scholarly journals Availability of population-level data sources for tracking the incidence of deaths and injuries from road traffic crashes in low-income and middle-income countries

2021 ◽  
Vol 6 (11) ◽  
pp. e007296
Author(s):  
Sudeshna Mitra ◽  
Kazuyuki Neki ◽  
Leah Watetu Mbugua ◽  
Hialy Gutierrez ◽  
Leen Bakdash ◽  
...  
Keyword(s):  
Low Income ◽  
Road Traffic ◽  
Information Source ◽  
Data Sources ◽  
Health Measurement ◽  
Official Statistics ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Fatal Injuries

IntroductionTracking progress towards Sustainable Development Goal (SDG) 3·6 of reducing traffic deaths and serious injuries poses a measurement challenge in most low-income and middle-income countries (LMICs) due to large discrepancies between reported official statistics and estimates from global health measurement studies. We assess the extent to which national population censuses and health surveys can fill the information gaps.MethodsWe reviewed questionnaires for nationally representative surveys and censuses conducted since 2000 in LMICs. We identified sources that provide estimates of household ownership of vehicles, incidence of traffic deaths and non-fatal injuries, and prevalence of disability.ResultsWe identified 802 data sources from 132 LMICs. Sub-Saharan African countries accounted for 43% of all measurements. The number of measurements since 2000 was high, with 97% of the current global LMIC population having at least one measurement for vehicle ownership, 77% for deaths, 90% for non-fatal injuries and 50% for disability due to traffic injuries. Recent data (since 2010) on traffic injuries were available from far fewer countries (deaths: 21 countries; non-fatal injuries: 62 and disability: 12). However, there were many more countries with recent data on less-specific questions about unintentional or all injuries (deaths: 41 countries, non-fatal: 87, disability: 32).ConclusionTraffic injuries are substantially underreported in official statistics of most LMICs. National surveys and censuses provide a viable alternative information source, but despite a large increase in their use to monitor SDGs, traffic injury measurements have not increased. We show that relatively small modifications and additions to questions in forthcoming surveys can provide countries with a way to benchmark their existing surveillance systems and result in a substantial increase in data for tracking road traffic injuries globally.

scholarly journals Foreign aid on economic growth in Africa: A comparison of low and middle-income countries

2015 ◽  
Vol 18 (4) ◽  
pp. 449-462 ◽  
Author(s):  
Aye Mengistu Alemu ◽  
Jin-Sang Lee
Keyword(s):  
Economic Growth ◽  
Foreign Aid ◽  
Low Income ◽  
Empirical Studies ◽  
Critical Role ◽  
Generalized Method Of Moments ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Theoretical Hypothesis

Previous empirical studies on the effects of foreign aid on economic growth have generated mixed results that make it difficult to draw policy recommendations. The main reason for such mixed results is the choice of a single aggregate list of countries, regardless of the disparities in levels of development. This study therefore fills the development gap by disaggregating the African data into a panel of 20 middle- income and 19 low- income African countries over a period of 15 years between 1995 and 2010, and employing a dynamic generalized method of moments (GMM) model to address the dynamic nature of economic growth as well as the problems of endogeneity. The results of this study support the theoretical hypothesis that a positive relationship between aid and GDP growth exists, but only for low-income African countries, not middle-income ones. On the other hand, the study reveals that middle- income African countries tend to experience a greater impact on their economic growth from foreign direct investment (FDI) and natural resources revenues, mainly oil exports. This implies that the frequent criticism that foreign aid has not contributed to economic growth is flawed, at least in the case of low-income African countries. In fact, foreign aid has played a critical role in stimulating economic growth in such countries through supplementing domestic sources of finance such as savings, thus increasing the amount of investment and capital stock in them.

P1586Research network in Africa (RNA): antihypertensive drugs strategies in 12 African countries

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kane ◽  
P Cavagna ◽  
I B Diop ◽  
B Gaye ◽  
J B Mipinda ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Low Income ◽  
Democratic Republic ◽  
Antihypertensive Drugs ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Sub Saharan

Abstract Background High Blood Pressure is the worldwide leading global burden of disease risk factor. In Sub-Saharan Africa, the number of adults with raised blood pressure has alarmingly increased from 0.59 to 1.13 billion between 1975 and 2015. Blood pressure-lowering medicines are cornerstone of cardiovascular risk reduction. Data on management of anti-hypertensive drugs in sub-Saharan Africa are squarce. Purpose Our study aims to describe antihypertensive drugs strategies in Africa. Methods We conducted a cross-sectional survey in urban clinics during outpatient consultation specialized in hypertension cardiology departments of 29 medical centers from 17 cities across 12 African countries (Benin, Cameroon, Congo, Democratic Republic of Congo, Gabon, Guinea, Ivory Coast, Mauritania, Mozambic, Niger, Senegal, Togo). Data were collected on demographics, treatment and standardized BP measures were made among the hypertensive patients attending the clinics. Country income was retrieved from the World Bank database. All analyses were performed through scripts developed in the R software (3.4.1 (2017–06–30)). Results A total of 2198 hypertensive patients (58.4±11.8 years; 39.9% male) were included. Among whom 2123 (96.6%) had at least one antihypertensive drug. Overall, 30.8% (n=653) received monotherapy and calcium-channel blockers (49.6%) were the most common monotherapy prescribed follow by diuretics (18.7%). Two-drug strategies were prescribed for 927 patients (43.6%). Diuretics and Angiotensin-converting enzyme inhibitors was the combination most frequently prescribed (33.7%). Combination of three drugs or more was used in 25.6% (n=543) of patients. The proportion of drugs strategies differed significantly according to countries (p<0.001), monotherapy ranged from 12.7% in Niger to 47.1% in Democratic Republic of the Congo (figure). Furthermore we observed a significantly difference of strategies between low and middle income countries (55.3% and 44.7% of monotherapy respectively) (p<0.001). According to hypertension grades 1, 2 and 3, the proportion of three-drugs or more combination was 25%, 28% and 34% in middle-income and lower in low-income countries (18%, 19% and 25%). Furthermore, Grade 3 hypertension in low income countries was still treated with monotherapy (36%) instead of 19% in middle income countries (p<0.01). Antihypertensive strategies by country Conclusion Our study described antihypertensive drugs use across 12 sub-Saharan countries, and identified disparities specific to the income context. Inequity in access to drugs combination is a serious barrier to tackle the burden of hypertension in Africa.

scholarly journals Establishment of a road traffic trauma registry for northern Sri Lanka

2020 ◽  
Vol 5 (1) ◽  
pp. e001818 ◽  
Author(s):  
Thayasivam Gobyshanger ◽  
Alison M Bales ◽  
Claire Hardman ◽  
Mary McCarthy
Keyword(s):  
Sri Lanka ◽  
Low Income ◽  
Trauma Registry ◽  
Road Traffic ◽  
Prehospital Care ◽  
Public Health Problem ◽  
Global Public Health ◽  
Middle Income ◽  
Road Traffic Crashes ◽  
Middle Income Countries

Road traffic injuries are a neglected global public health problem. Over 1.25 million people are killed each year, and middle-income countries, which are motorising rapidly, are the hardest hit. Sri Lanka is dealing with an injury-related healthcare crisis, with a recent 85% increase in road traffic fatality rates. Road traffic crashes now account for 25 000 injuries annually and 10 deaths daily. Development of a trauma registry is the foundation for injury control, care and prevention. Five northern Sri Lankan provinces collaborated with Jaffna Teaching Hospital to develop a local electronic registry. The Centre for Clinical Excellence and Research was established to provide organisational leadership, hardware and software were purchased, and data collectors trained. Initial data collection was modified after implementation challenges were resolved. Between 1 June 2017 and 30 September 2017, 1708 injured patients were entered into the registry. Among these patients, 62% were male, 76% were aged 21–50, 71.3% were motorcyclists and 34% were in a collision with another motorcyclist. There were frequent collisions with uncontrolled livestock (12%) and with fixed objects (14%), and most patients were transported by private vehicles without prehospital care. Head (n=315) and lower extremity (n=497) injuries predominated. Establishment of a trauma registry in low-income and middle-income countries is a significant challenge and requires invested local leadership; the most challenging issue is ongoing funding. However, this pilot registry provides a valuable foundation, identifying unique injury mechanisms, establishing priorities for prevention and patient care, and introducing the concept of an organised system to this region.

scholarly journals Global trends in adolescents’ road traffic injury mortality, 1990–2019

2021 ◽  
pp. archdischild-2020-319184
Author(s):  
Uzma Rahim Khan ◽  
Junaid A Razzak ◽  
Martin Gerdin Wärnberg
Keyword(s):  
Low Income ◽  
Road Traffic ◽  
Mortality Rates ◽  
Road Traffic Injury ◽  
Low Income Countries ◽  
Middle Income ◽  
Income Levels ◽  
Middle Income Countries ◽  
Traffic Injury ◽  
Road Users

ObjectiveThe aim of this study was to determine the trends of road traffic injury (RTI) mortality among adolescents aged 10–14 years and 15–19 years across different country income levels with respect to the type of road users from 1990 to 2019.MethodsWe conducted an ecological study. Adolescents’ mortality rates from RTIs at the level of high-income countries (HICs), upper-income to middle-income countries (UMICs), lower-income to middle-income countries and low-income countries were extracted from the Global Burden of Disease study. Time series were plotted to visualise the trends in mortality rates over the years. We also conducted Poisson regression using road traffic mortality rates as the dependent variable and year as the independent variable to model the trend of the change in the annual mean mortality rate, with incidence rate ratios (IRRs) and 95% CIs.ResultsThere were downward mortality trends in all types of road users and income levels among adolescents from 1990 to 2019. HICs had more pronounced reductions in mortality rates than countries of any other income level. For example, the reduction in pedestrians in HICs was IRR 0.94 (95% CI 0.90 to 0.98), while that in UMICs was IRR 0.97 (95% CI 0.95 to 0.99) in adolescents aged 10-14 years.ConclusionsThere are downward trends in RTI mortality in adolescents from 1990 to 2019 globally at all income levels for all types of road users. The decrease in mortality rates is small but a promising finding. However, prevention efforts should be continued as the burden is still high.

scholarly journals Current realities versus theoretical optima: quantifying efficiency and sociospatial equity of travel time to hospitals in low-income and middle-income countries

2019 ◽  
Vol 4 (4) ◽  
pp. e001552 ◽  
Author(s):  
Kerry LM Wong ◽  
Oliver J Brady ◽  
Oona Maeve Renee Campbell ◽  
Christopher I Jarvis ◽  
Andrea Pembe ◽  
...  
Keyword(s):  
Current Efficiency ◽  
Travel Time ◽  
Low Income ◽  
Urban Areas ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Average Travel Time ◽  
Sub Saharan ◽  
Aid Decision

BackgroundHaving hospitals located in urban areas where people, resources and wealth concentrate is efficient, but leaves long travel times for the rural and often poorer population and goes against the equity objective. We aimed to assess the current efficiency (mean travel time in the whole population) and equity (difference in travel time between the poorest and least poor deciles) of hospital care provision in four sub-Saharan African countries, and to compare them against their theoretical optima.MethodsWe overlaid the locations of 480, 115, 3787 and 256 hospitals in Kenya, Malawi, Nigeria and Tanzania, respectively, with high-resolution maps of travel time, population and wealth to estimate current efficiency and equity. To identify the potential optima, we simulated 7500 sets of hospitals locations based on various population and wealth weightings and percentage reallocations for each country.ResultsThe average travel time ranged from 38 to 79 min across countries, and the respective optima were mildly shorter (<15%). The observed equity gaps were wider than their optima. Compared with the best case scenarios, differences in the equity gaps varied from 7% in Tanzania to 77% in Nigeria. In Kenya, Malawi and Tanzania, narrower equity gaps without increasing average travel time were seen from simulations that held 75%–90% of hospitals at their current locations.InterpretationsCurrent hospital distribution in the four sub-Saharan African countries could be considered efficient. Simultaneous gains in efficiency and equity do not necessarily require a fundamental redesign of the healthcare system. Our analytical approach is readily extendible to aid decision support in adding and upgrading existing hospitals.

Prehospital epidemiology and management of injured children in Kigali, Rwanda

2020 ◽  
Vol 37 (3) ◽  
pp. 146-150 ◽  
Author(s):  
Myles Dworkin ◽  
Vizir Nsengimana ◽  
Ashley Rosenberg ◽  
John Scott ◽  
Robert Riviello ◽  
...  
Keyword(s):  
Low Income ◽  
Road Traffic ◽  
Descriptive Analysis ◽  
Traffic Incidents ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pain Medications ◽  
Prehospital Management ◽  
Common Causes ◽  
The Impact

IntroductionPaediatric injuries are a major cause of mortality and disability worldwide, yet little information exists regarding its epidemiology or prehospital management in low-income and middle-income countries. We aimed to describe the paediatric injuries seen and managed by the prehospital ambulance service, Service d’Aide Medicale d’Urgence (SAMU), in Kigali, Rwanda over more than 3 years.MethodsA retrospective, descriptive analysis was conducted of all injured children managed by SAMU in the prehospital setting between December 2012 and April 2016.ResultsSAMU responded to a total of 636 injured children, 10% of all patients seen. The incidence of paediatric injury in Kigali, Rwanda was 140 injuries per 100 000 children. 65% were male and the average age 13.5 (±5.3). Most patients were between 15 and 19 years old (56%). The most common causes of injuries were road traffic incidents (RTIs) (447, 72%), falls (70, 11%) and assaults (50, 8%). Most RTIs involved pedestrians (251, 56%), while 15% (65) involved a bicycle. Anatomical injuries included trauma to the head (330, 52%), lower limb (280, 44%) and upper limb (179, 28%). Common interventions included provision of pain medications (445, 70%), intravenous fluids (217, 34%) and stabilisation with cervical collar (190, 30%).ConclusionIn Kigali, RTIs were the most frequent cause of injuries to children requiring prehospital response with most RTIs involving pedestrians. Rwanda has recently instituted several programmes to reduce the impact of paediatric injuries especially with regard to RTIs. These include changes in traffic laws and increased road safety initiatives.

scholarly journals Beyond the metrics of health research performance in African countries

2021 ◽  
Vol 6 (7) ◽  
pp. e006019
Author(s):  
Rhona Mijumbi-Deve ◽  
Justin Parkhurst ◽  
Catherine Jones ◽  
Pamela A Juma ◽  
Joelle L Sobngwi-Tambekou ◽  
...  
Keyword(s):  
Low Income ◽  
Health Research ◽  
Research Performance ◽  
Learning Activities ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Partial Data ◽  
Health Community ◽  
And Performance

While it is important to be able to evaluate and measure a country’s performance in health research (HR), HR systems are complex and multifaceted in nature. As such, attempts at measurement can suffer several limitations which risk leading to inadequate indices or representations. In this study, we critically review common indicators of HR capacity and performance and explore their strengths and limitations. The paper is informed by review of data sources and documents, combined with interviews and peer-to-peer learning activities conducted with officials working in health and education ministries in a set of nine African countries. We find that many metrics that can assess HR performance have gaps in the conceptualisation or fail to address local contextual realities, which makes it a challenge to interpret them in relation to other theoretical constructs. Our study identified several concepts that are excluded from current definitions of indicators and systems of metrics for HR performance. These omissions may be particularly important for interpreting HR performance within the context and processes of HR in African countries, and thus challenging the relevance, utility, appropriateness and acceptability of universal measures of HR in the region. We discuss the challenges that scholars may find in conceptualising such a complex phenomenon—including the different and competing viewpoints of stakeholders, in setting objectives of HR measurement work, and in navigating the realities of empirical measurement where missing or partial data may necessitate that proxies or alternative indicators may be chosen. These findings are important to ensure that the global health community does not rely on over-simplistic evaluations of HR when analysing and planning for improvements in low-income and middle-income countries.

scholarly journals Where there is no local author: a network bibliometric analysis of authorship parasitism among research conducted in sub-Saharan Africa

2021 ◽  
Vol 6 (10) ◽  
pp. e006982
Author(s):  
Chris A Rees ◽  
Mohsin Ali ◽  
Rodrick Kisenge ◽  
Readon C Ideh ◽  
Stephanie J Sirna ◽  
...  
Keyword(s):  
Low Income ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Sao Tome And Principe ◽  
Funding Agencies ◽  
Choropleth Maps ◽  
Bibliometric Review ◽  
Sub Saharan

IntroductionAuthorship parasitism (ie, no authors affiliated with the country in which the study took place) occurs frequently in research conducted in low-income and middle-income countries, despite published recommendations defining authorship criteria. The objective was to compare characteristics of articles exhibiting authorship parasitism in sub-Saharan Africa to articles with author representation from sub-Saharan African countries.MethodsA bibliometric review of articles indexed in PubMed published from January 2014 through December 2018 reporting research conducted in sub-Saharan Africa was performed. Author affiliations were assigned to countries based on regular expression algorithms. Choropleth maps and network diagrams were created to determine where authorship parasitism occurred, and multivariable logistic regression was used to determine associated factors.ResultsOf 32 061 articles, 14.8% (n=4754) demonstrated authorship parasitism, which was most common among studies from Somalia (n=175/233, 75.1%) and Sao Tome and Principe (n=20/28, 71.4%). Authors affiliated with USA and UK institutions were most commonly involved in articles exhibiting authorship parasitism. Authorship parasitism was more common in articles: published in North American journals (adjusted OR (aOR) 1.26, 95% CI 1.07 to 1.50) than in sub-Saharan African journals, reporting work from multiple sub-Saharan African countries (aOR 8.41, 95% CI 7.30 to 9.68) compared with work from upper-middle income sub-Saharan African countries, with <5 authors (aOR 14.46, 95% CI 12.81 to 16.35) than >10 authors, and was less common in articles published in French (aOR 0.60, 95% CI 0.41 to 0.85) than English.ConclusionsAuthorship parasitism was common in articles reporting research conducted in sub-Saharan Africa. There were reliable predictors of authorship parasitism. Investigators and institutions in high-income countries, as well as funding agencies and journals should promote research from sub-Saharan Africa, including its publication, in a collaborative and equitable manner.

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