scholarly journals Protocol for a Multi-Level Policy Analysis of Non-Communicable Disease Determinants of Diet and Physical Activity: Implications for Low- and Middle-Income Countries in Africa and the Caribbean

2021 ◽  
Vol 18 (24) ◽  
pp. 13061
Author(s):  
Maylene Shung-King ◽  
Amy Weimann ◽  
Nicole McCreedy ◽  
Lambed Tatah ◽  
Clarisse Mapa-Tassou ◽  
...  
Keyword(s):  
Physical Activity ◽  
South Africa ◽  
Policy Development ◽  
Salt Intake ◽  
Communicable Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Promotion Of Physical Activity ◽  
Low And Middle Income

Non-communicable diseases (NCDs) are the leading cause of death globally. Despite significant global policy development for addressing NCDs, the extent to which global policies find expression in low-and-middle income countries’ (LMIC) policies, designed to mitigate against NCDs, is unclear. This protocol is part of a portfolio of projects within the Global Diet and Activity Research (GDAR) Network, which aims to support the prevention of NCDs in LMICs, with a specific focus on Kenya, Cameroon, South Africa and Jamaica. This paper outlines the protocol for a study that seeks to explore the current policy environment in relation to the reduction of key factors influencing the growing epidemic of NCDs. The study proposes to examine policies at the global, regional and country level, related to the reduction of sugar and salt intake, and the promotion of physical activity (as one dimension of healthy placemaking). The overall study will comprise several sub-studies conducted at a global, regional and country level in Cameroon, Kenya and South Africa. In combination with evidence generated from other GDAR workstreams, results from the policy analyses will contribute to identifying opportunities for action in the reduction of NCDs in LMICs.

scholarly journals Adolescent levers for diet and physical activity intervention across socio-ecological levels in Kenya, South Africa, Cameroon and Jamaica: A mixed-methods study protocol (Preprint)

2020 ◽  
Author(s):  
Feyisayo Adeola Odunitan-Wayas ◽  
Pamela Wadende ◽  
Ebele R.I Mogo ◽  
Anna Brugulat-Panés ◽  
Lisa K Micklesfield ◽  
...  
Keyword(s):  
Physical Activity ◽  
South Africa ◽  
Mixed Methods ◽  
Food Intake ◽  
Data Collection ◽  
Communicable Diseases ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries ◽  
Low And Middle Income

BACKGROUND The increasing burden of non-communicable diseases (NCDs), which are prevalent in low and middle income countries (LMICs), is largely attributed to modifiable behavioural risk factors such as poor/unhealthy diets and insufficient physical activity (PA). The adolescent stage–recently defined as 10-24 years of age–is an important formative phase of life and offers an opportunity to reduce NCD risk across the life course and for future generations. This protocol describes a portfolio of projects within the Global Diet and Activity Research (GDAR) Network, which aims to support the prevention of non-communicable diseases (NCD), including cardiovascular diseases, type 2 diabetes, and cancers in low and middle income countries (LMICs), with a specific focus on Kenya, Cameroon, South Africa and Jamaica. OBJECTIVE To utilise a convergent mixed methods design to explore exposures in the household, neighbourhood, school, and the journey from home to school, that may influence diet and PA behaviours in adolescents from LMICs. METHODS Male and female adolescents (n ≥150) aged between 13-24 years will be recruited from purposively selected high schools or households in project site countries to ensure socioeconomic diversity of perspectives and experiences at individual, home and neighbourhood levels. The project will be conducted in five sites in four countries; Kenya, Cameroon, Jamaica and South Africa (Cape Town and Johannesburg). Data on anthropometric measures, food intake and PA knowledge and behaviour will be collected using self-report questionnaires and objective measurement in a sub-sample. Additionally, a small number of learners (n=30-45) from each site will be purposively selected as citizen scientists to capture data (photos, audio notes, text, and geolocations) on their “lived experiences” in relation to food and physical activity, in their homes, the journey to and from school, and school and neighbourhood environments, using a mobile application (EpiCollect5). In-depth interviews will be conducted with the citizen scientists’ caregivers to explore household experiences and determinants of food intake and foodways, as well as physical activity of household members RESULTS This project is fully funded by the UK National Institutes of Health Research and conducted by the GDAR Network. Data collection is on-going and analysis will follow once data collection is complete. CONCLUSIONS This project protocol contributes to research that focuses on adolescents and the socio-ecological determinants of food intake and PA in LMIC settings. It includes innovative methodologies to interrogate and map the contexts of these determinants and will generate much needed data to understand the multi-level system of factors that can be leveraged through upstream and downstream strategies and interventions to improve health outcomes

The Economic Cost of Violence Against Women and Girls in Low- and Middle-Income Countries: A Systematic Review of the Evidence

2021 ◽  
pp. 152483802110160
Author(s):  
Seema Vyas ◽  
Melissa Meinhart ◽  
Katrina Troy ◽  
Hannah Brumbaum ◽  
Catherine Poulton ◽  
...  
Keyword(s):  
South Africa ◽  
Systematic Review ◽  
Violence Against Women ◽  
Economic Burden ◽  
Data Availability ◽  
Female Genital Cutting ◽  
Middle Income ◽  
Middle Income Countries ◽  
Women And Girls ◽  
Low And Middle Income

Evidence demonstrating the economic burden of violence against women and girls can support policy and advocacy efforts for investment in violence prevention and response programming. We undertook a systematic review of evidence on the costs of violence against women and girls in low- and middle-income countries published since 2005. In addition to understanding costs, we examined the consistency of methodological approaches applied and identified and assessed common methodological issues. Thirteen articles were identified, eight of which were from sub-Saharan Africa. Eight studies estimated costs associated with domestic or intimate partner violence, others estimated the costs of interpersonal violence, female genital cutting, and sexual assaults. Methodologies applied to estimate costs were typically based on accounting approaches. Our review found that out-of-pocket expenditures to individuals for seeking health care after an episode of violence ranged from US$29.72 (South Africa) to US$156.11 (Romania) and that lost productivity averaged from US$73.84 to US$2,151.48 (South Africa) per facility visit. Most studies that estimated provider costs of service delivery presented total programmatic costs, and there was variation in interventions, scale, and resource inputs measured which hampered comparability. Variations in methodological assumptions and data availability also made comparisons across countries and settings challenging. The limited scope of studies in measuring the multifaceted impacts of violence highlights the challenges in identifying cost metrics that extend beyond specific violence episodes. Despite the limited evidence base, our assessment leads us to conclude that the estimated costs of violence against women and girls are a fraction of its true economic burden.

scholarly journals Predictors of Contemporary under-5 Child Mortality in Low- and Middle-Income Countries: A Machine Learning Approach

2021 ◽  
Vol 18 (3) ◽  
pp. 1315
Author(s):  
Andrea Bizzego ◽  
Giulio Gabrieli ◽  
Marc H. Bornstein ◽  
Kirby Deater-Deckard ◽  
Jennifer E. Lansford ◽  
...  
Keyword(s):  
Machine Learning ◽  
Child Mortality ◽  
Learning Approach ◽  
Unique Contribution ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Machine Learning Approach ◽  
Operational Information ◽  
Low And Middle Income

Child Mortality (CM) is a worldwide concern, annually affecting as many as 6.81% children in low- and middle-income countries (LMIC). We used data of the Multiple Indicators Cluster Survey (MICS) (N = 275,160) from 27 LMIC and a machine-learning approach to rank 37 distal causes of CM and identify the top 10 causes in terms of predictive potency. Based on the top 10 causes, we identified households with improved conditions. We retrospectively validated the results by investigating the association between variations of CM and variations of the percentage of households with improved conditions at country-level, between the 2005–2007 and the 2013–2017 administrations of the MICS. A unique contribution of our approach is to identify lesser-known distal causes which likely account for better-known proximal causes: notably, the identified distal causes and preventable and treatable through social, educational, and physical interventions. We demonstrate how machine learning can be used to obtain operational information from big dataset to guide interventions and policy makers.

Strengthening Noncommunicable Disease Research Capacity and Chronic Disease Outcomes in Low- and Middle-Income Countries in South Asia: Implementation and Evaluation of the ASCEND Program

2019 ◽  
Vol 31 (6) ◽  
pp. 536-547
Author(s):  
Allison Byrnes ◽  
Tilahun Nigatu Haregu ◽  
Naanki Pasricha ◽  
Kavita Singh ◽  
Sathish Thirunavukkarasu ◽  
...  
Keyword(s):  
Online Learning ◽  
Communicable Disease ◽  
Research Capacity ◽  
Lessons Learned ◽  
Early Career ◽  
Noncommunicable Disease ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Low And Middle Income

This article describes the design, outcomes, challenges, and lessons learned from the ASian Collaboration for Excellence in Non-Communicable Disease (ASCEND) program, implemented between 2011 and 2015 in India, Sri Lanka, and Malaysia. The program involved a blended-delivery model, incorporating online and face-to-face training, mentoring, and supervision of trainees’ research projects. Evaluation data were collected at baseline, 6, 12, 18, and 24 months. Intended outcomes, lessons, and challenges were summarized using a logic model. During the program period, 48 participants were trained over 2 cohorts in June 2011 and 2012. The trainees published 83 peer-reviewed articles between 2011 and 2015. Additionally, 154 presentations were given by trainees at national and international conferences. Underutilization of the online learning management system was an important challenge. Utilizing a combination of intensive face-to-face and online learning and mentoring of early career researchers in low- and middle-income countries has great potential to enhance the research capacity, performance, and outputs.

scholarly journals Factors that influence patient empowerment in inpatient chronic care: early thoughts on a diabetes care intervention in South Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Nina Abrahams ◽  
Lucy Gilson ◽  
Naomi S. Levitt ◽  
Joel A. Dave
Keyword(s):  
South Africa ◽  
Diabetes Care ◽  
Chronic Care ◽  
Patient Empowerment ◽  
Self Management ◽  
Inpatient Setting ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Background The burden of non-communicable diseases is growing rapidly in low- and middle-income countries. Research suggests that health interventions that aim to improve patient self-management and empower patients to care actively for their disease will improve health outcomes over the long-term. There is, however, a gap in the literature about the potential role of the inpatient setting in supporting chronic care. This is particularly important in low-and-middle income countries where hospitals may be a rare prolonged point of contact between patient and health provider. The aim of this small scale, exploratory study was to understand what factors within the inpatient setting may affect patients’ feelings of empowerment in relation to their chronic disease care and provides recommendations for future inpatient-based interventions to support self-management of disease. Methods This study was based in a public, academic hospital in South Africa. Eighteen qualitative, semi-structured interviews were conducted with multiple participants with experience of diabetes care: inpatients and health professionals such as nurses, endocrinologists, and dieticians. Findings were analysed using a broad, exploratory, thematic approach, guided by self-management and chronic care literature. Results Interviews with both patients and providers suggest that patients living in low socio-economic contexts are likely to struggle to access appropriate healthcare information and services, and may often have financial and emotional priorities that take precedence over their chronic illness. Younger people may also be more dependent on their family and community, giving them less ability to take control of their disease care and lifestyle. In addition, hospital care remains bound by an acute care model; and the inpatient setting of focus is characterised by perceived staff shortages and ineffective communication that undermine the implementation of patient empowerment-focused interventions. Conclusions Patient and provider contexts are likely to make supporting patient engagement in long-term chronic care difficult in lower income settings. However, knowledge of these factors can be harnessed to improve chronic care interventions in South Africa and other similar countries.

scholarly journals Consumption of breast milk, formula and other non-human milk by children aged under 2 years: analysis of eighty-six low- and middle-income countries

2020 ◽  
pp. 1-9
Author(s):  
Paulo AR Neves ◽  
Aluísio JD Barros ◽  
Phillip Baker ◽  
Ellen Piwoz ◽  
Thiago M Santos ◽  
...  
Keyword(s):  
Breast Milk ◽  
Human Milk ◽  
Breast Feeding ◽  
Milk Formula ◽  
Milk Consumption ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Low And Middle Income ◽  
Economic Inequalities

Abstract Objective: To investigate the prevalence and socio-economic inequalities in breast milk, breast milk substitutes (BMS) and other non-human milk consumption, by children under 2 years in low- and middle-income countries (LMIC). Design: We analysed the prevalence of continued breast-feeding at 1 and 2 years and frequency of formula and other non-human milk consumption by age in months. Indicators were estimated through 24-h dietary recall. Absolute and relative wealth indicators were used to describe within- and between-country socio-economic inequalities. Setting: Nationally representative surveys from 2010 onwards from eighty-six LMIC. Participants: 394 977 children aged under 2 years. Results: Breast-feeding declined sharply as children became older in all LMIC, especially in upper-middle-income countries. BMS consumption peaked at 6 months of age in low/lower-middle-income countries and at around 12 months in upper-middle-income countries. Irrespective of country, BMS consumption was higher in children from wealthier families, and breast-feeding in children from poorer families. Multilevel linear regression analysis showed that BMS consumption was positively associated with absolute income, and breast-feeding negatively associated. Findings for other non-human milk consumption were less straightforward. Unmeasured factors at country level explained a substantial proportion of overall variability in BMS consumption and breast-feeding. Conclusions: Breast-feeding falls sharply as children become older, especially in wealthier families in upper-middle-income countries; this same group also consumes more BMS at any age. Country-level factors play an important role in explaining BMS consumption by all family wealth groups, suggesting that BMS marketing at national level might be partly responsible for the observed differences.

scholarly journals Cannabis use and physical activity among 89,777 adolescents aged 12-15 years from 21 low- and middle-income countries

2019 ◽  
Vol 205 ◽  
pp. 107584
Author(s):  
Garcia Ashdown-Franks ◽  
Catherine M. Sabiston ◽  
Davy Vancampfort ◽  
Lee Smith ◽  
Joseph Firth ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cannabis Use ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income
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