scholarly journals Unmasking the truth: experimental evidence of facemask compliance in Bangladesh, Kenya, and Nigeria during the COVID-19 pandemic

2021 ◽  
Author(s):  
Karen Grépin ◽  
Valerie Mueller ◽  
Nicole Wu ◽  
Atonu Rabbani
Keyword(s):  
Public Health ◽  
Social Desirability ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Measures ◽  
List Experiment ◽  
Using Data ◽  
Reported Data ◽  
Biased Estimates ◽  
Specific Country

Abstract High levels of compliance with public health measures are critical to ensuring a successful response to the COVID-19 pandemic, especially in low and middle-income countries (LMICs). However, most data on compliance are self-reported. Tendency to overreport due to social desirability can yield biased estimates of compliance. We estimate rates of compliance with facemask mandates in Kenya, Nigeria, and Bangladesh using data from phone surveys conducted in March-April 2021. Data on compliance are collected from different survey modules: self-reported compliance (stated) and a list experiment (elicited). We find substantial gaps between stated and elicited rates of facemask wearing for different groups depending on specific country contexts and high levels of overreporting of facemask compliance in self-reported surveys. We observe differences in rates of self-reported facemask wearing among key groups but not using the elicited responses from the list experiment, which suggest that social desirability bias may vary by demographics. Data collected from self-reported surveys may not be reliable to monitor ongoing compliance with public health measures. Moreover, elicited compliance rates indicate levels of mask wearing are likely much lower than those estimated using self-reported data.

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 Ethical and human rights considerations in public health in low and middle-income countries: an assessment using the case of Uganda’s responses to COVID-19 pandemic

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
John Barugahare ◽  
Fredrick Nelson Nakwagala ◽  
Erisa Mwaka Sabakaki ◽  
Joseph Ochieng ◽  
Nelson K Sewankambo
Keyword(s):  
Public Health ◽  
Human Rights ◽  
Critical Appraisal ◽  
Main Body ◽  
Middle Income ◽  
Middle Income Countries ◽  
Public Health Emergencies ◽  
Health Measures ◽  
Health Goals ◽  
The Government

Abstract Background In response to COVID-19 pandemic, the Government of Uganda adopted public health measures to contain its spread in the country. Some of the initial measures included refusal to repatriate citizens studying in China, mandatory institutional quarantine, and social distancing. Despite being a public health emergency, the measures adopted deserve critical appraisal using an ethics and human rights approach. The goal of this paper is to formulate an ethics and human rights criteria for evaluating public health measures and use it to reflect on the ethical propriety of those adopted by the government of Uganda to contain the spread of COVID-19. Main body We begin by illustrating the value of ethics and human rights considerations for public health measures including during emergencies. We then summarize Uganda’s social and economic circumstances and some of the measures adopted to contain the spread of COVID-19. After reviewing some of the ethics and human rights considerations for public health, we reflect upon the ethical propriety of some of Uganda’s responses to COVID-19. We use content analysis to identify the measures adopted by the government of Uganda to contain the spread of COVID-19, the ethics and human rights considerations commonly recommended for public health responses and their importance. Our study found that some of the measures adopted violate ethics and human rights principles. We argue that even though some human rights can sometimes be legitimately derogated and limited to meet public health goals during public health emergencies, measures that infringe on human rights should satisfy certain ethics and human rights criteria. Some of these criteria include being effective, strictly necessary, proportionate to the magnitude of the threat, reasonable in the circumstances, equitable, and least restrictive. We reflect on Uganda’s initial measures to combat the spread of COVID-19 and argue that many of them fell short of these criteria, and potentially limit their effectiveness. Conclusion The ethical legitimacy of public health measures is valuable in itself and for enhancing effectiveness of the measures. Such legitimacy depends on the extent to which they conform to ethics and human rights principles recommended for public health measures.

scholarly journals A Model Based Analysis for COVID-19 Pandemic in India: Implications for Health Systems and Policy for Low- and Middle-Income Countries

2020 ◽  
Author(s):  
Shankar Prinja ◽  
Pankaj Bahuguna ◽  
Yashika Chugh ◽  
Anna Vassall ◽  
Arvind Pandey ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Air Travel ◽  
Contact Tracing ◽  
System Response ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Measures ◽  
Travel Restrictions ◽  
The Impact

AbstractBackgroundOur analysis aims to model COVID-19 pandemic in India, potential impact of various measures, along with assessment of health system preparedness and cost to manage the epidemic.MethodsWe developed a susceptible-exposed-infectious-recovered (SEIR) mathematical model to predict the health outcomes under an unmitigated scenario which comprises of air travel restrictions alone, and the current scenario consisting of air travel restrictions along with 8-week lockdown. In addition, we also evaluate the effectiveness of 8-week lockdown along with intensified public health measures at varying level of effectiveness. We assessed the impact of these interventions on COVID-19 related health outcomes in comparison to the unmitigated scenario. Next, we ascertain the need for augmenting infrastructure and the costs of COVID-19 management in India.FindingsIn the event of a lockdown for 8 weeks, the peak of the epidemic shifts by 34-76 days, and the number of cases at the end of 8-week lockdown reduces by 69% to 97% with varying effectiveness of lockdown. However, the cumulative long-term cases remain the same. Intensification of public health surveillance measures with 60% effectiveness is estimated to reduce the cases at peak and cumulative number of infections by 70% and 26.6% respectively. The requirement of ICU beds and ventilators would reduce by 83% with intensified public health measures. The cost of managing COVID-19 in India is nearly 4.5% of the gross domestic product (GDP) in the absence of any intervention which increases to 6.2% with intensified public health measures for COVID-19 response.ConclusionLockdown measures delay the onset of peak, and give much needed time to health system to prepare. Strengthening the public health system response in terms of testing, isolation treatment of cases, and contact tracing needs would lead to significant gains in terms of case load, and meeting health system needs.SummaryWhat is already known?A few studies have been carried out in Indian context to model the epidemic. These models explored the impact of lockdowns and social distancing measures focusing more on the course of the epidemic but none of these evaluated the impact on health system’s response needed as well as the economic impact of COVID-19 management in India. The findings from these studies are limited in a sense that either these studies evaluated the hypothetical scenarios of strategies implemented or focusing to smaller geographical regions in India.What are the new findings?Evidence pertaining to health economic impact of COVID-19 management, in context to Low- and Middle-Income countries, is very limited. To address this, we used the susceptible-exposed-infectious-recovered (SEIR) model to assess:the health system preparedness challenge in terms of hospital beds for isolation, intensive care and ventilators which would be required to manage the epidemic and the economic implications of managing the COVID-19 pandemic in India.the incremental cost of intensified public health measures per infection and per death averted.What do the new finding imply?In India, measures such as lockdowns would certainly delays the onset of peak of COVID-19 epidemic. This would help delay the surge of cases, which would buy time for the health system to prepare. Strengthening the health system response in terms of enhanced testing, isolation of cases, treatment and contact tracing, as is being done currently, would have to be the mainstay to reduce the impact of the pandemic in terms of reduction in infected population and COID-19 deaths in India until vaccine becomes available.

scholarly journals Lifting the lockdown: what are the options for low and middle-income countries?

2020 ◽  
Author(s):  
Rajiv Chowdhury ◽  
Shammi Luhar ◽  
Nusrat Khan ◽  
Sohel Reza Choudhury ◽  
Imran Matin ◽  
...  
Keyword(s):  
Public Health ◽  
Health Resources ◽  
Community Based ◽  
Middle Income ◽  
The Public ◽  
Middle Income Countries ◽  
Health Measures ◽  
The Social ◽  
Context Specific ◽  
Low And Middle Income

To limit the social, economic and psychological damage caused by strict social distancing interventions, many low and middle-income countries (LMICs) are seeking to ease restrictions. However, it is unknown what a ‘safe reopening’ entails in LMICs given suboptimal diagnostic and surveillance capabilities. Here we discuss three community-based public health measures (sustained mitigation, zonal lockdown and dynamic rolling lockdowns) which seek to adequately balance the public health and economic priorities. Each of these options have limitations and prerequisites that may be context-specific and should be considered before implementation, including implementation and maintenance costs, social and economic costs, context-specific epidemic growth and the existing health resources.

Future Issues in Dissemination and Implementation Research

2017 ◽  
Author(s):  
Ross C. Brownson ◽  
Graham A. Colditz ◽  
Enola K. Proctor
Keyword(s):  
Public Health ◽  
Health Services ◽  
Implementation Research ◽  
Clinical Care ◽  
Dissemination And Implementation ◽  
Public Health Services ◽  
Middle Income ◽  
Middle Income Countries ◽  
Dissemination And Implementation Research ◽  
The Many

This chapter highlights just a sample of the many rich areas for dissemination and implementation research that will assist us in shortening the gap between discovery and practice, thus beginning to realize the benefits of research for patients, families, and communities. Greater emphasis on implementation in challenging settings, including lower and middle-income countries and underresourced communities in higher income countries will add to the lessons we must learn to fully reap the benefit of our advances in dissemination and implementation research methods. Moreover, collaboration and multidisciplinary approaches to dissemination and implementation research will help to make efforts more consistent and more effective moving forward. Thus, we will be better able to identify knowledge gaps that need to be addressed in future dissemination and implementation research, ultimately informing the practice and policies of clinical care and public health services.

An Overview of the Ethics of Injury in Public Health

2019 ◽  
pp. 597-603
Author(s):  
Adnan A. Hyder
Keyword(s):  
Public Health ◽  
Injury Prevention ◽  
Prevention And Control ◽  
Public Health Ethics ◽  
Ethical Challenges ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Ethics ◽  
Prompt Attention ◽  
And Control

This chapter briefly introduces ethics issues in injury prevention and control in low- and middle-income countries (LMICs), using a series of examples that prompt attention to the ethical principles of autonomy and justice. The chapter also introduces the section of The Oxford Handbook of Public Health Ethics dedicated to an examination of injury and public health ethics, with attention given to the complex ethical challenges arising in injury prevention and control in LMICs. The section’s two chapters discuss public health ethics issues arising in the prevention and control of unintentional injuries and intentional injuries, respectively. Those chapters define a set of ethics issues within international injury work and provide an initial analysis of the nature of those ethics issues, their specificity, and potential pathways for addressing them.

scholarly journals A road-map for addressing antimicrobial resistance in low- and middle-income countries: lessons learnt from the public private participation and co-designed antimicrobial stewardship programme in the State of Kerala, India

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sanjeev Singh ◽  
Esmita Charani ◽  
Sarada Devi ◽  
Anuj Sharma ◽  
Fabia Edathadathil ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Infection Prevention ◽  
The State ◽  
Action Plans ◽  
Public And Private ◽  
Middle Income ◽  
Middle Income Countries ◽  
Public Health Threat

Abstract Background The global concern over antimicrobial resistance (AMR) is gathering pace. Low- and middle-income countries (LMICs) are at the epicentre of this growing public health threat and governmental and healthcare organizations are at different stages of implementing action plans to tackle AMR. The South Indian state of Kerala was one of the first in India to implement strategies and prioritize activities to address this public health threat. Strategies Through a committed and collaborative effort from all healthcare related disciplines and its professional societies from both public and private sector, the Kerala Public Private Partnership (PPP) has been able to deliver a state-wide strategy to tackle AMR A multilevel strategic leadership model and a multilevel implementation approach that included developing state-wide antibiotic clinical guidelines, a revision of post-graduate and undergraduate medical curriculum, and a training program covering all general practitioners within the state the PPP proved to be a successful model for ensuring state-wide implementation of an AMR action plan. Collaborative work of multi-professional groups ensured co-design and development of disease based clinical treatment guidelines and state-wide infection prevention policy. Knowledge exchange though international and national platforms in the form of workshops for sharing of best practices is critical to success. Capacity building at both public and private institutions included addressing practical and local solutions to the barriers e.g. good antibiotic prescription practices from primary to tertiary care facility and infection prevention at all levels. Conclusion Through 7 years of stakeholder engagement, lobbying with government, and driving change through co-development and implementation, the PPP successfully delivered an antimicrobial stewardship plan across the state. The roadmap for the implementation of the Kerala PPP strategic AMR plan can provide learning for other states and countries aiming to implement action plans for AMR.

scholarly journals Childlessness, Individual Socioeconomic Resources, and Health: Exploring Variation in 20 Countries

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 515-516
Author(s):  
Nekehia Quashie ◽  
Christine Mair ◽  
Radoslaw Antczak ◽  
Bruno Arpino
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Health Indicators ◽  
Data Repository ◽  
Middle Income ◽  
Individual Level ◽  
Socioeconomic Resources ◽  
Middle Income Countries ◽  
Using Data ◽  
The Impact

Abstract Childless older adults may be at risk for poorer health cross-nationally, yet most studies on this topic analyze only a small number of countries and only 1 or 2 health outcomes. To our knowledge, two papers exist that explore associations between childlessness and multiple indicators of health using data from a large number of regionally diverse countries (e.g., 20 countries from North America, Asia, and Europe), but neither study includes an examination of socioeconomic resources. The level of health risk faced by childless older adults is likely to be distinctly shaped by older adults’ socioeconomic resources (e.g., education, income, wealth). Associations between childlessness, socioeconomic resources, and health may also differ by country context. Using harmonized, cross-national data for adults aged 50 and older across 20 high- and middle-income countries (United States (HRS), European Union (SHARE), Mexico (MHAS), and China (CHARLS) from the Gateway to Global Aging data repository), we explore if and how individual-level socioeconomic resources (income, education, wealth) moderate associations between childlessness and five health indicators (self-rated health, ADL limitations, IADL limitations, chronic conditions, and depression). Results suggest that associations between childlessness and health outcomes vary by individual socioeconomic resources in some country contexts, but not in others. We discuss these findings in light of the impact of individual-level socioeconomic resources on older adults’ support options and health outcomes cross-nationally.

scholarly journals Decompressive craniotomy: an international survey of practice

2021 ◽  
Author(s):  
Midhun Mohan ◽  
◽  
Hugo Layard Horsfall ◽  
Davi Jorge Fontoura Solla ◽  
Faith C. Robertson ◽  
...  
Keyword(s):  
Public Health ◽  
Randomized Trial ◽  
Bone Flap ◽  
Acute Subdural Hematoma ◽  
International Survey ◽  
Global Public Health ◽  
Health Issues ◽  
Middle Income ◽  
Middle Income Countries ◽  
Decompressive Craniotomy

Abstract Background Traumatic brain injury (TBI) and stroke have devastating consequences and are major global public health issues. For patients that require a cerebral decompression after suffering a TBI or stroke, a decompressive craniectomy (DC) is the most commonly performed operation. However, retrospective non-randomized studies suggest that a decompressive craniotomy (DCO; also known as hinge or floating craniotomy), where a bone flap is replaced but not rigidly fixed, has comparable outcomes to DC. The primary aim of this project was to understand the current extent of usage of DC and DCO for TBI and stroke worldwide. Method A questionnaire was designed and disseminated globally via emailing lists and social media to practicing neurosurgeons between June and November 2019. Results We received 208 responses from 60 countries [40 low- and middle-income countries (LMICs)]. DC is used more frequently than DCO, however, about one-quarter of respondents are using a DCO in more than 25% of their patients. The three top indications for a DCO were an acute subdural hematoma (ASDH) and a GCS of 9-12, ASDH with contusions and a GCS of 3-8, and ASDH with contusions and a GCS of 9-12. There were 8 DCO techniques used with the majority (60/125) loosely tying sutures to the bone flap. The majority (82%) stated that they were interested in collaborating on a randomized trial of DCO vs. DC. Conclusion Our results show that DCO is a procedure carried out for TBI and stroke, especially in LMICs, and most commonly for an ASDH. The majority of the respondents were interested in collaborating on a is a future randomized trial.

Sign in / Sign up

Export Citation Format

Share Document