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Tracking development assistance for health for low- and middle-income
...
countries gives policy makers information about spending patterns and potential improvements in resource allocation. We tracked the flows of development assistance and explored the relationship between national income, disease burden, and assistance
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The RehApp is specifically designed for fieldworkers in low-and middle-income
...
countries and aims to enhance their capacity to work with people with disabilities within the community: assess their abilities and inabilities, design rehabilitation interventions, provide care and support and refer appropriately. It consists of different chapters – covering various types of impairments – organised according to the International Classification of Functioning, Disability and Health, commonly known as the ICF.
The RehApp is available for free, and once downloaded, it can be used in any setting without internet access. It is currently available in English, French, Nepali, and Portuguese. Several chapters area also available in Amharic, Burmese, Khmer, Spanish, Tajik and Vietnamese. The App is available for Apple and for Android.
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, incon
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sistent and informed by evidence from high-income countries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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Background and aims: Current coverage of mental health care in low- and middle-income
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countries is limited, not only in terms of access to services but also in terms of financial protection of persons in need of care and treatment. This is especially pertinent considering the established relationship between mental illness and poverty and the need to ensure the financial risk protection of persons with mental disorders and their families as part of country's efforts to attain universal health coverage. This study set out to review the health and socio-economic contexts of Nigeria as well as to generate strategies for sustainable mental health financing that will be feasible, within the specific context of the country.
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To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, e
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valuate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions.
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The often-prominent role of external assistance in health financing in low- and middle-income
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countries raises the question of how such resources can enable the sustained or even expanded coverage of key health services and initiatives even after donor funding is no longer available. In response to this question, this paper analyses the process and outcomes of donor transitions in health—where countries or regions within countries are no longer eligible to receive grants or concessional loans from external sources based on eligibility criteria or change in donor policy.
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The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.
The global prevalence of diabetes* among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014.
Diabetes prevalence has been rising more rapidly in middle- and low-income
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countries.
Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.
In 2012, an estimated 1.5 million deaths were directly caused by diabetes and another 2.2 million deaths were attributable to high blood glucose.
Almost half of all deaths attributable to high blood glucose occur before the age of 70 years.
WHO projects that diabetes will be the 7th leading cause of death in 2030
Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes.
Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications.
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Most of the global burden of sepsis occurs in low- and middle-income
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countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, the lack of laboratory infrastructure in many LMICs has historically precluded an assessment of the pathogens leading to sepsis. A recent systematic review found that data describing antimicrobial resistance were absent for 43% of countries in Africa, and only two countries have national antimicrobial resistance plans. In addition, small studies have identified indiscriminate antibiotic use both in and out of hospital settings in sub-Saharan Africa. The absence of microbiological data and lack of antibiotic stewardship complicate sepsis management and almost certainly worsens outcomes, particularly in low-resource systems. The purpose of this study was to examine the prevalence, etiology, and outcomes of sepsis among a cohort of critically ill patients in a referral hospital of Malawi, with a focus on the prevalence of culture-confirmed bacteremia and urinary tract infections.
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This year’s MPI results show that more than two-thirds of the multidimensionally poor—886 millionpeople—live in middle-income countries. A fu
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rther 440 million live in low-income countries. In both groups, data show, simple national averagescan hide enormous inequality inpatterns of povertywithin countries. For instance, in Uganda 55 percentof the population experience multidimensional poverty—similartotheaverage in Sub-Saharan Africa. But Kampala, the capital city, has an MPI rate of sixpercent, whileinthe Karamojaregion, the MPI soars to 96 percent—meaningthat partsof Ugandaspan the extremes of Sub-Saharan Africa.There is even inequality under the same roof. In South Asia, for example, almost a quarter ofchildren under five live in households where at least one child in the household is malnourished but at least one child is not.
There is also inequality among the poor. Findings of the2019 global MPI paint a detailed picture of the many differences in how-and how deeply -people experience poverty. Deprivationsamong the poor varyenormously: in general, higher MPI valuesgo hand in hand with greater variationin the intensity of poverty. Results also show that children suffer poverty more intensely than adults and are more likely to be deprived in all 10 of the MPI indicators, lackingessentialssuch as clean water, sanitation, adequate nutrition or primary education
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3rd editionThe compendium provides guidance on low-cost handwashing facilities that can be widely used in low and middle-
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income 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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Overview
Learning objectives
• Understand the mental health treatment gap in low-, middle- and high-income countries.
• Understand the principles and aims of the Mental Health Gap Action Programme.
• Acquire an introduction to mhGAP Interv
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ention Guide (mhGAP-IG).
• Learn about mhGAP ToHP training methodology and what to expect from mhGAP ToHP
training.
• Prepare group training ground rules.
• Know the common presentations of mental, neurological and substance abuse (MNS)
conditions.
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In an environment of stagnant donor funding and increasing private sector investment in low- and middle-
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income countries, actors in both the public and private sectors are increasingly interested in using blended finance approaches to catalyze new funding for global health and achieve health outcomes. As USAID moves towards greater engagement with the private sector, blended finance will be an important component to help achieve development objectives.
Accessed 19th May 2019.
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The COVID-19 Hygiene Hub is a free service to help actors in low- and middle-income
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countries rapidly share, design, and adapt evidence-based hygiene interventions to combat COVID-19.
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The Defeat-NCD Partnership prioritises poorer countries because they bear the brunt of the enormous impact of NCDs with some 48% of premature deaths occurring in low
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and lower-middle income countries. The resident of a low-income country faces a lifetime chance of 20-30% of dying from an NCD under the age of 70; this is two-to-four-fold higher than the equivalent risk for a high-income country resident. Meanwhile, when poor countries start getting a little more prosperous, the prevalence of NCD risk factors tend to initially increase.
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How should humanitarian organisations prepare and respond to COVID-19 in humanitarian settings in low- and middle-
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income countries?
This Rapid Learning Review outlines 14 actions, insights and ideas for humanitarian actors to consider in their COVID-19 responses. It summarises and synthesises the best available knowledge and guidance for developing a health response to COVID-19 in low- and middle-income settings as at April 2020
The paper, supported by the UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Mark Lowcock, will be updated throughout 2020 to reflect emerging knowledge and evidence on the most effective approaches to respond to the COVID-19 Pandemic.
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Q6: What is the added advantage of doing neuroimaging in people with convulsive epilepsy in non-specialist settings in low and middle
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income countries?
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The seventh WHO Report on the global tobacco epidemic analyses national efforts to implement the most effective measures from the WHO Framework Convention on Tobacco Control (WHO FCTC) that are proven to reduce demand for tobacco.
The report showed that while only 23
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countries have implemented cessation support policies at the highest level, 116 more provide fully or partially cost-covered services in some or most health facilities, and another 32 offer services but do not cost-cover them, demonstrating a high level of public demand for support to quit.
Tobacco use has also declined proportionately in most countries, but population growth means the total number of people using tobacco has remained stubbornly high. Currently, there are an estimated 1.1 billion smokers, around 80% of whom live in low- and middle-income countries (LMICs).
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Accessed: 02.05.2020
The COVID-19 Hygiene Hub is a free service to help actors in low- and middle-in
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come countries rapidly share, design, and adapt evidence-based hygiene interventions to combat COVID-19.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-
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income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kinshasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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The incidence of circulatory disorders is increasing worldwide, affecting both low- and middle-income
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countries and some high-income countries. There is evidence of rising incidence and prevalence rates, even among younger individuals, along with an increasing prevalence of risk factors such as high blood pressure, diabetes, and obesity. These indicators suggest that current approaches are not
effective in managing and reducing the burden of conditions affecting circulatory health.
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