Public health challenges最新文献

Background and aims: The primary healthcare (PHC) system is a comprehensive, equitable, and efficient approach to supporting health and social well-being by offering prevention, treatment, and rehabilitation services close to living environments. The PHC system in Iraq is currently facing issues that limit its effectiveness and efficiency. This research aims to discover strategies to enhance the PHC system in Iraq.

Methods: We conducted a systematic search for articles on initiatives aimed at enhancing the PHC system, covering the period from 1980 to June 2024, using eight databases and Google Scholar. Included articles that met the criteria were analyzed with RevMan 5.3 software.

Results: A total of 18,705 articles were extracted. After removing duplicates and items without full text, 15,971 studies remained for title and abstract review, of which 14,175 were removed. Finally, 18 research articles related to PHC strengthening were used. Data collection methods included checking databases (12 studies), interviews (6 studies), focus groups (3 studies), questionnaires, and archival data (15 studies).

Conclusion: In the context of Society 5.0, smart technology's practical applications in healthcare aim to enhance decision-making, patient care, and service delivery. Smart technologies can help policymakers and health administrators make clinical decisions in complex care situations and streamline procedures like paperwork. This ultimately will improve the quality and effectiveness of healthcare services by providing accurate, timely, and personalized information to support decision-making. When rebuilding and strengthening the PHC system, addressing the historical, social, cultural, and economic variables is important.

Trial registration: Not applicable.

Sierra Leone and neighbouring countries are prone to the proliferation of illicit drugs due to porous borders, weak regulatory frameworks, and the activities of transnational criminal syndicates. Among the emerging drug threats in the region is the synthetic cannabinoid known as 'Kush', which has gained immense popularity. The use of this drug has surged in recent years, particularly among Sierra Leonean youths, leading to the declaration of a national state of emergency by the government. The Ministry of Health and Sanitation has been tasked with establishing a National Task Force on drugs and substance abuse to identify treatment and mitigation measures to combat Kush addiction among affected individuals. This commentary highlights the current situation of Kush abuse among youths, its usage patterns and socioeconomic implications for Sierra Leone and the surrounding countries with key recommendations that will inform strategies for prevention, treatment and regulation.

Background: Mammography serves as the primary screening tool for detecting breast cancer, and clinical breast examination serves as an additional low-risk technique. There are known socioeconomic disparities in screening accessibility that correlate with breast cancer mortality and tumor stage at diagnosis. Identifying patient barriers and sentiments is a vital step in increasing compliance rates amongst vulnerable populations.

Methods: A link to a survey available in English and Spanish was distributed across zip codes with the lowest median household incomes in Fort Worth, Texas. Data collection took place between November 2022 and November 2023. Only female participants aged 18 or older were included in the study. Statistical analysis was performed on IBM SPSS, Python, and Pandas library softwares.

Results: Hispanic, low-income, and less educated individuals were more likely to have inadequate screening mammography and clinical breast examination status. This is due to several self-reported barriers including cost, lack of knowledge, and lack of time. The majority of patients reported interest in receiving women's healthcare (67.3%), believed screening allowed for early breast cancer detection (72.7%), and believed screenings decreased breast cancer mortality (69.1%).

Conclusions: There are clear discrepancies in access to breast cancer screenings despite a majority of respondents acknowledging their benefit. We suggest the aforementioned demographics be targeted in interventions to improve free or low-cost access and education surrounding breast cancer screenings. This study would benefit from further data collection and expansion to multiple cities in the United States.

The Mediterranean Sea is the risky path utilized by migrants primarily seeking economic and physical security in Europe. Drowning is the most lethal among the many hardships they face on their way. In the pursuit of protecting individuals between countries of origin and destination, many European Union (EU) member states worked to decrease the number of migrants, most notably including the action involving the European agenda issued in 2015 when such migration peaked. Recognizing the nexus of migration and health policy underscores the imperative to develop comprehensive healthcare strategies that address the unique needs of migrant populations, promoting equitable access to healthcare services and safeguarding public health across borders. In an attempt to tackle the problem by its roots, European states established cooperation with third countries and provided multifaceted support, that is, economic assistance and personal safety, among others, to developing countries. They also relocated migrants to different parts of the region to decrease the stress faced by only selected countries. However, this plan, like other approaches, faced challenges. Despite their focus on enforcing the migration laws, the lack of unification of these laws hinders cooperation. Unifying the migration laws between EU members, a strict policy requiring the return of migrants at sea to their points of origin and making legal migration more accessible would render the process safer for all sides. A "New Pact on Migration and Asylum" has been proposed, but it still needs to be agreed on in full, and action must be taken. Moreover, these solutions could be joined by training programs in the countries of origin, in the hopes of securing employment in the country of destination, hence benefiting both countries. In addition, each EU country could partner with developing economies to create such job opportunities and build strong cooperative relations.

As we navigate the complex landscape of global public health in 2024, this article provides a comprehensive exploration of challenges, ranging from infectious diseases, mental health, and substance use to environmental sustainability and emerging technologies. The aftermath of the COVID-19 pandemic underscores the critical need to strengthen health systems, increase public financing, and foster effective international collaboration. The intricacies of global geopolitics, diplomacy, and public health highlight the importance of countries that do not address shared challenges through enhanced cooperative mechanisms and joint initiatives. From the imperative of global health security to the persistence of non-communicable diseases and health disparities, this study delves into multifaceted issues, advocating for collective action, targeted interventions, and a commitment to prioritizing public health on a global scale. Focusing on addressing root causes and fostering equity, this study emphasizes the role of sustainable practices, community engagement, and intersectionality of research in building a resilient global health landscape. In this dynamic environment, 2024 calls for a unified global vision that encourages nations to collaborate more effectively to build a healthier and more resilient global community, ultimately paving the way for a future characterized by a shared commitment to public health challenges.

Background: High hepatitis B vaccine uptake has led to significant reductions in hepatitis B infection rates and associated health burdens in many countries. Despite the administration of the same vaccine, there has been a lack of emphasis on pre-service health professionals. This study aimed at assessing uptake of hepatitis B vaccine among pre-service health professionals at the University of Rwanda.

Methods: This was a cross-sectional descriptive study. Data were collected using a self-administered questionnaire, whereas data analysis was performed using SPSS (Version 25; IBM Corp).

Results: A total of 360 respondents participated in the study; among them, 218 (60.6%) were males. About half of the participants, 170 (47.2%), scored between 40% and 60% on the knowledge assessment, whereas the majority of the respondents, 354 (98.3%), were aware of the hepatitis B vaccine. Most of the participants 334 (92.8%), were vaccinated, whereas 231 (69.2%) received the complete 3-dose vaccination. The most commonly cited reason for not getting vaccinated was lack of awareness (45%). The factors that influenced vaccination status were free vaccination provided by institutions, awareness of the vaccine, and knowledge of hepatitis B infection and its vaccine.

Conclusion: Pre-service health professionals are at risk of hepatitis infection due to low coverage of hepatitis B vaccination and lack of comprehensive knowledge and awareness regarding the hepatitis B infection and its vaccination.

Harm reduction strategies mitigate the adverse effects of problematic drug use through overdose prevention, disease transmission reduction, and improved access to treatment resources. However, educational resources for safe drug use remain sparse and are predominantly focused on abstinence-based approaches. This manuscript introduces the Drug-Use Safety Enhancement Model (DUSEM), a comprehensive framework designed to foster informed and healthy relationships with drugs. Grounded in interdisciplinary research, DUSEM encompasses eight domains: knowledge, motivation, set (mindset), setting, dose, administration, recovery, and evaluation. Each domain offers practical strategies for educators, professionals, and drug consumers to enhance drug-use safety. For the purpose of this analysis, "drugs" include all psychoactive substances regardless of whether they are legal in the United States. Our approach is rooted in the ethical, legal, and cultural practices common in the United States, particularly those related to best practices for providing care to people who use substances. The American context shaped how we understand and talk about drug use, which reflects the American reality of clinical practice in the fields of mental health and addictions. From the perspective of evaluation of the traditional, American conceptualization of the issues around drug use, our model's development acknowledges the need for a shift from outdated abstinence-focused paradigms toward empowering individuals with informed practices for safer drug use. While serving as an educational guidepost, the model underscores the necessity for further research to refine its application, efficacy, and curriculum development. Helping professionals, such as teachers, counselors, social workers, and psychologists, can use this model in various educational, clinical, or institutional settings to help their audiences explore their own relationships with drugs. Ultimately, DUSEM aims to destigmatize drug use, foster healthier relationships with drugs, and improve safety for consumers.

The situation of correctional facilities in African countries represents a critical threat to health due to overcrowding, poor living conditions, and limited access to medical services. With over 3000 facilities and nearly a million incarcerated individuals, the prevalence of health conditions such as HIV/AIDS, mental health disorders, and tuberculosis is alarmingly high. These conditions are exacerbated by physical and psychological abuse and inadequate healthcare infrastructure. Despite these challenges, the health needs of incarcerated individuals in Africa remain largely neglected. This article provides a review of the health status of incarcerated individuals in Africa, drawing on limited available data. Lessons from developed countries highlight the potential for effective interventions through structured healthcare programs and policies. Recommendations include adopting the World Health Organization (WHO) prison health framework, improving judicial efficiency to reduce overcrowding, ensuring healthcare is managed by health ministries, and establishing rehabilitation centers. These measures are crucial for integrating incarcerated individuals back into society and achieving equitable health coverage in Africa.

Background: Human papillomavirus (HPV) is a common cause of cervical cancer along with several other neoplasms. With the availability of HPV vaccination and cervical cancer screenings, it is more likely for cervical cancers to be prevented or caught early in their course. However, there are disparities and barriers preventing all individuals from obtaining proper preventative care.

Methods: An online survey analyzing compliance, barriers, and subjective perceptions of HPV vaccination and cervical cancer screening was distributed via flyers. These were placed in the half of zip codes with lowest median income in Fort Worth, Texas.

Results: Respondents with non-White race, income of $40,000 or less, and a maximum education of high school or less were 4.24, 3.2, and 1.2 times more likely to have incomplete HPV vaccination, respectively. Respondents with an income of $40,000 or less and a maximum education of high school were 3.2 and 2.6 times more likely to be overdue for cervical cancer screening, respectively. The most common barrier for HPV vaccination was lack of knowledge, and for cervical cancer screening, it was cost. Most respondents felt as though cervical cancer screening allows for early cancer detection and decreased mortality but also endorsed feelings of pain, embarrassment, and fear of the test.

Conclusions: HPV vaccine and cervical cancer screening non-compliance is likely multifactorial, including lack of knowledge and cost. Interventions such as increased access to pediatric care and increased opportunities for free preventative healthcare may be helpful in both reducing stigma and improving access to care.