Background Worldwide the leading risk factor for death is raised blood pressure  (BP), accounting for ~30,000 deaths daily.1 In Australia, high BP is responsible for 43% of coronary heart disease, 41% of stroke, 65% of the burden of hypertensive heart disease, 38% of chronic kidney disease, 32% of atrial fibrillation and flutter and 3.6% of dementia.2 Better BP control could save more lives than any other single treatment intervention.3 In Australia, BP control rates have stagnated since 2011 at ~32%,4, 5 leading to a 2022 call to action to improve uncontrolled BP in Australia.5 Hypertension (the condition you have from high BP) is called the "silent killer" because most people who have raised BP do not have any symptoms.6 In Australia, 34% of adults have hypertension,4 but millions remain unaware and undiagnosed.6, 7 Only one in two people detected to have high BP are aware of their condition.8 Innovative strategies to target wider and high-risk populations,

Nigeria has a history of poor maternal healthcare. Nigerian women are 500 times more likely to lose their lives during childbirth compared to women from high-income countries (HIC). In 2020, Nigeria had the highest number of maternal deaths (82,000) in the world and accounted for more than a quarter (28.5%) of global maternal deaths. This translates to about 145 maternal deaths every day. Low quality of care is a major driver of poor maternal health outcomes in Nigeria. Quality of care has two components: provision of care and experience of care. However, efforts aimed at improving maternity care in Nigeria often focus on the ‘provision’ aspect of care alone. While it is important to invest in the supply aspect of care, it is also imperative that women’s experiences of care are given equal attention.   Aims This study aims to map women’s pregnancy journey to examine their experiences in accessing care and investigate their ideas of satisfactory quality of mate

Background: In Mexico, one of the most pressing public health challenges is the rising prevalence of obesity and diet-related non-communicable diseases (NCDs). Approximately 75% of the population in Mexico is affected by obesity or being overweight. The situation is particularly critical in the northern region of the country, the Sonoran Desert, which borders the United States. The dietary habits in this region are heavily influenced by the US diet, leading to dietary fat consumption levels that are 200% above recommended guidelines. The local population also faces the challenges of high temperatures and water scarcity, which contribute to the high consumption of sugar-sweetened beverages. This was evident in 2012 when the average person in the region consumed 163 litres of sugar-sweetened beverages annually. The impact of these dietary choices is felt not only on personal health but also on the environment, as one-third of global greenhouse gas emissions are linked to the food system, including food

Background Acute Kidney Injury (AKI) affects up to 1 in 2 patients treated in the ICU, and is associated with poorer survival, reductions in long term kidney function and greater cost of treatment. There are no treatments proven to reduce these impacts of AKI but there is a growing evidence base suggesting that inhibitors of the sodium-glucose transport protein 2 (SGLT-2 inhibitors) in the kidney tubule may protect against AKI. SGLT-2 inhibitors were originally developed as a treatment for type 2 diabetes but have been proven in recent clinical trials to significantly improve outcomes for patients with heart disease and/or kidney impairment - with fewer patients progressing to dialysis, needing hospital care or dying. Later examination of these trials has also shown lower rates of AKI in participants receiving SGLT-2 treatment but, as these results were not the main outcome of the studies, these findings are not enough to change patient treatment. Aim To conduct a prospective, multi-centre, parall

BackgroundThe countries of Brazil, India and South Africa have mixed health systems wherein public and private providers operate side-by-side to deliver the same set of services. The health administrations in these countries are increasingly purchasing services from the private sector for delivering care. There is some evidence to suggest that the purchase arrangements could contribute to quick expansion of health access. But at the same time, community participation rooted in the human rights framework hitherto has largely been envisaged as part of the public health system for better responsiveness and accountabilities. But the changing scenario, of the governments actively engaging private providers (both private for-profit and private non-profit), is making health systems pluralistic. In such a pluralistic scenario does the conventional understanding of Community participation hold and whether community participation can still aim for better health system effectiveness?AimTo strengthen the participation an

Background Access to essential medicines is a critical building block of the health system, but many low-and middle-income countries (LMICs) continue to face major challenges in ensuring medicine accessibility, affordability and quality. The sale of medicines online (or e-pharmacy, we use the terms interchangeably)  represents a major disruption to pharmacy provision across the globe. Whilst e-pharmacy was initially the preserve of high-income countries (HICs), in the past decade it has been growing rapidly in LMICs, and this growth was further catalysed by widespread lockdowns during the COVID-19 pandemic. This rapid expansion of e-pharmacy has been largely uncontrolled and accompanied by significant public health concerns, the most commonly cited being the sale of prescription-only medicines (POMs) without a prescription, including opioids and antibiotics; the sale of substandard or falsified (counterfeit) medicines; inadequate provision of information to patients; and erosion of the doctor-pharm

Background The Fiji Ministry of Health & Medical Services (MHMS) will be conducting its third round of the STEPS Survey in 2024.  The George Institute has been engaged to provide the MHMS with technical assistance in the implementation, data analysis and reporting of the survey, as part of Australia’s support to strengthening Fiji’s health sector. The consultancy will be led by Dr Bindu Patel and supported by a team of multidisciplinary experts: Professor Rohina Joshi (UNSW), Dr Anna Campain, Professor Jaime Miranda (USYD), Professor Laurent Billot and Sana Shan. Why the STEPS Survey?  Fiji is experiencing an alarming rising trend in deaths from non-communicable diseases (NCDs), particularly heart disease and diabetes, before the age of 70.1 According to World Health Organization data from 2017, Fiji is ranked 39 out of 183 countries in the world in fatalities from heart disease.2 The three leading causes of heart disease in Fiji are raised blood pressure, high blood sugar and

Background Globally, tobacco use is one of the biggest public health threats and a leading cause of death and disease in India, affecting nearly 1.35 million people each year. India is also the world's second-largest producer and consumer of tobacco. The most smoked tobacco product in India is bidi. It is estimated that about 71.8 million adults smoke bidi in India. Bidis are small hand-rolled tobacco cigarettes wrapped in tendu or temburni leaf (Diospyros melanoxylon). Bidi smoke contains higher concentrations of nicotine, tar, and other toxic agents, in comparison to cigarette. The bidi industry employs approximately one million people, the vast majority of whom are women and children. Beedi workers are constantly exposed to tobacco dust, fumes, and other hazardous chemicals such as nitrosamines and nicotine, which can be easily absorbed by the body through the skin, respiratory epithelium, and mucous membranes. However, there is no evidence synthesis on the environmental risks and health hazards

This collaborative research project between The George Institute for Global Health and the Mexican National Institute of Public Health (INSP) explores the health and economic impacts of non-communicable diseases (NCDs) on women in Mexico. The 20-month project, which is funded by the Mexican Association of Pharmaceutical Research (AMIIF), employs mixed methods to deliver evidence-based insights into the drivers and characteristics of health inequities, particularly in relation to gender, as a consequence of NCDs. Women’s and patient’s voices, community members, and advocacy groups, as well as national and international experts, will be involved throughout the research process and guided by an expert advisory committee. Research outputs will include analyses of financial risk, lost productivity, and policy enablers, and will be of relevance not just to Mexico but to similar countries and contexts. Research insights will be used to enhance system-wide efforts to improve the prevention, management, and