The COVID-19 pandemic has revealed clear deficiencies in global public health policies and healthcare systems when confronted with the emergence of a novel and deadly infectious disease.

During the COVID-19 pandemic lockdown, we deployed a rapid, mobile phone-based survey to assess access and participation rates when using mobile phones to collect data on COVID-19 in Rakai, south-central Uganda. We sampled prior Rakai Community Cohort Study (RCCS) participants based on HIV status using mobile phone contacts. We administered a 30-minute phone-based interview to consenting participants to assess their knowledge about different aspects of COVID-19 and their access to care. Our analysis compares the mobile phone survey participation rates with historic participation rates in regular RCCS face-to-face interviews. We supplemented phone survey data with demographic, behavioral, and HIV status data from prior face-to-face RCCS surveys. Phone access in Round 19 of the RCCS was found to be 90.2%, with lower access among older people, and people living with HIV. When including only individuals who participated in the previous RCCS survey round, participation in the face-to-face survey (81.9%) was higher than participation in our phone survey (74.8%,  < .001). Survey participation was higher among people living with HIV compared to HIV-negative individuals (84.0% vs 81.4%,  < .001) in the face-to-face survey, but in the phone survey the reverse was found, with participation rates being higher among HIV-negative individuals compared to people living with HIV (78.0% vs 71.6%,  < .001). It was possible to collect data from an existing population cohort during the lockdown using phones. Phone access was high. Overall participation rates were somewhat lower in the phone survey, notably in people living with HIV, compared to the face-to-face survey.

Leadership skills are essential for middle-level healthcare manager efficacy. Capacity-building efforts may attempt behavioural change by filling 'knowledge gaps' while neglecting a sustainable application of that knowledge. Sustainable application of that knowledge, or implementation know-how, must resonate with local cultural patterns. When it is neglected, root issues like unclear decision-making space and local authority to interpret policy during implementation remain unaddressed. Particularly in decentralized healthcare systems, the impact can appear in implementation challenges, subjective decision-making, poor teamwork, and an absence of disseminating best practices.

The International Confederation of Midwives (ICM) defines and sets the Essential Competencies for Midwifery Practice and provides a framework for developing and reviewing midwifery curricula. This framework ensures that pre-service midwifery education designed for students leads to the demonstration of the required midwifery specific competencies. The development of the ICM competencies in 2024 confirms the timeliness of the effort of Rwanda to update its national curricula. This commentary showcases the blueprint followed by Rwanda to standardize and culturally adapt its midwifery curricula at diploma, bachelor and master's level to be competency-based and aligned with ICM. National ownership played a pivotal role in the standardization process, as the direction, priorities, and implementation of the curricula review initiative were driven by the country's own government, higher learning institutes, national midwifery association and other national organizations. Rwanda's experience in aligning its national curricula with international standards could serve as a model for south-south cooperation.

Notwithstanding the global goal of inclusive universal health coverage, and the notion of migrant-sensitive health systems, limited healthcare access or the exclusion of migrants from national health systems persists. South Africa has a rights-based constitution, but there is an inability or a failure of the health system to recognise and address the health needs of migrants.

Building a culture of quality is vital for sustaining high-quality healthcare, emphasising shared values and continuous improvement. The Quality Equity and Dignity (QED) network was a global initiative working toward this objective, focusing on maternal and newborn health. This paper aims to describe how QED influenced five identified attributes of quality culture in Ethiopia: leadership, people-centered interventions, collaboration, rewards, and ownership towards building and sustaining a culture of quality in healthcare establishments.

This study conducted an exploratory content analysis of TV food advertisements on the top three most popular channels for Filipino children aged two to 17 during school and non-school days.

Communities in which adolescent pregnancy and safe abortion care are taboo may benefit from culturally appropriate information, education, and communication.

Climate change presents a multifaceted challenge with unequal health implications, particularly for vulnerable populations with limited adaptive capacity. Socioeconomic factors are intricately linked with environmental health outcomes and environmental factors significantly exacerbate existing health inequities. Health equity as a goal of environmental justice can address these issues.

Since the 1990s, Tanzania has actively encouraged stakeholder participation in health services through Health Facility Governing Committees (HFGCs) to promote social accountability within its broader health system reforms. While previous studies have explored the functionality of the HFGCs, this study aimed to understand whether stakeholder participation in the HFGCs contributes to promoting social accountability in the health system.

Nigeria faces a critical shortage of healthcare professionals yet experiences a significant annual exodus of doctors and dentists. This alarming trend threatens the country's ability to provide equitable healthcare.

Intentional and unintentional pesticide poisoning is an important public health problem, especially in low- and middle-income countries. Individuals who have been exposed to toxic pesticides, particularly organophosphorus insecticides, need early treatment. Atropine autoinjector devices offer a potential solution, allowing storage of effective treatment near agricultural workers' fields and homes that could be reached within minutes by the worker or fellow villagers to provide first-line emergency care. Here we present the design of a qualitative, formative study that will constitute the first phase of an implementation science study exploring the introduction of atropine autoinjectors in rural villages.This study will employ a qualitative design to investigate the feasibility and operational opportunities and challenges in providing pre-hospital emergency care with atropine autoinjectors in rural communities in Sri Lanka. We will conduct semi-structured interviews, ethnographic observations, oral history interviews, participatory mapping, and focus group discussions in villages and in hospitals.This study will allow the design of an autoinjector intervention that is tailored to specific needs of rural communities, maximise the potential benefits in the villages where they are placed, and contribute to knowledge related to biomedical technologies designed for use in LMICs. It will also contribute to social science scholarship in the context of pesticide poisoning. Study approvals have been obtained from the University of Edinburgh Medical School Research Ethics Committee (23-EMREC-039) and from Ethics Review Committee, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka (ERC/2023/4).

Fuzzy cognitive mapping (FCM) is a practical tool in participatory research. Its main use is clarifying causal understandings from several knowledge sources. It provides a shared substrate or language for sharing views of causality. This makes it easier for different interest groups to agree what to do next. Each map is a collection of causal relationships with three elements: factors (cause and outcome), arrows linking factors, and weights indicating the perceived influence of each cause on its outcome. Stakeholder maps are soft models of how they see causes of an outcome, such as access to services or systemic racism. Based on a standardized FCM protocol, we present four moments in FCM analysis. (1) Agree shared meaning across maps. (2) Calculate the maximum influence of perceived causes. (3) Simplify the maps for communication. (4) Identify priorities for action. We provide explanations of the four moments in FCM analysis, with examples from five countries. FCM offers a practical means to guide health action. It incorporates local perspectives with transparent and traceable procedures.

Hypertension is a major global health concern, with deaths attributed to the condition expected to increase to 1.57 million by 2034, particularly affecting low-and-middle-income countries such as those within sub-Saharan Africa. Non-communicable diseases, with hypertension as a core contributor, account for 74.36% of global deaths. The burden of hypertension in sub-Saharan Africa is significant, with an estimated 10-20 million people currently affected. Systemic barriers, such as fragmented health services and socioeconomic inequalities, coupled with shifts in greater salt-intake, ultra-processed foods, more sedentary lifestyles, and overburdened healthcare services, have exacerbated elevated blood pressure and poorer management of people living with hypertension in sub-Saharan Africa. Most public health strategies focus on detecting, treating, and controlling hypertension through lifestyle modifications and medication. However, evidence suggests only 10% of population hypertension is well managed. This indicates a growing need to shift towards preventative efforts. Precision prevention, a tailored health intervention approach utilising individual and population-specific factors - genetic, environmental, and social determinants - offers a potential alternative. Precision prevention aims to deliver the right preventative measures to the right population at the right time, promising to enhance intervention efficiency and health outcomes. This paper highlights various intervention levers, including environmental, biological, and behavioural modifications, examines case studies from high-income countries, and discusses the potential for implementing precision prevention in South Africa. While precision prevention shows promise, we also discuss the significant barriers to its implementation in LMICs such as those within sub-Saharan Africa.

Maternal post-natal depression is a global public health problem. Parenting interventions targeting children's development may also bring benefits to mothers, but few parenting interventions have been studied thoroughly.

Dengue fever, a mosquito-borne viral illness transmitted by mosquitoes, continues to be a significant public health burden in tropical and subtropical regions. Traditional vector control methods, primarily reliant on insecticides and larvicides, face challenges because of emerging insecticide resistance and limited community engagement. This narrative review explores co-creation as a collaborative approach to dengue control, where communities actively participate in designing and implementing solutions. Through an examination of existing literature, we discuss the rationale for co-creation, the various methods employed, evidence for effectiveness, challenges, and other items. Findings from previous studies suggest that co-creation can empower communities by fostering a sense of ownership and responsibility for dengue control efforts. Using local knowledge and insights, co-creation approaches have also been shown to identify and address specific community needs and preferences, leading to more contextually relevant interventions. Additionally, co-creation initiatives have demonstrated success in promoting behavior change within communities, leading to increased uptakes of preventive measures such as proper waste management and use of personal protective measures. However, challenges such as building trust and collaboration, addressing power dynamics, and ensuring long-term sustainability remain critical factors that are essential to foster collaboration, empower communities, and develop sustainable strategies for dengue control in affected regions.

China is transforming its hospital-centric service delivery system into a people-centered integrated care model, with service delivery organized around the health needs and expectations of people.

Population data on mortality and causes of death among 5-19-year-olds are limited.

Frameworks conceptualising the quality of care abound and vary; some concentrate on specific aspects such as safety, effectiveness, others all-encompassing. However, to our knowledge, tailoring to systematically arrive at a comprehensive care for chronic conditions quality (CCCQ) framework has never been done. We conducted a scoping review and Delphi survey to produce a CCCQ framework, comprehensively delineating aims, determinants and measurable attributes. With the assumption that specific groups (people with chronic conditions, care providers, financiers, policy-makers, etc.) view quality of care differently, we analysed 48 scientific and 26 grey literature deductively and inductively using the Institute of Medicine's quality of care framework as the foundation. We produced a zero-version of the quality of chronic care framework, detailing aims, healthcare system determinants, and measurement mechanisms. This was presented in a Delphi survey to 49 experts with diverse chronic care expertise/experience around the world. Consensus was obtained after the first round, with the panel providing suggestions and justifications to expand the agreed-upon components. Through this exercise, a comprehensive CCCQ framework encompassing the journey through healthcare of people with chronic conditions was developed. The framework specifies seven CCCQ 'aims' and identifies health system determinants which can be acted upon with 'organising principles' and measured through chronic care quality 'attributes' related to structures, processes and outcomes. Tailoring quality of care based on the nature of the diseases/conditions and considering different views can be done to ensure a comprehensive offer of healthcare services, and towards better outcomes that are acceptable to both the health system and people with chronic conditions (PwCC).

Abortion stigma as reported globally has been inadequately documented empirically in Nigeria, Africa's most populous country with a restrictive abortion law and a high rate of unsafe abortions.

Direct obstetric causes of maternal mortality account for approximately 86% of all global maternal deaths. In Nepal, 12% of all deaths of women of reproductive age are due to preventable obstetric complications in significant part due to the limited distribution and skill level of human resources.