scholarly journals Peer driven or driven peers? A rapid review of peer involvement of people who use drugs in HIV and harm reduction services in low- and middle-income countries

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Judy Chang ◽  
Shaun Shelly ◽  
Machteld Busz ◽  
Claudia Stoicescu ◽  
Arif Rachman Iryawan ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Resource Scarcity ◽  
Rapid Review ◽  
People Who Use Drugs ◽  
Financial Barriers ◽  
Community Knowledge ◽  
Middle Income ◽  
Peer Involvement ◽  
Stigma And Discrimination ◽  
Low And Middle Income

Abstract Introduction Peer involvement of people who use drugs within HIV and harm reduction services is widely promoted yet under-utilised. Alongside political and financial barriers is a limited understanding of the roles, impacts, contexts and mechanisms for peer involvement, particularly in low- and middle-income settings. We conducted a rapid review of available literature on this topic. Methods Within a community-academic partnership, we used a rapid review approach, framed by realist theory. We used a network search strategy, focused on core journals and reference lists of related reviews. Twenty-nine studies were included. We developed thematic summaries framed by a realist approach of exploring interventions, their mechanisms, outcomes and how they are shaped by contexts. Results Reported outcomes of peer involvement included reduced HIV incidence and prevalence; increased service access, acceptability and quality; changed risk behaviours; and reduced stigma and discrimination. Mechanisms via which these roles work were trust, personal commitment and empathy, using community knowledge and experience, as well as ‘bridge’ and ‘role model’ processes. Contexts of criminalisation, under-resourced health systems, and stigma and discrimination were found to shape these roles, their mechanisms and outcomes. Though contexts and mechanisms are little explored within the literature, we identified a common theme across contexts, mechanisms and outcomes. Peer outreach interventions work through trust, community knowledge and expertise, and ‘bridge’ mechanisms (M) to counter criminalisation and constraining clinic and service delivery environments (C), contributing towards changed drug-using behaviours, increased access, acceptability and quality of harm reduction services and decreased stigma and discrimination (O). Conclusion Peer involvement in HIV and harm reduction services in low- and middle-income settings is linked to positive health outcomes, shaped by contexts of criminalisation, stigma, and resource scarcity. However, peer involvement is under-theorised, particularly on how contexts shape mechanisms and ultimately outcomes. Efforts to study peer involvement need to develop theory and methods to evaluate the complex mechanisms and contexts that have influence. Finally, there is a need to expand the range of peer roles, to embrace the capacities and expertise of people who use drugs.

Prevalence of mental health and suicide risk in prisons in low- and middle-income countries: a rapid review

2022 ◽  
pp. 1-16
Author(s):  
Kathryn Hill ◽  
Verity Wainwright ◽  
Caroline Stevenson ◽  
Jane Senior ◽  
Catherine Robinson ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicide Risk ◽  
Rapid Review ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Stigma and discrimination related to mental illness in low- and middle-income countries

2015 ◽  
Vol 24 (5) ◽  
pp. 382-394 ◽  
Author(s):  
M. Semrau ◽  
S. Evans-Lacko ◽  
M. Koschorke ◽  
L. Ashenafi ◽  
G. Thornicroft
Keyword(s):  
Mental Illness ◽  
Large Scale ◽  
Grey Literature ◽  
Middle Income ◽  
Middle Income Countries ◽  
Stigma And Discrimination ◽  
Effective Interventions ◽  
Long Term Follow Up ◽  
Context Specific ◽  
Low And Middle Income

Aims.This paper aims to provide an overview of evidence from low- and middle-income countries (LAMICs) worldwide to address: the nature of stigma and discrimination, relevant context-specific factors, global patterns of these phenomena and their measurement and quantitative and qualitative evidence of interventions intended to reduce their occurrence and impact. The background to this study is that the large majority of studies concerned with identifying effective interventions to reduce stigma and discrimination originate in high-income countries (HICs). This paper therefore presents such evidence from, and relevant to, LAMICs.Methods.Conceptual overview of the relevant peer-reviewed and grey literature on stigma and discrimination related to mental illness in LAMICs are available in English, Spanish, French and Russian.Results.Few intervention studies were identified related to stigma re-education in LAMICs. None of these addressed behaviour change/discrimination, and there were no long-term follow-up studies. There is therefore insufficient evidence at present to know which overall types of intervention may be effective and feasible and in LAMICs, how best to target key groups such as healthcare staff, and how far they may need to be locally customised to be acceptable for large-scale use in these settings. In particular, forms of social contacts, which have been shown to be the most effective intervention to reduce stigma among adults in HICs, have not yet been assessed sufficiently to know whether these methods are also effective in LAMICs.Conclusion.Generating information about effective interventions to reduce stigma and discrimination in LAMICs is now an important mental health priority worldwide.

The Identification and Evaluation of Methodologies to Assess the Quality of mHealth apps in High, Low & Middle-Income Countries: a Rapid Review (Preprint)

2021 ◽  
Author(s):  
Fionn Woulfe ◽  
Philip Kayode Fadahunsi ◽  
Simon Smith ◽  
Griphin Baxter Chirambo ◽  
Emma Larsson ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Healthcare Professionals ◽  
Rapid Review ◽  
Screening Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Mhealth Apps ◽  
Low And Middle Income

BACKGROUND There has been a rapid growth in the availability and use of mobile health (mHealth) apps around the world in recent years. However, consensus regarding an accepted standard to assess the quality of such apps does not exist. Differing interpretations of quality add to this problem. Consequently, it has become increasingly difficult for healthcare professionals to distinguish apps of high quality from those of lower quality. This exposes both patients and healthcare professionals to unnecessary risk. Despite progress, limited understanding of contributions by those in low- and middle- income countries (LMIC) on this topic exists. As such, the applicability of quality assessment methodologies in LMIC settings remains unexplored. OBJECTIVE The objectives of this rapid review are to; 1) Identify current methodologies within the literature to assess the quality of mHealth apps. 2) Understand what aspects of quality these methodologies address. 3) Determine what input has been made by authors from LMICs. 4) Examine the applicability of such methodologies in low- and middle- income settings. METHODS The review is registered with Prospero (CRD42020205149). A search of PubMed, EMBASE, Web of Science and Scopus was performed for papers relating to mHealth app quality assessment methodologies, published in English between 2005 and the 28th of December, 2020. A thematic and descriptive analysis of methodologies and papers was performed. RESULTS Electronic database searches identified 841 papers. After the screening process, 53 papers remained for inclusion; 6 proposed novel methodologies which could be used to evaluate mHealth apps of diverse medical areas of interest; 8 proposed methodologies which could be used to assess apps concerned with a specific medical focus; 39 used methodologies developed by other published authors to evaluate the quality of various groups of mHealth apps. Authors of 3 papers were solely affiliated to institutes in LMICs. A further 8 papers had at least one co-author affiliated to an institute in a LMIC. CONCLUSIONS Quality assessment of mHealth apps is complex in nature and at times, subjective. Despite growing research on this topic, to date an all-encompassing, appropriate means for evaluating the quality of mHealth apps does not exist. There has been engagement with authors affiliated to institutes in LMICs, however limited consideration of current generic methodologies for application in a LMIC settings have been identified.

Public attitudes and the challenge of stigma

2020 ◽  
pp. 6-11
Author(s):  
Nicole Votruba ◽  
Mirja Koschorke ◽  
Graham Thornicroft
Keyword(s):  
Mental Illness ◽  
Public Attitudes ◽  
Social Contact ◽  
Future Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Stigma And Discrimination ◽  
People With Mental Illness ◽  
Culturally Adapted ◽  
Low And Middle Income

People with mental illness frequently face challenges related to knowledge, attitudes, and behaviour. These challenges are more commonly known as stigma and discrimination, and appear universally with local and regional variations in their content and manifestations. They display in low levels of mental health literacy among the general population (ignorance/knowledge), negative affect towards people with experience of mental illness (prejudice/attitudes), and social exclusion and diminished citizenship for people with mental illness (discrimination/behaviour). This chapter looks at how people with mental illness are impacted by stigma and discrimination, considering the evidence of the implications of these knowledge, attitudes, and behaviour, and summarizes the literature on what can be done to effectively reduce stigma and discrimination. Increasingly strong evidence suggests that personal and social contact methods, including filmed/virtual contact, are the most strongly evidence-based method to reduce stigma and discrimination. Yet, most evidence is from high-income countries and tested for short- to mid-term efficacy. This evidence gap increases the need for more evidence from low- and middle-income countries and validation of sustainability in more long-term studies. In summary and for future research and interventions, service users will the key partners in anti-stigma programmes, and interventions specifically locally and culturally adapted for use in low- and middle-income countries are a pressing priority.

scholarly journals A rapid review of evidence on the determinants of and strategies for COVID-19 vaccine acceptance in low- and middle-income countries

2021 ◽  
Vol 11 ◽  
Author(s):  
Sandeep Moola ◽  
Nachiket Gudi ◽  
Devaki Nambiar ◽  
Neha Dumka ◽  
Tarannum Ahmed ◽  
...  
Keyword(s):  
Rapid Review ◽  
Vaccine Acceptance ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Customer Assistance Programs and Affordability Issues in Water Supply and Sanitation

2020 ◽  
Author(s):  
Joseph Cook
Keyword(s):  
Low Income ◽  
The United States ◽  
Resource Scarcity ◽  
Low Income Countries ◽  
Assistance Program ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Poor ◽  
Low And Middle Income ◽  
Housing Units

Concerns about water affordability have centered on access to networked services in low-income countries, but have grown in high-income countries as water, sewer, and stormwater tariffs, which fund replacement of aging infrastructure and management of demand, have risen. The political context includes a UN-recognized human right to water and a set of Sustainable Development Goals that explicitly reference affordable services in water, sanitation, and other sectors. Affordability has traditionally been measured as the ratio of combined water and sewer bills divided by total income or expenditures. Subjective decisions are then made about what constitutes an “affordable” ratio, and the fraction paying more than this is calculated. This measurement approach typically omits the coping costs associated with poor supply, notably the time costs of carrying water home. Three less commonly used approaches include calculating (a) the expenditure related to procuring a “lifeline” quantity of water as a percent of income or expenditures, (b) the amount of income left for other needs after water and sewer expenditures are subtracted, and (c) the number of hours of minimum wage work needed to purchase an essential quantity of water. Lowering water rates for all customers does not necessarily help those in need in low- and middle-income countries. This includes tariff structures that subsidize the price of water in the lowest block or tier (i.e., lifeline blocks) for all customers, not just the poor. Affordability programs that do not operate through tariffs can be characterized by (a) how they are administered and funded, (b) how they target the poor, and (c) how they deliver subsidies to the poor. Common types of delivery mechanisms include subsidizing public taps for unconnected households, subsidizing or financing the fees associated with obtaining a connection to the piped network, and subsidizing monthly bills for poor households. Means-tested consumption subsidies are most common in industrialized countries, whereas subsidizing public taps and connection fees are more common in low- and middle-income countries. A final challenge is directing subsidies to renters who are more likely to be poor and who do not have a direct relationship with a water utility because they pay for water through their landlord, either included as part of their rent or as a separate water payment. Based on data from the 2013 American Housing Survey, approximately 21% of all housing units in the United States are occupied by this type of “hard to reach” customer, although not all of them would be considered poor or eligible for an assistance program. This ratio is as high as 74% of all housing units in metropolitan areas like New York City. Because of data limitations, there are no similar estimates in low-income countries. Instead of sector-by-sector affordability policies, governments might do better to think about the entire package of services a poor person has a perceived right to consume. Direct income support, calculated to cover a package of basic services, could then be delivered to the poor, preserving their autonomy to make spending decisions and preserving the appropriate signals about resource scarcity.

scholarly journals Effectiveness of task-shifting for the detection of diabetic retinopathy in low- and middle-income countries: a rapid review protocol.

2020 ◽  
Author(s):  
Covadonga Bascaran ◽  
Nyawira Mwangi ◽  
Fabrizio D’Esposito ◽  
Iris Gordon ◽  
Juan Alberto Lopez Ulloa ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
English Language ◽  
Vision Loss ◽  
Data Extraction ◽  
Task Shifting ◽  
Rapid Review ◽  
Middle Income ◽  
Diabetic Retinopathy Screening ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Background Diabetic retinopathy is the most common ocular complication of diabetes and a cause of vision loss in adults. Diabetic retinopathy screening leading to early identification of the disease, followed by timely treatment, can prevent vision loss in people living with diabetes. A key barrier to the implementation of screening services in low- and middle-income countries is the low number of ophthalmologists per million population. Interventions that shift screening to non-ophthalmology cadres have been implemented in programmes in low- and middle-income countries and are routinely used in high-income countries. Methods We will search MEDLINE, Embase, Global Health and Cochrane Register of Studies for studies reporting task-shifting interventions for diabetic retinopathy detection. The review will include studies published in the last 10 years in the English language. We will include any interventional or observational comparative study measuring outcomes in terms of participation or access to diabetic retinopathy detection services (uptake) and quality of diabetic retinopathy detection services (detection, severity, diagnostic accuracy). For included studies cost-effectiveness of the task-shifting intervention will also be presented. Two reviewers will screen search results independently. The risk of bias assessment and data extraction will be carried out by one reviewer with verification of 10% of the papers by a second reviewer. The results will be synthesised narratively. Discussion The aim of this rapid review is to summarise the published literature reporting the effectiveness of task-shifting interventions for the detection of diabetic retinopathy by non-ophthalmologists low- and middle-income countries. The results will be of interest to policy makers and programme managers tasked with designing and implementing services to prevent and manage diabetes and its complications in similar settings. Rapid review registration OSF: osf.io/h5wgr

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