A Review of Drowning Prevention Interventions for Children and Young People in High, Low and Middle Income Countries

Most deaths by drowning (91%) have occurred in low- and middle-income countries (LMICs), particularly in Southeast Asia (35%) and Africa (20%), in proportion to total drowning deaths worldwide. Poor data collection in LMICs hinders the planning, implementation, and evaluation of prevention strategies. The objective of this study was to review the rates and risk factors of unintentional drowning in LMICs and to identify drowning prevention strategies within a socio-ecological health promotion framework. A systematic search, guided by PRISMA, was conducted on Ovid MEDLINE, CINAHL, Informit health, PsycINFO (ProQuest), Scopus, SafetyLit, Google Scholar, and BioMed Central databases for all relevant studies published between 2012 and 2017. McMaster appraisal guideline was used for critical review. The disparity of available drowning data was observed across selected countries. The highest rates were identified in low-middle income South-east Asian countries. The socio-economic background of the family, overcrowding, and living close to water bodies were important predictors for paediatric drowning in LMICs, while the presence of mother as caregiver was identified as a protective factor. The over-reliance on active injury prevention strategies was identified. Further research focusing on developing relevant upstream drowning prevention and water safety promotion is needed to ensure the sustainability of drowning prevention in LMICs.

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The Evolution of Young People's Mental Health during COVID-19: Evidence from four Low-and-Middle-Income-Countries

10.1101/2021.06.28.21259620 ◽

2021 ◽

Author(s):

Catherine Porter ◽

Annina Hittmeyer ◽

Marta Favara ◽

Douglas Scott ◽

Alan Sánchez

Keyword(s):

Mental Health ◽

Young People ◽

Food Insecurity ◽

Health Anxiety ◽

Infection Rates ◽

Middle Income ◽

Middle Income Countries ◽

Food Insecure Households ◽

Anxiety Depression ◽

Low And Middle Income

Background Though COVID-19 presents less risk to young people of serious morbidity or mortality, the resulting economic crisis has impacted their livelihoods. There is relatively little evidence on young people's mental health in Low-and-Middle-Income-Countries (LMICs) as the pandemic has progressed. Methods Two consecutive phone-surveys (August/October and November/December 2020) in Ethiopia, India, Peru and Vietnam interviewed around 9,000 participants of a 20-year cohort study who grew up in poverty (now aged 19 and 26). We investigate how young people's mental health has evolved in the four countries during the pandemic. Rates of (at least mild) anxiety (depression) measured by GAD-7 (PHQ-8) were compared across countries; between males/females, and food secure/food insecure households. Results Overall, rates of at least mild anxiety (depression) significantly decreased in all countries but Ethiopia as infection rates fell. However, young people in food insecure households report high rates of anxiety and depression and have not shown consistent improvements. Food insecure households are poorer, and have significantly more children (p<0.05) except in Ethiopia. Conclusions Food insecurity has increased during the COVID-19 pandemic and is negatively associated with young people's mental health. Urgent support is needed for the most vulnerable. Keywords COVID-19, mental health, anxiety, depression, food insecurity, youth

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Youth Conceptualization of Resilience Strategies in Four Low- and Middle-Income Countries

International Journal of Child Youth and Family Studies ◽

10.18357/ijcyfs111202019475 ◽

2020 ◽

Vol 11 (1) ◽

pp. 91-110

Author(s):

Panos Vostanis ◽

Sadiyya Haffejee ◽

Hikmet Yazici ◽

Sajida Hussein ◽

Munevver Ozdemir ◽

...

Keyword(s):

Young People ◽

Social Engagement ◽

Systems Approach ◽

Young Person ◽

Middle Income ◽

Disadvantaged Communities ◽

Middle Income Countries ◽

Template Analysis ◽

Participatory Research Methods ◽

Low And Middle Income

The concept of resilience is increasingly influential in the development of interventions and services for young people, yet there is limited knowledge of how resilience-building strategies are conceptualized by young people across different cultures, particularly in low- and middle-income countries. The aim of this study was to capture 274 young people’s voices in disadvantaged communities in Kenya, Turkey, Pakistan, and Brazil through participatory research methods. Young people defined strategies in response to 4 adversity scenarios reflecting socioecological systems (young person, family, school, and community). Template analysis, underpinned by thematic design, was used to establish three broad themes of intrapersonal (self-management, cognitive re-appraisal, agency), interpersonal (social engagement, informal supports, formal supports), and religious resources. Proposed strategies were largely similar across the sites, with some contextual differences depending on the scenario (stressor) and cultural group. The findings support an ecological systems approach to resilience, which is consistent with the development of multimodal interventions for vulnerable youth and their families in disadvantaged communities in low- and middle-income countries.

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Abstract P681: Implementation of Stroke Prevention Interventions in Low- and Middle-Income Countries: A Scoping Review

Stroke ◽

10.1161/str.52.suppl_1.p681 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Nessa Ryan ◽

Vida Rebello ◽

Desiree Gutierrez ◽

Kameko Washburn ◽

Alvaro Zevallos Barboza ◽

...

Keyword(s):

Scoping Review ◽

Stroke Prevention ◽

Health Workers ◽

Evidence Based ◽

Community Based Interventions ◽

Middle Income ◽

Middle Income Countries ◽

Implementation Outcomes ◽

Prevention Interventions ◽

Low And Middle Income

Background: Stroke is the second leading cause of death globally and an increasing concern in low- and middle-income countries (LMIC) where, due to limited capacity to treat stroke, preventative efforts are critically important. Although some research on evidence-based interventions for stroke prevention in LMIC exists, there remains a significant gap in understanding of their implementation across various contexts in LMIC. Objectives: In this scoping review, our objective was to identify and synthesize the implementation outcomes (using Proctor et al.’s taxonomy, 2011) for stroke prevention interventions, as well as to describe the diverse interventions employed. Methods: Eligible studies were empirical, focused on implementation of stroke prevention programs or policies, and occurred in at least one LMIC. Five databases were searched, including PubMed, PsycINFO, CINAHL, EMBASE, and Web of Science. Two reviewers independently assessed studies for selection and charted data; discrepancies were resolved through discussion with a third reviewer until consensus was reached. Narrative synthesis was used to analyze and interpret the findings. Results: Studies were predominantly focused in Asia, targeting primary or secondary prevention, and facility-based. Interventions were conducted at the level of individual (n=11), system (n=12), or both (n=4). Various implementation outcomes were reported, most commonly cost (n=10), acceptability (n=7), fidelity (n=7), and feasibility (n=6), but also adoption (n=4), penetration (n=3), appropriateness (n=1), and sustainability (n=1). Conclusions: Findings highlight the breadth of evidence-based interventions for stroke prevention available to implement in LMIC settings, including culturally acceptable education interventions, cost-effective medications, and community-based interventions implemented by community health workers. Implementation outcomes remain under-reported, and more rigorous research is needed to better plan and evaluate the implementation of these interventions to prevent stroke.

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