scholarly journals Mitigating the impact of COVID-19 on tuberculosis and HIV services: A cross-sectional survey of 669 health professionals in 64 low and middle-income countries

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0244936
Author(s):  
Mishal S. Khan ◽  
Sonia Rego ◽  
Joaquín Benítez Rajal ◽  
Virginia Bond ◽  
Razia Kaneez Fatima ◽  
...  
Keyword(s):  
Online Survey ◽  
Transport Sector ◽  
Food Supplementation ◽  
Medical Support ◽  
Cross Sectional ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

Objective The experiences of frontline healthcare professionals are essential in identifying strategies to mitigate the disruption to healthcare services caused by the COVID-19 pandemic. Methods We conducted a cross-sectional study of TB and HIV professionals in low and middle-income countries (LMIC). Between May 12 and August 6, 2020, we collected qualitative and quantitative data using an online survey in 11 languages. We used descriptive statistics and thematic analysis to analyse responses. Findings 669 respondents from 64 countries completed the survey. Over 40% stated that it was either impossible or much harder for TB and HIV patients to reach healthcare facilities since COVID-19. The most common barriers reported to affect patients were: fear of getting infected with SARS-CoV-2, transport disruptions and movement restrictions. 37% and 28% of responses about TB and HIV stated that healthcare provider access to facilities was also severely impacted. Strategies to address reduced transport needs and costs–including proactive coordination between the health and transport sector and cards that facilitate lower cost or easier travel—were presented in qualitative responses. Access to non-medical support for patients, such as food supplementation or counselling, was severely disrupted according to 36% and 31% of HIV and TB respondents respectively; qualitative data suggested that the need for such services was exacerbated. Conclusion Patients and healthcare providers across numerous LMIC faced substantial challenges in accessing healthcare facilities, and non-medical support for patients was particularly impacted. Synthesising recommendations of frontline professionals should be prioritised for informing policymakers and healthcare service delivery organisations.

scholarly journals Mitigating the impact of COVID-19 on tuberculosis and HIV services: a cross-sectional survey of 669 health professionals in 64 low and middle-income countries

2020 ◽  
Author(s):  
Mishal S. Khan ◽  
Sonia Rego ◽  
Joaquín Benítez Rajal ◽  
Virginia Bond ◽  
Razia Kaneez Fatima ◽  
...  
Keyword(s):  
Online Survey ◽  
Transport Sector ◽  
Food Supplementation ◽  
Medical Support ◽  
Cross Sectional ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

AbstractObjectiveThe experiences of frontline healthcare professionals are essential in identifying strategies to mitigate the disruption to healthcare services caused by the COVID-19 pandemic.MethodsWe conducted a cross-sectional study of TB and HIV professionals in low and middle-income countries (LMIC). Between May 12 and August 6 2020, we collected qualitative and quantitative data using an online survey in 11 languages. We used descriptive statistics and thematic analysis to analyse responses.Findings669 respondents from 64 countries completed the survey. Over 40% stated that it was either impossible or much harder for TB and HIV patients to reach healthcare facilities since COVID-19. The most common barriers reported to affect patients were: fear of getting infected with SARS-CoV-2, transport disruptions and movement restrictions. 37% and 28% of responses about TB and HIV stated that healthcare provider access to facilities was also severely impacted. Strategies to address reduced transport needs and costs – including proactive coordination between the health and transport sector and cards that facilitate lower cost or easier travel - were presented in qualitative responses. Access to non-medical support for patients, such as food supplementation or counselling, was severely disrupted according to 36% and 31% of HIV and TB respondents respectively; qualitative data suggested that the need for such services was exacerbated.ConclusionPatients and healthcare providers across numerous LMIC faced substantial challenges in accessing healthcare facilities, and non-medical support for patients was particularly impacted. Synthesising recommendations of frontline professionals should be prioritised for informing policymakers and healthcare service delivery organisations.

scholarly journals The impact of COVID-19 on the care of people living with noncommunicable diseases in low- and middle-income countries: an online survey of physicians and pharmacists in nine countries

2021 ◽  
Vol 22 ◽  
Author(s):  
Chris Bullen ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
Varsha Parag ◽  
Kannan Subramaniam ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare Workers ◽  
Online Survey ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Measures ◽  
The Impact ◽  
Low And Middle Income

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.

scholarly journals Exploring the influencing factors for non-utilisation of healthcare facilities during childbirth: a special mixed-method study of Bangladesh and 13 other low- and middle-income countries based on Demographic and Health Survey data

2019 ◽  
Vol 7 (4) ◽  
pp. e000008
Author(s):  
Tanjim Siddiquee ◽  
Henry Ratul Halder ◽  
Md Akhtarul Islam
Keyword(s):  
Birth Order ◽  
Health Survey ◽  
Mixed Method ◽  
Demographic And Health Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Middle Income Countries ◽  
Significant Factors ◽  
Low And Middle Income

ObjectiveTo identify the associated factors affecting the decision regarding institutional delivery for pregnant women in 14 low- and middle-income countries (LMICs).DesignA special mixed-method design was used to combine cross-sectional studies for harmonising data from Bangladesh and 13 other countries to obtain extended viewpoints on non-utilisation of institutional healthcare facilities during childbirth.SettingDemographic and Health Survey (DHS) data for 14 LMICs were used for the study.ParticipantsThere are several kinds of datasets in the DHS. Among them ‘IndividualWomen’s Records’ was used as this study is based on all ever-married women.ResultsIn the binary logistic and meta-analysis models for Bangladesh, ORs for birth order were 0.57 and 0.51 and for respondents’ age were 1.50 and 1.07, respectively. In all 14 LMICs, the most significant factors for not using institutional facilities during childbirth were respondents’ age (OR 0.903, 95% CI 0.790 to 1.032) and birth order (OR 0.371, 95% CI 0.327 to 0.421).ConclusionBirth order and respondents’ age were the two most significant factors for non-utilisation of healthcare facilities during childbirth in 14 LMICs.

scholarly journals The Impact of COVID-19 on the Care of Patients With Noncommunicable Diseases in Low- and Middle-Income Countries: An Online Survey of Patient Perspectives

2021 ◽  
Vol 8 ◽  
pp. 237437352110340
Author(s):  
Ratna Devi ◽  
Felicity Goodyear-Smith ◽  
Kannan Subramaniam ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
...  
Keyword(s):  
Health Care ◽  
Online Survey ◽  
Well Being ◽  
Control Measures ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact ◽  
Mental Well Being ◽  
Low And Middle Income

We sought to gain insights into the impacts of COVID-19 and associated control measures on health and health care of patients from low- and middle-income countries with cardiovascular disease, diabetes, and mental health conditions, using an online survey during the COVID-19 pandemic. The most common concern for the 1487 patients who took part was contracting COVID-19 when they accessed health care. Of those infected with COVID-19, half said that their health had been worse since being infected. Collectively, most people reported an increase in feelings of stress and loneliness. The COVID-19 pandemic has led to a range of health care impacts on patients with noncommunicable diseases, including constraints on access to care and health effects, particularly mental well-being.

Satisfaction and Acceptability Ratings of a Web-Based Self-Help Intervention for Depression: A Retrospective and Cross-Sectional Study from a Developing Country (Preprint)

2021 ◽  
Author(s):  
María Asunción Lara ◽  
Pamela Patiño ◽  
Marcela Tiburcio ◽  
Laura Navarrete
Keyword(s):  
Online Survey ◽  
Attempted Suicide ◽  
High Income ◽  
Paid Work ◽  
Cross Sectional ◽  
Middle Income ◽  
Web Based ◽  
Middle Income Countries ◽  
English Speaking ◽  
Low And Middle Income

BACKGROUND Web-based interventions can offer effective and accessible help for depression to large numbers of people at low cost. While these interventions have a long history in high-income countries, they are at an early stage in non-English-speaking low- and middle- income countries, where they remain relatively new and scarce. Help for Depression (HDep) is one of the few unguided web-based interventions available in Latin America. It is multimodal and based on the cognitive behavioral therapy (CBT) approach. The results of a usage/usability analysis of the original version of HDep served as the basis for generating a more user-friendly second version, freely available since 2014. OBJECTIVE The aim of this study was to explore participants’ satisfaction and acceptability ratings for the HDep, second version. METHODS A retrospective, cross-sectional design was used. An email invitation to complete an online survey was sent to all the people who accessed HDep in 2018. The questionnaire included satisfaction and acceptability scales and open-ended questions. Complete questionnaires were retrieved from 191 participants: 67 from those who visited only the home page (HPUs) and 124 from those who registered to use the program (PUs). RESULTS In all groups, users experienced high levels of depressive symptoms (98.9% CES-D > 16). Moderate levels of satisfaction (HPUs M = 21.90, SD = 6.7; PUs M = 21.10, SD = 5.8; range: 8-32) and acceptability (HPUs M = 13.84, SD = 3.97; PUs M = 13.97, SD = 3.29; range: 5-20) were found in both groups. Logistic regression analyses showed that among HPUs, women were more satisfied with HDep (OR = 3.44; 95% CI: 1.16-10.0), while among PUs, older respondents (OR = 1.04; 95% CI: 1.01-1.08), those with paid work (OR = 3.12; 95% CI: 2.40-7.69) those who had not been in therapy (OR = 2.42; 95% CI: 1.09-5.98), and those who had not attempted suicide (OR = 3.44; 95% CI: 1.08-11.11) showed higher satisfaction. None of the sociodemographic/mental health variables distinguished acceptability ratings among HPUs. Among PUs, those with paid work (OR = 2.50; 95% CI: 1.16-5.55), those who had not been in therapy (OR = 3.17; 95% CI: 1.38-7.30), those without disability (OR = 2.94; 95% CI: 1.35-6.66), and those who had not attempted suicide (OR = 2.63; 95% CI: 1.03-6.66) showed higher acceptability. CONCLUSIONS HDep has good levels of satisfaction and acceptability for just over half of its users, and the information provided by respondents suggested feasible ways to remedy some of the deficiencies. This qualitative-quantitative study from a low/middle-income non-English speaking country adds to existing knowledge regarding acceptance and satisfaction with CBT-based programs for depression in high-income countries. This information is important for the creation and adaptation of web-based interventions in low- and middle-income countries, where access to treatment is a major concern, and online prevention and treatment programs can help to deliver evidence-based alternatives. It is necessary to document the pitfalls, strengths, and challenges of such interventions in this context. Understanding how users perceive the intervention might suggest modifications to increase adherence.

scholarly journals Hierarchical disentanglement of contextual from compositional risk factors of diarrhoea among under-five children in low- and middle-income countries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
A. Olalekan Uthman ◽  
Latifat Ibisomi
Keyword(s):  
Risk Factors ◽  
National Level ◽  
Cross Sectional ◽  
Middle Income ◽  
Contextual Risk ◽  
Under Five ◽  
Factors Associated ◽  
Under Five Children ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractSeveral studies have documented the burden and risk factors associated with diarrhoea in low and middle-income countries (LMIC). To the best of our knowledge, the contextual and compositional factors associated with diarrhoea across LMIC were poorly operationalized, explored and understood in these studies. We investigated multilevel risk factors associated with diarrhoea among under-five children in LMIC. We analysed diarrhoea-related information of 796,150 under-five children (Level 1) nested within 63,378 neighbourhoods (Level 2) from 57 LMIC (Level 3) using the latest data from cross-sectional and nationally representative Demographic Health Survey conducted between 2010 and 2018. We used multivariable hierarchical Bayesian logistic regression models for data analysis. The overall prevalence of diarrhoea was 14.4% (95% confidence interval 14.2–14.7) ranging from 3.8% in Armenia to 31.4% in Yemen. The odds of diarrhoea was highest among male children, infants, having small birth weights, households in poorer wealth quintiles, children whose mothers had only primary education, and children who had no access to media. Children from neighbourhoods with high illiteracy [adjusted odds ratio (aOR) = 1.07, 95% credible interval (CrI) 1.04–1.10] rates were more likely to have diarrhoea. At the country-level, the odds of diarrhoea nearly doubled (aOR = 1.88, 95% CrI 1.23–2.83) and tripled (aOR = 2.66, 95% CrI 1.65–3.89) among children from countries with middle and lowest human development index respectively. Diarrhoea remains a major health challenge among under-five children in most LMIC. We identified diverse individual-level, community-level and national-level factors associated with the development of diarrhoea among under-five children in these countries and disentangled the associated contextual risk factors from the compositional risk factors. Our findings underscore the need to revitalize existing policies on child and maternal health and implement interventions to prevent diarrhoea at the individual-, community- and societal-levels. The current study showed how the drive to the attainment of SDGs 1, 2, 4, 6 and 10 will enhance the attainment of SDG 3.

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