scholarly journals Outcomes in Economic Evaluations of Public Health Interventions in Low- and Middle-Income Countries: Health, Capabilities and Subjective Wellbeing

2016 ◽  
Vol 25 ◽  
pp. 83-94 ◽  
Author(s):  
Giulia Greco ◽  
Paula Lorgelly ◽  
Inthira Yamabhai
Keyword(s):  
Public Health ◽  
Subjective Wellbeing ◽  
Health Interventions ◽  
Economic Evaluations ◽  
Public Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Factors influencing the scale-up of public health interventions in low- and middle-income countries: a qualitative systematic literature review

2019 ◽  
Vol 35 (2) ◽  
pp. 219-234 ◽  
Author(s):  
Susan E Bulthuis ◽  
Maryse C Kok ◽  
Joanna Raven ◽  
Marjolein A Dieleman
Keyword(s):  
Public Health ◽  
Scale Up ◽  
Scaling Up ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Factors Influencing ◽  
Low And Middle Income ◽  
The Way

Abstract To achieve universal health coverage, the scale-up of high impact public health interventions is essential. However, scale-up is challenging and often not successful. Therefore, a systematic review was conducted to provide insights into the factors influencing the scale-up of public health interventions in low- and middle-income countries (LMICs). Two databases were searched for studies with a qualitative research component. The GRADE-CERQual approach was applied to assess the confidence in the evidence for each key review finding. A multi-level perspective on transition was applied to ensure a focus on vertical scale-up for sustainability. According to this theory, changes in the way of organizing (structure), doing (practice) and thinking (culture) need to take place to ensure the scale-up of an intervention. Among the most prominent factors influencing scale-up through changes in structure was the availability of financial, human and material resources. Inadequate supply chains were often barriers to scale-up. Advocacy activities positively influenced scale-up, and changes in the policy environment hindered or facilitated scale-up. The most outstanding factors influencing scale-up through changes in practice were the availability of a strategic plan for scale-up and the way in which training and supervision was conducted. Furthermore, collaborations such as community participation and partnerships facilitated scale-up, as well as the availability of research and monitoring and evaluation data. Factors influencing scale-up through a change in culture were less prominent in the literature. While some studies articulated the acceptability of the intervention in a given sociocultural environment, more emphasis was placed on the importance of stakeholders feeling a need for a specific intervention to facilitate its scale-up. All identified factors should be taken into account when scaling up public health interventions in LMICs. The different factors are strongly interlinked, and most of them are related to one crucial first step: the development of a scale-up strategy before scaling up.

scholarly journals The Role of Implementation Science in Advancing Resource Generation for Health Interventions in Low- and Middle-Income Countries

2021 ◽  
Vol 14 ◽  
pp. 117863292199965
Author(s):  
Temitope Ojo ◽  
Laetitia Kabasele ◽  
Bethanny Boyd ◽  
Scholastica Enechukwu ◽  
Nessa Ryan ◽  
...  
Keyword(s):  
Public Health ◽  
Health Outcomes ◽  
Implementation Science ◽  
Health Workers ◽  
Contextual Factors ◽  
Health Interventions ◽  
Evidence Based ◽  
Public Health Interventions ◽  
Middle Income ◽  
Middle Income Countries

Low- and middle-income countries (LMICs) bear the brunt of communicable and non-communicable diseases and experience higher mortality and poor health outcomes compared to resource-rich countries. Chronic resource deficits in LMICs impede their ability to successfully address vexing health issues. Implementation science provides researchers with an approach to develop specific interventions that can generate and/or maximize resources to facilitate the implementation of other public health interventions, in resource-constrained LMIC settings. Resources generated from these interventions could be in the form of increased health workers’ skills, task shifting to free up higher-skilled health workers, increasing laboratory capacity, and using supply chain innovations to make medications available. Pivotal to the success of such interventions is ensuring feasibility in the LMIC context. We selected and appraised three case studies of evidence-based resource-generating health interventions based in LMICs (Zambia, Zimbabwe, and Madagascar), which generated or maximized resources to facilitate ongoing health services. We used a determinant implementation framework—Consolidated Framework for Implementation Research (CFIR) to identify and map contextual factors that are reported to influence implementation feasibility in an LMIC setting. Contextual factors influencing the feasibility of these interventions included leadership engagement, local capacity building and readiness for research and implementing evidence-based practices (EBPs), infrastructural support for multilevel scale-up, and cultural and contextual adaptations. These factors highlight the importance of utilizing implementation science frameworks to evaluate, guide, and execute feasible public health interventions and projects in resource-limited settings. Within LMICs, we recommend EBPs incorporate feasible resource-generating components in health interventions to ensure improved and sustained optimal health outcomes.

Economic Evaluation of Interventions to Reduce Road Traffic injuries - A Review of the Literature with Applications to Low and Middie-income Countries

2004 ◽  
Vol 16 (1) ◽  
pp. 23-31 ◽  
Author(s):  
H.R. Waters ◽  
A.A. Hyder ◽  
T.L. Phillips
Keyword(s):  
Public Health ◽  
Road Traffic ◽  
The United States ◽  
Economic Evaluations ◽  
Review Of The Literature ◽  
Middle Income ◽  
Road Traffic Injuries ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

Road Traffic Injuries (RTIs) kill over one million people worldwide annually. This article takes the perspective of economic costs and benefits to review the impact of available road safety interventions in industrialized countries - and the potential effect of these interventions in low and middle-income countries, where RTIs pose an increasingly large public health problem. A comprehensive review of the literature on cost-benefits and cost-effectiveness studies related to road traffic injuries internationally, with comparisons of costs adjusted for inflation and exchange differentials was conducted. In the United States (US), motor vehicle inspection laws resulted in annual savings of US $1.7 to $2.3 billion. The installation of seatbelts results in net savings of $162 per vehicle; with benefits outweighing costs by a factor ranging from 240 to 1,727. Other cost effective interventions include mandatory seatbelt use, lowering speed limits, motorcycle helmet laws, and traffic calming devices such as speed bumps and road deviations. The dearth of similar economic evaluations of interventions for road traffic injuries in low and middle-income countries represents a serious research gap and hinders the implementation of effective strategies in those countries. Asia Pac J Public Health 2004; 16(1): 23-31.

scholarly journals Which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases amongst children in low-income and middle-income countries (LMICs): protocol for an umbrella review

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032981
Author(s):  
Elodie Besnier ◽  
Katie Thomson ◽  
Donata Stonkute ◽  
Talal Mohammad ◽  
Nasima Akhter ◽  
...  
Keyword(s):  
Public Health ◽  
Global Health ◽  
Infectious Diseases ◽  
Health Inequalities ◽  
Low Income ◽  
Health Interventions ◽  
Umbrella Review ◽  
Public Health Interventions ◽  
Middle Income ◽  
Middle Income Countries

IntroductionDespite significant progress in the last few decades, infectious diseases remain a significant threat to children’s health in low-income and middle-income countries. Effective means of prevention and control for these diseases exist, making any differences in the burden of these diseases between population groups or countries inequitable. Yet, gaps remain in our knowledge of the effect these public health interventions have on health inequalities in children, especially in low-income and middle-income countries. This umbrella review aims to address some of these gaps by exploring which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases among children in low-income and middle-income countries.Methods and analysisAn umbrella review will be conducted to identify systematic reviews or evidence synthesis of public health interventions that reduce morbidity, mortality and/or health inequalities due to infectious diseases among children (aged under 5 years) in low-income and middle-income countries. The interventions of interest are public health interventions targeting infectious diseases or associated risk factors in children. We will search for reviews reporting health and health inequalities outcomes in and between populations. The literature search will be undertaken using the Cochrane Library, Medline, EMBASE, the CAB Global Health database, Health Evidence, the Campbell Collaboration Library of Systematic Reviews, International Initiative for Impact Evaluation Systematic review repository, Scopus, the Social Sciences Citation Index and PROSPERO. Additionally, a manual search will be performed in Google Scholar and three international organisations websites (UNICEF Office of Research—Innocenti, UNICEF, WHO) to capture grey literature. Data from the records meeting our inclusion/exclusion criteria will be collated using a narrative synthesis approach.Ethics and disseminationThis review will exclusively work with anonymous group-level information available from published reviews. No ethical approval was required.The results of the review will be submitted for publication in academic journals and presented at international public health conferences. Additionally, key findings will be summarised for dissemination to a wider policy and general public audience as part of the Centre for Global Health Inequalities Research’s policy work.PROSPERO registration numberCRD42019141673

scholarly journals Which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases amongst children in low- and middle-income countries (LMICs): An umbrella review

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0251905
Author(s):  
Elodie Besnier ◽  
Katie Thomson ◽  
Donata Stonkute ◽  
Talal Mohammad ◽  
Nasima Akhter ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Health Inequalities ◽  
Systematic Reviews ◽  
Health Interventions ◽  
Umbrella Review ◽  
Public Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Disadvantaged Groups

Despite significant progress in the last few decades, infectious diseases remain a major threat to child health in low- and middle-income countries (LMICs)—particularly amongst more disadvantaged groups. It is imperative to understand the best available evidence concerning which public health interventions reduce morbidity, mortality and health inequalities in children aged under five years. To address this gap, we carried out an umbrella review (a systematic reviews of reviews) to identify evidence on the effects of public health interventions (promotion, protection, prevention) on morbidity, mortality and/or health inequalities due to infectious diseases amongst children in LMICs. Ten databases were searched for records published between 2014–2021 alongside a manual search of gray literature. Articles were quality-assessed using the Assessment of Multiple Systematic Reviews tool (AMSTAR 2). A narrative synthesis was conducted. We identified 60 systematic reviews synthesizing 453 individual primary studies. A majority of the reviews reported on preventive interventions (n = 48), with a minority on promotion (n = 17) and almost no reviews covering health protection interventions (n = 2). Effective interventions for improving child health across the whole population, as well as the most disadvantaged included communication, education and social mobilization for specific preventive services or tools, such as immunization or bed nets. For all other interventions, the effects were either unclear, unknown or detrimental, either at the overall population level or regarding health inequalities. We found few reviews reporting health inequalities information and the quality of the evidence base was generally low. Our umbrella review identified some prevention interventions that might be useful in reducing under five mortality from infectious diseases in LMICs, particularly amongst the most disadvantaged groups.

scholarly journals The impact of COVID-19 on the care of people living with noncommunicable diseases in low- and middle-income countries: an online survey of physicians and pharmacists in nine countries

2021 ◽  
Vol 22 ◽  
Author(s):  
Chris Bullen ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
Varsha Parag ◽  
Kannan Subramaniam ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare Workers ◽  
Online Survey ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Measures ◽  
The Impact ◽  
Low And Middle Income

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.

scholarly journals Designing the next generation of implementation research training for learners in low- and middle-income countries

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Michael J. Penkunas ◽  
Shiau Yun Chong ◽  
Emma L. M. Rhule ◽  
Evangelia Berdou ◽  
Pascale Allotey
Keyword(s):  
Implementation Research ◽  
Research Training ◽  
Training Model ◽  
Learning By Doing ◽  
Health Interventions ◽  
System Level ◽  
High Quality Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractEfficacious health interventions tested through controlled trials often fail to show desired impacts when implemented at scale. These challenges can be particularly pervasive in low- and middle-income settings where health systems often lack the capacity and mechanisms required for high-quality research and evidence translation. Implementation research is a powerful tool for identifying and addressing the bottlenecks impeding the success of proven health interventions. Implementation research training initiatives, although growing in number, remain out of reach for many investigators in low- and middle-income settings, who possess the knowledge required to contextualize challenges and potential solutions in light of interacting community- and system-level features. We propose a realigned implementation research training model that centers on team-based learning, tailored didactic opportunities, learning-by-doing, and mentorship.

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