scholarly journals Including the voice of people living with viral hepatitis: lessons learned from Japan to accelerate progress towards global hepatitis elimination

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Atsuko Yonezawa ◽  
Rebecca Grant ◽  
Yusuke Shimakawa
Keyword(s):  
Viral Hepatitis ◽  
Low Income ◽  
50Th Anniversary ◽  
Lessons Learned ◽  
Middle Income ◽  
Middle Income Countries ◽  
Patient Groups ◽  
Successful Control ◽  
The Voice

AbstractDespite the growing momentum created by the WHO for eliminating viral hepatitis as a public health threat by 2030, the global response is still slow and more actions are needed to meet the elimination goals, especially in low-income and middle-income countries. Japan is one of a handful of countries currently on track to achieve the WHO hepatitis elimination targets by 2030. To better understand the successful control of viral hepatitis in Japan, it is important to recognize the role of the patient association for viral hepatitis, known as the “Japan Hepatitis Council”, which celebrates its 50th anniversary in 2021. The greatest impact of the Japan Hepatitis Council has been in achieving wider access to antiviral treatments for viral hepatitis. The example of Japan and the Japan Hepatitis Council highlights the need for the engagement of civil society and patient groups to ensure equitable access to hepatitis services and to accelerate the global hepatitis elimination.

scholarly journals Two cases of cholera O1 in South Batinah, Oman, April 2019: lessons learned

2019 ◽  
Vol 41 ◽  
pp. e2019033
Author(s):  
Zayid K. Al Mayahi ◽  
Nasser Al-Shaqsi ◽  
Hamid A. Elmutashi ◽  
Ali Al-Dhoyani ◽  
Azza Al Hattali ◽  
...  
Keyword(s):  
Infection Control ◽  
Low Income ◽  
Lessons Learned ◽  
Control Measures ◽  
Care Level ◽  
Middle Income ◽  
Primary Care Level ◽  
Middle Income Countries ◽  
Infection Control Measures ◽  
Detection Point

Cholera represents an ongoing threat to many low-income and middle-income countries, but some cases of cholera even occur in high-income countries. Therefore, to prevent or combat cholera outbreaks, it is necessary to maintain the capacity to rapidly detect cholera cases, implement infection control measures, and improve general hygiene in terms of the environment, water, and food. The 2 cases, 1 imported and 1 secondary, described herein are broadly indicative of areas that require improvement. These cases were missed at the primary health care stage, which should be the first detection point even for unusual diseases such as cholera, and the absence of strict infection control practices at the primary care level is believed to contribute to secondary cases of infection. This report also encourages countries to ensure that rapid diagnostic stool tests are available to enable quick detection, as well as to provide information to people travelling to areas where cholera is endemic.

scholarly journals Withholding and Withdrawal of Life-Sustaining Treatments in critically ill ICU patients: A study on attitude of Physicians of Bangladesh

2019 ◽  
Vol 7 (2) ◽  
pp. 66-72
Author(s):  
Mohammad Omar Faruq ◽  
ARM Nooruzzaman ◽  
Rownak Jahan Tamanna ◽  
Amina Sultana ◽  
Uzzwal Kumar Mallick ◽  
...  
Keyword(s):  
Low Income ◽  
International Study ◽  
Legal Rights ◽  
Asian Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Icu Physicians ◽  
Real Chance

Background : This study is a sub analysis of data submitted on behalf of Bangladesh in an International study ( ACME 2012) involving physicians working in Asian ICUs. Objective : To describe attitude of physicians of ICUs of Bangladesh toward withholding and withdrawal of life sustaining treatments in end of life care, to assess factors associated with these observations and to compare the findings especially with those of physicians of low – middle income Asian ICUs. Method : Self-administered pre-set structured and scenario based survey conducted among 101 physicians working in 38 ICUs of Bangladesh. Results : For patients with no real chance of recovering a meaningful life, 20 of 101 respondents reported that they almost always or often withheld life-sustaining treatments and 18 of 101 respondents almost always or often withdrew life-sustaining treatments.44 respondents in our study reported that they almost always or often withheld life sustaining treatments whereas 10 respondents almost always or often withdrew life sustaining treatments. 72% of all our respondents would implement DNR orders. In Bangladesh, religion (Islam) does not influence decision of complying with DNR order requested by family. Our study showed 71% of physicians were more likely to “do everything” if a patient with hypoxic-ischaemic encephalopathy developed septic shock. In our study, physicians were more ready to withdraw vasopressors and hemo dialysis than enteral feeding and intravenous fluids. Physicians from Bangladesh generally perceived more legal risk with limitation of life sustaining treatments because of lack of legislation for such practices. When it comes to limit aggressive lifesaving treatments, Bangladeshi physicians were less likely accede to families request to withdraw them on financial ground. Conclusion : Like physicians of low-middle income countries of Asia, Bangladeshi ICU physicians’ self-reported practice of limiting life sustaining treatments, role of families and surrogates and perception of legal rights were significantly different than physicians of high income countries of Asia. However unlike physicians from other low income Asian countries, physicians from Bangladesh were less likely to accede to families request to withdraw life sustaining treatments on financial ground. Bangladesh Crit Care J September 2019; 7(2): 66-72

scholarly journals Receiving Social Assistance in Low- and Middle-Income Countries: Negating Shame or Producing Stigma?

2019 ◽  
Vol 49 (4) ◽  
pp. 705-723 ◽  
Author(s):  
KEETIE ROELEN
Keyword(s):  
Low Income ◽  
Social Assistance ◽  
Low Income Countries ◽  
Policy Options ◽  
Negative Effects ◽  
Middle Income ◽  
Middle Income Countries ◽  
Critical Exploration ◽  
Low And Middle Income

AbstractDespite the centrality of shame and stigma within research on welfare in high-income countries, these issues only exist within the periphery of rapidly expanding practice in and research on social assistance in low- and middle-income countries. This oversight undermines social assistance’s potential in breaking the poverty-shame cycle and ignores its role in the (re)production of shame and stigma. This article offers a critical exploration of the role of social assistance in alleviating or reinforcing shame and stigma in low- and middle-income countries. Findings indicate that positive and negative effects co-exist but that far too little evidence is available to judge whether social assistance receipt overwhelmingly negates or plays into shame and stigma, particularly in low-income countries. Greater awareness of the interface between social assistance, shame and stigma, explorations of policy options that minimise or counter stigmatisation, and critical engagement with ideological and political discourse underpinning design and delivery of interventions represent crucial steps to move towards ‘shame proofing’ social assistance in low- and middle-income countries.

scholarly journals Primary healthcare policy and governance in low-income and middle-income countries: an evidence gap map

2019 ◽  
Vol 4 (Suppl 8) ◽  
pp. e001453 ◽  
Author(s):  
K M Saif-Ur-Rahman ◽  
Razib Mamun ◽  
Iffat Nowrin ◽  
Shahed Hossain ◽  
Khaleda Islam ◽  
...  
Keyword(s):  
Social Responsibility ◽  
Low Income ◽  
Primary Healthcare ◽  
Evidence Synthesis ◽  
Nominal Group ◽  
Provider Communication ◽  
Middle Income ◽  
Stakeholder Consultation ◽  
Middle Income Countries

IntroductionGovernance is one of the most important aspects for strong primary healthcare (PHC) service delivery. To achieve the targets for the Sustainable Development Goals, good governance may play a prime role in low-income and middle-income countries (LMICs). This evidence gap map (EGM) explored the available evidence in LMICs to identify the knowledge gap concerning PHC policy and governance in these settings.MethodsWe followed the standard 3ie EGM protocol, finalising the scope of the EGM through a stakeholder workshop. We searched a total of 32 bibliographic databases, systematic review databases, impact evaluation databases, and donor and bilateral agency databases using a comprehensive search strategy. Two reviewers screened retrieved studies, extracted data and performed quality assessment. We plotted the interventions and outcomes derived from the included studies in a dynamic platform to build the interactive EGM and conducted a stakeholder consultation with nominal group technique methods to prioritise the identified gaps.ResultsThe EGM included 24 systematic reviews and 7 impact evaluations focusing on PHC policy and governance in LMICs. Most of the sources emphasised workforce management and supervision. There were noticeable evidence gaps regarding accountability and social responsibility. The most highly prioritised themes were the role of accountability, the role of public–private partnerships and the role of user–provider communication in PHC governance.ConclusionsThis EGM identified some important aspects of PHC policy and governance such as accountability, social responsibility, public–private partnership, user–provider communication through the methodological approaches of evidence synthesis and stakeholder consultation. Identified gaps will provide directions for an implementation research plan to improve the governance of PHC in LMICs.

The Role of Technical Standards in Improving Digital Accessibility in Under-Resourced Regions and Communities

2021 ◽  
pp. 128-151
Author(s):  
Judy Brewer ◽  
Shadi Abou-Zahra
Keyword(s):  
Low Income ◽  
People With Disabilities ◽  
Indigenous Communities ◽  
Technical Standards ◽  
Middle Income ◽  
Barriers To Participation ◽  
Middle Income Countries

People with disabilities in under-resourced communities, including in low-income and lower middle-income countries and in many Indigenous communities, have not yet benefited as much from digital accessibility as have people with disabilities in higher-income regions. This chapter addresses factors that contribute to these disparities and describes the role of standards in promoting digital accessibility. It describes barriers to participation, approaches that can help improve opportunities for people from under-resourced communities to engage in development of accessibility standards and accessible technologies, and steps that can increase promotion and uptake of digital accessibility standards in under-resourced regions and communities.

scholarly journals Community health workers and early detection of breast cancer in low-income and middle-income countries: a systematic scoping review of the literature

2020 ◽  
Vol 5 (5) ◽  
pp. e002466
Author(s):  
James O'Donovan ◽  
Ashley Newcomb ◽  
MacKenzie Clark MacRae ◽  
Dorice Vieira ◽  
Chinelo Onyilofor ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Scoping Review ◽  
Low Income ◽  
Health Workers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Breast Cancer Early Detection ◽  
Cancer Early Detection

BackgroundBreast cancer is the leading cause of female mortality in low-income and middle-income countries (LMICs). Early detection of breast cancer, either through screening or early diagnosis initiatives, led by community health workers (CHWs) has been proposed as a potential way to address the unjustly high mortality rates. We therefore document: (1) where and how CHWs are currently deployed in this role; (2) how CHWs are trained, including the content, duration and outcomes of training; and (3) the evidence on costs associated with deploying CHWs in breast cancer early detection.MethodsWe conducted a systematic scoping review and searched eight major databases, as well as the grey literature. We included original studies focusing on the role of CHWs to assist in breast cancer early detection in a country defined as a LMIC according to the World Bank.Findings16 eligible studies were identified. Several roles were identified for CHWs including awareness raising and community education (n=13); history taking (n=7); performing clinical breast examination (n=9); making onward referrals (n=7); and assisting in patient navigation and follow-up (n=4). Details surrounding training programmes were poorly reported and no studies provided a formal cost analysis.ConclusionsDespite the relative paucity of studies addressing the role of CHWs in breast cancer early detection, as well as the heterogeneity of existing studies, evidence suggests that CHWs can play a number of important roles in breast cancer early detection initiatives in LMICs. However, if they are to realise their full potential, they must be appropriately supported within the wider health system.

scholarly journals Using social networks to scale up and sustain community-based programmes to improve physical activity and diet in low-income and middle-income countries: a scoping review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053586
Author(s):  
Nina Abrahams ◽  
Estelle V Lambert ◽  
Frederick Marais ◽  
Zoi Toumpakari ◽  
Charlie Foster
Keyword(s):  
Physical Activity ◽  
Social Networks ◽  
Scoping Review ◽  
Low Income ◽  
Scale Up ◽  
Community Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Review Protocol

IntroductionThe World Health Organisation endorses community-based programmes as a cost-effective, feasible and a ‘best buy’ in the prevention and management of non-communicable diseases (NCDs). These programmes are particularly successful when the community actively participates in its design, implementation and evaluation. However, they may be only useful insofar as they can be scaled up and sustained in some meaningful way. Social network research may serve as an important tool for determining the underlying mechanisms that contribute to this process. The aim of this planned scoping review is to map and collate literature on the role of social networks in scaling-up and sustaining community-based physical activity and diet programmes in low-income and middle-income countries.Methods and analysisThis scoping review protocol has been planned around the Arksey and O'Malley framework and its enhancement. Inclusion criteria are peer-reviewed articles and grey literature exploring the role of social networks in the scale-up and/or sustainability of NCD prevention community-based programmes in adult populations. Studies must have been published since 2000, in English, and be based in a low-income or middle-income country. The following databases will be used for this review: PubMed, Cochrane, Scopus, Web of Science, CINAHL, SocIndex, the International Bibliography of the Social Sciences, Google and Google Scholar. Books, conference abstracts and research focused only on children will be excluded. Two reviewers will independently select and extract eligible studies. Included publications will be thematically analysed using the Framework Approach.Ethics and disseminationEthical approval will not be sought for this review as no individual-level data or human participants will be involved. This protocol is registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/KG7TX). The findings from the review will be published in an accredited journal. The Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews checklist will be used to support transparency and guide translation of the review.

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