The region of Latin America and the Caribbean (LAC) has high levels of income inequality and urbanization. This leaves a large percentage of the population exposed and vulnerable to infectious disease outbreaks (1). The COVID-19 outbreak occurred suddenly, within a complex economic, social and polit...ical context and at a time of low economic growth and high levels of informal labour. Structural challenges of poverty, deep inequality across different dimensions, and weak health and social protection systems exacerbated the region’s vulnerability to the pandemic
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The often-prominent role of external assistance in health financing in low- and middle-income 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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Background and aims: Current coverage of mental health care in low- and middle-income 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 relationshi...p 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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Most neglected tropical diseases (NTDs) occur in remote areas of low- and middle-income countries, where health systems are often poorly developed. Therefore, these neglected patients generally lack access to quality preventive, diagnostic, and therapeutic care [1]. The difficulty to access NTD-ende...mic areas, challenging logistics, and the lack of skilled human resources in these areas are also major obstacles to conduct clinical research. We had to face these when conducting a good clinical practice/good clinical laboratory practice (GCP/GCLP)-compliant clinical study in eastern Sudan, a well-known endemic area for visceral leishmaniasis and other NTDs. We share here the challenges related to study preparation and implementation of this GCP/GCLP study that investigated the causes of persistent fever in a rural hospital located in Gedaref State in eastern Sudan. We think this type of paper may be of interest for researchers planning to conduct a clinical trial in a resource-limited setting as well as for funders of such research.
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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 unprecedented COVID-19 pandemic has seriously impacted people with pre-existing health conditions. People with TB are usually more vulnerable to other infectio...ns, 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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WHO lists 9th COVID-19 vaccine for emergency use to expand vaccination access in low-income countries, 17 December 2021
2nd edition.
The book is aimed at general health workers in low- and middle-income country settings and has some chapters on perinatal mental health. That said, it has definite applicability in high-income country settings too! In the new edition, there has been a big expansion of the psychosocial ...interventions. Thanks to your advocacy for such a resource being open-access (as the first edition was not), the book is freely available for download: https://www.cambridge.org/core/books/where-there-is-no-psychiatrist/47578A845CAFC7E23A181749A4190B54
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Poor quality health services are holding back progress on improving health in countries at all income levels.
Today, inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training an...d expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries.
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The attainment of Zambia’s goal of being a prosperous and middle-income country by 2030 as stipulated in its Vision 2030 is dependent on among others, a healthy and productive population. Therefore, the Government of the Republic of Zambia (GRZ) has prioritized health as a key socio-economic inves...tment in the Seventh National Development Plan 2017-2021. The government is also committed to achieving the targets under the health goal number three and other health related targets under other goals of the 2030 Sustainable Development agenda. Despite progress which has been made in improving the health of Zambians, the country still faces a high burden of communicable diseases and a growing burden of non-communicable diseases. Structural and social deprivation including poverty, inequalities and marginalisation also remain major threats to health. In order to effectively address all the social determinants of health, all sectors should take into account health and well-being as a key element of policy development.
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Best Practice for the Care of Patients with Tuberculosis: a Guide for Low-Income CountriesThe practical aspects of TB patient care from the onset of symptoms to the completion of treatment are covered in this guide.
The study collected data on the impact of HIV-related diseases on income, revenues, economic dependency, consumption, education, health, food security, stigma, discrimination, quality of life, and migration. The study also assessed people living with chronic diseases in order to compare the impact o...f living with HIV/AIDS with the impact of living with a chronic disease.
Stigma, discrimination, and socio-economic exclusion continue to affect the rights and socio-economic opportunities of people living with HIV in Myanmar. Households with a family member who has HIV, have lower incomes, fewer assets and lower home-ownership, compared to households that are not affected by HIV. They also have more household debt, and their families pay a higher rate of interest compared to families not affected by HIV.
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Non- Communicable Diseases (NCDs) over the years have not been given much attention in Ghana and in most Low and Middle- Income Countries (LMICs). The overwhelming burden of communicable diseases and the scarcity of resources has led to the health of all residents in Ghana, NCDs still remain largely... underfunded and less prioritized. Attempts in the past have achieved little success. The formulation of Ghana´s NCD policy in 2014 and the accompanying strategic plan is one such effort.
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Asthma is the commonest chronic respiratory tract disease in children. In low-income countries, challenges exist in asthma diagnosis. In surveys done in children, the prevalence of ‘asthma’ defined by symptoms is high compared to ‘doctor diagnosed asthma’. The questions answered by this revi...ew are What challenges have been experienced in the diagnosis of asthma in children? What solutions will address these challenges?
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The incidence of circulatory disorders is increasing worldwide, affecting both low- and middle-income 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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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (...SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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Over 90% of the morbidity and mortality related to chronic obstructive pulmonary disease (COPD) and asthma occurs in low-income and middle-income countries (LMICs) due to well documented factors including decreased access to screening, trained health professionals, and therapies for disease manageme...nt. Inhaler therapy (eg, aerosolised medications by inhalation, nebulisation, or propellant) is the mainstay of treatment for COPD and asthma. Adherence to maintenance medications for COPD and asthma results in improved lung function and quality of life, as well as decreased hospitalisation and mortality. WHO have included short-acting beta-agonists, long-acting muscarinic antagonists, and inhaled corticosteroids on the essential medications list, with a target goal of achieving 80% availability of these medications in public and private facilities. However, despite these efforts, accessibility, and affordability of medications for COPD and asthma remains scarce.
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Background
Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and ris...k factors for asthma in adolescents in an LMIC.
Methods
A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021.
Results
A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01.
Conclusion
Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
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Official development assistance (ODA) is one of the most important means for donor countries to foster diplomatic relations with low- and middle-income countries and contribute to the welfare of the international community.Objective: This study estimated the sectoral allocation of
Development assistance for health (DAH) is an important part of financing healthcare in low- and middle-income countries. We estimated the gross disbursement of DAH of the 29 Development Assistance Committee (DAC) member countries of the Organisation for Economic Co-operation and Development (OECD) ...for 2011–2019; and clarified its flows, including aid type,
channel, target region, and target health focus area. Data from the OECD iLibrary were used. The DAH definition was based on the OECD sector classification. For core funding to non-healthspecific multilateral agencies, we estimated DAH and its flows based on the OECD methodology for
calculating imputed multilateral official development assistance (ODA).
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