Validation of the SF12 mental and physical health measure for the population from a low-income country in sub-Saharan Africa

Abstract Background In light of the increasing burden of non-communicable diseases on health systems in low- and middle-income countries, particularly in Sub-Saharan Africa, context adapted cost effective service delivery models are now required as a matter of urgency. Multiple models have thus been trialled across Africa with varying degrees of success. Zimbabwe is a low-income country with unique socio-economic challenges but similar dual disease burden of infectious chronic diseases such as HIV and non-communicable diseases. We aim to describe the experience of setting up and organising a nurse-led Diabetes Mellitus (DM) and Hypertension (HTN) model of care in a rural context of a low-income country from July 2016 to June 2019.Methods A descriptive study based on a conceptual framework successfully applied in the roll-out of antiretroviral therapy in Manicaland Province, Zimbabwe. Attempting to mirror the HIV experience, we describe the key enablers in the design and implementation of the model: decentralization of services, integration of care, simplification of management guidelines, mentoring and task-sharing, provision of affordable medicines, quality assured laboratory support, patient empowerment, a dedicated monitoring and evaluation system, and a robust referral system.Results 11 out of 51 health facilities were selected in Chipinge district, of which nine were primary health care (PHC) clinics and two were hospitals. DM/HTN services were set up and integrated into the general out-patient department or pre-existing HIV clinics. In one hospital, an integrated chronic care clinic was established. Through structured intensive mentoring, including simplified protocols, nurses in seven PHC facilities and one hospital developed sufficient knowledge and skills to diagnose, initiate treatment and monitor DM/HTN patients. Overall, more than 3000 patients were registered in a dedicated recording system and offered education. Free medication with differentiated periodic refills and regular monitoring of blood pressure and/or blood glucose with the use of glycosylated haemoglobin were provided.Conclusion Our experience shows that it is feasible to implement nurse-led decentralized integrated DM/HTN care in a high HIV prevalence rural, low-income context. Developing a context-adapted efficient model of care is a dynamic process.

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Ethiopia’s homegrown economic reforms face challenges

Emerald Expert Briefings ◽

10.1108/oxan-db247239 ◽

2019 ◽

Keyword(s):

Economic Reform ◽

Low Income ◽

Income Country ◽

Middle Income ◽

Content Type ◽

Reform Agenda ◽

Low Income Country ◽

Debt Burden ◽

Sub Saharan ◽

The Government

Subject Outlook for Ethiopia's economic reform agenda. Significance The government has launched a “Homegrown Economic Reform” agenda, which aims to transform Ethiopia from a largely agrarian low-income country to an industrialised lower-middle-income country by 2030. This will require the private sector to take charge of growth amid waning public sector financing capacity. However, significant economic liberalisation within this timeframe is unrealistic given the entrenched nature of the old command economy. Impacts Ethiopia has overtaken Angola as Sub-Saharan Africa’s third-largest economy but slowing growth could threaten this new status. The large external debt burden and high import content of the new agenda will curb plans to liberalise the exchange rate. Ethio Telecom and Ethiopian Airlines will be the crown jewels among proposed privatisation offerings.

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Associations of day of week and time of day of ICU admission with hospital mortality in Malawi

Tropical Doctor ◽

10.1177/0049475520936011 ◽

2020 ◽

Vol 50 (4) ◽

pp. 303-311

Author(s):

Meghan Prin ◽

Ruoyu Ji ◽

Clement Kadyaudzu ◽

Guohua Li ◽

Anthony Charles

Keyword(s):

Intensive Care Unit ◽

Hospital Mortality ◽

Low Income ◽

Primary Outcome ◽

Time Of Day ◽

Sub Saharan Africa ◽

Low Income Country ◽

Sub Saharan ◽

Night And Day ◽

Time Of Admission

This prospective cohort study evaluated the associations of day and time of admission to the Intensive Care Unit (ICU) with hospital mortality at a referral hospital in Malawi, a low-income country in sub-Saharan Africa. Patients admitted to the ICU during the day (08:00–16:00) were compared to those admitted at night (16:01–07:59); patients admitted on weekdays (Monday–Friday) were compared to admissions on weekends/holidays. The primary outcome was hospital mortality. Most patients were admitted during daytime (56%) and on weekdays (72%). There was no difference in mortality between night and day admissions (58% vs. 56%, P = 0.8828; hazard ratio [HR] = 1.09, 95% confidence interval [CI = 0.82–1.44, P = 0.5614) or weekend/holiday versus weekday admissions (56% vs. 57%, P = 0.9011; HR = 0.87, 95% CI = 0.62–1.21, P = 0.4133). No interaction between time and day was found. These results may be affected by high overall hospital mortality.

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Survival and Quality of Life of Patients after Rectal Cancer Surgery in a Low-Income Country: A Study in Cameroon, Sub-Saharan African Region

Surgical Science ◽

10.4236/ss.2021.128027 ◽

2021 ◽

Vol 12 (08) ◽

pp. 261-273

Author(s):

Guy Aristide Bang ◽

Eric Patrick Savom ◽

Georges Bwelle Moto ◽

Julienne Yambassa Fayam ◽

Yannick Mahamat Ekani Boukar ◽

...

Keyword(s):

Quality Of Life ◽

Rectal Cancer ◽

Low Income ◽

Cancer Surgery ◽

Income Country ◽

Rectal Cancer Surgery ◽

African Region ◽

Low Income Country ◽

Sub Saharan

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Rational and design of SATRACD study: detecting subclinical anthracycline therapy related cardiac dysfunction in low income country

African Health Sciences ◽

10.4314/ahs.v21i2.21 ◽

2021 ◽

Vol 21 (2) ◽

pp. 647-654

Author(s):

Wanzhu Zhang ◽

Feriel Azibani ◽

Emmy Okello ◽

James Kayima ◽

Victoria Walusansa ◽

...

Keyword(s):

Cancer Survivors ◽

Cancer Patients ◽

Low Income ◽

Cardiac Dysfunction ◽

Cardiovascular Outcome ◽

Sub Saharan Africa ◽

Income Country ◽

Health Concern ◽

Low Income Country ◽

Anthracycline Therapy

Background: Anthracycline therapy-related cardiac dysfunction (ATRCD) is the most notorious adverse side-effect of chemotherapy. It has become a significant cardiovascular health concern for long-term cancer survivors. With the emerging concept of subclinical ATRCD and newer diagnostictools (Speckle Tracking Echocardiography (STE) and biomarkers), detecting anthracycline cardiac toxicity at an early stage has become an important step to prevent severe cardiac dysfunction and improve the cardiovascular outcome in cancer survivors. Despite the increasing population at risk in sub-Saharan Africa (SSA), there is no contemporary data in Uganda to address the burden, pathogenesis and risk factors of subclinical ATRCD. This big gap in knowledge has led to a lack of local guidelines for monitoring and management of ATRCD. Methods: SATRACD (Detecting Subclinical Anthracycline Therapy Related Cardiac Dysfunction In Low Income Country) study is an observational prospective cohort study. Three hundred and fifty-three anthracycline naïve cancer patients will be recruited at baseline. Patients are followed up on completion of anthracycline-based chemotherapy and at 6 months after completion of anthracycline therapy. Data on demographics, cancer profile and clinical presentation will be collected at baseline. Comprehensive cardiac assessment will be performed at each visit, including electrocardiogram, conventional echo- cardiography, STE, cardiac and oxidative stress markers. We will be able to determine the incidence of subclinical and clinical ATRCD at 6 months after completion of anthracycline therapy, determine whether hypertension is a major risk factor for ATRCD, evaluate the role of conventional echocardiography parameters, and biomarkers for detecting subclinical ATRCD. Conclusion: This SATRACD study will provide contemporary data on Ugandan cancer patients who have subclinical and clinical ATRCD, help in the development of local strategies to prevent and manage ATRCD, and improve cardiovascular outcome for Ugandan cancer survivors. Keywords: SATRACD study; subclinical anthracycline therapy; cardiac dysfunction; low income country.

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Monetary Policy in Sub-Saharan Africa

10.1093/oso/9780198785811.001.0001 ◽

2018 ◽

Cited By ~ 1

Keyword(s):

Monetary Policy ◽

Low Income ◽

Sub Saharan Africa ◽

Low Income Countries ◽

African Countries ◽

Policy Regimes ◽

Export Prices ◽

Policy Work ◽

Sub Saharan ◽

Policy Guidance

Having broadly stabilized inflation over the past two decades, many policymakers in sub-Saharan Africa are now asking more of their monetary policy frameworks. They are looking to avoid policy misalignments and respond appropriately to both domestic and external shocks, including swings in fiscal policy and spikes in food and export prices. In many cases they are finding current regimes—often characterized as ‘money targeting’—lacking, with opaque and sometimes inconsistent objectives, inadequate transmission of policy to the economy, and difficulties in responding to supply shocks. At the same time, little existing research on monetary policy is targeted to low-income countries. What do we know about the empirics of monetary transmission in low-income countries? (How) Does monetary policy work in countries characterized by a huge share of food in consumption, underdeveloped financial markets, and opaque policy regimes? (How) Can we use methods largely derived in advanced countries to answer these questions? And (how) can we use the results to guide policymakers? This book draws on years of research and practice at the IMF and in central banks from the region to shed empirical and theoretical light on these questions and to provide practical tools and policy guidance. A key feature of the book is the application of dynamic general equilibrium models, suitably adapted to reflect key features of low-income countries, for the analysis of monetary policy in sub-Saharan African countries.

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