scholarly journals Analysis of cervical cancer policy documents in East-African countries

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D W Njuguna ◽  
N M Mahrouseh ◽  
O V Varga
Keyword(s):  
Cervical Cancer ◽  
Low Income ◽  
Burden Of Disease ◽  
Scientific Evidence ◽  
Cancer Control ◽  
Low Income Countries ◽  
Surveillance Systems ◽  
East African ◽  
African Countries ◽  
Policy Documents

Abstract Background Cervical cancer is largely a preventable disease according to data by Global Burden of Disease. Among the 20 countries with the highest incidence of cervical cancer globally, 16 are African countries. Relevant cancer control interventions in most low-income countries are partially developed attributing to unavailability of statistics limiting understanding and approximation of the magnitude of the burden of cancer. In order to evaluate health policies for prevention and management for cervical cancer among East-African countries a legal mapping was carried out. Methods Legal mapping as a qualitative research method is used to determinate existing policies, collect and analyze the information, and ultimately measure the effect of these policies on health outcomes. Legislation was searched from government websites, national cancer institute sites, international and national legal databases in a uniform way. Nvivo 12 software for content analysis of unstructured qualitative data related information was used for analysis. Coding of the data was developed by two researchers. Reliability of policies assessed according to Cohen's Kappa inter-rater reliability. Results The sample included 24 policies, plans guidelines, acts and strategic documents from 10 East-African countries. No relevant legislation identified from Somali and Djibouti. Majority of the countries had policy documents related to cervical cancer and touched on the components of cancer control. Majority of the East-African countries have not established screening registries leading to poor or no reliable data for assessing the cancer burden. Prophylactic vaccination against HPV is yet to be included in the national immunization schedules. Conclusions Findings show limited coverage of the identified policies, discrepancy to international guides. To reduce the harmful impact of the discordance between scientific evidence and policies, surveillance systems have to be set up/strengthened. Key messages Legislation which is brought into force to prevent cervical cancer is a pillar of effective public health efforts. Evidence based policy mapping plays a key role in giving insight on the burden of disease thereby making informed decisions for health.

The analysis of evolution in eradicating mortalities caused by infectious diseases in East and Central African Countries coinciding with gross national income

2019 ◽  
Author(s):  
Xiao Haijun ◽  
Jean Pierre Namahoro
Keyword(s):  
Infectious Diseases ◽  
Low Income ◽  
National Income ◽  
Gross National Income ◽  
Low Income Countries ◽  
East African ◽  
African Countries ◽  
National Budget ◽  
Study Results ◽  
The Government

Abstract Background: Infectious diseases are predominantly within poor population living in low-income countries, while are either treatable or preventable with existing medicines in the first occurring. The highlighted cause is some government choose to spend national budget on several projects do not coincide the basic needs and demands of the population. The objectives of this study were to 1) compare the performance between new cases and deaths caused by diseases; 2) show the effect of gross national income (GNI) in the mortalities reduction, and 3) assess potential evolution in eradicating mortalities in East African countries. Method: WHO database contains data on several responses (new cases of Malaria, Neonates protected at birth against neonatal tetanus, mortalities from tuberculosis among HIV-negative people and new cases of leprosy) recorded from 2004 to 2015. IMB SPSS modeler and Origin 8 were used especially, One-way ANOVA and Pearson’s correlation to achieve the objectives of the study. Results: The p-values for either Levene’ and Brown-Forsythe compared with 0.05 significant level for testing the performance between countries, correlation between GNI with leprosy is -0.5 to -1.0, in five countries, with TB is closer t0 -1.0 in four countries, with deaths from Malaria, is -0.5 to -1.0 in three countries, and new cases from Malaria and protected neonates is 0.5 to 1.0. Conclusion: The relationship between GNI and new cases and deaths indicate the weak effect of GNI in the process of eradicating mortalities, therefore, the government should prioritize the healthcare and use a national budget to monitoring the all complications related to infectious diseases. Key wards: infectious diseases, eradicating mortalities, gross national income

Monetary Policy in Sub-Saharan Africa

2018 ◽  
Keyword(s):  
Monetary Policy ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
African Countries ◽  
Policy Regimes ◽  
Export Prices ◽  
Policy Work ◽  
Sub Saharan ◽  
Policy Guidance

Having broadly stabilized inflation over the past two decades, many policymakers in sub-Saharan Africa are now asking more of their monetary policy frameworks. They are looking to avoid policy misalignments and respond appropriately to both domestic and external shocks, including swings in fiscal policy and spikes in food and export prices. In many cases they are finding current regimes—often characterized as ‘money targeting’—lacking, with opaque and sometimes inconsistent objectives, inadequate transmission of policy to the economy, and difficulties in responding to supply shocks. At the same time, little existing research on monetary policy is targeted to low-income countries. What do we know about the empirics of monetary transmission in low-income countries? (How) Does monetary policy work in countries characterized by a huge share of food in consumption, underdeveloped financial markets, and opaque policy regimes? (How) Can we use methods largely derived in advanced countries to answer these questions? And (how) can we use the results to guide policymakers? This book draws on years of research and practice at the IMF and in central banks from the region to shed empirical and theoretical light on these questions and to provide practical tools and policy guidance. A key feature of the book is the application of dynamic general equilibrium models, suitably adapted to reflect key features of low-income countries, for the analysis of monetary policy in sub-Saharan African countries.

Infrastructure deficit and opportunities in Africa

2017 ◽  
Author(s):  
Albert Mafusire ◽  
Zuzana Brixiova ◽  
John Anyanwu ◽  
Qingwei Meng
Keyword(s):  
Private Sector ◽  
Low Income ◽  
Private Investment ◽  
Low Income Countries ◽  
Infrastructure Development ◽  
African Countries ◽  
Policy Makers ◽  
Private Sector Investment ◽  
Investment Opportunities ◽  
Financing Infrastructure

Private sector investment opportunities in Africa’s infrastructure are huge. Regulatory reforms across African countries are identified as critical to the realization of the expected investment flows in the infrastructure sector. However, planners and policy makers need to note that there are infrastructure deficiencies in all subsectors with low income countries (LICs) in Africa facing the greatest challenge. Inefficiencies in implementing infrastructure projects account for USD 17 billion annually and improving the capacity of African countries will help minimize these costs. In this regard, the donor community must play a greater role in African LICs while innovative financing mechanisms must be the focus in the relatively richer countries of the continent. Traditional sources of financing infrastructure development remain important but private investment is critical in closing the current gaps. Countries need to devise mechanisms to exploit opportunities and avoid pitfalls in investing in infrastructure.

scholarly journals Quantifying the under-estimation of cervical Cancer in remote regions of Tanzania

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mariah P. Gesink ◽  
Robert M. Chamberlain ◽  
Julius Mwaiselage ◽  
Crispin Kahesa ◽  
Kahima Jackson ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Low Income ◽  
Population Based ◽  
Capital City ◽  
Low Income Countries ◽  
Treatment Center ◽  
Large Country ◽  
Number Of Patients ◽  
Sub Saharan ◽  
Radiotherapy Treatment

Abstract Background Cervical cancer is the most common cancer among women in Sub-Saharan countries, including Tanzania. While early detection and diagnosis are available in some parts of this large country, radiotherapy has been only available at the Ocean Road Cancer Institute (ORCI), in the capital city of Dar es Salaam and is just starting in a few regions. Methods The objective of this study was to compare the observed incidence of cervical cancer for the two remote regions of Mwanza in western Tanzania and Mbeya in southern Tanzania, based on their patients treated at the ORCI from 2011 to 2014. Results: The number patients referred and treated at ORCI were (120 from Mwanza, and 171 from Mbeya, representing 24.6 and 32.8% of the patients histopathologically confirmed in the two sites, respectively. The results showed significant underestimation of cervical cancer in the two regions. The vast majority of patients who were histopathologically-confirmed in their local regions (73.92% from Mwanza and 65.1% from Mbeya), but did not receive the needed radiotherapy treatment at the ORCI. The estimated incidence for the two regions based on the number of patients treated at the ORCI were underestimated by 53.9% for Mwanza and 68.9% for Mbeya. Conclusions Local establishment of radiotherapy treatment facilities in remote regions in Tanzania and similar other low-income countries is essential for providing effective treatment and improving survival of diagnosed cervical cancer patients. Linkage between the records of local remote hospitals and the main cancer treatment center in the capital city can also help support the emerging the population-based cancer registry at ORCI.

scholarly journals International barriers and facilitators for cervical cancer screening among young people: a systematic review

2021 ◽  
Author(s):  
Abirami Kirubarajan ◽  
Shannon Leung ◽  
Xinglin Li ◽  
Matthew Yau ◽  
Mara Sobel
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Young People ◽  
Cervical Cancer Screening ◽  
Low Income ◽  
Healthcare Providers ◽  
Barriers And Facilitators ◽  
Low Income Countries ◽  
Age Group

Background Though cervical cancer is one of the leading causes of death globally, its incidence is nearly entirely preventable. Young people have been an international priority for screening. However, in both high-income and low-income countries, young people have not been screened appropriately according to country-specific guidelines and in many countries, screening rates for this age-group have even dropped. Objectives The aim of this systematic review was to systematically characterize the existing literature on barriers and facilitators for cervical cancer screening among young people globally. Search Strategy We conducted a systematic review following PRISMA guidelines of four databases: Medline-OVID, EMBASE, CINAHL, and ClinicalTrials.Gov. Selection Criteria We only examined original, peer-reviewed literature. Databases were examined from inception until the date of our literature searches (12/03/2020). Articles were excluded if they did not specifically discuss cervical cancer screening, were not specific to young people, or did not report outcomes or evaluation. Data Collection and Analysis All screening and extraction was completed in duplicate with two independent reviewers. Main Results Of the 2177 original database citations, we included 36 studies that met inclusion criteria. Our systematic review found that there are three large categories of barriers for young people: lack of knowledge/awareness, negative perceptions of the test, and practical barriers to testing. Facilitators included stronger relationships with healthcare providers, social norms, support from family, and self-efficacy. Conclusions Health systems worldwide should address the barriers and facilitators to increase cervical cancer screening rates in young people. Further research is required to understand this age group.

scholarly journals The acceptance of covid-19 vaccines in Sub-Saharan Africa: Evidence from 6 national phone surveys

2021 ◽  
Author(s):  
Shelton Kanyanda ◽  
Yannick Markhof ◽  
Philip Wollburg ◽  
Alberto Zezza
Keyword(s):  
Side Effects ◽  
Low Income ◽  
Urban Areas ◽  
Vaccine Coverage ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Vaccine Hesitancy ◽  
African Countries ◽  
Representative Sampling ◽  
Sub Saharan

Introduction Recent debates surrounding the lagging covid-19 vaccination campaigns in low-income countries center around vaccine supply and financing. Yet, relatively little is known about attitudes towards covid-19 vaccines in these countries and in Africa in particular. In this paper, we provide cross-country comparable estimates of the willingness to accept a covid-19 vaccine in six Sub-Saharan African countries. Methods We use data from six national high-frequency phone surveys from countries representing 38% of the Sub-Saharan African population (Burkina Faso, Ethiopia, Malawi, Mali, Nigeria, and Uganda). Samples are drawn from large, nationally representative sampling frames providing a rich set of demographic and socio-economic characteristics by which we disaggregate our analysis. Using a set of re-calibrated survey weights, our analysis adjusts for the selection biases common in remote surveys. Results Acceptance rates in the six Sub-Saharan African countries studied are generally high, with at least four in five people willing to be vaccinated in all but one country. Vaccine acceptance ranges from nearly universal in Ethiopia (97.9%, 97.2% to 98.6%) to below what would likely be required for herd immunity in Mali (64.5%, 61.3% to 67.8%). We find little evidence for systematic differences in vaccine hesitancy by sex or age but some clusters of hesitancy in urban areas, among the better educated, and in richer households. Safety concerns about the vaccine in general and its side effects emerge as the primary reservations toward a covid-19 vaccine across countries. Conclusions Our findings suggest that limited supply, not inadequate demand, likely presents the key bottleneck to reaching high covid-19 vaccine coverage in Sub-Saharan Africa. To turn intent into effective demand, targeted communication campaigns bolstering confidence in the safety of approved vaccines and reducing concerns about side effects will be crucial to safeguard the swift progression of vaccine rollout in one of the world's poorest regions.

Managing and Motivating

2011 ◽  
pp. 79-95
Author(s):  
Eilish Mc Auliffe ◽  
Ogenna Manafa ◽  
Cameron Bowie ◽  
Lucy Makoae ◽  
Fresier Maseko ◽  
...  
Keyword(s):  
Human Resources ◽  
Low Income ◽  
Low Income Countries ◽  
Critical Element ◽  
African Countries ◽  
Bilateral Agreements ◽  
Working Environments ◽  
Sub Saharan ◽  
And Performance ◽  
Source Countries

It is now more than a decade since the acknowledgement of the health human resources crisis that exists in many low-income countries. During that decade much attention has focused on addressing the “pull” factors (e.g. developing voluntary international recruitment guidelines and bilateral agreements between recruiting and source countries) and on scaling up the supply of health professionals. Drawing on research conducted in two sub-Saharan African countries, we argue that a critical element in the human resources crisis is the poor working environments in these countries that not only continue to act as a strong “push” factor, but also impact on the motivation and performance of those who remain in their home countries. Unless attention is focused on improving work environments, the human resources crisis will continue in a vicious cycle leading to further decline in the health systems of low-income countries.

P1586Research network in Africa (RNA): antihypertensive drugs strategies in 12 African countries

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kane ◽  
P Cavagna ◽  
I B Diop ◽  
B Gaye ◽  
J B Mipinda ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Low Income ◽  
Democratic Republic ◽  
Antihypertensive Drugs ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Sub Saharan

Abstract Background High Blood Pressure is the worldwide leading global burden of disease risk factor. In Sub-Saharan Africa, the number of adults with raised blood pressure has alarmingly increased from 0.59 to 1.13 billion between 1975 and 2015. Blood pressure-lowering medicines are cornerstone of cardiovascular risk reduction. Data on management of anti-hypertensive drugs in sub-Saharan Africa are squarce. Purpose Our study aims to describe antihypertensive drugs strategies in Africa. Methods We conducted a cross-sectional survey in urban clinics during outpatient consultation specialized in hypertension cardiology departments of 29 medical centers from 17 cities across 12 African countries (Benin, Cameroon, Congo, Democratic Republic of Congo, Gabon, Guinea, Ivory Coast, Mauritania, Mozambic, Niger, Senegal, Togo). Data were collected on demographics, treatment and standardized BP measures were made among the hypertensive patients attending the clinics. Country income was retrieved from the World Bank database. All analyses were performed through scripts developed in the R software (3.4.1 (2017–06–30)). Results A total of 2198 hypertensive patients (58.4±11.8 years; 39.9% male) were included. Among whom 2123 (96.6%) had at least one antihypertensive drug. Overall, 30.8% (n=653) received monotherapy and calcium-channel blockers (49.6%) were the most common monotherapy prescribed follow by diuretics (18.7%). Two-drug strategies were prescribed for 927 patients (43.6%). Diuretics and Angiotensin-converting enzyme inhibitors was the combination most frequently prescribed (33.7%). Combination of three drugs or more was used in 25.6% (n=543) of patients. The proportion of drugs strategies differed significantly according to countries (p<0.001), monotherapy ranged from 12.7% in Niger to 47.1% in Democratic Republic of the Congo (figure). Furthermore we observed a significantly difference of strategies between low and middle income countries (55.3% and 44.7% of monotherapy respectively) (p<0.001). According to hypertension grades 1, 2 and 3, the proportion of three-drugs or more combination was 25%, 28% and 34% in middle-income and lower in low-income countries (18%, 19% and 25%). Furthermore, Grade 3 hypertension in low income countries was still treated with monotherapy (36%) instead of 19% in middle income countries (p<0.01). Antihypertensive strategies by country Conclusion Our study described antihypertensive drugs use across 12 sub-Saharan countries, and identified disparities specific to the income context. Inequity in access to drugs combination is a serious barrier to tackle the burden of hypertension in Africa.

scholarly journals Access to Controlled Medicines in Low-Income Countries: Listening to Stakeholders in the Field

2020 ◽  
pp. 002073142090674
Author(s):  
Agnes Vitry ◽  
Gilles Forte ◽  
Jason White
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Structured Interviews ◽  
African Countries ◽  
Country Level ◽  
Written Information ◽  
Health Authorities ◽  
Psychotropic Medicines ◽  
Republic Of The Congo ◽  
International Conventions

Little is known on current practices and challenges associated with the legal trade of medicines controlled under international conventions in low-income countries. This qualitative survey involved semi-structured interviews of stakeholders engaged in the trade of controlled medicines at a global level or at a country level in 3 African countries (Uganda, Kenya, Democratic Republic of the Congo). Nine interviews were conducted, including 3 international wholesalers, 2 relief organizations, 2 procurement officers, and 2 regulatory officers. Additionally, 4 other participants provided written information. All participants consistently reported that the current process of procuring controlled medicines in compliance with international conventions was long and complex given the number of administrative steps required for obtaining export and import authorizations, which are mandatory for both narcotic and psychotropic medicines. It may be difficult or impossible to obtain import authorizations from some health authorities in low-income countries because of long delays, mistakes in forms, absence or shortage of staff, or when annual national estimates are exceeded. The complexities of the trade of controlled medicines directly contribute to the lack of access to essential controlled medicines, both narcotics and psychotropics, in low-income countries.

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