Factors affecting antenatal corticosteroid use in low- and middle-income countries: Facility characteristics, structural readiness, and past performance of CEmONC signal functions.

Antenatal corticosteroids (ACS) utilization is disproportionately limited in low- and middle-income countries where most global preterm newborns who could benefit from this intervention are born. Understanding the factors affecting ACS use is crucial for improving its uptake. This study aimed to investigate facility-level factors associated with ACS use in low-resource countries.

Selecting Cost-Effectiveness Methods for Health Benefits Package Design: A Systematic Approach.

Background: Cost-effectiveness (CE) is a common prioritization criterion in health benefits package (HBP) design. However, to assess CE is a time- and data-demanding process, so most HBP exercises rely wholly or partially on global evidence. Extensive investment has been made in analyses, models, and tools to support cost-effectiveness analyses (CEAs) for HBPs.

Pathways to an Intergovernmental Panel on Pandemics: lessons from the IPCC and IPBES.

Pandemics pose a global threat to human wellbeing, justice, economies, and ecosystems and are comparable with other planetary crises such as climate change and biodiversity loss in terms of urgency and impact. The global community would benefit from a dedicated scientific synthesis body to assess pandemic risks and solutions. In this Personal View, we explore proposals for an Intergovernmental Panel on Pandemics and assess potential pathways to its creation.

The effect of performance-based financing interventions on health worker motivation and job satisfaction: experimental evidence from six national pilots.

A long-standing concern suggests that performance-based financing (PBF) may undermine the intrinsic motivation of health workers by heightening extrinsic motivation concerns via the novel introduction of financial incentives. However, the theoretical effect of PBF on worker motivation and job satisfaction is ambiguous as these programs may also improve working conditions, staff engagement, and other factors that determine health worker morale. We use data from six evaluations of national pilots to empirically assess the effect of PBF on worker motivation and job satisfaction.

A cost-effectiveness analysis of Molnupiravir and Paxlovid for outpatient treatment of COVID-19 in three African countries.

Background: Two COVID-19 oral antivirals (COAVs), Molnupiravir and Paxlovid, have been shown to be cost-effective in high-income countries.

Aim: This study assesses the cost-effectiveness of Paxlovid and Molnupiravir, compared to usual care in three African countries.

Setting: The study was conducted using data from Ghana, Rwanda and Zambia.

Estimating global antibiotic needs for chronic obstructive pulmonary disease and community- and hospital-acquired pneumonia in 20 countries: A modelling analysis.

Introduction: Antibiotic stewardship advocates for prudent antibiotic use. However, estimates of "appropriate" antibiotic use remain limited.

Methods: We estimated the total antibiotics required to treat chronic obstructive pulmonary disease (COPD) exacerbations and pneumonia in 2019 across the 20 most populous countries.

Antenatal corticosteroids for pregnant women at risk of preterm labour in low- and middle-income countries: utilisation and facility readiness.

Background: Administering antenatal corticosteroids (ACS) to pregnant women at risk of imminent preterm labour improves newborn survival. However, ACS remains substantially underused in low- and middle-income countries (LMICs), where most preterm births occur globally. Providing ACS in inadequately equipped settings can be harmful.

Evolving Landscape of Modern Contraceptive Use in Ethiopia: A Two-Decade Analysis.

Objective: The prevalence of modern contraceptive use in Ethiopia has increased in the past two decades. Despite these efforts, unmet needs for modern contraception persist, with limited knowledge on regional variations and determining factors.

Method: We analyzed data from the Ethiopian Demographic and Health Surveys (EDHS) from 2000, 2005, 2011, 2016, and 2019.

Is health technology assessment value for money? Estimating the return on investment of health technology assessment in India (HTAIn).

An increasing investment in health technology assessment (HTA) in low-income and middle-income countries has generated greater interest from policy-makers about the value and return on investment (ROI) of HTA. Few studies have, however, quantified the benefits of HTA in terms of its value to the health system. This evaluation aims to quantify the impact and ROI achieved by the HTA agency in India (HTAIn).

The teachers who leave: Teacher attrition in Burkina Faso.

High teacher attrition affects education systems through direct costs in replacing teachers who left the service, and indirect costs in classroom disruption and loss in experience. Efforts to address teacher shortage must be informed by which teachers leave and why. Using administrative data from Burkina Faso, we aimed to analyze the demographic and geographic correlates of teacher turnover.

Rethinking Trust and Public Health Compliance: Introducing a Trust Continuum for Policy and Practice.

Trust in government has emerged as one of the strongest predictors of national performance in fighting COVID-19. This commentary aims to take stock of the vast literature on trust and compliance with public health measures that has emerged during the pandemic to synthesize policy-relevant recommendations about: 1) How to conceptualize trust; 2) Whether trust is always deserved; and 3) How governments can earn (appropriate levels of) trust. Based on a critical reading of the literature, we develop a framework that conceptualizes trust as falling along a continuum ranging from extreme distrust to blind trust with the ideal point- "informed" or "basic" trust-falling in the mid-point of the continuum.

Trends in functional limitations among middle-aged and older adults in the Asia-Pacific: survey evidence from 778,507 observations across six countries.

Background: There are few studies comparing health status trends among middle-aged and older adults in countries currently experiencing a rapid demographic and economic transition in the Asia-Pacific, relative to their high-income regional counterparts. This study investigates trends in functional limitations among individuals aged 45 years and above in six major Asia-Pacific countries, ranging from middle- to high-income, from 2001 to 2019 and examines disparities across socioeconomic and demographic sub-groups.

Methods: Data on 778,507 individuals from seven surveys in three high-income countries (Australia, Japan, South Korea) and three middle-income countries (China, Indonesia, and India) were used.

Exploring adaptive health technology assessment for evaluating 10 cancer interventions: insights and lessons from a pilot study in India.

Background: Health technology assessment (HTA) is a valuable tool for informing the efficient allocation of resources in healthcare. However, the resource-intensive nature of HTA can limit its application, especially in low-resource settings. Adapting HTA processes by assessing the available international evidence offers a pragmatic approach to provide evidence for decision-making where resources are constrained.

Health benefits package selection in oncology: a clinical audit of palliative chemotherapy for breast cancer in an Indian health insurance scheme.

Background: The effective operation of health insurance requires functioning administrative processes, including appropriate filing for reimbursements. The unlisted palliative care package is one of the most utilized oncology packages within Indian state health insurance schemes. We conducted a clinical audit to evaluate the appropriateness of claims for this package for patients with breast cancer.

Evaluating the Effectiveness and Scalability of the World Health Organization MyopiaEd Digital Intervention: Mixed Methods Study.

Background: The rapid rise of myopia worldwide, particularly in East and Southeast Asia, has implied environmental influences beyond genetics. To address this growing public health concern, the World Health Organization and International Telecommunication Union launched the MyopiaEd program. South Korea, with its high rates of myopia and smartphone use, presented a suitable context for implementing and evaluating the MyopiaEd program.

Maternal Wealth Implications of Child Incarceration: Examining the Upstream Consequences of Children's Incarceration for Women's Assets, Homeownership, and Home Equity.

Qualitative research has documented mothers' critical role in supporting adult children during and after incarceration. Yet, the implications of incarceration for mothers have been relatively unexplored. Wealth research has also largely overlooked the influence of adult children on parental wealth.

The Future of Health Technology Assessment in Low- and Middle-Income Countries.

In recent decades, low- and middle-income countries (LMICs) have turned to health technology assessment (HTA) to prioritize health care interventions in pursuit of universal health coverage. HTA has demonstrated its value through significant cost savings, as shown by Thailand and Brazil, where HTA processes facilitated substantial government savings and drug price reductions. Despite these successes, many LMICs still struggle with insufficient capacity to conduct HTA or incorporate its findings into policy decisions.

Global health 2050: the path to halving premature death by mid-century.

Global health 2050 (GH2050), a new report from the Lancet Commission on Investing in Health, finds that dramatic improvements in human welfare are achievable by mid-century with focused health investments. By 2050, countries that choose to do so can halve their probability of premature death (PPD)—the probability of dying before age 70—from their pre-pandemic level in 2019. We call this goal “50 by 50”: a 50% reduction in PPD by 2050.

Sexist textbooks: Automated analysis of gender bias in 1,255 books from 34 countries.

Textbooks play a critical role in schooling around the world. Small sample studies show that many books continue to under-represent women and girls, and to portray men and women in stereotypical gendered roles. In this paper, we use quantitative text analysis to assess the degree of gender bias in a newly assembled corpus of 1,255 English language school textbooks from 34 countries that are publicly available online.

Establishing national hospital costing systems: insights from the qualitative assessment of cost surveillance pilot in Indian hospitals.

Objective: The Indian Government launched Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY), the world's largest health insurance scheme, in 2018. To reform pricing and gather evidence on healthcare costs, a hospital cost-surveillance pilot was initiated among PM-JAY empanelled hospitals. We analysed the process and challenges from both healthcare providers and payer agency's perspectives and offer recommendations for implementing similar systems in lower- and middle-income countries.

Injectable antibiotic use in India: public-private share in volume and cost.

Background: Consumption of injectable antibiotics is not widely studied, despite injectables constitute a major share of antibiotic cost. This study aimed to understand the share of oral and injectable antibiotic consumption and cost at the national level in India, and the public and private sector shares in the provision and cost of injectables in Kerala state.

Methods: We used the PharmaTrac private sector sales dataset and the Kerala Medical Services Corporation public sector procurement dataset.

A pilot study of upcycled smartphone-based colposcopy for visual inspection of cervix performed by community healthcare workers in rural Vietnam.

Objective: This study assessed the feasibility of smartphone-based colposcopy (SBC) for visual inspection of the cervix by community healthcare workers in low-resource areas.

Methods: This was a retrospective study conducted in community villages in rural Vietnam, where 177 participants were enrolled for a cervical cancer screening. Cervical images were obtained by pre-trained community healthcare workers using a portable, upcycled SBC (Samsung Galaxy Note 20).