scholarly journals Lipid-based nutrient supplements and linear growth in children under 2 years: a review

2017 ◽  
Vol 76 (4) ◽  
pp. 580-588 ◽  
Author(s):  
Tonderayi M. Matsungo ◽  
Herculina S. Kruger ◽  
Cornelius M. Smuts ◽  
Mieke Faber
Keyword(s):  
Low Income ◽  
Linear Growth ◽  
Low Income Countries ◽  
Current Evidence ◽  
Future Research ◽  
Middle Income ◽  
Growth Faltering ◽  
Nutrient Supplements ◽  
Low And Middle Income

The prevalence of stunting remains high in low- and middle-income countries despite adoption of comprehensive nutrition interventions, particularly in low-income countries. In the present paper, we review current evidence on the acceptability and efficacy of small-quantity lipid-based nutrient supplements (SQ-LNS) on preventing stunting in children under 2 years, discuss the factors that affect their efficacy, highlight the implications of the current findings at pragmatic level and identify research priorities. Although the present paper is not a generic systematic review, we used a systematic approach to select relevant literature. The review showed that there is growing interest in the potential benefits of using SQ-LNS to prevent growth faltering. Acceptability studies showed that SQ-LNS are generally well accepted. However, results on the efficacy of SQ-LNS on improving linear growth or preventing growth faltering in infants and young children are still inconclusive. Factors that may affect efficacy include the duration of the trial, composition and dosage of SQ-LNS given, and baseline demographics and nutritional status of research participants. Future research should focus on controlled and long-term follow-up trials to obtain more conclusive results. In the long term, there will be need for studies to investigate how provision of SQ-LNS can be integrated with existing strategies to prevent stunting in low- and middle-income settings.

scholarly journals Patient-reported outcomes for diabetes and hypertension care in low- and middle-income countries: A scoping review

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245269
Author(s):  
Sarah Masyuko ◽  
Carrie J. Ngongo ◽  
Carole Smith ◽  
Rachel Nugent
Keyword(s):  
Scoping Review ◽  
Low Income ◽  
English Language ◽  
Patient Reported Outcome Measures ◽  
Low Income Countries ◽  
Future Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Patient Reported ◽  
Low And Middle Income

Introduction Patient-reported outcome measures (PROMs) assess patients’ perspectives on their health status, providing opportunities to improve the quality of care. While PROMs are increasingly used in high-income settings, limited data are available on PROMs use for diabetes and hypertension in low-and middle-income countries (LMICs). This scoping review aimed to determine how PROMs are employed for diabetes and hypertension care in LMICs. Methods We searched PubMed, EMBASE, and ClinicalTrials.gov for English-language studies published between August 2009 and August 2019 that measured at least one PROM related to diabetes or hypertension in LMICs. Full texts of included studies were examined to assess study characteristics, target population, outcome focus, PROMs used, and methods for data collection and reporting. Results Sixty-eight studies met the inclusion criteria and reported on PROMs for people diagnosed with hypertension and/or diabetes and receiving care in health facilities. Thirty-nine (57%) reported on upper-middle-income countries, 19 (28%) reported on lower-middle-income countries, 4 (6%) reported on low-income countries, and 6 (9%) were multi-country. Most focused on diabetes (60/68, 88%), while 4 studies focused on hypertension and 4 focused on diabetes/hypertension comorbidity. Outcomes of interest varied; most common were glycemic or blood pressure control (38), health literacy and treatment adherence (27), and acute complications (22). Collectively the studies deployed 55 unique tools to measure patient outcomes. Most common were the Morisky Medication Adherence Scale (7) and EuroQoL-5D-3L (7). Conclusion PROMs are deployed in LMICs around the world, with greatest reported use in LMICs with an upper-middle-income classification. Diabetes PROMs were more widely deployed in LMICs than hypertension PROMs, suggesting an opportunity to adapt PROMs for hypertension. Future research focusing on standardization and simplification could improve future comparability and adaptability across LMIC contexts. Incorporation into national health information systems would best establish PROMs as a means to reveal the effectiveness of person-centered diabetes and hypertension care.

scholarly journals Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2439
Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  
Keyword(s):  
Health Survey ◽  
Low Income ◽  
World Health ◽  
Low Income Countries ◽  
Multivariable Logistic Regression Analysis ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

scholarly journals Breast Cancer in Low- and Middle-Income Countries: An Emerging and Challenging Epidemic

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Arafat Tfayli ◽  
Sally Temraz ◽  
Rachel Abou Mrad ◽  
Ali Shamseddine
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Low Income ◽  
Therapeutic Interventions ◽  
Low Income Countries ◽  
Middle Income ◽  
Major Health ◽  
Middle Income Countries ◽  
Low And Middle Income

Breast cancer is a major health care problem that affects more than one million women yearly. While it is traditionally thought of as a disease of the industrialized world, around 45% of breast cancer cases and 55% of breast cancer deaths occur in low and middle income countries. Managing breast cancer in low income countries poses a different set of challenges including access to screening, stage at presentation, adequacy of management and availability of therapeutic interventions. In this paper, we will review the challenges faced in the management of breast cancer in low and middle income countries.

scholarly journals Impact of Medical Debt on the Financial Welfare of Middle- and Low-Income Families across China

2020 ◽  
Vol 17 (12) ◽  
pp. 4597 ◽  
Author(s):  
Jiajing Li ◽  
Chen Jiao ◽  
Stephen Nicholas ◽  
Jian Wang ◽  
Gong Chen ◽  
...  
Keyword(s):  
Low Income ◽  
Concentration Index ◽  
Financial Burden ◽  
Medical Insurance ◽  
Tobit Regression ◽  
Middle Income ◽  
Medical Debt ◽  
Low Income Families ◽  
Low And Middle Income

Background: Medical debt is a persistent global issue and a crucial and effective indicator of long-term family medical financial burden. This paper fills a research gap on the incidence and causes of medical debt in Chinese low- and middle-income households. Method: Data were obtained from the 2015 China Household Finance Survey, with medical debt measured as borrowings from families, friends and third parties. Tobit regression models were used to analyze the data. The concentration index was employed to measure the extent of socioeconomic inequality in medical debt incidence. Results: We found that 2.42% of middle-income families had medical debt, averaging US$6278.25, or 0.56 times average household yearly income and 3.92% of low-income families had medical debts averaging US$5419.88, which was equivalent to 2.49 times average household yearly income. The concentration index for low and middle-income families’ medical debt was significantly pro-poor. Medical debt impoverished about 10% of all non-poverty households and pushed poverty households deeper into poverty. While catastrophic health expenditure (CHE) was the single most important factor in medical debt, age, education, and health status of householder, hospitalization and types of medical insurance were also significant factors determining medical debt. Conclusions: Using a narrow definition of medical debt, the incidence of medical debt in Chinese low- and middle-income households was relatively low. But, once medical debt happened, it imposed a long-term financial burden on medical indebted families, tipping many low and middle-income households into poverty and imposing on households several years of debt repayments. Further studies need to use broader definitions of medical debt to better assess the long-term financial impact of medical debt on Chinese families. Policy makers need to modify China’s basic medical insurance schemes to manage out-of-pocket, medical debt and CHE and to take account of pre-existing medical debt.

scholarly journals The contribution of Dutch doctors in Global Health and Tropical Medicine to research in global health in low- and middle-income countries: an exploration of the evidence

2019 ◽  
Vol 50 (1) ◽  
pp. 43-49 ◽  
Author(s):  
Rob Mooij ◽  
Esther MJ Jurgens ◽  
Jeroen van Dillen ◽  
Jelle Stekelenburg
Keyword(s):  
Global Health ◽  
Low Income ◽  
Tropical Medicine ◽  
Low Income Countries ◽  
Global Health Research ◽  
Medical Doctors ◽  
Middle Income ◽  
Middle Income Countries ◽  
Phd Thesis ◽  
Low And Middle Income

Results from medical research from high-income countries may not apply to low- and middle-income countries. Some expatriate physicians combine clinical duties with research. We present global health research conducted by Dutch medical doctors in Global Health and Tropical Medicine in low- and middle-income countries and explore the value of their research. We included all research conducted in the last 30 years by medical doctors in Global Health and Tropical Medicine in a low- and middle-income country, resulting in a PhD thesis. Articles and co-authors were found through Medline. More than half of the 18 identified PhD theses concerned maternal health and obstetrics, and the majority of the research was conducted in low-income countries, mostly in rural hospitals. Over 70 local co-authors were involved. Different aspects of these studies are discussed.

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.

Smokers’ perceptions of incentivised smoking cessation programmes: Examining how payment thresholds change with income

2021 ◽  
Author(s):  
Rachel J Breen ◽  
Stuart G Ferguson ◽  
Matthew A Palmer
Keyword(s):  
Smoking Cessation ◽  
Low Income ◽  
Financial Incentive ◽  
Growth Models ◽  
Income Group ◽  
High Income ◽  
Future Research ◽  
Quadratic Trend ◽  
Middle Income ◽  
Low And Middle Income

Abstract Introduction Studies demonstrate that financial incentive programmes increase smoking cessation. However, there is little guidance on which incentive magnitudes will ensure optimal enrolment and motivation levels. This study investigates current smokers’ perceptions of varying incentive magnitudes to identify whether there is evidence for optimal amount(s), and whether perceptions differ by income group. Methods Studies 1 (N = 56) and 2 (N = 147) were conducted online via Prolific.co. Current smokers were randomly shown multiple hypothetical incentive programmes which differed only in the incentive amount offered. For each programme, smokers rated its appeal, their likelihood of enrolling, and predicted their motivation to quit if enrolled. Growth models were used to investigate the relationship between perspectives and the incentive amount. Results An increasing quadratic trend in smokers’ perceptions of programmes as the incentive amount increased was identified. Incentive amounts beyond approximately £50-75/week (£500 to £750 total) did not significantly alter perceptions of programmes. In Study 2, high-income smokers found programmes significantly less appealing and motivating than low-income smokers, although no significant between-group differences were observed in the likelihood of enrolment. No significant differences were observed between low- and middle-income smokers. Conclusions Increasing the incentive amount increased smoker’s perceptions of programmes. This relationship was curvilinear, meaning there may be a point beyond which further increasing the amount will not improve enrolment or motivation levels. Incentives appear equally appealing to low- and middle-income smokers; the population among whom smoking is most prevalent. Future research could explore other elements of programme design, and whether findings hold under real-world conditions. Implications While acknowledging that they work, policymakers frequently request information about the monetary amount needed for incentive programmes to be effective, and if this differs by income level. We investigated these questions using smokers’ perceptions of hypothetical cessation programmes which differed in the amount offered. An increasing quadratic trend in perceptions of programmes by the amount and potential cut-points were observed, suggesting a point may exist beyond which increasing the incentive will not improve perceptions of programmes or enrolment levels. High-income smokers may not perceive incentives to be as appealing as other income groups, but appear equally willing to enrol.

More than poverty

2016 ◽  
Vol 40 (6) ◽  
pp. 536-543 ◽  
Author(s):  
Theodore D. Wachs ◽  
Santiago Cueto ◽  
Haogen Yao
Keyword(s):  
Low Income ◽  
Large Scale ◽  
Cumulative Risk ◽  
Low Income Countries ◽  
Data Set ◽  
Middle Income ◽  
Middle Income Countries ◽  
Developmental Risks ◽  
The Impact ◽  
Low And Middle Income

Studies from both high and low-middle income (LAMI) countries have documented how being reared in poverty is linked to compromised child development. Links between poverty and development are mediated by the timing and extent of exposure to both risk factors nested under poverty and to protective influences which can attenuate the impact of risk. While children from high-, middle-, and low-income countries are exposed to similar types of developmental risks, children from low- and middle-income countries are exposed to a greater number, more varied and more intense risks. Given these contextual differences, cumulative risk models may provide a better fit than mediated models for understanding the nature of pathways linking economic insufficiency and developmental inequality in low- and middle-income countries, and for designing interventions to promote development of children from these countries. New evidence from a large scale UNICEF data set illustrates the application of a cumulative risk/protective perspective in low- and middle-income countries.

scholarly journals Schizophrenia outcome measures in the wider international community

2007 ◽  
Vol 191 (S50) ◽  
pp. s71-s77 ◽  
Author(s):  
Mohan Isaac ◽  
Prabhat Chand ◽  
Pratima Murthy
Keyword(s):  
Outcome Measures ◽  
Clinical Symptoms ◽  
Outcome Studies ◽  
Future Research ◽  
Sociocultural Factors ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

BackgroundOutcome of schizophrenia has been described as favourable in low-and middle-income countries. Recently, researchers have questioned these findingsAimsTo examine the outcome studies carried out in different countries specifically looking atthose from low-and middle-income countriesMethodsLong-term course and outcome studies in schizophrenia were reviewedResultsA wide variety of outcome measures are used. The most frequent are clinical symptoms, hospitalisation and mortality (direct indicators), and social/ occupational functioning, marriage, social support and burden of care (indirect indicators). Areas such as cognitive function, duration of untreated psychosis, quality of life and effect of medication have not been widely studied in low-and middle-income countriesConclusionsThe outcome of schizophrenia appears to be better in low-and middle-income countries. A host of sociocultural factors have been cited as contributing to this but future research should aim to understand this better outcome. There is a need for more culture-specific instruments to measure outcomes

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