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 ◽  
...  

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.

Author(s):  
Chris Bullen ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
Varsha Parag ◽  
Kannan Subramaniam ◽  
...  

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.


2021 ◽  
Author(s):  
Siân Herbert ◽  
Heather Marquette

This paper reviews emerging evidence of the impact of COVID-19 on governance and conflict, using a “governance and conflict first” approach in contrast to other research and synthesis on COVID-19 in the social sciences that tends to be structured through a public health lens. It largely focuses on evidence on low- and middle-income countries but also includes a number of examples from high-income countries, reflecting the global nature of the crisis. It is organised around four cross-cutting themes that have enabled the identification of emerging bodies of evidence and/or analysis: Power and legitimacy; Effectiveness, capacity, and corruption; Violence, unrest, and conflict; and Resilience, vulnerability, and risk. The paper concludes with three over-arching insights that have emerged from the research: (1) the importance of leadership; (2) resilience and what “fixing the cracks” really means; and (3) why better ways are needed to add up all the “noise” when it comes to COVID-19 and evidence.


Author(s):  
Katja Siefken ◽  
Andrea Varela Ramirez ◽  
Temo Waqanivalu ◽  
Nico Schulenkorf

Since 2020, the world has been navigating an epidemiologic transition with both infectious diseases (COVID-19) and noncommunicable diseases intertwined in complex and diverse ways. In fact, the pandemics of physical inactivity, noncommunicable diseases, and COVID-19 coincide in a tragically impactful ménage à trois with their detrimental long-term health consequences yet to be determined. We know that people in low- and middle-income countries not only have the highest risk of developing chronic diseases, they also develop the diseases at a younger age, they suffer longer, and they die earlier than people in high-income countries. This commentary features 5 compelling reasons for putting physical activity in low- and middle-income countries high up on the public health research agenda and calls for more commitment to inclusive and context-specific public health practices that are paired with locally relevant promotion and facilitation of PA practice, research, and policymaking.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract Objectives To discuss the added value of locally developed health policies and strategies in the context of Global Sustainable Development Goals. To discuss the capabilities, opportunities and limitations of public health institutes in low- and middle-income countries in contributing to health policies and strategies in their countries vis-à-vis the global policies, promoted by multilateral and UN institutions. To formulate recommendations for strengthening the role of local health research institutions in low- and middle-income countries in formulating evidence-based policies and strategies for achieving Sustainable Development Goals, in their countries and beyond their borders. Five panellists from public health and research institutes in Bangladesh, Laos, DR Congo, Uganda and Haiti, and one representative from the European Commission, discuss their experiences in the Support to Public Health Institutes Programme (financed by the European Union), and what they have achieved in influencing policy and practice. Have they been able to leave their ivory tower of science, and have they been able to enter into real dialogue with politicians, practitioners and users of health services? How have they dealt with scepticism in the era mistrust in science? How did they bridge the gap between science and politics, and what tangible products did they deliver to make an impact on health of the population through policy advice or strategy formulation? Did they really make a difference and if yes, how? How did the public health institutes relate to the global giants in health policy and strategies? Did they get support or encouragement for following a local route? Have the public health institutes been able to contribute to global development? Has an international exchange facilitated by the European Commission contributed to strengthening the institutes? After short introductions by the panelists about their work in the last five years, there will be answers to questions from the panel leader and the delegates in the workshop. Delegates are invited to share experiences from their countries. Most of the time of the workshop will be used for a discussion among all participants in the workshop: how can public health institutes and research institutions play a stronger role in policy advice and strategy development in the health sector in their country? What should change within the institutions? How can they demonstrate their added value? What should change in ministries of health and parliaments? What should change in decision-makers in health services? Which best practices do we know, can serve as an example? At the end of the workshop the participants will formulate concrete recommendations, to be presented to the global health community. Key messages Public health institutes and research institutions in low- and middle-income countries have a hidden potential to contribute to local solutions for global health problems. A paradigm shift in relations between academic institutions is needed to unleash the potential of public health institutes.


2017 ◽  
Vol 211 (5) ◽  
pp. 264-265 ◽  
Author(s):  
K. S. Jacob

SummarySuicide, a common cause of death in many low- and middle-income countries, has often been viewed through a medical/psychiatric lens. Such perspectives medicalise social and personal distress and suggest individual and medication-based treatments. This editorial argues for the need to examine suicide from a public health perspective and suggests the need for population-based social and economic interventions.


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