Stakeholders’ perception on including broader economic impact of vaccines in economic evaluations in low and middle income countries: a mixed methods study

Background: Little is known about how knowledge brokers (KBs) operate in low- and middle-income countries (LMICs) to translate evidence for health policy and practice. These intermediaries facilitate relationships between evidence producers and users to address public health issues. Aims and objectives: To increase understanding, a mixed-methods study collected data from KBs who had acted on evidence from the 2015 Global Maternal Newborn Health Conference in Mexico. Methods: Of the 1000 in-person participants, 252 plus 72 online participants (n=324) from 56 countries completed an online survey, and 20 participants from 15 countries were interviewed. Thematic analysis and application of knowledge translation (KT) theory explored factors influencing KB actions leading to evidence uptake. Descriptive statistics of respondent characteristics were used for cross-case comparison.Findings: Results suggest factors supporting the KB role in evidence uptake, which include active relationships with evidence users through embedded KB roles, targeted and tailored evidence communication to fit the context, user receptiveness to evidence from a similar country setting, adaptability in the KB role, and action orientation of KBs. Discussion and conclusions: Initiatives to increase evidence uptake in LMICs should work to establish supportive structures for embedded KT, identify processes for ongoing cross-country learning, and strengthen KBs already showing effectiveness in their roles. key messages <ol><li>Little is known about how knowledge brokers mobilise evidence in low- and middle-income countries.</li> <li>A multi-country study of knowledge brokers identified promising practices for evidence uptake.</li> <li>Embedded brokers who adapted messaging and evidence to context in active relationships worked well.</li> <li>Capacity building should use KB promising practices and facilitate multi-country evidence exchange.</li></ol>

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Intergenerational Contradictions in Body Image Standards Among Australian Immigrant Mothers and Children: A Mixed-Methods Study

Global Journal of Health Science ◽

10.5539/gjhs.v12n6p47 ◽

2020 ◽

Vol 12 (6) ◽

pp. 47

Author(s):

Tehzeeb Zulfiqar ◽

Catherine D’Este ◽

Lyndall Strazdins ◽

Cathy Banwell

Keyword(s):

Body Image ◽

Mixed Methods ◽

Weight Management ◽

Management Strategies ◽

Children Of Immigrants ◽

Mixed Methods Study ◽

Middle Income ◽

Immigrant Mothers ◽

Middle Income Countries ◽

Low And Middle Income

In this mixed-methods study, we explored how gender and cultural factors, including social status were linked with children’s immigrant backgrounds and their body image dissatisfaction and weight management strategies in Australia. Cross-sectional data analysis of 10-11-year-old children from the Birth cohort of the “Longitudinal Study of Australian Children” showed that approximately half of the children were dissatisfied with their body images. A higher proportion of these were children of immigrants from low-and-middle-income-countries. Additionally, about three-quarters children were actively managing their weights. Children of immigrants from low-and-middle-income-countries constituted a higher proportion of these also. Among boys, desiring a heavier body was highest for those with immigrant mothers from low-and-middle-income-countries, while the desire to be thinner was highest among girls of immigrants from low-and-middle-income-countries. Although the percentage of children who adopted strategies to gain weight was very small, boys of immigrants from low-and-middle-income-countries, in particular, were almost three times as likely as non-immigrant boys, to try to gain weight (18% vs 5.9%, respectively). Qualitative face-to-face interviews with immigrant mothers and their 8-11-year-old children revealed intergenerational variations in body image standards. Maternal body image standards were drawn from their origin countries, but children followed Australian norms. Despite increased obesity awareness amongst mothers, they desired higher body weight for their children, due to an association with high status and health in origin countries. However, children were aware of the stigma, unpopularity, and low status associated with high body weights in Australia. To reduce cultural and status-based obesity inequalities, Australian obesity prevention plans must include culturally responsive health promotion strategies for immigrant parents and their children to improve their knowledge about healthy weights and weight management strategies.

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Trauma Quality Improvement in Low and Middle Income Countries of the Asia–Pacific Region: A Mixed Methods Study

World Journal of Surgery ◽

10.1007/s00268-012-1593-1 ◽

2012 ◽

Vol 36 (8) ◽

pp. 1978-1992 ◽

Cited By ~ 18

Author(s):

Henry Thomas Stelfox ◽

Manjul Joshipura ◽

Witaya Chadbunchachai ◽

Ranjith N. Ellawala ◽

Gerard O’Reilly ◽

...

Keyword(s):

Quality Improvement ◽

Mixed Methods ◽

Mixed Methods Study ◽

Asia Pacific ◽

Pacific Region ◽

Asia Pacific Region ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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U.S. trainees’ experiences of ethical challenges during research in low- and middle-income countries: A mixed methods study

Global Public Health ◽

10.1080/17441692.2021.1933124 ◽

2021 ◽

pp. 1-17

Author(s):

Katherine Standish ◽

Katherine McDaniel ◽

Shirin Ahmed ◽

Nikole H. Allen ◽

Sohini Sircar ◽

...

Keyword(s):

Mixed Methods ◽

Mixed Methods Study ◽

Ethical Challenges ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Opportunities and barriers to implementing antibiotic stewardship in low and middle-income countries: Lessons from a mixed-methods study in a tertiary care hospital in Ethiopia

PLoS ONE ◽

10.1371/journal.pone.0208447 ◽

2018 ◽

Vol 13 (12) ◽

pp. e0208447 ◽

Cited By ~ 20

Author(s):

Gebremedhin Beedemariam Gebretekle ◽

Damen Haile Mariam ◽

Workeabeba Abebe ◽

Wondwossen Amogne ◽

Admasu Tenna ◽

...

Keyword(s):

Mixed Methods ◽

Antibiotic Stewardship ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Mixed Methods Study ◽

Care Hospital ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Foreword: Health Economic Evaluations in Low- and Middle-income Countries: Methodological Issues and Challenges for Priority Setting

Health Economics ◽

10.1002/hec.3319 ◽

2016 ◽

Vol 25 ◽

pp. 1-5 ◽

Cited By ~ 12

Author(s):

Catherine Pitt ◽

Anna Vassall ◽

Yot Teerawattananon ◽

Ulla K. Griffiths ◽

Lorna Guinness ◽

...

Keyword(s):

Health Economic ◽

Priority Setting ◽

Economic Evaluations ◽

Methodological Issues ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Cost of scaling up mental healthcare in low-and middle-income countries

The British Journal of Psychiatry ◽

10.1192/bjp.bp.107.038463 ◽

2007 ◽

Vol 191 (6) ◽

pp. 528-535 ◽

Cited By ~ 62

Author(s):

Dan Chisholm ◽

Crick Lund ◽

Shekhar Saxena

Keyword(s):

Low Income ◽

Scale Up ◽

Mental Healthcare ◽

Scaling Up ◽

Psychosocial Treatment ◽

Economic Evaluations ◽

Middle Income ◽

Middle Income Countries ◽

Per Capita ◽

Low And Middle Income

BackgroundNo systematic attempt has been made to calculate the costs of scaling up mental health services in low-and middle-income countries.AimsTo estimate the expenditures needed to scale up the delivery of an essential mental healthcare package over a 10-year period (2006–2015).MethodA core package was defined, comprising pharmacological and/or psychosocial treatment of schizophrenia, bipolar disorder, depression and hazardous alcohol use. Current service levels in 12 selected low-and middle-income countries were established using the WHO–AIMS assessment tool. Target-level resource needs were derived from published need assessments and economic evaluations.ResultsThe cost per capita of providing the core package attarget coverage levels (in US dollars) ranged from $1.85 to $2.60 per year in low-income countries and $3.20 to $6.25 per year in lower-middle-income countries, an additional annual investment of $0.18–0.55 per capita.ConclusionsAlthough significant new resources need to be invested, the absolute amount is not large when considered at the population level and against other health investment strategies.

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Cost and cost-effectiveness analysis of treatment for child undernutrition in low- and middle-income countries: A systematic review

Wellcome Open Research ◽

10.12688/wellcomeopenres.15781.2 ◽

2020 ◽

Vol 5 ◽

pp. 62

Author(s):

Rebecca G Njuguna ◽

James A Berkley ◽

Julie Jemutai

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Service Providers ◽

Productivity Loss ◽

Sub Saharan Africa ◽

Economic Evaluations ◽

Middle Income ◽

Child Undernutrition ◽

Middle Income Countries ◽

Low And Middle Income

Background: Undernutrition remains highly prevalent in low- and middle-income countries, with sub-Saharan Africa and Southern Asia accounting for majority of the cases. Apart from the health and human capacity impacts on children affected by malnutrition, there are significant economic impacts to households and service providers. The aim of this study was to determine the current state of knowledge on costs and cost-effectiveness of child undernutrition treatment to households, health providers, organizations and governments in low and middle-income countries (LMICs). Methods: We conducted a systematic review of peer-reviewed studies in LMICs up to September 2019. We searched online databases including PubMed-Medline, Embase, Popline, Econlit and Web of Science. We identified additional articles through bibliographic citation searches. Only articles including costs of child undernutrition treatment were included. Results: We identified a total of 6436 articles, and only 50 met the eligibility criteria. Most included studies adopted institutional/program (45%) and health provider (38%) perspectives. The studies varied in the interventions studied and costing methods used with treatment costs reported ranging between US$0.44 and US$1344 per child. The main cost drivers were personnel, therapeutic food and productivity loss. We also assessed the cost effectiveness of community-based management of malnutrition programs (CMAM). Cost per disability adjusted life year (DALY) averted for a CMAM program integrated into existing health services in Malawi was $42. Overall, cost per DALY averted for CMAM ranged between US$26 and US$53, which was much lower than facility-based management (US$1344). Conclusion: There is a need to assess the burden of direct and indirect costs of child undernutrition to households and communities in order to plan, identify cost-effective solutions and address issues of cost that may limit delivery, uptake and effectiveness. Standardized methods and reporting in economic evaluations would facilitate interpretation and provide a means for comparing costs and cost-effectiveness of interventions.

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Citizen engagement in public services in low‐ and middle‐income countries: A mixed‐methods systematic review of participation, inclusion, transparency and accountability (PITA) initiatives

Campbell Systematic Reviews ◽

10.1002/cl2.1025 ◽

2019 ◽

Vol 15 (1-2) ◽

Author(s):

Hugh Waddington ◽

Ada Sonnenfeld ◽

Juliette Finetti ◽

Marie Gaarder ◽

Denny John ◽

...

Keyword(s):

Systematic Review ◽

Mixed Methods ◽

Public Services ◽

Citizen Engagement ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income ◽

Transparency And Accountability

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Examining the use of economic evaluations in health-related humanitarian programmes in low- and middle-income countries: a systematic review

Health Policy and Planning ◽

10.1093/heapol/czz144 ◽

2019 ◽

Vol 35 (2) ◽

pp. 210-218 ◽

Cited By ~ 1

Author(s):

Lizna A Makhani ◽

Valerie Moran ◽

Zia Sadique ◽

Neha S Singh ◽

Paul Revill ◽

...

Keyword(s):

Systematic Review ◽

Economic Evaluation ◽

Bibliographic Databases ◽

Economic Evaluations ◽

Middle Income ◽

System Perspective ◽

Middle Income Countries ◽

Humanitarian Crises ◽

Health Related ◽

Low And Middle Income

Abstract The costly nature of health sector responses to humanitarian crises and resource constraints means that there is a need to identify methods for priority setting and long-term planning. One method is economic evaluation. The aim of this systematic review is to examine the use of economic evaluations in health-related humanitarian programmes in low- and middle-income countries. This review used peer-reviewed literature published between January 1980 and June 2018 extracted from four main electronic bibliographic databases. The eligibility criteria were full economic evaluations (which compare the costs and outcomes of at least two interventions and provide information on efficiency) of health-related services in humanitarian crises in low- and middle-countries. The quality of eligible studies is appraised using the modified 36-question Drummond checklist. From a total of 8127 total studies, 11 full economic evaluations were identified. All economic evaluations were cost-effectiveness analyses. Three of the 11 studies used a provider perspective, 2 studies used a healthcare system perspective, 3 studies used a societal perspective and 3 studies did not specify the perspective used. The lower quality studies failed to provide 7information on the unit of costs and did not justify the time horizon of costs and discount rates, or conduct a sensitivity analysis. There was limited geographic range of the studies, with 9 of the 11 studies conducted in Africa. Recommendations include greater use of economic evaluation methods and data to enhance the microeconomic understanding of health interventions in humanitarian settings to support greater efficiency and transparency and to strengthen capacity by recruiting economists and providing training in economic methods to humanitarian agencies.

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