Prescribing peritoneal dialysis and achieving good quality dialysis in low and low-middle income countries

2020 ◽  
Vol 40 (3) ◽  
pp. 341-348
Author(s):  
Adrian Liew
Keyword(s):  
Peritoneal Dialysis ◽  
Low Cost ◽  
Well Being ◽  
Adjunctive Treatment ◽  
Middle Income ◽  
Membrane Function ◽  
Middle Income Countries ◽  
Monitoring Tools ◽  
Low Middle Income Countries ◽  
End Stage

The provision of long-term renal replacement therapies for patients with end-stage kidney disease (ESKD) in low and low-middle income countries (LLMICs) has been a pervasive challenge, impeded mainly by monetary constraints, limited health-care resources, and geographical and logistic difficulties. Even for patients who could initiate dialysis, discontinuation of dialysis treatment due to the lack of financial sustainability is a valid concern. While the delivery of high-quality dialysis should not be compromised in these settings, perpetuity on dialysis is of paramount consideration for these patients, with sustaining life being just as important as achieving clinical well-being. As intensification of peritoneal dialysis (PD) prescription comes with immense cost in these settings, the strategy for stretching affordability of dialysis involves optimizing the number of PD exchanges required or delaying the transition to a high PD dose of four bags per day of continuous ambulatory PD (CAPD) prescription. This can be accomplished through the use of low-cost adjunctive treatment, by preserving residual kidney function and adopting incremental PD. The use of expensive, complex, or inaccessible monitoring tools for peritoneal membrane function and dialysis clearance could be replaced by clinical assessment and widely available biochemical indicators, which will significantly reduce the investigation costs, with consequent savings that could allow for lengthening the duration of PD therapy. Finally, it is important for each PD program in LLMICs to monitor these outcome indicators, to ensure the consistent delivery of acceptable quality of PD to their patients.

scholarly journals Neurosurgical digital teaching in low-middle income countries: beyond the frontiers of traditional education

2018 ◽  
Vol 45 (4) ◽  
pp. E17 ◽  
Author(s):  
Federico Nicolosi ◽  
Zefferino Rossini ◽  
Ismail Zaed ◽  
Angelos G. Kolias ◽  
Maurizio Fornari ◽  
...  
Keyword(s):  
Low Cost ◽  
Easy Access ◽  
Scientific Validity ◽  
Middle Income ◽  
Digital Platforms ◽  
Poor Countries ◽  
Middle Income Countries ◽  
Standard Education ◽  
Low Middle Income Countries ◽  
Learning Programs

OBJECTIVENeurosurgical training is usually based on traditional sources of education, such as papers, books, direct surgical experience, and cadaveric hands-on courses. In low-middle income countries, standard education programs are often unavailable, mainly owing to the lack of human and economic resources. Introducing digital platforms in these settings could be an alternative solution for bridging the gap between Western and poor countries in neurosurgical knowledge.METHODSThe authors identified from the Internet the main digital platforms that could easily be adopted in low-middle income countries. They selected free/low-cost mobile content with high educational impact.RESULTSThe platforms that were identified as fulfilling the characteristics described above are WFNS Young Neurosurgeons Forum Stream, Brainbook, NeuroMind, UpSurgeOn, The Neurosurgical Atlas, Touch surgery, The 100 UCLA Subjects in Neurosurgery, Neurosurgery Survival Guide, EANS (European Association of Neurosurgical Societies) Academy, Neurosurgical.TV, 3D Neuroanatomy, The Rhoton Collection, and Hinari. These platforms consist of webinars, 3D interactive neuroanatomy and neurosurgery content, videos, and e-learning programs supported by neurosurgical associations or journals.CONCLUSIONSDigital education is an emerging tool for contributing to the spread of information in the neurosurgical community. The continuous improvement in the quality of content will rapidly increase the scientific validity of digital programs. In conclusion, the fast and easy access to digital resources could contribute to promote neurosurgical education in countries with limited facilities.

scholarly journals Challenges for sustainable end-stage kidney disease care in low-middle-income countries: the problem of the workforce

2020 ◽  
Vol 10 (1) ◽  
pp. e49-e54 ◽  
Author(s):  
Charles R. Swanepoel ◽  
Mignon I. McCulloch ◽  
Georgi Abraham ◽  
Jo-Ann Donner ◽  
Mona N. Alrukhaimi ◽  
...  
Keyword(s):  
Kidney Disease ◽  
End Stage Kidney Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
End Stage

Mobile Health Literacy to Improve Health Outcomes in Low-Middle Income Countries

2017 ◽  
Vol 6 (4) ◽  
pp. 4-16 ◽  
Author(s):  
Nafisa Fatima Maria Vaz
Keyword(s):  
Health Literacy ◽  
Health Outcomes ◽  
Information And Communication Technologies ◽  
Mobile Phones ◽  
Health Indicators ◽  
Well Being ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Improve Health

Despite improvements in health indicators over time, such as decreased mortality and morbidity, significant challenges remain with regard to the quality in the delivery of healthcare in low and middle-income countries (LMIC's), especially in rural and remote regions of developing countries.In the effort to find feasible solutions to these issues, a lot of importance is given to the information and communication technologies (ICTs) The author reviews the evidence of the role mobile phones facilitating health literacy to contribute to improved health outcomes in the LMIC's. This was done by exploring the results of ten projects. The author examines the extent to which the use of mobile phones could help improve health outcomes in two specific ways: in improving health literacy and promoting health and well-being, thus increasing life expectancy in LMIC's. Analysis of the papers indicates that there is important evidence of mobile phones boosting increased access, promoting education and increased health literacy leads to the better health status of the population.

scholarly journals Respiratory epidemics and older people

2020 ◽  
Vol 49 (6) ◽  
pp. 896-900
Author(s):  
Sathyanarayanan Doraiswamy ◽  
Ravinder Mamtani ◽  
Marco Ameduri ◽  
Amit Abraham ◽  
Sohaila Cheema
Keyword(s):  
Older People ◽  
Well Being ◽  
Middle Income ◽  
Global Epidemic ◽  
The Public ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Full Participation ◽  
The Impact ◽  
Urgent Action

Abstract Coronavirus disease 2019 (COVID-19) has been particularly severe on older people. Past coronavirus epidemics namely Severe Acute Respiratory Syndrome and the Middle East Respiratory Syndrome have also been severe on older people. These epidemics lasted for only a limited period, however, and have proven short lived in the memories of both the public and public health systems. No lessons were learnt to mitigate the impact of future epidemics of such nature, on older people. This complacency we feel has claimed the lives of many older people during the current COVID-19 global epidemic. The nature of risks associated with acquiring infections and associated mortality among older people in respiratory epidemic situations are varied and of serious concern. Our commentary identifies demographic, biological, behavioural, social and healthcare-related determinants, which increase the vulnerability of older people to respiratory epidemics. We acknowledge that these determinants will likely vary between older people in high- and low-middle income countries. Notwithstanding these variations, we call for urgent action to mitigate the impact of epidemics on older people and preserve their health and dignity. Intersectoral programmes that recognise the special needs of older people and in unique contexts such as care homes must be developed and implemented, with the full participation and agreement of older people. COVID-19 has created upheaval, challenging humanity and threatening the lives, rights, and well-being of older people. We must ensure that we remain an age-friendly society and make the world a better place for all including older people.

scholarly journals EXTending availability of self-management structured EducatioN programmes for people with type 2 Diabetes in low-to-middle income countries (EXTEND)—a feasibility study in Mozambique and Malawi

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047425
Author(s):  
Emer M Brady ◽  
Catherine Bamuya ◽  
David Beran ◽  
Jorge Correia ◽  
Amelia Crampin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
International Diabetes Federation ◽  
Cost Effective ◽  
Well Being ◽  
Self Management ◽  
Middle Income ◽  
Structured Education ◽  
Middle Income Countries ◽  
Low Middle Income Countries

BackgroundGlobally, there are estimated 425 million people with type 2 diabetes (T2D) with 80% from low-middle income countries (LMIC). Diabetes self-management education (DSME) programmes are a vital and core component of the treatment pathway for T2D. Despite LMIC being disproportionally affected by T2D, there are no DSME available that meet international diabetes federation criterion.MethodsThe aims were to test the feasibility of delivering a proven effective and cost-effective approach used in a UK population in two urban settings in Malawi and Mozambique by; (1) developing a culturally, contextually and linguistically adapted DSME, the EXTending availability of self-management structured EducatioN programmes for people with type 2 Diabetes in low-to-middle income countries (EXTEND) programme; (2) using a mixed-method approach to evaluate the delivery of training and the EXTEND programme to patients with T2D.ResultsTwelve healthcare professionals were trained. Ninety-eight participants received the DSME. Retention was high (100% in Mozambique and 94% in Malawi). At 6 months HbA1c (−0.9%), cholesterol (−0.3 mmol/L), blood pressure (−5.9 mm Hg systolic and −6.1 mm Hg diastolic) improved in addition to indicators of well-being (problem areas in diabetes and self-efficacy in diabetes).ConclusionIt is feasible to deliver and evaluate the effectiveness of a culturally, contextually and linguistically adapted EXTEND programme in two LMIC. The DSME was acceptable with positive biomedical and psychological outcomes but requires formal testing with cost-effectiveness. Challenges exist in scaling up such an approach in health systems that do not have resources to address the challenge of diabetes.

The Impact of Covid 19 on Pregnant Women and Child Health

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1367-1373
Author(s):  
Nikhil Sanjay Mujbaile ◽  
Smita Damke
Keyword(s):  
Social Issues ◽  
Middle Income ◽  
Web Based ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
The Social ◽  
Social Separation ◽  
The Impact ◽  
And Child Health ◽  
General Wellbeing

The Covid illness (COVID-19) pandemic has spread rapidly all through the world and has had a drawn-out impact. The Pandemic has done incredible damage to society and made genuine mental injury to numerous individuals. Mental emergencies frequently cause youngsters to deliver sentiments of relinquishment, despondency, insufficiency, and fatigue and even raise the danger of self-destruction. Youngsters with psychological instabilities are particularly powerless during the isolate and colonial removing period. Convenient and proper assurances are expected to forestall the event of mental and social issues. The rising advanced applications and wellbeing administrations, for example, telehealth, web-based media, versatile wellbeing, and far off intuitive online instruction can connect the social separation and backing mental and conduct wellbeing for youngsters. Because of the mental advancement qualities of youngsters, this investigation additionally outlines intercessions on the mental effect of the COVID-19 Pandemic. Further difficulties in Low Middle-Income Countries incorporate the failure to actualize successful general wellbeing estimates, for example, social separating, hand cleanliness, definitive distinguishing proof of contaminated individuals with self-disconnection and widespread utilization of covers The aberrant impacts of the Pandemic on youngster wellbeing are of extensive concern, including expanding neediness levels, upset tutoring, absence of admittance to the class taking care of plans, decreased admittance to wellbeing offices and breaks in inoculation and other kid wellbeing programs. Kept tutoring is critical for kids in Low Middle-Income Countries. Arrangement of safe situations is mainly testing in packed asset obliged schools. 

Risk Factors of Mortality Among Patients with Stroke in Low Middle-Income Countries:  A Series of 180 Patients

2020 ◽  
Author(s):  
Larrey Kamabu ◽  
Hervé Monka Lekuya ◽  
Bienvenu Muhindo Kasusula ◽  
Nicole Kavugho Mutimani ◽  
Louange Maha Kathaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

Social Protection, Adolescent Well-Being, and Development in Low- and Middle-Income Countries

2018 ◽  
Author(s):  
Suman Verma
Keyword(s):  
Social Inclusion ◽  
Social Protection ◽  
Well Being ◽  
Middle Income ◽  
Developmental Potential ◽  
Goods And Services ◽  
Middle Income Countries ◽  
Social Protection Systems ◽  
Cycle Of Poverty ◽  
Low And Middle Income

Effective social protection policies are crucial to realizing adolescents’ rights, ensuring their well-being, breaking the cycle of poverty and vulnerability, and helping them realize their full developmental potential. Low- and middle-income countries (LMICs) have extended social security coverage to ensure basic protections—while continuing to develop social protection systems. Social protection for LMIC adolescents in the context of gross violations of their basic rights is examined. Prevalence, consequences of protection rights violations, and the role and impact of social protection programs in ensuring enhanced opportunities for development and well-being among young people are discussed. Results demonstrate direct impacts (e.g., increased income, consumption, goods and services access; greater social inclusion; reduced household stress). LMICs need integrated social protection policy and program expansion if the 2030 Agenda for Sustainable Development is to be realized. With adolescent-centered policies and investments, governments can help adolescents realize their rights to a fulfilling and productive life.

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