scholarly journals Features of Low-Income and Middle-Income Countries making Road Safety more Challenging

2020 ◽  
Vol 31 (3) ◽  
pp. 79-84
Author(s):  
R.F. Soames Job ◽  
William M Wambulwa
Keyword(s):  
Low Income ◽  
Road Safety ◽  
Cost Effective ◽  
Transit Systems ◽  
Middle Income ◽  
Crash Data ◽  
Middle Income Countries ◽  
Road Users ◽  
Road Crash ◽  
Vulnerable Road Users

Low- and Middle-Income Countries suffer the large majority (93%) of global road crash deaths and face particular challenges in managing this crisis. This paper presents global data and trends revealing underlying features of the problem for LMICs. LMICs are commonly grouped and described together in road safety commentaries, yet appreciation of the substantial differences between LICs and MICs is vital. While global deaths per 100,000 people have stabilized during the UN Decade of Road Safety, the population rate has increased in LICs (by 8.2%), while decreasing in HIC and MIC. LICs have less resources to address road safety and younger populations adding to risk. Wide variations on road safety performance exist within country income groups, with some of this variance occurring systematically between regions. Absolute numbers of deaths are increasing due to increasing population and increasing vehicle fleets in LMICs compared with HICs. The capacity of MICs, and especially LICs, to manage road safety is hampered by poor crash data to guide action as well less available funding and resources to achieve safer road engineering, safer vehicles, and protect the large proportions of vulnerable road users. Road crash deaths and injuries are retarding the economic growth of LMICs and investing road safety is a costeffective means by which LMICs can move towards becoming HICs. Vital opportunities for cost-effective savings of lives and debilitating injuries in LMICs include better management of speed (especially through infrastructure), improving safety infrastructure for pedestrians, increasing seatbelt use, and shifting travel from motorcycles to buses through provision of Bus Rapid Transit systems.

scholarly journals Roadway Safety Assessment and Star Rating using iRAP along SH-11A (Jind-Kaithal) in Haryana

2021 ◽  
Vol 889 (1) ◽  
pp. 012036
Author(s):  
Sunil ◽  
Abhishek Sharma
Keyword(s):  
Road Safety ◽  
Safety Assessment ◽  
Rapid Development ◽  
Analysis Tool ◽  
Middle Income ◽  
Star Rating ◽  
Middle Income Countries ◽  
State Highway ◽  
Road Users ◽  
Vulnerable Road Users

Abstract Figures cross 3,500 deaths and casualties on roads all around world every day in low- and middle-income countries and contribute about 90% of the 1.25 million road deaths. This number of road deaths is projected to increase by 50 percent by 2020. The compound problem for developing countries is caused by the rapid development of roads, irrespective of design or security, lack of attention to vulnerable road users and lack of a culture of road safety (i.e., safe behaviour, vehicle safety regulations, road safety policy, road safety assessment, and enforcement). This paper deals with the star rating and road safety assessment of State Highway-11A, Jind-Kaithal, Haryana though the section is straight but numerous causalities were reported on the route in recent years. ViDA, an online road safety assessment and star rating analysis tool is used to get the Star Rating Scores and Safer Roads Investment Plans.

scholarly journals Immunisation financing and programme performance in the Middle East and North Africa, 2010 to 2017

2019 ◽  
Vol 4 (2) ◽  
pp. e001248
Author(s):  
Helen Saxenian ◽  
Nahad Sadr-Azodi ◽  
Miloud Kaddar ◽  
Kamel Senouci
Keyword(s):  
Economic Growth ◽  
Middle East ◽  
North Africa ◽  
Low Income ◽  
Health Sector ◽  
Cost Effective ◽  
Middle Income ◽  
Middle Income Countries ◽  
Life Saving ◽  
Fiscal Space

Immunisation is a cornerstone to primary health care and is an exceptionally good value. The 14 low-income and middle-income countries in the Middle East and North Africa region make up 88% of the region’s population and 92% of its births. Many of these countries have maintained high immunisation coverage even during periods of low or negative economic growth. However, coverage has sharply deteriorated in countries directly impacted by conflict and political unrest. Approximately 1.3 million children were not completely vaccinated in 2017, as measured by third dose of diphtheria–pertussis–tetanus vaccine. Most of the countries have been slow to adopt the newer, more expensive life-saving vaccines mainly because of financial constraints and the socioeconomic context. Apart from the three countries that have had long-standing assistance from Gavi, the Vaccine Alliance, most countries have not benefited appreciably from donor and partner activities in supporting their health sector and in achieving their national and subnational immunisation targets. Looking forward, development partners will have an important role in helping reconstruct health systems in conflict-affected countries. They can also help with generating evidence and strategic advocacy for high-priority and cost-effective services, including immunisation. Governments and ministries of health would ensure important benefits to their populations by investing further in their immunisation programmes. Where possible, the health system can create and expand fiscal space from efficiency gains in harmonising vaccine procurement mechanisms and service integration; broader revenue generation from economic growth; and reallocation of government budgets to health, and from within health, to immunization.

scholarly journals Antiparasitic phytotherapy perspectives, scope and current development

Infectio ◽  
2019 ◽  
Vol 23 (2) ◽  
pp. 189 ◽  
Author(s):  
Jhon Carlos Castaño Osorio ◽  
Alejandra María Giraldo García
Keyword(s):  
Low Income ◽  
Public Health Problem ◽  
Cost Effective ◽  
Prolonged Treatment ◽  
Major Public Health Problem ◽  
Middle Income ◽  
Middle Income Countries ◽  
Commercial Markets ◽  
Health And Economic Development ◽  
New Treatments

Tropical protozoan diseases are currently a major public health problem throughout the world and are strongly linked with poverty, this combined with a lack of commercial markets for potential drugs has created a large burden on the health and economic development of low-income and middle-income countries in Africa, Asia, and the Americas. Due to the low research interest and the high increase of resistance against the existing treatments, as well as increasing inefficiency, toxicity, prolonged treatment schedules and costs, there is an urgent need for cost-effective, safe and easy-to-administer, new effective compounds with novel mechanisms of action. Several studies of crude plant extracts have already identified potential compounds to treat Chagas’ disease, Leishmaniasis, Toxoplasmosis, Giardiasis, and Malaria among other protozoan parasites. Natural compounds of medicinal plants have shown lower toxicity together with higher specificity, creating an optimistic view of new treatments for diseases. Out of 1010 new active substances approved as drugs for medical conditions by regulatory agencies during the past 25 years, 490(48.5%) were from a natural origin.

scholarly journals Global trends in adolescents’ road traffic injury mortality, 1990–2019

2021 ◽  
pp. archdischild-2020-319184
Author(s):  
Uzma Rahim Khan ◽  
Junaid A Razzak ◽  
Martin Gerdin Wärnberg
Keyword(s):  
Low Income ◽  
Road Traffic ◽  
Mortality Rates ◽  
Road Traffic Injury ◽  
Low Income Countries ◽  
Middle Income ◽  
Income Levels ◽  
Middle Income Countries ◽  
Traffic Injury ◽  
Road Users

ObjectiveThe aim of this study was to determine the trends of road traffic injury (RTI) mortality among adolescents aged 10–14 years and 15–19 years across different country income levels with respect to the type of road users from 1990 to 2019.MethodsWe conducted an ecological study. Adolescents’ mortality rates from RTIs at the level of high-income countries (HICs), upper-income to middle-income countries (UMICs), lower-income to middle-income countries and low-income countries were extracted from the Global Burden of Disease study. Time series were plotted to visualise the trends in mortality rates over the years. We also conducted Poisson regression using road traffic mortality rates as the dependent variable and year as the independent variable to model the trend of the change in the annual mean mortality rate, with incidence rate ratios (IRRs) and 95% CIs.ResultsThere were downward mortality trends in all types of road users and income levels among adolescents from 1990 to 2019. HICs had more pronounced reductions in mortality rates than countries of any other income level. For example, the reduction in pedestrians in HICs was IRR 0.94 (95% CI 0.90 to 0.98), while that in UMICs was IRR 0.97 (95% CI 0.95 to 0.99) in adolescents aged 10-14 years.ConclusionsThere are downward trends in RTI mortality in adolescents from 1990 to 2019 globally at all income levels for all types of road users. The decrease in mortality rates is small but a promising finding. However, prevention efforts should be continued as the burden is still high.

scholarly journals Overview of the Development, Impacts, and Challenges of Live-Attenuated Oral Rotavirus Vaccines

Vaccines ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 341 ◽  
Author(s):  
Olufemi Samuel Folorunso ◽  
Olihile M. Sebolai
Keyword(s):  
Low Income ◽  
Vaccine Development ◽  
Cost Effective ◽  
Low Income Countries ◽  
Effective Vaccine ◽  
Middle Income ◽  
Middle Income Countries ◽  
Rotavirus Vaccines ◽  
The Impact ◽  
Infants And Young Children

Safety, efficacy, and cost-effectiveness are paramount to vaccine development. Following the isolation of rotavirus particles in 1969 and its evidence as an aetiology of severe dehydrating diarrhoea in infants and young children worldwide, the quest to find not only an acceptable and reliable but cost-effective vaccine has continued until now. Four live-attenuated oral rotavirus vaccines (LAORoVs) (Rotarix®, RotaTeq®, Rotavac®, and RotaSIIL®) have been developed and licensed to be used against all forms of rotavirus-associated infection. The efficacy of these vaccines is more obvious in the high-income countries (HIC) compared with the low- to middle-income countries (LMICs); however, the impact is far exceeding in the low-income countries (LICs). Despite the rotavirus vaccine efficacy and effectiveness, more than 90 countries (mostly Asia, America, and Europe) are yet to implement any of these vaccines. Implementation of these vaccines has continued to suffer a setback in these countries due to the vaccine cost, policy, discharging of strategic preventive measures, and infrastructures. This review reappraises the impacts and effectiveness of the current live-attenuated oral rotavirus vaccines from many representative countries of the globe. It examines the problems associated with the low efficacy of these vaccines and the way forward. Lastly, forefront efforts put forward to develop initial procedures for oral rotavirus vaccines were examined and re-connected to today vaccines.

scholarly journals Lives Saved in Low- and Middle-Income Countries by Road Safety Initiatives Funded by Bloomberg Philanthropies and Implemented by Their Partners between 2007–2018

2021 ◽  
Vol 18 (21) ◽  
pp. 11185
Author(s):  
Delia Hendrie ◽  
Greg Lyle ◽  
Max Cameron
Keyword(s):  
Road Safety ◽  
Cost Effective ◽  
Potential Health ◽  
Middle Income ◽  
The Road ◽  
Middle Income Countries ◽  
Safety Interventions ◽  
Legislative Changes ◽  
Social Marketing Campaigns ◽  
Low And Middle Income

Over the past 12 years, Bloomberg Philanthropies (BP) and its partner organisations have implemented a global road safety program in low- and middle-income countries. The program was implemented to address the historically increasing number of road fatalities and the inadequate funding to reduce them. This study evaluates the performance of the program by estimating lives saved from road safety interventions implemented during the program period (2007–2018) through to 2030. We estimated that 311,758 lives will have been saved by 2030, with 97,148 lives saved up until 2018 when the evaluation was conducted and a further 214,608 lives projected to be saved if these changes are sustained until 2030. Legislative changes alone accounted for 75% of lives saved. Concurrent activities related to reducing drink driving, implementing legislative changes, and social marketing campaigns run in conjunction with police enforcement and other road safety activities accounted for 57% of the total estimated lives saved. Saving 311,758 lives with funding of USD $259 million indicates a cost-effectiveness ratio of USD $831 per life saved. The potential health gains achieved through the number of lives saved from the road safety initiatives funded by Bloomberg Philanthropies represent a considerable return on investment. This study demonstrates the extent to which successful, cost-effective road safety initiatives can reduce road fatalities in low- and middle-income countries.

scholarly journals Antimicrobial resistance surveillance: can we estimate resistance in bloodstream infections from other types of specimen?

2020 ◽  
Author(s):  
Karina-Doris Vihta ◽  
Nicola Claire Gordon ◽  
Nicole Stoesser ◽  
T. Phuong Quan ◽  
Carina SB Tyrrell ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Low Income ◽  
Bloodstream Infections ◽  
Cost Effective ◽  
Middle Income ◽  
E Coli ◽  
Middle Income Countries ◽  
Invasive Infections ◽  
Tract Infections ◽  
Over Time

SynopsisBackgroundAntimicrobial resistance (AMR) surveillance of bloodstream infections is challenging in low- and middle-income countries (LMICs), limited laboratory capacity preventing routine patient-level susceptibility testing. Other specimen types could provide an effective approach to surveillance.ObjectivesOur study aims to systematically evaluate the relationship between resistance prevalence in non-sterile sites and bloodstream infections.MethodsAssociations between resistance rates in Escherichia coli and Staphylococcus aureus isolates from blood and other specimens were estimated in Oxfordshire, UK, 1998-2018, comparing proportions resistant in each calendar year using time series cross-correlations and across drug-years. We repeated analysis across publicly-available data from four high-income and 12 middle-income countries, and in three hospitals/programmes in LMICs.Results8102 E. coli bloodstream infections, 322087 E. coli urinary tract infections, 6952 S. aureus bloodstream infections and 112074 S. aureus non-sterile site cultures were included from Oxfordshire. Resistance trends over time in blood versus other specimens were strongly correlated (maximum cross-correlation 0.51-0.99, strongest associations in the same year for 18/27 pathogen-drug combinations). Resistance prevalence was broadly congruent across drug-years for each species. 276/312 (88%) species-drug-years had resistance prevalence in other specimen types within ±10% of that blood isolates. Results were similar across multiple countries and hospitals/programmes in high/middle/low income-settings.ConclusionsResistance in bloodstream and less invasive infections are strongly related over time, suggesting the latter could be a surveillance tool for AMR in LMICs. These infection sites are easier to sample and cheaper to obtain the necessary numbers of susceptibility tests, providing more cost-effective evidence for decisions including empiric antibiotic recommendations.

scholarly journals Design and Implementation of a Highly Scalable, Low-Cost Distributed Traffic Violation Enforcement System in Phuket, Thailand

2021 ◽  
Vol 13 (3) ◽  
pp. 1210
Author(s):  
Somphop Limsoonthrakul ◽  
Matthew N. Dailey ◽  
Ramesh Marikhu ◽  
Vasan Timtong ◽  
Aphinya Chairat ◽  
...  
Keyword(s):  
Road Safety ◽  
Positive Impact ◽  
Small Scale ◽  
Middle Income ◽  
Middle Income Countries ◽  
Road Users ◽  
Traffic Violation ◽  
The Cost ◽  
The Impact ◽  
Low And Middle Income

The number of global road traffic accidents is rising every year and remains undesirably high. One of the main reasons for this trend is that, in many countries, road users violate road safety regulations and traffic laws. Despite improvements in road safety legislation, enforcement is still a major challenge in low- and middle-income countries. Information technology solutions have emerged for automated traffic enforcement systems in the last decade. They have been tested on a small scale, but until now, the cost of deployment of these systems is generally too high for nation-wide adoption in low- and middle-income countries that need them the most. We present the architectural design of a traffic violation enforcement system that can optimize the cost of deployment and resource utilization. Based on the proposed architecture, we describe the implementation and deployment of the system, and perform a comparison of two different versions of the video-based enforcement system, one using classical computer vision methods and another using deep learning techniques. Finally, we analyze the impact of the system deployed in Phuket, Thailand from 2017 to the present in terms of local road users’ compliance and the road safety situation. We conclude that the system has had a positive impact on road safety in Phuket at a moderate cost.

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