International Public Health Commons^™

The Role Of Social Health Insurance In Achieving Universal Health Coverage In Asia: A Systematic Review, Afaf Jauhar, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Universal Health Coverage (UHC) aims to ensure that all individuals have access to essential health services without financial hardship. Social Health Insurance (SHI) is critical in achieving this goal, especially in low- and middle-income countries. This systematic review explores the role of SHI systems in advancing UHC across 14 Asian countries, focusing on healthcare access, financial protection, and equity. A comprehensive search across PubMed, Scopus, and ScienceDirect identified 768 articles, and 37 studies were selected after screening, following the PRISMA guidelines. The chosen studies cover countries with varying SHI models across Asia. The findings reveal that high-income countries such as …

Priorities To Care Within The Military Health System: A Mixed Methods Study On Military Spouse Access To Care During Covid-19 On Okinawa, Elayne L. Wilson

Theses & Dissertations

Military spouses in Okinawa experienced denial of care at military treatment facilities and off base Japanese healthcare facilities during the COVID-19 pandemic. Over two years of travel restrictions further contributed to difficulties accessing healthcare while stationed on the island with their active-duty spouse. This study examined the implications of a priority-based access system through the TRICARE program implemented due to limited resources during COVID-19 and its impact on military spouses in a scarce medical resource environment. This concurrent mixed-methods research used a survey tool developed by Community First Hawaii to quantify access to healthcare and in-depth interviews to further explore …

Bio-Preparedness In A Global Context: Multi-Site International Study Investigating Global Health Security Challenges In Egypt, Oman, And The United States, Rima M. Al Balushi

Theses & Dissertations

The COVID-19 pandemic exposed myriad vulnerabilities globally within public health systems, from inadequate bio-risk management in laboratories to overwhelming utilization of hospital resources and disparities in vaccine access and uptake. The Global Health Security Index (GHSI), which critically evaluates health security domains including health systems and risk environments, reports serious weaknesses in global health security. This dissertation aims to investigate critical aspects of global health security domains by examining factors impacting biosafety and biosecurity capacities in laboratories in Egypt, healthcare resource utilization in hospitals in Oman relating to acute respiratory infections (ARI), and COVID-19 vaccine uptake in the United States. …

Analysis Of Public Opinion Polls About Covid-19 Vaccines: Theoretical And Policy Implications For Vaccine Communication And Campaigns To Address Vaccine Hesitancy, Muhammad Ittefaq, Hong Tien Vu, Ali Zain, Tayyeb Ramazan, Gary L. Kreps

School of Communication Studies - Faculty Scholarship

This study analyzed 1432 questions asked in 19 surveys (N = 43,014) on COVID-19 vaccines between January 2020 and August 2022 using dimensions including (1) information sources about COVID-19 vaccine, (2) information about the access, effectiveness, and side effects of COVID-19 vaccine, (3) COVID-19 vaccine hesitancy (i.e. false perception, skepticism, and vaccine refusal), (4) motivations to get the COVID-19 vaccine (i.e. to perform routine activities, convenience, incentives, influences, and travel requirement), (5) false perceptions caused vaccine refusal, and (6) intentions to get vaccinated. Our results show that vaccine refusal was rampant throughout the pandemic and mostly attributed to the …

Infant Mortality Data: Missing Pieces To Prevention In Lesotho, Jacinda Croissant

Master's Projects and Capstones

Lower-middle-income countries (LMICs) like Lesotho lack complete and quality infant mortality data. Without infant mortality data, it can be challenging to develop public health education, programming, and policies to address preventative infant deaths in specific populations (Rao et al., 2004). A literature review identified strategies to improve infant mortality data in LMICs. Through a community engagement model and digital storytelling, community members can gain awareness, begin an ongoing conversation about local public health issues, and participate in an improved data collection system. Infant mortality is often used as an indicator of health for a population; improved infant mortality data can …

The Challenge Of Regulating Pharmaceutical Clinical Trials In The 21st Century With A Focus On Guatemala, Alejandro Cerón, Antonio Ricafort, Carter Saccocio, Maria Delmonte, Jordan Vasquez, Amarri Bishop, Julia Atwood, Addison Bucsko, Jordan Lewis, Alexandra Welch, Itzael Garcia, Ella Wald, Selena Johnson, Crystal Jin, Talya Riciputi, Lindsey Speer, Vanessa Udo-Obong, Soren Engberg, Tessa Lindstrom

Anthropology: Undergraduate Student Scholarship

This report was prepared by the students and instructor of the "Right to Health in Theory and Practice" class taught in the fall of 2024 at the University of Denver. The report was prepared for the Vice Ministry of Health Regulation, Surveillance and Control of the Ministry of Public Health and Social Assistance of Guatemala. The work used the following guiding question: What can a country like Guatemala do to regulate international pharmaceutical clinical trials in the context of research commercialization? In other words, the work was guided by three important elements. First, the regulatory aspect of clinical trials. Second, …

Exploring The Contribution Of Mobile Money To The Well-Being Of Rural Tanzanian Villagers And Assessing Their Readiness To Adopt A Similar Model To Advance Their Healthcare Access An Exploratory Study, Sr. Magdalena P. Chubwa

Seton Hall University Dissertations and Theses (ETDs)

Background: Healthcare for rural villages in Tanzania has always been rudimentary. Lack of the infrastructure and poverty are among the many obstacles facing this population’s access to healthcare. While, the rise of telehealth has improved access to healthcare in many parts of the world, its use in rural Tanzania has been extremely limited to poor internet access. However, given the availability of non-internet connected mobile phones in rural Tanzania, the potential to use this devise to improve healthcare access exists. Individuals using mobile phones for financial transactions may be motivated to access healthcare via telehealth by using their non-internet connected …

Economic Growth, Poverty Gap, And Health Inequality: Implications Based On Panel Analysis Of Organization For Economic Cooperation And Development Data, Sangik Han

Kesmas

This study investigated the impact of economic growth and income distribution on health inequality using data from the Organization for Economic Cooperation and Development (OECD). Employing a panel analysis, this study amalgamated 21 years of data (spanning from 2000 to 2020) from 37 OECD countries. The dependent variables (life expectancy and avoidable mortality) were scrutinized against independent variables (gross domestic product and poverty gap). Control variables encompassed body mass index, consumption patterns, smoking rates, health workers availability, number of beds in health facilities, national medical expenses, and unemployment rates. This study revealed significant associations between economic growth, poverty gap, and …

Strategies To Enhance Diagnostic Capabilities For The New Drug-Resistant Tuberculosis (Dr-Tb) Drugs, Antonia Morita Iswari Saktiawati, Anca Vasiliu, Francesca Saluzzo, Onno W Akkerman

Faculty, Staff and Students Publications

The global burden of drug-resistant tuberculosis (DR-TB) continues to challenge healthcare systems worldwide. There is a critical need to tackle DR-TB by enhancing diagnostics and drug susceptibility testing (DST) capabilities, particularly for emerging DR-TB drugs. This endeavor is crucial to optimize the efficacy of new therapeutic regimens and prevent the resistance and overuse of these invaluable weapons. Despite this urgency, there remains a lack of comprehensive review of public health measures aimed at improving the diagnostics and DST capabilities. In this review, we outline strategies to enhance the capabilities, especially tailored to address the challenges posed by resistance to new …

Progress In Physical Activity Research, Policy, And Surveillance In Canada: The Global Observatory For Physical Activity – Gopa!, Ashley Cathro, John C Spence, Christine Cameron, Andrea Ramirez Varela, Diana Morales, Eduardo Ribes Kohn, Michael Pratt, Pedro C Hallal

Faculty, Staff and Student Publications

BACKGROUND: The purpose of this paper is to examine the evolution of physical activity research and the comprehensiveness of national physical activity policies and surveillance systems in Canada.

METHODS: A systematic review was conducted by the Global Observatory for Physical Activity (GoPA! ) on physical activity and health publications between 1950 and 2019. Findings from Canada were extracted and included in the present analysis. The number of articles published, female researcher involvement in authorship, author institution affiliations, and publication themes were examined. Policies were evaluated by determining if there was a standalone physical activity plan and if national guidelines existed. …

Sex Ratio At Birth Across 100 Years In Sweden And Risk Of Cardiovascular Disease And All-Cause Mortality – A National Register Study, Peter M Nilsson, Kristina Sundquist, Jan Sundquist, Casey Crump, Xinjun Li

Faculty, Staff and Student Publications

The human sex ratio at birth (SRB) undergoes temporary changes around a mean proportion of 0.51 male births. SRB has been well studied for historical, geographical, and secular trends, but until now not linked to health outcomes in the total population, e.g. for cardiovascular disease (CVD) or mortality during follow-up of birth cohorts. We used linkage analysis based on national registers in Sweden that cover all births from 1900 to 2016. SRB at birth was calculated by every 10-year birth cohort in all survivors living in 1997 for a follow-up analysis of risk of CVD and mortality with data from …

The Performance Relationship Between The Eq-5d-5l Composite "Anxiety/Depression" Dimension And Anxiety And Depression Symptoms In A Large, General Population Sample, Emily Stella Scott, Erica I. Lubetkin, Mathieu F. Janssen, John N. Yfantopolous, Gouke J. Bonsel, Juanita A. Haagsma

Publications and Research

Purpose

This cross-sectional study aims to understand the relationship between responses on the Anxiety/Depression (A/D) dimension of the EQ-5D-5L and symptoms of anxiety and depression on the GAD-7 and PHQ-9 instruments. In doing so, we investigate the comparative performance of the dimension between diagnostic groups (i.e. anxiety (GAD-7); depression (PHQ-9); anxiety & depression versus none). We additionally investigate the discriminatory performance between sub-populations based on gender, age, education and self-reported chronic conditions.

Methods

19,902 general population participants completed a health survey in May/June 2020, from five European countries and the United States. Performance of A/D was calculated using the Area …

Global Perspective Of The Risks Of Falsified And Counterfeit Medicines: A Critical Review Of The Literature, Aonghus J. Feeney, Jeffery A. Goad, Gerard T. Flaherty

Pharmacy Faculty Articles and Research

Background

Methods

Evaluating The Effectiveness Of Hiv/Aids Interventions In Lesotho, Maya Gomez Velardez

Master's Projects and Capstones

Lesotho faces a severe HIV/AIDS epidemic, with one of the highest prevalence rates globally, impacting its public health, economy, and society. Despite numerous efforts, the country continues to struggle with persistently high infection rates, highlighting the need to thoroughly evaluate current interventions. This review examines the effectiveness of various HIV/AIDS interventions in Lesotho, focusing on multi-level strategies within the Social Ecological Model. The paper synthesizes literature from 2013 to 2023, concentrating on antiretroviral therapy (ART) coverage, community initiatives, and efforts targeting high-risk groups. Key strategies involve expanding ART coverage, strengthening community-based healthcare through community health workers (CHWs), and enhancing initiatives …

The Frequency And Predictive Factors Of Change In Alcohol Consumption During The Covid-19 Pandemic: Results From A Multi-Country Longitudinal Study, Carolien Verhei, Nadja Alexandrov, Erica I. Lubetkin, Gouke J. Bonsel, John N. Yfantopoulos, Mathieu F. Janssen, Stephanie C.E. Schuit, Suzanne Polinder, Pleunie P.M. Rood, Juanita A. Haagsma

Publications and Research

Background: The COVID-19 pandemic has had multiple health and behavioral effects in the general population worldwide, including effects on nutritional and lifestyle behavior such as alcohol consumption. This study aimed to determine the frequency of and predictors for change in alcohol consumption two years after onset of the COVID-19 pandemic among participants from the general population of six countries. Methods: Longitudinal study design with 4999 participants (47% male; aged 18–75 years) from a general population cohort from six countries: Greece, Italy, the Netherlands, Sweden, the United Kingdom (UK) and the United States of America (US). Measurements: Three web-based surveys at …

The Relationship Between Healthcare Access And Change In Health-Related Quality-Of-Life Among The General Population Of Five Countries During The Covid-19 Pandemic, Nadja Alexandrov, Emily Stella Scott, Mathieu F. Janssen, Erica I. Lubetkin, John N. Yfantopoulos, Gouke J. Bonsel, Juanita A. Haagsma

Publications and Research

Purpose To determine whether (1) healthcare access at onset of the pandemic and (2) age, gender, socioeconomic status (SES), and pre-existing health status were associated with change in health-related quality-of-life (HRQoL) during the COVID-19 pandemic. The study includes a general population sample of five countries.

Methods An online questionnaire was administered to respondents from Greece, Italy, the Netherlands, the UK, and the US at the onset of the COVID-19 pandemic between April 22nd and May 5th of 2020, and 1 year later between May 23rd and June 29th of 2021. The questionnaire included questions on demographic background, health status, and …

Advanced Practice Nursing Initiatives In Africa, Moving Towards The Nurse Practitioner Role: Experiences From The Field, Deborah C. Gray, Melanie Rogers, Minna K. Miller

Ellmer School of Nursing Faculty Publications

AIM: This paper discusses the development and progression of the advanced practice nurse practitioner role in Africa.

BACKGROUND: Providing adequate primary health care is problematic in Africa. The World Health Organization and International Council of Nurses proposed that nurses, specifically advanced practice nurse practitioners with the requisite skills in disease prevention, diagnosis and management, can be key to solving the primary care issue.

SOURCES OF EVIDENCE: This paper utilized publications from PUBMED, CINAHL, policy papers, websites, workgroups, conferences, and the experiences and knowledge of authors involved in leading and moving forward key events and projects.

DISCUSSION: Four African countries have …

What Is The Efficacy Of The Newly Developed Hpv Vaccine, Cecolin, In Providing Protection Against Hpv-Induced Cervical Cancers In Females Aged 9-14 Years Old, Yolanda Williams

Rowan-Virtua Research Day

In low to middle income countries, there's a rise in invasive cervical squamous cell carcinoma. Affordability emerges as a crucial factor influencing this trend. This research is based on the development of a new HPV vaccine made in China called Ceolin priced at $47 and its efficacy to be incorporated into the WHO vaccination program. A peer review was conducted based on an ongoing randomized phase 3 clinical trial of a 2 dose regimen bivalent Cecolin vaccine (types 16,18) . The study includes 1025 females aged 9-14 years old split amongst 5 groups. The control group received Gardasil at the …

Association Between Cultural Factors And Postpartum Depression, Usha Modukuru

Rowan-Virtua Research Day

Postpartum depression (PPD) is present in 17.22% of the world population. The negative physical and psychological impacts of PPD impact not only the mother, but also those around her. This raises the importance of identifying factors contributing to its onset. Studies have shown that PPD prevalence rates vary between non-Western and Western regions of the world. Cultural postpartum practices differed significantly region to region. Search terms including postpartum depression and cultures were used to find peer-reviewed articles, primary surveys, and patient interviews between 2013-2023. Qualitative analyses were performed on the results. Ethnokinship cultures, commonly present in non-Western countries, prioritized social …

A Comparative Analysis Of Hiv/Aids In France And The United States: Historical Context And Preventative Actions, Rebecca A. Liebsack

Honors Program: Senior Projects (Public)

The HIV/AIDS pandemic is the result of transmission of a zoonotic disease known as simian immunodeficiency virus. The pandemic has had profound social and economic consequences and continues to be present today. France and the United States’ response to the discovery of HIV will be compared and the impact that HIV/AIDS had on their countries and future responses. They had rather similar responses, however, the United States had a slower initial response compared to France. Both had similar takeaways such as aiming at improving prevention and utilizing tactics developed during the start of the pandemic like frequent testing and vaccines.

Cost Saving And Resource Limited Public Health Interventions In Southeast Asia, Amanda Blackwelder

Electronic Theses and Dissertations

Background: Public health interventions are any activity with the objective of improving human health such as preventing or curing disease, reducing the severity or duration of a disease, or assisting in regaining function after a disease or injury. These interventions are known to be impactful; however, those living with the highest burden of disease such as individuals in low- and middle-income countries have limited money and resources to successfully implement these interventions. Southeast Asian countries are among some of the middle-income countries effected by the lack of affordable interventions. The aims of this study were to assess cost saving and …

February In Santiago Atitlan, Guatemala, Grace Milburn

Posters

Describes her experience working in Santiago Atitlan, Guatemala.

The Association Between Prenatal Care And Postpartum Depression: Current State And Future Directions, Esther Adebayo-Abikoye

Electronic Theses and Dissertations

Background

Postpartum depression (PPD) is a major public health challenge and associated with poor maternal and infant health outcomes. Quality prenatal care decreases adverse outcomes in pregnancy and may reduce PPD risk factors. This study critically reviews the evidence about the role of prenatal care practices in reducing PPD prevalence across population groups and examines the association between prenatal care timing and counseling content with PPD prevalence.

Methods

A scoping review was completed across eight databases to synthesize evidence about prenatal care and PPD across different contextual settings. National data from the Pregnancy Risk Assessment Monitoring System (PRAMS) was used …

One Year Follow Up Of A Cross-Sectional Study Of Hookworm Infection And Response To Deworming In Beposo, Ghana, Taylor Clarkson

Capstone Experience: Master of Public Health

Hookworms are soil-transmitted helminths that infect over 500 million people worldwide, primarily those in low-income countries. Infection with hookworm can cause anemia, malnutrition, and stunted physical and cognitive development. Deworming campaigns have attempted to combat hookworm infections in endemic areas for decades. However, there is growing variability in the effectiveness of deworming drugs, and post-treatment reinfections are abundant. There are significant gaps in our understanding of critical host-parasite factors that mediate hookworm infection, reinfection, and response to deworming treatment in endemic communities. A five-year prospective study was undertaken to better understand drivers of hookworm infection in rural Ghana and thus …

Expanding Global Health Dermatology Leadership: Launching The Gloderm International Mentorship Program, Alexis G. Strahan, Olivia M. Davies, Lucía T. Fernández, Inena Wa Inena Gaylord, Yared Getachew Mekonnen, Marlous L. Grijsen, Jose E. Ollague, Doriane Sabushimike, Luisa Polo Silveira, Toby Maurer, Roni P. Dodiuk-Gad, Archana Singal, Henry W. Lim, Arpita Bhose, Janet E. Lubov, Shivani Jain, Morvarid Zehtab, Tom Allison, Maud Guerin, Wendemagegn Enbiale, Wingfield Rehmus, Karolyn A. Wanat, L Claire Fuller, Elizabeth Bailey, Esther E. Freeman

School of Medicine Faculty Publications

No abstract provided.

Geographic Distribution Of Melanoma Cases In Maine: Identifying Vulnerable Counties For Targeted Intervention, Joshua R. Parbs, Madeline Prentiss, Calla Hladky, Henry Stoddard, Kathryn Stevens, Elizabeth V. Seiverling, Peggy Cyr

Journal of Maine Medical Center

Introduction: Maine has the twelfth highest incidence of melanoma in the United States. The purpose of this study was to determine which Maine counties were the most impacted by melanoma through the use of geographical methods. Identification of counties with the highest prevalence of melanoma will help in targeting future training and public health interventions.

Methods: All melanoma cases (n=5,340) reported to the Maine CDC Cancer Registry from 2013 to 2018 were sorted by pathologic T stage. Data were sorted by county and population-adjusted. Population data and provider data came from Area Health Resource Files. County and zip-code maps were …

Guest Editorial, Phyllis Ann Solari-Twadell Phd, Rn, Mpa, Faan

International Journal of Faith Community Nursing

None

Motivations Behind The Rise And Success Of Homeopathy In India, Kavya Patchipulusu

Senior Theses

Homeopathy is a form of medicine that is incredibly controversial and is often labeled as a fraudulent, placebo effect drug, that can have potentially dangerous side effects. This is the picture that is painted of homeopathy in the United States and many other countries in which these medicines are banned in distribution or highly unregulated. In contrast, India has popularized and well-integrated homeopathy into their medical systems with government backing and consistent funding towards accredited homeopathic institutions and funding hospital systems. This paper will explore the circumstances and health care dynamics of India that allowed homeopathy to gain the level …

Russians Fleeing Putin’S Country: Trauma, Daily Stressors, Anxiety, Depression, Post Traumatic Stress Disorder, Maria Mccready, David Witherington, Steven Verney, Dmitry Boltyanskiy

Brain & Behavioral Health Research Day

The turmoil unleashed by the Russian invasion of Ukraine in February 2022 triggered a mass migration of individuals from Russia to nearby countries like Armenia and Georgia. Amidst this upheaval, concerns have arisen regarding the mental well-being of Russian emigrants and their experiences during this turbulent period. To bridge this gap in knowledge, our study aims to examine the mental health status of adult Russian emigrants who departed from their homeland after the beginning of the conflict.

Drawing from a sample of 67 participants, comprising 30 females and 3 non-binary individuals, our research focuses on communities in Armenia and Georgia, …

Tuberculosis In People Of Ukrainian Origin In The European Union And The European Economic Area, 2019 To 2022, Krista Stoycheva, Veronica Cristea, Csaba Ködmön, Senia Rosales-Klintz, Dominik Zenner, Anca Vasiliu, Marieke Van Der Werf, Christoph Lange

Faculty, Staff and Students Publications

Approximately five million Ukrainians were displaced to the EU/EEA following the Russian invasion of Ukraine. While tuberculosis (TB) notification rates per 100,000 Ukrainians in the EU/EEA remained stable, the number of notified TB cases in Ukrainians increased almost fourfold (mean 2019-2021: 201; 2022: 780). In 2022, 71% cases were notified in three countries, and almost 20% of drug-resistant TB cases were of Ukrainian origin. Targeted healthcare services for Ukrainians are vital for early diagnosis and treatment, and preventing transmission.