Large-scale road safety programmes in low- and middle-income countries: An opportunity to generate evidence

2013 ◽  
Vol 8 (5) ◽  
pp. 504-518 ◽  
Author(s):  
Adnan A. Hyder ◽  
Katharine A. Allen ◽  
David H. Peters ◽  
Aruna Chandran ◽  
David Bishai
Keyword(s):  
Road Safety ◽  
Large Scale ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Large-Scale Food Fortification and Biofortification in Low- and Middle-Income Countries: A Review of Programs, Trends, Challenges, and Evidence Gaps

2018 ◽  
Vol 39 (2) ◽  
pp. 315-331 ◽  
Author(s):  
Saskia J. M. Osendarp ◽  
Homero Martinez ◽  
Greg S. Garrett ◽  
Lynnette M. Neufeld ◽  
Luz Maria De-Regil ◽  
...  
Keyword(s):  
Large Scale ◽  
Food System ◽  
Food Fortification ◽  
Micronutrient Deficiencies ◽  
Middle Income ◽  
Middle Income Countries ◽  
Essential Components ◽  
Quality Of Delivery ◽  
And Control ◽  
Low And Middle Income

Background: Food fortification and biofortification are well-established strategies to address micronutrient deficiencies in vulnerable populations. However, the effectiveness of fortification programs is not only determined by the biological efficacy of the fortified foods but also by effective and sustainable implementation, which requires continual monitoring, quality assurance and control, and corrective measures to ensure high compliance. Objective: To provide an overview of efficacy, effectiveness, economics of food fortification and biofortification, and status of and challenges faced by large-scale food fortification programs in low- and middle-income countries (LMIC). Methods: A literature review of PubMed publications in English from 2000 to 2017, as well as gray literature, targeting nongovernmental organizations whose work focuses on this topic, complemented by national reports and a “snowball” process of citation searching. The article describes remaining technical challenges, barriers, and evidence gap and prioritizes recommendations and next steps to further accelerate progress and potential of impact. Results: The review identifies and highlights essential components of successful programs. It also points out issues that determine poor program performance, including lack of adequate monitoring and enforcement and poor compliance with standards by industry. Conclusions: In the last 17 years, large-scale food fortification initiatives have been reaching increasingly larger segments of populations in LMIC. Large-scale food fortification and biofortification should be part of other nutrition-specific and nutrition-sensitive efforts to prevent and control micronutrient deficiencies. There are remaining technical and food system challenges, especially in relation to improving coverage and quality of delivery and measuring progress of national programs.

scholarly journals Stigma and discrimination related to mental illness in low- and middle-income countries

2015 ◽  
Vol 24 (5) ◽  
pp. 382-394 ◽  
Author(s):  
M. Semrau ◽  
S. Evans-Lacko ◽  
M. Koschorke ◽  
L. Ashenafi ◽  
G. Thornicroft
Keyword(s):  
Mental Illness ◽  
Large Scale ◽  
Grey Literature ◽  
Middle Income ◽  
Middle Income Countries ◽  
Stigma And Discrimination ◽  
Effective Interventions ◽  
Long Term Follow Up ◽  
Context Specific ◽  
Low And Middle Income

Aims.This paper aims to provide an overview of evidence from low- and middle-income countries (LAMICs) worldwide to address: the nature of stigma and discrimination, relevant context-specific factors, global patterns of these phenomena and their measurement and quantitative and qualitative evidence of interventions intended to reduce their occurrence and impact. The background to this study is that the large majority of studies concerned with identifying effective interventions to reduce stigma and discrimination originate in high-income countries (HICs). This paper therefore presents such evidence from, and relevant to, LAMICs.Methods.Conceptual overview of the relevant peer-reviewed and grey literature on stigma and discrimination related to mental illness in LAMICs are available in English, Spanish, French and Russian.Results.Few intervention studies were identified related to stigma re-education in LAMICs. None of these addressed behaviour change/discrimination, and there were no long-term follow-up studies. There is therefore insufficient evidence at present to know which overall types of intervention may be effective and feasible and in LAMICs, how best to target key groups such as healthcare staff, and how far they may need to be locally customised to be acceptable for large-scale use in these settings. In particular, forms of social contacts, which have been shown to be the most effective intervention to reduce stigma among adults in HICs, have not yet been assessed sufficiently to know whether these methods are also effective in LAMICs.Conclusion.Generating information about effective interventions to reduce stigma and discrimination in LAMICs is now an important mental health priority worldwide.

scholarly journals Ethical issues in the use of SMS messaging in HIV care and treatment in low- and middle-income countries: case examples from Mozambique

2017 ◽  
Vol 25 (4) ◽  
pp. 423-427 ◽  
Author(s):  
Ezequiel B Ossemane ◽  
Troy D Moon ◽  
Martin C Were ◽  
Elizabeth Heitman
Keyword(s):  
Large Scale ◽  
Ethical Issues ◽  
Scale Up ◽  
Hiv Care ◽  
Ethical Framework ◽  
Middle Income ◽  
Middle Income Countries ◽  
Retention In Hiv Care ◽  
Care And Treatment ◽  
Low And Middle Income

Abstract The introduction of mobile communication technologies in health care in low- and middle-income countries offers an opportunity for increased efficiencies in provision of care, improved utilization of scarce resources, reductions in workload, and increased reach of services to a larger target population. Short message service (SMS) technologies offer promise, with several large-scale SMS-based implementations already under way. Still largely lacking in the research literature are evaluations of specific ethical issues that arise when SMS programs are implemented and studied in resource-limited settings. In this paper, we examine the ethical issues raised by the deployment of SMS messaging to support patient retention in HIV care and treatment and in the research conducted to evaluate that deployment. We use case studies that are based in Mozambique and ground our discussion in the ethical framework for international research proposed by Emanuel et al., highlighting ethical considerations needed to guide the design and implementation of future SMS-based interventions. Such guidance is increasingly needed in countries such as Mozambique, where the local capacity for ethical study design and oversight is still limited and the scale-up and study of mHealth initiatives are still driven predominantly by international collaborators. These issues can be complex and will need ongoing attention on a case-by-case basis to ensure that appropriate protections are in place, while simultaneously maximizing the potential benefit of new mHealth technologies.

scholarly journals Road safety lessons to learn from Low and Middle-Income Countries

2020 ◽  
Vol 31 (3) ◽  
pp. 69-78
Author(s):  
Ray Shuey ◽  
Lori Mooren ◽  
Mark King
Keyword(s):  
Road Safety ◽  
Good Practice ◽  
Holistic Approach ◽  
Evidence Base ◽  
Policy And Practice ◽  
Middle Income ◽  
Middle Income Countries ◽  
Community Outcomes ◽  
High Level ◽  
Low And Middle Income

This paper presents aspects of policy and practice observed in low and middle-income countries (LMICs) and the lessons which can be learned from these and similar initiatives. The role of non-government organisations in capacity building programs and advocacy is identified as a strong foundation for road safety reform. Political will is discussed as a critical component of reform together with the need for a holistic approach to ensure sustainability. The requirement for a strong evidence-base to support evaluation is discussed and the need to ensure strong governance over law enforcement is profiled. Good practice programs are described as well as the importance of harnessing the enthusiasm and dedication of youth in developing and championing initiatives for safer community outcomes. While the lack of resources and financial support may appear as an impediment to some, if viewed as a surmountable challenge, safety outcomes can be achieved. The findings demonstrate that there is a rich environment in LMICs from which to source and undertake key and critical research to stimulate continuous road safety improvement especially in those countries where road trauma remains at a comparatively high level.

scholarly journals The Science of Scale for Violence Prevention: A New Agenda for Family Strengthening in Low- and Middle-Income Countries

2021 ◽  
Vol 9 ◽  
Author(s):  
Yulia Shenderovich ◽  
Jamie M. Lachman ◽  
Catherine L. Ward ◽  
Inge Wessels ◽  
Frances Gardner ◽  
...  
Keyword(s):  
Violence Prevention ◽  
Large Scale ◽  
Middle Income ◽  
Middle Income Countries ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Reduction Strategies ◽  
Development Goals ◽  
Family Strengthening ◽  
Low And Middle Income

Ending all violence against children by 2030 is a core part of Sustainable Development Goals 5 and 16. A number of promising violence reduction strategies have been identified in research studies. However, we lack an understanding of the implementation and impact of these programs in respect to their delivery at a large scale or within existing service systems, particularly in low- and middle-income countries (LMICs). We advocate for greater collaboration between researchers, policymakers, donors, governments, non-governmental organizations, and program managers and staff to study how violence prevention programs operate on a large scale. We describe a new initiative aiming to foster such collaborations in the field of family strengthening programs.

scholarly journals An Analysis of Essential Pediatric Surgical Cases Encountered During a Decade of Large-Scale Military Humanitarian Aid Missions

2020 ◽  
Vol 185 (11-12) ◽  
pp. e2143-e2149
Author(s):  
Alicia D Gaidry ◽  
Radhames E Lizardo ◽  
James M Prieto ◽  
Jason B Brill ◽  
Amy A Hernandez ◽  
...  
Keyword(s):  
Complication Rate ◽  
Large Scale ◽  
Perioperative Complications ◽  
Humanitarian Aid ◽  
Humanitarian Assistance ◽  
Middle Income ◽  
Middle Income Countries ◽  
Surgical Conditions ◽  
Host Nation ◽  
Low And Middle Income

Abstract Introduction Disease Control Priorities, 3rd Edition (DCP3) is an evidence-based, published resource that outlines essential procedures recommended for developing health care systems. These systems must consider various populations and the incidence of certain surgical conditions that require treatment. In relation to pediatric patients, the prevalence of certain surgical conditions encountered remains unclear in several low- and middle-income countries. Over the past 15 years, the USNS Mercy, one of the U.S. Navy’s large hospital ships, has led the Pacific Partnership missions, which provide large-scale humanitarian aid throughout Southeast Asia. The data collected during these missions provide an opportunity to analyze the scope of pediatric operations performed in resource-limited countries. This analysis may assist in future planning for specific needs during military humanitarian missions. Materials and Methods Surgical case data were prospectively collected during the six Pacific Partnership missions from 2006 to 2018. Demographic data were analyzed for all patients ≤8 years of age who underwent an operation. These data were retrospectively reviewed and all case logs were categorized by mission year, procedure-type, and host nation. Operations were classified based on 44 essential operations delineated in DCP3. Primary outcome was incidence of DCP3 essential operations. Secondary outcomes were perioperative complications. Standard statistical methods were performed for descriptive analysis. Results A total of 3,209 major and minor operations were performed during 24 port visits in nine countries. Pediatric cases represented 1,117 (38%) of these procedures. Pediatric surgeons performed 291 (26%) of these cases. Based on DCP3 criteria, 789 pediatric operations (71%) were considered essential procedures. The most common DCP3-aligned procedures were cleft lip repair (432, 57%), hernia repair (207, 27%), and hydrocelectomy (60, 8%). Operative volume for pediatric surgery was highest during the 2008 mission (522 cases), when two pediatric surgeons were deployed, and lowest during the 2018 mission (five cases), when the mission focus was on education rather than surgical procedures and lack of pediatric cases referred by the host nation. Overall complication rate for pediatric cases was 1%. Conclusions This study represents the largest known analysis of military humanitarian assistance. Pediatric operations represented over one-third of the surgical volume during Pacific Partnership missions from 2006 to 2018. The majority of cases were DCP3-aligned and associated with a low complication rate. Future humanitarian aid missions and host nations should allocate appropriate medical and educational resources to treat DCP3 pediatric surgical diseases in low- and middle-income countries to support long-term capacity building while maintaining optimal surgical outcomes.

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.

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