Cost-effectiveness and return on investment of protecting health workers in low- and middle-income countries during the COVID-19 pandemic

AbstractBackgroundIn this paper, we predict the health and economic consequences of immediate investment in personal protective equipment (PPE) for health care workers (HCWs) in low- and middle-income countries (LMICs).MethodsTo account for health consequences, we estimated mortality for health care workers (HCW), and present a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model with Bayesian multivariate sensitivity analysis and Monte Carlo simulation. Inputs were used from the World Health Organization Essential Supplies Forecasting Tool and the Imperial College of London epidemiologic model.ResultsAn investment of $9.6 billion USD would adequately protect HCWs in all LMICs. This intervention saves 2,299,543 lives across LMICs, costing $59 USD per HCW case averted and $4,309 USD per HCW life saved. The societal ROI is $755.3 billion USD, the equivalent of a 7,932% return. Regional and national estimates are also presented. In scenarios where PPE remains scarce, 70-100% of HCWs will get infected, irrespective of nationwide social distancing policies. Maintaining HCW infection rates below 10% and mortality below 1% requires inclusion of a PPE scale-up strategy as part of the pandemic response.DiscussionIn conclusion, wide-scale procurement and distribution of PPE for LMICs is an essential strategy to prevent widespread HCW morbidity and mortality. It is cost-effective and yields a large downstream return on investment.

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Prevalence of abuse against frontline health-care workers during the COVID-19 pandemic in low and middle-income countries

Eastern Mediterranean Health Journal ◽

10.26719/2021.27.5.441 ◽

2021 ◽

Vol 27 (5) ◽

pp. 441-442

Author(s):

Tamim Alsuliman ◽

Angie Mouki ◽

Okbah Mohamad

Keyword(s):

Health Care ◽

Health Care Workers ◽

Middle Income ◽

Middle Income Countries ◽

Care Workers ◽

Low And Middle Income

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Chemoprophylaxis against COVID-19 among health-care workers using Ivermectin in low- and middle-income countries: A systematic review and meta-analysis

Indian Journal of Pharmacology ◽

10.4103/ijp.ijp_117_21 ◽

2021 ◽

Vol 53 (6) ◽

pp. 493

Author(s):

TaoreedAdegoke Azeez ◽

Sulaiman Lakoh ◽

AdedapoAdegboyega Adeleke ◽

OluwanifemiTolulase Balogun ◽

BabatundeJohn Olanipekun ◽

...

Keyword(s):

Systematic Review ◽

Health Care ◽

Health Care Workers ◽

Meta Analysis ◽

Middle Income ◽

Middle Income Countries ◽

Care Workers ◽

Low And Middle Income

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31 Effectiveness of a palliative care resource toolkit for COVID 19 for low and middle income countries (LMICs) on health care workers knowledge and confidence levels

10.1136/spcare-2021-pcc.49 ◽

2021 ◽

Author(s):

Sunitha Daniel ◽

Chitra Venkateswaran ◽

Rajashree K Chittazhathu ◽

Smriti Rana ◽

Mhoira Leng ◽

...

Keyword(s):

Health Care ◽

Palliative Care ◽

Health Care Workers ◽

Middle Income ◽

Middle Income Countries ◽

Confidence Levels ◽

Care Workers ◽

Low And Middle Income

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Exposure to Occupational Hazards among Health Care Workers in Low- and Middle-Income Countries: A Scoping Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052603 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2603

Author(s):

Rajni Rai ◽

Sonia El-Zaemey ◽

Nidup Dorji ◽

Bir Doj Rai ◽

Lin Fritschi

Keyword(s):

Health Care ◽

Scoping Review ◽

Health Care Workers ◽

Occupational Hazards ◽

Inclusion Criteria ◽

Safety Measures ◽

Middle Income ◽

Middle Income Countries ◽

Care Workers ◽

Low And Middle Income

Health care workers are exposed to numerous workplace hazards. The implementation of safety measures in high-income countries has largely mitigated these risks. However, in many low- and middle- income countries (LMICs), resources to institute safety measures are lacking, increasing the risk of occupational exposures to these hazards. The aim of this scoping review is to map and synthesize the available research on occupational hazards among health care workers in LMICs, identify research gaps and inform policy. Searches for relevant articles were conducted in five electronic databases using a broad range of search terms. The inclusion criteria were: quantitative observational or experimental studies which examined exposure to one or more occupational hazards among health care workers in a LMCI; and the article was published in English in a peer-reviewed journal. A total of 99 studies met the inclusion criteria, and data were extracted from these studies. Large proportions of health care workers in LMICs were exposed to biological hazards (bloodborne pathogens, tuberculosis), psychosocial hazards (workplace violence, burnout, job dissatisfaction), ergonomic hazards (musculoskeletal complaints), and chemical hazards (exposure to latex and antineoplastic drugs). The implementation of risk reduction strategies was suboptimal. The majority of the literature was on biological hazards (48%), and research on other hazards was limited in comparison. Occupational safety needs to become a priority public health issue to protect health care workers in LMICs. More research is needed to understand the magnitude of the problem in these countries.

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Strengthening health care worker engagement with early adolescence in low- and middle-income countries: an overdue area for action

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2019-0171 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Marni Sommer ◽

Garrison Daly ◽

Caroline Kabiru ◽

Pema Lhaki ◽

Neville Okwaro ◽

...

Keyword(s):

Health Care ◽

Early Adolescence ◽

Health Care Workers ◽

Health Care Systems ◽

Young Adolescents ◽

Middle Income ◽

Middle Income Countries ◽

Care Workers ◽

Care Systems ◽

Low And Middle Income

AbstractThe very young adolescent population (ages 10–14) is currently under-served by health care systems, particularly in low- and middle-income countries. Although there is a substantial and growing effort to reach adolescents with the health services and commodities they need, such efforts often overlook the period of early adolescence given this population’s lower vulnerability to risk-taking behaviors. However, early adolescence is a period of significant change, with the onset of puberty introducing physiological, emotional, and social changes in girls’ and boys’ lives. This period also represents a time of intensifying gendered norms, and the transition of youth from childhood focused health care (e.g. deworming programs, nutrition interventions) to additional mid- and older adolescent related care [e.g. human papilloma virus (HPV) vaccine, and contraceptive provision). Strengthening young adolescents’ engagement with health care workers around preventative and promotive health behaviors could have profound impacts on their health and wellbeing, which in turn could have cascading effects across the course of their lives. Critically, young adolescents would gain trust in health care systems, and be more likely to return when significant health issues arise later in adolescence or adulthood. Such an effort requires sensitizing health care workers and building their capacity to respond to young adolescents’ unique needs, by defining a package of actions that they are mandated to provide, training them, providing them with desk reference tools, and putting in place systems to provide supportive supervision and collaborative learning on the one hand, and encouraging caregivers to connect their pubescent-aged boys and girls with the health care system, on the other hand. This paper presents an argument for increased focus in particular on building attitudes and capacities of health care workers on engaging with early adolescents, applying Principle 3 of the Society of Adolescent Medicine’s position paper entitled “Health Care Reform and Adolescents.”

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Mobile health and the performance of maternal health care workers in low- and middle-income countries: A realist review

International Journal of Care Coordination ◽

10.1177/2053434518779491 ◽

2018 ◽

Vol 21 (3) ◽

pp. 73-86 ◽

Cited By ~ 6

Author(s):

Ibukun-Oluwa Omolade Abejirinde ◽

Onaedo Ilozumba ◽

Bruno Marchal ◽

Marjolein Zweekhorst ◽

Marjolein Dieleman

Keyword(s):

Health Care ◽

Maternal Health ◽

Mobile Health ◽

Health Care Workers ◽

Health Workers ◽

Realist Review ◽

Middle Income ◽

Middle Income Countries ◽

Care Workers ◽

Low And Middle Income

Introduction Maternal health and the performance of health workers is a key concern in low- and middle-income countries. Mobile health technologies are reportedly able to improve workers’ performance. However, how this has been achieved for maternal health workers in low-resource settings is not fully substantiated. To address this gap by building theoretical explanations, two questions were posed: How does mobile health influence the performance of maternal health care workers in low- and middle-income countries? What mechanisms and contextual factors are associated with mobile health use for maternal health service delivery in low- and middle-income countries? Methods Guided by established guidelines, a realist review was conducted. Five databases were searched for relevant English language articles published between 2009 and 2016. A three-stage framework was developed and populated with explanatory configurations of Intervention–Context–Actors–Mechanism–Outcome. Articles were analyzed retroductively, with identified factors grouped into meaningful clusters. Results Of 1254 records identified, 23 articles representing 16 studies were retained. Four main mechanisms were identified: usability and empowerment explaining mobile health adoption, third-party recognition explaining mobile health utilization, and empowerment of health workers explaining improved competence. Evidence was skewed toward the adoption and utilization stage of the framework, with weak explanations for performance outcomes. Conclusions Findings suggest that health workers can be empowered to adopt and utilize mobile health in contexts where it is aligned to their needs, workload, training, and skills. In turn, mobile health can empower health workers with skills and confidence when it is perceived as useful and easy to use, in contexts that foster recognition from clients, peers, or supervisors.

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