scholarly journals Value of statistical life year in extreme poverty: a randomized experiment of measurement methods in rural Burkina Faso

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Stefan T. Trautmann ◽  
Yilong Xu ◽  
Christian König-Kersting ◽  
Bryan N. Patenaude ◽  
Guy Harling ◽  
...  

Abstract Background Value of a Statistical Life Year (VSLY) provides an important economic measure of an individual’s trade-off between health risks and other consumption, and is a widely used policy parameter. Measuring VSLY is complex though, especially in low-income and low-literacy communities. Methods Using a large randomized experiment (N = 3027), we study methodological aspects of stated-preference elicitation with payment cards (price lists) in an extreme poverty context. In a 2 × 2 design, we systematically vary whether buying or selling prices are measured, crossed with the range of the payment card. Results We find substantial effects of both the pricing method and the list range on elicited VSLY. Estimates of the gross domestic product per capita multiplier for VSLY range from 3.5 to 33.5 depending on the study design. Importantly, all estimates are economically and statistically significantly larger than the current World Health Organization threshold of 3.0 for cost-effectiveness analyses. Conclusions Our results inform design choice in VSLY measurements, and provide insight into the potential variability of these measurements and possibly robustness checks.

2021 ◽  
Vol 13 (4) ◽  
pp. 2324
Author(s):  
Sueny Andrade Batista ◽  
Elke Stedefeldt ◽  
Eduardo Yoshio Nakano ◽  
Mariana de Oliveira Cortes ◽  
Raquel Braz Assunção Botelho ◽  
...  

In the fight against foodborne diseases, expanding access to information for different groups is needed. In this aspect, it is crucial to evaluate the target audience’s particularities. This study constructed and validated an instrument containing three questionnaires to identify the level of knowledge, practices, and risk perception of food safety by low-income students between 11 and 14 years old. The following steps were used: systematic search of the databases; conducting and analyzing focus groups; questionnaires development; and questionnaires analysis. After two judges’ rounds, the final version was reached with 11 knowledge items, 11 practice items, and five risk perception items. The content validation index values were higher than 0.80. The adopted methodology considered the students’ understanding and perceptions, as well the appropriate language to be used. Besides, it allowed the development of questionnaires that directly and straightforwardly covers the rules set by the World Health Organization for foodborne disease control called Five Keys to Safer Food (keep clean; separate raw and cooked; cook thoroughly; keep food at safe temperatures; and use safe water and raw materials). Its use can result in a diagnosis for elaborating educational proposals and other actions against foodborne illness in the most vulnerable population.


Author(s):  
Eric D. McCollum ◽  
Melissa M. Higdon ◽  
Nicholas S. S. Fancourt ◽  
Jack Sternal ◽  
William Checkley ◽  
...  

Abstract Background Chest radiography is the standard for diagnosing pediatric lower respiratory infections in low-income and middle-income countries. A method for interpreting pediatric chest radiographs for research endpoints was recently updated by the World Health Organization (WHO) Chest Radiography in Epidemiological Studies project. Research in India required training local physicians to interpret chest radiographs following the WHO method. Objective To describe the methodology for training Indian physicians and evaluate the training’s effectiveness. Materials and methods Twenty-nine physicians (15 radiologists and 14 pediatricians) from India were trained by two WHO Chest Radiography in Epidemiological Studies members over 3 days in May 2019. Training materials were adapted from WHO Chest Radiography in Epidemiological Studies resources. Participants followed WHO methodology to interpret 60 unique chest radiographs before and after the training. Participants needed to correctly classify ≥80% of radiographs for primary endpoint pneumonia on the post-training test to be certified to interpret research images. We analyzed participant performance on both examinations. Results Twenty-six of 29 participants (89.7%) completed both examinations. The average score increased by 9.6% (95% confidence interval [CI] 5.0–14.1%) between examinations (P<0.001). Participants correctly classifying ≥80% of images for primary endpoint pneumonia increased from 69.2% (18/26) on the pretraining to 92.3% (24/26) on the post-training examination (P=0.003). The mean scores of radiologists and pediatricians on the post-training examination were not statistically different (P=0.43). Conclusion Our results demonstrate this training approach using revised WHO definitions and tools was successful, and that non-radiologists can learn to apply these methods as effectively as radiologists. Such capacity strengthening is important for enabling research to support national policy decision-making in these settings. We recommend future research incorporating WHO chest radiograph methodology to consider modelling trainings after this approach.


2020 ◽  
Author(s):  
Faith A. Okalebo ◽  
Eric M. Guantai ◽  
Aggrey O. Nyabuti

ABSTRACTBackgroundIrrational drug use is a global problem. However, the extent of the problem is higher in low-income countries. This study set out to assess and characterize drug use at the public primary healthcare centers (PPHCCs) in a rural county in Kenya, using the World Health Organization/ International Network for the Rational Use of Drugs (WHO/INRUD) core drug use indicators methodology.MethodsTen PPHCCs were randomly selected. From each PPHCC, ninety prescriptions from October to December 2018 were sampled and data extracted. Three-hundred (30 per PPHCC) patients and ten (1 per PPHCC) dispensers were also observed and interviewed. The WHO/INRUD core drug use indicators were used to assess the patterns of drug use.ResultsThe average number of drugs per prescription was 2.9 (SD 0.5) (recommended: 1.6– 1.8), percentage of drugs prescribed by generic names was 27.7% (recommended: 100%); the percentage of prescriptions with an antibiotic was 84.8% (recommended: 20.0–26.8%), and with an injection prescribed was 24.9% (recommended: 13.4–24.1%). The percentage of prescribed drugs from the Kenya Essential Medicines List was 96.7% (recommended: 100%). The average consultation time was 4.1 min (SD 1.7) (recommended: ≥10 min), the average dispensing time was 131.5 sec (SD 41.5) (recommended: ≥90 sec), the percentage of drugs actually dispensed was 76.3% (recommended: 100%), the percentage of drugs adequately labeled was 22.6% (recommended: 100%) and percentage of patients with correct knowledge of dispensed drugs was 54.7% (recommended: 100%). Only 20% of the PPHCCs had a copy of KEML available, and 80% of the selected essential drugs assessed were available.ConclusionThe survey shows irrational drug use practices, particularly polypharmacy, non-generic prescribing, overuse of antibiotics, short consultation time and inadequacy of drug labeling. Effective programs and activities promoting the rational use of drugs are the key interventions suggested at all the health facilities.


2021 ◽  
Author(s):  
Wilfried GUETS ◽  
Deepak Kumar Behera

Abstract Background COVID-19 outbreak has been declared as an emerging and conflict situation by the World Health Organization (WHO) due to the multiple nature of infection through international spread that poses a serious threat to populations’ health and socio-economic conditions household in general. Objective This study aims to analyse the behaviour adopted by households’ heads for preventing COVID-19 infection in Mali. Methods We collected data from the COVID-19 Panel Households survey collected in Mali by the National Statistical Office, Institut National de la Statistique (INSTAT), in collaboration with the World Bank in October 2020. We used a multivariate logistic regression model. Results A total of 1,514 households heads were included. The age between 20 and 90 years old. The poor households represented 27%. Being a household with a low-income reduced the probability of using masks (p < 0.1). Being poor increased the probability to agree with vaccination (p < 0.01). The health services utilisation increased the probability of wear masks (p < 0.01), getting tested (p < 0.01), and agree with the vaccine (p < 0.01). People with a high occupation volume were more likely to wear protective masks (p < 0.1). Conclusion Behaviour and attitude prevention varied according to households characteristics. Local government and policymakers should continue to provide more economic, medical and social assistance to protect the population, which would reduce the spread of the disease, particularly to households living in vulnerable regions of the country most affected by conflict and food insecurity.


2016 ◽  
Vol 36 (3) ◽  
pp. 239-243
Author(s):  
Grisel Marrero ◽  
Lilian P. Delgado ◽  
Humberto Caroll ◽  
Neise Ortiz ◽  
Alexis Musacchio ◽  
...  

Abstract A rapid, specific and sensible polystyrene latex-based reagent has been developed to detect rheumatoid factor (RF) in human sera. Detection of RF is one of the criteria for rheumatoid arthritis (RA) diagnosis. RF includes immunoglobulins IgG, IgM or IgA targeting human-IgG Fc region, found in sera of 70–90% of patients with RA. Spherical, clean polystyrene particles of 480±80 nm with a Z-potential of -28 mV were synthesized. Purified gamma-globulin human blood fraction, used as IgG source, was adsorbed on particles in glycine-buffered saline with a fivefold excess of the immunoglobulins needed to saturate the calculated total surface area of the particles. The reagent was calibrated against the World Health Organization international serum reference preparation and tested with commercial positive and negative RF controls. Reactivity of the developed diagnostic reagent with human sera, either positive or negative for RF, was evaluated. The sera were tested both intact and following complement inactivation. When complement-inactivated sera were used, our reagent showed 100% coincidence of results with a commercial diagnostic kit of specificity of 80% and sensibility of 93%. The in-house reagent developed in the present work is easy to prepare and at relatively low cost, making it ideal for RF detection in low-income settings.


PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 395-395
Author(s):  

The annual military bill is now approaching 450 billion US dollars, while official development aid accounts for less than 5 per cent of this figure. Four examples: 1. The military expenditure of only half a day would suffice to finance the whole malaria eradication programme of the World Health Organization, and less would be needed to conquer river-blindness, which is still the scourge of millions. 2. A modern tank costs about one million dollars; that amount could improve storage facilities for 100,000 tons of rice and thus save 4000 tons or more annually; one person can live on just over a pound of rice a day. The same sum of money could provide 1000 classrooms for 30,000 children. 3. For the price of one jet fighter (20 million dollars) one could set up about 40,000 village pharmacies. 4. One-half of one per cent of one year's world military expenditure would pay for all the farm equipment needed to increase food production and approach self-sufficiency in food-deficit low-income countries by 1990.


2018 ◽  
Vol 49 (3) ◽  
pp. 201-212
Author(s):  
Ana Carolina Amaya Arias ◽  
Óscar Zuluaga ◽  
Douglas Idárraga ◽  
Javier Hernando Eslava Schmalbach

Introduction: Most maternal deaths that occur in developing countries are considered unfair and can be avoided. In 2008, The World Health Organization (WHO) proposed a checklist for childbirth care, in order to assess whether a simple, low-cost intervention had an impact on maternal and neonatal mortality in low-income countries. Objective: To translate, adapt and validate the content of the WHO Safe Childbirth Checklist (SCC) for its use in Colombia Methods: The checklist was translated and adapted to the Colombian context. It was subsequently validated by a panel of experts composed of 17 health workers with experience in maternal and neonatal care and safety. Reliability among judges was estimated (Rwg) and items were modified or added to each section of the list according to the results. Results: Modifications were made to 28 items, while 19 new items were added, and none was removed. The most important modifications were made to the management guidelines included in each item, and the items added refer to risks inherent to our environment. Conclusion: The Colombian version of the SCC will be a useful tool to improve maternal and neonatal care and thereby contribute to reducing maternal and neonatal morbidity and mortality in our country.


2020 ◽  
Vol 110 (10) ◽  
pp. 1567-1572
Author(s):  
Drew Capone ◽  
Oliver Cumming ◽  
Dennis Nichols ◽  
Joe Brown

Objectives. To estimate the population lacking at least basic water and sanitation access in the urban United States. Methods. We compared national estimates of water and sanitation access from the World Health Organization/United Nations Children’s Fund Joint Monitoring Program with estimates from the US Department of Housing and Urban Development on homelessness and the American Community Survey on household water and sanitation facilities. Results. We estimated that at least 930 000 persons in US cities lacked sustained access to at least basic sanitation and 610 000 to at least basic water access, as defined by the United Nations. Conclusions. After accounting for those experiencing homelessness and substandard housing, our estimate of people lacking at least basic water equaled current estimates (n = 610 000)—without considering water quality—and greatly exceeded estimates of sanitation access (n = 28 000). Public Health Implications. Methods to estimate water and sanitation access in the United States should include people experiencing homelessness and other low-income groups, and specific policies are needed to reduce disparities in urban sanitation. We recommend similar estimation efforts for other high-income countries currently reported as having near universal sanitation access.


2014 ◽  
Vol 1 (3) ◽  
Author(s):  
Kenrad E. Nelson ◽  
James W. K. Shih ◽  
Jun Zhang ◽  
Qinjian Zhao ◽  
Ningshao Xia ◽  
...  

Abstract Recurrent, large, waterborne epidemics of hepatitis E virus (HEV) occur regularly after monsoon rains contaminate water supplies in Asia or during humanitarian crises in Africa. These epidemics commonly affect thousands of persons, and it has a high mortality in pregnant women who become infected. Although a subunit HEV vaccine has been developed by Chinese investigators and was found to be highly effective and safe in a large clinical trial, this vaccine is only available in China. Until it is prequalified by the World Health Organization, the vaccine may not be available for use outside of China in low-income countries that lack national vaccine regulatory agencies. In this manuscript, we explore possible strategies for providing access to this potentially important vaccine for international use in responding to epidemics of HEV in low-resource countries.


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