The development of a strong professional identity is influenced by the motivation behind enrolling in a nursing or midwifery programme. Professional identity is a driving force that sustains the commitment of nurses and midwives to nursing/midwifery and their dedication to the well‑being of those they serve. This study evaluated Ugandan students' reasons for enrolling in nursing and midwifery programmes. Furthermore, we investigated the nurse/midwifery practices that support professional identity creation in recent graduates and undergraduate nursing/midwifery students. A mixed‑method research approach was employed amongst nursing/midwifery students of Makerere University and Mbarara University of Science and Technology and recent nursing/midwifery graduates from Mulago National and Mbarara Regional referral hospitals. We collected quantitative data from 173 participants, and for qualitative data, we conducted six focus group discussions among recent graduates and students of nursing/midwifery. We used descriptive statistics and thematic analysis to analyse the quantitative and qualitative data. Nearly all - 95.4% (165/173) - of the participants were motivated to undertake nursing/midwifery as their programme of study, and 94.2% (163/173) participants identified as nurses/midwives, all with an average score above 3. They also strongly agreed that they took up the programmes because they wanted to learn new things [111/173 (64.2%)] and considered nurses' groups important [68.8% (119/173)]. Participants proposed measures to promote the formation of professional identity among students and graduates, including the improvement of clinical education, the phasing out of certain levels of practice, the empowerment and embedding of ethical principles, recognition and motivation, mentorship, leadership, career guidance and the inclusion of men and challenging of gender stereotypes. Participants were motivated to work in nursing. The ways to promote professional identity included the improvement of clinical education, the phasing out of certain levels of practice, the empowerment and instillation of ethical principles, recognition and motivation, mentorship, leadership, career guidance and male inclusiveness and the challenging of gender stereotypes. Nursing and midwifery leadership needs to provide guidance, mentorship and empowerment; challenge gender stereotypes in nursing/midwifery practice; and give support while advocating for ethical practice.

Heart failure (HF) is a leading cause of hospitalizations in Haiti. However, few patients return for outpatient care. The factors contributing to chronic HF care access are poorly understood. The purpose of this study is to investigate the facilitators and barriers to accessing care for chronic HF from the patients' perspectives. We conducted a qualitative descriptive study of 13 patients with HF participating in three group interviews and one individual interview. We recruited patients after discharge from a nongovernmental organization-supported academic hospital in rural Haiti. We employed thematic analysis using emergent coding and categorized themes using the socioecological model. Facilitators of chronic care included participants' knowledge about the importance of treatment for HF and engagement with health systems to manage symptoms. Social support networks helped participants access clinics. Participants reported low cost of care at this subsidized hospital, good medication accessibility, and trust in the healthcare system. Participants expressedstrong spiritual beliefs, with the view that the healthcare system is an extension of God's influence. Barriers to chronic care included misconceptions about the importance of adherence to medications when symptoms improve and remembering follow-up appointments. Unexpectedly, participants believed they should take their HF medications with food and that food insecurity resulted in missed doses. Lack of social support networks limited clinic access. The nonhealthcare costs associated with clinic visits were prohibitive for many participants. Participants expressed low satisfaction regarding the clinic experience. A barrier to healthcare was the belief that heart disease caused by mystical and supernatural spirits is incurable. We identified several facilitators and barriers to chronic HF care with meaningful implications for HF management in rural Haiti. Future interventions to improve chronic HF care should emphasize addressing misconceptions about HF management and fostering patient support systems for visit and medication adherence. Leveraging local spiritual beliefs may also promote care engagement.

The current Medical Education system of India, with its enormous workload and academic demands tend to cause the medical students stress. There is evidence showing medical students at a higher risk of depression, anxiety and burnout compared to other Indian students. Despite, the huge reported numbers, the proportion of students and doctors who seek help for their problems is alarmingly low. One of the reasons provided for the same is stigma towards mental health and an apprehension regarding labels and treatment history on the careers of the students. Increased awareness and with a National Health Programme catered towards mental health, there has been a boost in the utilization and provision of mental health services but it rarely translates into better mental health facilities for the healthcare providers. The special set of challenges faced by a medical students are gradually being recognized and efforts are being made to address them. Curriculum guidelines, teaching methods, student welfare centres and helplines have been the areas of intervention. There should also be changes in approaches towards the students who face problems and providing a safe environment for them to discuss their problems, including encouraging peer support. Thus, a fine balance needs to be present between ensuring the protection of the mental health of a medical student and ensuring a quality medical education for them. Further exploration to address stigma and building empathy among the students and evaluation of the intervention methods devised to address the same becomes very necessary to ensure fruitful interventions. It is the need of the hour to help Indian Medical students overcome their struggles with mental health.

Documentation of social behavioural change communication (SBCC) regarding challenges, opportunities and lessons drawn from past public health emergencies is worthwhile to inform priorities for future response efforts. The aim of this review is to scope the evidence on social behavioural change communication regarding challenges, opportunities and lessons drawn from Ebola, coronavirus disease 2019 (COVID-19), monkeypox and cholera outbreaks from studies published before March 2024, and suggest priorities for future response efforts. A Boolean strategy was used to search electronic databases for relevant published articles, complemented by relevant studies identified from reference lists. The challenges, opportunities, lessons learnt and priorities for SBCC were consistent across study contexts, showing marked variations over time. The significance of technology, infodemic management, and behavioural data generation emerged more frequently and became increasingly important over time. Identified challenges were uptake hesitancy, limited capacity to undertake infodemic management, inadequate funding and human resources for SBCC, competing priorities, parallel or conflicting interventions due to inadequate coordination, difficulties evaluating SBCC programmes and missed opportunities for integration into routine programmes. Existing supportive structures for SBCC, strong political will and participation, as well as rapid information exchange enabled by technological advancement, represented opportunities for enhancing the effectiveness of SBCC programmes. Key lessons were that a multisectoral approach and coordination, partnership and active collaboration amongst stakeholders; building/strengthening trust, target population segmentation and localization of interventions, are important for enhancing the effectiveness of SBCC programmes. Political will, involvement and participation represent the core of social behavioural change (communication) interventions during a public health emergency. SBCC programming for future response to public health emergencies and disease outbreaks should consider the diverse assortment of benefits, threats/challenges and opportunities brought about by technology, infodemics and behavioural data generation to be more effective.

The global burden of cardiometabolic renal disease is increasing, particularly in underserved communities. Twinepidemic Inc.'s Galvanize Healthy Living program conducts community screenings, risk assessments, and educational interventions globally. We screened 1209 subjects for cardiovascular-kidney-metabolic syndrome, assessing their disease knowledge and self-confidence. Mean age was 50, with 65% females and 35% males. Imaging post-risk assessment revealed abnormalities: EKG (16%), echocardiogram (10%), carotid plaque (9%), ABI (2.5%), and eye exam (3.6%, including 8 retinopathies, 14 cataracts). New onset DM was found in 8%, prediabetes in 18.5%, High LDL in 4.2%, low HDL in 40.2%, high triglycerides in 13.1%, and abnormal BP in 38%. In addition, 18.2% were reclassified to a higher category of risk levels after imaging. Significant improvements in knowledge and self-empowerment (all < 0.001) were seen after educational interventions. This study underscores early risk assessment's potential to enhance health outcomes globally for underserved populations, validating POC imaging and emphasizing the role of accessible care and education in patient engagement and empowerment.

The lack of information on exposure of opencast mineworkers to solar ultraviolet radiation, a group I carcinogen, was addressed. The feasibility of using electronic dosimeters in the determination of exposure to solar ultraviolet radiation was investigated. The objective of the study was to determine the feasibility of measuring the occupational exposure of opencast mineworkers to solar ultraviolet radiation using electronic dosimeters. The study followed a cross‑sectional design. Measurements were carried out at two opencast diamond mining operations hereafter referred to as site A and B, located in the Karas region of Namibia. Workers from all four outdoor occupations (bedrock, engineering, metallurgy and security) were recruited to participate in the study. The study was conducted over four days at each site during winter (site A: 28 June to 4 July 2018 and site B: 6-11 July 2018) in the Karas region of Namibia with 28 consenting workers taking part. The AlGaN photodiode‑based electronic dosimeters were worn above clothing on the dorsal wrists (one) and two placed on the horizontal, unshaded area from 08:00 to 16:00 for the measurement of personal and ambient solar ultraviolet radiation, respectively. Historical meteorological data for the measurement period were obtained from Solcast and Ozone Monitoring Instrument (OMI) NASA. Overall, clear skies and surface reflectivity of 0.19 were observed for both study sites. The mean ultraviolet indices were 2.43 (0.06-4.51) and 2.24 (0.09-4.88) for site A and B, respectively. Findings of valid measurements from nine participants showed the mean total daily personal solar ultraviolet radiation exposure of 1.9 ± 1.0 (1.01-1.57) standard erythemal dose (SED) for site A and 3.4 ± 2.6 (3.39-7.28) SED for site B. Personal solar ultraviolet radiation exposure above the occupational exposure limit (OEL) demonstrated the need to include the winter season in planning for protective measures for skin and eyes, since workers are at risk of excessive exposure to solar ultraviolet radiation.

This review examines key events, challenges, and responses to the mpox public health emergency following the Africa CDC's declaration of a Public Health Emergency of Continental Concern on August 13, 2024. In response to the crisis, over 3.6 million vaccine doses and more than $150 million in funding have been mobilized globally, with contributions from the United States, European Union, and Japan. However, challenges persist, particularly in the Democratic Republic of Congo, where a humanitarian crisis in Kinshasa has complicated mpox diagnostics and treatment. In response, the Africa CDC has deployed its One Continental Incident Management Support team, with a focus on decentralizing diagnostics and enhancing sample movement through additional PCR equipment, funded by the Pandemic Fund and USAID. To reinforce laboratory diagnostics, surveillance, and case management, the Africa CDC has adopted a comprehensive "One Team, One Plan, One Budget, One M&E" approach and has deployed 72 epidemiologists to improve data integration. Collaborative efforts with WHO, GAVI, and UNICEF aim to expedite vaccine distribution, with a target of 10 million doses by 2025, alongside enhanced vaccine safety monitoring.

The impacts of climate change are recognised as a key challenge of the 21st century. By 2030, Sub-Saharan Africa is projected to have the globally highest burden of disease due to climate change. This study aims to evaluate the strengths and weaknesses of the National Adaptation Plans (NAPs) of the Southern African Development Community (SADC), a sub-region under-represented at a global level, in addressing current and future climate change-related health impacts. It specifically assesses the NAPs of Botswana, Mozambique, Namibia, South Africa, and Zimbabwe. A thorough review was conducted, analysing articles, government reports, and national communications related to NAPs and climate change health outcomes in the selected countries. Sources were evaluated against pre-defined inclusion and exclusion criteria. All five countries prioritised health in their NAPs; however, health departments were excluded from assessments in two of the countries. Although health surveillance and early warning systems were included in the NAPs, there was limited evidence of their integration into broader climate, health, economic, and labour policies. National climate change focal points were identified, but governance and implementation at district and local levels were not well-documented. This review highlighted a need for greater inclusion of Indigenous and locally led knowledge. Common barriers identified included the lack of data with appropriate frequency and scale. Governance and implementation difficulties were also identified in all five countries; these difficulties included both a lack of coordination and a lack of institutional capacity. These challenges, especially a lack of political will to address the compound impacts of altered climate and health on all earth systems, are also found at the regional level. National strategies and implementation programs in SADC countries need to be agile in their ability to scale and adapt, yet they also need to include measurable actions and timeframes. Given the shared climate and health trends and the interconnected socio-economic, environmental, and political landscape, there is significant potential for regional coordination to address cross-border climate change impacts and to optimise resource use.

Pakistan's health system is expected to take a proactive position in the global health security arena amidst its own indigenous structural and systemic challenges. Henceforth, understanding the intricacies of this system is vital for creating effective strategies to prevent, detect, and respond to health emergencies, ensuring regional stability and overall global health security. This study has ventured to understand the perspectives, hurdles, threats, and both international and national implications of Pakistan's current health system capacity and the requisites for meeting global health security commitments. This descriptive qualitative study, based on phenomenology theory, involved key informant interviews with 16 senior policy‑level experts and public health professionals from the public and private sectors, international non‑governmental organizations (NGOs), development partners, and United Nations (UN) bodies. Thematic analysis was employed to identify key themes related to Pakistan's health system and its role in global health security. The study uncovered significant insights into the strengths and weaknesses of Pakistan's health system, the impact of the coronavirus disease 2019 (COVID‑19) pandemic, and challenges such as funding constraints and fragmented healthcare delivery. It also highlighted threats like antimicrobial resistance and emphasized the importance of international collaboration. Areas needing special attention include multi‑drug resistance, food safety in emergencies, surge capacity of the frontline workforce, patient safety to reduce healthcare‑associated infections, and strengthening points of entry. The COVID‑19 pandemic has highlighted both the vulnerabilities and the potential within Pakistan's health system. To enhance its contribution to global health security, Pakistan needs a national policy stance, targeted health system reforms, improved resource allocation, workforce development, and strengthened partnerships with development agencies.

To establish the prevalence of type 2 diabetes, overweight/obesity, and metabolic syndrome in individuals aged >18 years in Bogotá, Colombia and the variables associated with diabetes prevalence. This was a cross‑sectional population survey with a representative, probabilistic sample of Bogotá, Colombia collected between 2022 and 2023. The final sample size included 2,860 households, distributed among 19 localities of Bogotá. Clinical laboratory samples were taken from randomly selected individuals ( = 1,070). Data on the Adult Treatment Panel III (ATP III) and Latin American Diabetes Association (ALAD) criteria for metabolic syndrome were collected, including physical measurements. The prevalence of type 2 diabetes in Bogotá was 11.0% (95% confidence interval [CI], 9.0-13.5%). According to the ATP III and ALAD criteria, the prevalence proportions of metabolic syndrome were 33.9% (95% CI, 29.5-38.6) and 29.3% (95% CI, 26.1-32.7), respectively. The age of ≥55 years, abdominal obesity, hypertriglyceridemia, and noneducational level had higher adjusted prevalence ratios (APRs) of diabetes. The APRs of metabolic syndrome were higher in adults with a low education level (LEL) and female sex, with the ATP III and ALAD criteria, and noninsured adults or those with unknown affiliation with the healthcare system, with the ATP III criteria. We found a higher prevalence of type 2 diabetes in adults in Bogotá than expected in previous studies. Intervention from public policy should be requested, especially in those of lowest socioeconomic and education levels, to avoid a future increase in this prevalence. Studies on other Colombian cities are required.

In 2014, the Faculty of Health Sciences at Walter Sisulu University introduced a 20‑week long integrated longitudinal clinical clerkship (ILCC) rotation block as part of its commitment to community‑based education and social responsiveness, with the goal of ensuring that the curriculum is updated to align with the contemporary health system challenges in South Africa. To explore whether medical student participants underwent social and personal transformative learning in understanding complex societal health needs during their integrated longitudinal community clerkship program. This was an exploratory qualitative research study conducted among 113 5 year medical students based at 8 selected hospitals during their 20‑week‑long community clerkship. Data were collected through six focus group discussions, complemented by data from reflective learning journal entries. Audio recordings were transcribed verbatim and merged with complementary data for thematic analysis in NVivo Version 13®. Adaptation challenges, improved social relations, coping with work demands, acquisition of relevant knowledge and skills, perceived inadequate support from the training institution and perceived lengthy programme duration emerged as key themes and were linked to personal and social transformation. Personal and social transformation may have transpired amongst the student participants, as demonstrated by the observed thematic consistency between data sources. Further complementary studies are required to assess whether there was a shift in students' understanding of community health needs and how the ILCC may have assisted the students in responding to community needs to have a comprehensive conclusion on whether the ILCC can be a tool for transformative learning.

Experiential learning activities help students prepare for their future careers by providing opportunities for hands‑on practice experiencing real‑world scenarios. Innovations in technology can facilitate experiential learning and cross‑cultural connections for large groups of students in multiple global settings through a virtual platform. However, designing these opportunities with diverse groups of students for a virtual environment can be challenging. The purpose of this paper is to highlight three examples of innovative virtual experiential learning initiatives that were developed and implemented by the Global Health Program of the Association of Pacific Rim Universities (APRU), a non‑profit network of 60+ leading research universities in the Asia‑Pacific. We have leveraged the expertise of our wide network to enhance student learning through the purposeful design of virtual educational experiences centered around pedagogical approaches that emphasize active learning, self‑reflection, and knowledge exchange with people from other cultures and disciplines. The annual global health joint virtual courses, the annual APRU Virtual Global Health Case Competition, and the APRU Mini Certificate foster meaningful engagement with other students and experts in the field, expanding the lens of students to foster an increased awareness and appreciation of the diversity of perspectives represented in an international network such as APRU. These allow students to practice real‑world application of knowledge gained in a traditional didactic classroom setting. The benefits of virtual experiential learning to students greatly outweigh the challenges in the design and implementation of such programs. While relatively short‑term, these virtual initiatives have had a demonstrable impact on student participants. Such programs can enhance student learning and provide cost‑effective ways to allow large international cohorts to experience global experiential learning.

Students often seek opportunities to enrich their classroom learning. Providing students the chance to engage in research studies or global health projects allows for experiential enrichment. However, the impact on partners and partner sites, financial implications, and equity of student opportunity, as well as the logistical burden potentially placed on multiple parties, all need to be considered. If challenges are minimized, students can make meaningful contributions to projects, be a catalyst for partner engagement, and allow for formative learning.

Adherence to medications is a crucial factor in achieving the best therapeutic outcomes for patients who have human immunodeficiency virus (HIV). Little is known about the rate and predictors of adherence to antiretroviral therapy (ART) in Egypt. To assess the degree of adherence to ART among people living with HIV/AIDS (PLWHA) in Egypt and to explore the predictors of non-adherence. A cross-sectional study was conducted from January 2021 to December 2021 on 785 PLWHA attending an ART clinic at the main fever hospital in Alexandria, Egypt. Data collection was done using an interviewing questionnaire and pharmacy database records. Multivariate logistic regression analysis was done to identify the predictors of adherence to ART. The overall adherence rate to ART among the study subjects was 66.7%. Female sex (Adjusted Odds Ratio [95% CI]: 1.73 [1.01-2.96]), intravenous drug use (AOR [95% CI]: 2.87 [1.27-6.49]), fair satisfaction with the health service at ART clinics (OR [95% CI]: 1.86 [1.27-2.73]) appeared as independent predictors of poor adherence. The degree of adherence to ART among PLWHA in Egypt is noticeably high, although it was influenced by several patient-, healthcare-, and community-related factors. This work provides an accurate, standardized tool to measure adherence and identify factors that contribute to non-adherence.

Timor‑Leste is a lower‑middle‑income country in Southeast Asia. To control the significant local threat from infectious diseases, it is imperative to strengthen the knowledge and practice capabilities of the primary care workforce. We report and reflect on the development and delivery of a national training programme in infectious diseases called the Advancing Surveillance and Training to Enhance Recognition of Infectious Diseases (ASTEROID) programme, developed by the medical non‑governmental organisation (NGO) Maluk Timor and other Timorese stakeholders. The 1-week training course delivered by local doctors is multi‑modal, combining lectures with educational videos, interactive sessions and a mobile application. The ongoing training was delivered to every Timorese municipality in the participants' place of work and involved 540 healthcare professionals from 37 facilities. Training covered infectious diseases most relevant to the Timorese workforce, and focused on disease detection, management, prevention (including infection prevention and control issues) and notification. : Multiple choice question (MCQ) assessment during the training has shown an average improvement in test scores from 45% to 64%, improving to 71% and 79% at 3- and 12-month follow‑up respectively. The programme has been well‑received, with participants appreciating the use of local specialists in video content, the tailoring of content to the local context and the variety of educational methods. Difficulties have been faced when it comes to delivering adequate content in a week‑long format to a workforce which has not previously received significant professional development. This approach could provide a model for delivering training to national healthcare workforces in low- and middle‑income countries (LMIC) and could be further refined on the basis of the lessons detailed here.

Care of the critically ill in resource-limited areas, inside or outside the intensive care unit (ICU), is indispensable. Murthy and Adhikari noted that about 70% of patients in low-middle income (LMIC) areas could benefit from good critical care. Many patients in resource-limited settings still die before getting to the hospital. Investing in capacity building by strengthening and expanding ICU capability and training intensivists, critical care nurses, respiratory therapists, and other ICU staff is essential, but this process will take years. Also, having advanced healthcare facilities that are still far from remote areas will not do much to alleviate distance and mode of transportation as barriers to achieving good critical care. This paper discusses the importance of mobile critical care units (MCCUs) in supporting and enhancing existing emergency medical systems. MCCUs will be crucial in addressing critical delays in transportation and time to receive appropriate lifesaving critical care in remote areas. They are incredibly versatile and could be used to transfer severely ill patients to a higher level of care from the field, safely transfer critically ill patients between hospitals, and, sometimes, almost more importantly, provide standalone short-term critical care in regions where ICUs might be absent or immediately inaccessible. MCCUs should not be used as a substitute for primary care or to bypass readily available services at local healthcare centers. It is essential to rethink the traditional paradigm of 'prehospital care' and 'hospital care' and focus on improving the care of critically ill patients from the field to the hospital.

Anaemia is very prevalent globally and is thought to be linearly associated with wealth and to affect females and rural residents more than males and urban residents. This study was designed to investigate this thought in a population of adolescents in Ebonyi State, Nigeria. Standard clinical protocols were used. A total of 362 adolescents (63.5% females) were studied. Anaemia was diagnosed on the basis of the World Health Organization (WHO) criteria. Aggregate anaemia was found in 50.0% of the general population (43.9% males, 53.5% females) and was most prevalent in the urban upper socio‑economic status (SES) group (62.3%; 70.0% females, 52.2% males). Severe anaemia was present in 7.2% of the general population (9.1% males, 6.1% females). It was most prevalent amongst the 10-11 years age bracket (15.6%). Moderate and mild anaemia were found in 22.4% and 20.4% of the general population and in 13.0%, 11.4%, 8.3% and 6.0% of the urban upper, rural, urban low and middle SES groups, respectively. But in the rural area group, severe anaemia existed without wide sex variations. Moderate anaemia was most prevalent in the urban middle and upper SES groups (29.0% and 26.4%, respectively) with a clear female preponderance. Mild anaemia was the least prevalent (15.3%) in the urban middle SES group. The higher prevalence of severe anaemia in boys and the higher burden in the urban higher SES group warrant a rethink of the public health interventions used in Nigeria. Adolescent boys and urban upper SES groups should be targeted in nutrition interventions related to anaemia.

Bone fractures represent a significant health issue and impose a considerable burden on healthcare systems globally. However, data pertaining to bone fractures, especially among reproductive-age women in Malaysia, are very limited. Micronutrients like calcium, magnesium and phosphorus play vital roles in bone health, influencing bone mineral density and fracture risk. The objective of this study was to determine the prevalence of bone fractures among reproductive-age women and the association with dietary micronutrient intakes. In this cross-sectional study, a total of 1,730 participants of reproductive-age women from the Malaysia Prospective Urban and Rural Epidemiological (PURE) study were recruited. The participants' dietary intakes were assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Selected micronutrients in the participants' diets were calculated using the Malaysian food composition and the US Department of Agriculture food composition databases. The association between micronutrient intakes, comorbidities and physical activity levels with bone fractures were evaluated to identify predictors of bone fractures among reproductive-age women. The prevalence of bone fractures among Malaysian reproductive-age women was low (3.7%). The multiple logistic regression analysis showed that none of the micronutrients was associated with bone fractures. However, factors of diabetes and passive smoking in this study showed 2.6- and 4.0-times-higher odds of having bone fractures, respectively (AOR 2.580; 95% CI: 1.173-5.672) and (AOR 4.012; 95% CI: 2.265-7.107). It was found that the majority of women in this study were taking lower micronutrient intakes of calcium, magnesium, and vitamin K than the Malaysia recommended nutrient intakes (RNI). Although this study showed that a low micronutrient intake is not significantly associated with bone fractures, it is recommended that future studies focus on controlled trials or prospective data analyses to establish causal relationships and the optimal micronutrient requirements for maintaining strong and healthy bones in women of reproductive age.

Economic growth is associated with reductions in undernutrition. However, in developing countries, malnutrition still exists as a double burden. A better understanding of the dynamics of malnutrition in such societies as a means of aiding policymakers and implementers is thus needed. This study investigated the prevalence of malnutrition in Ebonyi State, Nigeria, and the role of socio‑economic status (SES) in driving it. Standard protocols were used for all measurements. Overweight/obesity, stunting and thinness were defined using the simplified age‑ and gender‑specific height and body mass index (BMI) field tables of the World Health Organization (WHO). A total of 781 adolescents (65.4% female adolescents) from nine secondary schools were studied. Subjects in the rural and urban low SES groups were shorter than the others despite being older, and were shorter than the WHO reference cohort. In the general population, 3.2% (2.0% for girls and 5.6% for boys) were stunted. Urban low SES boys had the highest prevalence of stunting (18.6%). Thinness was found in 2.6% (7.4% for girls and 2.2% for boys) of the general population. It affected rural female adolescents (16.9%) more than the others and, as with stunting, was absent in the urban upper SES group. Overweight/obesity was found in 13.8% (12.5% for girls and 16.3% for boys) of the general population. It was highest amongst the urban upper SES group (35.9%) and absent amongst rural male adolescents. Stunting coexisting with thinness or with overweight/obesity was found in 0.8% and 0.25% of the general population, respectively. Urban residence without improvements in SES is severely detrimental to the proper nutrition of adolescents.

The Registration of Births and Deaths Act (RBD) of 1969 in India mandates continuous recording of vital events; however, after more than 50 years of its enactment, universality remains elusive. Birth registration, a fundamental right, is essential for demographic analysis and effective policy planning. Birth registration is closely linked to child development, access to healthcare, and other societal factors. Analysing its trends helps in designing targeted interventions and monitoring progress toward the Sustainable Development Goals (SDGs). This paper aims to analyse the changes in birth registration across Indian states. This paper also examines the impact of institutionalization of births on registration and underscores its significance in policymaking. The study utilises data from the latest two rounds of National Family Health Survey (NFHS-4 & NFHS-5) to analyse birth registration trends in India. Multivariable logistic regression analysis was employed to examine the impact of place of delivery on birth registration. The comparison of NFHS-4 and NFHS-5 data demonstrates varying birth registration rates across Indian states, with notable progress in some regions and persistent challenges in others. Multivariable logistic regression analysis highlights the significant influence of place of delivery on registration likelihood. The interaction between wealth and place of delivery suggests a mitigating effect, indicating that increasing institutional births has a positive impact on birth registration, with this effect being more pronounced at different levels of household wealth. It highlights that wealthier households were more likely to register births due to the higher rate of institutional deliveries. India's journey towards universal birth registration under the SDGs presents progress and challenges. NFHS data shows improvements in birth registration, but disparities still persist. Socio-economic status, place of delivery, and maternal education have strong influences on birth registration. Institutional deliveries significantly increase registration likelihood, facilitated by programs like Janani Suraksha Yojana. Integrating birth registration with health services enhances health data accuracy and service delivery. By prioritising targeted interventions, addressing social barriers, and leveraging existing programs, India can ensure that every child's birth is registered, advancing towards a healthier, more equitable future.

Global health education is important for addressing health inequities nationally and internationally. Physician shortages in underserved areas suggest more exposure during training is needed. To study the impact of a global health training program on residents' perceived preparedness and intention to care for underserved populations. Observational mixed method evaluation of the impact of an educational intervention, the Global Health Scholars Program (GHSP), on perceived knowledge and intention to practice in underserved settings. The intervention consisted of a longitudinal global health training program addressing ethics, health equity, structural determinants of health, racism, colonialism, and systems-based practice. GHSP elective clinical rotations occurred at local underserved clinics, tribal and Indian Health Services (IHS) sites (Alaska, Arizona, Oregon), and in Botswana. A 16-item survey aligned with program objectives was administered to internal medicine residents at Oregon Health & Science University who completed the GHSP. This included five groups of residents who trained before coronavirus disease 2019 (COVID-19) (2016-2020) and three groups who trained during COVID-19 (2021-2023). Qualitative content analysis was conducted on open-ended text responses. Surveys were sent to 45 participants; 37 responded (82.2%). All perceived knowledge variables increased significantly after training in the pre-COVID cohort. Among seven residents participating in GHSP during COVID, baseline scores were higher than in the pre-COVID cohort. Qualitative results indicate GHSP was a transformative educational experience and impactful on practice. Among current trainees, 42.9% reported moderate and 26.8% reported high/very high intention to practice in underserved settings. Among graduates, 40.9% reported practicing in underserved settings. GHSP provides transformative educational experiences to residents, with knowledge gains on global health topics higher post-program compared with pre-program. Given 41% of participants in practice reported working in underserved settings, this intervention may help ameliorate physician workforce shortages.