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Publication Years
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2
Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme
...
resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas. These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
more
Providing improved water supply to low-income urban communities is a difficult challenge faced by water utilities throughout Africa and Asia.
This guide provides an introduction to available option
...
s for serving these communities.
The guide draws on sector experience in general, and more particularly on WSUP’s extensive experience of implementing urban WASH programmes in sub-Saharan Africa and elsewhere.
more
Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searc
...
hed medical databases and websites of medical societies and contacted international organizations.
Country-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
more
Asthma is the most common noncommunicable disease in children, and among the most common in adults. According to the most recent estimates from the Global Asthma Network Phase I study, around one in 10 children and adults have symptoms of asthma and one in 20 school-aged children have severe asthma
...
symptoms, with marked variations in prevalence and in prevalence trends between countries and regions of the world. The Global Burden of Disease Study estimated that asthma caused the loss of 21.6 million healthy years of life (disability-adjusted life years) and 461 069 deaths in 2019. Approximately 90% of the asthma burden of disease is borne by people living low and middle income countries (LMICs). Some countries report very high (up to 90%) rates of uncontrolled asthma. While the prevalence of asthma is highest in countries with a high Socio-Demographic Index (SDI), death rates from asthma are highest in countries with low and lower middle incomes.
more
The Health Literacy Toolkit For Low- and Middle-Income Countries
Sarity Dodson, Suvajee Good and Richard Osborne
World Health Organization - Regional Office South-East Asia
(2015)
A series of information sheets to help empower communities and strengthen health systems
This series of information sheets introduces health literacy, its
relevance to public policy, and the ways it can be used to inform
the promotion of good health, the prevention and management
of communicab
...
le and noncommunicable diseases, and the
reduction of health inequities. It provides information and links
to further resources to assist organizations and governments
to incorporate health literacy responses into practice, service
delivery systems, and policy.
more
Community-Based Rehabilitation Services in Low and Middle-Income Countries in the Asia-Pacific Region: Successes and Challenges in the Implementation of the CBR Matrix
Adela Cayetano, R.D.; and J. Elkins
Disability, CBR & Inclusive Development Journal (DCIDJ)
(2016)
CC
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.
more
Priorities for Tuberculosis Bacteriology Services in Low-Income Countries International Union
Hans L. Rieder, Armand Van Deun, Kai Man Kam, Sang Jae Kim, T. Martin Chonde, Arnaud Trébucq, Richard Urbanczik
International Union Against Tuberculosis and Lung Disease
(2007)
CC
Second Edition
October 2009 | Volume 6 | Issue 10 | e1000162
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.
more
Lancet Glob Health 2020Published OnlineNovember 27, 2020 https://doi.org/10.1016/S2214-109X(20)30449-6
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
Bas
...
eline Standards lay the foundation for effective care and address barriers such as inadequate
staffing levels, lack of support, limited access to nurse education and unsafe nursing environments.
more
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 study aimed to test both interventions in low-income and middle-income countries.
more
2016 ASCO EDUCATIONAL BOOK | asco.org/edbo
Global HIV control funding falls short of need. To maximize health outcomes, it is critical that national governments sustain reasonable commitments, and that international donor assistance be distributed according to country needs and funding gaps. We develop a country classification framework in t
...
erms of actual versus expected national domestic funding, considering resource needs and donor financing. With UNAIDS and World Bank data, we examine domestic and donor HIV program funding in relation to need in 84 low- and middle-income countries. We estimate expected domestic contributions per person living with HIV (PLWH) as a function of per capita income, relative size of the health sector, and per capita foreign debt service.
more
Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to des
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igning 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.
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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 h
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ealth worker has been used to refer to volunteers and salaried, professional or lay health workers with 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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Heart failure (HF) is a global public health concern with disproportionate socioeconomic, morbidity and mortality burden on low- and middle-income countries (LMICs). This review summarises contempor
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ary data on the demographic and clinical characteristics, aetiologies, treatment, economic burden and outcomes of HF in LMICs. Patients with HF in LMICs are younger than those from high-income countries (HICs) and present at advanced stages of the disease. Hypertension, ischaemic heart disease (IHD), cardiomyopathy (CMO), and rheumatic heart disease (RHD) are the leading causes of HF in LMICs. The contribution of infectious diseases to HF remains prominent in many LMICs. Most health facilities in LMICs lack adequate diagnostic tools for HF, and the use of evidence-based medical and device therapies is suboptimal. Further, HF in LMICs is associated with prolonged hospital stay and high in-hospital and one-year mortality. Finally, HF has profound economic impact on individual patients who, mostly, have no health insurance, and on societies where patients are young, comprising those who have the greatest potential to contribute to economic productivity.
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COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting
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are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios.
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Examining nursing practice guidelines to improve quality of care for patients with sepsis in low income countries is required. • A large amount of information about best practice standards in seps
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is management is available for healthcare professionals; however, implementation and adherence to practice guidelines recommended by the Surviving Sepsis Campaign remains low in low income countries.
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