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COVID-19 has altered health sector capacity in low-income and middle-income
...
countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios.
more
Background
How to finance progress towards universal health coverage in low-income and middle-income
...
countries is a subject of intense debate. We investigated how alternative tax systems aff ect the breadth, depth, and height of health system coverage.
Methods
We used cross-national longitudinal fi xed eff ects models to assess the relationships between total and diff erent types of tax revenue, health system coverage, and associated child and maternal health outcomes in 89 low-income and middle-income countries from 1995–2011.
more
The state of diabetes treatment coverage in 55 low-income and middle-income countries: a cross-sectional study of nationally representative, individual-level data in 680 102 adults 2021
Flood, D.; Seiglie, J.A.; Dunn, M.; et al.
The Lancet Healthy Longevity Volume 2, Issue 6e340-e351June 2021
(2021)
CC2
Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-incom
...
e countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nationally representative data on the current patterns of treatment coverage. The objectives of this study were to estimate the proportion of adults with diabetes in LMICs who receive coverage of recommended pharmacological and non-pharmacological diabetes treatment; and to describe country-level and individual-level characteristics that are associated with treatment.
more
The report shows that older people are not getting the healthcare treatments they desperately need. The COVID-19 response has disrupted services for non-communicable diseases such as cancer and diabetes, communicable diseases such as malaria,
...
and much-needed services for mental health. Combined with a loss of income, many older people are unable to get the medicines they need.
A Summary is available in Russian and Arabic
more
For the global community to be able to achieve ambitious targets relating to the prevention and treatment of HIV, viral hepatitis and sexually transmitted infections (STIs), multiple types of medici
...
nes must be widely accessible to all affected populations in all countries.
The purpose of this report is to provide forecasts of future demand for medicines used in the fields of HIV, viral hepatitis and STIs. This report jointly presents medicines forecasts across three disease areas in recognition of the benefits of addressing HIV, viral hepatitis and STIs in a coordinated manner.
more
The objectives of this guideline are the same as those of the 2011 edition, namely to provide evidence-based normative guidance on interventions to improve adolescent morbidity and mortality by reducing the chances of early pregnancy
...
and its resulting poor health outcomes. The specific objectives of the guideline were to: 1. identify effective interventions to prevent early pregnancy by influencing factors such as early marriage, coerced sex, unsafe abortion, access to contraceptives and access to maternal health services by adolescents; and 2. provide an analytical framework for policy-makers and programme managers to use when selecting evidence-based interventions to prevent early pregnancy and negative health outcomes when they occur that are most appropriate for the needs of their countries and context. The recommendations and best practice statements described in this document aim to enable evidence-based decision-making with respect to preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income country contexts.
more
Estimates of government spending and development assistance for tuberculosis exist, but less is known
about out-of-pocket and prepaid private spending. We aimed to provide comprehensive estimates o
...
f total spending on
tuberculosis in low-income and middle-income countries for 2000–17.
more
Demographic and epidemiological transitions are changing the age structure of the population and the most common diseases. Non-communicable respiratory diseases are an increasing problem at both end
...
s of the age range in low-income and middle-income countries. In children, who represent a large proportion of the total population, the increasing problem of asthma is a strain on health services. Improved survival of the older population is increasing the proportion of morbidity and mortality attributable to chronic lung diseases. Health services in low-resource countries are poorly adapted to treating chronic diseases. Designed to respond episodically to acute disease, almost all historical investment has focused on infectious diseases. Crucial to the successful management of chronic diseases is an infrastructure designed to support pro-active management, providing not only an accurate diagnosis, but also a secure supply of cost effective drugs at an affordable price. The absence of such an infrastructure in many countries and the market failure that makes drugs generally more expensive in low-resource regions means that many people with chronic non-communicable lung diseases are not given effective treatment. This has damaging economic consequences. The common causes of poor lung health in lowincome countries are not the same as those in richer countries, and there is a need to study why they are so common and how best to manage them.
more
This document presents an evidence-informed Checklist for implementing rural pathways to train and support the rural
health workforce in low and
...
middle income countries (LMIC). Rural areas are the most underserviced around the world.
more
It explains the importance of faecal sludge management in urban areas in which many people rely on on-site and decentralized sanitation facilities and emphasizes the place of treatment in the overal
...
l sanitation service chain. It defines terms used throughout the book, explains why faecal sludge and septage treatment is important, and identifies broad treatment objectives.
more
Resilience and mental health in children and adolescents living in areas of armed conflict – a systematic review of findings in low- and middle-income countries
Tol, Wietse A. , Song, Suzan, Jordans, Mark J. D.
The Journal of Child Psychology and Psychiatry
(2018)
C1
Researchers focused on mental health of conflict-affected children are increasingly interested in the concept of resilience. Knowledge on resilience may assist in developing interventions aimed at improving positive outcomes or reducing negative outcomes, termed promotive or protective interventions
...
.
more
Background: Asthma and chronic obstructive pulmonary disease (COPD) cause a considerable burden of morbidity
and mortality in low-income
...
and middle-income countries (LMICs). Access to safe, effective, quality-assured, and
affordable essential medicines is variable. We aimed to review the existing literature relating to the availability, cost,
and affordability of WHO’s essential medicines for asthma and COPD in LMICs.
more
The seven essential features of practice for scaling up are described with great clarity. They are practical and universal, and encourage local innovation. They include policy, funding
...
and local management structure, as well as working with all possible partners and developing local context adaptations. The case studies give ideas and inspiration to develop new programmes and find ways around obstacles in existing programmes, especially through involving those with most at stake including users and their families and local community leaders
more
Every year, an estimated 15 million babies are born preterm – before 37 weeks of pregnancy. That is more than 1 in 10 live births. Approximately 1 million children die each year worldwide due to complications from their early birth. Those that survive often face a lifetime of ill-health including
...
disability, learning difficulties, and visual and hearing problems.
Half of the babies born at or below 32 weeks (2 months early) die in low-income settings, due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all these babies survive.
more
Background
In the prevention of cardiovascular disease, a WHO target is that at least 50% of eligible people use statins. Robust evidence is needed to monitor progress towards this target in low-income an
...
d middle-income countries (LMICs), where most cardiovascular disease deaths occur. The objectives of this study were to benchmark statin use in LMICs and to investigate country-level and individual-level characteristics associated with statin use.
more
Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in
...
low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
more
Campbell Syst Review Vol. 18 no.1.
Despite progress in several dimensions of the global HIV response, there seems to be a significant gender and age disparity. Numerous organizations consider it a top priority to accelerate HIV prevention programmi
...
ng among Adolescent Girls and Young Women (AGYW) as unequal gender norms, limited agency and voice, and reduced access to resources put them at higher HIV risk. Gender and age have also been identified as critical gaps within prevention research to ensure the development of biomedical interventions that are responsive to the biological and social needs of AGYW. Towards this, the objectives of the proposed evidence and gap map are to; identify and map existing evidence and gaps on the use of diverse Social and Behaviour Change Communication (SBCC) strategies to strengthen adoption of HIV prevention measures and participation in research among AGYW in LMICs; and, identify areas where more interventions and evidence are needed to inform the design of future SBCC strategies and programs for AGYW engagement in HIV prevention and research.
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Background: Primary health care (PHC) is a driving force for advancing towards universal health coverage (UHC). PHC-oriented health systems bring enormous benefits but require substantial financial investments. Here, we aim to present measures for PHC investments
...
and project the associated resource needs. Methods: This modelling study analysed data from 67 low-income and middle-income countries (LMICs). Recognising the variation in PHC services among countries, we propose three measures for PHC, with different scope for included interventions and system strengthening. Measure 1 is centred on public health interventions and outpatient care; measure 2 adds general inpatient care; and measure 3 further adds cross-sectoral activities. Cost components included in each measure were based on the Declaration of Astana, informed by work delineating PHC within health accounts, and finalised through an expert and country validation meeting. We extracted the subset of PHC costs for each measure from WHO’s Sustainable Development Goal (SDG) price tag for the 67 LMICs, and projected the associated health impact. Estimates of financial resource need, health workforce, and outpatient visits are presented as PHC investment guide posts for LMICs.
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Introduction
In 2017, development assistance for health (DAH) comprised 5.3% of total health spending in lowincome countries. Despite the key role DAH plays in global health-spending, little is known about the characteristics of assistance that ma
...
y be associated with committed assistance that is actually disbursed. In this analysis, we examine associations between these characteristics and disbursement of committed assistance.
Methods
We extracted data from the Creditor Reporting System of the Organization for Economic Co-operation and Development, Institute for Health Metrics and Evaluation, and the WHO National Health Accounts database. Factors examined were off-budget assistance, administrative assistance, publicly sourced assistance and assistance to health systems strengthening. Recipient-country characteristics examined were perceived level of corruption, civil fragility and gross domestic product per capita (GDPpc). We used linear regression methods for panel of data to assess the proportion of committed aid that was disbursed for a given country-year, for each data source.
Results
Factors that were associated with a higher disbursement rates include off-budget aid (p<0.001), lower administrative expenses (p<0.01), lower perceived corruption in recipient country (p<0.001), lower fragility in recipient country (p<0.05) and higher GDPpc (p<0.05).
Conclusion
Substantial gaps remain between commitments and disbursements. Characteristics of assistance (administrative, publicly sourced) and indicators of government transparency and fragility are also important drivers associated with disbursement of DAH. There remains a continued need for better aid flow reporting standards and clarity around aid types for better measurement of DAH.
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