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Immunisation services in North-Eastern Nigeria: Perspectives of critical stakeholders to improve uptake and service delivery. 尼日利亚东北部的免疫服务:重要利益相关者对提高接受率和服务提供的看法。
IF 0.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-11-30 DOI: 10.4081/jphia.2023.1807
Semeeh Akinwale Omoleke, Babatunji Atunjeba Omotara, Adewale Luqman Oyeyemi, Omeiza Beida, Samuel O Etatuvie

We investigated the perspectives of parents, health workers (HWs) and traditional medical practitioners (TMPs) on immunisation advocacy, knowledge, attitudes and immunisation practice and ways of improving immunisation uptake in Borno State, North-eastern Nigeria. A cross-sectional study analysing quantitative data from the three stakeholders' categories. It was conducted across 18 local government areas of Borno State. A representative sample of 4288 stakeholders (n=1763 parents, n=1707 TMPs, and n=818 HWs aged 20 to 59years, had complete data. The sample has more males: 57.8% (Parents); 71.8% (TMPs) and 57.3% (HWs). The awareness of immunisation schedule among the stakeholders ranged from 87.2 to 93.4%. The study showed that 67.9% of the parent and 57.1% of the health workers had participated in immunisation except the TMPs (27.8%). Across the stakeholders' categories, between 61.9 and 72.6% have children who had Adverse Event Following Immunisation (AEFI). The most common AEFI was fever. Safety concerns, preference for herbs and charm, culture and religions, and vaccination perception as a western culture were the major barriers to immunisation uptake. While 63.6 to 95.7% of respondents indicated that community leaders, religious and spiritual leaders and TMPs should be involved in immunisation advocacy, 56.9-70.4% of them reported that community leaders should be involved in immunisation policy. Upscaling the critical stakeholders' involvement in advocacy, policy development and implementation of immunization activities may improve acceptance, create demand and engender ownership in vulnerable communities of Borno State, Nigeria. AEFI could be detrimental to immunisation access and utilization. Consequently, health education by health workers needs strengthening to minimise vaccine hesitancy.

我们调查了尼日利亚东北部博尔诺州的家长、卫生工作者(HWs)和传统医师(TMPs)对免疫接种宣传、知识、态度和免疫接种实践的看法,以及提高免疫接种率的方法。这是一项横断面研究,分析了来自三个利益相关者类别的定量数据。研究在博尔诺州的 18 个地方政府辖区进行。4288 名利益相关者(年龄在 20 岁至 59 岁之间的父母人数为 1763 人,TMP 人数为 1707 人,HW 人数为 818 人)的代表性样本拥有完整的数据。样本中男性较多:57.8%(家长)、71.8%(TMPs)和 57.3%(保健工作者)。利益相关者对免疫接种计划的了解程度从 87.2%到 93.4%不等。研究结果显示,67.9%的家长和 57.1%的卫生工作者参加过免疫接种,但母婴保健医生(27.8%)除外。在所有利益相关者类别中,61.9%至 72.6%的儿童出现过免疫接种后不良反应(AEFI)。最常见的不良反应是发烧。对安全性的担忧、对草药和符咒的偏好、文化和宗教信仰以及将疫苗接种视为西方文化,是阻碍儿童接受免疫接种的主要因素。63.6%至95.7%的受访者表示,社区领袖、宗教和精神领袖以及传统医师应参与免疫接种宣传,56.9%至70.4%的受访者表示,社区领袖应参与免疫接种政策的制定。扩大关键利益相关者参与免疫接种活动的宣传、政策制定和实施,可以提高尼日利亚博尔诺州弱势社区对免疫接种活动的接受程度,创造需求,并使其产生主人翁意识。AEFI 可能不利于免疫接种的获得和利用。因此,需要加强卫生工作者的健康教育,以尽量减少对疫苗的犹豫。
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引用次数: 0
Successful treatment of tuberculosis using a collaborative approach between family and health workers. 采用家庭与卫生工作者合作的方法成功治疗结核病。
IF 0.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-11-30 DOI: 10.4081/jphia.2023.2455
Stang, Sumarni Marwang, Muhammad Rachmat, Musthamin Balumbi, Fadjriah Ohorella

The optimization efforts of promotion, prevention, provision of preventive treatment, and infection control are strategies to overcome tuberculosis in Indonesia for the period 2020-2024. This research aims to analyze the effects of a collaborative model between health workers and family support to improve the success of treating patients with pulmonary tuberculosis. This is an experimental research using a one-group pre and post-test design. The study samples were TB patients treated at Bainamu and Bontosunggu Public Health Centers, Jeneponto Regency, from June 2021 to January 2022. Using McNemar's statistical test, the data analysis was conducted to determine the differences in patient behavior on factors that support and inhibit the recovery. The results showed that the collaborative model has an impact on eating, healthy living, and spiritual behaviors that support the recovery and cure rate of TB patients.

优化宣传、预防、提供预防性治疗和感染控制是印度尼西亚在 2020-2024 年期间战胜结核病的战略。本研究旨在分析卫生工作者与家庭支持合作模式对提高肺结核患者治疗成功率的影响。这是一项采用单组前后测试设计的实验研究。研究样本为 2021 年 6 月至 2022 年 1 月期间在杰内蓬托县贝纳穆和邦托松古公共卫生中心接受治疗的肺结核患者。研究采用麦克尼马统计检验法进行数据分析,以确定患者在支持和抑制康复的因素方面的行为差异。结果显示,合作模式对支持肺结核患者康复和治愈率的饮食、健康生活和精神行为产生了影响。
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引用次数: 0
The prevalence of health risk behavior engagement among grade 4 to 7 learners in primary schools: A phase one needs analysis. 小学四至七年级学生参与健康风险行为的普遍程度:第一阶段需求分析。
IF 0.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-11-30 DOI: 10.4081/jphia.2023.2328
Kurt John Daniels, Hamilton Pharaoh

Health risk behaviour, as it pertains to adolescent behaviour, poses a massive challenge for many fields of medicine, not only due to developmental and psychological concerns but also its inevitable contribution to the burden of disease through trauma and non-communicable diseases resulting from risky behavioural choices. The objective study is to explore the prevalence of health risk behavior engagement among grade 4-7 learners at four primary schools in the Western Cape, South Africa, as well as establish a need for a prevention program starting at primary school level. An observational, descriptive, quantitative design was used to conduct this study. Non-probability, heterogenous, purposive sampling was used to select the study population. A needs analysis assessment using a modified self-administered Child Health Risk Behaviour survey was conducted using 7-inch electronic tablets. Four primary schools agreed to participate yielding a total sample size of n=1147 learners in grades 4 to 7. Learners' age ranged from nine years old to fourteen years old with a mean age of 11.45 (SD 1.271). Riding a bicycle without a helmet, physical fight (86.1 and 64.1% among boys and girls respectively), ever smoked a cigarette (boys 36.3%; girls 28.3%) and consuming alcohol without permission (boys 28.7%; girls 23.8%) had the most engagement. Sexual curiosity questions had by far the most positive engagement and consistency of engagement among both boys and girls. This evidence reaffirms the need that early, bespoke and scientific intervention/prevention programs are needed to combat health risk behaviour and subsequently reduce the burden of disease.

与青少年行为有关的健康风险行为给许多医学领域带来了巨大的挑战,这不仅是由于发育和心理方面的原因,而且也是由于风险行为选择导致的创伤和非传染性疾病不可避免地加重了疾病负担。本研究旨在探讨南非西开普省四所小学的 4-7 年级学生参与健康风险行为的普遍程度,并确定从小学阶段开始实施预防计划的必要性。本研究采用了观察性、描述性和定量设计。在选择研究对象时,采用了非概率、异质、目的性抽样。研究人员使用 7 英寸电子平板电脑,通过修改后的自填式儿童健康风险行为调查进行了需求分析评估。四所小学同意参与,样本总数为 1147 名四至七年级学生。学生年龄从九岁到十四岁不等,平均年龄为 11.45 岁(标准差为 1.271)。骑自行车不戴头盔、打架斗殴(男生和女生分别占 86.1%和 64.1%)、曾经吸烟(男生占 36.3%;女生占 28.3%)和未经许可饮酒(男生占 28.7%;女生占 23.8%)是参与度最高的问题。到目前为止,性好奇心问题在男孩和女孩中的参与度和参与的持续性都是最积极的。这些证据再次证明,需要及早开展量身定制的科学干预/预防计划,以打击健康风险行为,进而减轻疾病负担。
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引用次数: 0
Diet behavior and consumption of iron inhibitors: Incidence anemia in adolescent girls. 饮食行为和铁抑制剂的消费:少女贫血症的发病率。
IF 0.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-11-30 DOI: 10.4081/jphia.2023.2593
Erna Kusuma Wati, Colti Sistiarani, Setiyowati Rahardjo

One of the strategies to prevent adolescent girls anemia through efforts to identify the factors that cause anemia. Adolescent girls are are prospective mothers who must prepare physically, mentally, with good knowledge so that they do not experience anemia during pregnancy. The aim of the study was to analyze the risk factors for the incidence of anemia in adolescent girls in Banyumas Regency, Indonesia. Quantitative approach used to identify factors that influence anemia in adolescent girls. Research variables are menstrual period, knowledge, diet attitudes and behavior, perception of body image, role of friends in prevention of anemia, role, exposure to information, consumption of iron, consumption of inhibitors and iron enhancers. The population of this research is young women aged 12-19 years. The taking technique by simple random sampling was amount 100, Data analysis was univariate, bivariate (chi square) and multivariate (linear regression). The results showed that the prevalence of anemia was 20%. Based on the results of statistical tests, it was obtained a P-value of 0.005 (<0.05) meaning that there was an influence on adolescent dietary behavior, the role of adolescents in preventing anemia and the consumption of iron inhibitors on the incidence of anemia. Anemia in young girls. There is an influence of eating behavior in female adolescents, the role of female adolescents in preventing anemia and consumption of iron inhibitors on the occurrence of anemia in female adolescents.

预防少女贫血的策略之一是努力找出导致贫血的因素。少女是未来的母亲,她们必须在身体、心理和知识方面做好准备,以免在怀孕期间出现贫血。本研究旨在分析印度尼西亚班尤马斯地区少女贫血症发病率的风险因素。研究采用定量方法来确定影响少女贫血的因素。研究变量包括月经期、知识、饮食态度和行为、对身体形象的看法、朋友在预防贫血中的作用、角色、信息接触、铁的摄入量、抑制剂和铁强化剂的摄入量。研究对象为 12-19 岁的年轻女性。数据分析采用单变量、双变量(卡方)和多变量(线性回归)分析。结果显示,贫血患病率为 20%。根据统计检验结果,P 值为 0.005 (
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引用次数: 0
A multilevel analysis of the predictors of diarrhea among children under 5 years of age in Eswatini. 对埃斯瓦提尼 5 岁以下儿童腹泻预测因素的多层次分析。
IF 0.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-11-30 DOI: 10.4081/jphia.2023.1149
Maswati S Simelane, Kerry Vermaak

Diarrhea remains a public health challenge and persistently affect children under 5 years of age, primarily in developing countries. The aim of the study was to investigate the effects of individual, household and community level factors on child diarrhea. Using combined data 2010 and 2014 Eswatini Multiple Indicator Cluster surveys, data for 4,363 under five children was analysed. Univariable, bivariable and multivariable multilevel logistic regression models were used for data analysis. We found that the prevalence of diarrhea was 16.2%, (95% confidence interval (CI): 15.3-18.1). Higher odds of diarrhea were observed among children aged 6-11 months (AOR: 2.67, 95% CI: 1.93, 3.71) and 12-23 months (AOR=2.12, 95% CI: 1.56, 2.87) compared to those aged less than 6 months. However, lower odds of diarrhea were observed among children aged 36-47 months (AOR=0.68, 95% CI: 0.48, 0.97) and 48-59 months (AOR=0.39, 95% CI: 0.26, 0.58), compared to children aged less than 6 months. Children born to mothers aged 35-39 years had lower odds of having diarrhea, (AOR=0.48, 95%CI: 0.30, 0.79) compared to those born to mothers aged 15-19 years. Higher odds of having diarrhea were observed among children from communities with a low proportion of households with improved toilet facility (AOR=1.29, 95% CI: 1.01, 1.66) compared to those from communities with a high proportion of households with improved toilet facility. We found that individual- and community-level factors were associated with child diarrhea in Eswatini. Programmes and policies that aim to mitigate child morbidity due to diarrhea should pay attention to the individual and community factors.

腹泻仍是一项公共卫生挑战,长期影响着五岁以下儿童,主要发生在发展中国家。本研究旨在探讨个人、家庭和社区层面的因素对儿童腹泻的影响。研究使用 2010 年和 2014 年斯威士兰多指标类集调查的合并数据,分析了 4363 名五岁以下儿童的数据。数据分析采用了单变量、双变量和多变量多层次逻辑回归模型。我们发现,腹泻发病率为 16.2%(95% 置信区间 (CI):15.3-18.1)。与 6 个月以下的儿童相比,6-11 个月的儿童(AOR:2.67,95% CI:1.93,3.71)和 12-23 个月的儿童(AOR=2.12,95% CI:1.56,2.87)发生腹泻的几率更高。然而,与 6 个月以下的儿童相比,36-47 个月的儿童(AOR=0.68,95% CI:0.48,0.97)和 48-59 个月的儿童(AOR=0.39,95% CI:0.26,0.58)发生腹泻的几率较低。与母亲年龄在 15-19 岁的儿童相比,母亲年龄在 35-39 岁的儿童患腹泻的几率较低(AOR=0.48,95%CI:0.30,0.79)。与厕所设施改善家庭比例高的社区相比,厕所设施改善家庭比例低的社区儿童患腹泻的几率更高(AOR=1.29,95%CI:1.01,1.66)。我们发现,个人和社区层面的因素与埃斯瓦提尼的儿童腹泻有关。旨在降低腹泻导致的儿童发病率的计划和政策应关注个人和社区因素。
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引用次数: 0
Newspaper depiction of mental illness in Nigeria. 尼日利亚报纸对精神病的描述。
IF 0.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-11-30 DOI: 10.4081/jphia.2023.1527
Joshua A Erubami, Paul Bebenimibo, Gregory H Ezeah, Omanwa I Muobike

Mental illness is fast becoming a leading cause of global disease burden, yet this aspect of public health remains highly neglected in Nigeria. The public relies on newspapers for diverse information needs and the way newspapers portray mental illness-related issues tends to sway public perception of such ailments. This study examined the level of media attention and prime discursive resources utilized by newspapers to depict mental illness-related issues from 2015 to 2019. Using a qualitative approach and ethnographic design, the study analyzed the manifest contents of three major Nigerian national newspapers selected through a multistage sampling technique. Data collection was done using a coding spreadsheet that reflected relevant content categories and units of analysis. Of the 920 health articles analyzed, only 79 (8.6%) articles discussed mental illness. Also, 84.8% of all mental illness-related articles were tucked in the inside pages of the newspapers and 58.2% of the stories were reported using the conventional straight news. The negative themes of suicide (36.7%) and substance abuse (32.9%) were the prime discursive resources that echoed in many of the analyzed articles. Overall, mental illness-related issues were grossly under-reported by Nigerian newspapers when compared to other health issues, and wrong media depiction of the problem remains a risk factor. Hence, Nigerian newspapers must strive toward setting better agenda that will actuate necessary policy actions from health stakeholders by providing adequate coverage and positive representation of mental illness-related issues.

精神疾病正迅速成为造成全球疾病负担的主要原因,但在尼日利亚,这方面的公共卫生问题仍被严重忽视。公众依赖报纸来满足各种信息需求,而报纸对精神疾病相关问题的描述方式往往会左右公众对此类疾病的看法。本研究考察了 2015 年至 2019 年期间报纸在描述精神疾病相关问题时所利用的媒体关注度和主要话语资源。本研究采用定性方法和人种学设计,分析了通过多阶段抽样技术选出的尼日利亚三家主要全国性报纸的显性内容。数据收集采用了反映相关内容类别和分析单位的编码电子表格。在分析的 920 篇健康文章中,只有 79 篇(8.6%)讨论了精神疾病。此外,84.8%与精神疾病有关的文章都刊登在报纸内页,58.2%的报道采用了传统的直接新闻报道方式。自杀(36.7%)和药物滥用(32.9%)这两个负面主题是许多分析文章的主要话语资源。总体而言,与其他健康问题相比,尼日利亚报纸对精神疾病相关问题的报道严重不足,媒体对该问题的错误描述仍然是一个风险因素。因此,尼日利亚报纸必须努力制定更好的议程,通过对精神疾病相关问题的充分报道和正面描述,促使健康利益相关者采取必要的政策行动。
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引用次数: 0
Expectations and experiences of urban and rural in-school adolescents of adolescent reproductive health services in Oyo State. 奥约州城市和农村在校青少年对青少年生殖健康服务的期望和体验。
IF 0.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-11-30 DOI: 10.4081/jphia.2023.2211
Oluwatosin Ruth Ilori, Sunday Olakunle Olarewaju, Phillip Oluwatobi Awodutire, Oluwatosin Stephen Ilori, James Olusegun Bamidele

Reproductive health information and services are fundamental to health, well-being and opportunities for women and young people, yet throughout the world, women and youths do not have access to quality reproductive health care thereby exposing them to unplanned pregnancy, teen birth, induced abortion as well as increased exposure to sexually transmitted diseases, HIV inclusive. This study is meant to explore the expectation of adolescents of an adolescent reproductive health services as well as to assess the experiences of those who had visited an ARHS at the centers. It was a descriptive cross-sectional prospective study, analytic in design using a multistage sampling technique where 452 secondary school pupils in both rural and urban communities were interviewed using a pretested validated questionnaire. Data was analyzed using SPSS version 21. Chi square was used to test for association between both rural and urban adolescents in issues relating to their expectation and experiences, with P-value of <0.05. More of the respondents in the urban communities (73,32.4%) have the expectation that Adolescent Reproductive Health Services (ARHS) should be provided in an existing health service with special attention to adolescents while a larger percentage of those who preferred a special adolescent health institution were from the rural communities (122, 54.2%) which was statistically significant with a P-value of 0.001. More of respondents from the rural communities also expect that contraception services should be provided in an ARHS center while life skill services are expected by more of the respondents from the urban communities (122, 55.6%). More of the rural community respondents (57,25.3%) expect that fee at the ARHS centers should be provided at a subsidized rate while more of the urban dwellers have the expectation that services provided should be free of charge. For respondents who had been to an ARHS center, more of the urban respondents were attended to by a Medical doctor and a large percentage (34, 94.4%) of those who had visited ARHS center before professed to be satisfied with the services rendered there. Expectations from adolescents from ARHS are very high. However, most of them prefer a free of charge service as well as a service area nearer to residential area. Confidentiality and having a young health professional at the service centers cannot be overemphasized in the provision of quality ARHS.

生殖健康信息和服务对妇女和青年的健康、福祉和机会至关重要,但在世界各地,妇女和青年无法获得高质量的生殖健康保健服务,从而使他们面临计划外怀孕、少女生育、人工流产以及感染性传播疾病(包括艾滋病毒)的风险增加等问题。本研究旨在探讨青少年对青少年生殖健康服务的期望,并评估那些曾在中心接受过青少年生殖健康服务的青少年的经历。这是一项描述性横断面前瞻性研究,采用多阶段抽样技术进行分析设计,使用预先测试过的有效问卷对农村和城市社区的 452 名中学生进行了访谈。数据使用 SPSS 21 版进行分析。采用卡方检验了农村和城市青少年在与期望和经历有关的问题上的相关性,P 值为
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引用次数: 0
An assessment on the implementation of same day antiretroviral therapy initiation in eThekwini clinics, KwaZulu-Natal, South Africa. 对南非夸祖鲁-纳塔尔省 eThekwini 诊所当天开始抗逆转录病毒疗法的实施情况进行评估。
IF 0.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-11-30 DOI: 10.4081/jphia.2023.2179
Sabina M Govere, Tawanda Manyangadze, Chester Kalinda, Moses J Chimbari

The World Health Organization (WHO) recommends same-day initiation (SDI) of antiretroviral therapy (ART) for all individuals diagnosed with HIV irrespective of CD4+ count or clinical stage. Implementation of program is still far from reaching its goals. This study assessed the level of implementation of same day ART initiation. A longitudinal study was conducted at four primary healthcare clinics in eThekwini municipality KwaZulu-Natal. Data was collected between June 2020 to October 2020 using a data extraction form. Data on individuals tested HIV positive, number of SDI of ART; and clinicians working on UTT program were compiled from clinic registers, and Three Interlinked Electronic Registers.Net (TIER.Net). Non-governmental organisations (NGO) supporting the facility and services information was collected. Among the 403 individuals who tested HIV positive, 279 (69.2%) were initiated on ART on the same day of HIV diagnosis from the four facilities. There was a significant association between health facility and number of HIV positive individuals initiated on SDI (chi-square=10.59; P-value=0.008). There was a significant association between facilities with support from all NGOs and ART SDI (chi-square=10.18; P-value=0.015. There was a significant association between staff provision in a facility and SDI (chi-square=7.51; P-value=0.006). Urban areas clinics were more likely to have high uptake of SDI compared to rural clinics (chi-square=11,29; P-value=0.003). Implementation of the Universal Test and Treat program varies by facility indicating the need for the government to monitor and standardize implementation of the policy if the program is to yield success.

世界卫生组织(WHO)建议,无论 CD4+ 细胞计数或临床阶段如何,所有确诊的艾滋病毒感染者都应在当天开始接受抗逆转录病毒疗法(ART)治疗。但该计划的实施远未达到其目标。本研究评估了当天启动抗逆转录病毒疗法的实施水平。这项纵向研究在夸祖鲁-纳塔尔省 eThekwini 市的四家初级医疗诊所进行。使用数据提取表收集了 2020 年 6 月至 2020 年 10 月期间的数据。有关艾滋病毒检测呈阳性的个人、接受抗逆转录病毒疗法(ART)的 SDI 人数以及从事 UTT 计划的临床医生的数据均来自诊所登记簿和 Three Interlinked Electronic Registers.Net (TIER.Net)。此外,还收集了支持设施和服务的非政府组织(NGO)的信息。在艾滋病毒检测呈阳性的 403 人中,有 279 人(69.2%)在四家医疗机构确诊艾滋病毒的当天就开始接受抗逆转录病毒疗法。医疗机构与接受 SDI 检测的 HIV 阳性者人数之间存在明显关联(chi-square=10.59;P-value=0.008)。获得所有非政府组织支持的医疗机构与接受抗逆转录病毒疗法 SDI 的人数之间存在明显关联(chi-square=10.18;P-value=0.015)。医疗机构的人员配备与 SDI 之间存在明显关联(卡方=7.51;P 值=0.006)。与农村诊所相比,城市诊所的 SDI 使用率更高(chi-square=11.29;P-value=0.003)。各医疗机构对 "普遍检测和治疗 "计划的执行情况不尽相同,这表明如果该计划要取得成功,政府有必要对政策的执行情况进行监督和标准化。
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引用次数: 0
The New Africa Digital Health Deal 非洲数字健康新政
IF 0.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-11-20 DOI: 10.4081/jphia.2023.2865
J. Nsengimana, Jean Kaseya
Not available.
不详。
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引用次数: 0
Empowering Africa's healthcare future: the crucial role of human capital development in bio- and pharmaceutical manufacturing 增强非洲医疗保健未来的能力:人力资本开发在生物和制药制造业中的关键作用
IF 0.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-11-20 DOI: 10.4081/jphia.2023.2866
M. Mynhardt, C. Mwila, M. Habtemariam, A. Tshangela, Mar Martinez, Ngashi Ngongo, Jean Kaseya, Nicaise Ndembi
Not available.
不详。
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引用次数: 0
期刊
Journal of Public Health in Africa
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