目的 综合评估中国人群丙肝知识知晓率现状，为开展丙肝防治工作提供参考依据。方法 检索中国知网、万方、维普、PubMed等数据库，收集2010-2024年公开发表的丙肝知识知晓率的调查研究文献，用STRORE声明对文献质量进行了评估，使用Stata17.0软件对丙肝知识知晓率进行Meta分析，采用随机效应模型合并各样本知晓率，并按地区、人群为分组开展知晓率的亚组分析。结果 共纳入34项文献，含中国人群57 902人。Meta分析结果显示，中国人群丙肝知识知晓率为56.61%(95%CI:47.42%～68.51%)。亚组分析结果显示，不同地区丙肝知识知晓率异质性无统计学意义（P>0.05），不同人群的丙肝知识知晓率异质性差异有统计学意义（P<0.05），医务人员丙肝知识知晓率（80.29%）明显高于普通人群（45.28%）(P<0.01)。结论 中国人群丙肝知识知晓率偏低，通过多种途径加强人群丙肝知识的健康科普在目前显得尤为迫切。

目的 评估身体活动对肥胖和超重儿童青少年身体健康、心理健康以及身体活动相关的健康行为的效益。方法 遵循PRISMA指南，系统性检索Web of Science、PubMed、Scopus、PsycINFO、Cochrane Library和中国知网中2016年至2024年间发表在科学引文索引Q4区及以上期刊的系统综述或Meta分析，内容涵盖身体活动或运动干预对6～18岁肥胖或超重儿童和青少年身体或心理健康的影响。采用AMSTAR 2工具对纳入文献进行质量评估，对中高水平质量文献进行系统综述。结果 共纳入8篇系统综述和Meta分析，涉及24 567例儿童和青少年，其中6篇为高质量，2篇为中等质量。在身体健康方面，结合有氧和阻力训练的复合运动干预在降低体质量指数(BMI)和体脂率方面表现最佳。每次60 min以上、每周3次、持续12周或更长时间的中、高强度运动干预可以显著降低肥胖和超重儿童的BMI和体脂率，且能提升心肺耐力和肌肉力量。在心理健康方面，身体活动对缓解儿童青少年抑郁和焦虑、提升自尊心具有积极效果。特别是舞蹈、户外探险活动和团队运动对改善儿童青少年的社交能力和情绪状态具有显著作用...

目的 系统评价基于格林模式的健康教育对脑卒中患者的干预效果。方法 计算机检索PubMed、Embase、Cochrane library、Web of Science、中国知网、维普数据库、万方数据库和中国生物医学文献数据库，检索格林模式健康教育对脑卒中患者干预效果影响的随机对照试验，时限为建库～2023年11月20日。由2名研究者独立筛选文献、资料提取和文献质量评价。采用RevMan 5.4软件进行Meta分析。结果 共纳入11篇文献，包括982例患者。Meta分析结果显示，与传统健康教育相比，格林模式的健康教育能有效改善脑卒中患者的整体健康行为水平（自我实现、健康责任、锻炼依从性、营养、人际关系、压力应对）、肢体运动功能、神经功能和自我感受负担。但在提升脑卒中患者日常生活能力方面，两组间未见显著差异。此外，根据亚组分析结果显示，干预时间≥6个月时，试验组锻炼依从性与对照组之间比较无明显差异[SMD=1.590,95%CI(-0.380,3.570),P=0.110]。结论 格林模式的健康教育有助于改善脑卒中患者整体健康行为水平，促进患者身体功能恢复和提升其生活质量。

目的 系统评价基于格林模式的健康教育对脑卒中患者的干预效果。方法 计算机检索PubMed、Embase、Cochrane library、Web of Science、中国知网、维普数据库、万方数据库和中国生物医学文献数据库，检索格林模式健康教育对脑卒中患者干预效果影响的随机对照试验，时限为建库～2023年11月20日。由2名研究者独立筛选文献、资料提取和文献质量评价。采用RevMan 5.4软件进行Meta分析。结果 共纳入11篇文献，包括982例患者。Meta分析结果显示，与传统健康教育相比，格林模式的健康教育能有效改善脑卒中患者的整体健康行为水平（自我实现、健康责任、锻炼依从性、营养、人际关系、压力应对）、肢体运动功能、神经功能和自我感受负担。但在提升脑卒中患者日常生活能力方面，两组间未见显著差异。此外，根据亚组分析结果显示，干预时间≥6个月时，试验组锻炼依从性与对照组之间比较无明显差异[SMD=1.590,95%CI(-0.380,3.570),P=0.110]。结论 格林模式的健康教育有助于改善脑卒中患者整体健康行为水平，促进患者身体功能恢复和提升其生活质量。

Background: Sexual and reproductive health (SRH) programmes and services aim to prevent complications of pregnancy and childbirth, unintended pregnancies, unsafe abortions, complications caused by sexually transmitted infections, including HIV, sexual violence and impacts from avoidable cancer. Objective: To systematically identify published economic evaluations of SRH programmes and services, assess the methods used and analyse how costs and outcomes are estimated in these studies. Settings: Low- and middle-income countries. Design: Systematic review and narrative synthesis. Methods: Eight databases were searched, including EMBASE, MEDLINE, Scopus, Health Technology Assessment, Web of Science, PsycINFO, National Health Service Economic Evaluation Database (NHS EED) and African Journals Online (AJOL) from 1998 to December 2023. The inclusion and exclusion criteria were developed using the Population, Intervention, Comparator, Outcome and Study Design framework. The review included economic evaluations alongside randomised trials and economic studies with modelling components. Study characteristics, methods and results of economic evaluations were extracted and tabulated. The quality of the studies was assessed using the Consensus Health Economic Criteria list and Philips checklists for trial-based and model-based studies, respectively. The review followed the reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the results were synthesised narratively in line with Centre for Reviews and Dissemination guidance. Results: 7575 studies were screened and categorised. 20 studies were included in the review. The studies assessed the cost-effectiveness and costs of SRH programmes and services from an individual, healthcare or societal perspective. The main SRH programme considered was contraceptive services. The main outcome measures reported were disability-adjusted life years, quality-adjusted life years, couple years of protection and pregnancies averted. Most of the studies did not indicate the costing approach used, and many of the studies evaluated direct medical costs only. Most of the study designs were model-based with significant heterogeneity between the models. The review showed that many studies did not fulfil all of the requirements for a high-quality economic evaluation. 1 out of the 20 studies reviewed considered equity. Conclusions: The review revealed heterogeneity in approaches to evaluating the costs and outcomes of SRH programmes. These methodological limitations may have implications for their use by public health decision-makers to inform optimal decision-making. Prospero registration number: CRD42023435241.

Background: The Trans-theoretical Model (TTM) has been applied in numerous empirical studies concerning physical activity (PA) interventions for children and adolescents. Consequently, the aim of this review is to identify and synthesize the evidence regarding the effectiveness of TTM-based interventions in promoting PA behavior change among this demographic, with the goal of informing future research and policy development. Methods: A systematic review was performed followed the PRISMA guideline, protocol was registered in PROSPERO (CRD42023416216). Computer-based searches were conducted in the CNKI, Wan-Fang, VIP, Web of Science (WOS), PubMed, and EBSCO databases to identify relevant literature. Two researchers independently conducted the literature screening and quality assessment. The quality of the randomized controlled trials (RCTs) was evaluated using the Risk of Bias Assessment Tool version 5.1.0, as recommended by the Cochrane Collaboration Network. For quality assessment of quasi experiments (QEs), the Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) tool was employed. Results: A total of 22 articles were included in the systematic review. Stage-matched interventions and interventions designed based on a more complete structure of the TTM are more likely to promote an increase in the actual levels of PA among children and adolescents, as well as to facilitate an increase in their PA stages. Interventions that combine health information and health behavior feedback are more likely to promote an increase in actual PA levels and the advancement of PA stages; while interventions that include PA programs are more likely to facilitate improvements in health indicators. Conclusion: The effectiveness of TTM-based PA behavior change interventions for children and adolescents depends on the specific measures employed. Interventions that are stage-matched and integrate multiple behavior change techniques using the complete TTM structure are more likely to enhance PA and its associated health benefits. However, there are several normative issues that remain. These include the misuse of incremental stages as a substitute for PA, neglect of stage specificity when applying the model, a lack of framework for behavior change techniques in targeted interventions, and an absence of a dynamic feedback process.

目的 对信息框架效应理论在健康管理领域内的应用进行范围综述，为相关研究者利用信息框架效应理论进行实践研究提供参考。方法 采用Arksey和O’ Malley范围综述的方法，系统检索中国知网、万方、维普、Sinomed、PubMed、Web of Science、Cochrane Library、Embase、CINAHL等国内外数据库，检索时间为建库至2023年12月，收集信息框架效应理论应用于健康管理领域的相关研究。结果 共检索出2 855篇文献，最终共纳入16篇文献。其中英文15篇，中文1篇。基于信息框架效应的健康管理内容要素涉及提供疾病知识、治疗等健康相关信息，自我护理，决策支持3个方面；应用形式涵盖视频、文本信息、电子信息、知识讲座、随访、健康手册、手机短信7种形式；结局指标涉及自我管理行为、身体活动行为、药物和治疗依从性3个方面，健康管理均有积极效果。结论 基于信息框架效应理论的实践研究是可行有效的，能显著提高患者的健康行为和健康信念，应用前景广阔；但我国研究与国外研究尚存在较大差距，我国学者应重视对该理论的解读，并在其指导下启动在健康管理方面的实践研究。

目的 对信息框架效应理论在健康管理领域内的应用进行范围综述，为相关研究者利用信息框架效应理论进行实践研究提供参考。方法 采用Arksey和O’ Malley范围综述的方法，系统检索中国知网、万方、维普、Sinomed、PubMed、Web of Science、Cochrane Library、Embase、CINAHL等国内外数据库，检索时间为建库至2023年12月，收集信息框架效应理论应用于健康管理领域的相关研究。结果 共检索出2 855篇文献，最终共纳入16篇文献。其中英文15篇，中文1篇。基于信息框架效应的健康管理内容要素涉及提供疾病知识、治疗等健康相关信息，自我护理，决策支持3个方面；应用形式涵盖视频、文本信息、电子信息、知识讲座、随访、健康手册、手机短信7种形式；结局指标涉及自我管理行为、身体活动行为、药物和治疗依从性3个方面，健康管理均有积极效果。结论 基于信息框架效应理论的实践研究是可行有效的，能显著提高患者的健康行为和健康信念，应用前景广阔；但我国研究与国外研究尚存在较大差距，我国学者应重视对该理论的解读，并在其指导下启动在健康管理方面的实践研究。

Background: The economic and public health benefits of adult pneumococcal vaccines vary across countries due to different epidemiology and costs. We systematically reviewed and summarized findings and assumptions of cost-effectiveness analyses (CEA) of the recently introduced 15- and 20-valent pneumococcal conjugate vaccines (PCV15 and PCV20) in adults. Methods: We performed a systematic search for CEA studies of PCV15 and/or PCV20 versus existing strategies via PubMed, EMBASE, CEA Registry, EconLit, HTA Database, and NITAG resource center through April 23, 2024. Study characteristics, methods, assumptions, and findings were extracted independently by two reviewers; quality was assessed using ECOBIAS. Results were synthesized qualitatively to summarize key attributes and conclusions. Results: Of 137 identified records, 26 studies were included; the majority (24/26) concerned high-income countries. All employed static Markov-type models comparing higher-valent PCVs used alone or in combination with 23-valent pneumococcal polysaccharide vaccine (PPSV23) to current recommendations (PPSV23 alone, PCV13 alone, PCV13 + PPSV23, no vaccination). Most studies (22/26) concluded PCV20 used alone was cost-saving (dominant) or cost-effective compared to other adult pneumococcal strategies (PPSV23 alone, PCV13 ± PPSV23, PCV15 ± PPSV23, or no vaccination). PCVs were generally assumed to have serotype-specific effectiveness equal to PCV13 efficacy in the pivotal trial, though four studies used estimates from a Delphi panel; protection was assumed to last between 10 and 20 years. PPSV23 was assumed to have lower effectiveness against non-bacteremic pneumonia and shorter duration of protection. Herd effects from higher-valent PCVs in childhood (12/26), serotype replacement (2/26), or both (1/26) were included in half (13/26) of studies, which attenuated adult vaccine impact. Most studies were assessed as low risk of bias; five abstracts did not provide sufficient information for assessment. Conclusion: Current evidence indicates that 20-valent PCV used alone is likely to be cost-effective or dominate other adult pneumococcal strategies. Future research is needed to address remaining uncertainties in assumptions and to support evidence-based policymaking.

目的 检索、评价和总结出血性脑卒中患者围术期静脉血栓栓塞症（venous thromboembolism,VTE）非药物管理的相关证据，为临床提供参考。方法 按“6S”证据金字塔模型，采用计算机检索BMJ Best Practice(BMJ),UpToDate，乔安娜布里格斯研究所（Joanna Briggs Institute,JBI）循证卫生保健中心数据库，美国国立指南库（national guideline clearinghouse,NGC），英国国家卫生与临床优化研究所指南网（national institute for health and care excellence,NICE），苏格兰院际指南网（Scottish intercollegiate guidelines network,SIGN），加拿大安大略注册护士学会（registered Nurses’Association of Ontario,RNAO）指南网，加拿大心脏与卒中基金会（Canadian Heart and Stroke Foundation,HSF），美国心脏协会/美国脑卒中协会（American Heart Association/American Stroke Association,AHA/ASA），美国神经重症监护学会（Neuro-critical Care Society,NCS），欧洲脑卒中组织（European Stroke Organization,ESO）,Cochrane Library、PubMed,Medline,CNKI,Web of Science,Embase,SinoMed，万方，医脉通，维普数据库，中华医学期刊全文数据库关于出血性脑卒中患者围术期静脉血栓栓塞症非药物管理的相关证据，包括临床实践指南，专家共识，系统评价，证据总结等。检索时限为建库至2024年4月11日。由2名研究人员独立对文献质量进行评价，提取、整合和总结出最佳证据。结果 共纳入23篇文献，包括12篇指南、5篇系统评价、4篇专家共识，2篇证据总结。从多学科团队合作、风险评估与筛查、基础预防、机械预防和健康教育5个方面汇总了31条最佳证据。结论 本研究总结了出血性脑卒中患者围术期VTE非药物管理的最佳证据，可为临床医护人员提供循证依据。

目的 系统检索和总结国内外关于乳腺癌患者出院计划的最佳证据，为临床实践提供循证依据。方法 系统检索Up To Date、BMJ Best Practice、国际指南协作网、英国国家卫生与临床优化研究所、美国国立指南库、苏格兰院际间指南网、加拿大医学会临床实践指南信息库、澳大利亚临床实践指南平台、新西兰临床指南网站、美国临床肿瘤学会、加拿大安大略省注册护士协会、美国国立综合癌症网络、澳大利亚乔安娜布里格斯研究所卫生保健数据库、Cochrane Library、Embase、CINAHL、PubMed、Web of Science、中国知网、中国生物医学文献数据库、维普数据库、万方数据知识服务平台、中华护理学会、中国临床肿瘤学会及医脉通中有关乳腺癌患者出院计划的临床决策、指南、证据总结、系统评价、专家共识和意见，检索时限为建库至2024年6月10日。由2名研究者独立进行文献质量评价、证据提取和整合。结果 共纳入10篇文献，其中临床决策2篇、指南2篇、系统评价4篇、证据总结2篇。共总结30条证据，包括5个主题，分别是早期评估、制定计划、健康教育、执行计划及追踪与评价。结论 该研究针对乳腺癌患...

Background: The internet + nursing service is an important initiative for implementing the strategy of healthy China and actively responding to the aging of the population. However, the current literature on residents' awareness and willingness to participate is insufficient and presents large variations and limitations. Therefore, this study aims to systematically evaluate the awareness and willingness of Chinese residents to participate in internet + nursing service to comprehensively understand the level of awareness and acceptance of this emerging service model among Chinese residents and to provide strong support for relevant policy formulation and service optimization. Methods: The PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, SinoMed, and VIP databases were electronically searched to collect cross-sectional studies related to the awareness and willingness of Chinese residents to participate in internet + nursing service from inception to January 2024. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias of the included studies. Results: A total of 27 cross-sectional studies involving 11,761 subjects were included. The results of the meta-analysis showed that the percentage of Chinese residents willing to participate in internet + nursing service was 76.3% (95% CI [71.2%, 81.3%]). The results of the subgroup analysis showed that residents who lived in Western regions (82.1%), had employee medical insurance (85.9%), were suffering from other diseases (89.2%), were under the age of 60 (87.8%), were not married (78.9%), and had an undergraduate degree or above (85.5%) had a relatively high willingness to participate in internet + nursing service. The rate of awareness of internet + nursing service among Chinese residents was 48.6% (95% CI [24.1%, 73.2%]), which shows a downwards trend over time (67.4% in 2019, 56.1% in 2020, and 45.1% in 2021). Conclusion: The willingness to participate in internet + nursing service among Chinese residents is high, but the awareness rate is low. It is necessary to improve the awareness and willingness of Chinese residents to use internet + nursing service through various channels and aspects of publicity and promotion to achieve the goal of innovating the health service model, accurately connecting with the diverse health needs of people, and actively responding to the aging population.

Rationale: Despite growing emphasis among healthcare decision-makers on patient perspectives and real-world outcomes to inform care and access decisions, understanding of patient journey experiences in rare diseases remains limited due to data collection and evaluation challenges. Aims and objectives: This systematic literature review (SLR) assessed study designs, methodologies, and outcomes reported in real-world investigations of rare disease patient journeys. Methods: Searches in PubMed and Google Scholar targeted English-language publications and congress proceedings from 1 January 2014, to 30 April 2024, including rare disease patients, caregivers, or healthcare providers. Keywords included 'Journey', 'Path', or 'Odyssey'. Two reviewers independently assessed eligibility and abstracted data. Descriptive analyses and quality assessments were conducted. Results: Thirty-one studies met inclusion criteria, with 296,548 participants spanning over 600 rare diseases. Most studies used prospective observational (61%) and cross-sectional (26%) designs and were conducted in Europe (45%). Interviews (39%) and surveys (29%) were common methodologies. Patients (87%) were the primary research focus, compared to caregivers (32%) or providers (10%). The most studied journey stages were 'Pre-diagnosis/Screening' (97%) and 'Diagnosis' (84%), while 'Disease Awareness' (16%) and 'Treatment Adherence' (6%) were less common. Across 164 outcomes reported, frequent outcomes included 'Healthcare Resource Utilization' (94%), 'Symptoms' (74%), and 'Time-to-Diagnosis' (71%). Fewer studies reported 'Costs' (19%), 'Caregiver/Family Burden' (16%), and 'Productivity' (13%). Time-to-diagnosis averaged 11.8 years and a median of 6.1 years. All but one study (97%) was rated low or very low quality due to observational designs. Conclusion: Most rare disease patient journey evidence focuses on 'Pre-diagnosis/Screening' and 'Diagnosis' stages using qualitative methods and surveys. While symptoms, time-to-diagnosis, and resource utilization were commonly reported, evidence gaps included treatment adherence, caregiver burden and productivity. Longitudinal assessments to collect real-world care and treatment burden outcomes, including caregiver perspectives, can enhance both clinician and policy decision-making for individuals living with rare diseases.

Background: In the World Health Organization (WHO) geographical region of South-East Asia, the mental health burden of adolescents appears high. Addressing this burden requires development of mental health policies consistent with international standards to assist governance, resource allocation and delivery of mental healthcare effectively. The aim was to identify current national mental health policies/plans/programs/legislation in South-East Asia, assess compliance with international standards and review inclusion of adolescents in these documents. Methods: Searches were conducted on WHO MiNDbank, official government websites, Google and Google Scholar. Documents were compiled and screened, data were extracted and evaluated following WHO Guidelines on Monitoring and Evaluation of Mental Health Policies and Plans. Frequencies of checklist and sub scores were calculated. Data were narratively synthesised. Findings: Fourteen mental health policies/plans/programs/legislation from 8 countries met inclusion criteria. Maldivian and Bangladeshi documents complied the greatest with WHO guidelines. All 8 countries considered adolescents to some extent in their documents. Only Indian documents consulted child health groups during policy development. Intra/Inter sectoral collaboration with child health divisions was highlighted in documents from Sri Lanka, Bangladesh, India and Maldives. Interpretation: Most South-East Asian nations had developed separate national mental health governance documents. However, their incorporation of adolescent mental health is rare and compliance with international standards were inconsistent. Binding mental health legislation separate from health legislation; inclusion of adolescents; addressing resource constraints; and guidelines for mental health policy development catered to low-and-middle-income countries are all essential to address the complex mental health needs of South-East Asian adolescents.

Several systematic reviews support nature-based interventions (NBIs) as a mechanism of enhancing mental health and wellbeing. However, the available evidence for the effectiveness of these interventions is fragmentary and mixed. The heterogeneity of existing evidence and significant fragmentation of knowledge within the field make it difficult to draw firm conclusions regarding the effectiveness of NBIs. This can only limit the development of interventions to support personal and planetary wellbeing, potentially resulting in ineffective and ill-targeted investment decisions. These concerns have hindered the translation of research evidence into practice and guidelines are urgently required to assist researchers, practitioners and policymakers in developing interventions to promote environmental stewardship and meet the health needs of diverse communities. A higher-order or meta-level synthesis is required to make sense of this evidence. This umbrella review synthesises evidence on the barriers and enablers to nature-based interventions through a summative review of existing published systematic reviews and meta-analyses. A systematic search in PsycINFO, PubMed, Greenfile, Web of Science, Embase, Scopus, Academic Search Complete (EBSCO), Environment Complete (EBSCO), Cochrane Library, CINAHL, Health Policy Reference Centre and Google Scholar was performed. This is a mixed method review, and systematic reviews with both quantitative and qualitative data synthesis were included. 64 systematic reviews were included in the synthesis. The descriptive data, extracted from each study, forms an overview of the characteristics of available evidence on nature-based interventions. A narrative synthesis is used to present the potential factors influencing the outcomes of NBIs. The risk of bias of the systematic reviews was assessed using a 16-item Assessment of Multiple Systematic Reviews 2 (AMSTAR2) checklist. Directions for future research, potential quality needs and recommendations for future research, policymaking, and practice are discusssed.

Background: Burkina Faso joined the Global Financing Facility for Women, Children and Adolescents (GFF) in 2017 to address persistent gaps in funding for reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N). Few empirical papers deal with how global funding mechanisms, and specifically GFF, support resource mobilisation for health nationally. Objective: This study describes the policy processes of developing the GFF planning documents (the Investment Case and Project Appraisal Document) in Burkina Faso. Methods: We conducted an exploratory qualitative policy analysis. Data collection included document review (N = 74) and in-depth semi-structured interviews (N = 23). Data were analysed based on the components of the health policy triangle. Results: There was strong national political support to RMNCAH-N interventions, and the process of drawing up the investment case (IC) and the project appraisal document was inclusive and multi-sectoral. Despite high-level policy commitments, subsequent implementation of the World Bank project, including the GFF contribution, was perceived by respondents as challenging, even after the project restructuring process occurred. These challenges were due to ongoing policy fragmentation for RMNCAH-N, navigation of differing procedures and perspectives between stakeholders in the setting up of the work, overcoming misunderstandings about the nature of the GFF, and weak institutional anchoring of the IC. Insecurity and political instability also contributed to observed delays and difficulties in implementing the commitments agreed upon. To tackle these issues, transformational and distributive leaderships should be promoted and made effective. Conclusions: Few studies have examined national policy processes linked to the GFF or other global health initiatives. This kind of research is needed to better understand the range of challenges in aligning donor and national priorities encountered across diverse health systems contexts. This study may stimulate others to ensure that the GFF and other global health initiatives respond to local needs and policy environments for better implementation.

The sexual and reproductive health (SRH) needs of youths in sub-Saharan Africa are not being fully met, as evidenced by high rates of unintended pregnancies and sexually transmitted infections in this population. Understanding service needs and preferences of sub-Saharan African youths aged 10-24 years is critical for improving access and SRH outcomes and the focus of this systematic review of qualitative research. Four databases were searched with key words to identify relevant studies, supplemented by citation search, with an update in June 2023. The eligibility criteria were clear and developed a priori. Twenty included studies from seven countries underwent quality appraisal using the Critical Appraisal Skills Programme (CASP). A meta-ethnographic approach was used to synthesise concepts across studies by the researchers. Four key themes were generated: information needs; service needs; social needs; and delivery preferences. Information needs encompassed desires for age-appropriate education on contraception, safer sex, bodily changes, and healthy relationships to fill knowledge gaps. Social needs consisted of life skills training, vocational development, substance use rehabilitation, and support systems to foster healthy behaviours. Service needs included accessible youth-friendly sexual health services, preventative care, sexually transmitted Infections (STI) management, and contraception; and delivery preferences including competent providers who maintain privacy and confidentiality, convenient youth-oriented settings, free or low-cost provisions, and youth involvement in service design. In conclusion, the identified themes emphasise the diverse nature of SRH needs and preferences among sub-Saharan African youths. Insights from their unique priorities and unmet needs inform policy development and intervention strategies. Tailored awareness campaigns, youth-centred training for providers, youth-friendly and confidential SRH models, comprehensive education, and engaging youth in developing relevant solutions may improve acceptability, access, and health outcomes. These efforts could address barriers around stigma, costs, and lack of knowledge, contributing to enhanced SRH and wellbeing. Fulfilling youth SRH needs in sub-Saharan Africa requires commitment across sectors to evidence-based, youth-focused strategies placing their perspectives at the centre.

Increasing evidence suggests that urban health objectives are best achieved through a multisectoral approach. This approach requires multiple sectors to consider health and well-being as a central aspect of their policy development and implementation, recognising that numerous determinants of health lie outside (or beyond the confines of) the health sector. However, collaboration across sectors remains scarce and multisectoral interventions to support health are lacking in Africa. To address this gap in research, we conducted a mixed-method systematic review of multisectoral interventions aimed at enhancing health, with a particular focus on non-communicable diseases in urban African settings. Africa is the world's fastest urbanising region, making it a critical context in which to examine the impact of multisectoral approaches to improve health. This systematic review provides a valuable overview of current knowledge on multisectoral urban health interventions and enables the identification of existing knowledge gaps, and consequently, avenues for future research. We searched four academic databases (PubMed, Scopus, Web of Science, Global Health) for evidence dated 1989-2019 and identified grey literature from expert input. We identified 53 articles (17 quantitative, 20 qualitative, 12 mixed methods) involving collaborations across 22 sectors and 16 African countries. The principle guiding the majority of the multisectoral interventions was community health equity (39.6%), followed by healthy cities and healthy urban governance principles (32.1%). Targeted health outcomes were diverse, spanning behaviour, environmental and active participation from communities. With only 2% of all studies focusing on health equity as an outcome and with 47% of studies published by first authors located outside Africa, this review underlines the need for future research to prioritise equity both in terms of research outcomes and processes. A synthesised framework of seven interconnected components showcases an ecosystem on multisectoral interventions for urban health that can be examined in the future research in African urban settings that can benefit the health of people and the planet.Paper ContextMain findings: Multisectoral interventions were identified in 27.8% of African countries in the African Union, targeted at major cities with five sectors present at all intervention stages: academia or research, agriculture, government, health, and non-governmental.Added knowledge: We propose a synthesised framework showcasing an ecosystem on multisectoral interventions for urban health that can guide future research in African urban settings.Global health impact for policy and action: This study reveals a crucial gap in evidence on evaluating the long-term impact of multisectoral interventions and calls for partnerships involving various sectors and robust community engagement to effectively deliver and sustain health-promoting policies and actions.

Objectives: The COVID-19 pandemic has had a disproportionate impact on the health of Indigenous Peoples in Canada, Australia, New Zealand and the USA, as reflected in the growing literature. However, Indigenous Peoples are often homogenised, with key differences often overlooked, failing to capture the complexity of issues and may lead to suboptimal public health policy-making. The objective of this review was to assess the extent to which the heterogeneity of the Indigenous Peoples in Canada, Australia, New Zealand and the USA has been reflected in COVID-19 research. Design: This study took the form of a scoping review. Data sources: Medline, Embase, CINAHL and Web of Science were searched for studies investigating COVID-19 pandemic outcomes among Indigenous Peoples in Canada, Australia, New Zealand and the USA. The search dates included January 2019 to January 2024. Eligibility criteria: All citations yielded by this search were subjected to title and abstract screening, full-text review and data extraction. We included original, peer-reviewed research investigating COVID-19-related outcomes among Indigenous Peoples in Canada, Australia, New Zealand or the USA. Data extraction and synthesis: Data extraction was conducted as an iterative process, reaching consensus between two of the study authors. All included studies were analysed through a combination of quantitative descriptive summary and qualitative thematic analysis. Results: Of the 9795 citations found by the initial search, 428 citations were deemed eligible for inclusion. Of these citations: 72.9% compared Indigenous participants to non-Indigenous participants; 10.0% aggregated Indigenous and non-white participants; and 17.1% provided findings for Indigenous participants exclusively. Conclusions: By overlooking the heterogeneity that exists among Indigenous Peoples in Canada, Australia, New Zealand and the USA, researchers and policy-makers run the risk of masking inequities and the unique needs of groups of Indigenous Peoples. This may lead to inefficient policy recommendations and unintentionally perpetuate health disparities during public health crises.

This review investigates the effectiveness of utilizing foreign physicians or International Medical Graduates to alleviate medical shortages in rural and underserved areas of developed countries. Conducted in February 2024, this systematic review follows PRISMA 2020 guidelines, analysing 15 English-language studies from the United States, Canada, Australia, and New Zealand. The focus is on comparing physicians with international graduation to national graduates in rural and underserved contexts. Results reveal diverse trends across countries: in the United States, national graduates are generally more represented in rural areas, while foreign physicians are more prevalent in Health Professional Shortage Areas. In Canada, foreign graduates are more common in rural areas, varying by province. Australia and New Zealand show foreign physicians practicing more in rural areas than national counterparts. This study underscores significant reliance on foreign physicians to mitigate rural healthcare disparities. While this strategy partially addresses immediate shortages, long-term effectiveness is uncertain due to retention and integration challenges. Future policies should focus on sustainable solutions for equitable healthcare access and physicians’ retention in underserved areas. This review emphasizes also the need for Europe-specific studies and further evaluation of policy effectiveness.