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Research Article
Spatial Clustering of Acute Respiratory Infection Among Under-five Children and Its Covariates: A Geo-Spatial Analysis Across 707 Districts in India
Koustav Ghosh*
,
Atreyee Sinha Chakraborty,
Anjali Radkar
Issue:
Volume 10, Issue 3, September 2025
Pages:
193-208
Received:
16 May 2025
Accepted:
30 May 2025
Published:
30 June 2025
Abstract: Introduction: Acute Respiratory Infection (ARI) is one of the leading causes of under-five mortality in low-income and developing countries like India. This study aimed to investigate the spatial prevalence of ARI among children and its covariates in 707 districts of India. Methodology: National Family Health Survey-5 data has been used to show the spatial clustering of ARI prevalence and spatial association with the covariates across districts in India. We applied Moran’s I statistics and the Spatial Regression Model to fulfill the study objectives. Results: The results of Moran’s I=0.27 (p<0.001) indicate that spatial clustering exists in the prevalence of ARI among children across the districts in India. As a result, it detects 58 hot-spot and 66 cold-spot districts in India. Most hot-spot districts are from Uttar Pradesh, Bihar, and Delhi, and some are from Maharashtra, Panjab, Jammu & Kashmir, Odisha, and Assam. The results of the Spatial Error Model (SEM) highlighted that Smoking exposure in the household (β: 0.03, p<0.05), mothers with asthma/respiratory infection (β: 0.27, p<0.001), children born with low birth weights (β: 0.06, p<0.01), children who had diarrhoea 2 weeks before the survey (β: 0.15, p<0.001), and concentration of particulate matter 2.5 (β: 0.02, p<0.001) were significantly associated with ARI prevalence. Conclusion: This information will help districts level policy formulation and advocacy, which can, in turn, play an important role in reducing child morbidity and mortality due to ARI. This may help achieve the country's SDG target of 3.2 by 2030.
Abstract: Introduction: Acute Respiratory Infection (ARI) is one of the leading causes of under-five mortality in low-income and developing countries like India. This study aimed to investigate the spatial prevalence of ARI among children and its covariates in 707 districts of India. Methodology: National Family Health Survey-5 data has been used to show the...
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Research Article
Knowledge and Perception of Adult Nigerians Towards COVID-19 Vaccination: A Case Study in Southwest Nigeria
Adetinuke Fadeke Ajayi,
Gideon Babatunde Ojo*,
Olusegun Gbenga Lala,
Olayinka Susan Ogundoyin,
Ozichi Nweke Emuoyibofarhe,
Amos Taiwo Okunade,
Ehidiame Simon Dawodu,
Olubayode Bamidele,
Lawrence Adedayo,
Oladiran Afolabi,
Olusola Oluwafemi Akande
Issue:
Volume 10, Issue 3, September 2025
Pages:
210-222
Received:
16 April 2025
Accepted:
28 April 2025
Published:
30 June 2025
Abstract: Introduction and Aim: In the wake of the COVID-19 pandemic, the proliferation of misinformation concerning the disease and its preventative vaccines became a significant issue. To address this, this study investigated the knowledge and perceptions of adult Nigerians in Southwest Nigeria concerning COVID-19 vaccination. Methods: Cross-sectional online surveys’, utilizing structured questionnaire distributed via Google Forms, was employed to gather data from 309 residents across Southwestern states. The collected data were then analyzed using percentages and Chi-Square tests in SPSS to determine associations between COVID-19 knowledge and various factors including sociodemographic, vaccination knowledge, perception, awareness, and exposure to misinformation Results: The average age of respondents was 28.37 years, with a strong positive view towards COVID-19 vaccination (77.7% in favor). A significant majority believed in the vaccine's potential to combat the pandemic (88.3%), and 65.5% perceived it as safe based on their knowledge. Conclusion: Public health campaigns in Southwest Nigeria effectively reduced COVID-19 and immunization misinformation. However, continued efforts are crucial to address remaining misconceptions, particularly in rural areas and across Nigerian communities, leveraging social media and telecommunications.
Abstract: Introduction and Aim: In the wake of the COVID-19 pandemic, the proliferation of misinformation concerning the disease and its preventative vaccines became a significant issue. To address this, this study investigated the knowledge and perceptions of adult Nigerians in Southwest Nigeria concerning COVID-19 vaccination. Methods: Cross-sectional onli...
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Review Article
The Promises and Perils of Mandatory Health Insurance in Nigeria Under the National Health Insurance Authority
Issue:
Volume 10, Issue 3, September 2025
Pages:
223-230
Received:
12 May 2025
Accepted:
27 May 2025
Published:
30 June 2025
Abstract: This narrative review examines the potential of Nigeria’s National Health Insurance Authority (NHIA) to achieve universal health coverage (UHC), with a focus on implementation challenges and policy gaps. The study synthesizes peer-reviewed literature (2013-2023), policy documents, and grey literature sourced using Boolean search strategies across PubMed, Scopus, Web of Science, and Google Scholar. Expert consultations with public health specialists further informed the analysis. The review highlights major barriers including limited public awareness and trust, underfunded health budgets, poor infrastructure, a critical healthcare workforce shortage, and concerns about service quality. Socioeconomic obstacles—such as widespread poverty and high out-of-pocket payments—compound these issues. Despite its potential, the NHIA’s effectiveness is constrained by these structural challenges. To enhance impact, the study recommends multi-sectoral reforms: sustainable financing beyond donor dependency, strengthened governance and accountability, strategic investments in health systems and workforce, integration of NHIA with essential services, and broad-based community engagement. Addressing these gaps is essential for the NHIA to fulfill its mandate and advance Nigeria’s progress toward UHC.
Abstract: This narrative review examines the potential of Nigeria’s National Health Insurance Authority (NHIA) to achieve universal health coverage (UHC), with a focus on implementation challenges and policy gaps. The study synthesizes peer-reviewed literature (2013-2023), policy documents, and grey literature sourced using Boolean search strategies across P...
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Research Article
Evaluation of MPOX Epidemiological Surveillance in Senegal, 2024
Issue:
Volume 10, Issue 3, September 2025
Pages:
231-239
Received:
11 June 2025
Accepted:
23 June 2025
Published:
18 July 2025
Abstract: Monkeypox (Mpox) is a zoonotic viral infection caused by a virus of the Orthopoxvirus genus. In response to global alerts, efforts in epidemiological surveillance and infection control have intensified, following WHO recommendations for enhanced monitoring, contact tracing, and the implementation of appropriate public health measures. This study aimed to assess the epidemiological surveillance of Mpox in Senegal in 2024. This was a retrospective, cross-sectional, descriptive, and analytical study conducted over a four-month period (from July 14 to November 10, 2024). The study population included all cases sampled as part of Mpox surveillance in Senegal during this period. Key strengths in the response included the adaptation to the IDSR Kit, training of personnel at all levels on the IDSR strategy, case definition and monitoring training, development of surveillance procedures, presence of focal points for surveillance, a diversified network of reference laboratories, and the use of an electronic case notification platform. A total of 56.25% of the initially planned priority activities were completed. During the surveillance period, 100 suspected Mpox cases were reported, corresponding to 6 cases per 1 million inhabitants. Biological samples were collected from all patients. At the time of the study, no confirmed cases of Mpox were detected. Alternative viral diagnoses were established in 32% of cases—most frequently varicella-zoster virus. Co-infections were observed in 4 patients (12.5%). The median delay between symptom onset and result availability was 7 days. Symptom duration had a median of 3 days, and the median interval from consultation to result delivery was 2 days. Longer delays were significantly observed in remote or hard-to-reach areas. Overall, patient-related delays were significantly longer than surveillance-related delays (p = 0.002). Strengthening epidemiological surveillance improves sample processing times and response effectiveness. This enhancement should be prioritized in border areas and hard-to-reach regions.
Abstract: Monkeypox (Mpox) is a zoonotic viral infection caused by a virus of the Orthopoxvirus genus. In response to global alerts, efforts in epidemiological surveillance and infection control have intensified, following WHO recommendations for enhanced monitoring, contact tracing, and the implementation of appropriate public health measures. This study ai...
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Research Article
Knowledge and Awareness of Lifestyle Modifications Among Type 2 Diabetes Patients in a Nigerian Tertiary Hospital
Issue:
Volume 10, Issue 3, September 2025
Pages:
240-247
Received:
6 June 2025
Accepted:
24 June 2025
Published:
21 July 2025
Abstract: Background: Diabetes Mellitus (DM) is a global health crisis contributing significantly to both illness and mortality. The prevalence of DM in Nigeria has increased from 2.2% in 1997 to 5.77% by 2018 and 7% 2024 in Nigeria. Effective management of this condition demands not only medical interventions but also lifestyle modifications, such as dietary changes and physical activity. Objective: To examine knowledge and awareness levels on diet and physical activity among individuals with type 2 diabetes attending a tertiary health institution in North Central Nigeria. Methods: This cross-sectional study was conducted at Jos University Teaching Hospital, North Central Nigeria. A sample of 300 patients with T2DM was selected using systematic random sampling. Data was collected using self-administered structured questionnaires encompassing sections on participant demographics, dietary knowledge, physical activity awareness, and self-reported behaviours. Data analysis was performed using SPSS with descriptive statistics and appropriate inferential tests. Results: The study revealed that 61.8% of respondents had a good understanding of the role diet plays in managing T2DM, while 38.2% demonstrated poor understanding. Regarding physical activity, 54.8% showed good understanding, while 45.1% fell into the poor understanding category. A majority (59%) were familiar with the recommended weekly physical activity guidelines for individuals with T2DM. Educational attainment was significantly associated with both dietary knowledge and physical activity awareness. Gender was significantly associated with dietary knowledge, with women demonstrating better understanding than men. Conclusion: While the majority of T2DM patients demonstrated adequate knowledge of dietary and physical activity recommendations, a significant proportion still lack sufficient awareness. Educational attainment emerged as a key factor influencing knowledge levels. These findings highlight the need for targeted educational interventions to address knowledge gaps, particularly among patients with lower educational backgrounds and male patients.
Abstract: Background: Diabetes Mellitus (DM) is a global health crisis contributing significantly to both illness and mortality. The prevalence of DM in Nigeria has increased from 2.2% in 1997 to 5.77% by 2018 and 7% 2024 in Nigeria. Effective management of this condition demands not only medical interventions but also lifestyle modifications, such as dietar...
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Review Article
Digital Transformation in Rubella Surveillance: A Scoping Review of Global Practices, Challenges, and Opportunities
Issue:
Volume 10, Issue 3, September 2025
Pages:
248-264
Received:
22 May 2025
Accepted:
12 June 2025
Published:
22 July 2025
Abstract: Background: The global fight against rubella and congenital rubella syndrome necessitates effective public health surveillance systems. Digital transformation in rubella surveillance has emerged as a pivotal solution to overcome challenges associated with traditional paper-based reporting methods, including inefficiencies in data collection, delays, and inaccuracies. This scoping review examines global practices, challenges, and opportunities in digital rubella surveillance. Method: A scoping review methodology was employed, guided by the Arksey and O'Malley framework and enhancements from the Joanna Briggs Institute. A systematic search was conducted across databases, including PubMed, Scopus, and the WHO Global Health Library, covering literature from 2010 to 2024. Eighteen studies meeting the inclusion criteria, focusing on digital surveillance tools and practices in rubella monitoring, were synthesised. Data were extracted and analysed thematically to identify common practices, challenges, and opportunities. Results: The most prominent theme was implementation challenges (50%), particularly data completeness, infrastructure limitations, privacy concerns, and training gaps. Surveillance effectiveness (38.9%) focused on diagnostic accuracy and reporting timeliness. Global practices (33.3%) highlighted mobile apps, EMRs, GIS, and DHIS2 use, with varied adoption across income settings. Opportunities (16.7%) included AI integration, age-structured data strategies, and cross-border collaborations to enhance CRS prevention and surveillance system performance. Conclusion: Digital transformation holds transformative potential for rubella surveillance, offering scalable and cost-effective solutions to address existing gaps. Policymakers and stakeholders must prioritise investments in digital infrastructure, training, and regulatory frameworks to optimise these systems and support rubella elimination goals.
Abstract: Background: The global fight against rubella and congenital rubella syndrome necessitates effective public health surveillance systems. Digital transformation in rubella surveillance has emerged as a pivotal solution to overcome challenges associated with traditional paper-based reporting methods, including inefficiencies in data collection, delays...
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Research Article
Emotion-Aware AI Chatbots for Mental Health Support in Low-Resource Public Health Systems: A Case Study from Ghana
Evans Ankomah,
Regina Esi Turkson*
Issue:
Volume 10, Issue 3, September 2025
Pages:
265-272
Received:
5 June 2025
Accepted:
8 July 2025
Published:
23 July 2025
Abstract: Mental health conditions are on the rise globally, yet many low-resource countries face systemic barriers such as stigma, underfunding, and a severe shortage of professionals to provide adequate care. This paper presents the design, implementation, and evaluation of an emotion-aware AI chatbot for mental health support within Ghana's public health context, aiming to bridge the mental health treatment gap. Leveraging deep learning for emotion detection and integrating a generative language model (GPT-3.5), the system delivers culturally relevant responses to users exhibiting symptoms of emotional distress. The study restructured the International Survey on Emotion Antecedents and Reactions (ISEAR) dataset into a 5-emotion model (Joy, Fear, Anger, Sadness, Neutral) to improve classification accuracy. A Convolutional Neural Network (CNN) emerged as the top-performing classifier (76.4% accuracy), outperforming LSTM, BiLSTM, and GRU models. This classifier was integrated with GPT-3.5 to enable context-aware, empathetic interactions. Field testing with 311 participants in Ghana revealed high satisfaction: 89% praised usability, 81% affirmed cultural relevance, and 78% reported emotional support. Notably, 66% felt encouraged to seek professional care, demonstrating the chatbot’s potential as a gateway to formal mental health services. The system’s anonymity and 24/7 accessibility addressed key barriers like stigma and resource limitations. The findings suggest that emotion-aware chatbots can complement mental health services in under-resourced settings and offer an innovative pathway for public health outreach. Future work will expand language options and crisis protocols. This research contributes a scalable, cost-effective model for global public health, emphasizing cultural adaptation and emotion-aware AI as critical tools in mental health innovation.
Abstract: Mental health conditions are on the rise globally, yet many low-resource countries face systemic barriers such as stigma, underfunding, and a severe shortage of professionals to provide adequate care. This paper presents the design, implementation, and evaluation of an emotion-aware AI chatbot for mental health support within Ghana's public health ...
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Research Article
Effect of the Voucher-based Health Financing Mechanism on Antenatal Care Quality and Registration Time of Beneficiaries in the Adamawa Region (Cameroon): A Quasi-experimental Study
Issue:
Volume 10, Issue 3, September 2025
Pages:
273-281
Received:
17 June 2025
Accepted:
30 June 2025
Published:
28 July 2025
Abstract: Background: Antenatal care (ANC) is the first basic health care and service for pregnant women. The quality of ANC remains a major challenge in countries with limited resources. This study aimed to analyse the quality of ANC and to situate the beneficiary’s registration time in the voucher scheme in relation to the continuum of maternal and newborn health care in the Adamawa region. Method: An evaluation study (with and without vouchers) was carried out with participants selected from 10 health facilities in 5 health districts. The ANC quality criteria were selected on the basis of the 5 axes recommended by the WHO, from which 12 interventions were selected. The beneficiary’s registration time in the voucher scheme was recorded via the voucher scheme’s deliverables. Descriptive statistics were performed, and the chi2 test or Fisher test was used for the comparison of proportions with a significance level of 5%. Results: The study participants were 700 pregnant women divided into 2 groups. A comparison of the qualitative aspects of ANC between the 2 groups (voucher and non-voucher groups) revealed a statistically significant difference, with 17.7% of the enrolled participants having benefited from quality ANC, unlike the non-enrolled group, where no woman obtained quality ANC (p< 0.001). Approximately 25.1% were enrolled outside ANC, 83% of whom were enrolled when a complication or pathology that could aggravate the pregnancy occurred. Conclusion: The quality of ANC was better in the enrolled group, although it remained low overall. A non-negligible number of beneficiaries were enrolled late, opening the question of vertical equity measures.
Abstract: Background: Antenatal care (ANC) is the first basic health care and service for pregnant women. The quality of ANC remains a major challenge in countries with limited resources. This study aimed to analyse the quality of ANC and to situate the beneficiary’s registration time in the voucher scheme in relation to the continuum of maternal and newborn...
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Research Article
Prevalence, Patterns and Perpetrators of Disrespect and Abuse of Women During Childbirth in Lagos State, Nigeria
Issue:
Volume 10, Issue 3, September 2025
Pages:
282-291
Received:
23 June 2025
Accepted:
7 July 2025
Published:
28 July 2025
Abstract: Disrespect and abuse (D&A) during childbirth violate human rights and undermine maternal care. Women expect compassion and respect, yet abusive care discourages facility-based childbirth, contributing to Nigeria’s high maternal mortality rate of 512 per 100,000 live births. This study examines the prevalence, patterns, and perpetrators of disrespect and abuse in Lagos State. The aim of this study was to assess the prevalence, patterns, and perpetrators of disrespect and abuse experienced by women during childbirth. A cross-sectional community-based study, using mixed methods, was conducted among mothers residing in Lagos State who had given birth within six months prior to the study. Multistage sampling was used to select 524 mothers. Data were analyzed using SPSS version 25. The prevalence of disrespect and abuse was 87%, with non-consented care (79.8%) being the most common. Stigma/discrimination (4.6%) and detention (4.6%) were least reported. Nurses/midwives (59.4%) were the primary perpetrators. The study revealed a high prevalence of disrespect and abuse, primarily by nurses/midwives indicating that training healthcare providers on respectful maternity care (RMC) is essential. These findings therefore will inform policies promoting respectful maternal care in Nigeria to achieve improved health outcomes.
Abstract: Disrespect and abuse (D&A) during childbirth violate human rights and undermine maternal care. Women expect compassion and respect, yet abusive care discourages facility-based childbirth, contributing to Nigeria’s high maternal mortality rate of 512 per 100,000 live births. This study examines the prevalence, patterns, and perpetrators of disrespec...
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Review Article
A Scoping Review of Mental Health Among Refugees in the United Kingdom
Issue:
Volume 10, Issue 3, September 2025
Pages:
292-300
Received:
18 June 2025
Accepted:
2 July 2025
Published:
30 July 2025
Abstract: Introduction: The World Health Organization (WHO) guidelines highlight mental health risks for refugees, including pre-departure trauma, travel stress, and challenges in host countries. This scoping review aims to investigate the mental health challenges faced by refugees in the United Kingdom by consulting the existing literature on pre-migration factors, migration experiences, and post-migration conditions. Methodology: The database search retrieved 1,636 studies after systematically searching five electronic databases. After completing the eligibility screening, 34 articles were selected. The scoping review adhered to the PRISMA-ScR checklist, which is an extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews. Results: The studies primarily consisted of published journal articles (73.5%). Mental health faced by refugees was categorised into pre-migration factors (n=10, 29.4%), such as trauma and violence, economic hardships, persecution, and human rights violations. Migration factors (n=13, 38.2%) included dangerous travel conditions, detention, human trafficking, and the stress of resettlement. Lastly, post-migration factors (n=11, 32.4%) such as acculturation and adaptation, Social Integration and Support, and Economic Stability. Conclusion: Comprehensive mental health assessments and customised interventions at each stage of the refugee experience are necessary to address these challenges. The mental well-being of refugees in the UK must be supported by the development and implementation of strategies that mitigate these stressors through the collaboration of policymakers, clinicians, and public health authorities.
Abstract: Introduction: The World Health Organization (WHO) guidelines highlight mental health risks for refugees, including pre-departure trauma, travel stress, and challenges in host countries. This scoping review aims to investigate the mental health challenges faced by refugees in the United Kingdom by consulting the existing literature on pre-migration ...
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Research Article
Prevalence of Psychosocial Disability and Unmet Needs for Access and Utilization of Services in Sierra Leone
Issue:
Volume 10, Issue 3, September 2025
Pages:
301-315
Received:
7 July 2025
Accepted:
17 July 2025
Published:
31 July 2025
DOI:
10.11648/j.wjph.20251003.21
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Abstract: Psychosocial disability (PD) refers to the difficulties that persons with severe and persistent mental illness (SPMI) have performing daily tasks because of their impairments, which often prevents them from participating in society through education, employment, recreation, relationships, and having a decent place to live. In the 2010 Global Burden of Disease Research, mental illness was the largest cause of years spent disabled, with most of those affected living in poor and middle-income nations (LMIC) like Sierra Leone. Based on the above, this study seeks to describe the prevalence of psychosocial disability and unmet needs for access and utilization of services in Sierra Leone in addressing the burden of PD. The research used a cross-sectional study design and analytic by type. The cross-sectional design was used to describe the factors influencing the delivery of quality healthcare in the Bombali District. Specifically, the research was conducted in Makeni, which is the largest city in the Bombali District (Northern Province) of Sierra Leone. The sample size for this study was 156 participants. Hence, a probability sampling technique was used for this study. Data for this study were analyzed into descriptive and inferential statistics. Statistical analysis was run at a 5% significance level using Stata v14.0 software. Our study findings highlight the significant burden of psychosocial disability in Bombali District, with over half of the respondents experiencing psychological distress. The unmet needs and barriers to service access underscore the urgent need for targeted interventions to improve mental health care and social inclusion. These findings provide a foundation for policy development and further research to address the complex challenges faced by individuals with psychosocial disabilities in Sierra Leone.
Abstract: Psychosocial disability (PD) refers to the difficulties that persons with severe and persistent mental illness (SPMI) have performing daily tasks because of their impairments, which often prevents them from participating in society through education, employment, recreation, relationships, and having a decent place to live. In the 2010 Global Burden...
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