The global neurosurgical workforce: a mixed-methods assessment of density and growth

2019 ◽  
Vol 130 (4) ◽  
pp. 1142-1148 ◽  
Author(s):  
Swagoto Mukhopadhyay ◽  
Maria Punchak ◽  
Abbas Rattani ◽  
Ya-Ching Hung ◽  
James Dahm ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
World Health ◽  
Middle Income ◽  
The Past ◽  
Country Level ◽  
Life Years ◽  
Recent Estimate ◽  
Health Organization ◽  
Key Steps ◽  
Workforce Density

OBJECTIVEIn 2000, the global density of neurosurgeons was estimated at 1 per 230,000 population, which remains the most recent estimate of the global neurosurgeon workforce density. In 2004, the World Health Organization (WHO) estimated that there were 33,193 neurosurgeons worldwide, including trainees. There have been no updates to this estimate in the past decade. Moreover, only WHO region–level granularity regarding neurosurgeon distribution exists; country-level estimates are limited. The neurosurgery workforce is a crucial component to meeting the growing burden of neurosurgical diseases, which not only represent high absolute incidences and prevalences, but also represent correspondingly high disability-adjusted life years affecting hundreds of millions of people worldwide. Combining the lack of knowledge about the availability of the neurosurgical workforce and the increasing demand for neurosurgical services underscores the need for a system of neurosurgical workforce density surveillance.METHODSThis study involved 3 key steps: 1) global survey/literature review to obtain the number of working neurosurgeons per WHO-recognized country, 2) regression to interpolate any missing data, and 3) calculation of workforce densities and comparison to available historical data by WHO region.RESULTSData for 198 countries were collected (158) or interpolated (40). The global total number of neurosurgeons was estimated at 49,940. Overall, neurosurgeon density ranged from 0 to 58.95 (standardized to per 1,000,000 population) with a median of 3.56 (IQR 0.29–8.26). Thirty-three countries were found to have no neurosurgeons (zero). The highest density, 58.95, was in Japan, where 7495 neurosurgeons are taking care of a population of 127,131,800.CONCLUSIONSIn 2015, the Lancet Commission on Global Surgery estimated that 143 million additional surgical procedures are needed in low- and middle-income countries each year, and a subsequent study revealed that approximately 15% of those surgical procedures are neurosurgical. Based on our results, we can conclude that there are approximately 49,940 neurosurgeons currently, worldwide. The availability of neurosurgeons appears to have increased in all geographic regions over the past decade, with Southeast Asia experiencing the greatest growth. Such remarkable expansion should be assessed to determine factors that could play a role in other regions where the acceleration of growth would be beneficial.

scholarly journals Tobacco Control in Low- and Middle-Income Countries: Changing the Present to Help the Future

2018 ◽  
Vol 13 (4) ◽  
pp. 187-188 ◽  
Author(s):  
Bethany Hipple Walters ◽  
Ionela Petrea ◽  
Harry Lando
Keyword(s):  
World Health Organization ◽  
World Health ◽  
Second Hand Smoke ◽  
Vulnerable Children ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Past ◽  
Second Hand Smoke Exposure ◽  
Health Organization ◽  
Low And Middle Income

While the global smoking rate has dropped in the past 30 years (from 41.2% of men in 1980 to 31.1% in 2012 and from 10.6% of women in 1980 to 6.2% in 2012), the number of tobacco smokers has increased due to population growth (Ng et al., 2014). This tobacco use and second-hand smoke exposure continue to harm people worldwide. Those harmed are often vulnerable: children, those living in low- and middle-income countries (LMICs), those with existing diseases, etc. As noted by the World Health Organization (WHO), nearly 80% of those who smoke live in a LMIC (World Health Organization, 2017). Furthermore, it is often those who are more socio-economically disadvantaged or less educated in LMICs that are exposed to second-hand smoke at home and work (Nazar, Lee, Arora, & Millett, 2015).

scholarly journals Intellectual disability in India: the evolving patterns of care

2011 ◽  
Vol 8 (2) ◽  
pp. 29-31
Author(s):  
Satish Chandra Girimaji
Keyword(s):  
Intellectual Disability ◽  
Urban Areas ◽  
Epidemiological Data ◽  
World Health ◽  
Indian Literature ◽  
Middle Income ◽  
The Past ◽  
History Of ◽  
Health Organization ◽  
Government Benefits

Intellectual disability was recognised in ancient Indian literature, but organised services have a history of just five decades. India shares many features of low- and middle-income (LAMI) countries regarding intellectual disability. There is a low level of awareness about its nature, causes and interventions. One can come across many superstitions, myths and misconceptions about intellectual disability. In general, services are inadequate, being concentrated in big cities and urban areas. There is generally limited access to support services and few government benefits, and these, in any case, are often of little value (World Health Organization, 2007). Locally and nationally, there are few relevant and reliable epidemiological data on the prevalence of intellectual disability. However, there have been some positive developments within the past three decades, and they are the focus of this paper.

Global evidence generation

2020 ◽  
pp. 453-464
Author(s):  
Adesola Ogunniyi
Keyword(s):  
Depressive Disorders ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Special Mention ◽  
Global Burden Of Diseases ◽  
Health Organization ◽  
Evidence Generation

Disparities in the distribution of neurological and mental health disorders (NMHD) in different regions of the world can provide clues on the putative risk factors while providing basis for intervention strategies. This chapter utilizes the Global Burden of Diseases (GBD) data and the disability adjusted life years (DALY) calculations in the different World Health Organization (WHO) regions to adduce reasons for the peculiarities observed. The focus is on the most common NMHD, particularly those for which preventive strategies are likely to result in improved health outcomes for the majority of those affected. In this regard, stroke, epilepsy, and depressive disorders have been given special attention because of their high societal impact and the extensive studies from different regions. Dementia deserves special mention in view of its looming epidemic in low and middle income countries (LMICs), while its burden is lessening in high income countries (HICs) due to appropriate interventions and higher education.

Facilitators and barriers in the utilization of World Health Organization’s Preventing Early Pregnancy Guidelines in formulating laws, policies and strategies: what do stakeholders in Ethiopia say?

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Sonjelle Shilton ◽  
Venkatraman Chandra-Mouli ◽  
Shadae Paul ◽  
Donna M. Denno
Keyword(s):  
Adolescent Pregnancy ◽  
Early Pregnancy ◽  
National Level ◽  
World Health ◽  
Policy Framework ◽  
Early Childbearing ◽  
Middle Income ◽  
Country Level ◽  
Facilitators And Barriers ◽  
Health Organization

Abstract Background Each year, approximately 16 million 15-19 year-old girls give birth. In 2011 the World Health Organization (WHO) published the evidence-based “Preventing Early Pregnancy and Poor Reproductive Outcomes among Adolescents in Low and Middle Income Countries” guidelines to inform policies and programs. However, little is known about their country-level use to influence supportive environments to reduce early childbearing. We sought to identify alignment of Ethiopian laws, polices and strategies with these guidelines, whether these guidelines contributed to them, and identify facilitators and barriers to their utilization. Methods First, we analyzed Ethiopian legal, policy, and strategy documents relating to adolescent pregnancy to determine their alignment with the WHO early pregnancy guidelines. We then conducted and thematically analyzed 11 interviews with key informants (KIs) working in adolescent and/or reproductive health at the national level. Results Laws, policies, and strategies to address early childbearing are in place in Ethiopia and address the six domains of the WHO adolescent pregnancy guidelines. KIs reported that they were aware of the WHO adolescent pregnancy guidelines, but none mentioned it without prompting. Six barrier/facilitator themes emerged: knowledge, national agenda, laws, resources, culture, and cooperation. Conclusions Ethiopia has a policy framework consistent with WHO’s adolescent pregnancy guidelines which may have contributed to their development. The lack of spontaneous identification of the guidelines by the KIs we interviewed, raises questions of their knowledge and use of the guidelines. Targeted dissemination of guidelines by WHO to relevant stakeholders may facilitate their use.

Defining Preterm Birth and Stillbirth in the Western Pacific: A Systematic Review

2021 ◽  
pp. 101053952110260
Author(s):  
Mairead Connolly ◽  
Laura Phung ◽  
Elise Farrington ◽  
Michelle J. L. Scoullar ◽  
Alyce N. Wilson ◽  
...  
Keyword(s):  
Preterm Birth ◽  
National Level ◽  
Health Indicators ◽  
Western Pacific ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Definition Of ◽  
Health Organization ◽  
The Impact

Preterm birth and stillbirth are important global perinatal health indicators. Definitions of these indicators can differ between countries, affecting comparability of preterm birth and stillbirth rates across countries. This study aimed to document national-level adherence to World Health Organization (WHO) definitions of preterm birth and stillbirth in the WHO Western Pacific region. A systematic search of government health websites and 4 electronic databases was conducted. Any official report or published study describing the national definition of preterm birth or stillbirth published between 2000 and 2020 was eligible for inclusion. A total of 58 data sources from 21 countries were identified. There was considerable variation in how preterm birth and stillbirth was defined across the region. The most frequently used lower gestational age threshold for viability of preterm birth was 28 weeks gestation (range 20-28 weeks), and stillbirth was most frequently classified from 20 weeks gestation (range 12-28 weeks). High-income countries more frequently used earlier gestational ages for preterm birth and stillbirth compared with low- to middle-income countries. The findings highlight the importance of clear, standardized, internationally comparable definitions for perinatal indicators. Further research is needed to determine the impact on regional preterm birth and stillbirth rates.

scholarly journals Morphological Characteristics, Classifications and Difficulties in the Use of Diagnostic Criteria for Serrated Lesions of the Large Intestine

2021 ◽  
Author(s):  
Cesar de Souza Bastos Junior ◽  
Vera Lucia Nunes Pannain ◽  
Adriana Caroli-Bottino
Keyword(s):  
Diagnostic Criteria ◽  
Morphological Characteristics ◽  
World Health ◽  
Diagnostic Tools ◽  
Serrated Adenoma ◽  
The Past ◽  
The World ◽  
Serrated Lesions ◽  
Health Organization

Abstract Introduction Colorectal carcinoma (CRC) is the most common gastrointestinal neoplasm in the world, accounting for 15% of cancer-related deaths. This condition is related to different molecular pathways, among them the recently described serrated pathway, whose characteristic entities, serrated lesions, have undergone important changes in their names and diagnostic criteria in the past thirty years. The multiplicity of denominations and criteria over the last years may be responsible for the low interobserver concordance (IOC) described in the literature. Objectives The present study aims to describe the evolution in classification of serrated lesions, based on the last three publications of the World Health Organization (WHO) and the reproducibility of these criteria by pathologists, based on the evaluation of the IOC. Methods A search was conducted in the PubMed, ResearchGate and Portal Capes databases, with the following terms: sessile serrated lesion; serrated lesions; serrated adenoma; interobserver concordance; and reproducibility. Articles published since 1990 were researched. Results and Discussion The classification of serrated lesions in the past thirty years showed different denominations and diagnostic criteria. The reproducibility and IOC of these criteria in the literature, based on the kappa coefficient, varied in most studies, from very poor to moderate. Conclusions Interobserver concordance and the reproducibility of microscopic criteria may represent a limitation for the diagnosis and appropriate management of these lesions. It is necessary to investigate diagnostic tools to improve the performance of the pathologist's evaluation, for better concordance, and, consequently, adequate diagnosis and treatment.

scholarly journals Countries with delayed COVID-19 introduction – characteristics, drivers, gaps, and opportunities

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Zheng Li ◽  
Cynthia Jones ◽  
Girum S. Ejigu ◽  
Nisha George ◽  
Amanda L. Geller ◽  
...  
Keyword(s):  
Geographic Location ◽  
Control Measures ◽  
World Health ◽  
Small Island ◽  
Influenza Surveillance ◽  
Middle Income ◽  
School Closing ◽  
Travel Restrictions ◽  
Potential Factors ◽  
Health Organization

Abstract Background Three months after the first reported cases, COVID-19 had spread to nearly 90% of World Health Organization (WHO) member states and only 24 countries had not reported cases as of 30 March 2020. This analysis aimed to 1) assess characteristics, capability to detect and monitor COVID-19, and disease control measures in these 24 countries, 2) understand potential factors for the reported delayed COVID-19 introduction, and 3) identify gaps and opportunities for outbreak preparedness, particularly in low and middle-income countries (LMICs). We collected and analyzed publicly available information on country characteristics, COVID-19 testing, influenza surveillance, border measures, and preparedness activities in these countries. We also assessed the association between the temporal spread of COVID-19 in all countries with reported cases with globalization indicator and geographic location. Results Temporal spreading of COVID-19 was strongly associated with countries’ globalization indicator and geographic location. Most of the 24 countries with delayed COVID-19 introduction were LMICs; 88% were small island or landlocked developing countries. As of 30 March 2020, only 38% of these countries reported in-country COVID-19 testing capability, and 71% reported conducting influenza surveillance during the past year. All had implemented two or more border measures, (e.g., travel restrictions and border closures) and multiple preparedness activities (e.g., national preparedness plans and school closing). Conclusions Limited testing capacity suggests that most of the 24 delayed countries may have lacked the capability to detect and identify cases early through sentinel and case-based surveillance. Low global connectedness, geographic isolation, and border measures were common among these countries and may have contributed to the delayed introduction of COVID-19 into these countries. This paper contributes to identifying opportunities for pandemic preparedness, such as increasing disease detection, surveillance, and international collaborations. As the global situation continues to evolve, it is essential for countries to improve and prioritize their capacities to rapidly prevent, detect, and respond, not only for COVID-19, but also for future outbreaks.

scholarly journals Active Aging in ASEAN Countries: Influences from Age-Friendly Environments, Lifestyles, and Socio-Demographic Factors

2021 ◽  
Vol 18 (16) ◽  
pp. 8290
Author(s):  
Sariyamon Tiraphat ◽  
Vijj Kasemsup ◽  
Doungjai Buntup ◽  
Murallitharan Munisamy ◽  
Thang Huu Nguyen ◽  
...  
Keyword(s):  
Older People ◽  
Quantitative Research ◽  
World Health ◽  
Cluster Sampling ◽  
Active Aging ◽  
Older Population ◽  
Cross Sectional ◽  
Middle Income ◽  
Multi Stage ◽  
Health Organization

Active aging is a challenging issue to promote older population health; still, there is little clarity on research investigating the determinants of active aging in developing countries. Therefore, this research aimed to examine the factors associated with the active aging of the older populations in ASEAN’s low and middle-income countries by focusing on Malaysia, Myanmar, Vietnam, and Thailand. The study is a cross-sectional quantitative research study using multi-stage cluster sampling to randomize the sample. The sample consists of 2031 older people aged 55 years and over, including 510 Thai, 537 Malaysian, 487 Myanmar, and 497 Vietnamese. We collected a quantitative questionnaire of age-friendly environmental scale and active aging scale based on the World Health Organization (WHO) concept. The predictors of active aging include age-friendly environments, lifestyles, and socioeconomic factors; the data are analyzed by using multiple logistic regression. After adjusting for other factors, we found that older people living in a community with higher levels of age-friendly environments are 5.52 times more active than those in lower levels of age-friendly environments. Moreover, the older population with healthy lifestyles such as good dietary intake and high physical activity will be 4.93 times more active than those with unhealthy lifestyles. Additionally, older adults with partners, higher education, and aged between 55 and 64 years will be 1.70, 2.61, and 1.63 times more active than those with separate/divorce/widow, primary education, and age at 75 years or higher, respectively. Our results contribute considerable evidence for ASEAN policy-making to promote active aging in this region.

74 Epidemiology and Outcomes of Cooking and Cookstove-related Burn Injuries: A World Health Organization (WHO) Global Burn Registry (GBR) Report

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S51-S52
Author(s):  
Kajal Mehta ◽  
Nikitha Thrikutam ◽  
Kiran K Nakarmi ◽  
Paa Ekow Hoyte-Williams ◽  
Michael Peck ◽  
...  
Keyword(s):  
Risk Factors ◽  
World Health Organization ◽  
Total Body Surface Area ◽  
Burn Injuries ◽  
World Health ◽  
Common Mechanism ◽  
Structural Factors ◽  
Middle Income ◽  
Improved Cookstove ◽  
Health Organization

Abstract Introduction Cooking- and cookstove-related burns (CSBs) comprise a large proportion of burn injuries globally. A cookstove is any apparatus that provides heat and is used for cooking (e.g., three-stone fire, traditional or improved cookstove). There are limited data on patterns of cooking behaviors and CSBs to inform prevention initiatives and advocacy. We aimed to describe the epidemiology, risk factors and outcomes of cooking-related burns and CSBs, specifically. Methods Patients with cooking and non-cooking related burns from 2018 to 2020 were identified in the World Health Organization (WHO) Global Burn Registry (GBR). Patient demographics, cooking arrangement, injury characteristics [mechanism, total body surface area (TBSA), revised Baux score] and outcomes were described. Differences in proportions and medians were compared. Bivariate regression was performed to identify risk factors associated with occurrence of CSB. Results GBR contained data of 6,965 burn-injured patients from 17 countries; 88% were from middle-income countries. One quarter of burn injuries (1,723 burns) were cooking-related. More than half of cooking-related burns (55%) occurred in females. Median age for cooking-related burns was 11 years (IQR 2–35). Of cooking-related burns, 22% were cookstove-related burns (CSBs; 311 burns). The most common mechanism in CSB was flame (87%), whereas the most common mechanism in other cooking burns was scald (62%). Patients with CSBs were more often female (65% vs 53%; p< 0.001) and much older than patients with other cooking burns (32 years, IQR 22–47 vs 5 years, IQR 2–30). CSBs were significantly larger in TBSA size (30%, IQR 15–45% vs 15%, IQR 10–25%; p< 0.001), had higher revised Baux scores (70, IQR 46–95 vs 28, IQR 10–25; p< 0.001) and more often resulted in death (41 vs 11%; p< 0.001) than other cooking burns (Table1). Patients with CSBs were more likely to be burned by fires (OR 4.74; 95% CI 2.99–7.54) and explosions (OR 2.91, 95% CI 2.03–4.18) than other cooking injuries. Kerosene had the highest odds of CSB than all other cooking fuels (OR 2.37, 95% CI 1.52–3.69). Conclusions Cooking-related burns are common and have different epidemiology than CSBs, specifically (e.g., more often female, older, larger burn size, higher mortality). CSBs were more likely caused by structural factors (e.g., explosion, fire) than behavioral factors (e.g., accidental movements) when compared to other cooking burns.

Impact of a poignant pandemic COVID-19 on Indian Economy

2020 ◽  
Vol 11 (SPL1) ◽  
Author(s):  
Krati Sethi ◽  
Manas Roy
Keyword(s):  
Public Health Emergency ◽  
World Health ◽  
Special Treatment ◽  
Supply Side ◽  
Growth Path ◽  
Indian Economy ◽  
The Past ◽  
Policy Measures ◽  
Health Organization ◽  
Consumption Demand

Coronavirus disease (COVID-19) is a contagious disease caused due to a “Severe Acute Respiratory Syndrome Coronavirus -2 virus” (SARS-COV-2). People who fall ill will experience mild to moderate fever and will retrieve without any special treatment. This pandemic was first seen at Wuhan, China in December 2019. After seen it’s dreadfulness it was declared as a “public health emergency of international concern” (World Health Organization, WHO). As on 1 May 2020 more than 35000 cases have been reported in India resulting in more than 1147 deaths in India till date. It has also led severe socio-economic global disruption. Presently significant slowdown is experienced by Indian economy over the past few quarters.To rectify sluggish consumption demand and investment a numeral of incentive measures has been taken to retrieve the economy towards prosperity. The last quarter of the current fiscal exhibits robust prospect of improvement. However, the new COVID-19 epidemic has contrived the recovery exceptionally arduous in the near to middle terms. The pandemic has thrown new threats for the Indian economy from demand as well as from the supply side. This study is descriptive. The objective of the current study is to find out the impacts of the outbreak of COVID-19 on different sectors of our country. In conclusion, this study suggests policy measures to safeguard the Indian economy from the outbreak of it and bring it back on the growth path.

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