scholarly journals 402Measles vaccine coverage: The rise of vaccine hesitancy in upper-middle income countries

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Bianca Cata-preta ◽  
Thiago M Santos ◽  
Aluisio JD Barros ◽  
Cesar G Victora ◽  
Fernando C Wehrmeister
Keyword(s):  
Vaccination Coverage ◽  
Vaccine Coverage ◽  
Wealth Quintile ◽  
Vaccine Hesitancy ◽  
Middle Income ◽  
Middle Income Countries ◽  
Poor Families ◽  
Classical Pattern ◽  
Per Capita ◽  
Poor Children

Abstract Background With the rise of vaccine hesitancy, which is allegedly more frequent among rich families, we hypothesized that the classical pattern of a positive gradient in coverage with rising wealth may no longer be observable in low- and middle-income countries (LMICs). Methods We analysed DHS and MICS surveys conducted from 2010-2018 in 88 LMICs. We estimated inequality in measles vaccination coverage by wealth quintile for children aged 12-23 months using the Slope Index of Inequality (SII). Negative SII values indicate higher coverage among poor children. We correlated the SII with per capita Gross Domestic Product (GDP), using countries as the units. Results Pearson’s correlation coefficient between SII and log per capita GDP was -0.35 (p < 0.001). The percentages of countries with higher coverage among children from poor families than among those from wealthy families were 14%, 21% and 54% in low, lower-middle and upper-middle income countries (p level for trend=0.001), respectively (Figure 1). Conclusions Our results are consistent with lower vaccination coverage among the wealthy when compared to poor families in countries with higher per capita GDPs. Key messages Vaccine hesitancy was initially detected in high-income countries, but our analyses show that it is also present in upper-middle income countries.

scholarly journals An International Analysis of Dialysis Services Reimbursement

2018 ◽  
Vol 14 (1) ◽  
pp. 84-93 ◽  
Author(s):  
Arjan van der Tol ◽  
Norbert Lameire ◽  
Rachael L. Morton ◽  
Wim Van Biesen ◽  
Raymond Vanholder
Keyword(s):  
Health Care ◽  
Peritoneal Dialysis ◽  
Replacement Therapy ◽  
Gdp Per Capita ◽  
Middle Income ◽  
Middle Income Countries ◽  
Number Of Patients ◽  
Kidney Replacement Therapy ◽  
Per Capita ◽  
Low And Middle Income

Background and objectivesThe prevalence of patients with ESKD who receive extracorporeal kidney replacement therapy is rising worldwide. We compared government reimbursement for hemodialysis and peritoneal dialysis worldwide, assessed the effect on the government health care budget, and discussed strategies to reduce the cost of kidney replacement therapy.Design, setting, participants, & measurementsCross-sectional global survey of nephrologists in 90 countries to assess reimbursement for dialysis, number of patients receiving hemodialysis and peritoneal dialysis, and measures to prevent development or progression of CKD, conducted online July to December of 2016.ResultsOf the 90 survey respondents, governments from 81 countries (90%) provided reimbursement for maintenance dialysis. The prevalence of patients per million population being treated with long-term dialysis in low- and middle-income countries increased linearly with Gross Domestic Product per capita (GDP per capita), but was substantially lower in these countries compared with high-income countries where we did not observe an higher prevalence with higher GDP per capita. The absolute expenditure for dialysis by national governments showed a positive association with GDP per capita, but the percent of total health care budget spent on dialysis showed a negative association. The percentage of patients on peritoneal dialysis was low, even in countries where peritoneal dialysis is better reimbursed than hemodialysis. The so-called peritoneal dialysis–first policy without financial incentive seems to be effective in increasing the utilization of peritoneal dialysis. Few countries actively provide CKD prevention.ConclusionsIn low- and middle-income countries, reimbursement of dialysis is insufficient to treat all patients with ESKD and has a disproportionately high effect on public health expenditure. Current reimbursement policies favor conventional in-center hemodialysis.

scholarly journals EXPLORING COVID-19 VACCINE ACCEPTANCE AND HESITANCY DETERMINANTS

2021 ◽  
Vol 03 (01) ◽  
pp. 80-91
Author(s):  
Tauheed Zahra ◽  
◽  
Farhan Ahmad Faiz ◽  
Farrah Ahmed ◽  
◽  
...  
Keyword(s):  
Educational Background ◽  
Vital Role ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Social Worlds ◽  
Vaccine Acceptance ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Health Organization

The World Health Organization recognizes vaccine related myths and conspiracies as the world's top threat to public health safety, particularly in low middle-income countries. The current study aims to explore the beliefs of the general public towards the vaccine acceptance and the hesitancy. The study explicates the COVID 19 vaccine acceptance and hesitancy determinants through an in-depth qualitative approach. A total of 30 male and female millennials from different education backgrounds were interviewed through an interview guide. This study reveals that people have different beliefs related to the vaccine authenticity which plays a vital role in the reluctance towards it. Findings from paper is similar to literature that people from good educational background have similar thoughts towards COVID 19 vaccination. Disregard for the vaccine was caused by various factors, such as misinformation, safety concerns, and personal knowledge. This level of distrust was associated with the social worlds that participants experienced during the pandemic. COVID-19 vaccine hesitancy is a complex relationship that involves the spread of misinformation. Vaccine programs should provide a focused, localized, and empathetic response to counter misinformation. Keywords: COVID-19, vaccines, myths, hesitancy, vaccines awareness, pandemic, conspiracy, corona virus

scholarly journals Worldwide routine immunisation coverage regressed during the first year of the COVID-19 pandemic

2021 ◽  
Author(s):  
Beth Evans ◽  
Thibaut Jombart
Keyword(s):  
Vaccination Coverage ◽  
First Year ◽  
Immunisation Coverage ◽  
Routine Immunisation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Model Predictions ◽  
Country Specific

AbstractWe modelled historical, country-specific routine immunisation trends using publicly available vaccination coverage data for diphtheria, tetanus and pertussis-containing vaccine first-dose (DTP1) and third-dose (DTP3) from 2000 to 2019. We evaluate changes in coverage in 2020 by comparing model predictions to WUENIC-reported coverage. We report a 2.9% (95%CI: [2.2%; 3.6%]) global decline in DTP3 coverage, and important increases in missed immunisations in some countries with middle-income countries, and the Americas, being most affected.

scholarly journals Change in Measles Vaccine Coverage and Estimated Impact on Measles Mortality in Low and Middle Income Countries, 2020: An Investigation into Secondary Public Health Effects of the COVID-19 Pandemic Using the Lives Saved Tool

2021 ◽  
Author(s):  
Lucy Claire Gregory
Keyword(s):  
Public Health ◽  
Health Effects ◽  
Vaccine Coverage ◽  
Surveillance Systems ◽  
Measles Vaccine ◽  
Middle Income ◽  
Middle Income Countries ◽  
National Immunization ◽  
Lives Saved Tool ◽  
Low Middle Income Countries

With the global COVID-19 pandemic, many public health services were severely disrupted. Estimating the overall health effects of this is difficult as most disease surveillance systems have also been substantially affected during the pandemic. For some diseases, this effect is mitigated by the methods enacted to fight the pandemic, such as use of facial coverings, social distancing and quarantine, but measles is infectious to the degree that this mitigation is likely to be limited. Thus, outbreaks and an increase in global measles mortality are expected. However, the severity of this impact is not yet known. In early 2020, a study by Roberton and colleagues predicted an additional 12,360 to 37,920 deaths in children under-five worldwide from measles over the coming year based on three potential levels of vaccine coverage reductions ranging from 18.5 to 51.9%. Our study investigates the magnitude of the increase in measles mortality due to decreased vaccine coverage because of COVID-19, based on official estimates of 2020 measles vaccine coverage from WHO/UNICEF released in July 2021. Using the Lives Saved Tool (LiST), an interventions modeling program, we estimated measles mortality for low/middle income countries (LMICs) based on the 2020 WHO/UNICEF estimates of national immunization coverage (WUENIC). Because these calculations use actual reported vaccine coverage, they provide a more accurate picture of measles mortality related to COVID-19 disruptions in 2020. Using the WUENIC data, LiST predicted fewer additional deaths in 2020 due to decreases in measles vaccine coverage than estimations made by LiST based on Roberton, 2020 due to remarkable recovery efforts by national immunization programmes in the second half of 2020.

scholarly journals Research and Development as a Moderating Variable for Sustainable Economic Performance: The Asian, European, and Kuwaiti Models

2020 ◽  
Vol 12 (18) ◽  
pp. 7525
Author(s):  
Ahmad Salman ◽  
Ali Al-Hemoud ◽  
Saja A. Fakhraldeen ◽  
Maha Al-Nashmi ◽  
Suad M. AlFadhli ◽  
...  
Keyword(s):  
Research And Development ◽  
Economic Performance ◽  
The State ◽  
Gdp Per Capita ◽  
Series Data ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Mean ◽  
Per Capita ◽  
The State Of Kuwait

The research and development (R&D) expenditure in Kuwait is insufficient to lead to innovation and a knowledge economy. Investment in R&D has been shown to sustain elevated economic performance. The objective of this study is to explore the association between three competing dimensions of R&D indicators that lead to sustainable economic performance within any given country, namely, R&D expenditure, the number of researchers, and the number of patent rights, using time-series data collected over a 20-year period (1996–2016) by the World Bank Group. R&D indicators were compared between high- and middle-income countries including models from Asian (South Korea, Singapore, and Malaysia) and European (Finland and Ireland) countries as well as the State of Kuwait. Moreover, a case study describing R&D investments in Kuwait is presented. Overall, the results reveal higher R&D spending, number of researchers, and gross domestic product (GDP) per capita for the Asian and European models. Current R&D expenditure in Kuwait is estimated at 0.08% of GDP (2016), which is significantly lower than the mean of the middle-income countries (1.58%). Furthermore, the number of researchers (per million) in Kuwait (386) is less than half of the mean number of researchers in middle-income countries (775) (2015). Low R&D investments in the State of Kuwait has gradually led to a decreased GDP per capita. Regression analysis shows that GDP per capita can be predicted solely based on the number of researchers (beta = 0.780, R2 = 0.608). The number of researchers is the most crucial variable to predict GDP per capita, and the R&D expenditure is a good indicator of the number of researchers. These findings offer invaluable insight into the sustainable development goals (SDG 9). To our knowledge, this paper presents the first application of the effect of R&D on sustainable economic performance with reference to the SDG target 9.5 “Research & Development”. Thus, in order to enhance scientific research (both academic, professional, and industrial), countries need to increase the number of researchers, and these actions are necessary to introduce sustainable growth to GDP.

scholarly journals Inferring antenatal care visit timing in low- and middle-income countries: Methods to inform potential maternal vaccine coverage

PLoS ONE ◽  
2020 ◽  
Vol 15 (8) ◽  
pp. e0237718
Author(s):  
Ranju Baral ◽  
Jessica Fleming ◽  
Sadaf Khan ◽  
Deborah Higgins ◽  
Nathaniel Hendrix ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Vaccine Coverage ◽  
Middle Income ◽  
Middle Income Countries ◽  
Antenatal Care Visit ◽  
Care Visit ◽  
Low And Middle Income

scholarly journals Oral Morphine Use in South India: A Population-Based Study

2017 ◽  
Vol 3 (6) ◽  
pp. 720-727 ◽  
Author(s):  
M.R. Rajagopal ◽  
Safiya Karim ◽  
Christopher M. Booth
Keyword(s):  
Temporal Trends ◽  
Oral Morphine ◽  
Population Based ◽  
Private Institutions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Provider Characteristics ◽  
Regional Trends ◽  
Per Capita ◽  
Over Time

Purpose Access to opioids for pain control is recognized as an urgent issue in low- and middle-income countries. Here we report temporal and regional trends in morphine use in Kerala, India. Methods Oral morphine use data for the State of Kerala (2012 to 2015) was used to describe temporal trends, regional variation, and provider characteristics. Total morphine use was calculated for each district of Kerala to derive an annual per capita use rate (milligrams per capita). Each provider was classified as government, private, nongovernment organization (NGO), or NGO partnership. Results Oral morphine use for Kerala was 1.32 mg/capita and increased over the study period 27% (from 1.23 mg/capita to 1.56 mg/capita). There was substantial variation in morphine use across districts (range, 0.49 mg/capita to 2.97 mg/capita; six-fold difference). This variation increased over time (19-fold difference in 2015). In 2015, 31% of morphine providers (51 of 167) were government institutions; they delivered 48% of total morphine in Kerala. Corresponding data for other providers are private institutions, 23% of centers and 13% of morphine; NGOs, 41% of centers and 34% of morphine; and NGO partnerships, 5% of centers and 4% of morphine. From 2012 to 2015, the total number of centers increased by 35%, from 124 to 167. Conclusion Oral morphine use has increased over time in Kerala but remains substantially lower than estimated need. There is significant geographic variation of use. Efforts are needed to improve palliative care in Kerala and to reduce regional disparities in access to opioids.

Industrial and Agricultural Pollution Patterns

2013 ◽  
Vol 13 (1) ◽  
pp. 1-24
Author(s):  
Don P. Clark ◽  
Alejandro E. Dellachiesa
Keyword(s):  
Economic Activity ◽  
Environmental Policies ◽  
Agricultural Pollution ◽  
Lower Income ◽  
Emissions Reductions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Per Capita ◽  
Pollution Emissions ◽  
Lower Income Countries

Industrial and agricultural pollution emissions are compared with levels of economic activity as countries move up the per capita income scale. Pollution emissions are found to be concentrated among the lower income countries. Industrial CH4 and both agricultural CH4 and N2O emissions display the highest degrees of concentration among poorer countries relative to their GDP shares. Agricultural CH4 and N2O emissions are more concentrated among the poorer countries than are industrial CH4 and N2O emissions. Little improvement in environmental quality will result from implementing costly emissions reductions in the industrial nations alone. Environmental policies must focus on lower- and middle-income countries. More attention must be devoted to reducing agricultural pollution emissions. Improving the economic activity–environmental tradeoff will require a global approach to reducing greenhouse gases.

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