Access Services Research Articles

Measuring postal access and direct delivery services among Native American reservations in Montana and South Dakota

ABSTRACT Over the past two decades voting by mail has increased. As the COVID-19 pandemic disrupted the 2020 political season, absentee voting increased to over 43% of all votes cast in the November Presidential Election. In recent years, many states have passed laws to limit the scope of absentee voting as necessary to curtail voter fraud. Though no evidence exists that fraud is more likely with mail-in voting, such laws have been found to have a disproportionate impact on some groups of voters more than others. This is true of many Native American communities that often rely on absentee voting. This study will utilize geospatial methods to examine postal realities for Native American on reservations in Montana and South Dakota. By illustrating where postal services are or are not located, a fuller contextual analysis of the issue can be provided. Such methods can enhance current methodologies utilized by political geographers.

Application of Wayfinding Principles in the Design of Nigerian Immigration Service Command’s Office Complex in Bauchi State, Nigeria

This paper explores the application of wayfinding principles in the proposed design of the Nigeria Immigration Service Command Office Complex in Durum, Bauchi State. Wayfinding principles aim to enhance navigation and spatial orientation within built environments. It investigates how effective wayfinding systems can enhance user experience, improve navigation efficiency, and support the operational needs of the complex. The research aims to identify specific wayfinding strategies tailored to the unique requirements of the Nigeria Immigration Service, considering cultural, environmental, and functional factors. The study adopted a qualitative research approach, involving a literature review and a case study of the Nigeria Immigration Service Command Office Complex. The findings will provide valuable insights for architects and planners in creating intuitive and accessible public service buildings in Nigeria by incorporating various wayfinding principles, including clear signage, distinct landmarks, and intuitive circulation paths. However, some areas for improvement were identified, such as the need for more prominent signage and enhanced visual differentiation between different sections of the complex. The study concludes that the intentional application of wayfinding principles can significantly enhance the usability and navigability of public buildings like the proposed Nigeria Immigration Service Command Office Complex, Durum, Bauchi.

Navigating Legal Frontiers: Contemporary Challenges and Opportunities in the Legal Landscape

This research aims to explore the contemporary challenges and opportunities in the legal landscape, focusing on navigating the legal frontiers. A qualitative approach is employed, utilizing in-depth interviews with legal professionals, case studies, and comprehensive literature reviews. The study examines the impact of technological advancements, globalization, and societal shifts on the legal profession and its practices. The findings reveal that the legal landscape is undergoing significant transformations driven by factors such as the digitalization of legal services, the emergence of alternative dispute resolution mechanisms, and the increasing complexity of cross-border transactions. These changes pose challenges in areas such as cybersecurity, data privacy, and the need for legal professionals to adapt to evolving client expectations and market dynamics. However, the research also highlights opportunities for innovation and growth within the legal sector. The integration of legal technology, the development of specialized legal fields, and the emphasis on interdisciplinary collaboration are identified as potential avenues for enhancing efficiency, accessibility, and client-centric services. The study concludes that navigating the legal frontiers requires a proactive approach, continuous learning, and a willingness to embrace change. By recognizing and addressing these challenges and opportunities, legal professionals and institutions can better position themselves to meet the demands of an ever-evolving legal landscape.

Parental Mental Health, Gender, and Lifestyle Effects on Post-Pandemic Child and Adolescent Psychosocial Problems: A Cross-Sectional Survey in Northern Italy.

The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, an analysis was conducted to understand how these elements continue to affect young populations in the post-pandemic era. In April 2023, a comprehensive online survey was administered to families in South Tyrol, Italy, with children aged 7-19 years, to ensure age and gender representation. The survey included parent ratings and adolescent (11-19 years) self-reports using standardized instruments to measure the symptoms of mental health problems (Strengths and Difficulties Questionnaire, SDQ), anxiety (Screen for Child Anxiety Related Emotional Disorders, SCARED), and depression (Patient Health Questionnaire-2, PHQ-2). Statistical analyses included descriptive statistics, chi-square tests, and unadjusted odds ratios (ORs). Of the 4525 valid responses, 1831 were self-reported by adolescents. Notable gender differences in mental health outcomes were identified, along with significant demographic predictors, such as age, single parenthood, parental mental health problems, and immigrant background. Negative effects were associated with reduced family climate and increased screen time, whereas physical activity showed beneficial effects. Proxy reports overestimated adolescents' mental health problems, whereas self-reports tended to underestimate them. Persistent mental health problems and gender disparities highlight the need for a public health approach. This should include accessible support services, resilience building, targeted support for vulnerable families and gender-specific interventions.

The Usage of a Chat-Based Help Service for Young People: A Nationwide Descriptive Study

Adolescents with subclinical depression are at high risk of developing mental disorders. Early interventions are effective but expensive. Affordable and accessible mental health services are needed. This multimethod study obtained its sample from the database of the Finnish national chat room service and describes the usage of the service among young people in Finland. All chats between 1.1-31.12.2018 were extracted and analysed using quantitative and qualitative methods. The usage frequency was analysed with descriptive statistics, while the specific content of the chat topics was first categorised with content analysis and then quantified and analysed using descriptive statistics. The association between the demographic characteristics and the usage were analysed. A total of 839 young people used chat room services. The great majority of the chat users were girls, and half were 12-14 years old. The use of the chat room varied in terms of the number of words and the duration of the chat discussions. Based on the chat room topics, young people had complex life situations with psychological distress, difficulties related to their social living environment, or they were involved in risky behaviour. The gender and the age of the users influenced their chat room usage. The results of this study can be used in the development of mental health services for young people.

Home-based transitional cardiac telerehabilitation in older adults post coronary artery bypass grafting: A randomized controlled trial

This randomized controlled trial evaluated the effectiveness of a 12-week home-based transitional cardiac telerehabilitation (Hb-T-CTR) program on health-related quality-of-life and therapeutic self-care in older adults’ post-Coronary Artery Bypass Grafting (CABG). The intervention group (n = 57) underwent Hb-T-CTR, incorporating preoperative counseling, postoperative education, a culturally adapted video, home visits, and telephone counseling, while the control group (n = 61) received standard care. Using the Coronary Revascularization Outcome Questionnaire and the Sidani Doran Therapeutic Self-Care Measure, data were collected at three time points. Results showed significant improvements in overall scores for both health-related quality of life (t1=3.386, P = 0.001; t2=4.224, P < 0.001) and therapeutic self-care (t1=7.104, P < 0.001; t2=4.242, P < 0.001) in the intervention group compared to controls. This telehealth approach provides convenient and accessible rehabilitation services for older adults’ post-CABG and highlights the importance of integrating Hb-T-CTR into routine care for personalized rehabilitation. This study underscores the potential of telehealth tools in overcoming barriers and enhancing patient-centered interventions.

Barriers to and Benefits of Mental Health Services in College Students with and without Depression, Anxiety, and Hazardous Alcohol Use

ABSTRACT College students are at risk for mental health concerns and hazardous alcohol use, yet few access services. We examined perceived barriers to and benefits of mental health services utilization (MHSU) among college students with and without symptoms of depression, anxiety, and/or hazardous alcohol use. Second-year students (n = 756; 63.4% female, 76.3% White non-Hispanic) were asked about depression, anxiety, alcohol use, and perceived barriers to and benefits of MHSU. Approximately 20% of students reported depression symptoms, anxiety symptoms, and/or hazardous alcohol use. About 40% of students with mental health symptoms and 25% of students engaging in hazardous alcohol use reported MHSU. Cost was the most cited barrier (89.1%), while improved mental health was the most cited benefit (97.7%). Compared to males, females had greater odds of reporting cost, lack of insurance, and not knowing where to go for help as barriers and increased communication as a benefit. Students reporting depression or anxiety symptoms endorsed more barriers than students without symptoms, specifically discomfort sharing feelings with another person, wanting to handle problems on one’s own, and lack of insurance. Campus administrators and counseling centers may benefit from understanding specific perceived benefits and barriers among students to develop strategies for outreach.

“I'm not very skilled in using gadgets:” A qualitative exploration of the facilitators and barriers to using telepharmacy services among Filipino senior citizens

BackgroundTelepharmacy provides remote care by pharmacists to distant patients via telecommunications. It is a new service used in the Philippines during the COVID-19 pandemic. However, its utilization among vulnerable populations, notably senior citizens, remains relatively unexplored. ObjectiveThis study explored the facilitators and barriers to telepharmacy use among senior citizens in Pasig City, Philippines. Pasig City, a highly urbanized area in Metro Manila, is known for its quality and accessible healthcare services and has a high population of senior citizens. MethodsSix focus groups were conducted: three with telepharmacy users and three with non-users, each with 3–5 participants. Focus groups were concluded upon reaching data saturation, where no new insights emerged. Verbatim transcripts were analyzed using deductive and inductive content analysis, guided by the Health Belief Model. Coding and data management were facilitated by MAXQDA software. ResultsFilipino senior citizens recognize the convenience and reliability of telepharmacy services for healthcare advice. Their use is influenced by social factors (friends, family, social media) and personal relevance, especially for those with chronic conditions. Positive experiences increase their likelihood of continued use and recommendations to peers. However, barriers such as poor service knowledge, low self-efficacy, and limited access (lack of smartphones, unreliable internet) hinder broader adoption. ConclusionsTelepharmacy enhances the health and well-being of Filipino senior citizens by offering convenient and effective pharmaceutical care. However, barriers exist that need to be addressed through a multifaceted approach, including education and training for seniors, improved internet infrastructure, and the design of user-friendly platforms.

The Rise of Virtual Health Care: Transforming the Health Care Landscape in the Kingdom of Saudi Arabia: A Review Article.

Background: The rise of virtual healthcare underscores the transformative influence of digital technologies in reshaping the healthcare landscape. As technology advances and the global demand for accessible and convenient healthcare services escalates, the virtual healthcare sector is gaining unprecedented momentum. Saudi Arabia, with its ambitious Vision 2030 initiative, is actively embracing digital innovation in the healthcare sector. Methods: In this narrative review, we discussed the key drivers and prospects of virtual healthcare in Saudi Arabia, highlighting its potential to enhance healthcare accessibility, quality, and patient outcomes. We also summarized the role of the COVID-19 pandemic in the digital transformation of healthcare in the country. Healthcare services provided by Seha Virtual Hospital in Saudi Arabia, the world's largest and Middle East's first virtual hospital, were also described. Finally, we proposed a roadmap for the future development of virtual health in the country. Results and conclusions: The integration of virtual healthcare into the existing healthcare system can enhance patient experiences, improve outcomes, and contribute to the overall well-being of the population. However, careful planning, collaboration, and investment are essential to overcome the challenges and ensure the successful implementation and sustainability of virtual healthcare in the country.

Care-seeking for difficulties conceiving in sub-Saharan Africa: findings from population-based surveys in eight geographies.

What is the nature of women's care-seeking for difficulties conceiving in sub-Saharan Africa (SSA), including the correlates of seeking biomedical infertility care at a health facility? Care-seeking for difficulties getting pregnant was low, much of which involved traditional or religious sources of care, with evidence of sociodemographic disparities in receipt of biomedical care. Nearly all research on infertility care-seeking patterns in SSA is limited to clinic-based studies among the minority of people in these settings who obtain facility-based services. In the absence of population-based data on infertility care-seeking, we are unable to determine the demand for services and disparities in the use of more effective biomedical sources of care. We used cross-sectional, population-based data from the Performance Monitoring for Action (PMA) female survey in eight geographies in SSA, including nationally representative data from Burkina Faso, Côte d'Ivoire, Kenya, and Uganda and regionally representative data from two provinces in the Democratic Republic of the Congo (DRC) (Kinshasa and Kongo Central) and two states in Nigeria (Kano and Lagos). We employed a multi-stage cluster random sampling design with probability proportional to size selection of clusters within each geography to produce representative samples of women aged 15-49. Samples ranged from 1144 in Kano, Nigeria, to 9489 in Kenya. PMA collected these data between November 2021 and December 2022. We restricted the sample to women who had ever had sex, with analytic samples ranging from 854 in Kano to 8,059 in Kenya, then conducted descriptive and bivariable analyses to examine characteristics of those who sought care for difficulties getting pregnant. Among those who reported seeking care, we conducted bivariable and multivariable logistic regression analyses to determine factors associated with receipt of biomedical services from a health facility. All analyses were conducted separately by geography. Our study found low levels of care-seeking for difficulties getting pregnant among sexually active women in eight geographies in SSA, ranging from 3.7% (Kenya) to 15.3% (Côte d'Ivoire). Of this, 51.8% (Burkina Faso) to 86.7% (Kinshasa) involved receipt of biomedical services in health facilities. While many factors were consistently associated with infertility care-seeking from any source across geographies, factors associated with receipt of biomedical care specifically were less pronounced. This may be a result of the highly limited sources of infertility services in SSA; thus, even privileged groups may struggle to obtain effective treatment for difficulties getting pregnant. However, we did observe disparities in biomedical care-seeking in our bivariable results in several geographies, with the wealthiest women, those with more education, and those residing in urban areas generally more likely to have sought biomedical care for difficulties getting pregnant. Our data lacked details on the nature of the services received and outcomes, and we do not have information on reasons why women chose the sources they did. Small samples of women who sought care limited our power to detect significant differences in care-seeking by women's characteristics in several geographies. Infertility and access to appropriate treatment are issues of reproductive health and human rights. While our results do not indicate to what extent use of non-biomedical sources of care is driven by preferences, cost, or lack of accessible services, it is clear from our results and existing literature that more needs to be done to ensure access to affordable, quality, cost-effective infertility services in SSA. This study was supported by grants from the Bill & Melinda Gates Foundation (INV009639) and the National Institute of Child Health and Human Development (K01HD107172). The funders were not involved in the study design, analyses, manuscript writing, or the decision to publish. The authors have no conflicts of interest to declare. N/A.

Perceived barriers and opportunities of providing quality family planning services among Palestinian midwives, physicians and nurses in the West Bank: a qualitative study

BackgroundDespite advancements in family planning (FP) services, several barriers persist in the Occupied Palestinian territory (oPt), blocking women’s access to suitable, high-quality and equitable FP services. The aim of this study was to understand how healthcare providers perceive their abilities, barriers and opportunities in providing good quality FP services. Furthermore, it seeks to explore knowledge and training regarding FP among healthcare providers engaged in providing FP services.MethodsA qualitative study was undertaken from August to September 2022 in seven Primary Health Care (PHC) clinics distributed in three governorates and operating under the Palestinian Ministry of Health (MoH) in the West Bank. Semi-structured, in-depth face-to-face interviews were conducted with 13 health providers (Physicians, midwives and nurses), using an interview guide in Arabic language. Transcripts were subsequently analyzed using the six phases of reflexive thematic analysis.ResultsFP services face various challenges, including shortages in resources such as staff, supplies, infrastructures and FP methods. Midwives possess significant potentials to offer accessible, high-quality, efficient and equitable FP services, yet, their capacities remain underutilized, representing a missed opportunity for a country like Palestine. The study provided a current overview of FP services while illustrating the need for quality FP services and the need for an updated continuous education and training, updated standardized guidelines and protocols and supportive supervision are needed across all levels of healthcare providers. Finally, providers reported a wide range of structural barriers to FP services.ConclusionsIt is crucial to meticulously address both community-related and health system factors to enhance the fulfillment of FP needs and reduce unintended and closely spaced pregnancies. Policymakers should invest in the development of laws and regulations regarding FP services, promoting a comprehensive and holistic approach to FP services. This includes formulating supportive policies, capacity building of human resources and maintaining security of FP commodities.

The political economy of mini-grid electricity development and innovation in Kenya

Accessible and affordable energy services are a prerequisite for socioeconomic growth and poverty reduction. Yet it is estimated that 600 million people in sub-Saharan Africa will not have access to electricity in 2030. Recent research suggests that universal access to electricity will be achieved through a mix of centralized and decentralized systems and that the diffusion of these technologies is a socio-technical process involving multiple actors. These actors include firms, networks, energy users, and government agencies that interact within a political landscape to deliver innovation within energy service systems. Thus, factors related to the political economy can impact the process of innovation and warrant analysis. This study aims to provide an analysis of the political economy factors that can influence the emergence of mini grid electricity development in the African context exemplified in Kenya as a case study. The study uses the Technology Innovation Systems (TIS) lens as an analytical framework to provide a critical analysis of how political economy factors have influenced the development of mini grid electricity in Kenya. The result shows that despite the presence of some favorable conditions for innovation, political economy factors significantly impede the deployment of mini grids in Kenya. Power and vested interests have created negative competition between public and private developers, limiting knowledge and information diffusion between actors and stalling mini grid developments where they are most needed.

Evolution of transgender rights in India: Better late than never.

The progress of transgender rights in India has seen significant strides with milestones such as the National Legal Services Authority (NALSA) judgment and the enactment of the Transgender Persons (Protection of Rights) Act in 2019. The NALSA judgment recognized the right of transgender individuals to self-identify their gender. This decision led to the formal recognition of a 'third gender', advancing legislative and social reforms. Prior to this, transgender individuals faced substantial hurdles, including limited access to education, employment, and healthcare due to a lack of legal recognition. Within a few years, The Transgender Persons (Protection of Rights) Act established a framework that safeguards the rights of transgender individuals and prohibits discrimination based on gender. This legislation requires the government to take measures like promoting education, providing vocational training opportunities, ensuring accessible healthcare services, and offering social security support. It also addresses the healthcare needs of transgender individuals thereby contributing to their overall well being. The Support for Marginalised Individuals for Livelihood and Enterprise (SMILE) program and Garima Greh are initiatives that provide spaces and empower a marginalized transgender individuals and promoting their inclusion, justice and empowerment. This article explores the progress pertaining to transgender rights and welfare, while highlighting efforts undertaken by the Indian government.

Biosocial environmental faces of climate variability in health care: A systematic review

Introduction: Human health is directly impacted by climate variations, leading to changes in weather patterns (e.g., heat waves, droughts, floods, storms), as well as indirectly affecting water, air, and food quality. This research aims to explore key strategies for addressing environmental risks resulting from climate variations in the healthcare sector. Methods: A systematic analytical approach was employed in this investigation, examining studies on climate change adaptation from 2022 to 2023. English publications were sought in renowned databases like Elsevier, PubMed, Web of Science, and Scopus. The search process consisted of two phases. Initially, articles focusing on climate change, climate variability, and global warming were identified using keywords like "Climate change," "Climate variability," and "Global warming." Subsequently, relevant articles were chosen for examination and analysis, using terms such as "Health," "Exposure," "Infectious disease," "Mental health," "Adaptation," and "Mitigation." Results: Primary healthcare systems are essential for enhancing resilience at both individual and community levels, acting as a critical framework for safeguarding global populations through accessible, cost-efficient, responsive, and dependable healthcare services. The evaluation of selected studies underscores the necessity of establishing resilient healthcare systems to counter climate change through adaptive or resilience-focused and mitigative strategies. Recommendations include bolstering the capacity of these systems, enhancing efficient and iterative risk management across all tiers, fostering collaboration across various sectors, formulating action plans, and making short- and long-term investments to enhance adaptability. Conclusion: Pivotal in safeguarding global populations, healthcare systems should prioritize the reinforcement of social resilience by implementing adaptive and mitigative measures in response to climate change.

P-473 Assessing patient perceptions: emotional support and clinic culture in fertility care. Examining changes in emotional support and clinic culture over 4 years

Abstract Study question How do patients perceive emotional support and clinic culture in the context of fertility care, what factors contribute to their overall experiences within fertility clinics? Summary answer Patients find clinic support lacking, rated 4.8/10, with &amp;lt;45% perceiving a supportive clinic culture. Despite increased awareness, emotional support perception declined from 2019 to 2023. What is known already Despite abundant research emphasising the necessity of psychosocial care in fertility treatment, notably by ESHRE, patients’ experiences indicate clinics are not consistently following these guidelines or offering sufficient emotional support. UK studies by the Human Fertilisation and Embryology Authority and Fertility Network emphasise the genuine emotional toll of fertility treatment, revealing that 40% of women undergoing treatment have experienced suicidal thoughts. These findings underscore the critical need for robust emotional support throughout the treatment journey. Study design, size, duration This study involved surveying 210 respondents undergoing fertility treatment. Employing an online survey format, disseminated within my online support communities (approx. 7,000 individuals), the study incorporated both qualitative and quantitative questions. Responses were collected across two distinct periods, 2019 and 2023, providing a comprehensive understanding of patients’ emotional experiences over the 4-year interval. Participants/materials, setting, methods The study gathered insights from 210 global respondents (97% receiving treatment in the UK, 3% in Europe and the USA), all participants were fertility patients undergoing treatment. Cohorts were surveyed in 2019 and 2023, responding to a 10-question online survey. This design enabled a comprehensive exploration of diverse perspectives on emotional support within fertility care over the specified 4-year period. Main results and the role of chance The study reveals a significant disparity between perceived and actual emotional support in fertility clinics. Despite clinics asserting excellence in support, patients rated the emotional support they received at 4.8 out of 10. An alarming 58% expressed scepticism about their clinic fostering a culture of support embraced by all staff, showcasing a disconnect between clinic claims and patient experiences. The study determined a decline in perceived support levels from 2019 to 2023, from 5.3/10 in 2019 to 4.6/10 in 2023. This downward trend raises concerns about the efficacy of efforts to enhance emotional support over the years despite an escalating focus and awareness surrounding the emotional challenges of fertility treatment. The participants’ qualitative responses unveiled a recurring theme across 2019 and 2023, indicating a persistent lack of improvement in emotional support. Patients felt like part of a production line, reduced to mere numbers in the clinic during their treatment journey. A resounding 66% of respondents expressed a desire for more accessible support services within their clinics. This study’s comprehensive findings shed light on the critical need for clinics to re-evaluate and fortify their emotional support infrastructure, ensuring it aligns with patient expectations and contributes positively to their overall experience. Limitations, reasons for caution Differences in participant demographics over study years may influence individual perspectives. Feedback could be influenced by participants’ mood on the survey day, and the global online distribution encompassing diverse clinics adds variability to responses. Wider implications of the findings The study reveals a gap in emotional support provision despite extensive research on IVF’s emotional impact. Patients hesitate to voice concerns, contributing to treatment dropout rates. Addressing this, the study suggests guidelines to help clinics establish a supportive culture from initial contact, potentially reducing dropout rates and improving patient experiences. Trial registration number not applicable

Access and Equity in Australian Higher Education: The Equity Initiatives Framework Version 2.0

Australia's higher education sector has seen substantial developments in equity and inclusivity as a result of initiatives which work to improve the numbers and experiences of students from a wide diversity of backgrounds. This practice report shares learnings from a recent national project about the impacts of a wide range of access and equity programs and services, shedding light on effective strategies throughout the student life cycle. The study, known as the Critical Interventions Framework Part 3 (CIF 3), analysed published studies which provide details about the impact of initiatives, highlighting the mechanisms which have enabled students to gain access to and succeed in higher education. The focus here is on a key outcome of the CIF 3, the updated Equity Initiatives Framework (EIF), designed for utility as a quick reference guide to aid equity practitioners and others working to support students in their educational endeavours.

Using digital technology to reduce drug-related harms: a targeted service users’ perspective of the Digital Lifelines Scotland programme

BackgroundDeaths due to drug overdose are an international issue, causing an estimated 128,000 global deaths in 2019. Scotland has the highest rate of drug-related deaths in Europe, with those in the most deprived areas at greater risk than those in affluent areas. There is a paucity of research on digital solutions, particularly from the perspective of those who use drugs who additionally access harm reduction and homelessness support services. The Digital Lifelines Scotland programme (DLS) provides vulnerable people who use/d drugs with digital devices to connect with services.MethodsThis paper reports on the evaluation of the DLS from the perspective of service users who accessed services for those at risk of drug-related harms. A mixed methods approach was used including an online-survey (n = 19) and semi-structured interviews (n = 21). Survey data were analysed descriptively and interview data through inductive coding, informed by the Technology, People, Organisations and Macroenvironmental factors (TPOM) framework, to investigate the use, access, and availability of devices, and people’s experiences and perceptions of them.ResultsMost participants lived in social/council housing (63.2%, n = 12), many lived alone (68.4%, n = 13). They were mainly over 40 years old and lived in a city. Participants described a desire for data privacy, knowledge, and education, and placed a nascent social and personal value on digital devices. Participants pointed to the person-centred individuality of the service provision as one of the reasons to routinely engage with services. Service users experienced an increased sense of value and there was a palpable sense of community, connection and belonging developed through the programme, including interaction with services and devices.ConclusionsThis paper presents a unique perspective which documents the experiences of service users on the DLS. Participants illustrated a desire for life improvement and a collective and individual feeling of responsibility towards themselves and digital devices. Digital inclusion has the potential to provide avenues by which service users can safely and constructively access services and society to improve outcomes. This paper provides a foundation to further cultivate the insight of service users on digital solutions in this emerging area.

Effect of Exclusive Breastfeeding on the Risk of ARI in Under-Five Children: Literature Review

Introduction: Acute Respiratory Infection (ARI) is a major health problem in under-five children which can cause death. Exclusive breastfeeding can prevent infections, one of which is ARI. Objective: This study aims to examine the relationship between exclusive breastfeeding and the risk of ARI in under-five children. Method: This research uses a literature review approach which measures the relationship between exclusive breastfeeding and the risk of ARI in under-five children. The data source uses secondary data in the form of articles obtained through two databases, namely Scopus and Springer Link. Result: There are 5 articles that meet the requirements for research. Four out of five articles prove that exclusive breastfeeding reduces the risk of children under five getting ARI. The finding of a higher risk of ARI in the group of children under five who are not exclusively breastfed can be caused by a decrease in the immunity of children under five, seeing that breast milk is proven to fight infection. The content of sIgA and lactoferrin in breast milk and immunization can increase the immune system in children under five who suffer from ARI. Conclusion: Breast milk has nutrients in it which are useful for preventing infectious diseases, such as ARI and pneumonia in children under five. Given the influence on the health of children under five, the findings of this study demonstrate the need for improvements in breastfeeding programs, with a particular emphasis on exclusive breastfeeding and ARI management. There is a need for widely accessible health workers, information, and services connected to care for moms.

Advancing Programme Science approaches to understand gaps in HIV prevention programme coverage for key populations in 12 Nigerian states: findings from the 2020 Integrated Biological and Behavioural Surveillance Survey.

Effective HIV prevention programme coverage is necessary to achieve Nigeria's goal of ending the epidemic by 2030. Recent evidence highlights gaps in service coverage and utilization across the country. The Effective Programme Coverage framework is a Programme Science tool to optimize a programme's population-level impact by examining gaps in programme coverage using data generated through programme-embedded research and learning. We apply the framework using Integrated Biological and Behavioural Surveillance Survey (IBBSS) data from Nigeria to examine coverage of four prevention interventions-condoms, HIV testing, and needle and syringe programmes (NSP)-among four key population groups-female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID) and transgender people. Data from Nigeria's 2020 IBBSS, implemented in 12 states, were analysed to examine HIV prevention programme coverage among key populations. For each key population group and prevention intervention of interest, weighted IBBSS data were used to retrospectively generate coverage cascades that identify and quantify coverage gaps. Required coverage targets were informed by targets articulated in Nigeria's National HIV/AIDS Strategic Framework or, in their absence, by guidelines from policy normative bodies. Availability-, outreach- and utilization coverage proxy indicators were defined using variables from IBBSS data collection tools. Sankey diagrams are presented to visualize pathways followed by participants between coverage cascade steps. Required coverage targets were missed for HIV testing and NSP among all key population groups. Condom availability coverage surpassed required coverage targets among FSW and MSM, while utilization coverage only among FSW exceeded the 90% required coverage target. Outreach coverage was low for all key population groups, falling below all required coverage targets. Our findings identify critical gaps in HIV prevention programme coverage for key populations in Nigeria and demonstrate non-linear movement across coverage cascades, signalling the need for innovative solutions to optimize coverage of prevention services. Programme-embedded research is required to better understand how key population groups in Nigeria access and use different HIV prevention services so that programmes, policies and resource allocation decisions can be optimized to achieve effective programme coverage and population-level impact.

Efficient Resource Allocation of Slicing Services in Softwarized Space-Aerial-Ground Integrated Networks for Seamless and Open Access Services

Efficient Resource Allocation of Slicing Services in Softwarized Space-Aerial-Ground Integrated Networks for Seamless and Open Access Services