BCPS who were exposed to emotional and verbal IPV had at least one emotional issue. IPV was found to be significantly associated with both participants and their partners being unemployed and having a lower level of education. IPV can adversely impact the health and well-being of BCPS as well as that of their children and families. Therefore, future research and practice must prioritize enhancing IPV awareness among patients with cancer and their families due to its profound effect on the health and well-being of those affected.

This study centres the voices of providers currently working with the child and adolescent population to analyse social and structural factors that facilitate or impede access and service utilisation among children and adolescents. We conducted semistructured interviews with 15 psychological health care providers across 4 metropolitan cities in India. Thematic analysis was guided by an immersion-crystallization study design. Following this modified grounded theory approach, structural stigma emerged as a salient factor. Participant narratives revealed interconnecting forms of stigma encountered by adolescents. There was a preference for therapy over pharmacological interventions. Providers indicate the need for institutional and policy support for schools to promote mental health and well-being among children. Training lay counsellors, and initiating tele-mental health services in a large-scale manner could be effective ways to distribute caseloads and reach vulnerable populations without access to high-quality mental healthcare in their geographic vicinity.

The displaced Rohingya population residing in Cox's Bazar, Bangladesh, must navigate their reproductive lives in this fragile context. This study examines the knowledge, attitudes and use of menstrual regulation/pregnancy termination services in four displaced persons' camps to understand women's engagement with these services and barriers to safe services using Bandura's social cognitive theory. We conducted a household, community-based survey with women of reproductive age in 2022 (n = 1173). Ninety-two percent of respondents knew that health facilities provide pregnancy terminations, yet knowledge about when access is permissible is incomplete. Only one-third knew that this service could be provided 11-12 weeks after last menstrual period, with most respondents believing that the cutoff was earlier. The respondents believed that menstrual regulation was provided only under certain conditions, and 99% stated that a husband's consent should be required for a woman to end a pregnancy (always or sometimes). One in five respondents (n = 223) knew someone who had ended a pregnancy since arriving in the camps. While knowledge about and support for pregnancy termination services are high, there is room for improvement in education about the conditions under which it can be accessed. The results fill a knowledge gap regarding the acceptability and use of pregnancy termination in the Bangladesh camps of displaced Rohingya.