scholarly journals Adapting chronic care models for diabetes care delivery in low-and-middle-income countries: A review

2015 ◽  
Vol 6 (4) ◽  
pp. 566 ◽  
Author(s):  
Grace Marie V Ku ◽  
Guy Kegels
Keyword(s):  
Diabetes Care ◽  
Chronic Care ◽  
Care Delivery ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Models ◽  
Low And Middle Income

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.

A Systematic Review of Innovative Diabetes Care Models in Low-and Middle-Income Countries (LMICs)

2014 ◽  
Vol 25 (1) ◽  
pp. 72-93 ◽  
Author(s):  
Yonah B. Esterson ◽  
Michelle Carey ◽  
John D. Piette ◽  
Nihal Thomas ◽  
Meredith Hawkins
Keyword(s):  
Systematic Review ◽  
Diabetes Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Models ◽  
Low And Middle Income

scholarly journals Impact of Merit-Based Immigration Policies on Brain Drain From Low- and Middle-Income Countries

2020 ◽  
pp. 185-189 ◽  
Author(s):  
Nagi S. El Saghir ◽  
Benjamin O. Anderson ◽  
Julie Gralow ◽  
Gilberto Lopes ◽  
Lawrence N. Shulman ◽  
...  
Keyword(s):  
Brain Drain ◽  
Care Delivery ◽  
International Medical ◽  
Immigration Policies ◽  
International Medical Graduates ◽  
Middle Income ◽  
Middle Income Countries ◽  
Medical Graduates ◽  
Trump Administration ◽  
Low And Middle Income

PURPOSE Brain drain is the migration of educated and skilled individuals from a less developed region or country to a more economically established one. The Trump administration proposed a merit-based immigration plan. This article addresses its potential impact on health care delivery in low- and middle-income countries (LMICs) and their preparedness to deal with it. MATERIALS AND METHODS Data on immigration policies, numbers of international medical graduates practicing in high-income countries (HICs), various scientific exchange methods, and efforts for capacity building in LMICs. RESULTS Talented individuals seek to advance their knowledge and skills, and may stay in HICs because of greater rewards and opportunities. HICs also rely on immigrant international medical graduates to supplement their physician workforces. CONCLUSION Ambitious individuals from LMICs need and should have opportunities to advance their education and training in more advanced countries. LMICs should increase their educational efforts, research capabilities, infrastructures, and living conditions to better serve their own populations and reduce their brain drain phenomenon.

scholarly journals Content, participants and outcomes of three diabetes care programmes in three low and middle income countries

2015 ◽  
Vol 9 (3) ◽  
pp. 196-202 ◽  
Author(s):  
Josefien Van Olmen ◽  
Ku Grace Marie ◽  
Darras Christian ◽  
Kalobu Jean Clovis ◽  
Bewa Emery ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Evidence gap map of performance measurement and management in primary care delivery systems in low- and middle-income countries – Study protocol

2018 ◽  
Vol 2 ◽  
pp. 27 ◽  
Author(s):  
Wolfgang Munar ◽  
Birte Snilstveit ◽  
Jennifer Stevenson ◽  
Nilakshi Biswas ◽  
John Eyers ◽  
...  
Keyword(s):  
Primary Care ◽  
Global Health ◽  
Performance Measurement ◽  
Study Design ◽  
Care Delivery ◽  
Delivery Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Care Delivery ◽  
Low And Middle Income

Background. For the last two decades there has been growing interest in governmental and global health stakeholders about the role that performance measurement and management systems can play for the production of high-quality and safely delivered primary care services. Despite recognition and interest, the gaps in evidence in this field of research and practice in low- and middle-income countries remain poorly characterized. This study will develop an evidence gap map in the area of performance management in primary care delivery systems in low- and middle-income countries. Methods. The evidence gap map will follow the methodology developed by 3Ie, the International Initiative for Impact Evaluation, to systematically map evidence and research gaps. The process starts with the development of the scope by creating an evidence-informed framework that helps identify the interventions and outcomes of relevance as well as help define inclusion and exclusion criteria. A search strategy is then developed to guide the systematic search of the literature, covering the following databases: Medline (Ovid), Embase (Ovid), CAB Global Health (Ovid), CINAHL (Ebsco), Cochrane Library, Scopus (Elsevier), and Econlit (Ovid). Sources of grey literature are also searched. Studies that meet the inclusion criteria are systematically coded, extracting data on intervention, outcome, measures, context, geography, equity, and study design. Systematic reviews are also critically appraised using an existing standard checklist. Impact evaluations are not appraised but will be coded according to study design. The process of map-building ends with the creation of an evidence gap map graphic that displays the available evidence according to the intervention and outcome framework of interest. Discussion. Implications arising from the evidence map will be discussed in a separate paper that will summarize findings and make recommendations for the development of a prioritized research agenda.

scholarly journals Maternal and neonatal data collection systems in low- and middle-income countries: scoping review protocol

2020 ◽  
Vol 4 ◽  
pp. 18 ◽  
Author(s):  
Mabel Berrueta ◽  
Ariel Bardach ◽  
Agustin Ciaponni ◽  
Xu Xiong ◽  
Andy Stergachis ◽  
...  
Keyword(s):  
Data Collection ◽  
Scoping Review ◽  
Care Delivery ◽  
Grey Literature ◽  
Adverse Event Reporting ◽  
Vulnerable Groups ◽  
Recent Analysis ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Background: Pregnant women and neonates represent one of the most vulnerable groups, especially in low- and middle-income countries (LMICs). A recent analysis reported that most vaccine pharmacovigilance systems in LMICs consist of spontaneous (passive) adverse event reporting. Thus, LMICs need effective active surveillance approaches, such as pregnancy registries. We intend to identify currently active maternal and neonatal data collection systems in LMICs, with the potential to inform active safety electronic surveillance for novel vaccines using standardized definitions. Methods: A scoping review will be conducted based on established methodology. Multiple databases of indexed and grey literature will be searched with a specific focus on existing electronic and paper-electronic systems in LMICs that collect continuous, prospective, and individual-level data from antenatal care, delivery, neonatal care (up to 28 days), and postpartum (up to 42 days) at the facility and community level, at the national and district level, and at large hospitals. Also, experts will be contacted to identify unpublished information on relevant data collection systems. General and specific descriptions of Health Information Systems (HIS) extracted from the different sources will be combined and duplicated HIS will be removed, producing a list of unique statements. We will present a final list of Maternal, Newborn, and Child Health systems considered flexible enough to be updated with necessary improvements to detect, assess and respond to safety concerns during the introduction of vaccines and other maternal health interventions. Selected experts will participate in an in-person consultation meeting to select up to three systems to be further explored in situ. Results and knowledge gaps will be synthesized after expert consultation.

25 Years of Health Care Delivery in Low- and Middle-Income Countries

2019 ◽  
Author(s):  
Paul Clyde ◽  
Andrew Haig ◽  
Ekta Jhaveri ◽  
Monika Karazja ◽  
Pascale Leroueil ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Methodology to Forecast Volume and Cost of Cancer Drugs in Low- and Middle-Income Countries

2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yehoda M. Martei ◽  
Sebathu Chiyapo ◽  
Surbhi Grover ◽  
Christina Hanna ◽  
Scott Dryden-Peterson ◽  
...  
Keyword(s):  
Care Delivery ◽  
Population Based ◽  
Public Health Care ◽  
Essential Medicines ◽  
Cancer Drugs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Incident Cancer ◽  
Incident Cases ◽  
Low And Middle Income

Purpose In low- and middle-income countries (LMICs), frequent outages of the stock of cancer drugs undermine cancer care delivery and are potentially fatal for patients with cancer. The aim of this study is to describe a methodologic approach to forecast chemotherapy volume and estimate cost that can be readily updated and applied in most LMICs. Methods Prerequisite data for forecasting are population-based incidence data and cost estimates per unit of drug to be ordered. We used the supplementary guidelines from the WHO list of essential medicines for cancer to predict treatment plans and ordering patterns. We used de-identified aggregate data from the Botswana National Cancer Registry to estimate incident cases. The WHO Management Sciences for Health International Price Indicator was used to estimate unit costs per drug. Results Chemotherapy volume required for incident cancer cases was estimated as the product of the standardized dose required to complete a full treatment regimen per patient, with a given cancer diagnosis and stage, multiplied by the total number of incident cancer cases with the respective diagnosis. The estimated chemotherapy costs to treat the 10 most common cancers in the public health care sector of Botswana is approximately 2.3 million US dollars. An estimated 66% of the budget is allocated to costs of rituximab and trastuzumab alone, which are used by approximately 10% of the cancer population. Conclusion This method provides a reproducible approach to forecast chemotherapy volume and cost in LMICs. The chemotherapy volume and cost outputs of this methodology provide key stakeholders with valuable information that can guide budget estimation, resource allocation, and drug-price negotiations for cancer treatment. Ultimately, this will minimize drug shortages or outages and reduce potential loss of lives that result from an erratic drug supply.

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