scholarly journals A Systematic Framework for Collecting Site-Specific Sampling and Survey Data to Support Analyses of Health Impacts from Land-Based Pollution in Low- and Middle-Income Countries

2021 ◽  
Vol 18 (9) ◽  
pp. 4676
Author(s):  
Katherine von Stackelberg ◽  
Pamela R.D. Williams ◽  
Ernesto Sánchez-Triana
Keyword(s):  
Health Outcomes ◽  
Health Impact ◽  
Adverse Outcomes ◽  
Health Impacts ◽  
Small Scale ◽  
Economic Activities ◽  
Middle Income ◽  
Middle Income Countries ◽  
Populations At Risk ◽  
Low And Middle Income

The rise of small-scale and localized economic activities in low- and middle-income countries (LMICs) has led to increased exposures to contaminants associated with these processes and the potential for resulting adverse health effects in exposed communities. Risk assessment is the process of building models to predict the probability of adverse outcomes based on concentration-response functions and exposure scenarios for individual contaminants, while epidemiology uses statistical methods to explore associations between potential exposures and observed health outcomes. Neither approach by itself is practical or sufficient for evaluating the magnitude of exposures and health impacts associated with land-based pollution in LMICs. Here we propose a more pragmatic framework for designing representative studies, including uniform sampling guidelines and household surveys, that draws from both methodologies to better support community health impact analyses associated with land-based pollution sources in LMICs. Our primary goal is to explicitly link environmental contamination from land-based pollution associated with specific localized economic activities to community exposures and health outcomes at the household level. The proposed framework was applied to the following three types of industries that are now widespread in many LMICs: artisanal scale gold mining (ASGM), used lead-acid battery recycling (ULAB), and small tanning facilities. For each activity, we develop a generalized conceptual site model (CSM) that describes qualitative linkages from chemical releases or discharges, environmental fate and transport mechanisms, exposure pathways and routes, populations at risk, and health outcomes. This upfront information, which is often overlooked, is essential for delineating the contaminant zone of influence in a community and identifying relevant households for study. We also recommend cost-effective methods for use in LMICs related to environmental sampling, biological monitoring, survey questionnaires, and health outcome measurements at contaminated and unexposed reference sites. Future study designs based on this framework will facilitate consistent, comparable, and standardized community exposure, risk, and health impact assessments for land-based pollution in LMICs. The results of these studies can also support economic burden analyses and risk management decision-making around site cleanup, risk mitigation, and public health education.

scholarly journals Estimating the Health Impact of Vaccination Against 10 Pathogens in 98 Low and Middle Income Countries from 2000 to 2030

2019 ◽  
Author(s):  
Xiang Li ◽  
Christinah Mukandavire ◽  
Zulma M. Cucunubá ◽  
Kaja Abbas ◽  
Hannah E. Clapham ◽  
...  
Keyword(s):  
Health Impact ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Effect of Food Environment Interventions on Anthropometric Outcomes in School-Aged Children and Adolescents in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Bianca Carducci ◽  
Christina Oh ◽  
Emily C Keats ◽  
Daniel E Roth ◽  
Zulfiqar A Bhutta
Keyword(s):  
Health Outcomes ◽  
Food Environment ◽  
Cochrane Library ◽  
Free Text ◽  
Environmental Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
School Aged Children ◽  
The Impact ◽  
Low And Middle Income

ABSTRACT Food environments may promote access to unhealthy foods, contributing to noncommunicable diseases in low- and middle- income countries (LMICs). This review assessed published evidence on the effects of food environment interventions on anthropometric (BMI and weight status) outcomes in school-aged children (5–9 y) and adolescents (10–19 y) (SACA) in LMICs. We summarized randomized controlled trials (RCTs) and quasi-experimental studies (QES) published since 2000 to August 2019 in the peer-reviewed and gray literature that assessed the effects of food-related behavioral and environmental interventions on diet-related health outcomes in SACA in LMICs. Electronic databases (MEDLINE, Embase, PsycINFO, Cochrane Library) were searched using appropriate keywords, Medical Subject Headings, and free text terms. Eleven RCTs and 6 QES met the inclusion criteria, testing multicomponent behavioral and environmental interventions in schools. Analysis of 6 RCTs (n  = 17,054) suggested an overall effect on change in BMI [mean difference (MD): −0.11, 95% CI: −0.19 , −0.03], whereas there was no observed effect in 5 studies using endline BMI (n  = 17,371) (MD: 0.05, 95% CI: −0.32, 0.21). There was no significant pooled effect among the 3 QES (n  = 5,023) that reported differences in change in BMI or endline (MD: −0.37, 95% CI: −0.95, 0.22). There is limited evidence to support the modification of diet-related health outcomes through school-based food environment interventions in SACA in LMICs. Further studies are needed to understand the impact of school and community-based food environment interventions on nutritional status in this population.

scholarly journals Older People, Mobility and Transport in Low- and Middle-Income Countries: A Review of the Research

2019 ◽  
Vol 11 (21) ◽  
pp. 6157 ◽  
Author(s):  
Mark Gorman ◽  
Sion Jones ◽  
Jeffrey Turner
Keyword(s):  
Older People ◽  
Low Income ◽  
Well Being ◽  
The State ◽  
Small Scale ◽  
Knowledge Gaps ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

Older populations are rising globally, which in high-income countries has helped to generate a growing literature on the impact of ageing on travel requirements and transport policy. This article aims to provide an initial assessment of the state of knowledge on the impact on transportation policy and usage of the increasing numbers of older people in low- and middle-income countries (LAMICs), through a review of the literature relating to older people and transportation. As both the academic and policy/practice-related literature specifically addressing ageing and transport in LAMICs is limited, the study looks beyond transportation to assess the state of knowledge regarding the ways in which older people’s mobility is affected by issues, such as health, well-being, social (dis)engagement and gender. We find significant knowledge gaps, resulting in an evidence base to support the implementation of policy is lacking. Most research in low-income countries (LICs) is either broad quantitative analysis based on national survey data or small-scale qualitative studies. We conclude that, although study of the differing contexts of ageing in LAMICs as they relate to older people’s mobilities and transport use has barely begun, institutions which both make and influence policymaking recognise the existence of significant knowledge gaps. This should provide the context in which research agendas can be established.

scholarly journals Infant Mortality in Low- and Middle-income Countries: Does Government Health Spending Matter?

2020 ◽  
Vol 5 (1) ◽  
pp. 54-73
Author(s):  
Micheal Kofi Boachie ◽  
Tatjana Põlajeva ◽  
Albert Opoku Frimpong
Keyword(s):  
Infant Mortality ◽  
Health Outcomes ◽  
Health Expenditure ◽  
Fixed Effects ◽  
Health Sector ◽  
Health Spending ◽  
Middle Income ◽  
Government Health ◽  
Middle Income Countries ◽  
Low And Middle Income

The issue of whether government health spending improves health outcomes has been a matter of contention over the years. There have been calls for governments to reduce their financing role in the health sector since such funding do not produce better health. This article examines the effect of public (i.e., government) health expenditure on infant mortality, a proxy of health outcomes, in low- and middle-income countries. We use data from the World Bank’s World Development Indicators database and employ fixed effects estimation technique, with three-stage least squares as a robustness check. The data cover the period 1995–2014. We find that public health expenditure improves health outcomes significantly, as it reduces infant mortality. The results further show that rising income and access to safe water are some of the reasons for improved health outcomes in low- and middle-income countries. Based on these results and the expected redistributive impact of government spending, governments in low- and middle-income countries may consider increasing health spending for better healthcare systems and improved health.

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