Medicine and Health Sciences Commons^™

Dcpr: A Deep Learning Framework For Circadian Phase Reconstruction, Xiao Han, Xiaochen Cen, Zhijin Li, Xiaobo Zhou, Zhiwei Ji

Faculty, Staff and Student Publications

Background: The circadian clock is an evolutionarily conserved system that orchestrates 24-h physiological rhythms through transcriptional and translational feedback loops. Mounting evidence suggests a bidirectional relationship between circadian rhythm alteration and disease progression, positioning the circadian clock as a potential therapeutic target. Due to the scarcity of high-resolution temporal omics data, it remains very challenging to elucidate the underlying regulatory mechanisms of the circadian system. As a practical alternative, public untimed transcriptomic datasets offer the potential to infer gene expression oscillations retrospectively. However, existing computational approaches for circadian phase estimation often suffer from limited predictive accuracy, reducing their ability to …

Kejadian Luar Biasa Gondongan Di Sd Islam X Samarinda, 2024, Rudy Agus Riyanto, Irfansyah Baharuddin Pakki, Mela Sabena, Meli Pasiakan, Erlina Erlina, Rima Andriani

Jurnal Epidemiologi Kesehatan Indonesia

Mumps outbreaks are a public health issue that still frequently occur in elementary school settings, particularly among children with low immunization coverage. Therefore, a comprehensive epidemiological understanding is needed as a basis for control. This research aims to describe the epidemiological picture and causative factors of the mumps outbreak that occurred at Islamic Elementary School X in Samarinda City in 2024, using a case series design. The outbreak occurred from April to October 2024, while epidemiological data collection and case verification were conducted from December 2nd to 8th, 2024. The analysis uses surveillance data, field observations, and questionnaires administered to …

Health Education On Operative Cataract Care: A Scoping Review, Luh Putu Prima Widya Ridwanti, I Ketut Swarjana, I Gusti Ngurah Made Kusuma Negara, Putu Gde Yudara Sandra Putra

Jurnal Epidemiologi Kesehatan Indonesia

Cataract is the leading cause of blindness worldwide, requiring surgery and appropriate patient and family education to ensure proper operative care. This literature review aimed to identify health education on operative cataract care. The type of this study is a scoping review using the PubMed database, ScienceDirect, and other sources that were published in the last 10 years (2015-2024). The PICO model (P: patients and families; I: audiovisual, booklets, leaflets, and others; C: standard care or education; O: knowledge and skills in cataract operative care) was used. The keywords used to search for articles are cataract surgery AND video OR …

Psychological Resilience As A Predictor Of Occupational Stress Among Teaching Staff In Course X, Indah Kusuma Wardani, Fajaria Nurcandra, Dr. Dyah Utari, Afif Amir Amrullah

Jurnal Epidemiologi Kesehatan Indonesia

Workplace stress is a common condition that may be triggered by the demands of professional involvement. Psychological resilience functions as a protective factor that enables individuals to maintain their level of work engagement despite experiencing job-related stress arising from work–life imbalance. This study aimed to examine the relationship between psychological resilience and occupational stress among teaching staff at Course X. The research employed a quantitative approach with a cross-sectional design, utilizing chi-square testing and Cox regression analysis, with a total sample of 98 participants. Data collection was conducted from April to June 2024. The instruments used included the Workplace Stress …

Analisis Cakupan Penemuan Kasus Tuberkulosis (Treatment Coverage) Berdasarkan Faktor Demografis Dan Komorbiditas Di Puskesmas Ciracas Tahun 2023-2024, Anggie Hardiyanti, Helda Helda, Mufti As Siddiq M. Irzal, Mareska Monica

Jurnal Epidemiologi Kesehatan Indonesia

Tuberculosis (TB) remains a major global and national health burden, with case detection coverage still below target in several regions. The success of TB control programs largely depends on achieving adequate treatment coverage. In East Jakarta, Ciracas Primary Health Center recorded a treatment coverage of 75% (497 cases) in 2023, the lowest among ten centers, and an increase to 84% (509 cases) in 2024, though still below the national target of 90%. To analyze TB case detection coverage based on demographic factors and comorbidities (diabetes mellitus and Human Immunodeficiency Virus) at Ciracas Primary Health Center during 2023–2024. This study …

Environmental Health Risks To Children In Sub-Saharan Africa: A Scoping Review Of Evidence And Gaps In Global Interventions, Tadius C. Chitambwe, Dewi Susanna

Jurnal Epidemiologi Kesehatan Indonesia

Sub-Saharan Africa’s (SSA) children experience a disproportionate burden of environmental health risks, contributing to over half of global under-five deaths despite representing only 27% of live births ¹. This scoping review synthesised evidence from sixty-seven (67) eligible studies (2010–2025) to map out environmental exposures affecting children (0–18 years) in Sub-Saharan Africa, and to identify gaps in global interventions. Included studies focused on children (0-18 years) in SSA, addressed one or more of the four predefined environmental exposure domains (air pollution, WASH, toxic chemicals, climate-related risks), and reported on child health outcomes or interventions. Guided by the PRISMA and Arksey …

Socio-Demographic Determinants Of Hospitalization Severity Among Type 2 Diabetes Mellitus-Related Hospitalization Visits In Indonesia: A Cross-Sectional Analysis Of Using Bpjs Health Secondary Data, 2023, Nadia Putri, Asri C. Adisasmita, Fitria Fitria, Sely Anggraini

Jurnal Epidemiologi Kesehatan Indonesia

Type 2 diabetes mellitus (T2DM) is a chronic disease with high prevalence and contributes significantly to the burden of inpatient care in Indonesia. The severity of T2DM-related hospitalization as classified under the INA-CBGs system, is an important indicator for assessing disparities in access to care and the health system’s response to vulnerable populations. This study aims to analyze the relationship between socio-demographic characteristics and the severity of T2DM-related hospitalization visits based on 2023 Social Security Administering Body for Health (BPJS Health) data. This study employed a cross-sectional design using secondary data from the 2023 BPJS Health Sample Data. The unit …

Implementasi Pelaksanaan Program I-Help (Integrated Help Promoting School) Pada Sekolah Menengah Pertama Di Jakarta, Rachma Dhiyaa' Arroyyan, Sarah Handayani

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background. The I-HELP (Integrated Help Promoting School Programs) initiative is a school-based behavioural change intervention that integrates health values and belief-related variables into daily school activities. This program was developed as a follow-up to the collaboration between Universitas Muhammadiyah Prof. DR. Hamka (UHAMKA) and SEAMEO RECFON.

Aim. his study aims to describe implementation of the I-HELP (Integrated Help Promoting School Programs) at the junior high school level in Jakarta in 2022.

Method. This qualitative research employed a case study design conducted at SMP Muhammadiyah 4 and SMP Muhammadiyah 36 Jakarta. Data collection techniques included in-depth interviews, focus group discussions (FGDs), …

Social Learning Theory Dan Status Merokok Pelajar Smp Negeri, Alya Putri Ansyari, Nur Rohmah, Lies Permana, Annissa Nurrachmawati, Rina Tri Agustini

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background. The prevalence of adolescent smokers aged 10–18 in Indonesia increased from 7.2% in 2013 to 9.1% in 2018. Approximately 70 million people in the country are active smokers, with 7.4% of them aged 10–18 years.

Aim. This study aims to investigate the association between knowledge, attitude and subjective norms with smoking status among students at a public junior high school in Samarinda.

Method. This study uses a cross-sectional design with a quantitative approach. A total of 159 respondents were randomly selected using proportionate stratified random sampling. Data were collected through interviews using a structured questionnaire and …

Hubungan Persepsi Manfaat Terhadap Kesadaran Kesehatan Pengguna Wearable Device Di Kota Banda Aceh, Raihanil Fitri, Tahara Dilla Santi, Hafnidar A. Rani

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background. Wearable devices are portable technologies designed to be worn directly on the body and capable of collecting and analyzing data related to various aspects of a user's health. Aim. This study aims to analyze the influence of perceived benefits on users' health awareness among wearable device users in Banda Aceh City.

Aim. This study aims to analyze association of perceived benefits on users' health awareness among wearable device users in Banda Aceh City.

Method. This research applied a descriptive quantitative design with a cross-sectional approach. Data were collected using a questionnaire from 106 active wearable device …

Korelasi Antara Intensitas Doomscrolling Konten Negatif Kehamilan Di Media Sosial Dengan Tingkat Stres Dan Kecemasan Ibu Hamil, Besse Aismaria Am, Yudiarsi Eppang B, Jusniati C

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background.The rapid development of social media has significantly influenced information-seeking behavior, including among pregnant women. One emerging phenomenon is doomscrolling, defined as the excessive consumption of negative information, which may trigger stress and anxiety.

Aim. This study aimed to analyze the correlation between the intensity of doomscrolling of negative pregnancy-related information on social media and levels of stress and anxiety among pregnant women in Pare-Pare City.

Method. This study employed a quantitative method with a cross-sectional design. The study population consisted of all pregnant women attending antenatal care at public health centers in Pare-Pare City, …

Efikasi Diri Dalam Melakukan Diet Sehat Pada Masyarakat Desa Cipacing, Sumedang, Hilmi Khairun Nisa, Neti Juniarti, Adelse Prima Mulya

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background. Noncommunicable diseases (NCDs) account for 57 million deaths (71%) worldwide and 73% of all deaths in Indonesia. Eating habits are one of the factors contributing to the incidence of NCDs. In the process of improving a healthy lifestyle, including a healthy diet, self-confidence or self-efficacy in maintaining a healthy diet is necessary.

Objective. This study aims to identify the level of self-efficacy in maintaining a healthy diet among the community in Cipacing Village, Sumedang.

Methods. This study was conducted using a quantitative descriptive research design among the community of Cipacing Village, Sumedang Regency, West Java. The sample was …

Ethical Considerations In Implementation Research: A Scoping Review Of Key Principles, Unintended Consequences, And Emerging Ethical Guidance, Emmanuel K Tetteh, Nwaliweaku Anidi, Gifty Aboagye-Mensah, Michelle Doering, Elvin H Geng, Byron J Powell, Mark D Huffman, Alison L Antes

2020-Current year OA Pubs

BACKGROUND: As dissemination and implementation research advances, research teams seek guidance on how to apply existing ethical standards to implementation research, given its unique study designs, multi-level intervention targets, and associated risks. This scoping review examines ethical principles and concerns in implementation research, identifies potential risks and unintended consequences, and explores ethical frameworks guiding responsible conduct.

METHODS: We searched PubMed, Web of Science, and Google Scholar for relevant literature published between January 2010 and January 2024. The search utilized a combination of standardized terms and keywords, including bioethics, ethics, research standards, responsible research, health services research, and dissemination and implementation …

Gender, Mental Health Symptoms, Loss To Clinic, And Viral Non-Suppression 6 Months After Hiv Care Initiation Among A Cohort Of People With Hiv In Cameroon, Angela M Parcesepe, Lindsey M Filiatreau, Peter Vanes Ebasone, Anastase Dzudie, Marcel Yotebieng, Kathryn Anastos, Eric Pefura-Yone, Annereke Nyenti, Denis Nash

2020-Current year OA Pubs

BACKGROUND: People with HIV (PWH) experience high levels of mental health or substance use disorders (MSDs) which may compromise HIV treatment outcomes. Differences in the relationship between MSDs and HIV treatment outcomes by gender remain understudied.

METHODS: We conducted interviews with 426 PWH aged ≥ 21 years initiating HIV care in Cameroon between June 2019 and March 2020. Clinic data and laboratory results were used to ascertain loss to clinic and viral non-suppression six months after HIV care initiation. We used log binomial regression models to assess the relationship between symptoms of depression (PHQ-9 scores > 9), anxiety (GAD-7 scores > 9), …

Chemotherapy-Induced Adipo-Lineage Cell Senescence Drives Bone Loss, Ganesh Kumar Raut, Taylor Malachowski, Anupama Melam, Renata Ramalho-Oliveira, Taylor Holt, Xianmin Luo, Zhangting Yao, Douglas V Faget, Qihao Ren, David G Denardo, Sheila A Stewart

2020-Current year OA Pubs

Chemotherapy-induced bone loss is a debilitating and common side effect of cancer treatment, though its underlying mechanisms remain poorly understood. Here, we show that, despite the systemic administration of chemotherapy, cellular senescence is restricted to bone marrow adipo-lineage cells specifically Cxcl12-abundant reticular (CAR) cells and bone marrow adipocytes (BMAds). Induction of senescence within these populations promotes RANK ligand (RANKL)-mediated osteoclastogenesis, leading to significant bone loss. Notably, we find that inhibition of the p38MAPK-MK2 pathway suppresses the senescence-associated secretory phenotype (SASP), including RANKL production abrogating bone loss. Furthermore, treatment with the senolytic combination dasatinib and quercetin (D + Q) selectively eliminates …

Efficacy And Safety Of Transcatheter Mitral Valve Repair (Mitraclip) Compared To Medical Therapy And Surgery In Patients With Secondary Mitral Regurgitation: A Systematic Review & Pairwise Meta-Analysis, Salma Younas, Aditya Rana, Mirza Faizan Ali Beig, Sweta Sahu, Cynthia Esohe Emanemua, Aisha Ashiq Reshie, Lamees Kaukab, Dileep Duggineni, S K S S P Ashish Gokavarapu, Padamati Bhavani, Afrasayab Khan, Peter G. Fattal

Journal of the Saudi Heart Association

Background: Secondary mitral regurgitation (SMR) is a frequent complication of heart failure, associated with high morbidity and mortality. While surgery is the standard for primary MR, many SMR patients are poor surgical candidates. Transcatheter mitral valve repair (TMVr) using the MitraClip offers a less invasive alternative, but its comparative efficacy and safety remain under active investigation and controversial. Methods: A systematic search of MEDLINE®, Embase®, and the Cochrane Library was conducted per PRISMA guidelines (PROSPERO ID: CRD420251016943). Eligible studies were randomized controlled trials (RCTs) comparing TMVr (MitraClip) with guideline-directed medical therapy (GDMT) or surgical repair in adult patients with SMR. …

Investigations On The Pharmacognostic Characteristics Of Capparis Species I-Lectins, Hussein Ali Hussein Al-Sa'idy, Abbas Khazaal Okab, Hussein K. Alkufi, Hayder Naji Sameer

Maaen Journal for Medical Sciences

Background: As glycoproteins widely distributed in the plants of carbohydrate binding specificity, lectins are considered macromolecules of paramount significance. Their sugar based binding dependent agglutination property nominates them for blood grouping as well as GIT complications management.

Objective: Exploring the nature, classifications, and pharmacological properties of lectins, particularly those found in Capparis species and their aqueous extracts within the last 20-25 years is the aim of this review.

Methods: This review evaluates pharmacological studies of Capparis lectins, emphasizing therapeutic effects identified through focused keyword searches.

Results: Capparis lectins and aqueous extracts exhibit diverse biological activities, including anti-rheumatic, hypoglycemic, immunomodulatory, and …

Hurricane Helene, One Year Later: Lived Experience, Geraldine A. Miller

Journal of Appalachian Health

Ashe County is located in the northwestern corner of North Carolina (NC), bordered by Virginia and Tennessee. The county is isolated, mountainous, and historically has lacked good highway access. Hurricane Helene, a category 4 hurricane at landfall, struck Western NC on September 27, 2024, resulting in flooding and wind damage that destroyed local communities in terms of land, homes, bridges, water, electricity, etc. with a damage of $59.6 billion.⁶ One year later, the recovery from the hurricane continues draining individuals and communities of their time, energy, and money. Geri Miller reflects on her hurricane impact experiences a year later. …

Associations Between Social Media Usage, Physical Activity And Flourishing In Rural University Students, Anna Dysart, Minu Sara Thomas

Journal of Appalachian Health

Introduction: Most adolescents and young adults report significant use of social media.^1-3 However, there is limited research on the effect of social media use, specifically on physical activity and flourishing.

Purpose: This pilot research study examines the correlation between social media usage and the physical activity and flourishing levels of college students at a rural university in Appalachia.

Methods: The authors conducted a survey including the validated Secure Flourishing Index and Stanford Leisure-Time Activity Categorical Item, containing questions on social media use and demographics. Spearman’s rho was used for nonparametric correlations. Pearson’s correlation was used to determine the correlation …

Impact Of West Virginia Abortion Ban On West Virginia Physician Trainee Practice Intentions, Rebecca Wald, Kristy Ward, Sarah Dotson

Journal of Appalachian Health

In June 2022, the Dobbs v Jackson Women’s Health Organization overturned the constitutional right to abortion established by Roe vs. Wade. Shortly after, West Virginia (WV) began enforcing a near total ban on abortion. Statewide restrictions on access to reproductive health care have important implications for the recruitment and retention of physicians. This project aimed to determine overall awareness of the 2022 changes in abortion laws among physician trainees, and whether the law influenced the intention of resident/fellow physicians to practice medicine in the state following completion of their medical training. A total of 178 resident and fellow physicians at …

Impact Of A Workshop On Rural Healthcare Delivery On Medical Student Attitudes, Robert L. Snedegar, Ryan Hayes, Jun Xiang, Treah Haggerty, Kendra Unger, Jason Oreskovich, Amie M. Ashcraft

Journal of Appalachian Health

Introduction: Rural residents in the United States (U.S.) experience significant health disparities due to social determinants such as poverty, geographic isolation, and limited healthcare access. Physician shortages in rural areas further exacerbate these challenges.

Purpose: This study evaluates the impact of an educational workshop on medical students’ attitudes toward rural healthcare barriers, aiming to determine whether targeted education can enhance their understanding and interest in rural practice.

Methods: Third-year medical students at the West Virginia University School of Medicine participated in a workshop that included a 20-minute pre-recorded lecture and a 90-minute interactive virtual session. Pre- and post-surveys assessed students’ …

Leveraging Community Health Worker’S Deep Community Knowledge To Address Food And Nutrition Security In Appalachia, Alexis Kimbro Scott, Melissa D. Olfert, Dawn Brewer, Makenzie Barr, Julie Plasencia

Journal of Appalachian Health

Introduction: Community health workers (CHWs) are trusted professionals in communities because of the deep understanding and cultural insights learned from their lived experiences. In Appalachia, CHWs are embedded in the community, giving them a unique understanding of how social determinants, like food and nutrition security, impact health outcomes.

Purpose: This study aimed to examine the professional characteristics and knowledge of CHWs while identifying culturally sensitive practices around food insecurity.

Methods: This cross-sectional, mixed-methods study used an online survey and in-depth phone interviews with CHWs in the Appalachian Region to examine their professional characteristics and knowledge on food security in their …

Stigmatization And Healthcare Inequity Perceived By Individuals Served By Homeless Shelters In An Appalachian City, Molly Powney, James M. Mears, Reagan Sharp, Lisa Calderwood

Journal of Appalachian Health

Introduction: People experiencing homelessness are medically vulnerable and suffer disproportionately from chronic physical and mental health conditions. Evidence-based standards to inform decisions surrounding care would be valuable for this population. Studies exploring how homeless individuals in Appalachia perceive their interactions with the healthcare system remain limited, however.

Purpose: The purpose of this study is to assess perceptions of the healthcare system among homeless individuals served by temporary housing shelters in an Appalachian city.

Methods: A voluntary anonymous survey was administered to residents at three shelters in Charleston, West Virginia (WV) from September 2023 – March 2024. Responses were collected utilizing …

Geospatial Analysis Of Breast Cancer Incidence, Mortality, And Access To Screening In Rural And Appalachian Virginia, Jennifer Osher, Caleb Brown, Phillip Nichols, Tariq Ayubi, Jeremy Powers

Journal of Appalachian Health

Introduction: Breast cancer is the most common malignancy among women in the United States (U.S.), despite recent survival rates improving nationally. However, rural and Appalachian regions have experienced slower mortality declines. These communities face unique health care-related challenges that may contribute to observed disparities.

Purpose: The purpose of this study is to assess differences in breast cancer incidence, mortality, and mortality-to-incidence ratio (MIR) between Appalachian and non-Appalachian counties, as well as rural and non-rural counties in Virginia (VA). Furthermore, we aim to evaluate whether availability of mammography is associated with these differences.

Methods: County-level breast cancer incidence and mortality data …

Influence Of Family Health History And Parental Education On Body Mass Index, Blood Pressure, And Lipid Levels In 5th Grade Children: A Secondary Data Analysis Of The Cardiac Project, Madha Rani Das, Lee A. Plyes, Eloise Elliott, Christa L. Lilly

Journal of Appalachian Health

Introduction: Childhood obesity and related cardiovascular risks reflect the interplay of genetic predispositions and socioeconomic adversity. Appalachia’s poverty, limited health care, and educational gaps worsen family health risks, driving early cardio-metabolic problems in children, highlighting the need for effective interventions.

Purpose: The purpose of this study is to examine the association of family health history and parental education with BMI, BP, and lipid profiles among 5^th grade children in West Virginia (WV).

Methods: The study used WV CARDIAC data from 2006–2009. Outcomes were BMI, SBP/DBP, and fasting lipids (HDL, LDL, TG). Predictors were parental education and family health history …

Understanding Breastfeeding Practices In Tennessee: Goals, Duration, And Reasons For Discontinuation, Amir Alakaam, Chia-Lin Chang, Hannah Jeffery

Journal of Appalachian Health

Introduction: Breastfeeding is widely recognized as the optimal source of infant nutrition, offering many health benefits.

Purpose: The purpose of this study was to examine goals, exclusivity, and duration of breastfeeding and explore factors that influence breastfeeding practices among individuals in Tennessee (TN).

Methods: A cross-sectional study was conducted among individuals (N = 1,249). Participants were recruited and data were collected from June – September 2021. The data were entered and analyzed from September 2022 – March 2023. Descriptive statistics, chi-square test, and ANOVA were used to analyze the data and identify associations between variables.

Results: About 32% of the …

Positive Psychology Interventions For Posttraumatic Stress Disorder (Ptsd) Among Earthquake Survivors In Nepal, Niusha Karki, Melissa C. Henry, Mark M. Leach

Trauma Counseling and Resilience

Natural disasters produce both community and individual trauma; Nepal’s 2015 and 2023 earthquakes exemplify this enduring impact. Previous literature has discussed the effects of PTSD and other mental health concerns post-disasters, providing some context to the difficulties in providing counseling services to those in need. However, little is known about unique psychological, cultural, and contextual factors in Nepal and how their influence and understanding may result in modifying traditional PTSD counseling interventions found in much of the existing professional literature. The purpose of this conceptual paper is to propose a culturally responsive, strengths-based framework that integrates positive psychology interventions, positive …

Individualised Homoeopathic Treatment Of Menstrual Distress In Adolescent Girls- A Case Series, Neha Kalra, Ritika Saxena, Anjula Narang, Subhash Kaushik

Indian Journal of Research in Homoeopathy

Introduction: Menstrual distress is a broad term describing the constellation of physical, emotional, and behavioural symptoms that occur about menstruation and cause discomfort or disruption to daily life. These symptoms can include abdominal cramps, backache, breast tenderness, mood swings, irritability and sleep disturbances. This complex impact ex tends beyond pain alone and reflects the multifaceted burden that menstruation may impose. This case series brings forth eight adolescent girls suffering from menstrual distress, who were successfully treated with individualised Homoeopathy. Case summary: The results of this case series demonstrate a mean reduction in total Menstrual Distress Questionnaire (MEDI-Q) score …

Effectiveness Of Homoeopathic Medicines In Reducing The Size Of Non-Specific Chronic Leg Ulcers - A Single-Arm, Prospective Observational Study, Greeshma Ik, Dastagiri P

Indian Journal of Research in Homoeopathy

Background: A chronic leg ulcer (CLU) is a chronic wound of the leg that does not tend to heal easily. Venous, arterial insufficiency, diabetes mellitus, or a combination of these factors may cause pain, restricted mobility, impaired social activities, and increased personal expenses, all of which can adversely affect the quality of life. Objectives: To determine the e ectiveness of homoeopathic medicines in reducing the size of non-specific chronic leg ulcers using the Leg Ulcer Measurement Tool (LUMT) and changes in the quality of life by the Euro QoL (EQ-5D-3L) score. Materials and methods: A prospective clinical study was …

Innovative Philanthropy And Community-Based Approaches: Bridging Access To Sustainable Solutions In Low-Infrastructure Settings, Stephanie Zabriskie

Journal of Nonprofit Innovation

Nonprofits operating in remote or low-infrastructure environments often encounter structural barriers that undermine social impact, especially for women and girls. These barriers are frequently attributed to funding shortages or lack of innovation. However, evidence from practice suggests that many social problems in these contexts persist not because solutions do not exist, but because they do not reach the communities who need them. This thought paper examines the role of nonprofit organizations as bridging agents that connect existing solutions to underserved communities, using women’s health access in East Africa as a case example. The analysis highlights the limitations of episodic philanthropic …