Many vaccines and drugs hold the promise of reducing mortality and morbidity among pregnant women and infants living in low- and middle-income countries (LMICs). However, sufficient information on the safety of drugs and vaccines in pregnant women is rarely available at the time of product licensure... or approval. To account for this, active safety surveillance efforts are needed during the post-licensure and post-approval
phase to assess the safety of drugs and vaccines in pregnant women and their offspring. Pregnancy exposure registries (PER) are used to monitor the safety of vaccines and drugs. PERs are observational studies that systematically collect health information on exposure to medical products such as drugs and vaccines during pregnancy. This review demonstrates that a number of resources presently exist in LMICs that perform active safety surveillance in pregnant populations. These results indicate such systems employ a wide variety of approaches, each with their own set of strengths and challenges, as summarized in the final section of the report.
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Guide for community-based management and care of people with dementia
Version 1.0
Mental Health and Substance Abuse
Division of NCD and Health through the Life-Course
World Health Organization Regional Office for the Western Pacific
This article looks at the Baseline Standards developed by the International Society for Paediatric
Oncology (SIOP) for paediatric oncology nursing care in low- and middle-income countries. The
Baseline Standards lay the foundation for effective care and address barriers such as inadequate
staffin...g levels, lack of support, limited access to nurse education and unsafe nursing environments.
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Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This s...tudy aimed to test both interventions in low-income and middle-income countries.
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Non-communicable diseases (NCDs) pose a substantial threat to many health systems, especially in low-income and middle-income countries (LMICs) where they are already overstretched. In the past few decades, deaths from NCDs in LMICs have spiked, whereas numbers in high-income countries have stabilis...ed. Worryingly, a large proportion of deaths from NCDs (29%) in LMICs occur among people younger than 60 years compared with the proportion in high-income countries (13%). This finding has been attributed to poor access to effective and equitable health-care services in most LMICs. The threat of NCDs in LMICs was recognised by the UN 2011 High-Level Meeting, and is now featured in Sustainable Development Goal 3 in the form of reducing premature mortality from NCDs by one-third before 2030. Cardiovascular diseases (CVDs) are the leading cause of deaths from NCDs (ie, 48% of all NCDs deaths). Therefore, substantial reductions in CVDs will have a major impact on reducing the overall burden of NCDs globally. The good news is that most CVDs can be prevented by addressing the key underlying behavioural risk factors, such as physical inactivity, unhealthy diet, tobacco use, and harmful use of alcohol, through population-wide approaches. Among individuals with or at high risk of CVD, early detection and effective management with appropriate counselling and medicines can reduce cardiovascular deaths substantially.
The importance of effective treatment for CVD has been recognised in the Global NCD Action Plan 2013–20, for which one of the nine global targets is that at least 50% of eligible individuals should receive drug therapy and counselling to prevent heart attacks and strokes by 2025.5 Although admirable, this is a hard target to achieve given that secondary prevention strategies in LMICs are often unaffordable or unavailable.
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October 2009 | Volume 6 | Issue 10 | e1000162
Conclusion: CBR has improved the quality of life, access to medical services, functional independence, autonomy, community inclusion, and empowerment of people with disabilities in LMICs in the Asia-Pacific region. However, challenges in the implementation of CBR remain. These include lack of awaren...ess and understanding of CBR, and physical, environmental, socio-economical and personal barriers.
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Data on the essential building blocks of mental health systems, including mental health
governance, financing, service delivery, human resources and information, are reported. For
mental health planning, it is important to know not only the level of resources in these six areas,
but also how thos...e resources are being organized and utilized. Thus, data on efficiency, access,
equity, linkages with other sectors and respect for human rights are reported as well.
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November 3, 2009https://doi.org/10.1371/journal.pmed.1000176
PLoS Med 6(11): e1000176. https://doi.org/10.1371/journal.pmed.1000176
PLoS Med. 2009 Oct;6(10):e1000159. doi: 10.1371/journal.pmed.1000159. Epub 2009 Oct 6.
PLoS Medicine Vol. 6 no. 10 (2009) e1000165
Health Services Insights Volume 10: 1–7
Antimicrobial resistance (AMR) is a growing threat to our health, causing at least 700,000 deaths globally every year. The death toll attributed to AMR is predicted to rise, with most lives lost in low and middle income countries (LMICs).
AMR is also a critical challenge for many other sectors, inc...luding animal health and welfare, aquaculture, agriculture, food safety and broader socioeconomic development. A coordinated, cross-sectoral and multi-pronged approach is needed at all levels of government to ensure an effective and targeted response to this mounting resistance.
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Health sector reforms not only require attention to specific components but also a supportive environment. In low- and middle-income countries (LMICs), there is still much to be done on ensuring that people receive prioritized healthcare services. Despite LIMCs spending an average of 6% of their GDP... on health, there have been minimal impacts compared to high-income countries. Health sector reform is a gradual process with complex systems; hence, the need for a vision and long-term strategies to realize the desired goals. In this chapter, we present our proposal to advance universal health coverage (UHC) in LMICs. Overall, our main aim is to provide strategies for achieving actual UHC and not aspirational UHC in LMICs by strengthening health systems, improving health insurance coverage and financial protection, and reducing disparities in healthcare coverage especially on prioritized health problems, and enhancing a primary care-oriented healthcare system.
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Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit...h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
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Burns are a global public health problem, accounting for close to 200,000 deaths annually. The majority of these occur in low- and middle-income countries, where a number of constraints complicate the public health task of addressing burns. While the primary prevention of burns in low- and middle-in...come countries is a pressing need, the World Health Organization (WHO) also actively encourages further development of burn-care systems, including the training of health-care providers in the appropriate triage and management of people with burns.
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Objective: To review the effectiveness of antibiotic stewardship interventions in hospitals in low- and middle-income countries.