To describe the prevalence and spatial distribution of anaemia among children aged 6–59 months in Madagascar and to explore individual-level and community-level correlates using data from the 2021 Madagascar Demographic and Health Survey.
A population-based cross-sectional study using secondary data from the 2021 Madagascar Demographic and Health Survey. Spatial statistical methods were used to assess geographic clustering and hotspot areas of anaemia.
The study was conducted across community and household levels throughout Madagascar, covering both rural and urban populations within the primary and secondary healthcare delivery contexts.
A weighted sample of 10 683 children aged 6–59 months was included. Sampling followed demographic health survey procedures, and only children with complete haemoglobin data were analysed.
No interventions were applied.
The primary outcome was anaemia, defined as haemoglobin
The overall point prevalence of anaemia was 47% (95% CI 45.60 to 48.36), showing significant spatial clustering (Global Moran’s I=0.136, p
Anaemia among Malagasy children remains a major public health concern and shows clear geographic variation. The findings describe important differences in prevalence across regions and population subgroups, providing useful evidence for public health planning and for generating hypotheses for future analytical research.
This study aimed to analyse patient-initiated compliment letters from a single institution, identify the key elements that patients value and offer actionable insights to enhance patient-centred care.
A retrospective, single-institution study using the Healthcare Complaints Analysis Tool (HCAT), text network analysis and latent Dirichlet allocation (LDA) topic modelling on patient compliment letters to pinpoint key valued care elements.
A newly established general hospital in Gwangmyeong, South Korea, opened on 22 March 2022.
A total of 1213 compliment letters were collected through the hospital’s feedback system, which accepted both online and on-site submissions between 25 March 2022 and 28 June 2024. Letters lacking substantive descriptive content and those containing purely administrative requests were excluded.
The HCAT was adapted to categorise positive statements into clinical, management and relationship domains, along with six stages of care. Inter-rater reliability was evaluated using Gwet’s AC1 statistic. A text network analysis, applying a term frequency–inverse document frequency approach, was conducted to identify prominent keywords. Subsequently, LDA was performed to extract thematic topics.
Most compliments concerned the ‘relationship’ domain (62%), particularly during the care in the ward stage (56%). Keyword analysis indicated that the most frequently mentioned terms were ‘gratitude’, ‘kindness’, ‘nurse’, ‘doctor’ and ‘heart/mind’, underscoring patients’ high valuation of positive interactions, professional competence and compassionate communication with medical staff. Topic modelling identified three primary topics, namely, ‘appreciation of nursing care’ (39%), ‘professionalism in surgery and treatment’ (35%) and ‘effective communication during consultations’ (26%).
Positive relationships with medical staff, particularly kindness, professionalism and effective communication, influence patient satisfaction. Patient compliment letters serve as important indicators of exceptional care and can inform quality improvement initiatives. Healthcare institutions should leverage these insights to enhance patient-centred services by strengthening patient–provider relationships and promoting a culture of excellence.