scholarly journals Reflections on the use of the World Health Organization’s (WHO) OneHealth Tool: Implications for health planning in low and middle income countries (LMICs)

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 157 ◽  
Author(s):  
John Q. Wong ◽  
Nel Jason Haw ◽  
Jhanna Uy ◽  
Diana Beatriz Bayani
Keyword(s):  
Health Insurance ◽  
Priority Setting ◽  
Health Planning ◽  
Noncommunicable Disease ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Service Coverage ◽  
Low And Middle Income

The World Health Organization (WHO) launched the OneHealth Tool (OHT) to help low and middle income countries to develop their capacities for sector-wide priority setting. In 2016, we sought to use the OHT to aid the Philippine Health Insurance Corporation (PHIC), the national health insurer of the Philippines, in decisions to expand benefit packages using cost-effectiveness analyses. With technical support from the WHO, we convened health planning officers from the Philippine Department of Health (DOH) and the Philippine Health Insurance Corporation (PHIC) conduct generalized cost-effective analyses (GCEA) of selected un-financed noncommunicable disease interventions using OHT. We collected epidemiological and cost data through health facility surveys, review of literature such as cost libraries and clinical practice guidelines, and expert consultations. Although we were unable to use GCEA results directly to set policy, we learnt important policy lessons which we outline here that might help inform other countries looking to inform service coverage decisions. Additionally, the entire process and GCEA visualizations helped high-level policymakers in the health sector, who have traditionally relied on ad hoc decision making, to realize the need for a systematic and transparent priority-setting process that can continuously provide the evidence needed to inform service coverage decisions.

scholarly journals Reflections on the use of the World Health Organization’s (WHO) OneHealth Tool: Implications for health planning in low and middle income countries (LMICs)

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 157
Author(s):  
John Q. Wong ◽  
Nel Jason Haw ◽  
Jhanna Uy ◽  
Diana Beatriz Bayani
Keyword(s):  
Health Insurance ◽  
Priority Setting ◽  
Health Planning ◽  
Noncommunicable Disease ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Service Coverage ◽  
Low And Middle Income

The World Health Organization (WHO) launched the OneHealth Tool (OHT) to help low and middle income countries to develop their capacities for sector-wide priority setting. In 2016, we sought to use the OHT to aid the Philippine Health Insurance Corporation (PHIC), the national health insurer of the Philippines, in decisions to expand benefit packages using cost-effectiveness analyses. With technical support from the WHO, we convened health planning officers from the Philippine Department of Health (DOH) and the Philippine Health Insurance Corporation (PHIC) conduct generalized cost-effective analyses (GCEA) of selected un-financed noncommunicable disease interventions using OHT. We collected epidemiological and cost data through health facility surveys, review of literature such as cost libraries and clinical practice guidelines, and expert consultations. Although we were unable to use GCEA results directly to set policy, we learnt important policy lessons which we outline here that might help inform other countries looking to inform service coverage decisions. Additionally, the entire process and GCEA visualizations helped high-level policymakers in the health sector, who have traditionally relied on ad hoc decision making, to realize the need for a systematic and transparent priority-setting process that can continuously provide the evidence needed to inform service coverage decisions.

scholarly journals Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2439
Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  
Keyword(s):  
Health Survey ◽  
Low Income ◽  
World Health ◽  
Low Income Countries ◽  
Multivariable Logistic Regression Analysis ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

scholarly journals The potential of low-intensity and online interventions for depression in low- and middle-income countries

2016 ◽  
Vol 3 ◽  
Author(s):  
C. L. H. Bockting ◽  
A. D. Williams ◽  
K. Carswell ◽  
A. E. Grech
Keyword(s):  
Mental Health ◽  
World Health ◽  
Online Interventions ◽  
Treatment Protocols ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Intensity ◽  
The World ◽  
Health Gap ◽  
Low And Middle Income

The World Health Organization (WHO) reports that low- and middle-income countries (LMICs) are confronted with a serious ‘mental health gap’, indicating an enormous disparity between the number of individuals in need of mental health care and the availability of professionals to provide such care (WHO in 2010). Traditional forms of mental health services (i.e. face-to-face, individualised assessments and interventions) are therefore not feasible. We propose three strategies for addressing this mental health gap: delivery of evidence-based, low-intensity interventions by non-specialists, the use of transdiagnostic treatment protocols, and strategic deployment of technology to facilitate access and uptake. We urge researchers from all over the world to conduct feasibility studies and randomised controlled studies on the effect of low-intensity interventions and technology supported (e.g. online) interventions in LMICs, preferably using an active control condition as comparison, to ensure we disseminate effective treatments in LMICs.

scholarly journals A Symptom-based COVID-19 Diagnostic Tool in case of Limited Testing Facilities

2020 ◽  
pp. 71-75
Author(s):  
Raiiq Ridwan ◽  
Md Robed Amin ◽  
Md Ridwanur Rahman
Keyword(s):  
World Health ◽  
Atypical Pneumonia ◽  
New Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Health Organization ◽  
Transmission Of Disease ◽  
Limited Testing ◽  
Low And Middle Income

Since December 2019, when a cluster of atypical pneumonia cases were identified in Wuhan, China a new disease has spread across the world. COVID-19 has since become the biggest pandemic in a century, touching lives in almost every country in the world. At the outset of COVID-19, the World Health Organization advised for testing to become a priority so that patients with COVID-19 could be quickly identified, isolated and treated to interrupt transmission of disease. However, testing shortages have been an increasing problem in low and middle income countries. Even when tests are available, it has proved time-consuming. Therefore, we propose a symptom-based tool to assist in the diagnosis of COVID-19 management in low and middle income Countries. It is based on the symptoms that have so far been described in the literature and advises the frontline healthcare worker on how to diagnose the likelihood of having COVID-19 and separate the patient into Red (very likely), Yellow (possible) and Green (unlikely) categories. J Bangladesh Coll Phys Surg 2020; 38(0): 71-75

scholarly journals Cervical cancer screening – The challenges of complete pathways of care in low-income countries: Focus on Malawi

2020 ◽  
Vol 16 ◽  
pp. 174550652091480
Author(s):  
Heather A Cubie ◽  
Christine Campbell
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
World Health ◽  
Middle Income ◽  
Low Resource ◽  
Middle Income Countries ◽  
The World ◽  
Health Organization ◽  
Pathways Of Care ◽  
Low And Middle Income

Cervical cancer is the fourth most common cancer among women globally, with approximately 580,000 new diagnoses in 2018. Approximately, 90% of deaths from this disease occur in low- and middle-income countries, especially in areas of high HIV prevalence, and largely due to limited prevention and screening opportunities and scarce treatment options. In this overview, we describe the opportunities and challenges faced in many low- and middle-income countries in delivery of cervical cancer detection, treatment and complete pathways of care. In particular, drawing on our experience and that of colleagues, we describe cervical screening and pathways of care provision in Malawi, as a case study of a low-resource country with high incidence and mortality rates of cervical cancer. Screening methods such as cytology – although widely used in high-income countries – have limited relevance in many low-resource settings. The World Health Organization recommends screening using human papillomavirus testing wherever possible; however, although human papillomavirus primary testing is more sensitive and detects precancers and cancers earlier than cytology, there are currently costs, infrastructure considerations and specificity issues that limit its use in low- and middle-income countries. The World Health Organization accepts the alternative screening approach of visual inspection with acetic acid as part of ‘screen and treat’ programmes as a simple and inexpensive test that can be undertaken by trained health workers and hence give wider screening coverage; however, subjectivity and variability in interpretation of findings between providers raise issues of false positives and overtreatment. Cryotherapy using either nitrous oxide or carbon dioxide is an established treatment for precancerous lesions within ‘screen and treat’ programmes; more recently, thermal ablation has been recognized as suitable to low-resource settings due to lightweight equipment, short treatment times, and hand-held battery-operated and solar-powered models. For larger lesions and cancers, complete clinical pathways (including loop excision, surgery, radiotherapy, chemotherapy and palliative care) are required for optimal care of women. However, provision of each of these components of cancer control is often limited due to limited infrastructure and lack of trained personnel. Hence, global initiatives to reduce cervical mortality need to adopt a holistic approach to health systems strengthening.

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