ISSN 2580-9296 (ONLINE) GHMJ (Global Health Management Journal) is an open-access, triannual, peer-reviewed, online journal with a strong emphasize on health and applied science in health. Authors are welcomed to submit original research paper, systematic review, best practice, perspectives, and photo essay in health-related topics to our journal. Registered since 19 June 2017 under the National Research and Innovation Agency of Indonesia , the journal is published by Yayasan Aliansi Cendekiawan Indonesia Thailand, also known as Indonesian Scholars' Alliance, based in Semarang, Central Java, Indonesia. To expand the user's engagement, the journal is indexed by Directory of Open Access Journal (DOAJ), Google Scholar, OCLC WorldCat, and Portal Garuda Indonesia Publication Index. The metadata is archived at the Index Copernicus International. The last publication is updated at JournalTOCs and Scilit (a comprehensive and open-access scholarly database developed and maintained by MDPI). 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Authors may use this manuscript template when preparing their paper (check submission checklist). ------------------------------------------------------------- The Global Health Management Journal (GHMJ) welcome high-quality, original research articles, reviews, photo essays, and case studies that contribute to advancements in the following categories: Health Promotion for Children, Youth, and Families, Health Services, Media, Management, and Policy, Health Education, Intervention, and Systems, Epidemiology, Nutrition, Health Behavior, and Public Health, Women's, Nursing, and Midwifery Health, Mental Health and Well-being, Environmental, Occupational Health, and Safety, Applied Science Related to Health Development, Medical Technology and Applications. The Global Health Management Journal (GHMJ) does not receive articles via email, but only through the OJS System. For more information regarding paper submission and publication policy, please visit our guidelines For Author in our website. We also invite scholars and practitioners to join us as peer review with criteria as stated in our For Peer Reviewers page. As 10 January - 3 March 2026 (Updated on doi.org/10.35898/ghmj-911331) Acceptance Rate : 49 % Days to First Editorial Decision : 5 days Days to accept : 56 days ================================================================ VOL. 9, NO. 2 (2026): ONLINE FIRST This Online First edition is featuring selected and double-blind peer-reviewed papers for the upcoming edition of Global Health Management Journal : Vol. 9, No. 2 (2026). Everyone is invited to submit an article at any time (no deadline for submission). Once the article is editorially accepted, it will be published as Online First before inclusion in an issue. PERSPECTIVES Data Without Dignity? A Critical Perspective on How Educational Assessment Systems Overlook the Financial and Safety Realities of Women Learners Dr. Moses Mhide Kpum, & Prof. Velisiwe Gasa RESEARCH ARTICLES Peroxisome Proliferator-Activated Receptor Gamma (PPARG2) rs3856806 Gene Polymorphism as a Risk Factor for Type 2 Diabetes Mellitus Fauzaan Azhar Rizqulloh, S.Ked., Donny Nauphar, M.Si.Med., & dr. Tiar Masykuroh Pratamawati, MM., M.Biomed. Correlation Between Cardiovascular Endurance and Changes in Blood Pressure in Employees of Universitas Swadaya Gunung Jati, Cirebon, Indonesia Ajeng Sanitaquin, S.Ked., dr. Kati Sriwiyati, M.Biomed, & dr. Sherly Cancerita, M.Ked (Cardio), Sp. JP, FIHA. Attributes Descriptions among the Medical Lecturers in Implementing the Problem-Based Learning (PBL) Based on the Onion Model Theory Alya Maharani, S.Ked, dr. Vivi Meidianawaty, M.Med.Ed, & dr. Tissa Octavira Permatasari, M.Med.Ed In Silico Structural Analysis of Malaria - Associated Single Nucleotide Polymorphisms in Human Genes TLR4, ICAM1, and IL22 dr. Venty Muliana Sari Soeroso, M.Si.Med., M.Sc., Agri Lesmana, S.Ked., dr. Alfa Januar Krista, M.Kes,Sp.OT, FICS, AIFO-K., & Dr. Arief Budi Witarto B.Eng., M.Eng. Climate Variability, Catastrophic Health Expenditure, and Non-Communicable Disease Outcomes in Nigeria Jude Igyo Ali, Ph.D., & Prof. Patricia Lindelwa Makoni Psychoactive Substance Uses and Risky Sexual Behaviors among Street-Connected Children in Kinshasa, Democratic Republic of Congo: Prevalence and the Associated Factors Rodriguez Kambamba Mboma, MD, MPH., Reagan Moluantuan Ndwaya, MD, MPH., Dan Nkelenda Mulumba, MD, MPH., Rodrigue Kumbu Khonde, MD, MPH., Joseph Wamu Oyombo, MD, MPH., Dieudonné Mukendi Mpunga, MD, MPH, PhD. REVIEW Entrepreneurship, Innovative Education, and Cross-Sector Collaboration as Catalyst for Sustainable Health System in Nigeria Dr. Isaac Msughter Peter, & Prof. Velisiwe Gasa
Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)
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Entrepreneurship, Innovative Education, and Cross-Sector Collaboration as Catalyst for Sustainable Health System in Nigeria
Section: Review Categories: Health Education, Intervention, and Systems Keywords: Entrepreneurship, Innovative education, Cross-sector collaboration, Sustainable health, Health system Subjects: Nigerian Health System, health service delivery Disciplines: Educational Administration and Planning Background: The challenges of the health system are further exacerbated by the growing impacts of climate change, particularly in northern Nigeria. Climate change-related issues such as heat waves, flooding, and insurgency have worsened the burden of disease and highlighted vulnerabilities in health infrastructure and management structures. Aims: This study investigated entrepreneurship, innovative education, and cross-sector collaboration as catalysts for a sustainable health system in Nigeria. Methods: This study adopted a desk research design, sourcing data from Google Scholar, ERIC, JSTOR, Scopus, ResearchGate, and other websites. A total of 20 documents were identified and screened; 10 studies were finally selected because they were written in English, had a clear study purpose, were obtained from the identified sources, met the inclusion and exclusion criteria, and were used for analysis. Results: The study revealed that entrepreneurship contributes to the sustainability of the Nigerian Health System. Entrepreneurship in healthcare is considered the ability to bridge gaps in health service delivery through market-driven innovations that promote efficiency and responsiveness. The study also found that innovative education influences the sustainability of the health system. The study revealed that cross-sector collaboration catalyses a sustainable health system in Nigeria by introducing market-driven innovation, business practices that enhance health system resilience, improving coordination, and addressing social determinants of health that fall outside the purview of the conventional health sector. Conclusion: Entrepreneurship, innovative education, and cross-sector collaboration offer a feasible approach to developing a resilient and sustainable health system in Nigeria. When a good environment is created, it enables the promotion of entrepreneurship, innovation, partnerships, and health policies. This study suggests that Nigeria could strengthen the sustainability of its health system by implementing policies and initiatives that promote entrepreneurship, foster innovation in health education, and enhance cross-sector collaboration.
Health Education, Intervention, and Systems
Copyright (c) 2026 Dr. Isaac Msughter Peter, Prof. Velisiwe Gasa http://creativecommons.org/licenses/by-nc-sa/4.0
Reviewer Acknowledgements and Highlights: Equity, Resilience, and the Human Dimensions of Health – GHMJ (Global Health Management Journal), Volume 9, Number 2, 2026
Section: Reviewer Acknowledgements Keywords: Reviewer Acknowledgements, GHMJ (Global Health Management Journal), Equity, Resilience, Human Dimensions of Health The Editorial Board gratefully acknowledges the reviewers who contributed their time, expertise, and careful judgment to the manuscripts published in the issue of the Global Health Management Journal (Vol. 9, No. 2, 2026). Many of the contributions in this issue share a common concern with the conditions that shape health opportunities and outcomes. Kpum and Gasa (2026) challenge educational systems to recognize the financial and safety realities faced by women learners, while Mboma et al. (2026) draw attention to the vulnerabilities experienced by street-connected children in Kinshasa. Beyond individual experiences, Ali and Makoni (2026) demonstrate how climate variability can intensify financial hardship and worsen health outcomes among households affected by non-communicable diseases, reinforcing the need for policies that respond to both social and environmental challenges. Looking ahead, Peter and Gasa (2026) highlight the potential of entrepreneurship, innovative education, and cross-sector collaboration in building more sustainable and resilient health systems. The recently completed publications from Faculty of Medicine, Universitas Swadaya Gunung Jati, processed under Special Edition commitment, represent new insights from biomedical and educational research. Genetic studies by Rizqulloh et al. (2026) and Soeroso et al. (2026) explore biological factors associated with diabetes and malaria, offering insights that may guide future research and disease prevention efforts. Within medical education, Maharani et al. (2026) examine the attributes of lecturers facilitating problem-based learning, emphasizing the continuing importance of student-centered approaches in preparing future health professionals. Completing the issue, Sanitaquin et al. (2026) explore cardiovascular endurance and blood pressure among university employees, adding to the ongoing conversation on lifestyle, health, and disease prevention. Together, the articles in this issue remind us that improving health requires not only scientific advances, but also a deeper understanding of the social, educational, economic, and environmental realities in which people live. We are grateful for the Editorial Boards and Reviewers’ commitment to advancing global health research and supporting a rigorous peer-review process. Link to download: https://publications.inschool.id/index.php/ghmj/issue/view/GHMJ.09.02 Editor-in-chief Prof. Andrew John Macnab Managing Editors Doni Marisi Sinaga, M.Sc. Kukuh Madyaningrana, M.Biotech. Ph.D. Journal Managers Suyitno, M.PHM Maretalinia, M.A External Reviewers Dr. Jude Ali Igyo (Mewar International University, Nigeria) Dr. Agi Christiana Ikpoyi (Joseph Sarwuan Tarka University, Nigeria) dr. Ratih Yulistika Utami, MMedEd (Universitas Muhammadiyah Sumatera Utara, Indonesia) Donny Nauphar, M.Si.Med. (Universitas Swadaya Gunung Jati, Indonesia) dr. Ike Sulistyowati, M.Biomed., Sp.Rad. (Universitas Bengkulu, Indonesia) drg. Musri Amurwaningsih, MMedEd (Universitas Islam Sultan Agung, Indonesia) dr. Ziske Maritska, M.Si.Med (Universitas Sriwijaya, Indonesia) dr. Siti Farhanah Aulia, M.Biomed (Universitas Yarsi, Indonesia) Emmanuel Aondongusha Asue, Ph.D (University of South Africa, South Africa) Dr. Isaac Msughter Peter (University of South Africa, South Africa) Rodrigue Nakasala, MD, MSc., MPH. (SANRU Asbl, Democratic Republic of the Congo) Dr. Tersoo Solomon Shaminja (Rev. Fr. Moses Orshio Adasu University, Nigeria) Dr. Fekumo Bolouembeledo (Federal University Otuoke, Nigeria) In recognition of their service, eligible reviewers may submit one Perspective or Guest Editorial article annually to a Special Edition free of publication charges. We further welcome collaboration with reviewers interested in contributing as members of our Editorial Board. Acceptance Rate : 43 % Days to First Editorial Decision : 18 days Days to accept : 47 days Published: 03 June 2026.
Copyright (c) 2026 GHMJ (Global Health Management Journal) http://creativecommons.org/licenses/by-nc-sa/4.0
Data Without Dignity? A Critical Perspective on How Educational Assessment Systems Overlook the Financial and Safety Realities of Women Learners
Section: Perspectives Categories: Health Education, Intervention, and Systems, Women's, Nursing, and Midwifery Health, Mental Health and Well-being Keywords: Educational assessment, Gender equity, Feminist epistemology, Period poverty, Financial precarity Disciplines: Education and Behavioral Sciences, Educational Psychology Educational assessment systems worldwide claim objectivity and meritocracy, yet they systematically fail to account for the gendered realities that shape women learners' access, performance, and persistence. This perspective paper critically examines how contemporary assessment frameworks, despite increasing datafication and loud claims of evidence-based practice, overlook the financial precarity and safety vulnerabilities that disproportionately affect women and girls in educational settings. The analysis draws on a critical synthesis of peer-reviewed empirical studies across diverse contexts, including South Asia, Sub-Saharan Africa, Europe, and North America, alongside policy documents from international organizations and recent large-scale quantitative and qualitative research. Assessment systems from primary through higher education are examined here. The paper is delimited to formal educational assessment contexts, standardized examinations, continuous assessment, and digital assessments, and focuses specifically on five categories of gendered barriers: period poverty, financial precarity, transportation and campus safety risks, intimate partner violence, and caregiving responsibilities. The analysis does not extend to informal assessment, workforce credentialing, or barriers arising from disability, though intersections with these are acknowledged where evidence permits. Through the lens of feminist epistemology, capability approach theory, and recent empirical evidence, the central argument holds that assessment systems function as technologies of inequality when they measure learning outcomes without acknowledging the material conditions required for dignified participation. Period poverty, transportation safety concerns, caregiving responsibilities, and economic vulnerability each create assessment disadvantages that are rendered invisible by ostensibly neutral measurement systems. In response, the paper proposes a dignity-centered assessment framework, one that treats safety and financial security as prerequisites for valid educational measurement rather than mere contextual variables. Concrete principles for gender-responsive assessment design are offered as a path toward transforming evaluation systems from instruments of exclusion into tools for genuine equity and empowerment.
Copyright (c) 2026 Dr. Moses Mhide Kpum, Prof. Velisiwe Gasa http://creativecommons.org/licenses/by-nc-sa/4.0
Peroxisome Proliferator-Activated Receptor Gamma (PPARG2) rs3856806 Gene Polymorphism as a Risk Factor for Type 2 Diabetes Mellitus
Section: Research Articles Categories: Applied science related to health development Keywords: PPARG2, rs3856806 Polymorphism, Type 2 Diabetes Mellitus Subjects: PPARG2, Type 2 diabetes mellitus, rs3856806 polymorphism Disciplines: Genetics Background: Diabetes Mellitus (DM) is a long-term metabolic illness brought on by either insufficient or inefficient insulin production by the pancreas. Worldwide, 537 million adults between the ages of 20 and 79 are thought to have DM. Genetics is one of the risk factors involved in the pathophysiology of type 2 DM. The gene encodes PPARG2 protein, a group of proteins that are part of the core receptor in carbohydrate and lipid metabolism. Among the two isoforms, PPARG2 is specific to adipose tissue and plays an important role in adipogenesis and mediating insulin sensitivity. Aims: This study aims to examine the PPARG2 rs3856806 gene polymorphism as a risk factor for the occurrence of type 2 diabetes mellitus in the Cirebon population. Methods: This case-control study involved 30 cases of type 2 DM and 30 healthy controls. Data were obtained with blood sugar level test, DNA extraction, and PCR-RFLP with Eco72I restriction enzyme, followed by visualization of results using gel electrophoresis. Results: The C Allele frequency was higher in the case group (76.6%) while the T Allele frequency was higher in the control group (56.6%). The CT heterozygote genotype frequency was more common in the control group (86.7%) and the TT homozygous mutant genotype frequency was higher in the case group (3%) compared to the control group (0%). The results of the Chi-Square Test obtained a p-value of 0.001 with an OR value of 0.118 (CI95%=0.033-0.422). Conclusion: The PPARG2 rs3856806 polymorphism was significantly associated with lower odds of type 2 diabetes mellitus in the population of Cirebon, Indonesia, when analyzed under a dominant genetic model comparing T-allele carriers (CT + TT) to non-carriers (CC).
Applied science related to health development
Copyright (c) 2026 Fauzaan Azhar Rizqulloh, S.Ked., Donny Nauphar, M.Si.Med., dr. Tiar Masykuroh Pratamawati, MM., M.Biomed. http://creativecommons.org/licenses/by-nc-sa/4.0
Correlation Between Cardiovascular Endurance and Changes in Blood Pressure in Employees of Universitas Swadaya Gunung Jati, Cirebon, Indonesia
Section: Research Articles Categories: Health Education, Intervention, and Systems Keywords: Cardiovascular endurance, Blood pressure, Hypertension Subjects: cardiovascular endurance, hypertension, blood pressure Disciplines: Basic Medical Science Background: Blood pressure is the force exerted by blood on the walls of blood vessels and depends on cardiac output and peripheral resistance. Blood pressure is influenced by various factors, one of which is cardiovascular endurance. Optimal cardiovascular endurance helps maintain blood pressure at normal levels, thereby decreasing the risk of high blood pressure and cardiovascular disease. Aims: To determine cardiovascular endurance and blood pressure changes before and after performing the Harvard step test and to analyze the correlation between cardiovascular endurance and blood pressure changes in employees of Universitas Swadaya Gunung Jati, Cirebon, Indonesia. Methods: This study was a quantitative analytical observational type with a cross-sectional method involving 77 employees who are not registered as teaching lecturers who met the inclusion and exclusion criteria. This study was conducted by collecting primary data in the form of blood pressure measurement, Harvard step test treatment and pulse rate measurement. The data was then analyzed statistically using a Spearman’s hypothesis test. Results: The majority of respondents were ≤40 years old (55.8%), male (64.9%), had a habit of smoking (55.8%), and abnormal HRR (83.1%). After conducting the Spearman test, p-value = 0.727; r = -0.041 for systolic and p-value = 0.314; r = -0.116 for diastolic. The correlation coefficient indicates a very weak negative correlation between cardiovascular endurance and blood pressure changes in employees of Universitas Swadaya Gunung Jati, Cirebon, Indonesia. Conclusion: There is no significant correlation between cardiovascular endurance and changes in blood pressure. Cardiovascular endurance showed a significant negative correlation with blood pressure, although other factors such as age, gender, physical activity, and smoking also play a role.
Copyright (c) 2026 Ajeng Sanitaquin, S.Ked., dr. Kati Sriwiyati, M.Biomed, dr. Sherly Cancerita, M.Ked (Cardio), Sp. JP, FIHA http://creativecommons.org/licenses/by-nc-sa/4.0
Attributes Descriptions among the Medical Lecturers in Implementing the Problem-Based Learning (PBL) Based on the Onion Model Theory
Section: Research Articles Categories: Health Education, Intervention, and Systems Keywords: Problem-Based Learning, Student-Centred Learning, Lecturer Attributes, Onion Model Theory Subjects: PBL, Student-Centred, Lecturer Attributes, Onion Model Disciplines: Medical Education Background: Lecturer attributes influence how Problem-Based Learning (PBL) is facilitated. However, the descriptive profile of lecturer attributes based on the Onion Model has not been previously documented at Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Indonesia. Understanding these attributes is important to inform faculty development, reflective practice, and curriculum quality improvement. Aims: To describe the attributes of medical lecturers in implementing the PBL based on the Onion Model framework. Methods: This descriptive observational study involved 58 medical lecturers who serve as PBL tutors with varying teaching experience. Participants were selected using purposive sampling and completed the Student-Centred Perspectives on Teaching (SCPT) questionnaire. Responses were measured using a 4-point Likert scale (1 = strongly disagree to 4 = strongly agree). Mean scores above 3 indicate high alignment with student-centred teaching attributes. Data were analysed using univariate descriptive statistics. Results: All Onion Model aspects demonstrated mean scores above 3, indicating generally positive lecturer attributes toward student-centred PBL. The highest mean score was observed in the Belief aspect (3.70), followed by Behaviour and Mission (3.67), Competence (3.56), Environment (3.54), and Identity (3.53). Conclusion: This study provides a descriptive profile of lecturer attributes in PBL implementation. The findings indicate that lecturers generally report student-centred teaching attributes across Onion Model domains. These findings describe lecturer characteristics and do not indicate effectiveness or causal impact on learning outcomes.
Copyright (c) 2026 Alya Maharani, S.Ked, dr. Vivi Meidianawaty, M.Med.Ed, dr. Tissa Octavira Permatasari, M.Med.Ed http://creativecommons.org/licenses/by-nc-sa/4.0
In Silico Structural Analysis of Malaria - Associated Single Nucleotide Polymorphisms in Human Genes TLR4, ICAM1, and IL22
Section: Research Articles Categories: Applied science related to health development Keywords: Genomic Variant, In Silico, Host, Malaria, Single Nucleotide Polymorphisms (SNPs) Subjects: Clinical variant, in silico, Malaria, SNPs Host Disciplines: Molecular biology, Genetics, Genomics Background Indonesia’s ethnic heterogeneity contributes to substantial human genetic diversity, including variation in genes associated with malaria susceptibility and severity. Single Nucleotide Polymorphisms (SNPs) in host genes encoding immune receptors and adhesion molecules may influence malaria pathogenesis by modulating inflammatory signaling and parasite–host cell interactions. Aims: This study aimed to evaluate the potential structural and functional impact of selected malaria-associated SNPs in human genes using a systematic in silico approach. Methods: A literature-guided and database-driven screening (dbSNP and UniProt) was used to identify relevant SNPs previously reported to be associated with malaria infection and/or the severity of infection. Inclusion criteria were: (1) localization within coding regions, (2) prior evidence of clinical relevance, (3) resulting in a nonsynonymous amino acid substitution, and (4) annotated with a reference SNP ID (rsID). Selected SNPs were subjected to protein structural modelling. Native and mutant protein structures were compared using PyMOL, conformational changes and differences were quantified using Root Mean Square Deviation (RMSD). Results: A total of 38 SNPs in TLR4, ICAM1, and IL-22 gene with reported clinical relevance to infection were identified, of which 6 SNPs (TLR4: n=2; ICAM1: n=3; IL-22: n=1) met all inclusion criteria for malaria-associated variants. Five selected SNPs were located in coding regions and resulted in amino acid substitutions, several of which involved changes in residue polarity, whereas one SNPs was located in non-coding region. Structural comparison showed detectable but minimal conformational differences between the native and mutant proteins, with low RMSD values (maximum 0.014 Å in TLR4 variant rs4986790). Conclusion:This in silico analysis suggests that the selected malaria-associated SNPs in TLR4, ICAM-1, and IL-22 genes are unlikely to induce major structural rearrangements but may contribute to localized changes that affect protein interaction interfaces or signaling functions. Their potential contribution to malaria severity may therefore involve minor structural deviation rather than large conformational changes. This study provides a systematic computational framework for prioritizing host genetic variants for further functional validation, particularly in genetically diverse populations such as Indonesia.
Copyright (c) 2026 dr. Venty Muliana Sari Soeroso, M.Si.Med., M.Sc., Agri Lesmana, S.Ked., dr. Alfa Januar Krista, M.Kes,Sp.OT, FICS, AIFO-K., Dr. Arief Budi Witarto B.Eng., M.Eng. http://creativecommons.org/licenses/by-nc-sa/4.0
Climate Variability, Catastrophic Health Expenditure, and Non-Communicable Disease Outcomes in Nigeria
Section: Research Articles Categories: Epidemiology, Nutrition, Health Behavior, and Public Health, Environmental, Occupational Health and Safety Keywords: Catastrophic Health Expenditure, Climate Variability, Non-Communicable Diseases, Health Financing, Nigeria Subjects: I15, I18, Q54, O55 Disciplines: Health and Economic Development, Climate; Natural Disasters; Global Warming, Environment and Development; Sustainability Background: The challenges posed by climate change and non-communicable diseases (NCDs) are among the most pressing but least explored areas in health economics. Aims: This study examines the impact of climate shocks, non-communicable diseases (NCDs), and catastrophic health expenditure (CHE) in a single micro-econometric model. Methods: The study estimates probit, logit, IV-probit, fixed-effects logit, and IV-2SLS models with temperature anomalies instrumented using the values of the ENSO Oceanic Niño Index to overcome the endogeneity problem, using a harmonized panel of 22,110 households in three waves of the Nigeria General Household Survey-Panel (2010/11, 2012/13 and 2015/16). Results: A 1 °C rise in temperature increases the likelihood of CHE by 4.3-6.1 percentage points and flood vulnerability by 7.1-8.3% points. Across the population affected by non-communicable diseases (NCDs), climate stressors increase the Propensity to experience catastrophic health expenditure (CHE) by approximately 9.4%. Climate variables account for 31.3% of the CHE inequality, with temperature alone explaining 13.6% of the index, and they have a disproportionate impact on poorer households. Instrumental variable projections suggest that an additional 1.9-2.7 million households could experience catastrophic health expenditure (CHE) by 2030 under continued warming trends. Conclusion: Health financing vulnerability in Nigeria is also a function of uneven climate variability, which requires increased health insurance, an enhanced NCD response, and climate-sensitive social protection policies. These results indicate the need for much-needed policy coordination among health, climate, and fiscal governance systems.
Epidemiology, Nutrition, Health Behavior, and Public Health
Environmental, Occupational Health and Safety
Climate; Natural Disasters; Global Warming
Environment and Development; Sustainability
Copyright (c) 2026 Jude Igyo Ali, Ph.D.; Prof. Patricia Lindelwa Makoni http://creativecommons.org/licenses/by-nc-sa/4.0
Psychoactive Substance Uses and Risky Sexual Behaviors among Street-Connected Children in Kinshasa, Democratic Republic of Congo: Prevalence and the Associated Factors
Section: Research Articles Categories: Health Promotion for Children, Youth, and Families, Epidemiology, Nutrition, Health Behavior, and Public Health Keywords: Psychoactive substances, Risky sexual behavior, Street-connected children, HIV risk, Democratic Republic of Congo Subjects: Use of psychoactive substances and risky sexual behaviors among street children in Kinshasa: challenges for the fight against HIV/AIDS Disciplines: Applied Health, Community Health Background: The street-connected children in Kinshasa endure very precarious living conditions and are exposed to a very high risk of violence, substance use, and risky sexual behaviors. In this population, the use of psychoactive substances (PAS) is a key determining vulnerability to HIV and other sexually transmitted infections. Aims: This study sought to ascertain the prevalence of psychoactive substance use and identify the associated factors related with risky sexual behaviors among street-connected children aged 10-24 years in Kinshasa. The dependent variables encompassed risky sexual practices, including the ingestion of psychoactive substances (PAS). Substance use disorders, age, gender, education level, and exercise performed are among the independent variables. Methods: An analytical cross-sectional study was executed from June and December 2024 with 425 street-connected children selected using snowball sampling. Data were gathered through a standardized questionnaire. We used descriptive statistics, chi-square tests, and logistic regression analysis to find factors that were related (p < 0.2). Results: An extremely high percentage of people used drugs, alcohol, and tobacco: 85.9 % for tobacco, 79.9 % for alcohol, and 32.5 % for drugs. The average age at which people started drinking alcohol was 11 ± 3 years, and the average age at which they started smoking tobacco was 12 ± 3 years. The average age at which girls and boys first had sex was 14 ± 4 years and 13 ± 2 years, respectively. Almost all of the people who took part (98 %) said they had more than one sexual relationship, and 83.7 % said they didn’t always use condoms. In multivariate analysis, risky sexual behavior was significantly associated with being under 20 years of age (10-14 years: OR = 4.11; 95 % CI [1.72 - 9.87]; p = 0.002 and 15-19 years: OR = 2.05; 95 % CI [1.05 - 4.04]; p = 0.037), male sex (OR= 1.78; CI [0.98 - 3.22]; p= 0.055); inactivity (OR= 3.63; 95 % CI [1.66 - 7.94]; p= 0.001) and alcohol consumption (OR= 3.96; 95 % CI [1.27 - 12.38]; p= 0.018). The duration of street life and peer influence were the primary factors related with psychoactive substance usage. Conclusion: Substance use and high-risky sexual behaviors are very common among street-connected youngsters in Kinshasa. These findings underscore the pressing necessity for integrated and multisectoral interventions aimed at substance use prevention, sexual health education, and the social reintegration of street-connected children.
Health Promotion for Children, Youth, and Families
Use of psychoactive substances and risky sexual behaviors among street children in Kinshasa: challenges for the fight against HIV/AIDS
Copyright (c) 2026 Rodriguez Kambamba Mboma, MD, MPH., Reagan Moluantuan Ndwaya, MD, MPH., Dan Nkelenda Mulumba, MD, MPH., Rodrigue Kumbu Khonde, MD, MPH., Joseph Wamu Oyombo, MD, MPH., Dieudonné Mukendi Mpunga, MD, MPH, PhD. http://creativecommons.org/licenses/by-nc-sa/4.0