scholarly journals Road Safety in Low-Income Countries: State of Knowledge and Future Directions

2019 ◽  
Vol 11 (22) ◽  
pp. 6249 ◽  
Author(s):  
Shahram Heydari ◽  
Adrian Hickford ◽  
Rich McIlroy ◽  
Jeff Turner ◽  
Abdulgafoor M. Bachani
Keyword(s):  
Low Income ◽  
Traffic Engineering ◽  
Road Safety ◽  
Scale Up ◽  
Safety Data ◽  
Low Income Countries ◽  
Future Research ◽  
Improvement Programs ◽  
Behavioural Aspects ◽  
The Impact

Road safety in low-income countries (LICs) remains a major concern. Given the expected increase in traffic exposure due to the relatively rapid motorisation of transport in LICs, it is imperative to better understand the underlying mechanisms of road safety. This in turn will allow for planning cost-effective road safety improvement programs in a timely manner. With the general aim of improving road safety in LICs, this paper discusses the state of knowledge and proposes a number of future research directions developed from literature reviews and expert elicitation. Our study takes a holistic approach based on the Safe Systems framework and the framework for the UN Decade of Action for Road Safety. We focused mostly on examining the problem from traffic engineering and safety policy standpoints, but also touched upon other sectors, including public health and social sciences. We identified ten focus areas relating to (i) under-reporting; (ii) global best practices; (iii) vulnerable groups; (iv) disabilities; (v) road crash costing; (vi) vehicle safety; (vii) proactive approaches; (viii) data challenges; (ix) social/behavioural aspects; and (x) capacity building. Based on our findings, future research ought to focus on improvement of data systems, understanding the impact of and addressing non-fatal injuries, improving estimates on the economic burden, implementation research to scale up programs and transfer learnings, as well as capacity development. Our recommendations, which relate to both empirical and methodological frontiers, would lead to noteworthy improvements in the way road safety data collection and research is conducted in the context of LICs.

scholarly journals The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Giorgia Gon ◽  
Abdunoor M. Kabanywanyi ◽  
Petri Blinkhoff ◽  
Simon Cousens ◽  
Stephanie J. Dancer ◽  
...  
Keyword(s):  
Pilot Study ◽  
Study Design ◽  
Low Income ◽  
High Volume ◽  
Surface Cleaning ◽  
Low Income Countries ◽  
Training Period ◽  
Future Research ◽  
Environmental Hygiene ◽  
The Impact

Abstract Background Healthcare associated infections (HAI) are estimated to affect up to 15% of hospital inpatients in low-income countries (LICs). A critical but often neglected aspect of HAI prevention is basic environmental hygiene, particularly surface cleaning and linen management. TEACH CLEAN is an educational intervention aimed at improving environmental hygiene. We evaluated the effectiveness of this intervention in a pilot study in three high-volume maternity and newborn units in Dar es Salaam, Tanzania. Methods This study design prospectively evaluated the intervention as a whole, and offered a before-and-after comparison of the impact of the main training. We measured changes in microbiological cleanliness [Aerobic Colony Counts (ACC) and presence of Staphylococcus aureus] using dipslides, and physical cleaning action using gel dots. These were analysed with descriptive statistics and logistic regression models. We used qualitative (focus group discussions, in-depth interviews, and semi-structured observation) and quantitative (observation checklist) tools to measure why and how the intervention worked. We describe these findings across the themes of adaptation, fidelity, dose, reach and context. Results Microbiological cleanliness improved during the study period (ACC pre-training: 19%; post-training: 41%). The odds of cleanliness increased on average by 1.33 weekly during the pre-training period (CI = 1.11–1.60), and by 1.08 (CI = 1.03–1.13) during the post-training period. Cleaning action improved only in the pre-training period. Detection of S. aureus on hospital surfaces did not change substantially. The intervention was well received and considered feasible in this context. The major pitfalls in the implementation were the limited number of training sessions at the hospital level and the lack of supportive supervision. A systems barrier to implementation was lack of regular cleaning supplies. Conclusions The evaluation suggests that improvements in microbiological cleanliness are possible using this intervention and can be sustained. Improved microbiological cleanliness is a key step on the pathway to infection prevention in hospitals. Future research should assess whether this bundle is cost-effective in reducing bacterial and viral transmission and infection using a rigorous study design.

scholarly journals High dose vitamin A capsules – Rusty bullets?

2017 ◽  
Vol 8 (1) ◽  
pp. 52
Author(s):  
Ane B Fisker ◽  
Ted Greiner
Keyword(s):  
Vitamin A ◽  
Low Income ◽  
Vitamin A Deficiency ◽  
Scale Up ◽  
Low Income Countries ◽  
High Dose ◽  
Magic Bullet ◽  
Vitamin A Status ◽  
The Impact ◽  
High Dose Vitamin

High-dose vitamin A capsules (HDVAC) are distributed to preschool children in low-income countries on the assumption that they reduce mortality and treat vitamin A deficiency. As for other so-called magic bullet approaches, donors and policy makers consider their large-scale distribution highly cost-effective. Consequently, other ways to improve vitamin A status have received less attention; both donors and governments assume HDVAC are doing most of what needs to be done. Yet, the only evidence for an effect on mortality comes from 25-year-old studies and this effect no longer appears to be substantial. Surprisingly, impact evaluations have been absent. The only study that might be considered an effectiveness or impact evaluation found HDVAC had no effect in northern India. It is not widely appreciated that the impact of HDVAC on vitamin A status is limited, temporary and not cumulative over time. Nor can it be given to women except immediately after giving birth, and thus it is an inappropriate intervention for tackling vitamin A deficiency. To ensure that we use limited resources wisely, we need to identity and scale up strategies which combat vitamin A deficiency and reduce mortality.

scholarly journals Impact of COVID-19 Pandemic on Palliative Care Workers: An International Cross-sectional Study

2021 ◽  
Vol 27 ◽  
pp. 299-305
Author(s):  
Tania Pastrana ◽  
Liliana De Lima ◽  
Katherine Pettus ◽  
Alison Ramsey ◽  
Genevieve Napier ◽  
...  
Keyword(s):  
Palliative Care ◽  
Low Income ◽  
Online Survey ◽  
International Association ◽  
Essential Medicines ◽  
Low Income Countries ◽  
Direct Patient Care ◽  
Future Research ◽  
Access To Essential Medicines ◽  
The Impact

Objectives: The COVID-19 pandemic and the measures taken to mitigate spread have affected countries in different ways. Healthcare workers, in particular, have been impacted by the pandemic and by these measures. This study aims to explore how COVID-19 has impacted on palliative care (PC) workers around the world. Materials and Methods: Online survey to members of the International Association for Hospice and PC during the initial months of the COVID-19 pandemic. Convenience sampling was used. Statistical descriptive and contingency analyses and Chi-square tests with P < 0.05 were conducted. Results: Seventy-nine participants (RR = 16%) from 41 countries responded. Over 93% of those who provide direct patient care reported feeling very or somewhat competent in PC provision for patients with COVID-19. Eighty-four felt unsafe or somewhat safe when caring for patients with COVID-19. Level of safety was associated with competence (P ≤ 0.000). Over 80% reported being highly or somewhat affected in their ability to continue working in their PC job, providing care to non-COVID patients and in staff availability in their workplace. About 37% reported that availability and access to essential medicines for PC were highly or somewhat affected, more so in low-income countries (P = 0.003). Conclusion: The results from this study highlight the impact of COVID-19 on the provision of PC. It is incumbent on government officials, academia, providers and affected populations, to develop and implement strategies to integrate PC in pandemic response, and preparedness for any similar future events, by providing appropriate and comprehensive education, uninterrupted access to essential medicines and personal protective equipment and ensure access to treatment and care, working together with all levels of society that is invested in care of individuals and populations at large. The long-term effects of the pandemic are still unknown and future research is needed to monitor and report on the appropriateness of measures.

scholarly journals Autism in Developing Countries: Lessons from Iran

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Sayyed Ali Samadi ◽  
Roy McConkey
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
Parental Support ◽  
Autism Spectrum ◽  
Low Income Countries ◽  
Future Research ◽  
Family Quality Of Life ◽  
English Speaking ◽  
Professional Resources ◽  
The Impact

Most research into Autism Spectrum Disorders has been conducted in affluent English-speaking countries which have extensive professional support services. This paper describes a series of investigations that was undertaken in Iran, and these findings, together with reviews of research in other low-income countries, are used to identify key lessons in three areas of service provision of particular relevance to developing countries with scarce professional resources: first, the issues to be considered in establishing the prevalence of the condition nationally; second, identification of parental understanding of ASD and the impact it has on them as carers; third, the education and training that could be provided to families when professional supports are sparse. It is concluded that culturally sensitive, parental support strategies must be central to the planning and development of services. Moreover, future research should further elucidate the needs of families and evaluate the impact of culturally tailored interventions designed to promote the children’s development and overall family quality of life.

scholarly journals Are Nanobiosensors an Improved Solution for Diagnosis of Leishmania?

Pharmaceutics ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 491
Author(s):  
Sona Jain ◽  
Wanessa Santana ◽  
Silvio S. Dolabella ◽  
André L. S. Santos ◽  
Eliana B. Souto ◽  
...  
Keyword(s):  
Low Income ◽  
Neglected Tropical Diseases ◽  
Diagnostic Techniques ◽  
Cross Reactivity ◽  
Low Income Countries ◽  
Future Research ◽  
Immunological Tests ◽  
Diagnostic Approaches ◽  
Signal Improvement ◽  
Adequate Management

Leishmaniasis is one of the deadliest neglected tropical diseases affecting 12–15 million people worldwide, especially in middle- and low-income countries. Rapid and accurate diagnosis of the disease is important for its adequate management and treatment. Several techniques are available for the diagnosis of leishmaniasis. Among these, parasitological and immunological tests are most widely used. However, in most cases, the utilized diagnostic techniques are not good enough, showing cross-reactivity and reduced accuracy. In recent years, many new methods have been reported with potential for improved diagnosis. This review focuses on the diagnosis of Leishmania exploring the biosensors and nanotechnology-based options for their detection. New developments including the use of nanomaterials as fluorophores, fluorescence quenchers as reducing agents and as dendrimers for signal improvement and amplification, together with the use of aptamers to replace antibodies are described. Future research opportunities to overcome the current limitations on the available diagnostic approaches are also discussed.

scholarly journals COVID-19 in children treated with immunosuppressive medication for kidney diseases

2020 ◽  
pp. archdischild-2020-320616
Author(s):  
Matko Marlais ◽  
Tanja Wlodkowski ◽  
Samhar Al-Akash ◽  
Petr Ananin ◽  
Varun Kumar Bandi ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Immunosuppressive Therapy ◽  
Low Income ◽  
Kidney Diseases ◽  
Low Income Countries ◽  
Reference Network ◽  
Immunosuppressive Medication ◽  
Immunosuppressive Medications ◽  
Significant Difference ◽  
The Impact

BackgroundChildren are recognised as at lower risk of severe COVID-19 compared with adults, but the impact of immunosuppression is yet to be determined. This study aims to describe the clinical course of COVID-19 in children with kidney disease taking immunosuppressive medication and to assess disease severity.MethodsCross-sectional study hosted by the European Rare Kidney Disease Reference Network and supported by the European, Asian and International paediatric nephrology societies. Anonymised data were submitted online for any child (age <20 years) with COVID-19 taking immunosuppressive medication for a kidney condition. Study recruited for 16 weeks from 15 March 2020 to 05 July 2020. The primary outcome was severity of COVID-19.Results113 children were reported in this study from 30 different countries. Median age: 13 years (49% male). Main underlying reasons for immunosuppressive therapy: kidney transplant (47%), nephrotic syndrome (27%), systemic lupus erythematosus (10%). Immunosuppressive medications used include: glucocorticoids (76%), mycophenolate mofetil (MMF) (54%), tacrolimus/ciclosporine A (58%), rituximab/ofatumumab (11%). 78% required no respiratory support during COVID-19 illness, 5% required bi-level positive airway pressure or ventilation. Four children died; all deaths reported were from low-income countries with associated comorbidities. There was no significant difference in severity of COVID-19 based on gender, dialysis status, underlying kidney condition, and type or number of immunosuppressive medications.ConclusionsThis global study shows most children with a kidney disease taking immunosuppressive medication have mild disease with SARS-CoV-2 infection. We therefore suggest that children on immunosuppressive therapy should not be more strictly isolated than children who are not on immunosuppressive therapy.

Agricultural Labor Supply

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Alexandra E. Hill ◽  
Izaac Ornelas ◽  
J. Edward Taylor
Keyword(s):  
Labor Supply ◽  
Low Income ◽  
Empirical Work ◽  
Low Income Countries ◽  
Future Research ◽  
Farm Labor ◽  
Annual Review ◽  
Publication Date ◽  
Agricultural Labor ◽  
Farm Work

The labor supply response to agricultural wages is critical to the viability of crop production in high-income countries, which hire a largely foreign farm work force, as well as in low-income countries, where domestic workers move off the farm as the agricultural transformation unfolds. Modeling agricultural labor supply is more challenging than modeling the supply of other agricultural inputs or of labor to other sectors of the economy owing to unique features of agricultural production and farm labor markets. Data and econometric challenges abound, and estimates of agricultural labor supply elasticities are sparse. This review explains the importance and challenges of modeling farm labor supply and describes researchers’ efforts to address these challenges. It summarizes estimates of agricultural labor supply elasticities over the last 80 years, provides insights into variation in these estimates, identifies priority areas for future research, and reviews the most influential empirical work related to this important topic. Expected final online publication date for the Annual Review of Resource Economics, Volume 13 is October 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Foreign capital inflows and economic growth: the experience of low-income countries in Sub Saharan Africa

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Atif Awad
Keyword(s):  
Low Income ◽  
Foreign Capital ◽  
Ordinary Least Squares ◽  
Capital Inflows ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Content Type ◽  
Long Run ◽  
Foreign Capital Inflows ◽  
The Impact

Purpose This paper aims to investigate the long-run impact of selected foreign capital inflows, including aid, remittances, foreign direct investment (FDI), trade and debt, on the economic growth of 21 low-income countries in the Sub Saharan Africa (SSA) region, during the period 1990–2018. Design/methodology/approach To obtain this objective and for robust analysis, a parametric approach, which was dynamic ordinary least squares, and a non-parametric technique, which was fully modified ordinary least squares, were used. Findings The results of both models confirmed that, in the long run, trade and aid affected the growth rate of the per capita income in these countries in a positive way. However, external debt seemed to have an adverse influence on such growth. Originality/value First, this is the initial study that has addressed this matter across a homogenous group of countries in the SSA region. Second, while most of the previous studies regarding capital inflows into the SSA region have focused on the impact of only one or two aspects of such foreign capital inflows on growth, the present study, instead, examined the impact of five types of foreign capital inflows (aid, remittances, FDI, trade and debt).

scholarly journals Poultry farmer response to disease outbreaks in smallholder farming systems

2020 ◽  
Author(s):  
Alexis Delabouglise ◽  
Nguyen Thi Le Thanh ◽  
Huynh Thi Ai Xuyen ◽  
Benjamin Nguyen-Van-Yen ◽  
Phung Ngoc Tuyet ◽  
...  
Keyword(s):  
Avian Influenza ◽  
Low Income ◽  
Low Income Countries ◽  
Farm Size ◽  
Small Scale ◽  
Flock Size ◽  
Smallholder Farming ◽  
Southern Vietnam ◽  
Poultry Farms ◽  
The Impact

AbstractAvian influenza outbreaks have been occurring on smallholder poultry farms in Asia for two decades. Farmer responses to these outbreaks can slow down or accelerate virus transmission. We used a longitudinal survey of 53 small-scale chicken farms in southern Vietnam to investigate the impact of outbreaks with disease-induced mortality on harvest rate, vaccination, and disinfection behaviors. We found that in small broiler flocks (≤16 birds/flock) the estimated probability of harvest was 56% higher when an outbreak occurred, and 214% higher if an outbreak with sudden deaths occurred in the same month. Vaccination and disinfection were strongly positively correlated with flock size and farm size, respectively. Small-scale farmers – the overwhelming majority of poultry producers in low-income countries – tend to rely on rapid sale of birds to mitigate losses from diseases. As depopulated birds are sent to markets or trading networks, this reactive behavior has the potential to enhance onward transmission.One sentence summaryA cohort study of fifty three small-scale poultry farms in southern Vietnam reveals that when outbreaks occur with symptoms similar to highly pathogenic avian influenza, farmers respond by sending their chickens to market early, potentially exacerbating the effects of the outbreak.

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