McGill Journal of Global Health

As Fractures in Global Health Deepen, Combating ‘Othering’ Is a Must

Shashika Bandara, Isabel Muñoz Beaulieu — Mon, 28 Apr 2025 00:00:00 -0400

The purpose of this editorial, therefore, is to put a red flag on these social, political and policy pathways of othering as a tool for power - and invite you to be a changemaker.

Addressing Medical Licensure Barriers to Improve Healthcare Access in Nunavut

Vincent Wong — Mon, 28 Apr 2025 00:00:00 -0400

Nunavut is the largest and least inhabited territory in Canada. While people often marvel at Nunavut’s natural beauty, we tend to overlook the stark healthcare realities faced by its inhabitants. One major challenge in Nunavut is achieving equitable access to healthcare. Medical transportation is widely normalized, and Nunavut residents are often forced to travel thousands of kilometers for treatment. The financial and human burdens of medical transportation are unjustifiable. This paper explores alternative solutions to healthcare sovereignty in northern Canada. Virtual care and recurrent locum physicians are methods that can bring care closer to Nunavut communities.

Socioeconomic Disparities, Chronic Stress, and Neurodegeneration: A Canadian Policy Perspective on Risk Reduction

Henry Xie — Mon, 28 Apr 2025 00:00:00 -0400

Global aging, driven by improved nutrition, sanitation, education, and healthcare, has increased neurodegenerative disease prevalence. Addressing the structural causes of chronic stress, particularly those linked to SES disparities, is crucial in mitigating the rising incidence
of neurodegenerative diseases. This perspective synthesizes literature to propose a framework linking socioeconomic status, chronic stress, and neurodegeneration and discusses how policy interventions with a focus on the Canadian context can address structural stressors to reduce neurodegenerative disease risk.

Exploring Access to Universal Healthcare among Indigenous Peoples in Canada

Rojina Aliakbar Shirazi — Mon, 28 Apr 2025 00:00:00 -0400

Canada’s healthcare system is founded on universality, yet Indigenous Peoples face significant barriers to equitable care. This paper explores the challenges Indigenous communities encounter, including jurisdictional disputes, systemic racism, and inadequate healthcare infrastructure. It argues that achieving inclusivity requires moving beyond one-size-fits-all policies toward culturally responsive, community-driven solutions that uphold Indigenous rights and self-determination. Strategies discussed include cultural safety programs, better healthcare provider education, and increased Indigenous participation in decision-making. It calls for a collaborative approach involving all levels of government, especially Indigenous governments, to improve policy development, resource allocation, and service delivery. Legal reform and clearer accountability frameworks are essential to shifting power dynamics and ensuring equitable access to healthcare.

The Dynamic Public Health Workforce: Who Is a Young Professional?

Mon, 28 Apr 2025 00:00:00 -0400

The interdisciplinary and inter-professional nature of the public health field has made it difficult to clearly define career pathways, which impacts those trying to enter the field, especially young public health professionals (YPHPs). Indeed, the regular use of the terminology "young professional" warrants discussion regarding its definition, significance, and the roles it encompasses. This study utilized an exploratory qualitative approach to explore the insights and underlying contexts that shape the perspectives surrounding YPHPs through a general survey followed by focus group discussions and key informant interviews. Findings suggest that the term "YPHPs" appears to associate the individual's role in the workforce, focusing on their years of practical experience. The terms and criteria of what fits its profile vary between organizations, countries, and contexts. Young professionals are attributed with enthusiasm for public health and are required to have numerous professional and human-centric competencies. There is a need for cooperation between schools of public health, employers, and young professionals to understand and meet the future public health workforce's needs. As public health is dynamic, defining and streamlining opportunities for young professionals in public health is necessary to strengthen the future of public health systems.

Time Series Analysis of Measles Incidence in Nigeria Using Surveillance Data from 2011 to 2022

Rasaq A. Ojasanya, Babafela B. Awosile, Praise Adeyemo, Essa Jarra, Olaf Berke — Mon, 28 Apr 2025 00:00:00 -0400

Background: Measles is a highly contagious viral disease that primarily affects children, especially in underdeveloped nations. In Nigeria, inadequate vaccine coverage has sustained measles endemicity. This study analyzed the trend and seasonality of measles in Nigeria and forecasted its trajectory from January 2023 to December 2026. Methods and Materials: Time series analysis was applied to laboratory-confirmed measles cases from the World Health Organization case-based surveillance data reported in Nigeria from January 2011 to December 2022. The analysis was conducted using Seasonal and Trend decomposition using Loess and the Seasonal Autoregressive Integrated Moving Average (SARIMA) model, with model selection determined by the Akaike Information Criterion and validated using residual diagnostics. Measles incidence forecasts for 2023 to 2026 were generated, with predictive accuracy assessed using the root mean square error and mean absolute error (MAE). Results: A total of 203,587 measles cases were reported during this period, with an average incidence of 7.5 cases per one million individuals. Seasonal peaks were consistently observed from January to March, with no discernible long-term trend. The SARIMA (3, 0, 1)(1, 1, 1)₁₂ model demonstrated the best fit for forecasting, achieving an MAE of 3.2 cases per one million population when comparing predicted and observed incidence in 2023. Forecasts suggest the seasonal patterns and magnitudes will persist through 2026, assuming all factors remain constant. Conclusion: This study highlights seasonal peaks in measles incidence from January to March in Nigeria, highlighting the urgent need for improved vaccination coverage and targeted public health interventions during peak seasons to mitigate the disease burden.

Factors Associated with Sexual Behaviour among Women Aged 15-49 in South African Low-Income Communities

Mon, 28 Apr 2025 00:00:00 -0400

Introduction: South Africa faces disproportionately high rates of sexually transmitted diseases (STDs), especially in low-income communities. Understanding how demographic, socioeconomic, and knowledge-based factors influence sexual behaviour is critical for targeted public health interventions. Therefore, this study examined the relationships between socioeconomic status (SES), education, ethnicity, marital status, STD awareness, and sexual behaviour among women aged 15 – 49 in low-income South African communities. Methods and Materials: We conducted a cross-sectional study utilizing data from the South Africa Demographic and Health Survey 2016 (SADHS 2016). Key variables included sexual behaviour (safe versus risky), SES, education, place of residence, ethnicity, marital status, and awareness of STDs. Bivariate and multivariable analyses were used to assess associations between sexual behaviour and the aforementioned variables. Results: Among 8,513 respondents, 22.3% (95% CI: 21.1–23.5) engaged in risky sexual behaviour. Higher SES was associated with increased odds of risky behaviour, as were White, Coloured, and Indian/Asian ethnicities compared to Black Africans. Conversely, higher education levels, being married or cohabiting, and STD awareness (having heard of AIDS) significantly reduced risky sexual behaviour. Urban residence had no significant effect. These findings highlight the influence of socioeconomic and educational factors on sexual health outcomes. Conclusion: Sexual behaviour may be influenced by a number of factors, and behavioural patterns vary across groups. Public health strategies and intersectional approaches to sexual health should be considered to enhance education and STD awareness to reduce risky behaviours and improve sexual health outcomes in different population groups.

Patients’ Profiles and Their Satisfaction with the Quality of Health Services Offered in Primary Healthcare Centers in Anambra State, Nigeria

Chidimma Obiejesi, Ronald Ferrer, Ebere Muoghalu — Mon, 28 Apr 2025 00:00:00 -0400

Background: The primary healthcare center (PHC) is the initial point of contact for individuals seeking healthcare within their community. Its purpose is to deliver comprehensive health services that cater to patients' unique needs and expectations. However, patient satisfaction from primary health centers has received negligible attention. This study aimed to evaluate patient satisfaction levels with healthcare services provided by primary health centers in Anambra State, Nigeria. Methods and Materials: We conducted a cross-sectional study in twelve primary health centers with a descriptive design employing Chi-square, Cramér's V, and linear regression to assess the relationship between patient profile and their satisfaction. Servqual dimensions were used to investigate whether a statistically significant correlation exists between patient profile and patient satisfaction level. Result: A total of 385 individuals responded to the survey. The responsiveness dimension of the Servqual dimension had the lowest mean score among the five dimensions assessed. No significant correlations were found between patient satisfaction levels and patient profiles: sex, age, marital status, highest educational attainment, and average monthly income. Conclusion: When assessed with the Servqual dimension, patients’ satisfaction with the quality of health services offered in the PHCs in Anambra state indicated a suboptimal level of satisfaction. Enhancements in infrastructure and healthcare worker training are essential to elevating the quality of health services provided.

Development, Implementation, and Evaluation of a Health Information System for a Rural Clinic in Pakistan: A Pilot Model for Low-Resource Settings

Saad Razzaq, Nazish Ilyas, Maryam Mazhar, Sayra Ilyas, Charles Larson — Mon, 28 Apr 2025 00:00:00 -0400

Background: Health information systems (HIS) play a pivotal role in modern healthcare by improving patient outcomes, enhancing data management, and supporting public health initiatives. Despite these benefits, HIS adoption remains limited in rural areas of low- and middle-income countries (LMICs), where healthcare challenges are more pronounced. This study describes the development, implementation, and evaluation of a clinician led HIS model in a rural clinic in Sadwal Kalaan, Punjab, Pakistan. Methods and Materials: A structured four-step approach was used in developing, implementing and evaluating the HIS: 1) assessing the need for a HIS through interviews and focus group discussions with the clinic manager, physicians, and auxiliary healthcare staff; 2) designing a system tailored to the clinic’s context; 3) implementing a patient intake form designed using a survey questionnaire; and 4) evaluating adoption guided by iterative feedback from key stakeholders and impact on healthcare delivery. Results: The HIS was successfully integrated into the clinic’s workflow, facilitating patient follow-up by enabling retrieval of previous medical visits. Data was collected from 3,900 patient encounters on demographics, medical presentation, management, and overall patient satisfaction. Nearly all (99.8%) of respondents provided sufficient information regarding their condition and treatment. The system enhanced clinic operations by facilitating data-driven decision-making, optimizing resource allocation, and informing medication stock management. Despite initial resistance from staff regarding additional documentation workload, structured training and workflow adaptations ensured successful adoption. Conclusion: Overall, the findings demonstrate that implementing a clinician-led HIS in rural Pakistan is feasible and beneficial, offering scalability for similar settings in other LMICs.