Medical tourism (MT)—the practice of traveling across borders to receive medical treatment outside of a patient’s home country—is a burgeoning industry globally. This article provides insights about MT and its impacts on sub-Saharan Africa. Globalization of medical care is a multi-billion-dollar phenomenon, associated with economic, ethical, legal, and cultural factors. Main drivers of MT are grounded in several factors, namely, medical costs, waiting lists, connectivity, and utilization of advanced technology. In contemporary Africa, health is no longer a fundamental human right but a commodity traded as a good in the marketplace, subject to forces of demand and supply. MT is increasingly embraced by the privileged in national governments to meet their health needs. To curb the growing medical expenditures abroad, the region needs to transform its health sector, reduce barriers to business growth, and create conditions conducive to strengthening health systems—especially in fragile and low-income countries. Thus, governments and other actors could design policies that implement the development of MT while upholding moral and ethical values.

Maternal and perinatal mortality remain unacceptably high in sub-Saharan Africa, yet the systematic surveillance and response mechanisms designed to address them are poorly implemented in many low-resource settings. This research aims to investigate the predictors of healthcare workers’ responsiveness in initiating maternal and perinatal death surveillance and response (MPDSR) across selected secondary health facilities in Kebbi State, Nigeria. Despite global and national efforts to reduce maternal and perinatal mortality, Nigeria continues to experience high rates, with numerous secondary health facilities yet to fully implement MPDSR strategies. This study will adopt a cross-sectional design and will use a mixed-methods approach to explore factors influencing healthcare workers’ responsiveness. Stratified random sampling will be used to select 384 healthcare workers from 28 secondary health facilities. The data will be collected through structured questionnaires and focus group discussions with healthcare professionals, including nurses, midwives, and doctors. The study aims to identify predictors, such as facility capacity, healthcare workers’ knowledge, and training, related to the initiation of MPDSR. Findings from this study will provide evidence-based recommendations for policymakers to improve MPDSR implementation, reduce maternal and perinatal mortality, and enhance healthcare systems in Nigeria. The results will guide the formulation of targeted interventions to foster increased engagement and responsiveness among healthcare workers. Additionally, our protocol will assess the roles of organizational culture, facility infrastructure, and leadership support in shaping healthcare workers’ readiness to initiate MPDSR, thereby contributing to the broader evidence base on health system strengthening in low-resource settings.

India has implemented demand-side financing programs, including Janani Bal Suraksha Yojana (JBSY) and Pradhan Mantri Matru Vandana Yojana (PMMVY), to reduce financial barriers and improve maternal and neonatal health outcomes. This study assesses their implementation and equity in Bihar, India. A cross-sectional survey across eight districts (N = 1,247) with qualitative interviews (n = 42) revealed severe deficits in awareness, coverage, and timeliness. Notably, 69.7% of women were unaware of PMMVY, and 13.7% were unaware of JBSY. Registration rates were low: 56.0% for JBSY and 2.4% for PMMVY. Only 39.0% of JBSY beneficiaries received payments within 30 days post-delivery. Significant socioeconomic inequities emerged: women from scheduled castes/scheduled tribes and those without formal education were markedly less likely to register or receive benefits. While JBSY beneficiaries incurred lower out-of-pocket expenditure (INR 1,509 vs. INR 2,619), persistent costs, delays, and informal payments undermined financial protection. Qualitative findings identified complex documentation, low digital literacy, and distrust in banking as barriers to Aadhaar-linked direct benefit transfers (DBT). Overall, the potential of conditional cash transfers remains constrained by low awareness, delayed payments, restrictive eligibility, and structural inequities. Strengthening impact requires robust awareness campaigns, simplified DBT systems with grievance redressal, targeted outreach to marginalized groups, and supply-side improvements.

Vaccination against human papillomavirus (HPV) is a key strategy for preventing cervical cancer, particularly in developing countries such as Brazil, where the disease remains a significant public health challenge. Despite well-established clinical efficacy, there is still limited systematic evidence regarding the cost-effectiveness of this intervention in the Brazilian context. This study aims to analyze the scientific production on the cost-effectiveness of HPV vaccination in cervical cancer prevention through a bibliometric approach. Searches were conducted in Scopus, Web of Science, and PubMed/MEDLINE for comparison, and the bibliometric analysis was performed using the Scopus dataset. The results indicate a significant growth in scientific production over time, structured around three main thematic areas: economic modeling, the social impact of immunization, and integration with public health policies. However, Brazilian scientific output remains limited, particularly regarding economic evaluations within the Unified Health System (SUS), highlighting important gaps in national research. These findings reinforce the importance of strengthening local scientific production and expanding evidence on cost-effectiveness to support more efficient and sustainable public health policies. Bibliometric analysis proves to be a useful tool for identifying trends, gaps, and collaboration patterns, contributing to more informed decision-making in immunization strategies.

Although Morocco has significantly improved its overall human development index and its health indicators in particular over the last three decades, achievements remain incomplete due to persistent social inequalities, health inequities, and territorial disparities. This paper focuses on health inequities in infant mortality, nutritional status, early marriage and adolescent childbearing. With 49.6% of its population under the age of 30 years, decision makers in Morocco are challenged by high levels of unemployment among the youth population, an unacceptable territorial disparity, and socio-economic inequalities that affect the disadvantaged segments of the population, particularly women, children, and young people. The unpleasant results revealed in this article are a sincere call for urgent action to reduce the inequalities that hinder human development and ensure well-being for all, leaving no one behind.

Congestive heart failure (CHF) and atrial fibrillation (AF) are major cardiovascular diseases, particularly among older adults. This study analyzes national mortality trends for CHF and AF in the United States from 1999 to 2020, focusing on demographic variations and addressing gaps in evidence regarding urbanization and state-level disparities. Data were extracted from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death Public Use database (1999-2020). Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated for adults aged ≥ 25 years. Mortality rates were stratified by year, gender, ethnicity, urbanization, census region, and state. Annual percent changes (APCs) were analyzed using the Joinpoint Regression Program. Between 1999 and 2020, 744,565 deaths related to CHF and AF were reported among adults aged ≥ 25 years. Overall, AAMR increased from 11.43 (95% CI: 11.27-11.58) in 1999 to 20.72 (95% CI: 20.55-20.89) in 2020, with significant APCs of 1.78% (1999-2010) and 3.38% (2010-2020). Males consistently showed higher AAMR (17.62) than females (14.13). Whites had the highest AAMR (16.42), while Asian/Pacific Islanders had the lowest (6.72). Among urbanization categories, Micropolitan areas exhibited the highest AAMR (18.61), while Large Central Metro areas exhibited the lowest (13.32). By region, the West had the highest AAMR (17.55), and the Northeast had the lowest (14.14). Mortality varied by state, with Oregon showing the highest (AAMR 25.65) and Nevada the lowest (AAMR 8.61). Rising CHF and AF-related mortality rates warrant targeted public health interventions, particularly in high-burden groups. Addressing healthcare issues, providing access, promoting early detection, and implementing evidence-based management are critical to reducing mortality.

Financial protection is a core pillar of universal health coverage and is explicitly captured under Sustainable Development Goal (SDG) 3.8.2. Yet Nigeria remains one of the poorest-performing countries globally on this indicator, despite over two decades of health financing reforms. Less than 5% of the population is covered by any form of health insurance, while out-of-pocket payments account for more than two-thirds of total health expenditure. Consequently, between one-quarter and one-third of Nigerian households experience catastrophic health expenditure annually, with the burden disproportionately borne by the poorest quintiles. This perspective aims to critically examine the structural determinants of Nigeria’s financial protection crisis, spanning revenue generation, risk pooling, benefit design, and governance, and to propose evidence-based reform pathways grounded in secondary literature and regional policy lessons. Drawing on national data, global benchmarks, and comparative experiences from peer African countries, including Rwanda, Ghana, Ethiopia, and Kenya, it argues that fragmented, voluntary, and underfunded insurance schemes cannot deliver financial protection in a predominantly informal economy. A shift toward tax-funded, unified pooling with explicit protection for primary care, chronic diseases, and catastrophic illness is presented as the most viable pathway to achieving SDG 3.8.2 and restoring public trust in Nigeria’s health system.

Humanitarian organizations operate in environments characterized by chronic insecurity, moral complexity, and increasing operational constraints. While stress among humanitarian personnel has traditionally been framed as an individual psychological issue, emerging evidence suggests that stress is structurally embedded within organizational systems. Building on prior analysis of humanitarian delegate stress, this article advances the concept of stress governance as a critical dimension of human security. Drawing on institutional practices of the International Committee of the Red Cross, including staff health management frameworks and specialized trauma interventions, as well as comparative insights from Médecins Sans Frontières and the International Federation of Red Cross and Red Crescent Societies, the article develops an integrated model linking structural stressors, organizational design, and policy responses into a coherent framework of stress governance. The article argues that unmanaged staff stress constitutes a systemic risk not only to organizational effectiveness but also to the protection of vulnerable populations. It concludes by outlining policy implications for humanitarian organizations, donors, and governance frameworks, emphasizing the need to embed stress management within broader human security strategies.