scholarly journals Challenges in Controlling SARS-CoV-2 in a Lower-middle Income Country and the Potential Unintended Effects due to Aggressive Restrictions

2020 ◽  
Author(s):  
Lincoln Lau ◽  
Peng Wu ◽  
Daryn Go ◽  
Warren Dodd ◽  
Charles Yu
Keyword(s):  
Health Systems ◽  
The Philippines ◽  
Unintended Consequences ◽  
Middle Income Country ◽  
Unintended Effects ◽  
Middle Income ◽  
Middle Income Countries ◽  
Number Of Patients ◽  
Community Transmission ◽  
Official Data

In response to the COVID-19 pandemic, the Philippines placed the majority of the country under enhanced community quarantine, restricting the movement of most of its 100 million plus population. These aggressive measures were initiated on March 15, 2020 and intensified on March 17. According to official data, the number of confirmed COVID-19 cases has exponentially increased during this period, but it is important to note that the number of patients tested also substantially increased during the same period. It is not conclusive that widespread transmission of COVID-19 only started in March and our analysis suggests that community transmission was happening earlier. In discussing extended quarantine measures, it is important to properly understand the trends and recognize the limitations of the data. The unintended consequences on the population, especially in lower-middle income countries with fragile health systems like the Philippines, must be carefully considered.

Forecasting the global need for high-dose methotrexate to prevent and mitigate shortages.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6571-6571
Author(s):  
Scott C. Howard ◽  
Andre Michel Ilbawi ◽  
Brian Lewis ◽  
Catherine Lam
Keyword(s):  
Low Income ◽  
Generic Drugs ◽  
Primary Cns Lymphoma ◽  
The Philippines ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Middle Income ◽  
Middle Income Countries ◽  
Dose Methotrexate ◽  
Number Of Patients

6571 Background: Causes of drug shortages in low-income and middle-income countries are numerous and often more than one cause contributes. Shortages are especially problematic when they involve drugs like high-dose methotrexate (HDMTX), which is required for several highly curable cancers and has no good substitute. Morocco is currently experiencing a national shortage of high-dose methotrexate that has so far lasted several months and has impacted the care of all patients whose protocol includes HDMTX. In this case, a single supplier left the market due to government-imposed pricing that made continued sales increasingly unprofitable. Practicing hematologist/oncologists in Myanmar, the Philippines, Vietnam, and Cambodia also reported shortages that reached patients during 2018. Methods: We created a forecasting model to identify the total annual national need for HDMTX and number of patients based on incidence by age, age distribution, and numbers of doses in typical protocols for osteosarcoma, primary CNS lymphoma, pediatric B-cell NHL, and ALL, curable cancers for which HDMTX is essential. Results: More than 200,000 patients per year need HDMTX (approximately 950,000 doses, see Table). 86% of these live in low- and middle-income countries, where access to inexpensive generic drugs is especially important. Conclusions: This forecasting tool will facilitate national purchasing and negotiating to assure continuous supply of HDMTX. It can be adapted for other drugs, and is especially relevant for low-cost generic drugs, which are disproportionately affected by shortages. [Table: see text]

scholarly journals Evidence for Better Lives Study: a comparative birth-cohort study on child exposure to violence and other adversities in eight low- and middle-income countries - foundational research (study protocol)

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e034986 ◽  
Author(s):  
Sara Valdebenito ◽  
Aja Murray ◽  
Claire Hughes ◽  
Adriana Băban ◽  
Asvini D Fernando ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Pregnant Women ◽  
Exposure To Violence ◽  
Well Being ◽  
The Philippines ◽  
Middle Income ◽  
Violence Against Children ◽  
Middle Income Countries ◽  
Stress Markers ◽  
Foundational Research

IntroductionViolence against children is a health, human rights and social problem affecting approximately half of the world’s children. Its effects begin at prenatal stages with long-lasting impacts on later health and well-being. The Evidence for Better Lives Study (EBLS) aims to produce high-quality longitudinal data from cities in eight low- and middle-income countries—Ghana, Jamaica, Pakistan, the Philippines, Romania, South Africa, Sri Lanka and Vietnam—to support effective intervention to reduce violence against children. EBLS-Foundational Research (EBLS-FR) tests critical aspects of the planned EBLS, including participant recruitment and retention, data collection and analysis. Alongside epidemiological estimates of levels and predictors of exposure to violence and adversity during pregnancy, we plan to explore mechanisms that may link exposure to violence to mothers’ biological stress markers and subjective well-being.Methods and analysesEBLS-FR is a short longitudinal study with a sample of 1200 pregnant women. Data are collected during the last trimester of pregnancy and 2 to 6 months after birth. The questionnaire for participating women has been translated into nine languages. Measures obtained from mothers will include, among others, mental and physical health, attitudes to corporal punishment, adverse childhood experiences, prenatal intimate partner violence, substance use and social/community support. Hair and dry blood spot samples are collected from the pregnant women to measure stress markers. To explore research participation among fathers, EBLS-FR is recruiting 300 fathers in the Philippines and Sri Lanka.Ethics and disseminationThe study received ethical approvals at all recruiting sites and universities in the project. Results will be disseminated through journal publications, conferences and seminar presentations involving local communities, health services and other stakeholders. Findings from this work will help to adjust the subsequent stages of the EBLS project.

scholarly journals Integrated Interventions Delivered in Health Systems, Home, and Community Have the Highest Impact on Breastfeeding Outcomes in Low- and Middle-Income Countries

2017 ◽  
pp. jn242321 ◽  
Author(s):  
Bireshwar Sinha ◽  
Ranadip Chowdhury ◽  
Ravi Prakash Upadhyay ◽  
Sunita Taneja ◽  
Jose Martines ◽  
...  
Keyword(s):  
Health Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals An International Analysis of Dialysis Services Reimbursement

2018 ◽  
Vol 14 (1) ◽  
pp. 84-93 ◽  
Author(s):  
Arjan van der Tol ◽  
Norbert Lameire ◽  
Rachael L. Morton ◽  
Wim Van Biesen ◽  
Raymond Vanholder
Keyword(s):  
Health Care ◽  
Peritoneal Dialysis ◽  
Replacement Therapy ◽  
Gdp Per Capita ◽  
Middle Income ◽  
Middle Income Countries ◽  
Number Of Patients ◽  
Kidney Replacement Therapy ◽  
Per Capita ◽  
Low And Middle Income

Background and objectivesThe prevalence of patients with ESKD who receive extracorporeal kidney replacement therapy is rising worldwide. We compared government reimbursement for hemodialysis and peritoneal dialysis worldwide, assessed the effect on the government health care budget, and discussed strategies to reduce the cost of kidney replacement therapy.Design, setting, participants, & measurementsCross-sectional global survey of nephrologists in 90 countries to assess reimbursement for dialysis, number of patients receiving hemodialysis and peritoneal dialysis, and measures to prevent development or progression of CKD, conducted online July to December of 2016.ResultsOf the 90 survey respondents, governments from 81 countries (90%) provided reimbursement for maintenance dialysis. The prevalence of patients per million population being treated with long-term dialysis in low- and middle-income countries increased linearly with Gross Domestic Product per capita (GDP per capita), but was substantially lower in these countries compared with high-income countries where we did not observe an higher prevalence with higher GDP per capita. The absolute expenditure for dialysis by national governments showed a positive association with GDP per capita, but the percent of total health care budget spent on dialysis showed a negative association. The percentage of patients on peritoneal dialysis was low, even in countries where peritoneal dialysis is better reimbursed than hemodialysis. The so-called peritoneal dialysis–first policy without financial incentive seems to be effective in increasing the utilization of peritoneal dialysis. Few countries actively provide CKD prevention.ConclusionsIn low- and middle-income countries, reimbursement of dialysis is insufficient to treat all patients with ESKD and has a disproportionately high effect on public health expenditure. Current reimbursement policies favor conventional in-center hemodialysis.

scholarly journals How Argentina is training their mental health residents to face its Silver Tsunami?

2018 ◽  
Vol 30 (10) ◽  
pp. 1573-1574
Author(s):  
Sergio A. Strejilevich ◽  
Florencia Vallejos ◽  
Julian Bustin
Keyword(s):  
Mental Health ◽  
Human Resources ◽  
Health Systems ◽  
Population Ageing ◽  
High Income ◽  
World Population ◽  
Demographic Changes ◽  
Middle Income ◽  
Middle Income Countries ◽  
Essential Step

In low- and middle-income countries, there is an increase in the percentage of aging population similar to or greater than that of high-income countries (World Population Ageing 1950–2050, UN, 2001). The emerging health and economical challenges due to these demographic changes will have to be addressed by their health systems. In this context, an adequate training of available human resources in geriatric psychiatry/psychogeriatrics (GP/PG) should be an essential step to meet those challenges.

The Impact of Cash Transfers: A Review of the Evidence from Low- and Middle-income Countries

2018 ◽  
Vol 48 (03) ◽  
pp. 569-594 ◽  
Author(s):  
FRANCESCA BASTAGLI ◽  
JESSICA HAGEN-ZANKER ◽  
LUKE HARMAN ◽  
VALENTINA BARCA ◽  
GEORGINA STURGE ◽  
...  
Keyword(s):  
Evidence Base ◽  
Cash Transfers ◽  
Cash Transfer ◽  
Future Research ◽  
Unintended Effects ◽  
Screening Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

AbstractThis article presents the findings of a review of the impact of non-contributory cash transfers on individuals and households in low- and middle-income countries, covering the literature of 15 years, from 2000 to 2015. Based on evidence extracted from 165 studies, retrieved through a systematic search and screening process, this article discusses the impact of cash transfers on 35 indicators covering six outcome areas: monetary poverty; education; health and nutrition; savings, investment and production; work; and empowerment. For most of the studies, cash transfers contributed to progress in the selected indicators in the direction intended by policymakers. Despite variations in the size and strength of the underlying evidence base by outcome and indicator, this finding is consistent across all outcome areas. The article also investigates unintended effects of cash transfer receipt, such as potential reductions in adult work effort and increased fertility, finding limited evidence for such unintended effects. Finally, the article highlights gaps in the evidence base and areas which would benefit from additional future research.

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