scholarly journals Improving the global diagnosis and management of asthma in children

Thorax ◽  
2018 ◽  
Vol 73 (7) ◽  
pp. 662-669 ◽  
Author(s):  
Warren Lenney ◽  
Andrew Bush ◽  
Dominic A Fitzgerald ◽  
Monica Fletcher ◽  
Anders Ostrem ◽  
...  
Keyword(s):  
School Attendance ◽  
Substantial Improvement ◽  
Optimal Care ◽  
Middle Income ◽  
Diagnosis And Management ◽  
Middle Income Countries ◽  
New Thinking ◽  
Specific Barriers ◽  
Selection Of

Asthma is the most common chronic condition in children worldwide. It affects daytime activities, sleep and school attendance and causes anxiety to parents, families and other carers. The quality of asthma diagnosis and management globally still needs substantial improvement. From infancy to the teenage years, there are age-specific challenges, including both underdiagnosis and overdiagnosis with stigma-related barriers to treatment in some cultures and in adolescents. Guidelines are increasingly evidence based, but their impact on improving outcomes has been negligible in many parts of the world, often due to lack of implementation. New thinking is needed to enable substantial improvements in outcomes. The disease varies globally and plans will need to differ for individual countries or places where region-specific barriers prevent optimal care. A wide selection of educational activities is needed, including community-targeted initiatives, to engage with families. The Paediatric Asthma Project Plan has been initiated to strengthen diagnosis and management of asthma. This encompasses a vision for the next 10–15 years, building on the knowledge and experience from previous educational projects. It will take into account the educational needs of patients, carers and healthcare professionals as well as the accessibility and affordability of medication, particularly in low and middle-income countries where the prevalence of asthma is rising more rapidly. This overview presents a first step for those involved in the diagnosis and management of childhood asthma to strengthen care for children globally.

scholarly journals Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review

2021 ◽  
Vol 6 (2) ◽  
pp. e004213
Author(s):  
Grace McCutchan ◽  
Bahr Weiss ◽  
Harriet Quinn-Scoggins ◽  
Anh Dao ◽  
Tom Downs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Cancer Treatment ◽  
Help Seeking ◽  
Middle Income ◽  
Cancer Symptoms ◽  
Middle Income Countries ◽  
Help Seeking Behaviour ◽  
Psychosocial Influences

IntroductionStarting cancer treatment early can improve outcomes. Psychosocial factors influencing patients’ medical help-seeking decisions may be particularly important in low and lower middle-income countries (LMIC) where cancer outcomes are poor. Comprehensive review evidence is needed to understand the psychosocial influences on medical help-seeking for cancer symptoms, attendance for diagnosis and starting cancer treatment.MethodsMixed-methods systematic review registered on PROSPERO (CRD42018099057). Peer-reviewed databases were searched until April 2020 for studies assessing patient-related barriers and facilitators to medical help-seeking for cancer symptoms, diagnosis and treatment in adults (18+ years) living in LMICs. Quality of included studies was assessed using the Critical Appraisal Skills Programme tool. Data were synthesised using meta-analytic techniques, meta-ethnography or narrative synthesis as appropriate.ResultsOf 3963 studies identified, 64 were included. In quantitative studies, use of traditional, complementary and alternative medicine (TCAM) was associated with 3.60 higher odds of prolonged medical help-seeking (95% CI 2.06 to 5.14). Qualitative studies suggested that use of TCAM was a key barrier to medical help-seeking in LMICs, and was influenced by causal beliefs, cultural norms and a preference to avoid biomedical treatment. Women face particular barriers, such as needing family permission for help-seeking, and higher stigma for cancer treatment. Additional psychosocial barriers included: shame and stigma associated with cancer such as fear of social rejection (eg, divorce/disownment); limited knowledge of cancer and associated symptoms; and financial and access barriers associated with travel and appointments.ConclusionDue to variable quality of studies, future evaluations would benefit from using validated measures and robust study designs. The use of TCAM and gender influences appear to be important barriers to help-seeking in LMIC. Cancer awareness campaigns developed with LMIC communities need to address cultural influences on medical help-seeking behaviour.

Social Support and Quality of Life Among People Living With HIV/AIDS (PLWHA) in Ghana

2021 ◽  
pp. 0192513X2110300
Author(s):  
Charles MS. Birore ◽  
Liyun Wu ◽  
Tina Abrefa-Gyan ◽  
Marilyn W. Lewis
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
People Living With Hiv ◽  
Middle Income ◽  
Middle Income Countries ◽  
Living With Hiv ◽  
Hiv Aids

Utilization of antiretroviral therapies (ART) prolongs life and heightens ability to engage in productive activities among people living with human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS). This study implemented a 6-week long Social Care Intervention (SCI) Program in Ghana and identified protective factors associated with Quality of Life (QoL) among people living with HIV/AIDS (PLWHA). We discovered that SCI model in the form of social support associated positively with differences in the QoL among PLWHA. Logistic regression revealed that social support, especially affectionate support, was positively associated with a higher level of QoL. People who were older and healthier tended to have higher levels of QoL compared with their counterparts who were younger and sicker. These findings suggest that building social support system can serve as an empowerment approach to promote quality of life among PLWHA in low- and middle-income countries (LMICs) where resources are limited.

scholarly journals Understanding How Incentives Influence Motivation and Retention of Health Workers

2012 ◽  
pp. 1148-1163
Author(s):  
Posy Bidwell ◽  
Stephen Thomas ◽  
Silvia Stringhini
Keyword(s):  
Human Resources ◽  
Financial Incentives ◽  
Health Workers ◽  
Critical Factor ◽  
Research Needs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Professional Ethos ◽  
Human Resources Strategies

A critical factor in addressing the human resources crisis in low and middle income countries (LMIC) is the ability to recruit, motivate, and retain health workers. Failure in this area is one of the main causes of decline in availability of services and quality of care. Various financial and non-financial incentives have been implemented and this chapter will explore available evidence to see whether they have influenced motivation. Additionally, Maslow’s hierarchy of needs is used to determine if there is a hierarchy of how incentives are valued. While Maslow’s model is a useful tool to classify themes of health worker needs, it would appear that workers are motivated without each level having to be fulfilled in turn. While financial incentives may help with retention, they can cause erosion of professional ethos, do not increase job satisfaction, or act as motivators to perform well. More research needs to be done in order to design more effective human resources strategies.

scholarly journals Global AgeWatch Index and Insights

2020 ◽  
Author(s):  
Gibran Cruz-Martinez ◽  
Gokce Cerev
Keyword(s):  
Older People ◽  
Composite Index ◽  
Quality Data ◽  
Transformative Change ◽  
Middle Income ◽  
Middle Income Countries ◽  
Good Quality Data ◽  
Low And Middle Income

Global AgeWatch Index and Insights by HelpAge International aim to contribute to achievement of long-term transformative change in respect to ageing and the lives of older people by advocating for better production of timely and good quality data to inform policy and program response.The Global AgeWatch Index is a composite index that measures quality of life of older people, and ranks countries based on four domains – income security, health status, enabling environment and capability. The index was developed in partnership with Professor Asghar Zaidi. The index was published during 2013-2015.The Global AgeWatch Insights is a research-based advocacy tool that examines situation of older people in low- and middle-income countries, assesses availability of relevant data and evidence to support the analysis, and identification of policy actions. The Insights are produced in partnership with AARP. The reports were launched in 2018 are planned to be released every three years with a different thematic focus. The first report focuses on the inequities of the health systems in twelve low- and middle-income countries.

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