scholarly journals Gender inequality and the double burden of disease in low-income and middle-income countries: an ecological study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e047388
Author(s):  
Mirte van der Ham ◽  
Renee Bolijn ◽  
Alcira de Vries ◽  
Maiza Campos Ponce ◽  
Irene G M van Valkengoed
Keyword(s):  
Gender Inequality ◽  
Low Income ◽  
Burden Of Disease ◽  
Ecological Study ◽  
Positive Association ◽  
Political Stability ◽  
Double Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
Life Years

IntroductionMany low-income and middle-income countries (LMIC) suffer from a double burden of infectious diseases (ID) and non-communicable diseases (NCD). Previous research suggests that a high rate of gender inequality is associated with a higher ID and NCD burden in LMIC, but it is unknown whether gender inequality is also associated with a double burden of disease. In this ecological study, we explored the association between gender inequality and the double burden of disease in LMIC.MethodsFor 108 LMIC, we retrieved the Gender Inequality Index (GII, scale 0–1) and calculated the double burden of disease, based on disability-adjusted life-years for a selection of relevant ID and NCD, using WHO data. We performed logistic regression analysis to study the association between gender inequality and the double burden of disease for the total population, and stratified for men and women. We adjusted for income, political stability, type of labour, urbanisation, government health expenditure, health infrastructure and unemployment. Additionally, we conducted linear regression models for the ID and NCD separately.ResultsThe GII ranged from 0.13 to 0.83. A total of 37 LMIC had a double burden of disease. Overall, the adjusted OR for double burden of disease was 1.05 per 0.01 increase of GII (95% CI 0.99 to 1.10, p=0.10). For women, there was a borderline significant positive association between gender inequality and double burden of disease (OR 1.05, 95% CI 1.00 to 1.11, p=0.06), while there was no association in men (OR 0.99, 95% CI 0.95 to 1.04, p=0.75).ConclusionWe found patterns directing towards a positive association between gender inequality and double burden of disease, overall and in women. This finding suggests the need for more attention for structural factors underlying gender inequality to potentially reduce the double burden of disease.

Injury prevention and control

2021 ◽  
pp. 361-376
Author(s):  
Corinne Peek-Asa ◽  
Adnan A. Hyder
Keyword(s):  
Injury Prevention ◽  
Low Income ◽  
Prevention And Control ◽  
Low Income Countries ◽  
Middle Income ◽  
Injury Rates ◽  
Middle Income Countries ◽  
Disability Adjusted Life ◽  
Life Years ◽  
And Control

Injuries are among the leading causes of death and disability throughout the world and contribute disproportionately to premature life lost. Injury rates are highest among middle- and low-income countries. According to analyses of the 2016 Global Burden of Disease data, injuries cause over 4.6 million deaths per year, accounting for nearly 8.4% of all deaths and 10.7% of disability-adjusted life years. Many opportunities to implement injury prevention strategies exist, and a systematic approach to injury prevention can help identify the most effective and efficient approaches. Building capacity for injury prevention activities in low- and middle-income countries is an important public health priority.

scholarly journals Examining the double burden of malnutrition for preschool children and women of reproductive age in low-income and middle-income countries: a scoping review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e054673
Author(s):  
Jason Mulimba Were ◽  
Saverio Stranges ◽  
Ishor Sharma ◽  
Juan Camilo Vargas-Gonzalez ◽  
M. Karen Campbell
Keyword(s):  
Preschool Children ◽  
Scoping Review ◽  
Low Income ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Double Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
Scoping Reviews ◽  
Double Burden Of Malnutrition

IntroductionThe majority of the populations in low-income and middle-income countries (LMICs) are encountering the double burden of malnutrition (DBM): the coexistence of both undernutrition and overnutrition sequalae. With DBM being a new phenomenon in research, little is known about its aetiology, operational definitions and risk factors influencing its manifestation. The proposed scoping review is aimed at mapping literature with regard to the DBM phenomenon among preschool children and women of reproductive age in LMICs who are among the most high-risk groups to encounter DBM.MethodsA comprehensive literature search will be conducted in the following electronic databases: MEDLINE, EMBASE, Scopus, CINAHL, LILACS and ProQuest Dissertations and Thesis Global. Additionally, searches in other government and institutional sources (WHO website and university repositories) and forward and backward citation tracking of seminal articles will also be done. Two reviewers will independently conduct title and abstract screening and full-text screening. Similarly, data extraction and coding will independently be done by two reviewers. Information extracted from included literature will be analysed qualitatively using thematic analysis approach and reported as per the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.Ethics and disseminationEthical approval is not required for this study because the review is based on literature from publicly available sources. The dissemination of our findings will be done through presentations in relevant conferences and publication in a peer-reviewed journal.

scholarly journals Global Disparities Between Pediatric Publications and Disease Burden From 2006 to 2015

2019 ◽  
Vol 6 ◽  
pp. 2333794X1983129 ◽  
Author(s):  
Elizabeth M. Keating ◽  
Heather Haq ◽  
Chris A. Rees ◽  
Kirk A. Dearden ◽  
Samuel A. Luboga ◽  
...  
Keyword(s):  
Burden Of Disease ◽  
Disease Burden ◽  
Rank Order ◽  
Original Research ◽  
Middle Income ◽  
Childhood Disease ◽  
Middle Income Countries ◽  
Funding Sources ◽  
Disability Adjusted Life ◽  
Life Years

There is a disproportionate burden of pediatric disease in low- and middle-income countries (LMICs); however, the proportion and relation of published articles to childhood disease burden in LMICs have not been assessed previously. This study aimed to determine whether published articles and disease topics from research conducted in LMICs in the most widely cited pediatric journals reflected the global burden of childhood disease. We reviewed all articles published from 2006 to 2015 in the 3 pediatric journals with the highest Eigenfactor scores to identify studies conducted in the World Bank–designated LMICs. We abstracted study topic, design, purpose, country, and funding sources. We derived descriptive statistics, Fisher’s exact χ2 test, Monte Carlo estimates, and Spearman’s rank order coefficients. Of the 19 676 articles reviewed, 10 494 were original research articles. Of those, 965 (9.2%) were conducted in LMICs. Over the study period, the proportion of published articles originating from LMICs increased ( r2 = 0.77). Disease topics did not reflect the underlying burden of disease as measured in disability-adjusted life years (Spearman’s rank order coefficient = 0.25). Despite bearing the majority of the world’s burden of disease, articles from LMICs made up a small proportion of all published articles in the 3 pediatric journals with the highest Eigenfactor scores. The number of published articles from LMICs increased over the study period; nevertheless, the topics did not coincide with the burden of disease in LMICs. These discrepancies highlight the need for development of a research agenda to address the diseases that are the greatest threat to the majority of children worldwide.

scholarly journals Role of food aid and assistance in addressing the double burden of malnutrition in Ghana: a qualitative policy analysis

2020 ◽  
pp. bmjnph-2020-000136
Author(s):  
Niisoja M Torto ◽  
Kelly D Brownell
Keyword(s):  
Low Income ◽  
Food Systems ◽  
Overweight And Obesity ◽  
Food Aid ◽  
Double Burden ◽  
Middle Income ◽  
Roles And Responsibilities ◽  
Middle Income Countries ◽  
Double Burden Of Malnutrition

Background and aimsIn many low-income and middle-income countries, the double burden of malnutrition threatens public health and economic progress, urging a re-evaluation of the roles and responsibilities of nutrition actors, both traditional and non-traditional. This study examines the food aid and assistance activities of the United Nations World Food Programme (WFP)—one non-traditional actor in the double burden conversation—and the potential for these activities to reach beyond their traditional mandate on undernutrition to also address overweight and obesity in Ghana.MethodsInformation on WFP activities in Ghana from 2012 up through its planning into 2023 was extracted from 11 WFP planning, operations and evaluation documents. WFP activities were then judged against the WHO’s framework on the determinants of the double burden of malnutrition to determine their potential to address the double burden. Semistructured interviews were also conducted with 17 key informants in the global nutrition landscape to identify challenges that may complicate the role of WFP and other actors in addressing the double burden.ResultsThe analysis demonstrates that WFP activities in Ghana can serve as a platform on which to address the double burden, particularly by targeting the food access, food systems and socioeconomic disadvantage determinants of the double burden. Actors’ uncertainty with what role WFP should play in addressing the double burden, insufficient government attention to malnutrition and poor data on overweight and obesity were identified as potential challenges that complicate addressing the double burden.ConclusionThe findings suggest that integrating WFP as a partner in the effort to address the double burden in Ghana might help amplify progress. To better address the double burden, WFP might prioritise retrofitting existing activities rather than implementing new interventions.

Changing exposures in a changing world: models for reducing the burden of disease

2016 ◽  
Vol 31 (1) ◽  
Author(s):  
William A. Suk ◽  
Sara Mishamandani
Keyword(s):  
Developing Countries ◽  
Burden Of Disease ◽  
Disease Risk ◽  
Global Network ◽  
Noncommunicable Diseases ◽  
Double Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
Global Initiative ◽  
Transfer Of Information

AbstractEnvironmental exposures are changing dramatically in location, intensity, and frequency. Many developing countries are undergoing a transition in which they face the double burden of infectious diseases as well as chronic diseases. Noncommunicable diseases have emerged as the leading cause of death and disability in developing countries. Globally, pollution is insufficiently appreciated and inadequately quantified as a cause of disease. The health burden from both noninfectious diseases and infectious disease, especially parasites, is high among exposed people. Mothers and children are particularly vulnerable to pollution-related diseases in developing countries. Exposures to pollution can cause protracted noncommunicable diseases across their life span. A global initiative to promote human health sciences and technologies would enhance collaborations and communications amongst investigators and public environmental health officials. Existing models that facilitate the transfer of information and research results exist and can provide insight into building such an international network, allowing better prediction of disease risk and provide ways to reduce exposure to environmental contaminants. A global network would bring together scientists from multiple disciplines and countries to work toward a better understanding of the double burden of disease, especially in low and middle income countries, and promote ways to improve public health.

scholarly journals Socioeconomic Factors Affecting Water Access in Rural Areas of Low and Middle Income Countries

Water ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 202 ◽  
Author(s):  
Mabel Gomez ◽  
Jordi Perdiguero ◽  
Alex Sanz
Keyword(s):  
Socioeconomic Factors ◽  
Low Income ◽  
Rural Areas ◽  
National Income ◽  
Political Stability ◽  
Water Access ◽  
Middle Income ◽  
Middle Income Countries ◽  
Development Goals ◽  
Low And Middle Income

Worldwide, 844 million people still lack access to basic drinking water, especially in the rural areas of low and middle income countries. However, considerable progress has been made in recent years due to work on the Millennium Development Goals and Sustainable Development Goals. Nevertheless, countries’ national characteristics have often impacted on this progress. This paper analyzes whether specific socioeconomic factors affect access to improved water sources in the rural areas of developing countries. In particular, we analyze access to ‘total improved’, piped on premises, as well as other improved sources of access in rural areas for low income, low-middle income, and high-middle income countries. Our results suggest that gross national income (GNI); female primary completion rate; agriculture; growth of rural population; and governance indicators, such as political stability, control of corruption, or regulatory quality are variables related to water access, although specific associations depend on the source of water and income group examined. Understanding these interrelations could be of great importance for decision makers in the water sector as well as for future research on this topic.

scholarly journals Simulating the impact of excise taxation for disease prevention in low-income and middle-income countries: an application to South Africa

2018 ◽  
Vol 3 (1) ◽  
pp. e000568 ◽  
Author(s):  
Nicholas Stacey ◽  
Amit Summan ◽  
Aviva Tugendhaft ◽  
Ramanan Laxminarayan ◽  
Karen Hofman
Keyword(s):  
South Africa ◽  
Population Health ◽  
Low Income ◽  
Uncertainty Interval ◽  
Middle Income ◽  
Excise Tax ◽  
Middle Income Countries ◽  
Excise Taxes ◽  
Life Years ◽  
The Impact

IntroductionExcise taxes are policy tools that have been applied internationally with some success to reduce consumption of products adversely impacting population health including tobacco, alcohol and increasingly junk foods and sugary beverages. As in other low-income and middle-income countries, South Africa faces a growing burden of lifestyle diseases; accordingly we simulate the impact of multiple excise tax interventions in this setting.MethodsWe construct a mathematical model to simulate the health and revenue effects of increased excise taxes, which is adaptable to a variety of settings given its limited data requirements. Applying the model to South Africa, we simulate the impact of increased tax rates on tobacco and beer and of the introduction of a tax on sugar-sweetened beverages (SSB). Drawing on surveys of product usage and risk factor prevalence, the model uses a potential impact fraction to simulate the health effects of tax interventions.ResultsAdopting an excise rate of 60% on tobacco would result in a gain of 858 923 life-years (95% uncertainty interval (UI) 480 188 to 1 310 329), while adopting an excise rate of 25% on beer would result in a gain of 568 063 life-years (95% UI 412 110 to 775 560) and the adoption of a 20% tax on SSBs would result in a gain of 688 719 life-years (95% UI 321 788 to 1 079 653).ConclusionMore aggressive excise tax policies on tobacco, beer and SSBs in South Africa could result in meaningful improvements in population health and raised revenue.

scholarly journals Emergency care surveillance and emergency care registries in low-income and middle-income countries: conceptual challenges and future directions for research

2019 ◽  
Vol 4 (Suppl 6) ◽  
pp. e001442 ◽  
Author(s):  
Hani Mowafi ◽  
Christine Ngaruiya ◽  
Gerard O'Reilly ◽  
Olive Kobusingye ◽  
Vikas Kapil ◽  
...  
Keyword(s):  
Data Collection ◽  
Emergency Care ◽  
Low Income ◽  
Working Group ◽  
Policy Making ◽  
Population Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Disability Adjusted Life ◽  
Life Years

Despite the fact that the 15 leading causes of global deaths and disability-adjusted life years are from conditions amenable to emergency care, and that this burden is highest in low-income and middle-income countries (LMICs), there is a paucity of research on LMIC emergency care to guide policy making, resource allocation and service provision. A literature review of the 550 articles on LMIC emergency care published in the 10-year period from 2007 to 2016 yielded 106 articles for LMIC emergency care surveillance and registry research. Few articles were from established longitudinal surveillance or registries and primarily composed of short-term data collection. Using these articles, a working group was convened by the US National Institutes of Health Fogarty International Center to discuss challenges and potential solutions for established systems to better understand global emergency care in LMICs. The working group focused on potential uses for emergency care surveillance and registry data to improve the quality of services provided to patients. Challenges included a lack of dedicated resources for such research in LMIC settings as well as over-reliance on facility-based data collection without known correlation to the overall burden of emergency conditions in the broader community. The group outlined potential solutions including incorporating data from sources beyond traditional health records, use of standard clinical forms that embed data needed for research and policy making and structured population-based research to establish clear linkages between what is seen in emergency units and the wider community. The group then identified current gaps in LMIC emergency care surveillance and registry research to form a research agenda for the future.

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