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Background: Christian mission hospitals provide critical assistance to communities that need their services the most, yet they often lack the financial and human resources needed to realize their full potential for community impact. Existing charity rating organizations rate few charities and lack transparency for donors, and limited resources exist to help volunteers find organizations that would benefit from their services the most. The objective of this article is to develop a transparent Transformational Impact Rating System (TIRS) that can be used by funding agencies and volunteer directing agencies to assess the potential for transformational impact of any hospital anywhere in the world. Methods: Research to inform the rating system was conducted via a comprehensive review of existing charity rating systems and literature, in-depth interviews, and surveys. TIRS was developed by identifying, selecting, categorizing, and allocating weights to variables. TIRS was implemented via a custom-built website to enable future testing and evolution. Results: A rating system was developed that generates an overall hospital score and scores in each of five categories (regional impact potential, financial health, operational performance, external relations, and volunteer experience) based on data collected from the hospital and surveys of donors, volunteers, staff, patients, and the local community. Discussion: TIRS in its current state is a proof of concept that demonstrates data-driven decision-making for funding and staffing hospitals with high potential for transformational impact. TIRS can be modified for future applications. Conclusion: TIRS provides a proof-of-concept system through which all hospitals in low-resource settings can make their impact potential visible to donors and volunteers. If TIRS (with suggested modifications) is used by those interested in helping mission hospitals, invisible hospitals that are struggling in remote areas will be more likely to receive much-needed resources. TIRS can help direct declining funds and manpower to hospitals that have the highest potential for transformational impact.

The aim of this article is to elucidate the rational foundations upon which personalist bioethics is built, thereby enhancing understanding regarding its place within the broader discourse of secular bioethics. Personalist bioethics, as a dynamic pursuit, actively engages with scientific discoveries, periodically revisiting them and considering contemporary individualsʼ diverse perceptions of identity and values. It integrates two foundational trunks: personalism and Aristotelian-Thomistic theology with metaphysical reference. The method employed by personalist bioethics is illustrated through triangulation: the exposition of biomedical reality, an in-depth study of anthropological significance, and the identification of values at stake. Rooted in a substantialist concept of the human person, it follows a systematic interaction of various knowledge spheres, aiming not only to describe problematic relations but also to propose prescriptive solutions. Personalism maintains that the human person is valuable for who he is and not only for the choices he makes; he is a source from which the choices proceed. According to personalist ethics, the ethical value of an act will have to be considered under the subjective aspect of intentionality, but it will also have to be considered in terms of its objective content and its consequences. The natural moral law that urges every conscience to do good and avoid evil, therefore, becomes concrete in respect for the human person in all the fullness of his values, his essence, and ontological dignity.

Doctors and nurses are bound to their oath: to serve the patients and provide them with the highest standard of professional care. However, as every medical personnel will understand, there are times when, despite best efforts, the patient is still dying in their duty shift. Dying is a human thing, and medical workers are more familiar with this than anyone else ever. But then, there are Christian medical workers. Christians are called to share their faith. But when?–or rather, when else? The patient is now critical, and it is unknown where the precious soul is going based on their faith. When the patient–who, based on the medical personnel’s best knowledge, does not know the Savior–finally dies, Christian medical caregivers may feel devastated: they may think they just lost the patient here on earth and there in eternity. This research aimed to identify the potential stress among Christian medical workers due to their inability to save terminal/critical patients and not having the chance or courage to share the gospel.

A vocation to serving in severely medically under-resourced settings invariably means facing of our own weakness in realizing that vocation. Christian teaching proclaims that God’s strength in made perfect in weakness, which is both a comfort and a mystery to many in facing their weaknesses. Without diminishing the mystery, experience demonstrates several ways in which this promise plays out in reality, providing an imaginative stimulus for how it may also be true in ways where it is less understood. Believing such teaching forms part of a necessary theological framework for Christians serving in areas of immense suffering as well as encouraging transparency and vulnerability in regards to their own weaknesses.

Health plays an important role in supporting educational success, with healthy students tending to have better concentration, endurance and motivation to learn. To achieve this, schools implement health education programmes aimed at improving studentsʼ knowledge, attitudes and skills in maintaining and improving their health. The programme includes formal and informal activities integrated in the curriculum, extracurricular initiatives and school health projects. Effective health education holds the potential to address these issues. While existing research has shown that health education can improve studentsʼ knowledge, attitudes, and skills related to health, direct evidence of its effect on studentsʼ health remains limited. The implications of health education are profound, including improved health knowledge, positive attitudes toward health, and the development of vital health maintenance skills. Additionally, it fosters a healthy learning environment, which is conducive to improved academic outcomes. Future interventions may involve the development of tailored materials, the integration of technology, and collaborative endeavors across multiple stakeholders. In conclusion, health education is a potent tool for enhancing student well-being and, consequently, educational success. By addressing health challenges and promoting healthy behaviors, health education contributes significantly to creating a brighter and healthier future for students in Indonesia and beyond.

Introduction: The tradition of charitable medical treatment can be drawn back to the early years of Christianity when the Church growth closely related to the care for the sick as well as other charitable activities. Though its purpose is charity, free medical service should also improve the quality of service. It can be achieved through the implementation of lean six sigma tools. One of its tools is a process map. Process map in Lean Six Sigma is commonly used as a diagnostic tool to determine the possible bottlenecks in the system. Methods: This is a brief pre and post quality improvement study. Before the implementation of a process map suggested by the researcher (period I), the patient flow was not properly organized. After the lunch break, the researcher introduced a new process map and briefed it to the committee. The patients flow in the afternoon (Period II) was using the process map. Patient numbers and wait times were measured within the time interval of this study. Results: Out of 159 patients who served during the period of this study, 63 (40%) were male and 96 (60%) were female. During Period I of the medical service, 50 patients (31%) were treated with average 17 patients per hour and approximate waiting time 36 minutes. After implementation of process map (Period II) the number of patients served were 109 (69%) with an average 36 patients per hour and an approximate waiting time of 17 minutes. Conclusion: The implementation of process map in free medical service may assist in increasing the number of patients served and reduce the waiting time as a result. Apart from reducing the confusion of where the patients were to go next, the process map also help the committee to identify possible hinderances and address the impediments to efficient charitable medical care.

This is a review of the book published by Dr. Stephen Ko in 2024. It is only highlighting certain sections of the book, and is not meant to be exhaustive, but to provide a little introduction to certain portions.Ko’s book is mean to help healthcare professionals with a deep mature Christian faith appreciate their understanding of the human body and how it is crucial to the link between physical and spiritual health. At the same time, written by a pastor, it is also meant for pastors and church planters who can see this connection.

Background: The threat posed by mosquito-borne diseases continues to increase globally. The increase of pesticide resistance is impacting vector control and public health globally. The development and testing of new pesticides faces several challenges, e.g., time for development, high cost, and regulatory hurdles. Adapting pesticides that are currently used within integrated vector management can help alleviate these challenges. Methoprene has demonstrated reduction of larval populations and fecundity in adult mosquitoes. The objective of the study was to demonstrate the efficacy of ProVector Entobac with methoprene (Entobac M) on mosquito populations in rural sites in Southeastern Georgia. Methods: ProVector® Military Camouflage Tubes with ProVector Entobac M pesticide were placed in a grid at test sites. A positive control test site and a negative control site were used to compare results statistically. Mosquito diversity and evenness among sites were measured using Shannon Diversity Index and Equitability. Results: Deployment of ProVector® Military Camouflage Tubes with ProVector Entobac M pesticide was effective in reducing total mosquito populations. The mosquito species shared among the test sites and positive control site were similar, and the negative control site was least similar in diversity and evenness. There was variation of control within Aedes, Anopheles, and Culex genera. Discussion: The aim of the study was to demonstrate the efficacy of the ProVector Military Camouflage Tube delivery of Entobac with methoprene (Entobac M) on mosquito populations. Mosquito-borne diseases are an increasing threat to communities around the world due to invasive species and global warming. In previous studies, ProVector® Entobac™ has been validated in laboratory and field studies to control both adult and larval mosquitoes in the United States and several other countries. Application of ecofriendly and target specific pesticides with no-resistance is critical in reducing mosquito populations and the risk of vector-borne diseases. Our study demonstrated a significant decrease in adult mosquito populations due to the utilization of a target specific mosquito larvicide that has been adapted to kill adult mosquitoes.

For the health system to function well, the population must have equitable access to quality, affordable pharmaceutical supplies; however, pharmaceutical systems in Africa are challenged by inadequate funding, drug stock outs and irregular supplies, a shortage of trained pharmacy personnel, and a lack of systems for drug regulation and quality. Faith-based health providers, as private, not-for-profit actors, have long complemented public sector efforts in the supply of pharmaceuticals in Africa. However, the contribution of faith-based health providers in pharmaceutical systems has not been formally studied. This study examines the nature and function of faith-based healthcare providers in improving access to pharmaceutical supplies in Africa. To do so, we conducted an exploratory qualitative systematic review to identify documents that contain information on faith-based involvement in pharmaceutical supply in Africa. The review identified 20 articles for inclusion. These articles were analyzed using thematic, narrative analysis. The analysis revealed a significant evidence gap relating to the contribution of private-not-for-profit, faith-based providers to African pharmaceutical systems. The review suggests that while faith-based drug supply organizations have existed for a long time and contribute significantly to national pharmaceutical systems, there is very little known about the nature of faith-based pharmaceutical providers and how they complement public sector pharmaceutical systems. In many contexts, faith-based involvement in pharmaceutical systems improved access for the general population and increased the supply of pharmaceuticals in national systems. Faith-based drug supply organizations also often provide pharmaceutical supplies to both rural and urban areas, often targeting rural and remote areas particularly. The review also indicates that faith-based drug supply organizations improved access to medicines and related commodities and, despite a lack of regulation in many contexts, have the potential to make a positive contribution to quality assurance of pharmaceuticals. In summary, the analysis confirmed that faith-based involvement in pharmaceutical supply chains contributes to strengthening the national health system by complementing the public pharmaceutical system through improved access to medicines and related commodities in Africa. These conclusions corroborate the need to continually document and acknowledge faith-based healthcare providers’ efforts which could guide the formulation of stringent, evidence-based strategies.

Jesusʾ self confessed mandate was to proclaim good news to the poor and validate this message through miracles like healing. He sent out his followers to do likewise. Mission hospitals are the penultimate example of restoring health in the name of a Saviour who loves them. As a group of healthcare missionaries at Mbingo Hospital, Cameroon, we see the role for mission hospitals/systems for the following reasons: compassionate care, competence, an opportunity to reflect our faith, humility, vision, perseverance, social justice, integrity and accountability. We provide examples for each. Missionary hospitals/systems in sub-Saharan Africa are a training group for the principles all of us need to mature in during our Christ-centered journey of life.

Background: Religious/Spiritual (R/S) care is often desired by mental health clients for culturally sensitive, patient-focused treatment that can promote positive health behaviors and outcomes. Yet providers may be hesitant or overlook this need and treatment guidelines are limited. This mixed-method study aimed to gain insights on existing R/S care, as well as perspectives on what support would be considered for patients choosing Biblical Framework Counseling (BFC) for schizophrenia. This is part of a project aimed to collaboratively extend population-based, mental health care access in resource–constrained communities of both the US, a High-Income Country (HIC), and Low-to-Middle Income Countries (LMICs) in Africa. The project was led by an Africa-Diaspora Citizen Engagement Collaborative (CEC) and is entitled Multi-level Engagement eCoCM (expanded Collaborative Care Model) for Mental Health Integration in Primary and Specialty Care of Resource-Constrained Communities. Methods: A mixed methods approach, comprising of 1) qualitative literature synthesis of 40 journal articles and medical education guidelines for spiritual care, 2) semi-structured survey of 54 multidisciplinary respondents, 3) case report of a patient with schizophrenia treated with Biblical Framework Counseling (BFC), and thematic analysis. Results: The literature review identified multidisciplinary health professional provision of R/S, medical, and/or psychological interventions as monotherapy, concurrent, or integrated strategies. There was a paucity of medical education guidelines. Qualitative themes encompassing literature review, multidisciplinary survey, and BFC case were developed from the extraction of coding categories of disciplines, treatment, and values. Overall themes included 1) there is some multidisciplinary willingness to provide or coordinate R/S care for mental health clients, with varying attitudes about BFC efficacy or implementing biblically based interventions; 2) the ways or extent of care to be provided involves a balance of patient preferences, provider practice considerations and scope; and 3) R/S care implementation can be facilitated via interprofessional education and research that inform on professional and patient-centered values and skills. Survey respondents supported interventions for confirmatory mental health diagnosis and history, scheduled patient follow-ups, ethical hand-offs or referrals, spiritual growth and maintenance, medication management and adherence, and individual psychotherapy depending on professional-patient spirituality congruence, comfort-level with biblical based interventions, and perceived relapse potential. Recognizing both healthcare and spiritual care treatment perspectives and ethical considerations could assist the selection of R/S care approach. Graduate Medical Education (GME) and other health professional programs and guidelines may incorporate these considerations, new and existing R/S interventions, and multidisciplinary provider scope of practice as options for clinician training, mobilization, and design of R/S care practice models. Future research steps should comprise anecdotal case reports, evidence-based case series, and implementation science studies across a broader range of mental disorders.

This cross-sectional study was conducted to determine the prevalence and intensity of infection of soil-transmitted helminths among school-aged children in Ife Central and Ife East Local Government Areas, Osun State, Nigeria.Fresh stool samples were collected from 324 pupils, comprising 162 males and 162 females (aged 5-12 years). The preserved fecal samples were processed using a modified Kato-Katz technique. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Of the 324 fecal samples examined, 79 (24.4%) tested positive for helminth eggs. The eggs were identified as Ascaris lumbricoides, with a prevalence of 22.2%, and hookworm; with a prevalence of 3.7%. Double infections were observed in 5 (1.5%) pupils. Private schools had a slightly higher prevalence (24.7%) than did public schools (24.1%). Sex-related prevalence was higher among males (25.9%) than females (22.8%), and no significant difference existed in the prevalence level between the sexes (p > 0.05).This study concluded that STH infection remains a public health risk among children in the study area.

Empirical evidence concerning differences in the quality of service offered by faith-based and public healthcare facilities in low-and middle-income countries is limited. This study contributes by examining the difference in clinical knowledge of staff based at faith-based and government facilities in Malawi. Using vignette data for individual healthcare workers from the 2018/2019 Malawi Harmonised Health Facility Assessment, we performed regression analysis of the relationship between ownership and the probability of respondents making the correct diagnosis, treatment, and management choices for eight childhood, adult, and pregnancy-related cases accounting for differences across healthcare workers, facilities, and geography. Staff employed at faith-based facilities, compared to staff at public facilities, are found less likely to correctly diagnose and treat children presenting with diarrhoea with severe dehydration but are better at diagnosing and treating adults presenting with diabetes. We do not find any differences in the diagnosis and treatment of the remaining six cases. Hence, we do not find compelling evidence of an overall difference in clinical knowledge across staff at faith-based compared to public facilities in Malawi.

Background: Psychological disturbances and mental illnesses are prevalent on the continent of Africa. There are shortages of mental health services and a lack of quality providers with limited training and supervision. It is perceived that faith-based entities for psycho-emotional health and wellbeing are filling the gap with positive impact. However, the risks associated with unconventional or extreme spiritual practices will be evaluated. The contributions of these entities, their roles in the global and African health system, and their implications for community development and policy making are highlighted. Methods: A mixed-methods systematic review was conducted in two phases to synthesise qualitative and quantitative data. The review sought evidence on faith-based health providers of mental health services in Africa looking at types, magnitude, and quality and included both peer-reviewed and grey literature published between 2007 and 2024 in English. A narrative thematic analysis was used for the qualitative part and meta-analyses was used for the quantitative part to back up the narrative element of this study. Results: This review identified 55 relevant items from 13 African countries. The results showed that faith-based, mental-health providers deliver a range of six types of alternative mental healthcare, faith-based, home care, and faith-based, biomedical, mental healthcare. The magnitude of these faith-based, mental health services were considered according to frequency of use and availability (accessibility, affordability, and acceptability), however evidence was limited. When the quality of the mental healthcare was assessed, some studies showed positive mental health outcomes from the utilisation of faith-based, mental healthcare, but some studies revealed bad quality practices due to harmful treatment. Conclusion: There are limitations regarding the vast array of faith-based, health providers and the mental healthcare they provide which include harmful practices used in Africa. Training interventions are needed to avoid harmful treatment. Faith-based, mental healthcare offers culturally influenced practices for mental-health which should be leveraged. Integration of faith-based, mental healthcare into any primary, health system is advised in order to attain universal health coverage. Finally, possible regulation of traditional and faith healing methods for emotional struggles could be implemented at a policy level.

Background: Clinical practice competence is affected by different factors in a clinical setting like the skill of the educator, staff–student interaction, and a clear assessment guideline. Effective mentoring and constructive feedback will also influence learning. Poor performance is caused by low competence and improving competency should improve performance. The purpose of this meta-analysis is to assess factors affecting the clinical practice competency of medical and health science students in Ethiopia. Methods: We conducted a related literature search (February up to March 2023) of PubMed and Web of Science databases for studies describing the factors associated with clinical practice competency among medical and health science students in Ethiopia. The quality of studies was independently assessed by the Newcastle–Ottawa quality scale (NOS), which was guided by the PRISMA checklist. The Q test and I2 statistics were used to evaluate the heterogeneity among selected studies. If the heterogeneity was obvious (I2>50%), the random effects model (REM) was used. If the heterogeneity was low (I2≤50%), the fixed effects model (FEM) was used. Results: There were 1613 participants in four (4) investigations. The pooled effect size of clinical practice competency among students in the form of odds ratio (OR) with the presence of a checklist was 3.40 (95% CI 2.50–4.62), p

This reports on a US-AID-funded project which engages faith-based organizations to strengthen their organizational capacity as they implement reproductive, maternal, newborn, and child health grant activities. Implementing partners in Kenya, Malawi, and South Sudan completed the self-administered Organization Capacity Assessment and created corresponding action plans based on the assessment results. Each organization completed the priority activities that they identified in their action plans; strengthening staff capacity, sharpening monitoring and evaluation systems; and improving information systems. We conclude that grantmakers’ investment in strengthening the organizational capacity of their implementing partners results in the grantees having improved internal systems and being better positioned to obtain and execute future grant opportunities.

Background & Aims: The COVID-19 pandemic had a significant impact on health in countries of every income level. While much is known about risk factors for COVID-19 severity, less is known about the relationship between COVID related risk perceptions and behaviors, particularly in low-income settings. The purpose of this study is to investigate the relationship between existing health status and COVID-19 risk perceptions and behaviors in Sierra Leone and Zimbabwe. Methods: Data for this study came from a cross-sectional survey conducted simultaneously among 1158 adults in Sierra Leone and 1154 in Zimbabwe during July and August of 2022. Respondents were recruited from among communities served by the Christian Health Association of Sierra Leone (CHASL) and Zimbabwe Association of Church-Related Hospitals (ZACH), both members of the Africa Christian Health Associations Network (ACHAP). Results: The relationship between health status and COVID-19 risk perceptions and behaviors varied significantly by health condition. Cardiovascular disease was significantly associated with heightened perceptions of COVID-19 risk, heightened perceived safety of COVID vaccines, and subsequent greater vaccine acceptance while cancer was likewise statistically significant in each of lower perceived susceptibility, perceived safety, and vaccination uptake. Similarly, obesity was associated with both lower perceived susceptibility of COVID-19 and decreased perceived safety of COVID vaccines. Conclusion: Results suggest that the association between health conditions and COVID perceptions and behaviors is neither clear nor consistent across a variety of NCDs. Hence, findings from this study may inform public health interventions aimed at reducing COVID-19 morbidity and mortality, including increasing vaccine acceptance and uptake in Sierra Leone and Zimbabwe. Further, findings potentially have broader implications for understanding how health status is associated with COVID-19 risk perceptions in other LMICs.

Faith-based organizations (FBOs) and faith-based service providers play a critical role in public health prevention, promotion, treatment, and community development. Effective capacity strengthening efforts through FBO partnerships can make a vital contribution toward effective localization. This case study details the efforts and results of a writing and publishing workshop provided in partnership with Corus International (IMA World Health) and the Africa Christian Health Associations Platform (ACHAP) in March of 2023. This case study also reports on workshop participantsʼ perceptions of the partnershipʼs approach to capacity strengthening. Three major and related themes emerged from the workshopʼs informal Focus Group Discussion transcription: 1) a safe and nurturing environment, 2) openness and shared decision-making, and 3) organizational humility.

Background & Aims: The coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide, making the uptake of effective vaccines critical to saving lives. In Sierra Leone and Zimbabwe, two countries selected for focus in a privately funded project to boost COVID-19 vaccination coverage through interventions carried out by faith-based networks in Africa, both supply-and demand-side challenges have made high rates of vaccination difficult to achieve. The current study seeks to describe vaccination rates and reasons for vaccine hesitancy in both Sierra Leone and Zimbabwe. Methods: A cross-sectional survey was conducted face-to-face in Sierra Leone and Zimbabwe. This study uses frequency statistics and multivariate regression analysis to identify key demographic predictors of COVID-19 vaccination acceptance and to examine perceived COVID-19 infection vulnerability in both countries. The Health Belief Model was used as a framework for sorting and understanding findings. Results and Conclusions: Individuals who were older, from Zimbabwe, and were healthcare workers or community leaders were more likely to be vaccinated. Those who were from Zimbabwe, had secondary or tertiary education, and were community leaders were more likely to be concerned about catching COVID-19 than community members. Faith leaders were less likely to be concerned about catching COVID-19 in public. These findings add to our understanding of attitudes that lead to vaccine hesitancy and uptake.

Background & Aims: Children are more susceptible to dermatophytes due to different predisposing factors, such as under developed immune system and high sensitivity of their skin to infection. This study investigated the epidemiology of dermatophyte infection among primary school children in Calabar municipality, Nigeria. Methods: Students attending two primary schools, DPS and PCNPS in Calabar Municipality, were clinically screened. Samples were collected from children with physical signs of dermatophytes on skin, scalp, and nails, and who were present on the day of sample collection. Affected areas were scraped and swabbed. Cultures were done on SDA, and Lactophenol cotton blue was used to prepare isolates for microscopy. Results: A total of 779 children aged 4-17 years were screened. 202(25.9%) were mycologically positive by culture. The occurrence of dermatophyte infection was significantly higher in young children aged 4-6 years than in older children. Male children were more frequently infected (17.6%) than females (8.3%). Trichophyton spp. was the most prevalent etiological agent (35.6%), followed by Microsporum spp. (31.7%), and Epidemophyton spp. (19.3%). Plates with mixed colonies constituted 13.4% of the entire culture. Dermatophytes were mostly isolated from the scalp (63.9%), followed by skin (32.2%), and nails (4%). The prevalence of dermatophyte infection among the two schools’ children was 32.0% and 21.9% in DPS and PCNPS, respectively. Conclusion: Dermatophyte infection is still prevalent among primary school children. Regular screening and use of educational health awareness of dermatophyte infection are recommended.

Schools have enormous potential to prevent and respond to violence against children. In this paper, we describe a new intervention to protect children from violence in Zimbabwe’s Catholic primary schools, initiated and developed by the Zimbabwe Catholic Bishops Conference (ZCBC). ZCBC and academic institutions in Zimbabwe and the UK are partnering to conduct formative research to understand the school context, barriers, and facilitators to intervention implementation. Semi-structured qualitative interviews with teachers and other stakeholders [n=18] suggest that this intervention will be well received. Perceived facilitators include utilising existing structures within the Church, the intervention being viewed as in alignment with Catholic values, and the use of familiar structures within Catholic schools to deliver intervention activities. Challenges will include perceptions of “child protection” among parents and teachers. ZCBC is refining the intervention model, which will be evaluated for effectiveness in reducing violence against children in a randomised controlled trial.

The Jogini, or Devadasi, system sees young girls “married” to a deity after which she is seen as the property of the village and required to perform religious duties and often sexual favours, typically without payment or freedom of choice. There is a paucity of published research on the factors which make women vulnerable to this exploitation and the factors which increase the likelihood that they are able to extricate themselves from it. This is a population study of 657 women who had previously been dedicated as Joginis living in 10 villages in Mahabubnagar district of Telangana, South India. The primary outcome of interest was whether the women were practicing as a Jogini at the time of the survey. Data was analyzed using a mixed effect logistic regression test to determine possible determinants of practicing status. Four factors were found to be significantly associated with continued Jogini practice: 1) being a person with a disability, 2) reason for dedication given as family tradition of other Joginis in the family, 3) poverty in the family of origin, and 4) living in a village with more than ten percent of the population belonging to a scheduled tribe. One factor significantly negatively associated with continued practice was having one or more male children. Analysis of the demographic data for these women confirmed the previously known fact that the exploitation in the form of the Jogini system disproportionately affects those who are already vulnerable in society — those from scheduled castes (SC) and tribes (ST), other backward castes (OBC), the disabled, the uneducated, and the poor. Between them, SCs, STs, and OBCs make up the non-forward castes, i.e., those who are socially disadvantaged. The scheduled castes, formally known as untouchables, are the lowest of the Indian castes. Scheduled tribes are tribal people, not part of any organized religion. Other backward castes are those between the forward castes and the scheduled castes in terms of social order.

Background and Objective: Anaemia is a common clinical condition that affects the majority of school aged children. Reduced resistance to disease, increased susceptibility to infection, impaired physical development, and poor school performance are all consequences of anaemia in this group. The present study was designed with the objective of estimating the prevalence of anaemia among school children in Bengaluru. This included identifying the associated factors or causes and consequences of anaemia. Methods: A school based cross-sectional study was conducted among children in schools from 3rd to 8th standard in Bengaluru Urban North Division Karnataka State, India, over a period of one year. 250 children were selected using convenience sampling. Results: The overall prevalence of anaemia among school going children was found to be 21.2%. Prevalence of anaemia was significant among variables like socioeconomic status, dietary habits, increased heart rate, breathlessness, lack of energy, dizziness, irregular menstrual cycles, jaundice, blood loss during menstruation, menstrual cycle pattern, pallor signs of palpebral conjunctiva, mucous membrane, and skin, splenomegaly and hepatomegaly, consumption of chicken, fish, citrus fruit, milk, Mizāj ‘Ām (overall mizaj of body, specifically choleric) duration of menstrual flow, headache, poor wound healing, and chronic disease. Conclusion: The overall prevalence of anaemia in our study of school children in Bengaluru (21.2%) was lower than the prevalence in the data recently shown by NFHS-5. Prevalence of anaemia was highly significant among variables like low socioeconomic status, dietary deficiencies, blood loss, and chronic infections. There were also highly significant correlations with several clinical findings.

Stress on students can cause a decrease in sleep quality and potentially reduce academic achievement. Understanding the effect of stress-induced sleep quality on academic achievement allows for selecting the most appropriate intervention. This study aimed to determine the impact of sleep quality due to stress on the academic achievement of medical students at Universitas Ciputra Surabaya. The method used in this study is quantitative research in the form of analytic observational with a cross-sectional approach. Sampling was done by using a random sampling technique. The population is 80 students from the Faculty of Medicine at the Universitas Ciputra Surabaya, third year and fourth year medical students. The sample size in this study was 63 students. Data was collected using the Depression Anxiety Stress Scale-21 (DASS-21) questionnaire to measure stress levels and the Pittsburgh Sleep Quality Index (PSQI) questionnaire to measure sleep quality. Sampling was only done with the consent of the respondent. The data analysis used was the correlation test which was carried out to determine the relationship between sleep quality and stress levels; the linear regression test was carried out to assess the effect of sleep quality due to stress on academic achievement. All respondents experienced stress and sleep disturbance to various degrees. The highest proportion was mild stress and moderate sleep disturbance, respectively, 50.8% and 73%. Correlation test results showed a significant relationship between sleep disturbances and stress levels (r= 0.29; p= 0.021), and the linear regression test results showed no effect of sleep quality due to stress on academic achievement (p= 0.241). Based on the data analysis, it can be concluded that the decrease in sleep quality due to stress does not affect academic achievement in medical students.

Introduction Moral injury among healthcare missionaries leads to negative consequences for the individual, healthcare team, patients, and sending agencies. Conflicting values in clinical care, culture, and spirituality provide unique potentially morally injurious experiences. The purpose of this qualitative study is to explore the phenomenon of moral injury among western healthcare missionaries to develop effective support and treatment strategies. Methods A qualitative interview guide was developed based on the existing literature on moral injury. Twenty-one key informant interviews were completed by two former healthcare missionaries. Participants were based in Africa, Asia, and Eastern Europe healthcare mission settings. Questions were based on clinical, cultural, and spiritual domains of potential ethical and moral conflicts. Protective factors were also explored based on one’s faith and spiritual practices. Interviews were transcribed and coded independently by two analysts. The team reviewed the codes and determined themes from across the three domains. Results Seven themes emerged from the interviews ranging from morally injurious experiences with cultural leadership practices and unfamiliar clinical care experiences to guilt over practicing outside of one’s scope of practice and addressing suffering alongside God’s sovereignty. The themes led to the development of an injury/growth pathway as a potential model for helping healthcare missionaries describe and move through potentially morally injurious experiences. Conclusion The themes allow for healthcare missionary sending agencies to develop strategies, training, and support systems for teams preparing to enter the mission field and for individuals already in the field. Recommendations for growing through potentially morally injurious experiences are suggested to guide practice and support for missionaries in the field. The growth values and strategies could inform the development of a screening tool to assess moral injury among healthcare missionaries.

Remote working led to organizational and adaptive processes at workplaces, with ergonomic and psychosocial risk factors being present that could be associated with musculoskeletal symptoms. This study identifies musculoskeletal discomfort developing in this setting among university professors working remotely because of the COVID 19 pandemic, evaluates risk levels associated with this workplace, and estimates the need for remedial action. The study had a quantitative, observational, cross-sectional design and used a secondary source of information. Statistical analysis used Jamovi software. Professors reported primarily neck discomfort, followed by discomfort in the dorsal or lumbar region. A statistically significant association was found between the category “requires action” and those who reported dedication to occupational activities more than eight hours per day. Work at home conducted by the professors is related to discomfort on the neck and dorsal or lumbar region. Risk assessment shows that, under these conditions, the professors required timely action to avoid worsening discomfort, functional limitation, and work absenteeism.El trabajo a distancia generó procesos de organización y adaptación de los lugares de trabajo, con presencia de factores de riesgo ergonómicos y psicosociales que podrían provocar la aparición de síntomas musculoesqueléticos. El estudio identifica molestias musculoesqueléticas, evalúa el nivel de riesgo asociado al ámbito laboral, estima la necesidad de actuación y las asociaciones existentes en los docentes universitarios que realizaron trabajo remoto debido a la pandemia del COVID-19. El estudio contó con diseño cuantitativo, observacional, transversal y fuente de información secundaria, con análisis estadístico a través del software Jamovi. Los profesores reportaron molestias en el cuello, seguido de la región dorsal o lumbar; se encontró asociación estadísticamente significativa entre la categoría “requiere acción” con aquellos que relataron dedicación a actividades ocupacionales > 8 h/día. Se concluye que el trabajo en casa realizado por los profesores estuvo relacionado con molestias en el cuello y región dorsal o lumbar; la evaluación de riesgos muestra que en esas condiciones los profesores requerían una actuación oportuna para evitar que se agudizaran las molestias, la limitación funcional y el ausentismo laboral.

As a result of Russia's full-scale military offensive on the territory of Ukraine, numerous international, non-governmental organizations have commenced providing assistance to the population through the implementation of different programs. Such assistance is manifested in various aspects, from humanitarian to financial. This article outlines the experience and legal basis for the operation of several international, non-governmental, medical and humanitarian organizations in Ukraine working under martial law imposed as a result of the war. To the purpose and objectives of the study, the work uses a combination of general and special methods of scholarly knowledge. The article uses the doctrinal provisions of science on the legal framework for the activities of international, medical and humanitarian, non-governmental organizations in Ukraine, as well as statistical data on the activities of public associations during the period of martial law. This study was conducted taking into account the experience of non-governmental organizations in other countries. The authors found that during the legal regime of martial law in Ukraine, international, non-governmental organizations such as Medecins Sans Frontieres, the International Committee of the Red Cross, and Oxfam play a leading role in providing humanitarian and medical assistance to war victims. These organizations play a key role in promoting democracy while helping to mitigate violence and the psychological trauma of war victims. It is the authors’ contention that such assistance furthers democratic governance, helps curb violence, and addresses the psychological trauma occasioned by the war.

Background & Aims: Sleep problems have become the most common complaint among the elderly. Various factors are involved in the prevalence of poor sleep quality in this age group. Due to the lack of community-based data, this study was conducted to determine the prevalence of poor sleep quality among the elderly in Amirkola, Northern Iran. Methods: This cross-sectional study is part of the second phase of the Amirkola Health and Ageing Project (AHAP), a cohort study conducted on all elderly aged 60 and over in Amirkola, Northern Iran, since 2011. The sleep quality and related factors were assessed through Pittsburgh Sleep Quality Index (PSQI-P) and interviews, respectively. Results: Of the 1675 older people, 914 (54.6%) were male, and 761 (45.4%) were female, of whom 714 (42.6%) had poor sleep quality. The prevalence of poor sleep quality in women and men was 56.9% and 30.7%, respectively (p

From the healing narratives of Jesus in the Gospels to the genesis of the first hospital to the practice of modern medicine, questions surrounding health and care for those who are sick and dying run through the heart of the Christian story. One way that individuals and communities have sought to live into their faith has been through missional medicine, that is, seeking to intentionally use the tools of medicine in step with and to bear witness to the life of Christ, particularly in crosscultural and global contexts. In this commentary, we take up the incisive question of the late missionary physician Raymond Downing, “is there a distinctive Christian approach to global health?” Or, what sets (and should set) Christian approaches to global health apart from other interventions? Here, we argue that there are at least three distinctive Christian contributions to global health. First, missional medicine movements have been committed to the building of long-standing hospitals and academic medical institutions that have left indelible marks on long-term health outcomes for people and communities. Second, practitioners motivated by Christian convictions disproportionately serve and remain long-term in marginalized, rural, and underserved areas; many of which are connected to fragile or under-developed health systems. Thirdly, Christian medical missionaries and global health workers ought to be, in the words of Jacques Ellul: preserving salt, revealing light, and “sheep in the midst of wolves.” This is a theologically framed vocation that accepts suffering and sacrifice, embracing solidarity through accompaniment. This paper is not meant to be a comprehensive history of missional medicine nor a defence of its problematic manifestations over the centuries. Rather, we candidly explore examples of the distinctive contributions that have been made, and we hope will continue to be made, by medical missionaries and global health workers who are motivated by their faith.