Health-related Sustainable Development Goals Research Articles

Rates and Causes of Neonatal Mortality In North-West of Iran

Background: The neonatal mortality rate (NMR) is a crucial indicator of a country's population health Objectives: This study aims to assess the rates and causes of NMR in West Azerbaijan. Methods: This population-based cross-sectional study utilizes data from the Child Mortality Surveillance System (CMSS) spanning from 2013 to 2022. The study population comprised all neonates (< 28 days old) with permanent residency in any of the 17 cities within the West Azerbaijan province who died within the stated period. Mortality rates, both all-cause and cause-specific, were determined per 1 000 live births for the years 2013, 2016, and 2022. Results: The investigation covered 3 689 reports of neonatal deaths (< 28 days old) from 2013 to 2022. Of these, 53% were males, with an average gestational age of 31.85 ± 5.56 weeks. Over 72% of the deaths occurred in preterm infants, and 69% were linked to cesarean section deliveries. Perinatal prematurity was the leading cause of death during the periods examined, with rates of 32.3%, 35.2%, and 36.8% in 2013, 2016, and 2022, respectively. The distribution of neonatal mortality across the province was uneven, with Poldasht city experiencing the highest mortality rates and Shot city the lowest (9.13 and 2.89 per 1 000 live births, respectively). Conclusions: West Azerbaijan province has achieved the Health-related Sustainable Development Goal (SDG-3) of reducing neonatal mortality to below 12 deaths per 1 000 live births by 2030. Nonetheless, significant disparities in NMR persist across the province. Further epidemiological research and the development of targeted health programs are essential to address areas with elevated mortality rates.

'Government don't know me and if I stop, they won't know': A qualitative study on the lived experiences of volunteer health workers in the Nigerian health system and their implications for the sustainable development goals.

Volunteer health workers play an important, but poorly understood role in the Nigerian health system. We report a study of their lived experiences, enabling us to understand their motivations, the nature of their work, and their relationships with formally employed health workers in Primary Healthcare Centres (PHCs) in Nigeria, the role of institutional incentives, and the implications for attaining the health-related sustainable development goals (SDGs) targets. The study used ethnographic observation of PHCs in Enugu State, supplemented with in-depth interviews with volunteers, formally employed health workers and health managers. The analysis employed a combination of narrative and reflexive thematic approaches. The lived experiences of most volunteers unfold in four stages as they move into and out of their volunteering status. The first stage signifies hope, arising from the ease with which they are accepted and integrated into the PHC space. The anger stage emerges when volunteers confront the marked disparity in their treatment compared to formal staff, despite their substantial contributions to healthcare. Then, the bargaining stage sets in, where they strive for recognition and respect by pursuing formal employment and advocating for fair treatment and improved stipends. A positive response, such as improved stipends, can reignite hope among volunteers. If not, most volunteers transition to the acceptance stage - the acknowledgement that their status may never be formalised, prompting many to lose hope and disengage. There should be a clear policy on recruitment, compensation, and protection of volunteers in the health systems, to enhance the contribution they can make to the achievement of the health-related SDG targets.

Bibliometric Analysis of Artificial Intelligence Revolutions in Healthrelated Sustainable Development Goals

Background: In line with the advancement of Artificial Intelligence (AI), innovative solutions have been designed to improve healthrelated Sustainable Development Goals (SDGs). Accordingly, there is an increasing trend in the realm of AI and SDG research areas.
 Objectives: This study aimed to analyze the trends and patterns of AI research in health-related SDGs using bibliometric analysis.
 Methods: The bibliometric approach facilitated the identification of key terms and countries from previous research. We used VOSviewer to map and analyze data obtained from three databases: Scopus, Web of Science, and PubMed.
 Results: Our findings illustrated that research on health has been a popular area of study in recent years. In particular, we observed a significant increase in research on AI in health-related SDGs during 2015 - 2022.
 Conclusions: This study provides insights into the trends and patterns of AI research in health-related SDGs using bibliometric analysis. The findings can guide future research by identifying key terms that require further investigation.

Role of social entrepreneurship in meeting the health-related UN sustainable development goals 2030 in India

Role of social entrepreneurship in meeting the health-related UN sustainable development goals 2030 in India

Mortes maternas como desafio para a assistência obstétrica em tempos da Covid-19 no Brasil

Abstract Objectives: to describe the effects of the Covid-19 pandemic on maternal mortality in Brazil in 2021. Methods: it is an exploratory study with description of the excess maternal mortality in Brazil for 2021, considering different scenarios: (i) 2015-2019 linear trend; (ii) 2020 observed number of deaths; (iii) 2015-2019 linear trend corrected for general mortality excess; (iv) 2020 observed number of deaths corrected for general mortality excess. Results: compared to the trend of the previous five years, the year 2021 showed an excess mortality of 39% (n=3030). The maternal mortality ratio for 2021 drastically exceeded the SDG target for this indicator, reaching approximately 110 maternal deaths per 100,000 live births. In any scenario described, there will be excess maternal mortality in 2021 higher than general mortality and higher than level presented in 2020. Analysis stratified by region demonstrates subnational heterogeneity. Conclusion: Covid-19 pandemic had a considerable impact on maternal health, not only by leading to increased deaths but also by increasing social health inequality. The year 2021 was the most critical period of the pandemic regarding the magnitude of mortality. Barriers to accessing and using essential health services are challenging to achieving health-related Sustainable Development Goals.

Factors associated with adolescent pregnancy in Maharashtra, India: a mixed-methods study

Reducing the adolescent birth rate is paramount in achieving the health-related Sustainable Development Goals, given that pregnancy and childbirth are the leading cause of mortality among young women aged 15–19. This study aimed to explore predictors of adolescent pregnancy among girls aged 13–18 years in Maharashtra, India, during the COVID-19 pandemic. Using a mixed-methods approach, primary data were gathered from two regions in Maharashtra between February and April 2022. Quantitative data from face-to-face interviews with 3049 adolescent girls assessed various household, social, and behavioural factors, as well as the socioeconomic and health impacts of COVID-19. Qualitative data from seven in-depth interviews were analysed thematically. The findings reveal that girls from low socioeconomic backgrounds face a higher likelihood of adolescent pregnancy. Multivariable analysis identified several factors associated with increased risk, including older age, being married, having more sexual partners, and experiencing COVID-19-related economic vulnerability. On the other hand, rural residence, secondary and higher secondary education of the participants, and higher maternal education were associated with a decreased likelihood of adolescent pregnancy. In the sub-sample of 565 partnered girls, partner's emotional abuse also correlated with higher rates of adolescent pregnancy. Thematic analysis of qualitative data identified four potential pathways leading to adolescent pregnancy: economic hardships and early marriage; personal safety, social norms, and early marriage; social expectations; and lack of knowledge on contraceptives. The findings underscore the significance of social position and behavioural factors and the impact of external shocks like the COVID-19 pandemic in predicting adolescent pregnancy in Maharashtra, India. Plain Language Summary: Adolescent pregnancy is an important health issue for young girls. In South Asia, one out of every five adolescent girls becomes a mother before turning 18, and in India, around 9% of girls aged 15–19 get pregnant yearly. This study focused on understanding the factors associated with adolescent pregnancy in Maharashtra, India, especially after the COVID-19 pandemic. We collected information from both urban and rural areas in Maharashtra. A total of 3049 adolescent girls participated in a survey, and seven girls participated in detailed interviews. Our analysis showed that factors like older age, being married, having multiple sexual partners, and experiencing economic difficulties due to COVID-19 increased the chances of adolescent pregnancy. On the other hand, living in rural areas, higher education for both the girls and their mothers reduced the likelihood of adolescent pregnancy. Qualitative analysis revealed that economic challenges, concerns about safety and societal norms, early marriage, societal expectations, and lack of knowledge about contraceptives could contribute to adolescent pregnancy in Maharashtra.

Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping review

IntroductionImproving healthcare quality in low-/middle-income countries (LMICs) is a critical step in the pathway to Universal Health Coverage and health-related sustainable development goals. This study aimed to map the available...

Health Literacy in Ethiopia: Evidence Synthesis and Implications.

Health literacy plays a pivotal role in healthcare utilization and health-related lifestyle choices. This makes health literacy a pressing concern, particularly in low-income countries like Ethiopia, where there are intricate health challenges. Despite its significance, there is a dearth of studies on the issue in Ethiopia. This study aimed to provide a comprehensive synthesis of the available evidence on health literacy in Ethiopia, and to discuss the implications for healthcare practice, health promotion, and research endeavors. A systematic scoping review was conducted to achieve the purpose of this study. A comprehensive search of databases such as PubMed, CINAHL, AJOL, and PLOS Global Public Health was conducted for eligible evidence. Searches were conducted from May 12 to September 9, 2022. The PRISMA flow diagram guideline was utilized to ensure transparent reporting of the reviews process. The data extraction tool used was based on the JBI methodology guidance for reviews. The search in total yielded 543 records. However, only 16 studies met the eligibility criteria after a thorough screening process. All eligible studies were conducted in health facilities and schools with limited scopes. The main findings of the eligible studies focused on health literacy levels, health information sources, and health literacy determinants among the studies participants. Many of the studies reported low health literacy levels and multiple predicting factors ranging from personal to socioeconomic conditions among the respondents. This review has provided critical insights into the state of health literacy in Ethiopia. There is a need for comprehensive research and the development of context-appropriate health literacy measurements tailored to the Ethiopian context, as well as evidence-based health literacy interventions. Prioritizing health literacy as a key research and intervention area is essential for improving the health of individuals and populations and achieving health-related Sustainable Development Goals in Ethiopia.

Space Based Application For The Inventory, Distribution And Analysis Of Healthcare Facilities In Nasarawa State, Nigeria

The study aimed at carrying out the inventory, distribution and analysis of healthcare facilities in Nasarawa state using remote sensing and geographic information system (GIS) techniques. Field mapping was conducted and coordinates with attributes of these healthcare facilities were recorded. GIS analysis using multiple ring buffer and cluster extension of the spatial analysis tool in ArcGIS 10.8 version was used. Result revealed a total of 1,119 healthcare facilities distributed across the state. Out of which 807 are government primary healthcare, while 227 are private primary and 24 government secondary whereas 60 are private secondary and one tertiary healthcare facility. Result also revealed significant disparities in the distribution of government tertiary healthcare facilities across the local government areas with only having such facility in the whole of Nasarawa State. This indicates limited access to specialized healthcare services. The general trend of health facilities in Nasarawa state is towards clustering because these facilities are intended to reside close to settlements and thus will present some degree of clustering though the level may differ between different types of facilities. The buffer analysis in secondary healthcare showed a wide number of settlements by local government that need more present of secondary healthcare facility in Nasarawa state showing good accessibility of health care facility to the settlement within 1 km and 10 km radius. The government own primary healthcare facilities record a z-score of -17.52725 and 0.677488 nearest neighbour ratio suggesting a very strong trend towards clustering, and from the analysis, there is a less than 1% chance of randomness or dispersion. This indicates that there is a lot needs to be done to ensure a more dispersed and competitive distribution of these facilities. The private primary healthcare facilities have a z-score of -18.527370 and nearest neighbour ratio of 0.357209, which shows very significant clustering alongside an identical 1% probability of random distribution. This clearly indicates that there is need for strategic planning and resource allocation to the health sector to ensure an equitable, dispersed and competitive distribution of these facilities. The findings from this study have implications for the actualization of the United Nations’ health-related Sustainable Development Goal (SDG-3) and also to achieve the Universal health coverage.

Health examination surveys for policy formulation

Abstract Health examination surveys (HES) are one of the key data sources for health policy formulation and evaluation as well as monitoring of several health related Sustainable Development Goals (SDG) and other internationally agreed indicators for NCDs. The presentation will 1) highlight importance of health examination surveys in reporting accurately SDG and other internationally agreed NCD indicators; 2) Identify internationally agreed NCD indicators for which HES is used as data source; 3) give an overview of current levels of implementation of HES in the WHO European Region; and 4) Briefly describe available WHO tools related to HES.

Why move abroad? Factors influencing migration intentions of final year students of health-related disciplines in Nigeria

BackgroundLimited human resource for health may impede the attainment of health-related sustainable development goals in low-income countries. This study aims to identify migration factors among final-year students of health-related disciplines at a Nigerian university, reflecting trends in Nigeria and sub-Saharan African countries.MethodsA cross-sectional study was conducted using a semi-structured, self-administered questionnaire to collect data from 402 final-year students of Medicine/Dentistry, Nursing, Pharmacy and Occupational therapy Physiotherapy at Obafemi Awolowo University, Ile Ife. Univariate, bivariate and multivariate data analysis were conducted and a p-value < 0.05 was taken as statistically significant.ResultsThe mean age of the respondents was 24.3 ± 2.3 years. Most (326; 81.1%) respondents had intentions to migrate and majority (216; 53.7%) of respondents had an unfavourable attitude towards practising in Nigeria. Students of Nursing constitute the highest proportion (68; 91.9%) of those willing to migrate (p = 0.009). The common preferred destinations for those who intend to migrate were the United Kingdom (84; 25.8%), Canada (81; 24.8%), and the United States of America (68; 20.9%). Respondents who had favourable attitude towards practicing abroad (AO.R: 2.9; 95% C.I 1.6–5.2; p = 0.001) were three times more likely to have migration intentions compared with those who had an unfavourable attitude towards practicing abroad, while the odds for those who had favourable attitude towards practicing in Nigeria (AO.R: 0.4; 95% C.I 0.2–0.7; p = 0.002) was two times less than those who had an unfavourable attitude towards practice in Nigeria. Respondents who desire specialist training (AO.R: 3.0; 95% C.I 1.7–5.4; p < 0.001) were three times more likely to have intention to migrate abroad when compared to those who were undecided or had no desire to pursue specialist training.ConclusionMost respondents had the intention to migrate abroad after graduation and this could be attributed to the desire for specialist training and their attitude towards practising in Nigeria. Interventions aimed at improving specialist training in Nigeria and incentivizing health care practice may reduce migration trends among Nigeria’s health professionals in training.

Health data ecosystem in Pakistan: a multisectoral qualitative assessment of needs and opportunities

ObjectiveData are essential for tracking and monitoring of progress on health-related sustainable development goals (SDGs). But the capacity to analyse subnational and granular data is limited in low and middle-income...

Reallocation of Cameroon’s Public Health Budget from the Central Administration to Regional Level: Is it Worthwhile?

Cameroon is a “decentralized unitary State” but is financially centralized. Its health sector faces inequities in financial resource allocation from central to peripheral levels generating significant disparities in healthcare delivery at the regional, district, and health facility levels. Despite a 68.3% increase in national financial allocation and 100% budget execution, the resource allocation inequities persist, with less than 50% of the resources allocated to integrated health centers reaching the intended benefactors. The main questions analysed are: why are most of the finances allocated to the Central level, and what current structures can be adapted to effectively “decentralize” the financial resources? The advantages of decentralizing health systems include increased efficiency, quality of health services, promotion of accountability and local governance of the health system, and 'shock-absorber' effects. Recommendations on making this budget reallocation sustainable in Cameroonian will eventually come through organizational change and the use of needs-based reallocation formulae to ensure objectivity and dilute subjectivity. Central Administration to act as a regulator with an ombudsman from the National Anti-Corruption Commission or the office of the Public Independent Conciliator to prevent financial leakages at the district and regional health levels. A close-to-ground governance system will help resolve staff absenteeism, motivation, career management, and retention issues. Centralization is needed to steer national policies, but decentralization will prevent embezzlement and corruption, avoid supply delays, promote Universal Health Coverage application, local autonomy tailored to the specific needs of different health districts and assist in achieving Sustainable Development Goal 3 and other health-related SDGs.

The Significance of Traditional and Complementary Medicine to Self-Care and Addressing Global Health Challenges: Advancing the Commitments of the Declaration of Astana Through a Strong Research Program.

The Declaration of Astana (DoA) developed at the Global Conference on Primary Health Care (PHC) in 2018 outlined a number of core commitments and aspirations that fall in line with the broader vision for advancing global health, addressing a number of health-related sustainable development goals and ultimately ensuring health for all. Two specific goals of the DoA that are of particular interest and concern to the argument posited here are as follows: "to build sustainable primary health care" and "to empower individuals and communities." Moreover, these specific goals and the broader declaration all point to and "highlight the importance of empowering individuals as self-carers." However, it would appear that the conception of PHC, the related health workforce and the types of self-care activities, practices and initiatives envisioned within the DoA fail to explicitly accommodate or fully acknowledge the importance of both traditional and complementary medicine (T&CM) and more specifically "T&CM self-care" in strengthening the health of all communities. The aim of this editorial is to help articulate the significance of T&CM to self-care and as a consequence to the success of the DoA and wider desired advances in global health.

Maternal mortality in Colombia during the COVID-19 pandemic: time series and social inequities

ObjectiveThe impact of the COVID-19 pandemic goes beyond morbidity and mortality from that disease. Increases in maternal mortality have also been described but have not been extensively studied to date....

Mapping of national population-based surveys for better reporting of health-related indicators in the Eastern Mediterranean Region

BackgroundPopulation-based surveys are the main data source to generate health-related indicators required to monitor progress toward national, regional and global goals effectively. Although the Eastern Mediterranean Region of World Health Organization (WHO) member states conduct many population-based surveys, they are not led regularly and fail to provide relevant indicators appropriately. Therefore, this study aims two-fold: to map out population-based surveys to be conducted data for the health-related indicators in the Region and propose a timetable for conducting national population-based surveys in the Region.MethodsThe study was conducted in six phases: 1) Selecting survey-based indicators; 2) Extracting and comparing relevant survey modules; 3) Identifying sources of data for the indicators; 4) Assessing countries' status in reporting on core health indicators; 5) Review and confirmation of the results by the experts.ResultsPopulation-based surveys are the sources of data for 44 (65%) out of 68 regional core health indicators and two (18%) out of 11 health-related Sustainable Development Goals (SDG) 3 indicators. The Health Examination Survey (HES) could cover 65% of the survey-based indicators. A total of 91% of survey-based indicators are obtained by a combination of HES, Demographic and Health Survey (DHS), Multiple Indicator Cluster Survey (MICS) and Global School-based Student Health Survey (GSHS).ConclusionIn order to effectively report health-related indicators, HES, DHS/MICS and GSHS are considered essential in national survey timetables. Each country needs to devise and implement a plan for population-based surveys by considering factors such as national health priorities, financial and human capacities, and previous experiences.

Analysis of Spatial Distribution of Health Care Facilities and its Effects on Access to Primary Healthcare in Rural Communities in Kpandai District, Ghana

Despite collaborative efforts by the government and the private sector in the provision of health facilities in Ghana, a substantial proportion of communities in rural Ghana still have poor access to primary health care. Employing a case study research design, this study presents an overview of the geographic distribution of healthcare facilities in Kpandai District and access to primary health care. Focus group discussions and interviews were conducted with randomly selected households, opinion leaders, healthcare and in-charges of health facilities to ascertain their perception of accessibility to health services. Geographic Information System (GIS) (ArcMap) was used to model the spatial distribution of health facilities. Spatially, 139 communities representing 50.5% of the communities are not accessible health facilities per World Health Organization and Ghana Health Service Survive distance threshold to health centers and Community-based Health Planning and Services (CHPS), and hospitals, respectively. Ideally, this implies that the majority of the population have to travel for more than 5 km to access health care services. This study found that the poor spatial distribution of health facilities has negative implications on access to primary health care in the district. Poor conditions of roads were a major barrier to the household’s accessibility to district hospitals. In addition to this, the availability, affordability, adequacy and acceptability which are major determinants of access to primary health care delivery were found to be fairly good. These findings have implications for the realization of the United Nations’ health-related Sustainable Development Goals.

Understanding medical corruption in China: a mixed-methods study.

Medical corruption is a significant obstacle to achieving health-related Sustainable Development Goals. However, the understanding of medical corruption is limited, especially in developing countries. As the largest developing country, China is also plagued by medical corruption. By employing a mixed-methods design and combining data from three resources, this study attempts to examine patterns of medical corruption in China, explore its key drivers and investigate the perceived effectiveness of recent anti-corruption interventions. Using extracted data from 3546 cases on the China Judgments Online website between 2013 and 2019, we found that bribery, embezzlement and insurance fraud accounted for 68.1%, 22.8% and 9.1% of all medical corruption cases, respectively. Bribery was the major form of medical corruption. Approximately 80% of bribe-takers were healthcare providers, and most bribe-givers were suppliers of pharmaceuticals, medical equipment and consumables. Using a nationally representative household survey, we further found that the prevalence of informal payments from patients remained at a low level between 2011 and 2018. In 2018, only 0.4% of outpatients and 1.4% of inpatients reported that they had ever given 'red envelopes' to physicians in the past. Finally, we conducted interviews with 17 key informants to explore drivers of medical corruption and investigated the perceived effectiveness of recent anti-corruption interventions in China. Interview results showed that financial pressure and weak oversight were two main reasons for corrupt behaviours. Interview results also suggested that the anti-corruption campaign since 2012, the national volume-based procurement, and the special campaign against medical insurance fraud had reduced opportunities for medical corruption, implying China's positive progress in combating medical corruption. These findings hold lessons for anti-corruption interventions in China as well as other developing countries.

Physical-mental health and awareness of HIV/STIs among men who have sex with men in selected cities of India

BackgroundMen who have Sex with Men being sexual minorities are a vulnerable section of society and are at greater risk of ill-treatment if they are ‘out of the closet’ regarding their sexuality. Previous evidence suggests that they experienced heightened susceptibility to physical and mental illnesses owing to widespread discrimination and victimization across different walks of life, particularly in developing countries. However, there is a paucity of sound data and scientific understanding related to linkages between physical-mental health and awareness about Human Immunodeficiency Virus/Sexually Transmitted Infections among Men who have Sex with Men in the Indian context.MethodsUsing a mixed-method approach, the present study examined the association between physical-mental well-being and awareness of comprehensive Human Immunodeficiency Virus/Sexually Transmitted Infections/relevant health behaviours based on primary data collected from 300 respondents from six selected metro cities in India. Descriptive statistics, chi-square test and binary logistic regression model have been used for the quantitative data analyses. In-depth interviews were conducted to contextualize and appreciate the substantive meanings and significance coming out from the quantitative results with the lived experiences of the study respondents.ResultsFinding suggests that one-fourth of the respondents were experiencing long-term illnesses while close to four out of ten respondents experienced short-term illnesses. About one-third of the respondents experienced disordered eating behaviour and mood swings. Close to one-fifth of the respondents reportedly contemplated suicidal thoughts. Awareness related to Sexually Transmitted Infections and preventive measures related to Human Immunodeficiency Virus risk was considerably low among Men who have Sex with Men.ConclusionAwareness about sexual and reproductive health issues among Men who have Sex with Men needs to be strengthened to curtail the disproportionate risk and vulnerability of Human Immunodeficiency Virus and Sexually Transmitted Infections. The public healthcare system needs to be sensitized and upgraded to cater user-friendly quality healthcare services, without any discrimination against sexual minorities including Men who have Sex with Men. Furthermore, generating public awareness about gender and sexuality-related matters and reducing stigma and discrimination is critical for achieving the health-related sustainable development goals in India without leaving no one behind.

Process of developing Country Cooperation Strategy in Tanzania, as an effective tool for aligning WHO's support to the member state in achieving health and health-related sustainable development goal.

an organization's long-term success and relevance are linked with compelling strategic development. To that end, the country office of WHO in the United Republic of Tanzania, in collaboration with stakeholders, developed a 6-year Country Cooperation Strategy (CCS), 2022-2027. This paper describes the various steps taken in developing the CCS for the United Republic of Tanzania. we reviewed the global guideline for the development of CCS. In addition, we analysed documents on the national health sector strategic plan, the 13th Global Program of Work for WHO (GPW13), and the Sustainable Development Goal (SDG). We also reviewed data from routine HMIS, the Global Burden of Disease (GBD), and assessment results of the UN on the status of SDGs through the Common Country Assessment (CCA). the performance on the overall Universal Health Coverage (UHC) effective coverage index, on a scale of 0-100, for Tanzania improved from 45.2 in 2010 to 55.2 in 2019. Strengthening health systems, protecting communities against public health emergencies, reducing or controlling exposure of individuals to risk factors, and better health governance, leadership, and accountability were the identified priorities for the CCS. the process of alignment of the CCS document with the national and global strategic goals would help the WHO to support and lead the country's effort towards achieving health-related SDGs. We believe the process we employed will lead to having detailed operational plans for implementation for achieving SDG targets. Country cooperation strategy (CCS), sustainable development goal (SDG), strategic document, 13th global program of work (GPW13), health sector strategy, stakeholders, Tanzania.