Background Global health education (GHE) in Italy has spread since the first decade of 21st century. The presence of global health (GH) courses in Italy was monitored from 2007 to 2013. In 2019, a new survey was proposed to assess the availability of educational opportunities in Italian medical schools. Methods An online survey was carried out using a questionnaire administered to a network of interested individuals with different roles in the academic world: students, professors, and members of the Italian Network for Global Health Education. The features of courses were analysed through a score. Results A total of 61 responses were received from affiliates of 33 out of the 44 medical schools in Italy. The national mean of GH courses for each faculty was 1.2, reflecting an increase from 2007. The courses increased nationwide, resulting in a dispersed GHE presence in northern, central and southern Italy. One of the most critical points was related to the nature of “elective” courses, which were not mandatory in the curricula. Enrollees tended to be students genuinely interested in GH issues. Some community and service-learning experiences, referred to as GH gyms, were also detected at national and international levels. Conclusions GHE has spreading in Italy in line with the vision of the Italian Network for Global Health Education. Although progress has been made to disperse GH courses around the country, more academic commitment is needed to include GH in the mandatory curricula of medical schools and other health faculties.

The COVID-19 pandemic exerted an extraordinary pressure on the Italian healthcare system (Sistema Sanitario Nazionale, SSN), determining an unprecedented health crisis. In this context, a multidisciplinary non-governmental initiative called Italian Response to COVID-19 (IRC-19) was implemented from June 2020 to August 2021 to support the Italian health system through multiple activities aimed to mitigate the effects of the pandemic. The objective of this study was to shed light on the role of NGOs in supporting the SSN during the first pandemic wave by specifically exploring: (1) the main challenges experienced by Italian hospitals and out-of-hospital care facilities and (2) the nature and extent of the IRC-19 interventions specifically implemented to support healthcare facilities, to find out if and how such interventions met healthcare facilities' perceived needs at the beginning of the pandemic. We conducted a cross-sectional study using an interviewer administered 32-item questionnaire among 14 Italian healthcare facilities involved in the IRC-19 initiative. Health facilities' main challenges concerned three main areas: healthcare workers, patients, and facilities' structural changes. The IRC-19 initiative contributed to support both hospital and out-of-hospital healthcare facilities by implementing interventions for staff and patients' safety and flow management and interventions focused on the humanization of care. The support from the third sector emerged as an added value that strengthened the Italian response to the COVID-19 pandemic. This is in line with the Health—Emergency and Disaster Risk Management (H-EDRM) precepts, that call for a multisectoral and multidisciplinary collaboration for an effective disaster management.

Background With antiretroviral therapy, more people living with HIV (PLHIV) in resource-limited settings are virally suppressed and living longer. WHO recommends differentiated service delivery (DSD) as an alternative, less resource-demanding way of expanding HIV services access. Monitoring client’s health-related quality of life (HRQoL) is necessary to understand patients’ perceptions of treatment and services but is understudied in sub-Saharan Africa. We assessed HRQoL among ART clients in Tanzania accessing two service models. Methods Cross-sectional survey from May–August 2019 among stable ART clients randomly sampled from clinics and clubs in the Shinyanga region providing DSD and clinic-based care. HRQoL data were collected using a validated HIV-specific instrument—Functional Assessment of HIV infection (FAHI), in addition to socio-demographic, HIV care, and service accessibility data. Descriptive analysis of HRQoL, logistic regression and a stepwise multiple linear regression were performed to examine HRQoL determinants. Results 629 participants were enrolled, of which 40% accessed DSD. Similar HRQoL scores [mean (SD), p-value]; FAHI total [152.2 (22.2) vs 153.8 (20.6), p 0.687] were observed among DSD and clinic-based care participants. Accessibility factors contributed more to emotional wellbeing among DSD participants compared to the clinic-based care participants (53.4% vs 18.5%, p =  < 0.001). Satisfactory (> 80% of maximum score) HRQoL scoring was associated with (OR [95% CI], p-value) being male (2.59 [1.36–4.92], p 0.004) among clinic participants and with urban residence (4.72 [1.70–13.1], p 0.001) among DSD participants. Conclusions Similar HRQoL was observed in DSD and clinic-based care. Our research highlights focus areas to identify supporting interventions, ultimately optimizing HRQoL among PLHIV.

Background: More people living with HIV (PLHIV) in resource-limited settings are virally suppressed and living longer, mainly due to an increased access to effective antiretroviral therapy (ART). With the expansion of ART programmes, the World Health Organisation recommended differentiated service delivery (DSD) as an alternative less resource-demanding way of accessing HIV services. While maintaining quality of care and continued adherence among patients are health system’s priorities, monitoring patient’s quality of life is key to ensure sustainability and uptake of services. However, health-related quality of life (HRQoL) is understudied in sub-Saharan Africa (SSA). We aimed to assess HRQoL among stable ART clients accessing ART care in adherence clubs implemented in Tanzania. Methods: We conducted a cross-sectional survey from May to August 2019 among stable ART clients randomly sampled among those accessing clinics and clubs daily in two sites, a rural and peri-urban setting in the Shinyanga region. HRQoL data was collected, after obtaining informed consent, using the interviewer-administered Functional Assessment of HIV infection (FAHI), a validated HIV-specific HRQoL instrument. We also collected on socio-demographic, HIV care and service accessibility factors. Descriptive analysis, modified Poisson regression with robust variance and a stepwise multiple linear regression were performed to analyse HRQoL and its determinants.Results: A total of 629 participants were enrolled, of which 40% were DSD patients. DSD and clinic participants showed similar HRQoL scores [mean (SD), p value]; FAHI total [152.2 (22.2) vs 153.8 (20.6), p 0.687]. Accessibility factors, e.g. less time spent during and less frequent DSD meetings, contributed to emotional wellbeing among DSD participants compared to those in clinic (53.4% vs 18.5%,p=<0.001). Satisfactory (>80% of achievable) HRQoL scoring was independently associated with (relative risk [95% confidence interval], p value) being male (1.18[1.06-1.31], p 0.002); being married (1.22 [1.01-1.45, p 0.043); and living in an urban setting (1.28 [1.09-1.49], p 0.001). Conclusions: DSD does not appear to compromise HRQoL and, encouragingly, it could contribute to an improvement in emotional wellbeing among patients. While DSD shows promise in improving acceptability among patients and, therefore, sustainability of such services, our research highlights future research avenues to identify supporting interventions to improve other HRQoL domains among PLHIV.