Rural Transportation Infrastructure in Low- and Middle-Income Countries: A Review of Impacts, Implications, and Interventions

Lessons from the COVID-19 Pandemic: Promoting Vaccination and Public Health Resilience, a Narrative Review

The COVID-19 pandemic has underscored the critical importance of adaptable and resilient public health systems capable of rapid response to emerging health crises. This paper synthesizes the lessons learned from the COVID-19 vaccination campaign and explores strategies to enhance vaccine uptake in the post-pandemic era. Key challenges identified include logistical, economic, sociocultural, and policy dimensions that impact vaccination efforts, particularly in low-resource settings. The analysis highlights the need for resilient supply chains, effective communication, community engagement, and equitable access to healthcare resources. The rapid development and deployment of mRNA vaccines exemplify the potential of innovative vaccine technologies, though public trust and acceptance remain crucial. Strategies such as partnerships with local leaders, tailored messaging, and integration of digital tools are essential for combating vaccine hesitancy. By applying these insights, future vaccination campaigns can be more efficient, equitable, and resilient, ultimately improving public health outcomes globally. This paper aims to inform policy and practice, ensuring that public health strategies are evidence based and context specific, thus better preparing for future health challenges.

Catalyzing sustainable development: Exploring the interplay between access to clean water, sanitation, renewable energy and electricity services in shaping China's energy, economic growth, and environmental landscape

The Sustainable Development Goals (SDGs) reflect the shift in global economic conversation toward inclusive growth. The growth can promote inclusivity and widespread sharing of its advancements by concentrating on four key dimensions. (a) Equality of opportunity, (b) sharing prosperity, (3) environmental sustainability/climate adaptation, and (4) macroeconomic stability. We used the Kao cointegration test to study how certain variables are connected over a long period. The relationship between CO2 and GDP per capita, renewable energy and tourism, improved water and sanitation, and access to power all have a positive feedback effect on each other. Based on FMOLS's findings, a 1 % increase in Inclusive growth leads to a 0.342 % (Model 1) and 0.258 % (Model 3) increase in CO2 emissions. An increase of 1 percent in energy consumption per person resulted in a rise of 1.343 % in CO2 emissions in Case 1, 0.524 % in Case 2, and 0.618 % in Case 3. Increasing the tourism sector's proportion of total exports by just one percent will reduce CO2 emissions by 0.221 % (case 1) and 0.234 % (case 3). Based on CCR findings, a 1 % improvement in inclusive growth leads to a 0.403.

Functional availability of medical oxygen for the management of hypoxaemia in Cameroon: A nationwide facility-based cross-sectional survey

Background

Medical oxygen is essential for managing hypoxaemia, which has a multifactorial origin, including acute and chronic lung diseases such as pneumonia, asthma, and severe malaria. The coronavirus disease 2019 (COVID-19) revealed substantial gaps in the availability and accessibility of safe medical oxygen, especially in low- and middle-income countries (LMICs). This study aimed to assess the availability and sources, as well as the barriers to the availability of functional medical oxygen in hospitals in Cameroon.

Methods

This was a nationwide cross-sectional descriptive study conducted from 26 March to 1 June 2021. Using a convenient sampling technique, we sampled accredited public and private COVID-19 treatment centres in all ten regions in Cameroon. Representatives from the selected hospitals were provided with a pre-designed questionnaire assessing the availability, type, and state of medical oxygen in their facilities. All analyses were performed using R.

Results

In total, 114 hospitals were included in this study, with functional medical oxygen available in 65% (74/114) of the hospitals. About 85% (23/27) of the reference hospitals and only 59% (51/87) of the district hospitals had available functional medical oxygen. Compared to district hospitals, reference hospitals were more likely to have central oxygen units (reference vs. district: 10 vs. 0%), oxygen cylinders (74 vs. 42%), and oxygen concentrators (79 vs. 51%). The most common barriers to the availability of medical oxygen were inadequate oxygen supply to meet needs (district vs. reference hospitals: 55 vs. 30%), long delays in oxygen bottle refills (51 vs. 49%), and long distances from oxygen suppliers (57 vs. 49%).

Conclusions

The availability of medical oxygen in hospitals in Cameroon is suboptimal and more limited in districts compared to reference hospitals. The cost of medical oxygen, delays related to refills and supplies, and long distances from medical sources were the most common barriers to availability in Cameroon.

An IoT-Based Road Bridge Health Monitoring and Warning System

Recent earthquakes worldwide have led to significant loss of life and structural damage to infrastructure, especially road bridges. Existing bridge monitoring systems have limitations, including restricted detection capabilities, subjectivity, human error, labor-intensive inspections, limited access to remote areas, and high costs. Aging infrastructures pose a critical concern for organizations and government funding policies, showing signs of decay and impending structural failure. To address these challenges, this research proposes an IoT-based bridge health status monitoring and warning system that is wireless, low-cost, durable, and user-friendly. The proposed system builds upon engineering standards and guidelines to classify bridge health status into categories ranging from excellent to collapse condition. It incorporates deflection, vibration, temperature, humidity, and infrared sensors, combined with IoT and a fuzzy logic algorithm. The primary objective is to reduce bridge maintenance costs, extend lifespans, and enhance transportation safety through an early warning system via a mobile application. Additionally, a Google Maps interface has been developed to display bridge conditions along with real-time traffic video. To validate the proposed system, a 3-D prototype model was constructed and tested. Practical testing of the fuzzy logic algorithm aligned with the simulation outcomes, demonstrating expected accuracy in determining bridge health status.

Management of Human Bites in a Rural Kenyan Setting: A Plastic Surgeon's 8-Year Experience

INTRODUCTION

The treatment of human bites is a common issue facing healthcare practitioners in the developing countries of Sub-Saharan Africa where it has been noted as a growing public health concern. Generally, the desired outcomes from surgical management are healing, function, and aesthetics. We share our 8-year experience at Kapsowar Hospital in Kenya with the presentation, management, and outcome of human bites. We are uniquely situated to do so given the prevalence of human biting in our community and the full-time presence of a plastic surgeon at our institution. To the best of our knowledge, this study is the first to present human bite surgical management by a plastic surgeon certified by the American Board of Surgery working full-time on the African continent.

METHODS

A retrospective chart review was conducted on all patients who presented to the operating theater at Kapsowar Hospital with a human bite between 2013-2021. After identification of eligible patients, charts were reviewed assessing parameters including age, gender, timing from injury to presentation at hospital, localization of bite, severity of facial wounds using Lackmann's classification, surgical procedure(s), postoperative complications, surgical revisions, antibiotics administered, and circumstance of incident. Data were analyzed using SPSS 29.0.0.0.

RESULTS

Forty-four patients were identified. Seventeen (38.6%) were female and 27 (61.4%) were male. Thirty-one patients had facial bites and 13 patients had bites to other parts of the body. Of facial bites, 70.3% resulted in amputation of the affected part while 29.7% were lacerations. Using Lackmann's classification for facial bite severity, IIIA bites (complete avulsion) were most common for both males (9) and females (7). Females comprised 68.4% of total lip bite victims. Bites to the extremity were associated with late presentation and infection. We report a salvage rate of 85.7% for infected digits.

CONCLUSIONS

Compared with most other studies on human bites, our patient population presents with a higher rate of avulsive lip injuries, most commonly among women. Our postoperative infection rate is lower than many others reported in the literature. Satisfactory cosmetic outcome with low risk of infection can be achieved by following well-established principles of wound healing and tension-free closure.

Education for sustainable development in rural communities: Parents' perceptions of children's willingness‐to‐study and learning difficulties associated with school transport in Ukerewe Island, Tanzania

Quality education and school transport are prerequisites for children to achieve sustainable development goals (SDGs), but they are disproportionately inadequate in rural communities. This study explores 350 parents' perceptions of the willingness‐to‐study (WTS) and learning difficulties of schoolchildren in Ukerewe Island (Tanzania) based on the mode of transport. The study surveyed 17 rural islands to build structural equation models based on Health Belief Model. The results showed that schoolchildren in Ukerewe Island have learning difficulties caused by the quality of their mode of transport to and from school. The children's learning difficulties were positively associated with perceived severity, self‐efficacy, and vulnerability. The perceived benefits of canoe transport supported the WTS. However, WTS could not buffer learning difficulties. Interestingly, male and female caregivers differ regarding the perceived WTS and their children's learning difficulties. This study contributes mitigation measures relevant to education and transport planning toward realizing SDGs 3, 4, and 10.

Drug delivery improvements to enable a flexible care setting for monoclonal antibody medications in oncology - Analogue-based decision framework

INTRODUCTION

The substantial acceleration in healthcare spending together with the expenditures to manage the COVID19 pandemic demand drug delivery solutions that enable a flexible care setting for high-dose monoclonal antibodies (mAbs) in oncology.

AREAS COVERED

This expert opinion introduces an analogue-based framework applied to guide decision-making for associated product improvements for mAb medications that are either already authorized or in late-stage clinical development. The four pillars of this framework comprise (1) the drug delivery profile of current and emerging treatments in the market, (2) the needs and preferences of people treated with mAbs, (3) existing healthcare infrastructures, and (4) country-dependent reimbursement and procurement models. The following product optimization examples for mAb-based treatments are evaluated based on original research and review articles in the field: subcutaneous formulations, an established drug delivery modality to reduce parenteral dosing complexity, fixed-dose combinations, an emerging concept to complement combination therapy, and (connected) on-body delivery systems, an identified future opportunity to support dosing outside of a controlled healthcare institutional environment.

EXPERT OPINION

Leveraging existing synergies and learnings from other disease areas is a measure to reduce associated development and commercialization costs and thus to provide sustainable product offerings already at the initial launch of a medication.

Assessing progress towards achieving the transport dimension of the SDGs in China

Transport is an important service industry in the national economy. Sustainable transport is central to sustainable development. Currently, investigating the sustainable development process and trade-offs in China's transport sector is urgent. In this study, 11 transport indicators were selected and constructed for the sustainable development goals (SDGs) under the UN indicator framework. The scores of each indicator were calculated, and spatiotemporal patterns and interactions were analyzed. The results revealed that China's transport infrastructure performed well in large transportation volumes and guaranteed traffic safety and strict land use control, with scores above 75. However, China's transport sector currently faces a challenge in using clean energy, and a more balanced development of bus ownership among the provinces is expected. The interaction analysis revealed three pairs of indicators with synergy (ρ > 0.5), but both the significant negative and positive relationships among the selected indicators accounted for approximately half, indicating the development of sustainable transport in China would move in zigzags. Road accessibility was an indicator interacting with most sustainable transport indicators. We suggest that more SDG indicators with indirect impacts should be included in future sustainable transport research.

Analysis of Spatial Patterns and Socioeconomic Activities of Urbanized Rural Areas in Fujian Province, China

Rural urbanization under China’s process of rapid urbanization entails significant rural transformation and is profoundly influencing sustainable development. However, little research has been undertaken on spatial patterns and socioeconomic activities. In this study, we defined urbanized rural areas as territories where the population size, economic output, and built-up land area are larger than in other rural and urban areas. Using large-scale and high-granularity spatial data, we delimited 255 urbanized rural areas from the 15,117 village-level administrative units in Fujian Province, China, in 2015. Analysis of the spatial patterns of the urbanized rural areas showed that spatial clustering, proximity to well-developed urban centers, and transportation accessibility influenced the development of the urbanized rural areas. Analysis of socioeconomic activities in the urbanized rural areas showed that the urbanized rural areas are rudimentary urban areas in terms of socioeconomic activities. Specifically, we found four representative socioeconomic activities in the urbanized rural areas: an urban-like housing model, diverse non-agricultural activities, transportation improvements, and sufficient health services. Based on our findings, we put forward several policy implications. This study can add valuable new knowledge for rural and urbanization studies.

Constructing Inclusive Infrastructure Evaluation Framework—Analysis Influence Factors on Rural Infrastructure Projects of China

The theory of inclusive growth has been widely studied. However, most studies focus on the measurement of macro-field research, and no systematic research has been carried out on the realization and path of micro-field research, especially in project management. This paper clarifies the key factors which impact the inclusive growth of rural infrastructure projects through a literature review to lay a foundation for evaluation and policy formulation in rural infrastructure projects. The analysis of factors identified by a literature review is conducted based on data derived from questionnaire results received from 135 stakeholders. The universality of 41 factors was verified by the Kruskal–Wallis test to examine whether the importance of influencing factors varies in different infrastructure types or different stakeholders. Factor analysis categorized 41 factors into seven common factors, thus, an inclusive evaluation framework for project management is constructed. The evaluation framework of inclusive infrastructure is constructed from seven perspectives. The evaluation framework is proposed for the first time in the field of rural infrastructure management, and a new evaluation system is proposed for the performance evaluation of rural infrastructure.

How Does New Infrastructure Investment Affect Economic Growth Quality? Empirical Evidence from China

The current phase of the technological revolution and the accelerated rate of industrial change have encouraged the structural transformation of global infrastructure investment. This study aims to identify and evaluate the impact of new infrastructure investment on economic growth quality. This paper explains the theoretical mechanisms in terms of their effects on technological innovation, industrial structure, and productivity, using the three-dimensional analysis framework of economic growth conditions, process, and results. We then carry out an empirical examination based on provincial panel data for China from 2004 to 2019. The findings demonstrate that new infrastructure investment can significantly improve economic growth quality, and this conclusion still seems valid after conducting endogeneity treatments and robustness tests. Further mechanism evaluations indicate that new infrastructure investments contribute to boosting economic growth quality in terms of the condition, process, and results of economic growth by promoting technological innovation, improving industrial structure, and enhancing production efficiency. Moreover, the magnitude and mechanism of the positive effects differ depending on the heterogeneity of the region examined. In terms of the nonlinear change characteristics, the significant dual-threshold effect reveals that the marginal effects of new infrastructure investment on economic growth quality tend to be incremental under the threshold condition. This study provides a theoretical and factual basis for governments to enforce new infrastructure investments in the digital economy era, and it also has some value as a reference regarding the economic sustainability of developing countries.