scholarly journals Influence of Individual and Contextual Perceptions and of Multiple Neighborhoods on Depression

2020 ◽  
Vol 17 (6) ◽  
pp. 1958
Author(s):  
Médicoulé Traoré ◽  
Cécile Vuillermoz ◽  
Pierre Chauvin ◽  
Séverine Deguen
Keyword(s):  
Low Income ◽  
Individual Characteristics ◽  
Cumulative Exposure ◽  
Middle Income ◽  
New Approach ◽  
Inequalities In Health ◽  
Logistic Regression Models ◽  
The One ◽  
Multiple Neighborhoods

The risk of depression is related to multiple various determinants. The consideration of multiple neighborhoods daily frequented by individuals has led to increased interest in analyzing socio-territorial inequalities in health. In this context, the main objective of this study was (i) to describe and analyze the spatial distribution of depression and (ii) to investigate the role of the perception of the different frequented spaces in the risk of depression in the overall population and in the population stratified by gender. Data were extracted from the 2010 SIRS (a French acronym for “health, inequalities and social ruptures”) cohort survey. In addition to the classic individual characteristics, the participants reported their residential neighborhoods, their workplace neighborhoods and a third one: a daily frequented neighborhood. A new approach was developed to simultaneously consider the three reported neighborhoods to better quantify the level of neighborhood socioeconomic deprivation. Multiple simple and cross-classified multilevel logistic regression models were used to analyze the data. Depression was reported more frequently in low-income (OR = 1.89; CI = [1.07–3.35]) or middle-income (OR = 1.91; CI = [1.09–3.36]) neighborhoods and those with cumulative poverty (OR = 1.64; CI = [1.10–2.45]). In conclusion, a cumulative exposure score, such as the one presented here, may be an appropriate innovative approach to analyzing their effects in the investigation of socio-territorial inequalities in health.

scholarly journals Role of Public Sector Bank in Financial Inclusion of Low or Middle Income Group in Chennai

2019 ◽  
Vol 8 (4S3) ◽  
pp. 40-44
Keyword(s):  
Public Sector ◽  
Low Income ◽  
Income Group ◽  
Financial Inclusion ◽  
Behavioral Ethics ◽  
Economic Equality ◽  
Middle Income ◽  
Middle Income Group ◽  
The Government

The role of public sector bank, in raising the economic equality on low income or middle income group, the term financial inclusion emphasis on redistribution of income within the same household, the deprive section of society avail the benefit with some standard provided by the government and how the approach have been taken by public sector bank to distribute the same and their behavioral ethics trail over the schemes. The study focused the dominant properties which fabricate imperative on financial inclusion among various categories of customers in public sector banks and also investigated the recognition of public in stand point of financial assistance and financial features offered by public sector bank through correlation statistical analysis with the sample of 200 with Chennai arena..

scholarly journals The paediatrician workforce and its role in addressing neonatal, child and adolescent healthcare in Kenya

2020 ◽  
Vol 105 (10) ◽  
pp. 927-931 ◽  
Author(s):  
Mike English ◽  
Brigid Strachan ◽  
Fabian Esamai ◽  
Thomas Ngwiri ◽  
Osman Warfa ◽  
...  
Keyword(s):  
Public Sector ◽  
Low Income ◽  
Tertiary Care ◽  
Leadership Role ◽  
Multiple Sources ◽  
Middle Income ◽  
The Public ◽  
Local Expert

ObjectiveTo examine the availability of paediatricians in Kenya and plans for their development.DesignReview of policies and data from multiple sources combined with local expert insight.SettingKenya with a focus on the public, non-tertiary care sector as an example of a low-income and middle-income country aiming to improve the survival and long-term health of newborns, children and adolescents.ResultsThere are 305 practising paediatricians, 1.33 per 100 000 individuals of the population aged <19 years which in total numbers approximately 25 million. Only 94 are in public sector, non-tertiary county hospitals. There is either no paediatrician at all or only one paediatrician in 21/47 Kenyan counties that are home to over a quarter of a million under 19 years of age. Government policy is to achieve employment of 1416 paediatricians in the public sector by 2030, however this remains aspirational as there is no comprehensive training or financing plan to reach this target and health workforce recruitment, financing and management is now devolved to 47 counties. The vast majority of paediatric care is therefore provided by non-specialist healthcare workers.DiscussionThe scale of the paediatric workforce challenge seriously undermines the ability of the Kenyan health system to deliver on the emerging survive, thrive and transform agenda that encompasses more complex health needs. Addressing this challenge may require innovative workforce solutions such as task-sharing, these may in turn require the role of paediatricians to be redefined. Professional paediatric communities in countries like Kenya could play a leadership role in developing such solutions.

scholarly journals Withholding and Withdrawal of Life-Sustaining Treatments in critically ill ICU patients: A study on attitude of Physicians of Bangladesh

2019 ◽  
Vol 7 (2) ◽  
pp. 66-72
Author(s):  
Mohammad Omar Faruq ◽  
ARM Nooruzzaman ◽  
Rownak Jahan Tamanna ◽  
Amina Sultana ◽  
Uzzwal Kumar Mallick ◽  
...  
Keyword(s):  
Low Income ◽  
International Study ◽  
Legal Rights ◽  
Asian Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Icu Physicians ◽  
Real Chance

Background : This study is a sub analysis of data submitted on behalf of Bangladesh in an International study ( ACME 2012) involving physicians working in Asian ICUs. Objective : To describe attitude of physicians of ICUs of Bangladesh toward withholding and withdrawal of life sustaining treatments in end of life care, to assess factors associated with these observations and to compare the findings especially with those of physicians of low – middle income Asian ICUs. Method : Self-administered pre-set structured and scenario based survey conducted among 101 physicians working in 38 ICUs of Bangladesh. Results : For patients with no real chance of recovering a meaningful life, 20 of 101 respondents reported that they almost always or often withheld life-sustaining treatments and 18 of 101 respondents almost always or often withdrew life-sustaining treatments.44 respondents in our study reported that they almost always or often withheld life sustaining treatments whereas 10 respondents almost always or often withdrew life sustaining treatments. 72% of all our respondents would implement DNR orders. In Bangladesh, religion (Islam) does not influence decision of complying with DNR order requested by family. Our study showed 71% of physicians were more likely to “do everything” if a patient with hypoxic-ischaemic encephalopathy developed septic shock. In our study, physicians were more ready to withdraw vasopressors and hemo dialysis than enteral feeding and intravenous fluids. Physicians from Bangladesh generally perceived more legal risk with limitation of life sustaining treatments because of lack of legislation for such practices. When it comes to limit aggressive lifesaving treatments, Bangladeshi physicians were less likely accede to families request to withdraw them on financial ground. Conclusion : Like physicians of low-middle income countries of Asia, Bangladeshi ICU physicians’ self-reported practice of limiting life sustaining treatments, role of families and surrogates and perception of legal rights were significantly different than physicians of high income countries of Asia. However unlike physicians from other low income Asian countries, physicians from Bangladesh were less likely to accede to families request to withdraw life sustaining treatments on financial ground. Bangladesh Crit Care J September 2019; 7(2): 66-72

scholarly journals Receiving Social Assistance in Low- and Middle-Income Countries: Negating Shame or Producing Stigma?

2019 ◽  
Vol 49 (4) ◽  
pp. 705-723 ◽  
Author(s):  
KEETIE ROELEN
Keyword(s):  
Low Income ◽  
Social Assistance ◽  
Low Income Countries ◽  
Policy Options ◽  
Negative Effects ◽  
Middle Income ◽  
Middle Income Countries ◽  
Critical Exploration ◽  
Low And Middle Income

AbstractDespite the centrality of shame and stigma within research on welfare in high-income countries, these issues only exist within the periphery of rapidly expanding practice in and research on social assistance in low- and middle-income countries. This oversight undermines social assistance’s potential in breaking the poverty-shame cycle and ignores its role in the (re)production of shame and stigma. This article offers a critical exploration of the role of social assistance in alleviating or reinforcing shame and stigma in low- and middle-income countries. Findings indicate that positive and negative effects co-exist but that far too little evidence is available to judge whether social assistance receipt overwhelmingly negates or plays into shame and stigma, particularly in low-income countries. Greater awareness of the interface between social assistance, shame and stigma, explorations of policy options that minimise or counter stigmatisation, and critical engagement with ideological and political discourse underpinning design and delivery of interventions represent crucial steps to move towards ‘shame proofing’ social assistance in low- and middle-income countries.

scholarly journals Primary healthcare policy and governance in low-income and middle-income countries: an evidence gap map

2019 ◽  
Vol 4 (Suppl 8) ◽  
pp. e001453 ◽  
Author(s):  
K M Saif-Ur-Rahman ◽  
Razib Mamun ◽  
Iffat Nowrin ◽  
Shahed Hossain ◽  
Khaleda Islam ◽  
...  
Keyword(s):  
Social Responsibility ◽  
Low Income ◽  
Primary Healthcare ◽  
Evidence Synthesis ◽  
Nominal Group ◽  
Provider Communication ◽  
Middle Income ◽  
Stakeholder Consultation ◽  
Middle Income Countries

IntroductionGovernance is one of the most important aspects for strong primary healthcare (PHC) service delivery. To achieve the targets for the Sustainable Development Goals, good governance may play a prime role in low-income and middle-income countries (LMICs). This evidence gap map (EGM) explored the available evidence in LMICs to identify the knowledge gap concerning PHC policy and governance in these settings.MethodsWe followed the standard 3ie EGM protocol, finalising the scope of the EGM through a stakeholder workshop. We searched a total of 32 bibliographic databases, systematic review databases, impact evaluation databases, and donor and bilateral agency databases using a comprehensive search strategy. Two reviewers screened retrieved studies, extracted data and performed quality assessment. We plotted the interventions and outcomes derived from the included studies in a dynamic platform to build the interactive EGM and conducted a stakeholder consultation with nominal group technique methods to prioritise the identified gaps.ResultsThe EGM included 24 systematic reviews and 7 impact evaluations focusing on PHC policy and governance in LMICs. Most of the sources emphasised workforce management and supervision. There were noticeable evidence gaps regarding accountability and social responsibility. The most highly prioritised themes were the role of accountability, the role of public–private partnerships and the role of user–provider communication in PHC governance.ConclusionsThis EGM identified some important aspects of PHC policy and governance such as accountability, social responsibility, public–private partnership, user–provider communication through the methodological approaches of evidence synthesis and stakeholder consultation. Identified gaps will provide directions for an implementation research plan to improve the governance of PHC in LMICs.

The Role of Technical Standards in Improving Digital Accessibility in Under-Resourced Regions and Communities

2021 ◽  
pp. 128-151
Author(s):  
Judy Brewer ◽  
Shadi Abou-Zahra
Keyword(s):  
Low Income ◽  
People With Disabilities ◽  
Indigenous Communities ◽  
Technical Standards ◽  
Middle Income ◽  
Barriers To Participation ◽  
Middle Income Countries

People with disabilities in under-resourced communities, including in low-income and lower middle-income countries and in many Indigenous communities, have not yet benefited as much from digital accessibility as have people with disabilities in higher-income regions. This chapter addresses factors that contribute to these disparities and describes the role of standards in promoting digital accessibility. It describes barriers to participation, approaches that can help improve opportunities for people from under-resourced communities to engage in development of accessibility standards and accessible technologies, and steps that can increase promotion and uptake of digital accessibility standards in under-resourced regions and communities.

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