Maiya Grace Block Ngaybe

Background: Despite the availability of effective vaccines, seasonal influenza remains a substantial global public health concern. Suboptimal influenza vaccination uptake is found across many populations. Using digital platforms, individuals can self-report health information through participatory surveillance programs. Though they are mainly used for infectious disease monitoring, their potential association with preventive behaviors such as influenza vaccination uptake has not been systematically evaluated. This review is necessary and urgent given the recurrent influenza outbreaks and the severity of illness due to low vaccination rates. Objective: This protocol details the design and methodology of a systematic review that will assess whether enrollment in participatory surveillance programs is associated with differences in seasonal influenza vaccination uptake compared with non-participation. Methods: This systematic review protocol follows the Cochrane guidelines, is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P), and is registered in PROSPERO (CRD420251274024). Eligible studies will include quantitative comparative designs, including randomized controlled trials, as well as observational and quasi-experimental studies with appropriate comparators. The population will comprise individuals eligible for influenza vaccination in settings where participatory surveillance programs are available. The primary outcome is influenza vaccination uptake. Searches will be conducted in PubMed, Embase, Cochrane CENTRAL, Scopus, CABI Global Health, and CINAHL, alongside selected grey literature sources, without restrictions on language, geography, or publication date. Two reviewers will independently screen studies, extract data using Covidence, and assess risk of bias using ROB 2 and ROBINS-I. Where appropriate, data will be synthesized using meta-analysis or narrative methods. Heterogeneity will be described using I ² , and certainty assessed using GRADE. Conclusions: This systematic review will provide an urgently needed summary of evidence regarding the association between participatory surveillance enrollment and influenza vaccination uptake. Findings will inform future research and the development of digital public health strategies that integrate disease surveillance and health promotion.

Dementia is a growing public health challenge in Sub-Saharan Africa (SSA), where population aging is expected to substantially increase the regional burden of dementia in the coming decades. Rapidly changing demographics, underdeveloped health infrastructure, and limited awareness of dementia symptoms and care pathways contribute to delayed diagnosis, treatment, and care. This scoping review examined literature published from 2021 to 2025 to identify gaps in dementia care across four key domains: environmental and social factors, technological capacity, community-based caregiving, and financial and economic factors. First, social and ecological factors, including low health literacy, rural residence, and weak primary care infrastructure, influence disease diagnosis and access to care. Second, technological capacity remains limited, including scarce access to neuroimaging and diagnostic tools, limited telemedicine coverage, weak electronic health information systems, and insufficient digital health solutions for early detection, management, and monitoring. Third, evidence from community-based care highlights heavy reliance on informal caregivers who often lack training and institutional support, resulting in substantial emotional, physical, and financial burden. Finally, inadequate public financing for dementia care, coupled with limited insurance coverage, further restricts access to dementia care services and support. Overall, this review highlights critical gaps in policy, evidence generation, cost-effective technology investment, caregiver support, and health systems strengthening across all levels of care. Addressing these multidimensional challenges is crucial to improving the quality of life for people living with dementia and their caregivers across SSA.

Objective: The objective of this scoping review is to characterize the extent and nature of the available research on photovoice studies examining how greenspaces influence community health, and to identify community actions and advocacy arising from these participatory projects. Introduction: Greenspaces have been shown to support physical, mental, and social health. Yet research often overlooks community perspectives, particularly in arid regions. Photovoice enables individuals to document and reflect on their lived environments, providing unique insights into the relationships between greenspaces, health, and community wellbeing. Synthesizing photovoice studies that examine how greenspaces impact health across different ecosystems and landscape designs is essential to capture community-driven knowledge and outcomes, including initiatives that inform policy and practice. The protocol is registered in Open Science Framework ( https://doi.org/10.17605/OSF.IO/2DYGA ). Inclusion criteria: This review will include primary studies employing photovoice methods with human participants, of any demographic or cultural background, that focus on greenspaces and associated health outcomes. Eligible studies may use qualitative or mixed methods designs, provided photovoice is a core component. Quantitative-only studies, reviews, editorials, and those addressing distal health measures will be excluded. Methods: Searches will be conducted in electronic databases (PubMed, PsycINFO, Embase, ERIC, CINAHL, Web of Science) and relevant grey literature sources. No language restrictions will be applied, and the time frame will extend from January 1997, when photovoice was first described as a methodology, to the present. Non-English studies will be translated using available translation tools and/or reviewed by a multilingual member of the team or colleague where feasible. Screening and data extraction will be conducted in duplicate using Covidence. Findings will be summarized descriptively and synthesized thematically. Empirical studies will be appraised using the JBI Critical Appraisal Tools, while grey literature source quality will be assessed using the AACODS checklist. Confidence in the synthesized qualitative findings will be assessed using GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative Research).

Food insecurity is a significant public health problem affecting almost a third of the global population [1]. By 2020, it was estimated that 11.7% of the global population faced severe food insecur...

Long-acting injectable pre-exposure prophylaxis (PrEP) has recently been approved for use, and dissemination, but has yet to be released in Uganda. To ensure uptake of this injectable option, and others like a future HIV vaccine, it is important to understand the preferences of the populations at the highest risk who will benefit the most. We present data on product preferences for HIV prevention practices and injectable HIV prevention among populations most at risk for HIV with a focus on injectable options such as long-acting PrEP or a future HIV Vaccine for primary prevention of HIV. From March 18–28, 2024, we conducted 20 semi-structured key informant interviews in English and Luganda among 10 experts in the field of HIV prevention, and 10 peer leaders of key or priority populations in Uganda. Participants were purposively selected to represent various groups, genders, occupations and locations to get diverse perspectives. Participants were included if they were determined to be at risk of contracting HIV and were above the age of 18. Both groups of participants were asked similar questions, with experts focusing on their experience with key populations, populations who are particularly vulnerable to HIV acquisition due to a combination of behavioral, biological, and social factors. Debriefs were held after each interview to monitor emerging themes and assess data saturation. The most common prevention practices mentioned by participants were condoms and PrEP. Participants mentioned barriers to prevention practices including duration (i.e., dosing length), accessibility issues such as transportation, location issues (i.e., distance), and stigma. The most important characteristics for participants when considering the uptake of a new injectable prevention product included efficacy, cost and side effects. Experts tended to believe that efficacy levels should be higher than peer leaders with lived experience. Participants who were peer leaders recognized that some had a fear of needles, though they also expressed motivation to receive injections due to the perception that they may work better than other modes of administration. According to experts and peer leader participants in this study, key populations in Uganda prefer high efficacy, lower side effects and confidentiality in their services. Participants emphasized the need for comprehensive and accessible information about specific HIV prevention methods to improve the uptake of these products. Tailored messaging and choice can accommodate the heterogeneity of preferences to best ensure HIV prevention in Uganda.

Adolescents and young people (AYP) in Kenya face unique health challenges, but there is a lack of research on their health knowledge and awareness needs. Digital health interventions (DHIs) could help address these gaps. Understanding AYP’s current knowledge will inform the development of effective, adolescent-centered interventions. Grounded in the inter-agency framework from WHO, UNICEF, UNFPA, and UNESCO for youth-centered DHIs, this study assessed AYP’s health knowledge and awareness in three regions of Kenya. The study focused specifically on HIV, intimate partner violence (IPV), substance use, mental health, sexual health, and nutrition. Additionally, it evaluated AYP’s preferences for and use of DHIs. This qualitative study used focus group discussions to assess health knowledge and awareness among AYP 19–24 years of age in Kibra (urban), Kikuyu (peri-urban), and Nachu (rural) Kenya. Participants were purposively selected. Data analysis involved independent coding using MAXQDA and thematic analysis to identify key themes. Seventy participants were included in the study with almost similar gender distribution of 36 female and 34 male participants. Young people in Kenya utilize online resources and apps for health information. Despite a general awareness of health issues, knowledge gaps exist concerning HIV prevention, stigma, and treatment. Participants also linked substance use with mental health problems. Cost of internet use and misinformation were barriers to using DHIs. The participants expressed a preference for future DHIs to enable interaction with peers and experts, include referral services, and prioritize privacy. Our study highlights that a targeted health-related app could benefit many adolescents across Kenya. The participatory design of our study was a notable strength. However, future studies could benefit from a less structured interview guide, allowing for deeper understanding of less common health issues. This research will inform the development of a health-focused DHI for Kenyan AYPs, utilizing a user-centered design approach.

Introduction: Childhood immunization is highly cost-effective, yet uptake is shaped by sociocultural and religious influences. In Bauchi State, Nigeria, coverage remains low (Penta3 58.2%; fully vaccinated 22.5% among children aged 12–23 months). Religious leaders shape community norms, but their perspectives on immunization in Bauchi are not well characterized. Guided by Oman and Syme’s religion/spirituality and health model, we explored religious leaders’ knowledge, beliefs, attitudes, practices and recommendations regarding childhood immunization. Methods: Between December 2022 and January 2023, we conducted semi-structured interviews with 22 religious leaders (all men; 21 Muslim, 1 Christian) purposively sampled across Bauchi State’s Local Government Areas. Interviews were conducted in Hausa or English, audio recorded, translated where necessary and transcribed. Sampling continued until thematic saturation. Data were analyzed using codebook thematic analysis informed by Braun and Clarke’s analytic phases and organized according to the pre-specified domains of knowledge, beliefs, attitudes, practices and recommendations. Ethical approval was obtained, and all participants provided verbal informed consent. Results: Most leaders described immunization as preventive and compatible with religious teachings. Many reported that observed child health benefits reinforced support and that earlier skepticism had shifted after religious and scientific explanation and lived experience. Persistent misinformation was reported, especially fertility-related and population control narratives. Leaders described three recurring influence practices: visible role modelling, sermon-based messaging aligned with scripture, and community mobilization through religious gatherings and support during outreach activities. Respectful health worker engagement and reliable service delivery appeared to strengthen trust and community uptake. Conclusions: Religious leaders in Bauchi State may be strategic partners for improving vaccine acceptance. Programs should consider structured engagement with religious leaders, bidirectional rumor tracking and response, and support for frontline health workers. Future research should include more diverse leaders and link engagement to measurable outcomes. KEY MESSAGES: What is already known on this topic: Childhood immunization coverage remains suboptimal in northern Nigeria, and religious leaders can influence vaccine-related beliefs and uptake, yet their perspectives and practical roles are not well characterized in Bauchi State. What this study adds: Among 22 interviewed religious leaders in Bauchi State, most viewed childhood immunization as compatible with religious teachings and described using role modelling, sermon-based messaging, and community mobilization to support uptake, while also reporting persistent fertility-related and population control rumors and service delivery barriers. How this study might affect research, practice or policy: Immunization programs may benefit from structured engagement with religious leaders, locally credible rumor response systems, and parallel improvements in respectful and reliable service delivery.

In resource-limited settings, healthcare providers face unique structural barriers to antibiotic delivery. Process mapping (PM) is a low-cost, low-technology approach used to understand the antibiotic delivery process and systematically identify barriers to timely antibiotic initiation. In this paper, we will use a 5-phase PM framework to provide the readers with a guide to developing antibiotic delivery process maps, identifying barriers to antibiotic delivery, and prioritizing the order in which these barriers should be addressed. We will then use our experience at the Uganda Cancer Institute in Kampala, Uganda as a case study to describe how we used PM to identify barriers to antimicrobial delivery for patients with neutropenic fever. We will also provide information about how to use low-cost supplies and open-access software to develop and analyze the process map. By the end of the paper, the reader will have the necessary tools to develop and analyze their own antibiotic delivery process maps. This will allow the reader to systematically identify barriers to antimicrobial delivery and understand how to prioritize which barriers to address using targeted interventions.

Background: Human immunodeficiency virus (HIV) affects more than 39 million people worldwide, with Uganda ranked 10th among countries with the highest number of cases. As new preventative HIV injectables emerge, it is vital to think about how best to tailor strategies to promote these injectable drugs, like PrEP and vaccines, when available, to the different populations most in need. Discrete choice experiments (DCEs) are economics-derived methods used to determine factors that influence engagement in a certain behavior. Objective: This study used a DCE to determine the preferences for a preventative HIV injectable drugs/vaccines among people at risk of HIV acquisition in urban and peri-urban areas of Uganda. Methods: In June 2024, we implemented a cross-sectional DCE survey in three urban sites in Uganda in English and Luganda. The survey collected information on demographics, HIV risk, vaccine confidence and responses to the 13 injection product choice tasks presented to determine preferences. We used community-based, respondent-driven sampling methods to recruit participants from three key populations: (1) female sex workers; (2) people who identify as lesbian, gay, bisexual or transgender; and (3) young women (18–24 years). We collected the data on tablets using the Sawtooth Lighthouse Studio software (v. 19.15.6), taking into consideration privacy and confidentiality, given the sensitivity of the information and recent governmental policies in Uganda. Data were analyzed using a split-sample mixed logit regression analysis. The study was approved by local ethical regulatory bodies. Results: From the total of 406 participants screened for this study, 376 participants met the eligibility criteria and were included in the final analysis (85 young women, 159 female sex workers, and 132 who identified as lesbian, gay, bisexual or transgender). The average age was 23.7 (SD: 5.7). The majority of participants had received some secondary school or vocational school (202, 53.7%) The attributes that explained the preferences were primarily severe compared to mild side effects (β: −0.69, 95% CI: −0.78, −0.60), a 30% increase in vaccine/drug effectiveness (β: 0.39, 95% CI: 0.34, 0.44), and a 50,000 UGX (or USD ~13.64) increase in cost (β: −0.22, 95% CI: −0.27, −0.17). There were no significant differences between the preferences for different injectable types. The sensitivity analyses suggested potential differences in preferences by the amount of help participants received from research assistants when completing the survey, although not by income level. Conclusions: Side effects had the greatest impact on participants’ preferences for injectable HIV prevention methods, followed closely by effectiveness and cost. It is therefore essential to develop affordable or free prevention options with minimal side effects. Policymakers should focus on reducing the financial barriers to access and emphasize transparent communication about the effectiveness and safety of these injectables in health promotion campaigns to maximize adoption and improve public health outcomes.

Background: In recent years, public health has confronted 2 formidable challenges: the devastating COVID-19 pandemic and the enduring threat of climate change. The convergence of these crises underscores the urgent need for resilient solutions. Resilience informatics (RI), an emerging discipline at the intersection of informatics and public health, leverages real-time data integration from health systems, environmental monitoring, and technological tools to develop adaptive responses to multifaceted crises. It offers promising avenues for mitigating and adapting to these challenges by proactively identifying vulnerabilities and fostering adaptive capacity in public health systems. Addressing critical questions regarding target audiences, privacy concerns, and scalability is paramount to fostering resilience in the face of evolving health threats. Objective: The University of Arizona held a workshop, titled Resilience Informatics in Public Health, in November 2023 to serve as a pivotal forum for advancing these discussions and catalyzing collaborative efforts within the field. This paper aims to present a qualitative thematic analysis of the findings from this workshop. Methods: A purposive sampling strategy was used to invite 40 experts by email from diverse fields, including public health, medicine, weather services, informatics, environmental science, and resilience, to participate in the workshop. The event featured presentations from key experts, followed by group discussions facilitated by experts. The attendees engaged in collaborative reflection and discussion on predetermined questions. Discussions were systematically recorded by University of Arizona students, and qualitative analysis was conducted. A detailed thematic analysis was performed using an inductive approach, supported by MAXQDA software to manage and organize data. Two independent researchers coded the transcripts; discrepancies in coding were resolved through consensus, ensuring a rigorous synthesis of the findings. Results: The workshop hosted 27 experts at the University of Arizona, 21 (78%) of whom were from public health–related fields. Of these 27 experts, 8 (30%) were from the field of resilience. In addition, participants from governmental agencies, American Indian groups, weather services, and a mobile health organization attended. Qualitative analysis identified major themes, including the potential of RI tools, threats to resilience (eg, health care access, infrastructure, and climate change), challenges with RI tools (eg, usability, funding, and real-time response), and standards for RI tools (eg, technological, logistical, and sociological). The attendees emphasized the importance of equitable access, community engagement, and iterative development in RI projects. Conclusions: The RI workshop emphasized the necessity for accessible, user-friendly tools bridging technical knowledge and community needs. The workshop’s conclusions provide a road map for future public health resilience, highlighting the need for scalable, culturally sensitive, community-driven interventions. Future directions include focused discussions to yield concrete outputs such as implementation guidelines and tool designs, reshaping public health strategies in the face of emerging threats.