A review of pedestrian safety models for urban areas in Low and Middle Income Countries

Abstract Globally, 40 million people need palliative care; about 69% are people over 60 years of age. The highest proportion (78%) of adults are from low- and middle-income countries (LMICs), where palliative care still developing and is primarily limited to urban areas. This integrative review describes strategies used by LMICs to establish palliative care in rural areas. A rigorous integrative review methodology was utilized using four electronic databases (Ovid MEDLINE, Ovid Emcare, Embase classic+Embase and CINAHL). The search terms were: ‘palliative care’, ‘hospice care’, ‘end of life care’, ‘home-based care’, ‘volunteer’, ‘rural’, ‘regional’, ‘remote’ and ‘developing countries’ identified by the United Nations (UN) as ‘Africa’, ‘Sub-Saharan Africa’, ‘low-income’ and ‘middle- income countries’. Thirty papers published in English from 1990 to 2019 were included. Papers were appraised for quality and extracted data subjected to analysis using a public health model (policy, drug availability, education and implementation) as a framework to describe strategies for establishing palliative care in rural areas. The methodological quality of the reviewed papers was low, with 7 of the 30 being simple programme descriptions. Despite the inclusion of palliative care in national health policy in some countries, implementation in the community was often reliant on advocacy and financial support from non-government organizations. Networking to coordinate care and medication availability near-patient homes were essential features of implementation. Training, role play, education and mentorship were strategies used to support health providers and volunteers. Home- and community-based palliative care services for rural LMICs communities may best be delivered using a networked service among health professionals, community volunteers, religious leaders and technology.

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Inequalities in Antenatal Care Coverage and Quality: an Analysis From 63 Low and Middle-income Countries Using the ANCq Content-qualified Coverage Indicator

10.21203/rs.3.rs-120640/v1 ◽

2020 ◽

Author(s):

Luisa Arroyave ◽

Ghada E Saad ◽

Cesar G Victora ◽

Aluisio J D Barros

Keyword(s):

Antenatal Care ◽

Urban Areas ◽

Global Analysis ◽

Socioeconomic Inequalities ◽

Middle Income ◽

National Surveys ◽

Middle Income Countries ◽

Wide Range ◽

The Difference ◽

Low And Middle Income

Abstract Background: Antenatal care (ANC) is an essential intervention associated with a reduction of maternal and new-born morbidity and mortality. However, evidence suggested substantial inequalities in maternal and child health, mainly in low- and middle-income countries (LMICs). We aimed to conduct a global analysis of socioeconomic inequalities in ANC using national surveys from LMICs.Methods: ANC was measured using the ANCq, a novel content-qualified ANC coverage indicator, created and validated using national surveys, based upon contact with the health services and content of care received. We performed stratified analysis to explore the socioeconomic inequalities in ANCq. We also estimated the slope index of inequality, which measures the difference in coverage along the wealth spectrum. Results: We analyzed 63 national surveys carried out from 2010 to 2017. There were large inequalities between and within countries. Higher ANCq scores were observed among women living in urban areas, with secondary or more level of education, belonging to wealthier families and with higher empowerment in nearly all countries. Countries with higher ANCq mean presented lower inequalities; while countries with average ANCq scores presented wide range of inequality, with some managing to achieve very low inequality.Conclusions: Despite all efforts in ANC programs, important inequalities in coverage and quality of ANC services persist. If maternal and child mortality Sustainable Development Goals are to be achieved, those gaps we documented must be bridged.

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Expanding the use of community health workers in urban settings: a potential strategy for progress towards universal health coverage

Health Policy and Planning ◽

10.1093/heapol/czz133 ◽

2019 ◽

Cited By ~ 3

Author(s):

Brian Wahl ◽

Susanna Lehtimaki ◽

Stefan Germann ◽

Nina Schwalbe

Keyword(s):

Health Services ◽

Community Health ◽

Low Income ◽

Urban Areas ◽

Access To Health Services ◽

Middle Income ◽

Urban Settings ◽

Middle Income Countries ◽

Access To Health ◽

Low And Middle Income

Abstract Community health worker (CHW) programmes have been used for decades to improve access to health services in rural settings in low- and middle-income countries. With more than half of the world’s population currently living in urban areas and this population expected to grow, equitable access to health services in urban areas is critically important. To understand the extent to which CHW programmes have been successfully deployed in low-income urban settings, we conducted a review of the literature between 2000 and 2018 to identify studies evaluating and describing CHW programmes implemented fully or partially in urban or peri-urban settings. We identified 32 peer-reviewed articles that met our inclusion criteria. Benefits have been documented in several urban settings in low- and middle-income countries including those to address TB/HIV, child health, maternal health and non-communicable diseases through a variety of study designs.

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Inequalities in antenatal care coverage and quality: an analysis from 63 low and middle-income countries using the ANCq content-qualified coverage indicator

International Journal for Equity in Health ◽

10.1186/s12939-021-01440-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Luisa Arroyave ◽

Ghada E. Saad ◽

Cesar G. Victora ◽

Aluisio J. D. Barros

Keyword(s):

Antenatal Care ◽

Urban Areas ◽

Global Analysis ◽

Socioeconomic Inequalities ◽

Middle Income ◽

National Surveys ◽

Middle Income Countries ◽

Wide Range ◽

The Difference ◽

Low And Middle Income

Abstract Background Antenatal care (ANC) is an essential intervention associated with a reduction of maternal and new-born morbidity and mortality. However, evidence suggested substantial inequalities in maternal and child health, mainly in low- and middle-income countries (LMICs). We aimed to conduct a global analysis of socioeconomic inequalities in ANC using national surveys from LMICs. Methods ANC was measured using the ANCq, a novel content-qualified ANC coverage indicator, created and validated using national surveys, based upon contact with the health services and content of care received. We performed stratified analysis to explore the socioeconomic inequalities in ANCq. We also estimated the slope index of inequality, which measures the difference in coverage along the wealth spectrum. Results We analyzed 63 national surveys carried out from 2010 to 2017. There were large inequalities between and within countries. Higher ANCq scores were observed among women living in urban areas, with secondary or more level of education, belonging to wealthier families and with higher empowerment in nearly all countries. Countries with higher ANCq mean presented lower inequalities; while countries with average ANCq scores presented wide range of inequality, with some managing to achieve very low inequality. Conclusions Despite all efforts in ANC programs, important inequalities in coverage and quality of ANC services persist. If maternal and child mortality Sustainable Development Goals are to be achieved, those gaps we documented must be bridged.

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Does connectivity reduce gender gaps in off-farm employment? Evidence from 12 low- and middle-income countries

10.35188/unu-wider/2021/937-2 ◽

2021 ◽

Author(s):

Eva-Maria Egger ◽

Aslihan Arslan ◽

Emanuele Zucchini

Keyword(s):

Young Women ◽

Gender Gap ◽

Rural Areas ◽

Urban Areas ◽

Sub Saharan Africa ◽

Gender Gaps ◽

Middle Income ◽

Middle Income Countries ◽

Entry Points ◽

Low And Middle Income

Gender gaps in labour force participation in developing countries persist despite income growth or structural change. We assess this persistence across economic geographies within countries, focusing on youth employment in off-farm wage jobs. We combine household survey data from 12 low- and middle-income countries in Asia, Latin America, and sub-Saharan Africa with geospatial data on population density, and estimate simultaneous probit models of different activity choices across the rural-urban gradient. The gender gap increases with connectivity from rural to peri-urban areas, and disappears in high-density urban areas. In non-rural areas, child dependency does not constrain young women, and secondary education improves their access to off-farm employment. The gender gap persists for married young women independent of connectivity improvements, indicating social norm constraints. Marital status and child dependency are associated positively with male participation, and negatively with female participation; other factors such as education are show a positive association for both sexes. These results indicate entry points for policy.

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Inequalities in antenatal care coverage and quality: an analysis from 63 low and middle-income countries using the ANCq content-qualified coverage indicator

10.1101/2020.11.11.20230102 ◽

2020 ◽

Author(s):

Luisa Arroyave ◽

Ghada E Saad ◽

Cesar G Victora ◽

Aluisio J D Barros

Keyword(s):

Antenatal Care ◽

Urban Areas ◽

Global Analysis ◽

Socioeconomic Inequalities ◽

Middle Income ◽

National Surveys ◽

Middle Income Countries ◽

Wide Range ◽

The Difference ◽

Low And Middle Income

AbstractObjectiveto conduct a global analysis of socioeconomic inequalities in antenatal care (ANC) using national surveys from low- and middle-income countries.MethodsANC was measured using the ANCq, a novel content-qualified ANC coverage indicator, created and validated using national surveys, based upon contact with the health services and content of care received. We performed stratified analysis to explore the socioeconomic inequalities in ANCq. We also estimated the slope index of inequality, which measures the difference in coverage along the wealth spectrum.ResultsWe analyzed 63 national surveys carried out from 2010 to 2017. There were large inequalities between and within countries. Higher ANCq scores were observed among women living in urban areas, with secondary or more level of education, belonging to wealthier families and with higher empowerment in nearly all countries. Countries with higher ANCq mean presented lower inequalities; while countries with average ANCq scores presented wide range of inequality, with some managing to achieve very low inequality.ConclusionsDespite all efforts in ANC programs, important inequalities in coverage and quality of ANC services persist. If maternal and child mortality Sustainable Development Goals are to be achieved, those gaps we documented must be bridged.

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The co-occurrence of overweight/obesity and anaemia among adult women, adolescent girls and children living in 52 low-and middle-income countries

Public Health Nutrition ◽

10.1017/s1368980021002512 ◽

2021 ◽

pp. 1-25

Author(s):

Ana Irache ◽

Paramjit Gill ◽

Rishi Caleyachetty

Keyword(s):

Adolescent Girls ◽

Urban Areas ◽

Household Wealth ◽

Education Level ◽

Demographic And Health Surveys ◽

Adult Women ◽

Middle Income ◽

Middle Income Countries ◽

Percentage Points ◽

Low And Middle Income

Abstract Objective: To investigate the magnitude and distribution of concurrent overweight/obesity and anaemia among adult women, adolescent girls and children living in low-and middle-income countries (LMICs). Design: We selected the most recent Demographic and Health Surveys with anthropometric and haemoglobin level measures. Prevalence estimates and 95% CIs of concurrent overweight/obesity and anaemia were calculated for every country, overall and stratified by household wealth quintile, education level, area of residence and sex (for children only). Regional and overall pooled prevalences were estimated using a random-effects model. We measured gaps, expressed in percentage points, to display inequalities in the distribution of the double burden of malnutrition (DBM). Setting: Nationally representative surveys from 52 LMICs. Participants: Adult women (n=825,769) aged 20-49 years, adolescent girls (n=192,631) aged 15-19 years, and children (n=391,963) aged 6-59 months. Results: The pooled prevalence of concurrent overweight/obesity and anaemia was 12.4% (95% CI: 11.1, 13.7) among adult women, 4.5% (95% CI: 4.0, 5.0) among adolescent girls and 3.0% (95% CI: 2.7, 3.3) among children. Overall, the DBM followed an inverse social gradient, with a higher prevalence among the richest quintile, most educated groups and in urban areas; however, important variations exist. The largest inequality gaps were observed among adult women in Yemen by household wealth (24.0 percentage-points) and in Niger by education level (19.6 percentage-points) and area of residence (11.9 percentage-points). Differences were predominantly significant among adult women; but less among girls and children. Conclusions: Context-specific, multifaceted, responses with an equity-lens are needed to reduce all forms of malnutrition.

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Socioeconomic and demographic drivers of red and processed meat consumption: implications for health and environmental sustainability

Proceedings of The Nutrition Society ◽

10.1017/s0029665116000100 ◽

2016 ◽

Vol 75 (3) ◽

pp. 367-373 ◽

Cited By ~ 21

Author(s):

Angie Clonan ◽

Katharine E. Roberts ◽

Michelle Holdsworth

Keyword(s):

Environmental Sustainability ◽

Urban Areas ◽

Communicable Disease ◽

Processed Meat ◽

Middle Income ◽

Clear Cut ◽

Middle Income Countries ◽

Demographic Patterns ◽

Red And Processed Meat ◽

Low And Middle Income

Red and processed meat (RPM) intake varies widely globally. In some high-income countries (HIC) the last decade has witnessed an overall decline or stabilisation in the consumption of RPM, in contrast to emerging economies where its consumption continues to increase with rising income and rapid urbanisation. The production and consumption of RPM have become major concerns regarding the environmental impacts of livestock in particular, but also because of associations between high RPM consumption and diet-related non-communicable disease. Therefore, it is important to identify socioeconomic and demographic drivers of the consumption of RPM. This paper explores how consumption of RPM differs with age, gender, socioeconomic status and in different global contexts. There are some key socioeconomic and demographic patterns in RPM consumption. Men tend to consume RPM more often and in higher quantities, and there is evidence of a social gradient in HIC, with lower socioeconomic groups consuming RPM more often and in larger quantities. Patterns for consumption with age are less clear cut. It is apparent that consumers in HIC are still consuming high levels of RPM, although the downward shifts in some socioeconomic and demographic groups is encouraging and suggests that strategies could be developed to engage those consumers identified as high RPM consumers. In low- and middle-income countries, RPM consumption is rising, especially in China and Brazil, and in urban areas. Ways of encouraging populations to maintain their traditional healthy eating patterns need to be found in low- and middle-income countries, which will have health, environmental and economic co-benefits.

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Hybrid Modes of Urban Water Delivery in Low- and Middle-Income Countries

Oxford Research Encyclopedia of Environmental Science ◽

10.1093/acrefore/9780199389414.013.679 ◽

2020 ◽

Author(s):

Alison Post ◽

Isha Ray

Keyword(s):

Urban Areas ◽

Service Providers ◽

Policy Formulation ◽

Small Scale ◽

Urban Water ◽

Water Delivery ◽

Middle Income ◽

Middle Income Countries ◽

Hybrid Nature ◽

Low And Middle Income

Most urban residents in high-income countries obtain piped and treated water for drinking and domestic use from centralized utility-run water systems. In low- and middle-income countries (LMICs), however, utilities work alongside myriad other service providers that deliver water to hundreds of millions of city-dwellers. Hybrid modes of water delivery in urban areas in low- and middle-income countries are systems in which a variety of state and nonstate actors contribute to the delivery of water to households, schools, healthcare facilities, businesses, and government offices. Historically, the field has evolved to include within-utility networks and outside-the-utility provision mechanisms. Utilities service the urban core through network connections, while nonstate, smaller-scale providers supplement utility services both inside and outside the piped network. The main reform waves since the 1990s—privatization and corporatization—have done little to alter the hybrid nature of provision. Numerous case studies of nonutility water providers suggest that they are imperfect substitutes for utilities. They reach millions of households with no access to piped water, but the water they deliver tends to be of uncertain quality and is typically far more expensive than utility water. Newer work on utility-provided water and utility reforms has highlighted the political challenges of private sector participation in urban water; debates have also focused on the importance of contractual details such as tariff structures and investor incentives. New research has produced numerous studies on LMICs on the ways in which utilities extend their service areas and service types through explicit and implicit relationships with front-line water workers and with supplemental nonstate water suppliers. From the nonutility perspective, debates animated by questions of price and quality, the desirability or possibility of regulation, and the compatibility (or lack thereof) between reliance on small-scale water providers and the human right to safe water, are key areas of research. While understanding the hybrid nature of water delivery is essential for responsible policy formulation and for understanding inequalities in the urban sphere, there is no substitute for the convenience and affordability of universal utility provision, and no question that research on the conditions under which particular types of reforms can improve utility provision is sorely needed.

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Need for an Integrated Deprived Area “Slum” Mapping System (IDEAMAPS) in Low- and Middle-Income Countries (LMICs)

Social Sciences ◽

10.3390/socsci9050080 ◽

2020 ◽

Vol 9 (5) ◽

pp. 80 ◽

Cited By ~ 5

Author(s):

Dana R. Thomson ◽

Monika Kuffer ◽

Gianluca Boo ◽

Beatrice Hati ◽

Tais Grippa ◽

...

Keyword(s):

Urban Areas ◽

Informal Settlement ◽

Social Characteristics ◽

Visual Interpretation ◽

Middle Income ◽

Household Level ◽

Middle Income Countries ◽

The People ◽

Low And Middle Income

Ninety percent of the people added to the planet over the next 30 years will live in African and Asian cities, and a large portion of these populations will reside in deprived neighborhoods defined by slum conditions, informal settlement, or inadequate housing. The four current approaches to neighborhood deprivation mapping are largely siloed, and each fall short of producing accurate, timely, and comparable maps that reflect local contexts. The first approach, classifying “slum households” in census and survey data, reflects household-level rather than neighborhood-level deprivation. The second approach, field-based mapping, can produce the most accurate and context-relevant maps for a given neighborhood, however it requires substantial resources, preventing up-scaling. The third and fourth approaches, human (visual) interpretation and machine classification of air or spaceborne imagery, both overemphasize informal settlements, and fail to represent key social characteristics of deprived areas such as lack of tenure, exposure to pollution, and lack of public services. We summarize common areas of understanding, and present a set of requirements and a framework to produce routine, accurate maps of deprived urban areas that can be used by local-to-international stakeholders for advocacy, planning, and decision-making across Low- and Middle-Income Countries (LMICs). We suggest that machine learning models be extended to incorporate social area-level covariates and regular contributions of up-to-date and context-relevant field-based classification of deprived urban areas.

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