scholarly journals Evaluating medical education regulation changes in Brazil: workforce impact

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Alexandre Medeiros Figueiredo ◽  
Danette Waller McKinley ◽  
Adriano Massuda ◽  
George Dantas Azevedo
Keyword(s):  
Medical Education ◽  
Public Schools ◽  
Low Income ◽  
School Enrollment ◽  
Health Coverage ◽  
Continuous Assessment ◽  
Middle Income ◽  
Unified Health System ◽  
Medical Undergraduate ◽  
The Impact

Abstract Background Shortages and inequitable distribution of physicians is an obstacle to move towards Universal Health Coverage, especially in low-income and middle-income countries. In Brazil, expansion of medical school enrollment, curricula changes and recruitment programs were established to increase the number of physicians in underserved areas. This study seeks to analyze the impact of these measures in reduce inequities in access to medical education and physicians’ distribution. Methods This is an observational study that analyzes changes in the number of undergraduate medical places and number of physicians per inhabitants in different areas in Brazil between the years 2010 and 2018. Data regarding the number of undergraduate medical places, number and the practice location of physicians were obtained in public databases. Municipalities with less than 20,000 inhabitants were considered underserved areas. Data regarding access to antenatal visits were analyzed as a proxy for impact in access to healthcare. Results From 2010 to 2018, 19,519 new medical undergraduate places were created which represents an increase of 120.2%. The increase in the number of physicians engaged in the workforce throughout the period was 113,702 physicians, 74,771 of these physicians in the Unified Health System. The greatest increase in the physicians per 1000 inhabitants ratio in the municipalities with the smallest population, the lowest Gross Domestic Product per capita and in those located in the states with the lowest concentration of physicians occurred in the 2013–2015 period. Increase in physician supply improved access to antenatal care. Conclusions There was an expansion in the number of undergraduate medical places and medical workforce in all groups of municipalities assessed in Brazil. Medical undergraduate places expansion in the federal public schools was more efficient to reduce regional inequities in access to medical education than private sector expansion. The recruitment component of More Doctors for Brazil Program demonstrated effectiveness to increase the number of physicians in underserved areas. Our results indicate the importance of public policies to face inequities in access to medical education and physician shortages and the necessity of continuous assessment during the period of implementation, especially in the context of political and economic changes.

scholarly journals Student Enrollment Patterns and Achievement in Ohio’s Online Charter Schools

2017 ◽  
Vol 46 (1) ◽  
pp. 44-57 ◽  
Author(s):  
June Ahn ◽  
Andrew McEachin
Keyword(s):  
Public Schools ◽  
Charter Schools ◽  
Online Education ◽  
Low Income ◽  
School Enrollment ◽  
Full Time ◽  
Enrollment Patterns ◽  
Traditional Public Schools ◽  
K 12 ◽  
The Impact

We utilize state data of nearly 1.7 million students in Ohio to study a specific sector of online education: K–12 schools that deliver most, if not all, education online, lack a brick-and-mortar presence, and enroll students full-time. First, we explore e-school enrollment patterns and how these patterns vary by student subgroups and geography. Second, we evaluate the impact of e-schools on students’ learning, comparing student outcomes in e-schools to outcomes in two other schooling types, traditional charter schools and traditional public schools. Our results show that students and families appear to self-segregate in stark ways where low-income, lower achieving White students are more likely to choose e-schools while low-income, lower achieving minority students are more likely to opt into the traditional charter school sector. Our results also show that students in e-schools are performing worse on standardized assessments than their peers in traditional charter and traditional public schools. We close with policy recommendations and areas for future research.

scholarly journals Experiences and impact of international medical volunteering: a multi-country mixed methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041599 ◽  
Author(s):  
Mary McCauley ◽  
Joanna Raven ◽  
Nynke van den Broek
Keyword(s):  
Low Income ◽  
Online Survey ◽  
Positive Impact ◽  
Healthcare Providers ◽  
International Medical ◽  
Middle Income ◽  
Use Of Resources ◽  
The Uk ◽  
Medical Volunteers ◽  
The Impact

ObjectiveTo assess the experience and impact of medical volunteers who facilitated training workshops for healthcare providers in maternal and newborn emergency care in 13 countries.SettingsBangladesh, Ghana, India, Kenya, Malawi, Namibia, Nigeria, Pakistan, Sierra Leone, South Africa, Tanzania, UK and Zimbabwe.ParticipantsMedical volunteers from the UK (n=162) and from low-income and middle-income countries (LMIC) (n=138).Outcome measuresExpectations, experience, views, personal and professional impact of the experience of volunteering on medical volunteers based in the UK and in LMIC.ResultsUK-based medical volunteers (n=38) were interviewed using focus group discussions (n=12) and key informant interviews (n=26). 262 volunteers (UK-based n=124 (47.3%), and LMIC-based n=138 (52.7%)) responded to the online survey (62% response rate), covering 506 volunteering episodes. UK-based medical volunteers were motivated by altruism, and perceived volunteering as a valuable opportunity to develop their skills in leadership, teaching and communication, skills reported to be transferable to their home workplace. Medical volunteers based in the UK and in LMIC (n=244) reported increased confidence (98%, n=239); improved teamwork (95%, n=232); strengthened leadership skills (90%, n=220); and reported that volunteering had a positive impact for the host country (96%, n=234) and healthcare providers trained (99%, n=241); formed sustainable partnerships (97%, n=237); promoted multidisciplinary team working (98%, n=239); and was a good use of resources (98%, n=239). Medical volunteers based in LMIC reported higher satisfaction scores than those from the UK with regards to impact on personal and professional development.ConclusionHealthcare providers from the UK and LMIC are highly motivated to volunteer to increase local healthcare providers’ knowledge and skills in low-resource settings. Further research is necessary to understand the experiences of local partners and communities regarding how the impact of international medical volunteering can be mutually beneficial and sustainable with measurable outcomes.

scholarly journals Innovations in medical education in Vietnam

2021 ◽  
Vol 7 (Suppl 1) ◽  
pp. s23-s29
Author(s):  
David B Duong ◽  
Tom Phan ◽  
Nguyen Quang Trung ◽  
Bao Ngoc Le ◽  
Hoa Mai Do ◽  
...  
Keyword(s):  
Medical Education ◽  
Education Reform ◽  
Low Income ◽  
Professional Education ◽  
Education Policies ◽  
Enabling Factors ◽  
Middle Income ◽  
Medical Graduates ◽  
Medical Education Reform ◽  
Crucial Component

Medical education reforms are a crucial component to ensuring healthcare systems can meet current and future population needs. In 2010, a Lancet commission called for ‘a new century of transformative health professional education’, with a particular focus on the needs of low-income and-middle-income countries (LMICs), such as Vietnam. This requires policymakers and educational leaders to find and apply novel and innovative approaches to the design and delivery of medical education. This review describes the current state of physician training in Vietnam and how innovations in medical education curriculum, pedagogy and technology are helping to transform medical education at the undergraduate and graduate levels. It also examines enabling factors, including novel partnerships and new education policies which catalysed and sustained these innovations. Our review focused on the experience of five public universities of medicine and pharmacy currently undergoing medical education reform, along with a newly established private university. Research in the area of medical education innovation is needed. Future work should look at the outcomes of these innovations on medical education and the quality of medical graduates. Nonetheless, this review aims to inspire future innovations in medical education in Vietnam and in other LMICs.

Impact of COVID-19 on FDIs, Remittances and Foreign Aids: A Case Study of Nepal

2021 ◽  
pp. 097639962097420
Author(s):  
Gaurav Bhattarai ◽  
Binita Subedi
Keyword(s):  
United Nations ◽  
Low Income ◽  
Global Economy ◽  
Grey Literature ◽  
Foreign Assistance ◽  
Foreign Direct Investments ◽  
Middle Income ◽  
Low Income Country ◽  
The Government ◽  
The Impact

The global economy has been severely paralysed, owing to the unprecedented crisis triggered by the COVID-19 pandemic, and different studies have indicated that the crisis is relatively more maleficent to the lower-income and middle-income economies. Methodologically, this study relied on the review and analysis of the grey literature, media reporting and data published by the Asian Development Bank, United Nations Conference on Trade and Development (UNCTAD), United Nations (UN), World Bank, International Monetary Fund (IMF) among others. The article begins by describing the impact of the pandemic on low-income and middle-income countries, and it discusses how they have responded to the crisis. While discussions have surfaced regarding whether COVID-19 will reverse the process of globalization, what will be its impact on the low-income country like Nepal? The study also highlights that with foreign direct investments speculated to shrink and foreign assistance and remittance taking a hit, how is Nepal struggling to keep its economy afloat? Analysing the new budget that the government unveiled in 2020, this study concludes with a note that instead of effectively implementing the plans and policies directed by the budget, Nepal is unnecessarily engaged in political mess and is needlessly being dragged into the geopolitical complications.

scholarly journals Psychological distress during COVID-19 pandemic in low-income and middle-income countries: a cross-sectional study of older persons in Thailand

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e047650
Author(s):  
Wiraporn Pothisiri ◽  
Paolo Miguel Manalang Vicerra
Keyword(s):  
Psychological Distress ◽  
Low Income ◽  
Older Persons ◽  
Online Survey ◽  
Well Being ◽  
Secondary Outcome ◽  
Ageing Society ◽  
Psychological Well Being ◽  
Middle Income ◽  
The Impact

ObjectiveThe COVID-19 situation in Thailand was controlled with various social measures. Much of the information covered in the media and in studies focused on the public health and economic aspects of the pandemic. This study aimed to explore the psychological well-being of older people, which is important especially in an ageing society categorised as low income or middle income due to the limits of economic and healthcare resources.SettingThe impact of COVID-19 on older persons in Thailand, an online survey, taken across nine provinces within the five regions of the country.ParticipantsInformation was collected from 1230 adults aged at least 60 years old.If an older person was illiterate, unable to access the internet or had a disability preventing them from responding to the survey, an intermediary residing in the community conducted the survey interview.Primary and secondary outcome measuresThe analysis focused on the worries of older adults and the factors associated with psychological distress experienced during the pandemic using logistic regression analysis.ResultsThe majority of people aged at least 60 years old experienced psychological distress during COVID-19. Employment loss (OR 1.08, 95% CI 0.78 to 1.38), inadequate income (OR 1.77, 95% CI 1.28 to 2.44) and debt incursion (OR 2.74, 95% CI 1.57 to 4.80) were detrimental to psychological well-being. The negative changes in the perception of their health status (OR 1.92, 95% CI 1.23 to 2.99) and decreased life satisfaction (OR 1.49, 95% CI 0.45 to 1.87) also weighed on older Thais. The protective factors for psychological well-being were residing in rural areas (OR 0.46, 95% CI 0.35 to 0.61) and being married (OR 0.75, 95% CI 0.55 to 1.01).ConclusionObserving the concerns of the older population is important for introducing policies that can alleviate their precarious financial and health statuses.

scholarly journals Multimorbidity Patterns and Function Among Adults in Low- and Middle-income Countries: a Scoping Review Protocol

2021 ◽  
Author(s):  
Karina Berner ◽  
Nassib Tawa ◽  
Quinette Louw
Keyword(s):  
Scoping Review ◽  
Low Income ◽  
Data Extraction ◽  
Rehabilitation Services ◽  
Health Coverage ◽  
Policy Planning ◽  
Functional Impairments ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Function

Abstract BackgroundA fifth of adults in low-income and middle-income countries (LMICs) have multimorbid conditions, which are linked to socio-economic deprivation and aging. Multimorbidity is associated with high rates of functional problems and disability, increased healthcare utilization and lower quality of life. Literature on multimorbidity and associations with function is mostly from high-income countries (HICs) and focused among adults. Data regarding patterns and their impact on person-centered outcomes are limited. There is need for research into understanding common patterns of multimorbidity, and their association with functional impairment, particularly in LMICs. Therefore, the need for evidence-based, and context-relevant strategic policy, planning and delivery models for health and rehabilitation services is imperative in attaining Universal Health Coverage (UHC). The planned scoping review aims to provide an overview of the scope and nature of existing literature on multimorbidity patterns and function among adults in LMICs. MethodsA scoping review will be conducted according to a five-step framework guidance. The PRISMA-ScR guidelines will be followed in reporting. A comprehensive electronic search of PubMed, Scopus, EBSCOhost (including MEDLINE and the Cumulative Index to Nursing and Allied Health Literature [CINAHL]), Scielo, Cochrane and Google Scholar will be conducted from January 1976 onwards. Studies will be included if they are primary or secondary, qualitative or quantitative research reported in English, published (between January 1976 and the search date) in a peer-reviewed journal, and describe multimorbidity patterns and associations with physical functional impairments, activity limitations or participation restrictions among adults in LMICs. Search results will be independently screened by two reviewers and data extraction will cover; study characteristics, participants’ characteristics, multimorbidity measures, patterns analysis and functional measures. Descriptive statistics and narrative synthesis will be used to synthesize and summarize the findings.DiscussionPatients with multimorbidity have unique and cross-cutting needs, hence the need for an integrated and person-centered approaches to policy, planning and delivery of medical and rehabilitation services. Considering the shift towards primary healthcare-led management of chronic diseases and UHC, the proposed scoping review is timely and the findings will provide insights into the current extent and scope of multimorbidity research, and guide future inquiry in the field. Protocol registrationOpen Science Framework (OSF), osf.io/gcy7z

Healthcare hackathons: fostering medical education through innovation in a developing country: a case study from Pakistan

2020 ◽  
Vol 7 (1) ◽  
pp. 103-108
Author(s):  
Waqaas Akmal Butt ◽  
Qurratulain Shahood ◽  
Walid Hussain Farooqi ◽  
Kulsoom Ghias ◽  
Saniya Sabzwari ◽  
...  
Keyword(s):  
Medical Education ◽  
Low Income ◽  
Teaching And Learning ◽  
Postgraduate Medical Education ◽  
Learning Potential ◽  
Learning Tool ◽  
Middle Income ◽  
Alternative Teaching ◽  
Before And After

BackgroundHackathons aim to develop solutions to preidentified problem domains and catalyse startup cultures. Recently, the teaching and learning potential of hackathons has also been documented. In this study, we make the case for utilisation of hackathons as an alternative teaching and learning tool geared towards entrepreneurship and as an opportunity for interprofessional integration.MethodsThis research study followed up with participants from the third hackathon at the Aga Khan University in Karachi, Pakistan. Hack MedEd was about solutions to problems of undergraduate and postgraduate medical education with an emphasis on low-income to middle-income countries. Participant evaluation data were filled at the end of the hackathon and gathered from three focused group discussions (FGDs): immediately before and after the event, a delayed follow-up after 11 months was recorded.ResultsOf 116 participants, the majority (71%) were under 30 years old, and over half were female. The evaluations provided by hackers were positive overall with a mean score of 4.37 out of 5 on a Likert Scale. During the FGDs, participants spoke positively of the process and felt that, by the end of the hackathon, they had learnt something new. In the delayed follow-up FGD, teams that had undergone incubation expressed that they had gained a critical and simple skillset that they might not have acquired otherwise.ConclusionHackathons business incubation programmes may be considered an alternative teaching and learning tool—especially for individuals studying or working within the healthcare discipline within low-resource settings.

Environmental Health

2019 ◽  
pp. 363-386
Author(s):  
Barry S. Levy
Keyword(s):  
Environmental Health ◽  
Global Climate Change ◽  
Low Income ◽  
Minority Groups ◽  
Global Climate ◽  
Social Injustice ◽  
Marginalized Populations ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact

This chapter describes the adverse impact of social injustice on environmental health. Environmental pollution is a social injustice for all people, with a disproportionate impact on low- and middle-income countries and, within countries, low-income people, minority groups, and other marginalized populations. The chapter describes the evolution of the environmental justice movement and the studies that have demonstrated disproportionate exposures and the disproportionate occurrence of pollution-related diseases among low-income people, minority groups, and other marginalized populations. A separate section describes the environmental and health consequences of global climate change. Three text boxes focus on childhood lead poisoning, the impact of natural disasters on social justice, and on the new interdiscipilinary field of planetary health.

scholarly journals Nonlinear Dynamics in the Finance-Inequality Nexus in China-CHNS Data

2019 ◽  
Vol 11 (1) ◽  
pp. 191 ◽  
Author(s):  
Mohammad Masudur Rahman ◽  
Guan Fuquan ◽  
Laila Arjuman Ara
Keyword(s):  
Financial Development ◽  
Low Income ◽  
Income Group ◽  
High Income Group ◽  
Middle Income ◽  
Linear Effect ◽  
Quantile Regression Model ◽  
Income Groups ◽  
Using Data ◽  
The Impact

This paper empirically investigates the effects of financial development on incomes of Chinese residents particularly within various income groups using data from six provinces by applying the Quantile Regression model. The Greenwood and Jovanovich hypothesis that illustrates the inverted U shaped relationship between financial development and income inequality is tested. This empirical study demonstrates that financial development has a positive but non-linear effect on the annual income of individuals from various income groups at different quantiles. The effect is an inverted U or Kuznets effect indicating an increase at first and then a drop. As for the distribution of the impact on various income groups, the low-income group is under the most dominant influence followed by the high-income group with the middle-income groups receiving relatively smaller influence. Findings indicate that promoting balanced financial development would help to ease the income gap between Chinese residents.

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