scholarly journals Does distance from a clinic and poverty impact visit adherence for noncommunicable diseases? A retrospective cohort study using electronic medical records in rural Haiti

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lily D. Yan ◽  
Dufens Pierre-Louis ◽  
Benito D. Isaac ◽  
Waking Jean-Baptiste ◽  
Serge Vertilus ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Multidimensional Poverty ◽  
Adult Patients ◽  
Noncommunicable Diseases ◽  
Future Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Visit Adherence ◽  
Hardship Financing

Abstract Background Adherence to regular outpatient visits is vital to managing noncommunicable diseases (NCDs), a growing burden in low and middle-income countries. We characterized visit adherence among patients with NCDs in rural Haiti, hypothesizing higher poverty and distance from the clinic were associated with lower adherence. Methods We analyzed electronic medical records from a cohort of adults in an NCD clinic in Mirebalais, Haiti (April 2013 to June 2016). Visit adherence was: 1) visit constancy (≥1 visit every 3 months), 2) no gaps in care (> 60 days between visits), 3) ≥1 visit in the last quarter, and 4) ≥6 visits per year. We incorporated an adapted measure of intensity of multidimensional poverty. We calculated distance from clinic as Euclidean distance or self-reported transit time. We used multivariable logistic regressions to assess the association between poverty, distance, and visit adherence. Results We included 463 adult patients, mean age 57.8 years (SE 2.2), and 72.4% women. Over half of patients had at least one visit per quarter (58.1%), but a minority (19.6%) had no gaps between visits. Seventy percent of patients had a visit in the last quarter, and 73.9% made at least 6 visits per year. Only 9.9% of patients met all adherence criteria. In regression models, poverty was not associated with any adherence measures, and distance was only associated with visit in the last quarter (OR 0.87, 95% CI [0.78 to 0.98], p = 0.03) after adjusting for age, sex, and hardship financing. Conclusions Visit adherence was low in this sample of adult patients presenting to a NCD Clinic in Haiti. Multidimensional poverty and distance from clinic were not associated with visit adherence measures among patients seen in the clinic, except for visit in the last quarter. Future research should focus on identifying and addressing barriers to visit adherence.

scholarly journals The impact of COVID-19 on the care of people living with noncommunicable diseases in low- and middle-income countries: an online survey of physicians and pharmacists in nine countries

2021 ◽  
Vol 22 ◽  
Author(s):  
Chris Bullen ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
Varsha Parag ◽  
Kannan Subramaniam ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare Workers ◽  
Online Survey ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Measures ◽  
The Impact ◽  
Low And Middle Income

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.

scholarly journals Outcomes of HIV treatment from the private sector in low-income and middle-income countries: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031844
Author(s):  
Gitau Mburu ◽  
Ewemade Igbinedion ◽  
Sin How Lim ◽  
Aung Zayar Paing ◽  
Siyan Yi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Private Sector ◽  
Clinical Outcomes ◽  
Low Income ◽  
Hiv Treatment ◽  
Future Research ◽  
Publication Date ◽  
Middle Income ◽  
Middle Income Countries ◽  
Secondary Outcomes

IntroductionPrivate sector provision of HIV treatment is increasing in low-income and middle-income countries (LMIC). However, there is limited documentation of its outcomes. This protocol reports a proposed systematic review that will synthesise clinical outcomes of private sector HIV treatment in LMIC.Methods and analysisThis review will be conducted in accordance with the preferred reporting items for systematic review and meta-analyses protocols. Primary outcomes will include: (1) proportion of eligible patients initiating antiretroviral therapy (ART); (2) proportion of those on ART with <1000 copies/mL; (3) rate of all-cause mortality among ART recipients. Secondary outcomes will include: (1) proportion receivingPneumocystis jirovecipneumonia prophylaxis; (2) proportion with >90% ART adherence (based on any measure reported); (3) proportion screened for non-communicable diseases (specifically cervical cancer, diabetes, hypertension and mental ill health); (iv) proportion screened for tuberculosis. A search of five electronic bibliographical databases (Embase, Medline, PsychINFO, Web of Science and CINAHL) and reference lists of included articles will be conducted to identify relevant articles reporting HIV clinical outcomes. Searches will be limited to LMIC. No age, publication date, study-design or language limits will be applied. Authors of relevant studies will be contacted for clarification. Two reviewers will independently screen citations and abstracts, identify full text articles for inclusion, extract data and appraise the quality and bias of included studies. Outcome data will be pooled to generate aggregative proportions of primary and secondary outcomes. Descriptive statistics and a narrative synthesis will be presented. Heterogeneity and sensitivity assessments will be conducted to aid interpretation of results.Ethics and disseminationThe results of this review will be disseminated through a peer-reviewed scientific manuscript and at international scientific conferences. Results will inform quality improvement strategies, replication of identified good practices, potential policy changes, and future research.PROSPERO registration numberCRD42016040053.

scholarly journals Early Mathematics Counts: Promising Instructional Strategies from Low- and Middle-Income Countries

2018 ◽  
Author(s):  
Yasmin Sitabkhan ◽  
Linda M. Platas
Keyword(s):  
Instructional Strategies ◽  
Future Research ◽  
Mathematics Interventions ◽  
Middle Income ◽  
Early Mathematics ◽  
Middle Income Countries ◽  
Informal Mathematics ◽  
Early Grade ◽  
Research And Policy ◽  
Low And Middle Income

This occasional paper examines common instructional strategies in early-grade mathematics interventions through a review of studies in classrooms in low- and middle-income countries. Twenty-four studies met the criteria for inclusion, and analyses reveal four sets of instructional strategies for which there is evidence from multiple contexts. Of the 24 studies, 16 involved the use of multiple representations, 10 involved the use of developmental progressions, 6 included supporting student use of explanation and justification, and 5 included integration of informal mathematics. Based on the review, we provide conclusions and recommendations for future research and policy.

scholarly journals Much research, but little learned to date: A scoping review on mental health of health workers in low- and lower-middle income countries and roadmap for future research

2021 ◽  
Author(s):  
Julia Lohmann ◽  
Denny John ◽  
Aso Dzay
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Health Workers ◽  
Tertiary Care ◽  
Psychological Wellbeing ◽  
Future Research ◽  
Measurement Tool ◽  
High Quality ◽  
Middle Income ◽  
Middle Income Countries

Abstract BackgroundSARS-CoV-2 has resulted in unprecedented research efforts on health workers’ work realities and their potential mental health impacts. To understand the latter, high-quality evidence on the baseline situation is paramount. With the aim of providing a comprehensive overview of existing evidence and to inform future research, we undertook a scoping review of the quantitative literature on mental health and psychological wellbeing of clinical skilled healthcare personnel working in all settings of care in low- and lower-middle income countries (LLMIC).MethodsWe performed a systematic search of the literature up to the end of 2019, in English or French language, in MEDLINE, EMBASE, PsychINFO, Global Health, and CAIRN. We included both studies estimating levels of mental health and studies investigating associations with other factors. We extracted data on study characteristics and methodology, and assessed the methodological quality of the included studies along nine criteria.ResultsWe found 143 relevant studies, 135 including data on mental health levels and 126 including data on associations with other factors. The studies covered 26 of the world’s 78 LLMICs, with most studies conducted in India, Nigeria, Pakistan, or Egypt, in urban secondary- and tertiary-care settings. 67% of studies assessed burnout, 25% general psychological wellbeing, and 20% other mental health outcomes. Only 19% of studies were of high quality due to shortcomings particularly in regards to sample representativeness, context-specific measurement tool validity, and reporting of methodological detail. We found much heterogeneity in investigated associated factors. Studies focused almost exclusively on potential determinants of mental health, while none linked mental health to objectively measured performance outcomes.ConclusionWe conclude that despite its impressive size, we can learn comparatively little from the current body of literature. Based on our findings, we outline areas for expansion, methodological improvement, and standardization of reporting in future research on mental health of health workers.Systematic review registrationPROSPERO no. CRD42019140036

scholarly journals Noncommunicable Diseases in Low- and Middle-Income Countries: A Strategic Approach to Develop a Global Implementation Research Workforce

Global Heart ◽  
2018 ◽  
Vol 13 (2) ◽  
pp. 131 ◽  
Author(s):  
Michael M. Engelgau ◽  
Joshua P. Rosenthal ◽  
Bradley J. Newsome ◽  
LeShawndra Price ◽  
Deshiree Belis ◽  
...  
Keyword(s):  
Implementation Research ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Strategic Approach ◽  
Research Workforce ◽  
Low And Middle Income

The Impact of Cash Transfers: A Review of the Evidence from Low- and Middle-income Countries

2018 ◽  
Vol 48 (03) ◽  
pp. 569-594 ◽  
Author(s):  
FRANCESCA BASTAGLI ◽  
JESSICA HAGEN-ZANKER ◽  
LUKE HARMAN ◽  
VALENTINA BARCA ◽  
GEORGINA STURGE ◽  
...  
Keyword(s):  
Evidence Base ◽  
Cash Transfers ◽  
Cash Transfer ◽  
Future Research ◽  
Unintended Effects ◽  
Screening Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

AbstractThis article presents the findings of a review of the impact of non-contributory cash transfers on individuals and households in low- and middle-income countries, covering the literature of 15 years, from 2000 to 2015. Based on evidence extracted from 165 studies, retrieved through a systematic search and screening process, this article discusses the impact of cash transfers on 35 indicators covering six outcome areas: monetary poverty; education; health and nutrition; savings, investment and production; work; and empowerment. For most of the studies, cash transfers contributed to progress in the selected indicators in the direction intended by policymakers. Despite variations in the size and strength of the underlying evidence base by outcome and indicator, this finding is consistent across all outcome areas. The article also investigates unintended effects of cash transfer receipt, such as potential reductions in adult work effort and increased fertility, finding limited evidence for such unintended effects. Finally, the article highlights gaps in the evidence base and areas which would benefit from additional future research.

scholarly journals Evaluating contextually adapted reading interventions with third-grade, Costa Rican students experiencing significant reading difficulties

2018 ◽  
Vol 40 (1) ◽  
pp. 3-24
Author(s):  
John C. Begeny
Keyword(s):  
School Psychology ◽  
Latin American ◽  
Group Intervention ◽  
Reading Interventions ◽  
Reading Difficulties ◽  
Third Graders ◽  
Future Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Future Research Directions

Scholarship in school psychology has continued to document the need and importance of contextually relevant intervention and prevention research, but this type of research remains relatively scarce. Also problematic, this type of research is even more limited in low- and middle-income countries (LMIC) compared to high-income countries. This situation within school psychology scholarship not only has negative implications for research and practice, it also limits internationalization within the discipline. The geographical context for the present study was in Costa Rica, currently a Latin American LMIC. Given the global importance of literacy, this article describes an experimental evaluation comparing two time- and resource-efficient reading interventions that differed only by instructional grouping: A one-on-one intervention, and an even more resource-efficient small-group intervention. Participants included third-graders experiencing significant reading difficulties. Analyses showed that all students benefitted from intervention, but some students responded somewhat more favorably to one intervention versus the other. Limitations, implications, and future research directions are discussed, particularly within the context of international school psychology and how professionals in the discipline can benefit from more intervention research in otherwise underrepresented global regions.

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