An Evidence-Based Approach on Public Health Decisions in Low-Middle Income Countries: Use Case of Senegal at the Verge of COVID-19

Similar to how physicians practice evidence-based medicine to treat individual patients, policymakers should govern the public's health according to evidence-based data. Initiated by the World Health Organization's directive to make COVID-19 research open and freely accessible, (1,2) multidisciplinary studies are still published daily. Collectively, policymakers worldwide have not used available data effectively to make noteworthy reductions in the pandemic that is now over a year old. This brief commentary introduces a policy problem, then shares 3 categories of successful case studies as possible solutions: [1] Low- and Middle-Income Countries (LMIC): Vietnam and Iran, (3,4) [2] public health practitioners: social workers in Africa and pharmacists in Zambia, (5,6) and [3] public health programs: a smoking cessation program and inmate health program. (7,8) Examples from LMIC were selected to demonstrate practical, cost-effective and duplicable methods. A collaborative multidisciplinary approach with community health partners is also proposed. (2,9)

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COVID-19: An opportunity to strengthen Public Health Policy and Advocacy Efforts in LMIC (Low- Middle-Income Countries)

10.31235/osf.io/5yp6h ◽

2021 ◽

Author(s):

Ponn P Mahayosnand ◽

Saman Essa ◽

ZM Sabra

Keyword(s):

Public Health ◽

Cost Effective ◽

World Health ◽

Evidence Based ◽

Middle Income ◽

Policy Problem ◽

Middle Income Countries ◽

Successful Case ◽

Low Middle Income Countries ◽

Public Health Practitioners

Similar to how physicians practice evidence-based medicine to treat individual patients, policymakers should govern the public's health according to evidence-based data. Initiated by the World Health Organization's directive to make COVID-19 research open and freely accessible, (1,2) multidisciplinary studies are still published daily. Collectively, policymakers worldwide have not used available data effectively to make noteworthy reductions in the pandemic that is now over a year old. This brief commentary introduces a policy problem, then shares 3 categories of successful case studies as possible solutions: [1] Low- and Middle-Income Countries (LMIC): Vietnam and Iran, (3,4) [2] public health practitioners: social workers in Africa and pharmacists in Zambia, (5,6) and [3] public health programs: a smoking cessation program and inmate health program. (7,8) Examples from LMIC were selected to demonstrate practical, cost-effective and duplicable methods. A collaborative multidisciplinary approach with community health partners is also proposed. (2,9)

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Change in Measles Vaccine Coverage and Estimated Impact on Measles Mortality in Low and Middle Income Countries, 2020: An Investigation into Secondary Public Health Effects of the COVID-19 Pandemic Using the Lives Saved Tool

10.1101/2021.09.07.21263236 ◽

2021 ◽

Author(s):

Lucy Claire Gregory

Keyword(s):

Public Health ◽

Health Effects ◽

Vaccine Coverage ◽

Surveillance Systems ◽

Measles Vaccine ◽

Middle Income ◽

Middle Income Countries ◽

National Immunization ◽

Lives Saved Tool ◽

Low Middle Income Countries

With the global COVID-19 pandemic, many public health services were severely disrupted. Estimating the overall health effects of this is difficult as most disease surveillance systems have also been substantially affected during the pandemic. For some diseases, this effect is mitigated by the methods enacted to fight the pandemic, such as use of facial coverings, social distancing and quarantine, but measles is infectious to the degree that this mitigation is likely to be limited. Thus, outbreaks and an increase in global measles mortality are expected. However, the severity of this impact is not yet known. In early 2020, a study by Roberton and colleagues predicted an additional 12,360 to 37,920 deaths in children under-five worldwide from measles over the coming year based on three potential levels of vaccine coverage reductions ranging from 18.5 to 51.9%. Our study investigates the magnitude of the increase in measles mortality due to decreased vaccine coverage because of COVID-19, based on official estimates of 2020 measles vaccine coverage from WHO/UNICEF released in July 2021. Using the Lives Saved Tool (LiST), an interventions modeling program, we estimated measles mortality for low/middle income countries (LMICs) based on the 2020 WHO/UNICEF estimates of national immunization coverage (WUENIC). Because these calculations use actual reported vaccine coverage, they provide a more accurate picture of measles mortality related to COVID-19 disruptions in 2020. Using the WUENIC data, LiST predicted fewer additional deaths in 2020 due to decreases in measles vaccine coverage than estimations made by LiST based on Roberton, 2020 due to remarkable recovery efforts by national immunization programmes in the second half of 2020.

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Opportunities and Challenges for Implementing Neurotrauma Prevention Program: A Practical Perspective for Developing Countries

Indian Journal of Neurotrauma ◽

10.1055/s-0039-3400438 ◽

2019 ◽

Vol 16 (02/03) ◽

pp. 077-081

Author(s):

Amrita Ghosh ◽

Ranabir Pal ◽

Luis Rafael Moscote-Salazar ◽

Huber Said Padilla-Zambrano ◽

Harsh Deora ◽

...

Keyword(s):

Public Health ◽

Traumatic Brain Injury ◽

Developed Countries ◽

Public Health Issue ◽

Evidence Based ◽

Middle Income ◽

Literature Research ◽

Middle Income Countries ◽

Literature Searches ◽

Low And Middle Income

AbstractNeurotrauma is an underestimated and less understood public health issue in low- and middle-income countries for which we need system-based approach to prevention plans. This study was initiated to find rationale of effective plan with projectile vision of neurotrauma prevention. In search of innovative ideas of neurotrauma prevention evidence was explored from the published literature research on traumatic brain injury. Evidence-based global guidelines on recommended content and scheduling on prevention of neurotrauma literature searches data were also synthesized and summarized from research in developed countries. Our study noted that a considerable number of victims of neurotrauma with death and disabilities put mammoth costs to the already compromised health systems of the low- and middle-income countries. We need systems-based four-pronged approach incorporating neurotrauma registry, neurotrauma surveillance, translational research programs, and current approved process for development of clinical guidelines for prevention.

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Just-in-time postnatal education programees to improve newborn care practices: needs and opportunities in low-resource settings

BMJ Global Health ◽

10.1136/bmjgh-2020-002660 ◽

2020 ◽

Vol 5 (7) ◽

pp. e002660

Author(s):

Laura Subramanian ◽

Seema Murthy ◽

Prasad Bogam ◽

Shirley D Yan ◽

Megan Marx Delaney ◽

...

Keyword(s):

Survey Data ◽

Newborn Care ◽

Just In Time ◽

Evidence Based ◽

Care Seeking ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Education Model ◽

Care Practices

Worldwide, many newborns die in the first month of life, with most deaths happening in low/middle-income countries (LMICs). Families’ use of evidence-based newborn care practices in the home and timely care-seeking for illness can save newborn lives. Postnatal education is an important investment to improve families’ use of evidence-based newborn care practices, yet there are gaps in the literature on postnatal education programees that have been evaluated to date. Recent findings from a 13 000+ person survey in 3 states in India show opportunities for improvement in postnatal education for mothers and families and their use of newborn care practices in the home. Our survey data and the literature suggest the need to incorporate the following strategies into future postnatal education programming: implement structured predischarge education with postdischarge reinforcement, using a multipronged teaching approach to reach whole families with education on multiple newborn care practices. Researchers need to conduct robust evaluation on postnatal education models incorporating these programee elements in the LMIC context, as well as explore whether this type of education model can work for other health areas that are critical for families to survive and thrive.

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The Role of Implementation Science in Advancing Resource Generation for Health Interventions in Low- and Middle-Income Countries

Health Services Insights ◽

10.1177/1178632921999652 ◽

2021 ◽

Vol 14 ◽

pp. 117863292199965

Author(s):

Temitope Ojo ◽

Laetitia Kabasele ◽

Bethanny Boyd ◽

Scholastica Enechukwu ◽

Nessa Ryan ◽

...

Keyword(s):

Public Health ◽

Health Outcomes ◽

Implementation Science ◽

Health Workers ◽

Contextual Factors ◽

Health Interventions ◽

Evidence Based ◽

Public Health Interventions ◽

Middle Income ◽

Middle Income Countries

Low- and middle-income countries (LMICs) bear the brunt of communicable and non-communicable diseases and experience higher mortality and poor health outcomes compared to resource-rich countries. Chronic resource deficits in LMICs impede their ability to successfully address vexing health issues. Implementation science provides researchers with an approach to develop specific interventions that can generate and/or maximize resources to facilitate the implementation of other public health interventions, in resource-constrained LMIC settings. Resources generated from these interventions could be in the form of increased health workers’ skills, task shifting to free up higher-skilled health workers, increasing laboratory capacity, and using supply chain innovations to make medications available. Pivotal to the success of such interventions is ensuring feasibility in the LMIC context. We selected and appraised three case studies of evidence-based resource-generating health interventions based in LMICs (Zambia, Zimbabwe, and Madagascar), which generated or maximized resources to facilitate ongoing health services. We used a determinant implementation framework—Consolidated Framework for Implementation Research (CFIR) to identify and map contextual factors that are reported to influence implementation feasibility in an LMIC setting. Contextual factors influencing the feasibility of these interventions included leadership engagement, local capacity building and readiness for research and implementing evidence-based practices (EBPs), infrastructural support for multilevel scale-up, and cultural and contextual adaptations. These factors highlight the importance of utilizing implementation science frameworks to evaluate, guide, and execute feasible public health interventions and projects in resource-limited settings. Within LMICs, we recommend EBPs incorporate feasible resource-generating components in health interventions to ensure improved and sustained optimal health outcomes.

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Machine learning health-related applications in low-income and middle-income countries: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2019-035983 ◽

2020 ◽

Vol 10 (5) ◽

pp. e035983

Author(s):

Rodrigo M Carrillo-Larco ◽

Lorainne Tudor Car ◽

Jonathan Pearson-Stuttard ◽

Trishan Panch ◽

J Jaime Miranda ◽

...

Keyword(s):

Public Health ◽

Machine Learning ◽

Scoping Review ◽

Low Income ◽

Clinical Medicine ◽

Scientific Publications ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Health Related

IntroductionMachine learning (ML) has been used in bio-medical research, and recently in clinical and public health research. However, much of the available evidence comes from high-income countries, where different health profiles challenge the application of this research to low/middle-income countries (LMICs). It is largely unknown what ML applications are available for LMICs that can support and advance clinical medicine and public health. We aim to address this gap by conducting a scoping review of health-related ML applications in LMICs.Methods and analysisThis scoping review will follow the methodology proposed by Levac et al. The search strategy is informed by recent systematic reviews of ML health-related applications. We will search Embase, Medline and Global Health (through Ovid), Cochrane and Google Scholar; we will present the date of our searches in the final review. Titles and abstracts will be screened by two reviewers independently; selected reports will be studied by two reviewers independently. Reports will be included if they are primary research where data have been analysed, ML techniques have been used on data from LMICs and they aimed to improve health-related outcomes. We will synthesise the information following evidence mapping recommendations.Ethics and disseminationThe review will provide a comprehensive list of health-related ML applications in LMICs. The results will be disseminated through scientific publications. We also plan to launch a website where ML models can be hosted so that researchers, policymakers and the general public can readily access them.

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14 Evidence based medicine in low-middle income countries; online or face-to-face teaching method?

10.1136/bmjebm-2018-111024.14 ◽

2018 ◽

Author(s):

Iman El Sayed ◽

Sherif Abdelmonem

Keyword(s):

Evidence Based Medicine ◽

Teaching Method ◽

Evidence Based ◽

Middle Income ◽

Face To Face ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Based Medicine

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Service transformation plans in the Eastern Cape informed by a needs-based gap analysis

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v21i2.823 ◽

2015 ◽

Vol 21 (2) ◽

pp. 5

Author(s):

Kiran Sukeri ◽

Orlando Alonso-Betancourt ◽

Robin Emsley

Keyword(s):

Mental Health ◽

Health Services ◽

Human Resource ◽

Gap Analysis ◽

Evidence Based ◽

Eastern Cape ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

The World

Objectives. Part I of this research paper presented a needs and gap analysis for the management of schizophrenia, bipolar mood disorder and major depression for the Eastern Cape Province, South Africa. It identified deficits and inequitable distribution of human resources and beds in the province. In this article, Part II, the authors propose a plan for public sector mental health services to address the human resource needs in the poorer eastern regions of the province. The plan focuses on human resource training and development. Methods. Evidence-based data on staff development in mental health from low-middle income countries were utilised to develop strategies to increase staff capacity to address unmet need. A financing model with a poverty index was developed to sustain a needs-based plan. Databases searched included Pubmed, Medline, Google and Google Scholar. The key words used included: mental health, mental health training, mental health resources, mental health in low-middle-income countries, mental health policy and plans, mental health needs- based planning, primary healthcare, primary mental healthcare, mental health financing. In addition the websites of the World Health Organization and the World Psychiatric Association were searched for similar resources.Conclusions. It is feasible, with careful attention to planning and implementation of evidence-based tools, to improve public mental health service delivery in this province. Sustained political will and professional commitment will ensure successful delivery of mental health services in a resource-limited province.

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