scholarly journals Idioms of resilience: Mental health and migration in India

2021 ◽  
pp. 002076402110429
Author(s):  
Raghu Raghavan ◽  
Brian Brown ◽  
Jonathan Coope ◽  
Mark Crossley ◽  
Muthusamy Sivakami ◽  
...  
Keyword(s):  
Lived Experience ◽  
Low Income ◽  
Physical Environment ◽  
Cultural Context ◽  
Idioms Of Distress ◽  
Community Members ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Migration ◽  
The City

Background: Resilience has proved to be a versatile notion to explain why people are not defeated by hardship and adversity, yet so far, we know little of how it might apply to communities and cultures in low to middle income countries. Aim: This paper aims to explore the notion of resilience in cross-cultural context through considering the lived experience of internal migration. Methods: A sample of 30 participants with experience of migration was recruited from a low-income slum dwelling neighbourhood in the city of Pune, India. These individuals participated in biographical narrative interviews in which they were encouraged to talk about their experience of migration, their adaptation to life in their new environment and making new lives for themselves. Results: Participants referred to a variety of intra-individual and external factors that sustained their resilience, including acceptance of their circumstances, the importance of memory, hope for their children’s futures as well as kindness from family friends and community members and aspects of the physical environment which were conducive to an improvement in their lives. Conclusions: By analogy with the widely used term ‘idioms of distress’, we advocate attention to the locally nuanced and culturally inflected ‘idioms of resilience’ or ‘eudaemonic idioms’ which are of crucial importance as migration and movement become ever more prominent in discussions of human problems. The nature and extent of people’s coping abilities, their aspirations and strategies for tackling adversity, their idioms of resilience and eudaemonic repertoires merit attention so that services can genuinely support their adjustment and progress in their new-found circumstances.

scholarly journals Community-level antibiotic access and use (ABACUS) in low- and middle-income countries: Finding targets for social interventions to improve appropriate antimicrobial use – an observational multi-centre study

2017 ◽  
Vol 2 ◽  
pp. 58 ◽  
Author(s):  
Heiman F.L. Wertheim ◽  
Nguyen Thi Kim Chuc ◽  
Sureeporn Punpuing ◽  
Wasif Ali Khan ◽  
Margaret Gyapong ◽  
...  
Keyword(s):  
Cultural Context ◽  
Qualitative Interviews ◽  
Antibiotic Use ◽  
Community Members ◽  
Multi Centre Study ◽  
Middle Income ◽  
Social Interventions ◽  
Middle Income Countries ◽  
Actual Use ◽  
Low And Middle Income

In many low- and middle-income countries (LMICs), a poor link between antibiotic policies and practices exists. Numerous contextual factors may influence the degree of antibiotic access, appropriateness of antibiotic provision, and actual use in communities. Therefore, improving appropriateness of antibiotic use in different communities in LMICs probably requires interventions tailored to the setting of interest, accounting for cultural context. Here we present the ABACUS study (AntiBiotic ACcess and USe), which employs a unique approach and infrastructure, enabling quantitative validation, contextualization of determinants, and cross-continent comparisons of antibiotic access and use. The community infrastructure for this study is the INDEPTH-Network (International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries), which facilitates health and population research through an established health and demographic surveillance system. After an initial round of formative qualitative research with community members and antibiotic suppliers in three African and three Asian countries, household surveys will assess the appropriateness of antibiotic access, provision and use. Results from this sample will be validated against a systematically conducted inventory of suppliers. All potential antibiotic suppliers will be mapped and characterized. Subsequently, their supply of antibiotics to the community will be measured through customer exit interviews, which tend to be more reliable than bulk purchase or sales data. Discrepancies identified between reported and observed antibiotic practices will be investigated in further qualitative interviews. Amartya Sen’s Capability Approach will be employed to identify the conversion factors that determine whether or not, and the extent to which appropriate provision of antibiotics may lead to appropriate access and use of antibiotics. Currently, the study is ongoing and expected to conclude by 2019. ABACUS will provide important new insights into antibiotic practices in LMICs to inform social interventions aimed at promoting optimal antibiotic use, thereby preserving antibiotic effectiveness.

scholarly journals Changes in mobility and socioeconomic conditions during the COVID-19 outbreak

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Marco Dueñas ◽  
Mercedes Campi ◽  
Luis E. Olmos
Keyword(s):  
Low Income ◽  
Urban Areas ◽  
Human Mobility ◽  
Policy Implications ◽  
Socioeconomic Conditions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Containment Measures ◽  
Novel Coronavirus ◽  
The City

AbstractSince the outbreak of the 2019 novel coronavirus (COVID-19) pandemic, governments have been implementing containment measures aimed at mitigating the spread of the virus, including restrictions to human mobility. The ability to adapt to the pandemic and respond to containment measures can be bound by socioeconomic conditions, which are heterogeneous in large urban areas of low-income and middle-income countries. In this paper, we analyse mobility changes following the implementation of containment measures in Bogotá, Colombia. We characterise the mobility network before and during the pandemic and analyse its evolution and changes between January and July 2020. We observe a general reduction in mobility trends, but the overall connectivity between different areas of the city remains after the lockdown, reflecting the resilience of the mobility network. Then, we estimate a gravity model to assess the effect of socioeconomic conditions on mobility flows. We find that the responses to lockdown policies depend on the socioeconomic conditions of the population. Before the pandemic, the population with better socioeconomic conditions shows higher mobility flows. Since the lockdown, mobility presents a general decrease, but the population with worse socioeconomic conditions shows lower reductions in mobility flows. We conclude by deriving policy implications.

scholarly journals Continued nursing education in low-income and middle-income countries: a narrative synthesis

2020 ◽  
Vol 5 (2) ◽  
pp. e001981
Author(s):  
Amee Azad ◽  
Jung-Gi Min ◽  
Sharjeel Syed ◽  
Sara Anderson
Keyword(s):  
Nursing Education ◽  
Patient Outcomes ◽  
Low Income ◽  
Cultural Context ◽  
Educational Interventions ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Train The Trainer ◽  
Middle Income Countries ◽  
Quasi Experimental

IntroductionContinued nursing education and development can reduce mortality and morbidity of patients and can alleviate the shortage of healthcare workers by training of nurses for high-demand skill sets. We reviewed patterns of educational interventions and strategies in initiating behaviour change, improving patient outcomes or knowledge for nurses in low- and middle-income countries (LMICs).MethodsThe study searched the MEDLINE (PubMed), Embase, CINAHL, Google Scholar and Web of Science databases. The study included interventional studies on continued nursing education from 2007 to 2017. Of the 6216 publications retrieved, 98 articles were included and analysed by three independent reviewers.ResultsOf the 98 studies that met inclusion criteria, five were randomised controlled trials, two were qualitative in design and the remaining 91 were quasi-experimental, before-and-after studies. Of these studies, the median sample size of participants was 64, and the majority were conducted in Asia (53.1%). During the 10-year study period, 20.4% was conducted in 2015, the highest proportion, with a general increase in number of studies over time from 2007 to 2017. Main themes that arose from the review included train-the-trainer models, low-dose/high-frequency models, use of multiple media for training, and emphasis on nurse empowerment, strong international partnerships, and the integration of cultural context. Overall, the studies were limited in quality and lacked rigorous study design.ConclusionContinued nursing education in LMICs is essential and effective in improving nurses’ knowledge base, and thus patient outcomes and quality of care. Long-term, randomised studies are needed to understand how training strategies compare in impact on nurses and patients.

scholarly journals Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2439
Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  
Keyword(s):  
Health Survey ◽  
Low Income ◽  
World Health ◽  
Low Income Countries ◽  
Multivariable Logistic Regression Analysis ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

scholarly journals Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

2020 ◽  
Vol 5 (11) ◽  
pp. e003423
Author(s):  
Dongqing Wang ◽  
Molin Wang ◽  
Anne Marie Darling ◽  
Nandita Perumal ◽  
Enju Liu ◽  
...  
Keyword(s):  
Weight Gain ◽  
North Africa ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Weight ◽  
Latin America And Caribbean ◽  
Nationally Representative ◽  
Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

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