scholarly journals Identification of relevant performance indicators for district healthcare systems in Ethiopia: a systematic review and expert opinion

2020 ◽  
Vol 32 (3) ◽  
pp. 161-172
Author(s):  
Elias Ali Yesuf ◽  
Mirkuzie Woldie ◽  
Damen Haile-Mariam ◽  
Daniela Koller ◽  
Gönter Früschl ◽  
...  
Keyword(s):  
Low Income ◽  
Performance Indicators ◽  
Data Extraction ◽  
Public Library ◽  
The United States ◽  
Healthcare Systems ◽  
Healthcare Research ◽  
Infant Mortality Rate ◽  
Low Income Countries ◽  
Treatment Rate

Abstract Purpose To identify potential performance indicators relevant for district healthcare systems of Ethiopia. Data sources Public Library of Medicine and Agency for Healthcare Research and Quality of the United States of America, Organization for Economic Cooperation and Development Library and Google Scholar were searched. Study selection Expert opinions, policy documents, literature reviews, process evaluations and observational studies published between 1990 and 2015 were considered for inclusion. Participants were national- and local-healthcare systems. The phenomenon of interest was the performance of healthcare systems. The Joanna Briggs Institute tools were adapted and used for critical appraisal of records. Data extraction Indicators of performance were extracted from included records and summarized in a narrative form. Then, experts rated the relevance of the indicators. Relevance of an indicator is its agreement with priority health objectives at the national and district level in Ethiopia. Results of data synthesis A total of 11 206 titles were identified. Finally, 22 full text records were qualitatively synthesized. Experts rated 39 out of 152 (25.7%) performance indicators identified from the literature to be relevant for district healthcare systems in Ethiopia. For example, access to primary healthcare, tuberculosis (TB) treatment rate and infant mortality rate were found to be relevant. Conclusion Decision-makers in Ethiopia and potentially in other low-income countries can use multiple relevant indicators to measure the performance of district healthcare systems. Further research is needed to test the validity of the indicators.

scholarly journals Satisfaction with health care system: A comparative study between market-based insurance model of the United States and “out-of-pocket” model in developing and low-income countries

2020 ◽  
Vol 6 (1) ◽  
pp. 41
Author(s):  
Ram Lakhan ◽  
Sean Y. Gillette ◽  
Sean Lee ◽  
Manoj Sharma
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Undergraduate Students ◽  
Low Income ◽  
Access To Health Care ◽  
The United States ◽  
Low Income Countries ◽  
Healthcare Needs ◽  
Care System

Background and purpose: Access to healthcare services is an essential component for ensuring the quality of life. Globally, there is inequity and disparities regarding access to health care. To meet the global healthcare needs, different models of healthcare have been adopted around the world. However, all healthcare models have some strengths and weaknesses. The purpose of this study was to examine the satisfaction among a group of undergraduate students from different countries with their health care models namely, insurance-based model in the United States and “out-of-pocket” model prevalent in low-income countries.Methods and materials: The study utilized a cross-sectional research design. Undergraduate students, representing different nationalities from a private Southeastern College, were administered a researcher-designed 14-item self-reported electronic questionnaire. Independent t-test and χ2 statistics were used to examine the differences between two health care systems and the qualitative responses were analyzed thematically.Results: Satisfaction towards health care system between the United States and low-income countries was found significantly different (p < .05). However, students in both settings experienced an inability toward affording quality healthcare due to economic factors and disparities.Conclusions: There is dissatisfaction with health care both in the United States and low-income developing countries among a sample of undergraduate students representing these countries. Efforts to ensure low-cost affordable health care should be a global goal.

scholarly journals Major disparities in COVID-19 test positivity for patients with non-English preferred language even after accounting for race and social factors in the United States in 2020

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah Cohen-Cline ◽  
Hsin-Fang Li ◽  
Monique Gill ◽  
Fatima Rodriguez ◽  
Tina Hernandez-Boussard ◽  
...  
Keyword(s):  
Low Income ◽  
Social Factors ◽  
The United States ◽  
Healthcare Systems ◽  
English Speakers ◽  
Health Records ◽  
Communities Of Color ◽  
Multi Level ◽  
Race Ethnicity ◽  
Barriers To Health

Abstract Background The COVID-19 pandemic has further exposed inequities in our society, demonstrated by disproportionate COVID-19 infection rate and mortality in communities of color and low-income communities. One key area of inequity that has yet to be explored is disparities based on preferred language. Methods We conducted a retrospective cohort study of 164,368 adults tested for COVID-19 in a large healthcare system across Washington, Oregon, and California from March – July 2020. Using electronic health records, we constructed multi-level models that estimated the odds of testing positive for COVID-19 by preferred language, adjusting for age, race/ethnicity, and social factors. We further investigated interaction between preferred language and both race/ethnicity and state. Analysis was performed from October–December 2020. Results Those whose preferred language was not English had higher odds of having a COVID-19 positive test (OR 3.07, p < 0.001); this association remained significant after adjusting for age, race/ethnicity, and social factors. We found significant interaction between language and race/ethnicity and language and state, but the odds of COVID-19 test positivity remained greater for those whose preferred language was not English compared to those whose preferred language was English within each race/ethnicity and state. Conclusions People whose preferred language is not English are at greater risk of testing positive for COVID-19 regardless of age, race/ethnicity, geography, or social factors – demonstrating a significant inequity. Research demonstrates that our public health and healthcare systems are centered on English speakers, creating structural and systemic barriers to health. Addressing these barriers are long overdue and urgent for COVID-19 prevention.

scholarly journals Clinical effectiveness of drugs in hospitalized patients with COVID-19 infection: a systematic review and meta-analysis.

2020 ◽  
Author(s):  
Roberto Ariel Abeldano Zuniga ◽  
Silvia Coca ◽  
Giuliana Abeldano ◽  
Ruth Ana Maria Gonzalez Villoria
Keyword(s):  
Systematic Review ◽  
Clinical Improvement ◽  
Low Income ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Hospitalized Patients ◽  
Low Income Countries ◽  
Qualitative Synthesis

Objective. The aim was to assess the clinical effectiveness of drugs used in hospitalized patients with COVID-19 infection. Method. We conducted a systematic review of randomized clinical trials assessing treatment with remdesivir, chloroquine, hydroxychloroquine, lopinavir, ritonavir, dexamethasone, and convalescent plasma, for hospitalized patients with a diagnosis of SARS-CoV-2 infection. The outcomes were mortality, clinical improvement, duration of ventilation, duration of oxygen support, duration of hospitalization), virological clearance, and severe adverse events. Results. A total of 48 studies were retrieved from the databases. Ten articles were finally included in the data extraction and qualitative synthesis of results. The meta-analysis suggests a benefit of dexamethasone versus standard care in the reduction of risk of mortality at day 28; and the clinical improvement at days 14 and 28 in patients treated with remdesivir. Conclusions. Dexamethasone would have a better result in hospitalized patients, especially in low-resources settings. Significance of results. The analysis of the main treatments proposed for hospitalized patients is of vital importance to reduce mortality in low-income countries; since the COVID-19 pandemic had an economic impact worldwide with the loss of jobs and economic decline in countries with scarce resources. Keywords: Drugs; Antivirals; Clinical improvement; Mortality; COVID-19; SARS-CoV2.

scholarly journals The Short Run Effects of Health Aid in Low Income Countries:Evidence from Panel Data Analysis

2019 ◽  
Author(s):  
Keneni Gutema Negeri
Keyword(s):  
Health Status ◽  
Panel Data ◽  
Low Income ◽  
Panel Data Analysis ◽  
Health Sector ◽  
Infant Mortality Rate ◽  
Low Income Countries ◽  
Health Coverage ◽  
Health Aid ◽  
Short Run

Abstract Background The effect of health targeted aid in developing countries is debatable. This paper examines the short run effect of health aid on health status in low income countries of the world. Method The study estimates the short run effect of health aid on health status in low income countries. Infant mortality rate was used as a proxy for health status and a panel data was constructed from 34 countries for the period between 2000 and 2017. For the estimation, first difference GMM and System GMM were employed. Results The estimation results confirm the argument that health aid has a beneficial and statistically significant short run effect on the health status of low income countries: doubling health aid saves the lives of 20 infants per 10,000 live births. Conclusion From the findings of this paper it can be concluded that health aid could be one of the best tools with which the broader health status gap currently observed between high income and low income groups, could be eliminated and hence the target of Universal Health Coverage is met. However, recipient countries need to find ways of promoting domestic factors that have favorable impact on health sector as they cannot persistently relay up on external resources.

scholarly journals Hypertensive Urgency in Tanzanian Adults: A 1-Year Prospective Study

2020 ◽  
Author(s):  
Karl G Reis ◽  
Raymond Wilson ◽  
Fredrick Kalokola ◽  
Bahati Wajanga ◽  
Myung-Hee Lee ◽  
...  
Keyword(s):  
Medication Adherence ◽  
High Risk ◽  
Prospective Study ◽  
Low Income ◽  
Hypertensive Crisis ◽  
The United States ◽  
Low Income Countries ◽  
Improve Medication Adherence ◽  
Hypertensive Urgency ◽  
Poor Outcomes

Abstract BACKGROUND Hypertensive urgency is associated with a high risk for cardiovascular events and mortality in the United States and Europe, but data from low-income countries and interventions to improve outcomes are lacking. METHODS We conducted a 1-year prospective study of the prevalence and outcomes of hypertensive urgency (blood pressure (BP) ≥180 mm Hg/120 mm Hg without end-organ damage) in a busy outpatient clinic in Tanzania. RESULTS Of 7,600 consecutive adult outpatients screened with 3 unattended automated BP measurements according to standard protocol, the prevalence of hypertensive crisis was 199/7,600 (2.6%) (BP ≥180 mm Hg/120 mm Hg) and the prevalence of hypertensive urgency was 164/7,600 (2.2%). Among 150 enrolled patients with hypertensive urgency, median age was 62 years (54–68), 101 (67.3%) were women, and 53 (35%) were either hospitalized or died within 1 year. In a multivariate model, the strongest predictor of hospitalization/death was self-reported medication adherence on a 3 question scale (hazard ratio: 0.06, P &lt; 0.001); 90% of participants with poor adherence were hospitalized or died within 1 year. CONCLUSIONS Patients with hypertensive urgency in Africa are at high risk of poor outcomes. Clinicians can identify the patients at highest risk for poor outcomes with simple questions related treatment adherence. New interventions are needed to improve medication adherence in patients with hypertensive urgency.

Immigration and Contract Problems Experienced by Foreign-Educated Nurses

2012 ◽  
Vol 69 (3) ◽  
pp. 351-365 ◽  
Author(s):  
Patricia Pittman ◽  
Carolina Herrera ◽  
Joanne Spetz ◽  
Catherine R. Davis
Keyword(s):  
United States ◽  
Health Care ◽  
Low Income ◽  
The United States ◽  
Low Income Countries ◽  
Labor Rights ◽  
Care Practice ◽  
Quality Health Care ◽  
International Recruitment ◽  
The Impact

More than 8% of employed RNs licensed since 2004 in the United States were educated overseas, yet little is known about the conditions of their recruitment or the impact of that experience on health care practice. This study assessed whether the labor rights of foreign-educated nurses were at risk during the latest period of high international recruitment: 2003 to 2007. Using consensus-based standards contained in the Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Health Professionals to the United States, this study found 50% of actively recruited foreign-educated nurses experienced a negative recruitment practice. The study also found that nurses educated in low-income countries and nurses with high contract breach fees, were significantly more likely to report such problems. If, as experts believe may occur, the nursing shortage in the United States returns around 2014, oversight of international recruitment will become critically important to delivering high-quality health care to Americans.

Are Low Income Countries Catching up or Falling Further Behind? Evidence from Income and Demographic Indicators

1993 ◽  
Vol 4 (1) ◽  
pp. 98-119
Author(s):  
N. Kakwani ◽  
K. Subbarao
Keyword(s):  
Low Income ◽  
Living Standards ◽  
Infant Mortality Rate ◽  
Standard Of Living ◽  
Low Income Countries ◽  
Demographic Indicators ◽  
Life Expectancy At Birth ◽  
Catching Up ◽  
The World ◽  
Per Capita

The main objective of this paper is to measure changes in living conditions in one hundred and ten countries of the World during the period 1961 to 1990. Our concern is whether the economic and social gap is narrowing or widening. We also examine in which countries has there been a consistent improvement in average living standards. The standard of living is measured in terms of (a) per capita income, (b) life expectancy at birth and (c) infant mortality rate. The justification of these indicators is provided in terms of functionings and capabilities.

scholarly journals Article processing charges, the geographic diversity of author communities, and barriers to publication for authors in the Global South

2020 ◽  
Author(s):  
Audrey Culver Smith ◽  
Leandra Merz ◽  
Jesse B. Borden ◽  
Chris Gulick ◽  
Akhil Ravindra Kshirsagar ◽  
...  
Keyword(s):  
Low Income ◽  
United States Of America ◽  
The United States ◽  
Global South ◽  
Low Income Countries ◽  
Editorial Boards ◽  
Geographic Diversity ◽  
The Usa ◽  
Article Processing Charges ◽  
The Relationship

Many OA journals require authors pay an article processing charge (APC), which researchers in the Global South often cite as an insurmountable financial barrier. This has led to speculation that there will be lower representation of these authors in OA journals charging APCs. We used “mirror journals” – APC-charging OA versions of paywalled (PW) titles with whom they share editorial boards and standards for acceptance – to investigate the relationship between APCs and the geographic diversity of authors. Most of the &gt;41,000 articles we reviewed were published in PW journals. Although lead authors were based in &gt;140 countries, ~45% were based in either the United States of America (USA) or China. After correcting for differences in sample size, we found no difference between OA and PW journals in the number of countries in which lead authors were based. After correcting for the dominance of China and the USA, we found that author diversity in OA journals was significantly lower than in PW journals. Most OA articles were written by authors in high-income countries; no articles in OA journals had first authors from low-income countries. Our results suggest APCs are a barrier to OA publication for scientists from the Global South.

scholarly journals Micronutrients - a Global Perspective on Intake, Health Benefits and Economics

2012 ◽  
Vol 82 (5) ◽  
pp. 316-320 ◽  
Author(s):  
Birgit Hoeft ◽  
Peter Weber ◽  
Manfred Eggersdorfer
Keyword(s):  
Low Income ◽  
Health Care Systems ◽  
The Elderly ◽  
The United States ◽  
Global Perspective ◽  
Low Income Countries ◽  
Micronutrient Deficiencies ◽  
Micronutrient Status ◽  
Care Systems ◽  
Development And Aging

The link between a sufficient intake of vitamins and long term health, cognition, healthy development and aging is increasingly supported by experimental animal, human and epidemiology studies. In low income countries billions of people still suffer from the burden of malnutrition and micronutrient deficiencies. However, inadequate micronutrient status might also be an issue in industrialized countries. Recent results from nutritional surveys in countries like the United States, Germany, and Great Britain indicate that the recommended intake of micronutrients is not reached. This notably concerns certain vulnerable population groups, such as pregnant women, young children and the elderly, but also greatly influences the general healthcare costs. An overview is provided on the gap that exists between current vitamin intakes and requirements, even in countries where diverse foods are plentiful. Folic acid and vitamin D intake and status are evaluated in more detail, providing insight on health and potential impact on health care systems.

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