scholarly journals Comparisons of Vaccine Hesitancy across Five Low- and Middle-Income Countries

Vaccines ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 155 ◽  
Author(s):  
Abram L. Wagner ◽  
Nina B. Masters ◽  
Gretchen J. Domek ◽  
Joseph L. Mathew ◽  
Xiaodong Sun ◽  
...  
Keyword(s):  
Addis Ababa ◽  
Cultural Influences ◽  
Education Level ◽  
Vaccine Hesitancy ◽  
Linear Regression Models ◽  
Middle Income ◽  
Middle Income Countries ◽  
Vaccine Decision Making ◽  
The Relationship ◽  
Low And Middle Income

Vaccine hesitancy is a continuum of behaviors ranging from delay in receipt to vaccination refusal. Prior studies have typically focused on high-income countries, where vaccine hesitancy is particularly prevalent in more affluent groups, but the relationship between socioeconomic status and vaccine hesitancy in Low- and Middle-Income Countries (LMICs) is less clear. The aim of this study was to describe vaccine hesitancy in five LMICs. Mothers of children in Sirajganj, Bangladesh (n = 60), Shanghai, China (n = 788), Addis Ababa, Ethiopia (n = 341), Guatemala City and Quetzaltenango, Guatemala (n = 767), and Chandigarh, India (n = 309), completed a survey between 2016 and 2018 using the WHO’s 10-item Vaccine Hesitancy Scale. The scores of different constructs were compared across countries and by the mother’s education level using linear regression models with generalized estimating equations. Compared to mothers in China, mothers in Bangladesh perceived less vaccination benefit (β: 0.56, P = 0.0001), however, mothers in Ethiopia (β: −0.54, P < 0.0001) and Guatemala (β: −0.74, P = 0.0004) perceived greater benefit. Education level was not significantly linked with vaccine hesitancy. Local circumstances are important to consider when developing programs to promote vaccines. We did not find consistent associations between education and vaccine hesitancy. More research is needed to understand socio-cultural influences on vaccine decision-making.

scholarly journals Maternal BMI mediates the impact of crop-related agricultural work during pregnancy on infant length in rural Pakistan: a mediation analysis of cross-sectional data

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Rebecca Pradeilles ◽  
Elizabeth Allen ◽  
Haris Gazdar ◽  
Hussain Bux Mallah ◽  
Azmat Budhani ◽  
...  
Keyword(s):  
Early Infancy ◽  
Cross Sectional ◽  
Middle Income ◽  
Negatively Associated ◽  
Agricultural Work ◽  
Middle Income Countries ◽  
Rural Pakistan ◽  
The Relationship ◽  
Maternal Bmi ◽  
Low And Middle Income

Abstract Background Stunted growth in early infancy is a public health problem in low-and-middle income countries. Evidence suggests heavy agricultural work during pregnancy is inversely associated with maternal body mass index (BMI) and infant birth weight in low- and middle-income countries; but pathways linking agricultural work to length-for-age Z-scores (LAZ) in early infancy have not been examined. This study aimed to investigate the relationship between agricultural work during pregnancy, post-natal maternal BMI and LAZ among young infants in rural Pakistan; and explored whether maternal BMI mediated the relationship between agricultural work and infant LAZ. Methods A cross-sectional survey was conducted from December 2015 to January 2016 in rural Sindh, Pakistan. Mother-infant dyads were recruited via systematic random cluster sampling at 2–12 weeks’ post-partum (n = 1161). Anthropometric measurements (maternal and infant height/length and weight) and questionnaire data were collected. Multivariable linear regression and structural-equation based mediation analyses were used to examine associations of agricultural work during pregnancy with maternal BMI and infant LAZ. Results During pregnancy, women reported engaging in livestock-related work (57.0%), crop-related work (42.7%), and cotton harvesting (28.4%). All three forms of agricultural work were negatively associated with maternal BMI (β = − 0.67 [− 1.06; − 0.28], β = − 0.97 [− 1.51; − 0.48]; and β = − 0.87 [− 1.33; − 0.45], respectively). Maternal engagement in cotton harvesting alone was negatively associated with infant LAZ after controlling for confounding factors. The total negative effect of cotton harvesting on infant LAZ was − 0.35 [− 0.53; − 0.16]. The indirect effect of maternal BMI on infant LAZ was − 0.06 [− 0.08; − 0.03], revealing that 16% (− 0.06/− 0.35) of the relationship between cotton harvesting and infant LAZ, after adjustment, was mediated via maternal BMI. Conclusion These results underscore a need to reduce labour-intensive agricultural workload demands during pregnancy, especially in cotton harvesting, to reduce risks of negative maternal energy balance and poor growth outcomes in early infancy.

scholarly journals Teaching psychiatry in Ethiopia

2006 ◽  
Vol 3 (2) ◽  
pp. 43-46 ◽  
Author(s):  
Charlotte Hanlon ◽  
Daniel Fekadu ◽  
Danny Sullivan ◽  
Atalay Alem ◽  
Martin Prince
Keyword(s):  
Psychiatric Hospital ◽  
Addis Ababa ◽  
High Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Addis Ababa University ◽  
Teaching Psychiatry ◽  
Low And Middle Income

There is a pressing need to train psychiatrists in low- and middle-income countries. Psychiatrists from high-income countries have an opportunity to share expertise in teaching and assessing trainees, while learning much in the process. Three trainees from a London psychiatric hospital were invited to help organise a revision course for the Department of Psychiatry, Addis Ababa University, and this paper reports their experiences.

scholarly journals Linking agriculture and health in low- and middle-income countries: an interdisciplinary research agenda

2012 ◽  
Vol 71 (2) ◽  
pp. 222-228 ◽  
Author(s):  
Alan D. Dangour ◽  
Rosemary Green ◽  
Barbara Häsler ◽  
Jonathan Rushton ◽  
Bhavani Shankar ◽  
...  
Keyword(s):  
Food Prices ◽  
World Population ◽  
Negative Effects ◽  
Double Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
Household Incomes ◽  
The Impact ◽  
The Relationship ◽  
Low And Middle Income

Recent global fluctuations in food prices and continuing environmental degradation highlight the future challenge of feeding a growing world population. However, current dialogues rarely address the relationship between agricultural changes and health. This relationship is traditionally associated with the role of food in nutrition and with food safety, and while these are key interactions, we show in this paper that the relationship is far more complex and interesting. Besides the direct effects of agriculture on population nutrition, agriculture also influences health through its impact on household incomes, economies and the environment. These effects are felt particularly in low- and middle-income countries, where dramatic changes are affecting the agriculture–health relationship, in particular the growth of nutrition-related chronic disease and the associated double burden of under- and over-nutrition. Greater understanding of the negative effects of agriculture on health is also needed. While lengthening food value chains make the chain of influence between agricultural policy, food consumption, nutrition and health more complex, there remain opportunities to improve health by changing agricultural systems. The first challenge in doing this, we suggest, is to improve our capacity to measure the impact of agricultural interventions on health outcomes, and vice versa.

scholarly journals Global aid for nutrition-specific and nutrition-sensitive interventions and proportion of stunted children across low- and middle-income countries: does aid matter?

2019 ◽  
Vol 34 (Supplement_2) ◽  
pp. ii18-ii27 ◽  
Author(s):  
Hina Khalid ◽  
Sitara Gill ◽  
Ashley M Fox
Keyword(s):  
Fixed Effects ◽  
Development Assistance ◽  
Scale Up ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Per Capita ◽  
Nutrition Sensitive ◽  
The Relationship ◽  
Low And Middle Income

Abstract Development assistance for health (DAH) has increased dramatically over the past two decades, and this increase has led to a debate on the benefits and perverse effects of scaling-up vs scaling back DAH, and the type of interventions DAH should support. Nutrition remains a contested category viewed as essential to achieving primary healthcare objectives but as falling outside of the direct ambit of the health system. Thus, despite the increase in DAH, it continues to remain an underfunded area and little is known about the relationship between aid for nutrition-specific and nutrition-sensitive interventions and the proportion of stunted children across low- and middle-income countries. We hypothesize that as nutrition-specific aid targets local needs of countries and is less fungible than nutrition-sensitive aid, it will contribute more to a reduction in the proportion of stunted children, with the steepest gains among countries that have the highest burden of malnutrition. We use fixed-effects regressions to examine the relationship between the proportion of stunted children and aid for nutrition interventions (specific and sensitive) to 116 low- and middle-income countries (2002–16). We construct our panel using the Creditor Reporting System, Institute of Health Metrics and Evaluation, Food and Agriculture Organization, World Health Organization and World Development indicators databases. We find a one-dollar increase in per capita nutrition-specific aid is associated with a reduction in the proportion of stunted children by 0.004 (P < 0.05). When stratified by burden of malnutrition, a one-dollar increase in per capita nutrition-specific aid to countries with the highest burden of malnutrition is associated with sharper reductions in the proportion of stunted children (0.013, P < 0.01). We also find a significant association for per capita nutrition-sensitive aid and proportion of stunted children when per capita aid for nutrition is lagged by 3 and 4 years (0.0002, P < 0.05), suggesting a long-run association between nutrition-sensitive aid and proportion of stunted children. Our findings suggest that in spite of criticisms that development assistance fails to adequately reach its intended beneficiaries, aid for nutrition has been successful at reducing the proportion of stunted children. Our findings imply a need to scale-up nutrition funding and improve targeting of aid.

scholarly journals The co-occurrence of overweight/obesity and anaemia among adult women, adolescent girls and children living in 52 low-and middle-income countries

2021 ◽  
pp. 1-25
Author(s):  
Ana Irache ◽  
Paramjit Gill ◽  
Rishi Caleyachetty
Keyword(s):  
Adolescent Girls ◽  
Urban Areas ◽  
Household Wealth ◽  
Education Level ◽  
Demographic And Health Surveys ◽  
Adult Women ◽  
Middle Income ◽  
Middle Income Countries ◽  
Percentage Points ◽  
Low And Middle Income

Abstract Objective: To investigate the magnitude and distribution of concurrent overweight/obesity and anaemia among adult women, adolescent girls and children living in low-and middle-income countries (LMICs). Design: We selected the most recent Demographic and Health Surveys with anthropometric and haemoglobin level measures. Prevalence estimates and 95% CIs of concurrent overweight/obesity and anaemia were calculated for every country, overall and stratified by household wealth quintile, education level, area of residence and sex (for children only). Regional and overall pooled prevalences were estimated using a random-effects model. We measured gaps, expressed in percentage points, to display inequalities in the distribution of the double burden of malnutrition (DBM). Setting: Nationally representative surveys from 52 LMICs. Participants: Adult women (n=825,769) aged 20-49 years, adolescent girls (n=192,631) aged 15-19 years, and children (n=391,963) aged 6-59 months. Results: The pooled prevalence of concurrent overweight/obesity and anaemia was 12.4% (95% CI: 11.1, 13.7) among adult women, 4.5% (95% CI: 4.0, 5.0) among adolescent girls and 3.0% (95% CI: 2.7, 3.3) among children. Overall, the DBM followed an inverse social gradient, with a higher prevalence among the richest quintile, most educated groups and in urban areas; however, important variations exist. The largest inequality gaps were observed among adult women in Yemen by household wealth (24.0 percentage-points) and in Niger by education level (19.6 percentage-points) and area of residence (11.9 percentage-points). Differences were predominantly significant among adult women; but less among girls and children. Conclusions: Context-specific, multifaceted, responses with an equity-lens are needed to reduce all forms of malnutrition.

scholarly journals Human development and international migration: Lessons from low- and middle-income countries

2019 ◽  
Vol 8 (3) ◽  
pp. 8-23
Author(s):  
Leonie Decrinis
Keyword(s):  
Human Development ◽  
Socioeconomic Development ◽  
Strong Support ◽  
Development Strategies ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Migration ◽  
Source Countries ◽  
The Relationship ◽  
Low And Middle Income

This paper analyses the relationship between human development and migration. In particular, it tests whether migration, as a function of human development, follows an inverted U-shaped curve, known as mobility transition. Understanding this relationship is important since many Western politicians have implemented socioeconomic development strategies in migrant source countries with the aim to reduce migration. Considering that previous studies have mainly concentrated on the economic factors of development, this study introduces the broader human development index, determined by income, health and education, as the main explanatory variable. Analysing the rate of migration from 111 low- and middle-income countries into the aggregate of 15 OECD countries between 2000 and 2010, the study finds strong support for the inverted U-shaped relationship between human development and migration. This indicates that development strategies aimed at reducing migration are misguided

scholarly journals Association between early childhood caries and intimate partner violence in 20 low- and middle-income countries: 2007-2017

2020 ◽  
Author(s):  
Morenike Oluwatoyin Folayan ◽  
Mary Obiyan ◽  
Maha El Tantawi ◽  
Arthur Kemoli ◽  
Ola B. Al-Batayneh ◽  
...  
Keyword(s):  
Early Childhood ◽  
Sexual Violence ◽  
Early Childhood Caries ◽  
Physical Violence ◽  
Middle Income ◽  
Middle Income Countries ◽  
High Prevalence ◽  
Eta Squared ◽  
The Relationship ◽  
Low And Middle Income

Abstract Background: To determine the relationship between country level prevalence of interpersonal violence (IPV) and the prevalence of early childhood caries (ECC) in children aged 3-5-year-olds. Method: This was an ecological study using extracted IPV (physical, sexual and emotional) and ECC data for 3-5-year-olds in 20 low- and middle-income countries for the period 2007-2017. Linear regression analysis was used to assess the relationship between the percentage of 3-5-year-old children with ECC (outcome variable) and the four IPV indicators (physical, sexual, emotional and a combination of the three). The model was adjusted for the country’s Gross National Income GNI. Partial eta squared (as measure of effect size), regression coefficients, confidence intervals and p values were calculated. Results: The strongest association was between ECC prevalence and exposure to physical violence (partial eta squared= 0.01), followed by exposure to sexual violence (partial eta squared= 0.005), and exposure to all types of IPV combined (partial eta squared= 0.001). Exposure to emotional violence had the weakest association with ECC (partial eta squared < 0.0001). For 1% higher percentage of women reporting exposure to physical violence and percentage of women reporting all types of IPV combined, there was a 0.18% higher prevalence of ECC. For 1% higher prevalence of sexual violence, there was 0.22% higher ECC prevalence. For 1% higher prevalence of emotional violence, there was 0.04% higher ECC prevalence. Conclusions: Countries with high prevalence of IPV will likely also have high prevalence of ECC. This needs further studies.

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