Socioeconomic and demographic drivers of red and processed meat consumption: implications for health and environmental sustainability

Red and processed meat (RPM) intake varies widely globally. In some high-income countries (HIC) the last decade has witnessed an overall decline or stabilisation in the consumption of RPM, in contrast to emerging economies where its consumption continues to increase with rising income and rapid urbanisation. The production and consumption of RPM have become major concerns regarding the environmental impacts of livestock in particular, but also because of associations between high RPM consumption and diet-related non-communicable disease. Therefore, it is important to identify socioeconomic and demographic drivers of the consumption of RPM. This paper explores how consumption of RPM differs with age, gender, socioeconomic status and in different global contexts. There are some key socioeconomic and demographic patterns in RPM consumption. Men tend to consume RPM more often and in higher quantities, and there is evidence of a social gradient in HIC, with lower socioeconomic groups consuming RPM more often and in larger quantities. Patterns for consumption with age are less clear cut. It is apparent that consumers in HIC are still consuming high levels of RPM, although the downward shifts in some socioeconomic and demographic groups is encouraging and suggests that strategies could be developed to engage those consumers identified as high RPM consumers. In low- and middle-income countries, RPM consumption is rising, especially in China and Brazil, and in urban areas. Ways of encouraging populations to maintain their traditional healthy eating patterns need to be found in low- and middle-income countries, which will have health, environmental and economic co-benefits.

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A review of pedestrian safety models for urban areas in Low and Middle Income Countries

Functional Pavement Design ◽

10.1201/9781315643274-176 ◽

2016 ◽

pp. 1597-1605

Author(s):

R.A. Kraidi ◽

H. Evdorides

Keyword(s):

Urban Areas ◽

Pedestrian Safety ◽

Middle Income ◽

Middle Income Countries ◽

Safety Models ◽

Low And Middle Income

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Strengthening Noncommunicable Disease Research Capacity and Chronic Disease Outcomes in Low- and Middle-Income Countries in South Asia: Implementation and Evaluation of the ASCEND Program

Asia Pacific Journal of Public Health ◽

10.1177/1010539519867791 ◽

2019 ◽

Vol 31 (6) ◽

pp. 536-547

Author(s):

Allison Byrnes ◽

Tilahun Nigatu Haregu ◽

Naanki Pasricha ◽

Kavita Singh ◽

Sathish Thirunavukkarasu ◽

...

Keyword(s):

Online Learning ◽

Communicable Disease ◽

Research Capacity ◽

Lessons Learned ◽

Early Career ◽

Noncommunicable Disease ◽

Middle Income ◽

Face To Face ◽

Middle Income Countries ◽

Low And Middle Income

This article describes the design, outcomes, challenges, and lessons learned from the ASian Collaboration for Excellence in Non-Communicable Disease (ASCEND) program, implemented between 2011 and 2015 in India, Sri Lanka, and Malaysia. The program involved a blended-delivery model, incorporating online and face-to-face training, mentoring, and supervision of trainees’ research projects. Evaluation data were collected at baseline, 6, 12, 18, and 24 months. Intended outcomes, lessons, and challenges were summarized using a logic model. During the program period, 48 participants were trained over 2 cohorts in June 2011 and 2012. The trainees published 83 peer-reviewed articles between 2011 and 2015. Additionally, 154 presentations were given by trainees at national and international conferences. Underutilization of the online learning management system was an important challenge. Utilizing a combination of intensive face-to-face and online learning and mentoring of early career researchers in low- and middle-income countries has great potential to enhance the research capacity, performance, and outputs.

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Strategies used to establish palliative care in rural low- and middle-income countries: an integrative review

Health Policy and Planning ◽

10.1093/heapol/czaa051 ◽

2020 ◽

Vol 35 (8) ◽

pp. 1110-1129

Author(s):

Atsede Aregay ◽

Margaret O’Connor ◽

Jill Stow ◽

Nicola Ayers ◽

Susan Lee

Keyword(s):

Palliative Care ◽

Low Income ◽

Rural Areas ◽

Urban Areas ◽

Care Home ◽

Sub Saharan Africa ◽

Integrative Review ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Abstract Globally, 40 million people need palliative care; about 69% are people over 60 years of age. The highest proportion (78%) of adults are from low- and middle-income countries (LMICs), where palliative care still developing and is primarily limited to urban areas. This integrative review describes strategies used by LMICs to establish palliative care in rural areas. A rigorous integrative review methodology was utilized using four electronic databases (Ovid MEDLINE, Ovid Emcare, Embase classic+Embase and CINAHL). The search terms were: ‘palliative care’, ‘hospice care’, ‘end of life care’, ‘home-based care’, ‘volunteer’, ‘rural’, ‘regional’, ‘remote’ and ‘developing countries’ identified by the United Nations (UN) as ‘Africa’, ‘Sub-Saharan Africa’, ‘low-income’ and ‘middle- income countries’. Thirty papers published in English from 1990 to 2019 were included. Papers were appraised for quality and extracted data subjected to analysis using a public health model (policy, drug availability, education and implementation) as a framework to describe strategies for establishing palliative care in rural areas. The methodological quality of the reviewed papers was low, with 7 of the 30 being simple programme descriptions. Despite the inclusion of palliative care in national health policy in some countries, implementation in the community was often reliant on advocacy and financial support from non-government organizations. Networking to coordinate care and medication availability near-patient homes were essential features of implementation. Training, role play, education and mentorship were strategies used to support health providers and volunteers. Home- and community-based palliative care services for rural LMICs communities may best be delivered using a networked service among health professionals, community volunteers, religious leaders and technology.

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Inequalities in Antenatal Care Coverage and Quality: an Analysis From 63 Low and Middle-income Countries Using the ANCq Content-qualified Coverage Indicator

10.21203/rs.3.rs-120640/v1 ◽

2020 ◽

Author(s):

Luisa Arroyave ◽

Ghada E Saad ◽

Cesar G Victora ◽

Aluisio J D Barros

Keyword(s):

Antenatal Care ◽

Urban Areas ◽

Global Analysis ◽

Socioeconomic Inequalities ◽

Middle Income ◽

National Surveys ◽

Middle Income Countries ◽

Wide Range ◽

The Difference ◽

Low And Middle Income

Abstract Background: Antenatal care (ANC) is an essential intervention associated with a reduction of maternal and new-born morbidity and mortality. However, evidence suggested substantial inequalities in maternal and child health, mainly in low- and middle-income countries (LMICs). We aimed to conduct a global analysis of socioeconomic inequalities in ANC using national surveys from LMICs.Methods: ANC was measured using the ANCq, a novel content-qualified ANC coverage indicator, created and validated using national surveys, based upon contact with the health services and content of care received. We performed stratified analysis to explore the socioeconomic inequalities in ANCq. We also estimated the slope index of inequality, which measures the difference in coverage along the wealth spectrum. Results: We analyzed 63 national surveys carried out from 2010 to 2017. There were large inequalities between and within countries. Higher ANCq scores were observed among women living in urban areas, with secondary or more level of education, belonging to wealthier families and with higher empowerment in nearly all countries. Countries with higher ANCq mean presented lower inequalities; while countries with average ANCq scores presented wide range of inequality, with some managing to achieve very low inequality.Conclusions: Despite all efforts in ANC programs, important inequalities in coverage and quality of ANC services persist. If maternal and child mortality Sustainable Development Goals are to be achieved, those gaps we documented must be bridged.

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Implementation barriers for mHealth for non-communicable diseases management in low and middle income countries: a scoping review and field-based views from implementers

Wellcome Open Research ◽

10.12688/wellcomeopenres.15581.2 ◽

2020 ◽

Vol 5 ◽

pp. 7 ◽

Cited By ~ 1

Author(s):

Josefien van Olmen ◽

Erica Erwin ◽

Ana Cristina García-Ulloa ◽

Bruno Meessen ◽

J. Jaime Miranda ◽

...

Keyword(s):

Scoping Review ◽

Text Messaging ◽

Communicable Disease ◽

Scale Up ◽

Research Network ◽

Implementation Barriers ◽

Middle Income ◽

Middle Income Countries ◽

Technical Requirements ◽

Low And Middle Income

Background: Mobile health (mHealth) has been hailed as a potential gamechanger for non-communicable disease (NCD) management, especially in low- and middle-income countries (LMIC). Individual studies illustrate barriers to implementation and scale-up, but an overview of implementation issues for NCD mHealth interventions in LMIC is lacking. This paper explores implementation issues from two perspectives: information in published papers and field-based knowledge by people working in this field. Methods: Through a scoping review publications on mHealth interventions for NCDs in LMIC were identified and assessed with the WHO mHealth Evidence Reporting and Assessment (mERA) tool. A two-stage web-based survey on implementation barriers was performed within a NCD research network and through two online platforms on mHealth targeting researchers and implementors. Results: 16 studies were included in the scoping review. Short Message Service (SMS) messaging was the main implementation tool. Most studies focused on patient-centered outcomes. Most studies did not report on process measures and on contextual conditions influencing implementation decisions. Few publications reported on implementation barriers. The websurvey included twelve projects and the responses revealed additional information, especially on practical barriers related to the patients’ characteristics, low demand, technical requirements, integration with health services and with the wider context. Many interventions used low-cost software and devices with limited capacity that not allowed linkage with routine data or patient records, which incurred fragmented delivery and increased workload. Conclusion: Text messaging is a dominant mHealth tool for patient-directed of quality improvement interventions in LMIC. Publications report little on implementation barriers, while a questionnaire among implementors reveals significant barriers and strategies to address them. This information is relevant for decisions on scale-up of mHealth in the domain of NCD. Further knowledge should be gathered on implementation issues, and the conditions that allow universal coverage.

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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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182413061 ◽

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.

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Implementation barriers for mHealth for non-communicable diseases prevention and management in low and middle income countries: a scoping review and field-based views from implementers

Wellcome Open Research ◽

10.12688/wellcomeopenres.15581.1 ◽

2020 ◽

Vol 5 ◽

pp. 7

Author(s):

Josefien van Olmen ◽

Erica Erwin ◽

Ana Cristina García-Ulloa ◽

Bruno Meessen ◽

J. Jaime Miranda ◽

...

Keyword(s):

Scoping Review ◽

Text Messaging ◽

Communicable Disease ◽

Scale Up ◽

Research Network ◽

Implementation Barriers ◽

Middle Income ◽

Middle Income Countries ◽

Technical Requirements ◽

Low And Middle Income

Background: Mobile health (mHealth) has been hailed as a potential gamechanger for non-communicable disease (NCD) management, especially in low- and middle-income countries (LMICs). Individual studies illustrate barriers to implementation and scale-up, but an overview of implementation issues for NCD mHealth interventions in LMICs is lacking. This paper explores implementation issues from two perspectives: information in published papers and field-based knowledge by people working in this field. Methods: Through a scoping review publications on mHealth interventions for NCDs in LMICs were identified and assessed with the WHO mHealth Evidence Reporting and Assessment (mERA) tool. A two-stage web-based survey on implementation barriers was performed within a NCD research network and through two online platforms on mHealth targeting researchers and implementors. Results: 18 studies were included in the scoping review. Short Message Service (SMS) messaging was the main implementation tool. Most studies focused on patient-centered outcomes. Most studies do not report on process measures and on contextual conditions influencing implementation decisions. Few publications reported on implementation barriers. The websurvey included twelve projects and the responses revealed additional information, especially on practical barriers related to the patients’ characteristics, low demand, technical requirements, integration with health services and with the wider context. Many interventions used low-cost software and devices with limited capacity that not allowing linkage with routine data or patient records, which incurred fragmented delivery and increased workload. Conclusion: Text messaging is a dominant mHealth tool for patient-directed of quality improvement interventions in LMICs. Publications report little on implementation barriers, while a questionnaire among implementors reveals significant barriers and strategies to address them. This information is relevant for decisions on scale-up of mHealth in the domain of NCD. Further knowledge should be gathered on implementation issues, and the conditions that allow universal coverage.

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Expanding the use of community health workers in urban settings: a potential strategy for progress towards universal health coverage

Health Policy and Planning ◽

10.1093/heapol/czz133 ◽

2019 ◽

Cited By ~ 3

Author(s):

Brian Wahl ◽

Susanna Lehtimaki ◽

Stefan Germann ◽

Nina Schwalbe

Keyword(s):

Health Services ◽

Community Health ◽

Low Income ◽

Urban Areas ◽

Access To Health Services ◽

Middle Income ◽

Urban Settings ◽

Middle Income Countries ◽

Access To Health ◽

Low And Middle Income

Abstract Community health worker (CHW) programmes have been used for decades to improve access to health services in rural settings in low- and middle-income countries. With more than half of the world’s population currently living in urban areas and this population expected to grow, equitable access to health services in urban areas is critically important. To understand the extent to which CHW programmes have been successfully deployed in low-income urban settings, we conducted a review of the literature between 2000 and 2018 to identify studies evaluating and describing CHW programmes implemented fully or partially in urban or peri-urban settings. We identified 32 peer-reviewed articles that met our inclusion criteria. Benefits have been documented in several urban settings in low- and middle-income countries including those to address TB/HIV, child health, maternal health and non-communicable diseases through a variety of study designs.

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