scholarly journals Determinants of Clean Birthing Practices in Low- and Middle-Income Countries: a Scoping Review

2020 ◽  
Author(s):  
Joanna Esteves Mills ◽  
Erin Flynn ◽  
Oliver Cumming ◽  
Robert Dreibelbis
Keyword(s):  
Healthcare Facility ◽  
Perinatal Period ◽  
Screening Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
Effective Interventions ◽  
Multi Stage ◽  
Behavioural Determinants ◽  
Birthing Practices ◽  
Low And Middle Income

Abstract Background Infection is a leading cause of maternal and newborn mortality in low- and middle-income countries (LMIC). Clean birthing practices are fundamental to infection prevention efforts, but these are inadequate in LMIC. This scoping study reviews the literature on studies that describe determinants of clean birthing practices of healthcare workers or mothers during the perinatal period in LMIC. Methods We reviewed literature published between January 2000 and February 2018 providing information on behaviour change interventions, behaviours or behavioural determinants during the perinatal period in LMIC. Following a multi-stage screening process, we extracted key data manually from studies. We mapped identified determinants according to the COM-B behavioural framework, which posits that behaviour is shaped by three categories of determinants – capability, opportunity and motivation. Results 78 studies were included: 47 observational studies and 31 studies evaluating an intervention. 51% had a household or community focus, 28% had a healthcare facility focus and 21% focused on both. We identified 31 determinants of clean birthing practices. Determinants related to clean birthing practices as a generalised set of behaviours featured in 50 studies; determinants related specifically to one or more of six predefined behaviours – commonly referred to as “the six cleans” – featured in 31 studies. Determinants of hand hygiene (n=13) and clean cord care (n=11) were most commonly reported. Reported determinants across all studies clustered around psychological capability (knowledge) and physical opportunity (access to resources). However, greater heterogeneity in reported behavioural determinants was found across studies investigating specific clean birthing practices compared to those studying clean birthing as a generalised set of behaviours. Conclusions Efforts to combine clean birthing practices into a single suite of behaviours – such as the “six cleans”– may simplify policy and advocacy efforts. However, each clean practice has a unique set of determinants and understanding what drives or hinders the adoption of these individual practices is critical to designing more effective interventions to improve hygiene behaviours and neonatal and maternal health outcomes in LMIC. Current understanding in this regard remains limited. More theory-grounded formative research is required to understand motivators and social influences across different contexts.

scholarly journals Determinants of Clean Birthing Practices in Low- and Middle-Income Countries: a Scoping Review

2019 ◽  
Author(s):  
Joanna Esteves Mills ◽  
Erin Flynn ◽  
Oliver Cumming ◽  
Robert Dreibelbis
Keyword(s):  
Healthcare Facility ◽  
Perinatal Period ◽  
Screening Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
Effective Interventions ◽  
Multi Stage ◽  
Behavioural Determinants ◽  
Birthing Practices ◽  
Low And Middle Income

Abstract Background Infection is a leading cause of maternal and newborn mortality in low- and middle-income countries (LMIC). Clean birthing practices are fundamental to infection prevention efforts, but these are inadequate in LMIC. This scoping study reviews the literature on studies that describe determinants of clean birthing practices of healthcare workers or mothers during the perinatal period in LMIC. Methods We reviewed literature published between January 2000 and February 2018 providing information on behaviour change interventions, behaviours or behavioural determinants during the perinatal period in LMIC. Following a multi-stage screening process, we extracted key data manually from studies. We mapped identified determinants according to the COM-B behavioural framework, which posits that behaviour is shaped by three categories of determinants – capability, opportunity and motivation. Results 78 studies were included: 47 observational studies and 31 studies evaluating an intervention. 51% had a household or community focus, 28% had a healthcare facility focus and 21% focused on both. We identified 31 determinants of clean birthing practices. Determinants related to clean birthing practices as a generalised set of behaviours featured in 50 studies; determinants related specifically to one or more of six predefined behaviours – commonly referred to as “the six cleans” – featured in 31 studies. Determinants of hand hygiene (n=13) and clean cord care (n=11) were most commonly reported. Reported determinants across all studies clustered around psychological capability (knowledge) and physical opportunity (access to resources). However, greater heterogeneity in reported behavioural determinants was found across studies investigating specific clean birthing practices compared to those studying clean birthing as a generalised set of behaviours. Conclusions Efforts to combine clean birthing practices into a single suite of behaviours – such as the “six cleans”– may simplify policy and advocacy efforts. However, each clean practice has a unique set of determinants and understanding what drives or hinders the adoption of these individual practices is critical to designing more effective interventions to improve hygiene behaviours and neonatal and maternal health outcomes in LMIC. Current understanding in this regard remains limited. More theory-grounded formative research is required to understand motivators and social influences across different contexts.

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.

scholarly journals Stigma and discrimination related to mental illness in low- and middle-income countries

2015 ◽  
Vol 24 (5) ◽  
pp. 382-394 ◽  
Author(s):  
M. Semrau ◽  
S. Evans-Lacko ◽  
M. Koschorke ◽  
L. Ashenafi ◽  
G. Thornicroft
Keyword(s):  
Mental Illness ◽  
Large Scale ◽  
Grey Literature ◽  
Middle Income ◽  
Middle Income Countries ◽  
Stigma And Discrimination ◽  
Effective Interventions ◽  
Long Term Follow Up ◽  
Context Specific ◽  
Low And Middle Income

Aims.This paper aims to provide an overview of evidence from low- and middle-income countries (LAMICs) worldwide to address: the nature of stigma and discrimination, relevant context-specific factors, global patterns of these phenomena and their measurement and quantitative and qualitative evidence of interventions intended to reduce their occurrence and impact. The background to this study is that the large majority of studies concerned with identifying effective interventions to reduce stigma and discrimination originate in high-income countries (HICs). This paper therefore presents such evidence from, and relevant to, LAMICs.Methods.Conceptual overview of the relevant peer-reviewed and grey literature on stigma and discrimination related to mental illness in LAMICs are available in English, Spanish, French and Russian.Results.Few intervention studies were identified related to stigma re-education in LAMICs. None of these addressed behaviour change/discrimination, and there were no long-term follow-up studies. There is therefore insufficient evidence at present to know which overall types of intervention may be effective and feasible and in LAMICs, how best to target key groups such as healthcare staff, and how far they may need to be locally customised to be acceptable for large-scale use in these settings. In particular, forms of social contacts, which have been shown to be the most effective intervention to reduce stigma among adults in HICs, have not yet been assessed sufficiently to know whether these methods are also effective in LAMICs.Conclusion.Generating information about effective interventions to reduce stigma and discrimination in LAMICs is now an important mental health priority worldwide.

scholarly journals Determinants of clean birthing practices in low- and middle-income countries: a scoping review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Joanna Esteves Mills ◽  
Erin Flynn ◽  
Oliver Cumming ◽  
Robert Dreibelbis
Keyword(s):  
Scoping Review ◽  
Middle Income ◽  
Middle Income Countries ◽  
Birthing Practices ◽  
Low And Middle Income

The Identification and Evaluation of Methodologies to Assess the Quality of mHealth apps in High, Low & Middle-Income Countries: a Rapid Review (Preprint)

2021 ◽  
Author(s):  
Fionn Woulfe ◽  
Philip Kayode Fadahunsi ◽  
Simon Smith ◽  
Griphin Baxter Chirambo ◽  
Emma Larsson ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Healthcare Professionals ◽  
Rapid Review ◽  
Screening Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Mhealth Apps ◽  
Low And Middle Income

BACKGROUND There has been a rapid growth in the availability and use of mobile health (mHealth) apps around the world in recent years. However, consensus regarding an accepted standard to assess the quality of such apps does not exist. Differing interpretations of quality add to this problem. Consequently, it has become increasingly difficult for healthcare professionals to distinguish apps of high quality from those of lower quality. This exposes both patients and healthcare professionals to unnecessary risk. Despite progress, limited understanding of contributions by those in low- and middle- income countries (LMIC) on this topic exists. As such, the applicability of quality assessment methodologies in LMIC settings remains unexplored. OBJECTIVE The objectives of this rapid review are to; 1) Identify current methodologies within the literature to assess the quality of mHealth apps. 2) Understand what aspects of quality these methodologies address. 3) Determine what input has been made by authors from LMICs. 4) Examine the applicability of such methodologies in low- and middle- income settings. METHODS The review is registered with Prospero (CRD42020205149). A search of PubMed, EMBASE, Web of Science and Scopus was performed for papers relating to mHealth app quality assessment methodologies, published in English between 2005 and the 28th of December, 2020. A thematic and descriptive analysis of methodologies and papers was performed. RESULTS Electronic database searches identified 841 papers. After the screening process, 53 papers remained for inclusion; 6 proposed novel methodologies which could be used to evaluate mHealth apps of diverse medical areas of interest; 8 proposed methodologies which could be used to assess apps concerned with a specific medical focus; 39 used methodologies developed by other published authors to evaluate the quality of various groups of mHealth apps. Authors of 3 papers were solely affiliated to institutes in LMICs. A further 8 papers had at least one co-author affiliated to an institute in a LMIC. CONCLUSIONS Quality assessment of mHealth apps is complex in nature and at times, subjective. Despite growing research on this topic, to date an all-encompassing, appropriate means for evaluating the quality of mHealth apps does not exist. There has been engagement with authors affiliated to institutes in LMICs, however limited consideration of current generic methodologies for application in a LMIC settings have been identified.

scholarly journals Impact of mobile health interventions during the perinatal period for mothers in low- and middle-income countries

2019 ◽  
Vol 17 (2) ◽  
pp. 137-146 ◽  
Author(s):  
Justine Dol ◽  
Marsha Campbell-Yeo ◽  
Gail Tomblin Murphy ◽  
Megan Aston ◽  
Douglas McMillan ◽  
...  
Keyword(s):  
Mobile Health ◽  
Perinatal Period ◽  
Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Development of a core outcome set for multimorbidity trials in low- and middle-income countries (COSMOS): Study Protocol

2021 ◽  
Author(s):  
Jan R. Boehnke ◽  
Rusham Zahra Rana ◽  
Jamie J. Kirkham ◽  
Louise Rose ◽  
Gina Agarwal ◽  
...  
Keyword(s):  
Core Outcome Set ◽  
Core Outcome ◽  
International Consensus ◽  
Long Term Conditions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Effective Interventions ◽  
Outcome Set ◽  
Wide Range ◽  
Low And Middle Income

Introduction 'Multimorbidity' describes the presence of two or more long-term conditions, which can include communicable and non-communicable diseases, and mental disorders. The rising global burden from multimorbidity is well-documented, but trial evidence for effective interventions in low- and middle-income countries (LMICs) is limited. Selection of appropriate outcomes is fundamental to trial design to ensure cross-study comparability, but there is currently no agreement on a core outcome set (COS) to include in trials investigating multimorbidity specifically in LMIC. Our aim is to develop international consensus on two COS for trials of interventions to prevent and treat multimorbidity in LMIC settings. Methods and Analysis Following methods recommended by the Core Outcome Measures in Effectiveness Trials (COMET initiative), the development of these two COS will occur in three stages: (1) generation of a long list of potential outcomes for inclusion; (2) two-round online Delphi surveys; and (3) consensus meetings. First, to generate an initial list of outcomes, we will conduct a systematic review of multimorbidity intervention and prevention trials and interviews with people living with multimorbidity and their caregivers in LMICs. Outcomes will be classified using an outcome taxonomy. Two-round Delphi surveys will be used to elicit importance scores for these outcomes from people living with multimorbidity, caregivers, healthcare professionals, policy makers, and researchers in LMICs. Finally, consensus meetings will be held to discuss the Delphi survey results and agree outcomes for inclusion in the two COS. Ethics and dissemination The study has been approved by the Research Governance Committee of the Department of Health Sciences, University of York, UK [HSRGC/2020/409/D:COSMOS]. Each participating country/research group will obtain local ethics board approval. Informed consent will be obtained from all participants. We will disseminate findings through peer-reviewed open access publications, and presentations at global conferences selected to reach a wide range of LMIC stakeholders.

scholarly journals Addressing malnutrition in low- and middle-income countries with double-duty actions

2018 ◽  
Vol 78 (3) ◽  
pp. 388-397 ◽  
Author(s):  
Rebecca Pradeilles ◽  
Kaleab Baye ◽  
Michelle Holdsworth
Keyword(s):  
Environmental Sustainability ◽  
De Novo ◽  
School Food ◽  
Double Burden ◽  
Middle Income ◽  
The Sustainable Development ◽  
Middle Income Countries ◽  
Effective Interventions ◽  
Double Burden Of Malnutrition ◽  
Low And Middle Income

Multiple forms of malnutrition co-exist (the double burden) in low- and middle-income countries, but most interventions and policies target only one form. Identifying shared drivers of the double burden of malnutrition is a first step towards establishing effective interventions that simultaneously address the double burden of malnutrition (known as double-duty actions). We identified shared drivers for the double burden of malnutrition, to assess which double-duty actions are likely to have the greatest reach in preventing all forms of malnutrition, in the context of the sustainable development goals. We reviewed existing conceptual frameworks of the drivers of undernutrition, obesity and environmental sustainability. Shared drivers affecting all forms of malnutrition and environmental sustainability were captured using a socio-ecological approach. The extent to which drivers were addressed by the five double-duty actions proposed by the WHO was assessed. Overall, eighty-three shared drivers for the double burden of malnutrition were identified. A substantial proportion (75·0%) could be addressed by the five WHO double-duty actions. ‘Regulations on marketing’ and ‘promotion of appropriate early and complementary feeding in infants’ addressed the highest proportion of shared drivers (65·1% and 53·0%, respectively). Twenty-four drivers were likely to be sensitive to environmental sustainability, with ‘regulations on marketing’ and ‘school food programmes and policies’ likely to have the greatest environmental reach. A quarter of the shared drivers remained unaddressed by the five WHO double-duty actions. Substantially more drivers could be addressed with minor modifications to the WHO double-duty actions and the addition of de novo actions.

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