scholarly journals Role of Multi-resolution Vulnerability Indices in COVID-19 spread: A Case Study in India

2021 ◽  
Author(s):  
Rupam Bhattacharyya ◽  
Anik Burman ◽  
Kalpana Singh ◽  
Sayantan Banerjee ◽  
Subha Maity ◽  
...  
Keyword(s):  
Epidemiological Data ◽  
Vulnerability Index ◽  
Mitigation Strategies ◽  
Mortality Data ◽  
Middle Income ◽  
Policy Makers ◽  
Middle Income Countries ◽  
Vulnerability Indicators ◽  
Indian State ◽  
Proactive Measures

Introduction The outbreak of COVID-19 has differentially affected countries in the world, with health infrastructure and other related vulnerability indicators playing a role in determining the extent of the COVID-19 spread. Vulnerability of a geographical region/country to COVID-19 has been a topic of interest, particularly in low- and middle-income countries like India to assess the multi-factorial impact of COVID-19 on the incidence, prevalence or mortality data. Datasets and Methods Based on publicly reported socio-economic, demographic, health-based and epidemiological data from national surveys in India, we compute contextual, COVID-19 Vulnerability Indices (cVIs) across multiple thematic resolutions for different geographical and spatial administrative regions. These multi-resolution cVIs were used in regression models to assess their impact on indicators of the spread of COVID-19 such as the average time-varying instantaneous reproduction number. Results Our observational study was focused on 30 districts of the eastern Indian state of Odisha. It is an agrarian state, prone to natural disasters and one of the largest contributors of an unprotected migrant workforce. Our analyses identified housing and hygiene conditions, availability of health care and COVID preparedness as important spatial indicators. Conclusion Odisha has demonstrated success in containing the COVID-19 infection to a reasonable level with proactive measures to contain the spread of the virus during the first wave. However, with the onset of the second wave of COVID, the virus has been making inroads into the hinterlands and peripheral districts of the state, burdening the already deficient public health system in these areas. The vulnerability index presented in this paper identified vulnerable districts in Odisha. While some of them may not have a large number of COVID-19 cases at a given point of time, they could experience repercussions of the pandemic. Improved understanding of the factors driving COVID-19 vulnerability will help policy makers prioritise resources and regions leading to more effective mitigation strategies for the COVID-19 pandemic and beyond.

scholarly journals An Assessment of Social and Physical Vulnerability to Hydroclimate Extremes in Appalachia

2021 ◽  
Author(s):  
Leah R. Handwerger ◽  
Jennifer R. Runkle ◽  
Ronald Leeper ◽  
Elizabeth Shay ◽  
Kara Dempsey ◽  
...  
Keyword(s):  
Social Vulnerability ◽  
Scientific Community ◽  
Vulnerability Index ◽  
Precipitation Variability ◽  
Mitigation Strategies ◽  
Climate Projections ◽  
Social Vulnerability Index ◽  
Physical Vulnerability ◽  
Vulnerable Communities ◽  
Vulnerability Indicators

Abstract Appalachia is a cultural region in the southern and central Appalachian Mountains that lags behind the nation in several social vulnerability indicators. Climate projections over this region indicate that precipitation variability will increase in both severity and frequency in future decades, suggesting that the occurrence of natural hazards related to hydroclimate extremes will also increase. The objective of this study was to investigate the spatiotemporal patterns of drought and precipitation and determine how trends overlap with vulnerable communities across Appalachia. The study utilized trend analysis through Mann-Kendall calculations and a Social Vulnerability Index, resulting in a bivariate map that displays areas most susceptible to adverse effects from hydroclimate extremes. Results show the southwestern portion of the region as most vulnerable to increased precipitation, and the central-southeast most vulnerable to an increase in drought-precipitation variability. This study is among the first to utilize the boundaries defined by the Appalachian Regional Commission from a climatological perspective, allowing findings to reach audiences outside the scientific community and bring more effective mitigation strategies that span from the local to federal levels.

scholarly journals Governing multisectoral action for health in low-income and middle-income countries: an agenda for the way forward

2018 ◽  
Vol 3 (Suppl 4) ◽  
pp. e000890 ◽  
Author(s):  
Kumanan Rasanathan ◽  
Vincent Atkins ◽  
Charles Mwansambo ◽  
Agnès Soucat ◽  
Sara Bennett
Keyword(s):  
Low Income ◽  
Implementation Research ◽  
Conflicts Of Interest ◽  
Health Sector ◽  
Middle Income ◽  
Policy Makers ◽  
Implementation Processes ◽  
Existing Structures ◽  
Middle Income Countries ◽  
The Way

Drawing on experiences reviewed in the accompanying supplement and other literature, we present an agenda for the way forward for policy-makers, managers, civil society and development partners to govern multisectoral action for health in low-income and middle-income countries and consider how such an agenda might be realised. We propose the following key strategies: understand the key actors and political ecosystem, including type of multisectoral action required and mapping incentives, interests and hierarchies; frame the issue in the most strategic manner; define clear roles with specific sets of interventions according to sector; use existing structures unless there is a compelling reason not to do so; pay explicit attention to the roles of non-state sectors; address conflicts of interest and manage tradeoffs; distribute leadership; develop financing and monitoring systems to encourage collaboration; strengthen implementation processes and capacity; and support mutual learning and implementation research. To support countries to strengthen governance for multisectoral action, the global community can assist by further developing technical tools and convening peer learning by policy-makers (particularly from beyond the health sector), supporting knowledge management and sharing of experiences in multisectoral action beyond health, developing an agenda for and execution of implementation research and, finally, driving multilateral and bilateral development partners to transcend their own silos and work in a more multisectoral manner.

scholarly journals Primary care financing: a systematic assessment of research priorities in low- and middle-income countries

2019 ◽  
Vol 4 (Suppl 8) ◽  
pp. e001483 ◽  
Author(s):  
Felicity Goodyear-Smith ◽  
Andrew Bazemore ◽  
Megan Coffman ◽  
Richard Fortier ◽  
Amanda Howe ◽  
...  
Keyword(s):  
Primary Care ◽  
Research Priorities ◽  
Knowledge Gaps ◽  
Middle Income ◽  
Policy Makers ◽  
Diverse Range ◽  
Middle Income Countries ◽  
Delphi Round ◽  
Research Questions ◽  
Low And Middle Income

IntroductionFinancing of primary healthcare (PHC) is the key to the provision of equitable universal care. We aimed to identify and prioritise the perceived needs of PHC practitioners and researchers for new research in low- and middle-income countries (LMIC) about financing of PHC.MethodsThree-round expert panel consultation using web-based surveys of LMIC PHC practitioners, academics and policy-makers sampled from global networks. Iterative literature review conducted in parallel. First round (Pre-Delphi survey) elicited possible research questions to address knowledge gaps about financing. Responses were independently coded, collapsed and synthesised to two lists of questions. Round 2 (Delphi Round 1) invited panellists to rate importance of each question. In Round 3 (Delphi Round 2), panellists ranked questions in order of importance.ResultsA diverse range of PHC practitioners, academics and policy-makers in LMIC representing all global regions identified 479 knowledge gaps as potentially critical to improving PHC financing. Round 2 provided 31 synthesised questions on financing for rating. The top 16 were ranked in Round 3e to produce four prioritised research questions.ConclusionsThis novel exercise created an expansive and prioritised list of critical knowledge gaps in PHC financing research questions. This offers valuable guidance to global supporters of primary care evaluation and implementation, including research funders and academics seeking research priorities. The source and context specificity of this research, informed by LMIC practitioners and academics on a global and local basis, should increase the likelihood of local relevance and eventual success in implementing the findings.

scholarly journals Avoidable Mortality: The Core of the Global Cancer Divide

2018 ◽  
pp. 1-12 ◽  
Author(s):  
Felicia Marie Knaul ◽  
Hector Arreola-Ornelas ◽  
Natalia M. Rodriguez ◽  
Oscar Méndez-Carniado ◽  
Xiaoxiao Jiang Kwete ◽  
...  
Keyword(s):  
Social Justice ◽  
Cancer Mortality ◽  
Premature Mortality ◽  
Income Group ◽  
Mortality Data ◽  
Avoidable Mortality ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Social ◽  
Cancer Types

Purpose The incidence of infection-associated cancers and lethality of cancers amenable to treatment are closely correlated with the income of countries. We analyzed a core part of this global cancer divide—the distribution of premature mortality across country income groups and cancers—applying novel approaches to measure avoidable mortality and identify priorities for public policy. Methods We analyzed avoidable cancer mortality using set lower- and upper-bound age limits of 65 and 75 years (empirical approach), applying cancer-specific and country income group–specific ages of death (feasibility approach), and applying cancer-specific ages of death of high-income countries to all low- and middle-income countries (LMICs; social justice approach). We applied these methods to 2015 mortality data on 16 cancers for which prevention is possible and/or treatment is likely to result in cure or significant increase in life expectancy. Results At least 30% and as much as 50% of cancer deaths are premature, corresponding to between 2.6 and 4.3 million deaths each year, and 70% to 80% are concentrated in LMICs. Using the feasibility approach, 36% of cancer deaths are avoidable; with the social justice approach, 45% of cancer deaths are avoidable. Five cancer types—breast, colorectal, lung, liver, and stomach—account for almost 75% of avoidable cancer deaths in LMICs and worldwide. Conclusion Each year, millions of premature cancer deaths could be avoided with interventions focused on four priority areas: infection-associated cancers, lifestyle and risk factors, women’s cancers, and children’s cancers. Our analysis of the global burden and the specific cancer types associated with avoidable cancer mortality suggests significant opportunities for health systems to redress the inequity of the global cancer divide.

scholarly journals The Impact of Trauma Care Systems in Low- and Middle-Income Countries

2017 ◽  
Vol 38 (1) ◽  
pp. 507-532 ◽  
Author(s):  
Teri A. Reynolds ◽  
Barclay Stewart ◽  
Isobel Drewett ◽  
Stacy Salerno ◽  
Hendry R. Sawe ◽  
...  
Keyword(s):  
Trauma Care ◽  
Resource Constraints ◽  
Inclusion Criteria ◽  
Middle Income ◽  
Policy Makers ◽  
Middle Income Countries ◽  
Care Systems ◽  
Outcome Type ◽  
The Impact ◽  
Low And Middle Income

Injury is a leading cause of death globally, and organized trauma care systems have been shown to save lives. However, even though most injuries occur in low- and middle-income countries (LMICs), most trauma care research comes from high-income countries where systems have been implemented with few resource constraints. Little context-relevant guidance exists to help policy makers set priorities in LMICs, where resources are limited and where trauma care may be implemented in distinct ways. We have aimed to review the evidence on the impact of trauma care systems in LMICs through a systematic search of 11 databases. Reports were categorized by intervention and outcome type and summarized. Of 4,284 records retrieved, 71 reports from 32 countries met inclusion criteria. Training, prehospital systems, and overall system organization were the most commonly reported interventions. Quality-improvement, costing, rehabilitation, and legislation and governance were relatively neglected areas. Included reports may inform trauma care system planning in LMICs, and noted gaps may guide research and funding agendas.

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