Introduction: Reviewing and updating research priorities is essential to assess progress and to ensure optimal allocation of financial and human resources in research. In 2001, WHO held a research priority setting workshop for herpes simplex virus type 2 (HSV-2) research in low-income and middle-income countries (LMICs). This study aimed to describe progress between 2000 and 2020 in three of the five key research priority areas outlined in the workshop: HSV-2/HIV interactions, HSV-2 control measures and HSV-2 mathematical modelling. The remaining priorities are addressed in a companion paper.
Method: A systematic literature search of MEDLINE, CINAHL, Global Health and Cochrane databases was carried out. Relevant primary research studies based in LMICs, written in English and published on 2000-2020 were included. Papers were screened by two independent reviewers, and suitable variables were selected for manual extraction from study texts. Data were organised into an Excel spreadsheet and analysed using IBM SPSS.
Results: In total, 3214 discrete papers were identified, of which 180 were eligible for inclusion (HSV-2/HIV interactions, 98; control measures, 58; mathematical modelling, 24). Most studies were conducted in East Africa. The majority of the 2001 WHO HSV-2 research priorities were addressed at least in part. Overall, despite several studies describing a strong relationship between HSV-2 and the acquisition and transmission of HIV, HSV-2 control repeatedly demonstrated little effect on HIV shedding or transmission. Further, although mathematical modelling predicted that vaccines could significantly impact HSV-2 indicators, HSV-2 vaccine studies were few. Studies of antiviral resistance were also few.
Conclusion: Since 2000, LMIC HSV-2 research addressing its control, HIV interactions and mathematical modelling has largely addressed the priorities set in the 2001 WHO HSV-2 workshop. However, key knowledge gaps remain in vaccine research, antiviral cost-effectiveness, antiviral resistance and specific geographical areas.
{"title":"20 years of herpes simplex virus type 2 (HSV-2) research in low-income and middle-income countries: systematic evaluation of progress made in addressing WHO priorities for research in HSV-2/HIV interactions, HSV-2 control and mathematical modelling.","authors":"Ela Mair Owen, Muna Jama, Belinder Nahal, Emily Clarke, Angela Obasi","doi":"10.1136/bmjgh-2024-015167","DOIUrl":"10.1136/bmjgh-2024-015167","url":null,"abstract":"<p><strong>Introduction: </strong>Reviewing and updating research priorities is essential to assess progress and to ensure optimal allocation of financial and human resources in research. In 2001, WHO held a research priority setting workshop for herpes simplex virus type 2 (HSV-2) research in low-income and middle-income countries (LMICs). This study aimed to describe progress between 2000 and 2020 in three of the five key research priority areas outlined in the workshop: HSV-2/HIV interactions, HSV-2 control measures and HSV-2 mathematical modelling. The remaining priorities are addressed in a companion paper.</p><p><strong>Method: </strong>A systematic literature search of MEDLINE, CINAHL, Global Health and Cochrane databases was carried out. Relevant primary research studies based in LMICs, written in English and published on 2000-2020 were included. Papers were screened by two independent reviewers, and suitable variables were selected for manual extraction from study texts. Data were organised into an Excel spreadsheet and analysed using IBM SPSS.</p><p><strong>Results: </strong>In total, 3214 discrete papers were identified, of which 180 were eligible for inclusion (HSV-2/HIV interactions, 98; control measures, 58; mathematical modelling, 24). Most studies were conducted in East Africa. The majority of the 2001 WHO HSV-2 research priorities were addressed at least in part. Overall, despite several studies describing a strong relationship between HSV-2 and the acquisition and transmission of HIV, HSV-2 control repeatedly demonstrated little effect on HIV shedding or transmission. Further, although mathematical modelling predicted that vaccines could significantly impact HSV-2 indicators, HSV-2 vaccine studies were few. Studies of antiviral resistance were also few.</p><p><strong>Conclusion: </strong>Since 2000, LMIC HSV-2 research addressing its control, HIV interactions and mathematical modelling has largely addressed the priorities set in the 2001 WHO HSV-2 workshop. However, key knowledge gaps remain in vaccine research, antiviral cost-effectiveness, antiviral resistance and specific geographical areas.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-04DOI: 10.1136/bmjgh-2024-015095
Helen Schneider, Woldekidan Amde, Corinne Carolissen, Brian Van Wyk, Uta Lehmann
Institutional capacity for doctoral training is key to addressing the complex challenges facing the global south. In the context of the need for skilled knowledge workers in health systems and growing demand for doctoral places, we reflect on the evolution of a public health doctoral programme in a South African School of Public Health. Through this case, we aim to contribute to wider debates on the form and content of emerging public health doctoral programmes in South Africa and the African continent. Drawing on a multi-level framework of 'curriculum responsiveness' we consider responsive public health doctoral education as simultaneously engaging macro-social, institutional/cultural, disciplinary and individual learning imperatives. We assess the responsiveness of the doctoral programme against these elements, describing the growth, institutional context and systems and pedagogical strategies introduced over the last decade, and areas for further development. We conclude by proposing the multi-level capacities required for responsive public health doctoral education. We highlight the need for diversified curricula (including professional doctorates) that support a wider set of graduate attributes and career trajectories beyond academia, greater investment in doctoral infrastructures within higher education institutions, and disciplinary practices and pedagogies that centre epistemic access and justice.
{"title":"Responsive public health doctoral education: experiences and reflections from a School of Public Health in South Africa.","authors":"Helen Schneider, Woldekidan Amde, Corinne Carolissen, Brian Van Wyk, Uta Lehmann","doi":"10.1136/bmjgh-2024-015095","DOIUrl":"10.1136/bmjgh-2024-015095","url":null,"abstract":"<p><p>Institutional capacity for doctoral training is key to addressing the complex challenges facing the global south. In the context of the need for skilled knowledge workers in health systems and growing demand for doctoral places, we reflect on the evolution of a public health doctoral programme in a South African School of Public Health. Through this case, we aim to contribute to wider debates on the form and content of emerging public health doctoral programmes in South Africa and the African continent. Drawing on a multi-level framework of 'curriculum responsiveness' we consider responsive public health doctoral education as simultaneously engaging macro-social, institutional/cultural, disciplinary and individual learning imperatives. We assess the responsiveness of the doctoral programme against these elements, describing the growth, institutional context and systems and pedagogical strategies introduced over the last decade, and areas for further development. We conclude by proposing the multi-level capacities required for responsive public health doctoral education. We highlight the need for diversified curricula (including professional doctorates) that support a wider set of graduate attributes and career trajectories beyond academia, greater investment in doctoral infrastructures within higher education institutions, and disciplinary practices and pedagogies that centre epistemic access and justice.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Equitable inclusion of low-income and middle-income country (LMIC) researchers and women in research authorship is a priority. A review of progress in addressing WHO-identified priorities provided an opportunity to examine the geographical and gender distribution of authorship in herpes simplex virus type-2 (HSV-2) research.
Methods: Publications addressing five areas prioritised in a WHO workshop and published between 2000 and 2020 were identified. Data on author country, gender, authorship position and research funding source were collected by manuscript review and internet searches and analysed using IBM SPSS V.26.
Results: Of, 297 eligible papers identified, (n=294) had multiple authors. Of these, 241 (82%) included at least one LMIC author and 143 (49%) and 122 (41%) had LMIC first and last authors, respectively. LMICs funded studies were more than twice as likely to include an LMIC first or last author as high-income country-funded studies (relative risk 2.36, 95% CI 1.93 to 2.89). Respectively, 129 (46%) and 106 (36%) studies had female first and last authors. LMIC first and last authorship varied widely by HSV-2 research area and increased over time to 65% and 59% by 2015-2020.
Conclusion: Despite location of the research itself in LMIC settings, over the 20-year period, LMIC researchers held only a minority of first and last authorship positions. While LMIC representation in these positions improved over time, important inequities remain in key research areas and for women. Addressing current and historical power disparities in global health research, research infrastructure and how it is funded may be key addressing to addressing these issues.
{"title":"A review of authorship in herpes simplex virus type-2 (HSV-2) research conducted in low-income and middle-income countries between 2000 and 2020.","authors":"Belinder Nahal, Ela Mair Owen, Muna Jama, Angela Obasi, Emily Clarke","doi":"10.1136/bmjgh-2023-012719","DOIUrl":"10.1136/bmjgh-2023-012719","url":null,"abstract":"<p><strong>Introduction: </strong>Equitable inclusion of low-income and middle-income country (LMIC) researchers and women in research authorship is a priority. A review of progress in addressing WHO-identified priorities provided an opportunity to examine the geographical and gender distribution of authorship in herpes simplex virus type-2 (HSV-2) research.</p><p><strong>Methods: </strong>Publications addressing five areas prioritised in a WHO workshop and published between 2000 and 2020 were identified. Data on author country, gender, authorship position and research funding source were collected by manuscript review and internet searches and analysed using IBM SPSS V.26.</p><p><strong>Results: </strong>Of, 297 eligible papers identified, (n=294) had multiple authors. Of these, 241 (82%) included at least one LMIC author and 143 (49%) and 122 (41%) had LMIC first and last authors, respectively. LMICs funded studies were more than twice as likely to include an LMIC first or last author as high-income country-funded studies (relative risk 2.36, 95% CI 1.93 to 2.89). Respectively, 129 (46%) and 106 (36%) studies had female first and last authors. LMIC first and last authorship varied widely by HSV-2 research area and increased over time to 65% and 59% by 2015-2020.</p><p><strong>Conclusion: </strong>Despite location of the research itself in LMIC settings, over the 20-year period, LMIC researchers held only a minority of first and last authorship positions. While LMIC representation in these positions improved over time, important inequities remain in key research areas and for women. Addressing current and historical power disparities in global health research, research infrastructure and how it is funded may be key addressing to addressing these issues.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-04DOI: 10.1136/bmjgh-2023-014483
Giuliana Raffaella Longworth, Janneke de Boer, Kunshan Goh, Danielle Marie Agnello, Lauren McCaffrey, Jorge Raul Zapata Restrepo, Qingfan An, Sebastien Chastin, Aaron Davis, Teatske Altenburg, Maite Verloigne, Maria Giné-Garriga
Background: Co-creation is seen as a way to ensure all relevant needs and perspectives are included and to increase its potential for beneficial effects and uptake process evaluation is crucial. However, existing process evaluation frameworks have been built on practices characterised by top-down developed and implemented interventions and may be limited in capturing essential elements of co-creation. This study aims to provide a review of studies planning and/or conducting a process evaluation of public health interventions adopting a co-creation approach and aims to derive assessed process evaluation components, used frameworks and insights into formative and/or participatory evaluation.
Methods: We searched for studies on Scopus and the Health CASCADE Co-Creation Database. Co-authors performed a concept-mapping exercise to create a set of overarching dimensions for clustering the identified process evaluation components.
Results: 54 studies were included. Conceptualisation of process evaluation included in studies concerned intervention implementation, outcome evaluation, mechanisms of impact, context and the co-creation process. 22 studies (40%) referenced ten existing process evaluation or evaluation frameworks and most referenced were the frameworks developed by Moore et al (14%), Saunders et al (5%), Steckler and Linnan (5%) and Nielsen and Randall (5%).38 process evaluation components were identified, with a focus on participation (48%), context (40%), the experience of co-creators (29%), impact (29%), satisfaction (25%) and fidelity (24%).13 studies (24%) conducted formative evaluation, 37 (68%) conducted summative evaluation and 2 studies (3%) conducted participatory evaluation.
Conclusion: The broad spectrum of process evaluation components addressed in co-creation studies, covering both the evaluation of the co-creation process and the intervention implementation, highlights the need for a process evaluation tailored to co-creation studies. This work provides an overview of process evaluation components, clustered in dimensions and reflections which researchers and practitioners can use to plan a process evaluation of a co-creation process and intervention.
{"title":"Navigating process evaluation in co-creation: a Health CASCADE scoping review of used frameworks and assessed components.","authors":"Giuliana Raffaella Longworth, Janneke de Boer, Kunshan Goh, Danielle Marie Agnello, Lauren McCaffrey, Jorge Raul Zapata Restrepo, Qingfan An, Sebastien Chastin, Aaron Davis, Teatske Altenburg, Maite Verloigne, Maria Giné-Garriga","doi":"10.1136/bmjgh-2023-014483","DOIUrl":"10.1136/bmjgh-2023-014483","url":null,"abstract":"<p><strong>Background: </strong>Co-creation is seen as a way to ensure all relevant needs and perspectives are included and to increase its potential for beneficial effects and uptake process evaluation is crucial. However, existing process evaluation frameworks have been built on practices characterised by top-down developed and implemented interventions and may be limited in capturing essential elements of co-creation. This study aims to provide a review of studies planning and/or conducting a process evaluation of public health interventions adopting a co-creation approach and aims to derive assessed process evaluation components, used frameworks and insights into formative and/or participatory evaluation.</p><p><strong>Methods: </strong>We searched for studies on Scopus and the Health CASCADE Co-Creation Database. Co-authors performed a concept-mapping exercise to create a set of overarching dimensions for clustering the identified process evaluation components.</p><p><strong>Results: </strong>54 studies were included. Conceptualisation of process evaluation included in studies concerned intervention implementation, outcome evaluation, mechanisms of impact, context and the co-creation process. 22 studies (40%) referenced ten existing process evaluation or evaluation frameworks and most referenced were the frameworks developed by Moore <i>et al</i> (14%), Saunders <i>et al</i> (5%), Steckler and Linnan (5%) and Nielsen and Randall (5%).38 process evaluation components were identified, with a focus on participation (48%), context (40%), the experience of co-creators (29%), impact (29%), satisfaction (25%) and fidelity (24%).13 studies (24%) conducted formative evaluation, 37 (68%) conducted summative evaluation and 2 studies (3%) conducted participatory evaluation.</p><p><strong>Conclusion: </strong>The broad spectrum of process evaluation components addressed in co-creation studies, covering both the evaluation of the co-creation process and the intervention implementation, highlights the need for a process evaluation tailored to co-creation studies. This work provides an overview of process evaluation components, clustered in dimensions and reflections which researchers and practitioners can use to plan a process evaluation of a co-creation process and intervention.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Low-income and middle-income countries (LMICs) have a high burden of herpes simplex virus type 2 (HSV-2) infection, which has been strongly associated with HIV. In 2001, the WHO hosted a workshop to set research priorities for HSV-2 in LMICs. Periodic re-evaluation of research priorities is essential to ensure effective allocation of resources. This study describes the progress made between 2000 and 2020 in addressing the priorities identified in two of the five thematic areas that were the workshop's focus: HSV-2 epidemiology and diagnostics. The remaining areas are addressed in a companion paper.
Methods: A systematic search of MEDLINE, CINAHL, Global Health and Cochrane databases was carried out. Relevant primary and secondary research studies conducted in LMICs, written in English and published from 2000-2020 were included. Two independent researchers screened, identified papers and extracted preidentified variables from study texts. Data were organised into an Excel spreadsheet and analysed using IBM SPSS V.26.
Results: Overall, 4445 discrete papers were identified, of which 165 publications were eligible for inclusion. The highest general population HSV-2 prevalence was reported in South and West Africa. Prevalence was higher among women than men and increased with age. HSV-2 prevalence studies among key populations were few, and the majority were in East and South Asia. Cohort studies of HSV-2 incidence among younger populations (mean age=25 years) and HSV-2 infection prevalence in North Africa and the Middle East were few. The most researched topic in HSV-2 diagnostics addressed serological techniques and direct molecular biology. Studies of point-of-care testing were also few.
Conclusion: HSV-2 research identified in LMICs has mainly addressed the epidemiology and diagnostics priorities identified by the 2001 WHO workshop. Unaddressed priorities include point-of-care testing, antiviral resistance and exploration of HSV-2 epidemiology in neglected geographical settings and population subgroups.
{"title":"Twenty years of herpes simplex virus type 2 (HSV-2) research in low-income and middle-income countries: systematic evaluation of progress made in addressing WHO prioritiesfor research in HSV-2 epidemiology and diagnostics.","authors":"Muna Jama, Ela Mair Owen, Belinder Nahal, Angela Obasi, Emily Clarke","doi":"10.1136/bmjgh-2023-012717","DOIUrl":"10.1136/bmjgh-2023-012717","url":null,"abstract":"<p><strong>Introduction: </strong>Low-income and middle-income countries (LMICs) have a high burden of herpes simplex virus type 2 (HSV-2) infection, which has been strongly associated with HIV. In 2001, the WHO hosted a workshop to set research priorities for HSV-2 in LMICs. Periodic re-evaluation of research priorities is essential to ensure effective allocation of resources. This study describes the progress made between 2000 and 2020 in addressing the priorities identified in two of the five thematic areas that were the workshop's focus: HSV-2 epidemiology and diagnostics. The remaining areas are addressed in a companion paper.</p><p><strong>Methods: </strong>A systematic search of MEDLINE, CINAHL, Global Health and Cochrane databases was carried out. Relevant primary and secondary research studies conducted in LMICs, written in English and published from 2000-2020 were included. Two independent researchers screened, identified papers and extracted preidentified variables from study texts. Data were organised into an Excel spreadsheet and analysed using IBM SPSS V.26.</p><p><strong>Results: </strong>Overall, 4445 discrete papers were identified, of which 165 publications were eligible for inclusion. The highest general population HSV-2 prevalence was reported in South and West Africa. Prevalence was higher among women than men and increased with age. HSV-2 prevalence studies among key populations were few, and the majority were in East and South Asia. Cohort studies of HSV-2 incidence among younger populations (mean age=25 years) and HSV-2 infection prevalence in North Africa and the Middle East were few. The most researched topic in HSV-2 diagnostics addressed serological techniques and direct molecular biology. Studies of point-of-care testing were also few.</p><p><strong>Conclusion: </strong>HSV-2 research identified in LMICs has mainly addressed the epidemiology and diagnostics priorities identified by the 2001 WHO workshop. Unaddressed priorities include point-of-care testing, antiviral resistance and exploration of HSV-2 epidemiology in neglected geographical settings and population subgroups.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rationale: A small number of earlier studies have suggested an effect of temporary abstinence campaigns on alcohol consumption. However, all were based on self-reported consumption estimates.
Objectives: Using a time series of 23-year monthly alcohol sales data, this study examined the effect of an annual temporary abstinence campaign, which has been organised annually since 2003 during the Buddhist Lent period (spanning 3 months), on population-level alcohol consumption.
Methods: Data used in the analysis included a time series of monthly alcohol sales data from January 1995 to September 2017 and the midyear population counts for those years. Generalised additive models (GAM) were applied to estimate trends as smooth functions of time, while identifying a relationship between the Buddhist Lent abstinence campaigns on alcohol consumption. The sensitivity analysis was performed using a seasonal autoregressive integrated moving average with exogenous variables (SARIMAX) model.
Intervention: The Buddhist Lent abstinence campaign is a national mass media campaign combined with community-based activities that encourages alcohol abstinence during the Buddhist Lent period, spanning 3 months and varying between July and October depending on the lunar calendar. The campaign has been organised annually since 2003.
Main outcome: Per capita alcohol consumption using monthly alcohol sales data divided by the midyear total population number used as a proxy.
Results: Median monthly per capita consumption was 0.43 (IQR: 0.37 to 0.51) litres of pure alcohol. Over the study period, two peaks of alcohol consumption were in March and December of each year. The significant difference between before-campaign and after-campaign coefficients in the GAM, -0.102 (95% CI: -0.163 to -0.042), indicated an effect of the campaign on alcohol consumption after adjusting for the time trend and monthly seasonality, corresponding to an average reduction of 9.97% (95% CI: 3.65% to 24.18%). The sensitivity analyses produced similar results, where the campaign was associated with a decrease in consumption of 8.1% (95% CI: 0.4% to 15.7%).
Conclusions: This study demonstrated that the temporary abstinence campaign was associated with a decrease in population-level alcohol consumption during campaign periods. The finding contributed to a growing body of evidence on the effectiveness of emerging temporary abstinence campaigns.
{"title":"The effect of an annual temporary abstinence campaign on population-level alcohol consumption in Thailand: a time-series analysis of 23 years.","authors":"Udomsak Saengow, Roengrudee Patanavanich, Paibul Suriyawongpaisul, Wichai Aekplakorn, Bundit Sornpaisarn, Huan Jiang, Jurgen Rehm","doi":"10.1136/bmjgh-2023-014428","DOIUrl":"10.1136/bmjgh-2023-014428","url":null,"abstract":"<p><strong>Rationale: </strong>A small number of earlier studies have suggested an effect of temporary abstinence campaigns on alcohol consumption. However, all were based on self-reported consumption estimates.</p><p><strong>Objectives: </strong>Using a time series of 23-year monthly alcohol sales data, this study examined the effect of an annual temporary abstinence campaign, which has been organised annually since 2003 during the Buddhist Lent period (spanning 3 months), on population-level alcohol consumption.</p><p><strong>Methods: </strong>Data used in the analysis included a time series of monthly alcohol sales data from January 1995 to September 2017 and the midyear population counts for those years. Generalised additive models (GAM) were applied to estimate trends as smooth functions of time, while identifying a relationship between the Buddhist Lent abstinence campaigns on alcohol consumption. The sensitivity analysis was performed using a seasonal autoregressive integrated moving average with exogenous variables (SARIMAX) model.</p><p><strong>Intervention: </strong>The Buddhist Lent abstinence campaign is a national mass media campaign combined with community-based activities that encourages alcohol abstinence during the Buddhist Lent period, spanning 3 months and varying between July and October depending on the lunar calendar. The campaign has been organised annually since 2003.</p><p><strong>Main outcome: </strong>Per capita alcohol consumption using monthly alcohol sales data divided by the midyear total population number used as a proxy.</p><p><strong>Results: </strong>Median monthly per capita consumption was 0.43 (IQR: 0.37 to 0.51) litres of pure alcohol. Over the study period, two peaks of alcohol consumption were in March and December of each year. The significant difference between before-campaign and after-campaign coefficients in the GAM, -0.102 (95% CI: -0.163 to -0.042), indicated an effect of the campaign on alcohol consumption after adjusting for the time trend and monthly seasonality, corresponding to an average reduction of 9.97% (95% CI: 3.65% to 24.18%). The sensitivity analyses produced similar results, where the campaign was associated with a decrease in consumption of 8.1% (95% CI: 0.4% to 15.7%).</p><p><strong>Conclusions: </strong>This study demonstrated that the temporary abstinence campaign was associated with a decrease in population-level alcohol consumption during campaign periods. The finding contributed to a growing body of evidence on the effectiveness of emerging temporary abstinence campaigns.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1136/bmjgh-2023-013615
Jane Fieldhouse, Lydia Nakiire, Joshua Kayiwa, Claire D Brindis, Ashley Mitchell, Issa Makumbi, Alex Riolexus Ario, Elizabeth Fair, Jonna A K Mazet, Mohammed Lamorde
Introduction As timeliness metrics gain traction to assess and optimise outbreak detection and response performance, implementation and scale-up require insight into the perspectives of stakeholders adopting these tools. This study sought to characterise the feasibility and utility of tracking One Health outbreak milestones across relevant human, animal, plant, and environmental sectors to systematically quantify timeliness metrics in Uganda, a country prone to outbreaks of WHO priority diseases. Methods A database of outbreak events occurring in Uganda between 2018 and 2022 was compiled. Outbreak reports meeting our inclusion criteria were reviewed to quantify the frequency of milestone reporting. Key informant interviews were conducted with expert stakeholders to explore the feasibility and utility of tracking metrics using a framework analysis. Quantitative and qualitative data were collected and analysed concurrently. Results Of the 282 public health emergencies occurring between 2018 and 2022, 129 events met our inclusion criteria, and complete data were available for 82 outbreaks. For our qualitative portion, 10 informants were interviewed from 7 institutions, representing the human, animal and environmental sectors. Informants agreed most One Health milestones are feasible to track, which was supported by the frequency of milestone reporting; however, there was a demonstrated need for increased reporting of after-action reviews, as well as outbreak start and end dates. Predictive alerts signalling potential outbreaks and preventive responses to alerts are seen as challenging to routinely capture, reflecting the lack of public health action for these domains. Conclusion Despite consensus among stakeholders that timeliness metrics are a beneficial tool to assess outbreak performance, not all One Health metrics are being tracked consistently, thereby missing opportunities to optimise epidemic intelligence, preparedness and prevention. The feasibility of tracking these metrics depends on the integration of reporting channels, enhanced documentation of milestones and development of guidance for early adopters, recognising country-specific on-the-ground realities and challenges to national scaling efforts. Data are available on reasonable request. The dataset generated and analysed in the study is available from the corresponding author, JAKM, on request.
{"title":"How feasible or useful are timeliness metrics as a tool to optimise One Health outbreak responses?","authors":"Jane Fieldhouse, Lydia Nakiire, Joshua Kayiwa, Claire D Brindis, Ashley Mitchell, Issa Makumbi, Alex Riolexus Ario, Elizabeth Fair, Jonna A K Mazet, Mohammed Lamorde","doi":"10.1136/bmjgh-2023-013615","DOIUrl":"https://doi.org/10.1136/bmjgh-2023-013615","url":null,"abstract":"Introduction As timeliness metrics gain traction to assess and optimise outbreak detection and response performance, implementation and scale-up require insight into the perspectives of stakeholders adopting these tools. This study sought to characterise the feasibility and utility of tracking One Health outbreak milestones across relevant human, animal, plant, and environmental sectors to systematically quantify timeliness metrics in Uganda, a country prone to outbreaks of WHO priority diseases. Methods A database of outbreak events occurring in Uganda between 2018 and 2022 was compiled. Outbreak reports meeting our inclusion criteria were reviewed to quantify the frequency of milestone reporting. Key informant interviews were conducted with expert stakeholders to explore the feasibility and utility of tracking metrics using a framework analysis. Quantitative and qualitative data were collected and analysed concurrently. Results Of the 282 public health emergencies occurring between 2018 and 2022, 129 events met our inclusion criteria, and complete data were available for 82 outbreaks. For our qualitative portion, 10 informants were interviewed from 7 institutions, representing the human, animal and environmental sectors. Informants agreed most One Health milestones are feasible to track, which was supported by the frequency of milestone reporting; however, there was a demonstrated need for increased reporting of after-action reviews, as well as outbreak start and end dates. Predictive alerts signalling potential outbreaks and preventive responses to alerts are seen as challenging to routinely capture, reflecting the lack of public health action for these domains. Conclusion Despite consensus among stakeholders that timeliness metrics are a beneficial tool to assess outbreak performance, not all One Health metrics are being tracked consistently, thereby missing opportunities to optimise epidemic intelligence, preparedness and prevention. The feasibility of tracking these metrics depends on the integration of reporting channels, enhanced documentation of milestones and development of guidance for early adopters, recognising country-specific on-the-ground realities and challenges to national scaling efforts. Data are available on reasonable request. The dataset generated and analysed in the study is available from the corresponding author, JAKM, on request.","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":null,"pages":null},"PeriodicalIF":8.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141586393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1136/bmjgh-2024-015289
Julie Marshall, Karen Wylie, Sharynne McLeod, Lindy McAllister, Helen Barrett, Nana Akua Owusu, Shyamani Hettiarachchi, Marie Atherton
### SUMMARY BOX Communication is essential to interaction and participation in life. The right to communicate is enshrined in the Universal Declaration of Human Rights1 and impacts achievement of all United Nations Sustainable Development Goals, enabling connectedness, expression of needs and participation in education, employment and society. Living with communication disability can impact education, work, play and well-being. Despite the high prevalence of communication disability, it is frequently overlooked in global disability service developments, policy initiatives and research. The needs of people with communication disability (PWCD) remain unheard. To achieve equity in health and disability services, communication disability needs foregrounding, particularly in low and middle-income countries (LMICs), where formal supports for PWCD are limited or non-existent and stigma is widespread.2 It is time to put the needs of PWCD on the agenda. Communication encompasses speaking, understanding, written, signed and non-verbal modalities. Communication disability is experienced when an individual communicates differently from the majority of people in their community, affecting their participation. Communication disability may result from a primary communication impairment, for example, developmental language disorder, voice disorder, stammering or can be linked to congenital, developmental, acquired and degenerative health conditions, for example, hearing loss, cerebral palsy, autism spectrum disorder, stroke, Parkinson’s disease. How an individual experiences communication disability depends on environmental and personal factors, such as the skills …
{"title":"Communication disability in low and middle-income countries: a call to action","authors":"Julie Marshall, Karen Wylie, Sharynne McLeod, Lindy McAllister, Helen Barrett, Nana Akua Owusu, Shyamani Hettiarachchi, Marie Atherton","doi":"10.1136/bmjgh-2024-015289","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-015289","url":null,"abstract":"### SUMMARY BOX Communication is essential to interaction and participation in life. The right to communicate is enshrined in the Universal Declaration of Human Rights1 and impacts achievement of all United Nations Sustainable Development Goals, enabling connectedness, expression of needs and participation in education, employment and society. Living with communication disability can impact education, work, play and well-being. Despite the high prevalence of communication disability, it is frequently overlooked in global disability service developments, policy initiatives and research. The needs of people with communication disability (PWCD) remain unheard. To achieve equity in health and disability services, communication disability needs foregrounding, particularly in low and middle-income countries (LMICs), where formal supports for PWCD are limited or non-existent and stigma is widespread.2 It is time to put the needs of PWCD on the agenda. Communication encompasses speaking, understanding, written, signed and non-verbal modalities. Communication disability is experienced when an individual communicates differently from the majority of people in their community, affecting their participation. Communication disability may result from a primary communication impairment, for example, developmental language disorder, voice disorder, stammering or can be linked to congenital, developmental, acquired and degenerative health conditions, for example, hearing loss, cerebral palsy, autism spectrum disorder, stroke, Parkinson’s disease. How an individual experiences communication disability depends on environmental and personal factors, such as the skills …","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":null,"pages":null},"PeriodicalIF":8.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141586414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1136/bmjgh-2024-015310
Angela E Apeagyei, Maitreyi Sahu
### Summary box In the effort to advance towards Universal Health Coverage (UHC), several African countries are implementing public health insurance programmes to increase financial risk protection, reduce catastrophic health expenditure and broaden access to services for treatment and prevention of disease.1 2 In sub-Saharan Africa (SSA), 8 out of 49 countries have implemented some form of national-level contributory public health insurance system, and at least 7 others have passed legislation or are in the process of planning a national health insurance programme (Figure 1).1 However, programmes face challenges with low enrolment, limited uptake of services and uncertain financial sustainability. These programmes can greatly benefit from analyses to identify opportunities for improvement and to support national policymaking. Figure 1 Does a national public insurance program exist, and has there been published research using claims data? *Status of …
{"title":"Claims data from health insurance programmes in sub-Saharan Africa: an untapped resource to promote Universal Health Coverage","authors":"Angela E Apeagyei, Maitreyi Sahu","doi":"10.1136/bmjgh-2024-015310","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-015310","url":null,"abstract":"### Summary box In the effort to advance towards Universal Health Coverage (UHC), several African countries are implementing public health insurance programmes to increase financial risk protection, reduce catastrophic health expenditure and broaden access to services for treatment and prevention of disease.1 2 In sub-Saharan Africa (SSA), 8 out of 49 countries have implemented some form of national-level contributory public health insurance system, and at least 7 others have passed legislation or are in the process of planning a national health insurance programme (Figure 1).1 However, programmes face challenges with low enrolment, limited uptake of services and uncertain financial sustainability. These programmes can greatly benefit from analyses to identify opportunities for improvement and to support national policymaking. Figure 1 Does a national public insurance program exist, and has there been published research using claims data? *Status of …","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":null,"pages":null},"PeriodicalIF":8.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141586392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-30DOI: 10.1136/bmjgh-2023-014318
Madeleine Randell, Tri Yunis Miko Wahyono, Michelle Dynes, Adeline Tinessia, Mu Li, Margie Danchin, Oktarinda, Fitriyani Fitriyani, Lintang Dian Saraswati, Kylie Jenkins, Khin Devi Aung, Abdul Khalil Noorzad, Mrunal Shetye, Lulu Dewi, Prima Yosephine, Julie Leask, Meru Sheel
Background: The COVID-19 pandemic resulted in extreme strain on health systems including the health workforce, essential health services and vaccination coverage. We examined disruptions to immunisation and maternal and child health (MCH) services, concerns of personal well-being and delivery of healthcare during the pandemic as well as factors associated with self-reported trauma or burnout among healthcare providers (HCPs).
Methods: In March-April 2022, we conducted a cross-sectional survey among HCPs in two provinces of Indonesia. HCPs involved in COVID-19 or routine immunisation and MCH services were randomly selected from district/city health office registration lists. We descriptively analysed service disruptions experienced by HCPs as well as trauma, burnout and concerns of personal well-being and delivery of healthcare during the pandemic. Multivariate logistic regression analyses were undertaken to identify factors associated with trauma or burnout.
Results: We recruited 604 HCPs. Mobilisation of staff from routine health services to COVID-19 response duties was a key reason for service disruptions (87.9%). Strategies such as community outreach and task shifting were implemented to overcome disruptions. Trauma or burnout during the pandemic was reported by 64.1% HCPs, with 23.5% reporting worse mental or emotional health.Factors associated with trauma or burnout included delivery of COVID-19 immunisation (adjusted OR (aOR) 2.54, 95% CI 1.08 to 5.94); and delivery of both COVID-19 immunisation and routine immunisation compared with no involvement in vaccination programmes (aOR 2.42, 95% CI 1.06 to 5.52); poor treatment in the workplace (aOR 2.26, 95% CI 1.51 to 3.38) and lower confidence to respond to patient queries on COVID-19 immunisation (aOR 1.51, 95% CI 1.03 to 2.22).
Conclusion: HCPs experienced service disruptions, trauma and burnout and implemented strategies to minimise disruptions to service delivery and improve patient experiences. Our study highlights the need to ensure that workforce resilience and strategies to protect and support HCPs are considered for pandemic planning, preparedness and management.
背景:COVID-19 大流行对卫生系统造成了极大的压力,包括卫生工作者、基本卫生服务和疫苗接种覆盖率。我们研究了大流行期间免疫接种和妇幼保健(MCH)服务的中断情况、对个人福祉和医疗保健服务的担忧,以及与医疗保健提供者(HCPs)自我报告的创伤或职业倦怠相关的因素:2022 年 3 月至 4 月,我们对印度尼西亚两个省的医护人员进行了横断面调查。参与 COVID-19 或常规免疫接种和母婴保健服务的医护人员是从地区/城市卫生局登记名单中随机抽取的。我们对卫生保健人员在大流行期间所经历的服务中断、创伤、职业倦怠以及对个人福祉和医疗保健服务的担忧进行了描述性分析。我们进行了多变量逻辑回归分析,以确定与创伤或职业倦怠相关的因素:我们招募了 604 名卫生保健人员。从日常医疗服务中调动人员执行 COVID-19 应对任务是服务中断的主要原因(87.9%)。我们采取了社区外联和任务转移等策略来克服服务中断问题。64.1%的卫生保健人员报告在大流行期间出现了心理创伤或职业倦怠,23.5%的卫生保健人员报告精神或情绪健康状况恶化。与精神创伤或职业倦怠相关的因素包括:提供 COVID-19 免疫接种(调整 OR 2.54,95% CI 1.08 至 5.94);同时提供 COVID-19 免疫接种和常规免疫接种,而不参与疫苗接种计划(aOR 2.42,95% CI 1.06 至 5.52);工作场所待遇差(aOR 2.26,95% CI 1.51 至 3.38);回答患者有关 COVID-19 免疫接种的询问时信心不足(aOR 1.51,95% CI 1.03 至 2.22):高级保健人员经历了服务中断、精神创伤和职业倦怠,他们实施了各种策略以尽量减少服务中断并改善患者体验。我们的研究强调,有必要确保在大流行病的规划、准备和管理中考虑到工作人员的复原力以及保护和支持高级保健人员的策略。
{"title":"Service disruptions, trauma and burnout during the COVID-19 pandemic among healthcare providers delivering immunisation and maternal and child health services in Indonesia.","authors":"Madeleine Randell, Tri Yunis Miko Wahyono, Michelle Dynes, Adeline Tinessia, Mu Li, Margie Danchin, Oktarinda, Fitriyani Fitriyani, Lintang Dian Saraswati, Kylie Jenkins, Khin Devi Aung, Abdul Khalil Noorzad, Mrunal Shetye, Lulu Dewi, Prima Yosephine, Julie Leask, Meru Sheel","doi":"10.1136/bmjgh-2023-014318","DOIUrl":"10.1136/bmjgh-2023-014318","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic resulted in extreme strain on health systems including the health workforce, essential health services and vaccination coverage. We examined disruptions to immunisation and maternal and child health (MCH) services, concerns of personal well-being and delivery of healthcare during the pandemic as well as factors associated with self-reported trauma or burnout among healthcare providers (HCPs).</p><p><strong>Methods: </strong>In March-April 2022, we conducted a cross-sectional survey among HCPs in two provinces of Indonesia. HCPs involved in COVID-19 or routine immunisation and MCH services were randomly selected from district/city health office registration lists. We descriptively analysed service disruptions experienced by HCPs as well as trauma, burnout and concerns of personal well-being and delivery of healthcare during the pandemic. Multivariate logistic regression analyses were undertaken to identify factors associated with trauma or burnout.</p><p><strong>Results: </strong>We recruited 604 HCPs. Mobilisation of staff from routine health services to COVID-19 response duties was a key reason for service disruptions (87.9%). Strategies such as community outreach and task shifting were implemented to overcome disruptions. Trauma or burnout during the pandemic was reported by 64.1% HCPs, with 23.5% reporting worse mental or emotional health.Factors associated with trauma or burnout included delivery of COVID-19 immunisation (adjusted OR (aOR) 2.54, 95% CI 1.08 to 5.94); and delivery of both COVID-19 immunisation and routine immunisation compared with no involvement in vaccination programmes (aOR 2.42, 95% CI 1.06 to 5.52); poor treatment in the workplace (aOR 2.26, 95% CI 1.51 to 3.38) and lower confidence to respond to patient queries on COVID-19 immunisation (aOR 1.51, 95% CI 1.03 to 2.22).</p><p><strong>Conclusion: </strong>HCPs experienced service disruptions, trauma and burnout and implemented strategies to minimise disruptions to service delivery and improve patient experiences. Our study highlights the need to ensure that workforce resilience and strategies to protect and support HCPs are considered for pandemic planning, preparedness and management.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141475934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}