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PLOS Mental Health

Self-compassion, psychological distress, and mental well-being in a predominantly young student sample: Cross-sectional associations and continuous interaction analysis

Ying Shi, Zhihui Cheng

Publisher abstract excerptThis study examined the cross-sectional associations of self-compassion and psychological distress with mental well-being in a predominantly young student sample and tested whether self-compassion modifies the association between distress and well-being. The dual-continua framework guided the simult…

Abstract & author credits for Self-compassion, psychological distress, and mental well-being in a predominantly young student sample: Cross-sectional associations and continuous interaction analysis

Authors: Ying Shi, Zhihui Cheng

This study examined the cross-sectional associations of self-compassion and psychological distress with mental well-being in a predominantly young student sample and tested whether self-compassion modifies the association between distress and well-being. The dual-continua framework guided the simultaneous consideration of distress and positive mental health. Participants (N = 278) completed the Self-Compassion Scale–Short Form (SCS-SF), General Health Questionnaire-12 (GHQ-12), and Warwick–Edinburgh Mental Well-Being Scale (WEMWBS). The principal analysis used mean-centred continuous predictors in hierarchical multiple regression, followed by simple-slopes and Johnson–Neyman analyses. Heteroscedasticity-consistent standard errors and sensitivity analyses were used to examine robustness. Secondary analyses comprised a median-split ANOVA examining categorical main and interaction effects and stratified Spearman correlations estimating the self-compassion–well-being association within distress groups. Higher self-compassion was associated with greater well-being, B = 0.230, 95% CI [0.126, 0.334], p < .001, whereas greater distress was associated with lower well-being, B = -1.450, 95% CI [-1.685, -1.214], p < .001. The continuous interaction was small, B = -0.028, 95% CI [-0.055, -0.001], ΔR² = .008, p = .039. The negative coefficient indicated that the positive self-compassion–well-being association weakened as distress increased and ran counter to the hypothesised protective buffering effect. The interaction was also sensitive to influential-case exclusions, alternative GHQ-12 scoring, and bootstrap estimation, while the secondary median-split ANOVA interaction was non-significant, p = .875. Higher self-compassion and lower psychological distress were independently associated with greater well-being. The small, specification-sensitive interaction provided no evidence of the hypothesised protective buffering effect. Parallel assessment of distress and well-being is warranted, while causal, clinical, and structural conclusions require longitudinal, experimental, and latent-variable research.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000653. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

PLOS Mental Health

Dynamic pathways of maternal well-being: A longitudinal latent class analysis of risk and adaptive trajectories in low-income families

Jesseca Perlman, Samantha Burns, Esther Yu, Jennifer Jenkins, Michal Perlman

Publisher abstract excerptMaternal well-being is shaped by a dynamic interplay of structural, relational, and psychological factors, yet most research has examined risk processes across broad economic ranges rather than within families experiencing persistent disadvantage. Grounded in ecological systems, family stress, and r…

Abstract & author credits for Dynamic pathways of maternal well-being: A longitudinal latent class analysis of risk and adaptive trajectories in low-income families

Authors: Jesseca Perlman, Samantha Burns, Esther Yu, Jennifer Jenkins, Michal Perlman

Maternal well-being is shaped by a dynamic interplay of structural, relational, and psychological factors, yet most research has examined risk processes across broad economic ranges rather than within families experiencing persistent disadvantage. Grounded in ecological systems, family stress, and resilience theories, this longitudinal study examined patterns of risk and resilience among 634 very low-income, racially diverse (25.6% White, 36.4% Black, 24.8% Asian, 11.4% Other) families, 43% of whom were single-parent households. Using latent class analysis, we identified four distinct maternal profiles based on mental health symptoms, parenting practices, parental conflict, and economic and demographic characteristics: (1) Cumulative Economic and Family Disadvantage (N = 137), (2) Relational Conflict with Relative Economic Stability (N = 163), (3) Adaptive Functioning Amid Family Disadvantage (N = 185), and (4) Stable Well-Being with Relative Economic Stability (N = 149). Analyses examining change in mental health from Time 1 to Time 2 revealed significant class-by-time interactions, indicating that maternal mental health trajectories varied across classes – some improving despite adversity, others declining despite initial advantage. Findings highlight the dynamic and heterogenous nature of maternal well-being and underscore the importance of contextual factors in shaping mental health trajectories among families experiencing economic disadvantage.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000596. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

PLOS Global Public Health

Social determinants of access to reproductive health services among Afghan migrant women in Iran: A qualitative study

Seyedeh Tahereh Mirmolaei, Zohreh Mahmoodi, Amirhossein Takian, Zahra Bayat Jozani

Publisher abstract excerptMigrant women, particularly those from low-resource settings, often face restricted access to reproductive health services in host countries due to intersecting social, economic, and structural barriers. This study explored these barriers among Afghan migrant women in Iran using the World Health Org…

Abstract & author credits for Social determinants of access to reproductive health services among Afghan migrant women in Iran: A qualitative study

Authors: Seyedeh Tahereh Mirmolaei, Zohreh Mahmoodi, Amirhossein Takian, Zahra Bayat Jozani

Migrant women, particularly those from low-resource settings, often face restricted access to reproductive health services in host countries due to intersecting social, economic, and structural barriers. This study explored these barriers among Afghan migrant women in Iran using the World Health Organization's Social Determinants of Health (SDH) model. This qualitative study employed semi-structured, in-depth interviews with 20 purposively sampled Afghan migrant women of reproductive age and 10 key informants from healthcare, midwifery, NGO, and policy backgrounds. Maximum variation sampling was used to ensure diversity in residency status, socioeconomic background, and service experiences. Data collection took place in Tehran from April 2024 over six months and analyzed using directed content analysis guided by the World Health Organization's Social Determinants of Health (SDH) framework. Prolonged member checking and peer debriefing enhanced the credibility and confirmability of the final categorization of structural and intermediary determinants. Three interconnected levels of determinants shape Afghan migrant women’s reproductive health access. Structural determinants include a restrictive legal and macroeconomic context, undocumented status, banking and communication barriers, and high out-of-pocket costs, compounded by patriarchal norms that limit women’s agency. Intermediary determinants include poor material circumstances, psychosocial stressors, and bio-behavioral responses, with care-seeking delays reflecting legal insecurity. Health system and cross-cutting factors, including the lack of migrant-sensitive facilities, linguistic mismatches, and perceived discrimination, further deter service utilization. Social capital and NGO support provide vital bridges to care, yet the intersection of these determinants creates a vulnerability that perpetuates health inequities and restricts access to essential services. This study clarifies how structural and intermediary determinants interact to shape the barriers Afghan migrant women face in accessing reproductive health services in Iran. These findings can inform targeted, migrant-sensitive policy and programmatic interventions to enhance service equity and lower long-term healthcare costs for both migrant populations and the host country.

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0007406. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

PLOS ONE

Dietary and lifestyle quality and endometrial cancer: Incidence and survivorship outcomes—An umbrella review of systematic reviews and meta-analyses

Ruqaiya Al Ramadhani, Newshaw Arvin, Saphy Moussa, Monika Janda, Mary C. Playdon, Andreas Obermair

Publisher abstract excerptComposite dietary and lifestyle indices capture the combined effects of multiple health-related behaviours and may better reflect real-world cancer risk and survivorship than single exposures. This umbrella review aimed to evaluate and grade the strength of evidence for associations between adherenc…

Abstract & author credits for Dietary and lifestyle quality and endometrial cancer: Incidence and survivorship outcomes—An umbrella review of systematic reviews and meta-analyses

Authors: Ruqaiya Al Ramadhani, Newshaw Arvin, Saphy Moussa, Monika Janda, Mary C. Playdon, Andreas Obermair

Composite dietary and lifestyle indices capture the combined effects of multiple health-related behaviours and may better reflect real-world cancer risk and survivorship than single exposures. This umbrella review aimed to evaluate and grade the strength of evidence for associations between adherence to composite dietary and lifestyle quality indices and endometrial cancer (EC) outcomes, including risk, EC-specific survival, overall survival, disease recurrence, quality of life, and new-onset cardiometabolic diseases. PubMed, Embase, Scopus, Web of Science, CINAHL, and Cochrane Library databases were systematically searched for relevant systematic reviews. Evidence was graded using prespecified umbrella review criteria. A total of 21 systematic reviews were included. Nine investigated diet quality (7 meta-analyses) and 12 investigated lifestyle exposure or interventions (8 meta-analyses). The outcomes assessed were EC risk (N = 14), all-cause or cancer-specific mortality (N = 5), recurrence (N = 4), overall or cancer-specific survival (N = 3), QoL (N = 5), and cardiometabolic events (N = 1). Following a Mediterranean diet was associated with 29% lower odds of EC (pooled OR = 0.71, 95% CI 0.51–0.98; class IV), whereas Western dietary patterns were associated with 20% higher odds of EC (pooled OR = 1.20, 95% CI 1.03–1.39; class IV). A combined healthy diet and lifestyle approach was associated with a 46% lower hazard of EC incidence (pooled HR = 0.54, 95% CI 0.42–0.71; class III), although heterogeneity was high. No significant associations were observed between lifestyle interventions and global or domain-specific quality of life (QoL) across follow-up durations ranging from 9 weeks to 12 months, irrespective of the validated assessment instruments used. Evidence remains limited regarding the associations between diet and lifestyle factors and EC recurrence, survival, mortality, and cardiometabolic outcomes. Our umbrella review identified suggestive (class III–IV) evidence for associations between healthy dietary patterns, particularly the Mediterranean diet, and combined healthy lifestyle approaches with lower EC incidence. Evidence remains insufficient or non‐significant for post-diagnosis outcomes, underscoring the need for further high-quality research.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360238. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

PLOS Global Public Health

Feasibility and immediate effects of a multimodal, dance-integrated educational video package on eye health knowledge and intentions in Nigeria: A pre-post pilot study

Ngozi Precious Uwagboe, Adaku Israel Obia, Onyinye Lilian Nwaolai, Pemije Gadimoh, Eghosa Osahon Alari, Carolyne Naana Yanney et al.

Publisher abstract excerptDance, as a culturally embedded and universally accessible form of art, offers a promising medium for health education in settings with diverse literacy levels. This pilot study evaluated the feasibility and immediate effects of a multimodal, dance-integrated educational video package designed to im…

Abstract & author credits for Feasibility and immediate effects of a multimodal, dance-integrated educational video package on eye health knowledge and intentions in Nigeria: A pre-post pilot study

Authors: Ngozi Precious Uwagboe, Adaku Israel Obia, Onyinye Lilian Nwaolai, Pemije Gadimoh, Eghosa Osahon Alari, Carolyne Naana Yanney, Nnamdi John Eseme, Uchechukwu Levi Osuagwu

Dance, as a culturally embedded and universally accessible form of art, offers a promising medium for health education in settings with diverse literacy levels. This pilot study evaluated the feasibility and immediate effects of a multimodal, dance-integrated educational video package designed to improve eye health knowledge, attitudes, and preventive intentions among Nigerian adults. Between April 11 and June 22, 2025, adults recruited through optometry clinics and community outreach programmes viewed culturally tailored educational videos addressing at least one eye condition (myopia, cataract, or glaucoma) and general eye health, including common myths and preventive practices. Pre–post changes were assessed using paired comparisons, with subgroup analyses by educational attainment. Among 438 participants, 77.7% were aged 18–44 years, 52.5% were female, 75.1% had higher education, 80.0% reported existing health-promoting behaviours, and 79.7% considered regular eye examinations important. Following the intervention, perceived eye health knowledge increased from 42.0% to 68.0% (absolute increase, 26.0 percentage points; relative increase, 61.9%; p = 0.013; Cramér’s V = 0.279), while objective eye health knowledge scores increased by 52.4 percentage points (p = 0.013; Cramér’s V = 0.069). Self-reported intentions to adopt protective practices, including wearing sunglasses, reducing screen time, and attending regular eye examinations, also increased. Overall intention to visit an eye clinic increased by 10%, although this change was not statistically significant (p = 0.443), likely reflecting high baseline health-seeking intentions. The largest improvements in willingness to attend regular check-ups occurred among participants with secondary education (27.5% to 96.3%, p < 0.001) and those with primary or no formal education (41.4% to 96.6%, p < 0.001). Dance-integrated educational videos were associated with immediate improvements in eye health knowledge and preventive intentions, particularly among participants with lower educational attainment, supporting their potential as a culturally relevant and scalable approach to eye health communication in diverse, resource-limited settings and community-based health promotion programmes.

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0005585. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

PLOS ONE

The dual burden of disease: Depression among patients with multidrug resistance tuberculosis in low-income and lower- middle-income countries: A systematic review and meta-analysis

Agmas Wasie Abate, Assasahegn Tedla, Gashaw Mehiret Wubet, Getasew Legas, Amsalu Belete, Kirubel Shiferaw et al.

Publisher abstract excerptIntroduction Multidrug-Resistant Tuberculosis (MDR-TB) continues to pose a serious global health challenge, particularly in low-income and lower-middle-income countries where the disease burden, fragile health systems, and socioeconomic hardships are most pronounced. These conditions not only compli…

Abstract & author credits for The dual burden of disease: Depression among patients with multidrug resistance tuberculosis in low-income and lower- middle-income countries: A systematic review and meta-analysis

Authors: Agmas Wasie Abate, Assasahegn Tedla, Gashaw Mehiret Wubet, Getasew Legas, Amsalu Belete, Kirubel Shiferaw, Getnet Mihretie Beyene, Assefa Agegnehu Teshome, Wondimnew Desalegn Addis, Melaku Mekonnen Agidew, Samuel Berihun Dagnew, Belete Asnake Sitotaw, Birhanu Mengist Munie

Introduction Multidrug-Resistant Tuberculosis (MDR-TB) continues to pose a serious global health challenge, particularly in low-income and lower-middle-income countries where the disease burden, fragile health systems, and socioeconomic hardships are most pronounced. These conditions not only complicate treatment but also worsen patients’ vulnerability to depression. Although numerous primary studies have investigated the prevalence of depression among individuals with MDR-TB, their findings have been inconsistent. To address this gap, the present study seeks to estimate the pooled prevalence of depression and identify its associated factors among MDR-TB patients in low- and lower-middle-income countries. Methods Relevant studies were sourced from Google Scholar, Scopus, PubMed, and Web of Science. Additionally, the reference lists of selected articles were manually reviewed to identify further eligible publications. A random-effects model was employed to calculate the pooled prevalence of depression among MDR-TB patients in low- and lower-middle-income countries. Results The meta-analysis incorporated 23 primary studies with a combined sample of 5,734 MDR-TB patients. The pooled prevalence of depression among this population was 41.89% (95% CI: 32.63–51.15; I² = 98.51%, P < 0.001). Several factors were significantly linked to depression, including female gender (AOR = 2.00, 95% CI: 1.66–2.41), financial hardship (AOR = 2.56, 95% CI: 1.44–4.55), presence of comorbidities (AOR = 3.72, 95% CI: 2.11–5.38), greater disease severity (AOR = 2.13, 95% CI: 1.42–3.12), medication-related side effects (AOR = 2.77, 95% CI: 2.20–3.48), and perceived stigma (AOR = 3.58, 95% CI: 2.13–6.02). Conclusions The prevalence of depression among MDR-TB patients in low- and lower-middle-income countries was found to be notably high. These findings emphasize the importance of implementing routine depression screening and integrating psychosocial support into patient care.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360738. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

PLOS ONE

Investigation of salivary microRNAs as non-invasive biomarkers for weaning stress in piglets: A preliminary study

Ga-Hyeon Jeong, Sung-Jea Park, Kyu-Sang Lim

Publisher abstract excerptWeaning exposes piglets to abrupt nutritional and environmental changes that induce physiological stress. Saliva, unlike serum or tissue samples, enables repeated and stress-free sampling, making it a practical biological matrix for monitoring early-life adaptation. To evaluate whether salivary micr…

Abstract & author credits for Investigation of salivary microRNAs as non-invasive biomarkers for weaning stress in piglets: A preliminary study

Authors: Ga-Hyeon Jeong, Sung-Jea Park, Kyu-Sang Lim

Weaning exposes piglets to abrupt nutritional and environmental changes that induce physiological stress. Saliva, unlike serum or tissue samples, enables repeated and stress-free sampling, making it a practical biological matrix for monitoring early-life adaptation. To evaluate whether salivary microRNAs (miRNAs) can serve as non-invasive indicators of these responses, we profiled miRNA expression in saliva collected from suckling and weaning piglets. Small RNA sequencing was conducted to detect salivary miRNAs and a total of 41 differentially expressed miRNAs (DEMs) were detected between the two groups, with 20 showing highly expression and 21 showing lowly expression in weaning piglets. Several of these DEMs have been previously associated with immune activity, inflammatory regulation, oxidative stress responses, and disease processes, highlighting their biological relevance during the weaning transition. Functional annotation of predicted target genes revealed enrichment in pathways such as TGF-beta, HIF-1, and AMPK signaling, as well as autophagy-related processes. These pathways are known to play key roles in stress adaptation, cellular metabolism, and immune modulation. These findings suggest that salivary miRNA profiles may reflect molecular changes associated with the weaning transition and may serve as candidate non-invasive indicators of physiological stress and health status in piglets. This approach may provide a basis for future development of saliva-based monitoring strategies after validation in larger cohorts and cost-effective targeted assays.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360727. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

PLOS ONE

Promoting good and equal health by advancing vulnerable students’ employment and income opportunities: Protocol for a multiple method research program leveraging student and school staff perspectives

Tina M. Olsson, Hanna Ginner Hau, Sabina Kapetanovic, Diana Kajic, Therése Skoog

Publisher abstract excerptSchool-level social determinants of health (SDOH) account for a large share of variation in students’ health behaviors. Because educational attainment is itself a key social determinant of health—shaping later employment, income, and health—efforts to promote equitable health must include understand…

Abstract & author credits for Promoting good and equal health by advancing vulnerable students’ employment and income opportunities: Protocol for a multiple method research program leveraging student and school staff perspectives

Authors: Tina M. Olsson, Hanna Ginner Hau, Sabina Kapetanovic, Diana Kajic, Therése Skoog

School-level social determinants of health (SDOH) account for a large share of variation in students’ health behaviors. Because educational attainment is itself a key social determinant of health—shaping later employment, income, and health—efforts to promote equitable health must include understanding and improving school climate as a mechanism influencing academic achievement and wellbeing. This project examines how school-level SDOH develop and how they relate to later employment, income, and health outcomes in a representative sample of Swedish young people. It also investigates how school staff and students perceive the school’s ability to address school-level SDOH and develops and pilots an intervention aimed at strengthening these determinants. This multi-method, multi-informant study uses a large longitudinal dataset following a representative cohort from ages 12–20. Additional primary data will be collected from school staff and students to assess perceptions of school-level SDOH. The project will also design and test an intervention intended to improve students’ academic achievement, a central pathway influencing later employment, income, and health. Combining longitudinal data with new qualitative and quantitative materials allows the project to examine the development of school-level SDOH and the mechanisms through which they shape long-term outcomes. Education is essential for strengthening skills, economic opportunities, and health equity. Strong links exist between education level, employment, income, and health, making this project relevant for students, families, school personnel, and broader policy development. Findings may guide schools and policymakers in improving school environments to support achievement and long-term health equity. The project involves extensive data collection and collaboration across disciplines and universities. By integrating multiple methods, it aims to advance knowledge on how education influences employment, income, and health while informing school-level and policy-level strategies to support academic achievement and wellbeing.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360645. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

PLOS ONE

Personalized assessment of high-definition slow-oscillatory transcranial direct current stimulation (so-tDCS) in older adults with sleep and subjective cognitive complaints: A study protocol for a randomized clinical trial

Hanna Lu, Xi Ni, Natalie Shu Yang, Yuk Shan Yuen, Yuqi Gong, Suk Ling Ma

Publisher abstract excerptBackground Subjective cognitive decline (SCD) is increasingly recognized as an early and potentially modifiable stage in the trajectory of neurodegenerative diseases. In older adults with SCD, untreated sleep disturbances may accelerate the neurodegenerative process, potentially via mechanisms invol…

Abstract & author credits for Personalized assessment of high-definition slow-oscillatory transcranial direct current stimulation (so-tDCS) in older adults with sleep and subjective cognitive complaints: A study protocol for a randomized clinical trial

Authors: Hanna Lu, Xi Ni, Natalie Shu Yang, Yuk Shan Yuen, Yuqi Gong, Suk Ling Ma

Background Subjective cognitive decline (SCD) is increasingly recognized as an early and potentially modifiable stage in the trajectory of neurodegenerative diseases. In older adults with SCD, untreated sleep disturbances may accelerate the neurodegenerative process, potentially via mechanisms involving amyloid-beta accumulation, and contribute to more rapid cognitive deterioration. Currently, non-pharmacological treatment options that concurrently manage SCD and sleep disturbances remain scarce. High-definition slow-oscillatory transcranial direct current stimulation (so-tDCS) is an emerging, frequency-specific neuromodulation technique designed to enhance brain health and cognition. Methods and design This is a randomized, double-blind, sham-controlled clinical trial. Right-handed Chinese older adults with SCD and sleep disturbances will be randomly assigned to receive either high-definition 0.75 Hz so-tDCS or sham stimulation over a 4-week intervention period, with 40 participants per group. Outcome measures, including galvanic skin response, subjective cognitive complaints, sleep quality, salivary amyloid-beta levels, and domain-specific cognitive performance, will be evaluated at four time points: baseline, week 4 (immediately post‑intervention), and follow‑up at weeks 8 and 12. Conclusions Personalized neurophysiological signals, namely electrode-skin impedance, will be monitored using state-of-the-art measurement during so-tDCS. The successful implement of this signal will provide researchers with access to an “add-on” setting that enables them to easily, quickly and quantitatively evaluate real-time neurophysiological signals, thereby facilitating the incorporation of transcranial brain stimulation into clinical practice. Trial registration ClinicalTrials.gov Identifier: NCT07433738

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360573. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

PLOS ONE

Assessing primary health care facilities in six prioritized Nigerian states: Linking facility readiness with service availability

Olufunke Fasawe, Abubakar Abba, Abubakar Yerima Mohammed, Cynthia Kukoyi, Kabiru A. Gulma, Ashiru A. Abubakar et al.

Publisher abstract excerptBackground Nigeria’s poor health indicators have been linked to its dysfunctional Primary Health Care (PHC) facilities. Policy gaps remain in achieving sustainable and equitable provision of PHC for Nigerians. Therefore, this study examined the relationship between health facilities’ readiness and s…

Abstract & author credits for Assessing primary health care facilities in six prioritized Nigerian states: Linking facility readiness with service availability

Authors: Olufunke Fasawe, Abubakar Abba, Abubakar Yerima Mohammed, Cynthia Kukoyi, Kabiru A. Gulma, Ashiru A. Abubakar, Abdulrahman Shuaibu, Bello Jamoh, Mohammed Nasir Mahmoud, Yahaya Shamsudeen, Ibrahim A. Mustafa, Ibrahim A. Dangana, Abubakar Yakubu, Ahmed Sani, Babawale Peter, Oyewole Oladapo, Nazeef Mohammed, Nasir Umar, Lawrence N. Anyanwu, Adebowale S. Ayo

Background Nigeria’s poor health indicators have been linked to its dysfunctional Primary Health Care (PHC) facilities. Policy gaps remain in achieving sustainable and equitable provision of PHC for Nigerians. Therefore, this study examined the relationship between health facilities’ readiness and service provision in Nigeria. Methods This was a cross-sectional assessment of 204 PHC facilities enrolled under the Basic Health Care Provision Fund program, in six prioritized states in Nigeria. The facilities were assessed for the provision of ≥80% of the three levels of primary healthcare services—Tier 1, Tier 2, Tier 3—as the outcome variables. The three tiers represent the minimum, intermediate, and comprehensive levels of essential PHC services, respectively, defined under Nigeria’s Minimum Service Package. Health Facility (HF) readiness (explanatory variable) was assessed across six domains, with five of the domains disaggregated into 3 levels (poor, fair, and good). Data were analysed using Principal Component Analysis (PCA) and multivariable logistic regression model (alpha = 0.05). Results The majority (81.9%) of the HFs have a functional management committee, 54.4% have an updated BHCPF annual quality improvement plan, 81.9% have standard operating procedures. While 16.2% met the World Health Organization standard ≥2.3 Health Care Workers (HCWs)/1000 population, none met the Minimum Service Package standard for HCWs across all cadres. The proportion of facilities with good readiness in each domain was: management and finance (42.6%); Health Management Information System tools/registers, supply chain tools/registers, and guidelines (40.2%); infrastructure and utility (33.3%); tracer equipment (34.8%); and tracer drugs (29.9%). The percentage of HF that provided ≥80% services was: Tier 1 (65.2%), Tier 2 (46.6%), and Tier 3 (35.8%); while 31.9% met ≥ 80% across all the service Tiers. Common predictors of providing ≥80% across the service Tiers were tracer drugs and equipment availability. The likelihood of delivering all Tiers of services was higher in HF with fair (aOR=2.38, 95% CI = 1.92-11.14, p < 0.05) and good (aOR=3.93, 95% CI = 1.96-8.49) levels of tracer equipment readiness compared to the poor. Conclusion Good PHC facility readiness supports the provision of health care services in Nigeria. Availability of tracer drugs and equipment predicts the provision of healthcare services in PHC facilities. Investment in PHC facility functionality and prioritization of funds for tracer drugs and equipment will therefore improve service availability and delivery in Nigerian public PHC facilities.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360425. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

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