Para athletes’ perceptions of abuse: a qualitative study across three lower resourced countries

2022 ◽  
pp. bjsports-2021-104545
Author(s):  
Emily Anne Rutland ◽  
Sakinah C Suttiratana ◽  
Sheila da Silva Vieira ◽  
Rekha Janarthanan ◽  
Michael Amick ◽  
...  
Keyword(s):  
Interpersonal Violence ◽  
Sport Participation ◽  
Evidence Base ◽  
Physical And Mental Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range ◽  
Disability Stigma ◽  
Group Interviews ◽  
Perceptions Of Abuse

ObjectivesInterpersonal violence is an increasingly recognised risk of sport participation and causally linked to negative physical and mental health outcomes. Para athletes from low- and middle-income countries may be at highest risk of physical, psychological, sexual and neglect-related violence due to various factors; however, their perceptions of these abusive behaviours are unknown. This study examined the perceptions and experiences of abuse in para athletes from three lower resourced countries: Ghana, India and Brazil.MethodsQualitative data from semistructured focus group interviews conducted with 26 individuals were collected to explore characteristics of abuse observed, navigated and experienced by para athletes. The framework method for multidisciplinary qualitative research guided data analysis.ResultsAthletes identified a wide range of abusive behaviours they experienced within and outside of sport, including psychological, emotional, physical, sexual and neglect-related violence, which operated on both interpersonal and systemic levels. Most athletes described three less easily recognised forms of abuse in greater detail and more frequently than others: financial abuse, neglect and disability stigma.ConclusionIt is important to hear directly from athletes with diverse experiences and backgrounds and to integrate their insights and priorities into sport safeguarding policies, programmes and interventions. Understanding the requirements and challenges of para athletes and para sport is needed to achieve safe, equitable and inclusive sport. As new insights from diverse sport settings are added to the evidence base, globally balanced, athlete-generated and locally relevant preventative strategies can better protect all athletes.

scholarly journals A global perspective on the issue of access to insulin

Diabetologia ◽  
2021 ◽  
Author(s):  
David Beran ◽  
Maria Lazo-Porras ◽  
Camille M. Mba ◽  
Jean Claude Mbanya
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Management ◽  
Multinational Companies ◽  
Global Perspective ◽  
Patient Access ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range ◽  
Pricing And Reimbursement

AbstractThe discovery of insulin in 1921 changed the prognosis for people with type 1 diabetes. A century later, availability and affordability of insulin remain a challenge in many parts of the globe. Using the WHO’s framework on understanding the life cycle of medicines, this review details the global and national challenges that affect patients’ abilities to access and afford insulin. Current research and development in diabetes has seen some innovations, but none of these have truly been game-changing. Currently, three multinational companies control over 95% of global insulin supply. The inclusion of insulin on the WHO’s Prequalification Programme is an opportunity to facilitate entry of new companies into the market. Many governments lack policies on the selection, procurement, supply, pricing and reimbursement of insulin. Moreover, mark-ups in the supply chain also affect the final price to the consumer. Whilst expenses related to diabetes are mostly covered by insurance in high-income countries, many patients from low- and middle-income countries have to pay out of their own pockets. The organisation of diabetes management within the healthcare system also affects patient access to insulin. The challenges affecting access to insulin are complex and require a wide range of solutions. Given that 2021 marks the centenary of the discovery of insulin, there is need for global advocacy to ensure that the benefits of insulin and innovations in diabetes care reach all individuals living with diabetes. Graphical abstract

scholarly journals Achieving Viral Suppression in 90% of People Living With Human Immunodeficiency Virus on Antiretroviral Therapy in Low- and Middle-Income Countries: Progress, Challenges, and Opportunities

2018 ◽  
Vol 66 (10) ◽  
pp. 1487-1491 ◽  
Author(s):  
Jean B Nachega ◽  
Nadia A Sam-Agudu ◽  
Lynne M Mofenson ◽  
Mauro Schechter ◽  
John W Mellors
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Suppression ◽  
Cost Effective ◽  
Term Treatment ◽  
Middle Income ◽  
Middle Income Countries ◽  
Long Term Treatment ◽  
Wide Range ◽  
Immunodeficiency Virus ◽  
Low And Middle Income

Abstract Although significant progress has been made, the latest data from low- and middle-income countries show substantial gaps in reaching the third “90%” (viral suppression) of the UNAIDS 90-90-90 goals, especially among vulnerable and key populations. This article discusses critical gaps and promising, evidence-based solutions. There is no simple and/or single approach to achieve the last 90%. This will require multifaceted, scalable strategies that engage people living with human immunodeficiency virus, motivate long-term treatment adherence, and are community-entrenched and ‑supported, cost-effective, and tailored to a wide range of global communities.

scholarly journals The burgeoning role of global health diplomacy to alleviate suffering of cancer patients in low- and middle-income countries

2020 ◽  
Vol 12 (3) ◽  
pp. 231-233
Author(s):  
Melissa Adomako ◽  
Alaei Kamiar ◽  
Abdulla Alshaikh ◽  
Lyndsay S Baines ◽  
Desiree Benson ◽  
...  
Keyword(s):  
Global Health ◽  
Evidence Base ◽  
International Affairs ◽  
Global Health Diplomacy ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Diplomacy ◽  
Health Practitioners ◽  
And Control ◽  
Low And Middle Income

Abstract The science of global health diplomacy (GHD) consists of cross-disciplinary, multistakeholder credentials comprised of national security, public health, international affairs, management, law, economics and trade policy. GHD is well placed to bring about better and improved multilateral stakeholder leverage and outcomes in the prevention and control of cancer. It is important to create an evidence base that provides clear and specific guidance for health practitioners in low- and middle-income countries (LMICs) through involvement of all stakeholders. GHD can assist LMICs to negotiate across multilateral stakeholders to integrate prevention, treatment and palliative care of cancer into their commercial and trade policies.

The Impact of Cash Transfers: A Review of the Evidence from Low- and Middle-income Countries

2018 ◽  
Vol 48 (03) ◽  
pp. 569-594 ◽  
Author(s):  
FRANCESCA BASTAGLI ◽  
JESSICA HAGEN-ZANKER ◽  
LUKE HARMAN ◽  
VALENTINA BARCA ◽  
GEORGINA STURGE ◽  
...  
Keyword(s):  
Evidence Base ◽  
Cash Transfers ◽  
Cash Transfer ◽  
Future Research ◽  
Unintended Effects ◽  
Screening Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

AbstractThis article presents the findings of a review of the impact of non-contributory cash transfers on individuals and households in low- and middle-income countries, covering the literature of 15 years, from 2000 to 2015. Based on evidence extracted from 165 studies, retrieved through a systematic search and screening process, this article discusses the impact of cash transfers on 35 indicators covering six outcome areas: monetary poverty; education; health and nutrition; savings, investment and production; work; and empowerment. For most of the studies, cash transfers contributed to progress in the selected indicators in the direction intended by policymakers. Despite variations in the size and strength of the underlying evidence base by outcome and indicator, this finding is consistent across all outcome areas. The article also investigates unintended effects of cash transfer receipt, such as potential reductions in adult work effort and increased fertility, finding limited evidence for such unintended effects. Finally, the article highlights gaps in the evidence base and areas which would benefit from additional future research.

Mental health in intellectual disability

2018 ◽  
pp. 265-272
Author(s):  
Sabyasachi Bhaumik ◽  
Dasari Mohan Michael ◽  
Reza Kiani ◽  
Avinash Hiremath ◽  
Shweta Gangavati ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Mental Health Problems ◽  
Current Knowledge ◽  
Premature Mortality ◽  
Health Problems ◽  
Physical And Mental Health ◽  
Middle Income ◽  
Middle Income Countries

This chapter focuses on the current knowledge in public health for people with intellectual disability and recognizes the extent of health inequalities these individuals experience. The prevalence of intellectual disability worldwide is discussed with special emphasis on the prevalence of mental health problems. Also highlighted are the population health characteristics, including physical and mental health problems. The issue of barriers to accessibility and the possible reasons are discussed. There is a section on premature mortality of people with intellectual disability and measures to improve the health status for this marginalized population. Recent initiatives, including prevention strategies and health promotional aspects, are discussed and solutions suggested, including those for low-and-middle income countries (LAMICs)emphasized. Training aspects to improve quality of health care in LAMICs is highlighted with the recognition of limitations in creating a sustainable transformation of services unless they are backed by authorities.

scholarly journals The effectiveness of workplace health promotion in low- and middle-income countries

2019 ◽  
Vol 35 (5) ◽  
pp. 1220-1229 ◽  
Author(s):  
Cong Tuan Pham ◽  
Dung Phung ◽  
Thi Vinh Nguyen ◽  
Cordia Chu
Keyword(s):  
Health Promotion ◽  
Manufacturing Industry ◽  
Workplace Health Promotion ◽  
Evaluation Studies ◽  
Cochrane Library ◽  
Workplace Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range ◽  
Low And Middle Income

Abstract Although many literature reviews synthesize literature regarding workplace health promotion (WHP) interventions, systematic reviews on the effectiveness of and factors influencing the operation of WHP activities in low- and middle-income countries (LMIC) are scarce. Therefore, we systematically reviewed evaluation studies to examine the effectiveness and factors related to the implementation of WHP programmes in LMIC. Twenty-six peer-reviewed and grey evaluation studies, published before November 2017, were included from electronic databases (PubMed, The Cochrane Library, PsycINFO, EMBASE and Web of Science) and manual searching. The results revealed that WHP intervention in LMIC was effective in reducing health risks in a wide range of industries and settings, including in resource-poor contexts such as small enterprises and the manufacturing industry. The main factors positively influencing the effectiveness of the intervention are long intervention time period, and needs-based and active intervention strategies. In addition, commitment from workplace leaders, the involvement of workers and support from authorities and professionals are factors contributing to a successful WHP programme. However, the evidence regarding the effectiveness of WHP in LMIC regarding the health outcomes and business productivity is inconclusive due to the several remaining methodological limitations. Future developments of more rigorous methods of evaluating the effectiveness of WHP activities should be addressed to produce higher-quality evidence that would inform future practice.

scholarly journals Developing the Evidence Base to Inform Best Practice: A Scoping Study of Breast and Cervical Cancer Reviews in Low- and Middle-Income Countries

PLoS ONE ◽  
2015 ◽  
Vol 10 (9) ◽  
pp. e0134618 ◽  
Author(s):  
Margaret M. Demment ◽  
Karen Peters ◽  
J. Andrew Dykens ◽  
Ann Dozier ◽  
Haq Nawaz ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Best Practice ◽  
Evidence Base ◽  
Middle Income ◽  
Scoping Study ◽  
Middle Income Countries ◽  
Breast And Cervical Cancer ◽  
Low And Middle Income

Confronting the Vector of Tobacco-Related Disease

2013 ◽  
Vol 39 (2-3) ◽  
pp. 308-331 ◽  
Author(s):  
Matthew Allen
Keyword(s):  
Tobacco Use ◽  
Evidence Base ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Past ◽  
Premature Deaths ◽  
Current Trends ◽  
Significant Burden ◽  
Tobacco Epidemic ◽  
Low And Middle Income

It has been estimated that the use of tobacco kills nearly 6 million people each year, with most deaths occurring in low- and middle-income countries. This disparity is expected to increase over the next few decades. On the basis of current trends, tobacco use will kill more than 8 million people worldwide per annum by 2030, with eighty percent of those premature deaths occurring in low- and middle-income countries. The significant burden of morbidity and mortality associated with tobacco use is well documented and proven and will not be repeated here.The evidence base for addressing the tobacco epidemic domestically, regionally, and globally has developed in a systematic fashion over the past five decades. Effective measures for tobacco control are now well known and have been canvassed widely in the published literature.

scholarly journals Interventions to Reduce Antibiotic Prescribing in LMICs: A Scoping Review of Evidence from Human and Animal Health Systems

Antibiotics ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. 2 ◽  
Author(s):  
Annie Wilkinson ◽  
Ayako Ebata ◽  
Hayley MacGregor
Keyword(s):  
Animal Health ◽  
Drug Distribution ◽  
Antibiotic Use ◽  
Evidence Base ◽  
Antibiotic Prescribing ◽  
System Quality ◽  
Middle Income ◽  
Targeted Interventions ◽  
Middle Income Countries ◽  
Healthcare Settings

This review identifies evidence on supply-side interventions to change the practices of antibiotic prescribers and gatekeepers in low- and middle-income countries (LMICs). A total of 102 studies met the inclusion criteria, of which 70 studies evaluated interventions and 32 provided insight into prescribing contexts. All intervention studies were from human healthcare settings, none were from animal health. Only one context study examined antibiotic use in animal health. The evidence base is uneven, with the strongest evidence on knowledge and stewardship interventions. The review found that multiplex interventions that combine different strategies to influence behaviour tend to have a higher success rate than interventions based on single strategies. Evidence on prescribing contexts highlights interacting influences including health system quality, education, perceptions of patient demand, bureaucratic processes, profit, competition, and cultures of care. Most interventions took place within one health setting. Very few studies targeted interventions across different kinds of providers and settings. Interventions in hospitals were the most commonly evaluated. There is much less evidence on private and informal private providers who play a major role in drug distribution in LMICs. There were no interventions involving drug detailers or the pharmaceutical companies despite their prominent role in the contextual studies.

scholarly journals Lactational amenorrhoea among adolescent girls in low-income and middle-income countries: a systematic scoping review

2020 ◽  
Vol 5 (10) ◽  
pp. e002492
Author(s):  
Martines N S Figaroa ◽  
Saverio Bellizzi ◽  
Therese Delvaux ◽  
Lenka Benova
Keyword(s):  
Family Planning ◽  
Low Income ◽  
Planning Method ◽  
Family Planning Method ◽  
Publication Date ◽  
Potential Contribution ◽  
Middle Income ◽  
Middle Income Countries ◽  
Postpartum Family Planning ◽  
Wide Range

IntroductionFertility levels among adolescents remain high in many settings. The objective of this paper was to review the available literature about postpartum and lactational amenorrhoea among adolescents in low-income and middle-income countries (LMICs).MethodsWe searched Medline, Embase, Global Health and CINAHL Plus databases using terms capturing adolescence and lactational or postpartum amenorrhoea. Inclusion criteria included publication date since 1990, data from LMICs, and topic related to lactational amenorrhoea as a postpartum family planning method or as an effect of (exclusive) breast feeding among adolescents. Thematic analysis and narrative synthesis were applied to summarise and interpret the findings.ResultsWe screened 982 titles and abstracts, reviewed 75 full-text articles and included nine. Eight studies assessed data from a single country (three from India, two from Bangladesh, two from Turkey, one from Nigeria). One study using Demographic and Health Survey data included 37 different LMICs. The five studies measuring duration of postpartum or lactational amenorrhoea reported a wide range of durations across the contexts examined. Four studies (from Bangladesh, Nigeria and Turkey) examined outcomes related to the use of lactational amenorrhoea as a family planning method among adolescents. We did not find any studies assessing adolescents’ knowledge of lactational amenorrhoea as a postpartum family planning method. Likewise, little is known about the effectiveness of lactational amenorrhoea method among adolescents using sufficiently large samples and follow-up time.ConclusionThe available evidence on lactational amenorrhoea among adolescents in LMICs is scarce. Given the potential contribution of lactational amenorrhoea to prevention of short interpregnancy intervals among adolescents and young women, there is a need for a better understanding of the duration of lactational amenorrhoea, and the knowledge and effective use of lactational amenorrhoea method for family planning among adolescents in a wider range of LMIC settings.

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