Innovative Implementation Strategies for Hypertension Control in Low- and Middle-Income Countries: a Narrative Review

2020 ◽  
Vol 22 (5) ◽  
Author(s):  
Tim Mercer ◽  
Shanti Nulu ◽  
Rajesh Vedanthan
Keyword(s):  
Implementation Strategies ◽  
Narrative Review ◽  
Hypertension Control ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals A Narrative Review of the Patient Journey Through the Lens of Non-communicable Diseases in Low- and Middle-Income Countries

2020 ◽  
Vol 37 (12) ◽  
pp. 4808-4830
Author(s):  
Ratna Devi ◽  
Komal Kanitkar ◽  
R. Narendhar ◽  
Kawaldip Sehmi ◽  
Kannan Subramaniam
Keyword(s):  
Communicable Diseases ◽  
Narrative Review ◽  
Patient Journey ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Innovative Approaches to Hypertension Control in Low- and Middle-Income Countries

2017 ◽  
Vol 35 (1) ◽  
pp. 99-115 ◽  
Author(s):  
Rajesh Vedanthan ◽  
Antonio Bernabe-Ortiz ◽  
Omarys I. Herasme ◽  
Rohina Joshi ◽  
Patricio Lopez-Jaramillo ◽  
...  
Keyword(s):  
Hypertension Control ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income ◽  
Innovative Approaches

Implementation outcomes of policy and programme innovations to prevent obstetric haemorrhage in low- and middle-income countries: a systematic review

2020 ◽  
Author(s):  
Nessa Ryan ◽  
Dorice Vieira ◽  
Dena Goffman ◽  
Evan M Bloch ◽  
Godwin O Akaba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Implementation Strategies ◽  
Skills Training ◽  
Practical Implementation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Implementation Outcomes ◽  
Obstetric Haemorrhage ◽  
Prevention Programmes ◽  
Low And Middle Income

Abstract Globally, obstetric haemorrhage (OH) remains the leading cause of maternal mortality. Much of the associated mortality is ascribed to challenges surrounding deployment of innovations rather than lack of availability. In low- and middle-income countries (LMICs), where the burden is highest, there is a growing interest in implementation research as a means to bridge the ‘know–do’ gap between proven interventions and their reliable implementation at scale. In this systematic review, we identified and synthesized qualitative and quantitative data across the implementation outcomes of OH prevention innovations in LMICs using a taxonomy developed by Proctor et al. We also identified service outcomes for the included innovations, as well as implementation strategies and implementation facilitators and barriers. Eligible studies were empirical, focused on the implementation of OH prevention programmes or policies and occurred in an LMIC. Eight databases were searched. Two authors independently assessed studies for selection and extracted data; the first author resolved discrepancies. Narrative synthesis was used to analyse and interpret the findings. Studies were predominantly focused in Africa and on primary prevention. Interventions included prophylactic use of uterotonics (n = 7), clinical provider skills training (n = 4) and provision of clinical guidelines (n = 1); some (n = 3) were also part of a multi-component quality improvement bundle. Various barriers were reported, including challenges among intervention beneficiaries, providers and within the health system; however, studies reported the development and testing of practical implementation solutions. These included training and monitoring of implementers, community and stakeholder engagement and guidance by external mentors. Some studies linked successful delivery to implementation outcomes, most commonly adoption and acceptability, but also feasibility, penetration and sustainability. Findings suggest that innovations to prevent OH can be acceptable, appropriate and feasible in LMIC settings; however, more research is needed to better evaluate these and other under-reported implementation outcomes.

scholarly journals Understanding kidney care needs and implementation strategies in low- and middle-income countries: conclusions from a “Kidney Disease: Improving Global Outcomes” (KDIGO) Controversies Conference

2016 ◽  
Vol 90 (6) ◽  
pp. 1164-1174 ◽  
Author(s):  
Vivekanand Jha ◽  
Mustafa Arici ◽  
Allan J. Collins ◽  
Guillermo Garcia-Garcia ◽  
Brenda R. Hemmelgarn ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Implementation Strategies ◽  
Care Needs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals The Importance of Iron Status for Young Children in Low- and Middle-Income Countries: A Narrative Review

2019 ◽  
Vol 12 (2) ◽  
pp. 59 ◽  
Author(s):  
Andrew E. Armitage ◽  
Diego Moretti
Keyword(s):  
Early Childhood ◽  
Iron Deficiency ◽  
Young Children ◽  
Iron Status ◽  
Tissue Growth ◽  
Narrative Review ◽  
Gastrointestinal Infections ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Early childhood is characterised by high physiological iron demand to support processes including blood volume expansion, brain development and tissue growth. Iron is also required for other essential functions including the generation of effective immune responses. Adequate iron status is therefore a prerequisite for optimal child development, yet nutritional iron deficiency and inflammation-related iron restriction are widespread amongst young children in low- and middle-income countries (LMICs), meaning iron demands are frequently not met. Consequently, therapeutic iron interventions are commonly recommended. However, iron also influences infection pathogenesis: iron deficiency reduces the risk of malaria, while therapeutic iron may increase susceptibility to malaria, respiratory and gastrointestinal infections, besides reshaping the intestinal microbiome. This means caution should be employed in administering iron interventions to young children in LMIC settings with high infection burdens. In this narrative review, we first examine demand and supply of iron during early childhood, in relation to the molecular understanding of systemic iron control. We then evaluate the importance of iron for distinct aspects of physiology and development, particularly focusing on young LMIC children. We finally discuss the implications and potential for interventions aimed at improving iron status whilst minimising infection-related risks in such settings. Optimal iron intervention strategies will likely need to be individually or setting-specifically adapted according to iron deficiency, inflammation status and infection risk, while maximising iron bioavailability and considering the trade-offs between benefits and risks for different aspects of physiology. The effectiveness of alternative approaches not centred around nutritional iron interventions for children should also be thoroughly evaluated: these include direct targeting of common causes of infection/inflammation, and maternal iron administration during pregnancy.

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