Access, interest and equity considerations for virtual global health activities during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: Global health activities (GHAs) reduce health disparities by promoting medical education, professional development, and resource sharing between high- and low- to middle-income countries (HICs and LMICs). Virtual global health activities facilitated continuity and bidirectionality in global health during the COVID-19 pandemic. While virtual engagement holds potential for promoting equity within partnerships, research on equitable access to and interest in virtual global health activities is limited. METHODS: We conducted a cross-sectional, online, mixed-methods survey from January to February 2022 examining access to virtual activities before and during the pandemic across resource settings. Eligible participants were participants or facilitators of global health activities. Closed- and open-ended questions elicited participants' access to and interest in virtual global health engagement. RESULTS: We analyzed 265 surveys from respondents in 45 countries (43.0% LMIC vs. HIC 57.0%). HIC respondents tended to report greater loss of in-person access due to the pandemic at their own institutions (16 of 17 queried GHAs), while LMIC respondents tended to report greater loss of in-person activities at another institution (9 of 17 queried GHAs). Respondents from LMICs were more likely to gain virtual access through another organization for all 17 queried VGHAs. HIC respondents had significantly more access to global health funding through their own organization (p < 0.01) and more flexibility for using funds. There were significant differences and trends between respondent groups in different resource environments in terms of accessibility to and interest in different virtual global health activities, both during and after the pandemic. CONCLUSIONS: Our results highlight the need to examine accessibility to virtual global health activities within partnerships between high- and low- to middle-income countries. While virtual activities may bridge existing gaps in global health education and partnerships, further study on priorities and agenda setting for such initiatives, with special attention to power dynamics and structural barriers, are necessary to ensure meaningful virtual global health engagement moving forward.

Understanding mother and child health-seeking behavior in urban Pakistan.

Pakistan has long held one of the highest rates in the world for mother and child mortality, albeit the leading causes of death are largely preventable. Unlike many other low and middle-income countries (LMIC), however, limited research has been conducted within conflict-ridden LMIC like Pakistan on health-seeking behavior. Even less is known about more developed localities within these nations. Between May and June 2016, a pre-tested cross-sectional pilot study was conducted in Islamabad. Seventy mothers were surveyed, and data were used to run descriptive analyses and generate multivariable regression models to evaluate a mother's desire to solicit medical attention. Mothers had higher self-health seeking behavioral scores if they were more likely to pursue care for their children and vice versa. In situations that potentially warranted medical intervention, they were also 1.84 times more likely to solicit care for their children than for themselves. While most women were inclined to take their children to an established provider for a variety of illnesses, many still faced prominent barriers to accessing healthcare. To improve population health in developing nations like Pakistan, evidence-based methods should be adopted that increase healthcare accessibility, improve health awareness, and prioritize the health status of everyone in the family.