COVID-19 vaccine hesitancy and acceptance: a comprehensive scoping review of global literature.

As countries continue the third year of the pandemic, we believe that there has been unfair attention to COVID-19 vaccine efficacy and safety, while tacitly ignoring serious challenges with vaccine uptake, without which vaccination may not be effective against the spread of COVID-19. While several studies have been published on COVID-19 vaccine hesitancy, there remains a need to conduct a comprehensive global analysis of vaccine hesitancy. We conducted a scoping review of 60 studies published globally on vaccine hesitancy and acceptance. We conducted a qualitative analysis to identify motivators and barriers to vaccination across several cultural and demographic contexts. We found the following factors to be relevant in any discussion about addressing or minimizing vaccine hesitancy: risk perceptions, trust in health care systems, solidarity, previous experiences with vaccines, misinformation, concerns about vaccine side effects and political ideology. We combine our insights from this comprehensive review of global literature to offer an important and practical discussion about two strategies that have been used to improve vaccine uptake: (i) communication and education and (ii) vaccine rollout and logistics.

The new criteria for a COVID19 patient for the clinical practice to determine the need for an early therapeutic regimen and to decrease mortality.

A new predictive criterion is being proposed for the determination of cytokine storm (CS) in COVID-19 (COVID-CS). It is comprised of results of laboratory that associate the pro-inflammatory status, systemic cell death, multi-organ tissue damage, and pre-renal electrolyte imbalance. The data identifies the patients' stay in hospitals and their mortality with the relevance of hyper-inflammation and tissue damage during the CS. The criteria can be readily used in clinical practice to determine the need for an early therapeutic regimen, block the hyper-immune response and possibly decrease mortality. It helps to understand the nature of the virus by following a specific criterion to predict the disease. The SARS-CoV-2 tells us in few days what nature has decided for the patient i.e., recovery, death or permanent disability.

Challenges in the sociocultural milieu of South Asia: a systematic review of community health workers.

INTRODUCTION: Community health workers (CHWs) connect patients in rural and remote communities to health service organizations. This diverse group of healthcare workers has helped improve healthcare access and outcomes and enhance the quality of life for people in hard-to-reach communities. However, CHWs face numerous challenges rooted in the sociocultural milieu of the region and country in which they reside. METHODS: This systematic review and qualitative meta-synthesis of 38 studies examines the sociocultural challenges that CHWs experience; it focuses on the unique history, geography, and sociocultural milieu of South Asia. RESULTS: This study found the following challenges that CHWs regularly face when working in communities: religious and cultural norms and practices, gender and biological sex, caste, and generation. All challenges in some way relate to one another and stem from the unique sociocultural milieu of South Asia, and the various subcultures that exist in this diverse region. CONCLUSION: This article presents important guidance for program planning and CHW deployment that reflects the sociocultural realities of practice. The findings of this investigation may serve as an essential resource for program planners and decision-makers in improving the effectiveness and reach of CHW programs.

The design and delivery of maternal health interventions in Pakistan: a scoping review.

Hundreds of women die daily due to preventable causes related to pregnancy and childbirth. Multiple programs have been developed to support efforts to reduce maternal mortality. However, no synthesis has been conducted to date that reviews the design, delivery, and impact of these initiatives in Pakistan. After conducting a systematic literature search, we found 23 articles describing interventions. We analyzed these articles for intervention characteristics. In this scoping review the authors identify the characteristics of interventions to improve maternal health services in Pakistan and priorities for future programs and research. Recommendations include multi-level interventions, stakeholder engagement, and rigorous evaluations of existing interventions.