Background: Menstrual Health (MH) knowledge, attitude and practice (KAP) are highly affected by access to information regarding menstruation. Despite being included in the school curriculum, Sexual and Reproductive Health (SRH) education is often not delivered in practice. School-based educational interventions have been shown to be effective in promoting MH. Methods: A school-based study was conducted in Indrawati rural municipality of Sindhupalchowk district in Nepal. 427 participants (175 boys and 252 girls), aged 11–13, completed a questionnaire evaluating MH KAP before receiving a structured training module on MH provided by experienced trainers from Putali Nepal using the Menstrupedia tool. The questionnaire was repeated one month after the training. Pre and post intervention scores were compared to determine the effect of the intervention. Focus group discussions were also conducted to understand the perceptions of participants toward SRH teaching. Association of independent socio-demographic with dependent variables knowledge and attitude towards menstrual health were analyzed using MANOVA test. The Wilcoxon signed-rank test was used to compare the median outcome of the pre and post-test attitude and knowledge. The maximum possible score was 6 for MH knowledge. The total attitude score ranged 14 to 70. Results: The median knowledge score increased by 1 point (p = <0.001) and the median attitude score by 5 points (p = <0.001), one month after delivery of the intervention. Higher knowledge scores were significantly associated with Hindu religion, female gender, higher father’s literacy, and mothers in an informal occupation on multivariate analysis. Higher attitude scores were significantly associated with Hindu religion while lower attitude scores were associated with a mother in an informal occupation. Conclusion: The Menstrupedia comic educational intervention improved knowledge and attitude towards menstruation among Nepali adolescents. A scale-up of the Menstrupedia based intervention would significantly change knowledge and attitude towards menstruation in Nepali adolescents.

Introduction: Following the introduction of the Global Health Security Index (GHSI), the coronavirus disease 2019 (COVID‑19) pandemic emerged as an unprecedented global health crisis, underscoring the need for robust health security frameworks and preparedness measures. This study conducts a scoping review to analyze the existing literature on the GHSI and assess national COVID‑19 responses across different countries. Method: A comprehensive search of electronic databases (EBSCO, EMBASE, PubMed, Scopus, and Web of Science) was conducted for articles published from 2020 to 2024. Search terms included “Global Health Security Index” and terms related to COVID‑19. The study followed the Preferred Reporting Items for Systematic Reviews and Meta‑analyses for Scoping Reviews (PRISMA‑ScR) guidelines. The Newcastle–Ottawa Scale (NOS), adjusted for cross‑sectional studies, was used for quality assessment. Results: A total of 3,243 studies were identified, of which 20 were finalized for data synthesis. Specific COVID‑19 parameters were analyzed to provide a comprehensive overview of each country’s pandemic response capacity. Among the selected studies, 17 (85%) had a low risk of bias, while 3 (15%) had a medium risk. Countries’ response capacities were categorized into five key parameters: detection, mortality, transmission, fatality, and recovery. Findings revealed significant discrepancies between GHSI scores and actual national responses, with some high‑scoring countries struggling to control the pandemic. This raises concerns about the GHSI’s predictive reliability. Conclusion: The study highlights that the GHSI does not fully capture a country’s capacity to respond effectively to COVID‑19. However, it remains a valuable tool for identifying gaps in pandemic preparedness. To enhance its relevance, the index should integrate a wider range of factors, including political leadership, governance, public health infrastructure, and socio‑cultural elements, which are crucial in managing public health emergencies.

Background: Limited research exists on the comorbidity of pulmonary tuberculosis with non-communicable diseases (NCDs) and its implications for healthcare utilization in Indonesia. The lack of investigation into NCD comorbidity among pulmonary tuberculosis patients could adversely affect both the healthcare system and the national health insurance scheme. Understanding the NCD comorbidity among pulmonary tuberculosis patients, associated factors, and healthcare utilization is crucial for ensuring the effective and efficient delivery of health services. Method: This study utilized an observational cross-sectional design based on anonymized sample data from tuberculosis cases covered by Indonesia's National Health Insurance in 2021. Chi-square tests were employed to analyze dependent and independent variables, while unadjusted and adjusted logistic regressions were used to explore further associations. Results: The prevalence of NCD comorbidity in tuberculosis patients was 11.81%. Aged over 60 (aOR 5.16; [CI] 4.23—6.3), married (aOR 1.19; [CI] 1.05—1.34), and unemployed (aOR 1.27; [CI] 1.08—1.49) were associated with the NCD comorbidity in pulmonary tuberculosis patients. Factors associated with increased inpatient service utilization among pulmonary tuberculosis patients included aged over 60 (aOR 5.69; [CI] 4.81—6.74), male (aOR 1.32; [CI] 1.23—1.40), self-employment (aOR 1.42; [CI] 1.29—1.56), having insurance subsidized by central government (aOR 1.89; [CI] 1.73—2.08) or local government funds (aOR 1.75; [CI] 1.58—1.93), and having comorbidity non-communicable diseases (aOR 1.80; [CI] 1.66—1.96). Conclusion: Pulmonary tuberculosis patients exhibit a significant prevalence of NCD comorbidity, which substantially impacts healthcare utilization. Early detection and management of these conditions are critical to mitigate burdens on both the healthcare system and the financial sustainability of the national health insurance scheme. Integrating health services for tuberculosis and NCDs through bidirectional screening is essential for comprehensive patient care.

Background: Maternal health services utilization is essential in the reduction of maternal mortality. Despite the implementation of a national health insurance scheme in 2003, Ghana still reports universal health coverage service index below the global average. This study investigates the association between health insurance coverage and maternal health service utilization. Methods: This study utilized data from the Ghana Demographic and Health Survey (GDHS) conducted in 2022. The independent variable of the study was health insurance coverage, and the outcome variable was maternal health service utilization by assessing indicators including the timing of the first ANC visit, completing the recommended number of ANC visits, skilled birth attendance, facility-based delivery, and post-natal care. The data was analyzed for both descriptive statistics and logistic regression. Results: The study sample consisted of 4303 women of reproductive age who had live births within the past 5 years of the survey. Health insurance coverage is associated with the likely odds of post-natal care (aOR 1.56; 1.15–2.12). Counterintuitively, women who were insured were less likely to give birth in a health facility (aOR 0.59; 0.45–0.78) in the presence of a skilled birth attendant (aOR 0.70; 0.57–0.86). Conclusion: This study shows that while health insurance coverage can boost maternal health service utilization, the implementation mechanisms of these policies play a more critical role. Addressing challenges like out-of-pocket payments for insured individuals is essential to enhance service utilization under the policy.

Introduction: Sedentary lifestyles, unhealthy work environments and occupational stress increase the risk of Non-Communicable Diseases (NCDs) among government employees, impacting healthcare costs and productivity. This study aimed to investigate the prevalence of hypertension, prediabetes, and diabetes, and identify risk factors among government employees in Nepal.Methods: A cross-sectional study was conducted among 994 government employees. Data on sociodemographic, anthropometric/biochemical measurements, behavioral and clinical factors were collected. Descriptive analysis analyzed the prevalence of NCDs among covariates. Multivariate logistic regression and ROC curves assessed the association between NCDs and covariates/risk factors. Significance was set at p < 0.05 and 95% CI.Results: Participants’ mean age was 33.1 ± 9.1 years, with 82.1% (n = 796) male, mostly from aged 30–39 (n = 397, 41%), and Brahmin/Chhetri (n = 454, 46.9%). Elders had a 6-times higher risk of hypertension (OR: 6.08, CI: 3.1–11.92), above 7-times higher risk of prediabetes (OR: 7.83, CI: 3.32–18.47), and above 16 times higher risk of diabetes (OR: 16.62, CI: 2.5–106.49) compared to aged 18–29. Smoking increased diabetes-risk (OR: 6.82 CI: 1.95–23.8), while alcohol-consumption increased risk of hypertension (OR: 1.51, CI: 1.02–1.63) and prediabetes (OR: 1.88, CI: 1.08–3.28). Overweight increased hypertension risk (OR: 2.79, CI: 1.90–4.09), while obesity increased both hypertension (OR: 3.04, CI: 1.73–5.34) and prediabetes-risk (OR: 2.43, CI: 1.18–4.99).Conclusion: This study recommends concerned authorities to implement workplace policies for health promotion, intensify awareness campaigns, establish routine screening for government employees, and focus on reducing risk factors and encouraging healthier lifestyles to enhance NCDs prevention.

Over the past few decades, there has been a notable decline in global maternal and child mortality, largely driven by the policies and initiatives introduced under the Millennium Development Goals (MDGs) and the Sustainable Development Goals (SDGs) [1,2]. Sustainable Development Goals target 3.1 aims to reduce maternal mortality to less than 70 maternal deaths per […]