Low-income health needs more than isolated innovation

2019 ◽  
Keyword(s):  
Low Income ◽  
Task Shifting ◽  
Health Needs ◽  
Financial Sustainability ◽  
Middle Income ◽  
Content Type ◽  
Remote Areas ◽  
Middle Income Countries ◽  
The World ◽  
Death And Loss

Subject Innovating in healthcare. Significance 'Burden of disease' is a concept that describes death and loss of health due to diseases, injuries and risk factors for all regions of the world. Innovation in healthcare is accelerating, fueling optimism that low-to-middle-income countries (LMICs) can expedite and broaden recent gains. Impacts Governmental donors as well as philanthropic organisations will place more emphasis on financial sustainability. More capacity and availability of diagnostic services, for example to identify patients, needs more spending on treatment infrastructure. Task-shifting (distributing tasks across health teams), will benefit from legislative and regulatory support raising acceptance and usage. Telemedicine is only available to connected patients; connecting more people, especially in remote areas of LIMCs, will be key.

scholarly journals Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2439
Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  
Keyword(s):  
Health Survey ◽  
Low Income ◽  
World Health ◽  
Low Income Countries ◽  
Multivariable Logistic Regression Analysis ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

Multilateral governance will advance despite obstacles

2018 ◽  
Keyword(s):  
Low Income ◽  
Public Investment ◽  
Low Income Countries ◽  
System Reform ◽  
Government Ownership ◽  
Middle Income ◽  
Content Type ◽  
The World ◽  
Host Government ◽  
Risk Insurance

Subject Reforming the multilateral development banks. Significance The multilateral development bank (MDB) system has resisted pressure on the international order from US nationalism, but the multiplication of MDBs has considerably reduced their collective effectiveness. This fragmentation is preventing them from adapting to global challenges and harnessing private capital for development. The World Bank spring meeting will consider the proposals that the G20 is exploring. Most do not entail institutional change, but others could pave the way for significant reforms. Impacts The ongoing debate about the World Bank’s need for a capital increase will be peripheral to the larger discussion on MDB system reform. If implemented, a cross-MDB risk insurance platform would create a one-stop shop for investors and opportunities for private reinsurers. System-wide securitisation would create new asset classes and expand opportunities for institutional investors. In-country MDB coordination platforms would boost host government ownership of projects in middle-income and stable low-income countries. Estimates suggest that one dollar of capital paid into MDBs can translate into 50 dollars of public investment if allocated effectively.

scholarly journals Task shifting interventions for cardiovascular risk reduction in low-income and middle-income countries: a systematic review of randomised controlled trials

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e005983 ◽  
Author(s):  
Gbenga Ogedegbe ◽  
Joyce Gyamfi ◽  
Jacob Plange-Rhule ◽  
Alisa Surkis ◽  
Diana Margot Rosenthal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Reduction ◽  
Low Income ◽  
Randomised Controlled Trials ◽  
Blood Pressure Reduction ◽  
Task Shifting ◽  
Controlled Trials ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomised Controlled

ObjectiveTo evaluate evidence from published randomised controlled trials (RCTs) for the use of task-shifting strategies for cardiovascular disease (CVD) risk reduction in low-income and middle-income countries (LMICs).DesignSystematic review of RCTs that utilised a task-shifting strategy in the management of CVD in LMICs.Data SourcesWe searched the following databases for relevant RCTs: PubMed from the 1940s, EMBASE from 1974, Global Health from 1910, Ovid Health Star from 1966, Web of Knowledge from 1900, Scopus from 1823, CINAHL from 1937 and RCTs from ClinicalTrials.gov.Eligibility criteria for selecting studiesWe focused on RCTs published in English, but without publication year. We included RCTs in which the intervention used task shifting (non-physician healthcare workers involved in prescribing of medications, treatment and/or medical testing) and non-physician healthcare providers in the management of CV risk factors and diseases (hypertension, diabetes, hyperlipidaemia, stroke, coronary artery disease or heart failure), as well as RCTs that were conducted in LMICs. We excluded studies that are not RCTs.ResultsOf the 2771 articles identified, only three met the predefined criteria. All three trials were conducted in practice-based settings among patients with hypertension (2 studies) and diabetes (1 study), with one study also incorporating home visits. The duration of the studies ranged from 3 to 12 months, and the task-shifting strategies included provision of medication prescriptions by nurses, community health workers and pharmacists and telephone follow-up posthospital discharge. Both hypertension studies reported a significant mean blood pressure reduction (2/1 mm Hg and 30/15 mm Hg), and the diabetes trial reported a reduction in the glycated haemoglobin levels of 1.87%.ConclusionsThere is a dearth of evidence on the implementation of task-shifting strategies to reduce the burden of CVD in LMICs. Effective task-shifting interventions targeted at reducing the global CVD epidemic in LMICs are urgently needed.

scholarly journals Is export-led growth hypothesis still valid for sub-Saharan African countries? New evidence from panel data analysis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nicholas M. Odhiambo
Keyword(s):  
Economic Growth ◽  
Granger Causality ◽  
Low Income ◽  
Middle Income ◽  
Content Type ◽  
Middle Income Countries ◽  
Stage Of Development ◽  
Panel Granger Causality ◽  
Causality Model ◽  
Ssa Countries

PurposeThis study examines the causal relationship between exports and economic growth in sub-Saharan African (SSA) countries during the period 1980 to 2017. The study also examines whether the causality between these two macroeconomic variables depends on the countries' stage of development as proxied by their per capita income.Design/methodology/approachThe study uses a panel cointegration test and panel Granger-causality model to examine the link between exports and growth. The study also incorporates external debt as an intermittent variable in a bivariate setting between exports and economic growth, thereby creating a dynamic multivariate panel Granger-causality model.FindingsAlthough the study found the existence of a long-run relationship between exports and economic growth, the study failed to find any export-led growth response in both low-income and middle-income countries. Instead, the study found evidence of a bidirectional causality and a neutrality response in middle-income and low-income countries, respectively. The study, therefore, concludes that the benefits of an export-led growth hypothesis may have been oversold, and that the strategy may not be desirable to some low-income developing countries.Practical implicationsThese findings have important policy implications as they indicate that the causality between exports and economic growth in SSA countries varies with the countries' stage of development. Consistent with the contemporary literature, the study cautions low-income SSA countries against over-relying on an export-led growth strategy to achieve a sustained growth path as no causality between exports and economic growth has been found to exist in those countries. Instead, such countries should consider pursuing new growth strategies by building the domestic demand side of their economies alongside their export promotion strategies in order to expand the real sector of their economies. For middle-income countries, the study recommends that both export promotion strategies and pro-growth policies should be intensified as economic growth and exports have been found to reinforce each other in those countries.Originality/valueUnlike the previous studies, the current study disaggregated the full sample of SSA countries into two subsets – one comprising of low-income countries and the other consisting of middle-income countries. In addition, the study uses a multivariate Granger-causality model in order to address the emission-of-variable bias. To our knowledge, this may be the first study of its kind in recent years to examine in detail the causal relationship between exports and economic growth in SSA countries using an ECM-based multivariate panel Granger-causality model.

Water Supply, Sanitation, and the Environment

2021 ◽  
Author(s):  
N. Vijay Jagannathan
Keyword(s):  
Water Supply ◽  
Low Income ◽  
Poor Performance ◽  
Low Income Countries ◽  
General Interest ◽  
Sustainable Development Goal ◽  
Middle Income ◽  
Development Goal ◽  
Middle Income Countries ◽  
The World

Sustainable Development Goal No. 6 (SDG 6) has committed all nations of the world to achieving ambitious water supply and sanitation targets by 2030 to meet the universal basic needs of humans and the environment. Many lower-middle-income countries and all low-income countries face an uphill challenge in achieving these ambitious targets. The cause of poor performance is explored, some possible ways to accelerate progress toward achieving SDG 6 are suggested. The analysis will be of interest to a three-part audience: (a) readers with a general interest on how SDG 6 can be achieved; (b) actors with policy interest on improving water supply and safe sanitation (WSS) service issues; and (c) activists skeptical of conventional WSS policy prescriptions who advocate out-of-the-box solutions to improve WSS delivery.

Internet Use around the World: An Empirical Assessment

2017 ◽  
Vol 16 (6) ◽  
pp. 683-699
Author(s):  
Minh Dao
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
Internet Use ◽  
Developed Countries ◽  
Computer Access ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Internet Application ◽  
Developing And Developed Countries

Abstract This paper empirically assesses the effect of the determinants of Internet use, using several samples of both developed and developing countries. Based on a sample of 23 low-income economies in 2015, we find that Internet use depends upon computer access. Using a sample of 38 lower middle-income countries we find that Internet use depends upon Internet quality and Internet affordability. Using a sample of 41 upper middle-income countries, we find that computer access and Internet affordability influence Internet use. From a sample of 45 high-income countries, we are able to show that computer access, Internet quality, and affordability do affect Internet use. Using a sample of thirty oecd countries, we find that Internet use depends upon computer access and Internet quality. When a sample of 150 developing and developed countries is used, results show that Internet use is influenced by computer access, Internet quality, Internet affordability, and Internet application.

Does foreign direct investment cause economic growth? A dynamic panel data analysis for SADC countries

2016 ◽  
Vol 11 (3) ◽  
pp. 316-332 ◽  
Author(s):  
Edmore E Mahembe ◽  
Nicholas M Odhiambo
Keyword(s):  
Economic Growth ◽  
Data Analysis ◽  
Causal Relationship ◽  
Low Income ◽  
Panel Data Analysis ◽  
Low Income Countries ◽  
Middle Income ◽  
Fdi Inflows ◽  
Content Type ◽  
Middle Income Countries

Purpose – The purpose of this paper is to examine the causal relationship between inward foreign direct investment (FDI) and economic growth in Southern African Development Community (SADC) countries over the period 1980-2012. It also investigates whether the causal relationship between FDI inflows and economic growth is dependent on the level of income. Design/methodology/approach – In order to assess whether the causal relationship between FDI inflows and economic growth is dependent on the level of income, the study divided the SADC countries into two groups, namely, the middle-income countries and the low-income countries. The study used the recent panel-data analysis methods to examine this linkage. The Granger causality test for the middle-income countries was conducted within a vector-error correction mechanism framework; while that of the low-income countries was conducted within a vector autoregressions framework. Findings – The results for the middle-income countries’ panel show that there is a uni-directional causal flow from GDP to FDI, and not vice versa. However, for the low-income countries’ panel, there was no evidence of causality in either direction. The study concludes that the FDI-led growth hypothesis does not apply to SADC countries. Research limitations/implications – Methodology applied in this study is a bivariate framework which is likely to suffer from the omission of variable bias (Odhiambo, 2008, 2011). Second, the Granger causality analysis employed in this only investigates the direction of causality and whether each variable can be used to explain another, but does not directly test for the mechanisms through which FDI leads to economic growth and economic growth leads to FDI. Practical implications – Future studies may include a third variable such as domestic savings, exports, or financial development in a trivariate or multivariate panel causality model. A more complete analysis which seeks to explain the channels through which FDI impacts growth is suggested for future studies. Lastly, sector level analysis will help policy makers draft effective industrial policies, which can guide allocation of incentives. Social implications – The results of this study support the Growth-led FDI hypothesis, but not the FDI-led growth hypothesis. In other words, it is economic growth that drives FDI inflows into the SADC region and into Southern Africa, and not vice versa. This implies that the recent high economic growth rates that have been recorded in some of the SADC countries, especially the middle-income countries, have led to a massive inflow of FDI into this region. Originality/value – At the regional level, SADC as a regional bloc has been actively pursuing policies and strategies aimed at attracting FDI into the region. Despite the important role of FDI in economic development, and the increase in FDI inflows into SADC countries in particular, there is a significant dearth of literature on the causal relationship between FDI and economic growth. The study used the recent panel-data analysis methods to examine the causal relationship between FDI and economic growth in SADC countries.

scholarly journals Socioeconomic Inequality in Smoking in Low-Income and Middle-Income Countries: Results from the World Health Survey

PLoS ONE ◽  
2012 ◽  
Vol 7 (8) ◽  
pp. e42843 ◽  
Author(s):  
Ahmad Reza Hosseinpoor ◽  
Lucy Anne Parker ◽  
Edouard Tursan d'Espaignet ◽  
Somnath Chatterji
Keyword(s):  
Health Survey ◽  
Low Income ◽  
Socioeconomic Inequality ◽  
World Health ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World

Are low- and middle-income countries profiting from fast fashion?

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Karan Khurana ◽  
S.S. Muthu
Keyword(s):  
Economic Development ◽  
Value Chain ◽  
Developed Countries ◽  
Environmental Cost ◽  
Fast Fashion ◽  
Middle Income ◽  
Content Type ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

PurposeIn the last two decades, the fashion value chain traveled to developing parts of the world. To these nations, it paved a path for socio-economic development initially but lately, the aftermath has costed more. This article visualizes the gains and losses of fast fashion to these countries.Design/methodology/approachAn in-depth systematic literature review was performed to analyze the secondary data from academic journals and reports from international organizations. The authors have compiled their empirical journeys in academia, research and industry from low- and middle-income countries (LMICs) based on Schon's (1983, 1990) theory of reflective practice. Further on, the article is structured using the value chain analysis (VCA) method which visualizes the aftermath of mass-producing fashion for the developed countries.FindingsIn this research it was found that LMICs have made substantial economic progress in the past two decades, however at a high social and environmental cost. It is the right time to find a balance between economic development and harm caused to the citizens of these nations.Originality/valueAt the moment the existing academic literature talks about unsustainable practices in the fashion sector around the world. This research precisely targets the LMICs where the aftermath is supposed to be much more severe. Further, it provides solutions and urges these nations to bring a substantial change throughout the value chain for a robust future.

Assessing Global Kidney Nutrition Care

2022 ◽  
pp. CJN.07800621 ◽  
Author(s):  
Angela Yee-Moon Wang ◽  
Ikechi G. Okpechi ◽  
Feng Ye ◽  
Csaba P. Kovesdy ◽  
Giuliano Brunori ◽  
...  
Keyword(s):  
International Society ◽  
Low Income ◽  
Interdisciplinary Communication ◽  
Care Delivery ◽  
Nutrition Status ◽  
Middle Income ◽  
Oral Nutrition ◽  
Content Type ◽  
Middle Income Countries ◽  
Nutrition Care

Background and objectivesNutrition intervention is an essential component of kidney disease management. This study aimed to understand current global availability and capacity of kidney nutrition care services, interdisciplinary communication, and availability of oral nutrition supplements.Design, setting, participants, & measurementsThe International Society of Renal Nutrition and Metabolism (ISRNM), working in partnership with the International Society of Nephrology (ISN) Global Kidney Health Atlas Committee, developed this Global Kidney Nutrition Care Atlas. An electronic survey was administered among key kidney care stakeholders through 182 ISN-affiliated countries between July and September 2018.ResultsOverall, 160 of 182 countries (88%) responded, of which 155 countries (97%) answered the survey items related to kidney nutrition care. Only 48% of the 155 countries have dietitians/renal dietitians to provide this specialized service. Dietary counseling, provided by a person trained in nutrition, was generally not available in 65% of low-/lower middle–income countries and “never” available in 23% of low-income countries. Forty-one percent of the countries did not provide formal assessment of nutrition status for kidney nutrition care. The availability of oral nutrition supplements varied globally and, mostly, were not freely available in low-/lower middle–income countries for both inpatient and outpatient settings. Dietitians and nephrologists only communicated “sometimes” on kidney nutrition care in ≥60% of countries globally.ConclusionsThis survey reveals significant gaps in global kidney nutrition care service capacity, availability, cost coverage, and deficiencies in interdisciplinary communication on kidney nutrition care delivery, especially in lower-income countries.

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