Humans have used botanicals as traditional medicines for millennia, yet Western biomedicine has shunned many of these as undefined and often unreliable. While not all botanicals have a strong scientific basis or can be directly used as therapeutics, two, Artemisia annua and Artemisia afra, are quite well-established for their safety and efficacy within ethnopharmacological and scientific literature. A. annua, being better studied, is especially effective against many diseases. It is inexpensive, has consistent phytochemical content within a cultivar grown in its local region, evades the evolution of parasite drug resistance, and can be reliably produced on both large and small scales. Well-defined botanical drugs offer major benefits for more sustainable global health-care. This review highlights these two plant species as examples of how the broader implementation of botanical drugs can decrease costs, promote environmental sustainability, and deliver economic benefits - especially to rural communities - by empowering them to manage their health-care needs more sustainably. Comparisons are made between the agricultural and production costs of an extracted natural product versus Artemisia as a traditional botanical medicine. The review also examines the impact of climate on these two crops and provides a brief comparison of the carbon footprints of traditionally produced botanical drugs versus their commercially produced counterparts. A specific, successful example of sustainable production of A. annua is also described. Overall, there are many well-established reasons to advocate for broader approval of botanical drugs to strengthen global health-care systems.

Type 2 diabetes (T2D) and obesity are closely interlinked metabolic disorders contributing significantly to global health challenges and economic burdens. Effective treatment strategies are crucial for improving patient outcomes and reducing healthcare costs. This review was conducted by selecting published articles that evaluate therapeutic options for individuals with T2D and obesity. A bibliographic search was performed, with a focus on the effectiveness and financial viability of semaglutide compared to other antidiabetic treatments. Obesity is a major risk factor for T2D. Global healthcare costs for T2D management are expected to reach $1.05 trillion by 2045, with obesity-related complications further escalating the economic burdens. The financial impacts of obesity-related comorbidities have been extensively documented. It has been demonstrated that a 5 - 10% weight loss can improve metabolic outcomes and reduce healthcare expenditures. Semaglutide, a glucagon-like peptide-1 receptor agonist, has demonstrated superior efficacy in weight reduction and glycemic control compared to other treatments. This medication also significantly reduced waist circumference and cardiovascular risks while improving lipid profiles. Cost-effectiveness analyses suggest that semaglutide offers long-term financial benefits by reducing T2D-related complications and hospitalizations. The evaluations by the Health Technology Assessment on semaglutide lend credence for including this medication in the national healthcare policies due to its potential to improve public health outcomes and aid in ensuring financial sustainability in healthcare systems. Semaglutide emerges as a highly effective therapeutic option for patients with T2D and obesity, providing both clinical and economic benefits. In summary, prioritizing access to effective weight management treatments like semaglutide can mitigate obesity-related complications, enhance quality of life, and generate substantial cost savings for healthcare providers worldwide.

Adolescence is a pivotal developmental period during which personality traits begin to crystallize and significantly impact mental health and behavioral outcomes. This review synthesizes existing literature on the role of personality traits in adolescence, with a particular focus on longitudinal studies and dimensional assessments. Key personality traits, such as conscientiousness, emotional stability, and extraversion, are associated with positive outcomes, including mental well-being and pro-social behavior. In contrast, traits such as neuroticism and impulsivity, as well as callous-unemotional traits, are linked to internalizing disorders, substance use, and antisocial behavior. Longitudinal research demonstrates that personality traits exhibit both stability and malleability during adolescence, offering critical insights into how these traits predict long-term outcomes, such as academic achievement, mental health disorders, and criminal behavior. The review identifies several research gaps, including the need for more cross-cultural studies and investigations into under-researched traits like openness to experience. Policy implications include the integration of personality assessments into mental health screening programs and the development of tailored interventions that focus on emotional regulation, self-control, and pro-social behaviors. By addressing these gaps and advancing intervention strategies, researchers and clinicians can better support adolescents in developing healthy personality traits that foster long-term mental well-being and positive behavioral outcomes.

Wars and political volatility in Iraq have decimated healthcare systems for decades. Meeting the country’s healthcare demands is not possible without a quality pharmaceutical system that regulates, supplies, and promotes the appropriate use of medicinal products. Healthcare services and pharmaceutical systems are interdependent. Without accurate reporting on Iraq’s pharmaceutical processes, systems, and challenges, meaningful healthcare reform consistent with national goals for social stability will remain out of reach. This article evaluates the current pharmaceutical system responsible for the delivery and use of medical products, with a focus on ensuring patient protection and optimizing health outcomes in Iraq. It outlines current challenges and presents potential solutions and recommendations. Narrative reviews were collected from peer-reviewed articles, government and non-government publications, and expert opinions sourced from PubMed, Scopus, Web of Science, and Google over the past 25 years. These articles were analyzed within the context of Iraq’s pharmaceutical environment. Figures were synthesized, and a diagram was developed to guide the recommendations. The administrative and technical units involved in regulatory processes are clarified, with emphasis placed on the lack of funding for streamlining these procedures. Significant findings include deficiencies in the oversight of private sectors and the Wneed to empower Iraq’s domestic pharmaceutical industry. Improvements in educational curricula and the training of pharmaceutical professionals are required. Moreover, the modernization of health information and research systems is deemed necessary. The establishment of a functional pharmaceutical system is closely associated with broader healthcare reform and the development of national economic interests that support state legitimacy.

The global healthcare system is inherently dynamic, shaped by the critical application of economic models aimed at delivering life-saving care to populations across all socioeconomic strata. However, when unprecedented crises, such as the COVID-19 pandemic (SARS-CoV-2), emerge, the unanticipated demand for healthcare facilities disrupts the socioeconomic stability of the global healthcare system. The surge in healthcare expenditures strains the existing financial structures, challenging their capacity to sustain essential services. Nonetheless, supplementary financial support, through crowdfunding, government funding, and private sector contributions, has assisted in stabilizing healthcare delivery during such a period. These financial shifts have driven the implementation of novel approaches in the global COVID-19 response. This review examines the economic landscape of the global healthcare system and highlights the fundamental managerial protocols during the COVID-19 pandemic.

Pandemics are global disease outbreaks that have significantly impacted societies, economies, and public health systems throughout history. From the bubonic plague to the Spanish flu and the recent COVID-19 pandemic, these crises have shaped human development and exposed vulnerabilities in health and economic systems. The epidemiological transition outlines three phases of human history: famine and pandemics, reduced outbreaks, and the current phase of degenerative diseases. The COVID-19 pandemic, a historic event, caused severe health, social, and economic disruptions globally. The economic consequences of pandemics are extensive, often persisting long after the health crisis subsides. The COVID-19 pandemic caused widespread unemployment, heightened poverty levels, and significant disruptions in industries and education. Governments implemented fiscal and monetary policies, including direct stimulus measures, to mitigate these effects. However, these actions introduced inflationary pressures and increased public debt, highlighting the complex balance between relief and economic stability. Public health responses, such as vaccination drives and non-pharmaceutical interventions, played a pivotal role in containing COVID-19. The pandemic emphasized the importance of integrating public health and economic policies to ensure comprehensive crisis management. Despite advancements in medical science and policy coordination, challenges such as misinformation, geopolitical tensions, and inadequate global cooperation hindered effective responses. Moving forward, governments must prioritize coordinated health and economic strategies to mitigate future pandemics. Strengthening global collaborations, improving public health systems, and leveraging technology will be crucial to building resilience and ensuring sustainable recovery from health crises.

The coronavirus disease 2019 (COVID-19) pandemic had a significant impact on people worldwide, including in India, where disadvantaged and marginalized populations reliant on institutional support were worse affected. In this context, healthcare and sanitation workers played a crucial role in addressing pressing health and sanitation needs. India’s National Service Scheme (NSS) fosters youth leadership through various programs and activities, with volunteering being a core component of its social services since its establishment. Conventionally, the NSS has been engaged in raising awareness about health issues and promoting community development; however, its visibility and effectiveness were diminished during the pandemic. This situation prompts an examination of the preparedness and capacity of NSS volunteers to effectively respond to community needs and manage health crises. Good health and well-being is one of the sustainable development goals, and the United Nations recognizes that achieving these goals is challenging without the active participation of youth. This study uses the institutional change model to analyze the current framework and roles of the NSS, exploring the potential of institutional and policy reforms in enhancing the participation of NSS youth volunteers in public health efforts, especially in tackling issues such as COVID-19. In addition, the study offers perspectives on current weaknesses in the organization, mobilization, and training of youth as a cohesive unit within community health systems, which may prevent them from responding effectively during times of crisis.

Sexuality and intimacy are often overlooked in long-term care settings, especially for elderly individuals with dementia, despite their significant role in emotional well-being and quality of life. This article explores the ethical, professional, familial, and organizational challenges caregivers face in supporting sexual expression in dementia care. This article also discusses the importance of respecting residents’ autonomy while ensuring their safety and emphasizes the need for proper staff training, family involvement, and clear institutional policies to provide a supportive care environment. This article aims to contribute to the ongoing discourse on improving dementia care practices by offering actionable recommendations that promote intimacy as a core element of person-centered care.

Mental health research in sub-Saharan Africa faces numerous barriers, even as the region experiences an increasing burden of mental health conditions, driven in part by the HIV epidemic, adolescent pregnancy, and the COVID-19 pandemic. Mental illness remains a leading cause of disability, yet access to evidence-based interventions is limited, contributing to a persistent treatment gap. Integrating mental health services into general healthcare settings and expanding telepsychiatry are promising but underutilized strategies. Strengthening research efforts is essential to understanding and addressing the region’s unique challenges. Key barriers include limited funding, poor economic conditions, inadequate research infrastructure, a shortage of skilled researchers, and insufficient mentorship. Socio-cultural factors, such as mental health stigma and conflicting traditional beliefs, further constrain research capacity. Addressing these issues requires enhancing funding, establishing sustainable financing models, investing in infrastructure, implementing capacity-building initiatives, and fostering international collaboration and advocacy. Equitable North-South partnerships and structured mentorship programs are vital for skills transfer and the development of context-specific approaches. Advocacy for supportive policy environments can help mobilize resources for both research and clinical services. Bridging biomedical science with socio-cultural understanding can yield culturally appropriate, community-based interventions. This article highlights the urgency of overcoming financial, structural, and socio-cultural barriers to strengthen mental health research in sub-Saharan Africa. Implementing these strategies can support the development of a robust evidence base, improve service delivery, and promote equitable and sustainable mental health systems - ultimately enhancing the quality of life and socioeconomic participation for millions affected by mental illness in the region.

By applying the Schematic Appraisals Model of Suicide, this study examined whether resilience mediates and perceived social support moderates the relationship between polyvictimization and suicidal thoughts/behaviors among college students. The study included 790 college students (71% female), whose ages ranged from 18 to 31 years. Their racial demographics included White (472; 55%), African American (128; 17%), Hispanic (94; 12%), and others (125; 16%). Models 4 and 5 from PROCESS Macro 4.2 in Statistical Package for the Social Sciences 29.0 were used to test the mediation and moderation effects. The results indicated a positive association between polyvictimization and suicidal thoughts/behaviors. Resilience exhibited an indirect association between polyvictimization and suicidal thoughts/behaviors. Specifically, if polyvictimized college students have higher levels of resilience, they are less likely to experience suicidal thoughts/behaviors. Perceived social support as a moderator explained the association between polyvictimization and suicidal thoughts/behaviors. This result suggests that when individuals who experience polyvictimization receive social support, they are less likely to have suicidal thoughts/behaviors. For polyvictimized college students, both resilience and perceived social support can serve as protective factors against suicidal thoughts/behaviors. This study offers insights for implementing campus-wide intervention programs to enhance college students’ resilience and interaction skills, thus contributing to preventing suicidal thoughts/behaviors among polyvictimized individuals.

This study examined state-level health expenditure, fiscal marksmanship, and COVID-19 deaths among selected states in India. It (1) compared health expenditure between the pre-COVID-19 and the COVID-19 period in India and selected states; (2) investigated the fiscal marksmanship in the context of health expenditure at the national and state level; and (3) assessed the relationship between COVID-19 deaths, population density, health expenditure, and fiscal marksmanship. The study period from 2017 to 2021 was divided into pre-COVID-19 (2017-late - 2019) and COVID-19 (late-2019 - 2021). This study focused on India and selected Indian states, using data from state budget documents, Census 2011 for population density, and COVID-19 data from the government website. Descriptive statistics, percentages, ratios, graphs, and tools such as Theil’s U-Statistic and Pearson’s correlation were employed for analysis. Simple linear regression was used to analyze the impact of fiscal marksmanship and other variables on the case fatality ratio. This study revealed challenges in maintaining fiscal discipline during COVID-19, with disparities in capital expenditure among states. The results emphasized the need for increased health spending and structural changes to enhance resilience to future health crises, advocating for investments in infrastructure and services to improve preparedness.

Sustainable procurement in the health sector is vital for integrating sustainability into the value chain, decreasing environmental impact, and ensuring socially beneficial practices. This study attempted to analyze the importance of sustainable procurement in hospitals, the applicability of the International Organization for Standardization (ISO) 20400 framework in healthcare, and the effect of the Consortium of Accredited Healthcare Organizations (CAHO) masterclass on professionals’ understanding of sustainable procurement. To understand sustainable procurement and its correlation to ISO 20400, a literature review was conducted. Statistical evaluation was employed to evaluate the impact of the CAHO’s masterclass on professionals’ awareness, intention to adopt, and perceived value of sustainable procurement through dialog and feedback from questionnaires. Data were kept confidential and anonymous. Leading organizations, such as the United Nations Development Program, World Health Organization, and ISO, are advocating for sustainable procurement. The ISO 20400 framework offers valuable guidance for sustainability in procurement and has many benefits if implemented in the healthcare sector. The masterclass significantly increased awareness, with 93% of participants agreeing on the benefits. Major strategies, challenges, and a mix of contributions by sustainable procurement toward efficiency and social responsibility were discussed throughout the sessions. The results indicate that training schemes are necessary for sustainable procurement globally. CAHO initiatives play a crucial role in raising awareness for global procurement, helping healthcare institutions enhance cost efficiency, minimize risks, and promote sustainability by enhancing economic, environmental, and social performance.

Child marriage is a significant public health issue, resulting in adverse effects that violate the rights of girls below 18 years old. Six out of ten countries with the highest prevalence of child marriage (over 50%) are located in Africa. Although numerous studies have been carried out to explore ways to reduce child marriage, there is limited research focusing on how ecological factors influence the prevalence of child marriage. This study’s objective was to determine the socioeconomic and reproductive factors linked to child marriage in Africa. Utilizing the Socio-ecological Model of Health as a guide, a correlational analysis was conducted using data from 54 African countries. Information for each country was obtained from surveys conducted with the support of reputable international agencies. Path analysis was utilized to determine the magnitude and direction of the factors connected to child marriage. The results illustrate that adolescent fertility, gross domestic product (GDP) per capita, and youth female literacy rates significantly accounted for 83% (R2) of variance for child marriage. In addition, child marriage and GDP per capita significantly predict maternal mortality ratio with 0.59 R2. African nations are encouraged to implement strategies and interventions that reduce child marriage and its associated critical factors by increasing enrollment, retention, and completion of school; improving economic opportunities; and establishing relevant laws and policies.

Unequal access to transport is an outcome of several factors which play a significant role in access to maternal healthcare services. This study examines the factors contributing to transport exclusion among pregnant women in southwestern Nigeria, with the objective of ascertaining lived experience among the respondents. A survey was conducted among 357 registered pregnant women from 113 hospitals across three local government areas in Oyo State. The analysis employed both descriptive and inferential statistics. Results revealed that transport exclusion is prevalent among pregnant women in the study area, with factors such as lack of money (95.0%), transport cost (72.0%), and the affordability of transportation means (60.2%) being key determinants. The study concluded that factors contributing to transport exclusion among pregnant women may have far-reaching effects on their ability to meet daily social needs, particularly healthcare access, given their vulnerable status, which in turn impacts their overall well-being. Further research may be needed to explain the connection between the transport exclusion of pregnant women and the ease of accessing medical care, as well as their overall well-being.

Occupational exposure to blood and body fluids (BBFs) has become a serious public health problem for healthcare workers (HCWs), especially in developing countries. This exposure increases the risk of contracting blood-borne infections, such as human immunodeficiency virus, hepatitis B, and hepatitis C. The present systematic review and meta-analysis were conducted to estimate the pooled prevalence of BBF exposure among HCWs in Cameroon. Relevant research reports were systematically searched and collected using online databases such as PubMed, Google Scholar, Cochrane Library, and Science Direct, as well as unpublished studies from the national library. Out of 539 records, only 15 studies were included in the final analysis. The I2 tests were employed to assess the heterogeneity of the included studies. Random-effects meta-analysis model was employed to estimate the lifetime and 12-month prevalence of BBF exposure among HCWs in Cameroon. The model indicated that the estimated overall pooled prevalence of 12-month and lifetime BBF exposure among HCWs in Cameroon was 55.44% (95% confidence interval [CI]: 41.20 - 69.68, I2 = 97.5%, p<0.001) and 57.27% (95% CI: 42.43 - 72.10, I2 = 97.7%, p<0.001), respectively. The highest 12-month pooled prevalence was observed in intermediate-level health facilities (84.73%, 95% CI: 85.55 - 88.50), whereas the highest lifetime prevalence was observed in the North-West and South-West regions (77.96%, 95% CI: 57.39 - 93.19). HCWs in Cameroon face a significant risk of BBF exposure, with a high prevalence of exposure over their lifetime and within a 12-month period. This study highlights the urgent need to enhance and implement effective occupational safety and health policies to protect HCWs in Cameroon.

The United Nations present the Sustainable Development Goals (SDGs) with the “leave no one behind” principle, with SDG 3 focusing on improving maternal and child health outcomes to reduce neonatal mortality (NM). Although global NM rates have declined significantly, NM persists as a pressing public health challenge across developing regions. This ongoing burden necessitates intensified, multifaceted interventions to accelerate progress toward SDG targets and enhance child survival worldwide. This study provides evidence on the impact of place of delivery on NM, an area that has received limited attention in existing research. The study utilized data from the Pakistan Demographic and Health Survey 2017 - 2018. A logistic regression model was employed to analyze the association between NM and place of delivery. The primary variable of interest was the place of delivery, whereas sociodemographic factors served as control variables. These factors included the mother’s employment status, child sex, birth order, maternal age, maternal education, residence, region, and size of the child. The analysis revealed that the place of delivery is a significant predictor of NM, with deliveries within facilities substantially reducing the odds of NM. Moreover, the study also found that the sex of a child, birth order, working status, and region are highly significant indicators for predicting NM. These findings indicate that most neonatal deaths occur during deliveries outside health facilities in Pakistan. It is recommended that the government emphasize accessible healthcare services and develop educational programs that focus on facility-based deliveries, prenatal care, and postnatal care for expectant mothers.

British Columbia implemented some of Canada’s strictest COVID-19 workplace vaccination mandates in the healthcare sector. Despite opposition from some healthcare worker (HCW) unions, most health establishments, policymakers, and academic researchers supported these mandates, which remained in effect until July 2024. While the perceived problem of vaccine hesitancy among HCWs has generated much research, HCWs’ experiences and views on vaccination mandates have been relatively neglected. Our study, conducted between June and July 2024, explored these experiences and views. We surveyed 166 HCWs recruited through social media and snowball sampling, regardless of vaccination status, age, gender, ethnicity, socioeconomic background, or health profession. Nearly half of the respondents had over 16 years of work experience, most were unvaccinated, and most had been terminated for non-compliance. Both unvaccinated and vaccinated respondents expressed concerns about vaccine safety, coercion, and mental health impacts, including suicidal thoughts. Most unvaccinated respondents were satisfied with their vaccination decision, but they reported financial losses, mental health struggles, and conflicts with colleagues and loved ones. The vaccinated respondents - a minority in our sample - were largely unsatisfied, with most experiencing post-vaccination adverse events, and over half feeling pressured by their employers to accept further doses despite these effects. Regardless of vaccination status, HCWs observed concerning changes in practice protocols and discrimination against unvaccinated patients. We argue that even if neglected by the literature, the multiple negative impacts of vaccination mandates identified in our study - on HCWs’ well-being, patient care, and ethical healthcare practices - are extremely worthy of consideration. They indicate the importance of prioritizing informed consent, engaging competing scientific evidence, and ensuring healthcare sustainability, particularly during emergencies.

Sustainable development relies on the efficient resource distribution among economic agents, requiring an integrated approach. A key principle of this concept is reducing inequality through more equitable resource distribution. This study examines the distribution of healthcare resources across countries amid rising intercountry disparities. The proposed hypothesis suggests that healthcare resource allocation follows a non-random pattern shaped by competitive dynamics. Using the law of competitor distribution, this paper models intercountry resource distribution through the “generalized theory of competition” to analyze rank-size dependencies. The World Bank and Organization for Economic Co-operation and Development data on health statistics were used as the initial dataset for constructing the rank-size dependencies of the of resource distribution. The findings indicate that the empirical distribution of healthcare resources deviates from the Pareto distribution law, reflecting the stochastic multiplicative nature of competition. When the empirical distribution was compared with the Pareto distribution, an uneven distribution of resources in the competition process was revealed. Further, the power law poorly approximated the size of the empirical distributions at both low and high ranks. To reduce inequality in the distribution of healthcare resources, the study advocates for an integrated development approach leveraging digital technologies.

Since 2000, Rwanda has prioritized universal health coverage (UHC) and universal health insurance, achieving significant health gains. Its UHC model - centered on Community-Based Health Insurance (CBHI) and supported by public and faith-based providers - now faces financial sustainability challenges. Under Vision 2050, Rwanda aims to meet upper-middle-income country health-care standards by 2035 and high-income country (HIC) standards by 2050. This study assesses the financial sustainability of Rwanda’s UHC model from 2011 to 2021, with projections through 2041 under four scenarios: Scenario I (status quo, fee-for-service): Projects growing deficits reaching Rwandan Franc (RWF) 89.71 billion and a cumulative RWF 913.03 billion by 2040/2041. Scenario II (Fully Active Strategic Purchasing): Project net income of RWF 81.61 billion and cumulative reserves of RWF 516.94 billion by 2040/2041. This approach supports near-free health care, aligns with SDG 3.8 and WHO’s UHC Cube, and promotes reforms such as tariff adjustments, medical tourism, dual practice, and a comfortable package integrated with Ejo Heza Pension benefits. Strategic purchasing could eliminate 56.89% of undue costs, enabling 70% prepayment for facility plans: 45% for health service delivery, 10% for prior co-payments, and 15% for staff incentives. The remaining 30% (post-verification) would fund additional essential medicines, inpatient nutrition, financial sustainability, and resilience initiatives. Scenario III (1% UHC-HRV 2050 tax): Forecasts RWF 849.41 billion in net income and RWF 6,985.66 billion in reserves. Scenario IV (equity and modernization): Aims to expand clinical capacity 12-fold by 2041. Leveraging a strengthened CBHI system and a modest 1% levy for UHC and HRV 2050, Rwanda could promote clinical capacity strengthening up to 12-fold by 2041, retention and repatriation of specialized professionals, health infrastructure modernization, and meet HIC health-care standards by 2036 - 2040, ahead of 2050 initial milestone, saving up to USD 922.86 per capita in health expenditure. Rwanda’s robust UHC commitment provides a replicable model for sustainable health reform across Africa.

Smartphones are widely used by physicians and patients. The carbon footprint of healthcare devices is poorly documented. Physicians report an average daily smartphone usage of 1 - 5 h for activities, such as reviewing diagnostic information, capturing patient photographs, conducting telehealth consultations, and advancing their medical education. Meanwhile, patients generate billions of daily queries on Google and millions on ChatGPT, trends likely to increase as artificial intelligence (AI)-driven search engines and large language models (LLMs) become more sophisticated and accessible. To explore the associated environmental impact, we evaluated the average lifetime carbon emissions linked to smartphone usage and the energy costs of manufacturing selected smartphone models. Our data were sourced from publicly accessible databases, corporate 10-K statements, and corporate social responsibility reports available on company websites. We then validated these findings by using four types of LLMs, including ChatGPT, Gemini, Claude.ai, and Meta AI. We found that all LLMs produced carbon emission estimates that differed from those reported in the companies’ official corporate literature. In an era of rapid AI adoption, establishing reliable environmental metrics is essential for informed decision-making and responsible technology use.