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.

scholarly journals Estimating private sector out-of-pocket expenditures on family planning commodities in low-and-middle-income countries

2021 ◽  
Vol 6 (4) ◽  
pp. e004635
Author(s):  
Michelle Weinberger ◽  
Nicole Bellows ◽  
John Stover
Keyword(s):  
Family Planning ◽  
Private Sector ◽  
Low Income ◽  
Low Income Countries ◽  
Sensitivity Testing ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range ◽  
Low And Middle Income

IntroductionThe role of the private sector in family planning (FP) is well studied; however, few efforts have been made to quantify the role of private out-of-pocket (OOP) expenditures on FP commodities across low-and-middle-income countries (LMICs). Calculating OOP expenditures is important to illuminate the magnitude of these contributions and to inform discussions on how financial burdens can be reduced.MethodsEstimates of FP users and commodities consumed by women getting their FP methods from the private sector were made for 132 LMICs. Next, unit price data were compiled from to estimate the average price of commodities in the private sector at both a commercial and subsidised price point. These unit prices were applied to commodity consumption estimates to calculate total private OOP expenditures. Sensitivity testing was conducted.ResultsTotal estimated private OOP expenditures for FP commodities in 2019 was $2.73 billion across 132 LMICs. Spending on contraceptive pills accounted for 80% of this total, and just over three-quarters of expenditure came from upper-middle-income countries. OOP expenditures on subsidised commodities were small but accounted for 20% of expenditures in low-income countries. Non-subsidised unit prices were found to be between 5 and 20 times higher in upper-middle-income countries compared with low-income countries, although wide variation exists. For low-income and lower-middle-income countries, subsidies appear to be greatest for intrauterine devices (IUDs) and pills.ConclusionLarge OOP expenditures across all income levels highlight a need for financing approaches that ensure that a wide range of contraceptives are both accessible and affordable.

scholarly journals Outcomes of HIV treatment from the private sector in low-income and middle-income countries: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031844
Author(s):  
Gitau Mburu ◽  
Ewemade Igbinedion ◽  
Sin How Lim ◽  
Aung Zayar Paing ◽  
Siyan Yi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Private Sector ◽  
Clinical Outcomes ◽  
Low Income ◽  
Hiv Treatment ◽  
Future Research ◽  
Publication Date ◽  
Middle Income ◽  
Middle Income Countries ◽  
Secondary Outcomes

IntroductionPrivate sector provision of HIV treatment is increasing in low-income and middle-income countries (LMIC). However, there is limited documentation of its outcomes. This protocol reports a proposed systematic review that will synthesise clinical outcomes of private sector HIV treatment in LMIC.Methods and analysisThis review will be conducted in accordance with the preferred reporting items for systematic review and meta-analyses protocols. Primary outcomes will include: (1) proportion of eligible patients initiating antiretroviral therapy (ART); (2) proportion of those on ART with <1000 copies/mL; (3) rate of all-cause mortality among ART recipients. Secondary outcomes will include: (1) proportion receivingPneumocystis jirovecipneumonia prophylaxis; (2) proportion with >90% ART adherence (based on any measure reported); (3) proportion screened for non-communicable diseases (specifically cervical cancer, diabetes, hypertension and mental ill health); (iv) proportion screened for tuberculosis. A search of five electronic bibliographical databases (Embase, Medline, PsychINFO, Web of Science and CINAHL) and reference lists of included articles will be conducted to identify relevant articles reporting HIV clinical outcomes. Searches will be limited to LMIC. No age, publication date, study-design or language limits will be applied. Authors of relevant studies will be contacted for clarification. Two reviewers will independently screen citations and abstracts, identify full text articles for inclusion, extract data and appraise the quality and bias of included studies. Outcome data will be pooled to generate aggregative proportions of primary and secondary outcomes. Descriptive statistics and a narrative synthesis will be presented. Heterogeneity and sensitivity assessments will be conducted to aid interpretation of results.Ethics and disseminationThe results of this review will be disseminated through a peer-reviewed scientific manuscript and at international scientific conferences. Results will inform quality improvement strategies, replication of identified good practices, potential policy changes, and future research.PROSPERO registration numberCRD42016040053.

scholarly journals Prevalence of Postpartum Family Planning Service Coverage in Selected Referral Facilities of Nepal

2020 ◽  
Vol 58 (221) ◽  
Author(s):  
Kusum Thapa ◽  
Rolina Dhital ◽  
Sameena Rajbhandari ◽  
Shikha Thapa ◽  
Sabina Pokhrel ◽  
...  
Keyword(s):  
Family Planning ◽  
Intrauterine Device ◽  
Cross Sectional Study ◽  
Planning Method ◽  
Family Planning Method ◽  
Postpartum Contraception ◽  
Cross Sectional ◽  
Postpartum Family Planning ◽  
Ethical Approval ◽  
Service Coverage

Introduction: Nepal Society of Obstetricians and Gynecologists jointly with the Nepalese governmentand with the support from the International Federation of Obstetrics and Gynecology hasimplemented an initiative to institutionalize postpartum family planning services in selected majorreferral facilities of Nepal to address the gap of low uptake of postpartum family planning in Nepal.The aim of the study is to find the prevalence of the service coverage of postpartum contraception inthe selected facilities. Methods: A descriptive cross-sectional study was conducted in seven major referral facilities acrossNepal. Data were collected from the hospital records of all women who delivered in these facilitiesbetween October 2018 and March 2019. Ethical approval for this study was obtained from NepalHealth Research Council. Data analysis was done with SPSS version 23. Results: Among the 29,072 deliveries from all the facilities, postpartum family planning counselingcoverage was 27,301 (93.9%). The prevalence of uptake of Postpartum Intrauterine Device is 1581(5.4%) and female sterilization is 1830 (6.3%). In total 11387 mothers (52.2%) had the intention tochoose a postpartum family planning method. However, 36% of mothers neither used nor had theintention to choose a postpartum family planning method. Conclusions: The coverage of Postpartum Intrauterine Device counseling service coverage in Nepal ishigher in 2018 as compared to 2016-2017 and in other countries implementing Postpartum IntrauterineDevice initiatives. However, the prevalence of service coverage of immediate Postpartum FamilyPlanning methods, mainly Postpartum Intrauterine Device in 2018 is lower in Nepal as compared to2016-2017, and other countries implementing Postpartum Intrauterine Device initiative. More effortsare needed to encourage mothers delivering in the facilities to use the postpartum family planningmethod.

scholarly journals The cost-effectiveness of hypertension management in low-income and middle-income countries: a review

2020 ◽  
Vol 5 (9) ◽  
pp. e002213
Author(s):  
Deliana Kostova ◽  
Garrison Spencer ◽  
Andrew E Moran ◽  
Laura K Cobb ◽  
Muhammad Jami Husain ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Low Income ◽  
Disease Risk ◽  
National Income ◽  
Economic Evaluations ◽  
Health Improvement ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range ◽  
The Cost

Hypertension in low-income and middle-income countries (LMICs) is largely undiagnosed and uncontrolled, representing an untapped opportunity for public health improvement. Implementation of hypertension control strategies in low-resource settings depends in large part on cost considerations. However, evidence on the cost-effectiveness of hypertension interventions in LMICs is varied across geographical, clinical and evaluation contexts. We conducted a comprehensive search for published economic evaluations of hypertension treatment programmes in LMICs. The search identified 71 articles assessing a wide range of hypertension intervention designs and cost components, of which 42 studies across 15 countries reported estimates of cost-effectiveness. Although comparability of results was limited due to heterogeneity in the interventions assessed, populations studied, costs and study quality score, most interventions that reported cost per averted disability-adjusted life-year (DALY) were cost-effective, with costs per averted DALY not exceeding national income thresholds. Programme elements that may reduce cost-effectiveness included screening for hypertension at younger ages, addressing prehypertension, or treating patients at lower cardiovascular disease risk. Cost-effectiveness analysis could provide the evidence base to guide the initiation and development of hypertension programmes.

scholarly journals Perioperative mortality rates in low-income and middle-income countries: a systematic review and meta-analysis

2018 ◽  
Vol 3 (3) ◽  
pp. e000810 ◽  
Author(s):  
Joshua S Ng-Kamstra ◽  
Sumedha Arya ◽  
Sarah L M Greenberg ◽  
Meera Kotagal ◽  
Catherine Arsenault ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Procedures ◽  
Low Income ◽  
Meta Analysis ◽  
Surgical Care ◽  
Low Income Countries ◽  
Perioperative Mortality ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range

IntroductionThe Lancet Commission on Global Surgery proposed the perioperative mortality rate (POMR) as one of the six key indicators of the strength of a country’s surgical system. Despite its widespread use in high-income settings, few studies have described procedure-specific POMR across low-income and middle-income countries (LMICs). We aimed to estimate POMR across a wide range of surgical procedures in LMICs. We also describe how POMR is defined and reported in the LMIC literature to provide recommendations for future monitoring in resource-constrained settings.MethodsWe did a systematic review of studies from LMICs published from 2009 to 2014 reporting POMR for any surgical procedure. We extracted select variables in duplicate from each included study and pooled estimates of POMR by type of procedure using random-effects meta-analysis of proportions and the Freeman-Tukey double arcsine transformation to stabilise variances.ResultsWe included 985 studies conducted across 83 LMICs, covering 191 types of surgical procedures performed on 1 020 869 patients. Pooled POMR ranged from less than 0.1% for appendectomy, cholecystectomy and caesarean delivery to 20%–27% for typhoid intestinal perforation, intracranial haemorrhage and operative head injury. We found no consistent associations between procedure-specific POMR and Human Development Index (HDI) or income-group apart from emergency peripartum hysterectomy POMR, which appeared higher in low-income countries. Inpatient mortality was the most commonly used definition, though only 46.2% of studies explicitly defined the time frame during which deaths accrued.ConclusionsEfforts to improve access to surgical care in LMICs should be accompanied by investment in improving the quality and safety of care. To improve the usefulness of POMR as a safety benchmark, standard reporting items should be included with any POMR estimate. Choosing a basket of procedures for which POMR is tracked may offer institutions and countries the standardisation required to meaningfully compare surgical outcomes across contexts and improve population health outcomes.

scholarly journals Understanding the implementation (including women’s use) of maternity waiting homes in low-income and middle-income countries: a realist synthesis protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e039531
Author(s):  
Daphne N McRae ◽  
Anayda Portela ◽  
Tamara Waldron ◽  
Nicole Bergen ◽  
Nazeem Muhajarine
Keyword(s):  
Low Income ◽  
Implementation Strategies ◽  
Realist Synthesis ◽  
Plain Language ◽  
Programme Theory ◽  
Middle Income ◽  
Middle Income Countries ◽  
Maternity Waiting Homes ◽  
Wide Range ◽  
Maternity Waiting Home

IntroductionMaternity waiting homes in low-income and middle-income countries provide accommodation near health facilities for pregnant women close to the time of birth to promote facility-based birth and birth with a skilled professional and to enable timely access to emergency obstetric services when needed. To date, no studies have provided a systematic, comprehensive synthesis explaining facilitators and barriers to successful maternity waiting home implementation and whether and how implementation strategies and recommendations vary by context. This synthesis will systematically consolidate the evidence, answering the question, ‘How, why, for whom, and in what context are maternity waiting homes successfully implemented in low-income and middle-income countries?’.Methods and analysisMethods include standard steps for realist synthesis: determining the scope of the review, searching for evidence, appraising and extracting data, synthesising and analysing the data and developing recommendations for dissemination. Steps are iterative, repeating until theoretical saturation is achieved. Searching will be conducted in 13 electronic databases with results managed in Eppi-Reviewer V.4. There will be no language, study-type or document-type restrictions. Items documented prior to 1990 will be excluded. To ensure our initial and revised programme theories accurately reflect the experiences and knowledge of key stakeholders, most notably the beneficiaries, interviews will be conducted with maternity waiting home users/nonusers, healthcare staff, policymakers and programme designers. All data will be analysed using context–mechanism–outcome configurations, refined and synthesised to produce a final programme theory.Ethics and disseminationEthics approval for the project will be obtained from the Mozambican National Bioethical Commission, Jimma University College of Health Sciences Institutional Review Board and the University of Saskatchewan Bioethical Research Ethics Board. To ensure results of the evaluation are available for uptake by a wide range of stakeholders, dissemination will include peer-reviewed journal publication, a plain-language brief, and conference presentations to stakeholders’ practice audiences.PROSPERO registration numberCRD42020173595.

scholarly journals A novel prison mental health in-reach service in Somaliland: a model for low-income countries?

2014 ◽  
Vol 11 (3) ◽  
pp. 61-64
Author(s):  
Jibril I. M. Handuleh ◽  
Ronan J. Mclvor
Keyword(s):  
Mental Health ◽  
Low Income ◽  
Low Income Countries ◽  
Middle Income ◽  
Independent State ◽  
International Agencies ◽  
Middle Income Countries ◽  
Wide Range ◽  
Assessment And Treatment ◽  
Local Agencies

Prison in-reach mental health services are reasonably well developed in advanced economies, but virtually nonexistent in low-and middle-income countries. We describe the development of a small prison in-reach project in Somaliland, a self-declared independent state which has experienced conflict and poverty in equal measure. After careful planning and cooperation with local agencies, the service provides sessional input to a regional prison, including assessment and treatment of a wide range of psychiatric conditions. The project has had some unexpected benefits, which are described. The success of the project reflects the effectiveness of collaboration between local stakeholders and international agencies, and could be used as a model for the development of in-reach services in other low-income countries.

scholarly journals The anthropocosmos model

2003 ◽  
Vol 70 (422/423) ◽  
pp. 391
Author(s):  
Athens Center Of Ekistics
Keyword(s):  
Low Income ◽  
Large Scale ◽  
Decision Makers ◽  
Human Settlements ◽  
Full Spectrum ◽  
Middle Income ◽  
Theoretical Concepts ◽  
Middle Income Countries ◽  
Wide Range ◽  
Complex Phenomena

The authors of the papers in all three double issues of volume 70 of Ekistics, coming from the broad fields of Geography, History and a wide range of social sciences in general, refer to Society. They focus on Anthropos - Jean Gottmann - and his life-long contribution, through concrete theoretical concepts, to the understanding of the nature and dynamics of urbanization, as well as the structure, function and evolution of Human Settlements Systems. They interpret these principles and emphasize their validity in large-scale Human Settlements - from Metropolis through Megalopolis to Eperopolis - mainly in high- and middle-income countries (less in low-income ones). They demonstrate the relevance of Gottmann's concepts in explaining current global complex phenomena of a social, political and cultural nature. They also identify a set of urgent desirable priority themes for further research, ranging from the clarification of epistemological issues among disciplines to defining ways for expanding the relevance of these principles to the full spectrum of Human Settlements, and bringing them to an explicitly operational level for use by decision makers.

scholarly journals Awareness and Practice on Postpartum Family Planning among Postpartum Mothers attending on Maternal and Child Health Clinic

2020 ◽  
Vol 16 (2) ◽  
pp. 88-92
Author(s):  
Sarita Shrestha ◽  
Radha Poudel ◽  
Jenny Napit
Keyword(s):  
Family Planning ◽  
Data Collection ◽  
Planning Method ◽  
Family Planning Method ◽  
Health Clinic ◽  
Morbidity Rate ◽  
Mortality And Morbidity ◽  
Unintended Pregnancies ◽  
Postpartum Family Planning ◽  
Postpartum Mothers

Background: Women in the postpartum period need effective contraceptives to prevent unintended pregnancies soon after child birth. This helps to promote the mother health as well as to reduce the child mortality and morbidity rate. The objective of study was to find out the awareness and practice regarding postpartum family planning among postpartum mothers. Methods: A descriptive study design was carried among 241 postpartum mothers having under6monthsage child came for vaccination at Sunaulo Bhabisya Nepal, Chitwan. Postpartum mothers were selected using purposive sampling technique. All the postpartum mothers were interviewed through semi structured questionnaire for data collection. Data collection was done from17th December 2019 to 14th January 2020. Data was analyzed by using descriptive statistics with the help of Statistical Package for Social Science (SPSS) version 20. Results: The findings of the study revealed that the mean age of the mothers was 25.36 years. Regarding the awareness on postpartum family planning,most of the mothers had below average (39%) and average (36.9%) level of awareness. Whereas few (24.1%) had above average level of awareness. More than one third of mothers (37.8%) were used family planning method. Conclusions: The study concluded that only few postpartum mothers had above average awareness. Practice of family planning method was low. Therefore it is recommended that routine counseling on postpartum family planning (PPFP) among antenatal and postnatal mother in health institute should be done. Keywords: awareness; practice; postpartum family planning.  

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