Why Multi-Sectoral Approaches Are Rarely Applied in Community Health Interventions in Some Countries in Sub-Saharan Africa?

The objective of this work is to analyze the reasons why community health interventions in Africa do not consider multisectoral approaches. To achieve it, we perform a mini-review of health development policies and plans available online in seven countries from four regions of Sub-Saharan Africa. Thus, two main reasons have been highlighted. First, national strategic plans and policies for health development, in their formulation, neither sufficiently emphasize multisectoral approaches, nor sufficiently make these approaches operational in strategies and activities. Second, the mindset of health professionals due to their initial training orientation based on the biomedical approach, stands that disease is only a result of a physiological imbalance in the body;therefore, to restore health, such an imbalance only needs sophisticated procedures and interventions to be overcome. Such an orientation completely ignores the social, cultural and economic context in which the individual lives, which has an irretrievable influence on the health imbalance. However, health, influenced by the conditions in which people are conceived, born, grow, live, work and aged, cannot be effectively improved in a sustainable way without taking into account all these conditions. Whence the importance of approaches based on every sector of human activity that influences the living conditions.

Workplace Health Interventions and Physical Fitness Status among Managers of Small-Scale Enterprises in Norway and Sweden

Background: The ability of managers of small-scale enterprises (SSEs) to prioritize health, working conditions, and their own physical fitness is an important issue for workplace health promotion in Norway and Sweden, where most owner-manager positions are in SSEs. Aim: To assess the physical fitness status of SSE managers compared to a norm population and to study changes in physical fitness status, self-reported physical activity, and sickness outcomes after workplace health interventions. Methods: The study allocated SSE managers to either an intervention or a reference group. The intervention, over twelve months, consisted of motivational input related to lifestyle and physical activity through tests and feedback, individual support, and courses on health and psychosocial working conditions. The participants (N = 28) completed health screening checks, questionnaires and testing before and after the intervention. Results: SSE managers in the study had positive outcomes for BMI levels and strength compared to the norm population, while percentage of fat for both men and women indicated poor results. There were no further improvements in the intervention group after comparison with the reference group. Separately, both groups seemed to improve strength and body composition. Conclusion: Workplace health interventions with essentially motivational components may increase SSE managers’ attention to physical fitness, but appear to have limited effects on objective and subjective physical fitness outcomes.

Alternative Public Health Interventions to Prevent Neonatal Deaths in Developing Countries： A Comparative Study

A number of evaluations of health education interventions in developing countries for the reduction of neonatal mortality have been reported. These interventions can be divided into two categories： those which include medical professionals and those without medical professionals. No systematic review has yet been performed that compares these two types of interventions. This study is an attempt to determine whether the inclusion of medical professionals in health education interventions more greatly decreases neonatal mortality in developing countries. Databases were searched for impact evaluation studies which： 1） had both experimental and control groups, 2） conducted both pre-tests and post-tests, 3） identified the intervention as a health education package, 4） were published in peer reviewed journals, 5） used neonatal mortality as an outcome measure, and 6） were undertaken in developing countries A total 14 studies were found that fit these criteria---eight of these studies included medical professionals in the intervention, and six studies were without medical professionals. To calculate the net effect of each intervention, both the difference-in-difference method and the use of log odds ratios were tested. Interventions involving medical professionals had significantly lower neonatal mortality rates than those without medical professionals. Interventions meant to decrease neonatal mortality in developing countries are recommended to involve medical professionals.

Enhancing adolescent mental health through cognitive and social support:Insights from study on depression in Chinese adolescents

Adolescent depression is a growing global health concern,affecting 14%of adolescents and leading to severe consequences such as academic failure,substance abuse,and suicidal ideation.The study by Yu et al,investigates the cognitive and social factors influencing depression in 795 Chinese adolescents.Findings reveal that negative life events(NLEs)and dysfunctional attitudes are strongly associated with depressive symptoms,while social support moderates the impact of NLEs but not dysfunctional attitudes.The study highlights the need for cognitivebehavioural interventions targeting perfectionism and autonomy,and the importance of strengthening social support systems in schools and communities.Culturally sensitive,holistic approaches to adolescent mental health are crucial for addressing both the internal vulnerabilities and external pressures contributing to depression.Further research is needed to explore the roles of peer and parental support and the long-term effects of these factors across diverse cultural contexts.

Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study

Background:Many simple,affordable and effective disease control measures have had limited impact due to poor access especially by the poorer populations(urban and rural)and inadequate community participation.A proven strategy to address the problem of access to health interventions is the Community Directed Interventions(CDI)approach,which has been used successfully in rural areas.This study was carried out to assess resources for the use of a CDI strategy in delivering health interventions in poorly-served urban communities in Ibadan,Nigeria.Methods:A formative study was carried out in eight urban poor communities in the Ibadan metropolis in the Oyo State.Qualitative methods comprising 12 focus group discussions(FGDs)with community members and 73 key informant interviews(KIIs)with community leaders,programme managers,community-based organisations(CBOs),non-government organisations(NGOs)and other stakeholders at federal,state and local government levels were used to collect data to determine prevalent diseases and healthcare delivery services,as well as to explore the potential resources for a CDI strategy.All interviews were audio recorded.Content analysis was used to analyse the data.Results:Malaria,upper respiratory tract infection,diarrhoea and measles were found to be prevalent in children,while hypertension and diabetes topped the list of diseases among adults.Healthcare was financed mainly by out-of-pocket expenses.Cost and location were identified as hindrances to utilisation of health facilities;informal cooperatives(esusu)were available to support those who could not pay for care.Immunisation,nutrition,reproductive health,tuberculosis(TB)and leprosy,environmental health,malaria and HIV/AIDs control programmes were the ongoing interventions.Delivery strategies included house-to-house,home-based treatment,health education and campaigns.Community participation in the planning,implementation and monitoring of development projects was reported as common practice.The resources available for these activities and which constitute potential resources for the CDI process include community volunteers,CBOs and NGOs.Others are landlords;professional,women and youth associations;social clubs,religious organisations and the available health facilities.Conclusion:This study’s findings support the feasibility of using the CDI process in delivering health interventions in urban poor communities and show that potential resources for the strategy abound in the communities.

Supporting and strengthening research on urban health interventions for the prevention and control of vector-borne and other infectious diseases of poverty:scoping reviews and research gap analysis

Background:More than half of the world’s population currently lives in urban settlements that grow both in size and number.By 2050,approximately 70%of the global population will be living in urban conglomerations,mainly in low-and middle-income countries.Mobility,poverty,different layers of inequalities as well as climate variability and change are some of the social and environmental factors that influence the exposure of human populations in urban settings to vector-borne diseases,which pose eminent public health threats.Accurate,consistent,and evidencebased interventions for prevention and control of vector-borne and other infectious diseases of poverty in urban settings are needed to implement innovative and cost-effective public policy and to promote inclusive and equitable urban health services.Main body:While there is growing awareness of vector-borne diseases epidemiology at the urban level,there is still a paucity of research and action being undertaken in this area,hindering evidence-based public health policy decisions and practice and strategies for active community engagement.This paper describes the collaboration and partnership of the Special Programme for Research and Training in Tropical Diseases(TDR)hosted by the World Health Organization(WHO)and the“VEctor boRne DiseAses Scoping reviews”(VERDAS)Research Consortium as they joined efforts in response to filling this gap in knowledge and evidence by supporting the development of a series of scoping reviews that highlight priority research gaps and policy implications to address vector-borne and other infectious diseases at the urban level.Conclusions:The set of scoping reviews proposed in this special issue presents a critical analysis of the state-of-the-art of research on urban health interventions for the prevention and control of vector-borne and other infectious diseases of poverty.The authors of the 6 reviews highlighted severe gaps in knowledge and identified organizational and theoretical limitations that need to be urgently tackled to improve cities preparedness and vector control response.The more pressing need at present is to ensure that more implementation research on vector-borne diseases in urban settings is conducted,addressing policy and practice implications and calling for more political commitment and social mobilization through adequate citizen engagement strategies.

COVID-19 epidemic prediction and the impact of public health interventions: A review of COVID-19 epidemic models

The coronavirus disease outbreak of 2019(COVID-19)has been spreading rapidly to all corners of the word,in a very complex manner.A key research focus is in predicting the development trend of COVID-19 scientifically through mathematical modelling.We conducted a systematic review of epidemic prediction models of COVID-19 and the public health intervention strategies by searching the Web of Science database.55 studies of the COVID-19 epidemic model were reviewed systematically.It was found that the COVID-19 epidemic models were different in the model type,acquisition method,hypothesis and distribution of key input parameters.Most studies used the gamma distribution to describe the key time period of COVID-19 infection,and some studies used the lognormal distribution,the Erlang distribution,and theWeibull distribution.The setting ranges of the incubation period,serial interval,infectious period and generation time were 4.9-7 days,4.41-8.4 days,2.3-10 days and 4.4-7.5 days,respectively,and more than half of the incubation periods were set to 5.1 or 5.2 days.Most models assumed that the latent period was consistent with the incubation period.Some models assumed that asymptomatic infections were infectious or pre-symptomatic transmission was possible,which overestimated the value of R0.For the prediction differences under different public health strategies,the most significant effect was in travel restrictions.There were different studies on the impact of contact tracking and social isolation,but it was considered that improving the quarantine rate and reporting rate,and the use of protective face mask were essential for epidemic prevention and control.The input epidemiological parameters of the prediction models had significant differences in the prediction of the severity of the epidemic spread.Therefore,prevention and control institutions should be cautious when formulating public health strategies by based on the prediction results of mathematical models.

Rural Resilience: A Comprehensive Study on Water Supply, Sanitation, Disease Patterns, and Hygiene Practices in Munshiganj, Bangladesh

This research project investigates the current status of water supply, sanitation, and hygiene practices in Munshiganj District, Bangladesh. Data collection involved a structured questionnaire and a reconnaissance survey. Findings reveal that 30% of individuals rely on surface water (hand-tube wells, rivers, and ponds), prioritized as canal > river > pond, while 70% depend on groundwater (subterranean electric motor, deep tube-well). Drinking water is generally sufficient, with 95% reporting adequacy throughout the year. About 45% use hand tube-well water, 28% use deep tube-well water, and 11% use supply tap water for various purposes. Bathing trends include underground water through electric motor > pond > hand tube-well water > river, while for cooking, the order is underground water through electric motor > pond > hand tube-well water > river. Toilet water supply ranks as supply tap water > hand tube-well water > deep tube-well water. Although sanitation awareness is high, some lack knowledge of good hygiene practices. After defecating, handwashing methods include soap, ash, soil, or water. Children’s waste disposal varies, with some discarding it in open areas. Approximately 40% suffer from diseases like Diarrhoea due to unsafe water, primarily affecting children and elders. Training exists, but a significant portion lacks sanitation education. Dry skin or exposure to cold water may cause temporary irritation. Local government involvement in sanitation efforts is less active compared to non-governmental organizations. Results emphasize the need to enhance community awareness of safe water supplies and sanitation practices. .

Three-dimensional psychological guidance combined with evidencebased health intervention in patients with liver abscess treated with ultrasound

BACKGROUND Liver abscess is a common clinical liver disease mainly caused by suppurative bacteria or amoebae,with early clinical signs of chills,high fever,jaundice,and other symptoms.Establishing its early diagnosis is difficult,which may lead to misdiagnosis.AIM To observe the effects of psychological guidance combined with evidence-based health intervention in patients with liver abscess treated with ultrasound.METHODS A total of 120 patients with bacterial liver abscess admitted to our hospital from May 2018 to February 2021 were selected and divided into groups according to their intervention plan.RESULTS After the intervention,Self-Rating Depression Scale,Self-Rating Anxiety Scale,Self-Perceived Burden Scale(SPBS),and quality of life scores(physical functioning,role physical,bodily pain,general health,vitality,social functioning,role emotional,mental health)were lower than before the intervention in the two groups.The observation group had lower negative sentiment,SPBS,and quality of life scores than the control group.In the observation group,31 and 24 patients had good and general compliance,respectively,with a compliance rate of 91.67%,which was significantly higher than that in the control group.The observation group had significantly lower total incidence of incision infection,abdominal abscess,hemorrhage,and severe abdominal pain than the control group.CONCLUSION Three-dimensional psychological guidance combined with evidence-based health intervention in treating liver abscess can reduce patients’burden and negative emotions,improve patient compliance and quality of life,and reduce complications.

公共卫生干预研究知情同意书伦理审查问题分析

目的 提高公共卫生干预研究知情同意书的完整性和规范性,保障研究参与者的合法权益。方法 汇总整理本机构2016年1月—2023年8月进行初始审查的公共卫生干预研究项目的伦理委员会审议决议,根据自拟的“知情同意书审查要素表”,对相关问题进行统计分析。结果 进行初始审查的39项公共卫生干预研究项目,知情同意书存在问题的项目共有36项(占92.3%)。主要问题包括干预试验内容告知不全(占91.7%),干预试验费用承担者及补偿措施的告知模糊(占38.9%),权益和风险的告知不充分(占55.6%),个人信息和生物样本收集、使用及保护措施的告知不全(占30.6%),知情同意书语言表达不规范(占27.8%)。结论 本机构公共卫生干预研究的知情同意书撰写仍存在很多问题,干预试验的相关各方可采取多种措施以提高知情同意书的完整性和规范性。伦理委员会可以向研究者提供知情同意书撰写模板,加强审查能力,根据审查要素表编写伦理审查指引,提高审查效率和质量,保护研究参与者的合法权益。

Chinese NGOs in action against HIV/AIDS

Chinese nongovernmental organizations (NGOs) have played a significant role in the battle against AIDS in the People’s Republic of China. This article provides a brief overview of the structure of these organizations, as well as an analysis of their principle accomplishments. Of great significance in this analysis is the fact that Chinese NGOs have effectively dealt with many sensitive health education areas that government authorities have felt reluctant to handle directly. As such, they have provided an indispensable component in the HIV/AIDS prevention and control calculus on the mainland.

China’s biggest, most neglected health challenge: non-communicable diseases

Background:Over the past two decades,international health policies focusing on the fight against the human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS),tuberculosis(TB),malaria,and those diseases that address maternal and child health problems,among others,have skewed disease control priorities in China and other Asian countries.Although these are important health problems,an epidemic of chronic,non-communicable diseases(NCDs)in China has accounted for a much greater burden of disease due to the ongoing rapid socioeconomic and demographic transition.Discussion:Although NCDs currently account for more than 80%of the overall disease burden in China,they remain very low on the nation’s disease control priorities,attracting marginal investment from central and local governments.This leaves the majority of patients with chronic conditions without effective treatment.International organizations and national governments have recognized the devastating social and economic consequences caused by NCDs in low-and middle-income countries,including China.Yet,few donor-funded projects that address NCDs have been implemented in these countries over the past decade.Due to a lack of strong support from international organizations and national governments for fighting against NCDs,affected persons in China,especially the poor and those who live in rural and less developed regions,continue to have limited access to the needed care.Costs associated with frequent health facility visits and regular treatment have become a major factor in medical impoverishment in China.This article argues that although China's ongoing health system reform would provide a unique opportunity to tackle current public health problems,it may not be sufficient to address the emerging threat of NCDs unless targeted steps are taken to assure that adequate financial and human resources are mapped for effective control and management of NCDs in the country.Summary:The Chinese government needs to develop a domestically-driven and evidence-based disease control policy and funding priorities that respond appropriately to the country’s current epidemiological transition,and rapid sociodemographic and lifestyle changes.

It’s not just science: challenges for public health intervention in Ebola epidemics in the Democratic Republic of Congo

The Democratic Republic of Congo (DRC) is suffering from the world’s second largest and most prolonged Ebola virus disease (EVD) epidemic on record (Figure 1). The current prevalence of EVD in the DRC makes this the 10th (and largest) EVD epidemic in the DRC since the first discovery of the Zaire Ebola virus in 1976 (Ilunga Kalenga, 2019).Globally, it is the second worst outbreak in the history of Ebola epidemics.