Public Health in Practice最新文献

{"title":"Human rabies exposure and associated risk factors in North-West Ethiopia","authors":"Workneh Wondimagegn Azalu ,&nbsp;Sefinew Alemu Mekonnen ,&nbsp;Ambaye Kenubih ,&nbsp;Araya Mengistu Kassa ,&nbsp;Wassie Abebe Molla ,&nbsp;Wudu Temesgen Jemberu","doi":"10.1016/j.puhip.2025.100651","DOIUrl":"10.1016/j.puhip.2025.100651","url":null,"abstract":"<div><h3>Objectives</h3><div>The study was conducted to assess community awareness of rabies, and incidence of human rabies exposure and its associated risk factors.</div></div><div><h3>Study design</h3><div>A retrospective cohort study was conducted to assess community awareness of rabies, and incidence of human rabies exposure and associated risk factors.</div></div><div><h3>Method</h3><div>A total of 642 study participants were selected using multistage cluster sampling from seven districts in Gondar zones in northwest Ethiopia. Data was collected using a questionnaire by face-to-face interviews. Logistic regression analysis was used to identify associations between rabies exposure and potential risk factors.</div></div><div><h3>Results</h3><div>The incidence of rabies exposure in the current study was estimated to be 20.95 % per year. Almost all (99.68 %) of respondents were aware of the existence of rabies, and 98.44 % of them know that rabies is a zoonotic disease. Residents of Genda Wuha (OR = 7.68) and Metema districts (OR = 7.12) had a greater risk of rabies exposure compared to those living in Debre Tabor district. Dog ownership (OR = 1.61) was greater risk for rabies exposure than non-dog ownership, larger family size (≥7 members) (OR = 2.23) had greater risk for rabies exposure.</div></div><div><h3>Conclusion</h3><div>The study outlined that although awareness of existence of rabies and its zoonotic risk was high, taking post-exposure prophylaxis was low. Therefore, use post exposure rabies vaccine of should be promoted.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100651"},"PeriodicalIF":1.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of antibiotic-resistant Salmonella in kratom: Three-year monitoring study","authors":"Vaclav Peroutka,&nbsp;Katerina Demnerova,&nbsp;Jana Kadava,&nbsp;Simona Lencova","doi":"10.1016/j.puhip.2025.100652","DOIUrl":"10.1016/j.puhip.2025.100652","url":null,"abstract":"<div><h3>Objectives</h3><div>Kratom, powder from <em>Mitragyna speciosa</em> leaves, is a popular psychoactive drug. It poses a health risk to consumers not only because of its narcotic and stimulating effects, but also because its quality is not controlled by the same laws as other food and pharmaceutical products. Due to the absence of mandatory quality control, kratom carries an increased risk of pathogenic bacteria contamination. Based on previous studies, the most relevant of these from a public health perspective are bacteria of the genus <em>Salmonella</em>, particularly serotypes that may cause severe gastrointestinal illness and exhibit resistance to antimicrobial agents. To assess the scale of the problem, we monitored the occurrence of <em>Salmonella</em> in commercially available kratom in the Czech Republic and determined its antimicrobial resistance.</div></div><div><h3>Study design</h3><div>Original microbiological research (long-term monitoring).</div></div><div><h3>Methods</h3><div>In 2022–2024, we tested 96 different kratom samples, from which <em>Salmonella</em> was isolated by the cultivation method according to EN ISO 6579. Series of biochemical and agglutination tests were used to determine the species, subspecies and serotypes. The disk diffusion method was used for testing susceptibility to 16 antimicrobial agents, and the results were interpreted using EUCAST and CLSI criteria.</div></div><div><h3>Results</h3><div><em>Salmonella</em> was isolated from 16 out of all 96 tested samples. Biochemical and agglutination tests revealed that <em>Salmonella enterica</em> subsp. <em>enterica</em> was the most prevalent species and subspecies (14 samples), with some of the identified serotypes being relatively rare. Regarding the susceptibility to antimicrobial agents, out of all isolates 15 were resistant to at least one tested antimicrobial agent, and three isolates were classified as multidrug resistant.</div></div><div><h3>Conclusions</h3><div>Based on our analysis, the rate of <em>Salmonella</em> contamination did not differ statistically over the three years of study. Our results highlight the need for the continuous monitoring of <em>Salmonella</em> in kratom and provide a basis for the implementation of legal restrictions of its sale.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100652"},"PeriodicalIF":1.9,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of establishing a Canadian Obstetric Survey System (CanOSS) for severe maternal morbidity: results of a nationwide survey","authors":"Isabelle Malhamé ,&nbsp;Rebecca J. Seymour ,&nbsp;Rizwana Ashraf ,&nbsp;Paige Gehrke ,&nbsp;Joseph Beyene ,&nbsp;Tegwende Seedu ,&nbsp;Rashid Ahmed ,&nbsp;Susie Dzakpasu ,&nbsp;Sara Thorne ,&nbsp;Deshayne Fell ,&nbsp;Amy Metcalfe ,&nbsp;Kenneth K. Chen ,&nbsp;Stephen Lapinsky ,&nbsp;Leslie Skeith ,&nbsp;Beth Murray-Davis ,&nbsp;Josie Chundamala ,&nbsp;Sarah A. Hutchinson ,&nbsp;Thomas Van den Akker ,&nbsp;Maria B. Ospina ,&nbsp;Prakesh S. Shah ,&nbsp;Rohan D'Souza","doi":"10.1016/j.puhip.2025.100650","DOIUrl":"10.1016/j.puhip.2025.100650","url":null,"abstract":"<div><h3>Objective</h3><div>Obtaining data on events, processes, and circumstances leading to severe maternal morbidity (SMM) could enable targeted interventions to improve care. We aimed to assess the feasibility of gathering such data from across Canada through an Obstetric Survey System (CanOSS).</div></div><div><h3>Study design</h3><div>A nationwide survey.</div></div><div><h3>Methods</h3><div>We administered the electronic survey in French or English to birthing unit leads across all Canadian provinces and territories using REDCap. We presented pooled participation rates (95 % confidence intervals [CI]) across birthing units from lowest, medium, and highest tiers of service using Freeman-Tukey double arcsine transformations and common-effect models.</div></div><div><h3>Results</h3><div>Of the 289 birthing units across Canada, 167 (57.8 %) participated in the survey. Pooled participation rates per province and territory stratified by highest, medium, and lowest tiers of service were 91.5 % (95 % CI [73.4, 100]), 58.6 % (95 % CI [48.5, 68.6]), and 54.4 % (95 % CI [41.7, 66.3]), respectively. Units reported postpartum hemorrhage (82.5 %), hypertensive disorders (65.7 %), infections (35.0 %), venous thromboembolism (16.0 %), and maternal birth injuries (15.4 %) as the leading causes of SMM. Most birthing units (80.3 %) had a system in place for reviewing SMM events. Although most review systems involved multidisciplinary expert panels with representation from birthing unit leads (82.0 %), nursing (78.0 %), and obstetrics (73.7 %), specialties, such as obstetric anaesthesia (42.4 %), midwifery (41.5 %), and internal medicine (16.9 %), were underrepresented. Lessons learned were rarely shared outside the hospital and never shared beyond regional health authorities. Importantly, 76.2 % of respondents were willing to contribute anonymized SMM data within a centralized reporting system.</div></div><div><h3>Conclusions</h3><div>Most responding Canadian birthing units have a process in place to review SMM and would be willing to share anonymized data as part of a centralized initiative, thereby demonstrating the feasibility of leveraging existing infrastructures to establish CanOSS.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100650"},"PeriodicalIF":1.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating a healthier economy: A rapid evidence review of inequalities in flexible working arrangements in the UK","authors":"A. Barnes ,&nbsp;C. Cartwright ,&nbsp;K. Kennedy ,&nbsp;A. Formby","doi":"10.1016/j.puhip.2025.100649","DOIUrl":"10.1016/j.puhip.2025.100649","url":null,"abstract":"<div><h3>Objectives</h3><div>Flexible working – the control people have over work scheduling to meet wellbeing needs – is one way to help create a healthier economy. We sought to identify and summarise evidence about inequalities in access to flexible working arrangements in the UK and implications for health and wellbeing to inform policy development.</div></div><div><h3>Study design</h3><div>Rapid evidence review.</div></div><div><h3>Methods</h3><div>A rapid review of peer-reviewed articles and reports from trusted sources was completed on inequalities in access to UK flexible working arrangements to inform regional and local policy development. Published articles were identified through database searches (OVID-Embase, Scopus, Cochrane, Assia-Proquest) in September–October 2024. Data was extracted directly into a table and findings synthesised narratively by theme.</div></div><div><h3>Results</h3><div>Evidence identified was limited in detail, but consistent in reporting inequalities in access to flexible working by occupational status, with some evidence of inequalities by gender, disability, geography and ethnicity; with implications for health promotion. There was limited detail on specific health outcomes or pathways to impacts, though the significance of flexible working for women's well-being and Disabled people was highlighted. Included evidence noted systemic issues in the UK economy (e.g. occupational hierarchies, gendered norms about caring, racism, disability discrimination, ‘ideal worker’ culture that values overwork, flexibility stigma) that contribute to flexible working inequalities.</div></div><div><h3>Conclusions</h3><div>Further research and multi-level policy action is needed to address flexible working inequalities to promote health. Research could usefully focus on intersectional inequality, including systemic societal processes (i.e. stigma, racism, discrimination) shaping flexible working in practice. Policy action could include: evaluating the implementation of existing flexible working legislation in relation to inequality; national-regional-local action to support inclusive business models in which the bargaining positions of employees around flexibility are more equalised (e.g. cooperatives); evaluation and strengthening of Fair Work Charters; and funding and showcasing of flexible working pilots focused on addressing unequal flexible working access.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100649"},"PeriodicalIF":1.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal health inequity in Somalia: A multivariate analysis of poverty and service utilization using nationwide cross-sectional survey data","authors":"Asma Mahamoud Abdillahi ,&nbsp;Omer Adam Farih ,&nbsp;Mustafe Abdillahi Ali ,&nbsp;Abdirizak Hassan Abokor ,&nbsp;Hodo Abdikarim ,&nbsp;Saeed Hassan Mohamed ,&nbsp;Awale Ali Omer ,&nbsp;Shabcan Mohamed Ali ,&nbsp;Abdisalam Hassan Muse","doi":"10.1016/j.puhip.2025.100647","DOIUrl":"10.1016/j.puhip.2025.100647","url":null,"abstract":"<div><h3>Objectives</h3><div>Maternal health is a fundamental human right, yet significant inequities persist in low-resource settings like Somalia. This study investigates the nexus between socioeconomic status and maternal healthcare utilization, specifically examining the determinants of antenatal care (ANC) visits and place of delivery, to inform strategies aimed at achieving health equity.</div></div><div><h3>Study design</h3><div>A quantitative, cross-sectional study.</div></div><div><h3>Methods</h3><div>We used data from the 2020 Somalia Health and Demographic Survey (SHDS), a nationwide survey. The final analytical sample included 8248 women with a recent birth. We analyzed two dependent variables: number of ANC visits and place of delivery (home vs. health facility). Independent variables included wealth index, maternal education, residence, region, and other social determinants. Zero-inflated Negative Binomial (ZINB) regression was used for ANC visits, and binary logistic regression was used for place of delivery, with all analyses adjusted for the complex survey design.</div></div><div><h3>Results</h3><div>Marked disparities were found based on wealth. A significantly larger proportion of poorer women delivered at home (87.6 %) compared to richer women (55 %). Richer women had higher rates of ANC visits (Adjusted Incidence Rate Ratio [aIRR] = 1.41, p &lt; 0.001) and were more likely to have facility-based deliveries (Adjusted Odds Ratio [AOR] = 1.57, p &lt; 0.001). Higher maternal education, mobile phone ownership, and not wanting to go alone to a facility were also associated with better utilization. Significant regional disparities were observed.</div></div><div><h3>Conclusions</h3><div>Socioeconomic status is a primary driver of maternal healthcare utilization in Somalia, leading to substantial health inequities. Addressing these disparities requires multisectoral, targeted interventions that tackle poverty, enhance education, improve access to technology, and address cultural barriers to care.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100647"},"PeriodicalIF":1.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring physical activity in the nursery setting in England. A qualitative study with staff and children","authors":"M. Winder,&nbsp;S. Busby,&nbsp;E. Wilson","doi":"10.1016/j.puhip.2025.100644","DOIUrl":"10.1016/j.puhip.2025.100644","url":null,"abstract":"<div><h3>Objectives</h3><div>Young children spend substantial time at formal childcare providers, including nurseries. Physical activity (PA) in childcare is highly varied. Qualitative research which can provide more in-depth understanding has been focused on adults, the voice of children is largely missing. This study aimed to triangulate staff and children's views and perspectives to develop a holistic understanding of PA in the nursery setting.</div></div><div><h3>Study design</h3><div>Qualitative study.</div></div><div><h3>Methods</h3><div>Separate focus groups with nursery staff and children in the nursery's preschool room (3 to &lt;5 years of age) were conducted at nurseries (Nottinghamshire, England). Analysis followed Braun and Clarke's 6 steps of thematic analysis.</div></div><div><h3>Results</h3><div>55 children and 47 staff participated. 6 themes were identified: PA and learning theory in the nursery setting, children's understanding of PA, nursery ethos and resource, staff understanding of PA, PA and the link to development, PA in the nursery setting and the interaction with the home environment.</div></div><div><h3>Conclusions</h3><div>The nursery setting was perceived as important for PA and physical development (opportunity for risk taking and peer learning) and promotion of equity. The study identified possible opportunities to enhance PA in nurseries including separating the concepts of outdoors and PA, limiting use of unhealthy rewards, addressing staff knowledge gaps (e.g. recommended daily amount of PA) and including ‘understanding the importance of PA’ into the ‘managing self’ section of the EYFS. Future research should aim to incorporate parental views and explore the use of technology as a learning source for PA.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100644"},"PeriodicalIF":1.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and adaptation of a statewide recovery friendly workplace initiative toolkit in the United States","authors":"Adekemi O. Suleiman ,&nbsp;Jennifer E. Sussman ,&nbsp;Alversia D. Wade ,&nbsp;Nancy Navarretta ,&nbsp;Megan A. O’Grady","doi":"10.1016/j.puhip.2025.100648","DOIUrl":"10.1016/j.puhip.2025.100648","url":null,"abstract":"<div><h3>Objectives</h3><div>Millions consider themselves to be in recovery from a substance use problem. Recovery Friendly Workplaces (RFWs) are an emerging model to engage employers in promoting substance use disorder (SUD) recovery. This paper describes the statewide implementation and adaptation of a RFW Toolkit in Connecticut, United States. The toolkit offers organizations comprehensive guidance on creating supportive work environments for individuals in recovery from SUD. It emphasizes the importance of reducing stigma, enhancing employee well-being, and improving workplace policies related to SUD recovery.</div></div><div><h3>Study design</h3><div>A multimethod statewide evaluation of the RFW Initiative Toolkit.</div></div><div><h3>Methods</h3><div>A focus group, meeting notes and quantitative surveys assessed the RFW toolkit’s use and adaptations in participating organizations across the State as well as policy and practice changes as a result of the RFW process. Summary statistics were calculated for quantitative data and thematic analysis was used for qualitative data.</div></div><div><h3>Results</h3><div>Organizations benefited from toolkit customization and streamlined processes (e.g., templates); practical adaptations increased fit to regional needs and enhanced support systems for employees in recovery.</div></div><div><h3>Conclusions</h3><div>Organizations changed practices, increased training, and created resources as part of the RFW initiative. Future public health practice and evaluation on RFWs should assess organizational readiness to implement new policy and practice related to SUD recovery and adjust implementation and adaptation accordingly. Results provide insights for other states or countries implementing similar workplace initiatives to support SUD recovery.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100648"},"PeriodicalIF":1.9,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Satisfaction of indigenous pregnant women with a mobile voice application in Quechua developed by midwives for prenatal care in Peru","authors":"Augusto Felix Olaza-Maguiña,&nbsp;Yuliana Mercedes De La Cruz-Ramirez","doi":"10.1016/j.puhip.2025.100645","DOIUrl":"10.1016/j.puhip.2025.100645","url":null,"abstract":"<div><h3>Objectives</h3><div>Despite the effort shown by health personnel, many of them still have limitations in communicating with Peruvian Quechua-speaking pregnant women. The mobile applications have become an alternative to complement health care during pregnancy, especially if, as in Peru, the use of mobile devices has increased significantly, even in indigenous communities. Thus, the objective of this research was to evaluate the satisfaction of indigenous pregnant women from a Peruvian rural community with a mobile voice application in Quechua developed by midwives for prenatal care.</div></div><div><h3>Study design</h3><div>Cross-sectional study with a questionnaire.</div></div><div><h3>Methods</h3><div>The research was developed with 120 pregnant women from the rural community of Marian (3320 m a.s.l., Huaraz, Peru), who after a thorough explanation and the voluntary signing of a declaration of informed consent, accepted the free installation of the application. Thus, after at least 6 months of use, they answered a previously validated questionnaire with 23 questions between August 2023 and July 2024. A descriptive analysis was applied.</div></div><div><h3>Results</h3><div>It was evidenced that 82.5 % of pregnant women were satisfied with the application. Three (21.4 %) of 14 features were rated with dissatisfaction or indifference such as speed of functions, content about maternal-foetal bonding and appearance, with scores of 2.98, 2.92 and 3.46, respectively. The best valued aspect was the information about warning signs during pregnancy, childbirth and postpartum with a score of 4.71, while the information about activities that promote maternal-foetal bonding received the lowest score (2.92).</div></div><div><h3>Conclusions</h3><div>The majority of indigenous pregnant women from Marian community were satisfied with mobile voice application in Quechua for prenatal care, so with some improvements such as appearance, speed of functions and content about maternal-foetal bonding, it could be used for free in rural areas as a solution proposal to language barriers that limit health care in vulnerable populations.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100645"},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Task sharing for the management of non-communicable diseases in a humanitarian setting: An innovative approach in a low-middle income country (LMIC)","authors":"Myrna Doumit ,&nbsp;Sahar Masri ,&nbsp;Iza Ciglenecki ,&nbsp;Manuel Albela","doi":"10.1016/j.puhip.2025.100643","DOIUrl":"10.1016/j.puhip.2025.100643","url":null,"abstract":"<div><div>The World Health Organization (WHO) defines task shifting as the balanced reallocation of tasks from highly experienced professionals to those with more limited training, thus allowing the existing human resources to be used more efficiently. In Lebanon, there is no documented evidence yet of task sharing between physicians and nurses in the usual primary healthcare setting, let alone for Non-Communicable Disease (NCD) management.</div></div><div><h3>Objective</h3><div>This study aims to explore the experiences of healthcare providers and patients regarding task sharing.</div></div><div><h3>Study design</h3><div>This study employed a qualitative descriptive design, utilizing a cross-sectional approach.</div></div><div><h3>Method</h3><div>Qualitative data collection started in April–May 2022. Data collection was conducted with three focus groups: nurses (n = 9), patients (n = 11), and physicians (n = 5) from two clinics in two different rural areas, using purposeful sampling. A thematic analysis method, as described by Braun and Clarke, was used to guide the analysis.</div></div><div><h3>Results</h3><div>This study yielded four themes: An innovative approach to care, A prevailing culture of trust and collaboration, a Synergistic Outcome, and A Call for Improvement.</div></div><div><h3>Conclusion</h3><div>This study has identified an innovative approach to care, as demonstrated by the practices performed at the two clinics. Task shifting is a means of ensuring nurses' satisfaction. Therefore, it may positively impact retention at a time when we are witnessing an unprecedented migration of nurses from low- and middle-income countries (LMICs) to high-income countries (HICs). Interprofessional education needs to be reinforced at the undergraduate level to enhance collaboration among health care workers after graduation. At the policy level, considerable work is necessary to ensure that all stakeholders’ voices are represented at the decision-making table and heard.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100643"},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the effects catastrophic health expenditure due to non-communicable diseases and coping strategies: A case study among households in Bangladesh","authors":"N.M. Rabiul Awal Chowdhury ,&nbsp;Salma Akter Urme ,&nbsp;Asaduzzaman Hridoy ,&nbsp;Fahima Nusrat ,&nbsp;Md Shahgahan Miah","doi":"10.1016/j.puhip.2025.100642","DOIUrl":"10.1016/j.puhip.2025.100642","url":null,"abstract":"<div><h3>Objectives</h3><div>Non-communicable diseases (NCDs), due to their chronic nature, lead to long-term and significant health burdens that result in catastrophic expenses for individuals and communities. This study explores the socioeconomic effects of catastrophic health costs on households with family members experiencing NCDs and their coping mechanisms in rural areas of Bangladesh.</div></div><div><h3>Study design</h3><div>Qualitative study.</div></div><div><h3>Methods</h3><div>Case studies were conducted with ten NCD patients who had experienced catastrophic events and their close contacts. Purposive sampling strategies were used to recruit participants from two sub-districts in areas with a high prevalence of NCDs. In-depth interviews and observations were conducted, and documents (e.g. hospital and diagnosis bills, medicine purchase receipts) were reviewed. Data were analysed using thematic analysis.</div></div><div><h3>Results</h3><div>Data revealed that the treatment costs of NCDs are multifaceted and long-term. This catastrophic health expenditure has many economic effects, such as compromising food, housing, living standards and quality of life. It also has non-economic effects, including social stigmatisation, adjusting wishes and dreams, hampering children's education, disrupting family relationships and undermining social dignity. Households' adaptive strategies include loaning and borrowing, selling assets, using savings, seeking assistance from friends and relatives, reconciling living standards and even adopting alternative medicines.</div></div><div><h3>Conclusions</h3><div>Thisstudy highlights the socioeconomic impact of catastrophic health costs associated with NCDs and how households adapt and cope with these expenses. The results increase understanding of the impact of NCDs and the importance of managing the economic burden. Results highlight the necessity for a strategic plan to aid families affected by chronic NCDs.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100642"},"PeriodicalIF":2.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}