A Research Agenda for Acute Care Services Delivery in Low- and Middle-income Countries

Cancer is a growing global health issue, and many countries are ill-prepared to deal with their current cancer burden let alone the increased burden looming on the horizon. Growing and aging populations are projected to result in dramatic increases in cancer cases and cancer deaths particularly in low- and middle-income countries. It is imperative that planning begin now to deal not only with those cancers already occurring but also with the larger numbers expected in the future. Unfortunately, such planning is hampered, because the magnitude of the burden of cancer in many countries is poorly understood owing to lack of surveillance and monitoring systems for cancer risk factors and for the documentation of cancer incidence, survival and mortality. Moreover, the human resources needed to fight cancer effectively are often limited or lacking. Cancer diagnosis and cancer care services are also inadequate in low-and middle-income countries. Late-stage presentation of cancers is very common in these settings resulting in less potential for cure and more need for symptom management. Palliative care services are grossly inadequate in low- and middle-income countries, and many cancer patients die unnecessarily painful deaths. Many of the challenges faced by low- and middle-income countries have been at least partially addressed by higher income countries. Experiences from around the world are reviewed to highlight the issues and showcase some possible solutions.

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Strategies to Improve Stroke Care Services in Low- and Middle-Income Countries: A Systematic Review

Neuroepidemiology ◽

10.1159/000479518 ◽

2017 ◽

Vol 49 (1-2) ◽

pp. 45-61 ◽

Cited By ~ 29

Author(s):

Jeyaraj Durai Pandian ◽

Akanksha G. William ◽

Mahesh P. Kate ◽

Bo Norrving ◽

George A. Mensah ◽

...

Keyword(s):

Systematic Review ◽

Health Care Services ◽

Cost Effective ◽

Stroke Care ◽

Evidence Based ◽

Middle Income ◽

Middle Income Countries ◽

Care Services ◽

Stroke Services ◽

Low And Middle Income

Background: The burden of stroke in low- and middle-income countries (LMICs) is large and increasing, challenging the already stretched health-care services. Aims and Objectives: To determine the quality of existing stroke-care services in LMICs and to highlight indigenous, inexpensive, evidence-based implementable strategies being used in stroke-care. Methods: A detailed literature search was undertaken using PubMed and Google scholar from January 1966 to October 2015 using a range of search terms. Of 921 publications, 373 papers were shortlisted and 31 articles on existing stroke-services were included. Results: We identified efficient models of ambulance transport and pre-notification. Stroke Units (SU) are available in some countries, but are relatively sparse and mostly provided by the private sector. Very few patients were thrombolysed; this could be increased with telemedicine and governmental subsidies. Adherence to secondary preventive drugs is affected by limited availability and affordability, emphasizing the importance of primary prevention. Training of paramedics, care-givers and nurses in post-stroke care is feasible. Conclusion: In this systematic review, we found several reports on evidence-based implementable stroke services in LMICs. Some strategies are economic, feasible and reproducible but remain untested. Data on their outcomes and sustainability is limited. Further research on implementation of locally and regionally adapted stroke-services and cost-effective secondary prevention programs should be a priority.

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Implementing smoke-free laws in low- and middle-income countries: a systematic literature review and proposed research Agenda

Tobacco Induced Diseases ◽

10.18332/tid/84668 ◽

2018 ◽

Vol 16 (1) ◽

Author(s):

M. Justin Byron ◽

Joanna Cohen ◽

Shannon Frattaroli ◽

Joel Gittelsohn ◽

David Jernigan

Keyword(s):

Literature Review ◽

Systematic Literature Review ◽

Research Agenda ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Adapting Elements of Cleft Care Protocols in Low- and Middle-income Countries During and After COVID-19: A Process-driven Review With Recommendations

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211069827 ◽

2022 ◽

pp. 105566562110698

Author(s):

Matthew Fell ◽

Michael Goldwasser ◽

B.S. Jayanth ◽

Rui Manuel Rodrigues Pereira ◽

Christian Tshisuz Nawej ◽

...

Keyword(s):

Surgical Procedures ◽

Working Group ◽

Care Providers ◽

Resource Constrained ◽

Middle Income ◽

Middle Income Countries ◽

International Working Group ◽

Consensus Recommendations ◽

Care Services ◽

Low And Middle Income

A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptations to cleft care protocols during and after COVID-19 as a priority learning area of need. A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendations for adaptations to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organizations involved in comprehensive cleft care. Foundational principles were agreed to enable recommendations to be globally relevant and two areas of focus within the specified topic were identified. First the safety aspects of cleft surgery protocols were scrutinized and COVID-19 adaptations, specifically in the pre- and perioperative periods, were highlighted. Second, surgical procedures and cleft care services were prioritized according to their relationship to functional outcomes and time-sensitivity. The surgical procedures assigned the highest priority were emergent interventions for breathing and nutritional requirements and primary palatoplasty. The cleft care services assigned the highest priority were new-born assessments, pediatric support for children with syndromes, management of acute dental or auditory infections and speech pathology intervention. A collaborative, interdisciplinary and international working group delivered consensus recommendations to assist with the provision of cleft care in low- and middle-income countries. At a time of global cleft care delays due to COVID-19, a united approach amongst global cleft care providers will be advantageous to advocate for children born with cleft lip and palate in resource-constrained settings.

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Interventions to improve school-based eye-care services in low- and middle-income countries: a systematic review

Bulletin of the World Health Organization ◽

10.2471/blt.18.212332 ◽

2018 ◽

Vol 96 (10) ◽

pp. 682-694D ◽

Cited By ~ 2

Author(s):

Anthea M Burnett ◽

Aryati Yashadhana ◽

Ling Lee ◽

Nina Serova ◽

Daveena Brain ◽

...

Keyword(s):

Systematic Review ◽

Eye Care ◽

Middle Income ◽

Middle Income Countries ◽

Care Services ◽

School Based ◽

Low And Middle Income

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What are the essential components of HIV treatment and care services in low and middle-income countries

AIDS ◽

10.1097/qad.0b013e32835bdde6 ◽

2012 ◽

Vol 26 ◽

pp. S97-S103 ◽

Cited By ~ 10

Author(s):

Paula Munderi ◽

Heiner Grosskurth ◽

Benson Droti ◽

David A. Ross

Keyword(s):

Hiv Treatment ◽

Middle Income ◽

Middle Income Countries ◽

Care Services ◽

Essential Components ◽

Low And Middle Income

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Better Late Than Never?! Five Compelling Reasons for Putting Physical Activity in Low- and Middle-Income Countries High Up on the Public Health Research Agenda

Journal of Physical Activity and Health ◽

10.1123/jpah.2021-0576 ◽

2021 ◽

pp. 1-2

Author(s):

Katja Siefken ◽

Andrea Varela Ramirez ◽

Temo Waqanivalu ◽

Nico Schulenkorf

Keyword(s):

Public Health ◽

Physical Activity ◽

Health Research ◽

Research Agenda ◽

Public Health Research ◽

Noncommunicable Diseases ◽

Middle Income ◽

The Public ◽

Middle Income Countries ◽

Low And Middle Income

Since 2020, the world has been navigating an epidemiologic transition with both infectious diseases (COVID-19) and noncommunicable diseases intertwined in complex and diverse ways. In fact, the pandemics of physical inactivity, noncommunicable diseases, and COVID-19 coincide in a tragically impactful ménage à trois with their detrimental long-term health consequences yet to be determined. We know that people in low- and middle-income countries not only have the highest risk of developing chronic diseases, they also develop the diseases at a younger age, they suffer longer, and they die earlier than people in high-income countries. This commentary features 5 compelling reasons for putting physical activity in low- and middle-income countries high up on the public health research agenda and calls for more commitment to inclusive and context-specific public health practices that are paired with locally relevant promotion and facilitation of PA practice, research, and policymaking.

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