scholarly journals A New Framework for Assessing Equid Welfare: A Case Study of Working Equids in Nepalese Brick Kilns

Animals ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 1074
Author(s):  
Stuart L. Norris ◽  
Laura M. Kubasiewicz ◽  
Tamlin L. Watson ◽  
Holly A. Little ◽  
Atish K. Yadav ◽  
...  
Keyword(s):  
Middle Income ◽  
Attitudes And Practices ◽  
Middle Income Countries ◽  
Brick Kilns ◽  
Key Indicator ◽  
Resource Limited ◽  
Trained Staff ◽  
Poor Welfare ◽  
New Framework

Equids fulfil many different roles within communities. In low- to middle-income countries (LMICs), in addition to providing a source of income, equids also provide essential transport of food, water, and goods to resource-limited and/or isolated communities that might otherwise lack access. The aim of this investigation was to understand the welfare conditions that donkeys, mules, and horses are exposed to whilst working in Nepalese brick kilns. To understand the welfare conditions of equids in Nepalese brick kilns, the Welfare Aggregation and Guidance (WAG) tool in conjunction with the Equid Assessment, Research and Scoping (EARS) tool was used to understand the health, behaviour, nutrition, living and working conditions in brick kilns. Further analysis of individual EARS responses focused on key indicator questions relating to demographic information was used to investigate specific areas of welfare concern and attitudes of handlers towards their equids. Trained staff carried out welfare assessments between December 2018 and April 2019. The information gathered using the EARS tool was summarised using the WAG tool to pinpoint areas of welfare concern and suggest possible strategies to mitigate poor welfare conditions and suggest areas to improve the welfare of equids. Overall, the results indicate that to improve the welfare of equids working in Nepalese brick kilns, there should be better provision of clean water, both when working and stabled, equipment should be removed and shade provided during rest periods, with improvements made to housing to allow the equids to rest and recuperate when not working. Further work should also focus on collaborating with owners and equid handlers to improve their attitudes and practices towards their equids. Such improvements can be implemented via training of equid handlers and kiln owners whilst using the EARS and WAG tools to provide a sound basis on which to monitor the effectiveness and impact of education programs on equid welfare.

scholarly journals Development and application of a hybrid implementation research framework to understand success in reducing under-5 mortality in Rwanda

2021 ◽  
Vol 5 ◽  
pp. 72
Author(s):  
Lisa R. Hirschhorn ◽  
Miriam Frisch ◽  
Jovial Thomas Ntawukuriryayo ◽  
Amelia VanderZanden ◽  
Kateri Donahoe ◽  
...  
Keyword(s):  
Health System ◽  
Implementation Research ◽  
Contextual Factors ◽  
Common Pathway ◽  
Middle Income ◽  
Middle Income Countries ◽  
Mixed Methods Case Study ◽  
Hybrid Framework ◽  
Successes And Challenges

Background: We describe the development and testing of a hybrid implementation research (IR) framework to understand the pathways, successes, and challenges in addressing amenable under-5 mortality (U5M) – deaths preventable through health system-delivered evidence-based interventions (EBIs) – in low- and middle-income countries (LMICs). Methods: We reviewed existing IR frameworks to develop a hybrid framework designed to better understand U5M reduction in LMICs from identification of leading causes of amenable U5M, to EBI choice, identification and testing of strategies, work to achieve sustainability at scale and key contextual factors. We then conducted a mixed-methods case study of Rwanda using the framework to explore its utility in understanding the steps the country took in EBI-related decision-making and implementation between 2000-2015, key contextual factors which hindered or facilitated success, and extract actionable knowledge for other countries working to reduce U5M. Results: While relevant frameworks were identified, none individually covered the scope needed to understand Rwanda’s actions and success. Building on these frameworks, we combined and adapted relevant frameworks to capture exploration, planning, implementation, contextual factors in LMICs such as Rwanda, and outcomes beyond effectiveness and coverage. Utilizing our hybrid framework in Rwanda, we studied multiple EBIs and identified a common pathway and cross-cutting strategies and contextual factors that supported the country’s success in reducing U5M through the health system EBIs. Using these findings, we identified transferable lessons for other countries working to accelerate reduction in U5M. Conclusions: We found that a hybrid framework building on and adapting existing frameworks was successful in guiding data collection and interpretation of results, emerging new insights into how and why Rwanda achieved equitable introduction and implementation of health system EBIs that contributed to the decline in U5M, and generated lessons for countries working to drop U5M.

scholarly journals Development of immunohistochemistry services for cancer care in western Kenya: Implications for low- and middle-income countries

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Kirtika Patel ◽  
R. Matthew Strother ◽  
Francis Ndiangui ◽  
David Chumba ◽  
William Jacobson ◽  
...  
Keyword(s):  
Cancer Care ◽  
Cost Model ◽  
Tertiary Care ◽  
Care Hospital ◽  
Middle Income ◽  
Western Kenya ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Limited Setting ◽  
Low And Middle Income

Background: Cancer is becoming a major cause of mortality in low- and middle-income countries. Unlike infectious disease, malignancy and other chronic conditions require significant supportive infrastructure for diagnostics, staging and treatment. In addition to morphologic diagnosis, diagnostic pathways in oncology frequently require immunohistochemistry (IHC) for confirmation. We present the experience of a tertiary-care hospital serving rural western Kenya, which developed and validated an IHC laboratory in support of a growing cancer care service.Objectives, methods and outcomes: Over the past decade, in an academic North-South collaboration, cancer services were developed for the catchment area of Moi Teaching and Referral Hospital in western Kenya. A major hurdle to treatment of cancer in a resource-limited setting has been the lack of adequate diagnostic services. Building upon the foundations of a histology laboratory, strategic investment and training were used to develop IHC services. Key elements of success in this endeavour included: translation of resource-rich practices to are source-limited setting, such as using manual, small-batch IHC instead of disposable- and maintenance-intensive automated machinery, engagement of outside expertise to develop reagent-efficient protocols and supporting all levels of staff to meet the requirements of an external quality assurance programme.Conclusion: Development of low- and middle-income country models of services, such as the IHC laboratory presented in this paper, is critical for the infrastructure in resource-limited settings to address the growing cancer burden. We provide a low-cost model that effectively develops these necessary services in a challenging laboratory environment.

scholarly journals Implementation Research Training Framework 2.0: Making the whole greater than the parts

2021 ◽  
Author(s):  
Keyword(s):  
Implementation Research ◽  
Research Training ◽  
Scale Up ◽  
Health Impact ◽  
Routine Practice ◽  
Tropical Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Training ◽  
New Framework

Clinical innovations alone do not generate public health impact. Implementation research (IR) is a powerful tool for identifying the bottlenecks impeding scale up efforts and helping to turn scientifically tested solutions into routine practice. To enhance the ability of investigators in low- and middle-income countries (LMICs) to design, conduct and interpret IR, several actors, such as the Special Programme for Research and Training in Tropical Diseases (TDR), have sought to strengthen researchers' capacity to design and undertake IR. This report outlines the development of a new framework for IR training in LMICs to inspire thinking and discussion on how training approaches can best serve learners' needs.

Peritoneal Dialysis for AKI in Cameroon: Commercial Vs Locally-Made Solutions

2018 ◽  
Vol 38 (4) ◽  
pp. 246-250 ◽  
Author(s):  
Dennis Palmer ◽  
William J. Lawton ◽  
Charles Barrier ◽  
B.D. Fine ◽  
Hayden Hemphill ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
High Mortality ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
Resource Limited Settings ◽  
Significant Cost ◽  
Middle Income ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Baptist Hospital

Background Acute kidney injury (AKI) is common in low- and middle-income countries, and is associated with a high mortality. The high mortality rate is in large part due to the inability to perform dialysis in resource-limited settings. Due to significant cost advantages, peritoneal dialysis (PD) has been used to treat AKI in these settings. The costs, however, remain high when commercial solutions are used. Methods This is a retrospective cohort study of the outcome, and of the peritonitis rates, of patients with AKI treated with either commercially manufactured PD solutions or locally-made PD solutions. A program to treat AKI with PD was started at Mbingo Baptist Hospital in Cameroon. Between May 2013 and January 2015, solutions and connection sets were provided by the Saving Young Lives Program. From January 2015 through March 2017, solutions were locally produced and available tubing was used. Results Mortality in hospitalized AKI patients was 28% during the period when commercial solutions and tubing were utilized, and 33% when locally produced solutions and available tubing were utilized. In both groups, peritonitis occurred in 16% of treatment courses. Conclusions Locally produced PD solutions, used with locally available tubing, were used to treat AKI with PD. The mortality and peritonitis rates were similar whether locally produced or commercial supplies were used.

scholarly journals Characteristics of a Nationwide Voluntary Antibiotic Resistance Awareness Campaign in India; Future Paths and Pointers for Resource Limited Settings/Low and Middle Income Countries

2019 ◽  
Vol 16 (24) ◽  
pp. 5141
Author(s):  
Ashok J. Tamhankar ◽  
Ramesh Nachimuthu ◽  
Ravikant Singh ◽  
Jyoti Harindran ◽  
Gautam Kumar Meghwanshi ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
World Health ◽  
Awareness Campaign ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Middle Income Countries ◽  
Awareness Campaigns ◽  
Resource Limited ◽  
Low And Middle Income

Antibiotic resistance has reached alarming proportions globally, prompting the World Health Organization to advise nations to take up antibiotic awareness campaigns. Several campaigns have been taken up worldwide, mostly by governments. The government of India asked manufacturers to append a ‘redline’ to packages of antibiotics as identification marks and conducted a campaign to inform the general public about it and appropriate antibiotic use. We investigated whether an antibiotic resistance awareness campaign could be organized voluntarily in India and determined the characteristics of the voluntarily organized campaign by administering a questionnaire to the coordinators, who participated in organizing the voluntary campaign India. The campaign characteristics were: multiple electro–physical pedagogical and participatory techniques were used, 49 physical events were organized in various parts of India that included lectures, posters, booklet/pamphlet distribution, audio and video messages, competitions, and mass contact rallies along with broadcast of messages in 11 local languages using community radio stations (CRS) spread all over India. The median values for campaign events were: expenditure—3000 Indian Rupees/day (US$~47), time for planning—1 day, program spread—4 days, program time—4 h, direct and indirect reach of the message—respectively 250 and 500 persons/event. A 2 min play entitled ‘Take antibiotics as prescribed by the doctor’ was broadcast 10 times/day for 5 days on CRS with listener reach of ~5 million persons. More than 85%ofcoordinators thought that the campaign created adequate awareness about appropriate antibiotic use and antibiotic resistance. The voluntary campaign has implications for resource limited settings/low and middle income countries.

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