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Publication Years
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The Lancet Global Health Published:May 12, 2020DOI:https://doi.org/10.1016/S2214-109X(20)30229-1
Background: Asthma and chronic obstructive pulmonary disease (COPD) cause a considerable burden of morbidity
and mortality in low-income and middle-incom
...
e countries (LMICs). Access to safe, effective, quality-assured, and
affordable essential medicines is variable. We aimed to review the existing literature relating to the availability, cost,
and affordability of WHO’s essential medicines for asthma and COPD in LMICs.
more
Resilience and mental health in children and adolescents living in areas of armed conflict – a systematic review of findings in low- and middle-income countries
Tol, Wietse A. , Song, Suzan, Jordans, Mark J. D.
The Journal of Child Psychology and Psychiatry
(2018)
C1
Researchers focused on mental health of conflict-affected children are increasingly interested in the concept of resilience. Knowledge on resilience may assist in developing interventions aimed at improving positive outcomes or reducing negative outcomes, termed promotive or protective interventions
...
.
more
Background
The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive health service delivery to
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wards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published.
Methods
We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. We developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. We considered four service delivery platforms, and modelled two scenarios with differing levels of ambition: a progress scenario, in which countries’ advancement towards global targets is constrained by their health system’s assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. We estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. We projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability.
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Front. Med., 27 November 2020 | https://doi.org/10.3389/fmed.2020.594728. The Checklist included eight actions for implementing rural pathways in LMICs: establishing community needs; policies and partners; exploring existing workers and scope; selecting health workers; education and training; workin
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g conditions for recruitment and retention; accreditation and recognition of workers; professional support/up-skilling and; monitoring and evaluation. For each action, a summary of LMICs-specific evidence and prompts was developed to stimulate reflection and learning. To support implementation, rural pathways exemplars from different WHO regions were also compiled. Field-testing showed the Checklist is fit for purpose to guide holistic planning and benchmarking of rural pathways, irrespective of LMICs, stakeholder, or health worker type.
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The objective of this report is to assess the situational landscape during mid-May 2020 surrounding the value chain of the production and distribution of generic antiretroviral medicines in low- and-middle-
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income countries and to provide recommendations on mitigating the risks of potential disruptions.
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The aim of this brief is to ensure that the COVID-19 pandemic does not disrupt the supply of and demand generation for condoms. Sexual relations may be transformed in the new context of the pandemic, but they have not stopped. While access to male and female condoms has been critical in the global r
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esponse to reduce HIV, sexually transmitted infections (STIs) and unintended pregnancies over the past three decades, these gains can be lost if condoms are not included in the essential commodities that are freely available to populations during the lockdown of countries. This brief for country condom programme managers and experts provides a summary of relevant actions to sustain supplies of male condoms, female condoms and lubricants, and to adjust approaches for condom promotion during the time of COVID-19
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Front. Public Health, 30 April 2021 | https://doi.org/10.3389/fpubh.2021.628744
Promotion, prevention and protection: interventions at the population- and community-levels for mental, neurological and substance use disorders in low- and middle-income countries
I. Petersen; , S. Evans‐Lacko; M. Semrau; et al.
International Journal of Mental Health Systems; BioMed Central
(2016)
CC
Petersen et al. Int J Ment Health Syst (2016) 10:30 DOI 10.1186/s13033-016-0060-z
Int J Hyg Environ Health. 2019 Jun; 222(5): 765–777. doi: 10.1016/j.ijheh.2019.05.004;
To develop updated estimates in response to new exposure and exposure-response data of the
burden of diarrhoea, respiratory infections, malnutrition, schistosomiasis, malaria, soil-transmitted helminth
infec
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tions and trachoma from exposure to inadequate drinking-water, sanitation and hygiene behaviours
(WASH) with a focus on low- and middle-income countries.
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While epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly l
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ow-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 challenges, 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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One of the main limitations to accessing hearing aids is the lack of diagnostic and rehabilitative services, especially at primary and secondary levels of care. This is due to the small number of specialists in ear and hearing care, and to their poor territorial distribution which is more evident in
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low- and middle-income countries
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Capacity-building for a strong public health nutrition workforce in low- resource countries
Delisle, H.; Shrimpton, R.; Blaney, S. et al.
Bulletin of the World Health Organization
(2017)
C_WHO
The document addresses the pressing issues of global malnutrition and the urgent need to build workforce capacity in public health nutrition, particularly in low- and middle-income
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countries. It highlights the dual burden of malnutrition, characterized by the coexistence of undernutrition and overnutrition. While maternal and child undernutrition remain critical concerns, there is a growing prevalence of chronic diseases linked to overnutrition, even in resource-limited settings.
A significant gap exists in the availability of trained nutrition professionals. Many countries lack sufficient numbers of nutritionists, particularly at the undergraduate level, and existing training programs often focus on curative rather than preventive approaches. This leaves health workers inadequately prepared to address complex public health nutrition challenges.
To address these issues, the document recommends increasing the number of trained nutritionists, incorporating updated nutrition training into medical and nursing curricula, and developing competency frameworks and hybrid training programs. Accreditation systems for nutrition professionals are also proposed to ensure standardized and effective training.
Sustainability remains a challenge, with the need for long-term financing and better integration of nutrition programs into health systems. The document calls for systemic approaches to strengthen workforce capacity, enabling countries to effectively tackle the underlying causes of malnutrition.
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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low
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NCDs mortality rates, current evidence suggests that SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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It is of utmost importance to low-income countries and some lower-middle income nations in the t
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ime of the SDG period that they are not on course to accomplish the health-related SDG 3 and its targets until 2030. If we honestly intend to support this goal and realize it for the people living in the regions that are facing the lowest survival chances, we also need to recognize that these countries are far from being in a position to raise the necessary resources solely with their own means.
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What is already known about this topic?
Roughly 80% of the global disease burden caused by diabetes comes from low-and-middle income countries, an
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d 60% of diabetics are located in Asia; 6 of the top 10 countries with the highest prevalence of diabetes are in Asia.
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Tuberculosis (TB) is the deadliest infectious disease in most low- and middle-income countries, claiming more than 4,000 lives each day. The unprec
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edented COVID-19 pandemic has seriously impacted people with pre-existing health conditions. People with TB are usually more vulnerable to other infections, including the novel coronavirus, due to pre-existing lung damage. They are also at higher risk of developing complications from COVID-19.
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The compendium provides guidance on low-cost handwashing facilities that can be widely used in low and middle-income
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countries. We hope that this can be shared extensively as governments and agencies tackle the crisis in low and middle-income countries where handwashing facilities are urgently needed in households, communities, schools and healthcare facilities.
The compendium includes information and further reading on: handwashing facilities – including facilities that are accessible for all, environmental cues to reinforce handwashing behaviours, physical distancing hygiene promotion.
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Severe and difficult asthma in a low- and middle-income country (LMIC) can relate to lack of availability of basic medications; potentially reversible factors such as poor adherence or comorbidities
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such as obesity inhibiting a good response to treatment; and (rarely) true severe, therapy-resistant asthma. However, definitions of severity should encompass not merely doses of prescribed medication, but also underlying risk. The nature of asthmatic airway disease shows geographical variation, and LMIC asthma should not be assumed to be phenotypically the same as that in high-income countries (HICs). The first assessment step is to ensure another diagnosis is not being missed. Largely, political action is needed if children with asthma are to get access to basic medications. If a child is apparently not responding to low dose, simple medications, the next step is not to increase the dose but perform a detailed assessment of what factors (for example co-morbidities such as obesity, or social factors like poor adherence) are inhibiting a treatment response; in most cases, an underlying reason can be found. An assessment of risk of future severe asthma attacks, side-effects of medication and impaired lung development is also important. True severe, therapy-resistant asthma is rare and there are multiple underlying molecular pathologies. In HICs, steroid-resistant eosinophilia would be treated with omalizumab or mepolizumab, but the cost of these is prohibitive in LMICs, the biomarkers of successful therapy are likely only relevant to HICs. In LMICs, a raised blood eosinophil count may be due to parasites, so treating asthma based on the blood eosinophil count may not be appropriate in these settings.
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Climate change is damaging human health now and is projected to have a greater impact in the future. Low- and middle-income countries are seeing th
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e worst effects as they are most vulnerable to climate shifts and least able to adapt given weak health systems and poor infrastructure. Low-carbon approach can provide effective, cheaper care while at the same time being climate smart. Low-carbon healthcare can advance institutional strategies toward low-carbon development and health-strengthening imperatives and inspire other development institutions and investors working in this space. Low-carbon healthcare provides an approach for designing, building, operating, and investing in health systems and facilities that generate minimal amounts of greenhouse gases. It puts health systems on a climate-smart development path, aligning health development and delivery with global climate goals. This approach saves money by reducing energy and resource costs. It can improve the quality of care in a diversity of settings. By prompting ministries of health to tackle climate change mitigation and foster low-carbon healthcare, the development community can help governments strengthen local capacity and support better community health.
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