International Journal of Public Health最新文献

Objectives: This paper explores the communication challenges faced by public health institutions in Switzerland during COVID-19 pandemic and identifies key barriers and facilitators of effective communication within and across public health institutions.

Methods: In 2021, we conducted qualitative online semi-structured interviews to collect opinions and experiences of representatives of Swiss public health institutions. Interview transcripts were analyzed using inductive thematic analysis to identify main themes.

Results: Key facilitators of effective communication included flexibility, dedicated resources, new processes, coordination, and experiential knowledge. Inter-institutional communication benefited from clear processes, active listening, mediation, and strong networks. Barriers mirrored these factors, such as role tensions, unclear responsibilities, and limited resources. Discrepancies across cantons and between government levels, especially between the confederation and cantons, often hindered communication.

Conclusion: To strengthen communication in public health crises, we recommend clear protocols, centralized structures, and bridging cultural and linguistic gaps. Ongoing training and diverse perspectives are key to effective communication within and across public health institutions in Switzerland and beyond.

Objectives: Hypertension is a major cardiovascular risk factor in Brazil and globally, requiring effective healthcare system strategies. This study examines how the health system in São Paulo manages hypertension, identifying patterns and connections that influence patient outcomes and resource use.

Methods: Using literature reviews and participatory discussions with experts, we developed a systems map, causal loop diagram, to illustrate dynamic complexity underpinning hypertension management. Thematic analysis of qualitative data informed the model, highlighting key interactions that shape screening, treatment, and long-term care.

Results: The analysis reveals critical dynamics at individual, community, and system levels. Early diagnosis and expanded treatment access improve adherence and reduce complications. However, these improvements also increase the number of patients needing long-term care. This creates a challenge where healthcare gains today can raise future demands if prevention efforts are underfunded.

Conclusion: Understanding these interconnections is crucial for balancing treatment expansion with sustainable prevention strategies. By mapping system-wide challenges, this study offers a framework to help policymakers allocate resources more effectively and strengthen urban health systems. Future research will focus on using simulation modeling to test policy interventions and improve hypertension outcomes.

Objectives: Poor hypertension prevention among people living with HIV (PLHIV) in sub-Saharan Africa may undermine progress in HIV prevention achieved within this population. This review synthesizes data on the prevalence, diagnosis, treatment, control, and challenges related to hypertension prevention among PLHIV in SSA.

Methods: A mixed-method systematic review with meta-analysis was conducted from January to December 2024. Data analysis was performed using random-effects modeling stratified by age and sex, along with thematic analysis. The JBI critical appraisal tool was used to assess study quality.

Results: A total of 31 studies, including 32286 PLHIV (±37 years old), were included. Hypertension affected 25% [95% CI, 21%-28%] of PLHIV, yet only 34% [95% CI, 11%-64%] of cases received treatment, and 19% [95% CI, 3%-34%] had controlled blood pressure, despite BP measurement in 95% [95% CI, 89%-100%] of them.

Conclusion: Hypertension prevention challenges stem from patient-related factors, healthcare providers, and health system gaps. Despite the high prevalence of hypertension among PLHIV, treatment initiation and blood pressure control rates remain low. Strengthening the integration of HIV and hypertension care services is urgently needed.

Objectives: Community engagement (CE) is vital for Primary Health Care (PHC) and for achieving the UN Sustainable Development Goals (SDGs) by 2030. However, large public health programs often prioritize measuring outcomes and impact over assessing CE itself. This paper proposes a comprehensive, community-centered Monitoring and Evaluation (M&E) framework with relevant indicators to strengthen CE assessment.

Methods: We reviewed international M&E frameworks and their applications from both public health and community perspectives. Our analysis drew on guidelines from international organizations and 10 years of project data from seven countries.

Results: Findings underscore the need to bridge program-level and community-level indicators while aligning recent M&E guidance with CE frameworks from international agencies. Accordingly, we present a revised, comprehensive, community-centered M&E framework, along with supporting actions for its implementation-such as contextual adaptation, research, digital innovation, resource mobilization, and recommended policy measures.

Conclusion: As the 2030 targets approach, strengthening normative and policy guidance on CE is essential to accelerate progress toward the SDGs. This publication reinforces CE's central role in PHC, Universal Health Coverage, and sustainable development strategies.

Objectives: The study examined the impact of varying prescription requirements for phosphodiesterase-5 inhibitors (PDE-5is) on the management of erectile dysfunction (ED) in men.

Methods: A survey involving 10,000 men from Germany, Norway, Poland, and Switzerland was conducted using the International Index of Erectile Function Questionnaire to identify men with ED and interview them regarding their treatment and experiences. The use of PDE-5is by men without ED was also investigated.

Results: The proportion of PDE-5i users with ED was higher in Norway and Poland (over-the-counter availability) and Switzerland (prescribed by pharmacist) than that in Germany (doctor's prescription required). Across all countries, men seeking to buy PDE-5is from pharmacies were advised to consult a doctor. The use of black market channels for purchasing PDE-5is was minimal in regions allowing non-prescription availability. The non-medical use was uncommon in all regions.

Conclusion: The need for a prescription for PDE-5is may hinder seeking treatment for ED and detecting underlying conditions. Therefore, PDE-5is should be approved as prescription-free medicines to improve the management of ED and to encourage men's engagement with the healthcare system.

Objective: This randomised controlled trial examined whether individuals with severe mental disorders (SMD) in a high-unemployment context benefit in mental health, functional and vocational outcomes when receiving the Individual Placement and Support (IPS) model, compared to vocational rehabilitation (VR).

Methods: A total of 557 individuals (ICD-10 F20-F29 or F31-F32.3) were screened. 63 met inclusion criteria and voluntarily participated. They were randomly assigned to IPS or VR groups. Assessments were conducted at baseline and six months. The study was ethically approved, registered and conducted with blinded evaluations.

Results: IPS participants achieved significantly higher rates of competitive employment and showed greater improvements in global functioning compared with VR. Other mental health and functional outcomes showed no significant group differences. However, participants who obtained employment reported greater improvements in quality of life. No adverse events, such as hospitalizations, were reported.

Conclusion: These findings suggest that IPS may be effective beyond employment outcomes, with some benefits in mental health and functional domains. Despite limitations such as short follow-up and modest sample size, the study supports the feasibility of IPS in challenging labor markets.

Objective: In Côte d'Ivoire, prevalence of hypertension was 39.9% in 2017. This study aimed to determine the prevalence, associate health conditions and evolution of chronic hypertension among pregnant women in Abidjan's neighborhood.

Methods: This was a prospective multicenter cohort study. Bivariate and multivariate analysis was performed.

Results: Prevalence of chronic hypertension was 8.6% [6.11-11.09]. Age (p = 0.001; 95% CI: 2.2-14.5); hyperglycemia (p = 0.04; 95% CI: 1.1-33.5); total cholesterol level (p = 0.02; 95% CI: 1.2-7.3); LDL cholesterol level (p = 0.01; 95% CI: 1.2-5.0); left ventricular hypertrophy (p = 0.03; 95% CI: 1.1-6.6) were significantly associated with chronic hypertension. After multivariate analysis, age ≥35 years (OR = 3.9; 95% CI: 1.4-11.8; p = 0.01) was the only variable statistically associated with chronic hypertension. During the follow-up to full-term pregnancy, systolic and diastolic blood pressures were significantly lower than those collected at inclusion. No complication such as preeclampsia was observed.

Conclusion: The prevalence of chronic hypertension was relatively high. Women aged 35 and over were most at risk of developing the disease. Blood pressure gradually fell and stabilized in the women. No complication was observed.