Health innovation is the creation and implementation of novel processes, products, programmes, policies or systems that lead to transformations or improvements in health and equity. This is the first instalment of "Innovation for Health," a knowledge product series dedicated to showcasing health inn...ovation in the Western Pacific and the roles governments can play. This case study documents the health innovation aimed at achieving equity in access to cataract surgical services in Malaysia, examines its enablers and barriers for further scaling up, and serves as a reference for Member States seeking new approaches to decentralize and deliver services to the unreached.
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While epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly low-income countries (LICs) including Liberia is lacking, prevalence in LICs is thought to be increasing. T1D care in LICs is often impacted by challenges in diagnosis and management. These challeng...es, including misdiagnosis and access to insulin, can affect T1D outcomes and frequency of severe complications. Despite the severe nature of T1D and growing burden in subSaharan Africa, little is currently known about the impact of T1D on patients and caregivers in the region. Methods We conducted a qualitative study consisting of interviews with patients with T1D, caregivers, providers, civil society members and a policy-maker in Liberia to better understand the psychosocial and economic impact of living with T1D, knowledge of T1D and selfmanagement, and barriers and facilitators for accessing T1D care.
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The Malawian government recently introduced cost-covering consultation fees for self-referral patients in tertiary public hospitals. Previously, patients received medicines free of charge in government-owned health facilities, but must pay elsewhere. Before the government implements a payment policy... in other areas of health care, it is important to investigate the prices, affordability and availability of essential medicines in Malawi.
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Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Afr...ica, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
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Asthma has a significant impact on people of all ages, particularly children. A lack of universally accepted case definition and confirmatory tests and a poor understanding of major risks interfere with a global response. We aimed to provide global estimates of asthma prevalence and cases in 2019 ac...ross four main epidemiological case definitions – current wheezing, ever wheezing, current asthma, and ever asthma. We further investigated major associated factors to determine regional and national distributions of prevalence and cases for current wheezing and ever asthma.
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Bronchial asthma is the most frequent chronic respiratory disease in both adults and children. The prevalence and burden of asthma vary considerably between different regions of the world. Information on asthma in Africa is fragmentary and relatively old.
THELANCETID-D-16-00800 S1473-3099(16)30318-8
Lancet Glob Health 2016; 4: e856–63. Open Access
The report is based on in-depth qualitative research in countries along the Eastern and Central Mediterranean routes. It focuses on Iraqi and Nigerian migrants as case studies, as Nigeria is the number one country of origin for migrants travelling along the Central Mediterranean route. Iraqis repres...ent the third biggest group of migrants who travelled along the Eastern Mediterranean route in 2016.
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Lancet Global Health 2017 Published Online February 22, 2017 http://dx.doi.org/10.1016/S2214-109X(17)30078-5
Clinical Infectious Diseases, cix705, https://doi.org/10.1093/cid/cix705
BMC Health Services Research 2012, 12:352
http://www.biomedcentral.com/1472-6963/12/352
Lancet 2017; 390: 2437–60
BMC Health Services Research BMC series – open, inclusive and trusted201818:251; https://doi.org/10.1186/s12913-018-3072-3
Journal of the International AIDS Society 2017, vol. 20:e25026
In Myanmar, men who have sex with men (MSM) experience high risk of HIV infection. However, access to HIV testing and prevention services remains a challenge among this marginalized population. The objective of this study was to est...imate population prevalence and correlates of prior HIV testing among young MSM (YMSM) and informs the development of HIV testing and intervention programmes that respond to the specific needs of this population.
https://doi.org/10.1002/jia2.25026
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Journal of the International AIDS Society Vol. 21 (2018) e25133
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the first day of antenatal care (“same-day” initiation...). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133
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