Inequity in Low- and Middle-Income Countries and the Colonial History of Public Health

Author(s):  
Mbuso Precious Mabuza
Author(s):  
Chris Bullen ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
Varsha Parag ◽  
Kannan Subramaniam ◽  
...  

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.


2017 ◽  
Vol 211 (5) ◽  
pp. 264-265 ◽  
Author(s):  
K. S. Jacob

SummarySuicide, a common cause of death in many low- and middle-income countries, has often been viewed through a medical/psychiatric lens. Such perspectives medicalise social and personal distress and suggest individual and medication-based treatments. This editorial argues for the need to examine suicide from a public health perspective and suggests the need for population-based social and economic interventions.


Author(s):  
Christopher B. Raymond ◽  
Paul R. Ward

(1) Background: COVID-19 disruptions offer researchers insight into how pandemics are at once biological and social threats, as communities struggle to construct meaning from novel challenges to their ontological status quo. Multiple epistemes, in which public health imperatives confront and negotiate locally derived knowledge and traditions, vie for legitimacy and agency, resulting in new cultural forms. (2) Methods: To investigate the context and construction of community responses, a systematic review of qualitative literature was conducted with the aim of evaluating those insights provided by empirical, social field research in low- and middle-income countries since the onset of COVID-19. Six scholarly databases were searched for empirical, qualitative, field-based, or participatory research that was published in peer-reviewed journals between December 2019 and August 2021. (3) Results: Twenty-five studies were selected for data extraction, following critical appraisal for methodological rigor by two independent reviewers, and were then analyzed thematically. Faced with unprecedented social ruptures, restrictions in social and physical mobility, and ever-looming uncertainties of infection, financial insecurity, stigma, and loss, communities worldwide reacted in multiple and complex ways. Pervasive misinformation and fear of social rejection resulted in noncompliance with pandemic sanctions, resistance, and increased isolation, allowing the spread of the disease. The meaning of, and understandings about, COVID-19 were constructed using traditional, religious, and biomedical epistemologies, which were occasionally in conflict with each other. Innovations and adaptations, through syntheses of traditional and biomedical discourses and practice, illustrated community resilience and provided models for successful engagement to improve public health outcomes. (4) Conclusion: Local context and community engagement were indispensable considerations when enacting effective public health interventions to meet the challenges of the pandemic.


2021 ◽  
pp. 33-46
Author(s):  
Than Sein

The history and development of public health in low- and middle-income countries (LMICs) shows that important breakthroughs in public health interventions have led to great improvements in economic development. Health determines economic productivity and prosperity, and the physical and emotional well- being of the people. The mindset of the population afflicted with a high infant mortality rate usually lacks the secure knowledge of its children’s longevity, witnesses higher fertility rates, and experiences the quality- quantity trade- off in child- rearing. Ever since the health- for- all movement was initiated over three decades ago, health, equity, and social justice remain the main themes of social and health policy. It is essential for all public health professionals to sustain these values, especially those in LMICs and the international community.


2019 ◽  
Vol 16 (02/03) ◽  
pp. 077-081
Author(s):  
Amrita Ghosh ◽  
Ranabir Pal ◽  
Luis Rafael Moscote-Salazar ◽  
Huber Said Padilla-Zambrano ◽  
Harsh Deora ◽  
...  

AbstractNeurotrauma is an underestimated and less understood public health issue in low- and middle-income countries for which we need system-based approach to prevention plans. This study was initiated to find rationale of effective plan with projectile vision of neurotrauma prevention. In search of innovative ideas of neurotrauma prevention evidence was explored from the published literature research on traumatic brain injury. Evidence-based global guidelines on recommended content and scheduling on prevention of neurotrauma literature searches data were also synthesized and summarized from research in developed countries. Our study noted that a considerable number of victims of neurotrauma with death and disabilities put mammoth costs to the already compromised health systems of the low- and middle-income countries. We need systems-based four-pronged approach incorporating neurotrauma registry, neurotrauma surveillance, translational research programs, and current approved process for development of clinical guidelines for prevention.


Sign in / Sign up

Export Citation Format

Share Document