scholarly journals Training Australian General Surgeons for Humanitarian Emergencies: A Comparison Between Trainee Logbooks and Emergency Medical Team Caseloads

2019 ◽  
Vol 34 (s1) ◽  
pp. s3-s3
Author(s):  
Charles Coventry ◽  
Lynette Dominquez ◽  
David Read ◽  
Miguel Trelles ◽  
Rebecca Ivers ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
The Philippines ◽  
Fracture Repair ◽  
Orthopedic Procedures ◽  
Middle Income ◽  
Middle Income Countries ◽  
Emergency Medical ◽  
Surgical Trainees ◽  
General Surgeons ◽  
Low And Middle Income

Introduction:Emergency medical teams (EMTs) have helped to provide surgical care in many recent sudden onset disasters (SODs), especially in low- and middle-income countries (LMICs). General surgical training in Australia has undergone considerable change in recent years, and it is not known whether the new generation of general surgeons is equipped with the broad surgical skills needed to operate as part of EMTs.Aim:To analyze the differences between the procedures performed by contemporary Australian general surgeons during training and the procedures performed by EMTs responding to SODs in low- and middle-income countries (LMICs).Methods:General surgical trainee logbooks between February 2008 and January 2017 were obtained from General Surgeons Australia. Operating theatre logs from EMTs working during the 2010 earthquake in Haiti, 2014 typhoon in the Philippines, and 2015 earthquake in Nepal were also obtained. These caseloads were collated and compared.Results:A total of 1,396,383 procedures were performed by Australian general surgical trainees in the study period. The most common procedure categories were abdominal wall hernia procedures (12.7%), cholecystectomy (11.7%), and specialist colorectal procedures (11.5%). Of note, Caesarean sections, hysterectomy, fracture repair, specialist neurosurgical, and specialist pediatric surgical procedures all made up <1% of procedures each. There were a total of 3,542 procedures recorded in the EMT case logs. The most common procedures were wound debridement (31.5%), other trauma (13.3%), and Caesarean section (12.5%). Specialist colorectal, hepato-pancreaticobiliary, upper gastrointestinal, urological, vascular, neurosurgical, and pediatric surgical procedures all made up <1% each.Discussion:Australian general surgical trainees get limited exposure to the obstetric, gynecological, and orthopedic procedures that are common during EMT responses to SODs. However, there is considerable exposure to the soft tissue wound management and abdominal procedures.

scholarly journals Strengthening the Capacity of Emergency Medical Services in Low and Middle Income Countries using Dispatcher-Coordinated Taxis

2020 ◽  
Vol 2674 (9) ◽  
pp. 338-345
Author(s):  
Vipul Mishra ◽  
Richa Ahuja ◽  
N. Nezamuddin ◽  
Geetam Tiwari ◽  
Kavi Bhalla
Keyword(s):  
Response Time ◽  
Emergency Medical Services ◽  
Road Traffic ◽  
International Standards ◽  
Medical Services ◽  
Road Traffic Crash ◽  
Middle Income ◽  
Middle Income Countries ◽  
Emergency Medical ◽  
Low And Middle Income

International standards recommend provision of one ambulance for every 50,000 people to fulfill demand for transporting patients to definitive care facilities in low and middle income countries (LMICs). Governments’ consistent attempt to build capacity of emergency medical services (EMS) in LMICs has been financially demanding. This study is an attempt to assess the feasibility of capacity building of existing EMS in Delhi, India by using taxis as an alternative mode of transport for emergency transportation of road traffic crash victims to enable improvement in response time for road traffic crashes where time criticality is deemed important. Performance of the proposed system is evaluated based on response time, coverage and distance. The system models the performance and quantifies the taxi–ambulance configuration for achieving EMS performance within international standards.

scholarly journals Adapting Elements of Cleft Care Protocols in Low- and Middle-income Countries During and After COVID-19: A Process-driven Review With Recommendations

2022 ◽  
pp. 105566562110698
Author(s):  
Matthew Fell ◽  
Michael Goldwasser ◽  
B.S. Jayanth ◽  
Rui Manuel Rodrigues Pereira ◽  
Christian Tshisuz Nawej ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Working Group ◽  
Care Providers ◽  
Resource Constrained ◽  
Middle Income ◽  
Middle Income Countries ◽  
International Working Group ◽  
Consensus Recommendations ◽  
Care Services ◽  
Low And Middle Income

A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptations to cleft care protocols during and after COVID-19 as a priority learning area of need. A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendations for adaptations to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organizations involved in comprehensive cleft care. Foundational principles were agreed to enable recommendations to be globally relevant and two areas of focus within the specified topic were identified. First the safety aspects of cleft surgery protocols were scrutinized and COVID-19 adaptations, specifically in the pre- and perioperative periods, were highlighted. Second, surgical procedures and cleft care services were prioritized according to their relationship to functional outcomes and time-sensitivity. The surgical procedures assigned the highest priority were emergent interventions for breathing and nutritional requirements and primary palatoplasty. The cleft care services assigned the highest priority were new-born assessments, pediatric support for children with syndromes, management of acute dental or auditory infections and speech pathology intervention. A collaborative, interdisciplinary and international working group delivered consensus recommendations to assist with the provision of cleft care in low- and middle-income countries. At a time of global cleft care delays due to COVID-19, a united approach amongst global cleft care providers will be advantageous to advocate for children born with cleft lip and palate in resource-constrained settings.

scholarly journals A New Standards-based Grammar for Linking Aggregate Datasets

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Derek Ritz ◽  
Bob Jolliffe ◽  
Xenophon Santas ◽  
James Kariuki
Keyword(s):  
Data Exchange ◽  
The Philippines ◽  
Use Cases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Integrating The Healthcare Enterprise ◽  
Hands On ◽  
The Us ◽  
Low And Middle Income

The theme of this session is the linking and cross-referencing of disparate aggregate datasets that need to be combined for pruporses of reporting and/or analysis. The session leverages, as a global case study, the US Government's President's Emergency Plan for AIDS Relief (PEPFAR) programme. PEPFAR is a $7 billion per year programme supporting the delivery of HIV-related services, medicines, and commodities in 58 low and middle-income countries (www.pepfar.gov). PEPFAR has an immense datastore of monitoring, evaluation and reporting (MER) indicators that have been collected from all its supported countries over the course of its 15 years of operations. The goal of the session is to describe for attendees a newly-developed, standards-based grammar for describing interoperable aggregate data exchange and the message schemas needed to support it. The session facilitators are the primary authors of this new standard. Using the PEPFAR case study as a working example, the session explores how disparate HIV data elements and indicators from PEPFAR-supported countries are cross-referenced to each other and collected into a single central datastore to support analysis, management and reporting across the global programme. The specific HIV example will be elaborated upon to illustrate generalizable techniques that can be applied to linking aggregate datasets in other use cases (e.g. reporting to the annual WHO global health observatory, multiple provinces reporting to a federal health data institute, etc.). The session will be facilitated by Xenophon Santas and James Kariuki of the US CDC, Bob Jolliffe of the University of Oslo's Health Information Systems Programme (HISP) and Derek Ritz of ecGroup Inc (a Canadian health informatics consultancy). All four facilitators are members of the Quality, Research and Publich Health (QRPH) technical committee of the international digital health standards body, Integrating the Healthcare Enterprise (IHE; www.ihe.net). The session's content and examples will leverage the facilitators' first-hand experience working on HIV-related projects in low and middle-income countries (e.g. South Africa, Rwanda, Kenya, Malawi, Zimbabwe, Uganda, Sierre Leone, Vietnam, the Philippines and elsewhere). It is intended that the session will be conducted using an interactive workshop style. Attendees who wish it will have an opportunity to engage in participative (hands-on) learning. To get started, information will be provided about the standards-based grammar and how it works. Then, results from the facilitators' efforts leveraging this method to link multiple disparate HIV-related datasets will be presented. As a hands-on activity, attendees who have notebook computers will be able to connect to an open source software solution (www.dhis2.org) and "play in a sandbox" to try for themselves some of the techniques that have been described. As learning objectives, it is expected that attendees will: Be introduced to data linking use cases outside of their everyday experience Learn about a new technique for expressing aggregate content schema that supports interoperable data exhange Apply new skills in a hands-on, worked example.

scholarly journals Health Technology Assessment capacity development in low- and middle-income countries: Experiences from the international units of HITAP and NICE

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 2119 ◽  
Author(s):  
Sripen Tantivess ◽  
Kalipso Chalkidou ◽  
Nattha Tritasavit ◽  
Yot Teerawattananon
Keyword(s):  
Health Technology Assessment ◽  
Priority Setting ◽  
Technology Assessment ◽  
Policy Research ◽  
Health Technology ◽  
The Philippines ◽  
Health Coverage ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Health Technology Assessment (HTA) is policy research that aims to inform priority setting and resource allocation. HTA is increasingly recognized as a useful policy tool in low- and middle-income countries (LMICs), where there is a substantial need for evidence to guide Universal Health Coverage policies, such as benefit coverage, quality improvement interventions and quality standards, all of which aim at improving the efficiency and equity of the healthcare system. The Health Intervention and Technology Assessment Program (HITAP), Thailand, and the National Institute for Health and Care Excellence (NICE), UK, are national HTA organizations providing technical support to governments in LMICs to build up their priority setting capacity. This paper draws lessons from their capacity building programs in India, Colombia, Myanmar, the Philippines, and Vietnam. Such experiences suggest that it is not only technical capacity, for example analytical techniques for conducting economic evaluation, but also management, coordination and communication capacity that support the generation and use of HTA evidence in the respective settings. The learned lessons may help guide the development of HTA capacity in other LMICs.

International price comparisons of Alzheimer's drugs: a way to close the affordability gap

2009 ◽  
Vol 21 (6) ◽  
pp. 1116-1126 ◽  
Author(s):  
Guk-Hee Suh ◽  
Anders Wimo ◽  
Serge Gauthier ◽  
Daniel O'Connor ◽  
Manabu Ikeda ◽  
...  
Keyword(s):  
Purchasing Power Parity ◽  
The Philippines ◽  
High Income ◽  
Power Parity ◽  
Middle Income ◽  
Middle Income Countries ◽  
International Price ◽  
Differential Pricing ◽  
Price Comparisons ◽  
Low And Middle Income

ABSTRACTBackground: Alzheimer's drugs are believed to have limited availability and to be unaffordable in low- and middle-income countries compared to high-income countries. The price, availability and affordability of Alzheimer's drugs have not been reported before.Methods: During 2007 an international survey was conducted in 21 countries in six continents (Argentina, Australia, Brazil, the Dominican Republic, France, India, Japan, Macedonia, Mexico, New Zealand, Nigeria, the Philippines, Portugal, Serbia, South Korea, Switzerland, Taiwan, Thailand, Uganda, the U.K. and the U.S.A.). Prices of Alzheimer's drugs were compared using the affordability index (the total number of units purchasable with one's daily income) derived from purchasing power parity (PPP) converted prices as well as raw prices.Results: Donepezil is available in all 21 countries, whereas the newer drugs are less available. A 5 mg tablet of branded originator donepezil costs just US$0.26 in India and US$0.31 in Mexico, whereas it costs US$6.64 in the U.S.A. Pricing conditions of rivastigmine, galantamine and memantine appear to be similar to that of donepezil. The cheapest branded originators are from India and Mexico. However, in terms of PPP, Alzheimer's drugs in other low- and middle-income countries are much more expensive than in high-income countries. Most people in low- and middle-income countries cannot afford Alzheimer's drugs.Conclusions: Alzheimer's drugs, albeit available, are often unaffordable for those who need them most. It is hoped that equitable differential pricing will be applied to Alzheimer's drugs.

scholarly journals Effects of Pantawid Pamilyang Pilipino Program (4Ps) and other Conditional Cash Transfer (CCT) Programs of Low and Middle – Income Countries on Human Development

2021 ◽  
Vol 2 (1) ◽  
pp. 2-11
Author(s):  
Ronald Diaz
Keyword(s):  
Human Development ◽  
Human Development Index ◽  
Conditional Cash Transfer ◽  
The Philippines ◽  
Cash Transfer ◽  
Transfer Program ◽  
Middle Income ◽  
Development Index ◽  
Middle Income Countries ◽  
Low And Middle Income

Despite the economic growth experienced by the Philippines in the recent years in terms of high GDP, poverty in the country still prevails. Prevalence of many poor families and individuals in the country prompted the Philippine government to implement the Pantawid Pamilyang Pilipino Program (Bridging Program for the Filipino Family) also known as 4Ps, the country’s conditional cash transfer (CCT) program that aims to provide conditional cash grants to the poorest of the poor. This paper aims to examine the effect of 4Ps on the country’s Human Development Index (HDI). It also seeks to find out if conditional cash transfer program provides significant effect on the HDIs of low and middle-income countries worldwide. The mean Human Development Index (HDI) of the Philippines before and throughout the implementation of 4Ps was compared. The difference between the HDIs of selected countries (low and middle-income) implementing and non-implementing the conditional cash transfer programs was determined. The findings of this study show that the Philippines has a significantly higher mean HDI during the implementation of 4Ps since 2008 to 2018 compared to its years when there was no 4Ps. The results further indicate that low and middle–income countries with CCT programs have significantly higher HDIs in comparison to their counterparts. A thorough evaluation of the CCT programs in terms of issues such as dependency and reviewing the conditionalities of the program to provide more significant and promising effect on HDI needs to be undertaken. Keywords: Pantawid Pamilyang Pilipino Program (4Ps), conditional cash transfer (CCT), Human Development Index (HDI)  

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