Exploration of Barriers to the Recommendation of Oral Rehydration Salts and Zinc Tablets for Acute Diarrhoea by Patent Medicine Vendors in Lagos State, Nigeria.

2020 ◽  
Vol 1 (3) ◽  
pp. 31-40
Author(s):  
L.D. Obijuru ◽  
◽  
O.O. Oyetunde ◽  
P.U. Ogbo ◽  
Keyword(s):  
Acute Diarrhoea ◽  
Watery Diarrhoea ◽  
Global Burden ◽  
Major Theme ◽  
Middle Income ◽  
Oral Rehydration ◽  
Middle Income Countries ◽  
Lagos State ◽  
Patent Medicine ◽  
Oral Rehydration Salts

Background: Diarrhoea has remained a global burden and leading cause of morbidity and mortality among under-five children especially in low and middle-income countries in spite of availability of oral rehydration salts and zinc tablets (ORS/Zn,), which are the proven and recommended treatments. This persistent global burden indicates possible barriers in the prescription, recommendation or use of ORS/Zn among stakeholders. Objective: This study explored the factors that act as barriers to the recommendation of ORS/Zn in the management of childhood acute watery diarrhoea (AWD) by Patent and Proprietary Medicine Vendors (PPMVs) License holders in Lagos State. Methods: A qualitative study carried out through interviews of PPMVs. A purposive recruitment of 24 PPMVs was done with 18 of them finally participating in the study. Thematic analysis through peer coding was employed to extract the findings of the study presented in themes and subthemes. Results: Three themes associated with barriers to recommending ORS/Zn emerged: rejection of ORS/Zn by parents of children with AWD, misconception about ORS/Zn and difficulties with ORS/Zn preparation. The enhancement of the taste of ORS was the major theme associated with factors that could facilitate recommendation of ORS/Zn. Conclusion: This study revealed that PPMVs knew that they should recommend ORS/Zn for AWD but encountered barriers such as rejection of ORS/Zn by parents, misconception of ORS/Zn and difficulties in the preparation of ORS. They opined that enhancement of the taste of ORS may facilitate acceptance by parents.

scholarly journals Barriers in Bangladesh

eLife ◽  
2018 ◽  
Vol 7 ◽  
Author(s):  
Senjuti Saha ◽  
Sudipta Saha ◽  
Samir K Saha
Keyword(s):  
Public Health ◽  
Burden Of Disease ◽  
Scientific Community ◽  
Public Health Surveillance ◽  
Health Surveillance ◽  
Global Burden ◽  
Middle Income ◽  
International Effort ◽  
Middle Income Countries ◽  
Conducting Research

Research laboratories in low- and middle-income countries, where the global burden of disease is highest, face systemic challenges in conducting research and public health surveillance. An international effort is needed to overcome the paywalls, customs regulations and lack of local suppliers that hinder the scientific community in these countries.

scholarly journals Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

2020 ◽  
Vol 8 (8) ◽  
pp. e1038-e1060 ◽  
Author(s):  
Kirsten E Wiens ◽  
Paulina A Lindstedt ◽  
Brigette F Blacker ◽  
Kimberly B Johnson ◽  
Mathew M Baumann ◽  
...  
Keyword(s):  
Low Income ◽  
Oral Rehydration Therapy ◽  
Middle Income ◽  
Oral Rehydration ◽  
Middle Income Countries ◽  
Geographical Inequalities

scholarly journals Treatment of pediatric diarrhea: a simulated client study at private pharmacies of Ujjain, Madhya Pradesh, India

2015 ◽  
Vol 9 (05) ◽  
pp. 505-511 ◽  
Author(s):  
Vishal Diwan ◽  
Yogesh D Sabde ◽  
Emma Byström ◽  
Ayesha De Costa
Keyword(s):  
Prescription Drugs ◽  
Urban Setting ◽  
Middle Income ◽  
Medical Treatments ◽  
Oral Rehydration ◽  
Middle Income Countries ◽  
Dispensing Practices ◽  
Tract Infections ◽  
Recommended Guidelines ◽  
Low And Middle Income

Introduction: In low- and middle-income countries such as India, private pharmacies play an important role in medical treatments, offering advice for common illnesses such as diarrhea and respiratory tract infections. There is a need to explore the details of the dispensing practices at the private pharmacies in low- and middle-income countries. Methodology: The present study used simulated client methodology to assess the actual dispensing practices for patients with pediatric diarrhea at private pharmacies in an urban setting of an Indian province. Results: This study identified 164 private pharmacies (84.10%) in the study setting that engaged in the practice of dispensing prescription drugs without prescriptions. Only about 40% asked clients if they had a prescription from a doctor. The average duration of consultations at the pharmacies was 1.3 minutes (range, 0.5–6 minutes). The dispensing of drugs was not in compliance with the recommended guidelines and regulations. The most commonly dispensed drugs were antibiotics (40.24%); of these, quinolones either alone or in combination with imidazoles were the most frequently dispensed. The other commonly dispensed drugs were antimotility drugs (31.10%) and Lactobacillus acidophilus (probiotics; 23.17%). The drugs were dispensed in inappropriate doses due to the absence of indications. Conclusions: Overuse and misuse of all these prescription drugs dispensed by pharmacies pose significant issues, such as resistance, dangerous side effects, and high costs. At the same time, the pharmacies did not dispense recommended drugs such as oral rehydration solution and zinc, which they are authorized to dispense without a prescription.

scholarly journals Barriers and facilitators to implementation of oral rehydration therapy in low- and middle-income countries: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249638
Author(s):  
Obidimma Ezezika ◽  
Apira Ragunathan ◽  
Yasmine El-Bakri ◽  
Kathryn Barrett
Keyword(s):  
Systematic Review ◽  
Implementation Research ◽  
Oral Rehydration Therapy ◽  
Barriers And Facilitators ◽  
World Health ◽  
Successful Implementation ◽  
Middle Income ◽  
Oral Rehydration ◽  
Middle Income Countries ◽  
Low And Middle Income

Background Oral rehydration therapy (ORT) is an effective and cheap treatment for diarrheal disease; globally, one of the leading causes of death in children under five. The World Health Organization launched a global campaign to improve ORT coverage in 1978, with activities such as educational campaigns, training health workers and the creation of designate programming. Despite these efforts, ORT coverage remains relatively low. The objective of this systematic review is to identify the barriers and facilitators to the implementation of oral rehydration therapy in low and middle-income countries. Methods A comprehensive search strategy comprised of relevant subject headings and keywords was executed in 5 databases including OVID Medline, OVID Embase, OVID HealthStar, Web of Science and Scopus. Eligible studies underwent quality assessment, and a directed content analysis approach to data extraction was conducted and aligned to the Consolidated Framework for Implementation Research (CFIR) to facilitate narrative synthesis. Results The search identified 1570 citations and following removal of duplicates as well as screening according to our inclusion/exclusion criteria, 55 articles were eligible for inclusion in the review. Twenty-three countries were represented in this review, with India, Bangladesh, Egypt, Nigeria, and South Africa having the most representation of available studies. Study dates ranged from 1981 to 2020. Overarching thematic areas spanning the barriers and facilitators that were identified included: availability and accessibility, knowledge, partnership engagement, and design and acceptability. Conclusion A systematic review of studies on implementation of ORT in low- and middle-income countries (LMICs) highlights key activities that facilitate the development of successful implementation that include: (1) availability and accessibility of ORT, (2) awareness and education among communities, (3) strong partnership engagement strategies, and (4) adaptable design to enhance acceptability. The barriers and facilitators identified under the CIFR domains can be used to build knowledge on how to adapt ORT to national and local settings and contribute to a better understanding on the implementation and use of ORT in LMICs. The prospects for scaling and sustaining ORT (after years of low use) will increase if implementation research informs local applications, and implementers engage appropriate stakeholders and test assumptions around localized theories of change from interventions to expected outcomes. Registration A protocol for this systematic review was developed and uploaded onto the PROSPERO international prospective register of systematic reviews database (Registration number: CRD420201695).

scholarly journals The Global Burden of Surgical Disease: An Analysis on Inaccessible Surgical Care in Low and Middle Income Countries

2018 ◽  
Vol 7 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Chau Huynh ◽  
Minh NQ Huynh
Keyword(s):  
Global Health ◽  
Financial Burden ◽  
Surgical Care ◽  
Anaesthetic Management ◽  
Global Burden ◽  
Political Climate ◽  
Middle Income ◽  
Surgical Interventions ◽  
Middle Income Countries ◽  
Low And Middle Income

Worldwide, 4.8 billion people do not have access to safe, adequate surgical care and anaesthetic management. Surgical care has been deemed “the neglected child of global health,” a startling reminder of the disparities in health services. The provision of surgical interventions can avert 11% of the global burden of disease and 1.5 million deaths each year. Many obstacles exist for low- and middle-income countries (LMIC) to progress towards accessible surgical care. The first challenge is delivering cost-effective surgical care despite financial constraints and political turmoil. Foreign aid was established to alleviate the financial burden and its contributions have been pivotal. However, based on the political climate in certain countries, funds are siphoned to government sectors other than health care. Moreover, the lack of infrastructure, equipment, and personnel in LMIC compound the issue. The other challenge is determining if surgery is as feasible and effective as non-surgical health interventions. Surgical care is crucial and this paper aims to assess the challenges that limit its stature in global health discussions. The paper will address the influence of financing, infrastructure, workforce, service delivery, and information management on surgical care, and the current resolutions, such as humanitarian aid missions.

scholarly journals Addressing the mental health needs of a rapidly growing megacity: the new Lagos Mental Health Initiative

2014 ◽  
Vol 11 (1) ◽  
pp. 20-22
Author(s):  
Olufemi Oluwatayo ◽  
Olufemi Olugbile ◽  
Ayodele Coker
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
State Government ◽  
Mental Health Policy ◽  
Health Needs ◽  
Mental Health Needs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Initiative ◽  
Lagos State

The Lagos State Government of Nigeria recently launched its Mental Health Policy and Work Plan aimed at addressing the mental health needs of Lagos, one of the world's fastest-growing megacities, and its nearby communities. This paper discusses the contextual basis of this initiative, its components and the challenges faced so far. It argues that urban centres deserve attention in the current push towards investing in mental health services in low- and middle-income countries.

scholarly journals Epidemiology and factors associated with diarrhoea among children under five years of age in the Engela District in the Ohangwena Region, Namibia

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Maria F. Bauleth ◽  
Honore K. Mitonga ◽  
Lusia N. Pinehas
Keyword(s):  
Informal Settlement ◽  
Acute Diarrhoea ◽  
Public Health Problem ◽  
Epidemiological Data ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Face To Face ◽  
Factors Associated ◽  
Middle Income Countries

Background: Diarrhoea remains a public health problem and an important cause of morbidity and mortality amongst children, mainly in low- and middle-income countries. In Namibia, the national prevalence of diarrhoea was 17%; it was responsible for 5% of all deaths in children under 5 years old and is the second leading cause of death.Aim: The purpose of this study was to assess the epidemiology and factors associated with acute diarrhoea amongst children less than 5 years of age in Engela district in the Ohangwena region, Namibia.Setting: The study was conducted in Ohangwena Region in Namibia which extends east to west along the borders of the southern part of Angola.Methods: A cross-sectional study was conducted. A structured questionnaire was administered through face-to-face interviews. Descriptive statistics were used to describe the socio-demographic and epidemiological data of diarrhoea and logistic regression analysis was used to determine the factors associated with the prevalence of diarrhoea.Results: The study found a prevalence of 23.8% for diarrhoea in the 2 weeks period preceding the survey amongst children aged under 5 years. The prevalence of diarrhoea was statistically significantly associated with children (p 0.05). The strongest predictor of the prevalence of diarrhoea was the residential area ‘informal settlement’, with an odds ratio of 36.42. This implies that children living in the informal settlement are 36.42 times at risk of contracting diarrhoea as compared to those living in other residential areas.Conclusion: epidemiology; factors; diarrhoea; under-5 years children; Engela district; Ohangwena region; Namibia.

Physical inactivity and non-communicable disease burden in low-income, middle-income and high-income countries

2021 ◽  
pp. bjsports-2020-103640
Author(s):  
Peter T Katzmarzyk ◽  
Christine Friedenreich ◽  
Eric J Shiroma ◽  
I-Min Lee
Keyword(s):  
Cardiovascular Disease ◽  
Low Income ◽  
Physical Inactivity ◽  
Communicable Diseases ◽  
High Income ◽  
Asia Pacific ◽  
Global Burden ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries

ObjectivesPhysical inactivity is a risk factor for premature mortality and several non-communicable diseases. The purpose of this study was to estimate the global burden associated with physical inactivity, and to examine differences by country income and region.MethodsPopulation-level, prevalence-based population attributable risks (PAR) were calculated for 168 countries to estimate how much disease could be averted if physical inactivity were eliminated. We calculated PARs (percentage of cases attributable to inactivity) for all-cause mortality, cardiovascular disease mortality and non-communicable diseases including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers of the bladder, breast, colon, endometrium, oesophagus, stomach and kidney.ResultsGlobally, 7.2% and 7.6% of all-cause and cardiovascular disease deaths, respectively, are attributable to physical inactivity. The proportions of non-communicable diseases attributable to physical inactivity range from 1.6% for hypertension to 8.1% for dementia. There was an increasing gradient across income groups; PARs were more than double in high-income compared with low-income countries. However, 69% of total deaths and 74% of cardiovascular disease deaths associated with physical inactivity are occurring in middle-income countries, given their population size. Regional differences were also observed, with the PARs occurring in Latin America/Caribbean and high-income Western and Asia-Pacific countries, and the lowest burden occurring in Oceania and East/Southeast Asia.ConclusionThe global burden associated with physical inactivity is substantial. The relative burden is greatest in high-income countries; however, the greatest number of people (absolute burden) affected by physical inactivity are living in middle-income countries given the size of their populations.

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