Search Results (86)

Background/Objectives: Antimicrobial resistance (AMR) surveillance is a cornerstone of national AMR strategies but requires sustained, cross-sectoral financing. While the need for such financing is well recognized, its quantification remains scarce in low- and middle-income countries. This study aimed to estimate the full costs of AMR surveillance across the human health, animal health, and food sectors (2021–2030) in selected facilities in Nepal and generate evidence to inform sustainable financing. Methods: A bottom-up micro-costing approach was used to analyze data from five sites. Costs were adjusted for inflation using projected gross domestic product deflators, and probabilistic sensitivity analyses were conducted to assess uncertainty in laboratory sample volumes under four scenarios. Results: The total cost of AMR surveillance in Nepal was $6.7 million: $3.4 million for human health (50.3% out of the aggregated costs), $2.7 million for animal health (39.8%), and $0.7 million for the food sector (9.9%). Laboratories accounted for >90% of total costs, with consumables and personnel as the main cost drivers. Average cost per sample was $150 (animal), $64 (food), and $6 (human). Conclusions: This study offers the first robust, multi-sectoral 10-year cost estimates of AMR surveillance in Nepal. The findings highlight that sustaining AMR surveillance requires predictable domestic financing, particularly to cover recurrent laboratory operations as donor support declines. These results provide cost evidence to support future budgeting and policy planning toward sustainable, nationally financed AMR surveillance in Nepal. Full article

Child marriage remains a major threat to adolescent girls’ health, development, and rights worldwide. Despite decades of progress, recent policy backsliding and sociopolitical instability have created new risks, with examples from Iraq, Afghanistan, and The Gambia illustrating how legal and political shifts are reshaping vulnerabilities for girls. This paper presents an integrated framework linking developmental science with legal and policy advocacy, emphasizing how evolving capacities and psychosocial maturity should inform marriage laws and protection mechanisms. It reframes advocacy and rights-based action as essential components of adolescent health systems, drawing on recent policy analyses and country examples to identify actionable, multisectoral strategies. The paper highlights an urgent need for collective, evidence-informed advocacy to protect adolescent girls and advance gender equality, an issue of growing importance amid renewed global attention to legal reforms on child marriage. Full article

The COVID-19 pandemic exacerbated structural, social, economic, and racial inequalities affecting immigrant, refugee, and asylum-seeking men—vulnerable populations often overlooked in men’s health research. This study investigated the health conditions of immigrant, refugee, and asylum-seeking men during the COVID-19 pandemic. A scoping review was conducted following Joanna Briggs Institute guidance, and a qualitative lexical analysis (text-mining of standardized study syntheses) was performed in IRaMuTeQ using similarity analysis, descending hierarchical classification, and factorial correspondence analysis. We identified 93 studies published between 2020 and 2023 across 35 countries. The evidence highlighted vaccine hesitancy, high epidemiological risks (infection, hospitalization, and mortality), barriers to accessing services and information, socioeconomic vulnerabilities, psychological distress (e.g., anxiety and depression), and structural inequalities. Findings were synthesized into four integrated thematic categories emphasizing the role of gender constructs in help-seeking and gaps in governmental responses. Most studies focused on immigrants, with limited evidence on refugees and especially asylum seekers; therefore, conclusions should be interpreted cautiously for these groups. Overall, the review underscores the urgency of multisectoral interventions, universal access to healthcare regardless of migration status, culturally and linguistically appropriate outreach, and gender-sensitive primary care strategies to support inclusive and resilient health systems. Full article

The One Health framework highlights the interconnectedness of human, animal, and environmental health, requiring interdisciplinary and multisectoral collaboration to address complex global health challenges. This scoping review protocol aims to guide the systematic mapping on how studies and policy initiatives have incorporated socioecological interconnections within the One Health paradigm, following the Joanna Briggs Institute guidance and the PRISMA Scr checklist. The experimental design includes searches in PubMed, Scopus, Web of Science, LILACS, Health Systems Evidence, Social Systems Evidence, and Google Scholar for the period from 2004 to 2025. The strategy, developed with librarian support and peer reviewed, includes terms in English, Portuguese, and Spanish. Pilot searches retrieved 5333 PubMed and 470 LILACS records. Eligible documents must explicitly present two or more of the six One Health dimensions: policies to strengthen health systems; antimicrobial resistance; food safety; environmental health; emerging and re-emerging zoonotic epidemics and pandemics; endemic zoonotic, neglected tropical and vector-borne diseases. A standardized tool was developed for data extraction, synthesizing in narrative, tabular, and graphical formats. The protocol’s utilization will provide comprehensive mapping of practices and policies, identifying achievements, barriers, and knowledge gaps to inform future strategies and strengthen global health governance. Full article

Emerging and re-emerging viruses continue to pose major threats to public health. Their ability to adapt, cross species barriers, and spread rapidly can trigger severe outbreaks or even pandemics. Strengthening preparedness with comprehensive and efficient strategies is therefore essential. Here, we explore the key components of viral outbreak preparedness, including surveillance systems, diagnostic capacity, prevention and control measures, non-pharmaceutical interventions, antiviral therapeutics, and research and development. We emphasize the increasing importance of genomic surveillance, wastewater-based surveillance, real-time data sharing, and the One Health approach to better anticipate zoonotic spillovers. Current challenges and future directions are also discussed. Effective preparedness requires transparent risk communication and equitable access to diagnostics, vaccines, and therapeutics. The COVID-19 pandemic highlighted both the promise of next-generation vaccine platforms and the necessity of maintaining diagnostic capacity, as early testing delays hindered containment efforts. Countries adopted various non-pharmaceutical interventions: risk communication and social distancing proved to be the most effective, while combined workplace infection-prevention measures outperformed single strategies. These experiences highlight the importance of early detection, rapid response, and multisectoral collaboration in mitigating the impact of viral outbreaks. By applying best practices and lessons learned from recent events, global health systems can strengthen resilience and improve readiness for future viral threats. Full article

Micronutrient deficiencies, also known as “hidden hunger,” remain a pervasive public health issue in low- and middle-income countries, particularly among vulnerable populations within these countries. The main drivers of these deficiencies are poverty, limited dietary diversity, weak nutritional strategies, poor health service delivery and general health access barriers. This review assesses the prevalence, drivers, and consequences of selected micronutrient deficiencies: iron, iodine, zinc, vitamin A and vitamin D, within the scope of undernutrition, food insecurity, and socioeconomic inequity. The consequences associated with these deficiencies include stunted growth, increased susceptibility to illness, poor cognitive and social functioning, and deepened poverty. The primary strategies to address these deficiencies include dietary diversification, supplement provision, biofortification, and the production of fortified foods. Barriers to progress include the high cost of food, weak healthcare infrastructure, low educational levels, and ineffective policy implementation. Integrated food systems, personalised nutrition, and innovative food technologies have the potential to address both nutritional and health inequities. Addressing barriers to safe and nutritious food and healthcare systems in order to address health inequities requires integrated, multisectoral planning and contextual policy. Improving individual health outcomes is crucial, but addressing micronutrient deficiencies has a ripple effect throughout society, enabling economic development through poverty reduction and increased productivity. Full article

Background: Socioeconomic factors may influence maternal nutrition knowledge (MNK), which directly affects the nutritional status of children under five. This study aims to explore the importance of socioeconomic factors associated with MNK and nutritional status. Methods: This cross-sectional study focused on mothers of children aged 36–59 months (n = 657). A structured questionnaire was employed to collect data on socioeconomic factors. Anthropometric measurements were taken to assess nutritional status. The Boruta algorithm, implemented using R Studio version R.4.5.1, was used to identify the most important socioeconomic factors associated with MNK and nutrition status. Results: The analysis revealed that socioeconomic status (SES) emerged as an important factor associated with MNK and nutrition status, particularly stunting and wasting. However, SES was not confirmed as an important factor associated with underweight. This study uncovered a bidirectional relationship between child nutrition outcomes; underweight was found to be an important factor related to stunting and wasting, whereas stunting and wasting were important factors for underweight. Furthermore, infant and young child feeding (IYCF) indicators, such as weaning practices and exclusive breastfeeding (BF), were found to be important factors for stunting and wasting. Conclusions: The interlinkage among forms of undernutrition, where each nutritional outcome is related to other outcomes, underscores the importance of comprehensively addressing child undernutrition, rather than focusing on single outcomes independently. Moreover, the association between SES and MNK, wasting, and stunting supports approaches based on holistic and multi-sectoral strategies to reduce poverty by WASH programs, promote IYCF practices, and improve healthcare access by providing health insurance coverage. Full article

Background: Stunting, a form of chronic malnutrition, is a global health concern, especially in South Asia. Stunting remains a significant public health issue in Pakistan, particularly in remote regions like Gilgit-Baltistan and Chitral, where geographic isolation and socioeconomic challenges exacerbate malnutrition. The Aga Khan Development Network is leading the implementation of a program, Central Asia Stunting Initiative (CASI), with an aim to reduce stunting through community-driven maternal and child health interventions in the targeted areas of Gilgit Baltistan and Chitral. This study aimed to evaluate the effectiveness of CASI in improving child nutritional outcomes in Gilgit-Baltistan and Chitral. Methods: In this study, a single-group pre–post evaluation design was employed using baseline and midline cross-sectional surveys among households with children aged 0–59 months in Gilgit-Baltistan and Chitral. Data on child anthropometry, household food security, maternal education, and child feeding practices were collected from over 500 households using stratified sampling. Results: Results showed improvement in child health indicators between baseline and midline. Between baseline and midline, stunting declined from 40.9% to 35.4% in GBC (p = 0.02), with severe stunting dropping significantly (17.8% to 10.9%, p < 0.001). Wasting and underweight rates also showed marked reductions. Improvements in breastfeeding rates (71.3% to 88.3%) and dietary diversity (4.0% to 26.8%) were observed. However, food security declined sharply from 95.2% to 11.9%, underscoring persistent economic stress. Conclusions: CASI interventions yielded substantial improvements in child nutrition and maternal behaviours. However, sustained progress requires integrated strategies addressing food insecurity, economic empowerment, and long-term resilience. Future programs should adopt a multi-sectoral approach to tackle chronic malnutrition comprehensively. Despite this, results indicated an overall improvement due to CASI interventions, signifying the importance of integrated, community-based approaches in addressing stunting. Full article

Background: Type 2 diabetes (T2D) is no longer a standalone clinical condition—it has become a syndemic shaped by food insecurity, social inequality, and digital marginalization in emerging economies. This convergence calls for a reimagining of public health through intersectoral, digitally enabled, and culturally grounded approaches. This study explores how intersectoral strategies, supported by digital innovation and rooted in food sovereignty, can help prevent and manage T2D in emerging countries. Methods: A narrative review was conducted using the PubMed, Scopus, and Web of Science databases. Studies published between 2014 and 2025 were included if they addressed T2D and food security in emerging contexts, focusing on intersectoral or multisectoral strategies. Studies on T1D, non-human subjects, and high-income settings were excluded from the study. Thirty-nine studies were critically synthesized. Results: Food insecurity acts as both a biological stressor and a sociopolitical condition that worsens poor glycemic control. Promising but underutilized intersectoral strategies include agroecological food systems, school-based nutrition programs, and community health worker networks. Digital tools, such as AI-driven diagnostics, blockchain food traceability, and mobile health platforms, offer scalable solutions but face challenges in infrastructure, digital literacy, and ethical governance. Conclusions: A digitally inclusive, ethically reflexive intersectoral paradigm is needed that recognizes food and digital access as human rights. Full article

Breast cancer remains a leading cause of global cancer burden, with marked differences in incidence across countries. While biological risk factors are well established, understanding the broader structural and sociocultural influences has been less comprehensive. In this study, we analyzed harmonized data from 183 countries (2017–2023), encompassing 33 variables and 7 subvariables related to demographics, nutrition, environment, health, and healthcare access, drawn from open-access international databases. Spearman correlation analysis identified strong positive associations between breast cancer incidence and discontinued breastfeeding, high LDL cholesterol, out-of-pocket healthcare expenditure, and educational attainment. Conversely, poor sanitation, lack of handwashing facilities, unsafe water, and certain nutritional deficiencies exhibited robust negative correlations, likely reflecting under detection and reporting limitations in lower-resource settings rather than true protective effects. These findings were further explored using multiple linear regression, which explained approximately 73% of the variance in global breast cancer incidence. The final model highlighted discontinued breastfeeding, prevalence of cocaine use, unsafe sanitation, high out-of-pocket healthcare expenditure, limited handwashing access, and high processed meat consumption as the most influential independent predictors. Receiver operating characteristic (ROC) analysis confirmed strong predictive value for discontinued breastfeeding and out-of-pocket expenditure, with sanitation and hygiene variables showing paradoxical inverse associations. Our results emphasize that breast cancer risk is shaped not only by individual behaviors and genetics, but also by larger-scale structural, socioeconomic, and environmental factors. These patterns suggest that targeted interventions addressing both lifestyle behaviors and systemic inequities—such as promoting breastfeeding, reducing financial barriers to healthcare, and strengthening public health infrastructure—could meaningfully reduce the global burden of breast cancer. In conclusion, this study underscores the importance of multisectoral, equity-focused prevention strategies. It also highlights the value of country-level ecological analyses in uncovering upstream determinants of cancer incidence and calls for further research to disentangle individual and contextual effects in cancer epidemiology. Full article

Smartphone addiction has emerged as a significant public health concern, particularly among adolescents and young adults. This narrative review, conducted in line with the ANDJ checklist, synthesizes evidence from 25 systematic reviews and meta-analyses, complemented by randomized controlled trials and clinical studies, to provide a structured overview of the field. The study selection flow and publication trends reveal a rapidly expanding research landscape, with most evidence produced in the last decade, reflecting both the ubiquity of smartphones and increasing awareness of their health impacts. The synthesis highlights converging findings across reviews: excessive smartphone use is consistently associated with psychosocial, behavioral, and academic challenges, alongside sleep disturbances and mental health symptoms. Common messages include the recognition of smartphone addiction as a multidimensional phenomenon, while emerging themes point to heterogeneity in definitions, tools, and methodological approaches. Comparative analysis of reviews underscores both shared risk factors—such as emotional dysregulation and social isolation—and differences in study designs and target populations. Importantly, this review identifies critical gaps, including the lack of standardized definitions, limited longitudinal evidence, and scarce cross-cultural validation. At the same time, promising opportunities are noted, from lifestyle-based interventions (e.g., physical activity) to educational and policy-level strategies fostering digital literacy and self-regulation. The post-pandemic context further emphasizes the need for sustained monitoring and adaptive responses. Overall, this review calls for youth-centered, multi-sector interventions aligned with WHO recommendations, supporting coordinated, evidence-based action across health, education, and policy domains. Full article

The rollout of COVID-19 vaccines marked a turning point in pandemic control, yet vaccine hesitancy emerged as a significant obstacle in sub-Saharan Africa (SSA). The study aims to investigate socio-behavioural drivers of vaccine hesitancy in three high-resistance countries: the Republic of Congo, the Democratic Republic of the Congo, and the Republic of Guinea-Bissau. By employing a qualitative ethnographic design, in the period from April to October 2022, the study enrolled 752 participants in semi-structured in-depth interviews and focus group discussions, involving community leaders, women’s leaders, healthcare providers, traditional practitioners, traditional leaders, drivers, and youth leaders, ensuring diverse perspectives. Findings indicate that vaccine hesitancy is fluid and contextual with three principal drivers: (1) denial of COVID-19’s existence, often reinforced by scepticism among healthcare providers and the belief that the disease is foreign or a governmental scheme for financial gain; (2) misinformation, including rumours about vaccine incompatibility with certain foods, and fears of sterility and witchcraft; (3) a firm reliance on traditional medicine, seen as effective alternative to biomedical interventions. Vaccine hesitancy can only be addressed through culturally responsive, multisectoral approaches centred on community dialogue, improved communication, and the integration of trusted networks. Without inclusive strategies, resistance will undermine pandemic response and future health interventions in SSA. Full article

Leptospirosis remains a pressing yet under-recognized public health burden in the Philippines with an alarming 43.45% rise in cases in early 2025. Outbreaks closely follow flooding, disproportionately affecting impoverished communities in informal, flood-prone settlements where poor sanitation, unsafe housing, and limited healthcare access compound vulnerability. Current responses remain largely hospital-based and reactive, straining resources during seasonal surges while leaving structural drivers unaddressed. This article calls for a shift to multisectoral, preventive strategies that reduce socioeconomic vulnerabilities through stronger intersectoral collaboration, investments in flood control and basic services, and enhanced digital surveillance. Without systemic reforms that integrate health, environment, and social policy, leptospirosis will continue to impose a recurring and inequitable burden on marginalized populations. Full article

Background/Objectives: Sub-Saharan Africa (SSA) is experiencing a rising burden of non-communicable diseases (NCDs), projected to surpass infectious diseases as the leading cause of mortality. This shift reflects a complex public health challenge driven by changing dietary patterns and persistent social and gender inequities. Women of reproductive age are particularly vulnerable due to biological and sociocultural factors, with diet playing a central role in NCD development and maternal health. This scoping review explores dietary determinants of NCDs in this population and identifies evidence gaps to support context-specific, gender-responsive interventions. Methods: The review followed the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. A comprehensive search was conducted across PubMed, Scopus, and Google Scholar for studies published between January 2010 and May 2025. After removing duplicates, 577 articles were screened, and 19 met the inclusion criteria. Data were synthesized using descriptive statistics and thematic analysis. An adapted conceptual framework informed by the ecological model was developed to illustrate the multilevel pathways linking dietary determinants to NCD outcomes. Results: Frequent consumption of ultra-processed foods, salty snacks, processed meats, and sugar-sweetened beverages was consistently associated with increased NCD risk. Central obesity was prevalent among nearly half of the women studied, and a high intake of sugary drinks was common across diverse populations. Among pregnant women, overweight was observed in approximately one-quarter of participants, despite the inadequate intake of protein and iron. Vitamin A deficiency was moderately prevalent, and urban residence was linked to a twofold increase in the coexistence of obesity and micronutrient deficiencies. These patterns were shaped by poverty, food insecurity, and the cultural norms influencing dietary behaviors and access to nutritious foods. Conclusion: Dietary determinants significantly contribute to the rising NCD burden among women of reproductive age in SSA, yet adolescent women remain underrepresented in research. Addressing these gaps through culturally sensitive, multisectoral interventions and biomarker-informed longitudinal studies is essential for guiding inclusive policies and sustainable health strategies for this vulnerable population. Full article

This study reviews the role of Child-Friendly Green Spaces (CFGS) in supporting children’s psychological, physical, and educational recovery following natural disasters. The main research question guiding this review is the following: how do CFGS contribute to holistic child well-being and resilience in disaster-affected contexts, and what barriers and strategies influence their effective integration into recovery frameworks? Employing a rigorous literature review methodology, we synthesized interdisciplinary evidence from environmental psychology, urban planning, public health, and education, encompassing studies published between 2000 and 2024. Findings demonstrate that CFGS significantly reduce trauma-related symptoms such as anxiety, depression, and post-traumatic stress, promotes physical health through active play, and foster educational engagement by improving concentration, attendance, and informal learning opportunities. Furthermore, CFGS contribute directly to multiple Sustainable Development Goals, particularly SDG 3 (Good Health and Well-being), SDG 4 (Quality Education), and SDG 11 (Sustainable Cities and Communities). Despite these advantages, CFGS are often overlooked in formal disaster recovery planning due to prioritization of immediate relief, financial and logistical challenges, and socio-cultural factors. To address these challenges, this study proposes a participatory, culturally sensitive framework for CFGS implementation, which integrates inclusive design, multi-sector collaboration, and ongoing monitoring and evaluation. Grounded in theoretical perspectives such as the Biophilia Hypothesis, Bronfenbrenner’s Ecological Systems Theory, and restorative environments, CFGS are reframed as critical infrastructures for children’s holistic recovery and resilience. The findings underscore the urgent need to embed CFGS within disaster recovery and urban planning policies to promote child-centered, sustainable community development. Full article