搜索结果：The Journal of nursing education

The development and integration of geriatric medicine into national health care systems vary widely across countries. While a robust care workforce requires providers from several disciplines, including nursing, social sector, rehabilitation, psychiatry, neurology, and others, a strong core of highly qualified geriatricians is essential to delivering older person-centred and integrated care. The number and professional profile of geriatricians, along with the status of the specialty, are important to informing efforts to reshape health care systems in response to the global ageing scenario. WHO developed and distributed a structured questionnaire to representatives of national geriatrics and gerontology societies beginning in March 2025. The survey collected data on the status of the geriatric medicine specialty, including its formal recognition at the country level, the estimated number of practising geriatricians, and information on training curricula, professional environments, and systemic challenges. A total of 48 national societies completed the survey. Recognition of geriatric medicine ranged widely, from full specialty status in some countries to subspecialty or non-recognition in others. The number of practicing geriatricians per 100,000 persons aged 60 years and older ranged from <0.1 to >30 across countries, illustrating marked workforce disparities and some severe shortages. Where the geriatric medicine specialty is formally available, pre-service training durations ranged from 24 to 96 months. Geriatricians worked in diverse settings, though integration into primary care and public health was limited. Training in and exposure to geriatric medicine principles during undergraduate and postgraduate medical training were minimal in many countries. Key challenges included workforce shortages, fragmentation of care, and undervaluation of the speciality's role in informing health care for older people. Strategic priorities reported by respondents included investment in training, policy development, and institutional support. The survey highlights disparities in geriatric medicine across countries and identifies several challenges and priorities. Strengthening education, policy, and workforce development is essential to meet the needs of ageing populations and support healthy ageing worldwide. At the same time, countries should also think of innovative approaches and building capacity of existing other health occupations to improve geriatric care. Future updates of this survey will provide longitudinal insights into workforce evolution. These findings provide a global evidence base to guide workforce planning and policy under the United Nations Decade of Healthy Ageing (2021-2030).

Access to safe, high quality, acceptable and sustainable general practice (GP) and primary care services is essential to improved health outcomes and quality of life for people living in residential aged care homes (RACH). There are, however, critically low levels of service availability and a decline in GPs providing RACH services globally, suggesting there is an urgent need for safe and effective models of care. Telehealth, delivered as part of a holistic model of care, offers a solution to address this gap but comprehensive, person-centred research is needed to directly assess its effect on safety and quality of care in RACH settings. This collaborative 4-year project (General practice and Residential Aged CarE: GRACE video-telehealth) will (1) scope current telehealth models of care and their acceptability and person-centredness, including identifying the barriers and enablers experienced by RACH residents, carers, staff, GPs and practice managers; (2) co-design a best-practice model of care with an accompanying suite of digital resources and education materials to improve the uptake of video-telehealth; and (3) implement and evaluate this best-practice model of care. This is a mixed-methods study of residents, carers, RACH staff, GPs and their practice teams that will be conducted across New South Wales, Australia. This protocol describes a staged approach across three phases. In Phase 1, we will collect baseline measures of the frequency of telehealth use in GP practices and RACHs, clinical outcomes (eg, hospitalisations), questionnaires to measure person-centred care, satisfaction and usability of telehealth and qualitative observations and semi-structured interviews. In Phase 2, we will conduct workshops to co-design an intervention that will include developing a model of care to support person-centred video-telehealth, with an accompanying online hub of resources and educational materials to facilitate and support its utilisation. In Phase 3, we will implement and evaluate the intervention. Data will be analysed statistically and thematically and synthesised. Ethics approval has been obtained from the University of Sydney Human Research Ethics Committee (2025/000340) (human.ethics@sydney.edu.au). Prior informed written consent will be obtained from all research participants. Findings from each phase of the study will be submitted for peer-reviewed publication. Project outputs will be disseminated for implementation more widely across New South Wales and Australia.

Comprehensive pain management in children requires a specialized skillset, with a limited number of clinicians possessing the level of expertise required to successfully navigate the complexities of holistic care. The emergence of pediatric anesthesia fellowship programs in sub-Saharan Africa presents an opportunity to embed a pediatric pain curriculum for trainees, improving the availability of specialist skill and knowledge in the field. Existing pain curricula fall short in addressing the sociocultural aspects of pediatric pain identified through research as being unique to the African context, and do not include elements of leadership and advocacy training required to navigate the complexities of resource-constrained healthcare settings. A Delphi survey including literature review, iterative rounds of surveys and expert consensus was used to establish a pediatric pain curriculum for pediatric anesthesia fellows undertaking advanced training in sub-Saharan Africa. The 22-member expert panel included anesthetists, nurses, surgeons, pharmacists, pediatricians, a physiotherapist and a patient-caregiver dyad with a lived experience of pain. After completing three rounds of surveys, a steering committee of five members was assembled to resolve outstanding items to achieve the final curriculum. The process yielded a curriculum containing 20 knowledge items and 23 skills items. Attitudes are a key component of the curriculum and were grouped into six themes. A further aspect of the process was the identification of foundational knowledge with which trainees should enter a fellowship training program. This was termed the foundational curriculum. Using a Delphi method, consensus has been achieved on a pediatric pain curriculum for pediatric anesthesia fellows in sub-Saharan Africa with potential to meet the identified need for transformative pain care in this patient population.

Effective coverage (EC) has emerged as a better measure of service coverage, in the past decades, compared to the simple crude coverage measures. It represents the proportion of a population in need of a service that successfully receives it with sufficient quality to achieve the intended health benefits. Nevertheless, EC in maternal and newborn health (MNH) services are significantly variable across and within countries. Therefore, this study aimed to identify the societal and health system factors that can explain why some countries are having higher EC of MNH services than others in Sub-Saharan Africa (SSA). A mixed-method case study design was employed with inclusion of document review. Effective coverage rates were estimated using countries demographic and health survey (DHS) datasets. Two countries were then selected for each MNH service domain from each performance category, high, medium, and low, for further analysis of explanatory factors. Data sources included DHS and health facility survey summary reports, the Global Health Expenditure Database, and TheGlobalEconomy.com. We found huge variation in EC of MNH services across countries in SSA. The scores range from 7% in Ethiopia to 64% in Liberia for 4+ ANC visits, 9% in Ethiopia and Nigeria to 81% in Rwanda for institutional delivery, 3% in Ethiopia to 77% in Gambia for PNC mothers, and 1% in Ethiopia to 68% in South Africa for PNC newborns. These discrepancies are highly likely influenced by multilevel health system and societal factors. High-performing countries in EC of MNH services have higher service availability and readiness scores than medium- and low-performing ones. For instance, Ghana and Liberia scored 83% and 84%, respectively, for tracer indicators of ANC service availability, compared to 43% in Ethiopia and 64% in Malawi. Similar pattern is observed between the selected countries EC estimates of MNH services and their health service specific readiness index scores. In addition, they also have favourable societal factors including high proportion of women attending primary and/or more school levels, better mass media and internet access, and relatively lower political instability indexes. Low-performing countries like Ethiopia and Nigeria had complex futures including having low health service availability and readiness scores and unfavourable societal factors including in women's education, and internet and mass media access. Furthermore, the two countries had weakest average political stability index that hinders the utilization and delivery of MNH services. The findings revealed that better health service availability and readiness, strong healthcare financing, favourable societal factors and having a relatively stable political index are critical in determining countries performance in EC of MNH services. Therefore, countries, particularly low performers in EC of MNH services need to learn from positive outliers in improving EC of MNH services. Strengthening existing health facilities with better staffing, training, and resources is crucial beyond merely expanding new ones.

Polypharmacy is a growing health care concern that is ameliorated through deprescribing, the process of safely removing inappropriate medications. Despite the proven benefits of deprescribing, formal deprescribing education in the health professions in the United States, including interprofessional deprescribing activities, is limited. A deprescribing interprofessional educational (IPE) simulation activity was conducted with 52 third- and fourth-year health professions students to improve their understanding of deprescribing and communication among the interprofessional health care team. The virtual simulation featured prebriefing, an unfolding case study, and debriefing. In total, 21 MD students, 20 PharmD (Doctor of Pharmacy) students, and 11 DNP (Doctor of Nursing Practice) and FNP (Family Nurse Practitioner) students participated in the IPE simulation activity. A retrospective pre/post survey was administered, with 49 students (94%) responding. Participants provided positive feedback about the simulation, indicating that they rated the activity highly, valued the unfolding case study used, and were able to consolidate their learning on deprescribing. IPE activities are a promising avenue for deprescribing education.

High-risk fertility behavior is a leading contributor to adverse maternal and child health outcomes. This study assessed the prevalence and determinants of high-risk fertility behavior among reproductive-age women in sub-Saharan Africa. We conducted a secondary analysis of Demographic and Health Survey data from eight sub-Saharan African countries with extremely high or very high maternal mortality. A weighted sample of 78,353 reproductive-age women who had given birth in the five years preceding the survey was included. A multilevel mixed-effects binary logistic regression model was used to identify individual- and community-level factors associated with high-risk fertility behavior, accounting for the hierarchical nature of the data. Statistical significance was determined using AOR with a 95% CI and a P-value &#x2264;0.05. The overall prevalence of high-risk fertility behavior was 71.46% (95% CI: 71.14%, 71.77%), with the highest prevalence observed in Chad (87.75%) and the lowest in Lesotho (40.49%). Key individual-level determinants included women's and husbands' education, religion, wealth status, child sex, marital status, mobile phone and Internet use, antenatal care attendance, history of pregnancy termination, and contraceptive use. At the community level, low poverty was associated with a reduced likelihood of high-risk fertility behavior. The prevalence of high-risk fertility behavior remains high in countries with extremely high and very high maternal mortality rates, highlighting a need to address it through urgent and concerted interventions. Policymakers and planners should prioritize interventions targeting the key determinants of high-risk fertility behavior to curb its occurrence and improve maternal and child health outcomes. High-risk fertility behavior (HRFB) is defined as having children at very young or older ages, having many births, or spacing pregnancies too closely, which can lead to serious health problems for mothers and children. This study aimed to determine the magnitude of high-risk fertility behaviors and the factors that affect the behavior among women in eight sub-Saharan African countries with very high maternal mortalities. Using data from over 78,000 women, we analyzed both individual- and community-level characteristics linked to HRFB. This study found that about 71% of women had HRFB. The highest rates were in Chad, and the lowest were in Lesotho. Factors such as low education, poverty, limited use of antenatal care, lack of contraception, and reduced access to mobile phones or the Internet increased the likelihood of HRFB. Communities with lower poverty showed lower rates. These findings underscore the need for targeted policies and programs to reduce HRFB and improve maternal and child health.

Group antenatal care (G-ANC), integrating medical care with education, has demonstrated positive effects on maternal and newborn health. Individual studies have shown promising evidence in sub-Saharan Africa, but systematically synthesising the existing research would facilitate implementation and identify gaps for further research. This systematic review aimed, therefore, to review the existing evidence on feasibility, acceptability and effectiveness of G-ANC in resource-limited settings to guide policy and support implementing G-ANC to reduce maternal and perinatal mortality. A systematic and comprehensive literature search was conducted in the PubMed/MEDLINE, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (Embase) and Google Scholar electronic databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews and meta-analyses of healthcare interventions were followed. Data were extracted using a prespecified protocol and quality was assessed using the Joanna Briggs Institute appraisal tool. Random-effects meta-analyses were used to pool estimates. The review is registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42024565501). Of the 576 articles identified, 34 articles with 42&#x2009;234 participants were included. G-ANC increased the likelihood of attending four or more ANC visits (pooled risk ratio (RR)=1.45; 95%&#x2009;CI 1.22 to 2.82), was associated with the likelihood of attending postnatal care visits (RR=1.23; 95%&#x2009;CI 1.03 to 1.47), increased uptake of postpartum family planning methods (RR=1.85; 95%&#x2009;CI 1.26 to 2.73) and was associated with improved birth weight (RR=1.53; 95%&#x2009;CI 1.09 to 2.14). It was also associated with improved quality of care, health literacy, psychosocial gains, empowerment and facilitating culturally sensitive discussions. There was, however, no significant difference found between groups regarding likelihood of giving birth at health facilities compared with the traditional ANC. Also, no cost-effectiveness studies of G-ANC were identified in sub-Saharan Africa, highlighting a key evidence gap for guiding future implementation and scale-up. Exposure to G-ANC enhances utilisation of maternal healthcare such as ANC attendance, postnatal care, family planning uptake and improves birth weight. It also improves maternal engagement, health literacy and empowerment through a highly participatory learning approach and peer support. Nevertheless, no notable difference was observed between the groups in terms of likelihood of giving birth in health facilities. CRD42024565501.

Nursing organizations have called for competencies that entry-level nurses must demonstrate for transition to practice, including demonstrating clinical judgment and use of informatics tools like the electronic health record (EHR). More information is needed to understand how the EHR supports clinical judgment in nursing students. This study employed a qualitative descriptive design. Semistructured interviews were conducted among prelicensure nursing students (N = 18) about EHR use. Content analysis was used to code statements in alignment with the domains of Tanner's clinical judgment model and the dimensions of the Lasater clinical judgment rubric. Students utilized the EHR to engage in clinical judgments associated with safe medication administration. Students described utilizing the EHR to inform all domains of clinical judgment, yet they engaged in the reflection domain least. There were barriers to student EHR use. The EHR is an important contributor to nursing clinical judgment and should be thoroughly integrated within prelicensure curriculum.

Undergraduate nursing students are expected to demonstrate primary palliative care competencies upon graduation. The growing aging population and rising prevalence of complex chronic illnesses highlight an urgent need to prepare nurses who can deliver high-quality palliative care. Despite the 2021 AACN Essentials outlining revised primary palliative care competencies, new graduates continue to report insufficient preparation in these competencies. A quasi-nonexperimental design with a purposeful sample of prelicensure nursing students was utilized. An interprofessional multimodal teaching approach was implemented to deliver the course content. UNPCKS-2.0 scores increased from preintervention (M = 17.60 [SD = 4.52]) to postintervention (M = 18.60 [SD = 1.34]). CARES PC 2.0 results showed improved interprofessional communication, with "strongly agree" responses increasing from 27% preintervention to 71% postintervention. Survey data and student reflections demonstrated improved understanding of goals of care and quality-of-life support. Findings support integrating palliative care competencies throughout undergraduate nursing curricula.

This study examined the effect of intramuscular (IM) injection training delivered using the Pecha Kucha (PK) method on nursing students' knowledge, skill, and satisfaction levels. A single-blind, randomized controlled trial was conducted with 76 first-year nursing students. The intervention group received training through the PK method, while the control group was trained using a traditional PowerPoint presentation. Data were collected using a descriptive information form, the Knowledge Test for Intramuscular Injection in the Ventrogluteal Region, the Skill Test for Intramuscular Injection in the Ventrogluteal Region, and the Visual Analog Satisfaction Scale. Although the PK group had higher scores, there were no statistically significant differences between the PK and traditional PowerPoint groups in terms of mean IM knowledge, skill, and satisfaction scores (p > .05). The PK approach should be implemented in diverse samples and various nursing skill training sessions to broaden applicability.

Snakebite envenomation remains a critical health challenge across the culturally and ecologically diverse sub-Saharan Africa (SSA). This study examined healthcare providers' (HCPs') knowledge, attitudes, and practices (KAP), and their determinants towards snakebite envenomation. A cross-sectional study was conducted across nine SSA countries using the validated Knowledge, Attitudes, and Practices of Snake Envenomation - Healthcare Providers Questionnaire (KAPSE-HCPQ). The fractional logistic regression was conducted to identify the factors associated with KAP. A total of 3,544 HCPs were enrolled through professional and digital networks. General practitioners represented approximately half of the participants (50.1%), whereas toxicologists were 3.2%. Considerable variations were reported across sub-Saharan countries. Uganda and Sierra Leone attained perfect median knowledge scores (100%, range: 93-100, 73-100, respectively) yet both demonstrated marked deficiencies in practice (range: 0-25% and 0-75%, respectively). Attitude scores ranged from the lowest in Ethiopia (79%, range: 75-85%) to the highest in Uganda (91%, range: 87-95%). Higher knowledge was significantly associated with advanced training, antivenom availability, curricular inclusion of toxicology, and self-study. Positive attitudes were significantly associated with prior clinical exposure, faculty-based education, informal information sources, and participants' countries. HCPs demonstrated incorrect practices, such as applying a tourniquet above the bite site, attempting to suck out the venom, incising the bite wound, and asking to run to the nearest health facility, which may accelerate the systemic venom spread. In contrast, pharmacists and HCPs unaware of management guidelines demonstrated poorer practices. The study identifies a substantial gap between theoretical knowledge and clinical practice among HCPs across SSA, with variations by country, profession, training, and resource availability. Urgent interventions training, protocol standardization, and reliable antivenom supply are required to improve snakebite outcomes. Although healthcare providers across sub-Saharan Africa generally have good knowledge and favorable attitudes towards snakebite management, their actual practices remain persistently inadequate, irrespective of their country&#x2019;s income level.Systemic barriers - limited formal training, absent institutional protocols, unreliable antivenom supply, and weak referral systems- are highly associated with inadequate clinical practice.Urgent standardization of training protocols and reliable antivenom supply are needed to improve snakebite outcomes across the SSA region.

Although critical thinking remains foundational to clinical judgment, it is often treated as a capability students have rather than a cognitive process to be intentionally developed. As competency frameworks and assessment models emphasize observable performance, the thinking processes that support learning and judgment development may receive less attention in nursing curricula. The purpose of this article is to revisit and clarify the role of critical thinking in the development of clinical judgment within nursing education. The distinctions among critical thinking, clinical reasoning, clinical decision-making, and clinical judgment are reviewed within the framework of educational strategies that may position critical thinking as implicit, despite its pivotal role in clinical judgment. Literature suggests that critical thinking underlies clinical reasoning and clinical judgment, but may receive inadequate attention when educational frameworks prioritize observable performance outcomes and competency demonstration. Clinical judgment cannot be developed or assessed without deliberate attention to the thinking processes that support it. Strengthening critical thinking requires intentional strategies that make thinking visible and integral to the application of learning in practice.

Human trafficking (HT) is a global, national, and local public health concern, yet victims often go unidentified due to limited provider education and a lack of screening protocols. This quality improvement project implemented an asynchronous online HT education module for senior nursing students to enhance knowledge and confidence in identifying victims through recognition of red flags and use of screening questions. The module addressed HT indicators, screening tools, screening questions, and available resources. Pre- and posttests using the PROTECT instrument assessed perceived knowledge, actual knowledge, and confidence. Postintervention scores showed statistically significant improvement (p < .001) in knowledge and confidence. Only 10.67% of participants had prior HT training, and 52% preferred online, asynchronous learning. HT education significantly improved nursing students' knowledge and confidence, supporting the integration of HT training into undergraduate nursing curricula.

Nursing students often have limited opportunities to engage with pediatric populations affected by socioeconomic disadvantage in outpatient or community settings. Partnerships with community-based programs can address this gap while fostering essential professional competencies. This qualitative descriptive study explored senior nursing students' perceptions of a clinical experience involving an after-school academic enrichment program (SHINE) serving youth from economically under-served communities. Postexperience questionnaires were completed by 21 baccalaureate nursing students following participation in the SHINE program. Data were analyzed thematically. Four primary themes emerged: (1) communication skills; (2) cultural competence; (3) advocacy; and (4) leadership and teamwork. Students described enhanced confidence when interacting with children from diverse backgrounds, increased awareness of social determinants of health, and recognition of the nurse's role in advocacy and collaboration. Embedding nursing students in community-based programs provides meaningful learning experiences that strengthen communication, cultural awareness, and leadership skills. These findings support continued integration of population-based clinical experiences in undergraduate nursing curricula.

Malnutrition remains a major public health challenge in low- and middle-income countries and disproportionately affecting children under five. Eggs, given their high nutrient density and relative physical or economic accessibility, have been tested for their effect on improving nutritional outcomes in children under five. However, findings from scientific exercises to test the impact of egg-based trials on child growth have not been systhematically pooled and synthesised. Therefore, this meta-analysis aimed to synthesise evidence on the impact of egg-based interventions on the nutritional status of children underfive as determined by weight-for-height Z-score (WHZ), weight-for-age z-score (WAZ), and height-for-age z-score (HAZ). Research articles of randomised controlled trials published between 2013 and 2023 were identified through a comprehensive search of PubMed/MEDLINE, Web of Science, CINAHL, Embase, Science Direct, Google Scholar, and African Index Medicus data bases. Articles evaluated the effect of egg-based interventions against alternative diets, behaviour-change education, or no alternative intervention were included. Primary outcomes are WHZ, WAZ, and HAZ. Random-effects models were used to pool effect sizes (mean difference), and subgroup analyses and meta-regression explored sources of heterogeneity. Publication bias was assessed using funnel plots and Egger's test. Seven studies involving 3673 children met the inclusion criteria. Egg-based intervention significantly improved WAZ (MD: 0.33; 95% CI: 0.11-0.55) and WHZ (MD: 0.30; 95% CI: 0.12-0.48). However, no significant effect was observed on HAZ (MD: 0.05; 95% CI: -0.05-0.14). It is figuredout that egg-based interventions can improve weight-related nutritional outcomes (WHZ and HAZ) among children underfive in sub-Saharan Africa,&#xa0;but not linear growth (HAZ).

Sub-Saharan Africa (SSA) continues to be the hub of the global HIV/AIDS pandemic, globally. Despite several attempts to meet their HIV prevention needs, men continue to have high rates of HIV infection. Pre-exposure prophylaxis (PrEP) is an effective treatment that, when taken as prescribed, can be very efficient in preventing and reducing the risk of HIV acquisition. HIV self-testing (HIVST) has been demonstrated to be acceptable among men in SSA. As such, this review aims to explore the existing literature on the integration of PrEP dispensing with HIVST among men in SSA. We will systematically search bibliometric databases, including PubMed/MEDLINE, Embase, Scopus, the Cumulative Index to Nursing and Allied Health Literature Plus, Sociological Abstracts, ProQuest Dissertations and Theses global. Our review will be guided by the Arskey and O'Malley framework and Levac et al. The review results will be reported using the preferred reporting items for systematic reviews and meta-analysis: extension for scoping reviews guidelines. To assess the methodological quality of the included articles, the mixed methods appraisal tool version 2018 will be used. We will use NVivo software (V.11) to synthesise data from the included studies using a thematic approach. Ethical approval is not required, as this review uses publicly available data. Findings will be disseminated through peer-reviewed publication, conference presentations and engagement with key stakeholders in HIV prevention and treatment across SSA.

Heath care and education have both experienced rapid growth in artificial intelligence (AI) use, especially with generative tools such as ChatGPT. This study explores nurse educators' perspectives on ChatGPT's educational value, implementation challenges, and implications for professional standards. Data collection included 26 semistructured interviews with Canadian undergraduate nursing educators. Seven themes were generated by the research team through thematic analysis. Despite the perceived usefulness of ChatGPT, educators expressed concerns about plagiarism, overreliance, diminished critical thinking, and risks to clinical competence. While nurse educators are cautiously optimistic about the potential for ChatGPT integration into nursing curricula, concerns remain. This study provides the first overview of Canadian undergraduate nurse educators' perspectives on ChatGPT use. As generative AI evolves and changes over time, nursing education must continue to evaluate and monitor the pedagogical influence and support necessary competencies for both students and educators to ensure responsible use.

Malaria remains a major public health burden among children under five in several Sub-Saharan African (SSA) countries, largely attributable to their underdeveloped immune systems, constrained access to healthcare services, and environmental conditions conducive to transmission. This study aims to identify the key determinants of malaria infection among children under five by examining both individual-level characteristics and community-level drivers within this vulnerable population. We conducted a secondary analysis of the Malaria Indicator Surveys (2016-2022), including 51,457 children under five from 17 SSA countries. A multilevel mixed-effects logistic regression model was applied, with significance set at p&#x2009;<&#x2009;0.05. Determinants were reported as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). The analysis showed that more than one-third of children under five in several sub-Saharan African (SSA) countries were infected with malaria. At the individual level, significant risk factors included age (1-2&#x2009;years: AOR&#x2009;=&#x2009;1.46) and low household wealth index (AOR&#x2009;=&#x2009;1.94). Protective factors were maternal primary education (AOR&#x2009;=&#x2009;0.84) and the use of insecticide-treated bed nets (AOR&#x2009;=&#x2009;0.80). At the community level, increased malaria risk was associated with rural residence (AOR&#x2009;=&#x2009;2.69) and high community illiteracy rates (AOR&#x2009;=&#x2009;1.76). The study findings highlight the sustained health threat that malaria poses to children under 5 years of age in many sub-Saharan African countries. Policymakers should prioritize reducing infections in vulnerable groups, expanding access to insecticide-treated bed nets, and promoting targeted health education to strengthen family and community awareness. Main findings: Malaria affects over one-third of children under five in sub-Saharan Africa, shaped by both individual (age, household wealth) and community-level (rural residence, illiteracy) determinants.Added knowledge: The study demonstrates how socio-economic and educational disparities directly influence malaria prevalence among young children.Global health impact for policy and action: Targeted interventions expanding bed net coverage, strengthening health education, and addressing community-level inequities are essential to reduce malaria infections in vulnerable populations.

The ongoing shortage of nursing faculty presents significant operational and ethical challenges for academic institutions. As competition for qualified educators intensifies, recruitment and retention increasingly test nursing's collective moral commitments, not because leaders lack ethical intent, but because prevailing leadership models offer limited guidance for navigating ethical boundaries. This article employs an ethical leadership framework grounded in deontological, utilitarian, and virtue ethics to analyze decision making related to faculty recruitment and retention. Four mechanisms, moral framing, ethical climate building, role modeling, and empowerment, are applied to dilemmas such as faculty poaching and workload equity. Ethical leadership provides a practical model for aligning institutional strategies with professional values. Through transparent, fair, and accountable practices, it strengthens the ethical climate and supports sustainable faculty engagement. Integrating ethics into governance and organizational culture advances moral integrity and institutional effectiveness, ensuring that nursing education fulfills its social mission amid faculty shortages.