Pub Date : 2025-12-01Epub Date: 2025-08-26DOI: 10.1016/j.dialog.2025.100235
Arn Migowski , Ruffo Freitas-Junior , Jose Bines , Angela Marie Jansen , Angélica Nogueira-Rodrigues , Maria del Pilar Estevez-Diz , Mariana Rico-Restrepo , Gayatri Sanku , André Mattar
Breast cancer (BC) remains a significant health concern in Brazil, particularly within its public healthcare system, the Unified Health System, known by its Portuguese acronym “SUS”, with early detection being one of the main challenges. A review of literature and policy documents was conducted to evaluate the performance and challenges of BC screening and early diagnosis in SUS. Brazilian experts in BC early detection attended a three-day meeting to discuss the challenges of SUS's existing early detection program and provide recommendations for surmounting them. The study identified that Brazil's current opportunistic BC screening model perpetuates issues with access to screening and regional disparities, while also generating low effectiveness and inefficiency. It also highlights several causes of delays in early diagnosis and treatment. The conclusions suggest an urgent need for an organized national BC screening program, in addition to the implementation of early diagnosis strategies, with multifaceted interventions, including urgent referral guidelines for suspected cases, training of key health professionals, patient navigation, and one-stop breast clinics. Implementing these changes could alleviate the economic strain on the healthcare system while improving patient outcomes.
{"title":"Cracking the code: Pioneering early detection and management of breast cancer in the Brazilian public healthcare system","authors":"Arn Migowski , Ruffo Freitas-Junior , Jose Bines , Angela Marie Jansen , Angélica Nogueira-Rodrigues , Maria del Pilar Estevez-Diz , Mariana Rico-Restrepo , Gayatri Sanku , André Mattar","doi":"10.1016/j.dialog.2025.100235","DOIUrl":"10.1016/j.dialog.2025.100235","url":null,"abstract":"<div><div>Breast cancer (BC) remains a significant health concern in Brazil, particularly within its public healthcare system, the Unified Health System, known by its Portuguese acronym “SUS”, with early detection being one of the main challenges. A review of literature and policy documents was conducted to evaluate the performance and challenges of BC screening and early diagnosis in SUS. Brazilian experts in BC early detection attended a three-day meeting to discuss the challenges of SUS's existing early detection program and provide recommendations for surmounting them. The study identified that Brazil's current opportunistic BC screening model perpetuates issues with access to screening and regional disparities, while also generating low effectiveness and inefficiency. It also highlights several causes of delays in early diagnosis and treatment. The conclusions suggest an urgent need for an organized national BC screening program, in addition to the implementation of early diagnosis strategies, with multifaceted interventions, including urgent referral guidelines for suspected cases, training of key health professionals, patient navigation, and one-stop breast clinics. Implementing these changes could alleviate the economic strain on the healthcare system while improving patient outcomes.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"7 ","pages":"Article 100235"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144987926","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}
Continuum of care (CoC) emphasizes the importance of establishing connections between maternal healthcare service provided at various stages throughout pregnancy, labour, and the postpartum period. The objective of this study was to investigate the CoC for maternal health, focusing on recent utilization and dropout pattern and to examine the underlying wealth inequality and its association with the dimensions of women's empowerment.
Material and methods
For our analysis, we focused on mothers who had given birth within the five years preceding the National family health survey (NFHS)-5 survey. Outcome variable, the CoC for maternal health was assessed at three distinct levels: CoC until 4+ antenatal care (ANC), CoC until skilled birth attendance (SBA), CoC until postnatal care (PNC) or complete CoC. Binary logistic regression, concentration curve and index were utilized to address the objectives of the study.
Results
Our study found that 93.8 % of women initiated maternal healthcare with at least one ANC visit, but only 63.1 % completed the recommended 4+ visits. Among them, 94.6 % received SBA, yet only 62 % continued to PNC. A concerning dropout pattern was observed across all states, with even prosperous states like Chandigarh, West Bengal, Goa, Kerala, New Delhi, and Gujarat showing higher dropout rates before PNC than the national average of 38 %. Concentration curves revealed pro-rich inequality in CoC. Women's social independence positively influenced CoC adherence, along with parity, pregnancy intention, wealth index, and region of residence as key determinants.
Conclusion
Our findings reveal significant gaps in the continuum of maternal healthcare, including high dropout rates before postnatal care and persistent wealth-based disparities. Addressing these issues requires targeted policies, greater women's empowerment, and equitable healthcare access. Future research should conduct a comprehensive analysis to understand why dropout rates remain high, even in relatively prosperous states, by examining health system inefficiencies, sociocultural barriers, and policy gaps.
{"title":"Pregnancy to postpartum: Analyzing dropouts and socioeconomic predictors of continuum of maternal healthcare in India","authors":"Pooja Singh , Sanjiv Singh , Kaushalendra Kumar Singh","doi":"10.1016/j.dialog.2025.100226","DOIUrl":"10.1016/j.dialog.2025.100226","url":null,"abstract":"<div><h3>Background</h3><div>Continuum of care (CoC) emphasizes the importance of establishing connections between maternal healthcare service provided at various stages throughout pregnancy, labour, and the postpartum period. The objective of this study was to investigate the CoC for maternal health, focusing on recent utilization and dropout pattern and to examine the underlying wealth inequality and its association with the dimensions of women's empowerment.</div></div><div><h3>Material and methods</h3><div>For our analysis, we focused on mothers who had given birth within the five years preceding the National family health survey (NFHS)-5 survey. Outcome variable, the CoC for maternal health was assessed at three distinct levels: CoC until 4+ antenatal care (ANC), CoC until skilled birth attendance (SBA), CoC until postnatal care (PNC) or complete CoC. Binary logistic regression, concentration curve and index were utilized to address the objectives of the study.</div></div><div><h3>Results</h3><div>Our study found that 93.8 % of women initiated maternal healthcare with at least one ANC visit, but only 63.1 % completed the recommended 4+ visits. Among them, 94.6 % received SBA, yet only 62 % continued to PNC. A concerning dropout pattern was observed across all states, with even prosperous states like Chandigarh, West Bengal, Goa, Kerala, New Delhi, and Gujarat showing higher dropout rates before PNC than the national average of 38 %. Concentration curves revealed pro-rich inequality in CoC. Women's social independence positively influenced CoC adherence, along with parity, pregnancy intention, wealth index, and region of residence as key determinants.</div></div><div><h3>Conclusion</h3><div>Our findings reveal significant gaps in the continuum of maternal healthcare, including high dropout rates before postnatal care and persistent wealth-based disparities. Addressing these issues requires targeted policies, greater women's empowerment, and equitable healthcare access. Future research should conduct a comprehensive analysis to understand why dropout rates remain high, even in relatively prosperous states, by examining health system inefficiencies, sociocultural barriers, and policy gaps.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"7 ","pages":"Article 100226"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580251","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 : 2025-12-01Epub Date: 2025-07-14DOI: 10.1016/j.dialog.2025.100230
Khuman Bhagirath Jetubhai
This paper examines the nature of Indian digital news reporting on suicides and suicide attempts within the LGBTQ+ community. The objective is to analyse how these incidents are framed by the media by identifying the dominant narratives, demographic characteristics highlighted, and attributed causes presented in news coverage. Following PRISMA guidelines, this study identified and analysed 164 unique digital news reports published between 2001 and 2022. The analysis reveals that news coverage most frequently focuses on individuals identified as trans women or lesbians, who are in the 19–24 and 25–44 age brackets, and are reported to be in a relationship. The most common narratives constructed in these reports attribute the suicides to family non-acceptance of their relationship or identity and partner separation. Furthermore, hanging and drug/poison ingestion are the most frequently reported methods of suicide, and joint/couple suicides are a significant feature of the media coverage. These findings demonstrate that the portrayal of LGBTQ+ suicide in Indian digital media is a curated narrative, likely shaped by journalistic news values rather than being a direct reflection of population-level trends. This research provides critical insights into the construction of media discourse on a sensitive public health issue and its implications for public perception and policy.
{"title":"Portrayals of suicide and suicide attempts among LGBTQ+ individuals in Indian digital news","authors":"Khuman Bhagirath Jetubhai","doi":"10.1016/j.dialog.2025.100230","DOIUrl":"10.1016/j.dialog.2025.100230","url":null,"abstract":"<div><div>This paper examines the nature of Indian digital news reporting on suicides and suicide attempts within the LGBTQ+ community. The objective is to analyse how these incidents are framed by the media by identifying the dominant narratives, demographic characteristics highlighted, and attributed causes presented in news coverage. Following PRISMA guidelines, this study identified and analysed 164 unique digital news reports published between 2001 and 2022. The analysis reveals that news coverage most frequently focuses on individuals identified as trans women or lesbians, who are in the 19–24 and 25–44 age brackets, and are reported to be in a relationship. The most common narratives constructed in these reports attribute the suicides to family non-acceptance of their relationship or identity and partner separation. Furthermore, hanging and drug/poison ingestion are the most frequently reported methods of suicide, and joint/couple suicides are a significant feature of the media coverage. These findings demonstrate that the portrayal of LGBTQ+ suicide in Indian digital media is a curated narrative, likely shaped by journalistic news values rather than being a direct reflection of population-level trends. This research provides critical insights into the construction of media discourse on a sensitive public health issue and its implications for public perception and policy.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"7 ","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703568","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 : 2025-06-01Epub Date: 2025-04-02DOI: 10.1016/j.dialog.2025.100214
Clement Kubreziga Kubuga
Objectives
Worldwide, women experience high prevalence of micronutrient deficiencies due to poor quality diets and elevated needs of the subpopulation. In Ghana, micronutrient deficiencies are pronounced in northern Ghana especially during the prolonged dry/lean season. This study aimed to investigate whether or not the results from an earlier pilot study to improve micronutrient intakes could be replicated through the entire dry season and to explore alternative and sustainable dry season gardening models to improve diet quality among women in northern Ghana.
Methods
In this quasi-experimental study, the experimental design comprised an experimental community (n = 102) and a control community (n = 104). Participants in the experimental community were provided with wooden containers, soil water retention technology (SWRT) beds, and water reservoirs for vegetables production. Control community did not receive any of the above.
Results
The pilot study's results were successfully replicated throughout the dry season: container and SWRT community-based gardening as alternative dry season farming models, improved diet quality among women during the dry/lean season. The proportion of women consuming non diverse diets declined by 41 % in the intervention group. Furthermore, community-based gardening was successfully supported by community-based water banks for five months. This finding offers a potential solution to the shortcomings of conventional irrigation systems in northern Ghana.
Conclusion
Alternative community-based dry season gardening models can contribute to improve micronutrient intakes and nutrition security in northern Ghana. Though the results of this study are promising, it is recognized that more extensive research is necessary.
{"title":"Alternative community-based gardening and water banks for micronutrients intake among women in northern Ghana","authors":"Clement Kubreziga Kubuga","doi":"10.1016/j.dialog.2025.100214","DOIUrl":"10.1016/j.dialog.2025.100214","url":null,"abstract":"<div><h3>Objectives</h3><div>Worldwide, women experience high prevalence of micronutrient deficiencies due to poor quality diets and elevated needs of the subpopulation. In Ghana, micronutrient deficiencies are pronounced in northern Ghana especially during the prolonged dry/lean season. This study aimed to investigate whether or not the results from an earlier pilot study to improve micronutrient intakes could be replicated through the entire dry season and to explore alternative and sustainable dry season gardening models to improve diet quality among women in northern Ghana.</div></div><div><h3>Methods</h3><div>In this quasi-experimental study, the experimental design comprised an experimental community (<em>n</em> = 102) and a control community (<em>n</em> = 104). Participants in the experimental community were provided with wooden containers, soil water retention technology (SWRT) beds, and water reservoirs for vegetables production. Control community did not receive any of the above.</div></div><div><h3>Results</h3><div>The pilot study's results were successfully replicated throughout the dry season: container and SWRT community-based gardening as alternative dry season farming models, improved diet quality among women during the dry/lean season. The proportion of women consuming non diverse diets declined by 41 % in the intervention group. Furthermore, community-based gardening was successfully supported by community-based water banks for five months. This finding offers a potential solution to the shortcomings of conventional irrigation systems in northern Ghana.</div></div><div><h3>Conclusion</h3><div>Alternative community-based dry season gardening models can contribute to improve micronutrient intakes and nutrition security in northern Ghana. Though the results of this study are promising, it is recognized that more extensive research is necessary.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"6 ","pages":"Article 100214"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-04-16DOI: 10.1016/j.dialog.2025.100217
Sabrina Zaman , Tamsel Ahammed , Md Abul Hasan , Md. Enamul Huque
Background
The COVID-19 pandemic has amplified concerns about global food insecurity, with dietary diversity emerging as a critical indicator of nutritional adequacy. These challenges have far-reaching implications for mental health, particularly in vulnerable populations.
Objective
This study delves into the intersection of post-COVID-19 household food insecurity, dietary diversity, and mental depression among affected households.
Methodology
A cross-sectional study conducted with a sample size of COVID 19 affected 500 households. Bivariate linear regression performed to establish associations with food insecurity, dietary diversity, and depression.
Result
The study found that only 33.4 % of households were food secure, while 40.8 % experienced moderate food insecurity. Most households (82.2 %) had a medium level of dietary diversity, and 45.6 % of respondents reported experiencing different level of depression. Urban residency, higher education, stable employment, and higher income were associated with lower food insecurity and better dietary diversity ((p < 0.05), whereas female-headed households, joint families, and older family heads had higher levels of depression. Job losses (63 %) and income reductions (69.8 %) during COVID-19 contributed significantly (p < 0.05) to increased food insecurity and depression. Households with stable jobs, higher incomes, and access to nutritional information enjoyed better food security, greater dietary diversity, and lower depression. In contrast, rising food prices and job changes worsened both food insecurity and mental health outcomes.
Conclusion
The COVID-19 pandemic has impacted food security, dietary diversity and mental health in Jashore, Bangladesh, exacerbating food insecurity and mental depression, especially among vulnerable groups. However, households with stable jobs, better education, and access to information fared better.
{"title":"COVID-19 effect on food security, livelihood, and mental health in affected households of Jashore, Bangladesh","authors":"Sabrina Zaman , Tamsel Ahammed , Md Abul Hasan , Md. Enamul Huque","doi":"10.1016/j.dialog.2025.100217","DOIUrl":"10.1016/j.dialog.2025.100217","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic has amplified concerns about global food insecurity, with dietary diversity emerging as a critical indicator of nutritional adequacy. These challenges have far-reaching implications for mental health, particularly in vulnerable populations.</div></div><div><h3>Objective</h3><div>This study delves into the intersection of post-COVID-19 household food insecurity, dietary diversity, and mental depression among affected households.</div></div><div><h3>Methodology</h3><div>A cross-sectional study conducted with a sample size of COVID 19 affected 500 households. Bivariate linear regression performed to establish associations with food insecurity, dietary diversity, and depression.</div></div><div><h3>Result</h3><div>The study found that only 33.4 % of households were food secure, while 40.8 % experienced moderate food insecurity. Most households (82.2 %) had a medium level of dietary diversity, and 45.6 % of respondents reported experiencing different level of depression. Urban residency, higher education, stable employment, and higher income were associated with lower food insecurity and better dietary diversity ((<em>p</em> < 0.05), whereas female-headed households, joint families, and older family heads had higher levels of depression. Job losses (63 %) and income reductions (69.8 %) during COVID-19 contributed significantly (<em>p</em> < 0.05) to increased food insecurity and depression. Households with stable jobs, higher incomes, and access to nutritional information enjoyed better food security, greater dietary diversity, and lower depression. In contrast, rising food prices and job changes worsened both food insecurity and mental health outcomes.</div></div><div><h3>Conclusion</h3><div>The COVID-19 pandemic has impacted food security, dietary diversity and mental health in Jashore, Bangladesh, exacerbating food insecurity and mental depression, especially among vulnerable groups. However, households with stable jobs, better education, and access to information fared better.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"6 ","pages":"Article 100217"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848158","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 : 2025-06-01Epub Date: 2025-02-19DOI: 10.1016/j.dialog.2025.100208
Laurel Davis , Marvin So , Andrew J. Barnes , Rebecca J. Shlafer
Purpose
To understand health care providers' perceptions, clinical considerations, and clinical actions towards children with incarcerated parents.
Methods
We implemented an experimental vignette study in which health care provider participants were randomly assigned a patient case describing a child with a parent absent for unspecified reasons (control) vs. incarceration (experimental). Participants completed a survey of closed- and open-ended items regarding their clinical approach. Groups were compared with chi-square and ANOVA. Qualitative data were analyzed inductively.
Results
Medical providers (N = 391) were predominantly non-Hispanic white, male, and physicians who had not received training on social determinants of health. There were no significant differences between the experimental and control groups in comfort with or approach towards the patient; specific conditions of concern; or number of concerns. Across groups, providers commonly endorsed intentions for additional emotional-behavioral screening and concerns for ADHD and adjustment disorders. Providers responding to the experimental vignette indicated interest in the child's psychosocial context (e.g., behavior/attention at home), current experiences (e.g., with trauma or abuse), relationships (e.g., with grandparents), perspectives of other reporters (e.g., teachers), and additional clinical actions (e.g., in-depth medical or developmental history).
Conclusion
Medical providers' approach to children of incarcerated parents may be similar to that of any child with an absentee parent, contrasting existing literature on teachers. When signaled about parental incarceration, providers evidenced attention to children's holistic contexts and needs.
{"title":"Medical provider perspectives on children with incarcerated parents: A mixed-methods study","authors":"Laurel Davis , Marvin So , Andrew J. Barnes , Rebecca J. Shlafer","doi":"10.1016/j.dialog.2025.100208","DOIUrl":"10.1016/j.dialog.2025.100208","url":null,"abstract":"<div><h3>Purpose</h3><div>To understand health care providers' perceptions, clinical considerations, and clinical actions towards children with incarcerated parents.</div></div><div><h3>Methods</h3><div>We implemented an experimental vignette study in which health care provider participants were randomly assigned a patient case describing a child with a parent absent for unspecified reasons (control) vs. incarceration (experimental). Participants completed a survey of closed- and open-ended items regarding their clinical approach. Groups were compared with chi-square and ANOVA. Qualitative data were analyzed inductively.</div></div><div><h3>Results</h3><div>Medical providers (<em>N</em> = 391) were predominantly non-Hispanic white, male, and physicians who had not received training on social determinants of health. There were no significant differences between the experimental and control groups in comfort with or approach towards the patient; specific conditions of concern; or number of concerns. Across groups, providers commonly endorsed intentions for additional emotional-behavioral screening and concerns for ADHD and adjustment disorders. Providers responding to the experimental vignette indicated interest in the child's psychosocial context (e.g., behavior/attention at home), current experiences (e.g., with trauma or abuse), relationships (e.g., with grandparents), perspectives of other reporters (e.g., teachers), and additional clinical actions (e.g., in-depth medical or developmental history).</div></div><div><h3>Conclusion</h3><div>Medical providers' approach to children of incarcerated parents may be similar to that of any child with an absentee parent, contrasting existing literature on teachers. When signaled about parental incarceration, providers evidenced attention to children's holistic contexts and needs.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"6 ","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-01-18DOI: 10.1016/j.dialog.2025.100206
Sri Juni Woro Astuti , Sayekti Suindyah Dwiningwarni , Suryo Atmojo
Child stunting is a significant problem in Indonesia and requires special attention even though the government has implemented various programs to overcome it. The formulation of this study is: 1) How is the management of stunting handling based on the government's perspective? 2) What is the role of parties involved in the prevention and handling of stunting? 3) What is an effective stunting management model? The objectives of this research are: 1) The implementation of local government stunting handling policies; 2) Analyze cross-sector collaboration and active participation of all stakeholders; and 3) Formulate an integrated model for handling stunting and the implementation of system synergy. The design of this study uses a qualitative approach with a phenomenological which was carried out in the period from January 2023 to September 2024 in Indonesia. The informants interviewed in this study were 60 people recruited using the purposive sampling method also involving Focus Group Discussions (FGD). The results of this study identify that the success of stunting reduction efforts depends on effective collaboration between various stakeholders. The study highlights that social capital, which consists of social networks, collective norms, and trusts, plays an important role in strengthening stunting reduction efforts. Further research is needed to explore the specific impacts of social capital in other contexts in Indonesia and to develop more adaptive intervention models to local social and cultural dynamics.
{"title":"Modeling environmental interactions and collaborative interventions for childhood stunting: A case from Indonesia","authors":"Sri Juni Woro Astuti , Sayekti Suindyah Dwiningwarni , Suryo Atmojo","doi":"10.1016/j.dialog.2025.100206","DOIUrl":"10.1016/j.dialog.2025.100206","url":null,"abstract":"<div><div>Child stunting is a significant problem in Indonesia and requires special attention even though the government has implemented various programs to overcome it. The formulation of this study is: 1) How is the management of stunting handling based on the government's perspective? 2) What is the role of parties involved in the prevention and handling of stunting? 3) What is an effective stunting management model? The objectives of this research are: 1) The implementation of local government stunting handling policies; 2) Analyze cross-sector collaboration and active participation of all stakeholders; and 3) Formulate an integrated model for handling stunting and the implementation of system synergy. The design of this study uses a qualitative approach with a phenomenological which was carried out in the period from January 2023 to September 2024 in Indonesia. The informants interviewed in this study were 60 people recruited using the purposive sampling method also involving Focus Group Discussions (FGD). The results of this study identify that the success of stunting reduction efforts depends on effective collaboration between various stakeholders. The study highlights that social capital, which consists of social networks, collective norms, and trusts, plays an important role in strengthening stunting reduction efforts. Further research is needed to explore the specific impacts of social capital in other contexts in Indonesia and to develop more adaptive intervention models to local social and cultural dynamics.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"6 ","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-03-25DOI: 10.1016/j.dialog.2025.100211
Jessica Ly , Christopher Blair , Helen Badge , Michael Camit , Khoi Do , Timmy Pham , Nicola Chappelow , Dennis J. Cordato , Mark W. Parsons
Background
South-Western Sydney (SWS) is home to a large Vietnamese community, who are at higher risk of stroke and adverse health outcomes than Australian-born individuals. There is limited research on the effect of educational interventions on stroke literacy in Vietnamese communities. This study aimed to characterise recognition of stroke symptoms, risk/protective factors, and stroke response in Vietnamese communities living in SWS and investigate whether culturally tailored education sessions could improve stroke literacy.
Methods
A prospective interventional study evaluated a single 1.5-h stroke education workshop. Data included pre/post-education surveys, participant demographics and stroke literacy. Change in literacy and contributing factors were analysed.
Results
There were 195 participants in three sessions. Stroke symptoms were recognised by the majority [Face:(56.4 %), Arms:(66.7 %), Speech:(61.5 %)], with 52.8 % identifying all three whilst 29.2 % recognised none. Most participants were confident calling an ambulance (60.0 %), aware of diabetes as a risk factor (73.9 %) and recognised healthy diet/exercise (82.5 %) as protective factors. Post-education, 24.6 % recognised more symptoms, with 73.4 % identifying all three and only 16.6 % recognising none. 33.1 % were more confident calling an ambulance, 32.4 % more aware of diabetes mellitus, and 29.8 % more aware of diet/exercise. Smaller group size [OR = 2.83, 95 %CI = 1.15–6.96 (p = 0.024), lower age [OR = 0.93, 95 %CI = 0.87–1.00 (p = 0.037)] and lower baseline literacy [OR = 6.38, 95 %CI = 2.48–16.41 (p < 0.001)] were significantly associated with improved stroke literacy post-education.
Conclusion
Stroke literacy in the SWS Vietnamese community improved with a single culturally tailored education session. This study underscores the importance of tailored educational interventions and highlights the need for strategies addressing low baseline literacy and age-related barriers.
{"title":"A culturally-specific education strategy to improve stroke health literacy in Vietnamese communities in South Western Sydney","authors":"Jessica Ly , Christopher Blair , Helen Badge , Michael Camit , Khoi Do , Timmy Pham , Nicola Chappelow , Dennis J. Cordato , Mark W. Parsons","doi":"10.1016/j.dialog.2025.100211","DOIUrl":"10.1016/j.dialog.2025.100211","url":null,"abstract":"<div><h3>Background</h3><div>South-Western Sydney (SWS) is home to a large Vietnamese community, who are at higher risk of stroke and adverse health outcomes than Australian-born individuals. There is limited research on the effect of educational interventions on stroke literacy in Vietnamese communities. This study aimed to characterise recognition of stroke symptoms, risk/protective factors, and stroke response in Vietnamese communities living in SWS and investigate whether culturally tailored education sessions could improve stroke literacy.</div></div><div><h3>Methods</h3><div>A prospective interventional study evaluated a single 1.5-h stroke education workshop. Data included pre/post-education surveys, participant demographics and stroke literacy. Change in literacy and contributing factors were analysed.</div></div><div><h3>Results</h3><div>There were 195 participants in three sessions. Stroke symptoms were recognised by the majority [Face:(56.4 %), Arms:(66.7 %), Speech:(61.5 %)], with 52.8 % identifying all three whilst 29.2 % recognised none. Most participants were confident calling an ambulance (60.0 %), aware of diabetes as a risk factor (73.9 %) and recognised healthy diet/exercise (82.5 %) as protective factors. Post-education, 24.6 % recognised more symptoms, with 73.4 % identifying all three and only 16.6 % recognising none. 33.1 % were more confident calling an ambulance, 32.4 % more aware of diabetes mellitus, and 29.8 % more aware of diet/exercise. Smaller group size [OR = 2.83, 95 %CI = 1.15–6.96 (<em>p</em> = 0.024), lower age [OR = 0.93, 95 %CI = 0.87–1.00 (<em>p</em> = 0.037)] and lower baseline literacy [OR = 6.38, 95 %CI = 2.48–16.41 (<em>p</em> < 0.001)] were significantly associated with improved stroke literacy post-education.</div></div><div><h3>Conclusion</h3><div>Stroke literacy in the SWS Vietnamese community improved with a single culturally tailored education session. This study underscores the importance of tailored educational interventions and highlights the need for strategies addressing low baseline literacy and age-related barriers.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"6 ","pages":"Article 100211"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
India is confronted with a multifaceted malnutrition landscape, characterized by the coexistence of stunting, underweight, and escalating overweight and obesity rates. Current programs predominantly target undernutrition, overlooking the surging prevalence of overweight and obesity. These trends carry substantial economic ramifications, with obesity-related costs expected to rise significantly. Addressing these challenges requires enhanced policy execution and strategic collaboration. This article seeks to help overcome policy inertia in addressing the other end of the malnutrition spectrum—overnutrition.
Methods
The National Family Health Survey (NFHS), a large-scale survey conducted by the Ministry of Health and Family Welfare, Government of India, provides high-quality data on population dynamics and health indicators. Data for relevant health indicators were extracted from NFHS-3 to NFHS-5 to identify trends and shifting paradigms in malnutrition profiles. Data from the latest NFHS (NFHS-5) were briefly analyzed to highlight the malnutrition dichotomy and perform linear regression analysis.
Results
The data revealed a declining trend in stunting and underweight prevalence alongside a rise in overweight prevalence. Linear regression analyses on NFHS-5 data showed a positive association between literacy and obesity in both men and women. The findings also indicated that children fed with minimum dietary diversity were more likely to be overweight, and revealed a significant association between elevated random blood glucose levels and obesity in women.
Conclusions
By implementing the necessary interventions and strategies, India can establish a holistic approach to addressing both undernutrition and overnutrition effectively, thus contributing to Sustainable Development Goal-2 and paving the way for a healthier and more productive future for India's population.
{"title":"Understanding the dynamics of malnutrition dichotomy in India: Trends and insights from the National Family Health Surveys","authors":"Himanshu Jindal , Vinay Suresh , Saniya Agarwal , Priyanshi Vyas , Nabeela Bari","doi":"10.1016/j.dialog.2025.100209","DOIUrl":"10.1016/j.dialog.2025.100209","url":null,"abstract":"<div><h3>Purpose</h3><div>India is confronted with a multifaceted malnutrition landscape, characterized by the coexistence of stunting, underweight, and escalating overweight and obesity rates. Current programs predominantly target undernutrition, overlooking the surging prevalence of overweight and obesity. These trends carry substantial economic ramifications, with obesity-related costs expected to rise significantly. Addressing these challenges requires enhanced policy execution and strategic collaboration. This article seeks to help overcome policy inertia in addressing the other end of the malnutrition spectrum—overnutrition.</div></div><div><h3>Methods</h3><div>The National Family Health Survey (NFHS), a large-scale survey conducted by the Ministry of Health and Family Welfare, Government of India, provides high-quality data on population dynamics and health indicators. Data for relevant health indicators were extracted from NFHS-3 to NFHS-5 to identify trends and shifting paradigms in malnutrition profiles. Data from the latest NFHS (NFHS-5) were briefly analyzed to highlight the malnutrition dichotomy and perform linear regression analysis.</div></div><div><h3>Results</h3><div>The data revealed a declining trend in stunting and underweight prevalence alongside a rise in overweight prevalence. Linear regression analyses on NFHS-5 data showed a positive association between literacy and obesity in both men and women. The findings also indicated that children fed with minimum dietary diversity were more likely to be overweight, and revealed a significant association between elevated random blood glucose levels and obesity in women.</div></div><div><h3>Conclusions</h3><div>By implementing the necessary interventions and strategies, India can establish a holistic approach to addressing both undernutrition and overnutrition effectively, thus contributing to Sustainable Development Goal-2 and paving the way for a healthier and more productive future for India's population.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"6 ","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-04-18DOI: 10.1016/j.dialog.2025.100216
Kwame Owusu-Edusei , Arijita Deb , Elamin H. Elbasha
Background
The risk of disease varies across populations based on factors like age, sex, race, ethnicity, socioeconomic status, and underlying medical conditions. Subgroup or subpopulation data are critical in planning, executing and evaluating public health interventions. However, most studies report the values for the overall (total) population with little or no information on the subgroups. As a result, finding subgroup specific data can be challenging.
Objective
In this report, a set of formulae that can be used to calculate subgroup or subpopulation data using the overall estimates and the reported or assumed relative estimates were derived.
Methods
A simple numerical example was used to illustrate the methodology. Next, symbolic formula for calculating the burden (e.g., incidence, prevalence, or average cost) for 3 (and extended to n number of) subgroups or subpopulations were derived. To account for uncertainty in the data, two statistical methods were used to estimate confidence intervals for the point estimates.
Results
The derived formulae indicated that each subgroup or subpopulation's burden (incidence, prevalence, or average cost) can be calculated as the overall burden adjusted by the ratio of that subgroup or subpopulation's relative burden to the sum of the proportion-weighted relative burden (incidence, prevalence, or average cost) of all the subgroups or subpopulations within the population.
Conclusion
These formulae can help to avoid or minimize potential quantitative and qualitative errors in subgroup or subpopulation disease burden estimates used for health research, interventions and/or policy analyses or deliberations.
{"title":"Formulae for calculating subgroup disease burden from overall and reported or assumed relative burden estimates","authors":"Kwame Owusu-Edusei , Arijita Deb , Elamin H. Elbasha","doi":"10.1016/j.dialog.2025.100216","DOIUrl":"10.1016/j.dialog.2025.100216","url":null,"abstract":"<div><h3>Background</h3><div>The risk of disease varies across populations based on factors like age, sex, race, ethnicity, socioeconomic status, and underlying medical conditions. Subgroup or subpopulation data are critical in planning, executing and evaluating public health interventions. However, most studies report the values for the overall (total) population with little or no information on the subgroups. As a result, finding subgroup specific data can be challenging.</div></div><div><h3>Objective</h3><div>In this report, a set of formulae that can be used to calculate subgroup or subpopulation data using the overall estimates and the reported or assumed relative estimates were derived.</div></div><div><h3>Methods</h3><div>A simple numerical example was used to illustrate the methodology. Next, symbolic formula for calculating the burden (e.g., incidence, prevalence, or average cost) for 3 (and extended to <em>n</em> number of) subgroups or subpopulations were derived. To account for uncertainty in the data, two statistical methods were used to estimate confidence intervals for the point estimates.</div></div><div><h3>Results</h3><div>The derived formulae indicated that each subgroup or subpopulation's burden (incidence, prevalence, or average cost) can be calculated as the overall burden adjusted by the ratio of that subgroup or subpopulation's relative burden to the sum of the proportion-weighted relative burden (incidence, prevalence, or average cost) of all the subgroups or subpopulations within the population.</div></div><div><h3>Conclusion</h3><div>These formulae can help to avoid or minimize potential quantitative and qualitative errors in subgroup or subpopulation disease burden estimates used for health research, interventions and/or policy analyses or deliberations.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"6 ","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874671","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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