Push Out, Pull Out, or Opting Out? Reasons Cited by Adolescents for Discontinuing Education in Four Low- and Middle-Income Countries

2018 ◽  
Author(s):  
Renu Singh ◽  
Protap Mukherjee
Keyword(s):  
Low Income ◽  
Social Protection ◽  
Life Course Perspective ◽  
School Factors ◽  
Pull Factors ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pull Out ◽  
Early School ◽  
The Cost

By drawing on Bronfenbrenner’s (1999) ecological framework, this mixed-method paper recognizes school discontinuation not as an event but as a culmination of an interplay of various factors over time. Adopting a life course perspective and analyzing reasons given by adolescents for “not being in school” across the four middle- and low-income Young Lives study countries, three broad categories of reasons for early school leaving emerge. These are push factors, pull factors, and opted-out factors. Findings revealed that pull factors emerge as the greatest contributor toward children discontinuing education as they enter middle and late adolescence. Besides household dynamics and shocks, boys in particular discontinue schooling due to paid work, while girls spend long hours in domestic chores at the cost of attending school. While in-school factors, particularly quality, cannot be ignored, it is important to provide social protection nets to the poorest families in order to achieve Sustainable Development Goal Goal 4.

scholarly journals The cost-effectiveness of hypertension management in low-income and middle-income countries: a review

2020 ◽  
Vol 5 (9) ◽  
pp. e002213
Author(s):  
Deliana Kostova ◽  
Garrison Spencer ◽  
Andrew E Moran ◽  
Laura K Cobb ◽  
Muhammad Jami Husain ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Low Income ◽  
Disease Risk ◽  
National Income ◽  
Economic Evaluations ◽  
Health Improvement ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range ◽  
The Cost

Hypertension in low-income and middle-income countries (LMICs) is largely undiagnosed and uncontrolled, representing an untapped opportunity for public health improvement. Implementation of hypertension control strategies in low-resource settings depends in large part on cost considerations. However, evidence on the cost-effectiveness of hypertension interventions in LMICs is varied across geographical, clinical and evaluation contexts. We conducted a comprehensive search for published economic evaluations of hypertension treatment programmes in LMICs. The search identified 71 articles assessing a wide range of hypertension intervention designs and cost components, of which 42 studies across 15 countries reported estimates of cost-effectiveness. Although comparability of results was limited due to heterogeneity in the interventions assessed, populations studied, costs and study quality score, most interventions that reported cost per averted disability-adjusted life-year (DALY) were cost-effective, with costs per averted DALY not exceeding national income thresholds. Programme elements that may reduce cost-effectiveness included screening for hypertension at younger ages, addressing prehypertension, or treating patients at lower cardiovascular disease risk. Cost-effectiveness analysis could provide the evidence base to guide the initiation and development of hypertension programmes.

scholarly journals TRACK Implementation: a Bangladesh Scenario

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Abdul Kader Mohiuddin
Keyword(s):  
Low Income ◽  
Diabetes Management ◽  
Health Care Cost ◽  
Lifestyle Changes ◽  
Health Concern ◽  
Diabetic Patients ◽  
Middle Income ◽  
Middle Income Countries ◽  
Hospitalization Costs ◽  
The Cost

With the increasing burden of non-communicable diseases in low-income and middle-income countries (LMICs), biological risk factors, such as hyperglycemia, are a major public health concern in Bangladesh. Optimization of diabetes management by positive lifestyle changes is urgently required for prevention of comorbidities and complications, which in turn will reduce the cost. Diabetes had 2 times more days of inpatient treatment, 1.3 times more outpatient visits, and nearly 10 times more medications than non- diabetes patients, as reported by British Medical Journal. And surprisingly, 80% of people with this so called “Rich Man's Disease” live in low- and middle-income countries. According to a recent study of American Medical Association, China and India collectively are home of nearly 110 million diabetic patients. The prevalence of diabetes in this region is projected to increase by 71% by 2035. Bangladesh was ranked as the 8th highest diabetic populous country in the time period of 2010-2011. In Bangladesh, the estimated prevalence of diabetes among adults was 9.7% in 2011 and the number is projected to be 13.7 million by 2045. The cost of diabetes care is considerably high in Bangladesh, and it is primarily driven by the medicine and hospitalization costs. According to Bangladesh Bureau of Statistics, in 2017 the annual average cost per T2DM was $864.7, which is 52% of per capita GDP of Bangladesh and 9.8 times higher than the general health care cost. Medicine is the highest source of direct cost (around 85%) for patients without hospitalization. The private and public financing of diabetes treatment will be severely constrained in near future, representing a health threat for the Bangladeshi population.

scholarly journals Cost-effectiveness of neonatal surgery for congenital anomalies in low-income and middle-income countries: a systematic review protocol

2020 ◽  
Vol 4 (1) ◽  
pp. e000755
Author(s):  
Na Eun Kim ◽  
Dominique Vervoot ◽  
Ahmad Hammouri ◽  
Cristiana Riboni ◽  
Hosni Salem ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Low Income ◽  
Congenital Anomalies ◽  
Surgical Intervention ◽  
Neonatal Surgery ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Burden ◽  
The Cost

IntroductionCongenital anomalies are the fifth leading cause of death in children under 5 years old globally (591 000 deaths reported in 2016). Over 95% of deaths occur in low-income and middle-income countries (LMICs). It is estimated that two-thirds of the congenital anomaly health burden could be averted through surgical intervention and that such interventions can be cost-effective. This systematic review aims to evaluate current evidence regarding the cost-effectiveness of neonatal surgery for congenital anomalies in LMICs.Methods and analysisA systematic literature review will be conducted in PubMed, MEDLINE, Embase, Cochrane Library, Scielo, Google Scholar, African Journals OnLine and Regional WHO’s African Index Medicus databases for articles on the cost-effectiveness of neonatal surgery for congenital anomalies in LMICs. The following search strings will be used: (1) congenital anomalies; (2) LMICs; and (3) cost-effectiveness of surgical interventions. Articles will be uploaded to Covidence software, duplicates removed and the remaining articles screened by two independent reviewers. Cost information for interventions or procedures will be extracted by country and condition. Outcome measurements by reported unit and cost-effectiveness ratios will be extracted. Methodological quality of each article will be assessed using the Drummond checklist for economic evaluations. The Agency for Healthcare Research and Quality’s Effective Health Care Program guidance will be followed to assess the grade of the studies.Ethics and disseminationNo ethical approval is required for conducting the systematic review. There will be no direct collection of data from individuals. The finalised article will be published in a scientific journal for dissemination. The protocol has been registered with PROSPERO (International Prospective Register of Systematic Reviews).ConclusionCongenital anomalies form a large component of the global health burden that is amenable to surgical intervention. This study will systematically review the current literature on the cost-effectiveness of neonatal surgery for congenital anomalies in LMICs.PROSPERO registration numberCRD42020172971.

scholarly journals TRACK (by NEHEP) Implementation: A Bangladesh Scenario

2019 ◽  
pp. 28-36
Author(s):  
Abdul Kader Mohiuddin
Keyword(s):  
Low Income ◽  
Diabetes Management ◽  
Health Care Cost ◽  
Lifestyle Changes ◽  
Health Concern ◽  
Diabetic Patients ◽  
Middle Income ◽  
Middle Income Countries ◽  
Hospitalization Costs ◽  
The Cost

With the increasing burden of non-communicable diseases in Low-Income and Middle-Income Countries (LMICs), biological risk factors, such as hyperglycemia, are a major public health concern in Bangladesh. Optimization of diabetes management by positive lifestyle changes is urgently required for prevention of comorbidities and complications, which in turn will reduce the cost. Diabetes had 2 times more days of inpatient treatment, 1.3 times more outpatient visits, and nearly 10 times more medications than non-diabetes patients, as reported by British Medical Journal. And surprisingly, 80% of people with this so called Rich Man’s Disease live in low-and middle-income countries. According to a recent study of American Medical Association, China and India collectively are home of nearly 110 million diabetic patients. The prevalence of diabetes in this region is projected to increase by 71% by 2035. Bangladesh was ranked as the 8th highest diabetic populous country in the time period of 2010-2011. In Bangladesh, the estimated prevalence of diabetes among adults was 9.7% in 2011 and the number is projected to be 13.7 million by 2045. The cost of diabetes care is considerably high in Bangladesh, and it is primarily driven by the medicine and hospitalization costs. According to Bangladesh Bureau of Statistics, in 2017 the annual average cost per Type 2 Diabetes Mellitus (T2DM) was $864.7, which is 52% of per capita Gross Domestic Product (GDP) of Bangladesh and 9.8 times higher than the general health care cost. Medicine is the highest source of direct cost (around 85%) for patients without hospitalization. The private and public financing of diabetes treatment will be severely constrained in near future, representing a health threat for the Bangladeshi population.

scholarly journals TRACK (by NEHEP) Implementation: A Bangladesh Scenario

2019 ◽  
Vol 1 (1) ◽  
pp. 01-10
Author(s):  
Abdul Mohiuddin
Keyword(s):  
Low Income ◽  
Diabetes Management ◽  
Health Care Cost ◽  
Lifestyle Changes ◽  
Health Concern ◽  
Diabetic Patients ◽  
Middle Income ◽  
Middle Income Countries ◽  
Hospitalization Costs ◽  
The Cost

With the increasing burden of non-communicable diseases in low-income and middle-income countries (LMICs), biological risk factors, such as hyperglycemia, are a major public health concern in Bangladesh. Optimization of diabetes management by positive lifestyle changes is urgently required for prevention of comorbidities and complications, which in turn will reduce the cost. Diabetes had 2 times more days of inpatient treatment, 1.3 times more outpatient visits, and nearly 10 times more medications than non- diabetes patients, as reported by British Medical Journal. And surprisingly, 80% of people with this so called “Rich Man's Disease” live in low- and middle-income countries. According to a recent study of American Medical Association, China and India collectively are home of nearly 110 million diabetic patients. The prevalence of diabetes in this region is projected to increase by 71% by 2035. Bangladesh was ranked as the 8th highest diabetic populous country in the time period of 2010-2011. In Bangladesh, the estimated prevalence of diabetes among adults was 9.7% in 2011 and the number is projected to be 13.7 million by 2045. The cost of diabetes care is considerably high in Bangladesh, and it is primarily driven by the medicine and hospitalization costs. According to Bangladesh Bureau of Statistics, in 2017 the annual average cost per T2DM was $864.7, which is 52% of per capita GDP of Bangladesh and 9.8 times higher than the general health care cost. Medicine is the highest source of direct cost (around 85%) for patients without hospitalization. The private and public financing of diabetes treatment will be severely constrained in near future, representing a health threat for the Bangladeshi population.

scholarly journals The Diabetes TRACK (by NEHEP) Vs Bangladesh

2020 ◽  
Vol 3 (1) ◽  
pp. 01-05
Author(s):  
Abdul Mohiuddin
Keyword(s):  
Low Income ◽  
Diabetes Management ◽  
Health Care Cost ◽  
Lifestyle Changes ◽  
Health Concern ◽  
Diabetic Patients ◽  
Middle Income ◽  
Middle Income Countries ◽  
Hospitalization Costs ◽  
The Cost

With the increasing burden of non-communicable diseases in low-income and middle-income countries (LMICs), biological risk factors, such as hyperglycemia, are a major public health concern in Bangladesh. Optimization of diabetes management by positive lifestyle changes is urgently required for prevention of comorbidities and complications, which in turn will reduce the cost. Diabetes had 2 times more days of inpatient treatment, 1.3 times more outpatient visits, and nearly 10 times more medications than non- diabetes patients, as reported by British Medical Journal. And surprisingly, 80% of people with this so called “Rich Man's Disease” live in low- and middle-income countries. According to a recent study of American Medical Association, China and India collectively are home of nearly 110 million diabetic patients. The prevalence of diabetes in this region is projected to increase by 71% by 2035. Bangladesh was ranked as the 8th highest diabetic populous country in the time period of 2010-2011. In Bangladesh, the estimated prevalence of diabetes among adults was 9.7% in 2011 and the number is projected to be 13.7 million by 2045. The cost of diabetes care is considerably high in Bangladesh, and it is primarily driven by the medicine and hospitalization costs. According to Bangladesh Bureau of Statistics, in 2017 the annual average cost per T2DM was $864.7, which is 52% of per capita GDP of Bangladesh and 9.8 times higher than the general health care cost. Medicine is the highest source of direct cost (around 85%) for patients without hospitalization. The private and public financing of diabetes treatment will be severely constrained in near future, representing a health threat for the Bangladeshi population.

scholarly journals Timing and determinants of age at menarche in low-income and middle-income countries

2020 ◽  
Vol 5 (12) ◽  
pp. e003689
Author(s):  
Tiziana Leone ◽  
Laura J Brown
Keyword(s):  
Life Course ◽  
Low Income ◽  
Fixed Effects ◽  
The Philippines ◽  
Life Course Perspective ◽  
Age At Menarche ◽  
Demographic And Health Surveys ◽  
Fertility Survey ◽  
Middle Income ◽  
Middle Income Countries

IntroductionUnderstanding the timing and determinants of age at menarche is key to determining potential linkages between onset of puberty and health outcomes from a life-course perspective. Yet, we have little information in low-income and middle-income countries (LMICs) mainly due to lack of data. The aim of this study was to analyse trends in the timing and the determinants of menarche in LMICs.MethodsUsing 16 World Fertility Survey and 28 Demographic and Health Surveys (DHS) from 27 countries, we analysed cohort trends and used fixed-effects models for DHS surveys to investigate sociodemographic and regional effects in the timing of age at menarche.ResultsTrends of the mean age at menarche across time within and between countries show a declining or stalling path. Results of the determinant modelling show the relationship with wealth changes over time although not consistently across countries. We see a shift from poorer women having earlier menarche in earlier surveys to richer women having earlier menarche in later surveys in Indonesia, the Philippines and Yemen, while in Egypt, the reverse pattern is evident.ConclusionsThere is a considerable gap in both literature and data on menarche. We see a trend which is declining rapidly (from 14.66 to 12.86 years for the 1932 and 2002 cohorts, respectively), possibly at a faster pace than high-income countries and with a strong link to socioeconomic status. This study calls for menarche questions to be included in more nationally representative surveys and greater use of existing data because of its impact on life-course health in fast-ageing settings. Further studies will need to investigate further the use of the age at menarche as an indicator of global health.

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