scholarly journals Differential influences of early growth and social factors on young children's cognitive performance in four low-and-middle-income birth cohorts (Brazil, Guatemala, Philippines, and South Africa)

2020 ◽  
Vol 12 ◽  
pp. 100648
Author(s):  
L.M. Richter ◽  
F.M. Orkin ◽  
L.S. Adair ◽  
M.F. Kroker-Lobos ◽  
N. Lee Mayol ◽  
...  
Keyword(s):  
South Africa ◽  
Cognitive Performance ◽  
Social Factors ◽  
Early Growth ◽  
Birth Cohorts ◽  
Middle Income ◽  
Low And Middle Income

The Economic Cost of Violence Against Women and Girls in Low- and Middle-Income Countries: A Systematic Review of the Evidence

2021 ◽  
pp. 152483802110160
Author(s):  
Seema Vyas ◽  
Melissa Meinhart ◽  
Katrina Troy ◽  
Hannah Brumbaum ◽  
Catherine Poulton ◽  
...  
Keyword(s):  
South Africa ◽  
Systematic Review ◽  
Violence Against Women ◽  
Economic Burden ◽  
Data Availability ◽  
Female Genital Cutting ◽  
Middle Income ◽  
Middle Income Countries ◽  
Women And Girls ◽  
Low And Middle Income

Evidence demonstrating the economic burden of violence against women and girls can support policy and advocacy efforts for investment in violence prevention and response programming. We undertook a systematic review of evidence on the costs of violence against women and girls in low- and middle-income countries published since 2005. In addition to understanding costs, we examined the consistency of methodological approaches applied and identified and assessed common methodological issues. Thirteen articles were identified, eight of which were from sub-Saharan Africa. Eight studies estimated costs associated with domestic or intimate partner violence, others estimated the costs of interpersonal violence, female genital cutting, and sexual assaults. Methodologies applied to estimate costs were typically based on accounting approaches. Our review found that out-of-pocket expenditures to individuals for seeking health care after an episode of violence ranged from US$29.72 (South Africa) to US$156.11 (Romania) and that lost productivity averaged from US$73.84 to US$2,151.48 (South Africa) per facility visit. Most studies that estimated provider costs of service delivery presented total programmatic costs, and there was variation in interventions, scale, and resource inputs measured which hampered comparability. Variations in methodological assumptions and data availability also made comparisons across countries and settings challenging. The limited scope of studies in measuring the multifaceted impacts of violence highlights the challenges in identifying cost metrics that extend beyond specific violence episodes. Despite the limited evidence base, our assessment leads us to conclude that the estimated costs of violence against women and girls are a fraction of its true economic burden.

scholarly journals Factors that influence patient empowerment in inpatient chronic care: early thoughts on a diabetes care intervention in South Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Nina Abrahams ◽  
Lucy Gilson ◽  
Naomi S. Levitt ◽  
Joel A. Dave
Keyword(s):  
South Africa ◽  
Diabetes Care ◽  
Chronic Care ◽  
Patient Empowerment ◽  
Self Management ◽  
Inpatient Setting ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Background The burden of non-communicable diseases is growing rapidly in low- and middle-income countries. Research suggests that health interventions that aim to improve patient self-management and empower patients to care actively for their disease will improve health outcomes over the long-term. There is, however, a gap in the literature about the potential role of the inpatient setting in supporting chronic care. This is particularly important in low-and-middle income countries where hospitals may be a rare prolonged point of contact between patient and health provider. The aim of this small scale, exploratory study was to understand what factors within the inpatient setting may affect patients’ feelings of empowerment in relation to their chronic disease care and provides recommendations for future inpatient-based interventions to support self-management of disease. Methods This study was based in a public, academic hospital in South Africa. Eighteen qualitative, semi-structured interviews were conducted with multiple participants with experience of diabetes care: inpatients and health professionals such as nurses, endocrinologists, and dieticians. Findings were analysed using a broad, exploratory, thematic approach, guided by self-management and chronic care literature. Results Interviews with both patients and providers suggest that patients living in low socio-economic contexts are likely to struggle to access appropriate healthcare information and services, and may often have financial and emotional priorities that take precedence over their chronic illness. Younger people may also be more dependent on their family and community, giving them less ability to take control of their disease care and lifestyle. In addition, hospital care remains bound by an acute care model; and the inpatient setting of focus is characterised by perceived staff shortages and ineffective communication that undermine the implementation of patient empowerment-focused interventions. Conclusions Patient and provider contexts are likely to make supporting patient engagement in long-term chronic care difficult in lower income settings. However, knowledge of these factors can be harnessed to improve chronic care interventions in South Africa and other similar countries.

Indoor air quality of low and middle income urban households in Durban, South Africa

2017 ◽  
Vol 156 ◽  
pp. 47-56 ◽  
Author(s):  
Nkosana Jafta ◽  
Lars Barregard ◽  
Prakash M. Jeena ◽  
Rajen N. Naidoo
Keyword(s):  
South Africa ◽  
Air Quality ◽  
Indoor Air Quality ◽  
Indoor Air ◽  
Middle Income ◽  
Urban Households ◽  
Low And Middle Income

scholarly journals Protocol for a Multi-Level Policy Analysis of Non-Communicable Disease Determinants of Diet and Physical Activity: Implications for Low- and Middle-Income Countries in Africa and the Caribbean

2021 ◽  
Vol 18 (24) ◽  
pp. 13061
Author(s):  
Maylene Shung-King ◽  
Amy Weimann ◽  
Nicole McCreedy ◽  
Lambed Tatah ◽  
Clarisse Mapa-Tassou ◽  
...  
Keyword(s):  
Physical Activity ◽  
South Africa ◽  
Policy Development ◽  
Salt Intake ◽  
Communicable Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Promotion Of Physical Activity ◽  
Low And Middle Income

Non-communicable diseases (NCDs) are the leading cause of death globally. Despite significant global policy development for addressing NCDs, the extent to which global policies find expression in low-and-middle income countries’ (LMIC) policies, designed to mitigate against NCDs, is unclear. This protocol is part of a portfolio of projects within the Global Diet and Activity Research (GDAR) Network, which aims to support the prevention of NCDs in LMICs, with a specific focus on Kenya, Cameroon, South Africa and Jamaica. This paper outlines the protocol for a study that seeks to explore the current policy environment in relation to the reduction of key factors influencing the growing epidemic of NCDs. The study proposes to examine policies at the global, regional and country level, related to the reduction of sugar and salt intake, and the promotion of physical activity (as one dimension of healthy placemaking). The overall study will comprise several sub-studies conducted at a global, regional and country level in Cameroon, Kenya and South Africa. In combination with evidence generated from other GDAR workstreams, results from the policy analyses will contribute to identifying opportunities for action in the reduction of NCDs in LMICs.

How Nurses in Johannesburg Address Intimate Partner Violence in Female Patients: Understanding IPV Responses in Low- and Middle-Income Country Health Systems

2015 ◽  
Vol 32 (11) ◽  
pp. 1591-1619 ◽  
Author(s):  
Courtenay Sprague ◽  
Abigail M. Hatcher ◽  
Nataly Woollett ◽  
Vivian Black
Keyword(s):  
South Africa ◽  
Intimate Partner Violence ◽  
Health Systems ◽  
Partner Violence ◽  
Intimate Partner ◽  
World Health ◽  
Public Health Response ◽  
Middle Income ◽  
Seek Health Care ◽  
Low And Middle Income

One in three women, globally, experiences intimate partner violence (IPV). Although 80% of the world’s population resides in the low- and middle-income countries (LMICs), health system responses to IPV are poorly understood. In 2013, the World Health Organization released new guidelines for IPV but universal screening was not recommended in LMICs due to perceived lack of capacity and insufficient evidence. South Africa, with IPV prevalence estimated at 31% to 55%, offers a window into LMIC health systems. South African women seek health care for partner abuse, yet no guidelines exist to direct providers. This research aimed to understand how and why nurses respond to IPV. Using a descriptive design, 25 nurses from five health facilities were interviewed, generating rich narratives of provider actions. Themes were coded and analyzed. An iterative process of constant comparison of emergent data was undertaken to verify and confirm final themes. In the absence of IPV guidelines, nurses employed interventions characterized as counseling, ascertaining abuse, and referral. Nurses’ actions were motivated by fear for patients’ survival, perceived professional obligations, patients’ expectations of receiving treatment, personal experiences of IPV, and weak police responses to IPV. Findings indicated nurses were responding to IPV in a routine manner, yet comprehensive guidelines remain essential to govern and locate their actions within the framework of a public health response. South Africa yields lessons for enhancing understanding of IPV responses in LMICs, while contributing to a slim evidence base of the “how” and “why” of provider actions toward IPV in patients.

scholarly journals Pilot Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa

2017 ◽  
Vol 3 (5) ◽  
pp. 502-508 ◽  
Author(s):  
Lindsay K. Dickerson ◽  
Anne F. Rositch ◽  
Susan Lucas ◽  
Susan C. Harvey
Keyword(s):  
Breast Cancer ◽  
South Africa ◽  
Knowledge Acquisition ◽  
Self Efficacy ◽  
Breast Ultrasound ◽  
Perceived Usefulness ◽  
Middle Income ◽  
Middle Income Countries ◽  
Post Test ◽  
Low And Middle Income

Purpose Breast cancer is the leading cause of cancer death in women worldwide, with high mortality in low- and middle-income countries because of a lack of detection, diagnosis, and treatment. With mammography unavailable, ultrasound offers an alternative for downstaging. The literature reports successful training in various domains, but a focus on the breast is novel. We assessed the feasibility (knowledge acquisition, perceived usefulness, and self-efficacy) of breast ultrasound training for nonphysician providers. Methods Training was implemented for 12 providers at Hlokomela Clinic in Hoedspruit, South Africa, over 3 weeks. Didactic presentations and example cases were followed by a presurvey and test (n = 12). All providers received hands-on training with nurses as models; five providers trained with patients. A post-test (n = 12) assessed knowledge acquisition and a postsurvey (n = 10) assessed perceived program usefulness and provider self-efficacy. Results The pre- to post-test averages improved by 68% in total and in four competencies (foundational knowledge, descriptive categories, benign v malignant, and lesion identification). On the postsurvey, providers expressed that ultrasound could significantly influence breast cancer detection (9.1 out of 10), treatment (7.9 out of 10), and survival (8.7 out of 10) in their community and endorsed moderate confidence in their scanning (6.3 out of 10) and interpreting abilities (5.6 out of 10). Conclusion Our research supports the feasibility of breast ultrasound training as part of a breast education program in low- and middle-income countries. Pre- and post-test results and observed proficiency indicate that training nonphysician providers is achievable; postsurvey responses indicate program acceptance, community-based ownership, and provider self-efficacy with ultrasound. Future work may show that breast ultrasound is viable for early detection where mammography is unavailable.

scholarly journals Poverty, early care, and stress reactivity in adolescence: Findings from a prospective, longitudinal study in South Africa

2017 ◽  
Vol 29 (2) ◽  
pp. 449-464 ◽  
Author(s):  
R. M. Pasco Fearon ◽  
Mark Tomlinson ◽  
Robert Kumsta ◽  
Sarah Skeen ◽  
Lynne Murray ◽  
...  
Keyword(s):  
South Africa ◽  
Longitudinal Study ◽  
Social Stress ◽  
Short Term ◽  
Cortisol Reactivity ◽  
Middle Income ◽  
Middle Income Countries ◽  
Prospective Longitudinal ◽  
Low And Middle Income

AbstractA considerable body of evidence suggests that early caregiving may affect the short-term functioning and longer term development of the hypothalamic–pituitary–adrenocortical axis. Despite this, most research to date has been cross-sectional in nature or restricted to relatively short-term longitudinal follow-ups. More important, there is a paucity of research on the role of caregiving in low- and middle-income countries, where the protective effects of high-quality care in buffering the child's developing stress regulation systems may be crucial. In this paper, we report findings from a longitudinal study (N = 232) conducted in an impoverished periurban settlement in Cape Town, South Africa. We measured caregiving sensitivity and security of attachment in infancy and followed children up at age 13 years, when we conducted assessments of hypothalamus–pituitary–adrenocortical axis reactivity, as indexed by salivary cortisol during the Trier Social Stress Test. The findings indicated that insecure attachment was predictive of reduced cortisol responses to social stress, particularly in boys, and that attachment status moderated the impact of contextual adversity on stress responses: secure children in highly adverse circumstances did not show the blunted cortisol response shown by their insecure counterparts. Some evidence was found that sensitivity of care in infancy was also associated with cortisol reactivity, but in this case, insensitivity was associated with heightened cortisol reactivity, and only for girls. The discussion focuses on the potentially important role of caregiving in the long-term calibration of the stress system and the need to better understand the social and biological mechanisms shaping the stress response across development in low- and middle-income countries.

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