scholarly journals Predictors of Delayed Entry into Medical Care of Children Diagnosed with HIV Infection: Data from an HIV Cohort Study in India

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Gerardo Alvarez-Uria ◽  
Praveen Kumar Naik ◽  
Manoranjan Midde ◽  
Raghavakalyan Pakam
Keyword(s):  
Cohort Study ◽  
Medical Care ◽  
Female Gender ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Middle Income ◽  
Delayed Entry ◽  
Middle Income Countries ◽  
Scheduled Castes ◽  
One Year

Data about the attrition before entry into care of children diagnosed with HIV in low- or middle-income countries are scarce. The aim of this study is to describe the attrition before engagement in HIV medical care in 523 children who were diagnosed with HIV from 2007 to 2012 in a cohort study in India. The cumulative incidence of children who entered into care was 87.2% at one year, but most children who did not enter into care within one year were lost to followup. The mortality before entry into care was low (1.3% at one year) and concentrated during the first three months after HIV diagnosis. Factors associated with delayed entry into care were being diagnosed after mother’s HIV diagnosis, belonging to scheduled castes, age <18 months, female gender, and living >90 minutes from the HIV centre. Children whose parents were alive and were living in a rented house were at a higher risk of delayed entry into care than those who were living in an owned house. The results of this study can be used to improve the linkage between HIV testing and HIV care of children diagnosed with HIV in India.

Chasing Informality: Evidence from Increasing Enforcement in Large Firms in Peru

2021 ◽  
Author(s):  
Mariano Bosch ◽  
Stephanie González ◽  
María Teresa Silva Porto
Keyword(s):  
Social Security ◽  
Social Insurance ◽  
Large Firms ◽  
Middle Income ◽  
Labor Control ◽  
Middle Income Countries ◽  
Self Employment ◽  
One Year ◽  
Labor Market Regulations ◽  
Proactive Monitoring

Evasion of labor market regulations in middle income countries is systemic. This is generally known as informality. In Latin America, where less than 50% of workers are registered with social security, this is a permanent phenomenon and encompasses a variety of economic realities ranging from subsistence self-employment to evasion of certain regulations including social security contributions. In this study we analyze the role of enforcement in curbing informality in large formal firms in Peru, where informality levels are around 70%. Through the Peruvian National Labor Control Superintendence (SUNAFIL) we randomly sent 697 letters to formal Peruvian firms of more than 50 workers, indicating their obligation to enroll workers in social insurance systems (health and pensions). Two types of letters were sent, one with a deterrence message and one emphasizing the benefits of formalization. One year after the letters were sent, we found a positive and statistically significant effect on the number of workers enrolled in social security (9.8% on average). Only strict deterrence messages had a significant impact, and only in very large firms. This evidence suggests that there is room for improvement in compliance with labor regulations through more proactive monitoring and behavioral tools such as reminders, but effects could be concentrated in the largest firms.

Health service costs and their association with functional impairment among adults receiving integrated mental health care in five low- and middle-income countries: the PRIME cohort study

2020 ◽  
Vol 35 (5) ◽  
pp. 567-576 ◽  
Author(s):  
Dan Chisholm ◽  
Emily Garman ◽  
Erica Breuer ◽  
Abebaw Fekadu ◽  
Charlotte Hanlon ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Health Care ◽  
Cohort Study ◽  
Health Service ◽  
Mental Health Care ◽  
Functional Impairment ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Service Costs

Abstract This study examines the level and distribution of service costs—and their association with functional impairment at baseline and over time—for persons with mental disorder receiving integrated primary mental health care. The study was conducted over a 12-month follow-up period in five low- and middle-income countries participating in the Programme for Improving Mental health carE study (Ethiopia, India, Nepal, South Africa and Uganda). Data were drawn from a multi-country intervention cohort study, made up of adults identified by primary care providers as having alcohol use disorders, depression, psychosis and, in the three low-income countries, epilepsy. Health service, travel and time costs, including any out-of-pocket (OOP) expenditures by households, were calculated (in US dollars for the year 2015) and assessed at baseline as well as prospectively using linear regression for their association with functional impairment. Cohort samples were characterized by low levels of educational attainment (Ethiopia and Uganda) and/or high levels of unemployment (Nepal, South Africa and Uganda). Total health service costs per case for the 3 months preceding baseline assessment averaged more than US$20 in South Africa, $10 in Nepal and US$3–7 in Ethiopia, India and Uganda; OOP expenditures ranged from $2 per case in India to $16 in Ethiopia. Higher service costs and OOP expenditure were found to be associated with greater functional impairment in all five sites, but differences only reached statistical significance in Ethiopia and India for service costs and India and Uganda for OOP expenditure. At the 12-month assessment, following initiation of treatment, service costs and OOP expenditure were found to be lower in Ethiopia, South Africa and Uganda, but higher in India and Nepal. There was a pattern of greater reduction in service costs and OOP spending for those whose functional status had improved in all five sites, but this was only statistically significant in Nepal.

A Framework to Inform Strategies to Improve the HIV Care Continuum in Low- and Middle-Income Countries

2016 ◽  
Vol 28 (4) ◽  
pp. 351-364 ◽  
Author(s):  
Christopher J. Hoffmann ◽  
Tonderai Mabuto ◽  
Kerrigan McCarthy ◽  
Catherine Maulsby ◽  
David R. Holtgrave
Keyword(s):  
Hiv Care ◽  
Hiv Care Continuum ◽  
Middle Income ◽  
Care Continuum ◽  
Middle Income Countries ◽  
Low And Middle Income

What are the costs of violence?

2017 ◽  
Vol 16 (4) ◽  
pp. 422-445 ◽  
Author(s):  
Anke Hoeffler
Keyword(s):  
Domestic Violence ◽  
Interpersonal Violence ◽  
Partner Violence ◽  
Middle Income ◽  
Middle Income Countries ◽  
Use Of Resources ◽  
Global Cost ◽  
One Year ◽  
Effective Use ◽  
The Cost

This article presents estimates of the global cost of collective and interpersonal violence for the period of one year. This includes war, terrorism, homicides, assaults and domestic violence against women and children. The cost of conventionally defined interpersonal violence, that is, homicides and assault, are about 7.5 times higher than the cost due to war and terrorism. I also estimate the costs of non-fatal domestic violence against children and women and suggest that these costs are much higher than the combined costs of homicide, assault, terrorism and war. The main reason is that the prevalence of these types of violence is very high: possibly as many as 16 per cent of all children are punished using violent methods and about 12 per cent of all women experience intimate partner violence. Richer societies have lower levels of violence, and there is evidence that prevalence rates have been declining over time. However, it is often unclear why this is the case. Much of the evidence from violence reducing interventions comes from high-income countries, and it is uncertain whether these programs would be similarly effective in low- and middle-income countries. However, although further research is needed to examine the effectiveness of violence-reducing interventions, it appears likely that some interventions would constitute a very effective use of resources.

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