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Gender norms regarding sexuality, sexual agency and bodily autonomy dictate what behaviours, roles and attributes are considered appropriate for women and girls, men and boys and transgender individuals. (1) These [...]

The paper presents the results of contact strength and tribological property tests of spare parts made of a popular resin using a 3D DLP printing technology. Two printer models by the same manufacturer were used in the study. The post-processing technique, which shapes the final functional properties, was diversified. Surface performance properties were compared, i.e. Shore hardness, indentation hardness, Martens hardness, elastic modulus, and parameters related to surface creep and relaxation. Tribo-logical durability in rotary motion and tribological wear in reciprocating linear motion were also evaluated using micro- and nanotribometers. This was followed by surface analyses of the friction track of the analysed materials using microscopic methods: a scanning electron microscope, a WLI interferometric microscope, and an optical microscope. The results were statistically processed and the relationship between the parameters determined in the indentation test was determined.

Traditional engagement with local governments often relies on financial and human resources from international or local partners, leading to direct implementation by organizations, which can hinder sustainability. While some organizations include sustainability indicators, few focus on transferring technical and financial ownership to governments. The Challenge Initiative (TCI) uses a phased coaching model-lead, assist, observe, and monitor-to build local government capacity for scaling family planning (FP) and adolescent and youth sexual and reproductive health (AYSRH) programs. TCI ensures local governments take the lead from day one, coaching them to manage and implement these programs sustainably, improving management, coordination, planning, budgeting, and data-driven decision-making. In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with stakeholders across 24 TCI sites in 8 countries-Benin, Kenya, India, Niger, Nigeria, Senegal, Tanzania, and Uganda-from October 2020 to March 2021. A total of 175 IDIs and 14 FGDs were conducted with 343 master coaches (52 TCI staff, 164 local government staff) and 127 coachees. Participants included TCI staff, local government officials, and health providers at both facility and community levels, all of whom received coaching. Examples were gathered to assess the impact of TCI's coaching model on government FP and AYSRH programs. TCI documented improvements in local government and health service provider leadership, management, and coordination of health programs through its coaching interventions. It linked health system outcomes to its coaching approach, building a cadre of master coaches and coachees at all levels. This strengthened local governments' capacity to lead and sustain the scale-up of FP and AYSRH programs beyond TCI's direct support. Improved monitoring and tracking of coaching quality is needed for further insights.

The article presents the results of the Polish research in 2014 and 2020 involving economic loss in enterprises due to employees' work disability due to road accidents. Road safety is one of the most essential global declines in social health, but marginal external road transport costs are not easy to measure. Typically, the aspect of risk in road safety in the operations of enterprises is viewed in the context of transport or logistic companies. However, the risk of becoming a road accident victim is not limited to fleet drivers. Better information about employee road accident costs needs to be provided in the literature. The Polish research shows that employees' work disability due to road accidents is extremely costly, often more than one would expect. A decrease in the risk of death in road safety in Poland in 2014-2019 did not reduce the costs to enterprises, which grew from PLN 1.1 million to PLN 1.6 million. Management of economic loss in enterprises due to road accidents is essential not only from the financial point of the organisation but also from the idea of corrective instruments to equate marginal social costs with marginal social benefits of transport The results of the conducted research bridge the research gap, vital from the point of view of community and corporate operations, regarding the volume of losses of enterprises due to employee turnover due to road accidents, which are likely to affect any. Further research should aim at specific conditions of minimizing employer losses discussed here, e.g. in the area of health policy improvement, which would allow a faster personal and professional recovery. The issue of the employer's employee social policy regarding creating suitable conditions for taking out life insurance is crucial. Ultimately, it is worth looking closer at employees' willingness to buy insurance coverage if the risk of a loss of life or health due to a road accident is real and substantial. Moreover, results show the critical direction for business – corporate social responsibility for road safety. It is warranted that further research should focus on recognizing and enhancing this role.

Background The Global Polio Eradication Initiative (GPEI) helped develop the standard acute flaccid paralysis surveillance (AFP) system worldwide, including, knowledge, expertise, technical assistance, and trained personnel. AFP surveillance can complement any disease surveillance system. Objective This study outlines AFP surveillance evolution in Bangladesh, its success and challenging factors, and its potential to facilitate other health goals. Methods This mixed-method study includes a grey literature review, survey, and key informant interviews (KIIs). We collected grey literature from online websites and paper documentation from GPEI stakeholders. Online and in-person surveys were conducted in six divisions of Bangladesh, including Dhaka, Rajshahi, Rangpur, Chittagong, Sylhet, and Khulna, to map tacit knowledge ideas, approaches, and experiences. We also conducted KIIs, and Data were then combined on focused emerging themes, including the history, challenges, and successes of AFP surveillance programme. Results According to the grey literature review, survey, and KII, AFP surveillance successfully contributed to decreasing polio in Bangladesh. The major facilitating factors were multi-sectoral collaboration, Surveillance Immunization Medical Officer (SIMO) network activities, social environment, community-based surveillance, and promising political commitment. On the other hand, high population growth, hard-to-reach areas, people residing in risky zones, and polio transition planning were significant challenges. Bangladesh is also utilizing these polio surveillance assets for other vaccine-preventable diseases. Conclusion As the world is so close to eradicating polio, the knowledge, and other assets of the AFP surveillance, could be used for other health programmes. In addition, its strengths can be leveraged for combating new and emerging diseases.

IntroductionThe enduring legacy of colonisation on global health education, research and practice is receiving increased attention and has led to calls for the 'decolonisation of global health'. There is little evidence on effective educational approaches to teach students to critically examine and dismantle structures that perpetuate colonial legacies and neocolonialist control that influence in global health.MethodsWe conducted a scoping review of the published literature to provide a synthesis of guidelines for, and evaluations of educational approaches focused on anticolonial education in global health. We searched five databases using terms generated to capture three concepts, 'global health', 'education' and 'colonialism'. Pairs of study team members conducted each step of the review, following Preferred Reporting Items for Systematic reviews and Meta-Analyse guidelines; any conflicts were resolved by a third reviewer.ResultsThis search retrieved 1153 unique references; 28 articles were included in the final analysis. The articles centred North American students; their training, their evaluations of educational experiences, their individual awareness and their experiential learning. Few references discussed pedagogical approaches or education theory in guidelines and descriptions of educational approaches. There was limited emphasis on alternative ways of knowing, prioritisation of partners' experiences, and affecting systemic change.ConclusionExplicit incorporation of anticolonial curricula in global health education, informed by antioppressive pedagogy and meaningful collaboration with Indigenous and low-income and middle-income country partners, is needed in both classroom and global health learning experiences.

Abstract Balanced energy protein (BEP) supplementation in pregnancy is recommended in the context of undernutrition for the reduction of small‐for‐gestational age neonates and stillbirths. To inform an effectiveness trial, we evaluated the acceptability of a packaged, ready‐to‐eat fortified BEP product among women of reproductive age and their health care providers (HCPs) in rural Bangladesh and explored the feasibility of adhering to daily supplementation. We implemented a formative study using focus groups discussions with women (n = 29) and HCPs (n = 17) to introduce the product and investigate components of acceptability. A “trials of improved practice” activity was conducted in subset of women (n = 16) to evaluate adherence to BEP over a 2‐week period, followed by focus group discussions to identify challenges with adherence and strategies employed. Contributors to BEP acceptability included the product's sensory attributes, such as taste, smell and texture; the attractive packaging and informative labelling; and the perceived benefits of use. Participants also identified household and community level factors influencing the adoption of BEP, such as trust in the provider, cultural beliefs on supplement use in pregnancy, and family member tasting and approval. Over the 2‐week period, women consumed over 80% of the supplements provided to them and identified strategies for adherence, including visual aids and reminders from family members or providers. HCPs recommended targeted communication messages for mothers‐in‐law to foster a supportive home environment. Findings informed changes to the BEP product to improve acceptability and shaped the content of communication messages to optimise adherence in a forthcoming effectiveness trial.

Abstract Balanced energy protein (BEP) supplementation is an efficacious intervention in pregnancy for improving birthweight and is recommended by World Health Organization (WHO) in countries with high maternal undernutrition. Few countries have implemented BEP programmes due in part to high cost, lack of data on acceptability and feasibility, and complexity of delivery. We sought to address implementation gaps in BEP interventions through a formative study designed to understand implementation outcomes. We conducted 52 in‐depth interviews and 8 focus‐group discussions with married women of reproductive age, family members, health care providers and pharmacists in three unions of the Gaibandha district in rural Bangladesh. Interviews were translated and transcribed in English and analysed using an analytic framework for implementation science in nutrition. BEP was viewed as an acceptable and appropriate intervention to combat undernutrition in this setting. There was a lack of clarity on who should or could be responsible for providing/distributing BEP in a way convenient to mothers. Many participants preferred door‐to‐door delivery and thought this approach could address social and gender inequities, but providers mentioned already being overworked and worried about adding new tasks. Participants were concerned about the affordability of BEP and opportunity costs associated with travel to proposed distribution sites such as ANC or pharmacies. Women in these communities do not always have the agency to travel without supervision or make purchasing decisions. BEP supplementation is a complex intervention; future trials seek to assess ways to overcome these implementation challenges and inform a long‐term systems‐owned BEP intervention.

Abstract Balanced energy protein supplementation (BEP) is recommended for contexts of high maternal undernutrition by the World Health Organization. Despite recent improvements in undernutrition, Bangladesh remains a context where BEP could help accelerate progress towards nutrition goals. In preparation for an effective trial testing a fortified BEP, a qualitative study was undertaken to better understand sociocultural factors influencing dietary behaviours in pregnancy. Married women of reproductive age (n = 23), their husbands (n = 6) and mothers‐in‐law (n = 6) were interviewed, and focus group discussions were conducted with women (n = 4). Women had a clear understanding of which nutritious foods are important to consume during pregnancy, including green leafy vegetables, dairy and other animal‐source foods. Many explained affordability as a barrier to consuming those foods with the desired frequency. Women acquired information about diet and nutrition in pregnancy from community health workers as well as other women in the community. Most preferred to seek information from their own networks before formal health care providers. Women and husbands generally had positive views about micronutrient supplements, although some mothers‐in‐law were more hesitant. Some food taboos relating to the consumption of certain foods like duck and pigeon meat persist, mainly stemming from concerns for the unborn child. Opportunities exist to build on existing perceptions of healthy diets, potentially framing food or nutrient supplements as a beneficial ‘add‐on’ to promote a healthy pregnancy. There is a scope to strengthen nutrition counselling, especially for the family members, to dispel myths and misconceptions and promote dietary and other support for pregnant women.

BackgroundEvidence-based decision-making is essential to improve public health benefits and resources, especially in low- and middle-income countries (LMICs), but the mechanisms of its implementation remain less straightforward. The availability of high-quality, reliable, and sufficient data in LMICs can be challenging due to issues such as a lack of human resource capacity and weak digital infrastructure, among others. Health information systems (HISs) have been critical for aggregating and integrating health-related data from different sources to support evidence-based decision-making. Nutrition information systems (NISs), which are nutrition-focused HISs, collect and report on nutrition-related indicators to improve issues related to malnutrition and food security—and can assist in improving populations’ nutritional statuses and the integration of nutrition programming into routine health services. Data visualization tools (DVTs) such as dashboards have been recommended to support evidence-based decision-making, leveraging data from HISs or NISs. The use of such DVTs to support decision-making has largely been unexplored within LMIC contexts. In Bangladesh, the Mukto dashboard was developed to display and visualize nutrition-related performance indicators at the national and subnational levels. However, despite this effort, the current use of nutrition data to guide priorities and decisions remains relatively nascent and underused. ObjectiveThe goal of this study is to better understand how Bangladesh’s NIS, including the Mukto dashboard, has been used and areas for improvement to facilitate its use for evidence-based decision-making toward ameliorating nutrition-related service delivery and the health status of communities in Bangladesh. MethodsPrimary data collection was conducted through qualitative semistructured interviews with key policy-level stakeholders (n=24). Key informants were identified through purposive sampling and were asked questions about the experiences and challenges with the NIS and related nutrition dashboards. ResultsMain themes such as trust, data usability, personal power, and data use for decision-making emerged from the data. Trust in both data collection and quality was lacking among many stakeholders. Poor data usability stemmed from unstandardized indicators, irregular data collection, and differences between rural and urban data. Insufficient personal power and staff training coupled with infrastructural challenges can negatively affect data at the input stage. While stakeholders understood and expressed the importance of evidence-based decision-making, ultimately, they noted that the data were not being used to their maximum potential. ConclusionsLeveraging DVTs can improve the use of data for evidence-based decision-making, but decision makers must trust that the data are believable, credible, timely, and responsive. The results support the significance of a tailored data ecosystem, which has not reached its full potential in Bangladesh. Recommendations to reach this potential include ensuring a clear intended user base and accountable stakeholders are present. Systems should also have the capacity to ensure data credibility and support ongoing personal power requirements.

Brochantite was precipitated using stoichiometric amounts of CuSO4 and NaOH and characterized by scanning electron microscopy, specific surface area, thermogravimetric analysis, and zeta potential. Brochantite can be converted into paratacamite, basic copper bromide, and copper phthalate by shaking the powder with solutions containing excess corresponding anions. By contrast, attempts to convert brochantite into basic iodide, acetate, nitrate, or rhodanide in a similar way failed, that is, the powder after shaking with solutions containing excess corresponding anions still showed the powder X-ray diffraction pattern of brochantite. Successful ion exchange resulted in a decrease in the specific surface area by a factor of 10, but the specific surface area was unchanged when attempts to exchange the anion failed. Interestingly enough, paratacamite can also be converted into brochantite by shaking with solution containing excess sulfate. Brochantite and paratacamite obtained by precipitation and the salts obtained by ion exchange showed a negative zeta potential at pH > 9.

Introduction Methods and validated tools for evaluating the performance of competency-based implementation research (IR) training programmes in low–middle-income countries (LMICs) are lacking. In this study, we developed tools for assessing the performance of IR training programmes based on a framework of IR core competencies in LMICs.Methods We developed self-assessment and objective-assessment tools drawing on the IR competency framework. We used exploratory factor analyses and a one-parameter logistic model to establish construct validity and internal consistency of the tools drawing on a survey conducted in 2020 with 166 trainees before and after an index IR course across five universities and LMICs under the Special Program for Research and Training in Tropical Diseases postgraduate IR training scheme. We conducted key informant interviews (KII) with 20 trainees and five trainers to reflect on the usefulness of the tools and framework for guiding IR training in LMICs.Results Two 16-item tools for self-assessment of IR knowledge and self-efficacy and a 40-item objective assessment tool were developed. The factor loadings of items in the self-assessment tools were 0.65–0.87 with Cronbach’s alpha (α) of 0.97, and 0.77–0.91 with α of 0.98 for the IR knowledge and self-efficacy tools, respectively. The distribution of item difficulty in the objective-assessment tool was consistent before and after the index IR course. Pearson correlation coefficient (r) between the self-assessed and objectively assessed IR knowledge before the index IR course was low, r=0.27 (p value:

Abstract Background The population aging, together with the shrinking caring potential of families, is a major challenge for social policy in the coming years. The aim of the study is to identify the factors that determine not only the use of long-term care (LTC) but also the selection of individual types of such care in Poland. Methods Using unique data collected from inpatient LTC facilities in Poland and the Survey on Health, Ageing and Retirement in Europe (SHARE) database, we estimate logistic regressions explaining the choice of LTC solution. Results Our results suggest that social inequalities play a role in choosing the type of LTC. Better educated people choose private institutions, while people without support network use more often social residential homes. The impact of multimorbidity on choosing different types of inpatient facilities is limited, thus the number of ADL limitations remains a better indicator of long term care utilization. Conclusions The study confirms that social inequalities influence decisions about the choice of LTC. However, multi-morbidity is a predictor of using LTC to a limited extent. The differences in LTC selection determinants between women and men are noticeable.