scholarly journals The critical role of obstetric anaesthesia in low-income and middle-income countries

2016 ◽  
Vol 4 (5) ◽  
pp. e290-e291 ◽  
Author(s):  
Jill M Mhyre
Keyword(s):  
Low Income ◽  
Critical Role ◽  
Middle Income ◽  
Obstetric Anaesthesia ◽  
Middle Income Countries

scholarly journals Foreign aid on economic growth in Africa: A comparison of low and middle-income countries

2015 ◽  
Vol 18 (4) ◽  
pp. 449-462 ◽  
Author(s):  
Aye Mengistu Alemu ◽  
Jin-Sang Lee
Keyword(s):  
Economic Growth ◽  
Foreign Aid ◽  
Low Income ◽  
Empirical Studies ◽  
Critical Role ◽  
Generalized Method Of Moments ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Theoretical Hypothesis

Previous empirical studies on the effects of foreign aid on economic growth have generated mixed results that make it difficult to draw policy recommendations. The main reason for such mixed results is the choice of a single aggregate list of countries, regardless of the disparities in levels of development. This study therefore fills the development gap by disaggregating the African data into a panel of 20 middle- income and 19 low- income African countries over a period of 15 years between 1995 and 2010, and employing a dynamic generalized method of moments (GMM) model to address the dynamic nature of economic growth as well as the problems of endogeneity. The results of this study support the theoretical hypothesis that a positive relationship between aid and GDP growth exists, but only for low-income African countries, not middle-income ones. On the other hand, the study reveals that middle- income African countries tend to experience a greater impact on their economic growth from foreign direct investment (FDI) and natural resources revenues, mainly oil exports. This implies that the frequent criticism that foreign aid has not contributed to economic growth is flawed, at least in the case of low-income African countries. In fact, foreign aid has played a critical role in stimulating economic growth in such countries through supplementing domestic sources of finance such as savings, thus increasing the amount of investment and capital stock in them.

scholarly journals Withholding and Withdrawal of Life-Sustaining Treatments in critically ill ICU patients: A study on attitude of Physicians of Bangladesh

2019 ◽  
Vol 7 (2) ◽  
pp. 66-72
Author(s):  
Mohammad Omar Faruq ◽  
ARM Nooruzzaman ◽  
Rownak Jahan Tamanna ◽  
Amina Sultana ◽  
Uzzwal Kumar Mallick ◽  
...  
Keyword(s):  
Low Income ◽  
International Study ◽  
Legal Rights ◽  
Asian Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Icu Physicians ◽  
Real Chance

Background : This study is a sub analysis of data submitted on behalf of Bangladesh in an International study ( ACME 2012) involving physicians working in Asian ICUs. Objective : To describe attitude of physicians of ICUs of Bangladesh toward withholding and withdrawal of life sustaining treatments in end of life care, to assess factors associated with these observations and to compare the findings especially with those of physicians of low – middle income Asian ICUs. Method : Self-administered pre-set structured and scenario based survey conducted among 101 physicians working in 38 ICUs of Bangladesh. Results : For patients with no real chance of recovering a meaningful life, 20 of 101 respondents reported that they almost always or often withheld life-sustaining treatments and 18 of 101 respondents almost always or often withdrew life-sustaining treatments.44 respondents in our study reported that they almost always or often withheld life sustaining treatments whereas 10 respondents almost always or often withdrew life sustaining treatments. 72% of all our respondents would implement DNR orders. In Bangladesh, religion (Islam) does not influence decision of complying with DNR order requested by family. Our study showed 71% of physicians were more likely to “do everything” if a patient with hypoxic-ischaemic encephalopathy developed septic shock. In our study, physicians were more ready to withdraw vasopressors and hemo dialysis than enteral feeding and intravenous fluids. Physicians from Bangladesh generally perceived more legal risk with limitation of life sustaining treatments because of lack of legislation for such practices. When it comes to limit aggressive lifesaving treatments, Bangladeshi physicians were less likely accede to families request to withdraw them on financial ground. Conclusion : Like physicians of low-middle income countries of Asia, Bangladeshi ICU physicians’ self-reported practice of limiting life sustaining treatments, role of families and surrogates and perception of legal rights were significantly different than physicians of high income countries of Asia. However unlike physicians from other low income Asian countries, physicians from Bangladesh were less likely to accede to families request to withdraw life sustaining treatments on financial ground. Bangladesh Crit Care J September 2019; 7(2): 66-72

scholarly journals Receiving Social Assistance in Low- and Middle-Income Countries: Negating Shame or Producing Stigma?

2019 ◽  
Vol 49 (4) ◽  
pp. 705-723 ◽  
Author(s):  
KEETIE ROELEN
Keyword(s):  
Low Income ◽  
Social Assistance ◽  
Low Income Countries ◽  
Policy Options ◽  
Negative Effects ◽  
Middle Income ◽  
Middle Income Countries ◽  
Critical Exploration ◽  
Low And Middle Income

AbstractDespite the centrality of shame and stigma within research on welfare in high-income countries, these issues only exist within the periphery of rapidly expanding practice in and research on social assistance in low- and middle-income countries. This oversight undermines social assistance’s potential in breaking the poverty-shame cycle and ignores its role in the (re)production of shame and stigma. This article offers a critical exploration of the role of social assistance in alleviating or reinforcing shame and stigma in low- and middle-income countries. Findings indicate that positive and negative effects co-exist but that far too little evidence is available to judge whether social assistance receipt overwhelmingly negates or plays into shame and stigma, particularly in low-income countries. Greater awareness of the interface between social assistance, shame and stigma, explorations of policy options that minimise or counter stigmatisation, and critical engagement with ideological and political discourse underpinning design and delivery of interventions represent crucial steps to move towards ‘shame proofing’ social assistance in low- and middle-income countries.

scholarly journals Innovative financing to fund surgical systems and expand surgical care in low-income and middle-income countries

2020 ◽  
Vol 5 (6) ◽  
pp. e002375 ◽  
Author(s):  
Ché L Reddy ◽  
Alexander W Peters ◽  
Desmond Tanko Jumbam ◽  
Luke Caddell ◽  
Blake C Alkire ◽  
...  
Keyword(s):  
Health Systems ◽  
Low Income ◽  
Critical Role ◽  
Scale Up ◽  
Surgical Care ◽  
Healthcare Intervention ◽  
Strengthen Health System ◽  
Middle Income ◽  
Middle Income Countries ◽  
Fiscal Space

Strong surgical systems are necessary to prevent premature death and avoidable disability from surgical conditions. The epidemiological transition, which has led to a rising burden of non-communicable diseases and injuries worldwide, will increase the demand for surgical assessment and care as a definitive healthcare intervention. Yet, 5 billion people lack access to timely, affordable and safe surgical and anaesthesia care, with the unmet demand affecting predominantly low-income and middle-income countries (LMICs). Rapid surgical care scale-up is required in LMICs to strengthen health system capabilities, but adequate financing for this expansion is lacking. This article explores the critical role of innovative financing in scaling up surgical care in LMICs. We locate surgical system financing by using a modified fiscal space analysis. Through an analysis of published studies and case studies on recent trends in the financing of global health systems, we provide a conceptual framework that could assist policy-makers in health systems to develop innovative financing strategies to mobilise additional investments for scale-up of surgical care in LMICs. This is the first time such an analysis has been applied to the funding of surgical care. Innovative financing in global surgery is an untapped potential funding source for expanding fiscal space for health systems and financing scale-up of surgical care in LMICs.

scholarly journals Primary healthcare policy and governance in low-income and middle-income countries: an evidence gap map

2019 ◽  
Vol 4 (Suppl 8) ◽  
pp. e001453 ◽  
Author(s):  
K M Saif-Ur-Rahman ◽  
Razib Mamun ◽  
Iffat Nowrin ◽  
Shahed Hossain ◽  
Khaleda Islam ◽  
...  
Keyword(s):  
Social Responsibility ◽  
Low Income ◽  
Primary Healthcare ◽  
Evidence Synthesis ◽  
Nominal Group ◽  
Provider Communication ◽  
Middle Income ◽  
Stakeholder Consultation ◽  
Middle Income Countries

IntroductionGovernance is one of the most important aspects for strong primary healthcare (PHC) service delivery. To achieve the targets for the Sustainable Development Goals, good governance may play a prime role in low-income and middle-income countries (LMICs). This evidence gap map (EGM) explored the available evidence in LMICs to identify the knowledge gap concerning PHC policy and governance in these settings.MethodsWe followed the standard 3ie EGM protocol, finalising the scope of the EGM through a stakeholder workshop. We searched a total of 32 bibliographic databases, systematic review databases, impact evaluation databases, and donor and bilateral agency databases using a comprehensive search strategy. Two reviewers screened retrieved studies, extracted data and performed quality assessment. We plotted the interventions and outcomes derived from the included studies in a dynamic platform to build the interactive EGM and conducted a stakeholder consultation with nominal group technique methods to prioritise the identified gaps.ResultsThe EGM included 24 systematic reviews and 7 impact evaluations focusing on PHC policy and governance in LMICs. Most of the sources emphasised workforce management and supervision. There were noticeable evidence gaps regarding accountability and social responsibility. The most highly prioritised themes were the role of accountability, the role of public–private partnerships and the role of user–provider communication in PHC governance.ConclusionsThis EGM identified some important aspects of PHC policy and governance such as accountability, social responsibility, public–private partnership, user–provider communication through the methodological approaches of evidence synthesis and stakeholder consultation. Identified gaps will provide directions for an implementation research plan to improve the governance of PHC in LMICs.

The Role of Technical Standards in Improving Digital Accessibility in Under-Resourced Regions and Communities

2021 ◽  
pp. 128-151
Author(s):  
Judy Brewer ◽  
Shadi Abou-Zahra
Keyword(s):  
Low Income ◽  
People With Disabilities ◽  
Indigenous Communities ◽  
Technical Standards ◽  
Middle Income ◽  
Barriers To Participation ◽  
Middle Income Countries

People with disabilities in under-resourced communities, including in low-income and lower middle-income countries and in many Indigenous communities, have not yet benefited as much from digital accessibility as have people with disabilities in higher-income regions. This chapter addresses factors that contribute to these disparities and describes the role of standards in promoting digital accessibility. It describes barriers to participation, approaches that can help improve opportunities for people from under-resourced communities to engage in development of accessibility standards and accessible technologies, and steps that can increase promotion and uptake of digital accessibility standards in under-resourced regions and communities.

scholarly journals Community health workers and early detection of breast cancer in low-income and middle-income countries: a systematic scoping review of the literature

2020 ◽  
Vol 5 (5) ◽  
pp. e002466
Author(s):  
James O'Donovan ◽  
Ashley Newcomb ◽  
MacKenzie Clark MacRae ◽  
Dorice Vieira ◽  
Chinelo Onyilofor ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Scoping Review ◽  
Low Income ◽  
Health Workers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Breast Cancer Early Detection ◽  
Cancer Early Detection

BackgroundBreast cancer is the leading cause of female mortality in low-income and middle-income countries (LMICs). Early detection of breast cancer, either through screening or early diagnosis initiatives, led by community health workers (CHWs) has been proposed as a potential way to address the unjustly high mortality rates. We therefore document: (1) where and how CHWs are currently deployed in this role; (2) how CHWs are trained, including the content, duration and outcomes of training; and (3) the evidence on costs associated with deploying CHWs in breast cancer early detection.MethodsWe conducted a systematic scoping review and searched eight major databases, as well as the grey literature. We included original studies focusing on the role of CHWs to assist in breast cancer early detection in a country defined as a LMIC according to the World Bank.Findings16 eligible studies were identified. Several roles were identified for CHWs including awareness raising and community education (n=13); history taking (n=7); performing clinical breast examination (n=9); making onward referrals (n=7); and assisting in patient navigation and follow-up (n=4). Details surrounding training programmes were poorly reported and no studies provided a formal cost analysis.ConclusionsDespite the relative paucity of studies addressing the role of CHWs in breast cancer early detection, as well as the heterogeneity of existing studies, evidence suggests that CHWs can play a number of important roles in breast cancer early detection initiatives in LMICs. However, if they are to realise their full potential, they must be appropriately supported within the wider health system.

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