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As in most countries worldwide, Sub-Saharan African countries are striving to build their human capital so they can compete for jobs and investments in an increasingly globalized world. In this region, which includes the largest number of countries that have not yet attained universal primary schooling, the ambitions and aspirations of Sub-Saharan African countries and their youth far exceed this basic goal. Over the past 20 years, educational levels have risen sharply across Sub-Saharan Africa. Already hard at work to provide places in primary schools for all children, most countries of the region are also rapidly expanding access to secondary and tertiary levels of education. Alongside this quantitative push is a growing awareness of the need to make sure that students are learning and acquiring the skills needed for life and work. Achieving education of acceptable quality is perhaps an even greater challenge than providing enough school places for all. Thus, Sub-Saharan African countries are simultaneously confronting many difficult challenges in the education sector, and much is at stake. This book gives those concerned with education in Sub-Saharan Africa an analysis of the sector from a cross-country perspective, aimed at drawing lessons that individual country studies alone cannot provide. A comparative perspective is useful not only to show the range of possibilities in key education policy variables but also to learn from the best performers in the region. (Although the report covers 47 Sub- Saharan African countries whenever possible, some parts of the analysis center on the region's low-income countries, in particular, a sample of 33 low-income countries). Although countries ultimately must make their own policy choices and decide what works best in their particular circumstances, Sub-Saharan African countries can benefit from learning about the experiences of other countries that are faced with, or have gone through, similar development paths. Given the large number of countries included in the analysis, the book finds that Sub-Saharan African countries have more choices and more room for maneuver than will appear if attention were focused on only one or a few country experiences. Countries can make better choices when understanding the breadth of policy choices available to them. They are well advised, however, to evaluate the applicability of policy options to their contexts and to pilot and evaluate the results for performance and subsequent improvement.

Rural populations disproportionately suffer from adverse health outcomes, including poorer health and higher age-adjusted mortality. We argue that these disparities are due in part to declining health care provider availability and accessibility in rural communities. Rural challenges are exacerbated by “structural urbanism”—elements of the current public health and health care systems that disadvantage rural communities. We suggest that biases in current models of health care funding, which treat health care as a service for an individual rather than as infrastructure for a population, are innately biased in favor of large populations. Until this bias is recognized, the development of viable models for care across the rural-urban continuum cannot move forward.

Overcoming the impact of the coronavirus pandemic (COVID-19) on primary schools is an emerging need and priority in the current social welfare system. Accordingly, this study presents an empirical learning package to support teachers, who perform frontline work in schools, in coping with stress, preventing burnout, improving their information and communications technology (ICT) competency, and introducing the principles of emotional intelligence (EI) in the classroom. The participants included 141 primary school teachers (M = 38.4 years, SD = 6.84; 54.6% women). They were randomly assigned to an experimental or control group. The experimental group participated in the 14-week teacher training program, whereas the control group did not participate in the program or receive any other training during the intervention. Repeated-measures analysis of variance (time x group) was performed to identify the effects of the teacher training program. Teachers who participated in the training program evaluated it positively and showed significant differences compared to the control group in their abilities to cope with stress and avoid burnout, their ICT competency, and their introduction of EI in the classroom. Implications for supporting teachers are discussed.

Background: Developmental dyslexia (DD) is a specific learning disorder concerning reading acquisition that may has a lifelong negative impact on individuals. A reliable estimate of the prevalence of DD serves as the basis for diagnosis, intervention, and evidence-based health resource allocation and policy-making. Hence, the present meta-analysis aims to generate a reliable prevalence estimate of DD worldwide in primary school children and explore the potential variables related to that prevalence. Methods: Studies from the 1950s to June 2021 were collated using a combination of search terms related to DD and prevalence. Study quality was assessed using the STROBE guidelines according to the study design, with study heterogeneity assessed using the I2 statistic, and random-effects meta-analyses were conducted. Variations in the prevalence of DD in different subgroups were assessed via subgroup meta-analysis and meta-regression. Results: The pooled prevalence of DD was 7.10% (95% CI: 6.27–7.97%). The prevalence in boys was significantly higher than that in girls (boys: 9.22%, 95%CI, 8.07–10.44%; girls: 4.66%, 95% CI, 3.84–5.54%; p < 0.001), but no significant difference was found in the prevalence across different writing systems (alphabetic scripts: 7.26%, 95%CI, 5.94–8.71%; logographic scripts: 6.97%, 95%CI, 5.86–8.16%; p > 0.05) or across different orthographic depths (shallow: 7.13%, 95% CI, 5.23–9.30%; deep: 7.55%, 95% CI, 4.66–11.04%; p > 0.05). It is worth noting that most articles had small sample sizes with diverse operational definitions, making comparisons challenging. Conclusions: This study provides an estimation of worldwide DD prevalence in primary school children. The prevalence was higher in boys than in girls but was not significantly different across different writing systems.

To explore the integration of traditional and complementary medicine in health systems and identify the enablers and barriers to the process. We searched PubMed®, Embase, Web of Science, Latin American and Caribbean Health Sciences Literature, China National Knowledge Infrastructure and WanFang Database for original research on integration of traditional and complementary medicine in health systems published from 1 January 2001 to 27 January 2025. We focused on low- and middle-income countries. We made a thematic analysis to identify the enablers of and barriers to integration. We mapped factors according to the six blocks of health-care systems: service delivery; health governance and financing; medical products; health information systems; health workforce; and service standards. We included 43 publications from 19 countries, with 55.8% (24/43) from countries in the African Region. Traditional and complementary medicine had the potential to strengthen various aspects of health systems, particularly in health-service delivery and products. We identified 11 determinant domains which could act as both an enabler of and barrier to integration. The most commonly mentioned determinants influencing integration of traditional and complementary medicine were policies and finance, resource availability, and efficacy, quality and safety. Our findings highlight the role of policies and finance in supporting integration of traditional and complementary medicine, and the need to ensure the quality and safety of traditional products through scientific methods. Reforms in medical education and strategic resource allocation are needed to create the necessary conditions for successful integration of traditional and complementary medicine.

COVID-19 has led to the closure of various schools in Japan to cope with the pandemic. This study explores how school closure influences parents’ work style based on short panel data for the period of school closure from mid-March to mid-April 2020. Specifically, we analyze how the presence of their children influences parents’ work at home and examine how the effect differs by the parent’s gender. After controlling for various factors, we find that in cases where parents are full-time employees and the children are: (1) in primary school, mothers are more likely to work remotely, while fathers are less likely to do so and (2) in junior high school, the parents’ work styles are hardly affected. This shows that mothers shoulder the burden of working remotely and caring for small children at home, while fathers tend to work in the office and spend less time with their childcare at home. Inevitably, COVID-19 has increased the inequality in the burden of child care.

Primary care providers deliver the majority of medical care serving as essential first points of contact and care coordinators. Despite the significant challenges they face, primary care research seems to lag behind and stay low-funded. Since the mid-1990s, academic reforms have emphasised metrics like third-party funding and high-impact publications. Medical schools were encouraged to develop distinct research profiles and to compete both internally and externally, leading to shifts in how research areas were prioritised, potentially disadvantaging primary care research. To investigate the thematic priorities in German medical schools' research, assess the diversification of these priorities, and examine the role of primary care research. We conducted an analysis of the research priorities of all 39 German medical schools associated with the German Association of Medical Faculties. Data was extracted from medical school websites in October 2023. Research priorities were categorised and analysed using descriptive statistics and relationship mapping. Research profile topics per medical school ranged from 1 to 7 (mean 3.51, SD 1.41). The most common research priorities were 'Neuroscience & Neurology' (69.2%), 'Immunology/Infectiology/Immunotherapy' (59.0%), and 'Oncology' (51.3%). Only a few institutions, primarily those in rural areas or recently established medical schools, prioritised adjacent primary care research fields such as health services research or community medicine. Our analysis reveals a significant concentration of research priorities in a few biomedical fields across German medical schools, with an underrepresentation of primary care research. This suggests a potential misalignment between academic focus and societal healthcare needs.

Healthy populations translate into productive and stable nations. Universal health care (UHC) is a pragmatic and ethical ideal that, thanks to social and economic progress, seems almost achievable. However, UHC means different things in different contexts. The minimum ideal is that no individual or family should suffer financial hardship because of accessing good-quality medical assistance. Bloom et al. review health priorities around the world and what will be needed in terms of skills, funds, and technology to achieve health care access for all. Science , this issue p. eaat9644 Universal health care (UHC) is garnering growing support throughout the world, a reflection of social and economic progress and of the recognition that population health is both an indicator and an instrument of national development. Substantial human and financial resources will be required to achieve UHC in any of the various ways it has been conceived and defined. Progress toward achieving UHC will be aided by new technologies, a willingness to shift medical tasks from highly trained to appropriately well-trained personnel, a judicious balance between the quantity and quality of health care services, and resource allocation decisions that acknowledge the important role of public health interventions and nonmedical influences on population health.

Resources in primary schools can be classified into three types: campus, teaching, and community resources. Urban–rural differences in the resources of Chinese county schools, which are triggered by population migration and residents’ preference for high-quality schools, are a common phenomenon emerging in the context of rapid urbanization. Despite the negative effects of these resource differences on social sustainability and the increasing need to comprehensively analyze urban–rural differences in school resources, to date there has not been an effective analytical framework for resolving these issues. To address this research gap, this study develops a method using the entropy-based Technique for Order Preference by Similarity to Ideal Solution (TOPSIS), spatial analysis, and statistical analysis for assessing resource equity in primary schools by means of the relative proximities of resources. The resource differences between urban and rural primary schools are quantitatively investigated through taking Yuncheng County as a case study. The urban–rural differences in the three types of resources are discovered and presented according to geographical location. The research findings make contributions to understanding the unbalanced distribution of school resources, promoting equity in education, and improving the social sustainability of counties. Additionally, the analytical framework has the potential to be extended to analyzing urban–rural resource differences in secondary or high schools.

This study examined the impact of integrating virtual science inquiry activities with Predict-Observe-Explain (POE) teaching strategies on 5th graders’ understanding of science concepts and epistemic beliefs in science. A cohort of 80 5th graders (mean age of 12 years old, 40 boys and 40 girls) from a public primary school in North China took part in the research. The data collected encompassed pre-test and post-test results on understanding of science concepts and epistemic beliefs, along with students’ behavioral data during virtual science inquiry. The findings demonstrated that integrating virtual science inquiry activities with POE strategies increased students’ understanding of science concepts and epistemic beliefs in science. Furthermore, notable differences were found in observation time and inquiry strategy between high and low achievers, while significant distinctions in page time allocation and page navigation behavior were evident between boys and girls. The results provided empirical support for enhancing the implementation of virtual science inquiry activities in primary school science learning.