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Research Article
Evaluation and Challenges on the Hygiene Quality of Environmental Surfaces and Staff Hands in Elderly Care Institutions in Guangxi, 2024
Tao Chunai
,
Gan Yongxin,
Tang Xiaolan*,
Xiong Jianwei,
Tang Liling,
Lu Xiayu,
Zhang Hongmei,
Xu Chengbao,
Chen Lianping,
Qin Shengwei,
Wang Jianglian
Issue:
Volume 1, Issue 1, December 2026
Pages:
1-7
Received:
7 August 2026
Accepted:
24 August 2026
Published:
15 September 2026
Abstract: The environmental quality of elderly care institutions is directly associated with the health of their residents. The elders are particularly vulnerable to environmental risk factors. However, deficiencies in environmental disinfection are common across many elder care institutions. Targeted research on the environmental quality of these facilities is of substantial practical significance for the protection of the health of elderly residents. In this study, 37 elderly care institutions across Guangxi were surveyed between August and December 2024. Frequently touched environmental surfaces and staff hands were sampled, and the total number of aerobic colony-forming units (CFU) were determined. The total number of aerobic colony count on each sample ≤ 10 CFU/cm2 is defined as qualified. A total of 1312 samples were collected. The overall qualification rate of the samples was 60.44%, with a qualification rate of 66.70% for environmental surfaces and 40.63% for staff hands. The qualification rate of tables and chairs (46.04%) and public activity utensils (48.31%) in public activity areas were relatively low. The qualification rate of total aerobic colonies on nurses' hands was the highest at 77.14%, while the qualification rates on the hands of cleaning staff and cooks were lower, at 30.95% and 7.84% respectively. The hygiene quality of environmental surfaces and staff hands in the surveyed elderly care institutions is substandard. Measures should be introduced to standardize the management and improve the hygiene quality of elderly care institutions.
Abstract: The environmental quality of elderly care institutions is directly associated with the health of their residents. The elders are particularly vulnerable to environmental risk factors. However, deficiencies in environmental disinfection are common across many elder care institutions. Targeted research on the environmental quality of these facilities...
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Review Article
Integrating Clinical Stewardship and Institutional Management to Control Antimicrobial Resistance in Primary Care During Wartime in Ukraine
Roman Yulianovych Grytsko*
Issue:
Volume 1, Issue 1, December 2026
Pages:
8-12
Received:
13 August 2026
Accepted:
22 August 2026
Published:
22 September 2026
Abstract: Background: Antimicrobial resistance (AMR) remains a growing global health threat, and in Ukraine the burden is compounded by unregulated over-the-counter access to antibiotics, disruption of routine immunization, and reduced microbiological diagnostic capacity across primary care facilities reorganized into Territorial Medical Associations (TMOs) since the 2018 healthcare reform, all occurring against the backdrop of full-scale war. AMR stewardship at the primary-care level continues to be framed almost exclusively as a clinical rather than a managerial task, which weakens the effectiveness of local antibiotic stewardship programs. Objective: To substantiate a practical framework that integrates evidence-based clinical principles of rational antibiotic therapy with institutional management mechanisms at the primary healthcare facility level, in order to strengthen AMR containment in primary care under conflict conditions. Methods: A narrative synthesis of international evidence on AMR control was conducted, covering the One Health concept, the “Start Smart – Then Focus” antibiotic stewardship principle, the WHO AWaRe antibiotic classification, point-of-care diagnostics, and immunization policy, integrated with the authors’ own prior work on managerial dysfunction in Ukraine’s polyclinic-outpatient network. Sources were retrieved from Cochrane Library, PubMed/MEDLINE and Journal Citation Reports-indexed journals, prioritizing systematic reviews, meta-analyses and multicentre validation studies published through 2026. Results: Five interdependent levers were identified as decisive for stewardship effectiveness at the facility level: a locally adapted first-line antibiotic formulary; routine antimicrobial consumption monitoring; prescribing audit and feedback; point-of-care C-reactive protein and rapid antimicrobial susceptibility testing; and vaccination policy as an upstream AMR-prevention tool. Conflict-related amplifiers — including extensively drug-resistant Gram-negative pathogens associated with war wounds and their documented spread into referral networks — further elevate the managerial stakes for primary care. Conclusion: Containing AMR in primary care is a joint clinical-managerial task. Evidence robustly supports each stewardship element individually, but institutional mechanisms determine whether these elements are reproduced systematically across a facility rather than remaining dependent on individual clinician initiative. Treating antibiotic stewardship as a management function of the TMO, not solely an individual physician’s discipline, is a promising direction for strengthening national AMR control programs under wartime conditions.
Abstract: Background: Antimicrobial resistance (AMR) remains a growing global health threat, and in Ukraine the burden is compounded by unregulated over-the-counter access to antibiotics, disruption of routine immunization, and reduced microbiological diagnostic capacity across primary care facilities reorganized into Territorial Medical Associations (TMOs) ...
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Research Article
Integrated Health and Nutrition Service Delivery Enhances Humanitarian Response in Conflict-Affected Darfur, Sudan
Issue:
Volume 1, Issue 1, December 2026
Pages:
13-19
Received:
29 September 2026
Accepted:
13 October 2026
Published:
28 October 2026
DOI:
10.11648/j.wjhpm.20260101.13
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Abstract: Displaced and host populations in protracted conflict settings face compounded risks of poor maternal, child and nutritional health, driven by damaged health infrastructure, health worker shortages and disrupted supply chains. This paper examines the health and nutrition component in conflict affected area in South Darfur State, Sudan, targeting South Sudanese refugees, internally displaced persons (IDPs) and host communities around the Bilel primary health care (PHC) clinic and surrounding camps. Using a mixed-methods post intervention evaluation household knowledge-attitudes-practices (KAP) surveys, key informant interviews, focus group discussions, health-facility observation, and a SMART nutrition survey. The study assessed primary health care utilization, maternal health service coverage, referral system performance, and treatment of acute malnutrition. Findings show that 43,883 primary health care consultations were delivered against a target of 46,422, while the proportion of women whose deliveries were attended by skilled staff rose from 60% to 74% and referrals to the regional hospital in Nyala reached 371 against a target of 150. On nutrition, 8,738 children under five were admitted for treatment of severe or moderate acute malnutrition reduced from 2,000. The 2020 SMART survey found global acute malnutrition (GAM) at 11.9% and severe acute malnutrition (SAM) at 0.8% in the surveyed locality. Despite these gains, persistent staff shortages at the Bilel PHC clinic (relative to a caseload of up to 200 patients per day), intermittent drug stock-outs, and rainy-season access barriers to therapeutic feeding constrained the consistency of care. The paper argues that integrating health, nutrition and community-based referral systems anchored in trained lay cadres such as traditional birth attendants and lead mothers is a transferable model for sustaining essential services in protracted, access-constrained displacement settings.
Abstract: Displaced and host populations in protracted conflict settings face compounded risks of poor maternal, child and nutritional health, driven by damaged health infrastructure, health worker shortages and disrupted supply chains. This paper examines the health and nutrition component in conflict affected area in South Darfur State, Sudan, targeting So...
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Research Article
Rabies in Iraq: Gaps in Surveillance, Prevention, and Control – A Narrative Review
Karar Ali Abdulkhuder*,
Farqad Abdulelah Ali Al-janahi
Issue:
Volume 1, Issue 1, December 2026
Pages:
20-30
Received:
24 September 2026
Accepted:
5 October 2026
Published:
31 October 2026
DOI:
10.11648/j.wjhpm.20260101.14
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Abstract: Rabies is a highly fatal zoonotic viral disease that continues to pose a significant public health threat, particularly in low- and middle-income countries such as Iraq. Despite the existence of safe and effective vaccines for both humans and animals, rabies remains a major cause of preventable mortality due to weaknesses in disease surveillance, insufficient prevention strategies, and inconsistent implementation of control measures. Iraq presents a complex epidemiological landscape where rabies persists, driven by factors including political instability, under-resourced veterinary services, inadequate reporting systems, and a rapidly growing population of stray dogs. Human rabies cases are frequently underreported, and animal surveillance remains minimal, limiting the ability to accurately assess the burden of the disease and to design targeted interventions. This narrative review critically examines the current epidemiology of rabies in Iraq, highlighting gaps in surveillance, prevention, and control measures. By synthesizing data from peer-reviewed literature, governmental reports, and guidance from international health organizations such as the World Health Organization (WHO) and the World Organisation for Animal Health (WOAH), the review identifies systemic weaknesses that hinder progress toward rabies elimination. Key challenges include insufficient dog vaccination coverage, delays in post-exposure prophylaxis administration, low public awareness regarding bite prevention, and fragmented coordination between human and veterinary health sectors. The review also emphasizes the importance of adopting a One Health approach, integrating human, animal, and environmental health initiatives to enhance disease monitoring, improve vaccination strategies, and promote community engagement. Strengthening surveillance systems, expanding dog vaccination campaigns, ensuring timely access to post-exposure prophylaxis, and implementing comprehensive public education programs are essential steps to reduce the burden of rabies in Iraq and move toward the global goal of zero human deaths from dog-mediated rabies by 2030.
Abstract: Rabies is a highly fatal zoonotic viral disease that continues to pose a significant public health threat, particularly in low- and middle-income countries such as Iraq. Despite the existence of safe and effective vaccines for both humans and animals, rabies remains a major cause of preventable mortality due to weaknesses in disease surveillance, i...
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Research Article
Sustainable Development Goals, Democratic Governance, and Maternal Health in Nigeria: A Sociological Assessment
Hussaini Ibn Mohammed*,
Mamuda Abubakar,
Suleiman Kawuwa
Issue:
Volume 1, Issue 1, December 2026
Pages:
31-41
Received:
9 October 2026
Accepted:
21 October 2026
Published:
31 October 2026
DOI:
10.11648/j.wjhpm.20260101.15
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Abstract: Maternal mortality remains one of the starkest indicators of social inequality and institutional failure in Nigeria, a country that accounts for a disproportionate share of global maternal deaths despite its enormous human and material resources. This paper offers a sociological assessment of the relationship between the Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality), democratic governance, and maternal health outcomes in Nigeria. Drawing on secondary data from the Nigeria Demographic and Health Survey, the World Health Organization, the World Bank, and civil-society budget analyses, the paper situates maternal mortality within a broader framework of structural functionalism, the social determinants of health, and institutional/governance theory. It argues that maternal death in Nigeria is not merely a clinical or logistical failure but a manifestation of weak democratic accountability, poor fiscal commitment to health, entrenched patriarchal norms, and uneven federal governance that leaves subnational health systems fragile and under-resourced. The paper reviews Nigeria's trajectory from military rule to the Fourth Republic, evaluates progress toward SDG 3.1, and identifies the sociological mechanisms corruption, elite capture, weak citizen participation, and gendered power relations that mediate the governance-health nexus. It concludes with policy-relevant recommendations anchored in strengthening democratic institutions, community participation, and gender-responsive budgeting as pathways to reducing maternal mortality and advancing the SDGs by 2030 and beyond.
Abstract: Maternal mortality remains one of the starkest indicators of social inequality and institutional failure in Nigeria, a country that accounts for a disproportionate share of global maternal deaths despite its enormous human and material resources. This paper offers a sociological assessment of the relationship between the Sustainable Development Goa...
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