Iran's Primary Health Care (PHC) system was designed and structured in the post-revolution era and rooted in the principles of the Alma-Ata Declaration, over four decades (1985-2025), it has evolved into one of the most resilient and equity-driven primary care platforms in the Global South. Serving a population exceeding 85 million, it illustrates how sustained investment in community-based care can generate population-level impact despite geopolitical pressures, economic sanctions, and shifting epidemiological realities. This review, as a commemoration of 40 years of PHC establishment, expansion, and institutionalization, synthesizes the system's historical evolution, transformative achievements, persistent constraints, and strategic directions for the decades ahead. Iran's PHC network has achieved near-universal rural coverage, dramatic reductions in maternal, neonatal, and child mortality, and substantial gains in life expectancy. These achievements have been preserved despite war, prolonged sanctions, and the COVID-19 pandemic. The Health Transformation Plan (HTP, 2014) represented a major step toward universal health coverage (UHC), reducing out-of-pocket payments. Yet substantial challenges remain: structural under-resourcing, insufficient community participation in urban settings, limited PHC coverage in large metropolitan areas, the rising burden of noncommunicable diseases, fragmentation, and insufficient inter-sectoral collaboration. Looking toward 2050, Iran's strategic trajectory depends on modernizing PHC through digital innovation, data-informed decision-making, strengthening self-care capabilities, reinforcing continuity of care for all population groups, revitalizing community engagement, particularly in urban settings, and embedding stronger equity safeguards across the entire system. With deliberate reorganization and sustained political commitment, supported by intersectoral governance, Iran's PHC system can consolidate four decades of progress and offer a compelling, adaptable blueprint for health systems navigating resource constraints and geopolitical adversity.

Plantago (Plantaginaceae family) exhibits remarkable diversity with over 200 species. These plants are closely associated with traditional medicine worldwide, particularly as a wound healing therapy. Recent research has revealed phytoconstituents in various Plantago species, including flavonoids, alkaloids, terpenoids, phenolic acid derivatives, iridoid glycosides, fatty acids, and polysaccharides. Despite the advanced ongoing research on Plantago extracts, there is still a gap in the evaluation of their potential as an effective topical product for chronic wounds and in the way phytoconstituents contribute to the overall effect in a single comprehensive systematic review. Therefore, this review aims to explore the wound healing capabilities of Plantago and its phytoconstituents, as well as elucidate their mechanisms of action. Our analysis emphasizes the significant wound healing potential in 25 Plantago species, notably Plantago major, Plantago lanceolata, Plantago australis, Plantago asiatica, and Plantago ovata. These plant species contain a diverse array of 57 phytoconstituents that collectively contribute to these activities. In conclusion, this review confirms the huge potential of Plantago genus as a topical wound healing agent. The healing mechanisms cover a wide array of effects such as anti-bacterial activity, anti-apoptosis, stimulation of collagen synthesis and deposition, promotion of angiogenesis, suppression of inflammatory response, inhibition of cyclooxygenase, inhibition of MAPKs phosphorylation, and enhancement of endogenous antioxidant enzyme activity. A study on the network pharmacology of such potential is worth investigating as further research.

The Alma-Ata 'Health for All' Declaration of 1978 emphasised community participation in health systems and the need to 'bring health care as close as possible to where people live and work'. Since then, decentralised approaches that leverage the proximity of local governments to their populations have emerged as the preferred model for health systems over fully centralised structures. The district health system, particularly in low- and middle-income countries, has evolved as a key framework to advance the Alma-Ata vision and strengthen health system governance in decentralised settings. However, implementation has often been hindered by limited local capacity, raising a persistent question: how can district health systems be strengthened to achieve decentralisation objectives? Using Malawi's ongoing Blantyre Prevention Strategy (BPS), a systems-based project designed to build local capacity at district and city levels for HIV prevention, as a case study, this paper-reviews policies and frameworks guiding health sector decentralisation in Malawi and examines how BPS is contributing to strengthening the district health system and supporting broader decentralisation efforts in Malawi's health sector.

Allergic diseases are a significant global health issue commonly triggered by house dust mite (HDM) allergens. Standardized HDM extracts are currently widely used in allergen immunotherapy (AIT) and diagnostic tests. However, in several tropical regions, such as Indonesia, these standardized extracts were either expensive, difficult to obtain, or did not represent local allergen exposure. Previous studies examined crude house dust extracts (CHDE) derived from locally collected dust as a possible substitute because they reflected the complex allergenic and other composition of the local environment. Therefore, this study aimed to review the potential of Local Crude House Dust Extracts (LCHDE) as a regionally relevant substitute source of allergens for both diagnostic and therapeutic applications. LCHDE reflects real environmental exposure, including region-specific mite, fungal, and bacterial components, which could better represent local allergen profiles. LCHDE offered a promising, cost-effective, and contextually relevant option for allergy diagnosis in developing regions. However, its application in immunotherapy necessitated rigorous allergen profiling, and regional collaboration was crucial to establish a CHDE suitable for clinical use.

Recent cuts to global health funding and US withdrawal from the World Health Organization have generated claims that global health has entered a new crisis. This essay argues that such accounts misread the present moment. The better view is that global health operates through a 'crisis form', a modality of governance in which structural inequality is treated as ordinary, acute disruptions (Big Events) are framed as emergencies, and responses to Big Events restore institutional authority without transforming the historically continuous racialized political economy in which global health is embedded. Drawing on past Big Events we trace this pattern from colonial medicine, through Alma Ata, HIV/AIDS, Ebola to COVID-19, showing how each Big Event exposed the underlying structural problems in global health and generated promises of change while preserving structural inequality. We then analyze early 2025 commentaries on aid cuts and US withdrawal from the World Health Organization to show how crisis discourse, even at a moment ripe with decolonial talk, channels political energy into the language of rescue and renewal, leaving deeper systemic questions of redress and redistribution untouched. In response, the essay develops reparatory global health as a political and conceptual orientation that calls for a refusal of restoration by taking the structural problems exposed by Big Events as the object of action, and by treating reparations as transformative, tactical, and oriented towards structural change and non-recurrence.

The high-performance industrial processes under dynamic and complicated workloads require efficient allocation of tasks and control of information. Traditional frameworks are based on unrestricted scheduling and have low scalability, low adaptability, and low resource demand, which in turn causes slow information latency and maintenance downtime, eventually reducing operation efficiency and productivity. The proposed research is the Integrated Information Analytical Framework (IIAF) to optimize the management of cognitive data and processing industrial tasks. The framework also includes an initial task category determination facility to allow task-oriented data processing and a smooth transition to the task allocation stream to enhance processing speed and the accuracy of classification. It also uses dynamic scheduling and smart data management in order to minimize information latency and responsiveness to dynamic workloads. There are real-time cognitive decision-making algorithms that are used to optimize the allocation of resources as well as enhance the scalability and throughput of systems. The experiments prove that IIAF enhances allocation rate by 7.03%, accuracy by 11.78%, lowers information latency by 12.03%, and allocates time by 20.89%. Moreover, it can minimize overload tasks by 18.65% and minimize downtime by up to 37.4%, which proves to be efficient in optimizing the industry.

BackgroundInadequate positioning and attachment in the early postpartum period frequently result in breast soreness, which is among the leading causes of breastfeeding discontinuation. These conditions compromise exclusive breastfeeding and may adversely affect infant nutrition, underscoring the importance of effective antenatal breastfeeding education. Yet, few studies have evaluated clinical approaches to improving breastfeeding technique during pregnancy in this setting.ObjectivesThis study aims to investigate the impact of antenatal breastfeeding education delivered through clinical demonstrations on the incidence of breast soreness among primiparous Indonesian women.MethodsA quasi-experimental design with equivalent-time samples will be used. Participants will be pregnant women in their third trimester, randomized 1:1 into experimental and control groups. The intervention group will receive two 40-minute sessions, including a clinical demonstration of correct breastfeeding positioning and attachment, and an educational electronic booklet ("e-booklet"), while the control group will receive standard educational materials once. Primary outcomes will be evaluated at 7 and 14 days postpartum. Data analysis will include independent t-tests and repeated-measures analysis of variance (ANOVA) to compare mean differences between groups, with multivariate logistic regression used to identify covariates.SummaryThis protocol will inform future interventions and programs aimed at strengthening breastfeeding education among primiparous mothers in Indonesian community settings. Findings may also guide the application of evidence-based best practices in similar contexts worldwide, with potential implications for reducing early feeding difficulties.

To advance towards a more responsive, equitable and sustainable model of primary care, it is necessary, among other actions, to move beyond the traditional structure centred on the roles of nurses and physicians. The existence of the primary care team is grounded in the principles established in the Declaration of Alma-Ata (1978). This article analyses the factors that currently hinder its effectiveness, based on the needs it is expected to address, and proposes criteria that may contribute to its improvement and further development, focusing efforts on providing comprehensive care to individuals from an individual, family and community perspective. Such development is possible by giving greater prominence to collaborative clinical management processes, as well as to training, communication and intra-team coordination, together with the assumption by all team members of new professional profiles and competencies, so that each activity is carried out by the professional most competent to do so. This transformation redefines professional roles, resulting in an interdisciplinary and multiprofessional team that brings together nurses, physicians and administrative staff with other professional roles -established roles that are not yet fully integrated into primary care teams-, such as physiotherapists, pharmacists, dentists, psychologists and nursing assistants. The aim is to jointly address diagnoses, treatments and care, as well as complex care processes, thereby enhancing problem-solving capacity and expanding care delivery beyond the physical structure of the health centre.

Primary care is essential in achieving universal health coverage and addressing health inequities. This article begins by tracing the historical evolution of primary care: its foundational principles, established by the Dawson Report and the Alma-Ata Declaration, which advocate for accessible, community-based health care as a fundamental human right. It focuses on the multifaceted contributions of primary care to health outcomes, disease prevention, and health promotion, underscoring its function as the entry point to the health care system. It also critiques the charity model in global health, proposing a solidarity-based approach that fosters equitable partnerships and local ownership in health care delivery.

Childhood overweight and obesity is a growing public health challenge in Indonesia, affecting approximately one in five school-aged children. Because children spend substantial time at school and frequently obtain meals and snacks from on-site canteens, these settings represent an important opportunity for nutrition-focused interventions. As an initial step towards understanding factors influencing canteen stocking decisions, we assessed perceived taste, acceptability, and feasibility of healthier local foods and beverages from the perspectives of canteen owners and school administrators (n = 10) across five primary schools (n = 2 urban, n = 3 rural) in Magelang, Indonesia. Participants completed in-person taste tests of selected food and beverage options and participated in in-depth interviews exploring drivers of stocking decisions. IndoMilk (multi-cereal, reduced-sugar dairy beverage) received the most favorable taste ratings and was perceived as the most feasible option to sell, followed by sate telur puyuh (braised quail eggs) and sate buah (fresh fruit skewers). In contrast, gethuk (cassava/coconut cake) and polo pendem (steamed tubers with boiled peanuts) were viewed as less appealing to children and unlikely to be sold. Participants identified children's taste preferences, affordability, visual appeal, and profitability as key considerations influencing stocking decisions, while perceptions of nutrition varied. Findings from this pilot study highlight contextual factors shaping school canteen food environments and may inform future interventions aimed at introducing healthier options while accounting for children's preferences and canteen operational constraints.

Childhood obesity is an increasing concern in Indonesia, yet little is known about the content and sources of foods offered in Indonesian school food environments. This study aimed to examine the composition and preparation of foods sold in primary school canteens, and to identify potential modifications to address diet-related obesity risk. A cross-sectional survey of canteen vendors (n = 10) and structured observations of prepared foods (n = 112) sold in canteens were conducted across eight private and public primary schools in Central Java, Indonesia. Foods were categorized by food group, preparation method, and meal type, and associations with factors such as cost, location of sale, and the individual responsible for preparation were analysed using chi-square and t-test analyses. Among all prepared foods observed, 73.2% were classified as main meals and 26.8% as desserts, with parents often playing a central role in food preparation. Nearly half (47.3%) of non-beverage items were deep-fried, and the majority of dishes did not align with Indonesian Balanced Nutrition Guidelines. A compositional analysis of each main meal's ingredients revealed that 29.3% lacked protein and 90.2% did not contain vegetables. Foods that were not deep-fried were priced significantly higher than deep-fried foods (x̄ = Rp.1846 ($0.11) vs Rp.1406 ($0.09); p < 0.001). Overall, the majority of prepared foods available to schoolchildren were low in nutritional quality, with limited fruits and vegetables and heavy reliance on frying. These findings highlight the need for strategies that combine parent education on healthy food preparation with economic incentives to increase the accessibility of healthier food options within Indonesian school canteens.