The researchers enrolled pregnant women at 36 weeks of gestation or later between March 21 and June 20, 2024. Two centers in Bahrain’s Southern Governorate delivered the intervention, while two in the Northern Governorate provided standard care. Of 193 women approached, 175 enrolled, comprising 81 in the intervention arm and 94 in controls. Each intervention package had three inseparable elements: a standardized session delivered by a trained mother-and-child health midwife during a routine antenatal visit, an early booking for a postnatal consultation between six weeks and six months after delivery, and QR-coded educational material. Control centers offered the national program’s usual verbal notification, with women expected to arrange their own postnatal visit after childbirth.

Within the intervention group, immediate changes were striking. Mean knowledge scores on a nine-item scale rose from 2.16 before the session to 8.48 afterward, a mean increase of 6.32 points (95% CI 5.62–7.03; p<0.001). Attitudes measured on an eight-item, 40-point scale increased from 25.79 to 35.89, a mean gain of 10.10 points (95% CI 8.77–11.43; p<0.001). The standardized effect sizes were large, with Cohen’s dz values of 1.98 for knowledge and 1.65 for attitude. Forty-eight percent of intervention participants scored at least 38 out of 40 after the session, and 31 reached the maximum. These measurements were taken minutes apart, however, and the control group was assessed only once. Without a concurrent second measurement, the increases could reflect immediate recall, repeated questionnaire exposure, social-desirability effects or the antenatal visit itself rather than the session alone.

Postnatal attendance was the outcome assessed identically in both arms, using electronic mother-and-child health records at each woman’s own center. A documented consultation with either a physician or a staff nurse counted as attendance. Six of the 175 participants could not be matched to a delivery record, leaving 169 outcomes; the result remained statistically significant under all four extreme assumptions about those missing observations. The observed difference was 31.4 percentage points (95% CI 17.3–45.6), corresponding to a risk ratio of 1.76 and a number needed to treat of about three women for one additional postnatal consultation. Both groups exceeded the 29% national attendance rate recorded in 2019, before face-to-face postnatal services were disrupted by the COVID-19 pandemic. The control proportion also exceeded the 27% found in a 2023 national survey, making it an imperfect estimate of attendance under untreated routine care.

Center-level results expose the study’s central weakness. Attendance was 69.7% and 75.0% in the two intervention centers, but 26.5% and 58.1% in the control centers. The 31.6-percentage-point gap between control centers was as large as the overall difference between study arms, and one control center performed almost as well as the intervention centers. The centers were selected by convenience, their division into study arms was not random, and the arms were geographically separated, making study group completely confounded with governorate. Historical service data were unavailable to establish baseline equivalence. An intraclass correlation coefficient of 0.091 for attendance produced a design effect of 4.73 and an effective sample of approximately 36 women rather than 169. When this clustering adjustment was applied, the confidence interval for the unadjusted odds ratio included the null value.

The adjusted logistic regression strengthened the reported association, with intervention-group status remaining the only significant predictor of attendance. Baseline knowledge and attitude did not independently predict attendance in the model or in exploratory comparisons. That absence of evidence does not establish that understanding and attitudes are unimportant, particularly because the study was not designed to prove an absence of effect. It instead suggests that the structural elements of care may have been more closely connected with attendance than individual scores measured after the session. The intervention cannot identify which component mattered because education, QR-coded material and advance booking were always delivered together. The design also did not measure session duration, training duration, delivery fidelity, staff workload or implementation cost.

The study population offers additional context. Participants were Bahraini women or non-Bahraini women married to Bahrainis, were at least 18 years old, attended antenatal care at 36 weeks or later, spoke Arabic or English, used smartphones and did not have diabetes, hypertension, sickle cell disease or difficulty understanding the educational material. Excluding women without smartphones improved comparability between arms but limited generalizability, since those women may face some of the greatest barriers to postnatal care. The intervention group was older and had a more favorable family-income distribution, while baseline knowledge was also higher and attitudes were less favorable. The study did not establish baseline equivalence between the four centers, and the sample fell short of its target of 100 women per group. Among exploratory medical comparisons, daily medication use was associated with lower attendance, 34.2% compared with 61.8% among women not taking medication, but the finding came from multiple uncorrected subgroup tests and requires dedicated study.

Awareness of the postnatal clinic largely depended on informal networks. Among respondents who knew the clinic existed, 20% cited friends and 18% cited family, making social connections the leading reported sources of information. Doctors during antenatal visits accounted for 17%, doctors after delivery for 16%, and formal health-education sessions for only 3%. These findings connect the intervention to a practical problem: accurate information was often available through relatives and peers, while structured channels were rarely used. The intervention also tested more than information alone. By securing an appointment before delivery, it attempted to remove an organizational step that women in the control arm had to complete independently after childbirth, a task that a prior national survey found many women did not know how to perform.

For practice, the findings support further testing of routine early booking and provider-led counseling as an integrated antenatal service, rather than treating education and appointment logistics as separate issues. Bahrain’s postnatal clinics provide a free consultation for a general maternal assessment, depression screening and counseling on breastfeeding and family planning. The package tested in this study was delivered within an existing antenatal appointment, but the research did not demonstrate its cost, sustainability or acceptability. Confirmation now requires a larger cluster-randomized trial or a stronger quasi-experimental design involving more centers, preferably one capable of separating midwife counseling from advance booking and QR-coded information. Until then, the scientifically supported conclusion is that the combined approach was associated with higher documented postnatal attendance in the participating centers, while knowledge and attitudes improved immediately within the intervention arm. The striking between-arm result warrants attention, but the equally striking center-to-center variation prevents a definitive claim that the package itself caused the increase.

Subject of Research: Antenatal counseling and early postnatal booking in Bahraini primary health care centers

Article Title: Antenatal health education with early postnatal booking and postnatal clinic attendance in primary health care centers in Bahrain: a quasi-experimental study

Article References: Alhaddad, M. E. E., Hubail, M. A. H., Rashed, M. M. A., Alnajjar, I. B. S., Husain, T. K. S., AlAali, F. A., Asoomi, H. A., Makarem, B., Chlif, S., Habbash, F., Almarabheh, A., Salah, A. B., & Shehata, M. H. (2026). Antenatal health education with early postnatal booking and postnatal clinic attendance in primary health care centers in Bahrain: a quasi-experimental study. Frontiers in Public Health, 14, Article 1938634. https://doi.org/10.3389/fpubh.2026.1938634

Image Credits: AI Generated

DOI: 10.3389/fpubh.2026.1938634

Keywords: Bahrain, postnatal care, antenatal education, early booking, maternal health, primary health care, clinic attendance, quasi-experimental study, health services, Antenatal, health, education

The study, led by Fatema Habbash of Arabian Gulf University and colleagues, used multistage and systematic sampling to recruit participants and conducted face-to-face interviews with a structured questionnaire. Among the 302 women surveyed, 181, or 59.9%, had undergone mammography at least once. But only 59, or 19.6%, had been screened within the recommended interval. That distinction matters enormously. A single mammogram can detect an existing tumour, but regular screening at fixed intervals is what allows radiologists to compare images over time and identify subtle changes that signal early malignancy. The low regular-screening rate suggests that many women view mammography as a one-time event rather than an ongoing preventive habit.

The barriers the researchers identified are striking in their ordinariness. The most common reason for not screening, cited by 67.9% of women, was simply believing mammography was unnecessary. Close behind, at 64.4%, was the absence of a physician recommendation. Insufficient information accounted for 42.4% of non-uptake. Fear of pain and fear of a cancer diagnosis each affected 30.9% of women, while fear of treatment or mastectomy affected 27.6%. Being asymptomatic was cited by 23.4%, embarrassment by 23.0%, concerns about radiation by 15.6%, and lack of time by 10.0%. Taken together, these numbers paint a picture of a population that largely does not see itself as at risk and has not been told otherwise by the medical professionals it trusts.

That last point deserves particular attention. The belief that mammography is unnecessary unless symptoms appear is a well-documented misconception in many populations, and it is especially consequential because early breast cancer is frequently asymptomatic. The whole purpose of screening is to detect disease before it announces itself. When nearly a quarter of women cite being asymptomatic as a reason not to screen, it signals a fundamental misunderstanding of what screening is for. Similarly, the finding that two-thirds of women lacked a physician recommendation highlights the decisive role that primary care providers play in translating public health guidelines into individual action.

When the researchers analysed which factors were actually associated with screening uptake, the results were unambiguous. Screening was significantly linked to age, family history of breast cancer, previous breast-related problems, and receiving a screening invitation from a healthcare provider. In multivariable analysis, which adjusts for the influence of other variables, receiving a formal screening invitation within the previous two years was strongly associated with higher uptake, with an adjusted odds ratio of 5.23 and a 95% confidence interval of 2.55 to 10.72. In practical terms, women who received a formal invitation were more than five times as likely to have been screened as those who did not. That is one of the strongest effects a public health intervention can produce, and it points to a remarkably simple lever for change.

The other significant predictors reinforce the clinical logic of existing screening programmes. Women aged 50 and above were more likely to undergo screening, consistent with the fact that breast cancer risk rises with age and that most international guidelines prioritise this group. Women with a family history of breast cancer were also more likely to screen, reflecting heightened perceived susceptibility. And those with previous breast-related problems were more likely to have had a mammogram, likely because such problems prompt clinical follow-up. What emerges is a pattern in which women who already perceive themselves as at risk, or who have been personally prompted by the health system, take action, while everyone else falls through the cracks.

The implications for Bahrain and the wider Gulf region are significant. The Gulf Cooperation Council countries share cultural, demographic, and healthcare-system characteristics, and the barriers identified here—misconceptions about necessity, fear of diagnosis, embarrassment, and reliance on physician prompting—are likely to resonate across the region. The study’s authors argue that culturally tailored health education, systematic screening invitations, and proactive physician recommendations may improve participation. The strength of the invitation effect suggests that a structured invitation system, in which every eligible woman receives a formal prompt at recommended intervals, could dramatically raise regular screening rates without requiring new technology or infrastructure.

The researchers also point toward the future of screening outreach. They call for future research to assess technology- and AI-supported outreach strategies, especially for younger, asymptomatic, and under-screened women. The logic is compelling: the women least likely to screen are those who feel well and see no reason to visit a clinic, and reaching them may require digital reminders, mobile health applications, or AI-driven risk stratification that identifies who needs prompting most. In a country with high smartphone penetration and a well-developed primary healthcare network, the technical foundations for such outreach already exist.

What makes this study particularly valuable is its methodological rigour. By randomly selecting participants across all four governorates using multistage and systematic sampling, the researchers produced a sample that reflects the broader population of Bahraini women in the target age range. The face-to-face interview approach minimised literacy barriers and ensured consistent data collection. The multivariable analysis distinguished between factors that merely correlate with screening and those that independently drive it. The finding that a formal invitation independently predicts uptake, even after adjusting for age, family history, and breast-related problems, gives policymakers a clear, evidence-based target.

For a condition that is the most common cancer among women worldwide, the gap between what screening can achieve and what regular screening rates actually are remains one of public health’s most stubborn challenges. This study shows that in Bahrain, the solution may not lie in convincing women one by one, but in building a system that reaches out to them automatically. A formal invitation, delivered at the right interval, backed by culturally attuned education and proactive primary care physicians, could transform mammography from an occasional event into a routine preventive habit. The evidence suggests that the simplest intervention—asking women to come in for screening—may be the most powerful one available.

Subject of Research: Public Health

Article Title: Determinants and barriers to mammography screening uptake among Bahraini women: a cross-sectional study in primary healthcare settings

Article References: Habbash, F., AlMohri, M., Waleed, A., Hamdan, H., Salman, K., Obaid, S., Abdulla, Z., Almarabheh, A., & Salah, A. B. (2026). Determinants and barriers to mammography screening uptake among Bahraini women: a cross-sectional study in primary healthcare settings. BMC Public Health. https://doi.org/10.1186/s12889-026-29859-9

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29859-9

Keywords: mammography, breast cancer screening, Bahrain, public health, preventive medicine, primary healthcare, cancer epidemiology, Determinants, barriers, screening, uptake, Bahraini

The study’s author, Subathra Jeyaram of the Department of Patient Well-Being at the Bahrain Oncology Centre within the Royal Medical Services, grounds the work in direct clinical observation rather than retrospective surveys. This real-time approach matters because the psychological landscape of a crisis is fluid: patients’ fears, coping strategies, and emotional states shift as the security situation evolves, and a snapshot taken months later would inevitably smooth out the very variability the research seeks to document. By describing response patterns as they emerged in clinical interactions, the study captures the heterogeneity of patient experience in a way that conventional distress measurement, which typically treats anxiety and depression as endpoints on a scale, does not.

The first and arguably most striking pattern is the defiant or adaptive response. Patients in this group appeared to absorb the external threat and, in a sense, metabolize it into resolve. Rather than collapsing under the combined weight of illness and insecurity, they continued treatment adherence and maintained engagement with care, sometimes framing their fight against cancer as a battle that no missile could interrupt. This pattern resonates with long-standing theoretical work on coping, particularly Susan Folkman’s influential 1997 model of positive psychological states and coping with severe stress, which demonstrated that even under extreme adversity, people can generate meaning, hope, and positive affect that sustain adaptive functioning. The Bahrain observations suggest that geopolitical crisis can, for some patients, activate rather than suppress these positive coping resources.

At the opposite end of the spectrum sits the overwhelmed pattern, in which the dual burden of cancer and crisis exceeds the patient’s regulatory capacity. These patients experienced the convergence of two existential threats as fundamentally destabilizing, with the uncertainty of the security situation amplifying the already profound uncertainty of a cancer diagnosis. The study situates this pattern within a well-documented research tradition on uncertainty in illness: recent work published in the Journal of Health Psychology in 2025 examined the relationship between illness-related uncertainty and psychological adjustment to chronic disease, finding that prolonged uncertainty is a potent driver of maladjustment. When national events inject a second, uncontrollable source of uncertainty into a patient’s life, the additive effect can push coping systems past their limits, producing acute distress that demands immediate clinical attention.

A third pattern, described as reassuring or other-focused, reveals a subtler psychological dynamic. Patients exhibiting this response directed their emotional energy toward calming family members, fellow patients, or caregivers, presenting themselves as composed even while internally struggling. This other-oriented coping style raises important questions about the accuracy of routine distress screening, because a patient who appears calm and who reassures others may score below clinical thresholds on standard instruments while carrying substantial hidden burden. The National Comprehensive Cancer Network’s Distress Management guidelines, updated in 2026, emphasize systematic screening as the cornerstone of psychosocial oncology care, and this Bahraini typology suggests that screening protocols may need to account for patients whose coping style is to mask their own distress behind caretaking of others.

The fourth pattern, anticipatory anxiety, captures patients whose distress was oriented toward feared future scenarios rather than present circumstances. These individuals experienced intrusive worry about what might happen next: further escalation, disruption of treatment supply chains, evacuation, or personal harm. Cognitive theory offers a lens for understanding this pattern. Research on catastrophic thinking, including a 2016 analysis by Gellatly and Beck published in Cognitive Therapy and Research, identifies catastrophizing as a transdiagnostic process that fuels anxiety across psychiatric conditions. In the oncology setting, where patients already face an uncertain prognosis, the geopolitical crisis supplied fresh material for catastrophic cognitions, effectively doubling the imagined futures over which the mind could ruminate.

Perhaps the most clinically novel contribution is the fifth pattern: caregiver-patient dyadic anxiety. This pattern recognizes that distress in oncology is rarely an individual phenomenon. The crisis did not stop at the patient’s bedside; it swept up spouses, children, and parents, whose fears about both the war and the illness fed back into the patient’s emotional state. Recent dyadic research in psycho-oncology, including a 2024 study in Psycho-Oncology examining patients’ and caregivers’ attachment orientations and mutually supportive care, underscores that patient and caregiver psychological states are intertwined systems. The Bahrain observations extend this insight into crisis conditions, suggesting that during geopolitical emergencies, the dyad, not the individual, should be the unit of assessment and intervention.

The theoretical significance of the typology lies in how it extends existing models of distress and coping. Classic frameworks such as Miller’s 1987 work on monitoring and blunting describe stable individual styles of information seeking under threat, and Folkman’s model describes how positive states can coexist with severe stress. The Bahrain typology adds a contextual layer: it shows that the same external crisis can evoke qualitatively different response configurations across patients, and that these configurations are observable in real time by trained clinicians. Rather than replacing established theory, the framework functions as an experience-informed bridge between abstract coping constructs and the practical decisions a psycho-oncologist must make during a crisis, such as which patients need urgent intervention, which need family-centered support, and which may benefit most from reinforcement of their existing adaptive strengths.

The context in which these patterns emerged was extraordinary even by the standards of a volatile region. According to reporting cited in the study, Iranian missiles reached Gulf cities in late February 2026 following strikes on Iran, causing casualties in the United Arab Emirates and sending shockwaves of fear through populations across the Arabian Peninsula. Bahrain, a small island nation hosting significant international presence, found itself within the psychological blast radius of a conflict that no one in the oncology ward had chosen. The study also situates the crisis within broader indicators of regional stability and human development, referencing the United Nations Development Programme’s 2023/2024 Human Development Report and comparative crime index data, underscoring that patients’ perceptions of safety are shaped by both objective conditions and the information environment surrounding them.

The practical implications reach far beyond Bahrain. Oncology centers worldwide operate in regions exposed to conflict, natural disaster, and political instability, and even centers in stable countries treat patients who carry trauma from crises elsewhere. The typology offers a vocabulary that clinicians can use to recognize response patterns quickly: the defiant patient who may need help sustaining rather than building coping; the overwhelmed patient who needs immediate stabilization; the reassuring patient who needs permission to disclose hidden fear; the catastrophizing patient who may respond to cognitive techniques targeting anticipatory anxiety; and the anxious dyad that benefits from family-inclusive care. The study also carries a quiet warning about clinician burden, referencing the literature on physician burnout, since frontline staff managing crisis-era oncology care must absorb not only their patients’ distress but the same ambient fear that patients experience.

Published as a conceptual contribution with no datasets generated or analyzed, the study is transparent about its nature: it is a practice-derived typology, not a statistical classification. Its strength is ecological validity, grounded in real interactions at a single tertiary center during an actual crisis; its limitation is the need for empirical validation across settings, cultures, and future emergencies. Yet the framework arrives at a moment when health systems are increasingly asked to plan for the psychosocial consequences of large-scale disruptions, from war to pandemic to climate-driven displacement. By naming five recognizable faces of patient response, the research transforms an amorphous crisis into something clinicians can see, discuss, and act upon, and it makes a compelling case that supportive cancer care must be designed not only for the disease inside the patient but for the world outside the hospital window.

Subject of Research: Psychological response patterns of cancer patients during geopolitical crisis

Article Title: Uncertainty, adaptation, and distress: Understanding cancer patient responses in a time of geopolitical crisis in Bahrain

Article References: Jeyaram, S. (2026). Uncertainty, adaptation, and distress: Understanding cancer patient responses in a time of geopolitical crisis in Bahrain. Supportive Care in Cancer, 34(10), Article 1026. https://doi.org/10.1007/s00520-026-11281-x

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11281-x

Keywords: psycho-oncology, cancer distress, geopolitical crisis, coping, uncertainty in illness, Bahrain, caregiver dyad, anticipatory anxiety, distress screening, resilience, supportive care, mental health

The study, covering the period from 2000 to 2024, departs from much of the existing environmental literature in a crucial way. Rather than relying on carbon emissions as the sole indicator of environmental degradation, the researchers used the ecological footprint, which captures a far broader range of demands, including land conversion, resource extraction, and waste absorption. This distinction matters particularly in arid, import-dependent economies, where the environmental costs of development extend well beyond the smokestack. The team also chose to examine the four countries as a coherent group rather than subsuming them into a large, heterogeneous international panel, because Saudi Arabia and the United Arab Emirates—the two remaining GCC members—lack sufficiently consistent ecological footprint data before 2024 and therefore fell outside the study period.

Methodologically, the analysis is anchored in the STIRPAT framework, a stochastic reformulation of the classic IPAT identity first proposed by Paul Ehrlich and John Holdren in 1971 and later refined by Thomas Dietz and Eugene Rosa. STIRPAT holds that environmental impact emerges from the interplay of population, affluence, and technology, but its great strength is flexibility: researchers can add context-specific variables where the empirical setting demands it. Here, the model was augmented with annual freshwater withdrawals, food imports as a share of merchandise imports, government effectiveness and control of corruption from the Worldwide Governance Indicators, and urbanization, alongside the conventional affluence and technology proxies of GDP per capita and energy use, the latter two entered in natural logarithmic form to stabilize their distributions.

The econometric strategy was tailored to the realities of a very small panel—just four countries observed annually over a quarter century. The researchers first confirmed through country-by-country Augmented Dickey–Fuller tests that no variable was integrated beyond first difference, a prerequisite for the Pooled Mean Group ARDL estimator they used to capture average long-run relationships. They then applied the Method of Moments Quantile Regression approach of Machado and Santos Silva, which allows coefficients to vary across the distribution of ecological footprint rather than forcing a single average effect. Robustness checks using Driscoll–Kraay standard errors, panel-corrected standard errors, and feasible generalized least squares, all with year effects, rounded out the design. Missing data—just 25 of 800 cells, or 3.1 percent—were handled by linear interpolation, and re-estimation on the non-imputed sample confirmed the findings were not artifacts of that choice.

The results tell a strikingly consistent story for three variables. Annual freshwater withdrawals, measured in billion cubic meters, carry a positive and significant association with ecological footprint in the long-run model and at the median and upper quantiles of the distribution, with standardized effects rising from 0.544 at the 25th percentile to 0.701 at the 75th. GDP per capita is positive and highly significant across every quantile and every robustness specification, its standardized coefficient climbing from 0.352 to 0.571 as ecological pressure intensifies. Energy use, similarly, is positive and significant throughout, though its effect diminishes slightly at higher quantiles. In a region where cooling demand persists for much of the year, desalinated water production is enormously energy-intensive, and transport networks span vast distances, this triad of water extraction, affluence, and energy consumption forms the backbone of ecological pressure.

Food imports present a more counterintuitive finding. The variable is negatively and significantly associated with ecological footprint across all quantiles and all robustness models, though not in the pooled long-run average. The authors are careful to warn against the tempting but incorrect interpretation that imports simply offload environmental pressure onto exporting nations. Because the Global Footprint Network’s footprint measure is consumption-based, it already incorporates the ecological demand embodied in imported goods. Instead, the negative coefficient more plausibly reflects that in economies where domestic agriculture would require prodigious inputs of water, energy, and land under brutal climatic conditions, sourcing food externally may be associated with less domestic ecological strain than expanding local production—a finding with real implications for food-security strategies across the arid world.

Perhaps the most provocative results concern governance. Government effectiveness, expected to reduce ecological pressure by improving regulatory quality and policy implementation, instead carries a positive and significant coefficient in the long-run model and is statistically insignificant elsewhere. Control of corruption behaves erratically, negative in the long-run specification but positive in several robustness models. Urbanization, anticipated to intensify ecological demand through construction, transport, and cooling, is consistently negative across specifications, though its significance varies. The authors suggest that in already almost fully urbanized societies, additional concentration may bring efficiencies of denser service delivery, and that stronger state capacity in the Gulf may simply execute resource-intensive development more effectively rather than restraining it. Institutional quality, they conclude, does not automatically translate into ecological restraint when the underlying development model remains materially demanding.

The descriptive statistics underline how extreme the setting is. Mean ecological footprint across the sample stands at 8.86 global hectares per capita, with a maximum of 16.43—figures that dwarf global averages. Urbanization averages 92.65 percent of population. Qatar records the highest footprints for most of the period, with pronounced peaks in the late 2000s and early 2010s, while Oman shows the lowest levels and the highest freshwater withdrawals. The Pesaran–Yamagata test rejects slope homogeneity across the four countries, confirming that the drivers of ecological pressure do not operate identically even within this seemingly uniform region, which is precisely why the authors combined distribution-sensitive estimation with multiple robustness checks rather than relying on a single average-effect model.

For policymakers, the message is that environmental strategy in arid, affluent economies should target the channels that matter most: demand management and leakage reduction in water systems, cleaner and more efficient energy provision, and the material intensity of income-linked consumption. Efforts to expand domestic food production deserve careful scrutiny of their water and energy requirements, since ecological sustainability and strategic resilience may not always point to the same policy choices. The authors also stress the limits of their evidence: with only four countries, the findings describe conditional associations rather than proven causal effects, and broad governance indicators cannot identify which specific institutional mechanisms matter. Future work, they suggest, should incorporate desalination intensity, wastewater reuse, cooling demand, and sector-specific governance measures as finer-grained data become available for all six GCC members.

Subject of Research: Determinants of ecological footprint in water-scarce Gulf Cooperation Council economies

Article Title: Ecological footprint in selected GCC economies: The roles of water withdrawals, food imports, governance, urbanization, income, and energy use

Article References: Ridwan, M., Antor, Z. A., Ko, J., Haseeb, M., Khudoykulov, K., & Lee, H. F. (2026). Ecological footprint in selected GCC economies: The roles of water withdrawals, food imports, governance, urbanization, income, and energy use. Environmental and Sustainability Indicators, 32, Article 101542. https://doi.org/10.1016/j.indic.2026.101542

Image Credits: AI Generated

DOI: 10.1016/j.indic.2026.101542

Keywords: ecological footprint, GCC, water scarcity, food imports, governance, urbanization, energy use, STIRPAT, quantile regression, Bahrain, Kuwait, Qatar