scholarly journals Development of immunohistochemistry services for cancer care in western Kenya: Implications for low- and middle-income countries

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Kirtika Patel ◽  
R. Matthew Strother ◽  
Francis Ndiangui ◽  
David Chumba ◽  
William Jacobson ◽  
...  
Keyword(s):  
Cancer Care ◽  
Cost Model ◽  
Tertiary Care ◽  
Care Hospital ◽  
Middle Income ◽  
Western Kenya ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Limited Setting ◽  
Low And Middle Income

Background: Cancer is becoming a major cause of mortality in low- and middle-income countries. Unlike infectious disease, malignancy and other chronic conditions require significant supportive infrastructure for diagnostics, staging and treatment. In addition to morphologic diagnosis, diagnostic pathways in oncology frequently require immunohistochemistry (IHC) for confirmation. We present the experience of a tertiary-care hospital serving rural western Kenya, which developed and validated an IHC laboratory in support of a growing cancer care service.Objectives, methods and outcomes: Over the past decade, in an academic North-South collaboration, cancer services were developed for the catchment area of Moi Teaching and Referral Hospital in western Kenya. A major hurdle to treatment of cancer in a resource-limited setting has been the lack of adequate diagnostic services. Building upon the foundations of a histology laboratory, strategic investment and training were used to develop IHC services. Key elements of success in this endeavour included: translation of resource-rich practices to are source-limited setting, such as using manual, small-batch IHC instead of disposable- and maintenance-intensive automated machinery, engagement of outside expertise to develop reagent-efficient protocols and supporting all levels of staff to meet the requirements of an external quality assurance programme.Conclusion: Development of low- and middle-income country models of services, such as the IHC laboratory presented in this paper, is critical for the infrastructure in resource-limited settings to address the growing cancer burden. We provide a low-cost model that effectively develops these necessary services in a challenging laboratory environment.

scholarly journals Opportunities and barriers to implementing antibiotic stewardship in low and middle-income countries: Lessons from a mixed-methods study in a tertiary care hospital in Ethiopia

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0208447 ◽  
Author(s):  
Gebremedhin Beedemariam Gebretekle ◽  
Damen Haile Mariam ◽  
Workeabeba Abebe ◽  
Wondwossen Amogne ◽  
Admasu Tenna ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Antibiotic Stewardship ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Mixed Methods Study ◽  
Care Hospital ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Characteristics of a Nationwide Voluntary Antibiotic Resistance Awareness Campaign in India; Future Paths and Pointers for Resource Limited Settings/Low and Middle Income Countries

2019 ◽  
Vol 16 (24) ◽  
pp. 5141
Author(s):  
Ashok J. Tamhankar ◽  
Ramesh Nachimuthu ◽  
Ravikant Singh ◽  
Jyoti Harindran ◽  
Gautam Kumar Meghwanshi ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
World Health ◽  
Awareness Campaign ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Middle Income Countries ◽  
Awareness Campaigns ◽  
Resource Limited ◽  
Low And Middle Income

Antibiotic resistance has reached alarming proportions globally, prompting the World Health Organization to advise nations to take up antibiotic awareness campaigns. Several campaigns have been taken up worldwide, mostly by governments. The government of India asked manufacturers to append a ‘redline’ to packages of antibiotics as identification marks and conducted a campaign to inform the general public about it and appropriate antibiotic use. We investigated whether an antibiotic resistance awareness campaign could be organized voluntarily in India and determined the characteristics of the voluntarily organized campaign by administering a questionnaire to the coordinators, who participated in organizing the voluntary campaign India. The campaign characteristics were: multiple electro–physical pedagogical and participatory techniques were used, 49 physical events were organized in various parts of India that included lectures, posters, booklet/pamphlet distribution, audio and video messages, competitions, and mass contact rallies along with broadcast of messages in 11 local languages using community radio stations (CRS) spread all over India. The median values for campaign events were: expenditure—3000 Indian Rupees/day (US$~47), time for planning—1 day, program spread—4 days, program time—4 h, direct and indirect reach of the message—respectively 250 and 500 persons/event. A 2 min play entitled ‘Take antibiotics as prescribed by the doctor’ was broadcast 10 times/day for 5 days on CRS with listener reach of ~5 million persons. More than 85%ofcoordinators thought that the campaign created adequate awareness about appropriate antibiotic use and antibiotic resistance. The voluntary campaign has implications for resource limited settings/low and middle income countries.

scholarly journals Editorial series: cancer care in low- and middle-income countries

2019 ◽  
Vol 36 (6) ◽  
pp. 477-480 ◽  
Author(s):  
Jörg Haier ◽  
Jonathan Sleeman ◽  
Jürgen Schäfers
Keyword(s):  
Cancer Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Trend in the use of neo-adjuvant chemotherapy for the management of muscle invasive bladder cancer at a major tertiary care hospital in Pakistan.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16033-e16033
Author(s):  
Adnan Abdul Jabbar ◽  
Muhammad Asad Maqbool ◽  
Muhammad Bilal Mirza
Keyword(s):  
Bladder Cancer ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Standard Of Care ◽  
Invasive Bladder Cancer ◽  
Care Hospital ◽  
Muscle Invasive Bladder Cancer ◽  
Middle Income ◽  
Middle Income Countries ◽  
Muscle Invasive

e16033 Background: Although the use of Neoadjuvant Chemotherapy (NAC) has now become the standard of care for Muscle Invasive Bladder Cancer (MIBC) in the world, most patients in lower- middle-income countries (LMIC), like Pakistan, are still undergoing upfront surgery despite being ideal candidates for chemotherapy. Multi-disciplinary tumor boards have been critical in the change of this trend in the developed world. We aimed to assess the trends in the use of NAC for patients with muscle invasive bladder cancer before undergoing definitive surgery. Methods: We included patients who underwent surgery for ≥ cT2 MIBC without distant metastasis between 2011 and 2015 at a tertiary care hospital in Karachi, Pakistan. We retrospectively assessed the trends in NAC compared to upfront surgery in these patients. Results: Among the 171 patients included in our study, only 4 (2.34%) received NAC, whereas the other 167 (97.67%) underwent upfront surgery without NAC. Out of the 90 patients who underwent surgery for MIBC between 2011 and 2013, none of them received NAC and underwent upfront surgery. Among the 81 patients with MIBC in 2014 and 2015, 4 patients received NAC before surgery whereas the other 77 underwent upfront surgery. Conclusions: The adoption of NAC for MIBC remains a challenge in lower- middle-income countries such as Pakistan. Introduction of a multidisciplinary tumor board in our hospital since 2014 has shown a slight change in this trend. Better communication between different departments remains the key in significantly changing the trend of a much desired standard of care.

scholarly journals Structural Barriers to Diagnosis and Treatment of Cancer in Low- and Middle-Income Countries: The Urgent Need for Scaling Up

2016 ◽  
Vol 34 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Eduardo Cazap ◽  
Ian Magrath ◽  
T. Peter Kingham ◽  
Ahmed Elzawawy
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Cancer Care ◽  
Health Care Systems ◽  
Diagnosis And Treatment ◽  
Middle Income ◽  
Health Crisis ◽  
Middle Income Countries ◽  
Care Systems ◽  
Low And Middle Income

Noncommunicable diseases are now recognized by the United Nations and WHO as a major public health crisis. Cancer is a main part of this problem, and health care systems are facing a great challenge to improve cancer care, control costs, and increase systems efficiency. The disparity in access to care and outcomes between high-income countries and low- and middle-income countries is staggering. The reasons for this disparity include cost, access to care, manpower and training deficits, and a lack of awareness in the lay and medical communities. Diagnosis and treatment play an important role in this complex environment. In different regions and countries of the world, a variety of health care systems are in place, but most of them are fragmented or poorly coordinated. The need to scale up cancer care in the low- and middle-income countries is urgent, and this article reviews many of the structural mechanisms of the problem, describes the current situation, and proposes ways for improvement. The organization of cancer services is also included in the analysis.

scholarly journals Study on nutritional status among children up to five years at tertiary care hospital, HIMS, Sitapur, Uttar Pradesh

2021 ◽  
Vol 8 (3) ◽  
pp. 1151
Author(s):  
Ravi Pachori ◽  
Jiratithigan Sillapasuwan
Keyword(s):  
Sample Size ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Normal Children ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Sociodemographic Profile

Background: Undernutrition makes children in particular much more vulnerable to disease and death; around 45% of deaths among children up to 5 years of age are linked to undernutrition and these mostly occur in low and middle-income countries. Malnutrition increases health care costs, reduces productivity, and slows economic growth, which can perpetuate a cycle of poverty and ill-health. Objective of the study was to assess the prevalence of underweight (weight-for-age), sociodemographic profile and to determination of differences exist by gender.Methods: The present study was hospital based descriptive cross-sectional study conducted from June 2019 to December 2019. The sample size calculated was 410, and accounting for 10% nonresponsive, the sample size calculated was 451. The data obtained were compiled and entered in MS-excel 2010 and analysed by using institutional SPSS (22.0).Results: Male children 230 (51.0%) was observed higher proportion as compared to female children 221 (49.0%) and same preponderance difference was found among underweight children. Literate fathers belong to 332 (73.6%) children and illiterate fathers belong to 96 (53.0%) underweight children. literate mother belongs to highly significant 283 (62.8%) children and illiterate mothers belong to highly significant 105 (58.0%) underweight children. Majority of father occupation belongs to other type job 294 (65.2) whereas labour occupation mostly belongs to underweight children 109 (60.2%) highly significant and most of the housewives belong to normal children 361 (80.1%) and underweight children 119 (65.8%) highly significant.Conclusions: Health education on nutrition to parents would be beneficiary for underweight children.

scholarly journals Etiologies of Neonatal Mortality in a Tertiary Care Hospital in a Resource-Limited Setting

2021 ◽  
Vol 11 (02) ◽  
pp. 268-280
Author(s):  
Calixte Ida Penda ◽  
Ritha Mbono Betoko ◽  
Danielle Kedy Koum ◽  
Essome Henri ◽  
Patricia Epée Eboumbou ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Resource Limited Setting ◽  
Care Hospital ◽  
Resource Limited ◽  
Limited Setting

scholarly journals Business models for primary health care delivery in low and middle income countries: a scoping study of nine social entrepreneurs

2020 ◽  
Author(s):  
Lutfi Lokman ◽  
Teresa Chahine
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Business Models ◽  
Tertiary Care ◽  
Social Enterprises ◽  
Social Entrepreneurs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Health ◽  
Low And Middle Income

Abstract Background: Social enterprises are organizations created to address social problems that use business models to sustain themselves financially. Social enterprises can help increase access to primary health care in low resource settings. Research on social enterprises in health care have focused either on high-income countries, or on secondary and tertiary care in low- and middle-income countries, where common business models include differential pricing to cross-subsidize low income populations. This is the first study to examine social enterprises providing primary health care in low- and middle-income countries using primary data. The purpose is to determine whether social enterprise is a viable model in this setting and to identify common patterns and characteristics that could inform the work of social entrepreneurs, funders, and researchers in this area.Methods: We identify social entrepreneurs working to deliver primary care in low- and middle-income countries who have been vetted by international organizations dedicated to supporting social entrepreneurship. Through in-depth interviews, we collect information on medical processes, business processes, social impact, and organizational impact according to the Battacharyya et al framework. We then conducted qualitative analysis to identify common patterns emerging within these four categories.Results: Common characteristics in the business models of primary health care social enterprises include flat rate rather than differential pricing; cross-subsidizing across services rather than patients. Subscription packages and in-house IT systems were utilized to generate revenue and increase reach through telemedicine, franchising, and mobile units. In some cases, alternate revenue streams are employed to help break even. About half of the social enterprises interviewed were for-profit, and about half non-profit. The majority faced challenges in engaging with the public sector. This is still a nascent field, with most organizations being under ten years old.Conclusions: Social enterprise has been demonstrated as a feasible model for providing primary care in low resource settings, with key characteristics differing from the previously commonly studied social enterprises in tertiary care. There are opportunities to complement existing public health systems, but most organizations face challenges in doing so. More research and attention is needed by researchers, governments and funders to support social entrepreneurs and avoid parallel systems.

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