Monitoring systems exist for clinical research transparency in high-income countries, but systematic assessment of these practices in global health (GH) research (GHR) is limited. We evaluated methods for monitoring GHR transparency and engagement.

Cross-sectional study.

Three sources were used: (a) ClinicalTrials.gov, (b) publications from 20 journals with ‘international’ or ‘global’ in the title and (c) outputs from selected GH funder websites.

From ClinicalTrials.gov, we selected 200 interventional trials on maternal health and tuberculosis (2008–2019), ensuring two-thirds were from low- and middle-income countries (LMIC). From journals, we included 200 trial publications (2011–2023). From funder websites, we included outputs with sufficient metadata to track trial registration and reporting.

Trials were extracted independently by two reviewers for result publications; journal articles were screened to confirm whether they reported trial results. Across all sources, we assessed registration timing, result reporting, open access and stakeholder engagement.

For 200 trials, 37% were prospectively registered, 65% published results in journals and 15% reported summary results in ClinicalTrials.gov. Only 34% reported results in any format within 24 months of completion. Of 200 publications, 72% were freely accessible, and 23% of the 100-article subsample included stakeholder engagement statements. The funder website sample yielded insufficient metadata for analysis.

Monitoring GHR is feasible using registries and journals, though funder websites provide limited tracking. While open-access rates are encouraging, timely reporting and engagement documentation remain weak. These results highlight opportunities for developing GHR-specific monitoring approaches through collaborative efforts among global stakeholders.

Ebola disease stigma hinders outbreak control and recovery by deterring care-seeking and driving social exclusion. Although this phenomenon is well recognised, gaps remain in understanding how stigma emerges and operates in outbreak settings, limiting the development of effective reduction strategies. The objective of this study was to examine the drivers, manifestations and public health impacts of stigma following the 2022–2023 Sudan ebolavirus outbreak in central Uganda.

We conducted a cross-sectional, mixed-methods survey to assess Ebola disease stigma in June 2024.

The study was conducted in the Ugandan districts of Mubende, Kassanda and Kyegegwa, which were heavily affected by the outbreak.

A total of 302 respondents completed the survey. Respondents included all 51 eligible adult Ebola survivors in the districts known to the research team, as well as household members, healthcare workers, outbreak support staff and the general public.

The interviewer-administered survey explored personal experiences of stigma, community attitudes and impacts on outbreak control. We used a pillar integration process to identify themes across quantitative and qualitative data in three domains (drivers, manifestations and impacts of stigma).

Participants identified several perceived drivers of stigma, including fear, hygiene-focused public health messaging, distrust in public services and criminal connotations inferred from the outbreak response. Manifestations, including self-stigma and associative stigma, endured beyond the outbreak and across contexts. Nearly all survivors interviewed (n=48, 94%) reported multiple experiences of stigmatisation since discharge, with almost half (n=25, 49%) reporting physical harm or threats. Stigma was reported to affect care-seeking, healthcare worker morale and community socioeconomic well-being.

Stigma remains a major barrier to Ebola disease outbreak control and recovery. The high levels of stigma reported by survivors and anticipated by community members highlight the urgent need for targeted interventions in future outbreaks. We specifically show there are opportunities to address misinformation, avoid criminal connotations in outbreak control efforts and enable peer support.

The effectiveness of humanitarian health and nutrition programmes in Somalia is critically dependent on seamless collaboration and coordination among a diverse array of actors. While existing literature acknowledges broad challenges to coordination such as insecurity, resource competition and fragmentation, a significant gap remains in understanding how these barriers and their corresponding enablers actively manifest in the daily operations and decision-making processes of frontline practitioners.

This study aims to provide a systematic, in-depth exploration of the barriers and enablers influencing collaboration and coordination mechanisms from the perspective of those directly involved in the response.

A qualitative study was conducted using semi-structured, in-depth interviews. Data were analysed using a deductive thematic approach guided by the Consolidated Framework for Implementation Research.

The study was conducted across the entire territory of Somalia, encompassing its five member states, the capital city Mogadishu, and the self-declared independent state of Somaliland.

A total of 26 participants, including executive directors, health and nutrition programme managers, coordinators from international and national non-governmental organisations (NGOs), government officials and community members, were interviewed.

Key barriers included poor adaptability and high complexity related to collaborative initiatives (intervention characteristics); armed conflicts, climatic shocks, deeply ingrained sociocultural practices and restrictive government policies (outer setting); inadequate information technology infrastructure and hierarchical communication (inner setting); high staff turnover (individual characteristics). Key enablers included strong inter-agency partnerships (outer setting); supportive organisational culture (inner setting); competent and motivated staff (individual characteristics); and robust planning, engaging and evaluation processes (process).

The study highlights the complex contextual factors that impact the effectiveness of collaboration and coordination mechanisms among humanitarianorganisations operating in Somalia. Policymakers should unify governance, agencies prioritise localisation and donors allocate quotas to local NGOs to enhance aid delivery.

To evaluate progress in the implementation of the WHO Eastern Mediterranean Regional Office (EMRO) Regional Framework for Action on Diabetes Prevention and Control, identify implementation barriers and facilitators, and provide recommendations for accelerating progress, with a particular focus on fragile, conflict-affected and vulnerable settings (FCVs).

Mixed-methods study combining secondary analysis of quantitative data from WHO datasets with qualitative synthesis of inputs from WHO consultative meetings with EMR member states.

22 countries of the WHO EMR, including 10 classified as FCV and 12 as non-FCV according to World Bank and WHO classifications.

Quantitative data were drawn from the 2021 WHO Country Capacity Survey targeting all EMR countries and other WHO sources. Qualitative data were based on insights from 16 country representatives during a regional WHO EMRO webinar, including non-communicable diseases programme managers, policy leads and WHO country office staff.

Among the 22 countries analysed, only 10% (1/10) of FCVs had a national diabetes action plan compared with 67% (8/12) of non-FCVs. A sugar-sweetened beverage tax was implemented in 75% (9/12) of non-FCVs but in just 10% (1/10) of FCVs. For diabetes management, detailed national guidelines were available in 30% (3/10) of FCVs compared with 83% (10/12) of non-FCVs; insulin was available in primary care in 50% (5/10) of FCVs compared with 83% (10/12) of non-FCVs. Surveillance systems were less robust in FCVs: while 70% (7/10) collected data on diabetes status, only 30% (3/10) had a national diabetes registry, compared with 83% (10/12) of non-FCVs.

Addressing diabetes in the EMR requires strategic collaboration and tailored approaches for FCVs, including strengthened governance, preparedness, integrated care, medication access and surveillance. Prioritising primary healthcare and embedding diabetes prevention and control in universal health coverage and emergency response frameworks is critical to reducing inequities and improving health outcomes in fragile contexts.

To contribute to the development of a people-centred global framework for collaborative action on tuberculosis (TB) and comorbidities, a rapid qualitative study on the perspectives of people with lived experience of TB and its associated comorbidities was undertaken.

From August to October 2021, TB survivors from high-burden countries, who encountered at least one comorbidity during TB treatment, were interviewed to explore their healthcare experiences and priorities. Thematic analysis drew on a healthcare acceptability model.

Participants (n=24, 13 women) were treated for drug-susceptible (n=13) or drug-resistant (n=11) TB between 2015 and 2021. They faced diverse comorbidities (mental health and substance use disorders, diabetes, Hepatitis C, lupus and HIV); half of whom reported more than one comorbidity, and all faced socioeconomic hardships. TB diagnosis and treatment exacerbated participants’ comorbidities and, in the absence of integrated support, precipitated mental health challenges. Four healthcare priorities for addressing TB-associated comorbidities were identified: (1) disclosure and early identification of comorbidities, (2) timely and affordable access to care for comorbidities, (3) tailored counselling and peer support and (4) coordinated and consolidated care for TB and comorbidities.

The syndemic manifestation of comorbidities in people affected by TB calls for a people-centred approach to care that facilitates building of trust with multiple care providers, timely linkages to non-TB programmes, access to integrated diagnosis and treatment, allaying intersecting stigmas and self-shame, and care coordination approaches that correspond to people’s needs and preferences. These healthcare priorities were included in the WHO’s Framework for collaborative action on TB and comorbidities.

Sense organ diseases (SODs) are among the leading causes of disability worldwide. They severely impact communication, mobility and quality of life, with rising prevalence and widening inequalities across populations. This study aims to provide an updated, comprehensive assessment of the global, regional and national burden and trends of SODs, and to inform strategies for prevention, treatment and health policy development.

This is a population-based observational study using secondary data from the Global Burden of Disease (GBD) 2021 study. SODs, defined in the GBD framework as age-related and other hearing loss (AHL), blindness and vision loss (BVL), and other sensory impairments, were analysed in terms of prevalence and disability-adjusted life years (DALYs). We focused on SODs overall and conducted specific analyses for AHL and BVL, stratified by age, sex and sociodemographic index (SDI).

Global dataset covering 204 countries and territories across all regions and sociodemographic strata from 1990 to 2021.

This study covered the global population represented in the GBD 2021 dataset, using aggregated population-level estimates with no direct individual recruitment.

Not applicable.

Primary outcomes were prevalence (cases and age-standardised prevalence rates) and DALYs (number and age-standardised DALY rates). Secondary outcomes included age–period–cohort effects, decomposition of contributors (population growth, ageing and epidemiological change), inequality metrics and burden projections to 2030.

Between 1990 and 2021, the global age-standardised rate (ASR) of DALYs for SODs increased from 884.07 to 912.8 per 100 000 population. The ASR of prevalence rose from 25 297.36 to 28 050.29 per 100 000. The disease burden increased across all age groups, with females experiencing a higher prevalence of SODs, and population growth and ageing as the leading contributors. AHL emerged as the predominant category of SODs. Socioeconomic disparities widened, with the slope index of inequality for DALYs rising from 128.82 in 1990 to 418.62 in 2021. In 2021, China reported the highest DALYs and case numbers. Predictive analysis showed a stable ASR of DALYs and prevalence, but a continued rise in cases through 2030, with COVID-19 further exacerbating the burden.

The global burden of SODs continues to rise, driven primarily by population ageing and growth, with widening disparities across sociodemographic levels. These findings emphasise the need for targeted prevention strategies, improved early detection and equitable access to sensory healthcare services. Monitoring the long-term impact of COVID-19 and demographic shifts remains a priority.

Not applicable. This study is a secondary analysis of GBD data and is not linked to a clinical trial.

Understanding contextual drivers of family planning is crucial for designing effective, context-specific policies and programmes. This study aimed to assess (1) the extent to which province-level contextual factors are associated with both coverage and wealth-related inequalities in demand for family planning satisfied by modern methods (mDFPS) across provinces in low- and middle-income countries (LMICs), and (2) whether these factors influence mDFPS at women’s level.

Observational study using multilevel modelling at both ecological and individual levels.

We analysed data from Demographic and Health Surveys between 2011 and 2022 in 46 LMICs.

Ecological analysis included 621 provinces. Individual-level analysis included 302 493 women aged 15–49 years, currently married or in union, and in need of contraception (unweighted).

Demand for family planning satisfied by modern methods (mDFPS) and wealth-related inequalities in mDFPS, assessed using the slope index of inequality (SII) and the concentration index (CIX).

In both income groups, at the province level, higher mean women’s schooling and greater proportion of employed women were positively associated with mDFPS coverage. In contrast, higher male-to-female educational attainment ratios were inversely associated with mDFPS. Provinces with higher means of women’s schooling also showed lower wealth-related inequalities in mDFPS. At the individual level, women residing in provinces with higher male-to-female educational attainment ratios were found to have lower odds of mDFPS, regardless of the income group. Additionally, the factors influencing individual women’s mDFPS varied depending on the income level of the country’s provinces.

Women’s empowerment and gender equality in education at the province level significantly influence family planning outcomes. Targeted interventions that address each region’s specific educational, economic and demographic contexts are crucial for improving coverage and reducing disparities in family planning services.

Human papillomavirus (HPV) affects nearly 85% of sexually active adults during their lifetime and is responsible for HPV-related cancers in both males and females. Although the HPV vaccine can prevent up to 90% of these cancers, vaccination rates remain low, particularly among college students. Recently, video has emerged as a powerful intervention for shaping public opinion and behaviour toward health-related topics; however, most interventions have primarily focused on adolescents, their parents and females. The primary objective of this study is to develop a video-based intervention, informed by input from a diverse group of stakeholders and evaluate its preliminary effectiveness in promoting HPV vaccination intention, attitudes toward vaccination, subjective norms, perceived behavioural control (PBC) and uptake of the first HPV vaccine dose among college students through a randomised controlled trial (RCT).

The study is guided by the Theory of Planned Behaviour. A Student Advisory Board of eight college students was established to provide insights and guidance across all phases, including the co-development of HPV and HPV vaccine-related videos with faculty mentors. A pilot RCT will then be conducted in which participants in the intervention group view the stakeholder-created videos, while those in the control group watch four Centers for Disease Control and Prevention (CDC)-based videos of comparable length and content. The effectiveness of the videos will be compared by measuring participants’ intentions, attitudes, subjective norms and PBC regarding the HPV vaccine between the intervention and control groups at baseline, immediately after the intervention and 2 months after implementing the intervention. The uptake of the first dose of the HPV vaccine will be assessed at the 2-month time point. Moderators, including message fatigue and processing fluency, participants’ satisfaction and intervention dose as well as confounding variables such as provider recommendation and encouragement will also be measured. A research team member responsible for data management and analysis will be blinded to the study condition/group allocation, while another team member will send reminder texts.

Ethical approval from the Michigan State University’s Biomedical and Health Institutional Review Board has been obtained (Study ID: STUDY00010264). The results will be disseminated to the broader public through public forums, social media and seminars organised by the college health centre, community resource centre and local health departments. Additionally, the findings will be shared with healthcare professionals through professional training and meetings, and with researchers via conferences and publications.

14 March 2025 submitted. Revised manuscript—V.1 27 September 2025.

NCT06397378.

To investigate the occurrence of unintentional injuries among children aged 3 to 12 in China over the past 5 years, and to provide a scientific basis for the prevention and control of such injuries.

A systematic review and meta-analysis. A random-effects model was specified a priori to synthesise study estimates given anticipated clinical and methodological heterogeneity across studies.

We searched CNKI, WanFang and PubMed for studies published between 1 January 2018 and 30 June 2024.

We included observational studies conducted in China with children aged 3–12 years, reporting incidence or person-time incidence of unintentional injuries and using clear injury definition criteria. Exclusion criteria included reviews, studies on special populations, duplicated datasets or incomplete data.

Two independent reviewers screened studies, extracted data and assessed study quality using Loney’s criteria. Heterogeneity was quantified with the I² statistic and Q test. Publication bias was assessed with funnel plots, Egger’s regression and fail-safe N. Certainty of evidence for primary outcomes was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

A total of 16 studies involving 37 877 participants were included. The results indicated that the combined effect size of the incidence of unintentional injuries among children aged 3 to 12 in China was 14.0% (95% CI 9.5% to 20.3%), and the person-time incidence was 15.3% (95% CI 8.6% to 25.8%), with falls demonstrating the highest combined effect size. Further subgroup analysis revealed several trends: the incidence of unintentional injuries was higher in boys (16.1%) than in girls (11.2%), among children aged 3–6 years (15.2%) compared with those aged 6–12 years (12.4%), in the western region (14.3%) versus the eastern region (13.1%) and when applying the 1996 injury criteria (17.7%) compared with the 2004 criteria (15.6%). All differences were statistically significant (p

The incidence of unintentional injuries among Chinese children aged 3–12 remains high, especially from falls. Injury rates differ significantly by gender, age, region and other factors. Future efforts should prioritise the safety of kindergarten children in western China, with a strong emphasis on preventing falls, which are a common type of injuries among children.

CRD42024604890.

In Tanzania, acute myocardial infarction (AMI) is underdiagnosed, and uptake of evidence-based care is suboptimal. Using an implementation science approach, an intervention was developed to address local barriers to care: the Multicomponent Intervention for Improving Myocardial Infarction Care in Tanzania (MIMIC).

This sequential cohort design trial was conducted in a single northern Tanzanian emergency department (ED). During the preintervention phase (February–August 2023) and the postintervention phase (September 2023–August 2024), adults presenting with chest pain and/or dyspnoea were prospectively enrolled and their ED care was observed. AMI was defined by the Fourth Universal Definition criteria. Telephone follow-ups were conducted to ascertain 30-day mortality. Pearson’s ² was used to compare care before and after MIMIC implementation.

A total of 275 participants were enrolled in the preintervention phase and 577 were enrolled in the postintervention phase. Following MIMIC implementation, significant increases were observed in ECG testing (89.4% of postintervention participants vs 55.3% preintervention, OR 6.82, 95% CI 4.79 to 9.79, p

The MIMIC intervention was associated with large increases in uptake of AMI testing, case identification and evidence-based treatment in a single Tanzanian ED. Multisite studies are needed to evaluate the effect of MIMIC on AMI care in diverse settings across Tanzania.

NCT04563546.

Pneumonia and diarrhoea are two of the major causes of child mortality globally. Countries affected by conflict and other humanitarian emergencies, such as Somalia, have a particularly high burden of these diseases. Published reports from UNICEF and WHO have shown that various factors, including social, economic and environmental factors, are all associated with the occurrence of childhood pneumonia and diarrhoea. The objective of this study was to determine the prevalence, burden and associated sociodemographic determinants of pneumonia and diarrhoea among children younger than 5 years (under-5 children) in Somalia.

A community-based survey using an interviewer-administered questionnaire was conducted employing a modified WHO Expanded Program on Immunization (EPI) 30-Cluster sampling technique to identify households and respondents in nine selected districts across six member states in Somalia. The interviewers began selecting households starting from house number 1 and continued until 75 households were surveyed in each cluster.

We considered the catchment areas of 12 target maternal and child health (MCH) centres as our study areas. Villages were considered as primary sampling units (PSU) while households within villages were considered as secondary sampling units, where women (with under-5 children) within households were the respondents.

A total of 36 clusters (villages) were selected from the catchment areas of 12 target MCH centres. All households within the selected villages’ PSUs were listed. The interviewer started interviewing from house number 1 and continued till 75 households were covered to conduct interviews with mothers of under-5 children. Data collection took place between October and December 2023.

The prevalence and burden of childhood pneumonia and diarrhoea were estimated. A logistic regression model was employed to examine the determinants of childhood pneumonia and diarrhoea.

A total of 2483 under-5 morbidities were reported, 1712 probable pneumonia cases and 825 diarrhoea cases. Our calculations suggest that the prevalence of overall under-5 morbidity was 458.4 per 1000 children (95% CI 444.3 to 472.6) in the last 90 days. The prevalence of pneumonia and diarrhoea was 316.0 (95% CI 303.5 to 328.8) and 152.3 (95% CI 142.2 to 162.8) per 1000 under-5 children, respectively. A total of 70 under-5 deaths occurred in the past year, of which 37 were infants. Our exploration depicts an under-5 mortality rate of 39.3 deaths per 1000 live births per year (95% CI 30.6 to 49.7), and the infant mortality rate was 20.8 per 1000 live births per year (95% CI 14.8 to 28.6) in the study area, which is much lower than earlier estimates. The crude birth rate was 106.6 per 1000 population, and the stillbirth rate was 149.8 per 1000 births (95% CI 134.9 to 165.7), which is very high. We explored probable causes of 70 under-5 deaths and found that the highest proportion of under-5 deaths (22.9%) was due to acute respiratory infections (ARI), and about 15.7% were due to diarrhoea. Among other probable causes, congenital diseases (12.9%), accidents (11.4%) and measles (8.6%) were noteworthy.

This study revealed a high burden of pneumonia and diarrhoea among the studied population in Somalia. The study also identified important sociodemographic and environmental determinants that tend to increase the risk of pneumonia and diarrhoea among under-5 children.

Adolescents in informal urban communities, defined as settlements that fall outside of formal governmental planning and regulatory frameworks, are at increasing risk of poor-quality diets and malnutrition in all its forms. The food environment is the interface of adolescent food choice and the broader food system, and food environment interventions have the potential to improve adolescent diets and nutritional outcomes.

We will conduct a mixed-methods study, integrating methods from participatory systems science and nutritional epidemiology to characterise linkages among adolescents’ neighbourhood and home food environments, and their food choices, diets and nutritional outcomes. We will recruit adolescents, caregivers, school staff and food system actors from five communities along a gradient of urban informality in Nairobi, Kenya, to participate in cognitive mapping, group-based modelling and a cohort study over one academic year to evaluate dietary choices and nutritional outcomes.

The study has been approved by the Research Ethics Committee of Rutgers University (Pro2024001981) and Amref Health Africa (P1831-2025). Adult participants will provide written informed consent, and adolescents will provide written informed assent to participate in the study. Findings will be disseminated through peer-reviewed journals, conference presentations and to participants through planned participatory interaction throughout the study.

To determine the spatial-temporal patterns of natural hazards and disasters in the Greater Horn of Africa, including climate and environmentally sensitive diseases, and compare the reporting consistencies across multiple open-access databases.

Cross-sectional retrospective secondary analysis of natural hazard and disaster data.

Djibouti, Eritrea, Ethiopia, Kenya, Somalia, Sudan, South Sudan and Uganda.

Primary data from Emergency Events Database (EM-DAT), and comparative data from ReliefWeb, WHO Disease Outbreak News (WHO-DON), FloodList and Global Unique Disaster Identifier Number (GLIDE).

EM-DAT reported 228 natural hazards and disasters affecting 145.7 million people; highest numbers reported in Uganda (n=48), Kenya (n=46), Somalia (n=38) and Ethiopia (n=35); 175 geophysical, hydrological, meteorological and climatological hazards reported, including 118 floods, 26 droughts, 11 storms and 17 landslides; 46 epidemics reported, primarily bacterial (eg, cholera) or viral (eg, yellow fever, measles) diseases, with 20% preceded by a flood, drought or landslide within the previous 3 months. Reporting consistency and content varied considerably across the five databases.

Natural hazards and disasters affect millions of people. There is an urgent need to improve database connectedness to facilitate better monitoring and mapping, which can inform disease forecasting and decision tools to develop preparedness and intervention strategies.

As of 2024, 123.2 million people had been forcibly displaced as a result of persecution, armed conflict or climate-related catastrophes, and these numbers are predicted to rise. There is a growing awareness of possible intergenerational effects of trauma on life-course health and well-being, however few studies have followed individuals longitudinally starting prenatally. This paper describes the first large prenatal birth cohort study in a refugee context in a lower middle-income country. This study aims to investigate the potential lifespan health and developmental implications of being born into a protracted humanitarian context, and what factors can buffer from the adversity posed by conflict and displacement.

We outline our approach of recruiting, consenting and gathering data from pregnant Rohingya refugee and host community women (N=2888; 80% Rohingya) over the course of 12 months in Cox’s Bazar, Bangladesh.

A fifth wave of data collection, when children were 6 months old, was completed in April 2025. Rohingya women were substantially less literate; were marrying and having children at slightly younger ages, were more likely to live in crowded, resource-limited households and exhibited higher rates of clinically significant post-traumatic stress disorder and anxiety than host community women.

There is a critical need for research in displaced populations in order to elucidate potentially lasting transgenerational impacts of experiencing conflict and displacement trauma, and the prenatal and postnatal factors that support health and development across the life span. The next follow-up is planned when the children turn 36 months of age (starting March 2026).

As global health education becomes more embedded in university curricula, the availability of experiential learning opportunities in this field has expanded as well. These programmes offer students valuable exposure to diverse cultural perspectives and help develop essential competencies in global health. However, concerns have arisen regarding the persistence of colonial-era dynamics, power imbalances and the potential negative impacts on host organisations in low- and middle-income countries. Much of the existing literature on this topic centres on short-term medical student experiences and is focused on the perspectives of the sending organisations. This study aims to fill this gap by examining a semester-long undergraduate global health experiential learning programme through the perspectives of host organisation staff.

This qualitative case study draws on interviews with 18 key informants from host organisations across seven countries. The research design, data collection and analysis were developed using an analytical framework based on recommendations made by previous studies.

Host organisations across seven countries participated in the study. Interviews were conducted remotely via Zoom. The interviews were audio-recorded, transcribed, coded in Dedoose software and analysed for emerging patterns and themes.

Eighteen key informants from host organisations were interviewed, representing seven countries — Tanzania, Ghana, Mexico, India, Bangladesh, Australia and the Philippines — and a range of institutions including research institutes, government agencies and UN bodies.

Participants generally viewed their engagement in experiential learning courses positively. They emphasised the importance of their role in mentoring American and other foreign global health students, building their research skills and cultural competency, and providing valuable insights into power dynamics, local health systems and the wider context in which global health operates. Beyond financial remuneration, participants emphasised multiple non-financial benefits for host organisations. The study identified three key themes in developing strong programmes: partnership, communication and cultural competence. These findings reinforce the value of longer-term programmes and offer actionable recommendations for their continued evolution in global health education.

Implementation science (IS) is increasingly recognised as vital in cancer control planning and integrating evidence-based interventions across the cancer care continuum. Contextual differences often cause variability in delivering optimised healthcare, which IS approaches could mitigate. While IS improves planning effectiveness, many programme and policy planners remain unaware of its benefits. To address this, we examined IS theories applied to national cancer control plans (NCCPs)/strategies across five domains: stakeholder engagement, situational analysis, capacity assessment, economic evaluation and impact assessment.

We conducted a scoping review using the Arksey and O’Malley framework to analyse NCCPs and strategies from 16 and 17 countries belonging to low and medium categories of Human Development Index (HDI), focusing on resource-constrained settings. We identified plans through the International Cancer Control Partnership portal, categorised them by WHO region and included only those available in English or French. We extracted data into a Microsoft Excel database and performed thematic analysis across five IS domains. Multiple IS experts, selected purposively based on their familiarity with resource-constrained settings, validated the findings, assessed policy relevance and helped develop a pathway for integrating IS into national cancer control planning. They reviewed structured questions in advance and provided feedback on analyses, practical utility, dissemination and simplifying IS application, which was used to refine the pathway and reach consensus.

While many NCCPs incorporated key IS elements such as stakeholder engagement, situational analysis and impact measurement, these often needed to be more explicit and consistently applied. None of the plans assessed health system capacity to determine readiness for implementing new interventions. Although most plans described stakeholder engagement, it was typically unstructured and incomplete. Four low HDI and nine medium HDI countries included costed plans, generally using an activity-based approach. All plans included impact measures (eg, key performance indicators), but five lacked mechanisms for engaging stakeholders or responsible entities to achieve the targets. These findings informed a proposed pathway to integrate IS principles into cancer control planning.

Integrating IS into national cancer control planning offers a structured framework for achieving equitable and feasible cancer control policies, particularly in resource-constrained settings, by enabling realistic goal setting and benchmarking against regional and global standards.

To compare international substandard and falsified (SF) medicine recall trends from published research papers based on governmental databases, summarise the extent of the problem in the legitimate supply chain, and identify ways to manage the issue.

Systematic review of published academic evidence.

Drug recall data in published literature, obtained from official international government regulator databases in the USA, the UK, Canada, Sri Lanka, Zambia, Portugal, Nepal, Saudi Arabia, Argentina, Brazil, Chile, Cuba, Colombia, Mexico, Bolivia, Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Panama, Peru and Venezuela.

A search for literature published between 2010 and 2024 was conducted using PubMed, MEDLINE and Embase. Included studies examined recall data of substandard and/or falsified medicines obtained through official government regulator websites.

Data were extracted using Excel files and synthesised using a thematic analysis approach.

13 research papers containing original data were included. Recall data were obtained from official regulatory databases in 23 different countries. Substandard medicines had significantly higher recall rates than falsified products, while parenteral drugs and tablets were the most recalled formulation types. The leading reasons for defective medicines were contamination, out-of-specification results, stability and packaging issues. India was identified as a common source of SF medicines in Zambia, Sri Lanka, Brazil and Nepal. Frequent recalls of anti-infective drugs were observed in countries with equatorial, tropical and subtropical climates, while high-income countries like Canada, Saudi Arabia and the UK faced issues with defective antihypertensive drugs. Interestingly, medicines affected by nitrosamines’ contamination were recalled in all regions examined in 2018, but in other recall cases, there were disparities among recall action.

There appeared to be similar international recall practices for some products like nitrosamines and not for others like rosiglitazone across the same time frame, which raises questions concerning international drug safety disparities. The requirement to align and globally strengthen regulatory frameworks was of emerging importance. Cooperation between regulatory authorities to create a harmonised approach to reporting medicine recalls and standardising the data included in a recall notification is proposed to facilitate a more accurate comparison of international trends surrounding recalled SF medicines.

Metabolic-associated fatty liver disease (MAFLD) is becoming increasingly prevalent worldwide, however, early diagnosis and intervention remain underachieved. This study aims to guide the prevention and diagnosis of MAFLD by analysing its risk factors within the adult population from Suzhong Region, China.

This was a cross-sectional study.

The study was conducted at the Health Management Department of Northern Jiangsu People’s Hospital.

A total of 49 776 asymptomatic Chinese participants (54.24% men) were enrolled.

Hepatic ultrasonography was performed to diagnose MAFLD based on the latest diagnostic criteria. The relevant blood routine and biochemical indicators were collected.

Among 49 776 participants, the prevalence of MAFLD was 29.89% (14 877/49 776). The results of restricted cubic spline (RCS) analysis showed a nonlinear relationship between age and MAFLD prevalence. As age increased, the overall trend of age in relation to MAFLD prevalence was initially increasing and then decreasing in the total study population and in males. In contrast, the overall trend of age in relation to MAFLD prevalence in females was initially increasing and then levelling off. The study found that age, body mass index (BMI), red blood cell (RBC) count, white blood cell (WBC) count, fasting blood glucose, albumin, total bilirubin, alanine aminotransferase (ALT), uric acid, triglycerides (TG) and low-density lipoprotein cholesterol were risk factors for MAFLD in adults, while aspartate aminotransferase, direct bilirubin, blood urea nitrogen, serum creatinine and high-density lipoprotein cholesterol were protective factors (p

The occurrence of MAFLD has a nonlinear relationship with age and the trend of this relationship varies significantly between males and females. BMI, ALT, TG, TyG, TyG-BMI and AIP are helpful factors in the diagnosis of MAFLD, especially TyG-BMI.

Clinical trials from the Northern Jiangsu People’s Hospital (SBLC23002).

The aim of this study was to prioritise a set of indicators to measure World Health Organization (WHO) quality-of-care standards for small and/or sick newborns (SSNB) in health facilities. The hypothesis is that monitoring prioritised indicators can support accountability mechanisms, assess and drive progress, and compare performance in quality-of-care (QoC) at subnational levels.

Prospective, iterative, deductive, stepwise process to prioritise a list of QoC indicators organised around the WHO Standards for improving the QoC for small and sick newborns in health facilities. A technical working group (TWG) used an iterative four-step deductive process: (1) articulation of conceptual framework and method for indicator development; (2) comprehensive review of existing global SSNB-relevant indicators; (3) development of indicator selection criteria; and (4) selection of indicators through consultations with a wide range of stakeholders at country, regional and global levels.

The indicators are prioritised for inpatient newborn care (typically called level 2 and 3 care) in high mortality/morbidity settings, where most preventable poor neonatal outcomes occur.

The TWG included 24 technical experts and leaders in SSNB QoC programming selected by WHO. Global perspectives were synthesised from an online survey of 172 respondents who represented different countries and levels of the health system, and a wide range of perspectives, including ministries of health, research institutions, technical and implementing partners, health workers and independent experts.

The 30 prioritised SSNB QoC indicators include 27 with metadata and 3 requiring further development; together, they cover all eight standard domains of the WHO quality framework. Among the established indicators, 10 were adopted from existing indicators and 17 adapted. The list contains a balance of indicators measuring inputs (n=6), processes (n=12) and outcome/impact (n=9).

The prioritised SSNB QoC indicators can be used at health facility, subnational and national levels, depending on the maturity of a country’s health information system. Their use in implementation, research and evaluation across diverse contexts has the potential to help drive action to improve quality of SSNB care. WHO and others could use this list for further prioritisation of a core set.

Infants born to pregnant women living with HIV (WLHIV) are at greater risk for morbidity and mortality and may also have poorer developmental outcomes as compared with infants who are not exposed to HIV. Nutrition interventions in pregnancy may affect developmental outcomes.

This study evaluated the effect of maternal vitamin D supplementation on infant development outcomes.

We conducted a secondary analysis of a randomised, triple-blind, placebo-controlled trial of maternal vitamin D supplementation from June 2015 to October 2019.

Antenatal care clinics in Dar es Salaam, Tanzania.

Pregnant WLHIV and their offspring.

Daily 3000 IU vitamin D₃ or placebo supplements taken during pregnancy and lactation.

Infants were assessed for cognitive, language and motor development at 1 year of age with the Caregiver Reported Early Development Instruments (CREDI).

A total of 2167 infants were eligible, and 1312 of them completed CREDI assessments at 1 year of age. Vitamin D supplementation had no effect on overall CREDI z-scores (standardised mean difference (SMD) 0.03, 95% CI –0.09, 0.15, p value 0.66). There was also no evidence of a difference between vitamin D and placebo groups in language (SMD 0.06, 95% CI –0.08, 0.21, p value 0.40), motor (SMD 0.02, 95% CI –0.09, 0.14, p value 0.69) or cognitive domain z-scores (SMD 0.05, 95% CI –0.08, 0.17, p 0.48).

Maternal vitamin D supplementation during pregnancy and lactation did not affect infant development outcomes.

ClinicalTrials.gov identifier: NCT02305927.