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Threats posed by stockpiles of expired pharmaceuticals in low- and middle-income countries: a Ugandan perspective
Pakoyo Fadhiru Kamba, Munanura Edson Ireeta, Sulah Balikuna et al.
World Health Organisation (WHO)
(2017)
C_WHO
Bull World Health Organ 2017;95:594–598
This online training is based on the Global Laboratory Initiative’s “Guide for providing technical support to TB laboratories in low- and middle
...
-income countries”. This guide is intended to familiarize those who are providing technical assistance to TB laboratories in low- and middle-income countries with WHO recommendations and international best practices.
more
International Development vol. 11. DOI 10.4073/csr.2015.15
Published: February 23, 2010
https://doi.org/10.1371/journal.pmed.1000235
Volume 7 | Issue 2 | e1000235
BMJ 2020;368:m1052 doi: 10.1136/bmj.m1052 (Published 13 March 2020)
Lancet Glob Health 2020Published OnlineNovember 27, 2020 https://doi.org/10.1016/S2214-109X(20)30449-6
This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and people’s access to and use of them in LMICs, where historic
...
and ongoing under-investments heighten vulnerability to a multiplicity of health threats. We use the term ‘vertical response’ to describe decisions, measures and actions taken solely with the purpose of preventing and containing COVID-19, often without adequate consideration of how this affects the wider health system and pre-existing resource constraints.
more
Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and
...
middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primary health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
more
ISN Public Affairs Kidney International Supplements (2020) 10, e19–e23
The toolkit provides guidance on where to get started, including the structures and resources that should be put in place at the national and health-care facility level, through a stepwise approach
...
in low-resource settings. As the ultimate goal of an AMS programme is sustainable behaviour change in physicians’ antibiotic prescribing practices, the toolkit also provides detailed guidance on how to plan, perform and assess AMS interventions – including feedback on antibiotic use over time. Finally, the toolkit provides an overview of the competencies an AMS team needs to guide health-care professionals in changing their antibiotic prescribing behaviours.
Please note that this course is part of a training package, so please register for the complementary course WHO Policy Guidance on Integrated Antimicrobial Stewardship Activities so that you can complete your learning journey.
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Socioeconomic status is associated with differences in risk factors for cardiovascular disease incidence and outcomes, including mortality. However, it is unclear whether the associations between cardiovascular disease
...
and common measures of socioeconomic status—wealth and education—differ among high-income, middle-income, and low-income countries, and, if so, why these differences exist. We explored the association between education and household wealth and cardiovascular disease and mortality to assess which marker is the stronger predictor of outcomes, and examined whether any differences in cardiovascular disease by socioeconomic status parallel differences in risk factor levels or differences in management.
more
Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-incom
...
e countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nationally representative data on the current patterns of treatment coverage. The objectives of this study were to estimate the proportion of adults with diabetes in LMICs who receive coverage of recommended pharmacological and non-pharmacological diabetes treatment; and to describe country-level and individual-level characteristics that are associated with treatment.
more
INTRODUCTION: Lower extremity peripheral artery disease (PAD) is increasing in prevalence in low- and middle-
...
income countries creating a large health care burden. Clinical management may require substantial resources but little consideration has been given to which treatments are appropriate for less advantaged countries.
EVIDENCE ACQUISITION: The aim of this review was to systematically appraise published data on the costs and effectiveness of PAD treatments used commonly in high-income countries, and for an international consensus panel to review that information and propose a hierarchy of treatments relevant to low- and middle-income countries.
EVIDENCE SYNTHESIS: Pharmacotherapy for intermittent claudication was found to be expensive and improve walking distance by a modest amount. Exercise and endovascular therapies were more effective and exercise the most cost-effective. For critical limb ischemia, bypass surgery and endovascular therapy, which are both resource intensive, resulted in similar rates of amputation-free survival. Substantial reductions in cardiovascular events occurred with use of low cost drugs (statins, ACE inhibitors, anti-platelets) and smoking cessation.
CONCLUSIONS: The panel concluded that, in low- and middle-income countries, cardiovascular prevention is a top priority, whereas a lower priority should be given to pharmacotherapy for leg symptoms and revascularisation, except in countries with established vascular units.
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Digital health technology can make health systems more efficient and sustainable, facilitating the provision of high-quality
care across a wide range of contexts and for diverse population healt
...
h needs. The pace of innovation in digital health is
rapid and constant, with new interventions being developed, implemented, tested and refined against a diversity of contexts,
constraints and challenges to address a variety of health and health system needs.
more
Tracking development assistance for health from India to low- and middle-income countries, 2009–2020
Development assistance for health (DAH) is an important source of financing for health for many low-income and some middle-
...
income countries. Most DAH has predominantly been contributed by high-income countries. However, in the context of economic progress and changing global priorities, DAH contributions from countries of the Global South such as India have gained importance. In this paper, we estimate DAH contributed by India between 2009 and 2020.
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Achieving universal health coverage (UHC) is a politicalambition in many low- and middle-income
...
countries(LMICs). Public funding has been recognized as funda-mental to the two dimensions of UHC: expanding healthservice coverage and increasing protection against health-related financial hardship. Relatedly, there is growing con-sensus in academic and applied policy circles that publicfinancial management (PFM)—the “systems engineering”of public financing—is a critical enabling factor for anyhealth system reform in support of UHC.
more
Vitamin A deficiency is a risk factor for blindness and for mortality from measles and diarrhoea in children aged 6–59 months. We aimed to estimate trends in the prevalence of vitamin A defi cienc
...
y between 1991 and 2013 and its mortality burden in low-income and middle-income countries.
more
