Global Public Health最新文献

Pandemics disproportionately affect women due to their dominant roles in healthcare, caregiving, and industries vulnerable to public health policies. Women face higher infection risks, greater unpaid care burdens, and job losses during crises. Violence against women and disrupted access to healthcare, including sexual and reproductive services, also increase. Despite clear evidence of these effects, global pandemic responses have historically been gender-blind, with only limited improvements during COVID-19. This study uses the READ approach to analyze UN Women COVID-19 policy documents published in 2020, examining recommendations related to socio-economic security, violence against women and girls (VAWG), and people living across borders. From these documents we also analyzed 301 recommendations using the WHO's Gender Responsive Scale to assess their transformative potential. The results show that while UN Women addressed key gendered impacts, the recommendations often stopped short of promoting systemic change, reflecting broader limitations in global health responses. The findings highlight the gap between acknowledging gender disparities and promoting (let alone implementing) transformative policies that address structural inequalities. This research contributes to ongoing debates on the role of global institutions in advancing gender-responsive pandemic policies and calls for more meaningful engagement in addressing gender inequities in global health governance.

The current mpox outbreak has challenged previous understanding of the disease, with human-to-human transmission being a significant mode of transmission, particularly among gay, bisexual, and other men who have sex with men (GBMSM). A knowledge gap exists on MSM's mpox experiences in Nigeria's restrictive sociolegal context. This study explored mpox awareness, knowledge, and experiences among MSM in Lagos, Nigeria, through 28 in-depth interviews. We analysed the interview transcripts thematically. Findings showed low awareness and knowledge of mpox among MSM, who prefer seeking healthcare outside public health facilities due to stigma. Intimate contact during sexual intercourse is a likely source of infection among MSM. The Nigerian mpox response does not centre MSM, and centreing them may not be ideal due to potential stigma. MSM seek care through various means, including drugs, herbal remedies, and KP-friendly sexual and reproductive health (SRH) services, but face stressful care-seeking due to limited social support and stigma. The study shows that Nigeria's mpox situation differs from the situation in mpox non-endemic contexts. The homophobic legal and social environment and heterogenous spread require unique disease framing and context-sensitive response. The study concludes that further surveillance is needed to deepen understanding around mpox care seeking among MSM in Nigeria.

Precision oncology (PO) has significantly advanced lung cancer treatment by enabling personalised therapy based on genetic mutations. However, equitable access to molecular testing and targeted therapies remains a challenge, particularly in resource-limited settings such as the Brazilian Public Health System (SUS). To identify the challenges faced by SUS in caring for patients with non-small cell lung cancer (NSCLC) in terms of access to Precision Oncology. Retrospective study with data from e-medical records of NSCLC treated between 2015-2021. 174 patients with NSCLC were included, of which 56% were females and 63% had non-squamous histology - 80% of early-stage patients and 32% of advanced-stage patients missed access to genomic testing, primarily due to short life expectancy or insufficient sample size. Only one participant underwent testing for all recommended biomarkers. Among patients with actionable mutations, 40% did not receive targeted therapy; however, regarding EGFR mutations, only 8% did not get it. Access to targeted therapy was associated with improved survival outcomes. The study highlights critical challenges and missed opportunities in the implementation of precision oncology for NSCLC management within the SUS and underscores the need for strategies to improve access to genomic testing in the public health setting.

This article presents the results of a mapping and analysis of key stakeholders operating in the field of Sexual, Reproductive, and Maternal Health and Rights (SRMHR) who are involved in the entitlement of health rights and access to health services for women, adolescents, LGBTQI+ individuals, migrants, indigenous people, Afro-descendants, and people with disabilities in Latin America and the Caribbean. Our study focuses on Argentina, Colombia, Guatemala, Guyana, Jamaica, Mexico, and Peru. The primary objective was to identify and comprehensively categorise the activities undertaken by them, since their actions shape, and promote or hinder the SRMHR political agenda in the region. The findings of this mapping can be useful in contributing to the development of public policy strategies.

Indigenous data sovereignty is of global concern. The power of data through its multitude of uses can cause harm to Indigenous Peoples, communities, organisations and Nations in Canada and globally. Indigenous research principles play a vital role in guiding researchers, scholars and policy makers in their careers and roles. We define data, data sovereignty principles, ways of practicing Indigenous research principles, and recommendations for applying and actioning Indigenous data sovereignty through culturally safe self-reflection, interpersonal and reciprocal relationships built upon respect, reciprocity, relevance, responsibility and accountability. Research should be co-developed, co-led, and co-disseminated in partnership with Indigenous Peoples, communities, organisations and/or nations to build capacity, support self-determination, and reduce harms produced through the analysis and dissemination of research findings. OCAP® (Ownership, Control, Access & Possession), OCAS (Ownership, Control, Access & Stewardship), Inuit Qaujimajatuqangit principles in conjunction the 4Rs (respect, relevance, reciprocity & responsibility) and cultural competency including self-examination of the 3Ps (power, privilege, and positionality) of researchers, scholars and policy makers can be challenging, but will amplify the voices and understandings of Indigenous research by implementing Indigenous data sovereignty in Canada.

Indigenous ways of knowing, being and doing are based on embodied sovereignty, relationality and countless generations of knowledge sharing. We call for epistemic justice in which Indigenous knowledge systems are recognised and valued in research-related contexts. We draw attention to how colonial knowledge systems silence, delegitimise and devalue specific knowers and ways of knowing, being and doing - through truth telling. This includes (1) the extent to which educational systems, research, practices, decisions, and reported outcomes are whitewashed - a process of structural and systemic discrimination, racism, and exclusion that actively alters or omits Indigenous and non-Euro-Western contributions and perspectives to fit Euro-Western norms and (2) whitewashed and racialised logic in scientific research that claims to be open, collaborative and transparent. Whitewashing not only obscures the history and contributions of Indigenous peoples and communities but also actively reinforces systemic biases and inequities. We assert the need for epistemic justice in public health research. Epistemic justice calls for Indigenous sovereignty and self-determination to be made visible. It may involve on how colonial policies, protocols, and regulations are connected to everyday lived inequities of Indigenous communities, families and individuals. Ultimately, epistemic justice is inherent to Indigenous peoples' health and wellness, self-determination and sovereignty.

To close persistent global health financing gaps, policymakers have in recent years promoted the idea of 'blended finance', i.e. the strategic use of public funds to attract additional private sector investment. To better understand this trend, this paper studies three major blended finance instruments, namely vaccine bonds, advanced market commitments, and matching funds. In doing so, this paper makes two important contributions. On a practical level, it shows that these three blended finance instruments tend to be expensive and of questionable effectiveness. Their high costs favour large corporate actors, private investors and middlemen, while their benefits for potential beneficiaries in low- and middle-income countries and for public donors remain unclear. On a theoretical level, the paper asks why these instruments remain popular in policy circles despite their shortcomings. It finds that blended finance mechanisms proliferate thanks to their seemingly innovative nature, a constant emphasis on urgency or crisis, and the promise of combining market-based self-interest with positive social impact. The paper ends on a call for much greater critical scrutiny concerning blended financing mechanisms.

Community pharmacies have expanded to include new services such as health screenings and medication reviews. However, developing and implementing new applications tends to be challenging and entails comprehensive planning by multiple stakeholders. This qualitative study explores stakeholders' perspectives of these new services and identifies perceived barriers or facilitators for implementing practice changes. The study held four focus group discussions with 27 stakeholders and was conducted in Al Baha province, Saudi Arabia. Participants described community pharmacy services as traditional and limited to dispensing prescriptions. Several barriers were identified, including a lack of public awareness, public privacy and confidentiality concerns, and inadequate communication and collaboration between community pharmacists and physicians. According to the participants, free training programmes and continuing education for community pharmacists (with a focus on independent and small-chain community pharmacies) and financial support from the government could facilitate extending the roles played by community pharmacists. Another suggestion was that implementing standards for accreditation could create a competitive environment for community pharmacies, granting them well-deserved privileges and enhancing public confidence in the quality and safety of pharmaceutical care. Developing interprofessional policy is also vital, as this would allow community pharmacies to integrate into the health system.