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Background: Anaemia remains widespread among Indian women and reflects persistent structural and gendered inequities.

Objective: This study examines how socio-demographic-economic, autonomy, and empowerment indicators interact to influence anaemia risk among married women in the Sixth Schedule districts of Assam, Northeast India.

Methods: This study analysed 5245 married women aged 18-49 years from Assam's seven Sixth Schedule districts using the NFHS-5 (2019-2021) data. Anaemia was modelled against sociodemographic-economic, autonomy, and empowerment indicators derived from contextually adapted indices (WAI-M and SWPER-M) using logistic regression to estimate unadjusted and adjusted odds ratios.

Results: Anaemia affected 66.0% of women, ranging from 58.0% in Kokrajhar to 83.7% in Udalguri; women in Udalguri remained nearly five times more likely to be anaemic than those in Kokrajhar (AOR = 4.76; 95% CI = 2.46-9.24). Low decision-making power (AOR = 2.24; 95% CI = 1.28-3.94) and limited social independence (AOR = 3.09; 95% CI = 1.70-5.60) were significant predictors of anaemia. Counterintuitively, women with medium-high (AOR = 95% CI = 0.56; 0.32-1.00) and medium-low (AOR = 0.48; 95% CI = 0.26-0.86) tolerance of wife-beating were less likely to be anaemic than those categorised as highly empowered.

Conclusions: Anaemia is not solely a biomedical condition but a manifestation of constrained autonomy, limited social independence, and unequal decision-making power. High-burden districts such as Udalguri and Baksa require structural interventions. Effective anaemia reduction necessitates a structural shift toward empowerment-centred interventions that integrate gender-transformative health and nutrition strategies.

Background: Type 2 diabetes is a global health issue, with unique challenges in Qassim, Saudi Arabia. Patients face barriers such as lifestyle, diet, healthcare access, and psychological impacts. Understanding these challenges is crucial for improving diabetes care and support.

Objective: The aim of this study was to explore the challenges and barriers faced by patients in managing Type 2 diabetes at a University Hospital in Qassim, Saudi Arabia, to provide insights for improving diabetes care and support.

Methods: A qualitative descriptive phenomenological design used semi-structured interviews and purposive sampling. Face-to-face interviews (Sept 2024-Jan 2025) were audio recorded and transcribed verbatim. Data were analyzed using Collaizi's thematic analysis.

Results: This study provides a comprehensive understanding of the key challenges and facilitators influencing the management of Type 2 diabetes. Thematic analysis identified five core themes: Challenges in Adapting Lifestyle and Behavior, Dietary Struggles and Social Pressures, Barriers to Effective Healthcare and Medication Use, Psychological and Emotional Burden of Diabetes, and Gaps in Patient Education and Support for Self-Management. Participants faced challenges of balancing self-care with work and social duties, dietary struggles tied to culture, healthcare barriers, emotional distress, and the vital role of education in disease management.

Conclusion: A patient-centered approach is key to managing Type 2 diabetes in Qassim, Saudi Arabia. Addressing lifestyle, healthcare, and psychological challenges can improve self-management and outcomes. Providers should offer tailored education, enhance care access, and support emotional and social needs. Policies should promote culturally sensitive, community-based interventions to improve adherence and quality of life.

Non-communicable diseases are increasingly prevalent in sub-Saharan Africa, and goal setting is often used to promote healthy self-management behaviours. In this review, we aimed to synthesise literature around how goal setting is used, for application in future interventions in the region. A systematic search was conducted in six databases and results screened for eligibility. Study characteristics, intervention details, goal setting components, feedback from participants and facilitators were extracted. Data were analysed using narrative synthesis and thematic analysis. The Mixed Methods Appraisal Tool was used to assess study quality. We included 24 publications describing 18 unique interventions. Included studies were of high to moderate methodological quality. Goal setting intervention components were informed by a variety of frameworks and involved a range of tasks. Interventions were often facilitator-led; many were conducted in group settings. Participants reported goal setting as useful for putting self-management into practice but encountered challenges related to language and literacy levels. Adequate detail on goal setting intervention components was not always present. Through this review, we provide a comprehensive picture of the variability of goal setting approaches in chronic disease prevention and management in sub-Saharan Africa and recommend more standardised use and reporting of goal setting intervention components.

Background: Against the backdrop of accelerating climate change and more frequent extreme weather events, typhoon disasters have become a major challenge to mental health. Based on the Social Determinants of Health theory and integrating the Cumulative Disadvantage Model with Structural Causal Influence analysis, this study evaluates how typhoon exposure affects the burden of mental health disorders and how these effects vary with social structural differences.

Objective: To investigate the mechanisms linking typhoon exposure to the burden of mental health disorders, and to quantify the moderating roles of macro-level social structural variables.

Methods: By constructing both main effect and year-on-year difference models, combined with structural equation modelling and multinational panel data, this research quantifies the moderating roles of macro-level social variables, including gross national income, Human Development Index, Gini coefficient, government health expenditure, out-of-pocket health spending, educational attainment, and life expectancy.

Results: Typhoons were found to increase prevalence, incidence, and disability-adjusted life years (DALYs) related to mental disorders, with the strongest impact in the 25-34 age group. High income, education, HDI, and public health investment were linked to greater resilience, while low income, high OOP, and high inequality indicated vulnerability. Secondary disaster frequency and the number of people affected acted as mediators, forming a pathway from 'typhoon' to 'social stress' to 'mental disorders.'

Conclusions: Typhoon impacts on mental health are shaped by both direct exposure and structural inequalities. Improving socioeconomic conditions, lowering OOP costs, reducing inequality, and increasing public health investment can strengthen psychological resilience and disaster response capacity.

Background: AI is rapidly transforming the design of communication messages across various sectors, including health and safety. However, little is known about its effectiveness for roughly 420 million native Arabic speakers worldwide.

Objective: This study examined characteristics of AI vs. human-generated road safety messages for a potential roadside billboard campaign in the United Arab Emirates.

Method: The study includes a computational analysis and an online evaluation with 186 participants from the United Arab Emirates (UAE), comparing messages generated by AI with those created by humans. To achieve this, an AI model (GPT-4) was utilized to generate 15 road safety messages, while three human experts created another set of 15 messages. Computational text analysis was employed to examine these messages, followed by an online study in which human participants evaluated all messages based on message clarity and message quality.

Results: The computational analysis revealed that AI-generated messages exhibited more positive sentiment with no significant differences in terms of readability/text difficulty. Participants evaluated both AI- and human-generated messages highly in terms of message quality and clarity, but human-generated messages were rated as slightly and significantly higher in terms of clarity.

Conclusion: These results add to a rapidly growing body of research demonstrating that AI-generated messages can augment public communication campaigns and point towards the need to assess how diverse, international audiences respond to AI-generated content.

Background: Neonatal mortality remains a global health concern. In South Africa, 32% of under-five mortality consists of neonates, with 48% of neonatal deaths attributed to prematurity. The Home and Community-Based Services (HCBS) aim to reduce deaths of very low birth weight (VLBW) neonates through community health worker (CHW) home visits.

Objectives: This study aimed to describe a cohort of VLBW neonates discharged from a regional hospital including their community follow-up, clinical outcomes and caregivers' perceptions of the HCBS.

Methods: This was a descriptive mixed methods study. Routine hospital health information from 1 January to 31 December 2018 was analysed to describe the cohort. The referral pathway and follow-up were assessed through stakeholder meetings and analysing referral forms. Caregivers were interviewed for HCBS data.

Results: There were 169 VLBW neonates. The mean (SD) gestational age was 30 (±2.21) weeks, and the median (IQR) birthweight was 1210 g (1045-1390 g). At delivery, 85% had respiratory distress and 64% had presumed sepsis. Maternal characteristics included primigravida deliveries (15%), smoking (11%), alcohol use (9%) and teenage pregnancy (5%); 14% required social worker referral. Folder reviews showed referral plans for 49 (43.4%); however, 20 (17.7%) forms were received by HCBS. All five of the interviewed caregivers had positive perceptions of the HCBS.

Conclusion: This study demonstrated a high burden of medically and socially vulnerable VLBW neonates discharged from a regional hospital. Even with established HCBS systems, few VLBW neonates were followed up at home. For the HCBS to be fully effective, promotion, strengthening and monitoring of the referral system are required.

Background: Rational use of essential medicines is a critical step towards prevention and treatment of many illnesses. However, it represents a significant challenge worldwide, and particularly for under-resourced health systems in conflict-affected areas.

Objective: To assess barriers to rational use of essential medicines at primary healthcare level in conflict-affected areas of Mali.

Methods: We conducted a cross-sectional study in twenty randomly selected community health centres (CHCs) in four health districts, by applying the World Health Organisation and International Network on Rational Use of Drugs core forms for the rational use of medicines. Seven hundred eighty-nine (789) prescriptions were retrospectively selected and analysed; four hundred forty-three (443) patients were interviewed: and health facility-related indicators were collected prospectively from the 20 CHCs.

Results: The average number of medicines per prescription was 3.89 ± 1.83; out of these, 94.0% were prescribed by generic name, and 91.0% belonged to Mali's National List of Essential Medicines. Overall, 68% of the assessed prescriptions included antibiotics; 58% included injectables; and 75.79% were characterized by polypharmacy, i.e. more than two medicines per prescription. In multivariate analysis, the study area and prescriber's sex were significantly associated with polypharmacy; prescriber's seniority and training were associated with antibiotic overprescription; the study area, prescriber's sex and seniority were associated with overprescription of injectables. Moreover, the average price of prescriptions was high in relation to average local income, likely making these unaffordable for many households.

Conclusion: Excessive polypharmacy and overprescription of antibiotics and injectables undermine the performance of the local health system and the achievement of intended therapeutic outcomes. Our findings provide a solid basis for more targeted and multidisciplinary research, to further inform relevant stakeholders on how best to mitigate the impact of conflict on the rational use of medicines.

Background: Concurrent anaemia and stunting (CAS) pose severe public health risks in low- and middle-income countries, affecting child health and development.

Objectives: To determine trends in CAS prevalence and associated factors among infants and young children aged 6-23 months in Rwanda.

Methods: Analyses of nationally representative samples from the Rwanda Demographic and Health Surveys (RDHS) of 2010, 2014/15, and 2019/20 were conducted. Participants' characteristics, trends, and prevalence of CAS were analysed using frequencies and percentages. Multivariable binary logistic regression analyses were used to assess factors associated with CAS.

Results: The prevalence of CAS among children aged 6-23 months in Rwanda declined from 21.3% in 2010 to 16.9% in 2019/20 (p = 0.005). Significant factors associated with CAS included child's age above 12 months, male sex, small/very small birth size, breastfeeding initiation 1 day post-birth, inadequate minimum acceptable diet, history of cough 2 weeks prior to the survey, multiple births, being from a mother with no or only primary education, mother aged below 20 years, mother with no iron supplementation during pregnancy, maternal anaemia, resident of an eastern province, resident of high altitude areas (>2000 m), low household wealth and unimproved toilet facilities.

Conclusions: This study reveals persistent CAS among infants and young children in Rwanda. CAS was associated with various child, maternal, and household-related factors. Despite a notable decline in CAS prevalence in Rwanda over the past decade, CAS remains a significant public health issue, requiring targeted interventions.

Households without access to a functioning and well-managed sanitation system produce untreated faecal waste. While connecting households to sewers is ideal in densely populated low-income areas, the connection rates often remain low. Most interventions to increase connectivity focused on addressing financial, social, and legal barriers; there is limited evidence on the effectiveness of behaviour change interventions in promoting sewer connections. Thus, we aim to understand the effectiveness of behaviour change interventions in increasing the uptake of sewer connections. We developed a review protocol with key search terms relating to households, sewers, behaviour change interventions, promotion, and effectiveness. We aimed to identify both the types of interventions deployed and their impact on increasing household sewer connections. Eleven articles met the eligibility criteria and were included in the review. Findings indicate that changes in rates of connection were associated with interventions that included a blend of indirect financial subsidy in the form of a free connection and community-engagement activities. There was limited evidence that behaviour change campaigns without financial incentives lead to changes in sewer connection rates. A multi-component package involving financial subsidies with community engagement is likely to improve the sewer connection rate.