scholarly journals Household cooking fuel estimates at global and country level for 1990 to 2030

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Oliver Stoner ◽  
Jessica Lewis ◽  
Itzel Lucio Martínez ◽  
Sophie Gumy ◽  
Theo Economou ◽  
...  
Keyword(s):  
Urban Areas ◽  
Middle Income ◽  
Gaseous Fuels ◽  
Middle Income Countries ◽  
Country Level ◽  
Urban Rural ◽  
Cooking Fuels ◽  
Sub Saharan ◽  
Global Population ◽  
Modelling Approach

AbstractHousehold air pollution generated from the use of polluting cooking fuels and technologies is a major source of disease and environmental degradation in low- and middle-income countries. Using a novel modelling approach, we provide detailed global, regional and country estimates of the percentages and populations mainly using 6 fuel categories (electricity, gaseous fuels, kerosene, biomass, charcoal, coal) and overall polluting/clean fuel use – from 1990-2020 and with urban/rural disaggregation. Here we show that 53% of the global population mainly used polluting cooking fuels in 1990, dropping to 36% in 2020. In urban areas, gaseous fuels currently dominate, with a growing reliance on electricity; in rural populations, high levels of biomass use persist alongside increasing use of gaseous fuels. Future projections of observed trends suggest 31% will still mainly use polluting fuels in 2030, including over 1 billion people in Sub-Saharan African by 2025.

scholarly journals What fuels the fire? Cooking fuel estimates at global, regional and country level for 1990-2030

2021 ◽  
Author(s):  
Oliver Stoner ◽  
Jessica Lewis ◽  
Itzel Martínez ◽  
Sophie Gumy ◽  
Theo Economou ◽  
...  
Keyword(s):  
Urban Areas ◽  
Middle Income ◽  
Gaseous Fuels ◽  
Middle Income Countries ◽  
Country Level ◽  
Urban Rural ◽  
Cooking Fuels ◽  
Sub Saharan ◽  
Global Population ◽  
Modelling Approach

Abstract Household air pollution generated from the use of polluting cooking fuels and technologies is a major source of disease and environmental degradation in low- and middle-income countries. Using a novel modelling approach, we provide global, regional and country estimates for 6 specific fuel categories (electricity, gaseous fuels, kerosene, biomass, charcoal, coal) and overall polluting/clean fuel use – from 1990-2020 and with urban/rural disaggregation. Model results show 53% of the global population relied on polluting cooking in 1990, dropping to 36% in 2020. In urban areas, gaseous fuels dominate, with a growing reliance on electricity; in rural populations, high levels of biomass use persist alongside increasing use of gaseous fuels. Future projections of observed trends suggest 31% will still lack access to clean cooking in 2030, and the Sub-Saharan African population relying on polluting fuels is on course to exceed 1 billion by 2025.

scholarly journals Current realities versus theoretical optima: quantifying efficiency and sociospatial equity of travel time to hospitals in low-income and middle-income countries

2019 ◽  
Vol 4 (4) ◽  
pp. e001552 ◽  
Author(s):  
Kerry LM Wong ◽  
Oliver J Brady ◽  
Oona Maeve Renee Campbell ◽  
Christopher I Jarvis ◽  
Andrea Pembe ◽  
...  
Keyword(s):  
Current Efficiency ◽  
Travel Time ◽  
Low Income ◽  
Urban Areas ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Average Travel Time ◽  
Sub Saharan ◽  
Aid Decision

BackgroundHaving hospitals located in urban areas where people, resources and wealth concentrate is efficient, but leaves long travel times for the rural and often poorer population and goes against the equity objective. We aimed to assess the current efficiency (mean travel time in the whole population) and equity (difference in travel time between the poorest and least poor deciles) of hospital care provision in four sub-Saharan African countries, and to compare them against their theoretical optima.MethodsWe overlaid the locations of 480, 115, 3787 and 256 hospitals in Kenya, Malawi, Nigeria and Tanzania, respectively, with high-resolution maps of travel time, population and wealth to estimate current efficiency and equity. To identify the potential optima, we simulated 7500 sets of hospitals locations based on various population and wealth weightings and percentage reallocations for each country.ResultsThe average travel time ranged from 38 to 79 min across countries, and the respective optima were mildly shorter (<15%). The observed equity gaps were wider than their optima. Compared with the best case scenarios, differences in the equity gaps varied from 7% in Tanzania to 77% in Nigeria. In Kenya, Malawi and Tanzania, narrower equity gaps without increasing average travel time were seen from simulations that held 75%–90% of hospitals at their current locations.InterpretationsCurrent hospital distribution in the four sub-Saharan African countries could be considered efficient. Simultaneous gains in efficiency and equity do not necessarily require a fundamental redesign of the healthcare system. Our analytical approach is readily extendible to aid decision support in adding and upgrading existing hospitals.

Abstract P137: Socioeconomic Status And Hypertension Control In Sub-saharan Africa: The Multination Eight Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Marie Antignac ◽  
Diane Macquart de Terline ◽  
Ibrahima Bara Diop ◽  
Kouadio E Kramoh ◽  
Dadhi M Balde ◽  
...  
Keyword(s):  
Low Income ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Uncontrolled Hypertension ◽  
Hypertension Control ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
The World ◽  
Sub Saharan

Introduction: Systemic hypertension is a rapidly growing epidemic in Sub-Saharan Africa. Adequacy of blood pressure(BP) control and the factors influencing it, especially the role of socio-economic status(SES) have not been well studied in this part of the world. Hypothesis: We therefore aimed to quantify the association of SES both at the individual and at the country level with BP control in Sub-Saharan Africa. Methods: We conducted a cross-sectional survey in urban clinics of twelve countries, both low-income and middle-income, in Sub-Saharan Africa. Data were collected on demographics, treatment and standardized BP measures were made among the hypertensive patients attending the clinics. BP control was defined as BP<140/90 mmHg and hypertension grades were defined according to European Society of Cardiology guidelines. Country income was retrieved from the World Bank database and patient’s individual wealth status was documented by the treating physician. The separate association between SES (both country-level income and individual patient wealth) and BP control was investigated using Generalized Linear Mixed-Effects Models adjusted on sex and age. Results: A total of 2198 hypertensive patients (58.4±11.8years; 39.9% male) were included, of whom 1017(46.3%) were from low-income and 1181(53.7%) from middle-income countries. Individual wealth level was low, mid and high in 376(17.6%), 1053(49.2%) and 713(33.3%) patients respectively. Uncontrolled hypertension was present in 1692 patients(77.4%) including 1044(47.7%) with ≥grade 2 hypertension. The proportion of uncontrolled hypertension progressively increased with decreasing level of patient individual wealth, respectively 72.8%, 79.3% and 81.8%(p for trend<0.01). Stratified analysis shows that these differences of uncontrolled hypertension according to individual wealth index were observed in low-income countries(p for trend=0.03) and not in middle-income countries(p for trend=0.26). In low-income countries the odds of uncontrolled hypertension increased 1.37 fold(OR=1.37 [0.99-1.90]) and 1.88 fold(OR=1.88 [1.10-3.21]) in patients with middle and low individual wealth as compared to high individual wealth. Similarly, the grade of hypertension increased progressively with decreasing level of individual patient wealth(p for trend <0.01). Conclusions: Low individual wealth was significantly associated with poor hypertension control, especially in low-income countries. Strategies for hypertension control in Sub-Saharan Africa should especially focus on people in the lowest individual wealth groups who also reside in low-income countries.

scholarly journals Global Plant-Based Food Intakes by Country Wealth and Socioeconomic Status: Findings from the Global Dietary Database

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 850-850
Author(s):  
Dimitra Karageorgou ◽  
Frederick Cudhea ◽  
Julia Reedy ◽  
Leah Puklin ◽  
Victoria Miller ◽  
...  
Keyword(s):  
Higher Education ◽  
Socioeconomic Status ◽  
Urban Areas ◽  
Vegetable Consumption ◽  
Age Groups ◽  
Potential Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Major Interest

Abstract Objectives Given the major interest in plant-based foods (PF) for global diets, we aimed to characterize inequalities in intakes of fruits, vegetables (non-starchy, potatoes, other starchy), legumes, grains (refined, whole), and nuts/seeds by country wealth and population socioeconomic status (SES). Methods PF intakes were derived from the Global Dietary Database, including 1144 national and subnational surveys from 1980 through 2015 covering 97.5% of the world's population. A Bayesian hierarchical prediction model combined stratum-specific individual-level intakes with survey-level and time-varying country-level (GDP, FAO's food balance sheets) covariates to estimate mean intakes and 95% uncertainty intervals jointly stratified by country (n = 185), year (1990–2015), sex, age (all ages, 20 age groups), urban-rural residence, and education (low, middle, high). Results Using the World Bank's country wealth categories, fruit intake, in 2015, was much higher in high-income (HIC) (120 g/d) and upper-middle income countries (UMIC) (107 g/d) compared with low (LIC) (72 g/d) and lower-middle income countries (LMIC) (68 g/d); and within nations, generally higher with higher education and in urban areas, except for HIC where it was higher for rural residents. Average intakes of non-starchy vegetables (148–153 g/d) and legumes (22–25 g/d) were similar by country wealth; highest vegetable consumption was among those of higher education in LIC. Legume consumption was highest among those of higher education in LIC and LMIC. Average refined and whole grain intakes were highest in HIC (128 and 42 g/d) and lowest in LIC (46 and 11 g/d), with notable heterogeneity by education; refined grains were highest with lower education in HIC and UMIC, whereas whole grains were highest with higher education. Findings on other PF, and over time will be presented. Conclusions Such global data provide novel evidence for substantial variation in PF intakes by country wealth, further linked to population SES, and can inform potential health impacts and country-specific nutrition policy priorities. Funding Sources Gates Foundation.

Local Economic Development in Sub-Saharan Africa

10.1068/c5p ◽  
2007 ◽  
Vol 25 (4) ◽  
pp. 516-536 ◽  
Author(s):  
Andrés Rodríguez-Pose ◽  
Sylvia A R Tijmstra
Keyword(s):  
Economic Development ◽  
Urban Areas ◽  
Local Economic Development ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Design And Implementation ◽  
City Regions ◽  
The World ◽  
Sub Saharan

It has often been argued that Africa in general, and Sub-Saharan Africa (SSA) in particular, is ‘different’ and that it therefore requires ‘exceptional’ solutions to its development problems. In contrast, in this paper we argue that strong internal heterogeneity combined with general trends similar to those experienced elsewhere in the world make local economic development (LED) as likely to succeed in SSA as in other low- and middle-income countries. The likelihood of success depends mostly on place-specific conditions. Many of the most prosperous parts of the continent already have the basic enabling conditions for the design and implementation of LED strategies in place. Less favourable resource endowments, poor accessibility, and relatively weak civil societies can undermine the viability of LED outside the wealthier and most prosperous areas. In smaller urban areas and intermediate regions and city-regions, which lack only a few of the basic preconditions for LED, further capacity building may still enable the success of the approach. In contrast, LED may not be relevant for the poorest and most remote parts of SSA, where existing conditions do not provide a strong enough base on which to build LED strategies.

scholarly journals Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

2020 ◽  
Vol 5 (11) ◽  
pp. e003423
Author(s):  
Dongqing Wang ◽  
Molin Wang ◽  
Anne Marie Darling ◽  
Nandita Perumal ◽  
Enju Liu ◽  
...  
Keyword(s):  
Weight Gain ◽  
North Africa ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Weight ◽  
Latin America And Caribbean ◽  
Nationally Representative ◽  
Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

scholarly journals A framework for designing medical devices resilient to low-resource settings

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Davide Piaggio ◽  
Rossana Castaldo ◽  
Marco Cinelli ◽  
Sara Cinelli ◽  
Alessia Maccaro ◽  
...  
Keyword(s):  
Delphi Study ◽  
Middle Income ◽  
Low Resource Settings ◽  
Health Technologies ◽  
Low Resource ◽  
Middle Income Countries ◽  
High Resource ◽  
International Experts ◽  
Global Population ◽  
Different Parts

Abstract Background To date (April 2021), medical device (MD) design approaches have failed to consider the contexts where MDs can be operationalised. Although most of the global population lives and is treated in Low- and Middle-Income Countries (LMCIs), over 80% of the MD market share is in high-resource settings, which set de facto standards that cannot be taken for granted in lower resource settings. Using a MD designed for high-resource settings in LMICs may hinder its safe and efficient operationalisation. In the literature, many criteria for frameworks to support resilient MD design were presented. However, since the available criteria (as of 2021) are far from being consensual and comprehensive, the aim of this study is to raise awareness about such challenges and to scope experts’ consensus regarding the essentiality of MD design criteria. Results This paper presents a novel application of Delphi study and Multiple Criteria Decision Analysis (MCDA) to develop a framework comprising 26 essential criteria, which were evaluated and chosen by international experts coming from different parts of the world. This framework was validated by analysing some MDs presented in the WHO Compendium of innovative health technologies for low-resource settings. Conclusions This novel holistic framework takes into account some domains that are usually underestimated by MDs designers. For this reason, it can be used by experts designing MDs resilient to low-resource settings and it can also assist policymakers and non-governmental organisations in shaping the future of global healthcare.

scholarly journals Predictors of Contemporary under-5 Child Mortality in Low- and Middle-Income Countries: A Machine Learning Approach

2021 ◽  
Vol 18 (3) ◽  
pp. 1315
Author(s):  
Andrea Bizzego ◽  
Giulio Gabrieli ◽  
Marc H. Bornstein ◽  
Kirby Deater-Deckard ◽  
Jennifer E. Lansford ◽  
...  
Keyword(s):  
Machine Learning ◽  
Child Mortality ◽  
Learning Approach ◽  
Unique Contribution ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Machine Learning Approach ◽  
Operational Information ◽  
Low And Middle Income

Child Mortality (CM) is a worldwide concern, annually affecting as many as 6.81% children in low- and middle-income countries (LMIC). We used data of the Multiple Indicators Cluster Survey (MICS) (N = 275,160) from 27 LMIC and a machine-learning approach to rank 37 distal causes of CM and identify the top 10 causes in terms of predictive potency. Based on the top 10 causes, we identified households with improved conditions. We retrospectively validated the results by investigating the association between variations of CM and variations of the percentage of households with improved conditions at country-level, between the 2005–2007 and the 2013–2017 administrations of the MICS. A unique contribution of our approach is to identify lesser-known distal causes which likely account for better-known proximal causes: notably, the identified distal causes and preventable and treatable through social, educational, and physical interventions. We demonstrate how machine learning can be used to obtain operational information from big dataset to guide interventions and policy makers.

scholarly journals Determinants of Long Immunization Clinic Wait Times in a Sub-Saharan African Country

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110282
Author(s):  
Osayame Austine Ekhaguere ◽  
Rosena Olubanke Oluwafemi ◽  
Angela Oyo-Ita ◽  
Burke Mamlin ◽  
Paul Bondich ◽  
...  
Keyword(s):  
Focus Group ◽  
Critical Mass ◽  
Wait Time ◽  
Wait Times ◽  
Group Discussions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Group Data ◽  
Focus Group Data ◽  
Sub Saharan

The wait time clients spend during immunization clinic visits in low- and middle-income countries is a not well-understood reported barrier to vaccine completion. We used a prospective, observational design to document the total time from client arrival-to-discharge and all sequential provider-client activities in 1 urban, semi-urban, and rural immunization clinic in Nigeria. We also conducted caregiver and provider focus group discussions to identify perceived determinants of long clinic wait times. Our findings show that the time from arrival-to-discharge varied significantly by the clinic and ranged between 57 and 235 minutes, as did arrival-to-all providers-client activities. Focus group data attributed workflow delays to clinic staff waiting for a critical mass of clients to arrive for their immunization appointment before starting the essential health education talk or opening specific vaccine vials. Additionally, respondents indicated that complex documentation processes caused system delays. Research on clinic workflow transformation and simplification of immunization documentation is needed.

scholarly journals Are low and middle-income countries prioritising high-value healthcare interventions?

2020 ◽  
Vol 5 (2) ◽  
pp. e001850
Author(s):  
Ashley A Leech ◽  
David D Kim ◽  
Joshua T Cohen ◽  
Peter J Neumann
Keyword(s):  
Cost Effectiveness ◽  
Cost Saving ◽  
National Health ◽  
Sub Saharan Africa ◽  
Health Plans ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Priority ◽  
Sub Saharan ◽  
Low And Middle Income

IntroductionSince resources are finite, investing in services that produce the highest health gain ‘return on investment’ is critical. We assessed the extent to which low and middle-income countries (LMIC) have included cost-saving interventions in their national strategic health plans.MethodsWe used the Tufts Medical Center Global Health Cost-Effectiveness Analysis Registry, an open-source database of English-language cost-per-disability-adjusted life year (DALY) studies, to identify analyses published in the last 10 years (2008–2017) of cost-saving health interventions in LMICs. To assess whether countries prioritised cost-saving interventions within their latest national health strategic plans, we identified 10 countries, all in sub-Saharan Africa, with the highest measures on the global burden of disease scale and reviewed their national health priority plans.ResultsWe identified 392 studies (63%) targeting LMICs that reported 3315 cost-per-DALY ratios, of which 207 ratios (6%) represented interventions reported to be cost saving. Over half (53%) of these targeted sub-Saharan Africa. For the 10 countries we investigated in sub-Saharan Africa, 58% (79/137) of cost-saving interventions correspond with priorities identified in country plans. Alignment ranged from 95% (21/22 prioritised cost-saving ratios) in South Africa to 17% (2/12 prioritised cost-saving ratios) in Cameroon. Human papillomavirus vaccination was a noted priority in 70% (7/10) of national health prioritisation plans, while 40% (4/10) of countries explicitly included prenatal serological screening for syphilis. HIV prevention and treatment were stated priorities in most country health plans, whereas 40% (2/5) of countries principally outlined efforts for lymphatic filariasis. From our sample of 45 unique interventions, 36% of interventions (16/45) included costs associated directly with the implementation of the intervention.ConclusionOur findings indicate substantial variation across country and disease area in incorporating economic evidence into national health priority plans in a sample of sub-Saharan African countries. To make health economic data more salient, the authors of cost-effectiveness analyses must do more to reflect implementation costs and other factors that could limit healthcare delivery.

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