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 Global Progress in PMTCT and Paediatric HIV Care and Treatment in Low-and Middle-Income Countries in 2004–2005

2007 ◽  
Vol 15 (30) ◽  
pp. 179-189 ◽  
Author(s):  
Chewe Luo ◽  
Priscilla Akwara ◽  
Ngashi Ngongo ◽  
Patricia Doughty ◽  
Robert Gass ◽  
...  
Keyword(s):  
Hiv Care ◽  
Middle Income ◽  
Paediatric Hiv ◽  
Middle Income Countries ◽  
Care And Treatment ◽  
Low And Middle Income

scholarly journals Improving retention in HIV care among adolescents and adults in low- and middle-income countries: A systematic review of the literature

PLoS ONE ◽  
2017 ◽  
Vol 12 (9) ◽  
pp. e0184879 ◽  
Author(s):  
Kate R. Murray ◽  
Lisa S. Dulli ◽  
Kathleen Ridgeway ◽  
Leila Dal Santo ◽  
Danielle Darrow de Mora ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Care ◽  
Review Of The Literature ◽  
Middle Income ◽  
Middle Income Countries ◽  
Retention In Hiv Care ◽  
Adolescents And Adults ◽  
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 Systematic review of the costs and effectiveness of interventions to increase infant vaccination coverage in low- and middle-income countries

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cristina Munk ◽  
Allison Portnoy ◽  
Christian Suharlim ◽  
Emma Clarke-Deelder ◽  
Logan Brenzel ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Scale Up ◽  
Immunization Coverage ◽  
Health Systems Strengthening ◽  
Cash Transfer ◽  
Immunization Programs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Objective Evidence ◽  
Low And Middle Income

Abstract Background In recent years, several large studies have assessed the costs of national infant immunization programs, and the results of these studies are used to support planning and budgeting in low- and middle-income countries. However, few studies have addressed the costs and cost-effectiveness of interventions to improve immunization coverage, despite this being a major focus of policy attention. Without this information, countries and international stakeholders have little objective evidence on the efficiency of competing interventions for improving coverage. Methods We conducted a systematic literature review on the costs and cost-effectiveness of interventions to improve immunization coverage in low- and middle-income countries, including both published and unpublished reports. We evaluated the quality of included studies and extracted data on costs and incremental coverage. Where possible, we calculated incremental cost-effectiveness ratios (ICERs) to describe the efficiency of each intervention in increasing coverage. Results A total of 14 out of 41 full text articles reviewed met criteria for inclusion in the final review. Interventions for increasing immunization coverage included demand generation, modified delivery approaches, cash transfer programs, health systems strengthening, and novel technology usage. We observed substantial heterogeneity in costing methods and incompleteness of cost and coverage reporting. Most studies reported increases in coverage following the interventions, with coverage increasing by an average of 23 percentage points post-intervention across studies. ICERs ranged from $0.66 to $161.95 per child vaccinated in 2017 USD. We did not conduct a meta-analysis given the small number of estimates and variety of interventions included. Conclusions There is little quantitative evidence on the costs and cost-effectiveness of interventions for improving immunization coverage, despite this being a major objective for national immunization programs. Efforts to improve the level of costing evidence—such as by integrating cost analysis within implementation studies and trials of immunization scale up—could allow programs to better allocate resources for coverage improvement. Greater adoption of standardized cost reporting methods would also enable the synthesis and use of cost data.

A Framework to Inform Strategies to Improve the HIV Care Continuum in Low- and Middle-Income Countries

2016 ◽  
Vol 28 (4) ◽  
pp. 351-364 ◽  
Author(s):  
Christopher J. Hoffmann ◽  
Tonderai Mabuto ◽  
Kerrigan McCarthy ◽  
Catherine Maulsby ◽  
David R. Holtgrave
Keyword(s):  
Hiv Care ◽  
Hiv Care Continuum ◽  
Middle Income ◽  
Care Continuum ◽  
Middle Income Countries ◽  
Low And Middle Income
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