Background:Medical laboratory diagnostic services play a critical role in the diagnosis,treatment,and manage-ment of diseases,forming the cornerstone of effective healthcare systems.Despite the crucial role of laboratory services,the quality and accessibility of medical laboratory services in sub-Saharan Africa(SSA)face signifi-cant challenges.Global health development aid has been pivotal in supporting SSA laboratory services.This study aimed to examine global health development aid initiatives that have successfully enhanced the quality of medical laboratory services and the challenges and barriers to effectively improving medical laboratory services through global health development aid in SSA.Methods:We used a narrative review study design.We searched PubMed,Web of Science and Scopus for articles published in the last 15 years.These three databases are generally considered premier databases for peer-reviewed articles in global health,public health,health systems,and biomedical sciences.The inclusion criteria for this review included research studies,reports,and grey literature.Only articles published in English from 2010 on-ward were considered.The analysis followed a qualitative approach,emphasizing thematic synthesis and critical interpretation.Results:Forty articles were included in this study.Of these,18 were primary research studies,11 were reports,7 were commentaries,and 4 were reviews.Five sub-themes from the successful global health development aid initiative themes were capacity building and training programs,infrastructure development,partnership models,policy advocacy and regulatory support,quality control and standardization of laboratory services.The sub-themes from the challenges and barrier theme were insufficient funding and resource allocation,human resource constraints,inadequate infrastructure and equipment,and political and institutional barriers.This review re-vealed that several factors,including financial sustainability,human resource capacity,institutional support,resilience,and effective monitoring systems,shape the sustainability of improvements in medical laboratory services in SSA.Conclusion:Achieving long-term sustainability requires strategies that ensure financial self-sufficiency,foster a skilled and stable workforce,and integrate laboratory services into national health frameworks.

Background:Antimicrobial resistance(AMR)poses a significant and growing public health challenge in East and Southern Africa.Despite formal commitments to the National Action Plans,domestic financing for AMR remains critically limited,with most countries continuing to depend heavily on external donor funding.Objective:This narrative review examines the current extent to which domestic fiscal commitments align with national AMR policy goals across the two regions.Methods:Government websites for ministries of health and finance,donor platforms,and three academic databases(Scopus,JSTOR,Google Scholar)were searched for eligible articles.National budget statements and media reports were also reviewed where available.Three researchers independently screened titles and sum-maries,followed by full-text reviews to confirm eligibility.Results:The findings reveal that while several countries have developed National Action Plans,very few have allocated domestic funding to implement them.Only Malawi,Nigeria and Uganda reported modest domestic con-tributions,while in other countries such as Zambia,Ethiopia,and South Africa,AMR programs remain largely donor-financed or lack dedicated budget lines altogether.Veterinary and laboratory sectors are particularly un-derfunded,with minimal integration into broader AMR strategies.While this review has several limitations in-cluding restricted access to current,comprehensive national budget data and a reliance on secondary sources such as donor and World Health Organization reports,which may introduce bias,the patterns identified in this review still offer valuable insight into regional funding dynamics and can inform future policy and research efforts.Conclusion:We conclude that without dedicated domestic financing and accountability mechanisms,AMR efforts in the region may face significant sustainability challenges observed in other health responses such as human immunodeficiency virus.Strengthening AMR governance requires clear budgetary commitments,sustainable co-financing models,and policy instruments to reduce dependency on external support.

Background:Antimicrobial resistance(AMR)poses a significant and growing public health challenge in East and Southern Africa.Despite formal commitments to the National Action Plans,domestic financing for AMR remains critically limited,with most countries continuing to depend heavily on external donor funding.Objective:This narrative review examines the current extent to which domestic fiscal commitments align with national AMR policy goals across the two regions.Methods:Government websites for ministries of health and finance,donor platforms,and three academic databases(Scopus,JSTOR,Google Scholar)were searched for eligible articles.National budget statements and media reports were also reviewed where available.Three researchers independently screened titles and sum-maries,followed by full-text reviews to confirm eligibility.Results:The findings reveal that while several countries have developed National Action Plans,very few have allocated domestic funding to implement them.Only Malawi,Nigeria and Uganda reported modest domestic con-tributions,while in other countries such as Zambia,Ethiopia,and South Africa,AMR programs remain largely donor-financed or lack dedicated budget lines altogether.Veterinary and laboratory sectors are particularly un-derfunded,with minimal integration into broader AMR strategies.While this review has several limitations in-cluding restricted access to current,comprehensive national budget data and a reliance on secondary sources such as donor and World Health Organization reports,which may introduce bias,the patterns identified in this review still offer valuable insight into regional funding dynamics and can inform future policy and research efforts.Conclusion:We conclude that without dedicated domestic financing and accountability mechanisms,AMR efforts in the region may face significant sustainability challenges observed in other health responses such as human immunodeficiency virus.Strengthening AMR governance requires clear budgetary commitments,sustainable co-financing models,and policy instruments to reduce dependency on external support.

Background:Medical laboratory diagnostic services play a critical role in the diagnosis,treatment,and manage-ment of diseases,forming the cornerstone of effective healthcare systems.Despite the crucial role of laboratory services,the quality and accessibility of medical laboratory services in sub-Saharan Africa(SSA)face signifi-cant challenges.Global health development aid has been pivotal in supporting SSA laboratory services.This study aimed to examine global health development aid initiatives that have successfully enhanced the quality of medical laboratory services and the challenges and barriers to effectively improving medical laboratory services through global health development aid in SSA.Methods:We used a narrative review study design.We searched PubMed,Web of Science and Scopus for articles published in the last 15 years.These three databases are generally considered premier databases for peer-reviewed articles in global health,public health,health systems,and biomedical sciences.The inclusion criteria for this review included research studies,reports,and grey literature.Only articles published in English from 2010 on-ward were considered.The analysis followed a qualitative approach,emphasizing thematic synthesis and critical interpretation.Results:Forty articles were included in this study.Of these,18 were primary research studies,11 were reports,7 were commentaries,and 4 were reviews.Five sub-themes from the successful global health development aid initiative themes were capacity building and training programs,infrastructure development,partnership models,policy advocacy and regulatory support,quality control and standardization of laboratory services.The sub-themes from the challenges and barrier theme were insufficient funding and resource allocation,human resource constraints,inadequate infrastructure and equipment,and political and institutional barriers.This review re-vealed that several factors,including financial sustainability,human resource capacity,institutional support,resilience,and effective monitoring systems,shape the sustainability of improvements in medical laboratory services in SSA.Conclusion:Achieving long-term sustainability requires strategies that ensure financial self-sufficiency,foster a skilled and stable workforce,and integrate laboratory services into national health frameworks.

In sub-Saharan Africa(SSA),63％of new human immunodeficiency virus(HIV)infections in 2021 were among women,particularly adolescent girls,and young women.There is a high incidence of HIV among pregnant and lactating women(PLW)in SSA.It is estimated that the risk of HIV-acquisition during pregnancy and the postpar-tum period more than doubles.In this article,we discuss the safety and effectiveness of drugs used for oral HIV pre-exposure prophylaxis(PrEP),considerations for initiating PrEP in PLW,the barriers to initiating and adher-ing to PrEP among them and suggest recommendations to address these barriers.Tenofovir/emtricitabine,the most widely used combination in SSA,is safe,clinically effective,and cost-effective among PLW.Any PLW who requests PrEP and has no medical contraindications should receive it.PrEP users who are pregnant or lactating may experience barriers to starting and adhering for a variety of reasons,including personal,pill-related,and healthcare facility-related issues.To address the barriers,we recommend an increased provision of information on PrEP to the women and the communities,increasing and/or facilitating access to PrEP among the PLW,and developing strategies to increase adherence.

Background and objective:To provide good health and well-being as established by the Sustainable Development Goal(SDG)3,access to digital technologies can act as conduits to achieve such progress in a population.As guided by the World Health Organization,antenatal care(ANC)attendance is one of the measures promoted to curtail the global health burden of maternal and infant mortality.ANC services are seldom utilized to their full potential in Zimbabwe.This study explores if any of the women's digital technology characteristics were associated with antenatal care visits.Methods:The study analyzed population-based cross-sectional data with a subsample of 1 932 women aged 15-49 years from the 2019 Zimbabwe Multiple Indicator Cluster Survey.Test of associations with chi-square test,bivariate,and multivariate multinomial logistic regression analyses were used to examine the predictors of adequate(4-7)and optimal(≥ 8)ANC visits relative to undesirable(1-3)antenatal care visits among women who had given births 2 years before the survey.Results:The results indicate that 64.5％(1246/1 932)of the women attained adequate ANC while about 9.8％(189/1 932)attained optimal ANC.Reading a newspaper/magazine at least once a week(odds ratio[OR]1.73,β'=0.551,t=2.030,P=0.043)and watching television at least once a week(OR 1.72,β'=0.545,t=2.454,P=0.015),listening to the radio less than once a week(OR 1.28,β'=0.247,t=1.750,P=0.080),and owning a mobile phone(OR 1.48,β'=0.394,t=3.020,P=0.003)were positively associated with adequate ANC.Optimal ANC was significantly associated with women being able to read a newspaper at least once a week(OR 2.93,β'=1.074,t=3.120,P=0.002),listen to the radio less than once a week(OR 2.07,β'=0.73,t=2.700,P=0.007)and have ownership of a mobile phone(OR 1.88,β'=0.631,t=2.620,P=0.009).Conclusion:Access to a newspaper,radio,television,and mobile phone were important predictors of a woman's ability to achieve her ANC attendance.Policies to improve the knowledge of ANC packages can be facilitated using digital technology to achieve adequate and preferably optimal ANC in Zimbabwe.It is important to improve digital infrastructure to support digital technologies in providing ANC services.

Globally,there have been multiple public health emergencies in recent decades.High rates of morbidity,occa-sionally mortality,and economic instability are usually associated with pandemics.One of the epidemics that has significantly increased morbidity and mortality worldwide is the human immunodeficiency virus(HIV)and acquired immune deficiency syndrome(AIDS)pandemic.HIV has a disproportionately negative impact on key populations.Strong leadership,effective communication,and sound science are necessary for public health emer-gency(PHE)responses to be successful.These three PHE response pillars are also essential for bridging the HIV response gap among key populations in the setting of restrictive laws.In this review,we explored the importance of these three pillars of successful PHEs responses,and how they are essential to closing the gap in the HIV response among key populations.Leaders must make decisions and instil a sense of authority in the populace during PHEs to foster trust and confidence.Leaders should base their choices on scientific evidence.Effective communication during PHEs should be proactive,polite,imaginative,innovative,and constructive.To address gaps in the HIV response among key populations,leaders must create a supportive environment for effective communication and scientific research,communication should be used to raise awareness of HIV and to dispel stigma and discrimination,while science should provide evidence of efficacy and effectiveness of interventions among key populations.

Health care workers (HCWs) are more than ten times more likely to be infected with coronavirus infectious disease 2019 (COVID-19) than the general population, thus demonstrating the burden of COVID-19 among HCWs. Factors that expose HCWs to a differentially high-risk of COVID-19 acquisition are important to elucidate, enable appropriate public health interventions to mitigate against high risk and reduce adverse outcomes from the infection. We conducted a systematic review and meta-analysis to summarize and critically analyze the existing evidence on SARS-CoV-2 risk factors among HCWs. With no geographical limitation, we included studies, in any country, that reported (i) the PCR laboratory diagnosis of COVID-19 as an independent variable (ii) one or more COVID-19 risk factors among HCWs with risk estimates (relative risk, odds ratio, or hazard ratio) (iii) original, quantitative study design, and published in English or Mandarian. Our initial search resulted in 470 articles overall, however, only 10 studies met the inclusion criteria for this review. Out of the 10 studies included in the review, inadequate/lack of protective personal equipment, performing tracheal intubation, and gender were the most common risk factors of COVID-19. Based on the random effects adjusted pooled relative risk, HCWs who reported the use of protective personal equipment were 29% (95% CI: 16% to 41%) less likely to test positive for COVID-19. The study also revealed that HCWs who performed tracheal intubations were 34% (95% CI: 14% to 57%) more likely to test positive for COVID-19. Interestingly, this study showed that female HCWs are at 11% higher risk (RR 1.11 95% CI 1.01–1.21) of COVID-19 than their male counterparts. This article presents initial findings from a living systematic review and meta-analysis, therefore, did not yield many studies; however, it revealed a significant insight into better understanding COVID-19 risk factors among HCWs; insights important for devising preventive strategies that protect them from this infection.

Coronavirus disease 2019 (Covid-19) poses an important occupational health risk to health workers (HWs) that has attracted global scrutiny. To date, several thousand HWs globally have been reported as infected with the severe acute respiratory syndrome coronavirus 2 virus that causes the disease. It is therefore a public health priority for policymakers to understand risk factors for this vulnerable group to avert occupational transmission. A rapid review was carried out on 20 April 2020 on Covid-19 risk factors among HWs in PubMed, Google Scholar, and EBSCOHost Web (Academic Search Complete, CINAHL Complete, MEDLINE with Full Text, CINAHL with Full Text, APA PsycInfo, Health Source—Consumer Edition, Health Source: Nursing/Academic Edition) and WHO Global Database. We also searched for preprints on the medRxiv database. We searched for reports, reviews, and primary observational studies (case control, case cross-over, cross-sectional, and cohort). The review included studies conducted among HWs with Covid-19 that reported risk factors irrespective of their sample size. Eleven studies met the inclusion criteria. Lack of personal protective equipment, exposure to infected patients, work overload, poor infection control, and preexisting medical conditions were identified as risk factors for Covid-19 among HWs. In the context of Covid-19, HWs face an unprecedented occupational risk of morbidity and mortality. There is need for rapid development of sustainable measures that protect HWs from the pandemic.