Pub Date : 2025-12-12DOI: 10.1016/j.dialog.2025.100263
Iqbal Ardiansyah , Agus Subagiyo , Arif widyanto , Army Mitasari
Central Java, Indonesia, experienced a 40.9 % COVID-19 positivity rate in 2022, exceeding the WHO benchmark. This study examines the association between changes in sociodemographic, environmental, and healthcare factors and the rise in COVID-19 prevalence, focusing on regional disparities across Central Java. Variables from public datasets were chosen based on the Social Determinants of Health (SDOH) framework. Data analysis begins with variable identification via Pearson correlation, followed by an Ordinary Least Squares (OLS) regression employing Stepwise Backward Elimination, and subsequent assumption tests including Jarque-Bera, Breusch-Pagan, Moran's I, and multicollinearity checks. Upon identifying spatial autocorrelation and heteroscedasticity, Geographically Weighted Regression (GWR) was applied to address spatial heterogeneity. Ordinary Least Squares (OLS) analysis identified Change in tourist arrival ratio per population, environmental health workforce ratio per land area, and community healthcare workforce ratio per land area as associated factors with change in COVID-19 prevalence. The Geographically Weighted Regression (GWR) model, with a higher R2 value of 0.66, better accounted for regional variations, especially in central and eastern regions. The findings indicate that traveler mobility and the spatial distribution of community health workers are linked to increased COVID-19 prevalence, whereas environmental health workers are associated with a protective result, but these are associations at the aggregate (district/city) level and may be influenced by confounding or reverse causation. Structural factors such as unequal access to resources, healthcare, and sanitation, driven by tourism-induced social inequality, contribute to the disproportionate impact of COVID-19 on vulnerable communities, making it essential for policymakers to address these disparities to protect both local populations and visitors. The study recommends regulating risk-based tourist activities, expanding the environmental health workforce, and enhancing spatial monitoring systems to inform evidence-based health policy.
{"title":"Determinants of COVID-19 prevalence in Central Java, Indonesia: An ecological study of socio-demographic, environmental, and healthcare factors","authors":"Iqbal Ardiansyah , Agus Subagiyo , Arif widyanto , Army Mitasari","doi":"10.1016/j.dialog.2025.100263","DOIUrl":"10.1016/j.dialog.2025.100263","url":null,"abstract":"<div><div>Central Java, Indonesia, experienced a 40.9 % COVID-19 positivity rate in 2022, exceeding the WHO benchmark. This study examines the association between changes in sociodemographic, environmental, and healthcare factors and the rise in COVID-19 prevalence, focusing on regional disparities across Central Java. Variables from public datasets were chosen based on the Social Determinants of Health (SDOH) framework. Data analysis begins with variable identification via Pearson correlation, followed by an Ordinary Least Squares (OLS) regression employing Stepwise Backward Elimination, and subsequent assumption tests including Jarque-Bera, Breusch-Pagan, Moran's I, and multicollinearity checks. Upon identifying spatial autocorrelation and heteroscedasticity, Geographically Weighted Regression (GWR) was applied to address spatial heterogeneity. Ordinary Least Squares (OLS) analysis identified Change in tourist arrival ratio per population, environmental health workforce ratio per land area, and community healthcare workforce ratio per land area as associated factors with change in COVID-19 prevalence. The Geographically Weighted Regression (GWR) model, with a higher R<sup>2</sup> value of 0.66, better accounted for regional variations, especially in central and eastern regions. The findings indicate that traveler mobility and the spatial distribution of community health workers are linked to increased COVID-19 prevalence, whereas environmental health workers are associated with a protective result, but these are associations at the aggregate (district/city) level and may be influenced by confounding or reverse causation. Structural factors such as unequal access to resources, healthcare, and sanitation, driven by tourism-induced social inequality, contribute to the disproportionate impact of COVID-19 on vulnerable communities, making it essential for policymakers to address these disparities to protect both local populations and visitors. The study recommends regulating risk-based tourist activities, expanding the environmental health workforce, and enhancing spatial monitoring systems to inform evidence-based health policy.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"8 ","pages":"Article 100263"},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791738","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}
Pub Date : 2025-12-11DOI: 10.1016/j.dialog.2025.100266
Anna-Lee B. Bandoy , Neil Marc S. Dasas , Alpha Issa Christianne P. Abegonia , John Piox J. Badiang , Chester Lloyd S. Berdan , Maria Lucille M. Magallanes , Jes Ivan D. Sian , Therese A. Sumague , Patricia Kei P. Tulio , Addy Mae P. Binoya , Ma. Cristina L. Erum , Alfredo A. Hinay Jr
Background
Animal bite injuries are a serious public health concern due to the risk of rabies infection. In March 2024, the Department of Health (DOH) reported 84 rabies cases with six fatalities from Iloilo City. The most crucial management of animal bite injuries includes immediate wound care and rabies post-exposure prophylaxis (PEP), typically administered at an Animal Bite Treatment Center (ABTC). In 2007, the Philippines established the Republic Act No. 9482, also known as the Anti-Rabies Act, which created the National Rabies Prevention and Control Program (NRPCP) to control and eliminate rabies. This study aimed to describe the functions and challenges faced by one of these government-run ABTCs in Iloilo City, specifically a) provision of rabies PEP for animal bite cases, b) instructions for proper wound care, c) documentation of animal bite cases, and d) conduct of health promotion activities.
Materials and methods
This mixed-methods study was conducted at an ABTC in Iloilo City between January and March 2024. The first phase of the study collected secondary data from the official registry from January 1, 2018, to December 31, 2023. In the second phase, data were collected through direct observation of practices during a site visit in February 2024. A validated checklist based on the DOH Manual of Operations and WHO health system framework was developed and used for objective points of observation. Descriptive analyses of frequencies and percentages were conducted using Microsoft Excel and compared with the NRPCP guidelines. Also, Mann-Kendall test was conducted to evaluate the temporal trends in bite incidence proportions.
Results
The non-hospital-based government ABTC operated under the Iloilo City Health Office provided a.) rabies PEP and wound care for animal bite cases, b.) documentation of animal bite cases, and c.) awareness campaigns. A total of 20,134 animal bite cases were documented from 2018 to 2023. Three types of vaccines were delivered to the center: Purified Vero Cell Rabies (PVRV) and Purified Chicken Embryo Cell (PCEC) for active immunization, and Equine Rabies Immunoglobulin (ERIG) for passive immunization. In 2023, the lowest number of category III ERIG recipients was 42.65 % (n = 534). Despite COVID-19 restrictions from 2020 to the middle of 2022, all patients completed their TCV vaccination between 2020 and 2023. Challenges, such as vaccine shortages, record inconsistencies, and referral issues, persist.
Conclusion
The non-hospital-based government-run ABTC has maintained rabies PEP services in Iloilo City from 2018 to 2023, despite challenges. Collaboration with the Local Government Unit (LGU) and DOH, increased campaigns, and lay lectures on the prevention of animal bites and rabies infection, along with increased healthcare funding, are needed for sustainable solutions.
{"title":"Functions and challenges of a government-run animal bite treatment center in the delivery of rabies post-exposure prophylaxis services in Iloilo City, Philippines: A 6-year descriptive study, 2018–2023","authors":"Anna-Lee B. Bandoy , Neil Marc S. Dasas , Alpha Issa Christianne P. Abegonia , John Piox J. Badiang , Chester Lloyd S. Berdan , Maria Lucille M. Magallanes , Jes Ivan D. Sian , Therese A. Sumague , Patricia Kei P. Tulio , Addy Mae P. Binoya , Ma. Cristina L. Erum , Alfredo A. Hinay Jr","doi":"10.1016/j.dialog.2025.100266","DOIUrl":"10.1016/j.dialog.2025.100266","url":null,"abstract":"<div><h3>Background</h3><div>Animal bite injuries are a serious public health concern due to the risk of rabies infection. In March 2024, the Department of Health (DOH) reported 84 rabies cases with six fatalities from Iloilo City. The most crucial management of animal bite injuries includes immediate wound care and rabies post-exposure prophylaxis (PEP), typically administered at an Animal Bite Treatment Center (ABTC). In 2007, the Philippines established the Republic Act No. 9482, also known as the Anti-Rabies Act, which created the National Rabies Prevention and Control Program (NRPCP) to control and eliminate rabies. This study aimed to describe the functions and challenges faced by one of these government-run ABTCs in Iloilo City, specifically a) provision of rabies PEP for animal bite cases, b) instructions for proper wound care, c) documentation of animal bite cases, and d) conduct of health promotion activities.</div></div><div><h3>Materials and methods</h3><div>This mixed-methods study was conducted at an ABTC in Iloilo City between January and March 2024. The first phase of the study collected secondary data from the official registry from January 1, 2018, to December 31, 2023. In the second phase, data were collected through direct observation of practices during a site visit in February 2024. A validated checklist based on the DOH Manual of Operations and WHO health system framework was developed and used for objective points of observation. Descriptive analyses of frequencies and percentages were conducted using Microsoft Excel and compared with the NRPCP guidelines. Also, Mann-Kendall test was conducted to evaluate the temporal trends in bite incidence proportions.</div></div><div><h3>Results</h3><div>The non-hospital-based government ABTC operated under the Iloilo City Health Office provided a.) rabies PEP and wound care for animal bite cases, b.) documentation of animal bite cases, and c.) awareness campaigns. A total of 20,134 animal bite cases were documented from 2018 to 2023. Three types of vaccines were delivered to the center: Purified Vero Cell Rabies (PVRV) and Purified Chicken Embryo Cell (PCEC) for active immunization, and Equine Rabies Immunoglobulin (ERIG) for passive immunization. In 2023, the lowest number of category III ERIG recipients was 42.65 % (<em>n</em> = 534). Despite COVID-19 restrictions from 2020 to the middle of 2022, all patients completed their TCV vaccination between 2020 and 2023. Challenges, such as vaccine shortages, record inconsistencies, and referral issues, persist.</div></div><div><h3>Conclusion</h3><div>The non-hospital-based government-run ABTC has maintained rabies PEP services in Iloilo City from 2018 to 2023, despite challenges. Collaboration with the Local Government Unit (LGU) and DOH, increased campaigns, and lay lectures on the prevention of animal bites and rabies infection, along with increased healthcare funding, are needed for sustainable solutions.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"8 ","pages":"Article 100266"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791740","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}
One of the regions in Indonesia that has the highest prevalence of stunting cases is West Nusa Tenggara, with a percentage of cases almost reaching 12.7 %, even though this province is a priority target for stunting reduction by 2022. Specifically in the East Lombok region, this study took this location point because of the high number of stunting cases in West Nusa Tenggara. Puskesmas Denggen was the target of the study, covering six working areas namely Denggen, East Dengen, Majidi, Rakam, Sekarteja, and Pancor, with a total of 3416 under-five data. The data were obtained through two measurements: the initial in February 2024 and the final in August 2024. This research integrates a multidisciplinary approach, encompassing health and nutrition science, psychology, education, and religion, to create comprehensive interventions for stunting prevention and employs machine learning models to predict future cases. The interventions include Motivation, Hygiene, Nutrition, Mental Health, and Infant Health, which are designed to cover all the essential needs of children in the growth and development process. The results of the six villages measured showed that significant changes in data were obtained in Denggen Village when compared before and after the intervention. The results of measuring the effectiveness of the anti-stunting educational interventions were also found to be effective across the five key aspects, with several showing dominant and statistically significant improvements. The machine learning algorithms used also achieved very high accuracy using Decision Tree and Gaussian Naive Bayes. This anti-stunting education model can be applied to the same case in a wider scope by paying attention to several aspects as an evaluation.
印度尼西亚发育迟缓病例发病率最高的地区之一是西努沙登加拉，尽管该省是到2022年减少发育迟缓的优先目标，但该地区的病例比例几乎达到12.7%。特别是在东龙目岛地区，本研究之所以选择这个地点，是因为西努沙登加拉有大量发育迟缓病例。Puskesmas Denggen是该研究的目标，涵盖六个工作区域，即Denggen， East Dengen, Majidi, Rakam， Sekarteja和Pancor，共有3416个5岁以下数据。数据是通过两次测量获得的：第一次是在2024年2月，最后一次是在2024年8月。这项研究整合了多学科方法，包括健康和营养科学、心理学、教育和宗教，为发育迟缓预防创造了全面的干预措施，并使用机器学习模型来预测未来的病例。干预措施包括动机、卫生、营养、心理健康和婴儿健康，旨在满足儿童在成长和发展过程中的所有基本需求。6个村的测量结果显示，干预前后，登根村的数据发生了显著变化。测量反发育迟缓教育干预措施有效性的结果也被发现在五个关键方面是有效的，其中几个方面显示出主导和统计显着的改善。使用的机器学习算法使用决策树和高斯朴素贝叶斯也达到了非常高的精度。这种反发育不良教育模式通过关注几个方面作为评价，可以在更广泛的范围内适用于同一案例。
{"title":"Integrating education-based interventions and machine learning for stunting prevention: A case study in East Lombok, Indonesia","authors":"Mhd. Lailan Arqam , Asno Azzawagama Firdaus , Ahmad Muslih Atmojo , Ginanjar Zukhruf Saputri , Furizal , Palahuddin , Retno Sirnopati","doi":"10.1016/j.dialog.2025.100264","DOIUrl":"10.1016/j.dialog.2025.100264","url":null,"abstract":"<div><div>One of the regions in Indonesia that has the highest prevalence of stunting cases is West Nusa Tenggara, with a percentage of cases almost reaching 12.7 %, even though this province is a priority target for stunting reduction by 2022. Specifically in the East Lombok region, this study took this location point because of the high number of stunting cases in West Nusa Tenggara. Puskesmas Denggen was the target of the study, covering six working areas namely Denggen, East Dengen, Majidi, Rakam, Sekarteja, and Pancor, with a total of 3416 under-five data. The data were obtained through two measurements: the initial in February 2024 and the final in August 2024. This research integrates a multidisciplinary approach, encompassing health and nutrition science, psychology, education, and religion, to create comprehensive interventions for stunting prevention and employs machine learning models to predict future cases. The interventions include Motivation, Hygiene, Nutrition, Mental Health, and Infant Health, which are designed to cover all the essential needs of children in the growth and development process. The results of the six villages measured showed that significant changes in data were obtained in Denggen Village when compared before and after the intervention. The results of measuring the effectiveness of the anti-stunting educational interventions were also found to be effective across the five key aspects, with several showing dominant and statistically significant improvements. The machine learning algorithms used also achieved very high accuracy using Decision Tree and Gaussian Naive Bayes. This anti-stunting education model can be applied to the same case in a wider scope by paying attention to several aspects as an evaluation.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"8 ","pages":"Article 100264"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738558","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}
Pub Date : 2025-12-03DOI: 10.1016/j.dialog.2025.100262
Eun-Young Lee , Heejun Lim
Purpose
Intersectionality is a theoretical framework that allows researchers to examine how multiple, overlapping social identities such as gender and socioeconomic status (SES) interact to shape individuals' experiences and contribute to inequalities. This study examined the associations between intersectional identity and mental health among South Korean adolescents and whether risk behaviors modify these associations.
Methods
The 2023 Korea Youth Behavior Web-Based Survey (n=52,880; 12–18 years) was used. Gender and family SES served as intersectional identities. Outcome included stress, depression, and loneliness. Alcohol, tobacco, and smartphone use were considered as potential effect modifiers. Decision tree models, logistic regressions, and moderation analyses were performed.
Results
Overall, girls reported poorer mental health than boys. When SES was considered, gender X SES was associated with loneliness only, and not with stress or depression. Among boys, the odds of reporting loneliness were higher with lower SES, and this association was further compounded by alcohol or tobacco use within each SES level. Girls reported higher odds of loneliness across all SES levels compared to boys, with low-SES girls experiencing the greatest burden. Alcohol and tobacco use further exacerbated the associations between intersectional identity and loneliness across all groups, particularly in girls. Smartphone use did not modify these associations.
Conclusions
Interventions targeting alcohol and tobacco use may be important to prevent loneliness for adolescents with intersectional identities. Loneliness may be shaped by both structural and behavioral factors, supporting the intersectionality as a useful analytical framework to better understand mental health disparities among adolescents.
{"title":"Intersectional identity, risk behaviors, and adolescent mental health in South Korea: who suffers the most in the loneliness epidemic?","authors":"Eun-Young Lee , Heejun Lim","doi":"10.1016/j.dialog.2025.100262","DOIUrl":"10.1016/j.dialog.2025.100262","url":null,"abstract":"<div><h3>Purpose</h3><div>Intersectionality is a theoretical framework that allows researchers to examine how multiple, overlapping social identities such as gender and socioeconomic status (SES) interact to shape individuals' experiences and contribute to inequalities. This study examined the associations between intersectional identity and mental health among South Korean adolescents and whether risk behaviors modify these associations.</div></div><div><h3>Methods</h3><div>The 2023 Korea Youth Behavior Web-Based Survey (n=52,880; 12–18 years) was used. Gender and family SES served as intersectional identities. Outcome included stress, depression, and loneliness. Alcohol, tobacco, and smartphone use were considered as potential effect modifiers. Decision tree models, logistic regressions, and moderation analyses were performed.</div></div><div><h3>Results</h3><div>Overall, girls reported poorer mental health than boys. When SES was considered, gender X SES was associated with loneliness only, and not with stress or depression. Among boys, the odds of reporting loneliness were higher with lower SES, and this association was further compounded by alcohol or tobacco use within each SES level. Girls reported higher odds of loneliness across all SES levels compared to boys, with low-SES girls experiencing the greatest burden. Alcohol and tobacco use further exacerbated the associations between intersectional identity and loneliness across all groups, particularly in girls. Smartphone use did not modify these associations.</div></div><div><h3>Conclusions</h3><div>Interventions targeting alcohol and tobacco use may be important to prevent loneliness for adolescents with intersectional identities. Loneliness may be shaped by both structural and behavioral factors, supporting the intersectionality as a useful analytical framework to better understand mental health disparities among adolescents.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"8 ","pages":"Article 100262"},"PeriodicalIF":0.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145697847","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}
Pub Date : 2025-12-01DOI: 10.1016/j.dialog.2025.100260
Isaac Nyarko Kwakye
Background and aim
Illness perception has emerged as a critical factor influencing self-care behaviours, psychological distress, and health outcomes among patients with diabetes. However, there is limited understanding of how individuals with diabetes in Ghana cognitively interpret their symptoms. Therefore, this study explored the interpretive processes of symptom perception among diabetes patients in the Eastern Region (Koforidua) of Ghana.
Methods
Using a qualitative design grounded in interpretative phenomenological analysis (IPA), data were collected through semi-structured interviews with 15 purposively selected participants attending the diabetes clinic at Koforidua Regional Hospital. The interpretative phenomenological analysis (IPA) approach was used to analyze the qualitative data.
Results
Two main themes with their subthemes were identified: symptoms identification (increased urination and sweet-smelling urine, persistent thirst and hunger, noticeable weight loss; routine check-up/blood pressure; blisters, foot sore, non-healing wounds), and patients' perception (perception of diabetes as “disease of the rich”; belief in spiritual or supernatural causation; diabetes as a life-threatening and unpredictable condition). Symptom interpretation was shaped not only by personal experiences but also by sociocultural beliefs and community narratives. These interpretations highlight how cultural frameworks influence illness representation and health-seeking behaviours, consistent with the Common-Sense Model of illness perception.
Conclusion
The study concludes that patients do not interpret symptoms in isolation but integrate them into broader belief systems, which significantly shape their responses to illness. To improve diabetes outcomes, public health interventions should prioritize culturally sensitive education that addresses misconceptions, enhances symptom recognition, and strengthens health literacy at the community level. Such strategies can empower patients to seek timely care, reduce late diagnosis, and improve self-management, particularly in resource-limited settings.
{"title":"Exploring the interpretive processes of symptom perception among diabetes patients in eastern region of Ghana","authors":"Isaac Nyarko Kwakye","doi":"10.1016/j.dialog.2025.100260","DOIUrl":"10.1016/j.dialog.2025.100260","url":null,"abstract":"<div><h3>Background and aim</h3><div>Illness perception has emerged as a critical factor influencing self-care behaviours, psychological distress, and health outcomes among patients with diabetes. However, there is limited understanding of how individuals with diabetes in Ghana cognitively interpret their symptoms. Therefore, this study explored the interpretive processes of symptom perception among diabetes patients in the Eastern Region (Koforidua) of Ghana.</div></div><div><h3>Methods</h3><div>Using a qualitative design grounded in interpretative phenomenological analysis (IPA), data were collected through semi-structured interviews with 15 purposively selected participants attending the diabetes clinic at Koforidua Regional Hospital. The interpretative phenomenological analysis (IPA) approach was used to analyze the qualitative data.</div></div><div><h3>Results</h3><div>Two main themes with their subthemes were identified: symptoms identification (increased urination and sweet-smelling urine, persistent thirst and hunger, noticeable weight loss; routine check-up/blood pressure; blisters, foot sore, non-healing wounds), and patients' perception (perception of diabetes as “disease of the rich”; belief in spiritual or supernatural causation; diabetes as a life-threatening and unpredictable condition). Symptom interpretation was shaped not only by personal experiences but also by sociocultural beliefs and community narratives. These interpretations highlight how cultural frameworks influence illness representation and health-seeking behaviours, consistent with the Common-Sense Model of illness perception.</div></div><div><h3>Conclusion</h3><div>The study concludes that patients do not interpret symptoms in isolation but integrate them into broader belief systems, which significantly shape their responses to illness. To improve diabetes outcomes, public health interventions should prioritize culturally sensitive education that addresses misconceptions, enhances symptom recognition, and strengthens health literacy at the community level. Such strategies can empower patients to seek timely care, reduce late diagnosis, and improve self-management, particularly in resource-limited settings.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"7 ","pages":"Article 100260"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622764","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}
Pub Date : 2025-12-01DOI: 10.1016/j.dialog.2025.100259
Mary Nthambi , Tiziana Lembo , Alicia Davis , Blandina T. Mmbaga , Nicholas Hanley
Household decisions shape health outcomes in subsistence farming communities in sub-Saharan Africa (SSA) where human wellbeing is closely linked to livestock productivity. We conducted a systematic review, guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), of 135 primary studies from Embase, Scopus, PubMed, Web of Science and Google Scholar. Using the Household Production of Health (HPH) framework, we structured research questions, extracted and synthesised evidence and identified health interventions in human and livestock health in SSA. We coded decision loci (sole vs joint decision-making) and characterised their prevalence, context and determinants of household health outcomes. Sole decisions dominated (40 % of human studies, 42 % of livestock studies) with men making the majority of the decisions, especially in livestock health, while joint decisions were less common (27 %, 32 % respectively) and focused on maternal, neonatal and child health. Women's decision-making power tended to increase with education, income and urban residence, while male authority was greater in rural areas where fewer income-earning opportunities for women prevail. The two HPH frameworks are tightly linked as behaviours that improve livestock health and productivity benefit nutrition, income and access to care for household members. We recommend gender-responsive, One Health policies that support women's control in areas of existing responsibility and engage men as active partners in shared decision-making within households to reduce inequalities. These efforts should be supported by progress towards universal health coverage, functioning health insurance schemes and accessible veterinary services to reduce inequalities and within-household trade-offs, and to improve health and livelihood resilience in SSA.
在撒哈拉以南非洲的自给农业社区（SSA），家庭决策影响着人类福祉与畜牧业生产力密切相关的健康结果。在系统评价和荟萃分析首选报告项目（PRISMA）的指导下，我们对来自Embase、Scopus、PubMed、Web of Science和谷歌Scholar的135项主要研究进行了系统评价。利用家庭健康生产（HPH）框架，我们构建了研究问题，提取和综合了证据，并确定了SSA地区人类和牲畜健康方面的卫生干预措施。我们编码了决策位点（单独决策与共同决策），并描述了它们的流行程度、背景和家庭健康结果的决定因素。单独决策占主导地位（在人类研究中占40%，在牲畜研究中占42%），大多数决策是由男性做出的，特别是在牲畜健康方面，而共同决策则不太常见（分别为27%和32%），并侧重于孕产妇、新生儿和儿童健康。妇女的决策权往往随着教育、收入和城市居住而增加，而在妇女挣钱机会普遍较少的农村地区，男性的权力更大。这两个卫生和健康框架紧密相连，因为改善牲畜健康和生产力的行为有利于家庭成员的营养、收入和获得护理的机会。我们建议促进性别平等的“同一个健康”政策，支持妇女控制现有责任领域，并使男子作为积极伙伴参与家庭内的共同决策，以减少不平等现象。这些努力应得到在实现全民健康覆盖、有效的健康保险计划和可获得的兽医服务方面取得的进展的支持，以减少不平等现象和家庭内部权衡，并提高SSA的健康和生计复原力。
{"title":"Understanding decision-making around human and livestock health in sub-Saharan Africa: A systematic literature review","authors":"Mary Nthambi , Tiziana Lembo , Alicia Davis , Blandina T. Mmbaga , Nicholas Hanley","doi":"10.1016/j.dialog.2025.100259","DOIUrl":"10.1016/j.dialog.2025.100259","url":null,"abstract":"<div><div>Household decisions shape health outcomes in subsistence farming communities in sub-Saharan Africa (SSA) where human wellbeing is closely linked to livestock productivity. We conducted a systematic review, guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), of 135 primary studies from Embase, Scopus, PubMed, Web of Science and Google Scholar. Using the Household Production of Health (HPH) framework, we structured research questions, extracted and synthesised evidence and identified health interventions in human and livestock health in SSA. We coded decision loci (sole vs joint decision-making) and characterised their prevalence, context and determinants of household health outcomes. Sole decisions dominated (40 % of human studies, 42 % of livestock studies) with men making the majority of the decisions, especially in livestock health, while joint decisions were less common (27 %, 32 % respectively) and focused on maternal, neonatal and child health. Women's decision-making power tended to increase with education, income and urban residence, while male authority was greater in rural areas where fewer income-earning opportunities for women prevail. The two HPH frameworks are tightly linked as behaviours that improve livestock health and productivity benefit nutrition, income and access to care for household members. We recommend gender-responsive, One Health policies that support women's control in areas of existing responsibility and engage men as active partners in shared decision-making within households to reduce inequalities. These efforts should be supported by progress towards universal health coverage, functioning health insurance schemes and accessible veterinary services to reduce inequalities and within-household trade-offs, and to improve health and livelihood resilience in SSA.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"7 ","pages":"Article 100259"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622765","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}
Proper management of menstrual hygiene is a topic of interest among women and is a requisite to the well-being of women and adolescent girls worldwide. But lack of information about menstruation and menstrual hygiene practices creates a culture of taboos leading to a big barrier in the path of menstrual hygiene management. A menstrual cup (M-Cup) is considered as an ideal green substitute for the disposable sanitary products. Being economical than disposable ones, M-Cup has several benefits compared to other menstrual management products mainly long term use and environmental sustainability. However due to several factors, such as affordability, accessibility etc., the level of awareness among the public is less. A programme was launched to curb menstrual waste, to create awareness and encourage women to use menstrual cups, and to ensure proper menstrual hygiene by distributing M-cups free of cost. The programme have reached out to more than 5, 00,000 beneficiaries across India including the tribal population of Jharkhand, Kerala, Karnataka etc. and studies are being carried out to analyze the acceptability, adaptability and usage of such an insertion device like M-Cups. By promoting M-Cups and empowering menstruates with knowledge and resources for sustainable menstrual hygiene management, the programme aims to achieve women empowerment, substantial carbon footprint reduction, preserve natural resources and enhance public health.
{"title":"Redefining menstrual hygiene management with menstrual cups through project Thinkal; from self care to environmental resilience","authors":"Parvathy Jayasree , Krishna Sreelekha Hemachandran","doi":"10.1016/j.dialog.2025.100261","DOIUrl":"10.1016/j.dialog.2025.100261","url":null,"abstract":"<div><div>Proper management of menstrual hygiene is a topic of interest among women and is a requisite to the well-being of women and adolescent girls worldwide. But lack of information about menstruation and menstrual hygiene practices creates a culture of taboos leading to a big barrier in the path of menstrual hygiene management. A menstrual cup (M-Cup) is considered as an ideal green substitute for the disposable sanitary products. Being economical than disposable ones, M-Cup has several benefits compared to other menstrual management products mainly long term use and environmental sustainability. However due to several factors, such as affordability, accessibility etc., the level of awareness among the public is less. A programme was launched to curb menstrual waste, to create awareness and encourage women to use menstrual cups, and to ensure proper menstrual hygiene by distributing M-cups free of cost. The programme have reached out to more than 5, 00,000 beneficiaries across India including the tribal population of Jharkhand, Kerala, Karnataka etc. and studies are being carried out to analyze the acceptability, adaptability and usage of such an insertion device like M-Cups. By promoting M-Cups and empowering menstruates with knowledge and resources for sustainable menstrual hygiene management, the programme aims to achieve women empowerment, substantial carbon footprint reduction, preserve natural resources and enhance public health.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"7 ","pages":"Article 100261"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693503","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}
Digital health interventions are increasingly used to prevent non-communicable diseases (NCDs) by promoting healthy behaviors, yet evidence on which digital features are most effective remains fragmented. This systematic scoping review aimed to (1) identify the most commonly used types of digital interventions and their target populations for NCD prevention, (2) examine the primary objectives associated with each digital feature, and (3) assess their effectiveness in improving knowledge, attitudes, and behaviors.
Methods
A comprehensive search was conducted across seven databases (PubMed, ScienceDirect, Scopus, JSTOR, Medline, CINAHL, and ProQuest). Following PRISMA guidelines, 20 peer-reviewed studies published between 2018 and 2024 met the inclusion criteria. Data were extracted on digital features, intervention objectives, and outcomes related to knowledge, attitudes, and behaviors.
Results
Messaging platforms were the most common (n = 7), followed by gamification, mobile applications, and wearables. Most interventions aimed to promote behavior change, especially those using mobile apps, messaging, and wearable tools. Similar digital features served different objectives depending on content design. Across studies, knowledge outcomes improved by 10–95 %, attitudinal outcomes by 2–40 %, and behavioral outcomes by 4–95 %. Messaging platforms showed the largest improvements in both knowledge and behavior, while gamification yielded moderate gains. Aligning digital tools with target users and intended outcomes enhanced overall impact.
Conclusions
Messaging platforms and mobile applications emerged as the most frequently used and effective digital features for NCD prevention. Multi-feature interventions and platform–outcome alignment appear crucial to maximize effectiveness in digital health programs promoting healthy behavior.
{"title":"The effect of digital health intervention in promoting healthy behavior: A systematic scoping review on strategies to prevent non-communicable diseases","authors":"Zahroh Shaluhiyah , Shabrina Arifia Qatrannada , Aditya Kusumawati , Mohammad Shahgahan Miah","doi":"10.1016/j.dialog.2025.100258","DOIUrl":"10.1016/j.dialog.2025.100258","url":null,"abstract":"<div><h3>Background</h3><div>Digital health interventions are increasingly used to prevent non-communicable diseases (NCDs) by promoting healthy behaviors, yet evidence on which digital features are most effective remains fragmented. This systematic scoping review aimed to (1) identify the most commonly used types of digital interventions and their target populations for NCD prevention, (2) examine the primary objectives associated with each digital feature, and (3) assess their effectiveness in improving knowledge, attitudes, and behaviors.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted across seven databases (PubMed, ScienceDirect, Scopus, JSTOR, Medline, CINAHL, and ProQuest). Following PRISMA guidelines, 20 peer-reviewed studies published between 2018 and 2024 met the inclusion criteria. Data were extracted on digital features, intervention objectives, and outcomes related to knowledge, attitudes, and behaviors.</div></div><div><h3>Results</h3><div>Messaging platforms were the most common (<em>n</em> = 7), followed by gamification, mobile applications, and wearables. Most interventions aimed to promote behavior change, especially those using mobile apps, messaging, and wearable tools. Similar digital features served different objectives depending on content design. Across studies, knowledge outcomes improved by 10–95 %, attitudinal outcomes by 2–40 %, and behavioral outcomes by 4–95 %. Messaging platforms showed the largest improvements in both knowledge and behavior, while gamification yielded moderate gains. Aligning digital tools with target users and intended outcomes enhanced overall impact.</div></div><div><h3>Conclusions</h3><div>Messaging platforms and mobile applications emerged as the most frequently used and effective digital features for NCD prevention. Multi-feature interventions and platform–outcome alignment appear crucial to maximize effectiveness in digital health programs promoting healthy behavior.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"7 ","pages":"Article 100258"},"PeriodicalIF":0.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578570","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}
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