Hypertension in Developing Countries: A Major Challenge for the Future.

PubMed

Mohsen Ibrahim, M

2018-05-01

Outline recent epidemiologic data regarding hypertension in developing countries, distinguish differences from developed countries, and identify challenges in management and future perspectives. Increased sugar intake, air and noise pollution, and low birth weight are emerging hypertension risk factors. The major challenges in management are difficulties in accurate diagnosis of hypertension and adequate blood pressure control. In contrast to developed countries, hypertension prevalence rates are on the rise in developing countries with no improvement in awareness or control rates. The increasing burden of hypertension is largely attributable to behavioral factors, urbanization, unhealthy diet, obesity, social stress, and inactivity. Health authorities, medical societies, and drug industry can collaborate to improve hypertension control through education programs, public awareness campaigns, legislation to limit salt intake, encourage generic drugs, development and dissemination of national guidelines, and involving nurses and pharmacists in hypertension management. More epidemiologic data are needed in the future to identify reasons behind increased prevalence and poor blood pressure control and examine trends in prevalence, awareness, treatment, and control. National programs for better hypertension control based on local culture, economic characteristics, and available resources in the population are needed. The role of new tools for hypertension management should be tested in developing world.

[The informed consent in international clinical trials including developing countries].

PubMed

Montenegro Surís, Alexander; Monreal Agüero, Magda Elaine

2008-01-01

The informed consent procedure has been one of the most important controversies of ethical debates about clinical trials in developing countries. In this essay we present our recommendations about important aspects to consider in the informed consent procedure for clinical trials in developing countries. We performed a full publications review identified by MEDLINE using these terms combinations: informed consent, developing countries, less developed countries and clinical trials. To protect volunteers in less developed countries should be valuated the importance of the community in the informed consent proceeding. The signing and dating of the informed consent form is not always the best procedure to document the informed consent. The informed consent form should be written by local translators. Alternative medias of communications could be needed for communicatios of the information to volunteers. Comparing with developed countries the informed consent proceeding in clinical trials in developing countries frequently require additional efforts. The developing of pragmatic researches is needed to implement informed consent proceedings assuring subjects voluntarily in each developing country. The main aspects to define in each clinical trial for each country are the influence of the community, the effective communication of the information, the documentation of the informed consent and local authority's control.

Health workforce development: a needs assessment study in French speaking African countries.

PubMed

Chastonay, Philippe; Moretti, Roberto; Zesiger, Véronique; Cremaschini, Marco; Bailey, Rebecca; Pariyo, George; Kabengele, Emmanuel Mpinga

2013-05-01

In 2006, WHO alerted the world to a global health workforce crisis, demonstrated through critical shortages of health workers, primarily in Sub-Saharan Africa (WHO in World Health Report, 2006). The objective of our study was to assess, in a participative way, the educational needs for public health and health workforce development among potential trainees and training institutions in nine French-speaking African countries. A needs assessment was conducted in the target countries according to four approaches: (1) Review at national level of health challenges. (2) Semi-directed interviews with heads of relevant training institutions. (3) Focus group discussions with key-informants. (4) A questionnaire-based study targeting health professionals identified as potential trainees. A needs assessment showed important public health challenges in the field of health workforce development among the target countries (e.g. unequal HRH distribution in the country, ageing of HRH, lack of adequate training). It also showed a demand for education and training institutions that are able to offer a training programme in health workforce development, and identified training objectives and core competencies useful to potential employers and future trainees (e.g. leadership, planning/evaluation, management, research skill). In combining various approaches our study was able to show a general demand for health managers who are able to plan, develop and manage a nation's health workforce. It also identified specific competencies that should be developed through an education and training program in public health with a focus on health workforce development.

Ongoing research in occupational health and environmental epidemiology in developing countries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Levy, B.S.; Kjellstrom, T.; Forget, G.

Research in occupational health and environmental epidemiology can play an important role in furthering our understanding of occupational and environmental health problems. Research guides us in the recognition, management, and prevention of health problems. However, in developing countries, where rates of occupational and environmental illnesses and injuries are higher and where these problems are often more severe than in developed countries, research capabilities are less developed. In mid-1990, a project was undertaken to (a) document ongoing research in occupational health and environmental epidemiology in developing countries, (b) facilitate the exchange of information among researchers in this field, (c) stimulate research,more » and (d) avoid unnecessary duplication among researchers in this field. A questionnaire was mailed, the purpose of which was to learn the current status of research in developing countries and to develop a directory of such ongoing research. The questionnaire was sent to 1,528 individuals. Of the 500 research projects identified, 77% were investigating chemical hazards; 26%, physical hazards; 10%, biological hazards; 10%, psychosocial hazards (some projects addressed multiple hazards). The chemical hazards studied most frequently were dusts, pesticides, and lead. The greatest number of research projects were identified in China, India, Brazil, Korea, and Thailand. Most projects were descriptive or cross-sectional epidemiologic studies or industrial hygiene or exposure-assessment studies. The World Health Organization has published a directory of the specific research projects that were identified in this survey.« less

Explaining patterns in the ratification of global environmental treaties

NASA Technical Reports Server (NTRS)

Cook, David W.

1991-01-01

A study was made of the ratification behavior of 160 countries with respect to 38 global environmental treaties. The study identifies and explains patterns in the ratification of treaties, providing two means of assessing the likelihood that any given country will support global environmental treaties. National ratification totals reveal a pattern of high ratification by countries in Western Europe, North America, Japan, Australia, and New Zealand. A country's standing within the range of high to low ratification rates can be explained by the statistical model developed in the study. This research allows one to identify countries likely to support global environmental treaties.

A methodology for small scale rural land use mapping in semi-arid developing countries using orbital imagery. 1: Introduction

NASA Technical Reports Server (NTRS)

Vangenderen, J. L. (Principal Investigator); Lock, B. F.

1976-01-01

The author has identified the following significant results. This research program has developed a viable methodology for producing small scale rural land use maps in semi-arid developing countries using imagery obtained from orbital multispectral scanners.

Developing and implementing national health identifiers in resource limited countries: why, what, who, when and how?

PubMed Central

Beck, Eduard J.; Tanna, Gaurang; Henning, Gerrit; de Vega, Ian; Andrews, Gail; Boucher, Philippe; Benting, Lionel; Garcia-Calleja, Jesus Maria; Cutler, John; Ewing, Whitney; Kijsanayotin, Boonchai; Kujinga, Tapiwanashe; Mahy, Mary; Makofane, Keletso; Marsh, Kim; Nacheeva, Chujit; Rangana, Noma; Varetska, Olga; Macharia Wanyee, Steven; Watiti, Stephen; Williams, Brian; Zhao, Jinkou; Nunez, Cesar; Ghys, Peter; Low-Beer, Daniel

2018-01-01

ABSTRACT Many resource-limited countries are scaling up health services and health-information systems (HISs). The HIV Cascade framework aims to link treatment services and programs to improve outcomes and impact. It has been adapted to HIV prevention services, other infectious and non-communicable diseases, and programs for specific populations. Where successful, it links the use of health services by individuals across different disease categories, time and space. This allows for the development of longitudinal health records for individuals and de-identified individual level information is used to monitor and evaluate the use, cost, outcome and impact of health services. Contemporary digital technology enables countries to develop and implement integrated HIS to support person centred services, a major aim of the Sustainable Development Goals. The key to link the diverse sources of information together is a national health identifier (NHID). In a country with robust civil protections, this should be given at birth, be unique to the individual, linked to vital registration services and recorded every time that an individual uses health services anywhere in the country: it is more than just a number as it is part of a wider system. Many countries would benefit from practical guidance on developing and implementing NHIDs. Organizations such as ASTM and ISO, describe the technical requirements for the NHID system, but few countries have received little practical guidance. A WHO/UNAIDS stake-holders workshop was held in Geneva, Switzerland in July 2016, to provide a ‘road map’ for countries and included policy-makers, information and healthcare professionals, and members of civil society. As part of any NHID system, countries need to strengthen and secure the protection of personal health information. While often the technology is available, the solution is not just technical. It requires political will and collaboration among all stakeholders to be successful. PMID:29502484

Worldwide wind/diesel hybrid power system study: Potential applications and technical issues

NASA Astrophysics Data System (ADS)

King, W. R.; Johnson, B. L., III

1991-04-01

The world market potential for wind/diesel hybrid technology is a function of the need for electric power, the availability of sufficient wind resource to support wind/diesel power, and the existence of buyers with the financial means to invest in the technology. This study includes data related to each of these three factors. This study does not address market penetration, which would require analysis of application specific wind/diesel economics. Buyer purchase criteria, which are vital to assessing market penetration, are discussed only generally. Countries were screened for a country-specific market analysis based on indicators of need and wind resource. Both developed countries and less developed countries (LDCs) were screened for wind/diesel market potential. Based on the results of the screening, ten countries showing high market potential were selected for more extensive market analyses. These analyses provide country-specific market data to guide wind/diesel technology developers in making design decisions that will lead to a competitive product. Section 4 presents the country-specific data developed for these analyses, including more extensive wind resource characterization, application-specific market opportunities, business conditions, and energy market characterizations. An attempt was made to identify the potential buyers with ability to pay for wind/diesel technology required to meet the application-specific market opportunities identified for each country. Additionally, the country-specific data are extended to corollary opportunities in countries not covered by the study. Section 2 gives recommendations for wind/diesel research based on the findings of the study.

Viability of Welfare Technology in Mass Technical Literacy Programme

ERIC Educational Resources Information Center

Achintya; Prabha, Manish

2009-01-01

Each developing country should be encouraged to identify its own priorities and develop welfare technology mobilizing its own natural and human resources and should not unnecessarily imitate the stereotyped technologies from the developed countries. The existing curriculum has to be updated and strengthened to include the concept of welfare…

Identifying Priorities for Post-Secondary Education in Qatar. Research Brief

ERIC Educational Resources Information Center

Stasz, Cathleen; Eide, Eric R.; Martorell, Francisco; Salem, Hanine; Constant, Louay; Goldman, Charles A.; Moini, Joy S.; Nadareishvili, Vazha

2007-01-01

Although Qatar has improved its post-secondary educational opportunities, the country's efforts have not undergone a broad strategic review. This study analyzed the extent to which the current offerings can meet the country's future needs and identified priorities for developing further educational options. Researchers found that Qataris' current…

Enhancement of Health Research Capacity in Nigeria through North-South and In-Country Partnerships

PubMed Central

Olaleye, David O.; Odaibo, Georgina N.; Carney, Paula; Agbaji, Oche; Sagay, Atiene S.; Muktar, Haruna; Akinyinka, Olusegun O.; Omigbodun, Akinyinka O.; Ogunniyi, Adesola; Gashau, Wadzani; Akanmu, Sulaimon; Ogunsola, Folasade; Chukwuka, Chinwe; Okonkwo, Prosper I.; Meloni, Seema T.; Adewole, Isaac; Kanki, Phyllis J.; Murphy, Robert L.

2014-01-01

Research productivity in Sub-Saharan Africa has the potential to affect teaching, student quality, faculty career development, and translational country-relevant research as it has in developed countries. Nigeria is the most populous country in Africa, with an academic infrastructure that includes 129 universities and 45 medical schools; however, despite the size, the country has unacceptably poor health status indicators. To further develop the research infrastructure in Nigeria, faculty and research career development topics were identified within the six Nigerian universities of the nine institutions of the Medical Education Partnership Initiative in Nigeria (MEPIN) consortium. The consortium identified a training model that incorporated multi-institutional “train the trainers” programs at the University of Ibadan, followed by replication at the other MEPIN universities. More than 140 in-country trainers subsequently presented nine courses to more than 1,600 faculty, graduate students, and resident doctors throughout the consortium during the program’s first three years (2011–2013). This model has fostered a new era of collaboration among the major Nigerian research universities, which now have increased capacity for collaborative research initiatives and improved research output. These changes, in turn, have the potential to improve the nation’s health outcomes. PMID:25072590

Arsenic removal methods for drinking water in the developing countries: technological developments and research needs.

PubMed

Kabir, Fayzul; Chowdhury, Shakhawat

2017-11-01

Arsenic pollution of drinking water is a concern, particularly in the developing countries. Removal of arsenic from drinking water is strongly recommended. Despite the availability of efficient technologies for arsenic removal, the small and rural communities in the developing countries are not capable of employing most of these technologies due to their high cost and technical complexity. There is a need for the "low-cost" and "easy to use" technologies to protect the humans in the arsenic affected developing countries. In this study, arsenic removal technologies were summarized and the low-cost technologies were reviewed. The advantages and disadvantages of these technologies were identified and their scopes of applications and improvements were investigated. The costs were compared in context to the capacity of the low-income populations in the developing countries. Finally, future research directions were proposed to protect the low-income populations in the developing countries.

Brain drain from developing countries: how can brain drain be converted into wisdom gain?

PubMed Central

Dodani, Sunita; LaPorte, Ronald E

2005-01-01

Brain drain is defined as the migration of health personnel in search of the better standard of living and quality of life, higher salaries, access to advanced technology and more stable political conditions in different places worldwide. This migration of health professionals for better opportunities, both within countries and across international borders, is of growing concern worldwide because of its impact on health systems in developing countries. Why do talented people leave their countries and go abroad? What are the consequences of such migrations especially on the educational sector? What policies can be adopted to stem such movements from developing countries to developed countries? This article seeks to raise questions, identify key issues and provide solutions which would enable immigrant health professionals to share their knowledge, skills and innovative capacities and thereby enhancing the economic development of their countries. PMID:16260795

Developed-developing country partnerships: benefits to developed countries?

PubMed

Syed, Shamsuzzoha B; Dadwal, Viva; Rutter, Paul; Storr, Julie; Hightower, Joyce D; Gooden, Rachel; Carlet, Jean; Bagheri Nejad, Sepideh; Kelley, Edward T; Donaldson, Liam; Pittet, Didier

2012-06-18

Developing countries can generate effective solutions for today's global health challenges. This paper reviews relevant literature to construct the case for international cooperation, and in particular, developed-developing country partnerships. Standard database and web-based searches were conducted for publications in English between 1990 and 2010. Studies containing full or partial data relating to international cooperation between developed and developing countries were retained for further analysis. Of 227 articles retained through initial screening, 65 were included in the final analysis. The results were two-fold: some articles pointed to intangible benefits accrued by developed country partners, but the majority of information pointed to developing country innovations that can potentially inform health systems in developed countries. This information spanned all six WHO health system components. Ten key health areas where developed countries have the most to learn from the developing world were identified and include, rural health service delivery; skills substitution; decentralisation of management; creative problem-solving; education in communicable disease control; innovation in mobile phone use; low technology simulation training; local product manufacture; health financing; and social entrepreneurship. While there are no guarantees that innovations from developing country experiences can effectively transfer to developed countries, combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is virgin and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardized method for reporting partnership benefits is needed--this is perhaps the single most immediate need in planning for, and realizing, the full potential of international cooperation between developed and developing countries.

Early Childhood Benefits at Low Cost--Evidence from a Randomized Trail in Mexico

ERIC Educational Resources Information Center

Cárdenas, Sergio; Evans, David K.; Holland, Peter

2015-01-01

The evidence that investments in early child development can pay high, long-term dividends, is mounting, both in developed and developing countries. However, recent meta-analysis identified very few studies in developing countries. The authors report on the evaluation impact of a low-cost, community-based parent training program for early child…

[Collaborating for the development of nursing in Africa].

PubMed

Oguisso, T

1993-04-01

The support offered by the ICN to the african countries of portuguese language, is described in this paper. The countries that participated of the ICN' Project were Angola, Cabo Verde, Guiné-Bissau, Moçambique, São Tomé and Principe. The purposes of the project are: analyse development of nursing in these countries; identify the needs of the nurses of the these countries; to evaluate the health systems and work to introduce the nurse in these systems; to identify the strughts and issues of the nursing associations; to promote the relationship among nurses and to establish plan to reinforce the national Nursing Association. We don't think that nursing is ready and well structured now, but this Project will be the first step in this direction. We have results an had some example of this is affiliation to the ICN of some African countries that have been made.

Utilization of solar energy in developing countries: Identifying some potential markets

NASA Technical Reports Server (NTRS)

Hein, G. F.; Siddiqi, T. A.

1978-01-01

The potential use of solar electricity generated from photovoltaic cells is examined for nineteen developing nations. Energy and economic profiles are summarized for each country. A comparison is made between the use of autogeneration and photovoltaics in a rural area of Haiti.

A review of risk management process in construction projects of developing countries

NASA Astrophysics Data System (ADS)

Bahamid, R. A.; Doh, S. I.

2017-11-01

In the construction industry, risk management concept is a less popular technique. There are three main stages in the systematic approach to risk management in construction industry. These stages include: a) risk response; b) risk analysis and evaluation; and c) risk identification. The high risk related to construction business affects each of its participants; while operational analysis and management of construction related risks remain an enormous task to practitioners of the industry. This paper tends towards reviewing the existing literature on construction project risk managements in developing countries specifically on risk management process. The literature lacks ample risk management process approach capable of capturing risk impact on diverse project objectives. This literature review aims at discovering the frequently used techniques in risk identification and analysis. It also attempts to identify response to clarifying the different classifications of risk sources in the existing literature of developing countries, and to identify the future research directions on project risks in the area of construction in developing countries.

Developed-developing country partnerships: Benefits to developed countries?

PubMed Central

2012-01-01

Developing countries can generate effective solutions for today’s global health challenges. This paper reviews relevant literature to construct the case for international cooperation, and in particular, developed-developing country partnerships. Standard database and web-based searches were conducted for publications in English between 1990 and 2010. Studies containing full or partial data relating to international cooperation between developed and developing countries were retained for further analysis. Of 227 articles retained through initial screening, 65 were included in the final analysis. The results were two-fold: some articles pointed to intangible benefits accrued by developed country partners, but the majority of information pointed to developing country innovations that can potentially inform health systems in developed countries. This information spanned all six WHO health system components. Ten key health areas where developed countries have the most to learn from the developing world were identified and include, rural health service delivery; skills substitution; decentralisation of management; creative problem-solving; education in communicable disease control; innovation in mobile phone use; low technology simulation training; local product manufacture; health financing; and social entrepreneurship. While there are no guarantees that innovations from developing country experiences can effectively transfer to developed countries, combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is virgin and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardized method for reporting partnership benefits is needed—this is perhaps the single most immediate need in planning for, and realizing, the full potential of international cooperation between developed and developing countries. PMID:22709651

Categorizing the telehealth policy response of countries and their implications for complementarity of telehealth policy.

PubMed

Varghese, Sunil; Scott, Richard E

2004-01-01

Developing countries are exploring the role of telehealth to overcome the challenges of providing adequate health care services. However, this process faces disparities, and no complementarity in telehealth policy development. Telehealth has the potential to transcend geopolitical boundaries, yet telehealth policy developed in one jurisdiction may hamper applications in another. Understanding such policy complexities is essential for telehealth to realize its full global potential. This study investigated 12 East Asian countries that may represent a microcosm of the world, to determine if the telehealth policy response of countries could be categorized, and whether any implications could be identified for the development of complementary telehealth policy. The countries were Cambodia, China, Hong Kong, Indonesia, Japan, Malaysia, Myanmar, Singapore, South Korea, Taiwan, Thailand, and Vietnam. Three categories of country response were identified in regard to national policy support and development. The first category was "None" (Cambodia, Myanmar, and Vietnam) where international partners, driven by humanitarian concerns, lead telehealth activity. The second category was "Proactive" (China, Indonesia, Malaysia, Singapore, South Korea, Taiwan, and Thailand) where national policies were designed with the view that telehealth initiatives are a component of larger development objectives. The third was "Reactive" (Hong Kong and Japan), where policies were only proffered after telehealth activities were sustainable. It is concluded that although complementarity of telehealth policy development is not occurring, increased interjurisdictional telehealth activity, regional clusters, and concerted and coordinated effort amongst researchers, practitioners, and policy makers may alter this trend.

Evidence-based healthcare in developing countries.

PubMed

Pearson, Alan; Jordan, Zoe

2010-06-01

Developing countries have limited resources, so it is particularly important to invest in healthcare that works. The case for evidence-based practice has long been made in the West. However, poor access to information makes this endeavour near impossible for health professionals working with vulnerable communities in low-income economies. This paper provides a call to action to create an evidence base for health professionals in developing countries and identify appropriate strategies for the dissemination of this information in realistic and meaningful ways.

Comprehensive taxonomy and worldwide trends in pharmaceutical policies in relation to country income status.

PubMed

Maniadakis, N; Kourlaba, G; Shen, J; Holtorf, A

2017-05-25

Rapidly evolving socioeconomic and technological trends make it challenging to improve access, effectiveness and efficiency in the use of pharmaceuticals. This paper identifies and systematically classifies the prevailing pharmaceutical policies worldwide in relation to a country's income status. A literature search was undertaken to identify and taxonomize prevailing policies worldwide. Countries that apply those policies and those that do not were then grouped by income status. Pharmaceutical policies are linked to a country's socioeconomics. Developed countries have universal coverage and control pharmaceuticals with external and internal price referencing systems, and indirect price-cost controls; they carry out health technology assessments and demand utilization controls. Price-volume and risk-sharing agreements are also evolving. Developing countries are underperforming in terms of coverage and they rely mostly on restrictive state controls to regulate prices and expenditure. There are significant disparities worldwide in the access to pharmaceuticals, their use, and the reimbursement of costs. The challenge in high-income countries is to maintain access to care whilst dealing with trends in technology and aging. Essential drugs should be available to all; however, many low- and middle-income countries still provide most of their population with only poor access to medicines. As economies grow, there should be greater investment in pharmaceutical care, looking to the policies of high-income countries to increase efficiency. Pharmaceutical companies could also develop special access schemes with low prices to facilitate coverage in low-income countries.

The Impact of Vocational Schooling on Human Capital Development in Developing Countries: Evidence from China

ERIC Educational Resources Information Center

Loyalka, Prashant; Huang, Xiaoting; Zhang, Linxiu; Wei, Jianguo; Yi, Hongmei; Song, Yingquan; Ren, Baoping; Shi, Yaojiang; Chu, James; Maani, May; Rozelle, Scott

2014-01-01

A number of developing countries currently identify vocational education and training (VET) as a key approach to building human capital. For example, the promotion of VET at the high school level ("vocational high school", which is used here interchangeably with VET throughout the paper) has become a policy priority among emerging…

Test development and use in five Iberian Latin American countries.

PubMed

Wechsler, Solange M; Oakland, Thomas; León, Carmem; Vivas, Eleonora; de Almeida, Leandro; Franco, Amanda; Pérez-Solís, María; Contini, Norma

2014-08-01

The abundance of scholarship on test development and use generally is higher in English-speaking than in Iberian Latin American countries. The purpose of this article is to help overcome this imbalance by describing and identifying similarities and differences in test development and use in two Iberian (Portugal and Spain) and three of the largest Latin American (Argentina, Brazil, and Venezuela) countries. The stages of test development in each country, roles of professional associations, presence of standards for test use, professionals' educational training, commonly used tests, together with prominent challenges to continued progress are discussed. Test development and use in these five countries are transitioning from a dependence on the use of translated tests to greater reliance on adapted and finally nationally constructed tests. Continued growth requires adherence to international standards guiding test development and use. Stronger alliance among professional associations in the Iberian Latin American countries could serve as a catalyst to promote test development in these regions. © 2014 International Union of Psychological Science.

Identifying Work Skills: International Case Summaries. Support Document

ERIC Educational Resources Information Center

Siekmann, Gitta

2017-01-01

The Organisation for Economic Co-operation and Development (OECD) is an intergovernmental economic organisation with 35 member countries, founded in 1961 to stimulate economic progress and world trade. The Organisation for works with countries to develop skills strategies tailored to specific needs and contexts. The Organisation prepared a global…

Participatory Model of Mental Health Programming: Lessons Learned from Work in a Developing Country.

ERIC Educational Resources Information Center

Nastasi, Bonnie K.; Varjas, Kristen; Sarkar, Sreeroopa; Jayasena, Asoka

1998-01-01

Describes application of participatory model for creating school-based mental health services in a developing country. Describes process of identifying individual and cultural factors relevant to mental health. Discusses importance of formative research and collaboration with stakeholders to ensure cultural specificity of interventions, and the…

Strategies for public health research in European Union countries.

PubMed

Grimaud, Olivier; McCarthy, Mark; Conceição, Claudia

2013-11-01

'Health' is an identifiable theme within the European Union multi-annual research programmes. Public Health Innovation and Research in Europe (PHIRE), led by the European Public Health Association, sought to identify public health research strategies in EU member states. Within PHIRE, national public health associations reviewed structures for health research, held stakeholder workshops and produced reports. This information, supplemented by further web searches, including using assisted translation, was analysed for national research strategies and health research strategies. All countries described general research strategies, outlining organizational and capacity objectives. Thematic fields, including health, are mentioned in some strategies. A health research strategy was identified for 15 EU countries and not for 12. Ministries of health led research strategies for nine countries. Public health research was identified in only three strategies. National research strategies did not refer to the European Union's health research programme. Public health research strategies of European countries need to be developed by ministries of health, working with the research community to achieve the European Research Area.

National Communicable Disease Surveillance System: A review on Information and Organizational Structures in Developed Countries.

PubMed

Bagherian, Hossein; Farahbakhsh, Mohammad; Rabiei, Reza; Moghaddasi, Hamid; Asadi, Farkhondeh

2017-12-01

To obtain necessary information for managing communicable diseases, different countries have developed national communicable diseases surveillance systems (NCDSS). Exploiting the lesson learned from the leading countries in development of surveillance systems provides the foundation for developing these systems in other countries. In this study, the information and organizational structure of NCDSS in developed countries were reviewed. The study reviewed publications found on the organizational structure, content and data flow of NCDSS in the United States of America (USA), Australia and Germany that were published in English between 2000 and 2016. The publications were identified by searching the CINAHL, Science Direct, ProQuest, PubMed, Google Scholar databases and the related databases in selected countries. Thirty-four studies were investigated. All of the reviewed countries have implemented the NCDSS. In majority of countries the department of health (DoH) is responsible for managing this system. The reviewed countries have created a minimum data set for reporting communicable diseases data and information. For developing NCDSS, establishing coordinator centers, setting the effective policies and procedures, providing appropriate communication infrastructures for data exchange and defining a communicable diseases minimum data set are essential.

Recommendations for the Improved Effectiveness and Reporting of Telemedicine Programs in Developing Countries: Results of a Systematic Literature Review.

PubMed

Khanal, Sumesh; Burgon, Joseph; Leonard, Saoirse; Griffiths, Matthew; Eddowes, Lucy A

2015-11-01

A lack of decisive evidence on the impact of telemedicine on financial and clinical outcomes has not prohibited significant investment in developing countries. Understanding characteristics that facilitate effective telemedicine programs is required to allow telemedicine to be used to its full potential. This systematic review aimed to identify organizational, technological, and financial features of successful telemedicine programs providing direct clinical care in developing countries. Databases were searched, and the results were reviewed systematically according to predefined inclusion/exclusion criteria. Information on location(s), measure of success, and organizational, technological, and financial characteristics were extracted. This review was impeded by inadequate program reporting, and so a concise checklist was developed to aid improved reporting, enabling future reviews to identify key characteristics of effective programs. This systematic review identified 46 articles reporting 36 programs that fulfilled the inclusion/exclusion criteria. Programs were distributed globally, including regional, national, and international programs. Technological modalities included synchronous technology, real-time teleconsultations, and asynchronous technology. Program integration with existing systems and twinning of international institutions were identified as factors enabling program success. Other factors included simple and easy-to-use technology, ability to reduce the burden on healthcare professionals, and technology able to maintain functionality in challenging environmental circumstances. Reports describing effectiveness and costs were limited. This systematic review identified key factors associated with telemedicine program success. However, inconsistencies in reporting represent an obstacle to establishment of successful programs in developing countries by limiting the application of previous experiences. Adhering to the guidelines suggested here may allow more quantitative assessments of effectiveness and impact for future programs.

Living with systemic lupus erythematosus in the developing world.

PubMed

Phuti, A; Schneider, M; Tikly, M; Hodkinson, B

2018-03-26

Most of our understanding of SLE and its negative impact originates from developed countries. This review aims to collate existing literature on Health-Related Quality of Life (HRQoL) in SLE patients living in developing countries to identify the gaps for the focus of future research. A narrative literature review was compiled using selected MeSH terms to search EBSCOHOST for articles published between January 1975 and February 2018 pertaining to HRQoL in SLE patients in developing countries. 31 studies from 11 countries were included for analysis. Only one longitudinal, one randomized controlled trial (RCT), one qualitative study, and two intervention studies were found. High disease activity and organ damage were associated with poor functional ability, mental health and low socio-economic status (SES). Poor SES is a recurring theme in developing countries, and worsens all SLE outcomes by reducing access to healthcare, mental, social and emotional support systems. In developing countries, SLE has a globally negative impact on patients' HRQoL, similar to that seen in developed countries. There is an urgent need for more HRQoL studies, and in particular, longitudinal, qualitative and interventional studies in these countries to investigate unmet needs, and to explore novel strategies to improve patient outcomes.

A Systematic Review of Mobile Health Technology Use in Developing Countries.

PubMed

Alghamdi, Manal; Gashgari, Horeya; Househ, Mowafa

2015-01-01

In developing countries, patients are now more informed about their healthcare options as a result of their use of mobile health (mHealth) technologies. The purpose of this paper is to describe the opportunities and challenges in using mHealth technologies for developing countries. In April 2015, Google Scholar and PubMed were searched to identify articles discussing the types, advantages and disadvantages, effectiveness, evaluation of mHealth technologies, and examples of mHealth implementation in developing countries. A total number of 3,803 articles were retrieved from both databases. Articles reporting the benefits and risks, effectiveness, and evaluation of mHealth were included. Articles that were written in English and from developing countries were also included. We excluded papers that were published before 2005, not written in English, and that were technical in nature. After screening the articles using the inclusion and exclusion criteria, 27 articles were selected for inclusion in the study. Of the 27 papers included in the review, eight described opportunities and challenges relating to mHealth, four focused on smoking cessation, three focused on weight loss, and four papers focused on chronic diseases. We also identified four articles discussing mHealth evaluation and four discussing the use of mHealth as a health promotion tool. We conclude that mHealth can improve healthcare delivery for developing countries. Some of the advantages of mHealth include: patient education, health promotion, disease self-management, decrease in healthcare costs, and remote monitoring of patients. However, there are several limitations in using mHealth technologies for developing countries, which include: interoperability, lack of evaluation standards, and lack of a technology infrastructure.

Palliative Care Medical Education in European Universities: A Descriptive Study and Numerical Scoring System Proposal for Assessing Educational Development.

PubMed

Carrasco, José Miguel; Lynch, Thomas J; Garralda, Eduardo; Woitha, Kathrin; Elsner, Frank; Filbet, Marilène; Ellershaw, John E; Clark, David; Centeno, Carlos

2015-10-01

The lack of palliative medicine (PM) education has been identified as a barrier to the development of the discipline. A number of international institutions have called for its implementation within undergraduate medical curricula. The objectives are to describe the situation of undergraduate PM education in Europe and to propose a scoring system to evaluate its status. This descriptive study was conducted with data provided by key experts from countries of the World Health Organization European Region (n = 53). A numerical scoring system was developed through consensus techniques. Forty-three countries (81%) provided the requested information. In 13 countries (30%), a PM course is taught in all medical schools, being compulsory in six of them (14%). In 15 countries (35%), PM is taught in at least one university. In 14 countries (33%), PM is not taught within medical curricula. A full professor of PM was identified in 40% of countries. Three indicators were developed to construct a scale (rank 0-100) of educational development: 1) proportion of medical schools that teach PM (weight = 32%); 2) proportion of medical schools that offer PM as a compulsory subject (weight = 40%); 3) total number of PM professors (weight = 28%). The highest level of PM educational development was found in Israel, Norway, the U.K., Belgium, France, Austria, Germany, and Ireland. PM is taught in a substantial number of undergraduate medical programs at European universities, and a qualified teaching structure is emerging; however, there is a wide variation in the level of PM educational development between individual countries. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Dominance and leadership in research activities: Collaboration between countries of differing human development is reflected through authorship order and designation as corresponding authors in scientific publications

PubMed Central

Park, Jinseo; Huamaní, Charles; Ramos, José M.

2017-01-01

Introduction Scientific collaboration is an important mechanism that enables the integration of the least developed countries into research activities. In the present study, we use the order of author signatures and addresses for correspondence in scientific publications as variables to analyze the interactions between countries of very high (VHHD), high (HHD), medium (MHD), and low human development (LHD). Methodology We identified all documents published between 2011 and 2015 in journals included in the Science Citation Index-Expanded categories’ of Tropical Medicine, Infectious Diseases, Parasitology, and Pediatrics. We then classified the countries participating in the publications according to their Human Development Index (HDI), analyzing the international collaboration; positioning and influence of some countries over others in cooperative networks; their leadership; and the impact of the work based on the HDI and the type of collaboration. Results We observed a high degree of international collaboration in all the areas analyzed, in the case of both LHD and MHD countries. We identified numerous cooperative links between VHHD countries and MHD/LHD countries, reflecting the fact that cooperative links are an important mechanism for integrating research activities into the latter. The countries with large emerging economies, such as Brazil and China stand out due to the dominance they exert in the collaborations established with the United States, the UK, and other European countries. The analysis of the leadership role of the countries, measured by the frequency of lead authorships, shows limited participation by MHD/LHD countries. This reduced participation among less developed countries is further accentuated by their limited presence in the addresses for correspondence. We observed significant statistical differences in the degree of citation according to the HDI of the participating countries. Conclusions The order of signatures and the address for correspondence in scientific publications are bibliographic characteristics that facilitate a precise, in-depth analysis of cooperative practices and their associations with concepts like dominance or leadership. This is useful to monitor the existing balance in research participation in health research publications. PMID:28792519

Training for Public Administration and Management in Developing Countries. A Review. World Bank Staff Working Papers Number 584. Management and Development Series Number 11.

ERIC Educational Resources Information Center

Paul, Samuel

Public administration and management training (PAMT) in developing countries has expanded and diversified in the past three decades. Five preconditions have been identified as necessary to ensure the effectiveness of that training: training policies and management of institutions, the educational system, the stock of educated personnel, personnel…

Distance learning--an educational tool for developing countries.

PubMed

Dobson, M B

2000-01-01

Many anaesthetists in small hospitals and developing countries have poor access to educational materials. The use of electronic means of publication and distribution, combined with the concepts of distance learning, can lead to better levels of knowledge and clinical practice. A project based on these principles has been set up in Zimbabwe, and is proving helpful to both trainers and trainees. All District Hospitals have been visited, and trainees in them identified. A survey has been completed to identify the subject areas in which training is most necessary. Trainees have been provided with reference materials on CD-ROM which they can access by computer (each hospital has a computer). Specialist anaesthesiologists in the country are producing interactive tutorials which can be sent out by e-mail to every hospital, and these are backed up by a programme of regular visits, seminars and clinical teaching. The programme is proving helpful to both trainees and tutors, and has the potential to be used in the future in other developing countries.

Ethical review of health research: a perspective from developing country researchers.

PubMed

Hyder, A A; Wali, S A; Khan, A N; Teoh, N B; Kass, N E; Dawson, L

2004-02-01

Increasing collaboration between industrialised and developing countries in human research studies has led to concerns regarding the potential exploitation of resource deprived countries. This study, commissioned by the former National Bioethics Advisory Commission of the United States, surveyed developing country researchers about their concerns and opinions regarding ethical review processes and the performance of developing country and US international review boards (IRBs). Contact lists from four international organisations were used to identify and survey 670 health researchers in developing countries. A questionnaire with 169 questions explored issues of IRB review, informed consent, and recommendations. The majority of the developing country researchers were middle aged males who were physicians and were employed by educational institutions, carrying out research on part time basis. Forty four percent of the respondents reported that their studies were not reviewed by a developing country IRB or Ministry of Health and one third of these studies were funded by the US. During the review process issues such as the need for local language consent forms and letters for approval, and confidentiality protection of participants were raised by US IRBs in significantly higher proportions than by host country IRBs. This survey indicates the need for the ethical review of collaborative research in both US and host countries. It also reflects a desire for focused capacity development in supporting ethical review of research.

Catastrophe risk data scoping for disaster risk finance in Asia

NASA Astrophysics Data System (ADS)

Millinship, Ian; Revilla-Romero, Beatriz

2017-04-01

Developing countries across Latin America, Africa, and Asia are some of the most exposed to natural catastrophes in the world. Over the last 20 years, Asia has borne almost half the estimated global economic cost of natural disasters - around 53billion annually. Losses from natural disasters can damage growth and hamper economic development and unlike in developed countries where risk is reallocated through re/insurance, typically these countries rely on budget reallocations and donor assistance in order to attempt to meet financing needs. There is currently an active international dialogue on the need to increase access to disaster risk financing solutions in Asia. The World Bank-GFDRR Disaster Risk Financing and Insurance Program with financial support from the Rockefeller Foundation, is currently working to develop regional options for disaster risk financing for developing countries in Asia. The first stage of this process has been to evaluate available catastrophe data suitable to support the design and implementation of disaster risk financing mechanisms in selected Asian countries. This project was carried out by a consortium of JBA Risk Management, JBA Consulting, ImageCat and Cat Risk Intelligence. The project focuses on investigating potential data sources for fourteen selected countries in Asia, for flood, tropical cyclone, earthquake and drought perils. The project was carried out under four stages. The first phase focused to identify and catalogue live/dynamic hazard data sources such as hazard gauging networks, or earth observations datasets which could be used to inform a parametric trigger. Live data sources were identified that provide credibility, transparency, independence, frequent reporting, consistency and stability. Data were catalogued at regional level, and prioritised at local level for five countries: Bangladesh, Indonesia, Pakistan, Sri Lanka and Viet Nam. The second phase was to identify, catalogue and evaluate catastrophe risk models that could quantify risk and provide a view of risk to support design and pricing of parametric disaster risk financing mechanisms. The third stage was to evaluate the usability of data sources and catastrophe models, and to develop index prototypes to outline how data and catastrophe models could be combined using local, regional and global data sources. Finally, the project identified priorities for investment to support the collection, analysis and evaluation of natural catastrophes in order to support disaster risk financing.

The Determinants of School Achievement in Developing Countries: A Review of the Research.

ERIC Educational Resources Information Center

Simmons, John; Alexander, Leigh

The goal of the review is to identify the factors which promote student cognitive achievement as measured by several studies conducted in developing countries. The major tool of analysis which measures the relationship between the school inputs, like teacher quality and school facilities, and cognitive achievement is the educational production…

A Tanzanian Perspective of the Technical Aspects of IT Service Management Education

ERIC Educational Resources Information Center

Kemppainen, Jyri; Tedre, Matti; Sutinen, Erkki

2012-01-01

Information technology (IT) professionals face markedly different kinds of challenges in developing countries from the ones in developed countries. Based on the research literature and our fourteen years of fieldwork in Iringa, Tanzania, we have identified eight groups of technical characteristics of IT work that significantly affect the work of…

Unsustainable development pathways caused by tropical deforestation.

PubMed

Carrasco, Luis Roman; Nghiem, Thi Phuong Le; Chen, Zhirong; Barbier, Edward B

2017-07-01

Global sustainability strategies require assessing whether countries' development trajectories are sustainable over time. However, sustainability assessments are limited because losses of natural capital and its ecosystem services through deforestation have not been comprehensively incorporated into national accounts. We update the national accounts of 80 nations that underwent tropical deforestation from 2000 to 2012 and evaluate their development trajectories using weak and strong sustainability criteria. Weak sustainability requires that countries do not decrease their aggregate capital over time. We adopt a strong sustainability criterion that countries do not decrease the value of their forest ecosystem services with respect to the year 2000. We identify several groups of countries: countries, such as Sri Lanka, Bangladesh, and India, that present sustainable development trajectories under both weak and strong sustainability criteria; countries, such as Brazil, Peru, and Indonesia, that present weak sustainable development but fail the strong sustainability criterion as a result of rapid losses of ecosystem services; countries, such as Madagascar, Laos, and Papua New Guinea, that present unsustainable development pathways as a result of deforestation; and countries, such as Democratic Republic of Congo and Sierra Leone, in which deforestation aggravates already unsustainable pathways. Our results reveal a large number of countries where tropical deforestation is both damaging to nature and not compensated by development in other sectors, thus compromising the well-being of their future generations.

Non-University Sectors and the Provision of Higher Education in OECD Countries: Problematics of Articulation.

ERIC Educational Resources Information Center

Campbell, Malcolm B.

This paper identifies issues currently arising in efforts to coordinate public policy concerning competing sectors of postsecondary education in the Organisation for Economic Cooperation and Development Countries (OECD). It is presented as a result of the OECD's advisement that these industrialized countries need to further strengthen education…

Programmes and calls for public health research in European countries.

PubMed

Conceição, Claudia; Grimaud, Olivier; McCarthy, Mark; Barnhoorn, Floris; Sammut, Marvic; Saliba, Amanda; Katreniakova, Zuzana; Narkauskaité, Laura

2013-11-01

Public health research, at population and organizational level, needs to be identified independently within 'health' research from biomedicine and life sciences. In PHIRE (Public Health Innovation and Research in Europe), we investigated the extent and character of public health research calls and programmes in European countries. Country respondents, identified through national member associations of the European Public Health Association completed a standardized recording instrument. Public health research was defined, and the call period limited to the latest full year (2010). Of the 30 countries included (EU 27 plus Iceland, Norway and Switzerland), there were reports for 25 countries A simple classification of the calls was developed. There were 75 calls and programmes included. Of these, 41 (55%) together were in France and the UK, and 34 in a further 14 countries, while 9 countries reported there were no calls or programmes opened in 2010. Calls were categorized across diseases, behaviours, determinants, services and methodologies. Some calls were broad, while others--particularly in the countries with several calls--were more detailed towards specific issues. Levels of funding varied markedly and were difficult to define. Where stated, in 32 responses, 19 calls were only open to national applicants and 13 from abroad. Most European countries have competitive programmes and calls relevant for public health research, but they are poorly identified. Only a minority of countries present a wide range of topics and specific fields. Effort is needed to develop classifications for public health programmes and calls for public health research, improve information (including financial) collection to enable systematic comparisons and build greater recognition of public health research within research communities, with national and European research funding organizations, and for practitioners and policymakers.

Establishment of the International Power Institute. Final technical report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Julius E. Coles

The International Power Institute, in collaboration with American industries, seeks to address technical, political, economic and cultural issues of developing countries in the interest of facilitating profitable transactions in power related infrastructure projects. IPI works with universities, governments and commercial organizations to render project-specific recommendations for private-sector investment considerations. IPI also established the following goals: Facilitate electric power infrastructure transactions between developing countries and the US power industry; Collaborate with developing countries to identify development strategies to achieve energy stability; and Encourage market driven solutions and work collaboratively with other international trade energy, technology and banking organizations.

Caregiver Behavior Change for Child Survival and Development in Low- and Middle-Income Countries: An Examination of the Evidence

PubMed Central

Elder, John P.; Pequegnat, Willo; Ahmed, Saifuddin; Bachman, Gretchen; Bullock, Merry; Carlo, Waldemar A.; Chandra-Mouli, Venkatraman; Fox, Nathan A.; Harkness, Sara; Huebner, Gillian; Lombardi, Joan; Murry, Velma McBride; Moran, Allisyn; Norton, Maureen; Mulik, Jennifer; Parks, Will; Raikes, Helen H.; Smyser, Joseph; Sugg, Caroline; Sweat, Michael

2014-01-01

In June of 2012, representatives from more than 80 countries promulgated a Child Survival Call to Action, which called for reducing child mortality to 20 or fewer child deaths per 1,000 live births in every country by 2035. To address the problem of ending preventable child deaths, the U.S. Agency for International Development and the United Nations Children's Fund convened, on June 3–4, 2013, an Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change. Six evidence review teams were established on different topics related to child survival and healthy development to identify the relevant evidence-based interventions and to prepare reports. This article was developed by the evidence review team responsible for identifying the research literature on caregiver change for child survival and development. This article is organized into childhood developmental periods and cross-cutting issues that affect child survival and healthy early development across all these periods. On the basis of this review, the authors present evidence-based recommendations for programs focused on caregivers to increase child survival and promote healthy development. Last, promising directions for future research to change caregivers' behaviors are given. PMID:25315597

Socioeconomic status is associated with global diabetes prevalence

PubMed Central

Xu, Zhiye; Yu, Dan; Yin, Xueyao; Zheng, Fenping; Li, Hong

2017-01-01

The incidence of diabetes is increasing globally. We investigated the relationship between diabetes prevalence and patient socioeconomic status across multiple countries. We searched PubMed to identify population-based surveys reporting diabetes prevalence between 1990 and May 2016. Search results were filtered, and Human Development Index (HDI) values from the United Nations Development Programme were used to assess socioeconomic status for a given nation. Our analysis included 45 national surveys from 32 countries. Diabetes prevalence was positively correlated with national HDI (r = 0.421 P = 0.041) in developing countries, and negatively correlated with HDI (r = −0.442 P = 0.045) in developed countries. Diabetes prevalence trends were the same in women and men, although men were associated with increased diabetes risk in developed countries (r = 0.459 P = 0.048). Thus, diabetes prevalence rises with increasing HDI in developing countries, and this is reversed in developed countries. Ours is the first study to investigate the relationship between diabetes and socioeconomic status at global level using HDI values. These results will aid in evaluating global diabetes prevalence and risk with respect to patient socioeconomic status, and will be useful in the development of policies that help reduce disease incidence. PMID:28574844

Socioeconomic status is associated with global diabetes prevalence.

PubMed

Xu, Zhiye; Yu, Dan; Yin, Xueyao; Zheng, Fenping; Li, Hong

2017-07-04

The incidence of diabetes is increasing globally. We investigated the relationship between diabetes prevalence and patient socioeconomic status across multiple countries. We searched PubMed to identify population-based surveys reporting diabetes prevalence between 1990 and May 2016. Search results were filtered, and Human Development Index (HDI) values from the United Nations Development Programme were used to assess socioeconomic status for a given nation. Our analysis included 45 national surveys from 32 countries. Diabetes prevalence was positively correlated with national HDI (r = 0.421 P = 0.041) in developing countries, and negatively correlated with HDI (r = -0.442 P = 0.045) in developed countries. Diabetes prevalence trends were the same in women and men, although men were associated with increased diabetes risk in developed countries (r = 0.459 P = 0.048). Thus, diabetes prevalence rises with increasing HDI in developing countries, and this is reversed in developed countries. Ours is the first study to investigate the relationship between diabetes and socioeconomic status at global level using HDI values. These results will aid in evaluating global diabetes prevalence and risk with respect to patient socioeconomic status, and will be useful in the development of policies that help reduce disease incidence.

Review on Rapid Seismic Vulnerability Assessment for Bulk of Buildings

NASA Astrophysics Data System (ADS)

Nanda, R. P.; Majhi, D. R.

2013-09-01

This paper provides a brief overview of rapid visual screening (RVS) procedures available in different countries with a comparison among all the methods. Seismic evaluation guidelines from, USA, Canada, Japan, New Zealand, India, Europe, Italy, UNDP, with other methods are reviewed from the perspective of their applicability to developing countries. The review shows clearly that some of the RVS procedures are unsuited for potential use in developing countries. It is expected that this comparative assessment of various evaluation schemes will help to identify the most essential components of such a procedure for use in India and other developing countries, which is not only robust, reliable but also easy to use with available resources. It appears that Federal Emergency Management Agency (FEMA) 154 and New Zealand Draft Code approaches can be suitably combined to develop a transparent, reasonably rigorous and generalized procedure for seismic evaluation of buildings in developing countries.

International Assistance for Low-Emission Development Planning: Coordinated Low Emissions Assistance Network (CLEAN) Inventory of Activities and Tools--Preliminary Trends

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cox, S.; Benioff, R.

2011-05-01

The Coordinated Low Emissions Assistance Network (CLEAN) is a voluntary network of international practitioners supporting low-emission planning in developing countries. The network seeks to improve quality of support through sharing project information, tools, best practices and lessons, and by fostering harmonized assistance. CLEAN has developed an inventory to track and analyze international technical support and tools for low-carbon planning activities in developing countries. This paper presents a preliminary analysis of the inventory to help identify trends in assistance activities and tools available to support developing countries with low-emission planning.

Information needs of academic medical scientists at Chulalongkorn University.

PubMed Central

Premsmit, P

1990-01-01

The information needs of scientists in English-speaking countries have been studied and reported in the library literature. However, few studies exist on the information-seeking patterns of scientists in developing countries, and no study has examined the information needs of medical scientists in developing Asian countries. This study investigated the information needs of academic medical scientists at Chulalongkorn University in Bangkok, Thailand. The results indicate that medical scientists have three types of information needs: identifying up-to-date information, obtaining relevant studies and data, and developing research topics. Thai scientists' information-seeking behavior was different from that of scientists in developed countries. The study shows a high use of libraries as information providers; Thai medical scientists rely heavily on information from abroad. PMID:2224302

The Problem of Soil Erosion in Developing Countries--Direct and Indirect Causes and Recommendations for Reducing It to a Sustainable Level.

ERIC Educational Resources Information Center

Middlebrook, Cathy H.; Goode, Pamela M.

1992-01-01

Presents direct and indirect causes of erosion in developing countries. Identifies soil conservation developments ranging from major international policy reforms to small-scale, local farming programs. Suggests that strategies at all levels, and the political will to implement them, are needed if erosion is to be reduced to a sustainable rate. (23…

Stereotactic radiotherapy of primary lung cancer and other targets: results of consultant meeting of the International Atomic Energy Agency.

PubMed

Nagata, Yasushi; Wulf, Joern; Lax, Ingmar; Timmerman, Robert; Zimmermann, Frank; Stojkovski, Igor; Jeremic, Branislav

2011-03-01

To evaluate the current status of stereotactic body radiotherapy (SBRT) and identify both advantages and disadvantages of its use in developing countries, a meeting composed of consultants of the International Atomic Energy Agency was held in Vienna in November 2006. Owing to continuous developments in the field, the meeting was extended by subsequent discussions and correspondence (2007-2010), which led to the summary presented here. The advantages and disadvantages of SBRT expected to be encountered in developing countries were identified. The definitions, typical treatment courses, and clinical results were presented. Thereafter, minimal methodology/technology requirements for SBRT were evaluated. Finally, characteristics of SBRT for developing countries were recommended. Patients for SBRT should be carefully selected, because single high-dose radiotherapy may cause serious complications in some serial organs at risk. Clinical experiences have been reported in some populations of lung cancer, lung oligometastases, liver cancer, pancreas cancer, and kidney cancer. Despite the disadvantages expected to be experienced in developing countries, SBRT using fewer fractions may be useful in selected patients with various extracranial cancers with favorable outcome and low toxicity. Copyright © 2011 Elsevier Inc. All rights reserved.

Women and smoking.

PubMed

Amos, A

1996-01-01

Smoking kills over half a million women each year and is the most important preventable cause of female premature death in several developed countries. However, in many countries, cigarette smoking still tends to be regarded as a mainly male problem. This paper explores the reasons why more attention needs to be paid to issues around smoking and women, even in countries which currently have low levels of female cigarette smoking. The article includes an overview of current patterns and trends of smoking among women, and the factors which influence smoking uptake and cessation in women compared to men. The experience of countries with the longest history of widespread female smoking is used to identify some of the key challenges facing developed and developing countries. Tobacco companies have identified women as a key target group, therefore particular attention is given to the ways in which they have attempted to reach women through advertising and other marketing strategies. It is concluded that in order to halt and ultimately reverse the tobacco epidemic among women, tobacco control policies need to encompass both gender-specific and gender-sensitive approaches. Examples are given of the types of action that are needed in relation to research, public policy and legislation, and education.

Part-Time Undergraduate Nursing Students' Perception and Attitude to ICT Supports for Distance Education in Nursing in Nigeria

ERIC Educational Resources Information Center

Irinoye, Omolola; Ayamolowo, Sunday; Tijnai, Olawale Kazeem

2016-01-01

The increase in demand for university education remains unmet especially in developing countries; this has made adoption of distance education imperative in our educational system. Information and Communications Technology (ICT) has been identified as a tool for improving education quality especially in developing countries. The study examined…

Contributions of Education for Sustainable Development (ESD) to Quality Education: A Synthesis of Research

ERIC Educational Resources Information Center

Laurie, Robert; Nonoyama-Tarumi, Yuko; Mckeown, Rosalyn; Hopkins, Charles

2016-01-01

This research is a synthesis of studies carried out in 18 countries to identify contributions of education for sustainable development (ESD) to quality education. Five common questions were used for the interviews in each country to solicit education leaders and practitioners' views on the outcome and implementation of ESD. The analysis revealed…

Physics Education: A Significant Backbone of Sustainable Development in Developing Countries

NASA Astrophysics Data System (ADS)

Akintola, R. A.

2006-08-01

In the quest for technological self-reliance, many policies, programs and projects have been proposed and implemented in order to procure solutions to the problems of technological inadequacies of developing countries. It has been observed that all these failed. This research identifies the problems and proposes lasting solutions to emancipate physics education in developing nations and highlight possible future gains. The statistical analysis employed was based on questionnaires, interviews and data analysis.

International Data Base for the U.S. Renewable Energy Industry

DOE Office of Scientific and Technical Information (OSTI.GOV)

none

1986-05-01

The International Data Base for the US Renewable Energy Industry was developed to provide the US renewable energy industry with background data for identifying and analyzing promising foreign market opportunities for their products and services. Specifically, the data base provides the following information for 161 developed and developing countries: (1) General Country Data--consisting of general energy indicators; (2) Energy Demand Data--covering commercial primary energy consumption; (3) Energy Resource Data--identifying annual average insolation, wind power, and river flow data; (4) Power System Data--indicating a wide range of electrical parameters; and (5) Business Data--including currency and credit worthiness data.

Lay and professional stakeholder involvement in scoping palliative care issues: Methods used in seven European countries.

PubMed

Brereton, Louise; Ingleton, Christine; Gardiner, Clare; Goyder, Elizabeth; Mozygemba, Kati; Lysdahl, Kristin Bakke; Tummers, Marcia; Sacchini, Dario; Leppert, Wojciech; Blaževičienė, Aurelija; van der Wilt, Gert Jan; Refolo, Pietro; De Nicola, Martina; Chilcott, James; Oortwijn, Wija

2017-02-01

Stakeholders are people with an interest in a topic. Internationally, stakeholder involvement in palliative care research and health technology assessment requires development. Stakeholder involvement adds value throughout research (from prioritising topics to disseminating findings). Philosophies and understandings about the best ways to involve stakeholders in research differ internationally. Stakeholder involvement took place in seven countries (England, Germany, Italy, Lithuania, the Netherlands, Norway and Poland). Findings informed a project that developed concepts and methods for health technology assessment and applied these to evaluate models of palliative care service delivery. To report on stakeholder involvement in the INTEGRATE-HTA project and how issues identified informed project development. Using stakeholder consultation or a qualitative research design, as appropriate locally, stakeholders in seven countries acted as 'advisors' to aid researchers' decision making. Thematic analysis was used to identify key issues across countries. A total of 132 stakeholders (82 professionals and 50 'lay' people) aged ⩾18 participated in individual face-to-face or telephone interviews, consultation meetings or focus groups. Different stakeholder involvement methods were used successfully to identify key issues in palliative care. A total of 23 issues common to three or more countries informed decisions about the intervention and comparator of interest, sub questions and specific assessments within the health technology assessment. Stakeholders, including patients and families undergoing palliative care, can inform project decision making using various involvement methods according to the local context. Researchers should consider local understandings about stakeholder involvement as views of appropriate and feasible methods vary. Methods for stakeholder involvement, especially consultation, need further development.

White Paper Report of the 2010 RAD-AID Conference on International Radiology for Developing Countries: Identifying Sustainable Strategies for Imaging Services in the Developing World

PubMed Central

Welling, Rodney D.; Azene, Ezana M.; Kalia, Vivek; Pongpirul, Krit; Starikovsky, Anna; Sydnor, Ryan; Lungren, Matthew P.; Johnson, Benjamin; Kimble, Cary; Wiktorek, Sarah; Drum, Tom; Short, Brad; Cooper, Justin; Khouri, Nagi F.; Mayo-Smith, William W.; Mahesh, Mahadevappa; Goldberg, Barry B.; Garra, Brian S.; DeStigter, Kristen K.; Lewin, Jonathan S.; Mollura, Daniel J.

2015-01-01

The 2010 RAD-AID Conference on International Radiology for Developing Countries was a multidisciplinary meeting to discuss data, experiences, and models pertaining to radiology in the developing world, where widespread shortages of imaging services reduce health care quality. The theme of this year’s conference was sustainability, with a focus on establishing and maintaining imaging services in resource-limited regions. Conference presenters and participants identified 4 important components of sustainability: (1) sustainable financing models for radiology development, (2) integration of radiology and public health, (3) sustainable clinical models and technology solutions for resource-limited regions, and (4) education and training of both developing and developed world health care personnel. PMID:21807349

Exploratory scoping of the literature on factors that influence oral health workforce planning and management in developing countries.

PubMed

Knevel, Rjm; Gussy, M G; Farmer, J

2017-05-01

The purpose of this study was to scope the literature that exists about factors influencing oral health workforce planning and management in developing countries (DCs). The Arksey and O'Malley method for conducting a scoping review was used. A replicable search strategy was applied, using three databases. Factors influencing oral health workforce planning and management in DCs identified in the eligible articles were charted. Four thousand citations were identified; 41 papers were included for review. Most included papers were situational analyses. Factors identified were as follows: lack of data, focus on the restorative rather than preventive care in practitioner education, recent increase in number of dental schools (mostly private) and dentistry students, privatization of dental care services which has little impact on care maldistribution, and debates about skill mix and scope of practice. Oral health workforce management in the eligible studies has a bias towards dentist-led systems. Due to a lack of country-specific oral health related data in developing or least developed countries (LDCs), oral health workforce planning often relies on data and modelling from other countries. Approaches to oral health workforce management and planning in developing or LDCs are often characterized by approaches to increase numbers of dentists, thus not ameliorating maldistribution of service accessibility. Governments appear to be reducing support for public and preventative oral healthcare, favouring growth in privatized dental services. Changes to professional education are necessary to trigger a paradigm shift to the preventive approach and to improve relationships between different oral healthcare provider roles. This needs to be premised on greater appreciation of preventive care in health systems and funding models. © 2016 The Authors. International Journal of Dental Hygiene Published by John Wiley & Sons Ltd.

Evaluation of community pharmacy-based services for type-2 diabetes in an Indonesian setting: pharmacist survey.

PubMed

Wibowo, Yosi; Parsons, Richard; Sunderland, Bruce; Hughes, Jeffery

2015-10-01

Diabetes is an emerging chronic disease in developing countries. Currently the management of diabetes in developing countries is mainly hospital or clinic based. With burgeoning numbers of patients with diabetes, other models need to be evaluated for service delivery in developing countries. Community pharmacists are an important option for provision of diabetes care. Currently, data regarding practices of community pharmacists in diabetes care have been limited to developed countries. To evaluate current community pharmacy-based services and perceived roles of pharmacists in type 2 diabetes care, and characteristics (pharmacist and pharmacy) associated with current practice. Community pharmacies in a developing country setting (Surabaya, Indonesia). A questionnaire was administered to pharmacists managing a random sample of 400 community pharmacies in Surabaya, Indonesia. Current practice and pharmacists' perceived roles were rated using Likert scales, whilst an open-ended question was used to identify priority roles. Logistic regression models determined characteristics associated with current practice. A response rate of 60% was achieved. Dispensing (100%) and education on how to use medications (72.6%) were common current pharmacy practices. More than 50% of pharmacists were supportive towards providing additional services beyond dispensing. The highest priorities for services beyond dispensing were education on medications [i.e. directions for use (58.6%) and common/important adverse effects (25.7%)], education on exercise (36.5%), education on diet (47.7%), and monitoring medication compliance (27.9%). Facilitators identified were: being perceived as part of a pharmacist's role (for all priority services), pharmacies with more than 50 diabetes customers per month (for diet education), and pharmacists' involvement in diabetes training (for compliance monitoring). The key barrier identified was lower pharmacist availability (for diet education as well as compliance monitoring). Most community pharmacies in Surabaya, Indonesia have only provided a basic service of dispensing for type 2 diabetes patients. Many pharmacists believed that they should extend their roles particularly regarding patient education and monitoring. The development of pharmacist professional roles would assist in managing the burgeoning burden of diabetes. The identified facilitators/barriers provide baseline data to support the development of community pharmacy-based diabetes services.

Health information technology in primary health care in developing countries: a literature review.

PubMed Central

Tomasi, Elaine; Facchini, Luiz Augusto; Maia, Maria de Fatima Santos

2004-01-01

This paper explores the debate and initiatives concerning the use of information technology (IT) in primary health care in developing countries. The literature from 1992-2002 was identified from searches of the MEDLINE, Latin American and Caribbean Health Science Literature Database (LILACS), Cochrane Library and Web of Science databases. The search identified 884 references, 350 of which were classified according to the scheme described by the Pan American Health Organization (PAHO). For the analysis of advantages, problems and perspectives of IT applications and systems, 52 articles were selected according to their potential contribution to the primary health-care processes in non-developed countries. These included: 10 on electronic patient registries (EPR), 22 on process and programmatic action evaluation and management systems (PPAEM) and 20 on clinical decision-support systems (CDS). The main advantages, limitations and perspectives are discussed. PMID:15640923

The Determinants of School Achievement in Developing Countries: The Educational Production Function. International Bank for Reconstruction and Development Staff Working Paper No. 201.

ERIC Educational Resources Information Center

Alexander, Leigh; Simmons, John

A number of studies are reviewed in an attempt to identify those schooling inputs that affect schooling outcomes, specifically cognitive achievement of students, in developing countries. Part 1 of the paper outlines the nature of the major tool of analysis, the educational production function (EPF), and the problems associated with its use as a…

Anesthesia-related mortality in pediatric patients: a systematic review.

PubMed

Gonzalez, Leopoldo Palheta; Pignaton, Wangles; Kusano, Priscila Sayuri; Módolo, Norma Sueli Pinheiro; Braz, José Reinaldo Cerqueira; Braz, Leandro Gobbo

2012-01-01

This systematic review of the Brazilian and worldwide literature aimed to evaluate the incidence and causes of perioperative and anesthesia-related mortality in pediatric patients. Studies were identified by searching EMBASE (1951-2011), PubMed (1966-2011), LILACS (1986-2011), and SciElo (1995-2011). Each paper was revised to identify the author(s), the data source, the time period, the number of patients, the time of death, and the perioperative and anesthesia-related mortality rates. Twenty trials were assessed. Studies from Brazil and developed countries worldwide documented similar total anesthesia-related mortality rates (<1 death per 10,000 anesthetics) and declines in anesthesia-related mortality rates in the past decade. Higher anesthesia-related mortality rates (2.4-3.3 per 10,000 anesthetics) were found in studies from developing countries over the same time period. Interestingly, pediatric perioperative mortality rates have increased over the past decade, and the rates are higher in Brazil (9.8 per 10,000 anesthetics) and other developing countries (10.7-15.9 per 10,000 anesthetics) compared with developed countries (0.41-6.8 per 10,000 anesthetics), with the exception of Australia (13.4 per 10,000 anesthetics). The major risk factors are being newborn or less than 1 year old, ASA III or worse physical status, and undergoing emergency surgery, general anesthesia, or cardiac surgery. The main causes of mortality were problems with airway management and cardiocirculatory events. Our systematic review of the literature shows that the pediatric anesthesia-related mortality rates in Brazil and in developed countries are similar, whereas the pediatric perioperative mortality rates are higher in Brazil compared with developed countries. Most cases of anesthesia-related mortality are associated with airway and cardiocirculatory events. The data regarding anesthesia-related and perioperative mortality rates may be useful in developing prevention strategies.

Injuries and noncommunicable diseases: emerging health problems of children in developing countries.

PubMed

Deen, J L; Vos, T; Huttly, S R; Tulloch, J

1999-01-01

The present article identifies, for children living in developing countries, the major causes of ill-health that are inadequately covered by established health programmes. Injuries and noncommunicable diseases, notably asthma, epilepsy, dental caries, diabetes mellitus and rheumatic heart disease, are growing in significance. In countries where resources are scarce it is to be expected that increasing importance will be attached to the development and implementation of measures against these problems. Their control may benefit from the application of elements of programmes directed against infectious, nutritional and perinatal disorders, which continue to predominate.

Principles of adoption of the successful environmental practices used in developed countries into mining industry in developing countries.

NASA Astrophysics Data System (ADS)

Masaitis, Alexandra

2013-04-01

The successful implementation of the environmental practices in the mining industry is of a paramount importance, as it not only prevents both local and trans-border pollution but also guarantees clean and healthy environment for the people regardless of their place of habitation. It is especially important to encourage the progress of the environmental practices implementation in developing countries because such countries have resource-oriented economy based on exploitation of nonrenewable resources. Poor environmental practices in developing countries will lead to local environmental crises that could eventually spill into surrounding countries including the most economically advanced. This abstract is a summary of a two-year research project attempted (1) to determine deficiencies of the mining sector ecological practices in developing countries and (2) to suggest substitute practices from developed countries that could be adapted to the developing countries reality. The following research methods were used: 1. The method of the system analysis, where the system is an interaction of the sets of environmental practices with the global mining sector; 2. The comparative method of inquiry, where the comparison was made between environmental protection practices as implemented in the US (developed country) and the developing countries such as RF, Mongolia mining sectors; 3. Quantitative date analysis, where date was collected from "The collection of statistic data", Russian Geographic Society Annual reports, the US EPA open reports, and the USGS Reports; The following results were obtained: Identified the systemic crisis of the ecological environmental policies and practices in the mining sector in developing countries based on the exploitation of nonrenewable resources, absence of the ecological interest by the mining companies that lack mechanisms of environmental and public health protection, the lack of insurance policy, the lack of risk assistance, and in the presence of the audit and monitoring that do not address the local conditions of the mining operations. Based on the above the following concepts were thought of to improve the environmental conditions in mining sector: 1. Was developed the Regional Environmental Management principle based on the local conditions such as physiographic region, local population, and socioeconomic conditions of the area; 2. Devised were criteria for the risk assessment for developing countries. Where the fundamental principals were public health, both near and far from the operation, environmental and biodiversity impact, waste management, long- and short- term rehabilitation plans, compliance with international standards and norms. 3. Developed was the mechanism of the economic motivation to make mining operations "environmentally friendly" that includes defrayal of expenses from both direct and indirect damages. 4. Identified were spheres of possible cooperation between mining companies, government organizations, and the NGOs. These include development of international standards for Good Neighbor Agreement, exchange of environmental information, exchange of successful environmental, health, and safety practices between mining operations from developed and developing countries. The study showed the dire necessity for the mining industry that operates in developing countries to adopt the successful environmental practices used in developed countries. To achieve this goal the Regional Environmental Management principle, the risk assessment criteria, the mechanism of the economic motivation and the principles for international cooperation can play an extremely important role.

Funding emergency medicine development in low- and middle-income countries.

PubMed

Doney, Michael K; Smith, Jeffrey; Kapur, G Bobby

2005-02-01

The specialty of EM is developing rapidly throughout the world. This growth is relatively lacking in the LICs, however. The lack of resources and financing capabilities in these regions may hinder specialty development. Further growth of the specialty in these countries requires an understanding of their health priorities and the global health and development agencies that often assist these countries in supporting the health sector. Identifying health priorities in these regions that intersect with EM is crucial and may form the basis for further expansion of EM. Many potential funding opportunities exist within the governmental and private sector, but all require some familiarity with application mechanisms and project cycles. Building relationships with personnel within these agencies and countries of interest is often fundamental to successful programmatic funding.

Nutrition in pregnancy and early childhood and associations with obesity in developing countries.

PubMed

Yang, Zhenyu; Huffman, Sandra L

2013-01-01

Concerns about the increasing rates of obesity in developing countries have led many policy makers to question the impacts of maternal and early child nutrition on risk of later obesity. The purposes of the review are to summarise the studies on the associations between nutrition during pregnancy and infant feeding practices with later obesity from childhood through adulthood and to identify potential ways for preventing obesity in developing countries. As few studies were identified in developing countries, key studies in developed countries were included in the review. Poor prenatal dietary intakes of energy, protein and micronutrients were shown to be associated with increased risk of adult obesity in offspring. Female offspring seem to be more vulnerable than male offspring when their mothers receive insufficient energy during pregnancy. By influencing birthweight, optimal prenatal nutrition might reduce the risk of obesity in adults. While normal birthweights (2500-3999 g) were associated with higher body mass index (BMI) as adults, they generally were associated with higher fat-free mass and lower fat mass compared with low birthweights (<2500 g). Low birthweight was associated with higher risk of metabolic syndrome and central obesity in adults. Breastfeeding and timely introduction of complementary foods were shown to protect against obesity later in life in observational studies. High-protein intake during early childhood however was associated with higher body fat mass and obesity in adulthood. In developed countries, increased weight gain during the first 2 years of life was associated with a higher BMI in adulthood. However, recent studies in developing countries showed that higher BMI was more related to greater lean body mass than fat mass. It appears that increased length at 2 years of age was positively associated with height, weight and fat-free mass, and was only weakly associated with fat mass. The protective associations between breastfeeding and obesity may differ in developing countries compared to developed countries because many studies in developed countries used formula feeding as a control. Future research on the relationship between breastfeeding, timely introduction of complementary feeding or rapid weight gain and obesity are warranted in developing countries. The focus of interventions to reduce risk of obesity in later life in developing countries could include: improving maternal nutritional status during pregnancy to reduce low birthweight; enhancing breastfeeding (including durations of exclusive and total breastfeeding); timely introduction of high-quality complementary foods (containing micronutrients and essential fats) but not excessive in protein; further evidence is needed to understand the extent of weight gain and length gain during early childhood are related to body composition in later life. © 2012 Blackwell Publishing Ltd.

HRD Trends Worldwide: Shared Solutions To Compete in a Global Economy. Improving Human Performance Series.

ERIC Educational Resources Information Center

Phillips, Jack J.

This book, which is intended for individuals involved in developing, delivering, and supporting human resource development (HRD) programs, discusses worldwide HRD trends that were identified in a study of the HRD practices in 35 countries. Chapter 1 discusses the importance of the HRD trends identified and explains how they were identified.…

Preparing the Future--Women, Literacy and Development. The Impact of Female Literacy on Human Development and the Participation of Literate Women in Change. ActionAid Development Report No. 4.

ERIC Educational Resources Information Center

Bown, Lalage

The outcomes of 43 project case studies and a country case study (Nepal) were examined to identify the impact of adult women's literacy. A look at women's situation in developing countries showed that women had multifarious roles, long working hours, and less access to education than males. The case studies revealed the following social effects of…

HEALTH TECHNOLOGY DISINVESTMENT WORLDWIDE: OVERVIEW OF PROGRAMS AND POSSIBLE DETERMINANTS.

PubMed

Orso, Massimiliano; de Waure, Chiara; Abraha, Iosief; Nicastro, Carlo; Cozzolino, Francesco; Eusebi, Paolo; Montedori, Alessandro

2017-01-01

In the past decade, there has been a growing interest in health technology disinvestment. A disinvestment process should involve all relevant stakeholders to identify and deliver the most effective, safe, and cost-effective healthcare interventions. The aim of the present study was to describe the state of the art of health technology disinvestment around the world and to identify parameters that could be associated with the implementation of disinvestment programs. A systematic review of the literature was performed from database inception to November 2014, together with the collection of original data on socio-economic indicators from forty countries. Overall, 1,456 records (1,199 from electronic databases and 257 from other sources) were initially retrieved. After analyzing 172 full text articles, 38 papers describing fifteen disinvestment programs/experiences in eight countries were included. The majority (12/15) of disinvestment programs began after 2006. As expected, these programs were more common in developed countries, 63 percent of which had a Beveridge model healthcare system. The univariate analysis showed that countries with disinvestment programs had a significantly higher level of Human Development Index, Gross Domestic Product per capita, public expenditure on health and social services, life expectancy at birth and a lower level of infant mortality rate, and of perceived corruption. The existence of HTA agencies in the country was a strong predictor (p = .034) for the development of disinvestment programs. The most significant variables in the univariate analysis were connected by a common factor, potentially related to the overall development stage of the country.

How do public health policies tackle alcohol-related harm: a review of 12 developed countries.

PubMed

Crombie, Iain K; Irvine, Linda; Elliott, Lawrence; Wallace, Hilary

2007-01-01

To identify how current public health policies of 12 developed countries assess alcohol-related problems, the goals and targets that are set and the strategic directives proposed. Policy documents on alcohol and on general public heath were obtained through repeated searches of government websites. Documents were reviewed by two independent observers. All the countries studied state that alcohol causes substantial harm to individual health and family well-being, increases crime and social disruption, and results in economic loss through lost productivity. All are concerned about consumption of alcohol by young adults and by heavy and problem drinkers. Few aim to reduce total consumption. Only five of the countries set specific targets for changes in drinking behaviour. Countries vary in their commitment to intervene, particularly on taxation, drink-driving, the drinking environment and for high-risk groups. Australia and New Zealand stand out as having coordinated intervention programmes in most areas. Policies differ markedly in their organization, the goals and targets that are set, the strategic approaches proposed and areas identified for intervention. Most countries could improve their policies by following the recommendations in the World Heath Organization's European Alcohol Action Plan.

How log-normal is your country? An analysis of the statistical distribution of the exported volumes of products

NASA Astrophysics Data System (ADS)

Annunziata, Mario Alberto; Petri, Alberto; Pontuale, Giorgio; Zaccaria, Andrea

2016-10-01

We have considered the statistical distributions of the volumes of 1131 products exported by 148 countries. We have found that the form of these distributions is not unique but heavily depends on the level of development of the nation, as expressed by macroeconomic indicators like GDP, GDP per capita, total export and a recently introduced measure for countries' economic complexity called fitness. We have identified three major classes: a) an incomplete log-normal shape, truncated on the left side, for the less developed countries, b) a complete log-normal, with a wider range of volumes, for nations characterized by intermediate economy, and c) a strongly asymmetric shape for countries with a high degree of development. Finally, the log-normality hypothesis has been checked for the distributions of all the 148 countries through different tests, Kolmogorov-Smirnov and Cramér-Von Mises, confirming that it cannot be rejected only for the countries of intermediate economy.

Natural gas projects in the developing world: An empirical evaluation of merits, obstacles, and risks

NASA Astrophysics Data System (ADS)

Mor, Amit

Significant amounts of natural gas have been discovered in developing countries throughout the years during the course of oil exploration. The vast majority of these resources have not been utilized. Some developing countries may benefit from a carefully planned utilization of their indigenous resources, which can either be exported or used domestically to substitute imported or exportable fuels or feedstock. Governments, potential private sector investors, and financiers have been searching for strategies to promote natural gas schemes, some of which have been in the pipeline for more than two decades. The purpose of this thesis is to identify the crucial factors determining the success or failure of launching natural gas projects in the developing world. The methodology used to evaluate these questions included: (1) establishing a representative sample of natural gas projects in developing countries that were either implemented or failed to materialize during the 1980-1995 period, (2) utilizing a Probit limited dependent variable econometric model in which the explained variable is project success or failure, and (3) choosing representing indicators to reflect the assumed factors affecting project success. The study identified two conditions for project success: (1) the economic viability of the project and (2) securing financing for the investment. The factors that explain the ability or inability of the sponsors to secure financing were: (1) the volume of investment that represented the large capital costs of gas transportation, distribution, and storage, (2) the level of foreign exchange constraint in the host country, and (3) the level of development of the country. The conditions for private sector participation in natural gas projects in developing countries were identified in the study by a Probit model in which the explained variable was private sector participation. The results showed that a critical condition for private sector participation is the financial profitability of a project. Other factors that explained private sector participation and the ability of the private-sector sponsor to secure financing for a project were: (1) the political risk associated with the project, (2) the foreign exchange constraint associated with the project, and (3) whether the project was domestic or export-oriented.

Sharing experiences: towards an evidence based model of dengue surveillance and outbreak response in Latin America and Asia

PubMed Central

2013-01-01

Background The increasing frequency and intensity of dengue outbreaks in endemic and non-endemic countries requires a rational, evidence based response. To this end, we aimed to collate the experiences of a number of affected countries, identify strengths and limitations in dengue surveillance, outbreak preparedness, detection and response and contribute towards the development of a model contingency plan adaptable to country needs. Methods The study was undertaken in five Latin American (Brazil, Colombia, Dominican Republic, Mexico, Peru) and five in Asian countries (Indonesia, Malaysia, Maldives, Sri Lanka, Vietnam). A mixed-methods approach was used which included document analysis, key informant interviews, focus-group discussions, secondary data analysis and consensus building by an international dengue expert meeting organised by the World Health Organization, Special Program for Research and Training in Tropical Diseases (WHO-TDR). Results Country information on dengue is based on compulsory notification and reporting (“passive surveillance”), with laboratory confirmation (in all participating Latin American countries and some Asian countries) or by using a clinical syndromic definition. Seven countries additionally had sentinel sites with active dengue reporting, some also had virological surveillance. Six had agreed a formal definition of a dengue outbreak separate to seasonal variation in case numbers. Countries collected data on a range of warning signs that may identify outbreaks early, but none had developed a systematic approach to identifying and responding to the early stages of an outbreak. Outbreak response plans varied in quality, particularly regarding the early response. The surge capacity of hospitals with recent dengue outbreaks varied; those that could mobilise additional staff, beds, laboratory support and resources coped best in comparison to those improvising a coping strategy during the outbreak. Hospital outbreak management plans were present in 9/22 participating hospitals in Latin-America and 8/20 participating hospitals in Asia. Conclusions Considerable variation between countries was observed with regard to surveillance, outbreak detection, and response. Through discussion at the expert meeting, suggestions were made for the development of a more standardised approach in the form of a model contingency plan, with agreed outbreak definitions and country-specific risk assessment schemes to initiate early response activities according to the outbreak phase. This would also allow greater cross-country sharing of ideas. PMID:23800243

Sharing experiences: towards an evidence based model of dengue surveillance and outbreak response in Latin America and Asia.

PubMed

Badurdeen, Shiraz; Valladares, David Benitez; Farrar, Jeremy; Gozzer, Ernesto; Kroeger, Axel; Kuswara, Novia; Ranzinger, Silvia Runge; Tinh, Hien Tran; Leite, Priscila; Mahendradhata, Yodi; Skewes, Ronald; Verrall, Ayesha

2013-06-24

The increasing frequency and intensity of dengue outbreaks in endemic and non-endemic countries requires a rational, evidence based response. To this end, we aimed to collate the experiences of a number of affected countries, identify strengths and limitations in dengue surveillance, outbreak preparedness, detection and response and contribute towards the development of a model contingency plan adaptable to country needs. The study was undertaken in five Latin American (Brazil, Colombia, Dominican Republic, Mexico, Peru) and five in Asian countries (Indonesia, Malaysia, Maldives, Sri Lanka, Vietnam). A mixed-methods approach was used which included document analysis, key informant interviews, focus-group discussions, secondary data analysis and consensus building by an international dengue expert meeting organised by the World Health Organization, Special Program for Research and Training in Tropical Diseases (WHO-TDR). Country information on dengue is based on compulsory notification and reporting ("passive surveillance"), with laboratory confirmation (in all participating Latin American countries and some Asian countries) or by using a clinical syndromic definition. Seven countries additionally had sentinel sites with active dengue reporting, some also had virological surveillance. Six had agreed a formal definition of a dengue outbreak separate to seasonal variation in case numbers. Countries collected data on a range of warning signs that may identify outbreaks early, but none had developed a systematic approach to identifying and responding to the early stages of an outbreak. Outbreak response plans varied in quality, particularly regarding the early response. The surge capacity of hospitals with recent dengue outbreaks varied; those that could mobilise additional staff, beds, laboratory support and resources coped best in comparison to those improvising a coping strategy during the outbreak. Hospital outbreak management plans were present in 9/22 participating hospitals in Latin-America and 8/20 participating hospitals in Asia. Considerable variation between countries was observed with regard to surveillance, outbreak detection, and response. Through discussion at the expert meeting, suggestions were made for the development of a more standardised approach in the form of a model contingency plan, with agreed outbreak definitions and country-specific risk assessment schemes to initiate early response activities according to the outbreak phase. This would also allow greater cross-country sharing of ideas.

Rheumatic heart disease across the Western Pacific: not just a Pacific Island problem.

PubMed

Abouzeid, Marian; Katzenellenbogen, Judith; Wyber, Rosemary; Watkins, David; Johnson, Timothy David; Carapetis, Jonathan

2017-01-01

Some of the highest recorded rheumatic heart disease (RHD) prevalence and mortality rates are from the World Health Organization's Western Pacific Region (WPR). RHD burden has been well documented in much of the WPR subregion of Oceania, but less is known about RHD outside the Pacific Islands and Australasia. We aimed to review RHD burden in WPR outside Oceania to identify countries with high RHD burden and those with contemporary data gaps. We searched the peer-reviewed literature for English-language primary studies published between 1980 and April 2017 that reported RHD prevalence or mortality in the 13 WPR countries/areas outside Oceania, and Taiwan. We also searched for official government reports and health indicator documents. Results were synthesised narratively and reported stratified by 2015 Human Development Index (HDI) level. 30 peer-reviewed publications fulfilling inclusion criteria were identified, representing nine countries/areas. RHD prevalence and mortality have fallen in association with economic development, particularly in very high HDI countries. In several countries that have undergone recent economic development, RHD persists particularly among older populations. In poorer WPR countries there is a persistent RHD burden, including in young populations. Some countries had no available data. Although RHD burden has declined in many high-resource settings across the WPR, in several poorer countries, the impact of RHD appears to continue. Elsewhere, insufficient contemporary data make it difficult to gauge the current status of RHD burden and control. Concerted efforts are needed to fill information gaps and implement action to address this avoidable disease.

Dengue Contingency Planning: From Research to Policy and Practice.

PubMed

Runge-Ranzinger, Silvia; Kroeger, Axel; Olliaro, Piero; McCall, Philip J; Sánchez Tejeda, Gustavo; Lloyd, Linda S; Hakim, Lokman; Bowman, Leigh R; Horstick, Olaf; Coelho, Giovanini

2016-09-01

Dengue is an increasingly incident disease across many parts of the world. In response, an evidence-based handbook to translate research into policy and practice was developed. This handbook facilitates contingency planning as well as the development and use of early warning and response systems for dengue fever epidemics, by identifying decision-making processes that contribute to the success or failure of dengue surveillance, as well as triggers that initiate effective responses to incipient outbreaks. Available evidence was evaluated using a step-wise process that included systematic literature reviews, policymaker and stakeholder interviews, a study to assess dengue contingency planning and outbreak management in 10 countries, and a retrospective logistic regression analysis to identify alarm signals for an outbreak warning system using datasets from five dengue endemic countries. Best practices for managing a dengue outbreak are provided for key elements of a dengue contingency plan including timely contingency planning, the importance of a detailed, context-specific dengue contingency plan that clearly distinguishes between routine and outbreak interventions, surveillance systems for outbreak preparedness, outbreak definitions, alert algorithms, managerial capacity, vector control capacity, and clinical management of large caseloads. Additionally, a computer-assisted early warning system, which enables countries to identify and respond to context-specific variables that predict forthcoming dengue outbreaks, has been developed. Most countries do not have comprehensive, detailed contingency plans for dengue outbreaks. Countries tend to rely on intensified vector control as their outbreak response, with minimal focus on integrated management of clinical care, epidemiological, laboratory and vector surveillance, and risk communication. The Technical Handbook for Surveillance, Dengue Outbreak Prediction/ Detection and Outbreak Response seeks to provide countries with evidence-based best practices to justify the declaration of an outbreak and the mobilization of the resources required to implement an effective dengue contingency plan.

The feasibility and appropriateness of introducing nursing curricula from developed countries into developing countries: a comprehensive systematic review.

PubMed

Jayasekara, Rasika; Schultz, Tim

The objective of this review was to appraise and synthesise the best available evidence on the feasibility and appropriateness of introducing nursing curricula from developed countries into developing countries. This review considered quantitative and qualitative research papers that addressed the feasibility and appropriateness of introducing developed countries' nursing curricula into developing countries. Papers of the highest level of evidence rating were given priority. Participants of interest were all levels of nursing staff, nursing students, healthcare consumers and healthcare administrators. Outcomes of interest that are relevant to the evaluation of undergraduate nursing curricula were considered in the review including cost-effectiveness, cultural relevancy, adaptability, consumer satisfaction and student satisfaction. The search strategy sought to find both published and unpublished studies and papers, limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second extensive search was then undertaken using all identified key words and index terms. Finally, the reference list of all identified reports and articles was searched, the contents pages of a few relevant journals were hand searched and experts in the field were contacted to find any relevant studies missed from the first two searches. Each paper was assessed by two independent reviewers for methodological quality before inclusion in the review using an appropriate critical appraisal instrument from the System for the Unified Management, Assessment and Review of Information (SUMARI) package. A total of four papers, including one descriptive study and three textual papers, were included in the review. Because of the diverse nature of these papers, meta-synthesis of the results was not possible. For this reason, this section of the review is presented in narrative form. In this review, a descriptive study and a textual opinion paper examined the cultural relevancy of borrowed curriculum models, and the global influence of American nursing. Another two opinion papers evaluated the adaptability of another country curriculum models in their countries. The evidence regarding the feasibility and appropriateness of introducing developed countries' nursing curricula into developing countries is weak because of the paucity of high-quality studies. However, some lower-level evidence suggesting that direct transfer of the curriculum model from one country to another is not appropriate without first assessing the cultural context of both countries. Second, the approach of considering international, regional and local experiences more feasible and presumably a more effective strategy for adapting of a country's curriculum into a culturally or economically different country.

The feasibility and appropriateness of introducing nursing curricula from developed countries into developing countries: a comprehensive systematic review.

PubMed

Jayasekara, Rasika; Schultz, Tim

2006-09-01

Objectives  The objective of this review was to appraise and synthesise the best available evidence on the feasibility and appropriateness of introducing nursing curricula from developed countries into developing countries. Inclusion criteria  This review considered quantitative and qualitative research papers that addressed the feasibility and appropriateness of introducing developed countries' nursing curricula into developing countries. Papers of the highest level of evidence rating were given priority. Participants of interest were all levels of nursing staff, nursing students, healthcare consumers and healthcare administrators. Outcomes of interest that are relevant to the evaluation of undergraduate nursing curricula were considered in the review including cost-effectiveness, cultural relevancy, adaptability, consumer satisfaction and student satisfaction. Search strategy  The search strategy sought to find both published and unpublished studies and papers, limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second extensive search was then undertaken using all identified key words and index terms. Finally, the reference list of all identified reports and articles was searched, the contents pages of a few relevant journals were hand searched and experts in the field were contacted to find any relevant studies missed from the first two searches. Methodological quality  Each paper was assessed by two independent reviewers for methodological quality before inclusion in the review using an appropriate critical appraisal instrument from the System for the Unified Management, Assessment and Review of Information (SUMARI) package. Results  A total of four papers, including one descriptive study and three textual papers, were included in the review. Because of the diverse nature of these papers, meta-synthesis of the results was not possible. For this reason, this section of the review is presented in narrative form. In this review, a descriptive study and a textual opinion paper examined the cultural relevancy of borrowed curriculum models, and the global influence of American nursing. Another two opinion papers evaluated the adaptability of another country curriculum models in their countries. Conclusion  The evidence regarding the feasibility and appropriateness of introducing developed countries' nursing curricula into developing countries is weak because of the paucity of high-quality studies. However, some lower-level evidence suggesting that direct transfer of the curriculum model from one country to another is not appropriate without first assessing the cultural context of both countries. Second, the approach of considering international, regional and local experiences more feasible and presumably a more effective strategy for adapting of a country's curriculum into a culturally or economically different country.

Reinterpreting Responsiveness for Health Systems Research in Low and Middle-Income Countries.

PubMed

Pratt, Bridget; Hyder, Adnan A

2015-07-01

The ethical concept of responsiveness has largely been interpreted in the context of international clinical research. In light of the increasing conduct of externally funded health systems research (HSR) in low- and middle-income countries (LMICs), this article examines how responsiveness might be understood for such research and how it can be applied. It contends that four features (amongst others) set HSR in LMICs apart from international clinical research: a focus on systems; being context-driven; being policy-driven; and being closely linked to development objectives. These features support reinterpreting responsiveness for HSR in LMICs as responsiveness to systems needs, where health system performance assessments can be relied upon to identify systems needs, and/or responsiveness to systems priorities, which entails aligning research with HSR priorities set through country-owned processes involving national and sub-national policymakers from host countries. Both concepts may be difficult to achieve in practice. Country ownership is not an established fact for many countries and alignment to their priorities may be meaningless without it. It is argued that more work is, therefore, needed to identify strategies for how the responsiveness requirement can be ethically fulfilled for HSR in LMICs under non-ideal conditions such as where host countries have not set HSR priorities via country-owned processes. Embeddedness is proposed as one approach that could be the focus of further development. © 2014 John Wiley & Sons Ltd.

Unsustainable development pathways caused by tropical deforestation

PubMed Central

Carrasco, Luis Roman; Nghiem, Thi Phuong Le; Chen, Zhirong; Barbier, Edward B.

2017-01-01

Global sustainability strategies require assessing whether countries’ development trajectories are sustainable over time. However, sustainability assessments are limited because losses of natural capital and its ecosystem services through deforestation have not been comprehensively incorporated into national accounts. We update the national accounts of 80 nations that underwent tropical deforestation from 2000 to 2012 and evaluate their development trajectories using weak and strong sustainability criteria. Weak sustainability requires that countries do not decrease their aggregate capital over time. We adopt a strong sustainability criterion that countries do not decrease the value of their forest ecosystem services with respect to the year 2000. We identify several groups of countries: countries, such as Sri Lanka, Bangladesh, and India, that present sustainable development trajectories under both weak and strong sustainability criteria; countries, such as Brazil, Peru, and Indonesia, that present weak sustainable development but fail the strong sustainability criterion as a result of rapid losses of ecosystem services; countries, such as Madagascar, Laos, and Papua New Guinea, that present unsustainable development pathways as a result of deforestation; and countries, such as Democratic Republic of Congo and Sierra Leone, in which deforestation aggravates already unsustainable pathways. Our results reveal a large number of countries where tropical deforestation is both damaging to nature and not compensated by development in other sectors, thus compromising the well-being of their future generations. PMID:28706988

Implementing the United Kingdom Government's 10-Year Teenage Pregnancy Strategy for England (1999-2010): Applicable Lessons for Other Countries.

PubMed

Hadley, Alison; Chandra-Mouli, Venkatraman; Ingham, Roger

2016-07-01

Teenage pregnancy is an issue of inequality affecting the health, well-being, and life chances of young women, young men, and their children. Consequently, high levels of teenage pregnancy are of concern to an increasing number of developing and developed countries. The UK Labour Government's Teenage Pregnancy Strategy for England was one of the very few examples of a nationally led, locally implemented evidence-based strategy, resourced over a long duration, with an associated reduction of 51% in the under-18 conception rate. This article seeks to identify the lessons applicable to other countries. The article focuses on the prevention program. Drawing on the detailed documentation of the 10-year strategy, it analyzes the factors that helped and hindered implementation against the World Health Organization (WHO) ExpandNet Framework. The Framework strives to improve the planning and management of the process of scaling-up of successful pilot programs with a focus on sexual and reproductive health, making it particularly suited for an analysis of England's teenage pregnancy strategy. The development and implementation of the strategy matches the Framework's key attributes for successful planning and scaling up of sexual and reproductive health programs. It also matched the attributes identified by the Centre for Global Development for scaled up approaches to complex public health issues. Although the strategy was implemented in a high-income country, analysis against the WHO-ExpandNet Framework identifies many lessons which are transferable to low- and medium-income countries seeking to address high teenage pregnancy rates. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Lessons for health care reform from the less developed world: the case of the Philippines.

PubMed

Obermann, Konrad; Jowett, Matthew R; Taleon, Juanito D; Mercado, Melinda C

2008-11-01

International technical and financial cooperation for health-sector reform is usually a one-way street: concepts, tools and experiences are transferred from more to less developed countries. Seldom, if ever, are experiences from less developed countries used to inform discussions on reforms in the developed world. There is, however, a case to be made for considering experiences in less developed countries. We report from the Philippines, a country with high population growth, slow economic development, a still immature democracy and alleged large-scale corruption, which has embarked on a long-term path of health care and health financing reforms. Based on qualitative health-related action research between 2002 and 2005, we have identified three crucial factors for achieving progress on reforms in a challenging political environment: (1) strive for local solutions, (2) make use of available technology and (3) work on the margins towards pragmatic solutions whilst having your ethical goals in mind. Some reflection on these factors might stimulate and inform the debate on how health care reforms could be pursued in developed countries.

Global patterns in overweight among children and mothers in less developed countries.

PubMed

Van Hook, Jennifer; Altman, Claire E; Balistreri, Kelly S

2013-04-01

Past research has identified increases in national income and urbanization as key drivers of the global obesity epidemic. That work further identified educational attainment and urban residence as important moderators of the effects of national income. However, such work has tended to assume that children and adults respond in the same way to these factors. In the present paper, we evaluate how the socio-economic and country-level factors associated with obesity differ between children and their mothers. We modelled the associations between maternal education, country-level income and urban residence with mother's and children's weight status. We analysed ninety-five nationally representative health and nutrition surveys conducted between 1990 and 2008 from thirty-three less developed countries. Our sample included children aged 2-4 years (n 253 442) and their mothers (n 228 655). Consistent with prior research, we found that mothers' risk of overweight was positively associated with economic development, urban residence and maternal education. Additionally, economic development was associated with steeper increases in mothers' risk of overweight among those with low (v. high) levels of education and among those living in rural (v. urban) areas. However, these associations were different for children. Child overweight was not associated with maternal education and urban residence, and negatively associated with national income. We speculate that the distinctive patterns for children may arise from conditions in low- and middle-income developing countries that increase the risk of child underweight and poor nutrition.

Infertility and the provision of infertility medical services in developing countries

PubMed Central

Ombelet, Willem; Cooke, Ian; Dyer, Silke; Serour, Gamal; Devroey, Paul

2008-01-01

BACKGROUND Worldwide more than 70 million couples suffer from infertility, the majority being residents of developing countries. Negative consequences of childlessness are experienced to a greater degree in developing countries when compared with Western societies. Bilateral tubal occlusion due to sexually transmitted diseases and pregnancy-related infections is the most common cause of infertility in developing countries, a condition that is potentially treatable with assisted reproductive technologies (ART). New reproductive technologies are either unavailable or very costly in developing countries. This review provides a comprehensive survey of all important papers on the issue of infertility in developing countries. METHODS Medline, PubMed, Excerpta Medica and EMBASE searches identified relevant papers published between 1978 and 2007 and the keywords used were the combinations of ‘affordable, assisted reproduction, ART, developing countries, health services, infertility, IVF, simplified methods, traditional health care'. RESULTS The exact prevalence of infertility in developing countries is unknown due to a lack of registration and well-performed studies. On the other hand, the implementation of appropriate infertility treatment is currently not a main goal for most international non-profit organizations. Keystones in the successful implementation of infertility care in low-resource settings include simplification of diagnostic and ART procedures, minimizing the complication rate of interventions, providing training-courses for health-care workers and incorporating infertility treatment into sexual and reproductive health-care programmes. CONCLUSIONS Although recognizing the importance of education and prevention, we believe that for the reasons of social justice, infertility treatment in developing countries requires greater attention at National and International levels. PMID:18820005

Neurobehavioural methods, effects and prevention: workers' human rights are why the field matters for developing countries.

PubMed

London, L

2009-11-01

Little research into neurobehavioural methods and effects occurs in developing countries, where established neurotoxic chemicals continue to pose significant occupational and environmental burdens, and where agents newly identified as neurotoxic are also widespread. Much of the morbidity and mortality associated with neurotoxic agents remains hidden in developing countries as a result of poor case detection, lack of skilled personnel, facilities and equipment for diagnosis, inadequate information systems, limited resources for research and significant competing causes of ill-health, such as HIV/AIDS and malaria. Placing the problem in a human rights context enables researchers and scientists in developing countries to make a strong case for why the field of neurobehavioural methods and effects matters because there are numerous international human rights commitments that make occupational and environmental health and safety a human rights obligation.

Enhancing pharmacists' role in developing countries to overcome the challenge of antimicrobial resistance: a narrative review.

PubMed

Sakeena, M H F; Bennett, Alexandra A; McLachlan, Andrew J

2018-01-01

Antimicrobial resistance (AMR) is a global health challenge and developing countries are more vulnerable to the adverse health impacts of AMR. Health care workers including pharmacists can play a key role to support the appropriate use of antimicrobials in developing countries and reduce AMR. The aim of this review is to investigate the role of pharmacists in the appropriate use of antibiotics and to identify how the pharmacists' role can be enhanced to combat AMR in developing countries. The databases MEDLINE, EMBASE, Web of Science and Google Scholar were searched for articles published between 2000 and the end of August 2017 that involved studies on the role of pharmacists in developing countries, the expanded services of pharmacists in patient care in developed countries and pharmacists' contributions in antimicrobial use in both developed and developing nations. In developing countries pharmacists role in patient care are relatively limited. However, in developed nations, the pharmacists' role has expanded to provide multifaceted services in patient care resulting in improved health outcomes from clinical services and reduced health care costs. Success stories of pharmacist-led programs in combating AMR demonstrates that appropriately trained pharmacists can be part of the solution to overcome the global challenge of AMR. Pharmacists can provide education to patients enabling them to use antibiotics appropriately. They can also provide guidance to their healthcare colleagues on appropriate antibiotic prescribing. This review highlights that appropriately trained pharmacists integrated into the health care system can make a significant impact in minimising inappropriate antibiotic use in developing countries. Strengthening and enhancing the pharmacists' role in developing countries has the potential to positively impact the global issue of AMR.

Development of health policy and systems research in Nigeria: lessons for developing countries' evidence-based health policy making process and practice.

PubMed

Uneke, Chigozie J; Ezeoha, Abel E; Ndukwe, Chinwendu D; Oyibo, Patrick G; Onwe, Friday

2010-08-01

Health policy and systems research (HPSR), which aims to produce reliable and rigorous evidence to inform the many critical decisions that must be made about health systems, is a new concept in Nigeria. In this study, policy makers and other stakeholders in the health sector identified the challenges and the potential intervention strategies to HPSR evidence use in policy making in Nigeria. The major challenges identified included capacity constraints at individual and organizational levels, communication gaps and poor networking between policy makers and researchers, and the non-involvement of healthcare recipients in identifying and planning care delivery needs. The main solutions suggested included promotion of strategies to encourage partnership between researchers and policy makers, improvement of staff incentives and facilities for research activities, improved budgetary provision for research, and sustainable institutional capacity development. These strategies have been shown to improve evidence-based policy making in developed countries and are likely to produce better outcomes in the developing world.

Development of Health Policy and Systems Research in Nigeria: Lessons for Developing Countries' Evidence-Based Health Policy Making Process and Practice

PubMed Central

Uneke, Chigozie J.; Ezeoha, Abel E.; Ndukwe, Chinwendu D.; Oyibo, Patrick G.; Onwe, Friday

2010-01-01

Health policy and systems research (HPSR), which aims to produce reliable and rigorous evidence to inform the many critical decisions that must be made about health systems, is a new concept in Nigeria. In this study, policy makers and other stakeholders in the health sector identified the challenges and the potential intervention strategies to HPSR evidence use in policy making in Nigeria. The major challenges identified included capacity constraints at individual and organizational levels, communication gaps and poor networking between policy makers and researchers, and the non-involvement of healthcare recipients in identifying and planning care delivery needs. The main solutions suggested included promotion of strategies to encourage partnership between researchers and policy makers, improvement of staff incentives and facilities for research activities, improved budgetary provision for research, and sustainable institutional capacity development. These strategies have been shown to improve evidence-based policy making in developed countries and are likely to produce better outcomes in the developing world. PMID:21804832

Spatial planning for a green economy: National-level hydrologic ecosystem services priority areas for Gabon

PubMed Central

Tallis, Heather; Cole, Aaron; Schill, Steven; Martin, Erik; Heiner, Michael; Paiz, Marie-Claire; Aldous, Allison; Apse, Colin; Nickel, Barry

2017-01-01

Rapidly developing countries contain both the bulk of intact natural areas and biodiversity, and the greatest untapped natural resource stocks, placing them at the forefront of “green” economic development opportunities. However, most lack scientific tools to create development plans that account for biodiversity and ecosystem services, diminishing the real potential to be sustainable. Existing methods focus on biodiversity and carbon priority areas across large geographies (e.g., countries, states/provinces), leaving out essential services associated with water supplies, among others. These hydrologic ecosystem services (HES) are especially absent from methods applied at large geographies and in data-limited contexts. Here, we present a novel, spatially explicit, and relatively simple methodology to identify countrywide HES priority areas. We applied our methodology to the Gabonese Republic, a country undergoing a major economic transformation under a governmental commitment to balance conservation and development goals. We present the first national-scale maps of HES priority areas across Gabon for erosion control, nutrient retention, and groundwater recharge. Priority sub-watersheds covered 44% of the country’s extent. Only 3% of the country was identified as a priority area for all HES simultaneously, highlighting the need to conserve different areas for each different hydrologic service. While spatial tradeoffs occur amongst HES, we identified synergies with two other conservation values, given that 66% of HES priority areas intersect regions of above average area-weighted (by sub-watersheds) total forest carbon stocks and 38% intersect with terrestrial national parks. Considering implications for development, we identified HES priority areas overlapping current or proposed major roads, forestry concessions, and active mining concessions, highlighting the need for proactive planning for avoidance areas and compensatory offsets to mitigate potential conflicts. Collectively, our results provide insight into strategies to protect HES as part of Gabon’s development strategy, while providing a replicable methodology for application to new scales, geographies, and policy contexts. PMID:28594870

A SURVEY OF ASTRONOMICAL RESEARCH: A BASELINE FOR ASTRONOMICAL DEVELOPMENT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ribeiro, V. A. R. M.; Russo, P.; Cárdenas-Avendaño, A., E-mail: vribeiro@ast.uct.ac.za, E-mail: russo@strw.leidenuniv.nl

Measuring scientific development is a difficult task. Different metrics have been put forward to evaluate scientific development; in this paper we explore a metric that uses the number of peer-reviewed, and when available non-peer-reviewed, research articles as an indicator of development in the field of astronomy. We analyzed the available publication record, using the Smithsonian Astrophysical Observatory/NASA Astrophysics Database System, by country affiliation in the time span between 1950 and 2011 for countries with a gross national income of less than 14,365 USD in 2010. This represents 149 countries. We propose that this metric identifies countries in ''astronomical development'' withmore » a culture of research publishing. We also propose that for a country to develop in astronomy, it should invest in outside expert visits, send its staff abroad to study, and establish a culture of scientific publishing. Furthermore, we propose that this paper may be used as a baseline to measure the success of major international projects, such as the International Year of Astronomy 2009.« less

The Social Development Summit and the developing countries.

PubMed

Barnabas, A P; Kulkarni, P D; Nanavatty, M C; Singh, R R

1996-01-01

This article discusses some concerns of the 1996 UN Summit on Social Development. Conference organizers identified the three key conference issues as poverty alleviation, social integration of the marginalized and disadvantaged, and expansion of productive employment. The goal of a "society for all" means dealing with the increasing differences between rich and poor countries, the survival of weaker economies in a competitive market system, wide variations in consumption patterns between countries, attainment of political stability while respecting ethnic identity, the rise in social problems among countries with a high human development index, and increasing joblessness. The Human Development Report for 1994 emphasizes human security. Social development is not the equivalent of human resource development nor a side issue of economic growth. The integration of ethnic groups poses social and political problems. There remains a question about what political system and culture would be best for social integration. Developed countries define poverty as the inability of people and government to provide resources and necessary services for people's productive activity. Poverty in developing countries is blamed on colonialism. Globally, developed countries control 71% of world trade. Sharing resources to meet basic needs throughout the world is not an operational ideal. The highest 20% of income earners receive 83% of the world income. The culture of poverty is the strategy used by the poor to survive. Welfare is not an end in itself but does enable the poor to improve their conditions. Development that focuses on productive employment is uncertain. Developed and developing countries do not share similar perceptions of human rights. There is a question as to who should set the priorities for social development. Sustainable social development is related to preservation of natural resources, control of population growth, and promotion of social security.

The Dynamics of Democracy, Development and Cultural Values

PubMed Central

Spaiser, Viktoria; Ranganathan, Shyam; Mann, Richard P.; Sumpter, David J. T.

2014-01-01

Over the past decades many countries have experienced rapid changes in their economies, their democratic institutions and the values of their citizens. Comprehensive data measuring these changes across very different countries has recently become openly available. Between country similarities suggest common underlying dynamics in how countries develop in terms of economy, democracy and cultural values. We apply a novel Bayesian dynamical systems approach to identify the model which best captures the complex, mainly non-linear dynamics that underlie these changes. We show that the level of Human Development Index (HDI) in a country drives first democracy and then higher emancipation of citizens. This change occurs once the countries pass a certain threshold in HDI. The data also suggests that there is a limit to the growth of wealth, set by higher emancipation. Having reached a high level of democracy and emancipation, societies tend towards equilibrium that does not support further economic growth. Our findings give strong empirical evidence against a popular political science theory, known as the Human Development Sequence. Contrary to this theory, we find that implementation of human-rights and democratisation precede increases in emancipative values. PMID:24905920

The dynamics of democracy, development and cultural values.

PubMed

Spaiser, Viktoria; Ranganathan, Shyam; Mann, Richard P; Sumpter, David J T

2014-01-01

Over the past decades many countries have experienced rapid changes in their economies, their democratic institutions and the values of their citizens. Comprehensive data measuring these changes across very different countries has recently become openly available. Between country similarities suggest common underlying dynamics in how countries develop in terms of economy, democracy and cultural values. We apply a novel Bayesian dynamical systems approach to identify the model which best captures the complex, mainly non-linear dynamics that underlie these changes. We show that the level of Human Development Index (HDI) in a country drives first democracy and then higher emancipation of citizens. This change occurs once the countries pass a certain threshold in HDI. The data also suggests that there is a limit to the growth of wealth, set by higher emancipation. Having reached a high level of democracy and emancipation, societies tend towards equilibrium that does not support further economic growth. Our findings give strong empirical evidence against a popular political science theory, known as the Human Development Sequence. Contrary to this theory, we find that implementation of human-rights and democratisation precede increases in emancipative values.

Characteristics of healthy weight advertisements in three countries.

PubMed

Pettigrew, Simone; Talati, Zenobia; Henriques, Isla; Morley, Belinda; Ball, Kylie

2018-02-01

High rates of population obesity have resulted in the dissemination of mass media campaigns that focus on achieving and maintaining a healthy weight. The aim of the present study was to analyse advertising techniques used in such campaigns to identify common and differential approaches in three countries with similar cultures and rates of obesity (Australia, the United Kingdom and the United States). An Internet search was conducted to identify healthy weight television advertisements aired in the three countries. Seventy-two advertisements were located and coded according to the advertising techniques employed. Despite the cultural similarity and comparable obesity rates of the three countries, there were few consistencies in advertising techniques employed. A main focus of the ads was diet, but disparate approaches were used to convey the message in each country. The identified wide variation in advertising techniques may suggest that campaign managers would benefit from greater certainty about which advertising approaches are most effective in encouraging lifestyle behaviours associated with a healthy weight. Implications for public health: A more robust evidence base would be useful to guide the development of healthy weight campaigns. © 2017 The Authors.

Preconception health assessment in China, Lebanon and the Philippines: applicability to other countries.

PubMed

Reeve, Mary-Elizabeth; Charafeddine, Lama; Zhong, Nanbert; Padilla, Carmencita D; Yunis, Khalid; El Rafei, Reem; Alamiddine, Kawthar; Zhao, Xinliang; Jiang, Xiaoqing; Howson, Christopher P

2014-07-01

To test the utility of a preconception checklist tool in identifying preconception health needs of women in three countries; China, Lebanon and the Philippines. An academic medical center within each country participated in the development and testing of a preconception checklist tool, which was administered over a 6 month period to selected target groups in each country. The checklist provided valuable data on the preconception health of 6,530 women. Aggregated data identified common preconception health needs across all countries, including provision of modern contraceptives and adequate immunization coverage; HIV and STI screening; treatment for anemia; and counseling for maintenance of a healthy weight. A preconception checklist tool was found to be useful in distinct cultural settings. The study was a pilot. Future steps include validation and standardization of the checklist, data from which could be used to help shape preconception care policies and implementation strategies.

Epidemiology of international terrorism involving fatal outcomes in developed countries (1994-2003).

PubMed

Wilson, Nick; Thomson, George

2005-01-01

We aimed to describe the public health burden and epidemiology of international terrorism (i.e. involving foreign nationals) with fatal outcomes in developed countries. Data was abstracted from a United States Department of State database for 21 'established market economy' countries and 18 'former socialist economies of Europe' for 1994-2003. To put the findings in a wider context, comparisons were made with WHO data on all homicides for each country. A total of 32 international terrorist attacks causing fatalities were identified over the 10-year period. These resulted in 3299 deaths, giving a crude annual mortality rate of 0.3 per million population. The mortality burden attributable to international terrorism in these countries was 208 times less than that attributable to other homicide. Even for the country with the highest mortality burden from international terrorism (the United States), this ratio was 60. There was no statistically significant trend in the number of attacks over time, but the attack severity (in terms of deaths per attack) was higher in the latter part of the 10-year period. A number of limitations with this data set were identified. If a more rigorous definition of 'international terrorism' was used, then this would substantially reduce the total number of such attacks defined in this way. In conclusion, there is a need for better quality data and improved classification systems for describing international terrorism. Nevertheless, the available data indicates that the mortality burden from international terrorism in developed countries is small compared to that from other homicide.

Creating and Implementing Professional Development with Self-Selected Literacy Content for Teachers in a Developing Country

ERIC Educational Resources Information Center

Regan, Tiffany Arnett

2017-01-01

The purpose of this descriptive case study was to identify teacher strengths and needs to create a site-specific professional development program for literacy. I was interested in studying how to identify teacher needs and strengths and explore the compatibility between teacher beliefs, current practice, and best practices in literacy. This study…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nagler, R.G.

This report, based solely on information available from unclassified sources, provides a coherent picture of the scope and trends of ballistic missile proliferation. The focus is on countries developing, producing, or owning ballistic missiles capable of threatening the military forces, assets, or populations of neighboring or geographically remote countries. The report also identifies other countries expected to obtain operational ballistic missile capabilities, discusses expected growth in performance, and examines the projected availability of warheads of mass destruction. The emphasis is on ballistic missiles of ranges greater than approximately 300 km, though shorter range battlefield weapons are discussed as forerunners. Themore » assessment excludes principal U.S. allies and countries formerly in the Warsaw Pact, except where these countries have sold missiles, technology; or personnel services to developing nations in support of their missile programs.« less

Information Professionals for the Industrial Sector.

ERIC Educational Resources Information Center

Carrion-Rodriguez, Guadalupe; Quevedo-Procel, Jose

In today's information society, the greatest challenge for information professionals is to accept and understand the information world and to identify their own professional roles. These roles may vary according to the needs and stages of development of different countries, for not all countries are equally aware of the importance of information,…

Characteristics and Trends of Published Adult Hip Research over the Last Decade

PubMed Central

Kwak, Hong Suk; Yoon, Pil Whan; Park, Moon Seok; Kim, Hee Joong

2015-01-01

Purpose We designed this study to demonstrate recent trends in the proportion of adult hip research in orthopedics, to identify countries leading the adult hip research, and to evaluate the relationship between the economic power of the countries and their contributions. Materials and Methods Studies published in seven select orthopedic journals were retrieved from PubMed. Among them, we determined the number of adult hip studies. The countries-of-origin of adult hip studies, and the economic power of the countries were investigated. Results A total of 7218 orthopedic publications and 1993 (27.6%) addressed adult hip research were identified. Adult hip studies increased from 313 (23.7%) in 2000 to 555 (27.9%) in 2011. Twenty-five countries accounted for 97.6% of the total number of adult hip studies, and gross domestic product correlated with publication volume (Spearman's rho, 0.723; p=0.000). Conclusion Researchers from a limited number of developed countries have published their studies in the adult hip discipline. PMID:25510756

Lessons learned from health sector reform: a four-country comparison.

PubMed

Talukder, Md Noorunnabi; Rob, Ubaidur; Mahabub-Ul-Anwar, Md

Various reforms have been undertaken to improve the functioning of health systems in developing countries, but there is limited comparative analysis of reform initiatives. This article discusses health sector reform experiences of four developing countries and identifies the lessons learned. The article is based on the review of background papers on Bangladesh, Pakistan, Indonesia, and Tanzania prepared as part of a multi-country study on health sector reform. Findings suggest that decentralization works effectively while implementing primary and secondary health programs. Decentralization of power and authority to local authorities requires strengthening and supporting these units. Along with the public sector, the private sector plays an effective role in institutional and human resources development as well as in improving service delivery. Community participation facilitates recruitment and development of field workers, facility improvement, and service delivery. For providing financial protection to the poor, there is a need to review user fees and develop affordable health insurance with an exemption mechanism. There is no uniform health sector reform approach; therefore, the experiences of other countries will help countries undertake appropriate reforms. Here, it is important to examine the context and determine the reform measures that constitute the best means in terms of equity, efficiency, and sustainability.

Partnering with migrant friendly organizations: a case example from a Canadian school of nursing.

PubMed

Hickey, Jason; Gagnon, Anita J; Merry, Lisa

2010-01-01

Worldwide immigration to many high-income countries suggests that these countries' health care systems must become responsive to a more diverse population. Experiences working with newly arrived populations can provide healthcare students, professionals, and teachers, with valuable insight into the health and social conditions these newcomers face in both source and receiving countries. One way to gain this experience may be by developing partnerships between schools of nursing in receiving countries and international health organizations working in areas that are major migrant source regions for these countries. In this paper, we use a case example to describe, the process of identifying international, migrant-focused organizations, and the steps involved in developing partnerships with these organizations, for the implementation of a migrant health component in health professional curricula. After creating a set of criteria to evaluate partnership potential, we identified a list of international health organizations with whom we thought a partnership might be possible. Following application of our criteria, future work is being pursued with two organizations. Potential implications of this partnership include benefits to all parties involved that may help us move towards increased population and public health capacity.

Assistive technology in developing countries: a review from the perspective of the Convention on the Rights of Persons with Disabilities.

PubMed

Borg, Johan; Lindström, Anna; Larsson, Stig

2011-03-01

The 'Convention on the Rights of Persons with Disabilities' (CRPD) requires governments to meet the assistive technology needs of citizens. However, the access to assistive technology in developing countries is severely limited, which is aggravated by a lack of related services. To summarize current knowledge on assistive technology for low- and lower-middle-income countries published in 1995 or later, and to provide recommendations that facilitate implementation of the CRPD. Literature review. Literature was searched in web-based databases and reference lists. Studies carried out in low- and lower-middle-income countries, or addressing assistive technology for such countries, were included. The 52 included articles are dominated by product oriented research on leg prostheses and manual wheelchairs. Less has been published on hearing aids and virtually nothing on the broad range of other types of assistive technology. To support effective implementation of the CRPD in these countries, there is a need for actions and research related particularly to policies, service delivery, outcomes and international cooperation, but also to product development and production. The article has a potential to contribute to CRPD compliant developments in the provision of assistive technology in developing countries by providing practitioners with an overview of published knowledge and researchers with identified research needs.

Comparison of approaches to rheumatic fever surveillance across Organisation for Economic Co-operation and Development countries.

PubMed

Oliver, Jane; Baker, Michael G; Pierse, Nevil; Carapetis, Jonathan

2015-11-01

Rheumatic fever (RF) prevention, control and surveillance are increasingly important priorities in New Zealand (NZ) and Australia. We compared RF surveillance across Organisation for Economic Co-operation and Development (OECD) member countries to assist in benchmarking and identifying useful approaches. A structured literature review was completed using Medline and PubMed databases, investigating RF incidence rates. Surveillance methods were noted. Health department websites were searched to assess whether addressing RF was a Government priority. Of 32 OECD member countries, nine reported RF incidence rates after 1999. Highest rates were seen in indigenous Australians, and NZ Māori and Pacific peoples. NZ and Australian surveillance systems are highly developed, with notification and register data compiled regularly. Only these two Governments appeared to prioritise RF surveillance and control. Other countries relied mainly on hospitalisation data. There is a lack of standardisation across incidence rate calculations. Israel and Italy may have relatively high RF rates among developed countries. RF lingers in specific populations in OECD member countries. At a minimum, RF registers are needed in higher incidence countries. Countries with low RF incidences should periodically review surveillance information to ensure rates are not increasing. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Setting priorities for safe motherhood programme evaluation: a participatory process in three developing countries.

PubMed

Madi, Banyana Cecilia; Hussein, Julia; Hounton, Sennen; D'Ambruoso, Lucia; Achadi, Endang; Arhinful, Daniel Kojo

2007-09-01

A participatory approach to priority setting in programme evaluation may help improve the allocation and more efficient use of scarce resources especially in low-income countries. Research agendas that are the result of collaboration between researchers, programme managers, policy makers and other stakeholders have the potential to ensure rigorous studies are conducted on matters of local priority, based on local, expert knowledge. This paper describes a process involving key stakeholders to elicit and prioritise evaluation needs for safe motherhood in three developing countries. A series of reiterative consultations with safe motherhood stakeholders from each country was conducted over a period of 36 months. In each country, the consultation process consisted of a series of participatory workshops; firstly, stakeholder's views on evaluation were elicited with parallel descriptive work on the contexts. Secondly, priorities for evaluation were identified from stakeholders; thirdly, the evaluation-priorities were refined; and finally, the evaluation research questions, reflecting the identified priorities, were agreed and finalised. Three evaluation-questions were identified in each country, and one selected, on which a full scale evaluation was undertaken. While there is a great deal written about the importance of transparent and participatory priority setting in evaluation; few examples of how such processes could be implemented exist, particularly for maternal health programmes. Our experience demonstrates that the investment in a participatory priority-setting effort is high but the process undertaken resulted in both globally and contextually-relevant priorities for evaluation. This experience provides useful lessons for public health practitioners committed to bridging the research-policy interface.

Consequences of infertility in developing countries.

PubMed

Rouchou, Brittany

2013-05-01

Infertility affects more than 10% of the world's population. In developing countries, there are severe social, psychological and economic consequences for infertile men and women. All of the cited references are compiled from primary peer-reviewed research articles that were conducted through one-to-one interviews or focus groups in countries of developing regions, such as Africa, Asia and the Middle East. The following paper seeks to raise awareness of the consequences of infertility in developing nations and identify infertility as an under-observed, but significant public health issue. It is proposed that education programmes tailored to each society's specific religious beliefs and grounded traditions must be implemented in order to reverse the social stigma, detrimental psychological effects, and loss of economic security that results from infertility.

Quantifying the risk of deforestation in Latin America and the Caribbean.

NASA Astrophysics Data System (ADS)

Manners, Rhys; Varela-Ortega, Consuelo

2015-04-01

Latin American and Caribbean countries have seen considerable deforestation due to a complex web of interconnected and interdependent causes, which include agricultural expansion, infrastructure development, social demographics and governmental policies and activity. It is necessary for successful and efficient policy development to understand how variability in these causes can potentially result in increased or decreased deforestation. The purpose of this study is to develop a tool that can quantify the risk, as in the threat or pressure, of potential deforestation, whilst identifying the key indicators that contribute to this risk. This tool will take the form of a composite index that will provide spatial and temporal trends of deforestation risk across Latin America and the Caribbean. The development of the Deforestation Risk Index (DRI) was based upon work performed in the EU project ROBIN1. Indicators of deforestation included in the index were identified based upon the multi-scalar approach adopted in ROBIN- nationally from principal component analysis and econometric modelling, provincially from extensive interviews with experts and farmers (subsistence and commercial) in Amazonian regions of Bolivia and Brazil, and locally from stakeholder workshops in Bolivia, Brazil and Mexico. The identification process was supported by an extensive literature review. In total, 11 indicators were identified and grouped into four components (biophysical, economic, governance and social) capable of explaining the risk of deforestation in Latin America and Caribbean countries. The DRI was calculated for 24 Latin American and Caribbean countries in the years 2000, 2005 and 2010 using national-level data collected from open access databases (FAOStat, WorldBank and UNDP). The DRI was subjected to two weighting schemes; the first based upon the opinions of experts from ROBIN (weighted biophysical and governance components heavily), and the second developed from the results of the ROBIN stakeholder workshops (heavily weighted the governance component). The results from the DRI were categorised as; low risk, moderate risk, at risk, elevated risk, high risk and extreme risk. The DRI demonstrated that in over 60% of countries, the risk of deforestation reduced between 2000-2010 with Belize, Costa Rica, Guyana and Venezuela being notable exceptions. Countries that saw reductions in their risk did so through economic growth (per capita GDP), institutional development (governmental effectiveness and regulatory quality), as well reductions in the scale of agricultural expansion. Despite the general trend towards lower risk, Amazonian countries were still found to be subject to potential deforestation. Bolivia, Ecuador, Guyana and Suriname were estimated to have an elevated risk of deforestation, with Brazil, Colombia and Peru considered to be at risk in 2010. The DRI provides an innovative, potentially multi-scalar tool, that can be used by national policy makers to identify where policies should be developed and directed, where specific measures in international programs such as REDD/+ could be most effectively pursued, and for international policy makers to identify and to tailor development or aid packages that reduce rather than contribute to deforestation.

Nontuberculous Mycobacteria in Saudi Arabia and Gulf Countries: A Review.

PubMed

Al-Ghafli, Hawra; Al-Hajoj, Sahal

2017-01-01

Nontuberculous Mycobacteria (NTM) are causing growing health problems worldwide. This is indicated by an increasing amount of scientific reports showing not only well-identified species reemerging but also emergence of new species. The emergence and reemergence of NTM are particularly worrying in developing countries due to scarce published data and improper identification. Here we aimed to examine the main epidemiological aspects and diagnostic challenges associated with NTM in countries of the Gulf Cooperation Council (GCC) and compare these findings to the international arena findings. Data revealed that countries of the GCC are largely dominated by rapidly growing mycobacteria species such as M. fortuitum (29%) and M. abscessus (17%) with high rate of definitive respiratory diseases. On the other hand, most of the developed countries are dominated by slowly growing mycobacteria such as MAC, M. kansasii , and M. gordonae . More efforts are needed, however, to gain insights into NTM issues in countries of the GCC.

Organizational Culture for Safety, Security, and Safeguards in New Nuclear Power Countries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kovacic, Donald N

2015-01-01

This chapter will contain the following sections: Existing international norms and standards for developing the infrastructure to support new nuclear power programs The role of organizational culture and how it supports the safe, secure, and peaceful application of nuclear power Identifying effective and efficient strategies for implementing safety, security and safeguards in nuclear operations Challenges identified in the implementation of safety, security and safeguards Potential areas for future collaboration between countries in order to support nonproliferation culture

Global Patterns in Overweight Among Children and Mothers in Less Developed Countries

PubMed Central

Van Hook, Jennifer; Altman, Claire; Balistreri, Kelly S.

2012-01-01

Objective Past research has identified increases in national income and urbanization as key drivers of the global obesity epidemic. This work further identifies educational attainment as an important moderator of these effects. However, this work has tended to assume that children and adults respond in the same way to these factors. Design In this article, we evaluate how the socioeconomic and country-level factors associated with obesity differ between children and their mothers. Setting We analyzed 95 nationally representative health and nutrition surveys conducted between 1990 and 2008 from 33 developing countries. Subjects Our sample includes children aged 2 to 4 (N=253,442) and their mothers (N = 228,655). Results Consistent with prior research, we found that mother’s risk of overweight was positively associated with economic development, urban residence, and maternal education. Additionally, economic development was associated with steeper increases in mothers’ risk of overweight among those with low (versus high) levels of education and among those living in rural (versus urban) areas. However, these associations were far weaker for children. Child overweight was unassociated with maternal education and urban residence, and negatively associated with national income. Conclusions We speculate that the distinctive patterns for children may arise from conditions in low- and middle-income developing countries that increase the risk of child underweight and poor nutrition. PMID:22583613

A national survey into desirable personality traits in anaesthesia trainees in a developing country.

PubMed

Khan, Fauzia Anis; Minai, Fauzia

2010-03-01

To explore personality traits considered to be important in selection of trainees by consultant anaesthetists in a developing country. A questionnaire listing 28 traits was sent to 125 consultant anaesthetists. The raters were asked to mark each trait on a scale of 1 to 10, with one being least desirable and 10 as most desirable. Listing of five most desirable and one least desirable trait was also required. The response rate was 79%. The most desirable trait was identified as reliability by 40%, followed by honesty 17%, functionality under stress 9%, punctuality 7%, and discipline 4%. The least desirable trait was considered as resourcefulness (21%), sense of humour (20%), unassuming mannerism (15%), high self esteem (11%), inquisitive (5%) and expedious (5%). Some traits have been identified as more desirable than others for trainees in our country. We plan to assess these in structured behavioural interviews in our residency programme.

Legal barriers in accessing opioid medicines: results of the ATOME quick scan of national legislation of eastern European countries.

PubMed

Vranken, Marjolein J M; Mantel-Teeuwisse, Aukje K; Jünger, Saskia; Radbruch, Lukas; Lisman, John; Scholten, Willem; Payne, Sheila; Lynch, Tom; Schutjens, Marie-Hélène D B

2014-12-01

Overregulation of controlled medicines is one of the factors contributing to limited access to opioid medicines. The purpose of this study was to identify legal barriers to access to opioid medicines in 12 Eastern European countries participating in the Access to Opioid Medication in Europa project, using a quick scan method. A quick scan method to identify legal barriers was developed focusing on eight different categories of barriers. Key experts in 12 European countries were requested to send relevant legislation. Legislation was quick scanned using World Health Organization guidelines. Overly restrictive provisions and provisions that contain stigmatizing language and incorrect definitions were identified. The selected provisions were scored into two categories: 1) barrier and 2) uncertain, and reviewed by two authors. A barrier was recorded if both authors agreed the selected provision to be a barrier (Category 1). National legislation was obtained from 11 of 12 countries. All 11 countries showed legal barriers in the areas of prescribing (most frequently observed barrier). Ten countries showed barriers in the areas of dispensing and showed stigmatizing language and incorrect use of definitions in their legislation. Most barriers were identified in the legislation of Bulgaria, Greece, Lithuania, Serbia, and Slovenia. The Cypriot legislation showed the fewest total number of barriers. The selected countries have in common as main barriers prescribing and dispensing restrictions, the use of stigmatizing language, and incorrect use of definitions. The practical impact of these barriers identified using a quick scan method needs to be validated by other means. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Automatic Identification of Subtechniques in Skating-Style Roller Skiing Using Inertial Sensors

PubMed Central

Sakurai, Yoshihisa; Fujita, Zenya; Ishige, Yusuke

2016-01-01

This study aims to develop and validate an automated system for identifying skating-style cross-country subtechniques using inertial sensors. In the first experiment, the performance of a male cross-country skier was used to develop an automated identification system. In the second, eight male and seven female college cross-country skiers participated to validate the developed identification system. Each subject wore inertial sensors on both wrists and both roller skis, and a small video camera on a backpack. All subjects skied through a 3450 m roller ski course using a skating style at their maximum speed. The adopted subtechniques were identified by the automated method based on the data obtained from the sensors, as well as by visual observations from a video recording of the same ski run. The system correctly identified 6418 subtechniques from a total of 6768 cycles, which indicates an accuracy of 94.8%. The precisions of the automatic system for identifying the V1R, V1L, V2R, V2L, V2AR, and V2AL subtechniques were 87.6%, 87.0%, 97.5%, 97.8%, 92.1%, and 92.0%, respectively. Most incorrect identification cases occurred during a subtechnique identification that included a transition and turn event. Identification accuracy can be improved by separately identifying transition and turn events. This system could be used to evaluate each skier’s subtechniques in course conditions. PMID:27049388

Energy efficiency and conservation in the developing world. World Bank policy paper. Energia: Eficiencia y conservacion en el mundo en desarrollo

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-01-01

Energy demand and production in developing countries are up, but efficiency of production and consumption are falling behind. The paper explores that issue and reviews the Bank's participation in energy projects. The paper conveys the Bank's strategy to promote efficiency through such means as transferring modern technology from the industrial countries and lending more selectively to energy-supply enterprises. The Bank identifies four factors that account for the differences in efficiency between the industrial and developing countries: energy pricing policies, control of energy supply enterprises, protection of energy-using industry from competition, and barriers to the productive functioning of markets.

Health policy and systems research agendas in developing countries.

PubMed

Gonzalez-Block, Miguel A

2004-08-05

BACKGROUND: Health policy and systems research (HPSR) is an international public good with potential to orient investments and performance at national level. Identifying research trends and priorities at international level is therefore important. This paper offers a conceptual framework and defines the HPSR portfolio as a set of research projects under implementation. The research portfolio is influenced by factors external to the research system as well as internal to it. These last include the capacity of research institutions, the momentum of research programs, funding opportunities and the influence of stakeholder priorities and public opinion. These dimensions can vary in their degree of coordination, leading to a complementary or a fragmented research portfolio. OBJECTIVE: The main objective is to identify the themes currently being pursued in the research portfolio and agendas within developing countries and to quantify their frequency in an effort to identify current research topics and their underlying influences. METHODS: HPSR topics being pursued by developing country producer institutions and their perceived priorities were identified through a survey between 2000 and 2002. The response to a call for letters of intent issued by the Alliance in 2000 for a broad range of topics was also analyzed. The institutions that were the universe of this study consisted of the 176 institutional partners of the Alliance for Health Policy and Systems Research producing research in low and middle income countries outside Europe. HPSR topics as well as the beneficiaries or issues and the health problems addressed were content analyzed. Topics were classified into 19 categories and their frequency analyzed across groups of countries with similar per capita income. Agendas were identified by analyzing the source of funding and of project initiation for projects under implementation. RESULTS: The highest ranking topic at the aggregate level is "Sector analysis", followed by "Disease burden" and "Management and organization". Categories at the bottom of this ranking are "Equity", "Policy process", "Economic policy and health" and "Information systems". "Disease burden" is more often funded than other topics for which there is more demand or perceived priority. Analysis suggests few although important differences across priorities, demand for funding and actual project funding. The donors' agenda coincides most with the ranking of research topics overall.Ranking across country income groups shows important differences. Topics that gain prominence in low income countries are "Disease burden" and "Accessibility". In lower middle income countries "Insurance" gains prominence. In upper middle income countries "Decentralization/local health systems", "Equity" and "Policy process" are more prominent. "Program evaluation" is the most consistently ranked topic across income regions, showing a neutral influence by donors, governments or researchers. CONCLUSIONS: The framework proposed offers a basis to identify and contrast research needs, projects and products at the international level and to identify the actor agendas and their influence. Research gaps are suggested when comparing topic ranking against the challenges to health system strengthening and scaling up of disease control programs. Differences across per capita income groups suggests the need for differentiated priority setting mechanisms guiding international support. Data suggests that stakeholders have different agendas, and that donors predominate in determining the research portfolio. High-level consensus building at the national and international levels is necessary to ensure that the diverse agendas play a complementary role in support of health system objectives.The Ministerial Summit for Health Research to be held in Mexico in November 2004 should be an opportunity to analyze further data and to commit funding for priorities identified through sharing and discussion of agendas.

Alternative method of highway traffic safety analysis for developing countries using delphi technique and Bayesian network.

PubMed

Mbakwe, Anthony C; Saka, Anthony A; Choi, Keechoo; Lee, Young-Jae

2016-08-01

Highway traffic accidents all over the world result in more than 1.3 million fatalities annually. An alarming number of these fatalities occurs in developing countries. There are many risk factors that are associated with frequent accidents, heavy loss of lives, and property damage in developing countries. Unfortunately, poor record keeping practices are very difficult obstacle to overcome in striving to obtain a near accurate casualty and safety data. In light of the fact that there are numerous accident causes, any attempts to curb the escalating death and injury rates in developing countries must include the identification of the primary accident causes. This paper, therefore, seeks to show that the Delphi Technique is a suitable alternative method that can be exploited in generating highway traffic accident data through which the major accident causes can be identified. In order to authenticate the technique used, Korea, a country that underwent similar problems when it was in its early stages of development in addition to the availability of excellent highway safety records in its database, is chosen and utilized for this purpose. Validation of the methodology confirms the technique is suitable for application in developing countries. Furthermore, the Delphi Technique, in combination with the Bayesian Network Model, is utilized in modeling highway traffic accidents and forecasting accident rates in the countries of research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Severe Maternal or Near Miss Morbidity: Implications for Public Health Surveillance and Clinical Audit.

PubMed

Kuklina, Elena V; Goodman, David A

2018-06-01

This chapter reviews the historical development of indicators to identify severe maternal morbidity/maternal near miss (SMM/MNM), and their use for public health surveillance, research, and clinical audit. While there has been progress toward identifying standard definitions for SMM/MNM within countries, there remain inconsistencies in the definition of SMM/MNM indicators and their application between countries. Using these indicators to screen for events that then trigger a clinical audit may both under identify select SMM/MNM (false negative)and over identify select SMM/MNM (false positive). Thus, indicators which support the efficient identification of SMM/MNM for the purpose of facility-based clinical audits are still needed.

Measuring nanotechnology development through the study of the dividing pattern between developed and developing countries during 2000-2014

NASA Astrophysics Data System (ADS)

Jafari, Mostafa; Zarghami, Hamid Reza

2016-07-01

This paper investigates the global nanotechnology and nanoscience (NN) indicators in a developmental context, during three 5-year periods from 2000 to 2014. Through bibliometric analyses of the longitudinal data from well-known databases, the growth patterns of NN articles and patents were investigated. Furthermore, the causal relationships among these indicators and some characteristics of the 105 countries studied were examined using regression and correlation analyses leading to the identification of the top 20 "science and innovation giants," in terms of all indicators, as well as the existence of significant, yet different, correlations among the indicators in developing and developed countries. In general, China's growth rate (GR) in NN publications was found to surpass USA, from 2010 to 2014, leading to a change in the ranking of the top countries and moving China, with about 25 % of world's NN articles, to top. A different trend was distinguished for patents in the area of nanotechnology, where USA, as the origin of over half of the world's granted patents, has been the undisputed leader. The shares of developing countries (i.e., the percent ratios of the number of nanotech patents granted to the citizens of developing countries over the total number of nanotech patents granted worldwide) was found to be incompatible with the countries' shares in the total NN articles, indicating a poor correlation between the two factors. However, developing countries were found to be superior in the GR of both NN articles and patents. Finally, the top countries identified can be regarded as suitable for comparative studies, and benchmarking by researchers and policy makers.

Type 2 diabetes self-management education programs in high and low mortality developing countries: a systematic review.

PubMed

Dube, Loveness; Van den Broucke, Stephan; Housiaux, Marie; Dhoore, William; Rendall-Mkosi, Kirstie

2015-02-01

Although self-management education is a key factor in the care for diabetes patients, its implementation in developing countries is not well documented. This systematic review considers the published literature on diabetes self-management education in high and low mortality developing countries. The aim is to provide a state of the art of current practices and assess program outcomes, cultural sensitivity, and accessibility to low literate patients. The Cochrane Library, PubMed, MEDLINE, PsycInfo, and PsycArticles databases were searched for peer-reviewed articles on type 2 diabetes published in English between 2009 and 2013. The World Bank and WHO burden of disease criteria were applied to distinguish between developing countries with high and low mortality. Information was extracted using a validated checklist. Three reviews and 23 primary studies were identified, 18 of which were from low mortality developing countries. Studies from high mortality countries were mostly quasi-experimental, those from low mortality countries experimental. Interventions were generally effective on behavior change and patients' glycemic control in the short term (≤9 months). While 57% of the studies mentioned cultural tailoring of interventions, only 17% reported on training of providers, and 39% were designed to be accessible for people with low literacy. The limited studies available suggest that diabetes self-management education programs in developing countries are effective in the short term but must be tailored to conform to the cultural aspects of the target population. © 2014 The Author(s).

The Developing Country Reactions to Biomedical Techniques and Plant Biotechnology: The Tunisian Experience

PubMed Central

Tebourski, Fethi

2004-01-01

In the present study we present the conditions offered to biotechnology development in Tunisia and we compare three main biotechnology applications which raise ethical and health problems: organ transplant, assisted reproductive techniques, and genetically modified organisms. We try to identify factors that have allowed success of the first two applications and failure of the latter. Conditions offered to biotechnology in other African countries are also discussed. PMID:15292577

International Collaboration and Its Contributions: Disseminating Knowledge and Supporting Evidence-Based Practices across Countries

ERIC Educational Resources Information Center

Collins, Belva C.; Tekin-Iftar, Elif; Olcay-Gul, Seray

2017-01-01

This article explores how international collaboration among researchers can contribute to developing evidence-based practices and disseminating knowledge in the field of special education. A review of a sample of special education journals published in English to identify articles written in collaboration by researchers from different countries is…

Public health laboratory quality management in a developing country.

PubMed

Wangkahat, Khwanjai; Nookhai, Somboon; Pobkeeree, Vallerut

2012-01-01

The article aims to give an overview of the system of public health laboratory quality management in Thailand and to produce a strengths, weaknesses, opportunities and threats (SWOT) analysis that is relevant to public health laboratories in the country. The systems for managing laboratory quality that are currently employed were described in the first component. The second component was a SWOT analysis, which used the opinions of laboratory professionals to identify any areas that could be improved to meet quality management systems. Various quality management systems were identified and the number of laboratories that met both international and national quality management requirements was different. The SWOT analysis found the opportunities and strengths factors offered the best chance to improve laboratory quality management in the country. The results are based on observations and brainstorming with medical laboratory professionals who can assist laboratories in accomplishing quality management. The factors derived from the analysis can help improve laboratory quality management in the country. This paper provides viewpoints and evidence-based approaches for the development of best possible practice of services in public health laboratories.

The current status and trend of clinical pharmacology in developing countries

PubMed Central

2013-01-01

Background Several international forums for promoting clinical pharmacology in developing countries have been held since 1980, and several clinical pharmacology programmes targeting developing countries were instituted such that the status of clinical pharmacology in developing countries is not where it was 50 years ago. Therefore, a survey and an appraisal of the literature on the current status of clinical pharmacology in developing countries were undertaken with a hope that it would enable development of appropriate strategies for further promotion of clinical pharmacology in these countries. Methods First, nine determinants (or enabling factors) for running a successful clinical pharmacology programme were identified, i.e., disease burden, drug situation, economic growth, clinical pharmacology activities, recognition, human capital, government support, international collaboration, and support for traditional/alternative medicines. These factors were then evaluated with regard to their current status in the developing countries that responded to an electronic questionnaire, and their historical perspective, using the literature appraisal. From these, a projected trend was constructed with recommendations on the way forward. Results Clinical pharmacology services, research and teaching in developing countries have improved over the past 50 years with over 90% of countries having the appropriate policies for regulation and rational use of medicines in place. Unfortunately, policy implementation remains a challenge, owing to a worsening disease burden and drug situation, versus fewer clinical pharmacologists and other competing priorities for the national budgets. This has led to a preference for training ‘a physician clinical pharmacologist’ in programmes emphasizing local relevancy and for a shorter time, and the training of other professionals in therapeutics for endemic diseases (task shifting), as the most promising strategies of ensuring rational use of medicines. Conclusion Clinical pharmacology in developing countries is advancing in a different way to that in the developed world and continuing support for these efforts will go a long way in promoting improved health for all. PMID:24074056

A comparative study of interprofessional education in global health care

PubMed Central

Herath, Chulani; Zhou, Yangfeng; Gan, Yong; Nakandawire, Naomie; Gong, Yanghong; Lu, Zuxun

2017-01-01

Abstract Background: The World Health Organization (WHO) and its partners identify interprofessional (IP) collaboration in education and practice as an innovative strategy that plays an important role in mitigating the global health workforce crisis. Evidence on the practice of global health level in interprofessional education (IPE) is scarce and hampered due to the absence of aggregate information. Therefore, this systematic review was conducted to examine the incidences of IPE and summarize the main features about the IPE programs in undergraduate and postgraduate education in developed and developing countries. Methods: The PubMed, Embase, Web of Science, and Google Scholar were searched from their inception to January 31, 2016 for relevant studies regarding the development of IPE worldwide, IPE undergraduate and postgraduate programs, IP interaction in health education, IPE content, clinical placements, and teaching methods. Countries in which a study was conducted were classified as developed and developing countries according to the definition by the United Nations (UN) in 2014. Results: A total of 65 studies from 41 countries met our inclusion criteria, including 45 studies from 25 developed countries and 20 studies from 16 developing countries. Compared with developing countries, developed countries had more IPE initiatives. IPE programs were mostly at the undergraduate level. Overall, the university was the most common academic institution that provided IPE programs. The contents of the curricula were mainly designed to provide IP knowledge, skills, and values that aimed at developing IP competencies. IPE clinical placements were typically based in hospitals, community settings, or both. The didactic and interactive teaching methods varied significantly within and across universities where they conducted IPE programs. Among all health care disciplines, nursing was the discipline that conducted most of the IPE programs. Conclusion: This systematic review illustrated that the IPE programs vary substantially across countries. Many countries, especially the academic institutions are benefiting from the implementation of IPE programs. There is a need to strengthen health education policies at global level aiming at initiating IPE programs in relevant institutions. PMID:28930816

Health workforce development in the European Union: A matrix for comparing trajectories of change in the professions.

PubMed

Pavolini, Emmanuele; Kuhlmann, Ellen

2016-06-01

This article assesses professional development trajectories in top-, middle- and basic-level health workforce groups (doctors, nurses, care assistants) in different European Union countries using available international databases. Three theoretical strands (labour market, welfare state, and professions studies) were connected to explore ideal types and to develop a matrix for comparison. With a focus on larger EU-15 countries and four different types of healthcare systems, Germany, Italy, Sweden and the United Kingdom serve as empirical test cases. The analysis draws on selected indicators from public statistics/OECD data and micro-data from the EU Labour Force Survey. Five ideal typical trajectories of professional development were identified from the literature, which served as a matrix to compare developments in the three health workforce groups. The results reveal country-specific trajectories with uneven professional development and bring opportunities for policy interventions into view. First, there is a need for integrated health labour market monitoring systems to improve data on the skills mix of the health workforce. Second, a relevant number of health workers with fixed contracts and involuntary part-time reveals an important source for better recruitment and retention strategies. Third, a general trend towards increasing numbers while worsening working conditions was identified across our country cases. This trend hits care assistants, partly also nurses, the most. The research illustrates how public data sources may serve to create new knowledge and promote more sustainable health workforce policy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Greening government procurement in developing countries: building capacity in China.

PubMed

Geng, Yong; Doberstein, Brent

2008-09-01

With increasing environmental issues and depleting resources, the effective application of green government procurement (GGP) is urgently needed and potentially can have greater impacts in the developing world rather than in the developed world. Such an approach can help promote the general goal of sustainable development and address environmental issues through purchasing and facilitating the use of environmentally friendly services and products. This paper addresses this issue by employing a case study on China. We first trace the development of the GGP concept, its spread to Asian countries, and a number of approaches used to expand GGP adoption. We then review current practices in China on GGP, and analyze and identify some of the current barriers and problems in promoting green procurement in the Chinese governmental sector. We finally seek to identify possible appropriate capacity-building solutions, in order to facilitate the application of GGP in China.

Common threads? Palliative care service developments in seven European countries.

PubMed

Clark, D; ten Have, H; Janssens, R

2000-11-01

Since the late 1960s hospice and palliative care services have been developing in many European countries. Although attention has been given to patterns of development in specific national contexts, so far we lack a comparative understanding of how these services are organized and delivered. Such a comparison poses certain practical and methodological difficulties. It does, however, allow a wider view of the current provision of palliative care in Europe, together with a consideration of implications for the future. We report on an analysis of palliative care developments in seven European countries which gave attention to early origins, patterns of provision, and structural and policy integration. We conclude that, despite different processes of development, the emergent discipline of palliative care now finds its most congenial home within the structures of the formal health care system. Accordingly, inequities between the seven countries can be more clearly identified, posing continuing challenges to policy makers and planners who operate with a European perspective.

Factors that influence a career choice in primary care among medical students from high-, middle-, and low-income countries: a systematic review.

PubMed

Puertas, E Benjamín; Arósquipa, Carlos; Gutiérrez, Daniela

2013-11-01

To determine which factors influence a medical student's decision to choose a career in primary care; and to establish if these factors are similar or different among students in high-, middle- and low-income countries. An extensive search was done of PubMed, Google Scholar, and Virtual Library of Health for articles on primary care careers published in 2003-2013 in English, Spanish, and/or Portuguese. Initially, 600 records were identified; 74 full-text articles were assessed for eligibility and 55 were selected (42 from high-income countries; 13 from middle- and low-income). These were assessed to identify intrinsic and extrinsic factors that influence career choice among medical students from high-, middle-, and low-income countries. A comparison framework with common and specific factors that influence career choice in primary care among medical students from high-, middle- and low-income was developed. Factors were classified as extrinsic or intrinsic, and as facilitators or barriers. Several factors common to all countries were identified: facilitators were exposure to rural location, role models, working conditions; barriers were low income, prestige, and medical school environment. Some factors specific to middle- and low-income countries were: understanding of rural needs and intellectual challenge. Other factors specific to high-income countries were: attitude towards social problems, voluntary work, influence of family, and length of residency. Further studies on the subject are needed, especially in low- and middle-income countries. Identifying factors as barriers or facilitators for career choice will promote a better understanding of the reasons behind the shortage of primary care professionals and will contribute to policy building, improved training, and recruitment and retention of these professionals.

The process of changing national malaria treatment policy: lessons from country-level studies.

PubMed

Williams, Holly Ann; Durrheim, David; Shretta, Rima

2004-11-01

Widespread resistance of Plasmodium falciparum parasites to commonly used antimalarials, such as chloroquine, has resulted in many endemic countries considering changing their malaria treatment policy. Identifying and understanding the key influences that affect decision-making, and factors that facilitate or undermine policy implementation, is critical for improving the policy process and guiding resource allocation during this process. A historical review of archival documents from Malaŵi and data obtained from in-depth policy studies in four countries (Tanzania, South Africa, Kenya and Peru) that have changed malaria treatment policy provides important lessons about decision-making, the policy cycle and complex policy environment, while specifically identifying strategies successfully employed to facilitate policy-making and implementation. Findings from these country-level studies indicate that the process of malaria drug policy review should be institutionalized in endemic countries and based on systematically collected data. Key stakeholders need to be identified early and engaged in the process, while improved communication is needed on all levels. Although malaria drug policy change is often perceived to be a daunting task, using these and other proven strategies should assist endemic countries to tackle this challenge in a systematic fashion that ensures the development and implementation of the rational malaria drug policy.

A cross-national comparison of aggressors, victims and defenders in preschools in England, Spain and Italy.

PubMed

Monks, Claire P; Palermiti, Annalisa; Ortega, Rosario; Costabile, Angela

2011-05-01

There is a small, but growing, body of research investigating peer-victimisation between preschoolers, an age which has been identified as being important both theoretically and practically for the development of interventions. This study compares aggressive and defending behaviour and victim status of preschoolers in three European countries; England, Spain and Italy. The results provide further confirmation that some children behave aggressively towards their peers during preschool in each of the countries studied. There are similarities between preschool children involved in peer-victimisation in the three countries in terms of the roles taken, sex differences and the types of aggressive behaviours used and experienced by the children. There were differences in the profiles of children identified as taking the roles by teachers and peers. Overall, it was found that those children identified by peers or teachers as being aggressive were more likely to be male, rated as physically strong and more likely to be rejected by classmates. Also, in general, the targets of peer-victimisation differed depending on the reporter. Peer-nominated victims were not identifiable in terms of gender, popularity or physical strength. Teacher-nominated victims were more likely to be socially rejected and physically weak. There are several subtle differences between the countries which deserve further investigation. The findings are discussed in relation to furthering our understanding of the development of peer-victimisation in preschools and the need for interventions which address this phenomenon.

Country-specific dietary patterns and associations with socioeconomic status in European children: the IDEFICS study.

PubMed

Fernández-Alvira, J M; Bammann, K; Pala, V; Krogh, V; Barba, G; Eiben, G; Hebestreit, A; Veidebaum, T; Reisch, L; Tornaritis, M; Kovacs, E; Huybrechts, I; Moreno, L A

2014-07-01

Children from lower socioeconomic status (SES) may be at higher risk of unhealthy eating. We described country-specific dietary patterns among children aged 2-9 years from eight European countries participating in the IDEFICS study and assessed the association of dietary patterns with an additive SES indicator. Children aged 2-9 years from eight European countries were recruited in 2007-2008. Principal component analysis was applied to identify dietary country-specific patterns. Linear regression analyses were applied to assess their association with SES. Two to four dietary patterns were identified in the participating regions. The existence of a 'processed' pattern was found in the eight regions. Also, a 'healthy' pattern was identified in seven of the eight regions. In addition, region-specific patterns were identified, reflecting the existing gastronomic and cultural differences in Europe. The 'processed' pattern was significantly inversely associated with the SES additive indicator in all countries except Sweden, whereas the 'healthy' pattern was positively associated with SES in the Belgian, Estonian, German and Hungarian regions, but was not significant in the Italian, Spanish and Swedish regions. A 'processed' pattern and a 'healthy' pattern were found in most of the participating countries in the IDEFICS study, with comparable food item profiles. The results showed a strong inverse association of SES with the 'processed' pattern, suggesting that children of parents with lower SES may be at higher risk of unhealthy eating. Therefore, special focus should be given to parents and their children from lower SES levels when developing healthy eating promotion strategies.

Dengue Contingency Planning: From Research to Policy and Practice

PubMed Central

Runge-Ranzinger, Silvia; Kroeger, Axel; Olliaro, Piero; McCall, Philip J.; Sánchez Tejeda, Gustavo; Lloyd, Linda S.; Hakim, Lokman; Bowman, Leigh R.; Horstick, Olaf; Coelho, Giovanini

2016-01-01

Background Dengue is an increasingly incident disease across many parts of the world. In response, an evidence-based handbook to translate research into policy and practice was developed. This handbook facilitates contingency planning as well as the development and use of early warning and response systems for dengue fever epidemics, by identifying decision-making processes that contribute to the success or failure of dengue surveillance, as well as triggers that initiate effective responses to incipient outbreaks. Methodology/Principal findings Available evidence was evaluated using a step-wise process that included systematic literature reviews, policymaker and stakeholder interviews, a study to assess dengue contingency planning and outbreak management in 10 countries, and a retrospective logistic regression analysis to identify alarm signals for an outbreak warning system using datasets from five dengue endemic countries. Best practices for managing a dengue outbreak are provided for key elements of a dengue contingency plan including timely contingency planning, the importance of a detailed, context-specific dengue contingency plan that clearly distinguishes between routine and outbreak interventions, surveillance systems for outbreak preparedness, outbreak definitions, alert algorithms, managerial capacity, vector control capacity, and clinical management of large caseloads. Additionally, a computer-assisted early warning system, which enables countries to identify and respond to context-specific variables that predict forthcoming dengue outbreaks, has been developed. Conclusions/Significance Most countries do not have comprehensive, detailed contingency plans for dengue outbreaks. Countries tend to rely on intensified vector control as their outbreak response, with minimal focus on integrated management of clinical care, epidemiological, laboratory and vector surveillance, and risk communication. The Technical Handbook for Surveillance, Dengue Outbreak Prediction/ Detection and Outbreak Response seeks to provide countries with evidence-based best practices to justify the declaration of an outbreak and the mobilization of the resources required to implement an effective dengue contingency plan. PMID:27653786

[The European countries confronting cancer: a set of indicators assessing public health status].

PubMed

Borella, Laurent

2008-11-01

We now know that efficient public policies for cancer control need to be global and take into account each and all the factors involved: economics and level of development, style of life and risk factors, access to screening, effectiveness of the care-providing system. A very simple scorecard is proposed, based on publicized public health indicators, which allows a comparison between European countries. We extracted 49 indicators from public databases and literature concerning 22 European countries. We made correlation calculations in order to identify relevant indicators from which a global score was extracted. Using a hierarchical clustering method we were then able to identify subsets of homogeneous countries. A 7 indicator scorecard was drawn up: national gross product, scientific production, smoking rate, breast screening participating rate, all cancer mortality rate (male population), 5 years relative survival for colorectal cancer and life expectancy at birth. A global score shows: 1) the better positioned countries: Switzerland, Sweden, Finland and France; 2) the countries where cancer control is less effective: Estonia, Hungary, Poland and Slovakia. Three subsets of countries with a fairly similar profile were identified: a high level of means and results group; a high level of means but a medium level of results group; and a low level of means and results group. This work emphasizes dramatically heterogeneous situations between countries. A follow-up, using a reduced but regularly updated set of public health indicators, would help induce an active European policy for cancer control.

Suicide rate in relation to the Human Development Index and other health related factors: A global ecological study from 91 countries.

PubMed

Khazaei, Salman; Armanmehr, Vajihe; Nematollahi, Shahrzad; Rezaeian, Shahab; Khazaei, Somayeh

2017-06-01

There has been no worldwide ecological study on suicide as a global major public health problem. This study aimed to identify the variations in suicide specific rates using the Human Development Index (HDI) and some health related variables among countries around the world. In this ecological study, we obtained the data from the World Bank Report 2013. The analysis was restricted to 91 countries for which both the epidemiologic data from the suicide rates and HDI were available. Overall, the global prevalence of suicide rate was 10.5 (95% confidence intervals: 8.8, 12.2) per 100,000 individuals, which significantly varied according to gender (16.3 in males vs. 4.6 in females, p<0.001) and different levels of human development (11.64/100,000 individuals in very high development countries, 7.93/100,000 individuals in medium development countries, and 13.94/100,000 individuals in high development countries, p=0.004). In conclusion, the suicide rate varies greatly between countries with different development levels. Our findings also suggest that male gender and HDI components are associated with an increased risk of suicide behaviors. Hence, detecting population subgroups with a high suicide risk and reducing the inequality of socioeconomic determinants are necessary to prevent this disorder around the world. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Noncommunicable diseases among urban refugees and asylum-seekers in developing countries: a neglected health care need

PubMed Central

2014-01-01

With the increasing trend in refugee urbanisation, growing numbers of refugees are diagnosed with chronic noncommunicable diseases (NCDs). However, with few exceptions, the local and international communities prioritise communicable diseases. The aim of this study is to review the literature to determine the prevalence and distribution of chronic NCDs among urban refugees living in developing countries, to report refugee access to health care for NCDs and to compare the prevalence of NCDs among urban refugees with the prevalence in their home countries. Major search engines and refugee agency websites were systematically searched between June and July 2012 for articles and reports on NCD prevalence among urban refugees. Most studies were conducted in the Middle East and indicated a high prevalence of NCDs among urban refugees in this region, but in general, the prevalence varied by refugees’ region or country of origin. Hypertension, musculoskeletal disease, diabetes and chronic respiratory disease were the major diseases observed. In general, most urban refugees in developing countries have adequate access to primary health care services. Further investigations are needed to document the burden of NCDs among urban refugees and to identify their need for health care in developing countries. PMID:24708876

Unexpected flood loss correlations across Europe

NASA Astrophysics Data System (ADS)

Booth, Naomi; Boyd, Jessica

2017-04-01

Floods don't observe country borders, as highlighted by major events across Europe that resulted in heavy economic and insured losses in 1999, 2002, 2009 and 2013. Flood loss correlations between some countries occur along multi-country river systems or between neighbouring nations affected by the same weather systems. However, correlations are not so obvious and whilst flooding in multiple locations across Europe may appear independent, for a re/insurer providing cover across the continent, these unexpected correlations can lead to high loss accumulations. A consistent, continental-scale method that allows quantification and comparison of losses, and identifies correlations in loss between European countries is therefore essential. A probabilistic model for European river flooding was developed that allows estimation of potential losses to pan-European property portfolios. By combining flood hazard and exposure information in a catastrophe modelling platform, we can consider correlations between river basins across Europe rather than being restricted to country boundaries. A key feature of the model is its statistical event set based on extreme value theory. Using historical river flow data, the event set captures spatial and temporal patterns of flooding across Europe and simulates thousands of events representing a full range of possible scenarios. Some known correlations were identified, such as between neighbouring Belgium and Luxembourg where 28% of events that affect either country produce a loss in both. However, our model identified some unexpected correlations including between Austria and Poland, and Poland and France, which are geographically distant. These correlations in flood loss may be missed by traditional methods and are key for re/insurers with risks in multiple countries. The model also identified that 46% of European river flood events affect more than one country. For more extreme events with a return period higher than 200 years, all events impact more than one country. These tail events also demonstrate that it is unlikely for the market to experience an extreme event which does not affect at least five European countries.

National nursing strategies in seven countries of the Region of the Americas: issues and impact.

PubMed

Shasanmi, Rebecca O; Kim, Esther M; Cassiani, Silvia Helena De Bortoli

2015-07-01

To identify and examine the current national nursing strategies and policy impact of workforce development regarding human resources for health in seven selected countries in the Region of the Americas: Argentina, Canada, Costa Rica, Jamaica, Mexico, Peru, and the United States. A review of available literature was conducted to identify publicly-available documents that describe the general backdrop of nursing human resources in these seven countries. A keyword search of PubMed was supplemented by searches of websites maintained by Ministries of Health and nursing organizations. Inclusion criteria limited documents to those published in 2008-2013 that discussed or assessed situational issues and/or progress surrounding the nursing workforce. Nursing human resources for health is progressing. Canada, Mexico, and the United States have stronger nursing leadership in place and multisectoral policies in workforce development. Jamaica shows efforts among the Caribbean countries to promote collaborative practices in research. The three selected countries in Central and South America championed networks to revive nursing education. Yet, overall challenges limit the opportunities to impact public health. The national nursing strategies prioritized multisectoral collaboration, professional competencies, and standardized educational systems, with some countries underscoring the need to align policies with efforts to promote nursing leadership, and others, focusing on expanding the scope of practice to improve health care delivery. While each country wrestles with its specific context, all require proper leadership, multisectoral collaboration, and appropriate resources to educate, train, and empower nurses to be at the forefront.

Analysing inter-relationships among water, governance, human development variables in developing countries

NASA Astrophysics Data System (ADS)

Dondeynaz, C.; Carmona Moreno, C.; Céspedes Lorente, J. J.

2012-10-01

The "Integrated Water Resources Management" principle was formally laid down at the International Conference on Water and Sustainable development in Dublin 1992. One of the main results of this conference is that improving Water and Sanitation Services (WSS), being a complex and interdisciplinary issue, passes through collaboration and coordination of different sectors (environment, health, economic activities, governance, and international cooperation). These sectors influence or are influenced by the access to WSS. The understanding of these interrelations appears as crucial for decision makers in the water sector. In this framework, the Joint Research Centre (JRC) of the European Commission (EC) has developed a new database (WatSan4Dev database) containing 42 indicators (called variables in this paper) from environmental, socio-economic, governance and financial aid flows data in developing countries. This paper describes the development of the WatSan4Dev dataset, the statistical processes needed to improve the data quality, and finally, the analysis to verify the database coherence is presented. Based on 25 relevant variables, the relationships between variables are described and organised into five factors (HDP - Human Development against Poverty, AP - Human Activity Pressure on water resources, WR - Water Resources, ODA - Official Development Aid, CEC - Country Environmental Concern). Linear regression methods are used to identify key variables having influence on water supply and sanitation. First analysis indicates that the informal urbanisation development is an important factor negatively influencing the percentage of the population having access to WSS. Health, and in particular children's health, benefits from the improvement of WSS. Irrigation is also enhancing Water Supply service thanks to multi-purpose infrastructure. Five country profiles are also created to deeper understand and synthetize the amount of information gathered. This new classification of countries is useful in identifying countries with a less advanced position and weaknesses to be tackled. The relevance of indicators gathered to represent environmental and water resources state is questioned in the discussion section. The paper concludes with the necessity to increase the reliability of current indicators and calls for further research on specific indicators, in particular on water quality at national scale, in order to better include environmental state in analysis to WSS.

Elaborating the History of Our Cementing Societies: An in-Use Stock Perspective.

PubMed

Cao, Zhi; Shen, Lei; Løvik, Amund N; Müller, Daniel B; Liu, Gang

2017-10-03

Modern cities and societies are built fundamentally based on cement and concrete. The global cement production has risen sharply in the past decades due largely to urbanization and construction. Here we deployed a top-down dynamic material flow analysis (MFA) model to quantify the historical development of cement in-use stocks in residential, nonresidential, and civil engineering sectors of all world countries. We found that global cement production spreads unevenly among 184 countries, with China dominating the global production and consumption after the 1990s. Nearly all countries have shown an increasing trend of per capita cement in-use stock in the past century. The present per capita cement in-use stocks vary from 10 to 40 tonnes in major industrialized and transiting countries and are below 10 tonnes in developing countries. Evolutionary modes identified from historical patterns suggest that per capita in-use cement stock growth generally complies with an S-shape curve and relates closely to affluence and urbanization of a country, but more in-depth and bottom-up investigations are needed to better understand socioeconomic drivers behind stock growth. These identified in-use stock patterns can help us better estimate future demand of cement, explore strategies for emissions reduction in the cement industry, and inform CO 2 uptake potentials of cement based products and infrastructure in service.

Investment in preventing and preparing for biological emergencies and disasters: social and economic costs of disasters versus costs of surveillance and response preparedness.

PubMed

Rushton, J; Upton, M

2006-04-01

Biological emergencies such as the appearance of an exotic transboundary or emerging disease can become disasters. The question that faces Veterinary Services in developing countries is how to balance resources dedicated to active insurance measures, such as border control, surveillance, working with the governments of developing countries, and investing in improving veterinary knowledge and tools, with passive measures, such as contingency funds and vaccine banks. There is strong evidence that the animal health situation in developed countries has improved and is relatively stable. In addition, through trade with other countries, developing countries are becoming part of the international animal health system, the status of which is improving, though with occasional setbacks. However, despite these improvements, the risk of a possible biological disaster still remains, and has increased in recent times because of the threat of bioterrorism. This paper suggests that a model that combines decision tree analysis with epidemiology is required to identify critical points in food chains that should be strengthened to reduce the risk of emergencies and prevent emergencies from becoming disasters.

Low- and middle-income countries face many common barriers to implementation of maternal health evidence products.

PubMed

Puchalski Ritchie, Lisa M; Khan, Sobia; Moore, Julia E; Timmings, Caitlyn; van Lettow, Monique; Vogel, Joshua P; Khan, Dina N; Mbaruku, Godfrey; Mrisho, Mwifadhi; Mugerwa, Kidza; Uka, Sami; Gülmezoglu, A Metin; Straus, Sharon E

2016-08-01

To explore similarities and differences in challenges to maternal health and evidence implementation in general across several low- and middle-income countries (LMICs) and to identify common and unique themes representing barriers to and facilitators of evidence implementation in LMIC health care settings. Secondary analysis of qualitative data. Meeting reports and articles describing projects undertaken by the authors in five LMICs on three continents were analyzed. Projects focused on identifying barriers to and facilitators of implementation of evidence products: five World Health Organization maternal health guidelines, and a knowledge translation strategy to improve adherence to tuberculosis treatment. Data were analyzed using thematic content analysis. Among identified barriers to evidence implementation, a high degree of commonality was found across countries and clinical areas, with lack of financial, material, and human resources most prominent. In contrast, few facilitators were identified varied substantially across countries and evidence implementation products. By identifying common barriers and areas requiring additional attention to ensure capture of unique barriers and facilitators, these findings provide a starting point for development of a framework to guide the assessment of barriers to and facilitators of maternal health and potentially to evidence implementation more generally in LMICs. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Conditions for research in general practice. Can the Dutch and British experiences be applied to other countries, for example Spain?

PubMed

van der Zee, Jouke; Kroneman, Madelon; Bolíbar, Bonaventura

2003-06-01

The aim of this study is to identify conditions for research as part of professional development in general practice. Based on the work of Andrew Abbott, who studied the dynamics of professional development, five conditions were identified. These are: the creation of associations among professionals; control of work; the establishment of specialised education; the development of professional knowledge; and the creation of organised structures for professional work. Two countries with a well-established research tradition in general practice (the UK and the Netherlands) and one country where GP research development is still limited (Spain) were evaluated on the basis of these conditions. The conditions identified as favourable were as follows: the existence of a scientific association; a peer-reviewed journal; a defined population resulting in a population denominator for practices; a gatekeeping system; chairs and departments of general practice at universities; the integration of education centres and research centres; GPs working in group practices or health centres; a certain degree of independence from the Ministry of Health; and financial support for practicing GPs to conduct research activities. We showed that most conditions for the successful scientific progress of general practice in Spain are present. However there is still a gap between academia and general practice and a lack of research organisation and support.

A methodology for small scale rural land use mapping in semi-arid developing countries using orbital imagery. Part 3: Review of land use surveys using orbital imagery in the USA

NASA Technical Reports Server (NTRS)

Vangenderen, J. L. (Principal Investigator); Lock, B. F.

1976-01-01

The author has identified the following significant results. Techniques of preprocessing, interpretation, classification, and ground truth sampling were studied. It has shown the need for a low cost, low level technology, viable, operational methodology to replace the emphasis given in the U.S. to machine processing, which many developing countries cannot afford, understand, nor implement.

A Copmarative Review of Electronic Prescription Systems: Lessons Learned from Developed Countries

PubMed Central

Samadbeik, Mahnaz; Ahmadi, Maryam; Sadoughi, Farahnaz; Garavand, Ali

2017-01-01

This review study aimed to compare the electronic prescription systems in five selected countries (Denmark, Finland, Sweden, England, and the United States). Compared developed countries were selected by the identified selection process from the countries that have electronic prescription systems. Required data were collected by searching the valid databases, most widely used search engines, and visiting websites related to the national electronic prescription system of each country and also sending E-mails to the related organizations using specifically designed data collection forms. The findings showed that the electronic prescription system was used at the national, state, local, and area levels in the studied countries and covered the whole prescription process or part of it. There were capabilities of creating electronic prescription, decision support, electronically transmitting prescriptions from prescriber systems to the pharmacies, retrieving the electronic prescription at the pharmacy, electronic refilling prescriptions in all studied countries. The patient, prescriber, and dispenser were main human actors, as well as the prescribing and dispensing providers were main system actors of the Electronic Prescription Service. The selected countries have accurate, regular, and systematic plans to use electronic prescription system, and health ministry of these countries was responsible for coordinating and leading the electronic health. It is suggested to use experiences and programs of the leading countries to design and develop the electronic prescription systems. PMID:28331859

Cheap and Nasty? The Potential Perils of Using Management Costs to Identify Global Conservation Priorities

PubMed Central

McCreless, Erin; Visconti, Piero; Carwardine, Josie; Wilcox, Chris; Smith, Robert J.

2013-01-01

The financial cost of biodiversity conservation varies widely around the world and such costs should be considered when identifying countries to best focus conservation investments. Previous global prioritizations have been based on global models for protected area management costs, but this metric may be related to other factors that negatively influence the effectiveness and social impacts of conservation. Here we investigate such relationships and first show that countries with low predicted costs are less politically stable. Local support and capacity can mitigate the impacts of such instability, but we also found that these countries have less civil society involvement in conservation. Therefore, externally funded projects in these countries must rely on government agencies for implementation. This can be problematic, as our analyses show that governments in countries with low predicted costs score poorly on indices of corruption, bureaucratic quality and human rights. Taken together, our results demonstrate that using national-level estimates for protected area management costs to set global conservation priorities is simplistic, as projects in apparently low-cost countries are less likely to succeed and more likely to have negative impacts on people. We identify the need for an improved approach to develop global conservation cost metrics that better capture the true costs of avoiding or overcoming such problems. Critically, conservation scientists must engage with practitioners to better understand and implement context-specific solutions. This approach assumes that measures of conservation costs, like measures of conservation value, are organization specific, and would bring a much-needed focus on reducing the negative impacts of conservation to develop projects that benefit people and biodiversity. PMID:24260502

Palliative Care Development in European Care Homes and Nursing Homes: Application of a Typology of Implementation.

PubMed

Froggatt, Katherine; Payne, Sheila; Morbey, Hazel; Edwards, Michaela; Finne-Soveri, Harriet; Gambassi, Giovanni; Pasman, H Roeline; Szczerbińska, Katarzyna; Van den Block, Lieve

2017-06-01

The provision of institutional long-term care for older people varies across Europe reflecting different models of health care delivery. Care for dying residents requires integration of palliative care into current care work, but little is known internationally of the different ways in which palliative care is being implemented in the care home setting. To identify and classify, using a new typology, the variety of different strategic, operational, and organizational activities related to palliative care implementation in care homes across Europe. We undertook a mapping exercise in 29 European countries, using 2 methods of data collection: (1) a survey of country informants, and (2) a review of data from publically available secondary data sources and published research. Through a descriptive and thematic analysis of the survey data, we identified factors that contribute to the development and implementation of palliative care into care homes at different structural levels. From these data, a typology of palliative care implementation for the care home sector was developed and applied to the countries surveyed. We identified 3 levels of palliative care implementation in care homes: macro (national/regional policy, legislation, financial and regulatory drivers), meso (implementation activities, such as education, tools/frameworks, service models, and research), and micro (palliative care service delivery). This typology was applied to data collected from 29 European countries and demonstrates the diversity of palliative care implementation activity across Europe with respect to the scope, type of development, and means of provision. We found that macro and meso factors at 2 levels shape palliative care implementation and provision in care homes at the micro organizational level. Implementation at the meso and micro levels is supported by macro-level engagement, but can happen with limited macro strategic drivers. Ensuring the delivery of consistent and high-quality palliative care in care homes is supported by implementation activity at these 3 levels. Understanding where each country is in terms of activity at these 3 levels (macro, meso, and micro) will allow strategic focus on future implementation work in each country. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Environmental influences on food security in high-income countries.

PubMed

Gorton, Delvina; Bullen, Chris R; Mhurchu, Cliona Ni

2010-01-01

Food security is a fundamental human right yet many people are food insecure, even in high-income countries. Reviewed here is the evidence for the physical, economic, sociocultural, and political environmental influences on household food security in high-income countries. The literature was evaluated using the ANGELO framework, which is a lens developed for understanding the environmental factors underpinning the obesity pandemic. A review of the literature identified 78 articles, which mostly reported on cross-sectional or qualitative studies. These studies identified a wide range of factors associated with food security. Foremost among them was household financial resources, but many other factors were identified and the complexity of the issue was highlighted. Few studies were prospective and even fewer tested the use of interventions other than the supplemental nutrition assistance program to address food security. This indicates a solution-oriented research paradigm is required to identify effective interventions and policies to enhance food security. In addition, comprehensive top-down and bottom-up interventions at the community and national levels are urgently needed.

Recombinase polymerase amplification: Emergence as a critical molecular technology for rapid, low-resource diagnostics.

PubMed

James, Ameh; Macdonald, Joanne

2015-01-01

Isothermal molecular diagnostics are bridging the technology gap between traditional diagnostics and polymerase chain reaction-based methods. These new techniques enable timely and accurate testing, especially in settings where there is a lack of infrastructure to support polymerase chain reaction facilities. Despite this, there is a significant lack of uptake of these technologies in developing countries where they are highly needed. Among these novel isothermal technologies, recombinase polymerase amplification (RPA) holds particular potential for use in developing countries. This rapid nucleic acid amplification approach is fast, highly sensitive and specific, and amenable to countries with a high burden of infectious diseases. Implementation of RPA technology in developing countries is critically required to assess limitations and potentials of the diagnosis of infectious disease, and may help identify impediments that prevent adoption of new molecular technologies in low resource- and low skill settings. This review focuses on approaching diagnosis of infectious disease with RPA.

Study of future world markets for agricultural aircraft

NASA Technical Reports Server (NTRS)

Gobetz, F. W.; Assarabowski, R. J.

1979-01-01

The future world market for US-manufactured agricultural aircraft was studied and the technology needs for foreign markets were identified. Special emphasis was placed on the developing country market, but the developed countries and the communist group were also included in the forecasts. Aircraft needs were projected to the year 2000 by a method which accounted for field size, crop production, treated area, productivity, and attrition of the fleet. A special scenario involving a significant shift toward aerial fertilization was also considered. An operations analysis was conducted to compare the relative application costs of various existing and hypothetical future aircraft. A case study was made of Colombia as an example of a developing country in which aviation is emerging as an important industry.

Review article: Associations between Helicobacter pylori and obesity--an ecological study.

PubMed

Lender, N; Talley, N J; Enck, P; Haag, S; Zipfel, S; Morrison, M; Holtmann, G J

2014-07-01

There is emerging debate over the effect of Helicobacter pylori infection on body mass index (BMI). A recent study demonstrated that individuals who underwent H. pylori eradication developed significant weight gain as compared to subjects with untreated H. pylori colonisation. To elucidate the association between H. pylori colonisation and the prevalence of overweight and obesity in developed countries. The literature was searched for publications reporting data on H. pylori prevalence rates and obesity prevalence rates. Studies selected reported H. pylori prevalence in random population samples with sample sizes of more than 100 subjects in developed countries (GDP >25,000 US$/person/year). Corresponding BMI distributions for corresponding countries and regions were identified. Nonparametric tests were used to compare the association between H. pylori and overweight and obesity rates. Forty-nine studies with data from 10 European countries, Japan, the US and Australia were identified. The mean H. pylori rate was 44.1% (range 17-75%), the mean rates for obesity and overweight were 46.6 (± 16)% and 14.2 (± 8.9)%. The rate of obesity and overweight were inversely and significantly (r = 0.29, P < 0.001) correlated with the prevalence of H. pylori infection. There is an inverse correlation between H. pylori prevalence and rate of overweight/obesity in countries of the developed world. Thus, the gradual decrease of the H. pylori colonisation that has been observed in recent decades (or factors associated with decrease of) could be causally related to the obesity endemic observed in the Western world. © 2014 John Wiley & Sons Ltd.

A New Approach for Analysing National Innovation Systems in Emerging and Developing Countries

ERIC Educational Resources Information Center

Seidel, Uwe; Muller, Lysann; Meier zu Kocker, Gerd; Filho, Guajarino de Araujo

2013-01-01

This paper presents a tool for the indicator-based analysis of national innovation systems (ANIS). ANIS identifies the economic strengths and weaknesses of a country-wide, regional or local system and includes a comprehensive examination and evaluation of the status of existing innovation systems. The use of a particular form of expert interviews…

Teacher Training Intervention for Early Identification of Common Child Mental Health Problems in Pakistan

ERIC Educational Resources Information Center

Hussein, S. A.; Vostanis, P.

2013-01-01

School-based interventions involving teacher training programmes have been shown to benefit teachers' ability to identify and manage child mental health problems in developed countries. However, very few studies have been conducted in low-income countries with limited specialist services. The aim of the study was to evaluate the impact of the…

A qualitative evaluation of leadership development workshops for mental health workers from four Pacific Island Countries.

PubMed

Fung, Paul; Montague, Ros

2015-06-01

This paper provides a qualitative evaluation of a series of leadership development workshops held at the New South Wales Institute of Psychiatry (NSWIOP) for mental health workers from Papua New Guinea, Federated States of Micronesia, Republic of Marshall Islands, and Palau. Fourteen mental health workers attended the week-long training focused on project management and partnership development skills. In-depth interviews were conducted with participants at the commencement and conclusion of the training, and questionnaires were completed. A focus group was conducted with the NSWIOP organisers. The data was analysed using qualitative techniques to identify emergent themes for both participants and NSWIOP project team. All Pacific Island participants responded positively to the training. All reported greater confidence in taking on formal or informal leadership roles in the workplace, developing project planning skills and interpersonal skills such as networking and partnerships. The NSWIOP organisers identified strengths and weaknesses in the delivery of this training. The strong partnerships developed between NSWIOP and the Ministry of Health in all four countries contributed to the success of the training. Leadership Development Programs are an important aspect of building capacity in the mental health services of Pacific Island Countries. © The Royal Australian and New Zealand College of Psychiatrists 2015.

A climate trend analysis of Uganda

USGS Publications Warehouse

Funk, Christopher C.; Rowland, Jim; Eilerts, Gary; White, Libby

2012-01-01

This brief report, drawing from a multi-year effort by the U.S. Agency for International Development (USAID) Famine Early Warning Systems Network (FEWS NET), identifies observed changes in rainfall and temperature in Uganda, based on an analysis of a quality-controlled, long time series of station observations throughout Uganda. Extending recent trends forward, it also provides a current and near-future context for understanding the actual nature of climate change impacts in the country, and a basis for identifying climate adaptations that may protect and improve the country's food security.

Strategies for personnel sustainable lifecycle at astronomical observatories and local industry development

NASA Astrophysics Data System (ADS)

Bendek, Eduardo A.; Leatherbee, Michael; Smith, Heather; Strappa, Valentina; Zinnecker, Hans; Perez, Mario

2014-08-01

Specialized manpower required to efficiently operate world-class observatories requires large investments in time and resources to train personnel in very specific areas of engineering. Isolation and distances to mayor cities pose a challenge to retain motivated and qualified personnel on the mountain. This paper presents strategies that we believe may be effective for retaining this specific know-how in the astronomy field; while at the same time develop a local support industry for observatory operations and astronomical instrumentation development. For this study we choose Chile as a research setting because it will host more than 60% of the world's ground based astronomical infrastructure by the end of the decade, and because the country has an underdeveloped industry for astronomy services. We identify the astronomical infrastructure that exists in the country as well as the major research groups and industrial players. We further identify the needs of observatories that could be outsourced to the local economy. As a result, we suggest spin-off opportunities that can be started by former observatory employees and therefore retaining the knowhow of experienced people that decide to leave on-site jobs. We also identify tools to facilitate this process such as the creation of a centralized repository of local capabilities and observatory needs, as well as exchange programs within astronomical instrumentation groups. We believe that these strategies will contribute to a positive work environment at the observatories, reduce the operation and development costs, and develop a new industry for the host country.

Building partnership in oral cancer research in a developing country: processes and barriers.

PubMed

Zain, Rosnah Binti; Ghani, Wan Maria Nabillah; Razak, Ishak Abdul; Latifah, Raja Jallaludin Raja; Samsuddin, Abdul Rani; Cheong, Sok Ching; Abdullah, Norlida; Ismail, Abdul Rashid; Hussaini, Haizal Bin; Talib, Norain Abu; Jallaludin, Amin

2009-01-01

The rising burden of cancer in the developing world calls for a re-evaluation of the treatment strategies employed to improve patient management, early detection and understanding of the disease. There is thus an increasing demand for interdisciplinary research that integrates two or more disciplines of what may seemed to be highly unrelated and yet very much needed as strategies for success in research. This paper presents the processes and barriers faced in building partnerships in oral cancer research in a developing country. A case study was undertaken in a developing country (Malaysia) to assess the strengths and weaknesses of the situation leading to the formation of a multidisciplinary research partnership in oral cancer. Following the formalization of the partnership, further evaluation was undertaken to identify measures that can assist in sustaining the partnership. The group identifies its strength as the existence of academia, research-intensive NGOs and good networking of clinicians via the existence of the government's network of healthcare provider system who are the policy makers. The major weaknesses identified are the competing interest between academia and NGOs to justify their existence due to the lack of funding sources and well trained human resources. With the growing partnership, the collaborative group recognizes the need to develop standard operating procedures (SOPs) and guidelines for the sharing and usage of resources in order to safeguard the interest of the original partners while also attending to the needs of the new partners.

Pharmaceutical products as emerging contaminant in water: relevance for developing nations and identification of critical compounds for Indian environment.

PubMed

Chinnaiyan, Prakash; Thampi, Santosh G; Kumar, Mathava; Mini, K M

2018-04-17

Pharmaceuticals and personal care products (PPCPs) are contaminants of emerging concern and have been detected worldwide in water bodies in trace concentrations. Most of these emerging contaminants are not regulated in water quality standards except a few in the developed countries. In the case of developing countries, research in this direction is at a nascent stage. For the effective management of Pharmaceutical contaminants (PC) in developing countries, the relevance of PCs as an emerging contaminant has to be analyzed followed by regular monitoring of the environment. Considering the resource constraints, this could be accomplished by identifying the priority compounds which is again region specific and dependent on consumption behavior and pattern. In this work, relevance of pharmaceutical compound as emerging contaminant in water for a developing country like India is examined by considering the data pertaining to pharmaceutical consumption data. To identify the critical Pharmaceutical Contaminants to be monitored in the Indian environment, priority compounds from selected prioritization methods were screened with the compounds listed in National List of Essential Medicine (NLEM), India. Further, information on the number of publications on the compound as an emerging contaminant, data on monitoring studies in India and the number of brands marketing the compound in India were also analyzed. It is found that out of 195 compounds from different prioritization techniques, only 77 compounds were found relevant to India based on NLEM sorting.

Contaminated land in Colombia: A critical review of current status and future approach for the management of contaminated sites.

PubMed

Arias Espana, Victor Andres; Rodriguez Pinilla, Alfonso R; Bardos, Paul; Naidu, Ravi

2018-03-15

Environmental contaminants can have negative effects on human health and land, air and water resources. Consequently, there have been significant advances in regulation for protecting the environment in developed countries including the development of remediation frameworks and guidelines. On the other hand, fewer studies have been reported on the risks and health effects of contaminants in developing regions and there is scarce information regarding contaminated land assessment and environmental remediation. Colombia is an important emerging economy and has started to take the first steps towards the development of a framework for the management of contaminated sites and there are opportunities for the country to learn from countries with well-established frameworks such as the United States (US) and the United Kingdom (UK) and for international collaboration with organisations such as CRC for Contamination Assessment and Remediation of the Environment (CARE). We review main pollution issues, current status of contaminated land management in Colombia to identify the gaps in policy and regulation. We also review the UK and US contaminated land policies and regulations to identify the elements of those experiences that could support progress in the country. Finally, we propose recommendations (e.g. risk based approach, soil screening criteria, clean-up funding, liability) for Colombia that could support further development and implementation of a more effective contaminated land management framework. Copyright © 2017 Elsevier B.V. All rights reserved.

Systems Science for Caribbean Health: the development and piloting of a model for guiding policy on diabetes in the Caribbean.

PubMed

Guariguata, L; Guell, C; Samuels, T A; Rouwette, E A J A; Woodcock, J; Hambleton, I R; Unwin, N

2016-10-26

Diabetes is highly prevalent in the Caribbean, associated with a high morbidity and mortality and is a recognised threat to economic and social development. Heads of Government in the Caribbean Community came together in 2007 and declared their commitment to reducing the burden of non-communicable diseases (NCDs), including diabetes, by calling for a multi-sectoral, systemic response. To facilitate the development of effective policies, policymakers are being engaged in the development and use of a system dynamics (SD) model of diabetes for Caribbean countries. Previous work on a diabetes SD model from the United States of America (USA) is being adapted to a local context for three countries in the region using input from stakeholders, a review of existing qualitative and quantitative data, and collection of new qualitative data. Three country models will be developed using one-on-one stakeholder engagement and iterative revision. An inter-country model will also be developed following a model-building workshop. Models will be compared to each other and to the USA model. The inter-country model will be used to simulate policies identified as priorities by stakeholders and to develop targets for prevention and control. The model and model-building process will be evaluated by stakeholders and a manual developed for use in other high-burden developing regions. SD has been applied with success for health policy development in high-income country settings. The utility of SD in developing countries as an aid to policy decision-making related to NCDs has not been tested. This study represents the first of its kind.

Challenges and barriers for implementation of the World Health Organization Global Disability Action Plan in low- and middle- income countries.

PubMed

Khan, Fary; Owolabi, Mayowa Ojo; Amatya, Bhasker; Hamzat, Talhatu Kolapo; Ogunniyi, Adesola; Oshinowo, Helen; Elmalik, Alaeldin; Galea, Mary P

2018-04-18

To identify potential barriers and facilitators for implementation of the World Health Organization Global Disability Action Plan (GDAP) in Nigeria and compare these with other low- and middle-income countries. A rehabilitation team from the Royal Melbourne Hospital, Parkville, Australia, conducted intensive workshops at medical/academic institutions in Nigeria for healthcare professionals from various local Physical Medicine and Rehabilitation facilities. A modified Delphi method identified challenges for person with disability, using 3 GDAP objectives. Findings were compared with similar exercises in Madagascar, Pakistan and Mongolia. Despite differences in the healthcare system and practice, the challenges reported in Nigeria were similar to those in other 3 low- and middle-income countries, at both macro (governmental/policymakers) and micro levels (community/social/individual). Common challenges identified were: limited knowledge of disability services, limited Physical Medicine and Rehabilitation workforce, guidelines and accreditation standards; coordination amongst healthcare sectors; social issues; data and research; legislation and political commitment. Common potential facilitators included: need for strong leadership; advocacy of disability-inclusive development; investment in infrastructure/human resources; coordination/partnerships in healthcare sector; and research. Disability care is an emerging priority in low- and middle-income countries to address the needs of people with disability. The challenges identified in Nigeria are common to most low- and middle-income countries. The GDAP framework can facilitate access and strengthen Physical Medicine and Rehabilitation services.

Developing child mental health services in resource-poor countries.

PubMed

Omigbodun, Olayinka

2008-06-01

Despite significant gains in tackling the major causes of child mortality and evidence of an urgent need for child mental health services, resource-poor countries continue to lag behind in child and adolescent mental health service development. This paper analyses possible barriers to the development of child mental health services in resource-poor countries and attempts to proffer solutions. Obstacles identified are the magnitude of child mental health problems that remain invisible to policy makers, an absence of child mental policies to guide the process of service development, and overburdened child mental health professionals. The belief systems about mental illness also prompt help seeking in alternative health systems, thereby reducing the evidence for the burden associated with health seeking. Solutions that may support child mental health service development are the provision of adequate advocacy tools to reveal the burden, poverty alleviation, health awareness programmes, enforcing legislation, training centred within the region, and partnerships with professionals in developed countries. These solutions require simultaneous approaches to encourage service development and utilization. Reductions in child mortality in resource-poor countries will be even more dramatic in the years to come and preparations need to be made to take care of the mental health needs of the children who will survive.

Effectiveness of medical equipment donations to improve health systems: how much medical equipment is broken in the developing world?

PubMed

Perry, Lora; Malkin, Robert

2011-07-01

It is often said that most of the medical equipment in the developing world is broken with estimates ranging up to 96% out of service. But there is little documented evidence to support these statements. We wanted to quantify the amount of medical equipment that was out of service in resource poor health settings and identify possible causes. Inventory reports were analyzed from 1986 to 2010, from hospitals in sixteen countries across four continents. The UN Human Development Index was used to determine which countries should be considered developing nations. Non-medical hospital equipment was excluded. This study examined 112,040 pieces of equipment. An average of 38.3% (42,925, range across countries: 0.83-47%) in developing countries was out of service. The three main causes were lack of training, health technology management, and infrastructure. We hope that the findings will help biomedical engineers with their efforts toward effective designs for the developing world and NGO's with efforts to design effective healthcare interventions.

Water footprint as an indicator of agricultural productivity in African countries

NASA Astrophysics Data System (ADS)

Chico Zamanillo, Daniel; Zhang, Guoping; Mathews, Ruth

2017-04-01

Sub-Saharan Africa is one of the regions with the largest scope for improved agricultural development that would contribute to global food security while respecting environmental boundaries. More importantly, undernourishment is a challenge for many African countries and needs to be addressed to achieve the 2030 Agenda for Sustainable Development. This study was conducted to support the Netherlands Ministry of Foreign Affair's Inclusive Green Growth aim of increasing water use efficiency by 25% in Dutch financed projects. A water footprint profile was developed for 7 Sub-Saharan countries; Benin, Ethiopia, Ghana, Kenya, Mali, Mozambique and Rwanda. The profiles provide an overview of water use from the perspective of the goods produced within the country, the consumption of goods, in particular agricultural crops, whether these goods are produced domestically or imported from other countries and the level of blue water scarcity experienced in the country. Across all countries, key food crops such as maize, and sorghum have low water productivity relative to the global water footprint benchmark. Export crops such as tea in Kenya or cocoa in Ghana show a good performance over global production. Furthermore, the water footprint of crops over the period 2006-2013 was compared to data from the period 1996-2005. Changes in yield and the resulting changes in the water footprint were assessed for both food and export crops. Yields in food crops improved in some countries, and in some years, but not consistently across all countries and years. The greatest gains in water productivity were in key export crops. The results provide insights into whether improvements have been made in water productivity in recent years and through comparison with the global water footprint benchmark, remaining opportunities for further gains in water productivity were identified. Going forward, policies that will enhance further improvement in water productivity and support greater food and water security should be considered. Agricultural practices that have improved yields and reduced water footprints should be identified and evaluated for their relative contribution to higher water productivity and to guide investments in agricultural extension and technology. Crops should be selected based on their comparative advantage relative to the water footprint and yields as well as their contribution to livelihoods and economic growth. Water resource management and planning needs to meet water demands for economic development while protecting and enhancing ecosystem services. Trade-offs between water resources allocation to grow food crops versus export crops and resulting reliance on internal versus external water resources for food security should be assessed and used to guide decisions. Achievement of the Sustainable Development Goals will require a multi-pronged approach to improving agricultural practices, strengthening farmers' livelihoods, increasing food security and protecting water security. The water footprint as it has been used in this study can support sustainable development by building an understanding of the water consumed and polluted in producing goods and identifying the opportunities for improving water efficiency and land productivity.

Population growth, human development, and deforestation in biodiversity hotspots.

PubMed

Jha, S; Bawa, K S

2006-06-01

Human population and development activities affect the rate of deforestation in biodiversity hotspots. We quantified the effect of human population growth and development on rates of deforestation and analyzed the relationship between these causal factors in the 1980s and 1990s. We compared the averages of population growth, human development index (HDI, which measures income, health, and education), and deforestation rate and computed correlations among these variables for countries that contain biodiversity hotspots. When population growth was high and HDI was low there was a high rate of deforestation, but when HDI was high, rate of deforestation was low, despite high population growth. The correlation among variables was significant for the 1990s but not for the 1980s. The relationship between population growth and HDI had a regional pattern that reflected the historical process of development. Based on the changes in HDI and deforestation rate over time, we identified two drivers of deforestation: policy choice and human-development constraints. Policy choices that disregard conservation may cause the loss of forests even in countries that are relatively developed. Lack of development in other countries, on the other hand, may increase the pressure on forests to meet the basic needs of the human population. Deforestation resulting from policy choices may be easier to fix than deforestation arising from human development constraints. To prevent deforestation in the countries that have such constraints, transfer of material and intellectual resources from developed countries may be needed. Popular interest in sustainable development in developed countries can facilitate the transfer of these resources.

Autism in Developing Countries: Lessons from Iran

PubMed Central

Samadi, Sayyed Ali; McConkey, Roy

2011-01-01

Most research into Autism Spectrum Disorders has been conducted in affluent English-speaking countries which have extensive professional support services. This paper describes a series of investigations that was undertaken in Iran, and these findings, together with reviews of research in other low-income countries, are used to identify key lessons in three areas of service provision of particular relevance to developing countries with scarce professional resources: first, the issues to be considered in establishing the prevalence of the condition nationally; second, identification of parental understanding of ASD and the impact it has on them as carers; third, the education and training that could be provided to families when professional supports are sparse. It is concluded that culturally sensitive, parental support strategies must be central to the planning and development of services. Moreover, future research should further elucidate the needs of families and evaluate the impact of culturally tailored interventions designed to promote the children's development and overall family quality of life. PMID:22937242

Global approach to reducing lead exposure and poisoning.

PubMed

Meyer, Pamela A; Brown, Mary Jean; Falk, Henry

2008-01-01

Lead poisoning is an important environmental disease that can have life-long adverse health effects. Most susceptible are children, and most commonly exposed are those who are poor and live in developing countries. Studies of children's blood-lead levels (BLLs) are showing cognitive impairment at increasingly lower BLLs. Lead is dangerous at all levels in children. The sources of lead exposure vary among and within countries depending on past and current uses. Sources of lead may be from historic contamination, recycling old lead products, or from manufacturing new products. In all countries that have banned leaded gasoline, average population BLLs have declined rapidly. In many developing countries where leaded gasoline is no longer used, many children and workers are exposed to fugitive emissions and mining wastes. Unexpected lead threats, such as improper disposal of electronics and children's toys contaminated with lead, continue to emerge. The only medical treatment available is chelation, which can save lives of persons with very high BLLs. However, chelating drugs are not always available in developing countries and have limited value in reducing the sequelae of chronic low dose lead exposure. Therefore, the best approach is to prevent exposure to lead. Because a key strategy for preventing lead poisoning is to identify and control or eliminate lead sources, this article highlights several major sources of lead poisoning worldwide. In addition, we recommend three primary prevention strategies for lead poisoning: identify sources, eliminate or control sources, and monitor environmental exposures and hazards.

Economic evaluations of non-communicable disease interventions in developing countries: a critical review of the evidence base

PubMed Central

Mulligan, Jo-Ann; Walker, Damian; Fox-Rushby, Julia

2006-01-01

Background Demographic projections suggest a major increase in non-communicable disease (NCD) mortality over the next two decades in developing countries. In a climate of scarce resources, policy-makers need to know which interventions represent value for money. The prohibitive cost of performing multiple economic evaluations has generated interest in transferring the results of studies from one setting to another. This paper aims to bridge the gap in the current literature by critically evaluating the available published data on economic evaluations of NCD interventions in developing countries. Methods We identified and reviewed the methodological quality of 32 economic evaluations of NCD interventions in developing countries. Developing countries were defined according to the World Bank classification for low- and lower middle-income countries. We defined NCDs as the 12 categories listed in the 1993 World Bank report Investing in Health. English language literature was searched for the period January 1984 and January 2003 inclusive in Medline, Science Citation Index, HealthStar, NHS Economic Evaluation Database and Embase using medical subheading terms and free text searches. We then assessed the quality of studies according to a set of pre-defined technical criteria. Results We found that the quality of studies was poor and resource allocation decisions made by local and global policy-makers on the basis of this evidence could be misleading. Furthermore we have identified some clear gaps in the literature, particularly around injuries and strategies for tackling the consequences of the emerging tobacco epidemic. Conclusion In the face of poor evidence the role of so-called generalised cost-effectiveness analyses has an important role to play in aiding public health decision-making at the global level. Further research is needed to investigates the causes of variation among cost, effects and cost-effectiveness data within and between settings. Such analyses still need to take a broad view, present data in a transparent manner and take account of local constraints. PMID:16584546

Opinions of researchers based in the UK on recruiting subjects from developing countries into randomized controlled trials.

PubMed

Newton, Sam K; Appiah-Poku, John

2007-12-01

Explaining technical terms in consent forms prior to seeking informed consent to recruit into trials can be challenging in developing countries, and more so when the studies are randomized controlled trials. This study was carried out to examine the opinions of researchers on ways of dealing with these challenges in developing countries. Recorded in-depth interviews with 12 lecturers and five doctoral students, who had carried out research in developing countries, at a leading school of public health in the United Kingdom. A purposive, snowballing approach was used to identify interviewees. Researchers were divided on the feasibility of explaining technical trials in illiterate populations; the majority of them held the view that local analogies could be used to explain these technical terms. Others were of the opinion that this could not be done since it was too difficult to explain technical trials, such as randomized controlled trials, even to people in developed countries. Researchers acknowledged the difficulty in explaining randomized controlled trials but it was also their perception that this was an important part of the ethics of the work of scientific research involving human subjects. These difficulties notwithstanding, efforts should be made to ensure that subjects have sufficient understanding to consent, taking into account the fact that peculiar situations in developing countries might compound this difficulty.

Researching routine immunization-do we know what we don't know?

PubMed

Clements, C John; Watkins, Margaret; de Quadros, Ciro; Biellik, Robin; Hadler, James; McFarland, Deborah; Steinglass, Robert; Luman, Elizabeth; Hennessey, Karen; Dietz, Vance

2011-11-03

The Expanded Programme on Immunization (EPI), launched in 1974, has developed and implemented a range of strategies and practices over the last three decades to ensure that children and adults receive the vaccines they need to help protect them against vaccine-preventable diseases. Many of these strategies have been implemented, resulting in immunization coverage exceeding 80% among children one year of age in many countries. Yet millions of infants remain under-immunized or unimmunized, particularly in poorer countries. In November 2009, a panel of external experts met at the United States Centers for Disease Control and Prevention (CDC) to review and identify areas of research required to strengthen routine service delivery in developing countries. Research opportunities were identified utilizing presentations emphasizing existing research, gaps in knowledge and key questions. Panel members prioritized the topics, as did other meeting participants. Several hundred research topics covering a wide range were identified by the panel members and participants. However there were relatively few topics for which there was a consensus that immediate investment in research is warranted. The panel identified 28 topics as priorities. 18 topics were identified as priorities by at least 50% of non-panel participants; of these, five were also identified as priorities by the panel. Research needs included identifying the best ways to increase coverage with existing vaccines and introduce new vaccines, integrate other services with immunizations, and finance immunization programmes. There is an enormous range of research that could be undertaken to support routine immunization. However, implementation of strategic plans, rather than additional research will have the greatest impact on raising immunization coverage and preventing disease, disability, and death from vaccine-preventable diseases. The panel emphasized the importance of tying operational research to programmatic needs, with a focus on efforts to scale up proven best practices in each country, facilitating the full implementation of immunization strategies. Copyright © 2011. Published by Elsevier Ltd.. All rights reserved.

Twelve Month Prevalence of and Risk Factors for Suicide Attempts in the WHO World Mental Health Surveys

PubMed Central

Borges, Guilherme; Nock, Matthew K.; Haro Abad, Josep M.; Hwang, Irving; Sampson, Nancy A.; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias C.; Beautrais, Annette; Bromet, Evelyn; Bruffaerts, Ronny; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Hu, Chiyi; Karam, Elie G; Kovess-Masfety, Viviane; Lee, Sing; Levinson, Daphna; Medina-Mora, Maria Elena; Ormel, Johan; Posada-Villa, Jose; Sagar, Rajesh; Tomov, Toma; Uda, Hidenori; Williams, David R.; Kessler, Ronald C.

2009-01-01

Objective Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiological survey database that estimates the 12-month prevalence of suicidal behaviors, identifies risk factors for suicide attempts, and combines these factors to create a risk index for 12-month suicide attempts separately for developed and developing countries. Method Data come from the WHO World Mental Health (WMH) Surveys (conducted 2001–2007) in which 108,705 adults from 21 countries were interviewed using the WHO Composite International Diagnostic Interview (CIDI). The survey assessed suicidal behaviors and potential risk factors across multiple domains including: socio-demographics, parent psychopathology, childhood adversities, DSM-IV disorders, and history of suicidal behavior. Results Twelve-month prevalence estimates of suicide ideation, plans and attempts are 2.0%, 0.6% and 0.3% respectively for developed countries and 2.1%, 0.7% and 0.4% for developing countries. Risk factors for suicidal behaviors in both developed and developing countries include: female sex, younger age, lower education and income, unmarried status, unemployment, parent psychopathology, childhood adversities, and presence of diverse 12-month DSM-IV mental disorders. Combining risk factors from multiple domains produced risk indices that accurately predicted 12-month suicide attempts in both developed and developing countries (AUC=.74–.80). Conclusion Suicidal behaviors occur at similar rates in both developed and developing countries. Risk indices assessing multiple domains can predict suicide attempts with fairly good accuracy and may be useful in aiding clinicians in the prediction of these behaviors. PMID:20816034

When South meets South.

PubMed

Wulf, D

1997-01-01

This article describes the establishment of a new organization, Partners in Population and Development, which promotes collaboration between developing countries. The organization was an outcome of the 1994 Cairo Conference on Population and Development. The basic aim is to share technical knowledge and experience between developing countries. In rural Ha Tay province in northern Vietnam, for example, a community mapping technique for tracking contraceptive use was implemented. The mapping technique was first developed in Indonesia and transferred to Vietnam via the Indonesian national family planning coordinating board. A Bangkok-based nongovernmental group was working in Ninh Binh province with income generation among rice workers as part of a reproductive health program. Partners in Population and Development includes high ranking government officials responsible for national family planning programs from Colombia, Egypt, Kenya, Indonesia, Mexico, Morocco, Thailand, Tunisia, and Zimbabwe. In 1996, a permanent secretariat was established in Dhaka, Bangladesh. The secretariat includes a small staff consisting of an executive director and three deputies from developing countries. The secretariat will act as a clearinghouse and coordinating unit between countries and projects. The office will answer field requests for assistance and help identify potential sources of donor support. The office will operate on funding from the UN Population Fund, the World Bank, and the Rockefeller Foundation. The Partnership will diffuse the appearance that developed countries are "demographic imperialists" and offer sound financial political advice. Projects will emphasize appropriateness and sustainability. The aim is to build bridges between countries where there are barriers and to extend services beyond regional borders.

A New Era Begins: Satellite Communications and Development.

ERIC Educational Resources Information Center

Pelton, Joseph N.

This overview of changes in the field of telecommunications development produced by satellite communications over the last 15 years focuses on applications of satellite systems for educational and health purposes in developing countries. Satellite communications development from 1974 to 1986 is identified as the first stage of telecommunications…

Contracts to devolve health services in fragile states and developing countries: do ethics matter?

PubMed

Jayasinghe, S

2009-09-01

Fragile states and developing countries increasingly contract out health services to non-state providers (NSPs) (such as non-governmental organisations, voluntary sector and private sector). The paper identifies ethical issues when contracts involve devolution of health services to NSPs and proposes procedures to prevent or resolve these ethical dilemmas. Ethical issues were identified by examining processes of contracting out. Health needs could be used to select areas to be contracted out and to identify service needs. Health needs comprise "disease-burden-related needs", "health-service needs", and "urgency of health-service needs". The mix of services should include an analysis of cost-effectiveness. NSPs should be selected fairly, without bias, and conflicts of interest during their work must be avoided. The population's views must be respected and accountability structures established. Devolved health services should ensure equity of access to healthcare. The services ought to be sustainable and evaluated objectively. Of these issues, conflicts of interest among NSPs and sustainability of health services have not attracted attention in the literature on ethics of health policy. Fair procedures could address these ethical issues-for example, public consultation on issues; decisions based on the public consultation and made on evidence; principles of decisions stated and reasonable; decisions given adequate publicity; a mechanism established to challenge decisions; assurance that mechanisms meet the above conditions; and regular review of the policies. These procedures are complemented by improving self-governance of NSPs, countries' development of guidelines for devolving health services, and measures to educate the public of the client countries on these issues.

Adolescent Psychosocial Development: A Review of Longitudinal Models and Research

ERIC Educational Resources Information Center

Meeus, Wim

2016-01-01

This review used 4 types of longitudinal models (descriptive models, prediction models, developmental sequence models and longitudinal mediation models) to identify regular patterns of psychosocial development in adolescence. Eight patterns of adolescent development were observed across countries: (1) adolescent maturation in multiple…

How People Interpret Healthy Eating: Contributions of Qualitative Research

ERIC Educational Resources Information Center

Bisogni, Carole A.; Jastran, Margaret; Seligson, Marc; Thompson, Alyssa

2012-01-01

Objective: To identify how qualitative research has contributed to understanding the ways people in developed countries interpret healthy eating. Design: Bibliographic database searches identified reports of qualitative, empirical studies published in English, peer-reviewed journals since 1995. Data Analysis: Authors coded, discussed, recoded, and…

Convention on the rights of persons with disabilities, assistive technology and information and communication technology requirements: where do we stand on implementation?

PubMed

Gould, Martin; Leblois, Axel; Cesa Bianchi, Francesca; Montenegro, Viviana

2015-07-01

This article presents 2013 data from a survey provided by G3ict and Disabled Peoples International (DPI). The Progress Report identifies the degree that each of the CRPD dispositions on ATs and ICTs accessibility are enacted in local laws, policies and regulations and their impacts. The initial methodology used to develop the survey involved several steps. First, a systematic review of CRPD AT and ICT technology requirements was conducted. Second, 57 variables were identified. Third, variables were grouped into three clusters representing countries': (a) legal, regulatory and programmatic commitments; (b) capacity to implement; and (c) actual implementation results. Surveys were completed by experts in a total of 74 countries. With respect to select CRPD AT and ICT dispositions, respondent countries report an: (a) average degree of compliance within their general legal and regulatory framework at 66%; (b) average 29% of the capacity to implement; and (c) average degree of implementation and impact of 42%. Implications for Rehabilitation Survey results reflect low levels of ratifying countries implementation of laws, policies or programs that promote awareness-raising and training programs about the CRPD and its AT and ICT technology requirements. Implication 1: CRPD ratifying countries need to promote disability-inclusive AT and ICT policies and programs identified as priority areas by key stakeholders Implication 2: Government leaders and key policymakers need to address gaps in capacity building such as professional training of professionals in the areas of AT and ICT accessibility and programming through disability-inclusive cooperative development practices.

U.S. Government Supports Low Emission Economic Growth (Fact Sheet)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Watson, A.; Sandor, D.; Butheau, M.

Countries around the world face the challenge of maintaining long-term sustainable economic growth and development under the threat of climate change. By identifying and pursuing a sustainable development pathway now, they are better positioned to reach their economic growth goals while addressing climate change impacts and lowering greenhouse gas (GHG) emissions. Low emission development strategies - development plans that promote sustainable social and economic development while reducing long-term GHG emissions - provide a pathway to preparing for a global low emission future. Partner country governments are working with the U.S. government through the Enhancing Capacity for Low Emission Development Strategiesmore » (EC-LEDS) program to further their national development objectives.« less

U.S. Government Supports Low Emission Economic Growth

DOE Office of Scientific and Technical Information (OSTI.GOV)

Countries around the world face the challenge of maintaining long-term sustainable economic growth and development under the threat of climate change. By identifying and pursuing a sustainable development pathway now, they are better positioned to reach their economic growth goals while addressing climate change impacts and lowering greenhouse gas (GHG) emissions. Low emission development strategies - development plans that promote sustainable social and economic development while reducing long-term GHG emissions - provide a pathway to preparing for a global low emission future. Partner country governments are working with the U.S. government through the Enhancing Capacity for Low Emission Development Strategiesmore » (EC-LEDS) program to further their national development objectives.« less

An overview of water disinfection in developing countries and the potential for solar thermal water pasteurization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burch, J.; Thomas, K.E.

This study originated within the Solar Buildings Program at the U.S. Department of Energy. Its goal is to assess the potential for solar thermal water disinfection in developing countries. In order to assess solar thermal potential, the alternatives must be clearly understood and compared. The objectives of the study are to: (a) characterize the developing world disinfection needs and market; (b) identify competing technologies, both traditional and emerging; (c) analyze and characterize solar thermal pasteurization; (d) compare technologies on cost-effectiveness and appropriateness; and (e) identify research opportunities. Natural consequences of the study beyond these objectives include a broad knowledge ofmore » water disinfection problems and technologies, introduction of solar thermal pasteurization technologies to a broad audience, and general identification of disinfection opportunities for renewable technologies.« less

Readiness factors for information system strategic planning among universities in developing countries: a systematic review

NASA Astrophysics Data System (ADS)

Irfan, M.; Putra, S. J.; Alam, C. N.; Subiyakto, A.; Wahana, A.

2018-03-01

The implementation of information system strategic planning (ISSP) in higher education institutions is to improve work efficiency, management effectiveness in order to improve organizational competitive advantage. However, the question of whether all universities are ready to implement ISSP as a way to achieve organizational goals has not been answered. This study aims to investigate the readiness phenomena through literature study. The method used is by using the Systematic Literature Review (SLR) instrument to identify readiness factors on the implementation of ISSP, especially among the institutions of higher education in developing countries. This study has identified 10 readiness measurement. There are three categories of measurement, namely people, processes and technologies that represent 11 factors of ISSP readiness measurement in universities.

Using information technology for an improved pharmaceutical care delivery in developing countries. Study case: Benin.

PubMed

Edoh, Thierry Oscar; Teege, Gunnar

2011-10-01

One of the problems in health care in developing countries is the bad accessibility of medicine in pharmacies for patients. Since this is mainly due to a lack of organization and information, it should be possible to improve the situation by introducing information and communication technology. However, for several reasons, standard solutions are not applicable here. In this paper, we describe a case study in Benin, a West African developing country. We identify the problem and the existing obstacles for applying standard ECommerce solutions. We develop an adapted system approach and describe a practical test which has shown that the approach has the potential of actually improving the pharmaceutical care delivery. Finally, we consider the security aspects of the system and propose an organizational solution for some specific security problems.

Considerations for sustainable influenza vaccine production in developing countries.

PubMed

Nannei, Claudia; Chadwick, Christopher; Fatima, Hiba; Goldin, Shoshanna; Grubo, Myriam; Ganim, Alexandra

2016-10-26

Through its Global Action Plan for Influenza Vaccines (GAP), the World Health Organization (WHO) in collaboration with the United States Department of Health and Human Services has produced a checklist to support policy-makers and influenza vaccine manufacturers in identifying key technological, political, financial, and logistical issues affecting the sustainability of influenza vaccine production. This checklist highlights actions in five key areas that are beneficial for establishing successful local vaccine manufacturing. These five areas comprise: (1) the policy environment and health-care systems; (2) surveillance systems and influenza evidence; (3) product development and manufacturing; (4) product approval and regulation; and (5) communication to support influenza vaccination. Incorporating the checklist into national vaccine production programmes has identified the policy gaps and next steps for countries involved in GAP's Technology Transfer Initiative. Lessons learnt from country experiences provide context and insight that complement the checklist's goal of simplifying the complexities of influenza prevention, preparedness, and vaccine manufacturing. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Decreased performance of live attenuated, oral rotavirus vaccines in low-income settings: causes and contributing factors.

PubMed

Velasquez, Daniel E; Parashar, Umesh; Jiang, Baoming

2018-02-01

Numerous studies have shown that the oral rotavirus vaccines are less effective in infants born in low income countries compared to those born in developed countries. Identifying the specific factors in developing countries that decrease and/or compromise the protection that rotavirus vaccines offer, could lead to a path for designing new strategies for the vaccines' improvement. Areas covered: We accessed PubMed to identify rotavirus vaccine performance studies (i.e., efficacy, effectiveness and immunogenicity) and correlated performance with several risk factors. Here, we review the factors that might contribute to the low vaccine efficacy, including passive transfer of maternal rotavirus antibodies, rotavirus seasonality, oral polio vaccine (OPV) administered concurrently, microbiome composition and concomitant enteric pathogens, malnutrition, environmental enteropathy, HIV, and histo blood group antigens. Expert commentary: We highlight two major factors that compromise rotavirus vaccines' efficacy: the passive transfer of rotavirus IgG antibodies to infants and the  co-administration of rotavirus vaccines with OPV. We also identify other potential risk factors that require further research because the data about their interference with the efficacy of rotavirus vaccines are inconclusive and at times conflicting.

The 2012 dengue outbreak in Madeira: exploring the origins.

PubMed

Wilder-Smith, A; Quam, M; Sessions, O; Rocklov, J; Liu-Helmersson, J; Franco, L; Khan, K

2014-02-27

In 2012, Madeira reported its first major outbreak of dengue. To identify the origin of the imported dengue virus, we investigated the interconnectivity via air travel between dengue-endemic countries and Madeira, and compared available sequences against GenBank. There were 22,948 air travellers to Madeira in 2012, originating from twenty-nine dengue-endemic countries; 89.6% of these international travellers originated from Venezuela and Brazil. We developed an importation index that takes into account both travel volume and the extent of dengue incidence in the country of origin. Venezuela and Brazil had by far the highest importation indices compared with all other dengue-endemic countries. The importation index for Venezuela was twice as high as that for Brazil. When taking into account seasonality in the months preceding the onset of the Madeira outbreak, this index was even seven times higher for Venezuela than for Brazil during this time. Dengue sequencing shows that the virus responsible for the Madeira outbreak was most closely related to viruses circulating in Venezuela, Brazil and Columbia. Applying the importation index, Venezuela was identified as the most likely origin of importation of dengue virus via travellers to Madeira. We propose that the importation index is a new additional tool that can help to identify and anticipate the most probable country of origin for importation of dengue into currently non-endemic countries.

Changing sero-epidemiology of hepatitis A in Asia Pacific countries: A systematic review.

PubMed

Gripenberg, Marissa; Aloysia D'Cor, Naveena; L'Azou, Maïna; Marsh, Grenville; Druelles, Sophie; Nealon, Joshua

2018-03-01

Hepatitis A is a viral liver disease whose prevalence is associated with low socio-economic and hygiene levels due to its faecal-oral transmission. Severity increases with age, and immunity is life-long. Decreased endemicity could result in increased age and severity of cases. A literature review was conducted to describe changes in age-stratified hepatitis A seroprevalence in Asia Pacific countries from 1980 to 2016, and to identify gaps in the literature. The PRISMA guidelines were followed. The PubMed database was searched for studies on age-specific hepatitis A seroprevalence in 17 Asia Pacific countries. All studies published in the English language, reporting human hepatitis A seroprevalence levels in any age group, were included. Seventy-three publications from 11 countries were identified. A trend of increasing age at first exposure over time was observed, particularly in developed countries such as Japan, Taiwan, Thailand, and Korea, suggesting a transition in terms of endemicity. Extensive gaps in the literature were identified between countries and year of publication, indicating the need for further research. Decreasing hepatitis A exposure and thus immunity conferred during childhood, may render older populations susceptible to infection. The public health and economic value of vaccination against hepatitis A should be assessed within this changing epidemiological context. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Scaling up access to oral rehydration solution for diarrhea: Learning from historical experience in low– and high–performing countries

PubMed Central

Wilson, Shelby E.; Morris, Saul S.; Gilbert, Sarah Skye; Mosites, Emily; Hackleman, Rob; Weum, Kristoffer L.M.; Pintye, Jillian; Manhart, Lisa E.; Hawes, Stephen E.

2013-01-01

Aim This paper aims to identify factors that systematically predict why some countries that have tried to scale up oral rehydration solution (ORS) have succeeded, and others have not. Methods We examined ORS coverage over time, across countries, and through case studies. We conducted expert interviews and literature and data searches to better understand the history of ORS scale–up efforts and why they failed or succeeded in nine countries. We used qualitative, pairwise (or three–country) comparisons of geographically or otherwise similar countries that had different outcomes in terms of ORS scale–up. An algorithm was developed which scored country performance across key supply, demand and financing activities to quantitatively assess the scale–up efforts in each country. Results The vast majority of countries have neither particularly low nor encouragingly high ORS use rates. We observed three clearly identifiable contrasts between countries that achieved and sustained high ORS coverage and those that did not. Key partners across sectors have critical roles to play to effectively address supply– and demand–side barriers. Efforts must synchronize demand generation, private provider outreach and public sector work. Many donor funds are either suspended or redirected in the event of political instability, exacerbating the health challenges faced by countries in these contexts. We found little information on the cost of scale–up efforts. Conclusions We identified a number of characteristics of successful ORS scale–up programs, including involvement of a broad range of key players, addressing supply and demand generation together, and working with both public and private sectors. Dedicated efforts are needed to launch and sustain success, including monitoring and evaluation plans to track program costs and impacts. These case studies were designed to inform programmatic decision–making; thus, rigorous academic methods to qualitatively and quantitatively evaluate country ORS scale–up programs might yield additional, critical insights and confirm our conclusions. PMID:23826508

Scaling up access to oral rehydration solution for diarrhea: Learning from historical experience in low- and high-performing countries.

PubMed

Wilson, Shelby E; Morris, Saul S; Gilbert, Sarah Skye; Mosites, Emily; Hackleman, Rob; Weum, Kristoffer L M; Pintye, Jillian; Manhart, Lisa E; Hawes, Stephen E

2013-06-01

This paper aims to identify factors that systematically predict why some countries that have tried to scale up oral rehydration solution (ORS) have succeeded, and others have not. We examined ORS coverage over time, across countries, and through case studies. We conducted expert interviews and literature and data searches to better understand the history of ORS scale-up efforts and why they failed or succeeded in nine countries. We used qualitative, pairwise (or three-country) comparisons of geographically or otherwise similar countries that had different outcomes in terms of ORS scale-up. An algorithm was developed which scored country performance across key supply, demand and financing activities to quantitatively assess the scale-up efforts in each country. The vast majority of countries have neither particularly low nor encouragingly high ORS use rates. We observed three clearly identifiable contrasts between countries that achieved and sustained high ORS coverage and those that did not. Key partners across sectors have critical roles to play to effectively address supply- and demand-side barriers. Efforts must synchronize demand generation, private provider outreach and public sector work. Many donor funds are either suspended or redirected in the event of political instability, exacerbating the health challenges faced by countries in these contexts. We found little information on the cost of scale-up efforts. We identified a number of characteristics of successful ORS scale-up programs, including involvement of a broad range of key players, addressing supply and demand generation together, and working with both public and private sectors. Dedicated efforts are needed to launch and sustain success, including monitoring and evaluation plans to track program costs and impacts. These case studies were designed to inform programmatic decision-making; thus, rigorous academic methods to qualitatively and quantitatively evaluate country ORS scale-up programs might yield additional, critical insights and confirm our conclusions.

Oral health workforce planning part 2: figures, determinants and trends in a sample of World Dental Federation member countries.

PubMed

Yamalik, Nermin; Ensaldo-Carrasco, Eduardo; Cavalle, Edoardo; Kell, Kathyrn

2014-06-01

A range of factors needs to be taken into account for an ideal oral health workforce plan. The figures related to dentists, specialists, auxiliaries, practice patterns, undergraduate and continuing dental education, laws/regulations, the attitudes of oral health-care providers and the general trends affecting the practice patterns, work conditions and preferences of oral health-care providers are among such determinants. Thus, the aim of the present study was to gather such information from a sample of World Dental Federation (FDI) member countries with different characteristics. A cross-sectional survey study was carried out among a sample of FDI member countries between March 2, 2012 and March 27, 2012. A questionnaire was developed addressing some main determinants of oral health workforce, such as its structure, involvement of the public/private sector to provide oral health-care services, specialty services, dental schools, trends in workforce and compliance with oral health needs, and a descriptive analysis was performed. The countries were classified as developed and developing countries and Mann-Whitney U-tests and chi-square tests were used to identify potential significant differences (P > 0.05) between developed and developing countries. All data were processed in SPSS v.19. In the18 questionnaires processed, the median number of dentists (P = 0.005), dental practices (P = 0.002), hygienists (P = 0.005), technicians (P = 0.013) and graduates per year (P = 0.037) was higher in developed countries. Only 12.5% of developed and 22.2% of developing countries reported having optimal number of graduates per year. It was noted that 66.7% of developing countries had more regions lacking enough dentists to meet the demand (P = 0.050) and 77.8% lacked the necessary specialist care (P = 0.015). Although developing countries reported mostly an oversupply of dentists, regardless of the level of development most countries did not report an oversupply of specialists. Most developed countries did not feel that their regulations (87.5%) complied with the needs and demands of the population and most developing countries did not feel that their undergraduate dental education (62.5%) complied. Migrating to other countries was a trend seen in developing countries, while, despite increased numbers of dentists, underserved areas and communities were reported. The cross-sectional survey study suggests that figures related to optimum or ideal oral health workforce and fair distribution of the available workforce does not seem to be achieved in many parts of the world. Further attention also needs to be dedicated to general trends that have the capacity to affect future oral health workforce. © 2014 FDI World Dental Federation.

Establishing sustainable GHG inventory systems in African countries for Agriculture and Land Use, Land-use Change and Forestry (LULUCF)

NASA Astrophysics Data System (ADS)

Wirth, T. C.; Troxler, T.

2015-12-01

As signatories to the United Nations Framework Convention on Climate Change (UNFCCC), developing countries are required to produce greenhouse gas (GHG) inventories every two years. For many developing countries, including many of those in Africa, this is a significant challenge as it requires establishing a robust and sustainable GHG inventory system. In order to help support these efforts, the U.S. Environmental Protection Agency (EPA) has worked in collaboration with the UNFCCC to assist African countries in establishing sustainable GHG inventory systems and generating high-quality inventories on a regular basis. The sectors we have focused on for these GHG inventory capacity building efforts in Africa are Agriculture and Land Use, Land-use Change and Forestry (LULUCF) as these tend to represent a significant portion of their GHG emissions profile and the data requirements and methodologies are often more complex than for other sectors. To support these efforts, the U.S. EPA has provided technical assistance in understanding the methods in the IPCC Guidelines, assembling activity data and emission factors, including developing land-use maps for representing a country's land base, and implementing the calculations. EPA has also supported development of various tools such as a Template Workbook that helps the country build the institutional arrangement and strong documentation that are necessary for generating GHG inventories on a regular basis, as well as performing other procedures as identified by IPCC Good Practice Guidance such as quality assurance/quality control, key category analysis and archiving. Another tool used in these projects and helps country's implement the methods from the IPCC Guidelines for the Agriculture and LULUCF sectors is the Agriculture and Land Use (ALU) tool. This tool helps countries assemble the activity data and emission factors, including supporting the import of GIS maps, and applying the equations from the IPPC Guidelines to estimate the carbon stock changes and emissions of non-CO2 GHG for all land uses and management practices as identified in the IPCC Guidelines at the Tier 1 or Tier 2 level.

Clean birth kits to improve birth practices: development and testing of a country level decision support tool.

PubMed

Hundley, Vanora A; Avan, Bilal I; Ahmed, Haris; Graham, Wendy J

2012-12-19

Clean birth practices can prevent sepsis, one of the leading causes of both maternal and newborn mortality. Evidence suggests that clean birth kits (CBKs), as part of package that includes education, are associated with a reduction in newborn mortality, omphalitis, and puerperal sepsis. However, questions remain about how best to approach the introduction of CBKs in country. We set out to develop a practical decision support tool for programme managers of public health systems who are considering the potential role of CBKs in their strategy for care at birth. Development and testing of the decision support tool was a three-stage process involving an international expert group and country level testing. Stage 1, the development of the tool was undertaken by the Birth Kit Working Group and involved a review of the evidence, a consensus meeting, drafting of the proposed tool and expert review. In Stage 2 the tool was tested with users through interviews (9) and a focus group, with federal and provincial level decision makers in Pakistan. In Stage 3 the findings from the country level testing were reviewed by the expert group. The decision support tool comprised three separate algorithms to guide the policy maker or programme manager through the specific steps required in making the country level decision about whether to use CBKs. The algorithms were supported by a series of questions (that could be administered by interview, focus group or questionnaire) to help the decision maker identify the information needed. The country level testing revealed that the decision support tool was easy to follow and helpful in making decisions about the potential role of CBKs. Minor modifications were made and the final algorithms are presented. Testing of the tool with users in Pakistan suggests that the tool facilitates discussion and aids decision making. However, testing in other countries is needed to determine whether these results can be replicated and to identify how the tool can be adapted to meet country specific needs.

How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS

PubMed Central

2012-01-01

Background Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders′ perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this. Methods A sub-analysis was conducted of selected data from a wider qualitative study that explored the interactions between health systems and HIV and AIDS responses in five sub-Saharan countries (Burkina Faso, the Democratic Republic of Congo, Ghana, Madagascar and Malawi). Key background documents were analysed and semi-structured interviews (n = 258) and focus group discussions (n = 45) were held with representatives of communities, health personnel, decision makers, civil society representatives and development partners at both national and district level. Results Health priorities were expressed either in terms of specific health problems and diseases or gaps in service delivery requiring a strengthening of the overall health system. In all five countries study respondents (with the exception of community members in Ghana) identified malaria and HIV as the two top health priorities. Community representatives were more likely to report concerns about accessibility of services and quality of care. National level respondents often referred to wider systemic challenges in relation to achieving the Millennium Development Goals (MDGs). Indeed, actual priority setting was heavily influenced by international agendas (e.g. MDGs) and by the ways in which development partners were supporting national strategic planning processes. At the same time, multi-stakeholder processes were increasingly used to identify priorities and inform sector-wide planning, whereby health service statistics were used to rank the burden of disease. However, many respondents remarked that health system challenges are not captured by such statistics. In all countries funding for health was reported to fall short of requirements and a need for further priority setting to match actual resource availability was identified. Pooled health sector funds have been established to some extent, but development partners′ lack of flexibility in the allocation of funds according to country-generated priorities was identified as a major constraint. Conclusions Although we found consensus on health priorities across all levels in the study countries, current funding falls short of addressing these identified areas. The nature of external funding, as well as programme-specific investment, was found to distort priority setting. There are signs that existing interventions have had limited effects beyond meeting the needs of disease-specific programmes. A need for more comprehensive health system strengthening (HSS) was identified, which requires a strong vision as to what the term means, coupled with a clear strategy and commitment from national and international decision makers in order to achieve stated goals. Prospective studies and action research, accompanied by pilot programmes, are recommended as deliberate strategies for HSS. PMID:23231820

How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS.

PubMed

Jenniskens, Françoise; Tiendrebeogo, Georges; Coolen, Anne; Blok, Lucie; Kouanda, Seni; Sataru, Fuseini; Ralisimalala, Andriamampianina; Mwapasa, Victor; Kiyombo, Mbela; Plummer, David

2012-12-11

Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders' perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this. A sub-analysis was conducted of selected data from a wider qualitative study that explored the interactions between health systems and HIV and AIDS responses in five sub-Saharan countries (Burkina Faso, the Democratic Republic of Congo, Ghana, Madagascar and Malawi). Key background documents were analysed and semi-structured interviews (n = 258) and focus group discussions (n = 45) were held with representatives of communities, health personnel, decision makers, civil society representatives and development partners at both national and district level. Health priorities were expressed either in terms of specific health problems and diseases or gaps in service delivery requiring a strengthening of the overall health system. In all five countries study respondents (with the exception of community members in Ghana) identified malaria and HIV as the two top health priorities. Community representatives were more likely to report concerns about accessibility of services and quality of care. National level respondents often referred to wider systemic challenges in relation to achieving the Millennium Development Goals (MDGs). Indeed, actual priority setting was heavily influenced by international agendas (e.g. MDGs) and by the ways in which development partners were supporting national strategic planning processes. At the same time, multi-stakeholder processes were increasingly used to identify priorities and inform sector-wide planning, whereby health service statistics were used to rank the burden of disease. However, many respondents remarked that health system challenges are not captured by such statistics.In all countries funding for health was reported to fall short of requirements and a need for further priority setting to match actual resource availability was identified. Pooled health sector funds have been established to some extent, but development partners' lack of flexibility in the allocation of funds according to country-generated priorities was identified as a major constraint. Although we found consensus on health priorities across all levels in the study countries, current funding falls short of addressing these identified areas. The nature of external funding, as well as programme-specific investment, was found to distort priority setting. There are signs that existing interventions have had limited effects beyond meeting the needs of disease-specific programmes. A need for more comprehensive health system strengthening (HSS) was identified, which requires a strong vision as to what the term means, coupled with a clear strategy and commitment from national and international decision makers in order to achieve stated goals. Prospective studies and action research, accompanied by pilot programmes, are recommended as deliberate strategies for HSS.

Strategies for risk assessment and control in welding: challenges for developing countries.

PubMed

Hewitt, P J

2001-06-01

Metal arc welding ranges from primitive (manual) to increasingly complex automated welding processes. Welding occupies 1% of the labour force in some industrialised countries and increasing knowledge of health risks, necessitating improved assessment strategies and controls have been identified by the International Institute of Welding (IIW), ILO, WHO and other authoritative bodies. Challenges for developing countries need to be addressed. For small scale production and repair work, predominantly by manual metal arc on mild steel, the focus in developing economies has correctly been on control of obvious physical and acute health affects. Development introduces more sophisticated processes and hazards. Work pieces of stainless steel and consumables with chromium, nickel and manganese constituents are used with increasingly complex semi-manual or automated systems involving variety of fluxes or gasses. Uncritical adoption of new welding technologies by developing countries potentiates future health problems. Control should be integral at the design stage, otherwise substantive detriments and later costs can ensue. Developing countries need particular guidance on selection of the optimised welding consumables and processes to minimise such detriments. The role of the IIW and the MFRU are described. Applications of occupational hygiene principals of prevention and control of welding fume at source by process modification are presented.

Research during medical school: is it particularly difficult in developing countries compared to developed countries?

PubMed Central

Siddaiah-Subramanya, Manjunath; Singh, Harveen; Tiang, Kor Woi

2017-01-01

Objectives Medical student involvement in research has been declining over the years. We reviewed the factors that hinder participation in research with a focus on developing countries. Methods Literature search was performed using PubMed, MEDLINE and Cochrane Library. Peer-reviewed articles published between 1995 and 2017 were screened for relevance to identify key factors affecting medical student involvement in research with a particular focus on developing world. Analytical review is presented here in this article in relation to commonly reported aspects related to research during medical school. Results This search revealed varied contributing factors that hinder students’ growth and interest in research. It commonly highlighted few aspects in relation to research during medical school, and they were “variability in research uptake among students and issues related to them, their knowledge and attitude toward research and organizational input and its influence on students”. Conclusion While early introduction to research by inculcating a mindset aimed at research has been proposed, it has not been seen in practice during either the medical school or beyond to an extent that was expected. It appears that developing countries, while they share some of the reasons with developed countries, have their own set of difficulties, which are influenced by culture, beliefs and priorities. PMID:29180910

Bucharest: poverty or population?

PubMed

1974-01-01

The controversy that occurred in Bucharest over the World Population Plan of Action had not been totally anticipated. Prior to the Conference, there appeared to be a general consensus that population growth was the crucial issue although it was recognized that population growth had to be considered in the context of socioeconomic and cultural development. What developed at Bucharest was a clear division between the developed countries who favored population control and implementation of family planning programs by 1986 and the developing countries who rejected the idea of population control unless it was associated with the redistribution of world resources. The reality of people having large families because they are poor cannot be denied, but, simultaneously, the problem of increasing numbers and their impact on the quality of life, nutrition, housing, education, and employment must be faced. Since affluent countries cannot be relied upon concerning the redistribution of their wealth, developing countries can bring about some change by redistributing the wealth within their countries. Adult literacy programs have been identified as a means to promote socioeconomic development, but these programs will only prove successful if they involve the adults in the process of learning by means of problem solving and cause them to reflect on their socioeconomic situation with the result of reinvolving themselves in society in order to change it.

Targeting populations at higher risk for malaria: a survey of national malaria elimination programmes in the Asia Pacific.

PubMed

Wen, Shawn; Harvard, Kelly E; Gueye, Cara Smith; Canavati, Sara E; Chancellor, Arna; Ahmed, Be-Nazir; Leaburi, John; Lek, Dysoley; Namgay, Rinzin; Surya, Asik; Thakur, Garib D; Whittaker, Maxine Anne; Gosling, Roly D

2016-05-10

Significant progress has been made in reducing the malaria burden in the Asia Pacific region, which is aggressively pursuing a 2030 regional elimination goal. Moving from malaria control to elimination requires National Malaria Control Programmes (NMCPs) to target interventions at populations at higher risk, who are often not reached by health services, highly mobile and difficult to test, treat, and track with routine measures, and if undiagnosed, can maintain parasite reservoirs and contribute to ongoing transmission. A qualitative, free-text questionnaire was developed and disseminated among 17 of the 18 partner countries of the Asia Pacific Malaria Elimination Network (APMEN). All 14 countries that responded to the survey identified key populations at higher risk of malaria in their respective countries. Thirteen countries engage in the dissemination of malaria-related Information, Education, and Communication (IEC) materials. Eight countries engage in diagnostic screening, including of mobile and migrant workers, military staff, and/or overseas workers. Ten countries reported distributing or recommending the use of long-lasting insecticide-treated nets (LLINs) among populations at higher risk with fewer countries engaging in other prevention measures such as indoor residual spraying (IRS) (two countries), spatial repellents (four countries), chemoprophylaxis (five countries), and mass drug administration (MDA) (three countries). Though not specifically tailored to populations at higher risk, 11 countries reported using mass blood surveys as a surveillance tool and ten countries map case data. Most NMCPs lack a monitoring and evaluation structure. Countries in the Asia Pacific have identified populations at higher risk and targeted interventions to these groups but there is limited information on the effectiveness of these interventions. Platforms like APMEN offer the opportunity for the sharing of protocols and lessons learned related to finding, targeting and successfully clearing malaria from populations at higher risk. The sharing of programme data across borders may further strengthen national and regional efforts to eliminate malaria. This exchange of real-life experience is invaluable to NMCPs when scarce scientific evidence on the topic exists to aid decision-making and can further support NMCPs to develop strategies that will deliver a malaria-free Asia Pacific by 2030.

Successful Implementation Factors for Using Computers in Iranian Schools during One Decade (1995-2005)

ERIC Educational Resources Information Center

Zamani, Bibi Eshrat

2010-01-01

The main purpose of this paper is to identify factors and conditions that are important for successful implementation of computers in Iranian schools during one decade from 1995 to 2005. The second focus of this paper is to examine how these factors relate to models of implementation in other countries such as developed countries. This paper is…

The Research on Educational Leadership and Management in the Arab World since the 1990s: A Systematic Review

ERIC Educational Resources Information Center

Oplatka, Izhar; Arar, Khalid

2017-01-01

As most of the scholarship about educational leadership and management refers to developed countries, our aim in this review is to systematically collect, document, scrutinise and critically analyse at time of writing date research on educational leadership in Arab countries and to identify the key strengths and weaknesses in the research…

Inequality, poverty and development.

PubMed

Ahluwalia, M S

1976-12-01

Dicussion explores the nature of the relationship between the distribution of income and the process of development on the basis of cross country data on income inequality. The results presented are based on a sample of 60 countries, including 40 developing countries, 14 developed countries, and 6 socialist countries. The approach adopted is essentially exploratory. Multivariate regression analysis was used to estimate cross country relationships between the income shares of different percentile groups and selected variables reflecting aspects of the development process which are likely to influence income inequality. The estimated equations are then used as a basis for broad generalizations about the relationship between income distribution and development. There was strong support for the proposition that relative inequaltiy increases substantially in the early stages of development, with a reversal of this tendency in the later stages. The propositions held whether the sample was restricted to developing countries or expanded to include developed and socialist countries. The process was most prolonged for the poorest group. There were a number of processes occurring "pari passu" with development which were correlated with income inequality and which can plausibly be interpreted as causal. These were intersectoral shifts in the structure of production, expansion in education attainment and skill level of the labor force; and reduction in the growth of population. The operation of these processes appeared to explain some of the improvement in income distribution observed in the later stages of development, but they did not serve to explain the marked deterioration observed in the earlier stages. The cross section results failed to support the stronger hypothesis that the deterioration in relative inequality reflected a prolonged absolute impoverishment of large sections of the population in the course of development. The cross country pattern showed average absolute incomes of the lower percentile groups rising as per capita gross national product rises, although slower than for upper income groups. The cross section results failed to support the view that a faster rate of growth is systematically associated with higher inequality than can be expected given the state of development realized. An appendix identifies data sources and problems.

International health IT benchmarking: learning from cross-country comparisons.

PubMed

Zelmer, Jennifer; Ronchi, Elettra; Hyppönen, Hannele; Lupiáñez-Villanueva, Francisco; Codagnone, Cristiano; Nøhr, Christian; Huebner, Ursula; Fazzalari, Anne; Adler-Milstein, Julia

2017-03-01

To pilot benchmark measures of health information and communication technology (ICT) availability and use to facilitate cross-country learning. A prior Organization for Economic Cooperation and Development-led effort involving 30 countries selected and defined functionality-based measures for availability and use of electronic health records, health information exchange, personal health records, and telehealth. In this pilot, an Organization for Economic Cooperation and Development Working Group compiled results for 38 countries for a subset of measures with broad coverage using new and/or adapted country-specific or multinational surveys and other sources from 2012 to 2015. We also synthesized country learnings to inform future benchmarking. While electronic records are widely used to store and manage patient information at the point of care-all but 2 pilot countries reported use by at least half of primary care physicians; many had rates above 75%-patient information exchange across organizations/settings is less common. Large variations in the availability and use of telehealth and personal health records also exist. Pilot participation demonstrated interest in cross-national benchmarking. Using the most comparable measures available to date, it showed substantial diversity in health ICT availability and use in all domains. The project also identified methodological considerations (e.g., structural and health systems issues that can affect measurement) important for future comparisons. While health policies and priorities differ, many nations aim to increase access, quality, and/or efficiency of care through effective ICT use. By identifying variations and describing key contextual factors, benchmarking offers the potential to facilitate cross-national learning and accelerate the progress of individual countries. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

How dietary intake has been assessed in African countries? A systematic review.

PubMed

Vila-Real, Catarina; Pimenta-Martins, Ana; Gomes, Ana Maria; Pinto, Elisabete; Maina, Ndegwa Henry

2018-04-13

Dietary patterns are often considered as one of the main causes of non-communicable diseases worldwide. It is of utmost importance to study dietary habits in developing countries since this work is scarce. To summarize the most recent research conducted in this field in African countries, namely the most used methodologies and tools. A systematic review was conducted on MEDLINE®/PubMed, aiming to identify scientific publications focused on studies of dietary intake of different African populations, in a ten-year period. Papers not written in English/Portuguese/Spanish, studies developed among African people but not developed in African countries, studies aiming to assess a particular nutrient/specific food/food toxin and studies that assessed dietary intake among children were excluded. Out of 99 included studies, the 24-hour recall and the food-frequency questionnaire were the most used dietary intake assessment tools, used to assess diet at an individual level. It was also observed that often country-unspecific food composition databases are used, and the methodologies employed are poorly validated and standardized. There is an emergent need to improve the existing food databases by updating food data and to develop suitable country-specific databases for those that do not have their own food composition table.

National, regional, and worldwide estimates of stillbirth rates in 2009 with trends since 1995: a systematic analysis.

PubMed

Cousens, Simon; Blencowe, Hannah; Stanton, Cynthia; Chou, Doris; Ahmed, Saifuddin; Steinhardt, Laura; Creanga, Andreea A; Tunçalp, Ozge; Balsara, Zohra Patel; Gupta, Shivam; Say, Lale; Lawn, Joy E

2011-04-16

Stillbirths do not count in routine worldwide data-collating systems or for the Millennium Development Goals. Two sets of national stillbirth estimates for 2000 produced similar worldwide totals of 3·2 million and 3·3 million, but rates differed substantially for some countries. We aimed to develop more reliable estimates and a time series from 1995 for 193 countries, by increasing input data, using recent data, and applying improved modelling approaches. For international comparison, stillbirth is defined as fetal death in the third trimester (≥1000 g birthweight or ≥28 completed weeks of gestation). Several sources of stillbirth data were identified and assessed against prespecified inclusion criteria: vital registration data; nationally representative surveys; and published studies identified through systematic literature searches, unpublished studies, and national data identified through a WHO country consultation process. For 2009, reported rates were used for 33 countries and model-based estimates for 160 countries. A regression model of log stillbirth rate was developed and used to predict national stillbirth rates from 1995 to 2009. Uncertainty ranges were obtained with a bootstrap approach. The final model included log(neonatal mortality rate) (cubic spline), log(low birthweight rate) (cubic spline), log(gross national income purchasing power parity) (cubic spline), region, type of data source, and definition of stillbirth. Vital registration data from 79 countries, 69 nationally representative surveys from 39 countries, and 113 studies from 42 countries met inclusion criteria. The estimated number of global stillbirths was 2·64 million (uncertainty range 2·14 million to 3·82 million) in 2009 compared with 3·03 million (uncertainty range 2·37 million to 4·19 million) in 1995. Worldwide stillbirth rate has declined by 14·5%, from 22·1 stillbirths per 1000 births in 1995 to 18·9 stillbirths per 1000 births in 2009. In 2009, 76·2% of stillbirths occurred in south Asia and sub-Saharan Africa. This study draws attention to the dearth of reliable data in regions where most stillbirths occur. The estimated trend in stillbirth rate reduction is slower than that for maternal mortality and lags behind the increasing progress in reducing deaths in children younger than 5 years. Improved data and improved use of data are crucial to ensure that stillbirths count in global and national policy. The Bill & Melinda Gates Foundation through the Global Alliance to Prevent Prematurity and Stillbirth, Saving Newborn Lives/Save the Children, and the International Stillbirth Alliance. The Department of Reproductive Health and Research, WHO, through the UN Development Programme, UN Population Fund, WHO, and World Bank Special Programme of Research, Development and Research Training in Human Reproduction. Copyright © 2011 Elsevier Ltd. All rights reserved.

Tuberculosis in Asia and the pacific: the role of socioeconomic status and health system development.

PubMed

Wu, Jie; Dalal, Koustuv

2012-01-01

To identify the relationship between socioeconomic status, health system development and the incidence, prevalence and mortality of tuberculosis in Asia and the Pacific. Incidence, prevalence and mortality rates of tuberculosis and 20 variables of socioeconomic, health system and biological-behavioral issues were included in the study involving all 46 countries of the Asian Development Bank region (2007 data). Both univariate and multivariate linear regressions were used. The worst three tuberculosis affected countries were Cambodia, India and Indonesia, while the least affected was Australia. Tuberculosis incidence, prevalence and mortality rate were higher in countries with lower human development index, corruption perception index, gross domestic product (GDP) per capita and countries with more people under minimum food supplements. Among the health system variables, total health expenditure per capita, governmental health expenditure per capita, hospital beds, and access to improved water and sanitation were strongly associated with tuberculosis. Socioeconomic determinants and health system development have significant effect on the control of tuberculosis in Asia and the Pacific region. The study has some policy implications by means of lowering the corruption and improving the sanitation.

Environmental Impact Assessment in the marine environment: A comparison of legal frameworks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guerra, Flávia, E-mail: f.c.diasguerra@vu.nl; Liga para a Protecção da Natureza, 1500-124 Lisboa; Grilo, Catarina

Environmental Impact Assessment (EIA) is a well-established practice in most developed countries, even though its application to projects in the marine environment is at a much earlier stage of development. We use the Portuguese example to address marine EIA legislation since its exclusive economic zone (EEZ) is currently the third largest in the European Union and its EIA legislation does not require various offshore activities with potentially negative environmental impacts to undergo EIA before being licensed. This paper aims to determine whether three types of projects implemented within Portuguese maritime zones – artificial reefs using sunken ships, hydrocarbon prospecting andmore » wave-energy generation – would benefit from application of an appropriately designed EIA. We have conducted a structured review of EIA legal provisions from seven other countries, and considered whether a full EIA was required for each project type. Consequently, 12 Environmental Impact Statements (EIS) have been compared to identify patterns of (dis)similarity across countries and project types. Additionally, we identified key descriptors and predicted impacts for each project type referred to in their EIS. The main conclusion is that ultimately all three projects would benefit from mandatory EIA in Portugal. This paper is relevant for countries with large maritime areas and underdeveloped marine EIA legislation, helping improve international policy-making relating to these three types of marine projects. - Highlights: • EIA is not mandatory for some project types developed in Portuguese maritime zones. • Artificial reefs, oil&gas prospecting and wave-energy licensing differ in 8 countries. • EIA should be mandatory in Portugal for artificial reefs and oil&gas prospecting. • However, an AEInc approach is enough for wave-energy projects in Portugal. • Findings could be extended to other EU countries with extensive maritime zones.« less

The Future of Workforce Development--A Global Perspective.

ERIC Educational Resources Information Center

Twigger, Anthony J.

Recent research has identified trends in the training systems of 13 countries in Africa (Egypt, Mauritius, South Africa); the Arab States (Bahrain, Jordan); Asia (Australia, Fiji, Malaysia); Eastern Europe (Albania, Slovenia); Western Europe (Ireland, Portugal); and the Mediterranean region (Malta). The trends identified are legislation;…

Cross-country analysis of strategies for achieving progress towards global goals for women's and children's health.

PubMed

Ahmed, Syed Masud; Rawal, Lal B; Chowdhury, Sadia A; Murray, John; Arscott-Mills, Sharon; Jack, Susan; Hinton, Rachael; Alam, Prima M; Kuruvilla, Shyama

2016-05-01

To identify how 10 low- and middle-income countries achieved accelerated progress, ahead of comparable countries, towards meeting millennium development goals 4 and 5A to reduce child and maternal mortality. We synthesized findings from multistakeholder dialogues and country policy reports conducted previously for the Success Factors studies in 10 countries: Bangladesh, Cambodia, China, Egypt, Ethiopia, the Lao People's Democratic Republic, Nepal, Peru, Rwanda and Viet Nam. A framework approach was used to analyse and synthesize the data from the country reports, resulting in descriptive or explanatory conclusions by theme. Successful policy and programme approaches were categorized in four strategic areas: leadership and multistakeholder partnerships; health sector; sectors outside health; and accountability for resources and results. Consistent and coordinated inputs across sectors, based on high-impact interventions, were assessed. Within the health sector, key policy and programme strategies included defining standards, collecting and using data, improving financial protection, and improving the availability and quality of services. Outside the health sector, strategies included investing in girls' education, water, sanitation and hygiene, poverty reduction, nutrition and food security, and infrastructure development. Countries improved accountability by strengthening and using data systems for planning and evaluating progress. Reducing maternal and child mortality in the 10 fast-track countries can be linked to consistent and coordinated policy and programme inputs across health and other sectors. The approaches used by successful countries have relevance to other countries looking to scale-up or accelerate progress towards the sustainable development goals.

Attention to Local Health Burden and the Global Disparity of Health Research

PubMed Central

Evans, James A.; Shim, Jae-Mahn; Ioannidis, John P. A.

2014-01-01

Most studies on global health inequality consider unequal health care and socio-economic conditions but neglect inequality in the production of health knowledge relevant to addressing disease burden. We demonstrate this inequality and identify likely causes. Using disability-adjusted life years (DALYs) for 111 prominent medical conditions, assessed globally and nationally by the World Health Organization, we linked DALYs with MEDLINE articles for each condition to assess the influence of DALY-based global disease burden, compared to the global market for treatment, on the production of relevant MEDLINE articles, systematic reviews, clinical trials and research using animal models vs. humans. We then explored how DALYs, wealth, and the production of research within countries correlate with this global pattern. We show that global DALYs for each condition had a small, significant negative relationship with the production of each type of MEDLINE articles for that condition. Local processes of health research appear to be behind this. Clinical trials and animal studies but not systematic reviews produced within countries were strongly guided by local DALYs. More and less developed countries had very different disease profiles and rich countries publish much more than poor countries. Accordingly, conditions common to developed countries garnered more clinical research than those common to less developed countries. Many of the health needs in less developed countries do not attract attention among developed country researchers who produce the vast majority of global health knowledge—including clinical trials—in response to their own local needs. This raises concern about the amount of knowledge relevant to poor populations deficient in their own research infrastructure. We recommend measures to address this critical dimension of global health inequality. PMID:24691431

Attention to local health burden and the global disparity of health research.

PubMed

Evans, James A; Shim, Jae-Mahn; Ioannidis, John P A

2014-01-01

Most studies on global health inequality consider unequal health care and socio-economic conditions but neglect inequality in the production of health knowledge relevant to addressing disease burden. We demonstrate this inequality and identify likely causes. Using disability-adjusted life years (DALYs) for 111 prominent medical conditions, assessed globally and nationally by the World Health Organization, we linked DALYs with MEDLINE articles for each condition to assess the influence of DALY-based global disease burden, compared to the global market for treatment, on the production of relevant MEDLINE articles, systematic reviews, clinical trials and research using animal models vs. humans. We then explored how DALYs, wealth, and the production of research within countries correlate with this global pattern. We show that global DALYs for each condition had a small, significant negative relationship with the production of each type of MEDLINE articles for that condition. Local processes of health research appear to be behind this. Clinical trials and animal studies but not systematic reviews produced within countries were strongly guided by local DALYs. More and less developed countries had very different disease profiles and rich countries publish much more than poor countries. Accordingly, conditions common to developed countries garnered more clinical research than those common to less developed countries. Many of the health needs in less developed countries do not attract attention among developed country researchers who produce the vast majority of global health knowledge--including clinical trials--in response to their own local needs. This raises concern about the amount of knowledge relevant to poor populations deficient in their own research infrastructure. We recommend measures to address this critical dimension of global health inequality.

Introduction: population migration and urbanization in developing countries.

PubMed

Kojima, R

1996-12-01

This introductory article discusses the correlation between migration and rapid urbanization and growth in the largest cities of the developing world. The topics include the characteristics of urbanization, government policies toward population migration, the change in absolute size of the rural population, and the problems of maintaining megacities. Other articles in this special issue are devoted to urbanization patterns in China, South Africa, Iran, Korea and Taiwan as newly industrialized economies (NIEs), informal sectors in the Philippines and Thailand, and low-income settlements in Bogota, Colombia, and India. It is argued that increased urbanization is produced by natural population growth, the expansion of the urban administrative area, and the in-migration from rural areas. A comparison of urbanization rates of countries by per capita gross national product (GNP) reveals that countries with per capita GNP of under US$2000 have urbanization rates of 10-60%. Rates are under 30% in Africa, the Middle East, South Asia, China, and Indonesia. Rapid urbanization appears to follow the economic growth curve. The rate of urbanization in Latin America is high enough to be comparable to urbanization in Europe and the US. Taiwan and Korea have high rates of urbanization that surpass the rate of industrialization. Thailand and Malaysia have low rates of urbanization compared to the size of their per capita GNP. Urbanization rates under 20% occur in countries without economic development. Rates between 20% and 50% occur in countries with or without industrialization. East Asian urbanization is progressing along with industrialization. Africa and the Middle East have urbanization without industrialization. In 1990 there were 20 developing countries and 5 developed countries with populations over 5 million. In 10 of 87 developing countries rural population declined in absolute size. The author identifies and discusses four patterns of urban growth.

Women's autonomy in health care decision-making in developing countries: a synthesis of the literature.

PubMed

Osamor, Pauline E; Grady, Christine

2016-01-01

Autonomy is considered essential for decision-making in a range of health care situations, from health care seeking and utilization to choosing among treatment options. Evidence suggests that women in developing or low-income countries often have limited autonomy and control over their health decisions. A review of the published empirical literature to identify definitions and methods used to measure women's autonomy in developing countries describe the relationship between women's autonomy and their health care decision-making, and identify sociodemographic factors that influence women's autonomy and decision-making regarding health care was carried out. An integrated literature review using two databases (PubMed and Scopus) was performed. Inclusion criteria were 1) publication in English; 2) original articles; 3) investigations on women's decision-making autonomy for health and health care utilization; and 4) developing country context. Seventeen articles met inclusion criteria, including eleven from South Asia, five from Africa, and one from Central Asia. Most studies used a definition of autonomy that included independence for women to make their own choices and decisions. Study methods differed in that many used study-specific measures, while others used a set of standardized questions from their countries' national health surveys. Most studies examined women's autonomy in the context of reproductive health, while neglecting other types of health care utilized by women. Several studies found that factors, including age, education, and income, affect women's health care decision-making autonomy. Gaps in existing literature regarding women's autonomy and health care utilization include gaps in the areas of health care that have been measured, the influence of sex roles and social support, and the use of qualitative studies to provide context and nuance.

Setting research priorities across science, technology, and health sectors: the Tanzania experience.

PubMed

de Haan, Sylvia; Kingamkono, Rose; Tindamanyire, Neema; Mshinda, Hassan; Makandi, Harun; Tibazarwa, Flora; Kubata, Bruno; Montorzi, Gabriela

2015-03-12

Identifying research priorities is key to innovation and economic growth, since it informs decision makers on effectively targeting issues that have the greatest potential public benefit. As such, the process of setting research priorities is of pivotal importance for favouring the science, technology, and innovation (STI)-driven development of low- and middle-income countries. We report herein on a major cross-sectoral nationwide research priority setting effort recently carried out in Tanzania by the Tanzania Commission for Science and Technology (COSTECH) in partnership with the Council on Health Research for Development (COHRED) and the NEPAD Agency. The first of its type in the country, the process brought together stakeholders from 42 sub-sectors in science, technology, and health. The cross-sectoral research priority setting process consisted of a 'training-of-trainers' workshop, a demonstration workshop, and seven priority setting workshops delivered to representatives from public and private research and development institutions, universities, non-governmental organizations, and other agencies affiliated to COSTECH. The workshops resulted in ranked listings of research priorities for each sub-sector, totalling approximately 800 priorities. This large number was significantly reduced by an expert panel in order to build a manageable instrument aligned to national development plans that could be used to guide research investments. The Tanzania experience is an instructive example of the challenges and issues to be faced in when attempting to identify research priority areas and setting an STI research agenda in low- and middle-income countries. As countries increase their investment in research, it is essential to increase investment in research management and governance as well, a key and much needed capacity for countries to make proper use of research investments.

Helping public sector health systems innovate: the strategic approach to strengthening reproductive health policies and programs.

PubMed

Fajans, Peter; Simmons, Ruth; Ghiron, Laura

2006-03-01

Public sector health systems that provide services to poor and marginalized populations in developing countries face great challenges. Change associated with health sector reform and structural adjustment often leaves these already-strained institutions with fewer resources and insufficient capacity to relieve health burdens. The Strategic Approach to Strengthening Reproductive Health Policies and Programs is a methodological innovation developed by the World Health Organization and its partners to help countries identify and prioritize their reproductive health service needs, test appropriate interventions, and scale up successful innovations to a subnational or national level. The participatory, interdisciplinary, and country-owned process can set in motion much-needed change. We describe key features of this approach, provide illustrations from country experiences, and use insights from the diffusion of innovation literature to explain the approach's dissemination and sustainability.

Analyses of fatalities from natural catastrophes in different income groups over time

NASA Astrophysics Data System (ADS)

Grimm, Tobias

2017-04-01

Identifying not only economic and insured losses but also numbers of fatalities from natural catastrophes provides new information on resilience and prevention measures in the countries affected. In this talk, we examine how fatalities from Munich Re's NatCatSERVICE database, caused by natural disasters have developed. In addition to the standard approach based on fatalities by country, we introduced a new measure, "fatalities per million inhabitants", and factored in population development over time. The World Bank definition was used to determine the wealth classification of individual countries. This methodology enables us to compare countries with different population sizes and thus produce an index for humanitarian impact. The analyses are key information on ascertaining whether prevention measures or early-warning systems have in fact reduced the number of fatalities in recent decades (1980-2016).

Cross-cultural differences in psychiatric nurses' attitudes to inpatient aggression.

PubMed

Jansen, Gerard J; Middel, Berry; Dassen, Theo W N; Reijneveld, Menno S A

2006-04-01

Little is currently known about the attitudes of psychiatric nurses toward patient aggression, particularly from an international perspective. Attitudes toward patient aggression of psychiatric nurses from five European countries were investigated using a recently developed and tested attitude scale. Data were collected from a convenience sample of 1,769 student nurses and psychiatric nurses. Regression analysis was performed to identify personal and occupational characteristics of the respondents able to predict their attitude toward aggression. Analysis of variance was used to identify significant differences in attitudes between and among countries. Attitude was predicted by sex, contractual status (full vs. part time), and the type of ward on which subjects worked. With one exception (communicative attitude), attitudes differed across countries. More research on attitude formation is needed to determine which factors account for these differences.

Mid-upper arm circumference as a screening tool for identifying children with obesity: a 12-country study.

PubMed

Chaput, J-P; Katzmarzyk, P T; Barnes, J D; Fogelholm, M; Hu, G; Kuriyan, R; Kurpad, A; Lambert, E V; Maher, C; Maia, J; Matsudo, V; Olds, T; Onywera, V; Sarmiento, O L; Standage, M; Tudor-Locke, C; Zhao, P; Tremblay, M S

2017-12-01

No studies have examined if mid-upper arm circumference (MUAC) can be an alternative screening tool for obesity in an international sample of children differing widely in levels of human development. Our aim is to determine whether MUAC could be used to identify obesity in children from 12 countries in five major geographic regions of the world. This observational, multinational cross-sectional study included 7337 children aged 9-11 years. Anthropometric measurements were objectively assessed, and obesity was defined according to the World Health Organization reference data. In the total sample, MUAC was strongly correlated with adiposity indicators in both boys and girls (r > 0.86, p < 0.001). The accuracy level of MUAC for identifying obesity was high in both sexes and across study sites (overall area under the curve of 0.97, sensitivity of 95% and specificity of 90%). The MUAC cut-off value to identify obesity was ~25 cm for both boys and girls. In country-specific analyses, the cut-off value to identify obesity ranged from 23.2 cm (boys in South Africa) to 26.2 cm (girls in the UK). Results from this 12-country study suggest that MUAC is a simple and accurate measurement that may be used to identify obesity in children aged 9-11 years. MUAC may be a promising screening tool for obesity in resource-limited settings. © 2016 World Obesity Federation.

Exploring substance use normalization among adolescents: a multilevel study in 35 countries.

PubMed

Sznitman, Sharon R; Kolobov, Tanya; Bogt, Tom Ter; Kuntsche, Emmanuel; Walsh, Sophie D; Boniel-Nissim, Meyran; Harel-Fisch, Yossi

2013-11-01

The substance use normalization thesis predicts that adolescent substance users are less likely to report substance use risk factors in high than in low prevalence countries. This study tests whether national population-level alcohol, cigarette and cannabis prevalence rates moderate the strength of the relationship between individual level social and behavioral risk factors and individual level alcohol, cigarette and cannabis use. Data from 2009/2010 Health Behaviour in School-Aged Children Study (N = 68,045, age = 15) from 35 countries was analyzed using logistic Hierarchical Linear Modeling. As expected based on low cannabis prevalence rates in all countries studied, no evidence of normalization was found for recent cannabis use. Also in line with the normalization thesis, results show that for substance use that reaches above 40% in at least some of the countries studied (drunkenness, alcohol and cigarette use), adolescents who reported use are less likely to report social and behavioral risk factors in high prevalence countries than in low prevalence countries. However, support for the normalization thesis was only partial in that results show that in models where evidence for normalization was found, there are risk factors that predict substance use to an equal degree regardless of country level prevalence rates. The current research shows that the normalization thesis is a useful framework for understanding the contextual aspects of adolescent alcohol, tobacco, and cannabis use. The study has implications for drug prevention as it suggests that selective prevention efforts may be particularly useful in low prevalence countries where screening based on risk factors may usefully identify adolescents at most risk for developing drug use problems. This approach may be less useful in high prevalence countries where screening based on risk factors is less likely to satisfactorily identify those at risk for developing drug use problems. Copyright © 2013 Elsevier Ltd. All rights reserved.

Hard-to-reach populations of men who have sex with men and sex workers: a systematic review on sampling methods.

PubMed

Barros, Ana B; Dias, Sonia F; Martins, Maria Rosario O

2015-10-30

In public health, hard-to-reach populations are often recruited by non-probabilistic sampling methods that produce biased results. In order to overcome this, several sampling methods have been improved and developed in the last years. The aim of this systematic review was to identify all current methods used to survey most-at-risk populations of men who have sex with men and sex workers. The review also aimed to assess if there were any relations between the study populations and the sampling methods used to recruit them. Lastly, we wanted to assess if the number of publications originated in middle and low human development (MLHD) countries had been increasing in the last years. A systematic review was conducted using electronic databases and a total of 268 published studies were included in the analysis. In this review, 11 recruitment methods were identified. Semi-probabilistic methods were used most commonly to survey men who have sex with men, and the use of the Internet was the method that gathered more respondents. We found that female sex workers were more frequently recruited through non-probabilistic methods than men who have sex with men (odds = 2.2; p < 0.05; confidence interval (CI) [1.1-4.2]). In the last 6 years, the number of studies based in middle and low human development countries increased more than the number of studies based in very high and high human development countries (odds = 2.5; p < 0.05; CI [1.3-4.9]). This systematic literature review identified 11 methods used to sample men who have sex with men and female sex workers. There is an association between the type of sampling method and the population being studied. The number of studies based in middle and low human development countries has increased in the last 6 years of this study.

Who Gains by Communications Development? Studies of Information Technolgies in Developing Countries. Working Paper 76-1.

ERIC Educational Resources Information Center

Clippinger, John H.

To identify the distribution of benefits that accrue from introducing communications technology in developing societies, two case studies were undertaken. The first case looks at telecommunications development in Algeria where telecommunications systems are being rapidly introduced to speed up industrialization and where a satellite system is in…

Russia as a Returning Donor--Four Roles in Development Assistance to Education

ERIC Educational Resources Information Center

Piattoeva, Nelli; Takala, Tuomas

2015-01-01

This article analyses the role of Russia in development assistance to education in light of the changing architecture of development assistance--the variety of positions identified with both "new" and "old" donor countries. We shed light on Russia's aims and agenda in the field of development assistance in general and…

Measuring teamwork and taskwork of community-based “teams” delivering life-saving health interventions in rural Zambia: a qualitative study

PubMed Central

2013-01-01

Background The use of teams is a well-known approach in a variety of settings, including health care, in both developed and developing countries. Team performance is comprised of teamwork and task work, and ascertaining whether a team is performing as expected to achieve the desired outcome has rarely been done in health care settings in resource-limited countries. Measuring teamwork requires identifying dimensions of teamwork or processes that comprise the teamwork construct, while taskwork requires identifying specific team functions. Since 2008 a community-based project in rural Zambia has teamed community health workers (CHWs) and traditional birth attendants (TBAs), supported by Neighborhood Health Committees (NHCs), to provide essential newborn and continuous curative care for children 0–59 months. This paper describes the process of developing a measure of teamwork and taskwork for community-based health teams in rural Zambia. Methods Six group discussions and pile-sorting sessions were conducted with three NHCs and three groups of CHW-TBA teams. Each session comprised six individuals. Results We selected 17 factors identified by participants as relevant for measuring teamwork in this rural setting. Participants endorsed seven functions as important to measure taskwork. To explain team performance, we assigned 20 factors into three sub-groups: personal, community-related and service-related. Conclusion Community and culturally relevant processes, functions and factors were used to develop a tool for measuring teamwork and taskwork in this rural community and the tool was quite unique from tools used in developed countries. PMID:23802766

Global survey of hospital pharmacy practice.

PubMed

Doloresco, Fred; Vermeulen, Lee C

2009-03-01

The current state of hospital pharmacy practice around the globe and key issues facing international hospital pharmacy practice were studied. This survey assessed multiple aspects of hospital pharmacy practice within each of the Member States recognized by the United Nations. An official respondent from each nation was identified by a structured nomination process. The survey instrument was developed; pilot tested; translated into English, French, and Spanish; and distributed in July 2007. The nature, scope, and breadth of hospital pharmacy practices in medication procurement, prescribing, preparation and distribution, administration, outcomes monitoring, and human resources and training were evaluated. Descriptive statistics were used to characterize the responses. Eighty-five countries (44% of the 192 Member States) responded to the survey. The respondent sample of countries was representative of all nations in terms of population, geographic region, World Health Organization region, and level of economic development. In addition to qualifying the nature of hospital pharmacy practice, the survey highlighted numerous challenges facing the profession of pharmacy in the hospital setting around the globe, including access to medicines and adequately trained pharmacists. While the practice of hospital pharmacy differs from country to country, many nations face similar challenges, regardless of their population, location, or wealth. These survey results provide a basis for identifying opportunities for growth and development, as well as for international collaboration, to advance the profession of pharmacy and ensure that patients worldwide receive the care that they deserve.

Roles beyond Instruction: Facilitating the Development of Preservice Teachers

ERIC Educational Resources Information Center

Franco, Yvonne

2014-01-01

Identifying a Signature Pedagogy that ensures high-quality teacher preparation is essential to the field of teacher education, as inconsistencies across programs throughout our country threaten our profession. Drawing on a comprehensive study of the professions, Lee Shulman (2005) provides a lens from which to identify Signature Pedagogy and the…

Benchmarking health IT among OECD countries: better data for better policy

PubMed Central

Adler-Milstein, Julia; Ronchi, Elettra; Cohen, Genna R; Winn, Laura A Pannella; Jha, Ashish K

2014-01-01

Objective To develop benchmark measures of health information and communication technology (ICT) use to facilitate cross-country comparisons and learning. Materials and methods The effort is led by the Organisation for Economic Co-operation and Development (OECD). Approaches to definition and measurement within four ICT domains were compared across seven OECD countries in order to identify functionalities in each domain. These informed a set of functionality-based benchmark measures, which were refined in collaboration with representatives from more than 20 OECD and non-OECD countries. We report on progress to date and remaining work to enable countries to begin to collect benchmark data. Results The four benchmarking domains include provider-centric electronic record, patient-centric electronic record, health information exchange, and tele-health. There was broad agreement on functionalities in the provider-centric electronic record domain (eg, entry of core patient data, decision support), and less agreement in the other three domains in which country representatives worked to select benchmark functionalities. Discussion Many countries are working to implement ICTs to improve healthcare system performance. Although many countries are looking to others as potential models, the lack of consistent terminology and approach has made cross-national comparisons and learning difficult. Conclusions As countries develop and implement strategies to increase the use of ICTs to promote health goals, there is a historic opportunity to enable cross-country learning. To facilitate this learning and reduce the chances that individual countries flounder, a common understanding of health ICT adoption and use is needed. The OECD-led benchmarking process is a crucial step towards achieving this. PMID:23721983

Benchmarking health IT among OECD countries: better data for better policy.

PubMed

Adler-Milstein, Julia; Ronchi, Elettra; Cohen, Genna R; Winn, Laura A Pannella; Jha, Ashish K

2014-01-01

To develop benchmark measures of health information and communication technology (ICT) use to facilitate cross-country comparisons and learning. The effort is led by the Organisation for Economic Co-operation and Development (OECD). Approaches to definition and measurement within four ICT domains were compared across seven OECD countries in order to identify functionalities in each domain. These informed a set of functionality-based benchmark measures, which were refined in collaboration with representatives from more than 20 OECD and non-OECD countries. We report on progress to date and remaining work to enable countries to begin to collect benchmark data. The four benchmarking domains include provider-centric electronic record, patient-centric electronic record, health information exchange, and tele-health. There was broad agreement on functionalities in the provider-centric electronic record domain (eg, entry of core patient data, decision support), and less agreement in the other three domains in which country representatives worked to select benchmark functionalities. Many countries are working to implement ICTs to improve healthcare system performance. Although many countries are looking to others as potential models, the lack of consistent terminology and approach has made cross-national comparisons and learning difficult. As countries develop and implement strategies to increase the use of ICTs to promote health goals, there is a historic opportunity to enable cross-country learning. To facilitate this learning and reduce the chances that individual countries flounder, a common understanding of health ICT adoption and use is needed. The OECD-led benchmarking process is a crucial step towards achieving this.

Factors affecting sustainable adoption of e-health technology in developing countries: an exploratory survey of Nigerian hospitals from the perspective of healthcare professionals

PubMed Central

Toycan, Mehmet

2018-01-01

Background E-health technology applications are essential tools of modern information technology that improve quality of healthcare delivery in hospitals of both developed and developing countries. However, despite its positive benefits, studies indicate that the rate of the e-health adoption in some developing countries is either low or underutilized. This is due in part, to barriers such as resistance from healthcare professionals, poor infrastructure, and low technical expertise among others. Objective The aim of this study is to investigate, identify and analyze the underlying factors that affect healthcare professionals decision to adopt and use e-health technology applications in developing countries, with particular reference to hospitals in Nigeria. Methods The study used a cross sectional approach in the form of a close-ended questionnaire to collect quantitative data from a sample of 465 healthcare professionals randomly selected from 15 hospitals in Nigeria. We used the modified Technology Acceptance Model (TAM) as the dependent variable and external factors as independent variables. The collected data was then analyzed using SPSS statistical analysis such as frequency test, reliability analysis, and correlation coefficient analysis. Results The results obtained, which correspond with findings from other researches published, indicate that perceived usefulness, belief, willingness, as well as attitude of healthcare professionals have significant influence on their intention to adopt and use the e-health technology applications. Other strategic factors identified include low literacy level and experience in using the e-health technology applications, lack of motivation, poor organizational and management policies. Conclusion The study contributes to the literature by pinpointing significant areas where findings can positively affect, or be found useful by, healthcare policy decision makers in Nigeria and other developing countries. This can help them understand their areas of priorities and weaknesses when planning for e-health technology adoption and implementation. PMID:29507830

Factors affecting sustainable adoption of e-health technology in developing countries: an exploratory survey of Nigerian hospitals from the perspective of healthcare professionals.

PubMed

Zayyad, Musa Ahmed; Toycan, Mehmet

2018-01-01

E-health technology applications are essential tools of modern information technology that improve quality of healthcare delivery in hospitals of both developed and developing countries. However, despite its positive benefits, studies indicate that the rate of the e-health adoption in some developing countries is either low or underutilized. This is due in part, to barriers such as resistance from healthcare professionals, poor infrastructure, and low technical expertise among others. The aim of this study is to investigate, identify and analyze the underlying factors that affect healthcare professionals decision to adopt and use e-health technology applications in developing countries, with particular reference to hospitals in Nigeria. The study used a cross sectional approach in the form of a close-ended questionnaire to collect quantitative data from a sample of 465 healthcare professionals randomly selected from 15 hospitals in Nigeria. We used the modified Technology Acceptance Model (TAM) as the dependent variable and external factors as independent variables. The collected data was then analyzed using SPSS statistical analysis such as frequency test, reliability analysis, and correlation coefficient analysis. The results obtained, which correspond with findings from other researches published, indicate that perceived usefulness, belief, willingness, as well as attitude of healthcare professionals have significant influence on their intention to adopt and use the e-health technology applications. Other strategic factors identified include low literacy level and experience in using the e-health technology applications, lack of motivation, poor organizational and management policies. The study contributes to the literature by pinpointing significant areas where findings can positively affect, or be found useful by, healthcare policy decision makers in Nigeria and other developing countries. This can help them understand their areas of priorities and weaknesses when planning for e-health technology adoption and implementation.

Global opportunities for mariculture development to promote human nutrition

PubMed Central

Molina, Renato; Wilson, Margaret; Halpern, Benjamin S.

2018-01-01

An estimated two billion people worldwide currently suffer from micronutrient malnutrition, and almost one billion are calorie deficient. Providing adequate nutrition is a growing global challenge. Seafood is one of the most important sources of both protein and micronutrients for many, yet production from wild capture fisheries has stagnated. In contrast, aquaculture is the world’s fastest-growing food production sector and now supplies over half of all seafood consumed globally. Mariculture, or the farming of brackish and marine species, accounts for roughly one-third of all aquaculture production and has received increasing attention as a potential supplement for wild-caught marine fisheries. By analyzing global patterns in seafood reliance, malnutrition levels, and economic opportunity, this study identifies where mariculture has the greatest potential to improve human nutrition. We calculate a mariculture opportunity index for 117 coastal nations by drawing on a diverse set of seafood production, trade, consumption, and nutrition data. Seventeen primary variables are combined into country-level scores for reliance on seafood, opportunity for nutritional improvement, and opportunity for economic development of mariculture. The final mariculture opportunity score identifies countries with high seafood reliance combined with high nutritional and economic opportunity scores. We find that island nations in Southeast Asia and the Caribbean are consistently identified as countries with high mariculture opportunity. In other regions, nutritional and economic opportunity scores are not significantly correlated, and we discuss the implications of this finding for crafting appropriate development policy. Finally, we identify key challenges to ameliorating malnutrition through mariculture development, including insufficient policy infrastructure, government instability, and ensuring local consumption of farmed fish. Our analysis is an important step towards prioritizing nations where the economic and nutritional benefits of expanding mariculture may be jointly captured. PMID:29761051

Pharmaceutical policies in European countries.

PubMed

Barros, Pedro Pita

2010-01-01

Pharmaceutical expenditures have an important role in Europe. The attempts to control expenditure have used a wide range of policy measures. We reviewed the main measures adopted by the European Union countries, especially in countries where governments are the largest third-party payers. To complement a literature review on the topic, data was gathered from national reviews of health systems and direct inquiries to several government bodies. Almost all countries regulate prices of pharmaceutical products. Popular policy measures include international referencing to set prices (using as benchmark countries that have set lower prices), internal reference pricing systems to promote price competition in domestic markets, and positive lists for reimbursement to promote consumption of generics (including in some cases substitution by pharmacists of drugs prescribed by physicians). Despite the wide range of policy measures, it is not possible to identify a "silver bullet" to control pharmaceutical expenditures. We also identified two main policy challenges: policy coordination among countries within the European Union to maintain incentives for R&D at the global level, and the development of new relationships with the pharmaceutical industry; namely, the so-called risk-sharing agreements between the pharmaceutical industry and governments/regulators (or large third-party payers).

EMS Systems in Lower-Middle Income Countries: A Literature Review.

PubMed

Suryanto; Plummer, Virginia; Boyle, Malcolm

2017-02-01

Introduction Prehospital care is one of the many issues that require addressing by lower-middle income countries (LMICs) where approximately 90% of global injuries occur. This may arise from more traffic in LMICs, poor road conditions, lack of public awareness of the importance of road safety, and the lack of ability to provide first aid to the victims. However, prehospital care in LMICs remains underdeveloped. Problem There is insufficient evidence regarding the development of prehospital care among LMICs. Thus, the objective of this study was to investigate the status of Emergency Medical Services (EMS) systems in these countries. A review of medical-related electronic databases was designed to identify the development of EMS systems in LMICs. A search of the literature was undertaken using three electronic databases, CINAHL, Ovid Medline, and EMBASE via Ovid, from their commencement date until the end of July 2015. The grey literature was searched using Google Scholar. Articles were included if they reported on the establishment and current status of an EMS system and were excluded if they were letters to the editor, articles focusing on disaster management, a combination of more than one country if the other country was not a LMIC, written in a language other than English or Bahasa Indonesia, and/or focusing only on in-hospital care. There were 337 articles identified in CINAHL, 731 in Ovid Medline, 891 in EMBASE via Ovid, and 41 in Google Scholar. Based on the title and abstract, 31 articles from CINAHL, 40 from Ovid Medline, 43 from EMBASE, and 11 from Google Scholar were retrieved for further review. There were 92 articles that met the inclusion criteria with 35 articles removed, as they were duplicated, leaving 57 articles to be reviewed. From those 48 countries categorized as LMICs, there were 16 (33.3%) countries that had information about an EMS system, including injury types, patient demographic, prehospital transport, and the obstacles in implementing the prehospital care system. The implementation and development of an EMS system is varied among LMICs. Many LMICs lack an organized EMS system with most ambulances used purely for transport and not as an emergency care vehicle. Financial issues are the most common problems faced by LMICs with support from developed countries a necessity. Suryanto , Plummer V , Boyle M . EMS systems in lower-middle income countries: a literature review. Prehosp Disaster Med. 2017;32(1):64-70.

The affordability of antiretroviral therapy in developing countries: what policymakers need to know.

PubMed

Forsythe, S S

1998-01-01

The objective of this paper is to assist policymakers in developing countries and international donors by providing an outline of economic information needed to make a decision regarding the purchase of drugs to provide highly active antiretroviral therapy (HAART). The following paper: (i) reviews existing experiences of policymakers in developing countries regarding the purchase of drugs needed for HAART, (ii) identifies issues that would need to be addressed and data that would be required to make more informed decisions regarding this issue, (iii) develops a cost-benefit model that could be utilized in designing an economic research project evaluating the economic costs and benefits of HAART, and (iv) performs a preliminary test of this model with data from Costa Rica. A review of experiences with this issue reveals that there are growing political, legal and budgetary pressures for countries to make tenable decisions regarding the purchase of drugs for HAART. An economic model describing the costs and benefits of HAART is proposed, although much of the required data for using such a model is currently neither available or in the process of being collected. It is imperative that economic data be collected to better inform policymakers in developing countries about their decision regarding the purchase of these drugs. It is recommended that such economic data be collected as organizations such as the United Nations Joint Programme on HIV/ AIDS (UNAIDS) initiate their medical assessments of HAART in developing countries.

Epilepsy surgery in developing countries.

PubMed

Williamson, P D; Jobst, B C

2000-01-01

Epilepsy surgery (ES) is a well-accepted treatment for medically intractable epilepsy patients in developed countries, but it is highly technology dependent. Such technology is not usually available in developing countries. For presurgical evaluation, magnetic resonance imaging (MRI) and electroencephalogram recording while videotaping the patient have been important. High technology equipment will, in conjunction with MRI, identify approximately 70% of ES candidates. Introducing ES into developing countries will require determining the candidates that are appropriate for the existing medical infrastructure. This article reviews ES and its possible introduction into conditions existing in developing countries. The authors address (a) the types of patients to be considered for resective ES (some patients require a fairly standard series of noninvasive studies: others will require extensive invasive studies), (b) ways to determine which patients might be appropriate for the existing situation (unilateral mesial temporal lobe epilepsy detected with MRI, epilepsy with a circumscribed MRI lesion, hemispheric lesions, circumscribed MRI detected neuronal migration, and development disorders), (c) surgical procedures (local resection, functional hemispherectomy, multiple subpial transections, corpus callosotomy, and implantation of a vagal nerve stimulator), (d) special considerations for introducing ES into developing countries (medical infrastructure, technology, seizure monitoring systems, selective intracarotid/carotid Amytal testing, and surgical equipment), and (e) the limitations, realistic expectations, personnel requirements, and educational function for selected professionals. Delivery of the technology and expertise to perform ES in developing regions of the world is a realizable project, but it would be limited by available technology and existing medical infrastructure. It should be possible in most areas to train local personnel and thereby leave a lasting legacy.

Nursing workforce policy and the economic crisis: a global overview.

PubMed

Buchan, James; O'May, Fiona; Dussault, Gilles

2013-09-01

To assess the impact of the global financial crisis on the nursing workforce and identify appropriate policy responses. This article draws from international data sources (Organisation for Economic Co-operation and Development [OECD] and World Health Organization), from national data sources (nursing regulatory authorities), and the literature to provide a context in which to examine trends in labor market and health spending indicators, nurse employment, and nurse migration patterns. A variable impact of the crisis at the country level was shown by different changes in unemployment rates and funding of the health sector. Some evidence was obtained of reductions in nurse staffing in a small number of countries. A significant and variable change in the patterns of nurse migration also was observed. The crisis has had a variable impact; nursing shortages are likely to reappear in some OECD countries. Policy responses will have to take account of the changed economic reality in many countries. This article highlights key trends and issues for the global nursing workforce; it then identifies policy interventions appropriate to the new economic realities in many OECD countries. © 2013 Sigma Theta Tau International.

Problem solving for breast health care delivery in low and middle resource countries (LMCs): consensus statement from the Breast Health Global Initiative.

PubMed

Harford, Joe B; Otero, Isabel V; Anderson, Benjamin O; Cazap, Eduardo; Gradishar, William J; Gralow, Julie R; Kane, Gabrielle M; Niëns, Laurens M; Porter, Peggy L; Reeler, Anne V; Rieger, Paula T; Shockney, Lillie D; Shulman, Lawrence N; Soldak, Tanya; Thomas, David B; Thompson, Beti; Winchester, David P; Zelle, Sten G; Badwe, Rajendra A

2011-04-01

International collaborations like the Breast Health Global Initiative (BHGI) can help low and middle income countries (LMCs) to establish or improve breast cancer control programs by providing evidence-based, resource-stratified guidelines for the management and control of breast cancer. The Problem Solving Working Group of the BHGI 2010 Global Summit met to develop a consensus statement on problem-solving strategies addressing breast cancer in LMCs. To better assess breast cancer burden in poorly studied populations, countries require accurate statistics regarding breast cancer incidence and mortality. To better identify health care system strengths and weaknesses, countries require reasonable indicators of true health system quality and capacity. Using qualitative and quantitative research methods, countries should formulate cancer control strategies to identify both system inefficiencies and patient barriers. Patient navigation programs linked to public advocacy efforts feed and strengthen functional early detection and treatment programs. Cost-effectiveness research and implementation science are tools that can guide and expand successful pilot programs. Copyright © 2011 Elsevier Ltd. All rights reserved.

Management of NCD in low- and middle-income countries.

PubMed

Checkley, William; Ghannem, Hassen; Irazola, Vilma; Kimaiyo, Sylvester; Levitt, Naomi S; Miranda, J Jaime; Niessen, Louis; Prabhakaran, Dorairaj; Rabadán-Diehl, Cristina; Ramirez-Zea, Manuel; Rubinstein, Adolfo; Sigamani, Alben; Smith, Richard; Tandon, Nikhil; Wu, Yangfeng; Xavier, Denis; Yan, Lijing L

2014-12-01

Noncommunicable disease (NCD), comprising cardiovascular disease, stroke, diabetes, and chronic obstructive pulmonary disease, are increasing in incidence rapidly in low- and middle-income countries (LMICs). Some patients have access to the same treatments available in high-income countries, but most do not, and different strategies are needed. Most research on noncommunicable diseases has been conducted in high-income countries, but the need for research in LMICs has been recognized. LMICs can learn from high-income countries, but they need to devise their own systems that emphasize primary care, the use of community health workers, and sometimes the use of mobile technology. The World Health Organization has identified "best buys" it advocates as interventions in LMICs. Non-laboratory-based risk scores can be used to identify those at high risk. Targeting interventions to those at high risk for developing diabetes has been shown to work in LMICs. Indoor cooking with biomass fuels is an important cause of chronic obstructive pulmonary disease in LMICs, and improved cookstoves with chimneys may be effective in the prevention of chronic diseases. Copyright © 2014 World Heart Federation (Geneva). All rights reserved.

Management of Noncommunicable Disease in Low- and Middle-Income Countries

PubMed Central

Checkley, William; Ghannem, Hassen; Irazola, Vilma; Kimaiyo, Sylvester; Levitt, Naomi S.; Miranda, J. Jaime; Niessen, Louis; Prabhakaran, Dorairaj; Rabadán-Diehl, Cristina; Ramirez-Zea, Manuel; Rubinstein, Adolfo; Sigamani, Alben; Smith, Richard; Tandon, Nikhil; Wu, Yangfeng; Xavier, Denis; Yan, Lijing L.

2014-01-01

Noncommunicable disease (NCD), comprising cardiovascular disease, stroke, diabetes, and chronic obstructive pulmonary disease, are increasing in incidence rapidly in low- and middle-income countries (LMICs). Some patients have access to the same treatments available in high-income countries, but most do not, and different strategies are needed. Most research on noncommunicable diseases has been conducted in high-income countries, but the need for research in LMICs has been recognized. LMICs can learn from high-income countries, but they need to devise their own systems that emphasize primary care, the use of community health workers, and sometimes the use of mobile technology. The World Health Organization has identified “best buys” it advocates as interventions in LMICs. Non-laboratory-based risk scores can be used to identify those at high risk. Targeting interventions to those at high risk for developing diabetes has been shown to work in LMICs. Indoor cooking with biomass fuels is an important cause of chronic obstructive pulmonary disease in LMICs, and improved cookstoves with chimneys may be effective in the prevention of chronic diseases. PMID:25592798

Vaccines to prevent pneumonia in children - a developing country perspective.

PubMed

Oliwa, Jacquie N; Marais, Ben J

2017-03-01

Pneumonia accounted for 15% of the 6.3 million deaths among children younger than five years in 2013, a total of approximately 935,000 deaths worldwide. Routine vaccination against common childhood illnesses has been identified as one of the most cost-effective strategies to prevent death from pneumonia. Vaccine-preventable or potentially preventable diseases commonly linked with respiratory tract infections include Streptococcus pneumoniae, Haemophilus influenza type-b (Hib), pertussis, influenza, measles, and tuberculosis. Although here have been great strides in the development and administration of effective vaccines, the countries that carry the largest disease burdens still struggle to vaccinate their children and newer conjugated vaccines remain out of reach for many. The Global Vaccine Action Plan (GVAP) has identified priority areas for innovation in research in all aspects of immunisation development and delivery to ensure equitable access to vaccines for all. Copyright © 2015 Elsevier Ltd. All rights reserved.

A new technique for measuring listening and reading literacy in developing countries

NASA Astrophysics Data System (ADS)

Greene, Barbara A.; Royer, James M.; Anzalone, Stephen

1990-03-01

One problem in evaluating educational interventions in developing countries is the absence of tests that adequately reflect the culture and curriculum. The Sentence Verification Technique is a new procedure for measuring reading and listening comprehension that allows for the development of tests based on materials indigenous to a given culture. The validity of using the Sentence Verification Technique to measure reading comprehension in Grenada was evaluated in the present study. The study involved 786 students at standards 3, 4 and 5. The tests for each standard consisted of passages that varied in difficulty. The students identified as high ability students in all three standards performed better than those identified as low ability. All students performed better with easier passages. Additionally, students in higher standards performed bettter than students in lower standards on a given passage. These results supported the claim that the Sentence Verification Technique is a valid measure of reading comprehension in Grenada.

The Self in Movement: Being Identified and Identifying Oneself in the Process of Migration and Asylum Seeking.

PubMed

Watzlawik, Meike; Brescó de Luna, Ignacio

2017-06-01

How migration influences the processes of identity development has been under longstanding scrutiny in the social sciences. Usually, stage models have been suggested, and different strategies for acculturation (e.g., integration, assimilation, separation, and marginalization) have been considered as ways to make sense of the psychological transformations of migrants as a group. On an individual level, however, identity development is a more complex endeavor: Identity does not just develop by itself, but is constructed as an ongoing process. To capture these processes, we will look at different aspects of migration and asylum seeking; for example, the cultural-specific values and expectations of the hosting (European) countries (e.g., as identifier), but also of the arriving individuals/groups (e.g., identified as refugees). Since the two may contradict each other, negotiations between identities claims and identity assignments become necessary. Ways to solve these contradictions are discussed, with a special focus on the experienced (and often missing) agency in different settings upon arrival in a new country. In addition, it will be shown how sudden events (e.g., 9/11, the Charlie Hebdo attack) may challenge identity processes in different ways.

Institutional radicalization, the state, and the development process in Africa.

PubMed

Mabogunje, A L

2000-12-05

The concept of "institutional radicalization" or "the changing of institutions from their roots" is put forward as critical for understanding the manner in which civil societies in most African countries have been grappling with the challenges of development. Given the well embedded precapitalist social formation in most African countries, various institutions have been radicalized around such critical identities as age, gender, land, occupation, credit, community, and rituals of solidarity to promote development. However, until the state intervenes to legitimize these initiatives of civil societies, their full impact on the development process is bound to be moot. The enormous tasks entailed in such legitimization through identifying, registering, realigning, providing incentives, directing, and monitoring these radicalized institutions remain critical and imperative for African countries if they are to accelerate and deepen the extent of their integration into the global free market economy and democratic governance.

Institutional radicalization, the state, and the development process in Africa

PubMed Central

Mabogunje, Akin L.

2000-01-01

The concept of “institutional radicalization” or “the changing of institutions from their roots” is put forward as critical for understanding the manner in which civil societies in most African countries have been grappling with the challenges of development. Given the well embedded precapitalist social formation in most African countries, various institutions have been radicalized around such critical identities as age, gender, land, occupation, credit, community, and rituals of solidarity to promote development. However, until the state intervenes to legitimize these initiatives of civil societies, their full impact on the development process is bound to be moot. The enormous tasks entailed in such legitimization through identifying, registering, realigning, providing incentives, directing, and monitoring these radicalized institutions remain critical and imperative for African countries if they are to accelerate and deepen the extent of their integration into the global free market economy and democratic governance. PMID:11087811

Low-Cost Method for Quantifying Sodium in Coconut Water and Seawater for the Undergraduate Analytical Chemistry Laboratory: Flame Test, a Mobile Phone Camera, and Image Processing

ERIC Educational Resources Information Center

Moraes, Edgar P.; da Silva, Nilbert S. A.; de Morais, Camilo de L. M.; das Neves, Luiz S.; de Lima, Kassio M. G.

2014-01-01

The flame test is a classical analytical method that is often used to teach students how to identify specific metals. However, some universities in developing countries have difficulties acquiring the sophisticated instrumentation needed to demonstrate how to identify and quantify metals. In this context, a method was developed based on the flame…

The nutrition policy process: the role of strategic capacity in advancing national nutrition agendas.

PubMed

Pelletier, David L; Menon, Purnima; Ngo, Tien; Frongillo, Edward A; Frongillo, Dominic

2011-06-01

Undernutrition is the single largest contributor to the burden of disease in developing countries and has documented effects on social and economic development, yet progress in reducing undernutrition remains slow. This paper identifies the range of factors that have influenced the nutrition agenda in developing countries, in order to inform the implementation of three major global initiatives related to undernutrition. Data sources include interviews with nutrition practitioners at the national and international level, written accounts from six African countries, and observations of the policy process in five countries. Data were thematically coded to identify recurrent factors that facilitated or inhibited progress in addressing undernutrition. The data reveal the following: First, societal conditions and catalytic events pose a variety of challenges and opportunities to enlarge and shape the nutrition agenda. Some countries have been successful in using such opportunities, while others have been less successful and there have been some unintended consequences. Second, disagreements over interventions and strategies are an almost universal feature of the nutrition policy process, occur primarily among mid-level actors rather than among politicians or senior administrators, and are primarily the product of structural factors such as organizational mandates, interests, and differences in professional perspectives. Third, many of these structural factors can be molded, aligned, and/or circumvented through strategic action on the part of the mid-level actors to strengthen movement on the nutrition agenda. This evidence that strategic action can redirect and/or overcome the effects of structural factors has important implications for future efforts to advance the nutrition agenda.

Prospects for foreign applications of wind-energy systems, preliminary report in response to Public Law 96-345

NASA Astrophysics Data System (ADS)

1981-11-01

Potential foreign applications were identified. Specific systems which would most closely match the applications requirements from a list of representative U.S. wind energy systems. The energy situation of each of 155 countries and 29 territories was reviewed. Wind resources availability for each country was assessed from existing data sources. The export potential was determined by analyzing a country's applications requirements, cost of alternative energy, financial condition, interest in the development of renewable energy technologies, and level of indigenous competition.

Improving nutrition surveillance and public health research in Central and Eastern Europe/Balkan Countries using the Balkan Food Platform and dietary tools.

PubMed

Gurinović, Mirjana; Milešević, Jelena; Novaković, Romana; Kadvan, Agnes; Djekić-Ivanković, Marija; Šatalić, Zvonimir; Korošec, Mojca; Spiroski, Igor; Ranić, Marija; Dupouy, Eleonora; Oshaug, Arne; Finglas, Paul; Glibetić, Maria

2016-02-15

The objective of this paper is to share experience and provide updated information on Capacity Development in the Central and Eastern Europe/Balkan Countries (CEE/BC) region relevant to public health nutrition, particularly in creation of food composition databases (FCDBs), applying dietary intake assessment and monitoring tools, and harmonizing methodology for nutrition surveillance. Balkan Food Platform was established by a Memorandum of Understanding among EuroFIR AISBL, Institute for Medical Research, Belgrade, Capacity Development Network in Nutrition in CEE - CAPNUTRA and institutions from nine countries in the region. Inventory on FCDB status identified lack of harmonized and standardized research tools. To strengthen harmonization in CEE/BC in line with European research trends, the Network members collaborated in development of a Regional FCDB, using web-based food composition data base management software following EuroFIR standards. Comprehensive nutrition assessment and planning tool - DIET ASSESS & PLAN could enable synchronization of nutrition surveillance across countries. Copyright © 2015 Elsevier Ltd. All rights reserved.

Design and Analysis of Cognitive Interviews for Comparative Multinational Testing

PubMed Central

Fitzgerald, Rory; Padilla, José-Luis; Willson, Stephanie; Widdop, Sally; Caspar, Rachel; Dimov, Martin; Gray, Michelle; Nunes, Cátia; Prüfer, Peter; Schöbi, Nicole; Schoua-Glusberg, Alisú

2011-01-01

This article summarizes the work of the Comparative Cognitive Testing Workgroup, an international coalition of survey methodologists interested in developing an evidence-based methodology for examining the comparability of survey questions within cross-cultural or multinational contexts. To meet this objective, it was necessary to ensure that the cognitive interviewing (CI) method itself did not introduce method bias. Therefore, the workgroup first identified specific characteristics inherent in CI methodology that could undermine the comparability of CI evidence. The group then developed and implemented a protocol addressing those issues. In total, 135 cognitive interviews were conducted by participating countries. Through the process, the group identified various interpretive patterns resulting from sociocultural and language-related differences among countries as well as other patterns of error that would impede comparability of survey data. PMID:29081719

National quality indicators and policies from 15 countries leading in adult end-of-life care: a systematic environmental scan.

PubMed

Virdun, Claudia; Luckett, Tim; Lorenz, Karl A; Phillips, Jane

2018-06-01

The importance of measuring the quality of end-of-life care provision is undisputed, but determining how best to achieve this is yet to be confirmed. This study sought to identify and describe national end-of-life care quality indicators and supporting policies used by countries leading in their end-of-life care provision. A systematic environmental scan that included a web search to identify relevant national policies and indicators; hand searching for additional materials; information from experts listed for the top 10 (n=15) countries ranked in the 'quality of care' category of the 2015 Quality of Death Index study; and snowballing from Index experts. Ten countries (66%) have national policy support for end-of-life care measurement, five have national indicator sets, with two indicator sets suitable for all service providers. No countries mandate indicator use, and there is limited evidence of consumer engagement in development of indicators. Two thirds of the 128 identified indicators are outcomes measures (62%), and 38% are process measures. Most indicators pertain to symptom management (38%), social care (32%) or care delivery (27%). Measurement of end-of-life care quality varies globally and rarely covers all care domains or service providers. There is a need to reduce duplication of indicator development, involve consumers, consider all care providers and ensure measurable and relevant indicators to improve end-of-life care experiences for patients and families. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Selecting indicators for patient safety at the health system level in OECD countries.

PubMed

McLoughlin, Vivienne; Millar, John; Mattke, Soeren; Franca, Margarida; Jonsson, Pia Maria; Somekh, David; Bates, David

2006-09-01

Concerns about patient safety have arisen with growing documentation of the extent and nature of harm. Yet there are no robust and meaningful data that can be used internationally to assess the extent of the problem and considerable methodological difficulties. This article describes a project undertaken as part of the Organization for Economic Cooperation and Development (OECD) Quality Indicator Project, which aimed at developing an initial set of patient safety indicators. Patient safety indicators from OECD countries were identified and then rated against three principal criteria: importance to patient safety, scientific soundness, and potential feasibility. Although some countries are developing multi-source monitoring systems, these are not yet mature enough for international exchange. This project reviewed routine data collections as a starting point. Of an initial set of 59 candidate indicators identified, 21 were selected which cover known areas of harm to patients. This project is an important initial step towards defining a usable set of patient safety indicators that will allow comparisons to be made internationally and will support mutual learning and quality improvement in health care. Measures of harm should be complemented over time with measures of effective improvement factors.

Identification of Challenges to the Availability and Accessibility of Opioids in Twelve European Countries: Conclusions from Two ATOME Six-Country Workshops.

PubMed

Linge-Dahl, Lisa; Vranken, Marjolein; Juenger, Saskia; North, Kate; Scholten, Willem; Payne, Sheila; Radbruch, Lukas

2015-12-01

Access to many controlled medicines is inadequate in a number of European countries. This leads to deficits in the treatment of moderate to severe pain as well as in opioid agonist therapy. The study objective was to elaborate the reasons for this inadequacy. The work plan of the Access to Opioid Medication in Europe (ATOME) project included two six-country workshops. These workshops comprised a national situational analysis, drafting tailor-made recommendations for improvement and developing action plans for their implementation. In total, 84 representatives of the national Ministries of Health, national controlled substances authorities, experts representing regulatory and law enforcement authorities, leading health care professionals, and patient representatives from 13 European countries participated in either one of the workshops. The delegates used breakout sessions to identify key common challenges. Content analysis was used for the evaluation of protocols and field notes. A number of challenges to opioid accessibility in the countries was identified in the domains of knowledge and educational, regulatory, legislative, as well as public awareness and training barriers that limit opioid prescription. In addition, short validity of prescriptions and bureaucratic practices resulting in overregulation impeded availability of some essential medicines. Stigmatization and criminalisation of people who use drugs remained the major impediment to increasing opioid agonist program coverage. The challenges identified during outcomes of the workshops were used as the basis for subsequent dissemination and implementation activities in the ATOME project, and in some countries the workshop proceedings already served as a stepping-stone for the first changes in regulations and legislation.

Monitoring gender equity in health using gender-sensitive indicators: a cross-national study.

PubMed

Diaz-Granados, Natalia; Pitzul, Kristen Blythe; Dorado, Linda M; Wang, Feng; McDermott, Sarah; Rondon, Marta B; Posada-Villa, Jose; Saavedra, Javier; Torres, Yolanda; Des Meules, Marie; Stewart, Donna E

2011-01-01

As gender is known to be a major determinant of health, monitoring gender equity in health systems remains a vital public health priority. Focusing on a low-income (Peru), middle-income (Colombia), and high-income (Canada) country in the Americas, this study aimed to (1) identify and select gender-sensitive health indicators and (2) assess the feasibility of measuring and comparing gender-sensitive health indicators among countries. Gender-sensitive health indicators were selected by a multidisciplinary group of experts from each country. The most recent gender-sensitive health measures corresponding to selected indicators were identified through electronic databases (CINAHL, PsycINFO, MEDLINE, Embase, LILACS, LIPECS, Latindex, and BIREME) and expert consultation. Data from population-based studies were analyzed when indicator information was unavailable from reports. Twelve of the 17 selected gender-sensitive health indicators were feasible to measure in at least two countries, and 9 of these were comparable among all countries. Indicators that were available were not stratified or adjusted by age, education, marital status, or wealth. The largest between-country difference was maternal mortality, and the largest gender inequity was mortality from homicides. This study shows that gender inequities in health exist in all countries, regardless of income level. Economic development seemed to confer advantages in the availability of such indicators; however, this finding was not consistent and needs to be further explored. Future initiatives should include identifying health system factors and risk factors associated with disparities as well as assessing the cost-effectiveness of including the routine monitoring of gender inequities in health.

A case study of polypharmacy management in nine European countries: Implications for change management and implementation.

PubMed

McIntosh, Jennifer; Alonso, Albert; MacLure, Katie; Stewart, Derek; Kempen, Thomas; Mair, Alpana; Castel-Branco, Margarida; Codina, Carles; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Illario, Maddalena; Junius-Walker, Ulrike; Kampolis, Christos F; Kardas, Przemyslaw; Lewek, Pawel; Malva, João; Menditto, Enrica; Scullin, Claire; Wiese, Birgitt

2018-01-01

Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives.

Developmental potential in the first 5 years for children in developing countries

PubMed Central

Grantham-McGregor, Sally; Cheung, Yin Bun; Cueto, Santiago; Glewwe, Paul; Richter, Linda; Strupp, Barbara

2007-01-01

Summary Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data—the prevalence of early childhood stunting and the number of people living in absolute poverty—to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty. PMID:17208643

Social cohesion matters in health.

PubMed

Chuang, Ying-Chih; Chuang, Kun-Yang; Yang, Tzu-Hsuan

2013-10-28

The concept of social cohesion has invoked debate due to the vagueness of its definition and the limitations of current measurements. This paper attempts to examine the concept of social cohesion, develop measurements, and investigate the relationship between social cohesion and individual health. This study used a multilevel study design. The individual-level samples from 29 high-income countries were obtained from the 2000 World Value Survey (WVS) and the 2002 European Value Survey. National-level social cohesion statistics were obtained from Organization of Economic Cooperation and Development datasets, World Development Indicators, and Asian Development Bank key indicators for the year 2000, and from aggregating responses from the WVS. In total 47,923 individuals were included in this study. The factor analysis was applied to identify dimensions of social cohesion, which were used as entities in the cluster analysis to generate a regime typology of social cohesion. Then, multilevel regression models were applied to assess the influences of social cohesion on an individual's self-rated health. Factor analysis identified five dimensions of social cohesion: social equality, social inclusion, social development, social capital, and social diversity. Then, the cluster analysis revealed five regimes of social cohesion. A multi-level analysis showed that respondents in countries with higher social inclusion, social capital, and social diversity were more likely to report good health above and beyond individual-level characteristics. This study is an innovative effort to incorporate different aspects of social cohesion. This study suggests that social cohesion was associated with individual self-rated after controlling individual characteristics. To achieve further advancement in population health, developed countries should consider policies that would foster a society with a high level of social inclusion, social capital, and social diversity. Future research could focus on identifying possible pathways by which social cohesion influences various health outcomes.

Ethical issues in medical research in the developing world: a report on a meeting organised by Fondation Mérieux.

PubMed

Perrey, Christophe; Wassenaar, Douglas; Gilchrist, Shawn; Ivanoff, Bernard

2009-08-01

This paper reports on a multidisciplinary meeting held to discuss ethical issues in medical research in the developing world. Many studies, including clinical trials, are conducted in developing countries with a high burden of disease. Conditions under which this research is conducted vary because of differences in culture, public health, political, legal and social contexts specific to these countries. Research practices, including standards of care for participants, may vary as a result. It is therefore not surprising that ethical issues emerge. This meeting sought to identify and discuss these issues from the perspectives of the many actors in such research, including community representatives, with a view to finding ethical and pragmatic solutions to these issues. Dialogue between these actors was also promoted, with a view to identifying the need to develop such dialogue in future. Drawing from the experiences of the speakers, the colloquium attempted to outline some answers to several key questions characterising the field today. Experiences related to epidemiologic research, vaccine trials, drug trials, diagnostic tests and to some fundamental ethical issues in health research. Speakers were from different countries, disciplines and professions. The meeting provided a forum for consultation and debate between different ethics actors. Both encouraging findings and challenges emerged.

Tracking progress towards global drinking water and sanitation targets: A within and among country analysis.

PubMed

Fuller, James A; Goldstick, Jason; Bartram, Jamie; Eisenberg, Joseph N S

2016-01-15

Global access to safe drinking water and sanitation has improved dramatically during the Millennium Development Goal (MDG) period. However, there is substantial heterogeneity in progress between countries and inequality within countries. We assessed countries' temporal patterns in access to drinking water and sanitation using publicly available data. We then classified countries using non-linear modeling techniques as having one of the following trajectories: 100% coverage, linear growth, linear decline, no change, saturation, acceleration, deceleration, negative acceleration, or negative deceleration. We further assessed the degree to which temporal profiles follow a sigmoidal pattern and how these patterns might vary within a given country between rural and urban settings. Among countries with more than 10 data points, between 15% and 38% showed a non-linear trajectory, depending on the indicator. Overall, countries' progress followed a sigmoidal trend, but some countries are making better progress and some worse progress than would be expected. We highlight several countries that are not on track to meet the MDG for water or sanitation, but whose access is accelerating, suggesting better performance during the coming years. Conversely, we also highlight several countries that have made sufficient progress to meet the MDG target, but in which access is decelerating. Patterns were heterogeneous and non-linearity was common. Characterization of these heterogeneous patterns will help policy makers allocate resources more effectively. For example, policy makers can identify countries that could make use of additional resources or might be in need of additional institutional capacity development to properly manage resources; this will be essential to meet the forthcoming Sustainable Development Goals. Copyright © 2015 Elsevier B.V. All rights reserved.

Building an international network for a primary care research program: reflections on challenges and solutions in the set-up and delivery of a prospective observational study of acute cough in 13 European countries

PubMed Central

2011-01-01

Background Implementing a primary care clinical research study in several countries can make it possible to recruit sufficient patients in a short period of time that allows important clinical questions to be answered. Large multi-country studies in primary care are unusual and are typically associated with challenges requiring innovative solutions. We conducted a multi-country study and through this paper, we share reflections on the challenges we faced and some of the solutions we developed with a special focus on the study set up, structure and development of Primary Care Networks (PCNs). Method GRACE-01 was a multi-European country, investigator-driven prospective observational study implemented by 14 Primary Care Networks (PCNs) within 13 European Countries. General Practitioners (GPs) recruited consecutive patients with an acute cough. GPs completed a case report form (CRF) and the patient completed a daily symptom diary. After study completion, the coordinating team discussed the phases of the study and identified challenges and solutions that they considered might be interesting and helpful to researchers setting up a comparable study. Results The main challenges fell within three domains as follows: i) selecting, setting up and maintaining PCNs; ii) designing local context-appropriate data collection tools and efficient data management systems; and iii) gaining commitment and trust from all involved and maintaining enthusiasm. The main solutions for each domain were: i) appointing key individuals (National Network Facilitator and Coordinator) with clearly defined tasks, involving PCNs early in the development of study materials and procedures. ii) rigorous back translations of all study materials and the use of information systems to closely monitor each PCNs progress; iii) providing strong central leadership with high level commitment to the value of the study, frequent multi-method communication, establishing a coherent ethos, celebrating achievements, incorporating social events and prizes within meetings, and providing a framework for exploitation of local data. Conclusions Many challenges associated with multi-country primary care research can be overcome by engendering strong, effective communication, commitment and involvement of all local researchers. The practical solutions identified and the lessons learned in implementing the GRACE-01 study may assist in establishing other international primary care clinical research platforms. Trial registration ClinicalTrials.gov Identifier: NCT00353951 PMID:21794112

Respiratory syncytial virus: a systematic scientometric analysis of the global publication output and the gender distribution of publishing authors

PubMed Central

Brüggmann, Dörthe; Köster, Corinna; Klingelhöfer, Doris; Bauer, Jan; Ohlendorf, Daniela; Bundschuh, Matthias; Groneberg, David A

2017-01-01

Objective Worldwide, the respiratory syncytial virus (RSV) represents the predominant viral agent causing bronchiolitis and pneumonia in children. To conduct research and tackle existing healthcare disparities, RSV-related research activities around the globe need to be described. Hence, we assessed the associated scientific output (represented by research articles) by geographical, chronological and socioeconomic criteria and analysed the authors publishing in the field by gender. Also, the 15 most cited articles and the most prolific journals were identified for RSV research. Design Retrospective, descriptive study. Setting The NewQIS (New Quality and Quantity Indices in Science) platform was employed to identify RSV-related articles published in the Web of Science until 2013. We performed a numerical analysis of all articles, and examined citation-based aspects (eg, citation rates); results were visualised by density equalising mapping tools. Results We identified 4600 RSV-related articles. The USA led the field; US-American authors published 2139 articles (46.5%% of all identified articles), which have been cited 83 000 times. When output was related to socioeconomic benchmarks such as gross domestic product or Research and Development expenditures, Guinea-Bissau, The Gambia and Chile were ranked in leading positions. A total of 614 articles on RSV (13.34% of all articles) were attributed to scientific collaborations. These were primarily established between high-income countries. The gender analysis indicated that male scientists dominated in all countries except Brazil. Conclusions The majority of RSV-related research articles originated from high-income countries whereas developing nations showed only minimal publication productivity and were barely part of any collaborative networks. Hence, research capacity in these nations should be increased in order to assist in addressing inequities in resource allocation and the clinical burden of RSV in these countries. PMID:28751483

Justice-based social assistance

PubMed Central

Barrientos, Armando

2016-01-01

What are the main objectives of social protection institutions in developing countries? What should be their scope and reach? What is the source of their legitimacy? Finding appropriate answers to these questions is essential to understanding, and shaping, the emergence of welfare institutions in low- and middle-income countries. Most available answers rely on instrumental arguments. Few make reference to normative principles. This article draws on three concepts from Rawls – social justice as regulating cooperation, the social minimum, and the need for a freestanding political notion of social justice – to develop a coherent argument for grounding social assistance on social justice. In line with this argument, it identifies some parameters for a justice-based social assistance. This article then discusses, with examples, the tensions existing between a social justice-based social minimum and ‘real’ social assistance institutions emerging in developing countries. PMID:27708544

Access to Orphan Drugs: A Comprehensive Review of Legislations, Regulations and Policies in 35 Countries.

PubMed

Gammie, Todd; Lu, Christine Y; Babar, Zaheer Ud-Din

2015-01-01

To review existing regulations and policies utilised by countries to enable patient access to orphan drugs. A review of the literature (1998 to 2014) was performed to identify relevant, peer-reviewed articles. Using content analysis, we synthesised regulations and policies for access to orphan drugs by type and by country. Fifty seven articles and 35 countries were included in this review. Six broad categories of regulation and policy instruments were identified: national orphan drug policies, orphan drug designation, marketing authorization, incentives, marketing exclusivity, and pricing and reimbursement. The availability of orphan drugs depends on individual country's legislation and regulations including national orphan drug policies, orphan drug designation, marketing authorization, marketing exclusivity and incentives such as tax credits to ensure research, development and marketing. The majority of countries (27/35) had in place orphan drug legislation. Access to orphan drugs depends on individual country's pricing and reimbursement policies, which varied widely between countries. High prices and insufficient evidence often limit orphan drugs from meeting the traditional health technology assessment criteria, especially cost-effectiveness, which may influence access. Overall many countries have implemented a combination of legislations, regulations and policies for orphan drugs in the last two decades. While these may enable the availability and access to orphan drugs, there are critical differences between countries in terms of range and types of legislations, regulations and policies implemented. Importantly, China and India, two of the largest countries by population size, both lack national legislation for orphan medicines and rare diseases, which could have substantial negative impacts on their patient populations with rare diseases.

Heatwave early warning systems and adaptation advice to reduce human health consequences of heatwaves.

PubMed

Lowe, Dianne; Ebi, Kristie L; Forsberg, Bertil

2011-12-01

With climate change, there has been an increase in the frequency, intensity and duration of heatwave events. In response to the devastating mortality and morbidity of recent heatwave events, many countries have introduced heatwave early warning systems (HEWS). HEWS are designed to reduce the avoidable human health consequences of heatwaves through timely notification of prevention measures to vulnerable populations. To identify the key characteristics of HEWS in European countries to help inform modification of current, and development of, new systems and plans. We searched the internet to identify HEWS policy or government documents for 33 European countries and requested information from relevant organizations. We translated the HEWS documents and extracted details on the trigger indicators, thresholds for action, notification strategies, message intermediaries, communication and dissemination strategies, prevention strategies recommended and specified target audiences. Twelve European countries have HEWS. Although there are many similarities among the HEWS, there also are differences in key characteristics that could inform improvements in heatwave early warning plans.

Cross-country analysis of strategies for achieving progress towards global goals for women’s and children’s health

PubMed Central

Ahmed, Syed Masud; Rawal, Lal B; Chowdhury, Sadia A; Murray, John; Arscott-Mills, Sharon; Jack, Susan; Hinton, Rachael; Alam, Prima M

2016-01-01

Abstract Objective To identify how 10 low- and middle-income countries achieved accelerated progress, ahead of comparable countries, towards meeting millennium development goals 4 and 5A to reduce child and maternal mortality. Methods We synthesized findings from multistakeholder dialogues and country policy reports conducted previously for the Success Factors studies in 10 countries: Bangladesh, Cambodia, China, Egypt, Ethiopia, the Lao People's Democratic Republic, Nepal, Peru, Rwanda and Viet Nam. A framework approach was used to analyse and synthesize the data from the country reports, resulting in descriptive or explanatory conclusions by theme. Findings Successful policy and programme approaches were categorized in four strategic areas: leadership and multistakeholder partnerships; health sector; sectors outside health; and accountability for resources and results. Consistent and coordinated inputs across sectors, based on high-impact interventions, were assessed. Within the health sector, key policy and programme strategies included defining standards, collecting and using data, improving financial protection, and improving the availability and quality of services. Outside the health sector, strategies included investing in girls’ education, water, sanitation and hygiene, poverty reduction, nutrition and food security, and infrastructure development. Countries improved accountability by strengthening and using data systems for planning and evaluating progress. Conclusion Reducing maternal and child mortality in the 10 fast-track countries can be linked to consistent and coordinated policy and programme inputs across health and other sectors. The approaches used by successful countries have relevance to other countries looking to scale-up or accelerate progress towards the sustainable development goals. PMID:27147765

Productivity in physical and chemical science predicts the future economic growth of developing countries better than other popular indices.

PubMed

Jaffe, Klaus; Caicedo, Mario; Manzanares, Marcos; Gil, Mario; Rios, Alfredo; Florez, Astrid; Montoreano, Claudia; Davila, Vicente

2013-01-01

Scientific productivity of middle income countries correlates stronger with present and future wealth than indices reflecting its financial, social, economic or technological sophistication. We identify the contribution of the relative productivity of different scientific disciplines in predicting the future economic growth of a nation. Results show that rich and poor countries differ in the relative proportion of their scientific output in the different disciplines: countries with higher relative productivity in basic sciences such as physics and chemistry had the highest economic growth in the following five years compared to countries with a higher relative productivity in applied sciences such as medicine and pharmacy. Results suggest that the economies of middle income countries that focus their academic efforts in selected areas of applied knowledge grow slower than countries which invest in general basic sciences.

Implementation of a Regional Training Program on African Swine Fever As Part of the Cooperative Biological Engagement Program across the Caucasus Region

PubMed Central

De Nardi, Marco; Léger, Anaïs; Stepanyan, Tatul; Khachatryan, Bagrat; Karibayev, Talgat; Sytnik, Igor; Tyulegenov, Samat; Akhmetova, Assel; Nychyk, Serhiy; Sytiuk, Mykola; Nevolko, Oleg; Datsenko, Roman; Chaligava, Tengiz; Avaliani, Lasha; Parkadze, Otar; Ninidze, Lena; Kartskhia, Natia; Napetvaridze, Tsira; Asanishvili, Zviad; Khelaia, Demna; Menteshashvili, Ioseb; Zadayan, Meruzhan; Niazyan, Lyudmila; Mykhaylovska, Nataliya; Brooks, Bradford Raymond; Zhumabayeva, Gulnara; Satabayeva, Saltanat; Metreveli, Magda; Gallagher, Theresa; Obiso, Richard

2017-01-01

A training and outreach program to increase public awareness of African swine fever (ASF) was implemented by Defense Threat Reduction Agency and the Ministries of Agriculture in Armenia, Georgia, Kazakhstan, and Ukraine. The implementing agency was the company SAFOSO (Switzerland). Integration of this regional effort was administered by subject matter experts for each country. The main teaching effort of this project was to develop a comprehensive regional public outreach campaign through a network of expertise and knowledge for the control and prevention of ASF in four neighboring countries that experience similar issues with this disease. Gaps in disease knowledge, legislation, and outbreak preparedness in each country were all addressed. Because ASF is a pathogen with bioterrorism potential and of great veterinary health importance that is responsible for major economic instability, the project team developed public outreach programs to train veterinarians in the partner countries to accurately and rapidly identify ASF activity and report it to international veterinary health agencies. The project implementers facilitated four regional meetings to develop this outreach program, which was later disseminated in each partner country. Partner country participants were trained as trainers to implement the outreach program in their respective countries. In this paper, we describe the development, execution, and evaluation of the ASF training and outreach program that reached more than 13,000 veterinarians, farmers, and hunters in the partner countries. Additionally, more than 120,000 booklets, flyers, leaflets, guidelines, and posters were distributed during the outreach campaign. Pre- and post-ASF knowledge exams were developed. The overall success of the project was demonstrated in that the principles of developing and conducting a public outreach program were established, and these foundational teachings can be applied within a single country or expanded regionally to disseminate disease information across borders; overall, this method can be modified to raise awareness about many other diseases. PMID:29124058

Gender quotas for women in national politics: A comparative analysis across development thresholds.

PubMed

Rosen, Jennifer

2017-08-01

Women's share of global lower or single house parliamentary seats has increased by over 70% over the course of the 21st century. Yet these increases have not been uniform across countries. Rather countries with low levels of socioeconomic development have outpaced developed democracies in terms of the gains made in the formal political representation of women. One reasonable explanation for this trend is the adoption in many poorer countries of national gender quota legislation, that is, affirmative action laws intended to compensate for sex discrimination in the electoral process. Yet, cross-national analyses examining quotas as an explanatory factor typically use a simple binary (yes/no) variable that either conflates the diverse intra-quota variations into a single variable or includes only one part of the many quota variations. By contrast, using an originally compiled dataset that includes 167 countries from 1992 to 2012, this paper employs measures of gender quota legislation that capture the complexity and considerable diversity of existing quota legislation. These measures allow us to identify the specific factors that have helped so many less developed countries rise to the top of international rankings in recent years. The findings indicate that the effect of each type of gender quota, as well as other explanatory variables, do not operate in the same way across all countries. Specifically, voluntary political party quotas are substantially more effective in developed countries, while reserved seat quotas are only significant in least developed countries. Electoral candidate quotas, on the other hand, can be significant across all countries, however only have a positive effect when they are accompanied by placement mandates that ensure women are placed in winnable positions, sanctions for non-compliance that are significant enough to force adherence, and a minimum mandated threshold of at least 30%. Copyright © 2017 Elsevier Inc. All rights reserved.

Waste heat recovery systems in the sugar industry: An Indian perspective

DOE Office of Scientific and Technical Information (OSTI.GOV)

Madnaik, S.D.; Jadhav, M.G.

1996-04-01

This article identifies the key role of the sugar industry in the rural development of developing countries. The Indian sugar industry, already second largest among the country`s processing industries, shows even greater potential, according to the Plan Documents (shown in a table). The potential of waste heat in sugar processing plants, which produce white crystal sugar using the double sulphitation clarification process, is estimated at 5757.9 KJ/kg of sugar. Efficient waste heat recovery (WHR) systems could help arrest the trend of increasing production costs. This would help the sugar industry not only in India, but in many other countries asmore » well. The innovative methods suggested and discussed briefly in this article include dehydration of prepared cane, bagasse drying, and juice heating using waste heat. These methods can reduce the cost of energy in sugar production by at least 10% and improve efficiency and productivity.« less

Consensus-based approach to develop a measurement framework and identify a core set of indicators to track implementation and progress towards effective coverage of facility-based Kangaroo Mother Care.

PubMed

Guenther, Tanya; Moxon, Sarah; Valsangkar, Bina; Wetzel, Greta; Ruiz, Juan; Kerber, Kate; Blencowe, Hannah; Dube, Queen; Vani, Shashi N; Vivio, Donna; Magge, Hema; De Leon-Mendoza, Socorro; Patterson, Janna; Mazia, Goldy

2017-12-01

As efforts to scale up the delivery of Kangaroo Mother Care (KMC) in facilities are increasing, a standardized approach to measure implementation and progress towards effective coverage is needed. Here, we describe a consensus-based approach to develop a measurement framework and identify a core set of indicators for monitoring facility-based KMC that would be feasible to measure within existing systems. The KMC measurement framework and core list of indicators were developed through: 1) scoping exercise to identify potential indicators through literature review and requests from researchers and program implementers; and 2) face-to-face consultations with KMC and measurement experts working at country and global levels to review candidate indicators and finalize selection and definitions. The KMC measurement framework includes two main components: 1) service readiness, based on the WHO building blocks framework; and 2) service delivery action sequence covering identification, service initiation, continuation to discharge, and follow-up to graduation. Consensus was reached on 10 core indicators for KMC, which were organized according to the measurement framework. We identified 4 service readiness indicators, capturing national level policy for KMC, availability of KMC indicators in HMIS, costed operational plans for KMC and availability of KMC services at health facilities with inpatient maternity services. Six indicators were defined for service delivery, including weighing of babies at birth, identification of those ≤2000 g, initiation of facility-based KMC, monitoring the quality of KMC, status of babies at discharge from the facility and levels of follow-up (according to country-specific protocol). These core KMC indicators, identified with input from a wide range of global and country-level KMC and measurement experts, can aid efforts to strengthen monitoring systems and facilitate global tracking of KMC implementation. As data collection systems advance, we encourage program managers and evaluators to document their experiences using this framework to measure progress and allow indicator refinement, with the overall aim of working towards sustainable, country-led data systems.

A fuzzy MICMAC analysis for improving supply chain performance of basic vaccines in developing countries.

PubMed

Chandra, Dheeraj; Kumar, Dinesh

2018-03-01

In recent years, demand to improve child immunization coverage globally, and the development of the latest vaccines and technology has made the vaccine market very complex. The rise in such complexities often gives birth to numerous issues in the vaccine supply chain, which are the primary cause of its poor performance. Figuring out the cause of the performance problem can help you decide how to address it. The goal of the present study is to identify and analyze important issues in the supply chain of basic vaccines required for child immunization in the developing countries. Twenty-five key issues as various factors of the vaccine supply chain have been presented in this paper. Fuzzy MICMAC analysis has been carried out to classify the factors based on their driving and dependence power and to develop a hierarchy based model. Further, the findings have been discussed with the field experts to identify the critical factors. Three factors: better demand forecast, communication between the supply chain members, and proper planning and scheduling have been identified as the critical factors of vaccine supply chain. These factors should be given special care to improve vaccine supply chain performance.

Integrated Child Development in Rural China.

ERIC Educational Resources Information Center

Xie, Qing; Young, Mary Eming

Since two thirds of the country's children reside in the countryside, improving child development services in rural areas is one of China's most pressing concerns. This report details the current situation of children in rural and urban China and identifies problems related to child development. The report also presents evidence of the effect of…

Postharvest technology for developing countries: challenges and opportunities in research, outreach and advocacy.

PubMed

Kitinoja, Lisa; Saran, Sunil; Roy, Susanta K; Kader, Adel A

2011-03-15

This article discusses the needs and challenges of developing good, science-based, simple methods for postharvest handling that can be made available in developing countries. Some of the traditional challenges have been successfully met (i.e. identifying causes and sources of losses for key crops, identifying many potential postharvest technologies of practical use for reducing losses), but many challenges remain. These include the characterization of indigenous crops in terms of their unique postharvest physiology (e.g. respiration rate, susceptibility to water loss, chilling sensitivity, ethylene sensitivity), ascertaining the differences between handling recommendations made for well-known varieties and the needs of local varieties of crops, and determining cost effectiveness of scale-appropriate postharvest technologies in each locale and for each crop. Key issues include building capacity at the local level in postharvest science, university teaching and extension, and continued adaptive research efforts to match emerging postharvest technologies to local needs as these continue to change over time. Development of appropriate postharvest technology relies upon many disciplines that are relevant to the overall success of horticulture, i.e. plant biology, engineering, agricultural economics, food processing, nutrition, food safety, and environmental conservation. The expanding pool of new information derived from postharvest research and outreach efforts in these areas can lead in many directions which are likely to have an impact on relieving poverty in developing countries. Copyright © 2011 Society of Chemical Industry.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Slunge, Daniel, E-mail: daniel.slunge@economics.gu.se; Tran, Trang Thi Huyen, E-mail: trang2k@yahoo.com

Building on new institutional theory, this paper develops an analytical framework for analyzing constraints to the institutionalization of strategic environmental assessment (SEA) at four different institutional levels. The framework is tested in an empirical analysis of the environmental assessment system in Vietnam, which is a frontrunner among developing countries regarding the introduction and use of SEA. Building on interviews with Vietnamese and international experts, as well as an extensive literature review, we identify institutional constraints which challenge the effective use of SEA in Vietnam. We conclude that commonly identified constraints, such as inadequate training, technical guidelines, baseline data and financialmore » resources, are strongly linked to constraints at higher institutional levels, such as incentives to not share information between ministries and severe restrictions on access to information and public participation. Without a thorough understanding of these institutional constraints, there is a risk that attempts to improve the use of SEA are misdirected. Thus, a careful institutional analysis should guide efforts to introduce and improve the use of SEA in Vietnam and other developing countries. The analytical framework for analyzing constraints to institutionalization of SEA presented in this paper represents a systematic effort in this direction. - Highlights: • A framework for analyzing constraints to institutionalizing SEA is developed • Empirical analysis of the strategic environmental assessment system in Vietnam • Constraints in the action arena linked to deeper institutional constraints • Institutional analysis needed prior to introducing SEA in developing countries.« less

Designing Mobile LMS Interfaces: Learners' Expectations and Experiences

ERIC Educational Resources Information Center

Ssekakubo, Grace; Suleman, Hussein; Marsden, Gary

2013-01-01

Purpose: This paper aims to present findings of a study that was carried out to identify strategies of enabling learners in developing countries to fully exploit the potential of learning management systems (LMSs). The study set out to: identify the services of learning management systems that are most needed and desired by university learners in…

Multinational trials-recommendations on the translations required, approaches to using the same language in different countries, and the approaches to support pooling the data: the ISPOR Patient-Reported Outcomes Translation and Linguistic Validation Good Research Practices Task Force report.

PubMed

Wild, Diane; Eremenco, Sonya; Mear, Isabelle; Martin, Mona; Houchin, Caroline; Gawlicki, Mary; Hareendran, Asha; Wiklund, Ingela; Chong, Lee Yee; von Maltzahn, Robyn; Cohen, Lawrence; Molsen, Elizabeth

2009-06-01

With the internationalization of clinical trial programs, there is an increased need to translate and culturally adapt patient-reported outcome (PRO) measures. Although guidelines for good practices in translation and linguistic validation are available, the ISPOR Patient-Reported Outcomes Translation and Linguistic Validation Task Force identified a number of areas where they felt that further discussion around methods and best practices would be beneficial. The areas identified by the team were as follows: 1) the selection of the languages required for multinational trials; 2) the approaches suggested when the same language is required across two or more countries; and 3) the assessment of measurement equivalence to support the aggregation of data from different countries. The task force addressed these three areas, reviewed the available literature, and had multiple discussions to develop this report. Decision aid tools have also been developed and presented for the selection of languages and the approaches suggested for the use of the same language in different countries. It is hoped that this report and the decision tools proposed will assist those involved with multinational trials to 1) decide on the translations required for each country; 2) choose the approach to use when the same language is spoken in more than one country; and 3) choose methods to gather evidence to support the pooling of data collected using different language versions of the same tool.

Country planning for health interventions under development: lessons from the malaria vaccine decision-making framework and implications for other new interventions

PubMed Central

Brooks, Alan; Ba-Nguz, Antoinette

2012-01-01

Traditionally it has taken years or decades for new public health interventions targeting diseases found in developing countries to be accessible to those most in need. One reason for the delay has been insufficient anticipation of the eventual processes and evidence required for decision making by countries. This paper describes research into the anticipated processes and data needed to inform decision making on malaria vaccines, the most advanced of which is still in phase 3 trials. From 2006 to 2008, a series of country consultations in Africa led to the development of a guide to assist countries in preparing their malaria vaccine decision-making frameworks. The guide builds upon the World Health Organization’s Vaccine Introduction Guidelines. It identifies the processes and data for decisions, when they would be needed relative to the development timelines of the intervention, and where they will come from. Policy development will be supported by data (e.g. malaria disease burden; roles of other malaria interventions; malaria vaccine impact; economic and financial issues; malaria vaccine efficacy, quality and safety) as will implementation decisions (e.g. programmatic issues and socio-cultural environment). This generic guide can now be applied to any future malaria vaccine. The paper discusses the opportunities and challenges to early planning for country decision-making—from the potential for timely, evidence-informed decisions to the risks of over-promising around an intervention still under development. Careful and well-structured planning by countries is an important way to ensure that new interventions do not remain unused for years or decades after they become available. PMID:22513733

An Approach to Identify and Characterize a Subunit Candidate Shigella Vaccine Antigen.

PubMed

Pore, Debasis; Chakrabarti, Manoj K

2016-01-01

Shigellosis remains a serious issue throughout the developing countries, particularly in children under the age of 5. Numerous strategies have been tested to develop vaccines targeting shigellosis; unfortunately despite several years of extensive research, no safe, effective, and inexpensive vaccine against shigellosis is available so far. Here, we illustrate in detail an approach to identify and establish immunogenic outer membrane proteins from Shigella flexneri 2a as subunit vaccine candidates.

Development of Evidence-Based Health Policy Documents in Developing Countries: A Case of Iran

PubMed Central

Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

2014-01-01

Background: Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. Methods: In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policymaking. Results: 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Conclusion: Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers and facilitators of a behavior. PMID:24762343

Development of evidence-based health policy documents in developing countries: a case of Iran.

PubMed

Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

2014-02-07

Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policy-making. 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers and facilitators of a behavior.

Evidence of physical activity participation among men and women in the countries of the Gulf cooperation council: a review.

PubMed

Mabry, R M; Reeves, M M; Eakin, E G; Owen, N

2010-06-01

Rapid socioeconomic development in the countries of the Gulf Cooperation Council (GCC) has resulted in demographic and epidemiological transitions, with obesity, diabetes and other chronic diseases becoming the leading causes of morbidity and mortality. This emerging disease pattern is often attributed to physically inactive lifestyles. Given that there is no consolidated evidence on physical activity participation, we reviewed studies to examine prevalence and gender differences among GCC adults. PubMed, CINAHL and reference list searches identified eight relevant studies. Based on the best-available data, the prevalence of adults being physically active for at least 150 min week(-1) (based on the international standard definition) ranged from 39.0% to 42.1% for men and 26.3% to 28.4% for women. Men were significantly more active than were women. Prevalence estimates for participation in physical activity in the GCC States are considerably lower than those for many developed countries. Studies using standardized methodologies with nationally representative samples are urgently required. Identifying prevalence and gender variations provides the basis for understanding the unique socio-cultural and environmental factors contributing to physical inactivity among adults in the countries of the GCC. This understanding must then inform population-health strategies to address the rising prevalence of obesity, type 2 diabetes and other chronic diseases.

Tuberculosis in Asia and the Pacific: The Role of Socioeconomic Status and Health System Development

PubMed Central

Wu, Jie; Dalal, Koustuv

2012-01-01

Objective: To identify the relationship between socioeconomic status, health system development and the incidence, prevalence and mortality of tuberculosis in Asia and the Pacific. Methods: Incidence, prevalence and mortality rates of tuberculosis and 20 variables of socioeconomic, health system and biological–behavioral issues were included in the study involving all 46 countries of the Asian Development Bank region (2007 data). Both univariate and multivariate linear regressions were used. Results: The worst three tuberculosis affected countries were Cambodia, India and Indonesia, while the least affected was Australia. Tuberculosis incidence, prevalence and mortality rate were higher in countries with lower human development index, corruption perception index, gross domestic product (GDP) per capita and countries with more people under minimum food supplements. Among the health system variables, total health expenditure per capita, governmental health expenditure per capita, hospital beds, and access to improved water and sanitation were strongly associated with tuberculosis. Conclusions: Socioeconomic determinants and health system development have significant effect on the control of tuberculosis in Asia and the Pacific region. The study has some policy implications by means of lowering the corruption and improving the sanitation. PMID:22355472

Future and potential spending on health 2015-40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries.

PubMed

2017-05-20

The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future spending can be beneficial for policy makers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending. We extracted GDP, government spending in 184 countries from 1980-2015, and health spend data from 1995-2014. We used a series of ensemble models to estimate future GDP, all-sector government spending, development assistance for health, and government, out-of-pocket, and prepaid private health spending through 2040. We used frontier analyses to identify patterns exhibited by the countries that dedicate the most funding to health, and used these frontiers to estimate potential health spending for each low-income or middle-income country. All estimates are inflation and purchasing power adjusted. We estimated that global spending on health will increase from US$9·21 trillion in 2014 to $24·24 trillion (uncertainty interval [UI] 20·47-29·72) in 2040. We expect per capita health spending to increase fastest in upper-middle-income countries, at 5·3% (UI 4·1-6·8) per year. This growth is driven by continued growth in GDP, government spending, and government health spending. Lower-middle income countries are expected to grow at 4·2% (3·8-4·9). High-income countries are expected to grow at 2·1% (UI 1·8-2·4) and low-income countries are expected to grow at 1·8% (1·0-2·8). Despite this growth, health spending per capita in low-income countries is expected to remain low, at $154 (UI 133-181) per capita in 2030 and $195 (157-258) per capita in 2040. Increases in national health spending to reach the level of the countries who spend the most on health, relative to their level of economic development, would mean $321 (157-258) per capita was available for health in 2040 in low-income countries. Health spending is associated with economic development but past trends and relationships suggest that spending will remain variable, and low in some low-resource settings. Policy change could lead to increased health spending, although for the poorest countries external support might remain essential. Bill & Melinda Gates Foundation. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Worldwide analysis of factors associated with medicines compendia publishing.

PubMed

Arguello, Blanca; Fernandez-Llimos, Fernando

2013-06-01

Medicines compendia, also called formularies, are the most commonly used drug information source among health care professionals. The aim was to identify the countries publishing medicines compendia and the socio-demographic factors associated to this fact. Additionally, we sought to determine the use of foreign compendia in countries lacking their own. Global web-based survey. Healthcare practitioners and researchers from 193 countries worldwide were invited to complete a web-based survey. The questionnaire investigated the existence of a national compendium, or the use of foreign compendia in the absence of one. Demographic and socioeconomic variables were used to predict compendia publishing through a multivariate analysis. Existence of national medicines compendia and foreign compendia used. Professionals from 132 countries completed the survey (response rate at a country level 68.4%, comprising 90.9% global population). Eighty-four countries (63.6%) reported publishing a medicines compendium. In the multivariate analysis, only two covariates had significant association with compendia publishing. Being a member of the Organisation for the Economic Cooperation and Development was the only variable positively associated with compendia publishing (OR = 37.5; 95% CI = 2.3:599.8). In contrast, the countries that listed French as an official language were less likely to publish a compendium (OR = 0.07; 95% CI = 0.007:0.585). Countries without national compendia reported using the British National Formulary most commonly, followed by the Dictionnaire Vidal. Publication of medicines compendia is associated with socio-economic development. Countries lacking a national compendium, use foreign compendia from higher-income countries. Creating an international medicines compendium under the leadership of the World Health Organisation, rather than merely a 'model', would reduce the risks of using information sources not-adapted to the necessities of developing countries.

What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries.

PubMed

Mackintosh, Maureen; Channon, Amos; Karan, Anup; Selvaraj, Sakthivel; Cavagnero, Eleonora; Zhao, Hongwen

2016-08-06

Private health care in low-income and middle-income countries is very extensive and very heterogeneous, ranging from itinerant medicine sellers, through millions of independent practitioners-both unlicensed and licensed-to corporate hospital chains and large private insurers. Policies for universal health coverage (UHC) must address this complex private sector. However, no agreed measures exist to assess the scale and scope of the private health sector in these countries, and policy makers tasked with managing and regulating mixed health systems struggle to identify the key features of their private sectors. In this report, we propose a set of metrics, drawn from existing data that can form a starting point for policy makers to identify the structure and dynamics of private provision in their particular mixed health systems; that is, to identify the consequences of specific structures, the drivers of change, and levers available to improve efficiency and outcomes. The central message is that private sectors cannot be understood except within their context of mixed health systems since private and public sectors interact. We develop an illustrative and partial country typology, using the metrics and other country information, to illustrate how the scale and operation of the public sector can shape the private sector's structure and behaviour, and vice versa. Copyright © 2016 Elsevier Ltd. All rights reserved.

Qualitative adaptation of child behaviour problem instruments in a developing-country setting.

PubMed

Khan, B; Avan, B I

2014-07-08

A key barrier to epidemiological research on child behaviour problems in developing countries is the lack of culturally relevant, internationally recognized psychometric instruments. This paper proposes a model for the qualitative adaptation of psychometric instruments in developing-country settings and presents a case study of the adaptation of 3 internationally recognized instruments in Pakistan: the Child Behavior Checklist, the Youth Self-Report and the Teacher's Report Form. This model encompassed a systematic procedure with 6 distinct phases to minimize bias and ensure equivalence with the original instruments: selection, deliberation, alteration, feasibility, testing and formal approval. The process was conducted in collaboration with the instruments' developer. A multidisciplinary working group of experts identified equivalence issues and suggested modifications. Focus group discussions with informants highlighted comprehension issues. Subsequently modified instruments were thoroughly tested. Finally, the instruments' developer approval further validated the qualitative adaptation. The study proposes a rigorous and systematic model to effectively achieve cultural adaptation of psychometric instruments.

Development of an exposure measurement database on five lung carcinogens (ExpoSYN) for quantitative retrospective occupational exposure assessment.

PubMed

Peters, Susan; Vermeulen, Roel; Olsson, Ann; Van Gelder, Rainer; Kendzia, Benjamin; Vincent, Raymond; Savary, Barbara; Williams, Nick; Woldbæk, Torill; Lavoué, Jérôme; Cavallo, Domenico; Cattaneo, Andrea; Mirabelli, Dario; Plato, Nils; Dahmann, Dirk; Fevotte, Joelle; Pesch, Beate; Brüning, Thomas; Straif, Kurt; Kromhout, Hans

2012-01-01

SYNERGY is a large pooled analysis of case-control studies on the joint effects of occupational carcinogens and smoking in the development of lung cancer. A quantitative job-exposure matrix (JEM) will be developed to assign exposures to five major lung carcinogens [asbestos, chromium, nickel, polycyclic aromatic hydrocarbons (PAH), and respirable crystalline silica (RCS)]. We assembled an exposure database, called ExpoSYN, to enable such a quantitative exposure assessment. Existing exposure databases were identified and European and Canadian research institutes were approached to identify pertinent exposure measurement data. Results of individual air measurements were entered anonymized according to a standardized protocol. The ExpoSYN database currently includes 356 551 measurements from 19 countries. In total, 140 666 personal and 215 885 stationary data points were available. Measurements were distributed over the five agents as follows: RCS (42%), asbestos (20%), chromium (16%), nickel (15%), and PAH (7%). The measurement data cover the time period from 1951 to present. However, only a small portion of measurements (1.4%) were performed prior to 1975. The major contributing countries for personal measurements were Germany (32%), UK (22%), France (14%), and Norway and Canada (both 11%). ExpoSYN is a unique occupational exposure database with measurements from 18 European countries and Canada covering a time period of >50 years. This database will be used to develop a country-, job-, and time period-specific quantitative JEM. This JEM will enable data-driven quantitative exposure assessment in a multinational pooled analysis of community-based lung cancer case-control studies.

Disputed climate science in the media: do countries matter?

PubMed

Grundmann, Reiner; Scott, Mike

2014-02-01

This article presents findings from a large-scale newspaper analysis of climate change discourses in four developed countries, using corpus linguistics methodology. We map the discourse over time, showing peaks and troughs of attention and explaining their causes. Different connotations of common terms such as global warming and climate change in different countries are analysed. Cluster and key-word analysis show the relative salience of specific words and word combinations during crucial periods. We identify main claims makers and the relative visibility of advocates and sceptics. The main finding is that former are far more prominent in all countries. We also look at the coverage of 'climategate'. Finally, we make reference to existing theoretical frameworks.

The psychosocial impact of wheelchair tennis on participants from developing countries.

PubMed

Richardson, Emma V; Papathomas, Anthony; Smith, Brett; Goosey-Tolfrey, Victoria L

2017-01-01

Individuals with physical disabilities in developing countries can experience many instances of psychosocial hardship. Although scholars have suggested that participation in sport can positively impact psychosocial health, few studies have explored this phenomenon within the disabled population of developing nations. Sixteen wheelchair tennis players were recruited across six developing countries and interviewed in regards to their experiences. Data were collected using semi-structured interviews, transcribed verbatim and subject to thematic analysis. Wheelchair tennis players perceived their participation in sport enhanced their psychosocial well-being. Three broad themes emerged from analysis of the interviews; (1) developed transferrable skills, (2) perceived personal growth and (3) benefits of an athletic identity. Sports participation, in this case wheelchair tennis, may be a viable means to promote psychosocial well-being in disabled populations within developing nations. Moreover, sport holds the potential to challenge negative perceptions of disability at an individual and societal level within these cultures. Implication for Rehabilitation Individuals with physical disabilities in developing countries may experience psychosocial hardship and cultural stigma. Wheelchair sport may be a viable means to enhance psychosocial well-being in this population. Skills learnt "on court" are transferrable to everyday life potentially improving independence and quality of life. Identifying as an athlete can challenge negative cultural perceptions of disability.

An assessment of the potential for the development of the shale gas industry in countries outside of North America.

PubMed

Le, Minh-Thong

2018-02-01

The revolution of shale gas in the United States (the US) has become a phenomenon at the beginning of the 21st century. It has been significantly influencing the United States' economy and the global gas market. Like America, other countries have also been searching for shale gas. However, the conditions for developing this resource are very different among regions and nations. On the other hand, there are also many doubts, debates and even strong oppositions to the development of shale gas because of the complicated issues that arise regarding its extraction, and also due to the fact that its impacts are not fully known. Therefore, at present, the development of shale gas is still a big question for regions, countries that have potential and desires to exploit such resources. Although it is difficult to identify all necessary or sufficient conditions to develop shale gas, the experiences of the United States could be instructive for other countries. In this article, the potential development of shale gas in China and Europe is analyzed, which relies on the fundamental conditions considered as important factors for the success of the shale gas industry in the US. Through these analyses and we demonstrate the difficulty of developing this resource outside North America.

The UCLan SDO Data Hub

NASA Astrophysics Data System (ADS)

Dalla, S.; Walsh, R. W.; Chapman, S. A.; Marsh, M.; Regnier, S.; Bewsher, D.; Brown, D. S.; Kelly, J.; Laitinen, T.; Alexander, C.

2010-12-01

A data pipeline for the distribution of SDO data products has been developed throughout a number of countries in the US, Europe and Asia. The UK node within this pipeline is at the University of Central Lancashire (UCLan), where a data center has been established to host a rolling AIA and HMI archive, aimed at supplying data to the country's large solar scientific community. This presentation will describe the hardware and software structures of the archive, as well as the best practice identified and feedback received from users of the facility. We will also discuss algorithms that are run locally in order to identify solar features and events.

Exposures Resulting in Safety and Health Concerns for Child Laborers in Less Developed Countries

PubMed Central

Shendell, Derek G.; Noomnual, Saisattha; Chishti, Shumaila; Sorensen Allacci, MaryAnn; Madrigano, Jaime

2016-01-01

Objectives. Worldwide, over 200 million children are involved in child labor, with another 20 million children subjected to forced labor, leading to acute and chronic exposures resulting in safety and health (S&H) risks, plus removal from formal education and play. This review summarized S&H issues in child labor, including forced or indentured domestic labor as other sectors of child labor. Specifically, we focused on exposures leading to S&H risks. Methods. We used PubMed, Scopus, Science Direct, and Google Scholar. References were in English, published in 1990–2015, and included data focused on exposures and S&H concerns of child labor. Results. Seventy-six journal articles were identified, 67 met criteria, 57 focused on individual countries, and 10 focused on data from multiple countries (comparing 3–83 countries). Major themes of concern were physical exposures including ergonomic hazards, chemical exposure hazards, and missed education. Childhood labor, especially forced, exploitative labor, created a significant burden on child development, welfare, and S&H. Conclusions. More field researche data emphasizing longitudinal quantitative effects of exposures and S&H risks are needed. Findings warranted developing policies and educational interventions with proper monitoring and evaluation data collection, plus multiple governmental, international organization and global economic reform efforts, particularly in lower-income, less developed countries. PMID:27382374

Lymphoedema management: an international intersect between developed and developing countries. Similarities, differences and challenges.

PubMed

Stout, Nicole L; Brantus, Pierre; Moffatt, Christine

2012-01-01

Lymphoedema is a chronic swelling condition that contributes to disability, dysfunction and lost quality of life. Significant disparities exist worldwide regarding the availability of resources necessary to identify, treat and manage lymphoedema. This disparity transcends socio-economic status and is a common problem in both developed and developing countries. The overall impact of lymphoedema as a public health problem, however, is underestimated, principally due to the lack of epidemiologic data. These problems pose barriers to optimal identification and management of this disabling, lifelong condition. In 1997, the World Health Organization (50.29) resolved that lymphatic filariasis should be eliminated as a public health problem. A component of this strategy focuses on disability management for those suffering from lymphatic filariasis-related morbidity. This initiative has enhanced lymphoedema awareness in developing countries. However, significant deficits persist in health care providers' knowledge, educational initiatives and basic disease identification and treatment. In developed countries, lymphoedema continues to be an underrecognised condition and assumed to be only cancer-related. Health care resources allocated to treat and manage the disease are insufficient for basic and ongoing care, resulting in disease progression and disability. The International Lymphoedema Framework project, established in 2002, seeks to establish a consensus for best practices in the management of lymphoedema worldwide to reduce this disability burden. A basic global construct for lymphoedema management is needed to decrease morbidity and promote optimal disease management across all cultural and socio-economic boundaries. Many countries are unaware of the importance of lymphoedema management and have not defined a national strategy with respect to this problem. The objective of this article is to define similarities and differences in strategies for lymphoedema management between developed and developing countries and advocate for a cohesive and concerted approach to disease management.

Methods to recognize work-related cancer in workplaces, the general population, and by experts in the clinic, a Norwegian experience

PubMed Central

2011-01-01

Background In most countries, the numbers of work-related cancer identified are much lower than are the estimated total burden of cancer caused by exposure at work. Therefore, there is a great need to use all available practical as well as epidemiological methods for identification as well as to develop new methods of recognizing cases of work-related cancers. Methods Primarily based on practical experiences from Norway, methods to identify cases of possible work-related cancers in the general population and at workplaces as well as methods to recognize more specific cases after referral to specialized clinics are reviewed in this publication. Results Countries applying a number of the available methods to detect work-related cancer reach a reporting rate of 60 such cases per million, while other countries that do not employ such methods hardly identify any cases. As most subjects previously exposed to cancer causing agents and substances at work are gradually recruited out of work, methods should be versatile for identification of cases in the general population, as well as at work. Conclusions Even in countries using a number of the available methods for identification, only a limited fraction of the real number of work-related cancer are notified to the labour inspectorate. Clinicians should be familiar with the methods and do the best to identify work-related cancer to serve prevention. PMID:21899752

Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis

PubMed Central

Cohen, Odeya; Feder-Bubis, Paula; Bar-Dayan, Yaron; Adini, Bruria

2015-01-01

Background Public health legal preparedness (PHLP) for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC) and developed countries. Objective This paper examines recent trends regarding public health legal preparedness for emergencies and discusses its role in the recent Ebola outbreak. Design A rigorous literature review was conducted using eight electronic databases as well as Google Scholar. The results encompassed peer-reviewed English articles, reports, theses, and position papers dating from 2011 to 2014. Earlier articles concerning regulatory actions were also examined. Results The importance of PHLP has grown during the past decade and focuses mainly on infection–disease scenarios. Amid LMICs, it mostly refers to application of international regulations, whereas in developed states, it focuses on independent legislation and creation of conditions optimal to promoting an effective emergency management. Among developed countries, the United States’ utilisation of health legal preparedness is the most advanced, including the creation of a model comprising four elements: law, competencies, information, and coordination. Only limited research has been conducted in this field to date. Nevertheless, in both developed and developing states, studies that focused on regulations and laws activated in health systems during emergencies, identified inconsistency and incoherence. The Ebola outbreak plaguing West Africa since 2014 has global implications, challenges and paralleling results, that were identified in this review. Conclusions The review has shown the need to broaden international regulations, to deepen reciprocity between countries, and to consider LMICs health capacities, in order to strengthen the national health security. Adopting elements of the health legal preparedness model is recommended. PMID:26449204

Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis.

PubMed

Cohen, Odeya; Feder-Bubis, Paula; Bar-Dayan, Yaron; Adini, Bruria

2015-01-01

Public health legal preparedness (PHLP) for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC) and developed countries. This paper examines recent trends regarding public health legal preparedness for emergencies and discusses its role in the recent Ebola outbreak. A rigorous literature review was conducted using eight electronic databases as well as Google Scholar. The results encompassed peer-reviewed English articles, reports, theses, and position papers dating from 2011 to 2014. Earlier articles concerning regulatory actions were also examined. The importance of PHLP has grown during the past decade and focuses mainly on infection-disease scenarios. Amid LMICs, it mostly refers to application of international regulations, whereas in developed states, it focuses on independent legislation and creation of conditions optimal to promoting an effective emergency management. Among developed countries, the United States' utilisation of health legal preparedness is the most advanced, including the creation of a model comprising four elements: law, competencies, information, and coordination. Only limited research has been conducted in this field to date. Nevertheless, in both developed and developing states, studies that focused on regulations and laws activated in health systems during emergencies, identified inconsistency and incoherence. The Ebola outbreak plaguing West Africa since 2014 has global implications, challenges and paralleling results, that were identified in this review. The review has shown the need to broaden international regulations, to deepen reciprocity between countries, and to consider LMICs health capacities, in order to strengthen the national health security. Adopting elements of the health legal preparedness model is recommended.

Hygiene Hypothesis: Is the Evidence the Same All Over the World?

PubMed

Leong, Rupert W; Mitrev, Nikola; Ko, Yanna

2016-01-01

The hygiene hypothesis refers to where modern living conditions are responsible for the increasing incidences of immune-related diseases including the development of inflammatory bowel diseases (IBD). Improved hygiene may result in decreased enteric microbiota diversity and dysbiosis, which may be responsible for the development of IBD. The rising incidence of IBD is well documented in developing regions of the world, in accordance with the hygiene hypothesis. What is unknown, however, is whether the hygiene hypothesis is applicable all over the world. Hygiene cannot be easily measured and proxy markers need to be used. These include regional data such as a country's gross domestic product or an individual's affluence or exposure to infection risk factors. A comparative case-control study of Caucasian Australian IBD subjects versus migrants from the Middle East to Australia identified that environmental risk factors are different in the 2 populations. Among Australian Caucasians, hygiene-related environmental risk factors are no longer relevant in the development of IBD. Given the country's high affluence, there has been high hygienic standard for several generations. However, migrants from less affluent countries exposed to hygiene-related environmental factors are at increased risks of developing IBD, especially in the second generation migrants born in the affluent country. Divergent risk factors include the use of antibiotics in childhood increasing the risk of IBD in developed societies but being a risk factor for developing IBD in migrants. In India, risk factors associated with infections were found to be positively associated with the development of ulcerative colitis, rather than protective. The hygiene hypothesis is not applicable to all populations worldwide, being most relevant in societies undergoing increasing affluence or following migration from less to more affluent countries. This review examines data from around the world that link the hygiene hypothesis with the development of IBD and in particular the divergent results arising from data from affluent countries versus less-affluent countries. © 2016 S. Karger AG, Basel.

Health and safety in clinical laboratories in developing countries: safety considerations.

PubMed

Ejilemele, A A; Ojule, A C

2004-01-01

Clinical laboratories are potentially hazardous work areas. Health and safety in clinical laboratories is becoming an increasingly important subject as a result of the emergence of highly infectious diseases such as hepatitis and HIV. This is even more so in developing countries where health and safety have traditionally been regarded as low priority issues, considering the more important health problems confronting the health authorities in these countries. We conducted a literature search using the medical subheadings titles on the INTERNET over a period of twenty years and summarized our findings. This article identifies hazards in the laboratories and highlights measures to make the laboratory a safer work place. It also emphasizes the mandatory obligations of employers and employees towards the attainment of acceptable safety standards in clinical laboratories in Third World countries in the face of the current HIV/AIDS epidemic in many of these developing countries especially in the sub-Saharan Africa while accommodating the increasing work load in these laboratories. Both the employer and the employee have major roles to play in the maintenance of a safe working environment. This can be achieved if measures discussed are incorporated into everyday laboratory practice.

Developing hand therapy skills in Bangladesh: experiences of Australian volunteers.

PubMed

O'Brien, Lisa; Hardman, Alison

2014-01-01

Bangladesh is a developing country whose health system is highly dependent on project funding from foreign countries. Interplast Australia & New Zealand have supported volunteer hand therapists to provide training to local staff in the management of hand injuries and burns since 2006. We aimed to explore and describe the volunteers' own experience and provide recommendations for future therapy capacity building projects in developing countries. This qualitative study involved nine volunteer therapists, who attended a focus group to discuss their experiences, including the key milestones, challenges, and progress achieved. The two authors analyzed transcripts independently and emergent themes were discussed and identified by consensus. Overall the experience was extremely positive and rewarding for volunteers. Key learnings and challenges encountered in this project were cultural differences in learning styles, the need to adapt our approach to 2 facilitate sustainable local solutions, attrition of skilled local staff, and concerns regarding volunteer health and safety. Recommendations for similar projects include allowing adequate time for in-country scoping and planning, coordination and pooling of resources, and the use of strategies that encourage the shift to confident local ownership of ongoing learning and skill development. Volunteering in a health capacity building program in developing countries can be a challenging but immensely rewarding experience. Programs designed to meet the health demands in developing countries should emphasize adequate training of professionals in the use of transferable, sustainable and cost effective techniques. Time spent in the scoping and planning phase is crucial, as is coordination of efforts and pooling of resources. 2C. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

Development of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) for migrants to Western societies: an international Delphi consensus process.

PubMed

Gagnon, Anita J; DeBruyn, Rebecca; Essén, Birgitta; Gissler, Mika; Heaman, Maureen; Jeambey, Zeinab; Korfker, Dineke; McCourt, Christine; Roth, Carolyn; Zeitlin, Jennifer; Small, Rhonda

2014-06-10

Through the World Health Assembly Resolution, 'Health of Migrants', the international community has identified migrant health as a priority. Recommendations for general hospital care for international migrants in receiving-countries have been put forward by the Migrant Friendly Hospital Initiative; adaptations of these recommendations specific to maternity care have yet to be elucidated and validated. We aimed to develop a questionnaire measuring migrant-friendly maternity care (MFMC) which could be used in a range of maternity care settings and countries. This study was conducted in four stages. First, questions related to migrant friendly maternity care were identified from existing questionnaires including the Migrant Friendliness Quality Questionnaire, developed in Europe to capture recommended general hospital care for migrants, and the Mothers In a New Country (MINC) Questionnaire, developed in Australia and revised for use in Canada to capture the maternity care experiences of migrant women, and combined to create an initial MFMC questionnaire. Second, a Delphi consensus process in three rounds with a panel of 89 experts in perinatal health and migration from 17 countries was undertaken to identify priority themes and questions as well as to clarify wording and format. Third, the draft questionnaire was translated from English to French and Spanish and back-translated and subsequently culturally validated (assessed for cultural appropriateness) by migrant women. Fourth, the questionnaire was piloted with migrant women who had recently given birth in Montreal, Canada. A 112-item questionnaire on maternity care from pregnancy, through labour and birth, to postpartum care, and including items on maternal socio-demographic, migration and obstetrical characteristics, and perceptions of care, has been created--the Migrant Friendly Maternity Care Questionnaire (MFMCQ)--in three languages (English, French and Spanish). It is completed in 45 minutes via interview administration several months post-birth. A 4-stage process of questionnaire development with international experts in migrant reproductive health and research resulted in the MFMCQ, a questionnaire measuring key aspects of migrant-sensitive maternity care. The MFMCQ is available for further translation and use to examine and compare care and perceptions of care within and across countries, and by key socio-demographic, migration, and obstetrical characteristics of migrant women.

Development of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) for migrants to Western societies: an international Delphi consensus process

PubMed Central

2014-01-01

Background Through the World Health Assembly Resolution, ‘Health of Migrants’, the international community has identified migrant health as a priority. Recommendations for general hospital care for international migrants in receiving-countries have been put forward by the Migrant Friendly Hospital Initiative; adaptations of these recommendations specific to maternity care have yet to be elucidated and validated. We aimed to develop a questionnaire measuring migrant-friendly maternity care (MFMC) which could be used in a range of maternity care settings and countries. Methods This study was conducted in four stages. First, questions related to migrant friendly maternity care were identified from existing questionnaires including the Migrant Friendliness Quality Questionnaire, developed in Europe to capture recommended general hospital care for migrants, and the Mothers In a New Country (MINC) Questionnaire, developed in Australia and revised for use in Canada to capture the maternity care experiences of migrant women, and combined to create an initial MFMC questionnaire. Second, a Delphi consensus process in three rounds with a panel of 89 experts in perinatal health and migration from 17 countries was undertaken to identify priority themes and questions as well as to clarify wording and format. Third, the draft questionnaire was translated from English to French and Spanish and back-translated and subsequently culturally validated (assessed for cultural appropriateness) by migrant women. Fourth, the questionnaire was piloted with migrant women who had recently given birth in Montreal, Canada. Results A 112-item questionnaire on maternity care from pregnancy, through labour and birth, to postpartum care, and including items on maternal socio-demographic, migration and obstetrical characteristics, and perceptions of care, has been created - the Migrant Friendly Maternity Care Questionnaire (MFMCQ) – in three languages (English, French and Spanish). It is completed in 45 minutes via interview administration several months post-birth. Conclusions A 4-stage process of questionnaire development with international experts in migrant reproductive health and research resulted in the MFMCQ, a questionnaire measuring key aspects of migrant-sensitive maternity care. The MFMCQ is available for further translation and use to examine and compare care and perceptions of care within and across countries, and by key socio-demographic, migration, and obstetrical characteristics of migrant women. PMID:24916892

Air void clustering.

DOT National Transportation Integrated Search

2015-06-01

Air void clustering around coarse aggregate in concrete has been identified as a potential source of : low strengths in concrete mixes by several Departments of Transportation around the country. Research was : carried out to (1) develop a quantitati...

How to achieve universal coverage of cataract surgical services in developing countries: lessons from systematic reviews of other services.

PubMed

Blanchet, Karl; Gordon, Iris; Gilbert, Clare E; Wormald, Richard; Awan, Haroon

2012-12-01

Since the Declaration of Alma Ata, universal coverage has been at the heart of international health. The purpose of this study was to review the evidence on factors and interventions which are effective in promoting coverage and access to cataract and other health services, focusing on developing countries. A thorough literature search for systematic reviews was conducted. Information resources searched were Medline, The Cochrane Library and the Health System Evidence database. Medline was searched from January 1950 to June 2010. The Cochrane Library search consisted of identifying all systematic reviews produced by the Cochrane Eyes and Vision Group and the Cochrane Effective Practice and Organisation of Care. These reviews were assessed for potential inclusion in the review. The Health Systems Evidence database hosted by MacMaster University was searched to identify overviews of systematic reviews. No reviews met the inclusion criteria for cataract surgery. The literature search on other health sectors identified 23 systematic reviews providing robust evidence on the main factors facilitating universal coverage. The main enabling factors influencing access to services in developing countries were peer education, the deployment of staff to rural areas, task shifting, integration of services, supervision of health staff, eliminating user fees and scaling up of health insurance schemes. There are significant research gaps in eye care. There is a pressing need for further high quality primary research on health systems-related factors to understand how the delivery of eye care services and health systems' capacities are interrelated.

The development of a screening tool for the early identification of risk for suicidal behaviour among students in a developing country

PubMed Central

Vawda, Naseema B. M.; Milburn, Norweeta G.; Steyn, Renier; Zhang, Muyu

2016-01-01

Objective Adolescent suicidal behaviour is a public health concern in South Africa. The purpose of this manuscript is to report on the development of a screening tool for teachers to identify South African students who are most at risk for suicidal behaviour. This need is addressed within the context of the limited number of mental health professionals available to provide screening and care services in South Africa. Method Grade 8 students participated by completing sociodemographic questionnaires and self-report psychometric instruments. A screening tool for suicidal behaviour was developed using a four phase approach. Results Twelve factors for high risk suicidal behaviour were identified and included in the screening tool. While further research is needed to validate the screening tool, the findings provide a useful preliminary starting point for teachers to refer students at high risk for suicidal behaviour to mental health services for treatment. Conclusion This screening tool is based on factors that were identified as being associated with suicidal behaviour from local research on South African adolescents. The tool contributes to research on adolescent mental health, particularly suicidal behaviour, in developing low and middle income countries like South Africa, with the aim of creating African prevention and intervention programmes. PMID:28459269

The development of a screening tool for the early identification of risk for suicidal behavior among students in a developing country.

PubMed

Vawda, Naseema B M; Milburn, Norweeta G; Steyn, Renier; Zhang, Muyu

2017-05-01

Adolescent suicidal behavior is a public health concern in South Africa. The purpose of this article is to report on the development of a screening tool for teachers to identify South African students who are most at risk for suicidal behavior. This need is addressed within the context of the limited number of mental health professionals available to provide screening and care services in South Africa. Grade 8 students participated by completing sociodemographic questionnaires and self-report psychometric instruments. A screening tool for suicidal behavior was developed using a 4-phase approach. Twelve factors for high-risk suicidal behavior were identified and included in the screening tool. While further research is needed to validate the screening tool, the findings provide a useful preliminary starting point for teachers to refer students at high risk for suicidal behavior to mental health services for treatment. This screening tool is based on factors that were identified as being associated with suicidal behavior from local research on South African adolescents. The tool contributes to research on adolescent mental health, particularly suicidal behavior, in developing low and middle income countries like South Africa, with the aim of creating African prevention and intervention programs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Workgroup Report: Public Health Strategies for Reducing Aflatoxin Exposure in Developing Countries

PubMed Central

Strosnider, Heather; Azziz-Baumgartner, Eduardo; Banziger, Marianne; Bhat, Ramesh V.; Breiman, Robert; Brune, Marie-Noel; DeCock, Kevin; Dilley, Abby; Groopman, John; Hell, Kerstin; Henry, Sara H.; Jeffers, Daniel; Jolly, Curtis; Jolly, Pauline; Kibata, Gilbert N.; Lewis, Lauren; Liu, Xiumei; Luber, George; McCoy, Leslie; Mensah, Patience; Miraglia, Marina; Misore, Ambrose; Njapau, Henry; Ong, Choon-Nam; Onsongo, Mary T.K.; Page, Samuel W.; Park, Douglas; Patel, Manish; Phillips, Timothy; Pineiro, Maya; Pronczuk, Jenny; Rogers, Helen Schurz; Rubin, Carol; Sabino, Myrna; Schaafsma, Arthur; Shephard, Gordon; Stroka, Joerg; Wild, Christopher; Williams, Jonathan T.; Wilson, David

2006-01-01

Consecutive outbreaks of acute aflatoxicosis in Kenya in 2004 and 2005 caused > 150 deaths. In response, the Centers for Disease Control and Prevention and the World Health Organization convened a workgroup of international experts and health officials in Geneva, Switzerland, in July 2005. After discussions concerning what is known about aflatoxins, the workgroup identified gaps in current knowledge about acute and chronic human health effects of aflatoxins, surveillance and food monitoring, analytic methods, and the efficacy of intervention strategies. The workgroup also identified public health strategies that could be integrated with current agricultural approaches to resolve gaps in current knowledge and ultimately reduce morbidity and mortality associated with the consumption of aflatoxin-contaminated food in the developing world. Four issues that warrant immediate attention were identified: a) quantify the human health impacts and the burden of disease due to aflatoxin exposure; b) compile an inventory, evaluate the efficacy, and disseminate results of ongoing intervention strategies; c) develop and augment the disease surveillance, food monitoring, laboratory, and public health response capacity of affected regions; and d) develop a response protocol that can be used in the event of an outbreak of acute aflatoxicosis. This report expands on the workgroup’s discussions concerning aflatoxin in developing countries and summarizes the findings. PMID:17185282

KNOW ESSENTIALS: a tool for informed decisions in the absence of formal HTA systems.

PubMed

Mathew, Joseph L

2011-04-01

Most developing countries and resource-limited settings lack robust health technology assessment (HTA) systems. Because the development of locally relevant HTA is not immediately viable, and the extrapolation of external HTA is inappropriate, a new model for evaluating health technologies is required. The aim of this study was to describe the development and application of KNOW ESSENTIALS, a tool facilitating evidence-based decisions on health technologies by stakeholders in settings lacking formal HTA systems. Current HTA methodology was examined through literature search. Additional issues relevant to resource-limited settings, but not adequately addressed in current methodology, were identified through further literature search, appraisal of contextually relevant issues, discussion with healthcare professionals familiar with the local context, and personal experience. A set of thirteen elements important for evidence-based decisions was identified, selected and combined into a tool with the mnemonic KNOW ESSENTIALS. Detailed definitions for each element, coding for the elements, and a system to evaluate a given health technology using the tool were developed. Developing countries and resource-limited settings face several challenges to informed decision making. Models that are relevant and applicable in high-income countries are unlikely in such settings. KNOW ESSENTIALS is an alternative that facilitates evidence-based decision making by stakeholders without formal expertise in HTA. The tool could be particularly useful, as an interim measure, in healthcare systems that are developing HTA capacity. It could also be useful anywhere when rapid evidence-based decisions on health technologies are required.

Development of a survey instrument to investigate the primary care factors related to differences in cancer diagnosis between international jurisdictions

PubMed Central

2014-01-01

Background Survival rates following a diagnosis of cancer vary between countries. The International Cancer Benchmarking Partnership (ICBP), a collaboration between six countries with primary care led health services, was set up in 2009 to investigate the causes of these differences. Module 3 of this collaboration hypothesised that an association exists between the readiness of primary care physicians (PCP) to investigate for cancer – the ‘threshold’ risk level at which they investigate or refer to a specialist for consideration of possible cancer – and survival for that cancer (lung, colorectal and ovarian). We describe the development of an international survey instrument to test this hypothesis. Methods The work was led by an academic steering group in England. They agreed that an online survey was the most pragmatic way of identifying differences between the jurisdictions. Research questions were identified through clinical experience and expert knowledge of the relevant literature. A survey comprising a set of direct questions and five clinical scenarios was developed to investigate the hypothesis. The survey content was discussed and refined concurrently and repeatedly with international partners. The survey was validated using an iterative process in England. Following validation the survey was adapted to be relevant to the health systems operating in other jurisdictions and translated into Danish, Norwegian and Swedish, and into Canadian and Australian English. Results This work has produced a survey with face, content and cross cultural validity that will be circulated in all six countries. It could also form a benchmark for similar surveys in countries with similar health care systems. Conclusions The vignettes could also be used as educational resources. This study is likely to impact on healthcare policy and practice in participating countries. PMID:24938306

Do we have the right models for scaling up health services to achieve the Millennium Development Goals?

PubMed

Subramanian, Savitha; Naimoli, Joseph; Matsubayashi, Toru; Peters, David H

2011-12-14

There is widespread agreement on the need for scaling up in the health sector to achieve the Millennium Development Goals (MDGs). But many countries are not on track to reach the MDG targets. The dominant approach used by global health initiatives promotes uniform interventions and targets, assuming that specific technical interventions tested in one country can be replicated across countries to rapidly expand coverage. Yet countries scale up health services and progress against the MDGs at very different rates. Global health initiatives need to take advantage of what has been learned about scaling up. A systematic literature review was conducted to identify conceptual models for scaling up health in developing countries, with the articles assessed according to the practical concerns of how to scale up, including the planning, monitoring and implementation approaches. We identified six conceptual models for scaling up in health based on experience with expanding pilot projects and diffusion of innovations. They place importance on paying attention to enhancing organizational, functional, and political capabilities through experimentation and adaptation of strategies in addition to increasing the coverage and range of health services. These scaling up approaches focus on fostering sustainable institutions and the constructive engagement between end users and the provider and financing organizations. The current approaches to scaling up health services to reach the MDGs are overly simplistic and not working adequately. Rather than relying on blueprint planning and raising funds, an approach characteristic of current global health efforts, experience with alternative models suggests that more promising pathways involve "learning by doing" in ways that engage key stakeholders, uses data to address constraints, and incorporates results from pilot projects. Such approaches should be applied to current strategies to achieve the MDGs.

Comparison of trauma care systems in Asian countries: A systematic literature review.

PubMed

Choi, Se Jin; Oh, Moon Young; Kim, Na Rae; Jung, Yoo Joong; Ro, Young Sun; Shin, Sang Do

2017-12-01

The study aims to compare the trauma care systems in Asian countries. Asian countries were categorised into three groups; 'lower middle-income country', 'upper middle-income country' and 'high-income country'. The Medline/PubMed database was searched for articles published from January 2005 to December 2014 using relevant key words. Articles were excluded if they examined a specific injury mechanism, referred to a specific age group, and/or did not have full text available. We extracted information and variables on pre-hospital and hospital care factors, and regionalised system factors and compared them across countries. A total of 46 articles were identified from 13 countries, including Pakistan, India, Vietnam and Indonesia from lower middle-income countries; the Islamic Republic of Iran, Thailand, China, Malaysia from upper middle-income countries; and Saudi Arabia, the Republic of Korea, Japan, Hong Kong and Singapore from high-income countries. Trauma patients were transported via various methods. In six of the 13 countries, less than 20% of trauma patients were transported by ambulance. Pre-hospital trauma teams primarily comprised emergency medical technicians and paramedics, except in Thailand and China, where they included mainly physicians. In Iran, Pakistan and Vietnam, the proportion of patients who died before reaching hospital exceeded 50%. In only three of the 13 countries was it reported that trauma surgeons were available. In only five of the 13 countries was there a nationwide trauma registry. Trauma care systems were poorly developed and unorganised in most of the selected 13 Asian countries, with the exception of a few highly developed countries. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

A methodology for producing small scale rural land use maps in semi-arid developing countries using orbital imagery

NASA Technical Reports Server (NTRS)

Vangenderen, J. L. (Principal Investigator); Lock, B. F.

1976-01-01

The author has identified the following significant results. Results have shown that it is feasible to design a methodology that can provide suitable guidelines for operational production of small scale rural land use maps of semiarid developing regions from LANDSAT MSS imagery, using inexpensive and unsophisticated visual techniques. The suggested methodology provides immediate practical benefits to map makers attempting to produce land use maps in countries with limited budgets and equipment. Many preprocessing and interpretation techniques were considered, but rejected on the grounds that they were inappropriate mainly due to the high cost of imagery and/or equipment, or due to their inadequacy for use in operational projects in the developing countries. Suggested imagery and interpretation techniques, consisting of color composites and monocular magnification proved to be the simplest, fastest, and most versatile methods.

Childhood growth and chronic disease: evidence from countries undergoing the nutrition transition.

PubMed

Stein, Aryeh D; Thompson, Angela M; Waters, Ashley

2005-07-01

Evidence is accumulating that the pattern of growth in childhood is associated with development of cardiovascular disease in adulthood, but such evidence comes mostly from developed countries. We conducted a review of studies from countries undergoing the nutrition transition. Five birth cohorts with measures of child growth and outcomes through adolescence were identified, from China, India, Guatemala, Brazil and the Philippines. Across studies there are major differences in data availability and in statistical approaches to modelling child growth and its effects. Nevertheless, generally consistent associations of growth failure in early childhood and development of overweight in later childhood with the risk of elevated blood pressure, glucose, and serum lipids in adulthood were observed. As these cohorts mature they will provide a wealth of critical information on the relation between early life factors and later disease risk, and efforts should be made to ensure ongoing follow-up using standardized approaches and more comprehensive assessments.

Generic medicines policies in the Asia Pacific region: ways forward.

PubMed

Nguyen, Tuan A; Hassali, Mohamed A A; McLachlan, Andrew

2013-01-01

Generic medicines are a key strategy used by governments and third-party payers to contain medicines costs and improve the access to essential medicines. This strategy represents an important opportunity provided by the global intellectual property regimes to discover and develop copies of original products marketed by innovator companies once the patent protection term is over. While there is an extensive experience regarding generic medicines policies in developed countries, this evidence may not translate to developing countries. The generic medicines policies workshop at the Asia Pacific Conference on National Medicines Policies 2012 provided an important opportunity to discuss and document country-specific initiatives for improving access to and the rational of use of generic medicines in the Asia Pacific region. Based on the identified barriers and enablers to implementation of generic medicines policies in the region, a set of future action plans and recommendations has been made.

Derisking Renewable Energy Investment. A Framework to Support Policymakers in Selecting Public Instruments to Promote Renewable Energy Investment in Developing Countries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Waissbein, Oliver; Glemarec, Yannick; Bayraktar, Hande

2013-03-15

This report introduces an innovative framework to assist policymakers to quantitatively compare the impact of different public instruments to promote renewable energy. The report identifies the need to reduce the high financing costs for renewable energy in developing countries as an important task for policymakers acting today. The framework is structured in four stages: (i) risk environment, (ii) public instruments, (iii) levelised cost and (iv) evaluation. To illustrate how the framework can support decision-making in practice, the report presents findings from illustrative case studies in four developing countries. It then draws on these results to discuss possible directions for enhancingmore » public interventions to scale-up renewable energy investment. UNDP is also releasing a financial tool for policymakers to accompany the framework. The financial tool is available for download on the UNDP website.« less

Pilot Study to Evaluate Hearing Aid Service Delivery Model and Measure Benefit Using Self-Report Outcome Measures Using Community Hearing Workers in a Developing Country

PubMed Central

Emerson, Lingamdenne Paul; Job, Anand; Abraham, Vinod

2013-01-01

Hearing loss is a major handicap in developing countries with paucity of trained audiologists and limited resources. In this pilot study trained community health workers were used to provide comprehensive hearing aid services in the community. One hundred and eleven patients were fitted with semi-digital hearing aid and were evaluated over a period of six months. They were assessed using self-report outcome measure APHAB. Results show that trained CHWs are effective in detecting disabling hearing loss and in providing HAs. APHAB can identify and pick up significant improvements in communication in daily activities and provides a realistic expectation of the benefits of a hearing aid. The model of using trained CHWs to provide rehabilitative services in audiology along with self-report outcome measures can be replicated in other developing countries. PMID:23724277

The relation between global migration and trade networks

NASA Astrophysics Data System (ADS)

Sgrignoli, Paolo; Metulini, Rodolfo; Schiavo, Stefano; Riccaboni, Massimo

2015-01-01

In this paper we develop a methodology to analyze and compare multiple global networks, focusing our analysis on the relation between human migration and trade. First, we identify the subset of products for which the presence of a community of migrants significantly increases trade intensity, where to assure comparability across networks we apply a hypergeometric filter that lets us identify those links which intensity is significantly higher than expected. Next, proposing a new way to define country neighbors based on the most intense links in the trade network, we use spatial econometrics techniques to measure the effect of migration on international trade, while controlling for network interdependences. Overall, we find that migration significantly boosts trade across countries and we are able to identify product categories for which this effect is particularly strong.

The "1+1:Life & Love" Simultaneous Exhibition: Cross-Border Collaboration in the Western Balkans

ERIC Educational Resources Information Center

Walters, Diana

2012-01-01

This article describes and analyzes a cross-border, "simultaneous exhibition" collaborative project in six post-conflict western Balkan countries. Through a process of collaboration, active learning, and audience development, professional and personal trust developed among eleven museums. Previously identified barriers were overcome and…

Using Indicators as a Catalyst for Inclusive Education in the Pacific Islands

ERIC Educational Resources Information Center

Sharma, Umesh; Forlin, Chris; Marella, Manjula; Jitoko, Filipe

2017-01-01

The Pacific Island countries are committed to promoting disability-inclusive education through enactment of the Pacific Education Development Framework. To support this move, key stakeholders have identified the need for developing local and contextually appropriate indicators for measuring progress of disability-inclusive education. This paper…

Entrepreneurship Perceptions and Career Intentions of International Students

ERIC Educational Resources Information Center

Davey, Todd; Plewa, Carolin; Struwig, Miemie

2011-01-01

Purpose: This paper aims to identify the differences between African and European students with regard to their entrepreneurial intentions, attitudes towards entrepreneurship, role models and entrepreneurial experience. It also aims to set the scene for future comparative research between developing and developed countries in the area of graduate…

Bibliometric study of research and development for neglected diseases in the BRICS.

PubMed

Bai, Jing; Li, Wei; Huang, Yang-Mu; Guo, Yan

2016-09-06

Large numbers of people are suffering from a group of diseases that mainly affect developing countries, as there are no available or affordable products for prevention or treatment. Research and development (R&D) for these diseases is still a low priority on the health agenda. Brazil, Russia, India, China and South Africa (BRICS) are quickly growing economies and having more and more positive impact on global health. Additionally, their R&D capacity is believed to be enhanced through decades of investment in education and life science research. The BRICS, as a group of emerging and developing countries, are expected to make greater contributions to solving the problem that mainly affects the entire developing countries community. However, there has been little research to provide a macroscopic overview of BRICS' effort in R&D for neglected diseases. The aim of this study is to investigate scientific production in BRICS countries in this area and their main research hotspots. Global relevant literature was searched without time limits through PubMed and high yield countries were identified using GoPubMed. Literature up to the end of 2013 from the BRICS was obtained and high frequency words were extracted and clustered using Bibliography Item Co-occurrence Mining System 2.0 (BICOMS) and Graphical Clustering Toolkit 1.0 (gCLUTO). In total, 32, 47, 51, 31 and 44 high frequency words from Brazil, Russia, India, China and South Africa respectively were extracted for clustering analysis. The clustering indicated that eight diseases were research hotspots in BRICS countries. India had the most extensive hotspots and Brazil came in second. The other three countries shared common research foci: helminthiasis, Human Immunodeficiency Virus infection and Acquired Immune Deficiency Syndrome (HIV/AIDS) and tuberculosis. Developed countries still make the majority of contributions to R&D on neglected diseases, but BRICS countries are playing a growing role. Instead of the "big three diseases" (HIV/AIDS, malaria and tuberculosis) recognized by WHO, the BRICS focus more on major causes of disease burden in their own countries. Disease burden and domestic policy, especially patent law, exert primary influence on the research focus.

Optical pre-screening in breast screening programs: Can we identify women who benefit most from limited mammography resources?

NASA Astrophysics Data System (ADS)

Walter, Jane; Loshchenov, Maxim; Zhilkin, Vladimir; Peake, Rachel; Stone, Jennifer; Lilge, Lothar

2017-04-01

Background: In excess of 60% of all cancers are detected in low and middle-income countries, with breast cancer (BC) the dominant malignancy for women. Incidence rates continue to climb, most noticeably in the less than 50-year-old population. Expansion of mammography infrastructure and resources is lacking, resulting in over 60% of women diagnosed with stage III/IV BC in the majority of these countries. Optical Breast Spectroscopy (OBS) was shown to correlate well with mammographic breast density (MBD). OBS could aid breast screening programs in low- and middle-income countries by lowering the number of mammographs required for complete population coverage. However, its performance needs to be tested in large population trails to ensure high sensitivity and acceptable specificity. Methods: For the planned studies in low- and middle-income countries in different continents, online methods need to be implemented to monitor the performance and data collection by these devices, operated by trained nurses. Based on existing datasets, procedures were developed to validate an individual woman's data integrity and to identify operator errors versus system malfunctions. Results: Using a dataset comprising spectra from 360 women collected by 2 instruments in different locations and with 3 different trained operators, automated methods were developed to identify 100% of the source or photodetector malfunctions as well as incorrect calibrations and 96% of instances of insufficient tissue contact. Conclusions: Implementing the dataset validation locally in each instrument and tethered to a cloud database will allow the planned clinical trials to proceed.

Vaccinovigilance in Europe--need for timeliness, standardization and resources.

PubMed Central

Lankinen, Kari S.; Pastila, Satu; Kilpi, Terhi; Nohynek, Hanna; Mäkelä, P. Helena; Olin, Patrick

2004-01-01

OBJECTIVE: To identify gaps in the systems for reporting adverse events following immunization (AEFI) in Europe by means of an interactive database constructed using a standardized approach. METHODS: A comparative survey was conducted in 1999-2000, using structured questionnaires addressed to the government authorities responsible for national immunization programmes and drug safety surveillance in all European Union (EU) Member States and in Norway and Switzerland. FINDINGS: The reporting of adverse vaccine reactions (AVRs) is covered by regulations in 13 of the 17 countries. Four countries have a specialized expert group with responsibility for vaccine safety. Only six professionals work full-time on vaccine safety in the 17 countries; in four of these countries the person is medically qualified. Fourteen countries have centralized reporting systems; in 14 countries the responsible authority is the drug regulatory agency. AEFI are reported using the procedure used for adverse drug reactions (ADRs) in all except four countries. The reporting form is not usually designed for vaccines and important details may therefore not be requested. Clinical definitions for vaccine reactions are not available. Twelve countries have appropriate official definitions for events or reactions, but the list of reportable events varies considerably between countries. The assessment of adverse vaccine reactions (AVRs) is hampered by lack of exact denominator data. Feedback to the rapporteurs was provided in 13 countries, but its quality was highly variable. CONCLUSION: The database facilitated a simple comparison of vaccinovigilance systems across participating countries. Most of the problems identified related to the reporting and analysis of AEFI could be solved through standardization and intensified international collaboration. On a national level, functional vaccinovigilance systems should be the shared responsibility of the drug regulatory authority and the national immunization programme. The resources for development and management of vaccine safety systems should be urgently improved. PMID:15640918

Restructuring Rural Communities. Part 2: Grazing the Ideas, Approaches, and Resources of Selected Countries. University Extension Press Monograph Series.

ERIC Educational Resources Information Center

Baker, Harold R.

This book examines cases of rural community development initiatives in the United States, Canada, and Europe, identified during a study of multicommunity collaboration projects. Section 1 includes 36 community development ideas operating at provincial, regional, and local levels. Included are ideas such as bank community development corporations,…

The Effects of Professional Development Activities on Principals' Perceived Instructional Leadership Practices: Multi-Country Data Analysis Using TALIS 2013

ERIC Educational Resources Information Center

Gumus, Emine; Bellibas, Mehmet Sukru

2016-01-01

The purpose of this study was to investigate the extent to which professional development predicts principals' instructional leadership in order to identify whether a relationship exists between the duration of principals' participation in distinct professional development activities and their perceived practice of instructional leadership while…

Civil society engagement in innovation and research through the European Public Health Association.

PubMed

Zeegers Paget, Dineke; Barnhoorn, Floris; McCarthy, Mark; Alexanderson, Kristina; Conceição, Claudia; Devillé, Walter; Grimaud, Olivier; Katreniakova, Zuzana; Narkauskaité, Laura; Saliba, Amanda; Sammut, Marvic; Voss, Margaretha

2013-11-01

The European Public Health Association (EUPHA) proposed and led PHIRE (Public Health Innovation and Research in Europe), with co-financing by the European Commission, to assess public health innovation and research at national level in Europe. PHIRE was also designed to promote organizational development and capacity building of EUPHA. We assess the success and limitations of using EUPHA's participative structures. In total, 30 European countries were included-27 EU countries, Iceland, Norway and Switzerland. EUPHA thematic section presidents were asked to identify country informants to report, through a web-based questionnaire, on eight public health innovations. National public health associations (EUPHA member organizations) were requested to identify their national public health research programmes and calls, review the health research system, coordinate a stakeholder workshop and provide a national report. The section and national reports were assessed for responses and completeness. Half of the final responding CIs were members of EUPHA sections and the other half gained from other sources. Experts declined to respond for reasons including lack of time, knowledge of the innovation or funding. National public health associations held PHIRE workshops with Ministries of Health in 14 countries; information for 10 countries was gained through discussions within the national association, or country visits by PHIRE partners. Six countries provided no response. Some national associations had too weak organizational structures for the work or insufficient financial resources or criticism of the project. EUPHA is the leading civil society organization giving support to public health research in Europe. PHIRE created new knowledge and supported organizational development. EUPHA sections gained expert reports on public health innovations in European countries and national public health associations reported on national public health research systems. Significant advances could be made if the European Commission worked more directly with EUPHA's expert members and with the national public health associations.

Improving HIV outcomes in resource-limited countries: the importance of quality indicators.

PubMed

Ahonkhai, Aima A; Bassett, Ingrid V; Ferris, Timothy G; Freedberg, Kenneth A

2012-11-24

Resource-limited countries increasingly depend on quality indicators to improve outcomes within HIV treatment programs, but indicators of program performance suitable for use at the local program level remain underdeveloped. Using the existing literature as a guide, we applied standard quality improvement (QI) concepts to the continuum of HIV care from HIV diagnosis, to enrollment and retention in care, and highlighted critical service delivery process steps to identify opportunities for performance indicator development. We then identified existing indicators to measure program performance, citing examples used by pivotal donor agencies, and assessed their feasibility for use in surveying local program performance. Clinical delivery steps without existing performance measures were identified as opportunities for measure development. Using National Quality Forum (NQF) criteria as a guide, we developed measurement concepts suitable for use at the local program level that address existing gaps in program performance assessment. This analysis of the HIV continuum of care identified seven critical process steps providing numerous opportunities for performance measurement. Analysis of care delivery process steps and the application of NQF criteria identified 24 new measure concepts that are potentially useful for improving operational performance in HIV care at the local level. An evidence-based set of program-level quality indicators is critical for the improvement of HIV care in resource-limited settings. These performance indicators should be utilized as treatment programs continue to grow.

Failure mode and effects analysis of the universal anaesthesia machine in two tertiary care hospitals in Sierra Leone

PubMed Central

Rosen, M. A.; Sampson, J. B.; Jackson, E. V.; Koka, R.; Chima, A. M.; Ogbuagu, O. U.; Marx, M. K.; Koroma, M.; Lee, B. H.

2014-01-01

Background Anaesthesia care in developed countries involves sophisticated technology and experienced providers. However, advanced machines may be inoperable or fail frequently when placed into the austere medical environment of a developing country. Failure mode and effects analysis (FMEA) is a method for engaging local staff in identifying real or potential breakdowns in processes or work systems and to develop strategies to mitigate risks. Methods Nurse anaesthetists from the two tertiary care hospitals in Freetown, Sierra Leone, participated in three sessions moderated by a human factors specialist and an anaesthesiologist. Sessions were audio recorded, and group discussion graphically mapped by the session facilitator for analysis and commentary. These sessions sought to identify potential barriers to implementing an anaesthesia machine designed for austere medical environments—the universal anaesthesia machine (UAM)—and also engaging local nurse anaesthetists in identifying potential solutions to these barriers. Results Participating Sierra Leonean clinicians identified five main categories of failure modes (resource availability, environmental issues, staff knowledge and attitudes, and workload and staffing issues) and four categories of mitigation strategies (resource management plans, engaging and educating stakeholders, peer support for new machine use, and collectively advocating for needed resources). Conclusions We identified factors that may limit the impact of a UAM and devised likely effective strategies for mitigating those risks. PMID:24833727

Target Salt 2025: A Global Overview of National Programs to Encourage the Food Industry to Reduce Salt in Foods

PubMed Central

Webster, Jacqui; Trieu, Kathy; Dunford, Elizabeth; Hawkes, Corinna

2014-01-01

Reducing population salt intake has been identified as a priority intervention to reduce non-communicable diseases. Member States of the World Health Organization have agreed to a global target of a 30% reduction in salt intake by 2025. In countries where most salt consumed is from processed foods, programs to engage the food industry to reduce salt in products are being developed. This paper provides a comprehensive overview of national initiatives to encourage the food industry to reduce salt. A systematic review of the literature was supplemented by key informant questionnaires to inform categorization of the initiatives. Fifty nine food industry salt reduction programs were identified. Thirty eight countries had targets for salt levels in foods and nine countries had introduced legislation for some products. South Africa and Argentina have both introduced legislation limiting salt levels across a broad range of foods. Seventeen countries reported reductions in salt levels in foods—the majority in bread. While these trends represent progress, many countries have yet to initiate work in this area, others are at early stages of implementation and further monitoring is required to assess progress towards achieving the global target. PMID:25195640

Target salt 2025: a global overview of national programs to encourage the food industry to reduce salt in foods.

PubMed

Webster, Jacqui; Trieu, Kathy; Dunford, Elizabeth; Hawkes, Corinna

2014-08-21

Reducing population salt intake has been identified as a priority intervention to reduce non-communicable diseases. Member States of the World Health Organization have agreed to a global target of a 30% reduction in salt intake by 2025. In countries where most salt consumed is from processed foods, programs to engage the food industry to reduce salt in products are being developed. This paper provides a comprehensive overview of national initiatives to encourage the food industry to reduce salt. A systematic review of the literature was supplemented by key informant questionnaires to inform categorization of the initiatives. Fifty nine food industry salt reduction programs were identified. Thirty eight countries had targets for salt levels in foods and nine countries had introduced legislation for some products. South Africa and Argentina have both introduced legislation limiting salt levels across a broad range of foods. Seventeen countries reported reductions in salt levels in foods-the majority in bread. While these trends represent progress, many countries have yet to initiate work in this area, others are at early stages of implementation and further monitoring is required to assess progress towards achieving the global target.

Are Your Students Ready for Anatomy and Physiology? Developing Tools to Identify Students at Risk for Failure

ERIC Educational Resources Information Center

Gultice, Amy; Witham, Ann; Kallmeyer, Robert

2015-01-01

High failure rates in introductory college science courses, including anatomy and physiology, are common at institutions across the country, and determining the specific factors that contribute to this problem is challenging. To identify students at risk for failure in introductory physiology courses at our open-enrollment institution, an online…

Identifying the Training Needs of Heads of Department in a Newly Established University in Vietnam

ERIC Educational Resources Information Center

Nguyen, Thi Lan Huong

2012-01-01

Although middle-level academic managers really need training in order to perform their roles adequately in the very changing context of higher education, little formal training is provided, particularly in less developed countries. This paper identifies the training needs of Heads of Department in a newly established university in Vietnam as a…

A Chronology of Global Assistance Funding for NCD.

PubMed

Nugent, Rachel

2016-12-01

Funding from the global community for noncommunicable disease (NCD) prevention and control in developing countries is miniscule-dwarfed by donor support for communicable diseases, maternal and child health, and other traditional health concerns in low-income countries. Yet, NCD now constitute the bulk of illness and deaths in low-income countries with, to date, only a small uptick in donor funding evident as a response. This paper describes recent magnitude and trends in the development of assistance for NCD; identifies the main sources among the 3 groupings of multilateral, bilateral, and private philanthropic funders; and discusses issues in tracking NCD donor funding, and challenges to mobilizing donor funding for NCD. Finally, it concludes with a more (slightly) optimistic outlook. Copyright © 2016 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

Addressing refugee health through evidence-based policies: a case study

PubMed Central

de Bocanegra, Heike Thiel; Carter-Pokras, Olivia; Ingleby, J. David; Pottie, Kevin; Tchangalova, Nedelina; Allen, Sophia I.; Smith-Gagen, Julie; Hidalgo, Bertha

2017-01-01

The cumulative total of persons forced to leave their country for fear of persecution or organized violence reached an unprecedented 24.5 million by the end of 2015. Providing equitable access to appropriate health services for these highly diverse newcomers poses challenges for receiving countries. In this case study, we illustrate the importance of translating epidemiology into policy to address the health needs of refugees by highlighting examples of what works as well as identifying important policy-relevant gaps in knowledge. First, we formed an international working group of epidemiologists and health services researchers to identify available literature on the intersection of epidemiology, policy, and refugee health. Second, we created a synopsis of findings to inform a recommendation for integration of policy and epidemiology to support refugee health in the US and other high-income receiving countries. Third, we identified eight key areas to guide the involvement of epidemiologists in addressing refugee health concerns. The complexity and uniqueness of refugee health issues, and the need to develop sustainable management information systems, require epidemiologists to expand their repertoire of skills to identify health patterns among arriving refugees, monitor access to appropriately designed health services, address inequities, and communicate with policy makers and multidisciplinary teams. PMID:28554498

Internet-based interventions for the prevention and treatment of depression in people living in developing countries: A systematic review.

PubMed

Martínez, Pablo; Rojas, Graciela; Martínez, Vania; Lara, María Asunción; Pérez, J Carola

2018-07-01

Internet-based interventions for depression may be a valuable resource to reduce the treatment gap for those living in developing countries. However, evidence comes mainly from developed countries. This systematic review summarized the evidence on preventive or therapeutic Internet-based interventions for depression for people who reside in developing countries. CINAHL, EMBASE, PubMed, SciELO Citation Indexes, the Journal of Medical Internet Research, and the Telemedicine and e-Health journal, were searched up to June 2017, to identify feasibility or effectiveness studies of preventive or therapeutic Internet-based interventions for depression, with or without human support. Studies included subjects residing in developing countries, and were published in English or Spanish. Study protocols were included. Risk of bias and/or quality of the reporting of the studies included was assessed. Five feasibility studies, aimed at the prevention of depression, and a study protocol were included in this systematic review. Reports came mostly from the Americas (n = 4). Internet-based interventions aimed at the prevention of depression presented low levels of human support, were useful and acceptable to their users, and require further design refinements to improve their use and retention. No gray literature was searched or included in this systematic review. Searches were limited to English and Spanish languages. Internet-based interventions aimed at the prevention of depression in people who reside in developing countries are in an early phase of development, limiting the generalizability of the results. Future studies must employ persuasive designs to improve user retention, incorporating larger samples and a control group to conclusively determine feasibility. Copyright © 2018 Elsevier B.V. All rights reserved.

Challenges in the management of rheumatoid arthritis in developing countries.

PubMed

Mody, Girish M; Cardiel, Mario H

2008-08-01

Rheumatoid arthritis (RA) is a systemic autoimmune disease which is characterized by chronic inflammation of the joints. Patients experience chronic pain and suffering, and increasing disability; without treatment, life expectancy is reduced. It is imperative to identify patients early so that control of inflammation can prevent joint destruction and disability. Although great advances have been made in the developed nations, early diagnosis remains a great challenge for developing countries during the Bone and Joint Decade (2000-2010) and beyond. Developing countries face important and competitive social, economic, health- and poverty-related issues, and this frequently results in chronic diseases such as RA being forgotten in health priorities when urgent health needs are considered in an environment with poor education and scarce resources. Epidemiological studies in developing countries show a lower but still important prevalence in different regions when compared to that in Caucasians. It seems that the severity of RA varies among different ethnic groups, and probably starts at a younger age in developing countries. Practising rheumatologists in these regions need to take into account several important problems that include suboptimal undergraduate education, inadequate diagnosis, late referrals, lack of human and technical resources, poor access to rheumatologists, and some deficiencies in drug availability. Infections are very important in RA, and special care is needed in developing countries as some endemic infections include tuberculosis, human immunodeficiency virus (HIV), hepatitis B, and hepatitis C. These infections should be carefully taken into account when medications are prescribed and monitored. This chapter presents published information covering the main challenges faced in these environments, and suggests strategies to overcome these important problems in RA management.

The direct and indirect effects of corruption on motor vehicle crash deaths.

PubMed

Hua, Law Teik; Noland, Robert B; Evans, Andrew W

2010-11-01

Recent empirical research has found that there is an inverted U-shaped or Kuznets relationship between income and motor vehicle crash (MVC) deaths, such that MVC deaths increase as national income increases and decrease after reaching a critical level. Corruption has been identified as one of the underlying factors that could affect this relationship, primarily by undermining institutional development and effective enforcement schemes. The total effect of corruption can be decomposed into two components, a direct and an indirect effect. The direct effect measures the immediate impact of corruption on MVC deaths by undermining effective enforcement and regulations, while the indirect effect captures the impact of corruption on hindering increases in per capita income and the consequent impact of reduced income on MVC deaths. By influencing economic growth, corruption can lead to an increase or decrease in MVC deaths depending on the income level. Using data from 60 countries between 1982 and 2003, these effects are estimated using linear panel and fixed effects negative binomial models. The estimation results suggest that corruption has different direct effects for less developed and highly developed countries. It has a negative (decreasing) effect on MVC deaths for less developed countries and a positive (increasing) effect on MVC deaths for highly developed countries. For highly developed countries, the total effect is positive at lower per capita income levels, but decreases with per capita income and becomes negative at per capita income levels of about US$ 38,248. For less developed countries, the total effect is negative within the sample range and decreases with increased per capita income. In summary, the results of this study suggest that reduction of corruption is likely a necessary condition to effectively tackle road safety problems. 2010 Elsevier Ltd. All rights reserved.

The impact of nursing leadership on patient safety in a developing country.

PubMed

Stewart, Lee; Usher, Kim

2010-11-01

This article is a report of a study to identify the ways nursing leaders and managers in a developing country have an impact on patient safety. The attempt to address the problem of patient safety in health care is a global issue. Literature addressing the significant impact that nursing leadership has on patient safety is extensive and focuses almost exclusively on the developed world. A critical ethnography was conducted with senior registered nursing leaders and managers throughout the Fiji Islands, specifically those in the Head Office of the Fiji Ministry of Health and the most senior nurse in a hospital or community health service. Semi-structured interviews were conducted with senior nursing leaders and managers in Fiji. Thematic analysis of the interviews was undertaken from a critical theory perspective, with reference to the macro socio-political system of the Fiji Ministry of Health. Four interrelated issues regarding the nursing leaders and managers' impact on patient safety emerged from the study. Empowerment of nursing leaders and managers, an increased focus on the patient, the necessity to explore conditions for front-line nurses and the direct relationship between improved nursing conditions and increased patient safety mirrored literature from developed countries. The findings have significant implications for developing countries and it is crucial that support for patient safety in developing countries become a focus for the international nursing community. Nursing leaders and managers' increased focus on their own place in the hierarchy of the health care system and on nursing conditions as these affect patient safety could decrease adverse patient outcomes. The findings could assist the global nursing community to better support developing countries in pursuing a patient safety agenda. © 2010 Blackwell Publishing Ltd.

Acute Sheehan's syndrome presenting as central diabetes insipidus.

PubMed

Robalo, Raquel; Pedroso, Célia; Agapito, Ana; Borges, Augusta

2012-11-06

Sheehan's syndrome occurs as a result of ischaemic pituitary necrosis due to severe postpartum haemorrhage. Improvements in obstetrical care have significantly reduced its incidence in developed countries, but postpartum pituitary infarction remains a common cause of hypopituitarism in developing countries. We report a case of severe postpartum haemorrhage followed by headache, central diabetes insipidus and failure to lactate, which prompted us to investigate and identify both anterior and posterior pituitary deficiency compatible with Sheehan's syndrome. A timely diagnosis allowed us to implement an adequate treatment and follow-up plan, which are known to improve clinical status and patient outcome.

Influenza surveillance: alternative laboratory techniques for a developing country*

PubMed Central

Canil, K. A.; Pratt, D.; Sungu, M. S.; Phillips, P. A.

1985-01-01

In developing countries it is often impractical to use conventional methods to isolate and identify influenza viruses. The use of trypsin-treated LLC-MK2 cells for the isolation of myxoviruses, in conjunction with the indirect fluorescent antibody technique for identification of isolates and for direct detection of viral antigens in specimens, was an effective combination of techniques which enabled our laboratory in Papua New Guinea to participate in an influenza surveillance programme. The application of these techniques in routine respiratory virus surveillance and in the investigation of an outbreak of influenza-like illness is described. PMID:3872737

Examining gender equity in health policies in a low- (Peru), middle- (Colombia), and high- (Canada) income country in the Americas.

PubMed

Stewart, Donna E; Dorado, Linda M; Diaz-Granados, Natalia; Rondon, Marta; Saavedra, Javier; Posada-Villa, Jose; Torres, Yolanda

2009-12-01

Gender inequities in health prevail in most countries despite ongoing attempts to eliminate them. Assessment of gender-sensitive health policies can be used to identify country specific progress as well as gaps and issues that need to be addressed to meet health equity goals. This study selected and measured the existence of gender-sensitive health policies in a low- (Peru), middle- (Colombia), and high (Canada)-income country in the Americas. Investigators selected 10 of 20 gender-sensitive health policy indicators and found eight to be feasible to measure in all three countries, although the wording and scope varied. The results from this study inform policy makers and program planners who aim to develop, improve, implement, and monitor national gender-sensitive health policies. Future studies should assess the implementation of policy indicators within countries and assess their performance in increasing gender equity.

Exoproteome and Secretome Derived Broad Spectrum Novel Drug and Vaccine Candidates in Vibrio cholerae Targeted by Piper betel Derived Compounds

PubMed Central

Barh, Debmalya; Barve, Neha; Gupta, Krishnakant; Chandra, Sudha; Jain, Neha; Tiwari, Sandeep; Leon-Sicairos, Nidia; Canizalez-Roman, Adrian; Rodrigues dos Santos, Anderson; Hassan, Syed Shah; Almeida, Síntia; Thiago Jucá Ramos, Rommel; Augusto Carvalho de Abreu, Vinicius; Ribeiro Carneiro, Adriana; de Castro Soares, Siomar; Luiz de Paula Castro, Thiago; Miyoshi, Anderson; Silva, Artur; Kumar, Anil; Narayan Misra, Amarendra; Blum, Kenneth; Braverman, Eric R.; Azevedo, Vasco

2013-01-01

Vibrio cholerae is the causal organism of the cholera epidemic, which is mostly prevalent in developing and underdeveloped countries. However, incidences of cholera in developed countries are also alarming. Because of the emergence of new drug-resistant strains, even though several generic drugs and vaccines have been developed over time, Vibrio infections remain a global health problem that appeals for the development of novel drugs and vaccines against the pathogen. Here, applying comparative proteomic and reverse vaccinology approaches to the exoproteome and secretome of the pathogen, we have identified three candidate targets (ompU, uppP and yajC) for most of the pathogenic Vibrio strains. Two targets (uppP and yajC) are novel to Vibrio, and two targets (uppP and ompU) can be used to develop both drugs and vaccines (dual targets) against broad spectrum Vibrio serotypes. Using our novel computational approach, we have identified three peptide vaccine candidates that have high potential to induce both B- and T-cell-mediated immune responses from our identified two dual targets. These two targets were modeled and subjected to virtual screening against natural compounds derived from Piper betel. Seven compounds were identified first time from Piper betel to be highly effective to render the function of these targets to identify them as emerging potential drugs against Vibrio. Our preliminary validation suggests that these identified peptide vaccines and betel compounds are highly effective against Vibrio cholerae. Currently we are exhaustively validating these targets, candidate peptide vaccines, and betel derived lead compounds against a number of Vibrio species. PMID:23382822

Industry Perspective of Pediatric Drug Development in the United States: Involvement of the European Union Countries.

PubMed

Onishi, Taku; Tsukamoto, Katsura; Matsumaru, Naoki; Waki, Takashi

2018-01-01

Efforts to promote the development of pediatric pharmacotherapy include regulatory frameworks and close collaboration between the US Food and Drug Administration and the European Medicines Agency. We characterized the current status of pediatric clinical trials conducted in the United States by the pharmaceutical industry, focusing on the involvement of the European Union member countries, to clarify the industry perspective. Data on US pediatric clinical trials were obtained from ClinicalTrials.gov . Binary regression analysis was performed to identify what factors influence the likelihood of involvement of European Union countries. A total of 633 US pediatric clinical trials that met inclusion criteria were extracted and surveyed. Of these, 206 (32.5%) involved a European Union country site(s). The results of binary regression analysis indicated that attribution of industry, phase, disease area, and age of pediatric participants influenced the likelihood of the involvement of European Union countries in US pediatric clinical trials. Relatively complicated or large pediatric clinical trials, such as phase II and III trials and those that included a broad age range of participants, had a significantly greater likelihood of the involvement of European Union countries ( P < .05). Our results suggest that (1) the pharmaceutical industry utilizes regulatory frameworks in making business decisions regarding pediatric clinical trials, (2) disease area affects the involvement of European Union countries, and (3) feasibility of clinical trials is mainly concerned by pharmaceutical industry for pediatric drug development. Additional incentives for high marketability may further motivate pharmaceutical industry to develop pediatric drugs.

A review on Sero diversity and antimicrobial resistance patterns of Shigella species in Africa, Asia and South America, 2001-2014.

PubMed

Kahsay, Atsebaha Gebrekidan; Muthupandian, Saravanan

2016-08-30

Shigella, gram negative bacterium, is responsible for Shigellosis/bacillary dysentery. It is a global concern although it predominates in developing countries. These are Shigella dysenteriae, Shigella flexneri, Shigella boydii and Shigella sonnei. Drug resistance by Shigella species is another headache of the world. Therefore; this study aimed to review distribution of Shigella Serogroups and their antimicrobial patterns carried out in Africa, Asia and South America. A literature search was performed to identify published studies between January 2001 and December 2014. Published studies were identified using an initial search of the MEDLINE/Index Medicus Database, PubMed, Project Management Consultant, Google Scholar, Science Direct, BioMed Central and Index Copernicus. Shigella flexneri was isolated predominately from seven studies in four African countries and eight studies in five Asian countries. The countries in which eligible studies carried out were Ethiopia, Kenya, Eritrea and Ghana in Africa and Pakistan, Iran, China, Nepal and India in Asia. S. sonnei was isolated predominately from one study in Africa, four in Asia and two South America. The countries in which eligible studies carried out were Ethiopia from Africa, Thailand, Vietnam and Iran from Asia and Chile and Trinidad from South America. S. dysentery was also reported majorly from one eligible study in Egypt and one in Nepal. S. boydii did not score highest prevalence in any one of the eligible studies. Three studies from Africa, five from Asia and one from South America were reviewed for antimicrobial resistance patterns of Shigella Serogroups. In all the regions, Ampicillin developed highly resistance to almost all the Serogroups of Shigella whereas all the strains were sensitive to Ciprofloxacin. The incidence of Shigella Serogroups in the selected three regions is different. The domination of S. flexneri is observed in Africa and Asia although S. sonnei in South America is dominant. Shigella Serogroups are becoming resistance to the commonly prescribed antimicrobial drugs in developing countries.

Air void clustering : [technical summary].

DOT National Transportation Integrated Search

2015-06-01

Air void clustering around coarse aggregate in concrete has been : identified as a potential source of low strengths in concrete mixes by : several Departments of Transportation around the country. Research : was carried out to (1) develop a quantita...

International variability in 20 m shuttle run performance in children and youth: who are the fittest from a 50-country comparison? A systematic literature review with pooling of aggregate results.

PubMed

Lang, Justin J; Tremblay, Mark S; Léger, Luc; Olds, Tim; Tomkinson, Grant R

2018-02-01

To describe and compare 20 m shuttle run test (20mSRT) performance among children and youth across 50 countries; to explore broad socioeconomic indicators that correlate with 20mSRT performance in children and youth across countries and to evaluate the utility of the 20mSRT as an international population health indicator for children and youth. A systematic review was undertaken to identify papers that explicitly reported descriptive 20mSRT (with 1-min stages) data on apparently healthy 9-17 year-olds. Descriptive data were standardised to running speed (km/h) at the last completed stage. Country-specific 20mSRT performance indices were calculated as population-weighted mean z-scores relative to all children of the same age and sex from all countries. Countries were categorised into developed and developing groups based on the Human Development Index, and a correlational analysis was performed to describe the association between country-specific performance indices and broad socioeconomic indicators using Spearman's rank correlation coefficient. Performance indices were calculated for 50 countries using collated data on 1 142 026 children and youth aged 9-17 years. The best performing countries were from Africa and Central-Northern Europe. Countries from South America were consistently among the worst performing countries. Country-specific income inequality (Gini index) was a strong negative correlate of the performance index across all 50 countries. The pattern of variability in the performance index broadly supports the theory of a physical activity transition and income inequality as the strongest structural determinant of health in children and youth. This simple and cost-effective assessment would be a powerful tool for international population health surveillance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A Survey on Pharmacovigilance Activities in ASEAN and Selected Non-ASEAN Countries, and the Use of Quantitative Signal Detection Algorithms.

PubMed

Chan, Cheng Leng; Ang, Pei San; Li, Shu Chuen

2017-06-01

Most Countries have pharmacovigilance (PV) systems in place to monitor the safe use of health products. The process involves the detection and assessment of safety issues from various sources of information, communicating the risk to stakeholders and taking other relevant risk minimization measures. This study aimed to assess the PV status in Association of Southeast Asian Nation (ASEAN) countries, sources for postmarket safety monitoring, methods used for signal detection and the need for a quantitative signal detection algorithm (QSDA). Comparisons were conducted with centres outside ASEAN. A questionnaire was sent to all PV centres in ASEAN countries, as well as seven other countries, from November 2015 to June 2016. The questionnaire was designed to collect information on the status of PV, with a focus on the use of a QSDA. Data were collected from nine ASEAN countries and seven other countries. PV activities were conducted in all these countries, which were at different stages of development. In terms of adverse drug reaction (ADR) reports, the average number received per year ranged from 3 to 50,000 reports for ASEAN countries and from 7000 to 1,103,200 for non-ASEAN countries. Thirty-three percent of ASEAN countries utilized statistical methods to help detect signals from ADR reports compared with 100% in the other non-ASEAN countries. Eighty percent agreed that the development of a QSDA would help in drug signal detection. The main limitation identified was the lack of knowledge and/or lack of resources. Spontaneous ADR reports from healthcare professionals remains the most frequently used source for safety monitoring. The traditional method of case-by-case review of ADR reports prevailed for signal detection in ASEAN countries. As the reports continue to grow, the development of a QSDA would be useful in helping detect safety signals.

Faster Growth of Road Transportation CO2 Emissions in Asia Pacific Economies: Exploring Differences in Trends of the Rapidly Developing and Developed Worlds

ERIC Educational Resources Information Center

Marcotullio, Peter J.

2006-01-01

Researchers have identified how in some rapidly developing countries, road and aviation transportation CO2 emissions are rising faster (over time) when compared to the experiences of the USA at similar levels of economic development. While suggestive of how experiences of the rapidly developing Asia are different from those of the developed world…

Identifying Future Disease Hot Spots: Infectious Disease Vulnerability Index.

PubMed

Moore, Melinda; Gelfeld, Bill; Okunogbe, Adeyemi; Paul, Christopher

2017-06-01

Recent high-profile outbreaks, such as Ebola and Zika, have illustrated the transnational nature of infectious diseases. Countries that are most vulnerable to such outbreaks might be higher priorities for technical support. RAND created the Infectious Disease Vulnerability Index to help U.S. government and international agencies identify these countries and thereby inform programming to preemptively help mitigate the spread and effects of potential transnational outbreaks. The authors employed a rigorous methodology to identify the countries most vulnerable to disease outbreaks. They conducted a comprehensive review of relevant literature to identify factors influencing infectious disease vulnerability. Using widely available data, the authors created an index for identifying potentially vulnerable countries and then ranked countries by overall vulnerability score. Policymakers should focus on the 25 most-vulnerable countries with an eye toward a potential "disease belt" in the Sahel region of Africa. The infectious disease vulnerability scores for several countries were better than what would have been predicted on the basis of economic status alone. This suggests that low-income countries can overcome economic challenges and become more resilient to public health challenges, such as infectious disease outbreaks.

Use of active management of the third stage of labour in seven developing countries.

PubMed

Stanton, Cynthia; Armbruster, Deborah; Knight, Rod; Ariawan, Iwan; Gbangbade, Sourou; Getachew, Ashebir; Portillo, Jose Angel; Jarquin, Douglas; Marin, Flor; Mfinanga, Sayoka; Vallecillo, Jesus; Johnson, Hope; Sintasath, David

2009-03-01

To document the use of active management of the third stage of labour for preventing postpartum haemorrhage and to explore factors associated with such use in seven developing countries. Nationally representative samples of facility-based deliveries were selected and observed to determine the use of active management of the third stage of labour and associated factors. Policies on active management were assessed through document review and interviews with relevant professionals. Use of a uterotonic during the third or fourth stages of labour was nearly universal. Correct use of active management of the third stage of labour was found in only 0.5% to 32% of observed deliveries due to multiple deficiencies in practice. In every country except Indonesia, policies regarding active management were conflicting. Developing countries have not targeted decreasing postpartum haemorrhage as an achievable goal; there is little use of active management of the third stage of labour, and policies regarding such management often conflict. Studies are needed to identify the most effective components of active management so that the most efficient package of practices can be promoted.

Epidemiology, Incidence and Mortality of Breast Cancer in Asia.

PubMed

Ghoncheh, Mahshid; Momenimovahed, Zohre; Salehiniya, Hamid

2016-01-01

Breast cancer is the most common malignancy in women around the world. Information on the incidence and mortality of breast cancer is essential for planning health measures. This study aimed to investigate the incidence and mortality of breast cancer in the world using age-specific incidence and mortality rates for the year 2012 acquired from the global cancer project (GLOBOCAN 2012) as well as data about incidence and mortality of the cancer based on national reports. It was estimated that 1,671,149 new cases of breast cancer were identified and 521,907 cases of deaths due to breast cancer occurred in the world in 2012. According to GLOBOCAN, it is the most common cancer in women, accounting for 25.1% of all cancers. Breast cancer incidence in developed countries is higher, while relative mortality is greatest in less developed countries. Education of women is suggested in all countries for early detection and treatment. Plans for the control and prevention of this cancer must be a high priority for health policy makers; also, it is necessary to increase awareness of risk factors and early detection in less developed countries.

Exposure to particulate matter in India: A synthesis of findings and future directions.

PubMed

Pant, Pallavi; Guttikunda, Sarath K; Peltier, Richard E

2016-05-01

Air pollution poses a critical threat to human health with ambient and household air pollution identified as key health risks in India. While there are many studies investigating concentration, composition, and health effects of air pollution, investigators are only beginning to focus on estimating or measuring personal exposure. Further, the relevance of exposures studies from the developed countries in developing countries is uncertain. This review summarizes existing research on exposure to particulate matter (PM) in India, identifies gaps and offers recommendations for future research. There are a limited number of studies focused on exposure to PM and/or associated health effects in India, but it is evident that levels of exposure are much higher than those reported in developed countries. Most studies have focused on coarse aerosols, with a few studies on fine aerosols. Additionally, most studies have focused on a handful of cities, and there are many unknowns in terms of ambient levels of PM as well as personal exposure. Given the high mortality burden associated with air pollution exposure in India, a deeper understanding of ambient pollutant levels as well as source strengths is crucial, both in urban and rural areas. Further, the attention needs to expand beyond the handful large cities that have been studied in detail. Copyright © 2016 Elsevier Inc. All rights reserved.

Lessons from local engagement in Latin American health systems.

PubMed

Meads, Geoffrey D; Griffiths, Frances E; Goode, Sarah D; Iwami, Michiyo

2007-12-01

To examine the management of recent policies for stronger patient and public involvement in Latin American health systems, identifying common features and describing local practice examples of relevance to the UK. Participation is a core principle of many contemporary policies for health system reform. In Latin America, as in the UK, it is frequently associated with innovations in primary care services and their organizational developments. This shared interest in alternative models of local engagement offers new opportunities for collaborative research and policy development. Commissioned by UK policy makers, a 4-year research programme was designed to promote exchanges with international counterparts focusing on how modern reform policies are being implemented. The selected countries possessed comparable principles and timeframes for their reforms. A series of individual country case studies were undertaken. Data were drawn from literature and documentary reviews; semi-structured interviews with national policy makers and expert advisers; and with management representatives at local exemplar sites. The aggregate data were subjected to thematic analysis applying a model for sustainable development. Six common factors were identified in Latin American policies for stronger patient and public involvement. From these the most significant transferable learning for the UK relates to the position and status of professions and non-governmental agencies. Illustrative case exemplars were located in each of the eight countries studied.

End-of-life care in the intensive care unit: Report from the Task Force of World Federation of Societies of Intensive and Critical Care Medicine.

PubMed

Myburgh, John; Abillama, Fayez; Chiumello, Davide; Dobb, Geoff; Jacobe, Stephen; Kleinpell, Ruth; Koh, Younsuk; Martin, Claudio; Michalsen, Andej; Pelosi, Paolo; Torra, Lluis Blanch; Vincent, Jean-Louis; Yeager, Susan; Zimmerman, Janice

2016-08-01

End-of-life care in the intensive care unit (ICU) was identified as an objective in a series of Task Forces developed by the World Federation of Societies of Intensive and Critical Care Medicine Council in 2014. The objective was to develop a generic statement about current knowledge and to identify challenges relevant to the global community that may inform regional and local initiatives. An updated summary of published statements on end-of-life care in the ICU from national Societies is presented, highlighting commonalities and differences within and between international regions. The complexity of end-of-life care in the ICU, particularly relating to withholding and withdrawing life-sustaining treatment while ensuring the alleviation of suffering, within different ethical and cultural environments is recognized. Although no single statement can therefore be regarded as a criterion standard applicable to all countries and societies, the World Federation of Societies of Intensive and Critical Care Medicine endorses and encourages the role of Member Societies to lead the debate regarding end-of-life care in the ICU within each country and to take a leading role in developing national guidelines and recommendations within each country. Copyright © 2016 Elsevier Inc. All rights reserved.

Rheumatology in Africa-challenges and opportunities.

PubMed

Mody, Girish M

2017-03-07

Africa faces many health challenges despite sustained growth and development over the past decade. Contributory factors are the lack of financial resources, an inadequate health professional workforce, a high burden of communicable diseases, and an increasing burden of non-communicable diseases. Rheumatology services are limited or non-existent in many parts of sub-Saharan Africa. Over the past decade, partnerships with international academic institutions have resulted in some progress in the training of rheumatologists and health professionals and development of rheumatology services in countries such as Kenya, Nigeria, and Zambia. Basic diagnostic tests, biological agents, and arthroplasty are either unavailable or not affordable by the majority of the population. Urbanization has resulted in a change in the epidemiology of rheumatic diseases with an increase in the prevalence of gout, rheumatoid arthritis, systemic lupus erythematosus, and scleroderma over the past four decades. Future growth of rheumatology services will depend on identifying committed individuals in underserved countries for training and supporting them to educate medical students, physicians, and health professionals in their home countries. There is a need to develop models of care using all categories of health workers and identify prevention strategies and cost-effective management programs for low resource settings. Africa affords an opportunity for collaborative research, including genetic and epigenetic studies, to improve our understanding of many of the rheumatic diseases.

National baselines for the Sustainable Development Goals assessed in the SDG Index and Dashboards

NASA Astrophysics Data System (ADS)

Schmidt-Traub, Guido; Kroll, Christian; Teksoz, Katerina; Durand-Delacre, David; Sachs, Jeffrey D.

2017-08-01

The Sustainable Development Goals (SDGs) -- agreed in 2015 by all 193 member states of the United Nations and complemented by commitments made in the Paris Agreement -- map out a broad spectrum of economic, social and environmental objectives to be achieved by 2030. Reaching these goals will require deep transformations in every country, as well as major efforts in monitoring and measuring progress. Here we introduce the SDG Index and Dashboards as analytical tools for assessing countries' baselines for the SDGs that can be applied by researchers in the cross-disciplinary analyses required for implementation. The Index and Dashboards synthesize available country-level data for all 17 goals, and for each country estimate the size of the gap towards achieving the SDGs. They will be updated annually. All 149 countries for which sufficient data is available face significant challenges in achieving the goals, and many countries' development strategies are imbalanced across the economic, social and environmental priorities. We illustrate the analytical value of the index by examining its relationship with other widely used development indices and by showing how it accounts for cross-national differences in subjective well-being. Given significant data gaps, scope and coverage of the Index and Dashboards are limited, but we suggest that these analyses represent a starting point for a comprehensive assessment of national SDG baselines and can help policymakers determine priorities for early action and monitor progress. The tools also identify data gaps that must be closed for SDG monitoring.

Heavy metals in drinking water: Occurrences, implications, and future needs in developing countries.

PubMed

Chowdhury, Shakhawat; Mazumder, M A Jafar; Al-Attas, Omar; Husain, Tahir

2016-11-01

Heavy metals in drinking water pose a threat to human health. Populations are exposed to heavy metals primarily through water consumption, but few heavy metals can bioaccumulate in the human body (e.g., in lipids and the gastrointestinal system) and may induce cancer and other risks. To date, few thousand publications have reported various aspects of heavy metals in drinking water, including the types and quantities of metals in drinking water, their sources, factors affecting their concentrations at exposure points, human exposure, potential risks, and their removal from drinking water. Many developing countries are faced with the challenge of reducing human exposure to heavy metals, mainly due to their limited economic capacities to use advanced technologies for heavy metal removal. This paper aims to review the state of research on heavy metals in drinking water in developing countries; understand their types and variability, sources, exposure, possible health effects, and removal; and analyze the factors contributing to heavy metals in drinking water. This study identifies the current challenges in developing countries, and future research needs to reduce the levels of heavy metals in drinking water. Copyright © 2016 Elsevier B.V. All rights reserved.

Risk factors for stillbirth in developing countries: a systematic review of the literature.

PubMed

Di Mario, Simona; Say, Lale; Lincetto, Ornella

2007-07-01

To identify risk factors for stillbirth in developing countries and to measure their impact by calculating the population attributable fraction (PAF) for each risk factor. Systematic review of published studies on risk factors for stillbirth within 3 broadly defined categories: infections, other clinical conditions, and context-dependent conditions such as socioeconomic status, maternal literacy, and receipt of antenatal care. Where statistically significant associations were found between a risk factor and occurrence of stillbirth, the PAF (the proportion of cases occurring in the total population that would be avoided if the exposure was removed) was calculated. A total of 33 studies, conducted in 31 developing countries, were included in the review. The definition of stillbirth varied widely in these studies. Risk factors for stillbirth having a PAF higher than 50% were maternal syphilis, chorioamnionitis, maternal malnutrition, lack of antenatal care, and maternal socioeconomic disadvantage. Maternal syphilis prevention, screening and treatment together with other interventions targeting universal use of antenatal care (that includes screening for syphilis) and improving the socioeconomic conditions including nutritional status of the mother, could effectively contribute towards reducing the unacceptably high burden due to stillbirth in developing countries.

Minimizing cross-cultural maladaptation: How minority status facilitates change in international acculturation.

PubMed

Volpone, Sabrina D; Marquardt, Dennis J; Casper, Wendy J; Avery, Derek R

2018-03-01

Culturally savvy organizations recognize that selecting and developing people who can be effective in a global workforce is important in today's business environment. Nevertheless, many companies struggle to identify and develop talent who are happy and successful working and living outside their home country. We examine 1 factor that may foster success in a host country-minority status in 1's home country-as a predictor of change in acculturation over time. Specifically, we draw on the conservation of resources model to suggest that international students who have been a member of more minority groups in their home country have unique experiences working with dissimilar others that offer advantages when acculturating to new cultures and novel situations. Then, change in host country acculturation is explored as a mechanism to explain how minority status in the home country relates to intentions to leave the host country and psychological well-being 6 months after entry. Two moderators (cultural intelligence, perceived diversity climate of the host institution) of these relationships are also examined. Results revealed that the relationship between minority status in the home country and change in host country acculturation was positive and stronger for those with higher cultural intelligence. Further, the relationship between change in host country acculturation and psychological well-being was positive when perceived diversity climate of the host institution was high, but was not significant when perceived diversity climate was low. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

In Search of the Third Eye, When the Two Others Are Shamefacedly Shut? Comment on "Are Sexual and Reproductive Health Policies Designed for All? Vulnerable Groups in Policy Documents of Four European Countries and Their Involvement in Policy Development".

PubMed

Keygnaert, Ines

2016-02-11

Ivanova et al explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH) policies in 4 countries. They adapted the EquiFrame of Amin and colleagues of 2011, to SRH vulnerable groups which we believe could now be used for analysis of national SRH polices beyond those 4 countries. Although we fully agree with the authors' two main findings that vulnerable groups and human rights' principles are not sufficiently integrated in SRH policies nor granted the possibility to participate in the process of development in those four countries, we do believe that these shortcomings are not limited to those countries only nor to the identified vulnerable groups either. We are convinced that the issue of SRH as such is still framed within a very limited logic for all with vulnerable groups being perceived as an extra threat or an extra burden. © 2016 by Kerman University of Medical Sciences.

Health Systems' Responsiveness and Its Characteristics: A Cross-Country Comparative Analysis

PubMed Central

Robone, Silvana; Rice, Nigel; Smith, Peter C

2011-01-01

Objectives Responsiveness has been identified as one of the intrinsic goals of health care systems. Little is known, however, about its determinants. Our objective is to investigate the potential country-level drivers of health system responsiveness. Data Source Data on responsiveness are taken from the World Health Survey. Information on country-level characteristics is obtained from a variety of sources including the United Nations Development Program (UNDP). Study Design A two-step procedure. First, using survey data we derive a country-level measure of system responsiveness purged of differences in individual reporting behavior. Secondly, we run cross-sectional country-level regressions of responsiveness on potential drivers. Principal Findings Health care expenditures per capita are positively associated with responsiveness, after controlling for the influence of potential confounding factors. Aspects of responsiveness are also associated with public sector spending (negatively) and educational development (positively). Conclusions From a policy perspective, improvements in responsiveness may require higher spending levels. The expansion of nonpublic sector provision, perhaps in the form of increased patient choice, may also serve to improve responsiveness. However, these inferences are tentative and require further study. PMID:21762144

Patterns, trends and sex differences in HIV/AIDS reported mortality in Latin American countries: 1996-2007

PubMed Central

2011-01-01

Background International cohort studies have shown that antiretroviral treatment (ART) has improved survival of HIV-infected individuals. National population based studies of HIV mortality exist in industrialized settings but few have been presented from developing countries. Our objective was to investigate on a population basis, the regional situation regarding HIV mortality and trends in Latin America (LA) in the context of adoption of public ART policies and gender differences. Methods Cause of death data from vital statistics registries from 1996 to 2007 with "good" or "average" quality of mortality data were examined. Standardized mortality rates and Poisson regression models by country were developed and differences among countries assessed to identify patterns of HIV mortality over time occurring in Latin America. Results Standardized HIV mortality following the adoption of public ART policies was highest in Panama and El Salvador and lowest in Chile. During the study period, three overall patterns were identified in HIV mortality trends- following the adoption of the free ART public policies; a remarkable decrement, a remarkable increment and a slight increment. HIV mortality was consistently higher in males compared to females. Mean age of death attributable to HIV increased in the majority of countries over the study period. Conclusions Vital statistics registries provide valuable information on HIV mortality in LA. While the introduction of national policies for free ART provision has coincided with declines in population-level HIV mortality and increasing age of death in some countries, in others HIV mortality has increased. Barriers to effective ART implementation and uptake in the context of free ART public provision policies should be further investigated. PMID:21801402

High-resolution microendoscope for the detection of cervical neoplasia.

PubMed

Grant, Benjamin D; Schwarz, Richard A; Quang, Timothy; Schmeler, Kathleen M; Richards-Kortum, Rebecca

2015-01-01

Cervical cancer causes 275,000 deaths each year with 85 % of these deaths occurring in the developing world. One of the primary reasons for the concentration of deaths in developing countries is a lack of effective screening methods suited for the infrastructure of these countries. In order to address this need, we have developed a high-resolution microendoscope (HRME). The HRME is a fiber-based fluorescence microscope with subcellular resolution. Using the vital stain proflavine, we are able to image cell nuclei in vivo and evaluate metrics such as nuclear-to-cytoplasmic ratio, critical to identifying precancerous epithelial regions. In this chapter, we detail the materials and methods necessary to build this system from commercially available parts.

DRG systems in Europe: variations in cost accounting systems among 12 countries.

PubMed

Tan, Siok Swan; Geissler, Alexander; Serdén, Lisbeth; Heurgren, Mona; van Ineveld, B Martin; Redekop, W Ken; Hakkaart-van Roijen, Leona

2014-12-01

Diagnosis-related group (DRG)-based hospital payment systems have gradually become the principal means of reimbursing hospitals in many European countries. Owing to the absence or inaccuracy of costs related to DRGs, these countries have started to routinely collect cost accounting data. The aim of the present article was to compare the cost accounting systems of 12 European countries. A standardized questionnaire was developed to guide comprehensive cost accounting system descriptions for each of the 12 participating countries. The cost accounting systems of European countries vary widely by the share of hospital costs reimbursed through DRG payment, the presence of mandatory cost accounting and/or costing guidelines, the share of cost collecting hospitals, costing methods and data checks on reported cost data. Each of these aspects entails a trade-off between accuracy of the cost data and feasibility constraints. Although a 'best' cost accounting system does not exist, our cross-country comparison gives insight into international differences and may help regulatory authorities and hospital managers to identify and improve areas of weakness in their cost accounting systems. Moreover, it may help health policymakers to underpin the development of a cost accounting system. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The Tip of the Iceberg: The Quest for Innovation at the Base of the Pyramid

NASA Astrophysics Data System (ADS)

Gordon, M. D.; Awad, N. F.

Much of the world in Asia, Latin America, and Africa is at an early stage of economic development similar to what the United States and other developed countries experienced many decades ago. Yet, much as their needs for hard and soft infrastructure, effective business practices, and an educated workforce parallel similar needs that underlay earlier development in the West, replicating Western development would overlook the hallmarks of the current century: widely available information and communications technology; a set of electronic linkages among the world; and a global business environment, to name just a few. Consequently, it should be possible to allow developing countries to use "leapfrog" technologies that were inconceivable decades ago to support their development. One means of identifying these opportunities is by matching traditional development needs with novel support by connecting previously unrelated literatures.

Worldwide clustering of the corruption perception

NASA Astrophysics Data System (ADS)

Paulus, Michal; Kristoufek, Ladislav

2015-06-01

We inspect a possible clustering structure of the corruption perception among 134 countries. Using the average linkage clustering, we uncover a well-defined hierarchy in the relationships among countries. Four main clusters are identified and they suggest that countries worldwide can be quite well separated according to their perception of corruption. Moreover, we find a strong connection between corruption levels and a stage of development inside the clusters. The ranking of countries according to their corruption perfectly copies the ranking according to the economic performance measured by the gross domestic product per capita of the member states. To the best of our knowledge, this study is the first one to present an application of hierarchical and clustering methods to the specific case of corruption.

Economic implications of mercury exposure in the context of the global mercury treaty: Hair mercury levels and estimated lost economic productivity in selected developing countries.

PubMed

Trasande, Leonardo; DiGangi, Joseph; Evers, David C; Petrlik, Jindrich; Buck, David G; Šamánek, Jan; Beeler, Bjorn; Turnquist, Madeline A; Regan, Kevin

2016-12-01

Several developing countries have limited or no information about exposures near anthropogenic mercury sources and no studies have quantified costs of mercury pollution or economic benefits to mercury pollution prevention in these countries. In this study, we present data on mercury concentrations in human hair from subpopulations in developing countries most likely to benefit from the implementation of the Minamata Convention on Mercury. These data are then used to estimate economic costs of mercury exposure in these communities. Hair samples were collected from sites located in 15 countries. We used a linear dose-response relationship that previously identified a 0.18 IQ point decrement per part per million (ppm) increase in hair mercury, and modeled a base case scenario assuming a reference level of 1 ppm, and a second scenario assuming no reference level. We then estimated the corresponding increases in intellectual disability and lost Disability-Adjusted Life Years (DALY). A total of 236 participants provided hair samples for analysis, with an estimated population at risk of mercury exposure near the 15 sites of 11,302,582. Average mercury levels were in the range of 0.48 ppm-4.60 ppm, and 61% of all participants had hair mercury concentrations greater than 1 ppm, the level that approximately corresponds to the USA EPA reference dose. An additional 1310 cases of intellectual disability attributable to mercury exposure were identified annually (4110 assuming no reference level), resulting in 16,501 lost DALYs (51,809 assuming no reference level). A total of $77.4 million in lost economic productivity was estimated assuming a 1 ppm reference level and $130 million if no reference level was used. We conclude that significant mercury exposures occur in developing and transition country communities near sources named in the Minamata Convention, and our estimates suggest that a large economic burden could be avoided by timely implementation of measures to prevent mercury exposures. Copyright © 2016 Elsevier Ltd. All rights reserved.

Monitoring the HIV continuum of care in key populations across Europe and Central Asia.

PubMed

Brown, A E; Attawell, K; Hales, D; Rice, B D; Pharris, A; Supervie, V; Van Beckhoven, D; Delpech, V C; An der Heiden, M; Marcus, U; Maly, M; Noori, T

2018-05-08

The aim of the study was to measure and compare national continuum of HIV care estimates in Europe and Central Asia in three key subpopulations: men who have sex with men (MSM), people who inject drugs (PWID) and migrants. Responses to a 2016 European Centre for Disease Prevention and Control (ECDC) survey of 55 European and Central Asian countries were used to describe continuums of HIV care for the subpopulations. Data were analysed using three frameworks: Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets; breakpoint analysis identifying reductions between adjacent continuum stages; quadrant analysis categorizing countries using 90% cut-offs for continuum stages. Overall, 29 of 48 countries reported national data for all HIV continuum stages (numbers living with HIV, diagnosed, receiving treatment and virally suppressed). Six countries reported all stages for MSM, seven for PWID and two for migrants. Thirty-one countries did not report data for MSM (34 for PWID and 41 for migrants). In countries that provided key-population data, overall, 63%, 40% and 41% of MSM, PWID and migrants living with HIV were virally suppressed, respectively (compared with 68%, 65% and 68% nationally, for countries reporting key-population data). Variation was observed between countries, with higher outcomes in subpopulations in Western Europe compared with Eastern Europe and Central Asia. Few reporting countries can produce the continuum of HIV care for the three key populations. Where data are available, differences exist in outcomes between the general and key populations. While MSM broadly mirror national outcomes (in the West), PWID and migrants experience poorer treatment and viral suppression. Countries must develop continuum measures for key populations to identify and address inequalities. © 2018 British HIV Association.

Costs and cost-effectiveness of HIV community services: quantity and quality of studies published 1986-2011.

PubMed

Beck, Eduard J; Fasawe, Olufunke; Ongpin, Patricia; Ghys, Peter; Avilla, Carlos; De Lay, Paul

2013-06-01

Community services comprise an important part of a country's HIV response. English language cost and cost-effectiveness studies of HIV community services published between 1986 and 2011 were reviewed but only 74 suitable studies were identified, 66% of which were performed in five countries. Mean study scores by continent varied from 42 to 69% of the maximum score, reflecting variation in topics covered and the quality of coverage: 38% of studies covered key and 11% other vulnerable populations - a country's response is most effective and efficient if these populations are identified given they are key to a successful response. Unit costs were estimated using different costing methods and outcomes. Community services will need to routinely collect and analyze information on their use, cost, outcome and impact using standardized costing methods and outcomes. Cost estimates need to be disaggregated into relevant cost items and stratified by severity and existing comorbidities. Expenditure tracking and costing of services are complementary aspects of the health sector 'resource cycle' that feed into a country's investment framework and the development and implementation of national strategic plans.

Targeting global conservation funding to limit immediate biodiversity declines

PubMed Central

Waldron, Anthony; Mooers, Arne O.; Miller, Daniel C.; Nibbelink, Nate; Redding, David; Kuhn, Tyler S.; Roberts, J. Timmons; Gittleman, John L.

2013-01-01

Inadequate funding levels are a major impediment to effective global biodiversity conservation and are likely associated with recent failures to meet United Nations biodiversity targets. Some countries are more severely underfunded than others and therefore represent urgent financial priorities. However, attempts to identify these highly underfunded countries have been hampered for decades by poor and incomplete data on actual spending, coupled with uncertainty and lack of consensus over the relative size of spending gaps. Here, we assemble a global database of annual conservation spending. We then develop a statistical model that explains 86% of variation in conservation expenditures, and use this to identify countries where funding is robustly below expected levels. The 40 most severely underfunded countries contain 32% of all threatened mammalian diversity and include neighbors in some of the world’s most biodiversity-rich areas (Sundaland, Wallacea, and Near Oceania). However, very modest increases in international assistance would achieve a large improvement in the relative adequacy of global conservation finance. Our results could therefore be quickly applied to limit immediate biodiversity losses at relatively little cost. PMID:23818619

Heatwave Early Warning Systems and Adaptation Advice to Reduce Human Health Consequences of Heatwaves

PubMed Central

Lowe, Dianne; Ebi, Kristie L.; Forsberg, Bertil

2011-01-01

Introduction: With climate change, there has been an increase in the frequency, intensity and duration of heatwave events. In response to the devastating mortality and morbidity of recent heatwave events, many countries have introduced heatwave early warning systems (HEWS). HEWS are designed to reduce the avoidable human health consequences of heatwaves through timely notification of prevention measures to vulnerable populations. Objective: To identify the key characteristics of HEWS in European countries to help inform modification of current, and development of, new systems and plans. Methods: We searched the internet to identify HEWS policy or government documents for 33 European countries and requested information from relevant organizations. We translated the HEWS documents and extracted details on the trigger indicators, thresholds for action, notification strategies, message intermediaries, communication and dissemination strategies, prevention strategies recommended and specified target audiences. Findings and Conclusions: Twelve European countries have HEWS. Although there are many similarities among the HEWS, there also are differences in key characteristics that could inform improvements in heatwave early warning plans. PMID:22408593

Targeting global conservation funding to limit immediate biodiversity declines.

PubMed

Waldron, Anthony; Mooers, Arne O; Miller, Daniel C; Nibbelink, Nate; Redding, David; Kuhn, Tyler S; Roberts, J Timmons; Gittleman, John L

2013-07-16

Inadequate funding levels are a major impediment to effective global biodiversity conservation and are likely associated with recent failures to meet United Nations biodiversity targets. Some countries are more severely underfunded than others and therefore represent urgent financial priorities. However, attempts to identify these highly underfunded countries have been hampered for decades by poor and incomplete data on actual spending, coupled with uncertainty and lack of consensus over the relative size of spending gaps. Here, we assemble a global database of annual conservation spending. We then develop a statistical model that explains 86% of variation in conservation expenditures, and use this to identify countries where funding is robustly below expected levels. The 40 most severely underfunded countries contain 32% of all threatened mammalian diversity and include neighbors in some of the world's most biodiversity-rich areas (Sundaland, Wallacea, and Near Oceania). However, very modest increases in international assistance would achieve a large improvement in the relative adequacy of global conservation finance. Our results could therefore be quickly applied to limit immediate biodiversity losses at relatively little cost.

Large scale land acquisitions and REDD+: a synthesis of conflicts and opportunities

NASA Astrophysics Data System (ADS)

Carter, Sarah; Manceur, Ameur M.; Seppelt, Ralf; Hermans-Neumann, Kathleen; Herold, Martin; Verchot, Lou

2017-03-01

Large scale land acquisitions (LSLA), and Reducing Emissions from Deforestation and forest Degradation (REDD+) are both land based phenomena which when occurring in the same area, can compete with each other for land. A quantitative analysis of country characteristics revealed that land available for agriculture, accessibility, and political stability are key explanatory factors for a country being targeted for LSLA. Surprisingly LSLA occur in countries with lower accessibility. Countries with good land availability, poor accessibility and political stability may become future targets if they do not already have LSLA. Countries which high levels of agriculture-driven deforestation and LSLA, should develop interventions which reduce forest loss driven either directly or indirectly by LSLA as part of their REDD+ strategies. Both host country and investor-side policies have been identified which could be used more widely to reduce conflicts between LSLA and REDD+. Findings from this research highlight the need for and can inform the development of national and international policies on land acquisitions including green acquisitions such as REDD+. Land management must be considered with all its objectives—including food security, biodiversity conservation, and climate change mitigation—in a coherent strategy which engages relevant stakeholders. This is not currently occurring and might be a key ingredient to achieve the targets under the Sustainable Development Goals 2 and 15 and 16 (related to food security and sustainable agriculture and the protection of forests) among others.

Women’s autonomy in health care decision-making in developing countries: a synthesis of the literature

PubMed Central

Osamor, Pauline E; Grady, Christine

2016-01-01

Autonomy is considered essential for decision-making in a range of health care situations, from health care seeking and utilization to choosing among treatment options. Evidence suggests that women in developing or low-income countries often have limited autonomy and control over their health decisions. A review of the published empirical literature to identify definitions and methods used to measure women’s autonomy in developing countries describe the relationship between women’s autonomy and their health care decision-making, and identify sociodemographic factors that influence women’s autonomy and decision-making regarding health care was carried out. An integrated literature review using two databases (PubMed and Scopus) was performed. Inclusion criteria were 1) publication in English; 2) original articles; 3) investigations on women’s decision-making autonomy for health and health care utilization; and 4) developing country context. Seventeen articles met inclusion criteria, including eleven from South Asia, five from Africa, and one from Central Asia. Most studies used a definition of autonomy that included independence for women to make their own choices and decisions. Study methods differed in that many used study-specific measures, while others used a set of standardized questions from their countries’ national health surveys. Most studies examined women’s autonomy in the context of reproductive health, while neglecting other types of health care utilized by women. Several studies found that factors, including age, education, and income, affect women’s health care decision-making autonomy. Gaps in existing literature regarding women’s autonomy and health care utilization include gaps in the areas of health care that have been measured, the influence of sex roles and social support, and the use of qualitative studies to provide context and nuance. PMID:27354830

A model for 'reverse innovation' in health care.

PubMed

Depasse, Jacqueline W; Lee, Patrick T

2013-08-30

'Reverse innovation,' a principle well established in the business world, describes the flow of ideas from emerging to more developed economies. There is strong and growing interest in applying this concept to health care, yet there is currently no framework for describing the stages of reverse innovation or identifying opportunities to accelerate the development process. This paper combines the business concept of reverse innovation with diffusion of innovation theory to propose a model for reverse innovation as a way to innovate in health care. Our model includes the following steps: (1) identifying a problem common to lower- and higher-income countries; (2) innovation and spread in the low-income country (LIC); (3) crossover to the higher-income country (HIC); and (4) innovation and spread in the HIC. The crucial populations in this pathway, drawing from diffusion of innovation theory, are LIC innovators, LIC early adopters, and HIC innovators. We illustrate the model with three examples of current reverse innovations. We then propose four sets of specific actions that forward-looking policymakers, entrepreneurs, health system leaders, and researchers may take to accelerate the movement of promising solutions through the reverse innovation pipeline: (1) identify high-priority problems shared by HICs and LICs; (2) create slack for change, especially for LIC innovators, LIC early adopters, and HIC innovators; (3) create spannable social distances between LIC early adopters and HIC innovators; and (4) measure reverse innovation activity globally.

Working toward decreasing infant mortality in developing countries through change in the medical curriculum

PubMed Central

2011-01-01

Background High infant and maternal mortality rates are one of the biggest health issues in Pakistan. Although these rates are given high priority at the national level (Millennium Development Goals 4 and 5, respectively), there has been no significant decrease in them so far. We hypothesize that this lack of success is because the undergraduate curriculum in Pakistan does not match local needs. Currently, the Pakistani medical curriculum deals with issues in maternal and child morbidity and mortality according to Western textbooks. Moreover, these are taught disjointedly through various departments. We undertook curriculum revision to sensitize medical students to maternal and infant mortality issues important in the Pakistani context and educate them about ways to reduce the same through an integrated teaching approach. Methods The major determinants of infant mortality in underdeveloped countries were identified through a literature review covering international research produced over the last 10 years and the Pakistan Demographic Health Survey 2006-07. An interdisciplinary maternal and child health module team was created by the Medical Education Department at Shifa College of Medicine. The curriculum was developed based on the role of identified determinants in infant and maternal mortality. It was delivered by an integrated team without any subject boundaries. Students' knowledge, skills, and attitudes were assessed by multiple modalities and the module itself by student feedback using questionnaires and focus group discussions. Results Assessment and feedback demonstrated that the students had developed a thorough understanding of the complexity of factors that contribute to infant mortality. Students also demonstrated knowledge and skill in counseling, antenatal care, and care of newborns and infants. Conclusions A carefully designed integrated curriculum can help sensitize undergraduate medical students and equip them to identify and address complex issues related to maternal and infant mortality in underdeveloped countries. PMID:21871130

A review of early influences on physical activity and sedentary behaviors of preschool-age children in high-income countries.

PubMed

Lindsay, Ana Cristina; Greaney, Mary L; Wallington, Sherrie F; Mesa, Tatiana; Salas, Carlos F

2017-07-01

Promoting physical activity (PA) is a key component of preventing and controlling childhood obesity. Despite well-documented benefits of PA, globally, rates of PA among young children have declined over the past decades, and most children are not accruing sufficient PA daily. Helping children develop the foundation for PA habits early in life is critical for the promotion of health in childhood and prevention of chronic diseases later in life, and will ultimately promote longer and healthier lives for individuals and the general population. The purpose of this review is to provide a synthesis of current evidence on influences on PA and sedentary behaviors of preschool-age children in high-income countries. A systematic review of three databases was performed. Studies conducted in high-income countries and published from 2000 onward that addressed influences on PA and sedentary behaviors of preschool-age children were identified and reviewed. Additionally, reference lists of identified articles and relevant published reviews were reviewed. Studies that met the following inclusion criteria were considered: (a) sample included preschoolers (age ≤5 years); (b) PA and/or sedentary behaviors or factors associated with PA and/or sedentary behaviors was assessed; (c) published in English; (d) used either quantitative or qualitative methods; and (e) conducted in a high-income country. Data were extracted from selected studies to identify influences on PA and sedentary behaviors of preschool-age children and organized using the social-ecological model according to multiple levels of influence. Results from included studies identify multiple factors that influence PA and sedentary behaviors of young children in high-income countries at the various levels of the social-ecological model including intrapersonal, interpersonal, environmental, organizational, and policy. Given pediatric nurses' role as primary care providers, and their frequent and continued contact with parents and their children throughout childhood through well-child visits, immunization, and minor acute illnesses, they are well positioned to promote and support the development of early healthful PA habits of children starting in early childhood. © 2017 Wiley Periodicals, Inc.

The Process of Choosing a Management Career: Evaluation of Gender and Contextual Dynamics in a Comparative Study of Six Countries--Hungary, Israel, North Cyprus, Turkey, UK and the USA

ERIC Educational Resources Information Center

Tanova, Cem; Karatas-Ozkan, Mine; Inal, Gozde

2008-01-01

Purpose: The aim of this article is to identify the reasons MBA students have for their career choices, and to explore the contextual and gender-related aspects of career choice and development, based on a comparative study carried out with participants in six countries, i.e. Hungary, Israel, North Cyprus, Turkey, the UK and the USA. The paper…

Sources and Focus of Health Development Assistance, 1990-2014.

PubMed

Dieleman, Joseph L; Graves, Casey; Johnson, Elizabeth; Templin, Tara; Birger, Maxwell; Hamavid, Hannah; Freeman, Michael; Leach-Kemon, Katherine; Singh, Lavanya; Haakenstad, Annie; Murray, Christopher J L

2015-06-16

The governments of high-income countries and private organizations provide billions of dollars to developing countries for health. This type of development assistance can have a critical role in ensuring that life-saving health interventions reach populations in need. To identify the amount of development assistance that countries and organizations provided for health and to determine the health areas that received these funds. Budget, revenue, and expenditure data on the primary agencies and organizations (n = 38) that provided resources to developing countries (n = 146-183, depending on the year) for health from 1990 through 2014 were collected. For each channel (the international agency or organization that directed the resources toward the implementing institution or government), the source and recipient of the development assistance were determined and redundant accounting of the same dollar, which occurs when channels transfer funds among each other, was removed. This research derived the flow of resources from source to intermediary channel to recipient. Development assistance for health (DAH) was divided into 11 mutually exclusive health focus areas, such that every dollar of development assistance was assigned only 1 health focus area. Since 1990, $458.0 billion of development assistance has been provided to maintain or improve health in developing countries. The largest source of funding was the US government, which provided $143.1 billion between 1990 and 2014, including $12.4 billion in 2014. Of resources that originated with the US government, 70.6% were provided through US government agencies, and 41.0% were allocated for human immunodeficiency virus (HIV)/AIDS. The second largest source of development assistance for health was private philanthropic donors, including the Bill and Melinda Gates Foundation and other private foundations, which provided $69.9 billion between 1990 and 2014, including $6.2 billion in 2014. These resources were provided primarily through private foundations and nongovernmental organizations and were allocated for a diverse set of health focus areas. Since 1990, 28.0% of all DAH was allocated for maternal health and newborn and child health; 23.2% for HIV/AIDS, 4.3% for malaria, 2.8% for tuberculosis, and 1.5% for noncommunicable diseases. Between 2000 and 2010, DAH increased 11.3% annually. However, since 2010, total DAH has not increased as substantially. Funding for health in developing countries has increased substantially since 1990, with a focus on HIV/AIDS, maternal health, and newborn and child health. Funding from the US government has played a substantial role in this expansion. Funding for noncommunicable diseases has been limited. Understanding how funding patterns have changed across time and the priorities of sources of international funding across distinct channels, recipients, and health focus areas may help identify where funding gaps persist and where cost-effective interventions could save lives.

Analysis of industrial pollution prevention programs in selected Asian countries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chiu, S.Y.

1995-05-01

Industrialization in developing countries is causing increasing environmental damage. Pollution prevention (P2) is an emerging environmental concept that could help developing countries achieve leapfrog goals, bypassing old and pollutive technologies and minimizing traditional control practices. The current P2 promotion activities in Hong Kong, the Republic of Korea, the Philippines, Singapore, Taiwan, and Thailand are discussed. These programs, generally initiated in the last 5 years, are classified into five categories: awareness promotion, education and training, information transfer, technical assistance, and financial incentives. All important at the early stages of P2 promotion, these programs should inform industries of the benefits of P2more » and help them identify applicable P2 measures. Participation in these programs is voluntary. The limited data indicate that adoption of P2 measures in these countries is not yet widespread. Recommendations for expanding P2 promotion activities include (1) strengthening the design and enforcement of environmental regulations; (2) providing P2 training and education to government workers, nongovernmental organizations and labor unions officials, university faculties, and news media; (3) tracking the progress of P2 programs; (4) implementing selected P2 mandatory measures; (5) identifying cleaner production technologies for use in new facilities; (6) implementing special programs for small and medium enterprises; and (7) expanding P2 promotion to other sectors, such as agriculture and transportation, and encouraging green design and green consumerism.« less

Testing the relationship between personality characteristics, contextual factors and entrepreneurial intentions in a developing country.

PubMed

Karimi, Saeid; Biemans, Harm J A; Naderi Mahdei, Karim; Lans, Thomas; Chizari, Mohammad; Mulder, Martin

2017-06-01

Drawing upon the theory of planned behaviour (TPB), we developed and tested a conceptual model which integrates both internal personality factors and external contextual factors to determine their associations with motivational factors and entrepreneurial intentions (EIs). We then investigated if the model of EI applies in a developing country, namely Iran. We also set out to identify the most relevant factors for EI within this developing country context. Do distal predictors of EI including personality factors (i.e. need for achievement, risk taking and locus of control) and contextual factors (i.e. perceived barriers and support) significantly relate to EI via proximal predictors including motivational factors (i.e. attitudes towards entrepreneurship and perceived behavioural control [PBC])? Data were collected on 331 students from 7 public universities. The findings support the TPB for EI in Iran. All three motivational factors related to EI, but PBC showed the strongest association, which is different than in developed country contexts. Possible explanations for these differences are discussed. All three personality characteristics indirectly related to EI via the proximal attitudes towards entrepreneurship and PBC. Perceived contextual support and barriers indirectly related to EI via proximal PBC while perceived barriers also directly related to EI. © 2015 International Union of Psychological Science.

Youth Organizing: From Youth Development to School Reform

ERIC Educational Resources Information Center

Warren, Mark R.; Mira, Meredith; Nikundiwe, Thomas

2008-01-01

Over the past twenty years, youth organizing has grown across the country. Through organizing, young people identify issues of concern and mobilize their peers to build action campaigns to achieve their objectives. Youth organizing has been appreciated for its contributions to youth and community development. The authors use two case studies to…

Motivation in Cross-Cultural Settings: A Papua New Guinea Psychometric Study

ERIC Educational Resources Information Center

Nelson, Genevieve F.; O'Mara, Alison J.; McInerney, Dennis M.; Dowson, Martin

2006-01-01

There is a paucity of research on motivation and education in developing countries. Although psychological constructs relating to academic engagement and achievement have been identified and researched in a number of cross-cultural settings this body of research has rarely been extended to the developing world. The processes by which students from…

Better Skills, Better Jobs, Better Lives: A Strategic Approach to Skills Policies

ERIC Educational Resources Information Center

OECD Publishing (NJ3), 2012

2012-01-01

Recognising both the complexity of skills policies and the potential for peer learning, the OECD has developed a global Skills Strategy that helps countries to identify the strengths and weaknesses of their national skills systems, benchmark them internationally, and develop policies that can transform better skills into better jobs, economic…

On the Development of Citizenship Education Outlook in China

ERIC Educational Resources Information Center

Xiaoman, Zhu; Xiujun, Feng

2008-01-01

A source-identifying and comparative study of the development of the outlook on citizenship education in China and the Western countries indicates that there emerges a tendency of similar orientations in terms of relations between citizens and the state and society, between citizens' rights and obligations and between citizenship education and…

Initiating a Developmental Motor Skills Program for Identified Primary Students.

ERIC Educational Resources Information Center

Harville, Valerie Terrill

A physical education specialist at an elementary school in one of the fastest growing sections of the country developed and implemented a developmental motor skills program for primary school students. The program focused on: (1) developing a method of referring students for testing; (2) providing a specialized motor diagnostic test; (3) improving…

Incremental costs associated with myocardial infarction and stroke in patients with type 2 diabetes mellitus: an overview for economic modeling.

PubMed

Brennan, Victoria K; Colosia, Ann D; Copley-Merriman, Catherine; Mauskopf, Josephine; Hass, Bastian; Palencia, Roberto

2014-07-01

To identify cost estimates related to myocardial infarction (MI) or stroke in patients with type 2 diabetes mellitus (T2DM) for use in economic models. A systematic literature review was conducted. Electronic databases and conference abstracts were screened against inclusion criteria, which included studies performed in patients who had T2DM before experiencing an MI or stroke. Primary cost studies and economic models were included. Costs were converted to 2012 pounds sterling. Fifty-four studies were identified: 13 primary cost studies and 41 economic evaluations using secondary sources for complication costs. Primary studies provided costs from 10 countries. Estimates for a fatal event ranged from £2482-£5222 for MI and from £4900-£6694 for stroke. Costs for the year a non-fatal event occurred ranged from £5071-£29,249 for MI and from £5171-£38,732 for stroke. Annual follow-up costs ranged from £945-£1616 for an MI and from £4704-£12,926 for a stroke. Economic evaluations from 12 countries were identified, and costs of complications showed similar variability to the primary studies. The costs identified within primary studies varied between and within countries. Many studies used costs estimated in studies not specific to patients with T2DM. Data gaps included a detailed breakdown of resource use, which affected the ability to compare data across countries. In the development of economic models for patients with T2DM, the use of accurate estimates of costs associated with MI and stroke is important. When country-specific costs are not available, clear justification for the choice of estimates should be provided.

Access in Community College Policy: An Examination of the Social and Political Space Afforded Disabled Students in California Community College Policies

ERIC Educational Resources Information Center

Hoggatt, Michael J.

2017-01-01

Access to education has long been seen as a fundamental element of a developed country. Specifically, the relative availability and access to education by various constituent groups has been identified as an essential metric in educational evaluation. Yet, individuals with disabilities have been identified as being underrepresented within…

Forest and rangeland ecosystem condition indicators: identifying national areas of opportunity using data development analysis

Treesearch

John G. Hof; Curtis H. Flather; Tony J. Baltic; Rudy M. King

2004-01-01

This article reports the methodology and results of a data envelopment analysis (DEA) that attempts to identify areas in the country where there is maximum potential for improving the forest and rangeland condition, based on 12 indicator variables. This analysis differs from previous DEA studies in that the primary variables are measures of human activity and...

Clostridium difficile infection in low- and middle-human development index countries: a systematic review.

PubMed

Forrester, Joseph D; Cai, Lawrence Z; Mbanje, Chenesa; Rinderknecht, Tanya N; Wren, Sherry M

2017-10-01

To describe the impact and epidemiology of Clostridium difficile infection (CDI) in low- and middle-human development index (LMHDI) countries. Prospectively registered, systematic literature review of existing literature in the PubMed, Ovid and Web of Science databases describing the epidemiology and management of C. difficile in LMHDI countries. Risk factors were compared between studies when available. Of the 218 abstracts identified after applying search criteria, 25 studies were reviewed in detail. The weighted pooled infection rate among symptomatic non-immunosuppressed inpatients was 15.8% (95% CI 12.1-19.5%) and was 10.1% (95% CI 3.0-17.2%) among symptomatic outpatients. Subgroup analysis of immunosuppressed patient populations revealed pooled infection rates similar to non-immunosuppressed patient populations. Risk factor analysis was infrequently performed. While the percentages of patients with CDI in LMHDI countries among the reviewed studies are lower than expected, there remains a paucity of epidemiologic data evaluating burden of C. difficile infection in these settings. © 2017 John Wiley & Sons Ltd.

Prospects and problems of medical tourism in Bangladesh.

PubMed

Mamun, Muhammad Z; Andaleeb, Syed Saad

2013-01-01

The growing trend of Bangladeshi patients travelling abroad for medical services has led to some soul-searching in policy circles. While other countries of the Southeast Asia region are profiting from medical tourism, Bangladesh not only lags behind, it also loses patients to these countries in a continuous stream. This exodus for medical treatment is seemingly driven by the higher perceived quality of treatment abroad, despite the fact that similar treatment is available more cost-effectively within the country. Certainly the Bangladesh health care system is not without its problenis, which have diminished the perception of quality in the sector. Thus, this study focuses on key factors for Bangladeshi health service providers to address. By doing so, they will be better able to develop the local health care sector and retain Bangladeshi patients within the country. Subsequently, by identifying strategic niches, Bangladesh could focus on delivering higher quality health care services to develop medical tourism and attract patients from abroad in specific categories of health care.

Pediatric burns mortality risk factors in a developing country’s tertiary burns intensive care unit

PubMed Central

Agbenorku, Pius; Agbenorku, Manolo; Fiifi-Yankson, Papa Kwesi

2013-01-01

Aim: This study aimed at identifying risk factors related to pediatric burns mortality in a middle income country such as Ghana. Methods: The data for the three years retrospective study (May 2009 – April 2012) was obtained from the pediatric burn admissions records and patients’ folders of the Reconstructive Plastic Surgery & Burns Unit (RPSBU), Komfo Anokye Teaching Hospital (KATH), Ghana. Data retrieved included: Demographic features, Total Burned Surface Area (TBSA) incurred; Aetiology of burns; Duration of the admission; Outcome of admission; Part of the body affected and Cost incurred. Ethical approval for this study was obtained from the KNUST-SMS/KATH Committee on Human Research, Publications and Ethics. Data analyses were performed with SPSS 17.0 version. Results: Information on 197 patients was completely retrieved for the study. Burns mortality rate for the study was identified to be 21.3% (N=42). The mean age of the 42 dead patients was 3.7±0.3 years, ranging from 0-13 years, while, males (54.8%, N= 23) outnumbered females (45.2%, N=19). The TBSA burned interquartile range was 48%. In terms of etiology of burns Scald (73.8%, N=31) was the commonest cause of injury. Mortality risk factors identified were Age <6 years (P=0.028); Scald especially hot water and soup (P=0.016); TBSA >36% (P=0.028) and Inhalation injury (P=0.040). Conclusion: Age, scald, TBSA and Inhalation Injury were identified as pediatric burns mortality risk factors in a developing country such as Ghana’s RPSBU. These identified factors will serve as a guideline for plastic surgeons and other health professionals practicing in countries such as Ghana. PMID:23875121

Migration and mental health: a study of low-income Ethiopian women working in Middle Eastern countries.

PubMed

Anbesse, Birke; Hanlon, Charlotte; Alem, Atalay; Packer, Samuel; Whitley, Rob

2009-11-01

Few studies have explored influences on mental health of migrants moving between non-Western countries. Focus group discussions were used to explore the experiences of Ethiopian female domestic migrants to Middle Eastern countries, comparing those who developed severe mental illness with those remaining mentally well. Prominent self-identified threats to mental health included exploitative treatment, enforced cultural isolation, undermining of cultural identity and disappointment in not achieving expectations. Participants countered these risks by affirming their cultural identity and establishing socio-cultural supports. Mental health of migrant domestic workers may be jeopardized by stressors, leading to experience of social defeat.

Status of health sector strategic plans in five countries of the WHO African Region.

PubMed

Barry, S P; Sambo, L G; Bakeera, S; Kirigia, J M; Diarra-Nama, A J

2009-01-01

To assess the adequacy of the existing strategic plans and compare the format and content of health sector strategic plans with the guidelines in selected countries of the African region. The health strategic plans for Gambia, Liberia, Malawi, Tanzania and Uganda, which are kept at the WHO/AFRO, were reviewed. All health strategic plans among the Anglophone countries (Gambia, Ghana, Kenya, Liberia, Malawi, Mauritius, Tanzania, Uganda, Zambia and Zimbabwe) that were developed after the year 2000 were eligible for inclusion. Fifty percent of these countries that fitted this criterion were randomly selected. They included Gambia, Liberia, Malawi, Tanzania and Uganda. The analysis framework used in the review included situation analysis; an assessment of appropriateness of strategies that are selected; well developed indicators for each strategy; the match between the service and outcomes targets with available resources; and existence of a clear framework for partnership engagement for implementation. Most of the strategic plans identify key ill health conditions and their contributing factors. Health service and resource gaps are described but not quantified in the Botswana, Gambia, Malawi, Tanzania strategic documents. Most of the plans selected strategies that related to the situational analysis. Generally, countries' plans had clear indicators. Matching service and outcome targets to available resources was the least addressed area in majority of the plans. Most of the strategic plans identified stakeholders and acknowledged their participation in the implementation, providing different levels of comprehensiveness. Some of the areas that are well addressed according to the analysis framework included: addressing the strategic concerns of the health policies; identifying key partners for implementation; and selection of appropriate strategies. The following areas needed more emphasis: quantification of health system gaps; setting targets that are cognisant of the local resource base; and being more explicit in what stakeholders' roles are during the implementation period.

Project analysis procedures for an OPEC country: case study of Qatar's Northwest Dome Gas Project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ali, A.B.; Khalifah, H.

1986-01-01

The discovery of oil in most OPEC countries in the 1940s changed the economies of these countries from a state of capital shortage and stagnation to a state of capital surplus and economic growth. This growth, however, is lopsided. Oil production and export dominate the gross domestic products (GDPs) of those economies. Concern arising during the 1970s about overdependence on crude oil export as the main source of national income has resulted in the initiation of various industrial development programs in OPEC states aiming to diversify their economies. This study was conducted with two primary objectives: (1) to identify andmore » understand the features of selected OPEC countries' development problems, strategies and plans, focusing on the role of oil and gas resources and opportunities for diversification, and (2) to suggest an appropriate development strategy, with project evaluation implications, for capital-abundant, labor-scarce OPEC countries in the Gulf region such as Qatar. This proposed approach is designed to evaluate the project from its contribution to the national income, people's welfare, the expansion of the economy's absorptive capacity, and relief of the economy's dependence on nonrenewable resources. The Northwest Dome Gas Project in Qatar was selected as an illustrative case study for this approach.« less

A case study of polypharmacy management in nine European countries: Implications for change management and implementation

PubMed Central

MacLure, Katie; Stewart, Derek; Kempen, Thomas; Mair, Alpana; Castel-Branco, Margarida; Codina, Carles; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Illario, Maddalena; Junius-Walker, Ulrike; Kampolis, Christos F.; Kardas, Przemyslaw; Lewek, Pawel; Malva, João; Menditto, Enrica; Scullin, Claire; Wiese, Birgitt

2018-01-01

Background Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Methods Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Results Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Conclusion Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives. PMID:29668763

Local perceptions on factors influencing the introduction of international healthcare accreditation in Pakistan.

PubMed

Sax, Sylvia; Marx, Michael

2014-12-01

One contributor to poor health outcomes in developing countries is weak health systems; key to strengthening them are interventions to improve quality of health services. Though the value of healthcare accreditation is increasingly recognized, there are few case studies exploring its adaptation in developing countries. The aim of our study in Pakistan was to identify perceived factors influencing the adaptation of international healthcare accreditation within a developing country context. We used qualitative methods including semi-structured interviews, a structured group discussion, focus groups and non-participant observation of management meetings. Data analysis used a grounded theory approach and a conceptual framework adapted from implementation science. Using our conceptual framework categories of 'inner' and 'outer' setting, we found six perceived inner health system factors that could influence the introduction of healthcare accreditation and two 'outer' setting factors, perceived as external to the health system but able to influence its introduction. Our research identified that there is no 'one size fits all' approach to introducing healthcare accreditation as a means to improve healthcare quality. Those planning to support healthcare accreditation, such as national and provincial ministries and international development partners, need to understand how the three components of healthcare accreditation fit into the local health system and into the broader political and social environment. In our setting this included moving to supportive and transparent external evaluation mechanisms, with a first step of using locally developed and agreed standards. In addition, sustainable implementation of the three components was seen as a major challenge, especially establishment of a well-managed, transparent accreditation agency able to lead processes such as training and support for peer surveyors. Consideration of local change mechanisms and cultural practices is important in designing a local accreditation approach. The results of our study are important for health systems strengthening in Pakistan and in other developing countries. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Determinants of maternal immunization in developing countries.

PubMed

Pathirana, Jayani; Nkambule, Jerome; Black, Steven

2015-06-12

Maternal immunization is an effective intervention to protect newborns and young infants from infections when their immune response is immature. Tetanus toxoid vaccination of pregnant women is the most widely implemented maternal vaccine in developing countries where neonatal mortality is the highest. We identified barriers to maternal tetanus vaccination in developing African and Asian countries to identify means of improving maternal immunization platforms in these countries. We categorized barriers into health system, health care provider and patient barriers to maternal tetanus immunization and conducted a literature review on each category. Due to limited literature from Africa, we conducted a pilot survey of health care providers in Malawi on barriers they experience in immunizing pregnant women. The major barriers of the health system are due to inadequate financial and human resources which translate to inadequate vaccination services delivery and logistics management. Health care providers are limited by poor attendance of Antenatal Care and inadequate knowledge on vaccinating pregnant women. Patient barriers are due to lack of education and knowledge on pregnancy immunization and socioeconomic factors such as low income and high parity. There are several factors that affect maternal tetanus immunization. Increasing knowledge in health care providers and patients, increasing antenatal care attendance and outreach activities will aid the uptake of maternal immunization. Health system barriers are more difficult to address requiring an improvement of overall immunization services. Further analyses of maternal immunization specific barriers and the means of addressing them are required to strengthen the existing program and provide a more efficient delivery system for additional maternal vaccines. Copyright © 2015 Elsevier Ltd. All rights reserved.

Are French general practitioners consulted before travel to developing countries? A cross-sectional study conducted in a French airport.

PubMed

Rovira, C; Buffel du Vaure, C; Partouche, H

2015-08-01

General practitioners (GPs) could play a central role in preventing travel-related health issues. The aim of this study was to assess, in travellers departing to developing countries from a French airport, the proportion of individuals having sought GP counseling before departure and to identify determinants for having consulted a GP. Cross-sectional study conducted between November 2012 and July 2013, in all adults living in France. Sociodemographic, health characteristics, type of travel and resources consulted before departure were collected. A descriptive analysis was performed. Determinants for having consulted a GP before departure were investigated using a logistic regression analysis. Of the 360 travellers included, 230 (64%) sought health counseling before departure. GPs were the main source of information for 134 (58%) travellers having sought health information and the only one for 49 (21%). Almost half of the travellers (48%) departing to sub-Saharan countries did not seek health counseling from a medical doctor (GP, non-GP specialist, specialist consulted in an international vaccination center or occupational physician). Individuals significantly more likely to travel without having consulted a GP were young and male, held foreign nationality, had travelled more than five times before, rarely consulted their GP and were travelling to a non-malarious area. GPs were the main but not the only source of information and counseling before traveling to a developing country. This study helps identify the characteristics of individuals likely to travel without having consulted a GP before departure. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Pharmaceutical strategic purchasing requirements in Iran: Price interventions and the related effective factors.

PubMed

Bastani, Peivand; Dinarvand, Rasoul; SamadBeik, Mahnaz; Pourmohammadi, Kimia

2016-01-01

Pharmaceutical access for the poor is an essential factor in developing countries that can be improved through strategic purchasing. This study was conducted to identify the elements affecting price in order to enable insurance organizations to put strategic purchasing into practice. This was a qualitative study conducted through content analysis with an inductive approach applying a five-stage framework analysis (familiarization, identifying a thematic framework, indexing, mapping, and interpretation). Data analysis was started right after transcribing each interview applying ATLAS.ti. Data were saturated after 32 semi-structured interviews by experts. These key informants were selected purposefully and through snowball sampling. Findings showed that there are four main themes as Pharmaceutical Strategic Purchasing Requirements in Iran as follows essential and structural factors, international factors, economical factors, and legal factors. Moreover, totally 14 related sub-themes were extracted in this area as the main effective variables. It seems that paying adequate attention to the four present themes and 14 sub-themes affecting price can enable health system policy-makers of developing countries like Iran to make the best decisions through strategic purchasing of drugs by the main insurers in order to improve access and health in the country.

Improving Access to Essential Medicines: How Health Concerns can be Prioritised in the Global Governance System

PubMed Central

Sridhar, Devi

2008-01-01

This paper discusses the politics of access to essential medicines and identifies ‘space’ in the current system where health concerns can be strengthened relative to trade. This issue is addressed from a global governance perspective focusing on the main actors who can have the greatest impact. These include developing country coalitions and citizens in developed countries though participation in civil society organisations. These actors have combined forces to tackle this issue successfully, resulting in the 2001 Doha Declaration on Public Health. The collaboration has been so powerful due to the assistance of the media as well as the decision to compromise with pharmaceutical companies and their host countries. To improve access to essential medicines, six C's are needed: coalitions, civil society, citizenship, compromise, communication and collaboration. PMID:19461853

Utilization of open source electronic health record around the world: A systematic review.

PubMed

Aminpour, Farzaneh; Sadoughi, Farahnaz; Ahamdi, Maryam

2014-01-01

Many projects on developing Electronic Health Record (EHR) systems have been carried out in many countries. The current study was conducted to review the published data on the utilization of open source EHR systems in different countries all over the world. Using free text and keyword search techniques, six bibliographic databases were searched for related articles. The identified papers were screened and reviewed during a string of stages for the irrelevancy and validity. The findings showed that open source EHRs have been wildly used by source limited regions in all continents, especially in Sub-Saharan Africa and South America. It would create opportunities to improve national healthcare level especially in developing countries with minimal financial resources. Open source technology is a solution to overcome the problems of high-costs and inflexibility associated with the proprietary health information systems.

Emergence of biopharmaceutical innovators in China, India, Brazil, and South Africa as global competitors and collaborators.

PubMed

Rezaie, Rahim; McGahan, Anita M; Frew, Sarah E; Daar, Abdallah S; Singer, Peter A

2012-06-06

Biopharmaceutical innovation has had a profound health and economic impact globally. Developed countries have traditionally been the source of most innovations as well as the destination for the resulting economic and health benefits. As a result, most prior research on this sector has focused on developed countries. This paper seeks to fill the gap in research on emerging markets by analyzing factors that influence innovative activity in the indigenous biopharmaceutical sectors of China, India, Brazil, and South Africa. Using qualitative research methodologies, this paper a) shows how biopharmaceutical innovation is taking place within the entrepreneurial sectors of these emerging markets, b) identifies common challenges that indigenous entrepreneurs face, c) highlights the key role played by the state, and d) reveals that the transition to innovation by companies in the emerging markets is characterized by increased global integration. It suggests that biopharmaceutical innovators in emerging markets are capitalizing on opportunities to participate in the drug development value chain and thus developing capabilities and relationships for competing globally both with and against established companies headquartered in developed countries.

Emergence of biopharmaceutical innovators in China, India, Brazil, and South Africa as global competitors and collaborators

PubMed Central

2012-01-01

Biopharmaceutical innovation has had a profound health and economic impact globally. Developed countries have traditionally been the source of most innovations as well as the destination for the resulting economic and health benefits. As a result, most prior research on this sector has focused on developed countries. This paper seeks to fill the gap in research on emerging markets by analyzing factors that influence innovative activity in the indigenous biopharmaceutical sectors of China, India, Brazil, and South Africa. Using qualitative research methodologies, this paper a) shows how biopharmaceutical innovation is taking place within the entrepreneurial sectors of these emerging markets, b) identifies common challenges that indigenous entrepreneurs face, c) highlights the key role played by the state, and d) reveals that the transition to innovation by companies in the emerging markets is characterized by increased global integration. It suggests that biopharmaceutical innovators in emerging markets are capitalizing on opportunities to participate in the drug development value chain and thus developing capabilities and relationships for competing globally both with and against established companies headquartered in developed countries. PMID:22672351

Questions About Cervical and Breast Cancer Screening Knowledge, Practice, and Outcomes: A Review of Demographic and Health Surveys.

PubMed

Viens, Laura; Perin, Doug; Senkomago, Virginia; Neri, Antonio; Saraiya, Mona

2017-05-01

United Nation's Sustainable Development Goals and the World Health Organization's Global Monitoring Framework support a strong global commitment to reducing the high burden of cervical and breast cancers among low- and middle-income countries. Strategies include vaccination, screening, and early diagnosis. Population-based surveys, such as those conducted by the Demographic and Health Surveys (DHS) Program, can collect the information needed to guide cancer control efforts in a standardized comparable manner. We identified and evaluated the breadth of breast and cervical cancer screening information that was collected by the DHS from 1984 through 2015. Then, we determined if these surveys currently provide the specific and measurable data about both the quantity and quality of cancer screening needed to guide national efforts to reduce the overall effects of cervical and breast cancers. We searched the DHS website to identify surveys conducted between the start of the DHS Program in 1984 and November 2015 that included questions about breast and cervical cancer screening. The relevant questions were extracted from the questionnaire, translated into English, and grouped by themes. Of the 90 countries where DHS surveys have been implemented, cervical cancer screening questions were included in 22 countries (24.4%) and breast cancer screening questions in 18 countries (20.0%). The common themes identified were disease knowledge, screening knowledge, screening practice, and screening outcomes. Most countries with survey questionnaires available for review addressed at least one aspect of screening practice (88.9% of cervical and 87.5% of breast), although few countries queried knowledge and outcomes. Questions that assess varied aspects of breast and cervical cancer screening have been incorporated into relatively few DHS surveys. The themes identified could guide the design of a standard set of questions for use in future population-based surveys and enable evaluation beyond the existence of screening, which would include assessment of the quality and impact of cervical and breast cancer screening.

How Can Eastern/Southern Mediterranean Countries Resolve Quality and Safety Issues in Transfusion Medicine?

PubMed Central

Haddad, Antoine; Bou Assi, Tarek; Garraud, Olivier

2018-01-01

Unlike their Western counterparts, some of the Eastern/Southern Mediterranean countries lack centralized coordinated blood transfusion services leading to an unequal blood safety level. This was recently highlighted by a recent World Health Organization (WHO) regional committee report in which WHO urges these countries to establish and implement a national blood system with well-coordinated blood transfusion activities and to make attempts to reach 100% voluntary non-remunerated blood donation. The objective is thus to meet the same levels or standards as Western countries in term of self-sufficiency and blood safety. This raises the question whether these countries can either comply with Western countries’ guidelines and experiences or develop their own safety scheme based on proper sociopolitical and economic features. Another option is to identify efficient and cost-effective strategies setup successfully in neighbor countries sharing cultural and economic features. To address this issue—and make an attempt to achieve this goal—we designed a number of surveys specifically addressed to Mediterranean countries, which were sent out to the national authorities; so far, five surveys aim at covering all aspects in blood collection, processing, testing, inventory and distribution, as well as patient immune-hematological testing and follow-up (including surveillance and vigilances). It is anticipated that such practice can help identifying and then sharing the more successful and cost-effective experiences, and be really focused on Mediterranean areas while not necessarily copying and pasting experiences designed for Western/Northern areas with significantly distinct situations. PMID:29536009

International testicular cancer incidence trends: generational transitions in 38 countries 1900-1990.

PubMed

Znaor, Ariana; Lortet-Tieulent, Joannie; Laversanne, Mathieu; Jemal, Ahmedin; Bray, Freddie

2015-01-01

Rapid increases in testicular cancer incidence have marked the second half of the last century. While these secular rises, observed mainly in countries attaining the highest levels of human development, appear to have attenuated in the last decade, rates continue to increase in countries transiting toward high developmental levels. The purpose of our study was to provide a comprehensive analysis and presentation of the cohort-specific trends in testicular cancer incidence rates in 38 countries worldwide. We used an augmented version of the Cancer Incidence in Five Continents series to analyze testicular cancer incidence in men aged 15-54 in 38 countries, via age-period-cohort analysis. In many European countries, the USA, Canada, Australia, and New Zealand, there is a continuation of the increasing risk among successive generations, yet rates are attenuating in male cohorts born since the 1970s in several Northern European countries, in contrast to the steeply increasing trends in recent cohorts in Southern Europe. Incidence rates have also been increasing in the populations traditionally at rather low risk, such as in the Philippines, Singapore, China, and Costa Rica. The attenuation of testicular cancer risk in younger generations (in the most developed countries) alongside concomitant increases (in countries undergoing developmental change) is indicative of a global transition in the risk of testicular cancer. While identifying the underlying causes remains a major challenge, increasing awareness and adapting national healthcare systems to accommodate a growing burden of testicular cancer may prevent future avoidable deaths in young men.

Social cohesion matters in health

PubMed Central

2013-01-01

Introduction The concept of social cohesion has invoked debate due to the vagueness of its definition and the limitations of current measurements. This paper attempts to examine the concept of social cohesion, develop measurements, and investigate the relationship between social cohesion and individual health. Methods This study used a multilevel study design. The individual-level samples from 29 high-income countries were obtained from the 2000 World Value Survey (WVS) and the 2002 European Value Survey. National-level social cohesion statistics were obtained from Organization of Economic Cooperation and Development datasets, World Development Indicators, and Asian Development Bank key indicators for the year 2000, and from aggregating responses from the WVS. In total 47,923 individuals were included in this study. The factor analysis was applied to identify dimensions of social cohesion, which were used as entities in the cluster analysis to generate a regime typology of social cohesion. Then, multilevel regression models were applied to assess the influences of social cohesion on an individual’s self-rated health. Results and discussion Factor analysis identified five dimensions of social cohesion: social equality, social inclusion, social development, social capital, and social diversity. Then, the cluster analysis revealed five regimes of social cohesion. A multi-level analysis showed that respondents in countries with higher social inclusion, social capital, and social diversity were more likely to report good health above and beyond individual-level characteristics. Conclusions This study is an innovative effort to incorporate different aspects of social cohesion. This study suggests that social cohesion was associated with individual self-rated after controlling individual characteristics. To achieve further advancement in population health, developed countries should consider policies that would foster a society with a high level of social inclusion, social capital, and social diversity. Future research could focus on identifying possible pathways by which social cohesion influences various health outcomes. PMID:24165541

Status of national health research systems in ten countries of the WHO African Region.

PubMed

Kirigia, Joses M; Wambebe, Charles

2006-10-19

The World Health Organization (WHO) Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4) which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country) bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. The key findings were as follows: the response rate was 21.7% (10/46); three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS); two countries confirmed the existence of a functional national health research management forum (NHRMF); six countries had a functional ethical review committee (ERC); five countries had a scientific review committee (SRC); five countries reported the existence of health institutions with institutional review committees (IRC); two countries had a health research programme; and three countries had a national health research institute (NHRI) and a faculty of health sciences in the national university that conducted health research. Four out of the ten countries reported that they had a budget line for health research in the Ministry of Health budget document. Governments of countries of the African Region, with the support of development partners, private sector and civil society, urgently need to improve the research policy environment by developing health research policies, strategic plans, legislations, programmes and rolling plans with the involvement of all stakeholders, e.g., relevant sectors, research organizations, communities, industry and donors. In a nutshell, development of high-performing national health research systems in the countries of the WHO African Region, though optional, is an imperative. It may be the only way of breaking free from the current vicious cycle of ill-health and poverty.

Status of national health research systems in ten countries of the WHO African Region

PubMed Central

Kirigia, Joses M; Wambebe, Charles

2006-01-01

Background The World Health Organization (WHO) Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4) which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. Methods A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country) bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. Results The key findings were as follows: the response rate was 21.7% (10/46); three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS); two countries confirmed the existence of a functional national health research management forum (NHRMF); six countries had a functional ethical review committee (ERC); five countries had a scientific review committee (SRC); five countries reported the existence of health institutions with institutional review committees (IRC); two countries had a health research programme; and three countries had a national health research institute (NHRI) and a faculty of health sciences in the national university that conducted health research. Four out of the ten countries reported that they had a budget line for health research in the Ministry of Health budget document. Conclusion Governments of countries of the African Region, with the support of development partners, private sector and civil society, urgently need to improve the research policy environment by developing health research policies, strategic plans, legislations, programmes and rolling plans with the involvement of all stakeholders, e.g., relevant sectors, research organizations, communities, industry and donors. In a nutshell, development of high-performing national health research systems in the countries of the WHO African Region, though optional, is an imperative. It may be the only way of breaking free from the current vicious cycle of ill-health and poverty. PMID:17052326

Survey of stranded gas and delivered costs to Europe of selected gas resources

USGS Publications Warehouse

Attanasi, E.D.; Freeman, P.A.

2011-01-01

Two important trends affecting the expected growth of global gas markets are (1) the shift by many industrialized countries from coal-fired electricity generation to the use of natural gas to generate electricity and (2) the industrialization of the heavily populated Asian countries of India and China. This paper surveys discovered gas in stranded conventional gas accumulations and presents estimates of the cost of developing and producing stranded gas in selected countries. Stranded gas is natural gas in discovered or identified fields that is not currently commercially producible for either physical or economic reasons. Published reserves of gas at the global level do not distinguish between volumes of gas in producing fields and volumes in nonproducing fields. Data on stranded gas reported here-that is the volumes, geographical distribution, and size distributions of stranded gas fields at the country and regional level-are based on the examination of individual-field data and represent a significant improvement in information available to industry and government decision makers. Globally, stranded gas is pervasive, but large volumes in large accumulations are concentrated in only a few areas. The cost component of the paper focuses on stranded conventional gas accumulations in Africa and South America that have the potential to augment supplies to Europe. The methods described for the computation of extraction and transport costs are innovative in that they use information on the sizes and geographical distribution of the identified stranded gas fields. The costs are based on industry data specific to the country and geologic basin where the stranded gas is located. Gas supplies to Europe can be increased significantly at competitive costs by the development of stranded gas. Net extraction costs of producing the identified gas depend critically on the natural-gas-liquids (NGLs) content, the prevailing prices of liquids, the size of the gas accumulation, and the deposit's location. The diversity of the distribution of stranded gas is one obstacle to the exercise of market power by the Gas Exporting Countries Forum (GECF). Copyright ?? 2011 Society of Petroleum Engineers.

Reviving the Mediterranean Olive Community

ERIC Educational Resources Information Center

Zaferatos, Nicholas C.

2011-01-01

This article presents the findings of a collaborative investigation by six nongovernment organisations (NGOs) from five European-Mediterranean countries to identify a framework for reversing rural marginalisation in Mediterranean communities through sustainable forms of community-based agricultural development. The project brought together…

International perspectives on work-family policies: lessons from the world's most competitive economies.

PubMed

Earle, Alison; Mokomane, Zitha; Heymann, Jody

2011-01-01

The United States does not guarantee families a wide range of supportive workplace policies such as paid maternity and paternity leave or paid leave to care for sick children. Proposals to provide such benefits are invariably met with the complaint that the costs would reduce employment and undermine the international competitiveness of American businesses. In this article, Alison Earle, Zitha Mokomane, and Jody Heymann explore whether paid leave and other work-family policies that support children's development exist in countries that are economically competitive and have low unemployment rates. Their data show that the answer is yes. Using indicators of competitiveness gathered by the World Economic Forum, the authors identify fifteen countries, including the United States, that have been among the top twenty countries in competitiveness rankings for at least eight of ten years. To this group they add China and India, both rising competitors in the global economy. They find that every one of these countries, except the United States, guarantees some form of paid leave for new mothers as well as annual leave. And all but Switzerland and the United States guarantee paid leave for new fathers. The authors perform a similar exercise to identify thirteen advanced countries with consistently low unemployment rates, again including the United States. The majority of these countries provide paid leave for new mothers, paid leave for new fathers, paid leave to care for children's health care needs, breast-feeding breaks, paid vacation leave, and a weekly day of rest. Of these, the United States guarantees only breast-feeding breaks (part of the recently passed health care legislation). The authors' global examination of the most competitive economies as well as the economies with low unemployment rates makes clear that ensuring that all parents are available to care for their children's healthy development does not preclude a country from being highly competitive economically.

Bridging the Gap: Identifying Global Trends in Gender Disparity Among the Radiology Physician Workforce.

PubMed

Cater, Sarah Wallace; Yoon, Sora C; Lowell, Dorothy A; Campbell, James C; Sulioti, Gary; Qin, Rosie; Jiang, Brian; Grimm, Lars J

2018-02-01

Women make up half of American medical school graduates, but remain underrepresented among radiologists. This study sought to determine whether workforce gender disparities exist in other countries, and to identify any country-specific indices associated with increased female representation. In this cross-sectional study, 95 professional radiology organizations in 75 countries were contacted via email to provide membership statistics, including proportion of female members, female members aged 35 or under, and women in society leadership positions. Country-specific metrics collected included gross domestic product, Gini index, percent female medical school enrollment, and Gender Development Index for the purposes of univariate multiple regression analysis. Twenty-nine organizations provided data on 184,888 radiologists, representing 26 countries from Europe (n = 12), North America (n = 2), Central/South America (n = 6), Oceania (n = 2), Asia (n = 3), and Africa (n = 1) for a response rate of 34.7% (26/75). Globally, 33.5% of radiologists are female. Women constitute a higher proportion of younger radiologists, with 48.5% of radiologists aged 35 or under being female. Female representation in radiology is lowest in the United States (27.2%), highest in Thailand (85.0%), and most variable in Europe (mean 40.1%, range 28.8%-68.9%). The proportion of female radiologists was positively associated with a country's Gender Development Index (P = .006), percent female medical student enrollment (P = .001), and Gini index (P = .002), and negatively associated with gross domestic product (P = .03). Women are underrepresented in radiology globally, most notably in the United States. Countries with greater representation of women had higher gender equality and percent female medical school enrollment, suggesting these factors may play a role in the gender gap. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Incentives for retaining and motivating health workers in Pacific and Asian countries.

PubMed

Henderson, Lyn N; Tulloch, Jim

2008-09-15

This paper was initiated by the Australian Agency for International Development (AusAID) after identifying the need for an in-depth synthesis and analysis of available literature and information on incentives for retaining health workers in the Asia-Pacific region. The objectives of this paper are to: 1. Highlight the situation of health workers in Pacific and Asian countries to gain a better understanding of the contributing factors to health worker motivation, dissatisfaction and migration. 2. Examine the regional and global evidence on initiatives to retain a competent and motivated health workforce, especially in rural and remote areas. 3. Suggest ways to address the shortages of health workers in Pacific and Asian countries by using incentives. The review draws on literature and information gathered through a targeted search of websites and databases. Additional reports were gathered through AusAID country offices, UN agencies, and non-government organizations. The severe shortage of health workers in Pacific and Asian countries is a critical issue that must be addressed through policy, planning and implementation of innovative strategies--such as incentives--for retaining and motivating health workers. While economic factors play a significant role in the decisions of workers to remain in the health sector, evidence demonstrates that they are not the only factors. Research findings from the Asia-Pacific region indicate that salaries and benefits, together with working conditions, supervision and management, and education and training opportunities are important. The literature highlights the importance of packaging financial and non-financial incentives. Each country facing shortages of health workers needs to identify the underlying reasons for the shortages, determine what motivates health workers to remain in the health sector, and evaluate the incentives required for maintaining a competent and motivated health workforce. Decision-making factors and responses to financial and non-financial incentives have not been adequately monitored and evaluated in the Asia-Pacific region. Efforts must be made to build the evidence base so that countries can develop appropriate workforce strategies and incentive packages.

An interpretive structural modeling (ISM) and decision-making trail and evaluation laboratory (DEMATEL) method approach for the analysis of barriers of waste recycling in India.

PubMed

Chauhan, Ankur; Singh, Amol; Jharkharia, Sanjay

2018-02-01

Increasing amount of wastes is posing great difficulties for all countries across the world. The problem of waste management is more severe in developing countries such as India where the rates of economic growth and urbanization are increasing at a fast pace. The governments in these countries are often constrained by limited technical and financial capabilities, which prevent them from effectively addressing these problems. There is a limited participation from the private players too in terms of setting up of waste recycling units. The present study aims at identifying various barriers that challenge the establishment of these units, specific to India. Further, it attempts to identify the most influential barriers by utilizing multicriterion decision-making tools of interpretive structural modeling (ISM) and decision-making trail and evaluation laboratory (DEMATEL). The findings of the study suggest that the lack of funds, input material, and subsidy are the most influential barriers that are needed to be addressed for the development of waste recycling infrastructure in India. This work has been carried out to address the problem of proper waste management in India. To deal with this problem, the method of waste recycling has been felt appropriate by the government of various countries, including India. Therefore, the barriers that play vital role in waste recycling for private players have been identified and their importance has been established with the help of ISM and DEMATEL methods. Doing so will assist the government to take appropriate steps for the betterment of waste recycling infrastructure in India and enhance waste management.

Trends and topics in eye disease research in PubMed from 2010 to 2014.

PubMed

Boudry, Christophe; Denion, Eric; Mortemousque, Bruno; Mouriaux, Fréderic

2016-01-01

The purpose of this study is to provide a report on scientific production during the period 2010-2014 in order to identify the major topics as well as the predominant actors (journals, countries, continents) involved in the field of eye disease. A PubMed search was carried out to extract articles related to eye diseases during the period 2010-2014. Data were downloaded and processed through developed PHP scripts for further analysis. A total of 62,123 articles were retrieved. A total of 3,368 different journals were found, and 19 journals were identified as "core journals" according to Braford's law. English was by far the predominant language. A total of 853,182 MeSH terms were found, representing an average of 13.73 (SD = 4.98) MeSH terms per article. Among these 853,182 MeSH terms, 14,689 different MeSH terms were identified. Vision Disorders, Glaucoma, Diabetic Retinopathy, Macular Degeneration, and Cataract were the most frequent five MeSH terms related to eye diseases. The analysis of the total number of publications showed that Europe and Asia were the most productive continents, and the USA and China the most productive countries. Interestingly, using the mean Five-Year Impact Factor, the two most productive continents were North America and Oceania. After adjustment for population, the overall ranking positions changed in favor of smaller countries (i.e. Iceland, Switzerland, Denmark, and New Zealand), while after adjustment for Gross Domestic Product (GDP), the overall ranking positions changed in favor of some developing countries (Malawi, Guatemala, Singapore). Due to the large number of articles included and the numerous parameters analyzed, this study provides a wide view of scientific productivity related to eye diseases during the period 2010-2014 and allows us to better understand this field.

The World Report on Disability and its implications for rehabilitation psychology.

PubMed

MacLachlan, Malcolm; Mannan, Hasheem

2014-05-01

This study reviewed the World Report on Disability (World Health Organization & World Bank, 2011) and explored its implications for rehabilitation psychology. Key findings and recommendations were identified within the World Report and issues that are salient to the profession, practice and research within rehabilitation psychology were highlighted. The World Report has a particular emphasis on disability in low-income countries, where the majority of people with disabilities live. Despite the origins and development of rehabilitation psychology within high-income countries, the profession has much to contribute to addressing many of the challenges identified in the World Report. Specific targeted contributions might include addressing the human resources for health crisis in rehabilitation; developing prosocial and community-based interventions and programs; helping to identify and overcome difficulties to accessing health care; refining the measurement and classification of disability; and strengthening research, policy and advocacy for and with people with disabilities. The World Report on Disability presents exciting and challenging opportunities that exist for rehabilitation psychology practitioners and researchers, and for the profession itself. (c) 2014 APA, all rights reserved.

Occupational health research priorities in Malaysia: a Delphi study.

PubMed

Sadhra, S; Beach, J R; Aw, T C; Sheikh-Ahmed, K

2001-07-01

As part of a consultancy project on occupational health, the Delphi method was used to identify research priorities in occupational health in Malaysia. Participation was sought from government ministries, industry, and professional organisations, and university departments with an interest in occupational and public health. Two rounds of questionnaires resulted in a final list of priorities, with noticeable differences between participants depending on whether they worked in industry or were from government organisations. The participation rate of 71% (55 of 78) was obtained for the first questionnaire and 76% (72 of 95) for the second questionnaire. The participants identified occupational health problems for specific groups and industries as the top research priority area (ranked as top priority by 25% of participants). Ministry of Health participants placed emphasis on healthcare workers (52% ranking it as top priority), whereas those from industry identified construction and plantation workers as groups, which should be accorded the highest priority. Evaluation of research and services was given a low priority. The priorities for occupational health determined with the Delphi approach showed differences between Malaysia, a developing country, and findings from similar European studies. This may be expected, as differences exist in stages of economic development, types of industries, occupational activities, and cultural attitudes to occupational health and safety. Chemical poisonings and workplace accidents were accorded a high priority. By contrast with findings from western countries, workplace psychosocial problems and musculoskeletal injuries were deemed less important. There also seemed to be greater emphasis on adopting interventions for identified problems based on experience in other countries rather than the need to evaluate local occupational health provisions.

Respiratory syncytial virus: a systematic scientometric analysis of the global publication output and the gender distribution of publishing authors.

PubMed

Brüggmann, Dörthe; Köster, Corinna; Klingelhöfer, Doris; Bauer, Jan; Ohlendorf, Daniela; Bundschuh, Matthias; Groneberg, David A

2017-07-26

Worldwide, the respiratory syncytial virus (RSV) represents the predominant viral agent causing bronchiolitis and pneumonia in children. To conduct research and tackle existing healthcare disparities, RSV-related research activities around the globe need to be described. Hence, we assessed the associated scientific output (represented by research articles) by geographical, chronological and socioeconomic criteria and analysed the authors publishing in the field by gender. Also, the 15 most cited articles and the most prolific journals were identified for RSV research. Retrospective, descriptive study. The NewQIS (New Quality and Quantity Indices in Science) platform was employed to identify RSV-related articles published in the Web of Science until 2013. We performed a numerical analysis of all articles, and examined citation-based aspects (eg, citation rates); results were visualised by density equalising mapping tools. We identified 4600 RSV-related articles. The USA led the field; US-American authors published 2139 articles (46.5%% of all identified articles), which have been cited 83 000 times. When output was related to socioeconomic benchmarks such as gross domestic product or Research and Development expenditures, Guinea-Bissau, The Gambia and Chile were ranked in leading positions. A total of 614 articles on RSV (13.34% of all articles) were attributed to scientific collaborations. These were primarily established between high-income countries. The gender analysis indicated that male scientists dominated in all countries except Brazil. The majority of RSV-related research articles originated from high-income countries whereas developing nations showed only minimal publication productivity and were barely part of any collaborative networks. Hence, research capacity in these nations should be increased in order to assist in addressing inequities in resource allocation and the clinical burden of RSV in these countries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Attributes of quality programs in universities in developing countries: Case studies of two private universities in Ecuador and beyond

NASA Astrophysics Data System (ADS)

Uriguen, Monica I.

This study sought to identify the key attributes of high-quality programs with an eye toward helping developing countries such as Ecuador advance program quality. The dissertation is divided into five chapters: (1) introduction to high-quality programs; (2) literature review of attributes of high-quality programs; (3) grounded theory method (including interviews with 60 individuals) used to identify program attributes that enhance student learning; (4) findings; and (5) conclusions and recommendations. Following are the five clusters and thirteen attributes of high-quality programs that I identified: Cluster One: Highly Qualified Participants: (1) Highly Qualified Faculty, and (2) Highly Qualified Students; Cluster Two: Learning-Centered Cultures: (3) Shared Program Direction Focused on Learning, (4) Real-World Learning Experiences, (5) Reading-Centered Culture, and (6) Supportive and Risk-Taking Environment; Cluster Three: Interactive Teaching and Learning: (7) Integrative learning: Theory with Practice, Self with Subject, and (8) Exclusive Tutoring and Mentoring; Cluster Four: Connected Program Requirements: (9) Planned Breadth and Depth Course Work, and (10) Tangible Products; and Cluster Five: Adequate Resources: (11) Support for Students, (12) Support for Faculty, and (13) Support for Campus Infrastructure. The study was guided by Haworth and Conrad's (1997) "Engagement Theory of High-Quality Programs." Eleven of the attributes of high-quality programs are closely connected to Haworth and Conrad's theory and the other two attributes---real-world learning experiences and a reading-centered culture---make the signature theoretical contributions of the study. Real-world learning experiences encourage the active involvement of stakeholders in designing curricula with real-world learning experiences. The second attribute---a reading-centered culture---has never before been identified in the literature. There are four key differences between Haworth and Conrad's theory and the theory developed in this study. This study identified four attributes that are highly important in Ecuador and, possibly, other developing countries: highly-qualified faculty, highly-qualified students, reading-centered cultures, and real-world learning experiences. If Latin American universities implement the recommendations proposed in the study, particularly Ecuadorian universities, there is a foundation for envisioning a better future for Ecuadorian universities.

Inbound medical tourism to Barbados: a qualitative examination of local lawyers' prospective legal and regulatory concerns.

PubMed

Crooks, Valorie A; Cohen, I Glenn; Adams, Krystyna; Whitmore, Rebecca; Morgan, Jeffrey

2015-07-28

Enabled by globalizing processes such as trade liberalization, medical tourism is a practice that involves patients' intentional travel to privately obtain medical care in another country. Empirical legal research on this issue is limited and seldom based on the perspectives of destination countries receiving medical tourists. We consulted with diverse lawyers from across Barbados to explore their views on the prospective legal and regulatory implications of the developing medical tourism industry in the country. We held a focus group in February 2014 in Barbados with lawyers from across the country. Nine lawyers with diverse legal backgrounds participated. Focus group moderators summarized the study objective and engaged participants in identifying the local implications of medical tourism and the anticipated legal and regulatory concerns. The focus group was transcribed verbatim and analyzed thematically. Five dominant legal and regulatory themes were identified through analysis: (1) liability; (2) immigration law; (3) physician licensing; (4) corporate ownership; and (5) reputational protection. Two predominant legal and ethical concerns associated with medical tourism in Barbados were raised by participants and are reflected in the literature: the ability of medical tourists to recover medical malpractice for adverse events; and the effects of medical tourism on access to health care in the destination country. However, the participants also identified several topics that have received much less attention in the legal and ethical literature. Overall this analysis reveals that lawyers, at least in Barbados, have an important role to play in the medical tourism sector beyond litigation - particularly in transactional and gatekeeper capacities. It remains to be seen whether these findings are specific to the ecology of Barbados or can be extrapolated to the legal climate of other medical tourism destination countries.

Health indicators and human development in the Arab region

PubMed Central

Boutayeb, Abdesslam; Serghini, Mansour

2006-01-01

Background The present paper deals with the relationship between health indicators and human development in the Arab region. Beyond descriptive analysis showing geographic similarities and disparities inter countries, the main purpose is to point out health deficiencies and to propose pragmatic strategies susceptible to improve health conditions and consequently enhance human development in the Arab world. Methods Data analysis using Principal Components Analysis is used to compare the achievements of the Arab countries in terms of direct and indirect health indicators. The variables (indicators) are seen to be well represented on the circle of correlation, allowing for interesting interpretation and analysis. The 19 countries are projected on the first and second plane respectively. Results The results given by the present analysis give a good panorama of the Arab countries with their geographic similarities and disparities. The high correlation between health indicators and human development is well illustrated and consequently, countries are classified by groups having similar human development. The analysis shows clearly how health deficits are impeding human development in the majority of Arab countries and allows us to formulate suggestions to improve health conditions and enhance human development in the Arab World. Discussion The discussion is based on the link between different direct and indirect health indicators and the relationship between these indicators and human development index. Without including the GDP indicator, our analysis has shown that the 19 Arab countries may be classified, independently of their geographic proximity, in three different groups according to their global human development level (Low, Medium and High). Consequently, while identifying health deficiencies in each group, the focus was made on the countries presenting a high potential of improvement in health indicators. In particular, maternal mortality and infant mortality which are really challenging health authorities of the first and third group were critically discussed. Conclusion The Arab countries have made substantial economic and social progress during the last decades by improving life expectancy and reducing maternal and infant mortality. However, considering its natural wealth and human resources, the Arab region has accomplished less than expected in terms of human development. Huge social inequalities and health inequities exist inter and intra Arab countries. In most Arab countries, a large percentage of populations, especially in rural areas, are deprived of access to health facilities. Consequently, many women still die during pregnancy and labour, yielding unacceptable levels of maternal and infant mortality. However, the problem is seen to be more complex, going beyond geography and technical accessibility to health care, it compasses, among others, levels of literacy, low social and economic status of women, qualification of health staff, general behaviour and interactions between patients and medical personnel (including corruption). PMID:17194309

Multi-Criteria Analysis of Uavs Regulations in 6 Countries Using the Analytical Hierarchical Process and Expert Knowledge

NASA Astrophysics Data System (ADS)

Morales, A. C.; Paez, D.; Arango, C.

2015-08-01

To analyze the current situation of Colombian regulation, it is necessary to compare some specific aspects with the legislation used in other countries where the UAVs topic dates to many years ago. This study is focused on evaluating all the possibilities to make the Colombian regulation effective without closing opportunities of research and development growth, but still guarantee the privacy and intimacy rights of the population. Results from our study are currently being used in the development of the Colombian regulation and they are proven useful to instigate informative debates and identify areas where specific needs are to be address in Colombia.

Targeting Appropriate Interventions to Minimize Deterioration of Drinking-water Quality in Developing Countries

PubMed Central

Trevett, Andrew F.; Carter, Richard C.

2008-01-01

In developing countries, it has been observed that drinking-water frequently becomes recontaminated following its collection and during storage in the home. This paper proposes a semi-quantified ‘disease risk index' (DRI) designed to identify communities or households that are ‘most at risk' from consuming recontaminated drinking-water. A brief review of appropriate physical and educational intervention measures is presented, and their effective use is discussed. It is concluded that incorporating a simple appraisal tool, such as the proposed DRI, into a community water-supply programme would be useful in shaping the overall strategy requiring only a minimum of organizational learning. PMID:18686547

Using exercises to improve public health preparedness in Asia, the Middle East and Africa

PubMed Central

2014-01-01

Background Exercises are increasingly common tools used by the health sector and other sectors to evaluate their preparedness to respond to public health threats. Exercises provide an opportunity for multiple sectors to practice, test and evaluate their response to all types of public health emergencies. The information from these exercises can be used to refine and improve preparedness plans. There is a growing body of literature about the use of exercises among local, state and federal public health agencies in the United States. There is much less information about the use of exercises among public health agencies in other countries and the use of exercises that involve multiple countries. Results We developed and conducted 12 exercises (four sub-national, five national, three sub-regional) from August 2006 through December 2008. These 12 exercises included 558 participants (average 47) and 137 observers (average 11) from 14 countries. Participants consistently rated the overall quality of the exercises as very good or excellent. They rated the exercises lowest on their ability to identifying key gaps in performance. The vast majority of participants noted that they would use the information they gained at the exercise to improve their organization’s preparedness to respond to an influenza pandemic. Participants felt the exercises were particularly good at raising awareness and understanding about public health threats, assisting in evaluating plans and identifying priorities for improvement, and building relationships that strengthen preparedness and response across sectors and across countries. Participants left the exercises with specific ideas about the most important actions that they should engage in after the exercise such as improved planning coordination across sectors and countries and better training of health workers and response personnel. Conclusions These experiences suggest that exercises can be a valuable, low-burden tool to improve emergency preparedness and response in countries around the world. They also demonstrate that countries can work together to develop and conduct successful exercises designed to improve regional preparedness to public health threats. The development of standardized evaluation methods for exercises may be an additional tool to help focus the actions to be taken as a result of the exercise and to improve future exercises. Exercises show great promise as tools to improve public health preparedness across sectors and countries. PMID:25063987

Measuring political commitment and opportunities to advance food and nutrition security: piloting a rapid assessment tool.

PubMed

Fox, Ashley M; Balarajan, Yarlini; Cheng, Chloe; Reich, Michael R

2015-06-01

Lack of political commitment has been identified as a primary reason for the low priority that food and nutrition interventions receive from national governments relative to the high disease burden caused by malnutrition. Researchers have identified a number of factors that contribute to food and nutrition's 'low-priority cycle' on national policy agendas, but few tools exist to rapidly measure political commitment and identify opportunities to advance food and nutrition on the policy agenda. This article presents a theory-based rapid assessment approach to gauging countries' level of political commitment to food and nutrition security and identifying opportunities to advance food and nutrition on the policy agenda. The rapid assessment tool was piloted among food and nutrition policymakers and planners in 10 low- and middle-income countries in April to June 2013. Food and nutrition commitment and policy opportunity scores were calculated for each country and strategies to advance food and nutrition on policy agendas were designed for each country. The article finds that, in a majority of countries, political leaders had verbally and symbolically committed to addressing food and nutrition, but adequate financial resources were not allocated to implement specific programmes. In addition, whereas the low cohesion of the policy community has been viewed a major underlying cause of the low-priority status of food and nutrition, the analysis finds that policy community cohesion and having a well thought-out policy alternative were present in most countries. This tool may be useful to policymakers and planners providing information that can be used to benchmark and/or evaluate advocacy efforts to advance reforms in the food and nutrition sector; furthermore, the results can help identify specific strategies that can be employed to move the food and nutrition agenda forward. This tool complements others that have been recently developed to measure national commitment to advancing food and nutrition security. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Country ownership and capacity building: the next buzzwords in health systems strengthening or a truly new approach to development?

PubMed Central

2012-01-01

Background During the last decade, donor governments and international agencies have increasingly emphasized the importance of building the capacity of indigenous health care organizations as part of strengthening health systems and ensuring sustainability. In 2009, the U.S. Global Health Initiative made country ownership and capacity building keystones of U.S. health development assistance, and yet there is still a lack of consensus on how to define either of these terms, or how to implement “country owned capacity building”. Discussion Concepts around capacity building have been well developed in the for-profit business sector, but remain less well defined in the non-profit and social sectors in low and middle-income countries. Historically, capacity building in developing countries has been externally driven, related to project implementation, and often resulted in disempowerment of local organizations rather than local ownership. Despite the expenditure of millions of dollars, there is no consensus on how to conduct capacity building, nor have there been rigorous evaluations of capacity building efforts. To shift to a new paradigm of country owned capacity building, donor assistance needs to be inclusive in the planning process and create true partnerships to conduct organizational assessments, analyze challenges to organizational success, prioritize addressing challenges, and implement appropriate activities to build new capacity in overcoming challenges. Before further investments are made, a solid evidence base should be established concerning what works and what doesn’t work to build capacity. Summary Country-owned capacity building is a relatively new concept that requires further theoretical exploration. Documents such as The Paris Declaration on Aid Effectiveness detail the principles of country ownership to which partner and donor countries should commit, but do not identify the specific mechanisms to carry out these principles. More evidence as to how country-owned capacity building plays out in practice is needed to guide future interventions. The Global Health Initiative funding that is currently underway is an opportunity to collect evaluative data and establish a centralized and comprehensive evidence base that could be made available to guide future country-owned capacity building efforts. PMID:22818046

Country ownership and capacity building: the next buzzwords in health systems strengthening or a truly new approach to development?

PubMed

Goldberg, Jessica; Bryant, Malcolm

2012-07-20

During the last decade, donor governments and international agencies have increasingly emphasized the importance of building the capacity of indigenous health care organizations as part of strengthening health systems and ensuring sustainability. In 2009, the U.S. Global Health Initiative made country ownership and capacity building keystones of U.S. health development assistance, and yet there is still a lack of consensus on how to define either of these terms, or how to implement "country owned capacity building". Concepts around capacity building have been well developed in the for-profit business sector, but remain less well defined in the non-profit and social sectors in low and middle-income countries. Historically, capacity building in developing countries has been externally driven, related to project implementation, and often resulted in disempowerment of local organizations rather than local ownership. Despite the expenditure of millions of dollars, there is no consensus on how to conduct capacity building, nor have there been rigorous evaluations of capacity building efforts. To shift to a new paradigm of country owned capacity building, donor assistance needs to be inclusive in the planning process and create true partnerships to conduct organizational assessments, analyze challenges to organizational success, prioritize addressing challenges, and implement appropriate activities to build new capacity in overcoming challenges. Before further investments are made, a solid evidence base should be established concerning what works and what doesn't work to build capacity. Country-owned capacity building is a relatively new concept that requires further theoretical exploration. Documents such as The Paris Declaration on Aid Effectiveness detail the principles of country ownership to which partner and donor countries should commit, but do not identify the specific mechanisms to carry out these principles. More evidence as to how country-owned capacity building plays out in practice is needed to guide future interventions. The Global Health Initiative funding that is currently underway is an opportunity to collect evaluative data and establish a centralized and comprehensive evidence base that could be made available to guide future country-owned capacity building efforts.

White Paper Report of the RAD-AID Conference on International Radiology for Developing Countries: identifying challenges, opportunities, and strategies for imaging services in the developing world.

PubMed

Mollura, Daniel J; Azene, Ezana M; Starikovsky, Anna; Thelwell, Aduke; Iosifescu, Sarah; Kimble, Cary; Polin, Ann; Garra, Brian S; DeStigter, Kristen K; Short, Brad; Johnson, Benjamin; Welch, Christian; Walker, Ivy; White, David M; Javadi, Mehrbod S; Lungren, Matthew P; Zaheer, Atif; Goldberg, Barry B; Lewin, Jonathan S

2010-07-01

The RAD-AID Conference on International Radiology for Developing Countries was an assembly of individuals and organizations interested in improving access to medical imaging services in developing countries where the availability of radiology has been inadequate for both patient care and public health programs. The purpose of the meeting was to discuss data, experiences, and models pertaining to radiology in the developing world and to evaluate potential opportunities for future collaboration. Conference participants included radiologists, technologists, faculty members of academic medical institutions, and leadership of nongovernmental organizations involved in international health care and social entrepreneurship. Four main themes from the conference are presented in this white paper as important factors for the implementation and optimization of radiology in the developing world: (1) ensuring the economic sustainability of radiologic services through financial and administrative training support of health care personnel; (2) designing, testing, and deploying clinical strategies adapted for regions with limited resources; (3) structuring and improving the role of American radiology residents interested in global health service projects; and (4) implementing information technology models to support digital imaging in the developing world. Published by Elsevier Inc.

Factors influencing global antiretroviral procurement prices.

PubMed

Wirtz, Veronika J; Forsythe, Steven; Valencia-Mendoza, Atanacio; Bautista-Arredondo, Sergio

2009-11-18

Antiretroviral medicines (ARVs) are one of the most costly parts of HIV/AIDS treatment. Many countries are struggling to provide universal access to ARVs for all people living with HIV and AIDS. Although substantial price reductions of ARVs have occurred, especially between 2002 and 2008, achieving sustainable access for the next several decades remains a major challenge for most low- and middle-income countries. The objectives of the present study were twofold: first, to analyze global ARV prices between 2005 and 2008 and associated factors, particularly procurement methods and key donor policies on ARV procurement efficiency; second, to discuss the options of procurement processes and policies that should be considered when implementing or reforming access to ARV programs. An ARV-medicines price-analysis was carried out using the Global Price Reporting Mechanism from the World Health Organization. For a selection of 12 ARVs, global median prices and price variation were calculated. Linear regression models for each ARV were used to identify factors that were associated with lower procurement prices. Logistic regression models were used to identify the characteristics of those countries which procure below the highest and lowest direct manufactured costs. Three key factors appear to have an influence on a country's ARV prices: (a) whether the product is generic or not; (b) the socioeconomic status of the country; (c) whether the country is a member of the Clinton HIV/AIDS Initiative. Factors which did not influence procurement below the highest direct manufactured costs were HIV prevalence, procurement volume, whether the country belongs to the least developed countries or a focus country of the United States President's Emergency Plan For AIDS Relief. One of the principal mechanisms that can help to lower prices for ARV over the next several decades is increasing procurement efficiency. Benchmarking prices could be one useful tool to achieve this.

Access to Orphan Drugs: A Comprehensive Review of Legislations, Regulations and Policies in 35 Countries

PubMed Central

Gammie, Todd

2015-01-01

Objective To review existing regulations and policies utilised by countries to enable patient access to orphan drugs. Methods A review of the literature (1998 to 2014) was performed to identify relevant, peer-reviewed articles. Using content analysis, we synthesised regulations and policies for access to orphan drugs by type and by country. Results Fifty seven articles and 35 countries were included in this review. Six broad categories of regulation and policy instruments were identified: national orphan drug policies, orphan drug designation, marketing authorization, incentives, marketing exclusivity, and pricing and reimbursement. The availability of orphan drugs depends on individual country’s legislation and regulations including national orphan drug policies, orphan drug designation, marketing authorization, marketing exclusivity and incentives such as tax credits to ensure research, development and marketing. The majority of countries (27/35) had in place orphan drug legislation. Access to orphan drugs depends on individual country’s pricing and reimbursement policies, which varied widely between countries. High prices and insufficient evidence often limit orphan drugs from meeting the traditional health technology assessment criteria, especially cost-effectiveness, which may influence access. Conclusions Overall many countries have implemented a combination of legislations, regulations and policies for orphan drugs in the last two decades. While these may enable the availability and access to orphan drugs, there are critical differences between countries in terms of range and types of legislations, regulations and policies implemented. Importantly, China and India, two of the largest countries by population size, both lack national legislation for orphan medicines and rare diseases, which could have substantial negative impacts on their patient populations with rare diseases. PMID:26451948

Mass Customization and Personalization Prospects in Developing Country: Indonesian Context

NASA Astrophysics Data System (ADS)

Risdiyono; Djati Widodo, Imam; Mahtarami, Affan

2016-01-01

The advancement of information technology (IT) has changed many modes and ways for people in doing their businesses. Mass Customization and Personalization (MCP) is one example of business modes that has been dramatically evolve, mainly due to the currently very fast IT development. MCP has enabled people to involve in adjusting some design parameters of a product to meet their personal requirements before purchased. The advancement of IT has made MCP more successful as it makes the process faster, easier, simpler and more joyful. The success stories of MCP are easily found in many developed countries, where the IT infrastructure has firmly been established. For developing countries, there are very few industries have implemented the MCP concept, including Indonesia. This paper discusses a descriptive study to depict what people think about MCP implementation in Indonesia especially in Small and Medium Enterprises (SMEs). Kano model was used to see the perception of both producers and consumers in relation with MCP implementation. Five dummy MCP prototypes were developed for five creative products including plaques, hats, invitation card, t-shirts and leather bags. Based on the KANO questionnaire analyses, it is clear that there are big opportunities to implement MCP in Indonesia especially for creative products produced by SMEs. Identifying the correct product features is an important key for successful MCP implementation in developing countries.

A systematic review of micro correlates of maternal mortality.

PubMed

Yakubu, Yahaya; Mohamed Nor, Norashidah; Abidin, Emilia Zainal

2018-05-05

In the year 2000, the World Health Organization launched the Millennium Development Goals (MDGs) which were to be achieved in 2015. Though most of the goals were not achieved, a follow-up post 2015 development agenda, the Sustainable Development Goals (SDGs) was launched in 2015, which are to be achieved by 2030. Maternal mortality reduction is a focal goal in both the MDGs and SDGs. Achieving the maternal mortality target in the SDGs requires multiple approaches, particularly in developing countries with high maternal mortality. Low-income developing countries rely to a great extent on macro determinants such as public health expenditure, which are spent mostly on curative health and health facilities, to improve population health. To complement the macro determinants, this study employs the systematic review technique to reveal significant micro correlates of maternal mortality. The study searched MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Science Direct, and Global Index Medicus of the World Health Organization. Our search was time framed from the 1st January, 2000 to the 30th September, 2016. In the overall search result, 6758 articles were identified, out of which 33 were found to be eligible for the review. The outcome of the systematic search for relevant literature revealed a concentration of literature on the micro factors and maternal mortality in developing countries. This shows that maternal mortality and micro factors are a major issue in developing countries. The studies reviewed support the significant relationship between the micro factors and maternal mortality. This study therefore suggests that more effort should be channelled to improving the micro factors in developing countries to pave the way for the timely achievement of the SDGs' maternal mortality ratio (MMR) target.

A strategy for cancer prevention and control research*

PubMed Central

Greenwald, Peter; Caban, Carlos E.

1986-01-01

Cancer is an important cause of morbidity and mortality in industrial countries. Recently changes in life-style and the environment in developing countries have coincided with increases in the incidence of certain cancers which might be related to these factors. A strategy for the prevention of all such cancers is presented, which involves research in a sequence of five phases to identify suitable interventions and to confirm their effectiveness in population studies, prior to their application on a nationwide scale. PMID:3524884

International trends in health science librarianship: part 3--the Nordic countries.

PubMed

Haglund, Lotta; Buset, Karen J; Kristiansen, Hanne M; Ovaska, Tuulevi; Murphy, Jeannette

2012-09-01

This is the third in a series of articles exploring international trends in health science librarianship in the first decade of the 21st century. The invited authors carried out a survey of librarians in Sweden, Denmark, Norway and Finland to identify common developments in their countries. A focus on pedagogy was seen as the most important trend. Future issues will track trends in Southern Europe and Latin America. JM. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

Adaptation and translation of mental health interventions in Middle Eastern Arab countries: a systematic review of barriers to and strategies for effective treatment implementation.

PubMed

Gearing, Robin E; Schwalbe, Craig S; MacKenzie, Michael J; Brewer, Kathryne B; Ibrahim, Rawan W; Olimat, Hmoud S; Al-Makhamreh, Sahar S; Mian, Irfan; Al-Krenawi, Alean

2013-11-01

All too often, efficacious psychosocial evidence-based interventions fail when adapted from one culture to another. International translation requires a deep understanding of the local culture, nuanced differences within a culture, established service practices, and knowledge of obstacles and promoters to treatment implementation. This research investigated the following objectives to better facilitate cultural adaptation and translation of psychosocial and mental health treatments in Arab countries: (1) identify barriers or obstacles; (2) identify promoting strategies; and (3) provide clinical and research recommendations. This systematic review of 22 psychosocial or mental health studies in Middle East Arab countries identified more barriers (68%) than promoters (32%) to effective translation and adaptation of empirically supported psychosocial interventions. Identified barriers include obstacles related to acceptability of the intervention within the cultural context, community and system difficulties, and problems with clinical engagement processes. Whereas identified promoter strategies centre on the importance of partnering and working within the local and cultural context, the need to engage with acceptable and traditional intervention characteristics, and the development of culturally appropriate treatment strategies and techniques. Although Arab cultures across the Middle East are unique, this article provides a series of core clinical and research recommendations to assist effective treatment adaptation and translation within Arab communities in the Middle East.

Modelling the elements of country vulnerability to earthquake disasters.

PubMed

Asef, M R

2008-09-01

Earthquakes have probably been the most deadly form of natural disaster in the past century. Diversity of earthquake specifications in terms of magnitude, intensity and frequency at the semicontinental scale has initiated various kinds of disasters at a regional scale. Additionally, diverse characteristics of countries in terms of population size, disaster preparedness, economic strength and building construction development often causes an earthquake of a certain characteristic to have different impacts on the affected region. This research focuses on the appropriate criteria for identifying the severity of major earthquake disasters based on some key observed symptoms. Accordingly, the article presents a methodology for identification and relative quantification of severity of earthquake disasters. This has led to an earthquake disaster vulnerability model at the country scale. Data analysis based on this model suggested a quantitative, comparative and meaningful interpretation of the vulnerability of concerned countries, and successfully explained which countries are more vulnerable to major disasters.

Country clustering applied to the water & sanitation sector: a new tool with potential applications in research & policy

PubMed Central

Onda, Kyle; Crocker, Jonny; Kayser, Georgia Lyn; Bartram, Jamie

2013-01-01

The fields of global health and international development commonly cluster countries by geography and income to target resources and describe progress. For any given sector of interest, a range of relevant indicators can serve as a more appropriate basis for classification. We create a new typology of country clusters specific to the water and sanitation (WatSan) sector based on similarities across multiple WatSan-related indicators. After a literature review and consultation with experts in the WatSan sector, nine indicators were selected. Indicator selection was based on relevance to and suggested influence on national water and sanitation service delivery, and to maximize data availability across as many countries as possible. A hierarchical clustering method and a gap statistic analysis were used to group countries into a natural number of relevant clusters. Two stages of clustering resulted in five clusters, representing 156 countries or 6.75 billion people. The five clusters were not well explained by income or geography, and were unique from existing country clusters used in international development. Analysis of these five clusters revealed that they were more compact and well separated than United Nations and World Bank country clusters. This analysis and resulting country typology suggest that previous geography- or income-based country groupings can be improved upon for applications in the WatSan sector by utilizing globally available WatSan-related indicators. Potential applications include guiding and discussing research, informing policy, improving resource targeting, describing sector progress, and identifying critical knowledge gaps in the WatSan sector. PMID:24054545

Developmental origins of health and disease--global public health implications.

PubMed

Hanson, M A; Gluckman, P D

2015-01-01

The rapidly rising prevalence of non-communicable diseases (NCDs) represents a major challenge to public health and clinical medicine globally. NCDs are increasing rapidly in high-income countries, but even more rapidly in some low-middle-income countries with insufficient resources to meet the challenge. Whilst not identified in the Millennium Development Goals, there is much attention paid to NCDs in the discussions at many levels on the Sustainable Development Goals, as they underpin economic, social and environmental development in the post-2015 era. In this article, we discuss how a life-course approach to health, commencing of necessity in early development, can provide new opportunities for addressing this challenge. The approach can leverage human health capital throughout life and across generations. New insights into mechanisms, especially those processes by which the developmental environment affects epigenetic processes in the developing offspring, offer the prospect of identifying biomarkers of future risks. New interventions to promote health literacy, lifestyle and physical fitness in adolescents, young adults and their children hold great promise. In this respect, health-care professionals concerned with preconceptional, pregnancy and newborn care will have a vital role to play. Copyright © 2014 Elsevier Ltd. All rights reserved.

Strengthening care for injured persons in less developed countries: a case study of Ghana and Mexico.

PubMed

Mock, Charles; Arreola-Risa, Carlos; Quansah, Robert

2003-01-01

In all countries, the priority for reducing road traffic injuries should be prevention. Nonetheless, there are low-cost ways to strengthen the care of injured persons, that will help to lower the toll from road traffic. The purpose of this review was to elucidate ways to accomplish this goal in the context of less developed countries. Studies selected for this review were obtained by Medline review, selecting on key words such as trauma, injury, trauma care, essential health services, and developing country. Articles pertaining to any country and all available years were considered. In addition, the authors utilized articles from the gray literature and journals from Mexico and Ghana that are not Medline referenced. Studies surveyed point to road safety and other forms of injury prevention, as well as prehospital care, as likely priorities for developing countries. Nonetheless, hospital-based improvements can contribute to decreases in mortality and, especially, decreases in disability. For both prehospital and hospital based care, studies revealed several critical weak points to address in: (1) human resources (staffing and training); (2) physical resources (equipment, supplies, and infrastructure); and (3) administration and organization. The 'essential services' approach, which has contributed to progress in a variety of fields of international health, needs to be developed for the care of the injured. This would define the trauma treatment services that could realistically be made available to virtually every injured person. It would then address the inputs of human resources, physical resources, and administration necessary to assure these services optimally in the different geographic and socioeconomic environments worldwide. Finally, it would identify and target deficiencies in these inputs that need to be strengthened.

Biosecurity measures for backyard poultry in developing countries: a systematic review

PubMed Central

2012-01-01

Background Poultry represents an important sector in animal production, with backyard flocks representing a huge majority, especially in the developing countries. In these countries, villagers raise poultry to meet household food demands and as additional sources of incomes. Backyard production methods imply low biosecurity measures and high risk of infectious diseases, such as Newcastle disease or zoonosis such as Highly Pathogenic Avian Influenza (HPAI). We reviewed literature on biosecurity practices for prevention of infectious diseases, and published recommendations for backyard poultry and assessed evidence of their impact and feasibility, particularly in developing countries. Documents were sourced from the Food and Agriculture Organization (FAO) website, and from Pubmed and Google databases. Results A total of 62 peer-reviewed and non-referred documents were found, most of which were published recently (after 2004) and focused on HPAI/H5N1-related biosecurity measures (64%). Recommendations addressed measures for flock management, feed and water management, poultry trade and stock change, poultry health management and the risk to humans. Only one general guideline was found for backyard poultry-related biosecurity; the other documents were drawn up for specific developing settings and only engaged their authors (e.g. consultants). These national guidelines written by consultants generated recommendations regarding measures derived from the highest standards of commercial poultry production. Although biosecurity principles of isolation and containment are described in most documents, only a few documents were found on the impact of measures in family poultry settings and none gave any evidence of their feasibility and effectiveness for backyard poultry. Conclusions Given the persistent threat posed by HPAI/H5N1 to humans in developing countries, our findings highlight the importance of encouraging applied research toward identifying sustained and adapted biosecurity measures for smallholder poultry flocks in low-income countries. PMID:23216706

The Breast Health Global Initiative: clinical practice guidelines for management of breast cancer in low- and middle-income countries.

PubMed

Yip, Cheng Har; Anderson, Benjamin O

2007-08-01

Breast cancer is an increasingly urgent problem in low- and mid-level resource countries of the world. Despite knowing the optimal management strategy based on guidelines developed in wealthy countries, clinicians are forced to provide less-than-optimal care to patients when diagnostic and/or treatment resources are lacking. For this reason, it is important to identify which resources commonly applied in resource-abundant countries most effectively fill the healthcare needs in limited-resource regions, where patients commonly present with more advanced disease at diagnosis, and to provide guidance on how new resource allocations should be made in order to maximize improvement in outcome. Established in 2002, the Breast Health Global Initiative (BHGI) created an international health alliance to develop evidence-based guidelines for countries with limited resources (low- and middle-income countries) to improve breast health outcomes. The BHGI serves as a program for international guideline development and as a hub for linkage among clinicians, governmental health agencies and advocacy groups to translate guidelines into policy and practice. The BHGI collaborated with 12 national and international health organizations, cancer societies and nongovernmental organizations to host two BHGI international summits. The evidence-based BHGI Guidelines, developed at the 2002 Global Summit, were published in 2003 as a theoretical treatise on international breast healthcare. These guidelines were then updated and expanded at the 2005 Global Summit into a fully comprehensive and flexible framework to permit incremental improvements in healthcare delivery, based upon outcomes, cost, cost-effectiveness and use of healthcare services.

The impact of mobile health interventions on chronic disease outcomes in developing countries: a systematic review.

PubMed

Beratarrechea, Andrea; Lee, Allison G; Willner, Jonathan M; Jahangir, Eiman; Ciapponi, Agustín; Rubinstein, Adolfo

2014-01-01

Rates of chronic diseases will continue to rise in developing countries unless effective and cost-effective interventions are implemented. This review aims to discuss the impact of mobile health (m-health) on chronic disease outcomes in low- and middle-income countries (LMIC). Systematic literature searches were performed using CENTRAL, MEDLINE, EMBASE, and LILACS databases and gray literature. Scientific literature was searched to identify controlled studies evaluating cell phone voice and text message interventions to address chronic diseases in adults in low- or middle-income countries. Outcomes measured included morbidity, mortality, hospitalization rates, behavioral or lifestyle changes, process of care improvements, clinical outcomes, costs, patient-provider satisfaction, compliance, and health-related quality of life (HRQoL). From the 1,709 abstracts retrieved, 163 articles were selected for full text review, including 9 randomized controlled trials with 4,604 participants. Most of the studies addressed more than one outcome. Of the articles selected, six studied clinical outcomes, six studied processes of care, three examined healthcare costs, and two examined HRQoL. M-health positively impacted on chronic disease outcomes, improving attendance rates, clinical outcomes, and HRQoL, and was cost-effective. M-health is emerging as a promising tool to address access, coverage, and equity gaps in developing countries and low-resource settings. The results for m-health interventions showed a positive impact on chronic diseases in LMIC. However, a limiting factor of this review was the relatively small number of studies and patients enrolled, highlighting the need for more rigorous research in this area in developing countries.

Challenges in the Management of Mucopolysaccharidosis Type II (Hunter's Syndrome) in a Developing Country: a Case Report.

PubMed

Rasheeedah, Ibraheem; Patrick, Oladele; Abdullateef, AbdulAzeez; Mohammed, Abdulkadri; Sherifat, Katibi; Gbadebo, Ibraheem

2015-07-01

Mucopolysaccharidosis type II (Hunter's syndrome) is an X-linked chromosomal storage disorder due to deficiency of the lysosomal enzyme iduronate-2-sulfatase with patients rarely living till adulthood. Failure to identify patients early could contribute to an increased morbidity as identified in this case report. An eight year old patient with Hunter's syndrome identified five years after disease onset with severe cardiovascular complications exemplifies the challenges faced in resource-limited countries towards making diagnosis and treatment of rare conditions. Elevated urinary glycosaminoglycans levels or a strong clinical suspicion of Hunter's syndrome, as identified in the index case, is a prerequisite for enzyme activity testing. Urinary mucopolysaccharide(MPS) level was 69.6 mg/mmol(normal range is 0.0 - 11.6 mg/mmol), and the confirming MPS electrophoresis analysis showed elevated heparan sulphate in the urine sample. Enzyme activity testing, with absent or very low iduronate-2-sulfatase activity, is diagnostic. However, the scarce availability and high cost of these tests is another constraint in making a diagnosis. Identification and management of mucopolysaccharidosis type II pose a problem in resource-constrained countries due to late presentation, lack of facility for diagnosis and treatment, cost and expertise required for the management.

Addressing refugee health through evidence-based policies: a case study.

PubMed

Thiel de Bocanegra, Heike; Carter-Pokras, Olivia; Ingleby, J David; Pottie, Kevin; Tchangalova, Nedelina; Allen, Sophia I; Smith-Gagen, Julie; Hidalgo, Bertha

2018-06-01

The cumulative total of persons forced to leave their country for fear of persecution or organized violence reached an unprecedented 24.5 million by the end of 2015. Providing equitable access to appropriate health services for these highly diverse newcomers poses challenges for receiving countries. In this case study, we illustrate the importance of translating epidemiology into policy to address the health needs of refugees by highlighting examples of what works as well as identifying important policy-relevant gaps in knowledge. First, we formed an international working group of epidemiologists and health services researchers to identify available literature on the intersection of epidemiology, policy, and refugee health. Second, we created a synopsis of findings to inform a recommendation for integration of policy and epidemiology to support refugee health in the United States and other high-income receiving countries. Third, we identified eight key areas to guide the involvement of epidemiologists in addressing refugee health concerns. The complexity and uniqueness of refugee health issues, and the need to develop sustainable management information systems, require epidemiologists to expand their repertoire of skills to identify health patterns among arriving refugees, monitor access to appropriately designed health services, address inequities, and communicate with policy makers and multidisciplinary teams. Copyright © 2017 Elsevier Inc. All rights reserved.

Techniques for assessing water resource potentials in the developing countries: with emphasis on streamflow, erosion and sediment transport, water movement in unsaturated soils, ground water, and remote sensing in hydrologic applications

USGS Publications Warehouse

Taylor, George C.

1971-01-01

Hydrologic instrumentation and methodology for assessing water-resource potentials have originated largely in the developed countries of the temperature zone. The developing countries lie largely in the tropic zone, which contains the full gamut of the earth's climatic environments, including most of those of the temperate zone. For this reason, most hydrologic techniques have world-wide applicability. Techniques for assessing water-resource potentials for the high priority goals of economic growth are well established in the developing countries--but much more are well established in the developing countries--but much more so in some than in other. Conventional techniques for measurement and evaluation of basic hydrologic parameters are now well-understood in the developing countries and are generally adequate for their current needs and those of the immediate future. Institutional and economic constraints, however, inhibit growth of sustained programs of hydrologic data collection and application of the data to problems in engineering technology. Computer-based technology, including processing of hydrologic data and mathematical modelling of hydrologic parameters i also well-begun in many developing countries and has much wider potential application. In some developing counties, however, there is a tendency to look on the computer as a panacea for deficiencies in basic hydrologic data collection programs. This fallacy must be discouraged, as the computer is a tool and not a "magic box." There is no real substitute for sound programs of basic data collection. Nuclear and isotopic techniques are being used increasingly in the developed countries in the measurement and evaluation of virtually all hydrologic parameter in which conventional techniques have been used traditionally. Even in the developed countries, however, many hydrologists are not using nuclear techniques, simply because they lack knowledge of the principles involved and of the potential benefits. Nuclear methodology in hydrologic applications is generally more complex than the conventional and hence requires a high level of technical expertise for effective use. Application of nuclear techniques to hydrologic problems in the developing countries is likely to be marginal for some years to come, owing to the higher costs involved and expertise required. Nuclear techniques, however, would seem to have particular promise in studies of water movement in unsaturated soils and of erosion and sedimentation where conventional techniques are inadequate, inefficient and in some cases costly. Remote sensing offers great promise for synoptic evaluations of water resources and hydrologic processes, including the transient phenomena of the hydrologic cycle. Remote sensing is not, however, a panacea for deficiencies in hydrologic data programs in the developing countries. Rather it is a means for extending and augmenting on-the-ground observations ans surveys (ground truth) to evaluated water resources and hydrologic processes on a regionall or even continental scale. With respect to economic growth goals in developing countries, there are few identifiable gaps in existing hydrologic instrumentation and methodology insofar as appraisal, development and management of available water resources are concerned. What is needed is acceleration of institutional development and professional motivation toward more effective use of existing and proven methodology. Moreover, much sophisticated methodology can be applied effectively in the developing countries only when adequate levels of indigenous scientific skills have been reached and supportive institutional frameworks are evolved to viability.

Science and technology issues in coastal ecotourism. Background paper

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

Nature-based tourism, increasingly called 'ecotourism'--one of the fastest growing sectors of tourism worldwide, is fast gaining the attention of developed and developing countries as a potential means to conserve natural resources and support sustainable economic progress. The paper presents information on the ecotourism trends; identifies issues related to resource conservation, ecotourism development and management, and planning; and presents questions for possible further consideration.

A strategic approach to the unfinished fortification agenda: feasibility, costs, and cost-effectiveness analysis of fortification programs in 48 countries.

PubMed

Fiedler, John L; Macdonald, Barbara

2009-12-01

Food fortification is a promising strategy for combating micronutrient deficiencies, which plague one-third of the world's population. Which foods to fortify, with which micronutrients, and in which countries remain essential questions that to date have not been addressed at the global level. To provide a tool for international agencies to identify and organize the next phase of the unfinished global fortification agenda by prioritizing roughly 250 potential interventions in 48 priority countries. By explicitly defining the structure and operations of the fortification interventions in a detailed and transparent manner, and incorporating a substantial amount of country-specific data, the study also provides a potentially useful starting point for policy discussions in each of the 48 countries, which--it is hoped--will help to catalyze the development of public-private partnerships and accelerate the introduction of fortification and reduction of micronutrient deficiencies. Forty-eight high-priority countries were identified, and the feasibility of fortifying vegetable oil and sugar with vitamin A and fortifying wheat flour and maize flour with two alternative multiple micronutrient formulations was assessed. One hundred twenty-two country-, food-, and fortification formulation-specific interventions were assessed to be feasible, and the costs of each intervention were estimated. Assuming a 30% reduction in the micronutrient deficiencies of the persons consuming the food, the number of disability-adjusted life years (DALYs) saved by each of the programs was estimated. The cost per DALY saved was calculated for each of the 122 interventions, and the interventions were rank-ordered by cost-effectiveness. It is estimated that the 60 most cost-effective interventions would carry a 10-year price tag of US$1 billion and have costs per DALY saved ranging from US$1 to US$134. The single "best bet" intervention--i.e., the most cost-effective intervention--in each of the 48 countries was identified. This study provides a detailed, transparent, evidence-based approach to defining and estimating the costs and cost-effectiveness of the unfinished global fortification agenda in the 48 priority countries. Other considerations in designing a strategic approach to the unfinished global fortification agenda are also discussed.

The global nutrition transition: trends, disease burdens and policy interventions.

PubMed

Ronto, Rimante; Wu, Jason Hy; Singh, Gitanjali M

2018-03-06

Non-communicable diseases (NCD) have increased dramatically in developed and developing countries. Unhealthy diet is one of the major factors contributing to NCD development. Recent evidence has identified deterioration in aspects of dietary quality across many world regions, including low- and middle-income countries (LMIC). Most burdens of disease attributable to poor diet can be prevented or delayed as they occur prematurely. Therefore, it is important to identify and target unhealthy dietary behaviours in order to have the greatest impact. National dietary-related programmes have traditionally focused on micronutrient deficiency and food security and failed to acknowledge unhealthy dietary intakes as a risk factor that contributes to the development of NCD. Inadequate intakes of healthy foods and nutrients and excess intakes of unhealthy ones are commonly observed across the world, and efforts to reduce the double burden of micronutrient deficiency and unhealthy diets should be a particular focus for LMIC. Interventions and policies targeting whole populations are likely to be the most effective and sustainable, and should be prioritized. Population-based approaches such as health information and communication campaigns, fiscal measures such as taxes on sugar-sweetened beverages, direct restrictions and mandates, reformulation and improving the nutrient profile of food products, and standards regulating marketing to children can have significant and large impacts to improve diets and reduce the incidence of NCD. There is a need for more countries to implement population-based effective approaches to improve current diets.

A Systematic Study of Sustainable Development Goal (SDG) Interactions

NASA Astrophysics Data System (ADS)

Pradhan, Prajal; Costa, Luís.; Rybski, Diego; Lucht, Wolfgang; Kropp, Jürgen P.

2017-11-01

Sustainable development goals (SDGs) have set the 2030 agenda to transform our world by tackling multiple challenges humankind is facing to ensure well-being, economic prosperity, and environmental protection. In contrast to conventional development agendas focusing on a restricted set of dimensions, the SDGs provide a holistic and multidimensional view on development. Hence, interactions among the SDGs may cause diverging results. To analyze the SDG interactions we systematize the identification of synergies and trade-offs using official SDG indicator data for 227 countries. A significant positive correlation between a pair of SDG indicators is classified as a synergy while a significant negative correlation is classified as a trade-off. We rank synergies and trade-offs between SDGs pairs on global and country scales in order to identify the most frequent SDG interactions. For a given SDG, positive correlations between indicator pairs were found to outweigh the negative ones in most countries. Among SDGs the positive and negative correlations between indicator pairs allowed for the identification of particular global patterns. SDG 1 (No poverty) has synergetic relationship with most of the other goals, whereas SDG 12 (Responsible consumption and production) is the goal most commonly associated with trade-offs. The attainment of the SDG agenda will greatly depend on whether the identified synergies among the goals can be leveraged. In addition, the highlighted trade-offs, which constitute obstacles in achieving the SDGs, need to be negotiated and made structurally nonobstructive by deeper changes in the current strategies.

DEVELOPMENT OF AN ASTROVIRUS RT-PCR DETECTION ASSAY FOR USE WITH CONVENTIONAL, REAL-TIME, AND INTEGRATED CELL CULTURE/RT-PCR

EPA Science Inventory

Astrovirus is a common cause of gastroenteritis in humans that has been determined to be responsible for outbreaks of illness in several countries. Since astrovirus can be waterborne, it is important to be able to identify this virus in environmental water. We have developed an...

Identification of Special Educational Needs for Early Childhood Inclusive Education in Ghana

ERIC Educational Resources Information Center

Mensah, Florence Akua; Badu-Shayar, Jeremiah

2016-01-01

Early Childhood Education is a key element for the growth and development of every country. This paper, provides a summary of reviewing the impact of early childhood special educational assessment on children to be "at risk" of developing special educational needs. It was identified mainly that early identification of at-risk factors for…

A Systematic Literature Review of Funding for Higher Education Institutions in Developed Countries

ERIC Educational Resources Information Center

Zhang, Qilong; Ning, Kang; Barnes, Ruth

2016-01-01

Resource allocation and funding in higher education is crucial to the success of reform and transformation of our higher education system. With a view to identifying trends and best practices in the area, utilizing a method of systematic literature review, we have critically reviewed relevant theories and practices from developed counties that are…

Dissecting the African Digital Divide: Diffusing E-Learning in Sub-Saharan Africa

ERIC Educational Resources Information Center

Beaudoin, Michael F.

2007-01-01

Many countries identified with the developing world, such as those in sub-Saharan Africa, have been recipients of aid programs over the past five decades totaling billions of dollars and aimed at fostering social and economic development to achieve global parity with the industrialized world. Much of this activity has been focused on building…

German experience in managing stormwater with green infrastructure

EPA Science Inventory

This paper identifies and describes experience with ‘green’ stormwater management practices in Germany. It provides the context in which developments took place and extracts lessons learned to inform efforts of other countries in confronting urban stormwater challenges. Our findi...

[Anthropology and oral health projects in developing countries].

PubMed

Grasveld, A E

2016-01-01

The mouth and teeth play an important role in social interactions around the world. The way people deal with their teeth and mouth, however, is determined culturally. When oral healthcare projects are being carried out in developing countries, differing cultural worldviews can cause misunderstandings between oral healthcare providers and their patients. The oral healthcare volunteer often has to try to understand the local assumptions about teeth and oral hygiene first, before he or she can bring about a change of behaviour, increase therapy compliance and make the oral healthcare project sustainable. Anthropology can be helpful in this respect. In 2014, in a pilot project commissioned by the Dutch Dental Care Foundation, in which oral healthcare was provided in combination with anthropological research, an oral healthcare project in Kwale (Kenia) was evaluated. The study identified 6 primary themes that indicate the most important factors influencing the oral health of school children in Kwale. Research into the local culture by oral healthcare providers would appear to be an important prerequisite to meaningful work in developing countries.

Vaccines for viral and bacterial pathogens causing acute gastroenteritis: Part I: Overview, vaccines for enteric viruses and Vibrio cholerae.

PubMed

O'Ryan, Miguel; Vidal, Roberto; del Canto, Felipe; Salazar, Juan Carlos; Montero, David

2015-01-01

Efforts to develop vaccines for prevention of acute diarrhea have been going on for more than 40 y with partial success. The myriad of pathogens, more than 20, that have been identified as a cause of acute diarrhea throughout the years pose a significant challenge for selecting and further developing the most relevant vaccine candidates. Based on pathogen distribution as identified in epidemiological studies performed mostly in low-resource countries, rotavirus, Cryptosporidium, Shigella, diarrheogenic E. coli and V. cholerae are predominant, and thus the main targets for vaccine development and implementation. Vaccination against norovirus is most relevant in middle/high-income countries and possibly in resource-deprived countries, pending a more precise characterization of disease impact. Only a few licensed vaccines are currently available, of which rotavirus vaccines have been the most outstanding in demonstrating a significant impact in a short time period. This is a comprehensive review, divided into 2 articles, of nearly 50 vaccine candidates against the most relevant viral and bacterial pathogens that cause acute gastroenteritis. In order to facilitate reading, sections for each pathogen are organized as follows: i) a discussion of the main epidemiological and pathogenic features; and ii) a discussion of vaccines based on their stage of development, moving from current licensed vaccines to vaccines in advanced stage of development (in phase IIb or III trials) to vaccines in early stages of clinical development (in phase I/II) or preclinical development in animal models. In this first article we discuss rotavirus, norovirus and Vibrio cholerae. In the following article we will discuss Shigella, Salmonella (non-typhoidal), diarrheogenic E. coli (enterotoxigenic and enterohemorragic), and Campylobacter jejuni.

Vaccines for viral and bacterial pathogens causing acute gastroenteritis: Part I: Overview, vaccines for enteric viruses and Vibrio cholerae

PubMed Central

O’Ryan, Miguel; Vidal, Roberto; del Canto, Felipe; Salazar, Juan Carlos; Montero, David

2015-01-01

Efforts to develop vaccines for prevention of acute diarrhea have been going on for more than 40 y with partial success. The myriad of pathogens, more than 20, that have been identified as a cause of acute diarrhea throughout the years pose a significant challenge for selecting and further developing the most relevant vaccine candidates. Based on pathogen distribution as identified in epidemiological studies performed mostly in low-resource countries, rotavirus, Cryptosporidium, Shigella, diarrheogenic E. coli and V. cholerae are predominant, and thus the main targets for vaccine development and implementation. Vaccination against norovirus is most relevant in middle/high-income countries and possibly in resource-deprived countries, pending a more precise characterization of disease impact. Only a few licensed vaccines are currently available, of which rotavirus vaccines have been the most outstanding in demonstrating a significant impact in a short time period. This is a comprehensive review, divided into 2 articles, of nearly 50 vaccine candidates against the most relevant viral and bacterial pathogens that cause acute gastroenteritis. In order to facilitate reading, sections for each pathogen are organized as follows: i) a discussion of the main epidemiological and pathogenic features; and ii) a discussion of vaccines based on their stage of development, moving from current licensed vaccines to vaccines in advanced stage of development (in phase IIb or III trials) to vaccines in early stages of clinical development (in phase I/II) or preclinical development in animal models. In this first article we discuss rotavirus, norovirus and Vibrio cholerae. In the following article we will discuss Shigella, Salmonella (non-typhoidal), diarrheogenic E. coli (enterotoxigenic and enterohemorragic), and Campylobacter jejuni. PMID:25715048

The rise of health biotechnology research in Latin America: A scientometric analysis of health biotechnology production and impact in Argentina, Brazil, Chile, Colombia, Cuba and Mexico

PubMed Central

2018-01-01

This paper analyzes the patterns of health biotechnology publications in six Latin American countries from 2001 to 2015. The countries studied were Argentina, Brazil, Chile, Colombia, Cuba and Mexico. Before our study, there were no data available on HBT development in half of the Latin-American countries we studied, i.e., Argentina, Colombia and Chile. To include these countries in a scientometric analysis of HBT provides fuller coverage of HBT development in Latin America. The scientometric study used the Web of Science database to identify health biotechnology publications. The total amount of health biotechnology production in the world during the period studied was about 400,000 papers. A total of 1.2% of these papers, were authored by the six Latin American countries in this study. The results show a significant growth in health biotechnology publications in Latin America despite some of the countries having social and political instability, fluctuations in their gross domestic expenditure in research and development or a trade embargo that limits opportunities for scientific development. The growth in the field of some of the Latin American countries studied was larger than the growth of most industrialized nations. Still, the visibility of the Latin American research (measured in the number of citations) did not reach the world average, with the exception of Colombia. The main producers of health biotechnology papers in Latin America were universities, except in Cuba were governmental institutions were the most frequent producers. The countries studied were active in international research collaboration with Colombia being the most active (64% of papers co-authored internationally), whereas Brazil was the least active (35% of papers). Still, the domestic collaboration was even more prevalent, with Chile being the most active in such collaboration (85% of papers co-authored domestically) and Argentina the least active (49% of papers). We conclude that the Latin American countries studied are increasing their health biotechnology publishing. This strategy could contribute to the development of innovations that may solve local health problems in the region. PMID:29415003

The rise of health biotechnology research in Latin America: A scientometric analysis of health biotechnology production and impact in Argentina, Brazil, Chile, Colombia, Cuba and Mexico.

PubMed

León-de la O, Dante Israel; Thorsteinsdóttir, Halla; Calderón-Salinas, José Víctor

2018-01-01

This paper analyzes the patterns of health biotechnology publications in six Latin American countries from 2001 to 2015. The countries studied were Argentina, Brazil, Chile, Colombia, Cuba and Mexico. Before our study, there were no data available on HBT development in half of the Latin-American countries we studied, i.e., Argentina, Colombia and Chile. To include these countries in a scientometric analysis of HBT provides fuller coverage of HBT development in Latin America. The scientometric study used the Web of Science database to identify health biotechnology publications. The total amount of health biotechnology production in the world during the period studied was about 400,000 papers. A total of 1.2% of these papers, were authored by the six Latin American countries in this study. The results show a significant growth in health biotechnology publications in Latin America despite some of the countries having social and political instability, fluctuations in their gross domestic expenditure in research and development or a trade embargo that limits opportunities for scientific development. The growth in the field of some of the Latin American countries studied was larger than the growth of most industrialized nations. Still, the visibility of the Latin American research (measured in the number of citations) did not reach the world average, with the exception of Colombia. The main producers of health biotechnology papers in Latin America were universities, except in Cuba were governmental institutions were the most frequent producers. The countries studied were active in international research collaboration with Colombia being the most active (64% of papers co-authored internationally), whereas Brazil was the least active (35% of papers). Still, the domestic collaboration was even more prevalent, with Chile being the most active in such collaboration (85% of papers co-authored domestically) and Argentina the least active (49% of papers). We conclude that the Latin American countries studied are increasing their health biotechnology publishing. This strategy could contribute to the development of innovations that may solve local health problems in the region.

Cardiovascular, respiratory, and related disorders: key messages from Disease Control Priorities, 3rd edition

PubMed Central

Prabhakaran, Dorairaj; Anand, Shuchi; Watkins, David; Gaziano, Thomas; Wu, Yangfeng; Mbanya, Jean Claude; Nugent, Rachel

2018-01-01

Cardiovascular, respiratory, and related disorders (CVRDs) are the leading causes of adult death worldwide, and substantial inequalities in care of patients with CVRDs exist between countries of high income and countries of low and middle income. Based on current trends, the UN Sustainable Development Goal to reduce premature mortality due to CVRDs by a third by 2030 will be challenging for many countries of low and middle income. We did systematic literature reviews of effectiveness and cost-effectiveness to identify priority interventions. We summarise the key findings and present a costed essential package of interventions to reduce risk of and manage CVRDs. On a population level, we recommend tobacco taxation, bans on trans fats, and compulsory reduction of salt in manufactured food products. We suggest primary health services be strengthened through the establishment of locally endorsed guidelines and ensured availability of essential medications. The policy interventions and health service delivery package we suggest could serve as the cornerstone for the management of CVRDs, and afford substantial financial risk protection for vulnerable households. We estimate that full implementation of the essential package would cost an additional US$21 per person in the average low-income country and $24 in the average lower-middle-income country. The essential package we describe could be a starting place for low-income and middle-income countries developing universal health coverage packages. Interventions could be rolled out as disease burden demands and budgets allow. Our outlined interventions provide a pathway for countries attempting to convert the UN Sustainable Development Goal commitments into tangible action. PMID:29108723

Joint External Evaluation—Development and Scale-Up of Global Multisectoral Health Capacity Evaluation Process

PubMed Central

Bell, Elizabeth; Ijaz, Kashef; Bartee, Maureen; Fernandez, Jose; Burris, Hannah; Sliter, Karen; Nikkari, Simo; Chungong, Stella; Rodier, Guenael; Jafari, Hamid

2017-01-01

The Joint External Evaluation (JEE), a consolidation of the World Health Organization (WHO) International Health Regulations 2005 (IHR 2005) Monitoring and Evaluation Framework and the Global Health Security Agenda country assessment tool, is an objective, voluntary, independent peer-to-peer multisectoral assessment of a country’s health security preparedness and response capacity across 19 IHR technical areas. WHO approved the standardized JEE tool in February 2016. The JEE process is wholly transparent; countries request a JEE and are encouraged to make its findings public. Donors (e.g., member states, public and private partners, and other public health institutions) can support countries in addressing identified JEE gaps, and implementing country-led national action plans for health security. Through July 2017, 52 JEEs were completed, and 25 more countries were scheduled across WHO’s 6 regions. JEEs facilitate progress toward IHR 2005 implementation, thereby building trust and mutual accountability among countries to detect and respond to public health threats. PMID:29155678

Material wealth in 3D: Mapping multiple paths to prosperity in low- and middle- income countries.

PubMed

Hruschka, Daniel J; Hadley, Craig; Hackman, Joseph

2017-01-01

Material wealth is a key factor shaping human development and well-being. Every year, hundreds of studies in social science and policy fields assess material wealth in low- and middle-income countries assuming that there is a single dimension by which households can move from poverty to prosperity. However, a one-dimensional model may miss important kinds of prosperity, particularly in countries where traditional subsistence-based livelihoods coexist with modern cash economies. Using multiple correspondence analysis to analyze representative household data from six countries-Nepal, Bangladesh, Ethiopia, Kenya, Tanzania and Guatemala-across three world regions, we identify a number of independent dimension of wealth, each with a clear link to locally relevant pathways to success in cash and agricultural economies. In all cases, the first dimension identified by this approach replicates standard one-dimensional estimates and captures success in cash economies. The novel dimensions we identify reflect success in different agricultural sectors and are independently associated with key benchmarks of food security and human growth, such as adult body mass index and child height. The multidimensional models of wealth we describe here provide new opportunities for examining the causes and consequences of wealth inequality that go beyond success in cash economies, for tracing the emergence of hybrid pathways to prosperity, and for assessing how these different pathways to economic success carry different health risks and social opportunities.

International comparisons of health system performance among OECD countries: opportunities and data privacy protection challenges.

PubMed

Oderkirk, Jillian; Ronchi, Elettra; Klazinga, Niek

2013-09-01

Health data constitute a significant resource in most OECD countries that could be used to improve health system performance. Well-intended policies to allay concerns about breaches of confidentiality and to reduce potential misuse of personal health information may be limiting data use. A survey of 20 OECD countries explored the extent to which countries have developed and use personal health data and the reasons why data use may be problematic in some. Countries are divided, with one-half engaged regularly in national data linkage studies to monitor health care quality. Country variation is linked to risk management in granting an exemption to patient consent requirements; in sharing identifiable data among government authorities; and in project approvals and granting access to data. The resources required to comply with data protection requirements is a secondary problem. The sharing of person-level data across borders for international comparisons is rarely reported and there were few examples of studies of health system performance. Laws and policies enabling data sharing and data linkage are needed to strengthen national information infrastructure. To develop international studies comparing health care quality and health system performance, actions are needed to address heterogeneity in data protection practices. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

A Regional Decision Support Scheme for Pest Risk Analysis in Southeast Asia.

PubMed

Soliman, T; MacLeod, A; Mumford, J D; Nghiem, T P L; Tan, H T W; Papworth, S K; Corlett, R T; Carrasco, L R

2016-05-01

A key justification to support plant health regulations is the ability of quarantine services to conduct pest risk analyses (PRA). Despite the supranational nature of biological invasions and the close proximity and connectivity of Southeast Asian countries, PRAs are conducted at the national level. Furthermore, some countries have limited experience in the development of PRAs, which may result in inadequate phytosanitary responses that put their plant resources at risk to pests vectored via international trade. We review existing decision support schemes for PRAs and, following international standards for phytosanitary measures, propose new methods that adapt existing practices to suit the unique characteristics of Southeast Asia. Using a formal written expert elicitation survey, a panel of regional scientific experts was asked to identify and rate unique traits of Southeast Asia with respect to PRA. Subsequently, an expert elicitation workshop with plant protection officials was conducted to verify the potential applicability of the developed methods. Rich biodiversity, shortage of trained personnel, social vulnerability, tropical climate, agriculture-dependent economies, high rates of land-use change, and difficulties in implementing risk management options were identified as challenging Southeast Asian traits. The developed methods emphasize local Southeast Asian conditions and could help support authorities responsible for carrying out PRAs within the region. These methods could also facilitate the creation of other PRA schemes in low- and middle-income tropical countries. © 2016 Society for Risk Analysis.

Evaluation of regional project to strengthen national health research systems in four countries in West Africa: lessons learned.

PubMed

Sombié, Issiaka; Aidam, Jude; Montorzi, Gabriela

2017-07-12

Since the Commission on Health Research for Development (COHRED) published its flagship report, more attention has been focused on strengthening national health research systems (NHRS). This paper evaluates the contribution of a regional project that used a participatory approach to strengthen NHRS in four post-conflict West African countries - Guinea-Bissau, Liberia, Sierra Leone and Mali. The data from the situation analysis conducted at the start of the project was compared to data from the project's final evaluation, using a hybrid conceptual framework built around four key areas identified through the analysis of existing frameworks. The four areas are governance and management, capacities, funding, and dissemination/use of research findings. The project helped improve the countries' governance and management mechanisms without strengthening the entire NHRS. In the four countries, at least one policy, plan or research agenda was developed. One country put in place a national health research ethics committee, while all four countries could adopt a research information management system. The participatory approach and support from the West African Health Organisation and COHRED were all determining factors. The lessons learned from this project show that the fragile context of these countries requires long-term engagement and that support from a regional institution is needed to address existing challenges and successfully strengthen the entire NHRS.

The Road Traffic Injuries Research Network: a decade of research capacity strengthening in low- and middle-income countries.

PubMed

Hyder, Adnan A; Norton, Robyn; Pérez-Núñez, Ricardo; Mojarro-Iñiguez, Francisco R; Peden, Margie; Kobusingye, Olive

2016-02-27

Road traffic crashes have been an increasing threat to the wellbeing of road users worldwide; an unacceptably high number of people die or become disabled from them. While high-income countries have successfully implemented effective interventions to help reduce the burden of road traffic injuries (RTIs) in their countries, low- and middle-income countries (LMICs) have not yet achieved similar results. Both scientific research and capacity development have proven to be useful for preventing RTIs in high-income countries. In 1999, a group of leading researchers from different countries decided to join efforts to help promote research on RTIs and develop the capacity of professionals from LMICs. This translated into the creation of the Road Traffic Injuries Research Network (RTIRN) - a partnership of over 1,100 road safety professionals from 114 countries collaborating to facilitate reductions in the burden of RTIs in LMICs by identifying and promoting effective, evidenced-based interventions and supporting research capacity building in road safety research in LMICs. This article presents the work that RTIRN has done over more than a decade, including production of a dozen scientific papers, support of nearly 100 researchers, training of nearly 1,000 people and 35 scholarships granted to researchers from LMICs to attend world conferences, as well as lessons learnt and future challenges to maximize its work.

Policy Development for Environmental Licensing and Biodiversity Offsets in Latin America

PubMed Central

Villarroya, Ana; Barros, Ana Cristina; Kiesecker, Joseph

2014-01-01

Attempts to meet biodiversity goals through application of the mitigation hierarchy have gained wide traction globally with increased development of public policy, lending standards, and corporate practices. With interest in biodiversity offsets increasing in Latin America, we seek to strengthen the basis for policy development through a review of major environmental licensing policy frameworks in Argentina, Brazil, Chile, Colombia, Mexico, Peru and Venezuela. Here we focused our review on an examination of national level policies to evaluate to which degree current provisions promote positive environmental outcomes. All the surveyed countries have national-level Environmental Impact Assessment laws or regulations that cover the habitats present in their territories. Although most countries enable the use of offsets only Brazil, Colombia, Mexico and Peru explicitly require their implementation. Our review has shown that while advancing quite detailed offset policies, most countries do not seem to have strong requirements regarding impact avoidance. Despite this deficiency most countries have a strong foundation from which to develop policy for biodiversity offsets, but several issues require further guidance, including how best to: (1) ensure conformance with the mitigation hierarchy; (2) identify the most environmentally preferable offsets within a landscape context; (3) determine appropriate mitigation replacement ratios; and (4) ensure appropriate time and effort is given to monitor offset performance. PMID:25191758

Reuse of samples: ethical issues encountered by two institutional ethics review committees in Kenya.

PubMed

Langat, Simon K

2005-10-01

There is growing concern about the reuse and exploitation of biological materials (human tissues) for use in research worldwide. Most discussions about samples have taken place in developed countries, where genetic manipulation techniques have greatly advanced in recent years. There is very little discussion in developing countries, although collaborative research with institutions from developed countries is on the increase. The study sought to identify and describe ethical issues arising in the storage, reuse and exportation of samples in a developing country. Research protocols presented to two Ethics Review Committees in Kenya during a period of two years were reviewed. A record was made of the protocol title, sample collected, request for storage, reuse or exportation and whether or not subject consent was sought. The findings indicated that about 25% out of the 388 protocols sought permission for reuse and only half of those actually informed subjects of the contemplated re-use. Less than 20% requested storage and again, about half of them sought consent from subjects. There is an indication that investigators do not see the need to seek consent for storage, reuse and exportation of samples. It is proposed that these issues should be addressed through policy interventions at both the national and global levels.

Policy development for environmental licensing and biodiversity offsets in Latin America.

PubMed

Villarroya, Ana; Barros, Ana Cristina; Kiesecker, Joseph

2014-01-01

Attempts to meet biodiversity goals through application of the mitigation hierarchy have gained wide traction globally with increased development of public policy, lending standards, and corporate practices. With interest in biodiversity offsets increasing in Latin America, we seek to strengthen the basis for policy development through a review of major environmental licensing policy frameworks in Argentina, Brazil, Chile, Colombia, Mexico, Peru and Venezuela. Here we focused our review on an examination of national level policies to evaluate to which degree current provisions promote positive environmental outcomes. All the surveyed countries have national-level Environmental Impact Assessment laws or regulations that cover the habitats present in their territories. Although most countries enable the use of offsets only Brazil, Colombia, Mexico and Peru explicitly require their implementation. Our review has shown that while advancing quite detailed offset policies, most countries do not seem to have strong requirements regarding impact avoidance. Despite this deficiency most countries have a strong foundation from which to develop policy for biodiversity offsets, but several issues require further guidance, including how best to: (1) ensure conformance with the mitigation hierarchy; (2) identify the most environmentally preferable offsets within a landscape context; (3) determine appropriate mitigation replacement ratios; and (4) ensure appropriate time and effort is given to monitor offset performance.

Protozoan Parasites in Drinking Water: A System Approach for Improved Water, Sanitation and Hygiene in Developing Countries

PubMed Central

Tussupova, Kamshat; Berndtsson, Ronny; Sharapatova, Kulyash

2018-01-01

Improved water, sanitation and hygiene (WASH) are significant in preventing diarrhea morbidity and mortality caused by protozoa in low- and middle-income countries. Due to the intimate and complex relationships between the different WASH components, it is often necessary to improve not just one but all of these components to have sustainable results. The objective of this paper was to review the current state of WASH-related health problems caused by parasitic protozoa by: giving an overview and classification of protozoa and their effect on people’s health, discussing different ways to improve accessibility to safe drinking water, sanitation services and personal hygiene behavior; and suggesting an institutional approach to ensure improved WASH. The findings indicate that Giardia and Cryptosporidium are more often identified during waterborne or water-washed outbreaks and they are less sensitive than most of the bacteria and viruses to conventional drinking water and wastewater treatment methods. There are various institutions of control and prevention of water-related diseases caused by protozoa in developed countries. Unfortunately, the developing regions do not have comparable systems. Consequently, the institutional and systems approach to WASH is necessary in these countries. PMID:29534511

Incident Management Systems and Building Emergency Management Capacity during the 2014-2016 Ebola Epidemic - Liberia, Sierra Leone, and Guinea.

PubMed

Brooks, Jennifer C; Pinto, Meredith; Gill, Adrienne; Hills, Katherine E; Murthy, Shivani; Podgornik, Michelle N; Hernandez, Luis F; Rose, Dale A; Angulo, Frederick J; Rzeszotarski, Peter

2016-07-08

Establishing a functional incident management system (IMS) is important in the management of public health emergencies. In response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC established the Emergency Management Development Team (EMDT) to coordinate technical assistance for developing emergency management capacity in Guinea, Liberia, and Sierra Leone. EMDT staff, deployed staff, and partners supported each country to develop response goals and objectives, identify gaps in response capabilities, and determine strategies for coordinating response activities. To monitor key programmatic milestones and assess changes in emergency management and response capacities over time, EMDT implemented three data collection methods in country: coordination calls, weekly written situation reports, and an emergency management dashboard tool. On the basis of the information collected, EMDT observed improvements in emergency management capacity over time in all three countries. The collaborations in each country yielded IMS structures that streamlined response and laid the foundation for long-term emergency management programs.The activities summarized in this report would not have been possible without collaboration with many U.S and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).

Protozoan Parasites in Drinking Water: A System Approach for Improved Water, Sanitation and Hygiene in Developing Countries.

PubMed

Omarova, Alua; Tussupova, Kamshat; Berndtsson, Ronny; Kalishev, Marat; Sharapatova, Kulyash

2018-03-12

Improved water, sanitation and hygiene (WASH) are significant in preventing diarrhea morbidity and mortality caused by protozoa in low- and middle-income countries. Due to the intimate and complex relationships between the different WASH components, it is often necessary to improve not just one but all of these components to have sustainable results. The objective of this paper was to review the current state of WASH-related health problems caused by parasitic protozoa by: giving an overview and classification of protozoa and their effect on people's health, discussing different ways to improve accessibility to safe drinking water, sanitation services and personal hygiene behavior; and suggesting an institutional approach to ensure improved WASH. The findings indicate that Giardia and Cryptosporidium are more often identified during waterborne or water-washed outbreaks and they are less sensitive than most of the bacteria and viruses to conventional drinking water and wastewater treatment methods. There are various institutions of control and prevention of water-related diseases caused by protozoa in developed countries. Unfortunately, the developing regions do not have comparable systems. Consequently, the institutional and systems approach to WASH is necessary in these countries.

Incidence and Mortality and Epidemiology of Breast Cancer in the World.

PubMed

Ghoncheh, Mahshid; Pournamdar, Zahra; Salehiniya, Hamid

2016-01-01

Breast cancer is the most common malignancy in women around the world. Information on the incidence and mortality of breast cancer is essential for planning health measures. This study aimed to investigate the incidence and mortality of breast cancer in the world using age-specific incidence and mortality rates for the year 2012 acquired from the global cancer project (GLOBOCAN 2012) as well as data about incidence and mortality of the cancer based on national reports. It was estimated that 1,671,149 new cases of breast cancer were identified and 521,907 cases of deaths due to breast cancer occurred in the world in 2012. According to GLOBOCAN, it is the most common cancer in women, accounting for 25.1% of all cancers. Breast cancer incidence in developed countries is higher, while relative mortality is greatest in less developed countries. Education of women is suggested in all countries for early detection and treatment. Plans for the control and prevention of this cancer must be a high priority for health policy makers; also, it is necessary to increase awareness of risk factors and early detection in less developed countries.

Phone traffic as a measurement of agricultural events

NASA Astrophysics Data System (ADS)

Martín, Samuel; Borondo, Javier; Morales, Alfredo; Losada, Juan Carlos; Tarquis, Ana M.; Benito, Rosa Maria

2015-04-01

Inspired by empirical studies of networked systems such as the Internet, social networks, and biological networks, researchers have in recent years developed a variety of techniques and models to help us understand or predict the behaviour of these systems (1). However, it has been recently when global food system has been seen as a complex web of production, processing, storage and transportation opening new challenges in their analysis. Agricultural activities in developing countries remain as important today as in the 1950s implying seasonal workers mobilization. The proliferation of mobile phones (MPs) offers an unprecedented tool to analyze human activity mapping. We would like to mention that in developed countries, the number of MP subscribers has surpassed the total population, with a penetration rate now reaching 121%, whereas in developing countries, it is as high as 90% and continuing to rise (2). As an example, we have analyzed the impact that agricultural activities, such as the growing of groundnut, have on Senegal. To this end we have analyzed the Normalized Difference Vegetation Index (NDVI) time series of the whole of Senegal and spotted the regions where groundnut is grown to identify the time period when this crop growth. By analyzing phone calls at each region of the country we found that a significant fraction of antennas exhibit two well defined peaks of activity corresponding with the begging and end of the growing season. Antennas located on regions identified as growing regions present this pattern. However, other antennas, located in non growing regions, such as Dakar, also present the two peaks pattern pointing out the synchronization between growing regions and key points in cities that emerges from the agricultural activity. References 1. Marta C. González, César A. Hidalgo and Albert-László Barabási (2008) Understanding individual human mobility patterns. Nature 453, 779-78. 2. International Telecommunication Union (2014) World Telecommunication Development Conference (WTDC-2014): Final Report. (ITU, Dubai, United Arab Emirates).

National policy on physical activity: the development of a policy audit tool.

PubMed

Bull, Fiona C; Milton, Karen; Kahlmeier, Sonja

2014-02-01

Physical inactivity is a leading risk factor for noncommunicable disease worldwide. Increasing physical activity requires large scale actions and relevant, supportive national policy across multiple sectors. The policy audit tool (PAT) was developed to provide a standardized instrument to assess national policy approaches to physical activity. A draft tool, based on earlier work, was developed and pilot-tested in 7 countries. After several rounds of revisions, the final PAT comprises 27 items and collects information on 1) government structure, 2) development and content of identified key policies across multiple sectors, 3) the experience of policy implementation at both the national and local level, and 4) a summary of the PAT completion process. PAT provides a standardized instrument for assessing progress of national policy on physical activity. Engaging a diverse international group of countries in the development helped ensure PAT has applicability across a wide range of countries and contexts. Experiences from the development of the PAT suggests that undertaking an audit of health enhancing physical activity (HEPA) policy can stimulate greater awareness of current policy opportunities and gaps, promote critical debate across sectors, and provide a catalyst for collaboration on policy level actions. The final tool is available online.

Global Seasonality of Rotavirus Disease

PubMed Central

Patel, Manish M.; Pitzer, Virginia; Alonso, Wladimir J.; Vera, David; Lopman, Ben; Tate, Jacqueline; Viboud, Cecile; Parashar, Umesh D.

2012-01-01

Background A substantial number of surveillance studies have documented rotavirus prevalence among children admitted for dehydrating diarrhea. We sought to establish global seasonal patterns of rotavirus disease before widespread vaccine introduction. Methods We reviewed studies of rotavirus detection in children with diarrhea published since 1995. We assessed potential relationships between seasonal prevalence and locality by plotting the average monthly proportion of diarrhea cases positive for rotavirus according to geography, country development, and latitude. We used linear regression to identify variables that were potentially associated with the seasonal intensity of rotavirus. Results Among a total of 99 studies representing all six geographical regions of the world, patterns of year-round disease were more evident in low- and low-middle income countries compared with upper-middle and high income countries where disease was more likely to be seasonal. The level of country development was a stronger predictor of strength of seasonality (P=0.001) than geographical location or climate. However, the observation of distinctly different seasonal patterns of rotavirus disease in some countries with similar geographical location, climate and level of development indicate that a single unifying explanation for variation in seasonality of rotavirus disease is unlikely. Conclusion While no unifying explanation emerged for varying rotavirus seasonality globally, the country income level was somewhat more predictive of the likelihood of having seasonal disease than other factors. Future evaluation of the effect of rotavirus vaccination on seasonal patterns of disease in different settings may help understand factors that drive the global seasonality of rotavirus disease. PMID:23190782

Mapping of nutrition and sectoral policies addressing malnutrition in Latin America.

PubMed

Tirado, María Cristina; Galicia, Luis; Husby, Hannah M; Lopez, Jaime; Olamendi, Stephania; Pia Chaparro, Maria; González, María A; Grajeda, Rubén

2016-08-01

To map existing policies addressing malnutrition in all its forms in Latin America and identify gaps in enabling environments supporting the five priority lines of action outlined in the World Health Organization Comprehensive Implementation Plan on Maternal, Infant and Young Child Nutrition (CIP) approved in 2014. This descriptive study consisted of a systematic Internet search for and mapping of publicly available nutrition-related and sectoral policies already in place to address malnutrition in all its forms in 18 Latin American countries (Argentina, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, and Uruguay). The policies were described in documents retrieved from the websites of ministries of health, education, agriculture, labor, and development; the national congress; and other government agencies. All 18 countries had relevant policies to address malnutrition, especially undernutrition and micronutrient deficiencies, but only a few had policies to address overweight and obesity. Nutrition actions were incorporated in food and nutrition security and social protection policies in all 18 countries, and were part of education, environment, agricultural, development, and/or employment policies in some countries. Information on human and financial resources assigned to nutrition was not available through the search strategies used in the study. All 18 countries included in this review had established enabling environments to support CIP implementation. However, each of the 18 countries needs to develop integrated policies for the promotion of nutrition and prevention of noncommunicable diseases through cross-sector involvement and multi-stakeholder collaboration.

Challenges and opportunities for meningococcal vaccination in the developing world.

PubMed

Shaker, Rouba; Fayad, Danielle; Dbaibo, Ghassan

2018-05-04

Meningococcal disease continues to be a life threatening infection with high morbidity and mortality even in appropriately treated patients. Meningococcal vaccination plays a major role in the control of the disease; however, implementing vaccination remains problematic in the developing world. The objective of this review is to identify the challenges facing the use of meningococcal vaccines in the developing world in order to discuss the opportunities and available solutions to improve immunization in these countries. Inadequate epidemiologic information necessary to implement vaccination and financial challenges predominate. Multiple measures are needed to achieve the successful implementation of meningococcal conjugate vaccination programs that protect against circulating serogroups in developing countries including enhanced surveillance systems, financial support and aid through grants, product development partnerships that are the end result of effective collaboration and communication between different interdependent stakeholders to develop affordable vaccines, and demonstration of the cost-effectiveness of new meningococcal vaccines.

Contemporary migration patterns in the prevalence of Helicobacter pylori infection: A systematic review.

PubMed

Morais, Samantha; Costa, Ana Rute; Ferro, Ana; Lunet, Nuno; Peleteiro, Bárbara

2017-06-01

A rapid growth in the number of international migrants over the past years has occurred with most traveling to more affluent settings. As Helicobacter pylori infects over half of the adult population and its prevalence is higher in developing countries, understanding the prevalence of infection in migrants can provide insight into future trends in the burden and management of infection. We aimed to describe the prevalence of H. pylori among migrants through a systematic literature review. We searched PubMed ® from inception to September 2015 to identify studies reporting the prevalence of H. pylori in international migrants according to country of birth for first-generation, and country of birth and parents' nationality for successive generations. Comparable data from origin and destination populations were obtained from the same studies or, when not present, from a previous systematic review on H. pylori worldwide. A total of 28 eligible studies were identified with data for 29 origin and 12 destination countries. Two studies that evaluated refugees presented prevalences of infection higher than both the origin and destination countries. Otherwise, the prevalences among migrants were generally similar or below that of the origin and higher than the destination. Second- or more generation had lower prevalences compared to first-generation migrants. Our study findings are consistent with what would be expected based on the prevalence of H. pylori worldwide. The results of this review show that migrants are particularly at risk of infection and help to identify gaps in the knowledge of migrants' prevalence of infection globally. © 2017 John Wiley & Sons Ltd.

Health systems' responsiveness and its characteristics: a cross-country comparative analysis.

PubMed

Robone, Silvana; Rice, Nigel; Smith, Peter C

2011-12-01

OBJECTIVES. Responsiveness has been identified as one of the intrinsic goals of health care systems. Little is known, however, about its determinants. Our objective is to investigate the potential country-level drivers of health system responsiveness. DATA SOURCE. Data on responsiveness are taken from the World Health Survey. Information on country-level characteristics is obtained from a variety of sources including the United Nations Development Program (UNDP). STUDY DESIGN. A two-step procedure. First, using survey data we derive a country-level measure of system responsiveness purged of differences in individual reporting behavior. Secondly, we run cross-sectional country-level regressions of responsiveness on potential drivers. PRINCIPAL FINDINGS. Health care expenditures per capita are positively associated with responsiveness, after controlling for the influence of potential confounding factors. Aspects of responsiveness are also associated with public sector spending (negatively) and educational development (positively). CONCLUSIONS. From a policy perspective, improvements in responsiveness may require higher spending levels. The expansion of nonpublic sector provision, perhaps in the form of increased patient choice, may also serve to improve responsiveness. However, these inferences are tentative and require further study. © Health Research and Educational Trust.

Current drivers and future directions of global livestock disease dynamics

PubMed Central

Perry, Brian D.; Grace, Delia; Sones, Keith

2013-01-01

We review the global dynamics of livestock disease over the last two decades. Our imperfect ability to detect and report disease hinders assessment of trends, but we suggest that, although endemic diseases continue their historic decline in wealthy countries, poor countries experience static or deteriorating animal health and epidemic diseases show both regression and expansion. At a mesolevel, disease is changing in terms of space and host, which is illustrated by bluetongue, Lyme disease, and West Nile virus, and it is also emerging, as illustrated by highly pathogenic avian influenza and others. Major proximate drivers of change in disease dynamics include ecosystem change, ecosystem incursion, and movements of people and animals; underlying these are demographic change and an increasing demand for livestock products. We identify three trajectories of global disease dynamics: (i) the worried well in developed countries (demanding less risk while broadening the circle of moral concern), (ii) the intensifying and market-orientated systems of many developing countries, where highly complex disease patterns create hot spots for disease shifts, and (iii) the neglected cold spots in poor countries, where rapid change in disease dynamics is less likely but smallholders and pastoralists continue to struggle with largely preventable and curable livestock diseases. PMID:21576468

Assesment of publication practices in geosciences in developing countries

NASA Astrophysics Data System (ADS)

Cazenave, A.; Barbe, V.

2003-12-01

We present results of a study which goal was to investigate in which journals scientists in geosciences (i.e., in the fields covered by the AGU) in developing countries publish most of their papers.We were interested in particular in looking at the percentage of publications in AGU journals. Using science indicators collected by the Institute for Scientific Information (ISI), we analysed publication practices for 1997-2002 in the following countries : India, China, Russia, Brazil, Argentina and Chile. We investigated the evolution of the number of publications through time, identified most used journals, determined times cited and impact factors of papers published in the top 15 most used journals. We also determined the percentage of articles published in AGU journals versus other journals. We found that for the 6 counties considered, this percentage varies from about 2 to 3 percent (Argentina, China) to about 8 percent (the other 4 countries). Investigation of authors addresses indicates that the majority of articles published in AGU journals are multi-countries publications, involving international collaboration mainly with scientists from North America and Europe. Implications on page-charge and access to AGU journals are also discussed.

Primary Health Care as a Foundation for Strengthening Health Systems in Low- and Middle-Income Countries.

PubMed

Bitton, Asaf; Ratcliffe, Hannah L; Veillard, Jeremy H; Kress, Daniel H; Barkley, Shannon; Kimball, Meredith; Secci, Federica; Wong, Ethan; Basu, Lopa; Taylor, Chelsea; Bayona, Jaime; Wang, Hong; Lagomarsino, Gina; Hirschhorn, Lisa R

2017-05-01

Primary health care (PHC) has been recognized as a core component of effective health systems since the early part of the twentieth century. However, despite notable progress, there remains a large gap between what individuals and communities need, and the quality and effectiveness of care delivered. The Primary Health Care Performance Initiative (PHCPI) was established by an international consortium to catalyze improvements in PHC delivery and outcomes in low- and middle-income countries through better measurement and sharing of effective models and practices. PHCPI has developed a framework to illustrate the relationship between key financing, workforce, and supply inputs, and core primary health care functions of first-contact accessibility, comprehensiveness, coordination, continuity, and person-centeredness. The framework provides guidance for more effective assessment of current strengths and gaps in PHC delivery through a core set of 25 key indicators ("Vital Signs"). Emerging best practices that foster high-performing PHC system development are being codified and shared around low- and high-income countries. These measurement and improvement approaches provide countries and implementers with tools to assess the current state of their PHC delivery system and to identify where cross-country learning can accelerate improvements in PHC quality and effectiveness.