Over the past two decades, fertility services have experienced significant shifts in ownership structures worldwide, transitioning from predominantly public or physician-owned clinics to a market increasingly influenced by private equity. These changes raise debates about treatment efficacy, cost transparency, and the ethical implications of profit-driven health care. This review provides an evidence-based overview of trends in fertility clinic ownership (public, physician-owned, and private equity-backed), along with reported success rates and implications for treatment quality, cost transparency, and patient well-being. A narrative synthesis was conducted using peer-reviewed literature, registry data, and industry reports published between 2000 and 2025 (projected). Ownership distribution, reported live birth rates, and financial transparency were examined. Regional studies, market analyses, and professional guidelines were used to infer trends when global data were unavailable. Ownership trends show a decline in public- and physician-owned clinics, with private equity projected to control up to 50% of fertility centers in some regions by 2025. Treatment efficacy improved across all clinic types, with live birth rate per in vitro fertilization cycle rising from ~25 - 30% in 2000 to ~35 - 45% by 2020 in younger cohorts; higher rates in private equity clinics may reflect patient selection and reporting variability. Cost transparency remains inconsistent, particularly in private equity networks where bundled pricing and aggressive marketing may obscure true costs and incentivize unnecessary add-ons. The consolidation of fertility centers under corporate ownership has reshaped reproductive health care. Ongoing concerns include pricing opacity, the clinical value of “add-on” treatments, and the ethical positioning of clinicians in profit-driven settings.

Around the world, countries strive to provide high-quality healthcare while also attempting to control the growth of healthcare spending. In recent decades, vertically integrated care models have been developed and implemented. In Portugal, vertical integration has been achieved through the establishment of local health units. Over 25 years after the founding of the first unit, and more than a decade since the creation of the most recent one, this model was rolled out nationwide in January 2024, promoting the integration of hospitals and primary care centers into a single institutional and management entity. This approach aims to deliver integrated healthcare, ensure continuity of care, strengthen community primary care services, and emphasize health promotion. The primary objectives of this study are to gain a deeper understanding of vertical healthcare integration, particularly in Portugal, and to evaluate the outcomes of this integration model. As an exploratory study, the methodology includes a review of the relevant literature and national legislation on the topic. The literature presents mixed, limited, inconsistent results, with no distinctly positive trend emerging. While the vertical integration model has the potential to realize the expected theoretical benefits, several factors and vulnerabilities must be considered; otherwise, it may transform a potential oasis into a fleeting opportunity mirage.

Health disparities, characterized by avoidable differences in health outcomes and access to healthcare services, disproportionately affect vulnerable populations, including racial and ethnic minorities, economically disadvantaged groups, and individuals in rural areas. Addressing health disparities is crucial for achieving health equity and enhancing the overall well-being of vulnerable populations. This article explores the contributing factors to health disparities, including socioeconomic, cultural, and environmental determinants, and examines the challenges faced by vulnerable populations in accessing healthcare services. It outlines strategies to address these disparities through health education, culturally competent care, policy initiatives, and community-based approaches. The review identifies socioeconomic status, education, geographic location, and race/ethnicity as significant factors contributing to health disparities. Promising interventions include improving cultural competence among healthcare providers, implementing community health worker programs, and advancing mobile health clinics. To mitigate health disparities, it is critical to address both the social determinants of health and systemic barriers that limit vulnerable populations from receiving equitable care. Effective interventions, along with policy and advocacy efforts, can significantly improve health outcomes. Ongoing research and data collection are necessary to monitor progress and ensure prioritized health equity in healthcare systems. This article is intended to inform both academic and practitioner audiences by providing theoretical insights for researchers and students, while also offering practical strategies for policymakers and health program implementers.

Environmental degradation is proportional to the number of humans. Despite the general reduction in birth rates, the global population continues to grow, and the tendencies of decrease are insufficient for sustainability. Efficient solutions would need refactoring of certain moral stereotypes and introduction of new approach, that no population group, locally or globally, would achieve benefits through a faster growth. High fertility is used for geopolitical advance and, as such, should be counteracted. Nations receiving immigrants decide whom they accept, although in many cases, the aliens enter and remain illegally. Birth control has been rejected in some countries on the grounds of presumed national interests, such as stronger economy and defenses, which can be enhanced by demographic growth. International tensions are among the motives for supporting high fertility since the military needs young people. The overpopulation-related problems are delineated here with examples from the former Soviet Union and some other regions. Furthermore, reproductive coercion is discussed as a mechanism of birth rate elevation. Preventable life shortening may be interpreted as homicide. Conversely, birth rate restriction is ethically neutral. Notwithstanding the prospects of cheaper and cleaner energy, there is no solution to a fall in regional and global populations. However, the declining population issue is somewhat still within our control and it will not remain indefinitely.

Mental health literacy plays a vital role in addressing mental health challenges among young people in Africa. This paper examines the present state of mental health literacy among African youth, identifies key barriers to its enhancement, and proposes strategies for improvement. Mental health literacy, defined as the knowledge and beliefs about mental disorders that aid in their recognition, management, and prevention, is particularly crucial for young people as it facilitates early recognition of mental health difficulties and promotes help-seeking behaviors. The paper indicates that Africa faces significant challenges, including limited mental health professionals, inadequate support for common mental disorders, and insufficient tailored interventions for youth. The paper concludes that addressing mental health literacy among African youth requires a collaborative approach involving policymakers, educators, healthcare providers, and community leaders.

Climate change exacerbates mental health issues among young individuals, making education a crucial tool for providing knowledge, resilience, and coping strategies. By integrating discussions on emotions, mental health, and coping mechanisms into climate change education, educational initiatives can foster resilience and support young people in navigating these challenges. Educational programs that focus on environmental literacy, sustainability, and innovative teaching methods are essential for equipping youth with the necessary skills to address the complex interplay between climate change and mental well-being. However, implementing such programs in developing countries faces challenges such as resource limitations and cultural barriers. Successful models have overcome these challenges through partnerships, cultural sensitivity, and community engagement. Ultimately, education can act as a catalyst for positive change by fostering resilience, promoting environmental literacy, and empowering young individuals to contribute to sustainable development. By investing in inclusive educational endeavors, developing nations can equip youth with the skills needed to confront climate change-induced mental health challenges effectively.

In contexts like Ethiopia, where formal health insurance and financial markets are underdeveloped, households face significant challenges in managing the economic consequences of health shocks. This study analyzes household coping strategies in response to illness and death shocks using two rounds of nationally representative Ethiopian Socioeconomic Survey data. A multivariate probit model is employed to capture the interdependent nature of five active coping strategies. The findings reveal that coping responses vary across household characteristics, including poverty status, gender of the household head, and rural-urban location. Death shocks commonly trigger increased labor participation, particularly among rural and female-headed households, while urban households often combine labor responses with asset sales or informal help. In contrast, illness shocks are primarily addressed through savings, with urban and male-headed households supplementing savings by selling assets, and rural households relying on a mix of savings and credit. Vulnerable groups - especially poor and female-headed households - tend to depend on coping mechanisms, such as asset liquidation and informal borrowing, which pose long-term risks to their economic stability. These results underscore the need for integrated policy interventions. Expanding community-based and social health insurance, providing accessible microfinance, strengthening preventive health programs, and enhancing targeted social protection are critical steps to mitigate the welfare losses associated with health shocks. Strengthening household resilience is essential not only for public health but also for advancing sustainable development and poverty reduction in Ethiopia and similar low-income settings.

Annual reports have indicated a progressive decline in immunization coverage in Yaoundé. This study aimed to identify knowledge gaps and organizational deficiencies in the implementation of routine immunization in health facilities (HFs) in the Efoulan health district (HD) of Yaoundé. A descriptive cross-sectional study was conducted in Efoulan, an urban HD of Yaoundé, the capital of Cameroon, in May 2022. A self-administered questionnaire and an observation grid were used to collect knowledge-related data. A total of 46 healthcare workers (HCWs) providing vaccinations in the nine health areas of the HD were enrolled in the study. Almost all participants (93.5%) were unable to name all the diseases that the pentavalent vaccine protects against. More than half of the respondents (59%) were aware of the 15-month booster dose of the measles-rubella (MR) vaccine included in the Expanded Program on Immunization (EPI). Half of the respondents were aware of the type of antigen contained in the Bacillus Calmette-Guérin vaccine (52%). More than two-thirds of the respondents (72%) had not identified the 6-month MR vaccine as recommended for HIV-positive children. Almost all the respondents (87%) had poor knowledge of vaccination norms and standards. Most of the visited HFs did not follow the monthly EPI monitoring curve (87%), did not store vaccines according to standards (80%), or lacked an EPI case reporting form (93%). There are still significant deficiencies in the implementation of routine immunization in most HFs in Efoulan HD, which correlate with the staff’s lack of knowledge of EPI norms and standards. Strengthening the capacity of HCWs through ongoing training and supervision is necessary.

Mine accidents remain a significant concern despite ongoing investments in health and safety training. This study explores mineworkers’ perceptions of workplace hazards to better understand accident prevention and the protection of health, life, and property. A total of 205 workers from Nampundwe Mine participated in the study, including managers, supervisors, machine operators, general miners, and contractors. A mixed-methods approach was employed, incorporating semi-structured interviews, focus group discussions, and document reviews. The findings revealed that occupational health hazards significantly affect contractors’ monthly income. Workers have good to fair knowledge of occupational hazards, with supervisors having the highest level of awareness and contractors the lowest. Despite receiving training in emergency response and awareness of health and safety measures, workers rarely followed standard operating procedures. The major causes of accidents identified were violation of safety rules, falls from heights, and incidents involving trackless vehicles. These findings highlight the need for improved adherence to safety protocols to prevent accidents. Targeted interventions are necessary to enhance workplace safety and reduce accidents in the mining industry. Our study provides valuable insights into the perceptions of mineworkers and identifies areas for improvement. By addressing these gaps, mining companies can create a safer working environment and protect the health and well-being of their workers.

Inflation—the sustained increase in the general price level of goods and services—presents a significant economic and social challenge with substantial impacts on living standards, financial stability, and public health. This paper explores the multifaceted impacts of inflation, with a particular focus on its disproportionate effects on low-income and fixed-income populations. Inflation directly impacts access to essential goods and services—such as food, housing, and healthcare—compelling households to make trade-offs that often result in adverse health outcomes. Malnutrition, limited access to medical care, and elevated rates of stress-related illnesses represent some of the most pronounced health consequences. In developing countries, such as Pakistan, inflation has intensified financial pressures on households, reducing their consumption of nutritious food and essential healthcare services. Among low-income populations, these compromises worsen existing health disparities, perpetuating a cycle in which poor health reduces economic productivity and deepens poverty. Escalating healthcare costs introduce an additional burden, rendering many individuals unable to afford treatment, medications, or preventive services. In addition, inflation exerts indirect effects on mental health, as financial instability contributes to increased levels of stress, anxiety, and depression, particularly among vulnerable populations. Households striving to manage constrained budgets often face difficult decisions, including prioritizing immediate expenses over long-term health investments. This paper also highlights inflation’s impact on savings, as it erodes the real value of savings, complicating efforts to secure financial stability and access to health-related services. Policymakers must address inflation’s dual economic and health effects through targeted interventions—such as subsidies for essential goods, improved access to healthcare, and initiatives aimed at price stabilization.

Measles remains a significant public health challenge in sub-Saharan Africa, including Cameroon, where vaccination coverage (77%) falls below the World Health Organization target of 95%. This study assessed the coverage of the second dose of measles-containing vaccine (MCV2) and identified factors influencing vaccination uptake in Ngog-Mapubi Health District (HD), Cameroon. A community-based cross-sectional survey was conducted in this rural HD in March 2024, involving 140 parents or guardians of children aged 15-23 months. Data were collected using a pre-tested questionnaire, covering sociodemographic characteristics, vaccination status, and barriers to uptake. Determinants of MCV2 vaccination were identified through logistic regression. Data were analyzed using R statistics version 4.4.2. p<0.05 was considered statistically significant. The study revealed a MCV2 vaccination coverage of 46.4% (95% confidence interval [CI]: 38.0-55.0). Among unvaccinated children, 85.3% (95% CI: 75.3-92.4) of caregivers expressed willingness to vaccinate, indicating high acceptance but persistent barriers. Distance to health facilities (43%), lack of information about vaccine availability (37%), and missed opportunities during health visits (25%) were the most cited obstacles. Awareness of MCV2 was high (89%), but knowledge gaps persisted, with 61% of respondents demonstrating poor understanding of vaccination schedules. Multivariate analysis identified the absence of advanced vaccination strategies (e.g., outreach programs) as the strongest predictor of non-vaccination (adjusted odds ratio = 7.15; 95% CI: 3.19-17.2; p<0.001). Despite a high MCV2 acceptance rate, low MCV2 coverage in this rural district underscores the need for improved access through advanced vaccination strategies and targeted community education. Addressing structural and informational barriers is essential to achieving equitable immunization coverage.

COVID-19 vaccine mandates for healthcare workers (HCWs) in British Columbia (BC) were implemented in October 2021 and remained effective until July 2024, despite public protests and opposition from some unions. This study explored HCWs’ lived experiences under these mandates, focusing on decision-making processes, personal and professional impacts, and perceived consequences for patient care. We conducted a reflexive thematic analysis of qualitative responses from 90 HCWs, collected through one open-ended survey question and elaborations on closed questions. The survey, conducted in May-June 2024, recruited a convenience sample of 166 HCWs of varying vaccination status, professions, and demographics through social media and professional networks. Findings are reported in accordance with the consolidated criteria for reporting qualitative studies (COREQ) checklist (Table A1). Most respondents were unvaccinated and had lost employment due to non-compliance. Participants reported significant personal losses and expressed overwhelmingly negative views on mandates. Six key themes emerged: (1) conflict with scientific evidence and clinical practice; (2) violations of medical ethics, especially informed consent; (3) dismissed personal and economic hardships; (4) overlooked vaccine-related physical harms; (5) discrimination against unvaccinated HCWs and patients; and (6) negative impacts on care delivery. Our findings suggest that vaccine mandates caused substantial social and economic harm, contributed to staffing shortages, degraded workplace morale, and compromised patient care. Drawing on respondents’ experiences and the scientific evidence available at the time, we conclude that mandatory COVID-19 vaccination for HCWs lacked scientific justification and violated foundational ethical principles in health-care policy and practice.

The Cameroon Health Sector Strategy (HSS) aims to foster a healthy and productive population, aligning with the Sustainable Development Goals. This retrospective study assesses progress toward the objectives of the HSS and key health indicators in the Center Region and nationally, providing a critical sub-national benchmark. In April 2023, we collected data for the period up to 2022 from the national DHIS2 database, online documents, and surveys, including the Demographic and Health Survey and the Multiple Indicator Cluster Survey. Data underwent rigorous validation for completeness and accuracy before analysis. Nationally, performance was highest for antenatal antiretroviral therapy coverage (99%) and lowest for the reduction of chronic malnutrition among children under five (63% of target). The Center Region achieved the national malnutrition target (11% prevalence) but showed the lowest coverage of long-lasting insecticidal nets among children. A key infrastructural finding was the disparity in health facility density, which exceeded the national target (2.3/10,000) overall but remained below this target in the Center Region (1.4). In the Center Region, vaccination coverage for tracer antigens (Pentavalent 3, Bacille Calmette-Guérin) declined over 5 years, falling below the 95% target in 2022, although it remained above the national average. Similarly, antenatal care attendance and intermittent preventive treatment coverage remained persistently low from 2018 to 2022. While significant progress has been made in strengthening the health system, these findings highlight the need for targeted efforts to prevent malaria, improve routine immunization and antenatal care utilization, and address the underlying causes of nutritional insecurity in lagging regions. This analysis offers crucial evidence for strategic health planning and resource allocation.

Biosimilars are biological drugs that closely resemble a reference product (RP) without clinically meaningful differences in quality, efficacy, or safety. Their primary objective is to enhance access to affordable treatments, necessitating adherence to varied global regulatory guidelines. This paper analyzes Argentina’s biosimilar regulations, including the latest 2025 guidelines on comparability and the stance of medical societies, comparing them with international guidelines from Brazil, the European Union, and the United States - with a focus on definitions, comparability, interchangeability, extrapolation, pharmacovigilance, and traceability. A key finding of this study is Argentina’s lack of specific regulatory guidance on interchangeability and substitution, which contrasts with international practices. Seven Argentinian medical associations generally support biosimilar use, particularly in fields, such as autoimmune, dermatological, gastrointestinal, rheumatic, and endocrine diseases, recognizing their potential to reduce costs and enhance patient access. However, these societies advocate caution regarding interchangeability and automatic substitution due to limited supporting evidence, favoring physician-approved product changes and robust pharmacovigilance. As of April 2025, Argentina’s biosimilar market is expanding, with over 67 approved products and significant price reductions (39-88%) reported for biosimilars of adalimumab, infliximab, and etanercept compared to their RPs. Despite ongoing challenges, the new Argentinian regulations offer promising prospects for future advancements, with expectations that increased regulatory experience, harmonized health policies, and comprehensive pharmacovigilance will refine standards and address existing gaps.

Health insurance is vital for healthcare financing and aligns with the 2030 Sustainable Development Goal agenda. Women of reproductive age face unique barriers to affordable care due to higher health risks and caregiving responsibilities. This study aims to estimate the proportion of women with health insurance coverage (HIC) and to identify factors associated with such coverage. Data were drawn from the latest round of the Bangladesh Demographic and Health Survey 2022, comprising a total sample of 19,987 women. Unadjusted odds ratios (UORs) with 95% confidence intervals (CIs) were reported. The median age of the women was 32.0 years (interquartile range: 25.0 - 39.0). Only 0.3% of respondents reported having HIC. The odds of having HIC were significantly higher among the women in the study who had an account with a bank or other financial institution (UOR: 2.27; 95% CI: 1.36 - 3.79), those with post-secondary education (either themselves or their husbands), those in the richest wealth quintile (UOR: 3.32; 95% CI: 1.45 - 7.60), and those with adequate media exposure (UOR: 2.78; 95% CI: 1.41 - 5.47). The study highlights the need for promoting higher education for both sexes, addressing wealth-based disparities, and leveraging mass media to increase the uptake of HIC.