Zeus Aranda

Background: Artificial intelligence (AI) tools are increasingly deployed within community health worker (CHW) programmes, but evidence on their use, readiness, risks, and priorities is limited. We characterised the current state of AI in these programmes across stakeholder groups. Methods: Cross-sectional, self-administered online survey in English, French and Spanish of a convenience sample of CHW-programme stakeholders, covering AI activity, readiness, risks, governance, and investment priorities. Analyses were descriptive. Findings: 283 respondents from 41 countries participated (157 CHWs, 28 supervisors; 42% working in Kenya). 189 (67%) were aware of AI tools in CHW programmes, but only 31 (11%) described mature or at-scale use. Perceived readiness of the systems supporting CHW work was low across all eight domains, a mean of 28% rating any domain high and none above 33%. 230 (81%) agreed AI should support rather than replace CHW judgement (mean 4·35 [SD 1·16] of 5) and 211 (75%) wanted clear escalation pathways, yet only 39 (14%) found national AI policy clear. Among 185 CHWs and supervisors, 141 (76%) used tools they identified as AI-enabled, but of 152 answering the training item only 36 (24%) had ongoing training and 55 (36%) very brief training. Connectivity was the most-cited barrier (201 [71%]), yet offline-first infrastructure was prioritised by only 96 (34%). CHWs and supervisors were more confident than other stakeholders that current AI is safe and reliable (55% vs 29% and 23%), while more concerned about de-skilling (51% vs 24% and 34%) and workload (48% vs 17% and 34%). Interpretation: AI in CHW programmes is largely pre-scale, against low readiness, limited training, and no clear national policy, but with strong consensus for human-in-the-loop design. Stated investment priorities do not consistently track reported barriers, and those closest to the work view risk differently from those who design and fund the tools. Funding: No specific funding was received for this study.

The population of migrant and refugee children and adolescents increased in the first two decades of the 21st century in the Americas region. This analysis was conducted with the aim of shedding light on the association between the living conditions of migrant minors in Mexico, one of the main transit countries for migrants in the region, and the evolution of health-related quality of life throughout the migration process. Data were collected on 192 minors aged one year or older in transit to the United States through their caregivers in shelters on Mexico’s northern border, including sociodemographic/socioeconomic information and health-related quality of life information prior to departure and during the period of travel. Differences in the evolution of health-related quality of life between origin and travel were explored for different categories of sociodemographic/socioeconomic variables. Several social groups experienced a greater deterioration in some aspects of health-related quality of life, such as those in more precarious situations at origin and along the route, younger minors, or minors whose primary caregivers identified as Afro-descendants and/or indigenous. Minors who had experienced child abuse in their place of origin and adolescents experienced improvements in certain aspects of their health-related quality of life throughout the journey. Despite the exploratory nature of the analysis, it constitutes a first step in identifying populations of children and adolescents on the move in Mexico who should be prioritized for interventions aimed at promoting their well-being.

Introduction: The population of migrant, refuge, and asylum-seeking children and adolescents across the globe has increased in recent decades. These minors often undergo adverse experiences that negatively impact their mental health and psychosocial well-being (MHPWB). In light of the transient nature and multiple stressors inherent in the transit stage, this scoping review was conducted to characterize the evidence on interventions aimed at promoting the MHPWB of minors during their migration journey. Methods: Following the PRISMA-ScR guidelines, we systematically searched the MEDLINE, Embase, Global Health, APA PsycInfo, and Web of Science databases, as well as the Google Scholar search engine, for studies published between January 2010 and September 2025 that included the evaluation of some aspect of interventions aimed at promoting MHPWB in minors during transit, regardless of the language and location where the study was conducted. Systematic reviews of the literature were excluded. The data most relevant to answering the research questions were presented in tables and accompanied by a narrative synthesis. Results: Of the 1,835 unique documents identified, 28 met the inclusion criteria. Most of the interventions had been implemented in refugee camps and were aimed at school-age children and adolescents who had been forcibly displaced, mainly from the Middle East. Most of the interventions combined different approaches, such as psychoeducation and cognitive-behavioral therapy, and had a family or group approach. All interventions reported some degree of positive change on children’s MHPWB. However, few studies considered at-risk subgroups, and no interventions targeted two of the main forcibly displaced populations at the time of the study, Venezuelans and South Sudanese. Conclusions: Our study effectively describes existing interventions aimed at promoting MHPWB for minors in transit and their effectiveness and/or implementation process, as well as identifies gaps in the current evidence and lessons learned that can help improve future interventions.