Background:Medical emergencies in dental settings are uncommon but potentially life-threatening, and the response depends on practitioner training, institutional protocols and available equipment. Little has been published on these elements in Ghanaian dental services. This study described self-reported emergency encounters, training status, protocol awareness, equipment availability and perceived challenges at one tertiary facility. Methodology:A descriptive cross-sectional study was conducted at the Oral Health Directorate, Komfo Anokye Teaching Hospital, Kumasi. All 78 dentists on the roster were approached (attempted census); 62 returned completed self-administered questionnaires over 14 consecutive working days (response rate 79.5%). All variables were categorical, summarised as frequencies and percentages. Associations of rank and years of practice with formal emergency-management training status were examined using χ 2 tests with Yates' correction and Fisher's exact test with odds ratios (ORs). Results:Percentages denote the proportion of 62 respondents reporting each multiple-response item, not the frequency of events among patients. Hypoglycaemia (87.1%) and syncope (79.0%) were most often reported as ever encountered, then asthma attack (69.4%), seizures (62.9%) and anaphylaxis (48.4%). Thirty-six (58.1%) reported formal training, 22 (35.5%) a written protocol and none an automated external defibrillator (AED). Training was reported more often by senior than junior dentists (69.2% vs. 39.1%; p = 0.040; OR 3.50, 95% confidence interval [CI] 1.19-10.29); the association with years of practice was borderline and test-dependent (Yates-corrected p = 0.052; Fisher's exact p = 0.039; OR 3.20, 95% CI 1.12-9.15). Commonest challenges were inadequate equipment (87.1%), lack of training (72.6%) and no clear protocol (69.4%). Conclusion:Two in five dentists reported no formal emergency-management training, most were unaware of a written protocol, and none reported access to an AED. These self-reported, single-centre findings suggest that periodic training, written protocols and verified equipment stocks merit institutional attention; confirmation in larger multi-centre studies is needed.
Introduction:The World Health Organization (WHO) 90‑70‑90 cervical cancer elimination targets aim for 90% human papillomavirus (HPV) vaccination rates, 70% cervical screening rates, and 90% treatment rates for women with cervical disease. Although progress has been made in vaccination and screening in South Africa, less is known about treatment coverage following abnormal screening results. We focused on adherence to colposcopy clinic referrals among women with abnormal cytology. Methods:We conducted a retrospective descriptive study of cervical cytology samples collected in 2022 from women attending 19 public healthcare facilities within a sub‑district of Cape Town. All cytology results reported as high‑grade intraepithelial lesions or invasive cervical carcinoma (HSIL+) were included. Colposcopy clinic attendance was defined as documented histological sampling within 24 months of diagnosis. Colposcopy clinic attendance rates (CCARs), test time intervals, and distance from referral hospital were calculated for each facility. Facilities were compared using percentile distributions, and distance to referral hospitals was analyzed as a potential spatial barrier. Results:Of 9,069 cervical samples, 556 (6.1%) were reported as HSIL+. Overall, 65.8% of women underwent histological sampling within 24 months. CCARs varied across facilities, ranging from 42.5% to 87.5% (mean 63.1%). Distance to referral hospitals (range 0-22 km; mean 10.8 km) showed no correlation with colposcopy clinic attendance. Conclusion:A substantial gap exists between current CCARs and the WHO treatment target. Variability among facilities, independent of geographic distance, suggests that health system factors, such as communication, recall, and referral processes, play a key role in treatment outcomes.
Background:Weak medicines regulation contributes to the circulation of substandard and falsified medicines, undermining treatment outcomes, accelerating antimicrobial resistance and eroding public trust in health systems. This review synthesised evidence on regulatory structures and functions, mapped regional capacity, documented the public health consequences of regulatory failure and identified pathways toward stronger and more equitable pharmaceutical governance in Africa. Methods:This narrative review synthesised peer-reviewed and grey literature published between 2000 and 2025. Sources were identified through PubMed/MEDLINE, Scopus, Web of Science, Google Scholar and institutional reports from the World Health Organisation (WHO), World Bank, African Union Development Agency New Partnership for Africa's Development (AUDA-NEPAD) and national regulatory authorities. Studies were eligible if they addressed regulatory functions, the consequences of substandard and falsified medicines, WHO Global Benchmarking Tool (GBT) maturity assessments, regional harmonisation initiatives or policy responses. The search yielded 633 records, of which 122 underwent full‑text review, and 38 met the inclusion criteria. Evidence was organised thematically across regulatory functions, capacity gaps, pathways of harm, documented incidents and regulatory strengthening initiatives. Results:Evidence shows that regulatory weaknesses affect public health through therapeutic failure, toxicity, antimicrobial resistance, avoidable expenditure and inequitable exposure among vulnerable populations. African regulatory systems show substantial heterogeneity, with some authorities achieving the WHO GBT Maturity Level 3, whereas many remain at lower maturity levels. Recent advances include digital regulatory platforms, reliance mechanisms, regional harmonisation, WHO prequalification and the establishment of the African Medicines Agency. Conclusion:Strengthening national regulatory authorities to WHO GBT Maturity Level 3 and above requires sustained political commitment, predictable financing, legal reform, robust post‑market surveillance, accredited laboratory capacity and effective regional reliance mechanisms. Medicines regulation should be recognised as a core public health and health‑security priority, serving as a foundational investment in protecting populations and ensuring equitable access to quality‑assured medicines.
Introduction:Student stress is an important public health concern. Mindfulness and Therapeutic Yoga Practice (Sorig Zhiney and Luejong) has been introduced in selected Bhutanese schools to promote student well-being, but evidence regarding students' perceived stress and experiences of these practices remains limited. Methods:This comparative cross-sectional study included 1035 students in Classes IX-XII from four selected secondary schools in Punakha and Pemagatshel, Bhutan, 2025. Schools were purposively selected according to program implementation, and students were randomly selected from eligible student lists. Stress levels were measured using the Perceived Stress Scale (PSS), and factors associated with high perceived stress were identified using logistic regression. Results:Data from 490 students in schools implementing the program and 545 in schools without the program were analyzed. High perceived stress was reported by 28 (5.87%) students and 33 (6.25%) students, respectively (p = 0.946), mean PSS scores were similar (19.15 ± 4.87 vs. 19.18 ± 4.76; p = 0.910). Program availability was not associated with high perceived stress (adjusted odds ratio [OR] 0.91, 95% confidence interval [CI] 0.39-2.10; p = 0.823). Female sex, Class XII, very frequent disconnection from family, and poor appetite were associated with higher odds of high perceived stress. Among students in program schools, 392 (83.76%) practiced a few times weekly, 333 (68.38%) reported perceived benefits, and 435 (89.51%) recommended the practices to others. Conclusion:Students in schools with and without the program had similar levels of perceived stress. Students in program schools reported generally favorable perceptions and experiences.
The enactment of the One Big Beautiful Bill Act (OBBBA) in July 2025 represents a fundamental shift in United States global health financing, with significant implications for African public health systems. For more than three decades, US development assistance for health particularly through initiatives such as the President's Emergency Plan for AIDS Relief (PEPFAR), the President's Malaria Initiative, and maternal and child health programs-has been central to disease control and health system strengthening across sub-Saharan Africa. OBBBA institutionalizes reduced funding baselines under an "America First Global Health Strategy," constraining bilateral assistance and limiting flexible mechanisms that previously supported surveillance, laboratory systems, workforce development, and pandemic preparedness. This perspective examines the anticipated consequences of OBBBA for African public health through three interconnected lenses: disease-specific impacts on HIV/AIDS, tuberculosis, malaria, and maternal and child health; systemic effects on health systems, including workforce sustainability, supply chains, surveillance, and research infrastructure; and broader economic and geopolitical implications for health sovereignty and partnership dynamics. Drawing on existing empirical evidence, modeling studies, and historical analogues of funding disruptions, we argue that abrupt reductions in US global health financing risk reversing hard-won gains in disease control, exacerbating health system fragility, and increasing vulnerability to emerging infectious threats. At the same time, the policy shift may accelerate diversification of partnerships and prompt renewed debates on domestic resource mobilization and African health sovereignty. We conclude that coordinated responses by African governments, regional bodies, international institutions, and development partners are urgently required to mitigate risks, protect treatment continuity, and sustain progress toward global health security and the Sustainable Development Goals.
Background:Cholera persists as a public health threat in Ghana, particularly in coastal communities with inadequate water, sanitation and hygiene (WASH) infrastructure. This study assessed the knowledge, attitudes and practices (KAP) toward cholera among residents of Ada Foah, a high-risk coastal district in Ghana, to identify gaps and inform targeted interventions. Methods:A community-based analytical cross-sectional study was conducted among 400 adults (≥18 years) selected via multi-stage systematic random sampling. Data were collected using a pretested, structured questionnaire and analysed using descriptive statistics, chi-square tests, exploratory factor analysis (EFA) and multivariable logistic regression. To address quasi-complete separation in the practice model, Firth's penalized likelihood regression was applied. Results:Awareness of cholera was high (93.5%), but significant knowledge gaps persisted regarding aetiology and symptoms. Although attitudes were predominantly positive (80.5% rated as 'Good'), preventive practices were inconsistent. Notably, 43.5% never treated drinking water, and 40.3% reported practising open defecation 'sometimes/always'. Higher educational attainment and peri-urban residence were significant predictors of good knowledge (p < 0.05). EFA revealed four distinct practice dimensions: core hygiene, Proactive Food and Water Safety, health system engagement, and risk recognition. Willingness to accept oral cholera vaccine was high (67.0%) despite low awareness (43.0%). Firth's regression confirmed that positive attitude was inversely associated with adequate practice (aOR = 0.04, 95% CI: 0.01-0.18), whereas the four practice factors showed expected directional associations. Conclusions:A significant attitude-behaviour gap exists, with high awareness and positive attitudes not translating into consistent preventive practices. Cholera control in Ada Foah requires a multifaceted strategy integrating targeted health education, sustainable WASH infrastructure improvements and strategic deployment of oral cholera vaccines.
Bovine tuberculosis (BTB) remains a significant zoonotic disease in livestock production, causing considerable animal welfare and economic losses, particularly in communal farming communities where human-animal contact is close, and veterinary services are limited. This study aimed to assess communal cattle owners' knowledge, attitudes and practices regarding BTB using a structured questionnaire in the Eastern Cape province of South Africa. A cross-sectional survey design was employed, and a systematic random sampling approach was used to recruit participants from villages in the Makana, Raymond Mhlaba and Enoch Mgijima local municipalities. Face-to-face interviews were conducted with 186 cattle owners using a structured questionnaire administered in IsiXhosa or English. Data were analysed using descriptive statistics, Pearson's correlation analyses, and binary logistic regression in SPSS (version 28) and RStudio (version 4.4.2). The findings of this study revealed low awareness: Only 18.8% of cattle owners had heard of BTB, and a limited understanding of its transmission routes, including the consumption of raw milk, undercooked meat and shared grazing land. Although 61.3% of cattle owners supported culling infected cattle, resistance to control measures persists, particularly among experienced farmers, as indicated by a negative Pearson's correlation between experience and attitude towards BTB control (r = -0.170, p < 0.05). The low awareness levels, insufficient testing and inadequate preventive measures increase the likelihood of undetected infections and contribute to the potential spread of BTB within herds and to human beings.
Reckless driving remains a major contributor to road traffic injuries and fatalities in Ghana, posing significant public health and development challenges. This systematic review synthesizes multidisciplinary evidence to examine the multidimensional determinants of reckless driving, its socio-economic and health consequences and global best practices for sustainable reform. Drawing on the theory of planned behaviour (TPB) and the safe systems approach (SSsA), the study integrates behavioural, institutional, infrastructural and economic perspectives. The findings indicate that speeding, dangerous overtaking, weak enforcement credibility, commercial transport incentive structures and inadequate road design collectively sustain high crash rates. Ghana records thousands of road traffic fatalities annually, with substantial productivity losses and economic costs estimated at 3%-5% of gross domestic product (GDP). Vulnerable road users, particularly pedestrians, bear a disproportionate burden of fatalities. Comparative evidence from countries implementing comprehensive Safe Systems reforms demonstrates that sustained reductions in road deaths are achievable through integrated enforcement, infrastructure redesign, licensing modernization and institutional strengthening. The review concludes that reckless driving in Ghana is preventable through coordinated, evidence-based policy action and long-term governance commitment aligned with national development goals.
Background:The disease burden among school-aged children (5-17 years) in low- and middle-income countries remains poorly characterized, with health policies predominantly focused on children under five. This study described the morbidity profile and examined associated demographic factors among school-aged children attending a primary care facility in Ghana. Methods:A retrospective review of outpatient records was conducted at Ho Polyclinic in the Volta Region. Data from all consultations for children aged 5-17 years between January 2018 and December 2022 were extracted. The facility has a historical specialization in dermatological care because it was formally a leprosarium. Descriptive statistics summarized demographics and morbidity frequencies. Chi-square tests assessed associations between age group, sex, and the three leading diagnostic categories. Results:Among 10,428 consultations (mean age 10.3 ± 4.0 years; 54.4% female), skin conditions (38.3%), malaria (23.0%), and respiratory conditions (16.1%) constituted 77.4% of all diagnoses. This pattern remained consistent across the 5-year study period. No statistically significant associations were found between age group or sex and diagnosis of skin conditions (age p = 0.598; sex p = 0.611), malaria (age p = 0.176; sex p = 0.452), or respiratory conditions (age p = 0.839; sex p = 0.555). Conclusion:A consistent triad of infectious and environmental conditions dominates the morbidity profile of school-aged children in this setting. The uniformity of this burden across demographic subgroups underscores the need for integrated, school-based health interventions targeting skin health, malaria prevention, and respiratory hygiene to address this neglected demographic.
Background:Intimate partner violence (IPV) is a major public health and human rights issue globally, with a particularly high burden in sub-Saharan Africa. Despite this, evidence on the predictors of IPV in Mozambique remains limited. This study aimed to identify predictors of IPV among women of reproductive age in Mozambique using nationally representative data. Methods:This study utilised secondary data from the 2022 to 2023 Mozambique Demographic and Health Survey (DHS). A total of 4454 women aged 15-49 years who responded to the domestic violence module were included. IPV was defined as experiencing at least one act of physical, sexual or emotional violence by a current or former intimate partner in the 12 months preceding the survey. Logistic regression, accounting for sampling weights, clustering and stratification, was used to identify independent predictors of IPV. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Results:The prevalence of IPV among reproductive-age women in Mozambique was 24.8% (1103/4454). In the adjusted model, higher education was associated with significantly reduced odds of IPV (AOR = 0.420, 95% CI: 0.243-0.725). Employment was associated with increased odds of IPV (AOR = 1.192, 95% CI: 1.022-1.390). Partner alcohol use was the strongest predictor (AOR = 2.078, 95% CI: 1.781-2.425), followed by a history of father-to-mother violence (AOR = 2.022, 95% CI: 1.681-2.432). Women in the richest wealth quintile had significantly lower odds of IPV (AOR = 0.631, 95% CI: 0.462-0.862). Conclusion:IPV remains highly prevalent among women in Mozambique and is strongly influenced by relational and intergenerational factors. Partner alcohol consumption and exposure to parental violence significantly increase the risk, whereas higher education offers protection. These findings highlight the need for integrated interventions addressing alcohol use, intergenerational violence and gender norms, alongside efforts to promote women's education and empowerment.
Background:Heavy episodic drinking (HED) is a harmful pattern of alcohol use associated with sexual health outcomes. Global prevalence of HED is expected to increase from 20% to 23% by 2030, with females more likely to experience its negative health consequences. This study aimed to determine prevalence, predictors and sexual health correlates of HED among females of reproductive age in Ghana. Methods:This study employed a cross-sectional study design that relied on a dataset from the Ghana Demographic and Health Survey, 2022, which consisted of alcohol use history, background characteristics and sexual behaviours and health of 15,014 females. Associations and correlates were identified using chi-square and binary logistic regression analyses, respectively. Results:Prevalence of HED among the study population was determined to be 2.1%, with age of 40-44 years (adjusted odds ratio [AOR] = 4.19; 95% confidence interval [CI] = 1.27, 13.87), smoking of cigarettes daily (AOR = 4.46; 95% CI = 1.00, 19.86) and history of terminated pregnancy (AOR = 1.65; 95% CI = 1.24, 2.20) identified as predictors of HED. Females with three extra-spousal sexual partners (AOR = 6.45; 95% CI = 1.60, 26.10) and females who have had a genital discharge in the last 12 months (AOR = 3.57; 95% CI = 2.19, 5.81) had high odds of engaging in HED. Conclusion:This study found a low prevalence of HED (2.1%) but identified key high-risk subgroups. Risky sexual behaviour and adverse sexual health were strongly associated with HED. Public health strategies should consider integrating alcohol screening into sexual and reproductive health services.
Zoonotic diseases with epidemic potential pose a serious public health threat in Sierra Leone, where the One Health (OH) approach has been adopted to strengthen multi-sectoral preparedness and response. This study assessed the operationalization of OH in responding to such diseases at the central level and in two districts, Kambia and Kailahun, using content analysis of semi-structured interviews, focus group discussions and key documents. Manifest and latent analysis generated themes, including coordination and collaboration, surveillance and reporting, human resource capacity, communication, funding, and community engagement and awareness. Our study found that at the central level, OH sectors showed strong coordination, a functional surveillance system, established communication platforms and relatively strong capacity. District and community levels, by contrast, showed weak coordination, fragmented surveillance and limited communication, along with low animal health (AH) workforce capacity and OH awareness. Community level AH workers lacked an integrated approach to preventing, detecting and reporting zoonotic disease risks. Across all levels, OH activities lacked dedicated funding and relied solely on partner support, with the AH sector facing notable workforce shortages. OH, implementation was markedly weaker at district and community levels than at the central level, a disparity largely attributable to the absence of dedicated funding. Despite these gaps, the OH approach holds considerable potential for mitigating and managing zoonotic disease risks in Sierra Leone.
Background:Dietary diversity (DD) assesses the access and consumption of varieties of food types, there are few studies conducted on DD, the current study targeted adolescent girls in high schools in Addis Ababa, Ethiopia. Objective:To assess the magnitude of DD and its associated factors among high school adolescent girls in Addis Ababa, Ethiopia. Methods:An institutional-based cross-sectional study was conducted on 621 female adolescents from May 1 to 30, 2025. A multistage sampling technique was used to select study participants. The data were entered into epi-data version 3.1 and were exported to SPSS version 25. Variables were screened using the bivariable logistic regression analysis model. Those candidate variables having p value ≤ 0.25 were exported to the multivariable logistic analysis. Statistical significance was declared if p < 0.05. Result:The prevalence of inadequate dietary diversity score (DDS) among adolescent girls was 33.4%, 95%CI [29.66%, 37.14%] with average of 6.48 food groups consumed daily. Grains/roots and tubers (77.7%) were the most commonly consumed food groups in the last 24 h dietary recall. Maternal education [adjusted odds ratio (AOR) = 1.42, 95%CI, (1.12-2.99)], Meal frequency [AOR = 1.54, 95%CI, (1.06-2.25)], Nutritional education [AOR = 1.53, 95%CI, (1.35-1.80)] and Consumption of sweet foods [AOR = 1.71, 95%CI, (1.17-2.50)] were independent predictors of inadequate DDS. Conclusion:One third of female adolescents had inadequate DDS. Grains/tubers and roots were the most consumed food groups. Maternal education, meal frequency, nutritional education, and nonconsumption of more sweet foods/drinks were significantly associated with the inadequate DDS.
Youth represent the largest and most interconnected generation but remain underserved by traditional and global health structures. In Africa alone, nearly 60% of the population is under the age of 25, and the continent's youthful population is projected to reach almost 1 billion by 2050. This narrative synthesis draws on proceedings from the 2025 Global Health Focus Youth Conference in Kigali, Rwanda, and triangulates them with recent peer-reviewed evidence to discuss how young professionals contribute to health equity in three domains: education, research, and leadership. Participants called for mandatory equity-oriented curricula grounded in local realities, expanded mentorship networks, and scholarship schemes that lower barriers for students from low- and middle-income countries (LMICs). Research data reveal persistent authorship and funding asymmetries, but targeted seed grants and South-led capacity-building programs are increasing local first- and last-author representation. Conference dialogues underscored that equitable partnerships, reinforced by funder requirements and journal policies, are key to decolonizing knowledge production. Leadership discussions have highlighted successful youth-driven innovations and advocacy campaigns that influence national and global agendas. Synthesizing these insights, this article offers recommendations for universities, funders, and policymakers to institutionalize mentorship, earmark youth-led research funds, and legislate youth seats in governance. Implementing these actions would transform young people from occasional consultees into co-architects of sustainable, context-responsive global health solutions.
Introduction:Giving only breast milk in the first 6 months lowers the chances of childhood diseases and death. Still, it is difficult to promote ideal breastfeeding among internally displaced persons (IDPs) in camps. This research is intended to find out how many mothers are feeding their children under five with only breast milk in IDPs camps in Goma, eastern Democratic Republic of Congo (DRC). Methods:Between November 2024 and February 2025, an analytical cross-sectional study was conducted in five major IDPs camps in Goma. A total of 407 eligible mothers or primary caregivers were recruited and participated in the study using a structured and pre-tested questionnaire. Data were collected on sociodemographic characteristics, including maternal age, place of residence, and infant feeding practices. The chi-square (χ 2) test was employed to assess associations between exclusive breastfeeding (EBF) and selected explanatory variables, with statistical significance determined at p < 0.05. Results:The prevalence of EBF was 20.9%. Significant associations were observed between EBF and maternal age (χ 2 = 18.8 and p < 0.05), educational level (p < 0.05), marital status (p < 0.05), presence of both parents (p < 0.05), prematurity status (χ 2 = 7.64 and p = 0.022), and source of household income (χ 2 = 28.3 and p < 0.001). Higher EBF rates were reported among younger mothers, those with higher education, married women, and households receiving humanitarian aid (51.6%) compared to those relying on trade (16.2%). No significant associations were found between EBF and child's sex (χ 2 = 0.177 and p = 0.674), camp of residence (χ 2 = 0.688 and p = 0.953), or household size (χ 2 = 3.78 and p = 0.052). Conclusion:IDPs camps demonstrate markedly low levels of exclusive breastfeeding, highlighting significant disparities between displaced populations and the general population. These findings underscore the need for targeted, context-specific interventions, including strengthened maternal education, increased paternal support, and enhanced breastfeeding support programs, to improve infant health outcomes in humanitarian and crisis settings.
Introduction:The UK private healthcare self-testing market has grown quickly, especially since the COVID-19 pandemic. Self-tests offer convenience and autonomy, but concerns persist about their accuracy, regulation, oversight and follow-up care. Media coverage shapes public views, but systematic analysis is lacking. Our aims were to examine UK media coverage of private self-testing kits, identifying key themes, reported benefits and risks and overall media attitudes. Methods:A search of online media articles published between 2019 and 2023 was conducted using Google. Eligible articles discussed privately purchased self-testing kits, were in English, and were free to access. Articles were grouped by health area, and thematic analysis found key patterns. Results:Fifty-nine articles met inclusion criteria. Themes that were described as positive included autonomy, accessibility and use alongside the National Health Service (NHS). Negative themes included concerns about accuracy, the use of inappropriate biomarkers, insufficient regulation, lack of follow-up, the risk of misinterpretation, psychological distress and an increased burden on the NHS. Media reports noted a lack of standardisation compared with NHS pathways. Conclusion:UK media coverage was predominantly critical of self-tests, although benefits such as accessibility and autonomy were recognised. Media representations are influenced by journalistic framing, selective sourcing and broader tendencies toward risk-focused reporting. Future research should explore how this influences public behaviour, engagement with self-testing technologies and subsequent healthcare utilisation.
Under-5 child mortality due to vaccine preventable diseases (VPDs) contributes to an estimated burden of ∼5.2 million deaths globally, mostly within low- and middle-income countries (LMICs). Despite ongoing efforts to expand immunisation coverage, gaps in immunisation remain a persistent public health concern, underscoring the need to examine recent trends and determinants of full immunisation in India. The objective of this study is to estimate vaccination coverage and identify factors associated with full immunisation among children aged 12-23 months from 2015 to 2021. We utilised the National Family Health Survey-4 (NFHS-4) and NFHS-5 datasets to determine the vaccination status (fully vaccinated/not fully vaccinated) among children aged 12-23 months using multilevel logistic regression analysis. The full vaccination coverage increased from 62.54% [95% CI: 61.81, 63.26] in 2015-16 (NFHS-4) to 76.81% [95% CI: 76.18, 77.42] in 2019-21 (NFHS-5). The factors associated with significantly higher odds of full vaccination in both NFHS-4 and NFHS-5 included higher maternal age and education, higher wealth quintile, having ≥4 antenatal care visits, institutional delivery, pregnancy registration and exposure to media. The lower odds of full immunisation were associated with having more than one child and being Muslim in both NFHS-4 and NFHS-5. The elimination of rural residence as a significant factor for lower child vaccination odds in NFHS-5, a contrast to NFHS-4, suggests that national health policies have become more effective at reducing geographical disparities and therefore more equitable. With increasing saturation of vaccination coverage, the government programme needs a specific focus on addressing key determinants associated with vaccine uptake to achieve complete vaccination.
Introduction:Pregnancy-related misconceptions are common in low- and middle-income countries and may adversely influence maternal behaviours. Evidence from urban populations is limited. This study assessed the prevalence and determinants of pregnancy-related misconceptions among pregnant women in urban Bangladesh. Methods:A cross-sectional baseline analysis was conducted among 861 first-trimester pregnant women (6-14 weeks) from urban and semi-urban Dhaka, Bangladesh (2014-2015). Only pre-intervention data from a registered trial were used. A pre-tested, interviewer-administered questionnaire assessed nine misconceptions. Correct responses were scored 1 (0-9); 'do not know' was scored incorrect. Scores were categorised as poor (0-3), average (4-6) or good (7-9). Multivariable logistic regression identified determinants of good knowledge. Results:The mean knowledge score was 4.9 ± 2.1. Only 13.8% of participants had good knowledge, whereas 73.3% and 12.9% had average and poor knowledge, respectively. Misconceptions were most common regarding diabetes (65.2%), consumption of oily foods during pregnancy (61.4%) and physical activity (30.5%). Women with more than 10 years of education were significantly more likely to have good knowledge than those with lower educational attainment (adjusted odds ratio [OR] 2.26; 95% confidence interval [CI] 1.41-3.63; p = 0.001). No significant associations were observed for age, household income, occupation, religion or area of residence. Sensitivity analyses using continuous knowledge scores produced similar findings. Conclusion:Pregnancy-related misconceptions remain widespread among pregnant women in urban Bangladesh. Maternal education is the key determinant of accurate knowledge, underscoring the need for culturally appropriate antenatal education and community-based interventions. Trial Registration:ClinicalTrials.gov NCT01924013.
Background:Despite global declines in neonatal mortality, Sub-Saharan Africa continues to bear a disproportionate burden. In Ethiopia, available evidence is largely derived from facility-based studies, yet pooled evidence from these studies remains limited. Therefore, this study aimed to estimate the pooled proportion of neonatal deaths among admitted neonates and identify associated factors in Ethiopia. Methods:We searched major databases, including Web of Science, Scopus, PubMed, Google Scholar, and African Journals Online. Data were extracted using standardized Microsoft Excel spreadsheet. Study quality was assessed using the Joanna Briggs Institute appraisal checklist. A random-effects meta-analysis estimated pooled proportion of neonatal deaths, with heterogeneity measured by I 2 and publication bias assessed using a funnel plot and Egger's test. Results:The pooled proportion of admitted neonatal deaths in Ethiopia was 14.31% (95% confidence interval [CI]: 12.59-16.03), indicating a high burden of neonatal deaths within healthcare facilities, with substantial heterogeneity across studies (I 2 = 98.93%). Given this extreme heterogeneity, the pooled estimate should be interpreted cautiously and should not be considered a fixed national figure. Lack of antenatal care (ANC) (adjusted odds ratio [AOR] = 2.7, 95% CI: 1.5-3.96), birth asphyxia (AOR = 5.1, 95% CI: 3.0-7.1), low-birth weight (AOR = 4.1, 95% CI: 1.6-6.6), preterm birth (AOR = 2.2, 95% CI: 1.3-3.1), and hypothermia (AOR = 2.4, 95% CI: 1.2-3.7) were identified as significant risk factors for neonatal deaths. Conclusion:A considerable proportion of neonatal deaths occurred among admitted neonates in Ethiopia, indicating a high burden of neonatal mortality within healthcare facilities. The major risk factors for neonatal deaths were lack of ANC, asphyxia, low-birth weight, preterm birth, and hypothermia. As the evidence was derived predominantly from facility-based studies, the findings mainly reflect the proportion of deaths among neonates receiving care in health facilities and should not be considered nationally representative of all neonates in Ethiopia.
Background:In Ghana and sub-Saharan Africa, there is limited understanding of how people's subjective perceptions influence the broader conceptualisation of ageing and disability. Cultural and social factors play a critical role in shaping these perceptions, but existing research has not adequately explored this relationship. This study addresses this gap by using the newly developed Subjective Perception of Ageing and Disability Scale (SPADS) and the Conceptualisation of Ageing and Disability Scale (CADS) to examine how individual beliefs and functional abilities interact with cultural and social contexts to shape views on ageing and disability in Ghana. Methods:An exploratory sequential mixed-methods research design explored how ageing symptoms are associated with disability among residents of Dodowa in the Shai Osudoku District, Greater Accra region. The initial qualitative phase involved 14 participants, followed by a quantitative phase with 175 participants. Themes from the qualitative study informed the development of instruments for the quantitative study. SPADS and CADS developed through Cronbach's α analysis and exploratory factor analysis. An Independent samples t-test, analysis of variance (ANOVA) and structural equation modelling assessed subjective perceptions of ageing and disability and their broader conceptualisation, respectively. Findings:The findings indicate a close relationship between subjective perceptions of ageing and disability in Ghana. Ageing symptoms identified in the qualitative phase-cognition, physical attributes, sensory impairment, and potential disability-were associated with disability. Most participants associated disability with ageing symptoms as reflected in their SPADS responses. SPADS was a strong predictor of CADS, with a positive relationship between the two scales. Most participants conceptualised ageing as being inherently linked to disability. Conclusion:Ageing is predominantly perceived as being associated with disability. The findings suggest a lack of adequate knowledge about ageing and disability. Educational campaigns are recommended to improve understanding of these phenomena. Future research should explore longitudinal changes in perception and rural-urban differences.
