Food irradiation: regulatory aspects in the Asia and Pacific region

NASA Astrophysics Data System (ADS)

Luckman, Gary James

2002-03-01

Irradiation treatment of food is becoming an increasingly accepted processing option for countries in the Asia Pacific region wishing to meet growing sanitary and phytosanitary requirements in international trade. There remain however, large differences between the regulatory requirements in the countries in this region. This paper gives an outline on existing food irradiation regulations in the separate countries of the Asia Pacific region. New developments such as the recent decision by the Australia New Zealand Food Authority to start assessing applications for food irradiation treatment are discussed. Australia's intention to regulate the export of food treated by irradiation will also be outlined. Details of the decision to harmonise food irradiation regulations by 13 countries in the Asia Pacific region based on conformance with Codex requirements is outlined. The likelihood of other Asia Pacific countries enacting similar harmonisation of their regulations will be examined. Future development such as certification of irradiation as a sanitary treatment for food are discussed. The expected result of these initiatives is a likely increase in irradiated foods traded within the Asia Pacific region.

Global economic prospects and the developing countries, 1995

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

NONE

1995-12-01

The report`s central message is that the increasing integration of developing countries into the global economy constitutes perhaps the most important opportunity for raising the welfare of both developing and industrial countries over the long term. But the process of integration will not be without frictions that give rise to protectionist pressures. And, as recent events in Mexico have shown, it will increase the complexity of economic management for developing country policymakers. Globalization comes with liberalization, deregulation, and more mobile and potentially volatile cross-border capital flows, which means that sound macroeconomic management commands an increasingly high premium. Penalties for policymore » errors rise. Globalization thus requires closer monitoring and quicker policy responses at the country, regional, and global levels.« less

Financing Renewable Energy Projects in Developing Countries: A Critical Review

NASA Astrophysics Data System (ADS)

Donastorg, A.; Renukappa, S.; Suresh, S.

2017-08-01

Access to clean and stable energy, meeting sustainable development goals, the fossil fuel dependency and depletion are some of the reasons that have impacted developing countries to transform the business as usual economy to a more sustainable economy. However, access and availability of finance is a major challenge for many developing countries. Financing renewable energy projects require access to significant resources, by multiple parties, at varying points in the project life cycles. This research aims to investigate sources and new trends in financing RE projects in developing countries. For this purpose, a detail and in-depth literature review have been conducted to explore the sources and trends of current RE financial investment and projects, to understand the gaps and limitations. This paper concludes that there are various internal and external sources of finance available for RE projects in developing countries.

Developing Science: Scientific Performance and Brain Drains in the Developing World

PubMed Central

Weinberg, Bruce A.

2016-01-01

Establishing a strong scientific community is important as countries develop, which requires both producing and retaining of important scientists. We show that developing countries produce a sizeable number of important scientists, but that they experience a tremendous brain drain. Education levels, population, and per capita GDP are positively related to the number of important scientists born in and staying in a country. Our analysis indicates that democracy and urbanization are associated with the production of more important scientists although democracy is associated with more out-migration. PMID:27152061

Why and how to monitor the cost and evaluate the cost-effectiveness of HIV services in countries.

PubMed

Beck, Eduard J; Santas, Xenophon M; Delay, Paul R

2008-07-01

The number of people in the world living with HIV is increasing as HIV-related mortality has declined but the annual number of people newly infected with HIV has not. The international response to contain the HIV pandemic, meanwhile, has grown. Since 2006, an international commitment to scale up prevention, treatment, care and support services in middle and lower-income countries by 2010 has been part of the Universal Access programme, which itself plays an important part in achieving the Millennium Development Goals by 2015. Apart from providing technical support, donor countries and agencies have substantially increased their funding to enable countries to scale up HIV services. Many countries have been developing their HIV monitoring and evaluation systems to generate the strategic information required to track their response and ensure the best use of the new funds. Financial information is an important aspect of the strategic information required for scaling up existing services as well as assessing the effect of new ones. It involves two components: tracking the money available and spent on HIV at all levels, through budget tracking, national health accounts and national AIDS spending assessments, and estimating the cost and efficiency of HIV services. The cost of service provision should be monitored over time, whereas evaluations of the cost-effectiveness of services are required periodically; both should be part of any country's HIV monitoring and evaluation system. This paper provides country examples of the complementary relationship between monitoring the cost of HIV services and evaluating their cost-effectiveness. It also summarizes global initiatives that enable countries to develop their own HIV monitoring and evaluation systems and to generate relevant, robust and up-to-date strategic information.

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.

Use of intraocular lenses in cataract surgery in developing countries: memorandum from a WHO meeting.

PubMed Central

1991-01-01

Visual loss or disability from cataract represents a massive public health and socioeconomic problem in most developing countries. At present, some 13.5 million cases require treatment and this number will increase, as most countries in the Third World are unable to cope with both the backlog and new cases. Cataract extraction with intraocular lens (IOL) implantation is now the established and preferred method in industrialized countries. The introduction of IOLs in developing countries, however, depends on their having adequately trained manpower and facilities (equipment and supplies, including IOLs) for surgery. This will inevitably increase the cost per operated case which, despite the scarce resources for cataract surgery in many developing countries, may be justified by the improved restoration of the patient's vision. Experience has led to the following generic designs for IOLs: the one-piece or three-piece C-loop polymethylmethacrylate (PMMA) posterior chamber lens, which is the current favourite; and, the flexible or rigid one-piece all-PMMA anterior chamber lens, which is a valid alternative in many situations. Further scientific evaluation of the use of these lenses in a wide variety of settings in developing countries is required. Operations research is also needed in order better to define and standardize the various steps and procedures in the surgical and post-operative management of IOL implantation in Third World settings. Meanwhile, the following should be available to ensure safe and good quality cataract surgery using IOLs in developing countries: properly trained surgeons; the needed facilities and equipment with regular supplies; a good quality lens of appropriate design; and the necessary means for careful follow-up of operated patients. PMID:1786616

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.

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

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.

Climate volatility deepens poverty vulnerability in developing countries

NASA Astrophysics Data System (ADS)

Ahmed, Syud A.; Diffenbaugh, Noah S.; Hertel, Thomas W.

2009-07-01

Extreme climate events could influence poverty by affecting agricultural productivity and raising prices of staple foods that are important to poor households in developing countries. With the frequency and intensity of extreme climate events predicted to change in the future, informed policy design and analysis requires an understanding of which countries and groups are going to be most vulnerable to increasing poverty. Using a novel economic-climate analysis framework, we assess the poverty impacts of climate volatility for seven socio-economic groups in 16 developing countries. We find that extremes under present climate volatility increase poverty across our developing country sample—particularly in Bangladesh, Mexico, Indonesia, and Africa—with urban wage earners the most vulnerable group. We also find that global warming exacerbates poverty vulnerability in many nations.

Global resources outlook. [Requires best leadership of U. S. and other countries

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

Bovay, H.E. Jr.

Worldwide resource planning that is rational and equitable will dictate an orderly flow of materials between nations and require the best leadership the U.S. and other nations can develop. Resource trends show that the developing nations have begun asserting their power as suppliers of essential resources and that proliferation of nuclear materials could lead to wars of redistribution as competition for basic commodities intensifies. The trend in recent years has been toward the interdependence of nations, with most having some resources and depending on other nations for the rest of their needs. Since consumption trends for minerals, metals, and energymore » parallel the gross national product, developing countries will be increasing their consumption levels to raise their standard of living. Population projections indicate the lowest growth in the developed countries and a steep increase in the Third World, where living standards must be raised before effective birth control can take hold. Food production in developing countries has kept pace with population growth, but only the developed countries are able to develop a surplus. South America and Africa both contain large areas of land that is arable if the technology for clearing and cultivating is available. Other trends are outlined to show the need for new management of fishing, the use and dependency of minerals and fuels, metals, and the environment and technology as resources. (DCK)« less

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.

HIS priorities in developing countries.

PubMed

Amado Espinosa, L

1995-04-01

Looking for a solution to fulfill the requirements that the new global economical system demands, developing countries face a reality of poor communications infrastructure, a delay in applying information technology to the organizations, and a semi-closed political system avoiding the necessary reforms. HIS technology has been developed more for transactional purposes on mini and mainframe platforms. Administrative modules are the most frequently observed and physicians are now requiring more support for their activities. The second information systems generation will take advantage of PC technology, client-server models and telecommunications to achieve integration. International organizations, academic and industrial, public and private, will play a major role to transfer technology and to develop this area.

Recommendations for routine reporting on indications for cesarean delivery in developing countries.

PubMed

Stanton, Cynthia; Ronsmans, Carine

2008-09-01

Cesarean delivery rates are increasing rapidly in many developing countries, particularly among wealthy women. Poor women have lower rates, often so low that they do not reach the minimum rate of 1 percent. Little data are available on clinical indications for cesarean section, information that could assist in understanding why cesarean delivery rates have changed. This paper presents recommendations for routine reporting on indications for cesarean delivery in developing countries. These recommendations resulted from an international consultation of researchers held in February 2006 to promote the collection of comparable data to understand change in, or composition of, the cesarean delivery rate in developing countries. Data are presented from selected countries, categorizing cesareans by three classification systems. A single classification system was recommended for use in both high and low cesarean delivery rate settings, given that underuse and overuse of cesarean section are evident within many populations. The group recommended a hierarchical categorization, prioritizing cesareans performed for absolute maternal indications. Categorization among the remaining nonabsolute indications is based on the primary indication for the procedure and include maternal and fetal indications and psychosocial indications, required for high cesarean delivery rate settings. Data on indications for cesarean sections are available everywhere the procedure is performed. All that is required is compilation and review at facility and at higher levels. Advocacy within ministries of health and medical professional organizations is required to advance these recommendations since researchers have inadequately communicated the health effects of both underuse and overuse of cesarean delivery.

A strategy to improve priority setting in developing countries.

PubMed

Kapiriri, Lydia; Martin, Douglas K

2007-09-01

Because the demand for health services outstrips the available resources, priority setting is one of the most difficult issues faced by health policy makers, particularly those in developing countries. Priority setting in developing countries is fraught with uncertainty due to lack of credible information, weak priority setting institutions, and unclear priority setting processes. Efforts to improve priority setting in these contexts have focused on providing information and tools. In this paper we argue that priority setting is a value laden and political process, and although important, the available information and tools are not sufficient to address the priority setting challenges in developing countries. Additional complementary efforts are required. Hence, a strategy to improve priority setting in developing countries should also include: (i) capturing current priority setting practices, (ii) improving the legitimacy and capacity of institutions that set priorities, and (iii) developing fair priority setting processes.

Technological Innovation and Developmental Strategies for Sustainable Management of Aquatic Resources in Developing Countries

NASA Astrophysics Data System (ADS)

Agboola, Julius Ibukun

2014-12-01

Sustainable use and allocation of aquatic resources including water resources require implementation of ecologically appropriate technologies, efficient and relevant to local needs. Despite the numerous international agreements and provisions on transfer of technology, this has not been successfully achieved in developing countries. While reviewing some challenges to technological innovations and developments (TID), this paper analyzes five TID strategic approaches centered on grassroots technology development and provision of localized capacity for sustainable aquatic resources management. Three case studies provide examples of successful implementation of these strategies. Success requires the provision of localized capacity to manage technology through knowledge empowerment in rural communities situated within a framework of clear national priorities for technology development.

Technological innovation and developmental strategies for sustainable management of aquatic resources in developing countries.

PubMed

Agboola, Julius Ibukun

2014-12-01

Sustainable use and allocation of aquatic resources including water resources require implementation of ecologically appropriate technologies, efficient and relevant to local needs. Despite the numerous international agreements and provisions on transfer of technology, this has not been successfully achieved in developing countries. While reviewing some challenges to technological innovations and developments (TID), this paper analyzes five TID strategic approaches centered on grassroots technology development and provision of localized capacity for sustainable aquatic resources management. Three case studies provide examples of successful implementation of these strategies. Success requires the provision of localized capacity to manage technology through knowledge empowerment in rural communities situated within a framework of clear national priorities for technology development.

Assessing E-Learning System in Higher Education Institutes: Evidence from Structural Equation Modelling

ERIC Educational Resources Information Center

Ali, Muhammad; Raza, Syed Ali; Qazi, Wasim; Puah, Chin-Hong

2018-01-01

Purpose: This study aims to examine university students' acceptance of e-learning systems in Pakistan. A Web-based learning system is a new form of utilizing technological features. Although, developed countries have initiated and established the concept for e-learning, developing countries require empirical support to implement e-learning.…

Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation.

PubMed

Alemnji, George; Edghill, Lisa; Guevara, Giselle; Wallace-Sankarsingh, Sacha; Albalak, Rachel; Cognat, Sebastien; Nkengasong, John; Gabastou, Jean-Marc

2017-01-01

Implementing quality management systems and accrediting laboratories in the Caribbean has been a challenge. We report the development of a stepwise process for quality systems improvement in the Caribbean Region. The Caribbean Laboratory Stakeholders met under a joint Pan American Health Organization/US Centers for Disease Control and Prevention initiative and developed a user-friendly framework called 'Laboratory Quality Management System - Stepwise Improvement Process (LQMS-SIP) Towards Accreditation' to support countries in strengthening laboratory services through a stepwise approach toward fulfilling the ISO 15189: 2012 requirements. This approach consists of a three-tiered framework. Tier 1 represents the minimum requirements corresponding to the mandatory criteria for obtaining a licence from the Ministry of Health of the participating country. The next two tiers are quality improvement milestones that are achieved through the implementation of specific quality management system requirements. Laboratories that meet the requirements of the three tiers will be encouraged to apply for accreditation. The Caribbean Regional Organisation for Standards and Quality hosts the LQMS-SIP Secretariat and will work with countries, including the Ministry of Health and stakeholders, including laboratory staff, to coordinate and implement LQMS-SIP activities. The Caribbean Public Health Agency will coordinate and advocate for the LQMS-SIP implementation. This article presents the Caribbean LQMS-SIP framework and describes how it will be implemented among various countries in the region to achieve quality improvement.

Issues of environmental compliance in developing countries.

PubMed

Singh, S; Rajamani, S

2003-01-01

Environmental laws define the scarcity of environmental resources as they affect the factor endowment of a country and therefore its position in the international division of labour. There is now also a general agreement that applying the "polluter pays" principle should solve environmental problems. As the burden of abatement increases, as measured by the ratio of abatement expenditure to sales, there is definitely an incentive for firms to either invest in cleaner technology or more efficient abatement technology. There is also evidence that taxes and charges, designed to internalise externalities, can actually affect trade. It is interesting to know if the developing countries face particular market access problems in the face of stringent environmental standards and regulations. While it is true that stringent measures impose market access restrictions and cause limitations on competitiveness, this is much more widely felt by the developing countries because of lack of infrastructure and monitoring facilities, limited technology choices, inadequate access to environment-friendly raw materials, lack of complete information, presence of small-scale exporters and emergence of environmental standards in sectors of export interest to developing countries. The small and medium enterprises often divert sales either to the domestic market or to external markets where environmental requirements are less stringent, in order to save on their costs. In developing countries, 80% of the tanning industry is comprised of small and medium enterprises (SMEs) processing raw to semi-finished leather, usually less than 2 tons per day. In Europe and other developed countries the SMEs in the leather sector have vanished due to strict environmental legislation and this will likely occur in developing countries also. The environmental legislation has not always been practical, either because the laws are too ambitious or unrealistic in certain parameters, or because they have lacked effective instrumentation and institutional support. Some environmental regulations have not succeeded as they do not match the technical requirements and economic reality of the country or region, or because they do not take the institutional capabilities of the society that has to implement them into consideration. For the survival and sustenance of the SMEs in the leather industry, it may be a viable alternative to carry out the tanning process in a decentralized fashion such that the raw to semi-finished process is carried out in the large scale sector while the semi-finished to finished process could either be reserved or open to competition as per the countries' requirements. But the issue of concern is whether it is fair that the raw to semi-finished tanning process, containing 70% of the pollution discharge should be undertaken by developing countries alone, especially if it is at the cost of their survival! However, the game analysed in the paper reveals that tanning units in developing countries would prefer to comply with the regulations and stay in the industry, the alternatives being to collude or to compete!

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.

Satisfaction des exigences minimales du marché du travail par le système éducatif: Evaluation dans un contexte de faible système d'information sur la formation et l'emploi

NASA Astrophysics Data System (ADS)

Pieume, Calice Olivier

2016-12-01

Satisfying the minimum requirements of the labour market through the education system: Assessment in a context of weak training and employment data - The number of young people entering the labour market in Africa will increase considerably over the next two decades. With nearly 200 million young people aged 15-24, Africa has the youngest population in the world; this volume will double by 2045. As the question of the professional integration of young people in Africa is set to become even more pressing over the next two decades, it is imperative that African countries prepare for this time bomb. The education system, while not the only deciding factor, bears a responsibility in the difficult professional integration of young people. To fully play its role, it must be organised according to the country's development needs and the demands of the labour market. Establishing a proven process of assessing, analysing and anticipating economic demand is an essential first step. Yet the majority of African countries have still not implemented such a system. Meanwhile, the education system must take steps to satisfy the minimum short-term requirements of the labour market. This article, which seeks to highlight these requirements, presents a method that enables countries to assess the minimum requirements of the labour market at specific periods and, in return, to assess the degree to which the education system satisfies these requirements. The method is developed especially for countries with weak systems of collecting data on education, training and employment, as is the case in most sub-Saharan countries.

The future of transgenic plants in developing countries.

PubMed

Weil, A

2001-12-01

Whatever their own policies may be, developing countries will inevitably be affected by the development of genetically-modified organisms in industrialized countries. While maintaining a cautious attitude, most of these countries wish to keep their options open, thus protecting themselves from the risk of being deprived of future technologies that might allow them to achieve self-sufficiency in food production, to resolve certain problems confronting their most vulnerable populations and to preserve the international competitiveness of their products. Companies should see that it is in their interest to help these countries implement their own policies, notably through an open attitude to industrial property. If the value of genetic engineering is thus confirmed, then it perhaps in this manner that GMOs will earn the legitimacy required to make them acceptable to the people of Northern countries where the majority of solvent markets are located.

Potential impacts of imposing methyl bromide phaseout on US strawberry growers: a case study of a nomination for a critical use exemption under the Montreal Protocol.

PubMed

Norman, Catherine S

2005-04-01

The Montreal Protocol on Substances that Deplete the Ozone Layer requires developed countries to phaseout methyl bromide production and non-quarantine uses by 2005 and developing countries to do the same by 2015. Exemptions to phaseout have been significant in slowing the process of abatement; many countries have applied for exemptions for some uses, partly on grounds that phaseout is economically infeasible. Data on the US strawberry market are used to investigate grower costs arising from substitution away from methyl bromide, the impact of trends in and characteristics of the demand for fresh strawberries, and characteristics of trade with countries not yet required to eliminate use of the compound. It appears that actual net costs to growers will be much smaller than the simple increase in production costs cited in the US nomination for exemption.

Soft tissue coverage of the elbow in a developing country.

PubMed

Pirela-Cruz, Miguel A; Reddy, Kartheek K; Higgs, Matthew

2007-09-01

Two cases that required soft tissue coverage to the anterior aspect of the elbow are presented. A fasciocutaneous intercostal perforator chest wall flap was used for one patient when only skin and fascia coverage was required. A latissimus dorsi myocutaneous flap was used to provide soft tissue coverage and supply motor power for elbow flexion after contracture release in the other. The surgical techniques for each of these flaps are discussed in the context of addressing soft tissue traumatic injuries about the elbow in a developing country with limited resources.

Development management for nursing administration.

PubMed

Heyden, R; Luyas, G; Henry, B

1990-04-01

What are the needs of a nurse administrator in a developing country? For that matter, what are the requirements for a nurse administrator in areas of lesser developed delivery in this country (e.g., care of the homeless, care of indigent populations)? Heyden, Luyas, and Henry look at the educational needs of these nurse managers and compare the needs to the typical education received in nursing administration programs.

[Developing a harmonised system for the recognition of clinical trials for veterinary product registration].

PubMed

Maliandi, F S

2008-12-01

The increase of commerce between developing countries requires a harmonised system for accepting the results of clinical trials (CT) of veterinary products, similar to those that exist in developed countries. The objective of this paper is to propose a basis for the creation of a system that harmonises CTs for approving veterinary products (VP) for registration. Such a system would be a step towards unifying the CTs of different countries, while maintaining country-specific variations that are compatible with the scientific method, international standards, and the principles of objectivity, transparency and confidentiality. Basic requirements to be fulfilled by both private institutions and public offices are described, as are professional responsibilities and possible administrative procedures that could be adapted in each country. The conclusion reached is that a harmonised system is feasible, as has been demonstrated in numerous countries throughout the world. A harmonised system will result in a more efficient product approval process, a reduction in costs, greater transparency in controls, an improvement in the reliability of the health system, and a reduction in the time the process takes. It will also contribute to animal welfare by avoiding the need to repeat trials. The author acknowledges that there are cultural, technological and economic limitations and that these problems, and others, have yet to be overcome.

Ethical review issues in collaborative research between us and low-middle income country partners: a case example.

PubMed

McIntosh, Scott; Sierra, Essie; Dozier, Ann; Diaz, Sergio; Quiñones, Zahira; Primack, Aron; Chadwick, Gary; Ossip-Klein, Deborah J

2008-09-01

The current ethical structure for collaborative international health research stems largely from developed countries' standards of proper ethical practices. The result is that ethical committees in developing countries are required to adhere to standards that might impose practices that conflict with local culture and unintended interpretations of ethics, treatments, and research. This paper presents a case example of a joint international research project that successfully established inclusive ethical review processes as well as other groundwork and components necessary for the conduct of human behavior research and research capacity building in the host country.

Planning and evaluating mental health services in low- and middle-income countries using theory of change

PubMed Central

Breuer, Erica; De Silva, Mary J.; Shidaye, Rahul; Petersen, Inge; Nakku, Juliet; Jordans, Mark J. D.; Fekadu, Abebaw; Lund, Crick

2016-01-01

Background There is little practical guidance on how contextually relevant mental healthcare plans (MHCPs) can be developed in low-resource settings. Aims To describe how theory of change (ToC) was used to plan the development and evaluation of MHCPs as part of the PRogramme for Improving Mental health carE (PRIME). Method ToC development occurred in three stages: (a) development of a cross-country ToC by 15 PRIME consortium members; (b) development of country-specific ToCs in 13 workshops with a median of 15 (interquartile range 13–22) stakeholders per workshop; and (c) review and refinement of the cross-country ToC by 18 PRIME consortium members. Results One cross-country and five district ToCs were developed that outlined the steps required to improve outcomes for people with mental disorders in PRIME districts. Conclusions ToC is a valuable participatory method that can be used to develop MHCPs and plan their evaluation. PMID:26447178

Factors Influencing the Acceptance of E-Learning Adoption in Libya's Higher Education Institutions

ERIC Educational Resources Information Center

Benghet, Mahfoud; Helfert, Markus

2014-01-01

The growing influence of technologies on all aspects of life, including the education sector, requires developing countries to follow the example of the developed countries and adopt technology in their education systems. Libya has been able to boost its economic and educational position over the years, and this brings it to the concern of…

Trends and affordability of cigarette prices: ample room for tax increases and related health gains

PubMed Central

Guindon, G; Tobin, S; Yach, D

2002-01-01

Objectives: To compare cigarette price data from more than 80 countries using varying methods, examine trends in prices and affordability during the 1990s, and explore various policy implications pertaining to tobacco prices. Design: March 2001 cigarette price data from the Economist Intelligence Unit are used to compare cigarette prices across countries. To facilitate comparison and to assess affordability, prices are presented in US dollars, purchasing power parity (PPP) units using the Big Mac index as an indicator of PPP and in terms of minutes of labour required to purchase a pack of cigarettes. Annual real percentage changes in cigarette prices between 1990 and 2000 and annual changes in the minutes of labour required to buy cigarettes between 1991 and 2000 are also calculated to examine trends. Results: Cigarette prices tend to be higher in wealthier countries and in countries that have strong tobacco control programmes. On the other hand, minutes of labour required to purchase cigarettes vary vastly between countries. Trends between 1990 and 2000 in real prices and minutes of labour indicate, with some exceptions, that cigarettes have become more expensive in most developed countries but more affordable in many developing countries. However, in the UK, despite recent increases in price, cigarettes are still more affordable than they were in the 1960s. Conclusions: The results suggest that there is ample room to increase tobacco prices through taxation. In too many countries, cigarette prices have failed to keep up with increases in the general price level of goods and services, rendering them more affordable in 2000 than they were at the beginning of the decade. Opportunities to increase government revenue and improve health through reduced consumption brought about by higher prices have been overlooked in many countries. PMID:11891366

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.

Untapped potential of health impact assessment.

PubMed

Winkler, Mirko S; Krieger, Gary R; Divall, Mark J; Cissé, Guéladio; Wielga, Mark; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

2013-04-01

The World Health Organization has promoted health impact assessment (HIA) for over 20 years. At the 2012 United Nations Conference on Sustainable Development (Rio+20), HIA was discussed as a critical method for linking health to "green economy" and "institutional framework" strategies for sustainable development. In countries having a high human development index (HDI), HIA has been added to the overall assessment suite that typically includes potential environmental and social impacts, but it is rarely required as part of the environmental and social impact assessment for large development projects. When they are performed, project-driven HIAs are governed by a combination of project proponent and multilateral lender performance standards rather than host country requirements. Not surprisingly, in low-HDI countries HIA is missing from the programme and policy arena in the absence of an external project driver. Major drivers of global change (e.g. population growth and urbanization, growing pressure on natural resources and climate change) inordinately affect low- and medium-HDI countries; however, in such countries HIA is conspicuously absent. If the cloak of HIA invisibility is to be removed, it must be shown that HIA is useful and beneficial and, hence, an essential component of the 21st century's sustainable development agenda. We analyse where and how HIA can become fully integrated into the impact assessment suite and argue that the impact of HIA must not remain obscure.

Untapped potential of health impact assessment

PubMed Central

Krieger, Gary R; Divall, Mark J; Cissé, Guéladio; Wielga, Mark; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

2013-01-01

Abstract The World Health Organization has promoted health impact assessment (HIA) for over 20 years. At the 2012 United Nations Conference on Sustainable Development (Rio+20), HIA was discussed as a critical method for linking health to “green economy” and “institutional framework” strategies for sustainable development. In countries having a high human development index (HDI), HIA has been added to the overall assessment suite that typically includes potential environmental and social impacts, but it is rarely required as part of the environmental and social impact assessment for large development projects. When they are performed, project-driven HIAs are governed by a combination of project proponent and multilateral lender performance standards rather than host country requirements. Not surprisingly, in low-HDI countries HIA is missing from the programme and policy arena in the absence of an external project driver. Major drivers of global change (e.g. population growth and urbanization, growing pressure on natural resources and climate change) inordinately affect low- and medium-HDI countries; however, in such countries HIA is conspicuously absent. If the cloak of HIA invisibility is to be removed, it must be shown that HIA is useful and beneficial and, hence, an essential component of the 21st century’s sustainable development agenda. We analyse where and how HIA can become fully integrated into the impact assessment suite and argue that the impact of HIA must not remain obscure. PMID:23599554

Improving the quality of life.

PubMed

Suyono, H

1993-12-01

It is encouraging that most developing countries now have population policies, but it is discouraging that some countries have been unable to implement their policies. Therefore, Indonesia believes technical cooperation should be strengthened among developing countries. International cooperation is working in 108 developing countries, but the desired impact has yet to be reached, and the quality of life in many countries is still unacceptable. For example, life expectancy at birth in developing countries is 14-17 years shorter for females and 10-13 years shorter for males as compared to developed countries which have superior health and welfare systems. The speed of population growth is also hindering efforts to help improve living conditions, and the biggest increase in growth will occur in Asia and Africa. This will increase the numbers of poor, hungry, and illiterate in developing countries and will lead to a lack of arable land, deterioration in education, and increase in unsafe sanitation. In order to slow population growth, quality family planning (FP) services must be provided to those who want them. By the year 2000, developed countries and donors should be ready to provide half of the required US$10.5 billion to FP services in developing countries. In Indonesia, population programs and policies have been governed by the National FP Coordinating Board as well as by the State Ministry for Population and the Environment, which was divided into two ministries in 1993 in order to deal with the enormity and seriousness of the two issues.

Telemedicine for Developing Countries. A Survey and Some Design Issues.

PubMed

Combi, Carlo; Pozzani, Gabriele; Pozzi, Giuseppe

2016-11-02

Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized physicians are not available, when patients and physicians in rural villages need assistance in the delivery of health care. Moreover, the requirements of telemedicine applications for developing countries are somewhat more demanding than for developed countries. Indeed, further social, organizational, and technical aspects need to be considered for successful telemedicine applications in developing countries. We consider all the major projects in telemedicine, devoted to developing countries, as described by the proper scientific literature. On the basis of such literature, we want to define a specific taxonomy that allows a proper classification and a fast overview of telemedicine projects in developing countries. Moreover, by considering both the literature and some recent direct experiences, we want to complete such overview by discussing some design issues to be taken into consideration when developing telemedicine software systems. We considered and reviewed the major conferences and journals in depth, and looked for reports on the telemedicine projects. We provide the reader with a survey of the main projects and systems, from which we derived a taxonomy of features of telemedicine systems for developing countries. We also propose and discuss some classification criteria for design issues, based on the lessons learned in this research area. We highlight some challenges and recommendations to be considered when designing a telemedicine system for developing countries.

Telemedicine for Developing Countries

PubMed Central

Combi, Carlo; Pozzani, Gabriele

2016-01-01

Summary Background Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized physicians are not available, when patients and physicians in rural villages need assistance in the delivery of health care. Moreover, the requirements of telemedicine applications for developing countries are somewhat more demanding than for developed countries. Indeed, further social, organizational, and technical aspects need to be considered for successful telemedicine applications in developing countries. Objective We consider all the major projects in telemedicine, devoted to developing countries, as described by the proper scientific literature. On the basis of such literature, we want to define a specific taxonomy that allows a proper classification and a fast overview of telemedicine projects in developing countries. Moreover, by considering both the literature and some recent direct experiences, we want to complete such overview by discussing some design issues to be taken into consideration when developing telemedicine software systems. Methods We considered and reviewed the major conferences and journals in depth, and looked for reports on the telemedicine projects. Results We provide the reader with a survey of the main projects and systems, from which we derived a taxonomy of features of telemedicine systems for developing countries. We also propose and discuss some classification criteria for design issues, based on the lessons learned in this research area. Conclusions We highlight some challenges and recommendations to be considered when designing a telemedicine system for developing countries. PMID:27803948

Production of antiretroviral drugs in middle- and low-income countries.

PubMed

Pinheiro, Eloan dos Santos; Brüning, Karin; Macedo, M Fernanda; Siani, Antonio C

2014-01-01

This review outlines the main issues concerning the production of antiretroviral (ARV) drugs in middle- and low-income countries and the relevant political, legal and technical requirements for supporting such production. The requirements for efficient local production, including the manufacture of generic and branded products and public demand, have been considered from economic, market and socio-political perspectives. A steady and consistent government policy is crucial to success. Additional crucial factors in establishing local production are adequate infrastructure, qualified human resources in technical and managerial areas, and production-distribution logistics systems. The creation or strengthening of a national drug regulatory agency is a basic requirement. Production of ARVs relies on the structure of the international market for active pharmaceutical ingredients (APIs), which are highly monopolized for inclusion in branded or patented drugs, or are concentrated in a few Asian generic companies. Countries seeking to begin local production must develop strategies to overcome the various barriers. For instance, sub-Saharan African countries may benefit from developing multilateral health agreements with neighbouring countries. Such agreements are recommended and should be complemented by technology transfers, especially for the manufacture of APIs. Achieving a production level that is sustainable in the long term is crucial to maintaining patients' access to ARVs.

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

Problems of modern urban drainage in developing countries.

PubMed

Silveira, A L L

2002-01-01

Socio-economic factors in developing countries make it more difficult to solve problems of urban drainage than in countries that are more advanced. Factors inhibiting the adoption of modern solutions include: (1) in matters of urban drainage, 19th-century sanitary philosophy still dominates; (2) both legal and clandestine land settlement limits the space that modern solutions require; (3) contamination of storm runoff by foul sewage, sediment and garbage prevents adoption of developed-country practices; (4) climatic and socio-economic factors favour the growth of epidemics where runoff is retained for flood-avoidance and to increase infiltration; (5) lack of a technological basis for adequate drainage management and design; (6) lack of the interaction between community and city administration that is needed to obtain modern solutions to urban drainage problems. Awareness of these difficulties is fundamental to the search for modern and viable solutions appropriate for developing countries.

Environmental lead exposure: a public health problem of global dimensions.

PubMed Central

Tong, S.; von Schirnding, Y. E.; Prapamontol, T.

2000-01-01

Lead is the most abundant of the heavy metals in the Earth's crust. It has been used since prehistoric times, and has become widely distributed and mobilized in the environment. Exposure to and uptake of this non-essential element have consequently increased. Both occupational and environmental exposures to lead remain a serious problem in many developing and industrializing countries, as well as in some developed countries. In most developed countries, however, introduction of lead into the human environment has decreased in recent years, largely due to public health campaigns and a decline in its commercial usage, particularly in petrol. Acute lead poisoning has become rare in such countries, but chronic exposure to low levels of the metal is still a public health issue, especially among some minorities and socioeconomically disadvantaged groups. In developing countries, awareness of the public health impact of exposure to lead is growing but relatively few of these countries have introduced policies and regulations for significantly combating the problem. This article reviews the nature and importance of environmental exposure to lead in developing and developed countries, outlining past actions, and indicating requirements for future policy responses and interventions. PMID:11019456

Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation

PubMed Central

Alemnji, George; Edghill, Lisa; Wallace-Sankarsingh, Sacha; Albalak, Rachel; Cognat, Sebastien; Nkengasong, John; Gabastou, Jean-Marc

2017-01-01

Background Implementing quality management systems and accrediting laboratories in the Caribbean has been a challenge. Objectives We report the development of a stepwise process for quality systems improvement in the Caribbean Region. Methods The Caribbean Laboratory Stakeholders met under a joint Pan American Health Organization/US Centers for Disease Control and Prevention initiative and developed a user-friendly framework called ‘Laboratory Quality Management System – Stepwise Improvement Process (LQMS-SIP) Towards Accreditation’ to support countries in strengthening laboratory services through a stepwise approach toward fulfilling the ISO 15189: 2012 requirements. Results This approach consists of a three-tiered framework. Tier 1 represents the minimum requirements corresponding to the mandatory criteria for obtaining a licence from the Ministry of Health of the participating country. The next two tiers are quality improvement milestones that are achieved through the implementation of specific quality management system requirements. Laboratories that meet the requirements of the three tiers will be encouraged to apply for accreditation. The Caribbean Regional Organisation for Standards and Quality hosts the LQMS-SIP Secretariat and will work with countries, including the Ministry of Health and stakeholders, including laboratory staff, to coordinate and implement LQMS-SIP activities. The Caribbean Public Health Agency will coordinate and advocate for the LQMS-SIP implementation. Conclusion This article presents the Caribbean LQMS-SIP framework and describes how it will be implemented among various countries in the region to achieve quality improvement. PMID:28879149

Strengthening International Collaboration: Geosciences Research and Education in Developing Countries

NASA Astrophysics Data System (ADS)

Fucugauchi, J. U.

2009-05-01

Geophysical research increasingly requires global multidisciplinary approaches and global integration. Global warming, increasing CO2 levels and increased needs of mineral and energy resources emphasize impact of human activities. The planetary view of our Earth as a deeply complex interconnected system also emphasizes the need of international scientific cooperation. International collaboration presents an immense potential and is urgently needed for further development of geosciences research and education. In analyzing international collaboration a relevant aspect is the role of scientific societies. Societies organize meetings, publish journals and books and promote cooperation through academic exchange activities and can further assist communities in developing countries providing and facilitating access to scientific literature, attendance to international meetings, short and long-term stays and student and young researcher mobility. Developing countries present additional challenges resulting from limited economic resources and social and political problems. Most countries urgently require improved educational and research programs. Needed are in-depth analyses of infrastructure and human resources and identification of major problems and needs. Questions may include what are the major limitations and needs in research and postgraduate education in developing countries? what and how should international collaboration do? and what are the roles of individuals, academic institutions, funding agencies, scientific societies? Here we attempt to examine some of these questions with reference to case examples and AGU role. We focus on current situation, size and characteristics of research community, education programs, facilities, economic support, and then move to perspectives for potential development in an international context.

Cooking up an open source EMR for developing countries: OpenMRS - a recipe for successful collaboration.

PubMed

Mamlin, Burke W; Biondich, Paul G; Wolfe, Ben A; Fraser, Hamish; Jazayeri, Darius; Allen, Christian; Miranda, Justin; Tierney, William M

2006-01-01

Millions of people are continue to die each year from HIV/AIDS. The majority of infected persons (>95%) live in the developing world. A worthy response to this pandemic will require coordinated, scalable, and flexible information systems. We describe the OpenMRS system, an open source, collaborative effort that can serve as a foundation for EMR development in developing countries. We report our progress to date, lessons learned, and future directions.

Integration of Educational and Research Constituents of the Process of Specialists' Professional Training in the Universities of Developed Countries

ERIC Educational Resources Information Center

Sbruieva, Alina

2015-01-01

In the article the characteristic of strategies of the integration of educational and research constituents of the process of specialists' professional training in the universities of developed countries has been given. The relevance of the problem in the context of requirements to the graduate represented in the European qualifications framework…

Mexico's Labor Market: The Importance of Education-Occupation Matching on Wages and Productivity in Developing Countries

ERIC Educational Resources Information Center

Quinn, Michael A.; Rubb, Stephen

2006-01-01

The positive impact of education on earnings, wages, and economic growth is well documented; however, the issue of education-occupation matching in developing countries has been largely ignored. Since workers' levels of schooling and their occupations' required level of education both affect wages, policymakers may find it useful to note if such…

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.

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.

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

The Pacific experience: supporting small island countries and territories to meet their 2012 International Health Regulations (2005) commitments.

PubMed

Craig, Adam; Kool, Jacob; Nilles, Eric

2013-01-01

By 15 June 2012, States Parties to the International Health Regulations (2005), or IHR (2005), were required to have established the core capacities required to implement Annex 1 of IHR (2005). The Pacific is home to 10 million people spread over 21 Pacific island countries and territories. Seven of those have populations of less than 25 000 people; 14 of the 21 Pacific island countries and territories are States Parties to the IHR (2005). The World Health Organization Division of the South Pacific embarked on an initiative to support Pacific Island States Parties meet their 15 June 2012 IHR obligations. We adapted the 2012 IHR Monitoring Questionnaire (IHRMQ) to assist Pacific island countries and territories determine if they had met the capacities required to implement Annex 1 of the IHR (2005). If a Pacific island country or territory determined that it had not yet met the requirements, it could use the assessment outcome to develop a plan to address identified gaps. Direct support was provided to 19 of 21 (91%) Pacific island countries and territories including 13 of 14 (93%) States Parties. Twelve of 14 (86%) fulfilled their requirements by 15 June 2012; those that had not yet met the requirements requested extensions and submitted plans describing how the IHR core capacities would be met. Adapting the 2012 IHRMQ for this purpose provided an efficient tool for assessing national capacity to implement Annex 1 of IHR (2005) and provided clear indication of what capacities required strengthening.

[Meeting of calory and protein requirements in developing countries].

PubMed

Cremer, H D

1976-03-01

While we have definite ideas regarding the requirements for energy and proteins, we have to rely on statistical data whether these requirements are actually met. In spite of the common unreliability of these data, they serve as an useful indicator of the general situation. The supply of nutritional energy represents the average energy requirement for the populations of most developing countries. However, the insufficient supply of high grade protein remains the main nutritional problem of most of these countries. To solve these problems, the following possibilities exist: --Ensuring a sufficient calorie supply so that valuable protein is not wasted for the production of energy --Improving the supply of protein-rich staple food --Supplementing of food with local protien-rich products --Introducing lifestock only when the foodstuff available cannot be used directly for human consumption -- Improving the staple food, introducing higher grade strains of cereals --Producing protein-rich vegetable mixture from local foodstuff --Utilization of synthetic amino acids and of new protein sources. To meet the requirements for calories, and especially for hgih grade protein, is possible only by international and interdisciplinary efforts of all experts concerned with nutrition in any way.

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency.

PubMed

Hanna, Timothy P; Kangolle, Alfred C T

2010-10-13

Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) PROCESS: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) OUTCOME: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important.

Balancing economic development with environmental protection in developing and lesser developed countries

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

El-Ashry, M.T.

1993-01-01

Recent experience suggests that poverty and environmental degradation go hand in hand. Economic development, on the other hand, provides the financial and technical resources needed for the protection of human health and natural ecosystems. Balancing economic development and environmental protection in developing countries requires a refocusing of economic activity -- not towards producing less, but producing differently. Strategies for the integration of economic development and environmental protection are outlined here, as is the proposed role that will need to be played by the World Bank. 4 refs., 3 figs.

Constraints facing Arab banks

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

Khadra, F.

1980-04-01

Development projects in the Arab world have enormous investment requirements that Arab banks at present can only partially handle due to: (1) the low level of personal savings in a number of Arab countries as a result of low income levels; (2) the low capitalization of most Arab banks relative to the volume of lending activity required; (3) the reluctance of oil surplus countries to deposit any sizeable part of their funds with their own banks instead of foreign banks. Funds available in the currencies of the oil surplus countries are very limited compared to the volume of funds requiredmore » for projects. It is necessary therefore that the majority of loans be made in foreign currencies, making it necessary for Arab banks to have high international credit status. Arab banking practices and laws, which vary from country to country, are not compatible with the requirements of international lending or the establishment of well-developed financial markets. Some of the banks' organizational structures and internal practices may have become so entrenched as to make any transition not feasible. In some cases it may be more practical to establish a new financial institution with different orientations and activities than to transform the existing one. Another major constraint of the Arab banking environment is the lack of a permanent intermediary, acceptable to both the surplus countries' banks and to the borrowers. The final constraint discussed, the political environment, has prompted many Arab countries to enact legislation to guarantee a politically stable environment to safeguard risk against expropriation, nationalization, or freezing of assets. (SAC)« less

Obstacles to integrated pest management adoption in developing countries

PubMed Central

Parsa, Soroush; Morse, Stephen; Bonifacio, Alejandro; Chancellor, Timothy C. B.; Condori, Bruno; Crespo-Pérez, Verónica; Hobbs, Shaun L. A.; Kroschel, Jürgen; Ba, Malick N.; Rebaudo, François; Sherwood, Stephen G.; Vanek, Steven J.; Faye, Emile; Herrera, Mario A.; Dangles, Olivier

2014-01-01

Despite its theoretical prominence and sound principles, integrated pest management (IPM) continues to suffer from anemic adoption rates in developing countries. To shed light on the reasons, we surveyed the opinions of a large and diverse pool of IPM professionals and practitioners from 96 countries by using structured concept mapping. The first phase of this method elicited 413 open-ended responses on perceived obstacles to IPM. Analysis of responses revealed 51 unique statements on obstacles, the most frequent of which was “insufficient training and technical support to farmers.” Cluster analyses, based on participant opinions, grouped these unique statements into six themes: research weaknesses, outreach weaknesses, IPM weaknesses, farmer weaknesses, pesticide industry interference, and weak adoption incentives. Subsequently, 163 participants rated the obstacles expressed in the 51 unique statements according to importance and remediation difficulty. Respondents from developing countries and high-income countries rated the obstacles differently. As a group, developing-country respondents rated “IPM requires collective action within a farming community” as their top obstacle to IPM adoption. Respondents from high-income countries prioritized instead the “shortage of well-qualified IPM experts and extensionists.” Differential prioritization was also evident among developing-country regions, and when obstacle statements were grouped into themes. Results highlighted the need to improve the participation of stakeholders from developing countries in the IPM adoption debate, and also to situate the debate within specific regional contexts. PMID:24567400

Protecting HIV information in countries scaling up HIV services: a baseline study.

PubMed

Beck, Eduard J; Mandalia, Sundhiya; Harling, Guy; Santas, Xenophon M; Mosure, Debra; Delay, Paul R

2011-02-06

Individual-level data are needed to optimize clinical care and monitor and evaluate HIV services. Confidentiality and security of such data must be safeguarded to avoid stigmatization and discrimination of people living with HIV. We set out to assess the extent that countries scaling up HIV services have developed and implemented guidelines to protect the confidentiality and security of HIV information. Questionnaires were sent to UNAIDS field staff in 98 middle- and lower-income countries, some reportedly with guidelines (G-countries) and others intending to develop them (NG-countries). Responses were scored, aggregated and weighted to produce standard scores for six categories: information governance, country policies, data collection, data storage, data transfer and data access. Responses were analyzed using regression analyses for associations with national HIV prevalence, gross national income per capita, OECD income, receiving US PEPFAR funding, and being a G- or NG-country. Differences between G- and NG-countries were investigated using non-parametric methods. Higher information governance scores were observed for G-countries compared with NG-countries; no differences were observed between country policies or data collection categories. However, for data storage, data transfer and data access, G-countries had lower scores compared with NG-countries. No significant associations were observed between country score and HIV prevalence, per capita gross national income, OECD economic category, and whether countries had received PEPFAR funding. Few countries, including G-countries, had developed comprehensive guidelines on protecting the confidentiality and security of HIV information. Countries must develop their own guidelines, using established frameworks to guide their efforts, and may require assistance in adapting, adopting and implementing them.

Coming to terms: toward a North-South bargain for the environment.

PubMed

Speth, J G

1989-06-01

To attack the major environmental problems, global warming, natural resource losses, and loss of biological diversity, an understanding between the industrialized and developing countries must occur. Weather patterns and sea levels are being affected by global warming which is caused by the use of fossil fuels and deforestation. The industrialized countries must cut back on the use of fossil fuels, and developing countries need to slow the process of deforestation. The loss of genetic resources and the extinction of species is happening rapidly, and most of it is in the tropical forests of developing countries. The developing countries are more dependent on their natural resources, forests, minerals, soils, and fisheries than industrialized countries. They are being depleted more rapidly with the population growth, social inequalities, and poor policies. Industrial countries are partly to blame also since they make investment and development decisions without concerns for the environment. The 4 major actions that can be initiated by industrialized countries are as follows. The initiation of national and international movements to reduce gas emissions that cause the greenhouse effect. The increased distribution of new technology and financing for population programs, sustainable development and environmental protection. The reduction of the external dept of developing countries, and the creation of programs to give technical assistance, scientific and other training for environmental problems of developing countries. Financial assistance can be linked to population programs and to environmental issues of the developing countries. Carbon dioxide taxes could be used to finance forest management and ecological zoning. The exchange of forest conservation for debt relief is a possible solution. Any dept restructuring plan should include strong environmental conservation provisions and policy reform requirements.

Pediatric sepsis in the developing world: challenges in defining sepsis and issues in post-discharge mortality.

PubMed

Wiens, Matthew O; Kumbakumba, Elias; Kissoon, Niranjan; Ansermino, J Mark; Ndamira, Andrew; Larson, Charles P

2012-01-01

Sepsis represents the progressive underlying inflammatory pathway secondary to any infectious illness, and ultimately is responsible for most infectious disease-related deaths. Addressing issues related to sepsis has been recognized as an important step towards reducing morbidity and mortality in developing countries, where the majority of the 7.5 million annual deaths in children under 5 years of age are considered to be secondary to sepsis. However, despite its prevalence, sepsis is largely neglected. Application of sepsis definitions created for use in resource-rich countries are neither practical nor feasible in most developing country settings, and alternative definitions designed for use in these settings need to be established. It has also been recognized that the inflammatory state created by sepsis increases the risk of post-discharge morbidity and mortality in developed countries, but exploration of this issue in developing countries is lacking. Research is urgently required to characterize better this potentially important issue.

Chronic airflow limitation in developing countries: burden and priorities

PubMed Central

Aït-Khaled, Nadia; Enarson, Donald A; Ottmani, Salah; Sony, Asma El; Eltigani, Mai; Sepulveda, Ricardo

2007-01-01

Respiratory disease has never received priority in relation to its impact on health. Estimated DALYs lost in 2002 were 12% globally (similar for industrialized and developing countries). Chronic airflow limitation (due mainly to asthma and COPD) alone affects more than 100 million persons in the world and the majority of them live in developing countries. International guidelines for management of asthma (GINA) and COPD (GOLD) have been adopted and their cost-effectiveness demonstrated in industrialized countries. As resources are scarce in developing countries, adaptation of these guidelines using only essential drugs is required. It remains for governments to set priorities. To make these choices, a set of criteria have been proposed. It is vital that the results of scientific investigations are presented in these terms to facilitate their use by decision-makers. To respond to this emerging public health problem in developing countries, WHO has developed 2 initiatives: “Practical Approach to Lung Health (PAL)” and the Global Alliance Against Chronic Respiratory Diseases (GARD)”, and the International Union Against Tuberculosis and Lung Diseases (The Union) has launched a new initiative to increase affordability of essential asthma drugs for patients in developing countries termed the “Asthma Drug Facility” (ADF), which could facilitate the care of patients living in these parts of the world. PMID:18044686

Chronic airflow limitation in developing countries: burden and priorities.

PubMed

Aït-Khaled, Nadia; Enarson, Donald A; Ottmani, Salah; El Sony, Asma; Eltigani, Mai; Sepulveda, Ricardo

2007-01-01

Respiratory disease has never received priority in relation to its impact on health. Estimated DALYs lost in 2002 were 12% globally (similar for industrialized and developing countries). Chronic airflow limitation (due mainly to asthma and COPD) alone affects more than 100 million persons in the world and the majority of them live in developing countries. International guidelines for management of asthma (GINA) and COPD (GOLD) have been adopted and their cost-effectiveness demonstrated in industrialized countries. As resources are scarce in developing countries, adaptation of these guidelines using only essential drugs is required. It remains for governments to set priorities. To make these choices, a set of criteria have been proposed. It is vital that the results of scientific investigations are presented in these terms to facilitate their use by decision-makers. To respond to this emerging public health problem in developing countries, WHO has developed 2 initiatives: "Practical Approach to Lung Health (PAL)" and the Global Alliance Against Chronic Respiratory Diseases (GARD)", and the International Union Against Tuberculosis and Lung Diseases (The Union) has launched a new initiative to increase affordability of essential asthma drugs for patients in developing countries termed the "Asthma Drug Facility" (ADF), which could facilitate the care of patients living in these parts of the world.

Telecommunications forecast for ITU Region 2 to the year 1995

NASA Technical Reports Server (NTRS)

Hollansworth, J. E.; Salzman, J. A.; Ramler, J. R.

1985-01-01

Telecommunications activity was studied. The primary objective was to forecast the need for fixed service satellites (FSS) by countries within ITU Region 2 excluding the United States and Greenland. Forecasts of telecommunications equipment needs were developed as a yardstick of the relative level of telecommunications activity among developing countries within the region. A likely scenario for the implementation of domestic and regional communications satellites is forecasted to provide services to and among countries in ITU Region 2. By 1995, it is forecast that 15 fixed service satellites will be implemented. A forecast of the countries requirements indicates that, with the possible exception of Canada, this constellation of satellites will meet these countries' needs to beyond the year 2000.

Informal payments and the financing of health care in developing and transition countries.

PubMed

Lewis, Maureen

2007-01-01

Informal, under-the-table payments to public health care providers are increasingly viewed as a critically important source of health care financing in developing and transition countries. With minimal funding levels and limited accountability, publicly financed and delivered care falls prey to illegal payments, which require payments that can exceed 100 percent of a country's median income. Methods to address the abuse include establishing official fees, combined with improved oversight and accountability for public health care providers, and a role for communities in holding providers accountable.

Selecting a Learning Management System (LMS) in Developing Countries: Instructors' Evaluation

ERIC Educational Resources Information Center

Cavus, Nadire

2013-01-01

Learning management systems (LMSs) contain hidden costs, unclear user environments, bulky developer and administration manuals, and limitations with regard to interoperability, integration, localization, and bandwidth requirements. Careful evaluation is required in selecting the most appropriate LMS for use, and this is a general problem in…

Radiology education in Europe: Analysis of results from 22 European countries

PubMed Central

Rehani, Bhavya; Zhang, Yi C; Rehani, Madan M; Palkó, András; Lau, Lawrence; Lette, Miriam N Mikhail; Dillon, William P

2017-01-01

AIM To assess the state of radiology education across Europe by means of a survey study. METHODS A comprehensive 23-item radiology survey was distributed via email to the International Society of Radiology members, national radiological societies, radiologists and medical physicists. Reminders to complete the survey were sent and the results were analyzed over a period of 4 mo (January-April 2016). Survey questions include length of medical school and residency training; availability of fellowship and subspecialty training; number of residency programs in each country; accreditation pathways; research training; and medical physics education. Descriptive statistics were used to analyze and summarize data. RESULTS Radiology residency training ranges from 2-6 years with a median of 5 years, and follows 1 year of internship training in 55% (12 out of 22) European countries. Subspecialty fellowship training is offered in 55% (12 out of 22) European countries. Availability for specialization training by national societies is limited to eight countries. For nearly all respondents, less than fifty percent of radiologists travel abroad for specialization. Nine of 22 (41%) European countries have research requirements during residency. The types of certifying exam show variation where 64% (14 out of 22) European countries require both written and oral boards, 23% (5 out of 22) require oral examinations only, and 5% (1 out of 22) require written examinations only. A degree in medical physics is offered in 59% (13 out of 22) European countries and is predominantly taught by medical physicists. Nearly all respondents report that formal examinations in medical physics are required. CONCLUSION Comparative learning experiences across the continent will help guide the development of comprehensive yet pragmatic infrastructures for radiology education and collaborations in radiology education worldwide. PMID:28298965

A proposal for cervical screening information systems in developing countries.

PubMed

Marrett, Loraine D; Robles, Sylvia; Ashbury, Fredrick D; Green, Bo; Goel, Vivek; Luciani, Silvana

2002-11-20

The effective and efficient delivery of cervical screening programs requires information for planning, management, delivery and evaluation. Specially designed systems are generally required to meet these needs. In many developing countries, lack of information systems constitutes an important barrier to development of comprehensive screening programs and the effective control of cervical cancer. Our report outlines a framework for creating such systems in developing countries and describes a conceptual model for a cervical screening information system. The proposed system is modular, recognizing that there will be considerable between-region heterogeneity in current status and priorities. The proposed system is centered on modules that would allow for the assembly and computerization of data on Pap tests, since these represent the main screening modality at the present time. Additional modules would process data and create and maintain a screening database (e.g., standardize, edit, link and update modules) and allow for the integration of other types of data, such as cervical histopathology results. An open systems development model is proposed, since it is most compatible with the goals of local stakeholder involvement and capacity-building. Copyright 2002 Wiley-Liss, Inc.

Modelling linoleic acid and α-linolenic acid requirements for infants and young children in developing countries.

PubMed

Yang, Zhenyu; Huffman, Sandra L

2013-01-01

Essential fatty acids (EFAs), linoleic acid (LA) and α-linolenic acid (ALA), play a critical role in the growth and development of infants and young children. However, national guidelines for recommended intakes of EFAs are lacking in most developing countries. The objective of this study was to convert international EFA recommendations based on % of daily energy intake to recommended daily amounts for children aged 6-23 months in developing countries. The Food and Agriculture Organization (FAO) reports adequate intakes (AIs) for ALA as 0.4-0.6% of energy intake for children 6-23 months of age and as 3.0-4.5% of energy intake for LA. In order to estimate energy intakes, FAO daily energy requirements based on body weight were used. The daily AI amounts for these EFAs were calculated using the median body weight of the World Health Organization (WHO) Growth Standard population and median body weights with varying levels of malnutrition. The AI for ALA is equivalent to 0.3-0.4, 0.3-0.5 and 0.4-0.6 g day(-1), and the AI for LA is equivalent to 2.1-3.1, 2.4-3.5 and 2.8-4.3 g day(-1) for children aged 6-8, 9-11 and 12-23 months, respectively. While the lower median body weights of children in developing countries and associated reduced energy intake recommendations give lower estimated EFA requirements, recommendations based on median body weights in the WHO Reference Growth Standard is suggested. The upper levels of these calculated AIs are lower than or equal to those in North America (ALA: 0.5 and 0.7 g day(-1); LA: 4.6 and 7 g day(-1) for children aged 6-12 months and 1-3 years, respectively). The FAO AIs (g day(-1)) calculated here for ALA and LA can serve as a guideline for developing countries for setting national standards. © 2012 Blackwell Publishing Ltd.

Veterinary vaccines and their use in developing countries.

PubMed

Lubroth, J; Rweyemamu, M M; Viljoen, G; Diallo, A; Dungu, B; Amanfu, W

2007-04-01

The burden of infectious diseases in livestock and other animals continues to be a major constraint to sustained agricultural development, food security, and participation of developing and in-transition countries in the economic benefits of international trade in livestock commodities. Targeted measures must be instituted in those countries to reduce the occurrence of infectious diseases. Quality veterinary vaccines used strategically can and should be part of government sanctioned-programmes. Vaccination campaigns must be part of comprehensive disease control programmes, which, in the case of transboundary animal diseases, require a regional approach if they are to be successful. This paper focuses on the salient transboundary animal diseases and examines current vaccine use, promising vaccine research, innovative technologies that can be applied in countries in some important developing regions of the world, and the role of public/private partnerships.

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

Scientific publishing in non industrialized countries: a pilot wireless internet project for Africa.

PubMed

Azzi, Angelo

2005-01-01

There is general agreement that the internet is the major means of future scientific communication and education. However not everybody appreciates that the development of electronic communication in industrialized societies is not matched, even to a small extent, in developing countries. Several new technologies offer the potential for developing countries to provide connectivity. Terrestrial wireless and satellite technologies offer many advantages in that they do not require installation of wire-line networks. Satellite facilities can also be installed where communication is needed, even in remote and isolated areas, rather than waiting for terrestrial networks to be extended from the cities.

Definition and Classification of Generic Drugs Across the World.

PubMed

Alfonso-Cristancho, Rafael; Andia, Tatiana; Barbosa, Tatiana; Watanabe, Jonathan H

2015-08-01

Our aim was to systematically identify and compare how generic medications, as defined by the US Food and Drug Administration (FDA), World Health Organization (WHO), and European Medicines Agency (EMA), are classified and defined by regulatory agencies around the world. We focused on emerging markets and selected the most populated countries in each of the WHO regions: Africa, the Americas, Eastern Mediterranean, Europe, Southeast Asia, and Western Pacific. A structured review of published literature was performed through December 2013. Direct information from regulatory agencies and Ministries of Health for each country was extracted. Additionally, key informant interviews were performed for validation. Of the 21 countries selected, approximately half provided an official country-level definition for generic pharmaceuticals. The others did not have any definition or referred to the WHO. Only two-thirds of the countries had specific requirements for generic pharmaceuticals, often associated with clinical interchangeability. Most countries with requirements mention bioequivalence, but few required bioavailability studies explicitly. Over 30% of the countries had other terms associated with generics in their definitions and processes. In countries with generic drug policies, there is reference to patent and/or data protection during the drug registration process. Several countries do not mention good manufacturing practices as part of the evaluation process. Countries in Africa and Eastern Mediterranean regions appear to have a less developed regulatory framework. In summary, there is significant variability in the definition and classification of generic drugs in emerging markets. Standardization of the definitions is necessary to make international comparisons viable.

World Trade Organization, ILO conventions, and workers' compensation.

PubMed

LaDou, Joseph

2005-01-01

The World Trade Organization, the World Bank, and the International Monetary Fund can assist in the implementation of ILO Conventions relating to occupational safety and health in developing countries. Most countries that seek to trade globally receive permission to do so from the WTO. If the WTO required member countries to accept the core ILO Conventions relating to occupational safety and health and workers' compensation, it could accomplish something that has eluded international organizations for decades. International workers' compensation standards are seldom discussed, but may at this time be feasible. Acceptance of a minimum workers' compensation insurance system could be a requirement imposed on applicant nations by WTO member states.

Financing children's vaccines.

PubMed

Nelson, E Anthony S; Sack, David; Wolfson, Lara; Walker, Damian G; Seng, Lim Fong; Steele, Duncan

2009-11-20

A 2006 Commonwealth Association of Paediatric Gastroenterology and Nutrition workshop on financing children's vaccines highlighted the potential for vaccines to control diarrhoea and other diseases as well as spur economic development through better health. Clear communication of vaccination value to decision-makers is required, together with sustainable funding mechanisms. GAVI and partners have made great progress providing funding for vaccines for children in the poorest countries but other solutions may be required to achieve the same gains in middle- and high-income countries. World Health Organization has a wealth of freely available country-level data on immunisation that academics and advocates can use to communicate the economic and health benefits of vaccines to decision-makers.

ELSI practices in genomic research in East Asia: implications for research collaboration and public participation

PubMed Central

2014-01-01

Common infrastructures and platforms are required for international collaborations in large-scale human genomic research and policy development, such as the Global Alliance for Genomics and Health and the ‘ELSI 2.0’ initiative. Such initiatives may require international harmonization of ethical and regulatory requirements. To enable this, however, a greater understanding of issues and practices that relate to the ethical, legal and social implications (ELSI) of genomic research will be needed for the different countries and global regions involved in such research. Here, we review the ELSI practices and regulations for genomic research in six East Asian countries (China, Indonesia, Japan, Singapore, South Korea and Taiwan), highlighting the main similarities and differences between these countries, and more generally, in relation to Western countries. While there are significant differences in ELSI practices among these East Asian countries, there is a consistent emphasis on advancing genomic science and technology. In addition, considerable emphasis is placed on informed consent for participation in research, whether through the contribution of tissue samples or personal information. However, a higher level of engagement with interested stakeholders and the public will be needed in some countries. PMID:24944586

Trade, TRIPS, and pharmaceuticals.

PubMed

Smith, Richard D; Correa, Carlos; Oh, Cecilia

2009-02-21

The World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) set global minimum standards for the protection of intellectual property, substantially increasing and expanding intellectual-property rights, and generated clear gains for the pharmaceutical industry and the developed world. The question of whether TRIPS generates gains for developing countries, in the form of increased exports, is addressed in this paper through consideration of the importance of pharmaceuticals in health-care trade, outlining the essential requirements, implications, and issues related to TRIPS, and TRIPS-plus, in which increased restrictions are imposed as part of bilateral free-trade agreements. TRIPS has not generated substantial gains for developing countries, but has further increased pharmaceutical trade in developed countries. The unequal trade between developed and developing countries (ie, exporting and importing high-value patented drugs, respectively) raises the issue of access to medicines, which is exacerbated by TRIPS-plus provisions, although many countries have not even enacted provision for TRIPS flexibilities. Therefore this paper focuses on options that are available to the health community for negotiation to their advantage under TRIPS, and within the presence of TRIPS-plus.

Grand canonical validation of the bipartite international trade network.

PubMed

Straka, Mika J; Caldarelli, Guido; Saracco, Fabio

2017-08-01

Devising strategies for economic development in a globally competitive landscape requires a solid and unbiased understanding of countries' technological advancements and similarities among export products. Both can be addressed through the bipartite representation of the International Trade Network. In this paper, we apply the recently proposed grand canonical projection algorithm to uncover country and product communities. Contrary to past endeavors, our methodology, based on information theory, creates monopartite projections in an unbiased and analytically tractable way. Single links between countries or products represent statistically significant signals, which are not accounted for by null models such as the bipartite configuration model. We find stable country communities reflecting the socioeconomic distinction in developed, newly industrialized, and developing countries. Furthermore, we observe product clusters based on the aforementioned country groups. Our analysis reveals the existence of a complicated structure in the bipartite International Trade Network: apart from the diversification of export baskets from the most basic to the most exclusive products, we observe a statistically significant signal of an export specialization mechanism towards more sophisticated products.

Grand canonical validation of the bipartite international trade network

NASA Astrophysics Data System (ADS)

Straka, Mika J.; Caldarelli, Guido; Saracco, Fabio

2017-08-01

Devising strategies for economic development in a globally competitive landscape requires a solid and unbiased understanding of countries' technological advancements and similarities among export products. Both can be addressed through the bipartite representation of the International Trade Network. In this paper, we apply the recently proposed grand canonical projection algorithm to uncover country and product communities. Contrary to past endeavors, our methodology, based on information theory, creates monopartite projections in an unbiased and analytically tractable way. Single links between countries or products represent statistically significant signals, which are not accounted for by null models such as the bipartite configuration model. We find stable country communities reflecting the socioeconomic distinction in developed, newly industrialized, and developing countries. Furthermore, we observe product clusters based on the aforementioned country groups. Our analysis reveals the existence of a complicated structure in the bipartite International Trade Network: apart from the diversification of export baskets from the most basic to the most exclusive products, we observe a statistically significant signal of an export specialization mechanism towards more sophisticated products.

Polymerase Chain Reaction/Rapid Methods Are Gaining a Foothold in Developing Countries.

PubMed

Ragheb, Suzan Mohammed; Jimenez, Luis

Detection of microbial contamination in pharmaceutical raw materials and finished products is a critical factor to guarantee their safety, stability, and potency. Rapid microbiological methods-such as polymerase chain reaction-have been widely applied to clinical and food quality control analysis. However, polymerase chain reaction applications to pharmaceutical quality control have been rather slow and sporadic. Successful implementation of these methods in pharmaceutical companies in developing countries requires important considerations to provide sensitive and robust assays that will comply with good manufacturing practices. In recent years several publications have encouraged the application of molecular techniques in the microbiological assessment of pharmaceuticals. One of these techniques is polymerase chain reaction (PCR). The successful application of PCR in the pharmaceutical industry in developing countries is governed by considerable factors and requirements. These factors include the setting up of a PCR laboratory and the choice of appropriate equipment and reagents. In addition, the presence of well-trained analysts and establishment of quality control and quality assurance programs are important requirements. The pharmaceutical firms should take into account these factors to allow better chances for regulatory acceptance and wide application of this technique. © PDA, Inc. 2014.

Bologna Process and Basic Nursing Education in 21 European Countries.

PubMed

Humar, L; Sansoni, J

2017-01-01

The Bologna Process and the Directives of the European Union have had a profound impact on nursing education in Europe. The aim of this study was to identify the similarities and differences within nursing education framework at entry level in 2014 in European countries. A questionnaire was devised by the researchers and distributed via e-mail to the nursing associations/nursing regulatory bodies of 30 European countries. Data were collected from January to May 2014. Responses were received from 21 European Countries. Results indicated that while a completion of 12 years of general education was a requirement to access nursing education in almost all respondent countries, other admission requirements differed between countries. Nursing courses were offered mostly by Faculties of Nursing and Faculties of Health Sciences (in higher education Institutions) and lecturers and management staff were mainly nurses. The results indicated significant different educational requirements for nurse educators. A foreign language was mandatory in half of the respondent countries. Nursing profession was represented at government level in just over half of the respondent countries, often with a Directorate position. The Bologna Process has helped harmonise initial nursing education in Europe but clear standards for nursing education need to be set up. Therefore, the research about the influence of the Bologna process on the development of the nursing profession should be further encouraged.

Trends and affordability of cigarette prices: ample room for tax increases and related health gains.

PubMed

Guindon, G E; Tobin, S; Yach, D

2002-03-01

Increasing the price of tobacco products is arguably the most effective method of curbing the prevalence and consumption of tobacco products. Price increases would reduce the global burden of disease brought about by tobacco consumption. To compare cigarette price data from more than 80 countries using varying methods, examine trends in prices and affordability during the 1990s, and explore various policy implications pertaining to tobacco prices. March 2001 cigarette price data from the Economist Intelligence Unit are used to compare cigarette prices across countries. To facilitate comparison and to assess affordability, prices are presented in US dollars, purchasing power parity (PPP) units using the Big Mac index as an indicator of PPP and in terms of minutes of labour required to purchase a pack of cigarettes. Annual real percentage changes in cigarette prices between 1990 and 2000 and annual changes in the minutes of labour required to buy cigarettes between 1991 and 2000 are also calculated to examine trends. Cigarette prices tend to be higher in wealthier countries and in countries that have strong tobacco control programmes. On the other hand, minutes of labour required to purchase cigarettes vary vastly between countries. Trends between 1990 and 2000 in real prices and minutes of labour indicate, with some exceptions, that cigarettes have become more expensive in most developed countries but more affordable in many developing countries. However, in the UK, despite recent increases in price, cigarettes are still more affordable than they were in the 1960s. The results suggest that there is ample room to increase tobacco prices through taxation. In too many countries, cigarette prices have failed to keep up with increases in the general price level of goods and services, rendering them more affordable in 2000 than they were at the beginning of the decade. Opportunities to increase government revenue and improve health through reduced consumption brought about by higher prices have been overlooked in many countries.

The Global Fund's paradigm of oversight, monitoring, and results in Mozambique.

PubMed

Warren, Ashley; Cordon, Roberto; Told, Michaela; de Savigny, Don; Kickbusch, Ilona; Tanner, Marcel

2017-12-12

The Global Fund is one of the largest actors in global health. In 2015 the Global Fund was credited with disbursing close to 10 % of all development assistance for health. In 2011 it began a reform process in response to internal reviews following allegations of recipients' misuse of funds. Reforms have focused on grant application processes thus far while the core structures and paradigm have remained intact. We report results of discussions with key stakeholders on the Global Fund, its paradigm of oversight, monitoring, and results in Mozambique. We conducted 38 semi-structured in-depth interviews in Maputo, Mozambique and members of the Global Fund Board and Secretariat in Switzerland. In-country stakeholders were representatives from Global Fund country structures (eg. Principle Recipient), the Ministry of Health, health or development attachés bilateral and multilateral agencies, consultants, and the NGO coordinating body. Thematic coding revealed concerns about the combination of weak country oversight with stringent and cumbersome requirements for monitoring and evaluation linked to performance-based financing. Analysis revealed that despite the changes associated with the New Funding Model, respondents in both Maputo and Geneva firmly believe challenges remain in Global Fund's structure and paradigm. The lack of a country office has many negative downstream effects including reliance on in-country partners and ineffective coordination. Due to weak managerial and absorptive capacity, more oversight is required than is afforded by country team visits. In-country partners provide much needed support for Global Fund recipients, but roles, responsibilities, and accountability must be clearly defined for a successful long-term partnership. Furthermore, decision-makers in Geneva recognize in-country coordination as vital to successful implementation, and partners welcome increased Global Fund engagement. To date, there are no institutional requirements for formalized coordination, and the Global Fund has no consistent representation in Mozambique's in-country coordination groups. The Global Fund should adapt grant implementation and monitoring procedures to the specific local realities that would be illuminated by more formalized coordination.

Comparison and cost analysis of drinking water quality monitoring requirements versus practice in seven developing countries.

PubMed

Crocker, Jonny; Bartram, Jamie

2014-07-18

Drinking water quality monitoring programs aim to support provision of safe drinking water by informing water quality management. Little evidence or guidance exists on best monitoring practices for low resource settings. Lack of financial, human, and technological resources reduce a country's ability to monitor water supply. Monitoring activities were characterized in Cambodia, Colombia, India (three states), Jordan, Peru, South Africa, and Uganda according to water sector responsibilities, monitoring approaches, and marginal cost. The seven study countries were selected to represent a range of low resource settings. The focus was on monitoring of microbiological parameters, such as E. coli, coliforms, and H2S-producing microorganisms. Data collection involved qualitative and quantitative methods. Across seven study countries, few distinct approaches to monitoring were observed, and in all but one country all monitoring relied on fixed laboratories for sample analysis. Compliance with monitoring requirements was highest for operational monitoring of large water supplies in urban areas. Sample transport and labor for sample collection and analysis together constitute approximately 75% of marginal costs, which exclude capital costs. There is potential for substantive optimization of monitoring programs by considering field-based testing and by fundamentally reconsidering monitoring approaches for non-piped supplies. This is the first study to look quantitatively at water quality monitoring practices in multiple developing countries.

Achieving value for money in health: a comparative analysis of OECD countries and regional countries.

PubMed

Çelik, Yusuf; Khan, Mahmud; Hikmet, Neşet

2017-10-01

To measure efficiency gains in health sector over the years 1995 to 2013 in OECD, EU, non-member European countries. An output-oriented DEA model with variable return to scale, and residuals estimated by regression equations were used to estimate efficiencies of health systems. Slacks for health care outputs and inputs were calculated by using DEA multistage method of estimating country efficiency scores. Better health outcomes of countries were related with higher efficiency. Japan, France, or Sweden were found to be peer-efficient countries when compared to other developed countries like Germany and United States. Increasing life expectancy beyond a certain high level becomes very difficult to achieve. Despite declining marginal productivity of inputs on health outcomes, some developed countries and developing countries were found to have lowered their inefficiencies in the use of health inputs. Although there was no systematic relationship between political system of countries and health system efficiency, the objectives of countries on social and health policy and the way of achieving these objectives might be a factor increasing the efficiency of health systems. Economic and political stability might be as important as health expenditure in improving health system goals. A better understanding of the value created by health expenditures, especially in developed countries, will require analysis of specific health interventions that can increase value for money in health. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Ship Operation Research and Development, A Program for Industry.

DTIC Science & Technology

1983-01-01

severe economic pressures. While protective legislation may still be afforded the U.S. merchant marine, both the market and the government require...national strategy to enhance the country’s competi- tive posture in international markets . 2 o Research and development pr-->,b in other countries having...operation, maritime technology, market analysis, and the use of ports and terminals. As of October 1981, the agency had 157 projects under way

Future oil and gas: Can Iran deliver?

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

Takin, M.

1996-11-01

Iran`s oil and gas production and exports constitute the country`s main source of foreign exchange earnings. The future level of these earnings will depend on oil prices, global demand for Iranian exports, the country`s productive capability and domestic consumption. The size of Iranian oil reserves suggests that, in principle, present productive capacity could be maintained and expanded. However, the greatest share of production in coming years still will come from fields that already have produced for several decades. In spite of significant remaining reserves, these fields are not nearly as prolific as they were in their early years. The operationsmore » required for further development are now more complicated and, in particular, more costly. These fields` size also implies that improving production, and instituting secondary and tertiary recovery methods (such as gas injection), will require mega-scale operations. This article discusses future oil and gas export revenues from the Islamic Republic of Iran, emphasizing the country`s future production and commenting on the effects of proposed US sanctions.« less

Applying the system engineering approach to devise a master’s degree program in space technology in developing countries

NASA Astrophysics Data System (ADS)

Jazebizadeh, Hooman; Tabeshian, Maryam; Taheran Vernoosfaderani, Mahsa

2010-11-01

Although more than half a century is passed since space technology was first developed, developing countries are just beginning to enter the arena, focusing mainly on educating professionals. Space technology by itself is an interdisciplinary science, is costly, and developing at a fast pace. Moreover, a fruitful education system needs to remain dynamic if the quality of education is the main concern, making it a complicated system. This paper makes use of the System Engineering Approach and the experiences of developed countries in this area while incorporating the needs of the developing countries to devise a comprehensive program in space engineering at the Master's level. The needs of the developing countries as regards space technology education may broadly be put into two categories: to raise their knowledge of space technology which requires hard work and teamwork skills, and to transfer and domesticate space technology while minimizing the costs and maximizing its effectiveness. The requirements of such space education system, which include research facilities, courses, and student projects are then defined using a model drawn from the space education systems in universities in North America and Europe that has been modified to include the above-mentioned needs. Three design concepts have been considered and synthesized through functional analysis. The first one is Modular and Detail Study which helps students specialize in a particular area in space technology. Second is referred to as Integrated and Interdisciplinary Study which focuses on understanding and development of space systems. Finally, the third concept which has been chosen for the purpose of this study, is a combination of the other two, categorizing the required curriculum into seven modules, setting aside space applications. This helps students to not only specialize in one of these modules but also to get hands-on experience in a real space project through participation in summer group projects and also working in space systems laboratories or choose and write a thesis based on experiences gained through an internship program.

Strategies and challenges for safe injection practice in developing countries.

PubMed

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, Kc Vikash

2013-01-01

Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of "Safe Injection Global Network (SIGN)" was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice.

Strategies and challenges for safe injection practice in developing countries

PubMed Central

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, KC Vikash

2013-01-01

Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of “Safe Injection Global Network (SIGN)” was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice. PMID:23662018

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.

Managing the effect of TRIPS on availability of priority vaccines.

PubMed Central

Milstien, Julie; Kaddar, Miloud

2006-01-01

The stated purpose of intellectual property protection is to stimulate innovation. The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) requires all Members of the World Trade Organization (WTO) to enact national laws conferring minimum standards of intellectual property protection by certain deadlines. Critics of the Agreement fear that such action is inconsistent with ensuring access to medicines in the developing world. A WHO convened meeting on intellectual property rights and vaccines in developing countries, on which this paper is based, found no evidence that TRIPS has stimulated innovation in developing market vaccine development (where markets are weak) or that protection of intellectual property rights has had a negative effect on access to vaccines. However, access to future vaccines in the developing world could be threatened by compliance with TRIPS. The management of such threats requires adherence of all countries to the Doha Declaration on TRIPS, and the protections guaranteed by the Agreement itself, vigilance on TRIPS-plus elements of free trade agreements, developing frameworks for licensing and technology transfer, and promoting innovative vaccine development in developing countries. The role of international organizations in defining best practices, dissemination of information, and monitoring TRIPS impact will be crucial to ensuring optimal access to priority new vaccines for the developing world. PMID:16710544

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.

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.

Challenges for the registration of vaccines in emerging countries: Differences in dossier requirements, application and evaluation processes.

PubMed

Dellepiane, Nora; Pagliusi, Sonia

2018-06-07

The divergence of regulatory requirements and processes in developing and emerging countries contributes to hamper vaccines' registration, and therefore delay access to high-quality, safe and efficacious vaccines for their respective populations. This report focuses on providing insights on the heterogeneity of registration requirements in terms of numbering structure and overall content of dossiers for marketing authorisation applications for vaccines in different areas of the world. While it also illustrates the divergence of regulatory processes in general, as well as the need to avoid redundant reviews, it does not claim to provide a comprehensive view of all processes nor existing facilitating mechanisms, nor is it intended to touch upon the differences in assessments made by different regulatory authorities. This report describes the work analysed by regulatory experts from vaccine manufacturing companies during a meeting held in Geneva in May 2017, in identifying and quantifying differences in the requirements for vaccine registration in three aspects for comparison: the dossier numbering structure and contents, the application forms, and the evaluation procedures, in different countries and regions. The Module 1 of the Common Technical Document (CTD) of 10 countries were compared. Modules 2-5 of the CTDs of two regions and three countries were compared to the CTD of the US FDA. The application forms of eight countries were compared and the registration procedures of 134 importing countries were compared as well. The analysis indicates a high degree of divergence in numbering structure and content requirements. Possible interventions that would lead to significant improvements in registration efficiency include alignment in CTD numbering structure, a standardised model-application form, and better convergence of evaluation procedures. Copyright © 2018.

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

PubMed Central

2010-01-01

Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important. PMID:20942937

A Review on the Rising Prevalence of International Standards: Threats or Opportunities for the Agri-Food Produce Sector in Developing Countries, with a Focus on Examples from the MENA Region.

PubMed

Faour-Klingbeil, Dima; Todd, Ewen C D

2018-03-03

Food safety standards are a necessity to protect consumers' health in today's growing global food trade. A number of studies have suggested safety standards can interrupt trade, bringing financial and technical burdens on small as well as large agri-food producers in developing countries. Other examples have shown that economical extension, key intermediaries, and funded initiatives have substantially enhanced the capacities of growers in some countries of the Middle East and North Africa (MENA) region to meet the food safety and quality requirements, and improve their access to international markets. These endeavors often compensate for the weak regulatory framework, but do not offer a sustainable solution. There is a big gap in the food safety level and control systems between countries in the MENA region and those in the developed nations. This certainly has implications for the safety of fresh produce and agricultural practices, which hinders any progress in their international food trade. To overcome the barriers of legal and private standards, food safety should be a national priority for sustainable agricultural development in the MENA countries. Local governments have a primary role in adopting the vision for developing and facilitating the implementation of their national Good Agricultural Practices (GAP) standards that are consistent with the international requirements and adapted to local policies and environment. Together, the public and private sector's support are instrumental to deliver the skills and infrastructure needed for leveraging the safety and quality level of the agri-food chain.

A Review on the Rising Prevalence of International Standards: Threats or Opportunities for the Agri-Food Produce Sector in Developing Countries, with a Focus on Examples from the MENA Region

PubMed Central

Faour-Klingbeil, Dima

2018-01-01

Food safety standards are a necessity to protect consumers’ health in today’s growing global food trade. A number of studies have suggested safety standards can interrupt trade, bringing financial and technical burdens on small as well as large agri-food producers in developing countries. Other examples have shown that economical extension, key intermediaries, and funded initiatives have substantially enhanced the capacities of growers in some countries of the Middle East and North Africa (MENA) region to meet the food safety and quality requirements, and improve their access to international markets. These endeavors often compensate for the weak regulatory framework, but do not offer a sustainable solution. There is a big gap in the food safety level and control systems between countries in the MENA region and those in the developed nations. This certainly has implications for the safety of fresh produce and agricultural practices, which hinders any progress in their international food trade. To overcome the barriers of legal and private standards, food safety should be a national priority for sustainable agricultural development in the MENA countries. Local governments have a primary role in adopting the vision for developing and facilitating the implementation of their national Good Agricultural Practices (GAP) standards that are consistent with the international requirements and adapted to local policies and environment. Together, the public and private sector’s support are instrumental to deliver the skills and infrastructure needed for leveraging the safety and quality level of the agri-food chain. PMID:29510498

Global estimates of country health indicators: useful, unnecessary, inevitable?

PubMed Central

AbouZahr, Carla; Boerma, Ties; Hogan, Daniel

2017-01-01

ABSTRACT Background: The MDG era relied on global health estimates to fill data gaps and ensure temporal and cross-country comparability in reporting progress. Monitoring the Sustainable Development Goals will present new challenges, requiring enhanced capacities to generate, analyse, interpret and use country produced data. Objective: To summarize the development of global health estimates and discuss their utility and limitations from global and country perspectives. Design: Descriptive paper based on findings of intercountry workshops, reviews of literatureon and synthesis of experiences. Results: Producers of global health estimates focus on the technical soundness of estimation methods and comparability of the results across countries and over time. By contrast, country users are more concerned about the extent of their involvement in the estimation process and hesitate to buy into estimates derived using methods their technical staff cannot explain and that differ from national data sources. Quantitative summaries of uncertainty may be of limited practical use in policy discussions where decisions need to be made about what to do next. Conclusions: Greater transparency and involvement of country partners in the development of global estimates will help improve ownership, strengthen country capacities for data production and use, and reduce reliance on externally produced estimates. PMID:28532307

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.

Cultural differences in Research project management

NASA Astrophysics Data System (ADS)

Barbier, Michele

2016-04-01

Scientific Projects today have increased in complexity, requiring multidisciplinarity, and requiring a mix of diverse individuals from different countries who must be integrated into an effective project. Effective team building is one of the prime responsibilities of the project manager. When the project is supported by a funding, the integration and the implication of the different partners are quite easy. Particularly when partners are developing high-performing teams. However, management of research project requires further skills when the budget is not very high and/or when partners are from non-European countries and are not using the same vocabulary. The various cultures, values, beliefs and social usages, particularly with Mediterranean countries cause a special style of communication for an individual or group of individuals. This communication style participates in the success of the project and encompasses a lot of diplomatic skills which will be highlighted.

Impact, regulation and health policy implications of physician migration in OECD countries

PubMed Central

Forcier, Mélanie Bourassa; Simoens, Steven; Giuffrida, Antonio

2004-01-01

Background In the face of rising demand for medical services due to ageing populations, physician migration flows are increasingly affecting the supply of physicians in Organisation for Economic Co-operation and development (OECD) countries. This paper offers an integrated perspective on the impact of physician migration on home and host countries and discusses international regulation and policy approaches governing physician migration. Methods Information about migration flows, international regulation and policies governing physician migration were derived from two questionnaires sent to OECD countries, a secondary analysis of EUROSTAT Labour Force Surveys, a literature review and official policy documents of OECD countries. Results OECD countries increasingly perceive immigration of foreign physicians as a way of sustaining their physician workforce. As a result, countries have entered into international agreements regulating physician migration, although their success has been limited due to the imposition of licensing requirements and the protection of vested interests by domestic physicians. OECD countries have therefore adopted specific policies designed to stimulate the immigration of foreign physicians, whilst minimising its negative impact on the home country. Measures promoting immigration have included international recruitment campaigns, less strict immigration requirements and arrangements that foster shared learning between health care systems. Policies restricting the societal costs of physician emigration from developing countries such as good practice guidelines and taxes on host countries have not yet produced their expected effect or in some cases have not been established at all. Conclusions Although OECD countries generally favour long-term policies of national self-sufficiency to sustain their physician workforce, such policies usually co-exist with short-term or medium-term policies to attract foreign physicians. As this is likely to continue, there is a need to create a global framework that enforces physician migration policies that confer benefits on home and host countries. In the long term, OECD countries need to put in place appropriate education and training policies rather than rely on physician migration to address their future needs. PMID:15257752

The challenge of electronic waste (e-waste) management in developing countries.

PubMed

Osibanjo, O; Nnorom, I C

2007-12-01

Information and telecommunications technology (ICT) and computer Internet networking has penetrated nearly every aspect of modern life, and is positively affecting human life even in the most remote areas of the developing countries. The rapid growth in ICT has led to an improvement in the capacity of computers but simultaneously to a decrease in the products lifetime as a result of which increasingly large quantities of waste electrical and electronic equipment (e-waste) are generated annually. ICT development in most developing countries, particularly in Africa, depends more on secondhand or refurbished EEEs most of which are imported without confirmatory testing for functionality. As a result large quantities of e-waste are presently being managed in these countries. The challenges facing the developing countries in e-waste management include: an absence of infrastructure for appropriate waste management, an absence of legislation dealing specifically with e-waste, an absence of any framework for end-of-life (EoL) product take-back or implementation of extended producer responsibility (EPR). This study examines these issues as they relate to practices in developing countries with emphasis on the prevailing situation in Nigeria. Effective management of e-waste in the developing countries demands the implementation of EPR, the establishment of product reuse through remanufacturing and the introduction of efficient recycling facilities. The implementation of a global system for the standardization and certification/labelling of secondhand appliances intended for export to developing countries will be required to control the export of electronic recyclables (e-scarp) in the name of secondhand appliances.

Psychiatric brain collection in Macedonia: general lessons for scientific collaboration among countries of differing wealth.

PubMed

Rosoklija, G; Duma, A; Dwork, A J

2013-01-01

Macedonia is a small country, and the current state has been independent for only 22 years. Medical research, which requires an extensive infrastructure, has been limited. We describe our experience in developing Macedonian research through a mutually beneficial collaboration between institutions in Macedonia and the United States.

Motherhood, Migration and Methodology: Giving Voice to the "Other"

ERIC Educational Resources Information Center

De Souza, Ruth

2004-01-01

This paper discusses the need for multi-cultural methodologies that develop knowledge about the maternity experience of migrant women and that are attuned to womens maternity-related requirements under multi-cultural conditions. Little is known about the transition to parenthood for mothers in a new country, particularly when the country is New…

Managerial Selection Decisions in Multinational Corporations: Teaching International Business Using Problem-Based Learning

ERIC Educational Resources Information Center

Zisk, Daniel S.; Owyar-Hosseini, Marion M.; DuBose, Philip B.

2015-01-01

Companies face many challenges as they staff managerial positions in overseas operations, including decisions on whether to staff using expatriates, host-country nationals, or third-country nationals. We developed an exercise--designed to help students understand the differences between these three groups of employees--that requires students to…

Achieving Excellence: Investing in People, Knowledge and Opportunity. Canada's Innovation Strategy.

ERIC Educational Resources Information Center

2002

To become one of the world's most innovative countries, Canada requires a national innovation strategy for the 21st century. It is progressing toward a more innovative economy, but lags behind many developed countries in terms of overall innovation performance. A national innovation strategy to meet Canada's innovation challenge proposes goals,…

An integrated approach to scale up the market penetration of low carbon technologies in developing countries and water scarce regions

NASA Astrophysics Data System (ADS)

Thompson, Michelle Angela

Water scarcity is a global challenge that stifles social and economic growth. There is a growing concern to examine the water-energy nexus to understand the importance of applying energy and water interactions to technology. In developing countries there are many communities that live off-grid in remote region with no access to electricity or clean water. Additionally, there are developed countries that are located in regions with electricity but no access to clean water. Recent developments in renewable energy technology and energy policies have greatly reduced the costs of renewable energy making them more attractive and affordable. The purpose of this dissertation is to evaluate the main barriers to deploying renewables to non-Organization for Economic Co-operation and Development (non-OECD) countries and member countries of the Organization for Economic Co-operation and Development (OECD). This dissertation examines the potential of renewable desalination technology systems across emerging countries. The findings of this research can serve as the basis for investors interested in entering this market. The combined chapters seek to address potential problems regarding the costs, methods, and tools required for the implementation of the appropriate water purification technologies for off-grid, community scale infrastructures.

Municipal solid waste development phases: Evidence from EU27.

PubMed

Vujić, Goran; Gonzalez-Roof, Alvaro; Stanisavljević, Nemanja; Ragossnig, Arne M

2015-12-01

Many countries in the European Union (EU) have very developed waste management systems. Some of its members have managed to reduce their landfilled waste to values close to zero during the last decade. Thus, European Union legislation is very stringent regarding waste management for their members and candidate countries, too. This raises the following questions: Is it possible for developing and developed countries to comply with the European Union waste legislation, and under what conditions? How did waste management develop in relation to the economic development in the countries of the European Union? The correlation between waste management practices and economic development was analysed for 27 of the European Union Member States for the time period between 1995 and 2007. In addition, a regression analysis was performed to estimate landfilling of waste in relation to gross domestic product for every country. The results showed a strong correlation between the waste management variables and the gross domestic product of the EU27 members. The definition of the municipal solid waste management development phases followed a closer analysis of the relation between gross domestic product and landfilled waste. The municipal solid waste management phases are characterised by high landfilling rates at low gross domestic product levels, and landfilling rates near zero at high gross domestic product levels. Hence the results emphasize the importance of wider understanding of what is required for developing countries to comply with the European Union initiatives, and highlight the importance of allowing developing countries to make their own paths of waste management development. © The Author(s) 2015.

Energy efficiency through integrated environmental management.

PubMed

Benromdhane, Souad Ahmed

2015-05-01

Integrated environmental management became an economic necessity after industrial development proved to be unsustainable without consideration of environmental direct and indirect impacts. Energy dependency and air pollution along with climate change grew into major challenges facing developed and developing countries alike. Thus, a new global market structure emerged and changed the way we do trade. The search intensified for alternatives to petroleum. However, scientists, policy makers, and environmental activists agreed to focus on strategic conservation and optimization of energy use. Environmental concerns will remain partially unaddressed with the current pace of consumption because greenhouse gas emissions will continue to rise with economic growth. This paper discusses energy efficiency, steady integration of alternative sources, and increased use of best available technologies. Energy criteria developed for environmental labeling certification are presented. Our intention is to encourage manufacturers and service providers to supply consumers with less polluting and energy-consuming goods and services, inform consumers of the environmental and energy impacts, and thereby instill sustainable and responsible consumption. As several programs were initiated in developed countries, environmental labeling requirements created barriers to many exports manufactured in developing countries, affecting current world trade and putting more pressure on countries to meet those requirements. Defining an institutional and legal framework of environmental labeling is a key challenge in implementing such programs for critical economic sectors like tourism, textiles, and food production where energy needs are the most important aspect to control. A case study of Tunisia and its experience with eco-labeling is presented.

Monitoring Sustainable Development Goal 3: how ready are the health information systems in low-income and middle-income countries?

PubMed

Nabyonga-Orem, Juliet

2017-01-01

Sustainable Development Goals (SDGs) present a broader scope and take a holistic multisectoral approach to development as opposed to the Millennium Development Goals (MDGs). While keeping the health MDG agenda, SDG3 embraces the growing challenge of non-communicable diseases and their risk factors. The broader scope of the SDG agenda, the need for a multisectoral approach and the emphasis on equity present monitoring challenges to health information systems of low-income and middle-income countries. The narrow scope and weaknesses in existing information systems, a multiplicity of data collection systems designed along disease programme and the lack of capacity for data analysis are among the limitations to be addressed. On the other hand, strong leadership and a comprehensive and longer-term approach to strengthening a unified health information system are beneficial. Strengthening country capacity to monitor SDGs will involve several actions: domestication of the SDG agenda through country-level planning and monitoring frameworks, prioritisation of interventions, indicators and setting country-specific targets. Equity stratifiers should be country specific in addressing policy concerns. The scope of existing information systems should be broadened in line with the SDG agenda monitoring requirements and strengthened to produce reliable data in a timely manner and capacity for data analysis and use of data built. Harnessing all available opportunities, emphasis should be on strengthening health sector as opposed to SDG3 monitoring. In this regard, information systems in related sectors and the private sector should be strengthened and data sharing institutionalised. Data are primarily needed to inform planning and decision-making beyond SGD3 reporting requirements.

Monitoring Sustainable Development Goal 3: how ready are the health information systems in low-income and middle-income countries?

PubMed Central

Nabyonga-Orem, Juliet

2017-01-01

Sustainable Development Goals (SDGs) present a broader scope and take a holistic multisectoral approach to development as opposed to the Millennium Development Goals (MDGs). While keeping the health MDG agenda, SDG3 embraces the growing challenge of non-communicable diseases and their risk factors. The broader scope of the SDG agenda, the need for a multisectoral approach and the emphasis on equity present monitoring challenges to health information systems of low-income and middle-income countries. The narrow scope and weaknesses in existing information systems, a multiplicity of data collection systems designed along disease programme and the lack of capacity for data analysis are among the limitations to be addressed. On the other hand, strong leadership and a comprehensive and longer-term approach to strengthening a unified health information system are beneficial. Strengthening country capacity to monitor SDGs will involve several actions: domestication of the SDG agenda through country-level planning and monitoring frameworks, prioritisation of interventions, indicators and setting country-specific targets. Equity stratifiers should be country specific in addressing policy concerns. The scope of existing information systems should be broadened in line with the SDG agenda monitoring requirements and strengthened to produce reliable data in a timely manner and capacity for data analysis and use of data built. Harnessing all available opportunities, emphasis should be on strengthening health sector as opposed to SDG3 monitoring. In this regard, information systems in related sectors and the private sector should be strengthened and data sharing institutionalised. Data are primarily needed to inform planning and decision-making beyond SGD3 reporting requirements. PMID:29104767

The economic case for low carbon waste management in rapidly growing cities in the developing world: The case of Palembang, Indonesia.

PubMed

Papargyropoulou, Effie; Colenbrander, Sarah; Sudmant, Andrew Heshedahl; Gouldson, Andy; Tin, Lee Chew

2015-11-01

The provision of appropriate waste management is not only an indicator of development but also of broader sustainability. This is particularly relevant to expanding cities in developing countries faced with rising waste generation and associated environmental health problems. Despite these urgent issues, city authorities often lack the evidence required to make well-informed decisions. This study evaluates the carbon and economic performance of low-carbon measures in the waste sector at a city level, within the context of a developing country. Palembang in Indonesia is used as a case of a medium-sized city in a newly industrialized country, with relevance to other similar cities in the developing world. Evidence suggests that the waste sector can achieve substantial carbon emission reductions, and become a carbon sink, in a cost effective way. Hence there is an economic case for a low carbon development path for Palembang, and possibly for other cities in developing and developed countries facing similar challenges. Copyright © 2015 Elsevier Ltd. All rights reserved.

Return of talent programs: rationale and evaluation criteria for programs to ameliorate a 'brain drain'.

PubMed

Keely, C B

1986-03-01

The term, brain drain, describes the loss of skilled professionals and the nonreturn of students from advanced study abroad. It is now used almost exclusively in reference to mobility from less developed countries to more developed countries. Controversy centers on whether needed skills are being drawn off unfairly at subsidized rates from developing to developed countries or whether excess capability is being utilized in developed countries rather than underemployed or wasted at home. Some causes of high level personnel migration include: 1) wage differentials between sending and receiving countries; 2) absence of opportunities for career development or mobility for reasons other than merit or accomplishment; 3) lack of high quality facilities, equipment, time, and other costly supports in developing countries; 4) employer's lack of knowledge of employee work and the resulting wages; and 5) political disagreement or persecution. Prospects for closing wage gaps and upgrading working conditions on a large scale in developing countries are dim. Growth of the labor force coupled with national needs that are not congruent with professions requiring costly facilities, supplies, and equipment make this a slim possibility. Increasing career mobility possibilities seems to be a more promising route to reducing brain drain. One form of preventive measure is offering study abroad which requires service at the end of the study period; a variation is to guarantee employment for university graduates or for certain sectors, such as scientists. Restructuring decisions on hiring and promotion would have a positive effect, as would developing a better evaluation of expected productivity by type of training. Successful return of talent programs will be relatively modest in terms of the number of people returning and should be thought of as a part of human capital investment. Programs that are concerned with filling positions rather than with luring talent home are more likely to be efficient. The employing agency should be involved and should have some flexibility in negotiation with employment candidates to curb the unnecessary use of resources. In summary, return of talent programs should be used as a tool for development that reduces the incentives for nonreturn from training of for emigration by experienced professionals, not as a brain drain cure.

A comparative review of the pharmacoeconomic guidelines in South Africa.

PubMed

Carapinha, João L

2017-01-01

To compare the pharmacoeconomic guidelines in South Africa (SA) with other middle- and high-income countries. A comparative review of key features of the pharmacoeconomic guidelines in SA was undertaken using the Comparative Table of Pharmacoeconomic Guidelines developed by the International Society of Pharmacoeconomics and Outcomes Research, and published country-level pharmacoeconomics guidelines. A random sample of guidelines in high- and middle-income countries were analyzed if data on all key features were available. Key features of the pharmacoeconomic guidelines in SA were compared with those in other countries, and divergent features were identified and elaborated. Five upper middle-income countries (Brazil, Colombia, Cuba, Malaysia, and Mexico), one lower middle-income country (Egypt), and six high-income countries (Germany, Ireland, Norway, Portugal, Taiwan, and the Netherlands) were analyzed. The pharmacoeconomic guidelines in SA differ in important areas when compared with other countries. In SA, the study perspective and costs are limited to private health-insurance companies, complex modelling is discouraged and models require pre-approval, equity issues are not explicitly stated, a budget impact analysis is not required, and pharmacoeconomic submissions are voluntary. Future updates to the pharmacoeconomic guidelines in SA may include a societal perspective with limitations, incentivize complex and transparent models, and integrate equity issues. The pharmacoeconomic guidelines could be improved by addressing conflicting objectives with policies on National Health Insurance, incentivize private health insurance companies to disclose reimbursement data, and require the inclusion of a budget impact analysis in all pharmacoeconomic submissions. Further research is also needed on the impact of mandatory pharmacoeconomic submissions in middle-income countries.

Wartime Transitions: Historical Case Analyses Applied to the US Campaign in Afghanistan (2001 to Present)

DTIC Science & Technology

2017-05-25

operate independently without external nation support; (3) a custom approach is necessary in security forces development based on political requirements...independently without external nation support; (3) a custom approach is necessary in security forces development based on political requirements...interventions both successful and unsuccessful, that an external country must craft a custom approach to develop local security forces based on the

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.

The ethics of intellectual property rights in an era of globalization.

PubMed

Shah, Aakash Kaushik; Warsh, Jonathan; Kesselheim, Aaron S

2013-01-01

Since the 1980s, developed countries, led by the United States and the countries of the European Union, have sought to incorporate intellectual property rights provisions into global trade agreements. These countries successfully negotiated the World Trade Organization's 1994 Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), which required developing countries to adopt intellectual property provisions comparable to developed countries. In this manuscript, we review the policy controversy surrounding TRIPS and examine the two main ethical arguments articulated in its support--a theory of natural rights and a utilitarian argument. We contend that these theories provide insufficient bases for an intellectual property rights regime that compromises access to essential medicines in the developing world. While the policy community has engaged in active debate around the policy effects of TRIPS, scholars have not thoroughly considered the full ethical underpinnings of those policy arguments. We believe that a more robust understanding of the ethical implications of the agreement should inform policy discussions in the future. © 2013 American Society of Law, Medicine & Ethics, Inc.

Medical Humanities in Nepal: Present Scenario.

PubMed

Dhakal, Ajaya Kumar; Shankar, P Ravi; Dhakal, Sanjaya; Shrestha, Devendra; Piryani, Rano Mal

2014-01-01

Humanities have an essential role in medical education. The current gap between the humanities and medicine has to be bridged and there should be continuous and vigorous debate about the theory and practice of medical humanities. Medical humanities is a relatively new concept even in developed countries, and is at infancy stage in developing countries. In Nepal, modules on medical humanities have been initiated in certain medical schools by enthusiastic faculties and it requires further debates for inclusion in curriculum.

Influenza vaccine production for Brazil: a classic example of successful North-South bilateral technology transfer.

PubMed

Miyaki, Cosue; Meros, Mauricio; Precioso, Alexander R; Raw, Isaias

2011-07-01

Technology transfer is a promising approach to increase vaccine production at an affordable price in developing countries. In the case of influenza, it is imperative that developing countries acquire the technology to produce pandemic vaccines through the transfer of know-how, as this will be the only way for the majority of these countries to face the huge demand for vaccine created by influenza pandemics. Access to domestically produced influenza vaccine in such health crises is thus an important national defence strategy. However, technology transfer is not a simple undertaking. It requires a committed provider who is willing to transfer a complete production process, and not just the formulation and fill-finish parts of the process. It requires a recipient with established experience in vaccine production for human use and the ability to conduct research into new developments. In addition, the country of the recipient should preferably have sufficient financial resources to support the undertaking, and an internal market for the new vaccine. Technology transfer should create a solid partnership that results in the joint development of new competency, improvements to the product, and to further innovation. The Instituto Butantan-sanofi pasteur partnership can be seen as a model for successful technology transfer and has led to the technological independence of the Instituto Butantan in the use a strategic public health tool. Copyright © 2011 Elsevier Ltd. All rights reserved.

Development and Dematerialization: An International Study

PubMed Central

Steinberger, Julia K.; Krausmann, Fridolin; Getzner, Michael; Schandl, Heinz; West, Jim

2013-01-01

Economic development and growth depend on growing levels of resource use, and result in environmental impacts from large scale resource extraction and emissions of waste. In this study, we examine the resource dependency of economic activities over the past several decades for a set of countries comprising developing, emerging and mature industrialized economies. Rather than a single universal industrial development pathway, we find a diversity of economic dependencies on material use, made evident through cluster analysis. We conduct tests for relative and absolute decoupling of the economy from material use, and compare these with similar tests for decoupling from carbon emissions, both for single countries and country groupings using panel analysis. We show that, over the longer term, emerging and developing countries tend to have significantly larger material-economic coupling than mature industrialized economies (although this effect may be enhanced by trade patterns), but that the contrary is true for short-term coupling. Moreover, we demonstrate that absolute dematerialization limits economic growth rates, while the successful industrialization of developing countries inevitably requires a strong material component. Alternative development priorities are thus urgently needed both for mature and emerging economies: reducing absolute consumption levels for the former, and avoiding the trap of resource-intensive economic and human development for the latter. PMID:24204555

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

PubMed Central

Strother, R. Matthew; Ndiangui, Francis; Chumba, David; Jacobson, William; Dodson, Cecelia; Resnic, Murray B.; Strate, Randall W.; Smith, James W.

2016-01-01

Background Cancer is becoming a major cause of mortality in low- and middle-income countries. Unlike infectious disease, malignancy and other chronic conditions require significant supportive infrastructure for diagnostics, staging and treatment. In addition to morphologic diagnosis, diagnostic pathways in oncology frequently require immunohistochemistry (IHC) for confirmation. We present the experience of a tertiary-care hospital serving rural western Kenya, which developed and validated an IHC laboratory in support of a growing cancer care service. Objectives, methods and outcomes Over the past decade, in an academic North-South collaboration, cancer services were developed for the catchment area of Moi Teaching and Referral Hospital in western Kenya. A major hurdle to treatment of cancer in a resource-limited setting has been the lack of adequate diagnostic services. Building upon the foundations of a histology laboratory, strategic investment and training were used to develop IHC services. Key elements of success in this endeavour included: translation of resource-rich practices to a resource-limited setting, such as using manual, small-batch IHC instead of disposable- and maintenance-intensive automated machinery, engagement of outside expertise to develop reagent-efficient protocols and supporting all levels of staff to meet the requirements of an external quality assurance programme. Conclusion Development of low- and middle-income country models of services, such as the IHC laboratory presented in this paper, is critical for the infrastructure in resource-limited settings to address the growing cancer burden. We provide a low-cost model that effectively develops these necessary services in a challenging laboratory environment. PMID:28879100

Ethical Review Issues in Collaborative Research between US and Low – Middle Income Country Partners: A Case Example

PubMed Central

McIntosh, Scott; Sierra, Essie; Dozier, Ann; Diaz, Sergio; Quiñones, Zahira; Primack, Aron; Chadwick, Gary; Ossip-Klein, Deborah J.

2012-01-01

The current ethical structure for collaborative international health research stems largely from developed countries’ standards of proper ethical practices. The result is that ethical committees in developing countries are required to adhere to standards that might impose practices that conflict with local culture and unintended interpretations of ethics, treatments, and research. This paper presents a case example of a joint international research project that successfully established inclusive ethical review processes as well as other groundwork and components necessary for the conduct of human behavior research and research capacity building in the host country. PMID:18554278

Simulating future supply of and requirements for human resources for health in high-income OECD countries.

PubMed

Tomblin Murphy, Gail; Birch, Stephen; MacKenzie, Adrian; Rigby, Janet

2016-12-12

As part of efforts to inform the development of a global human resources for health (HRH) strategy, a comprehensive methodology for estimating HRH supply and requirements was described in a companion paper. The purpose of this paper is to demonstrate the application of that methodology, using data publicly available online, to simulate the supply of and requirements for midwives, nurses, and physicians in the 32 high-income member countries of the Organisation for Economic Co-operation and Development (OECD) up to 2030. A model combining a stock-and-flow approach to simulate the future supply of each profession in each country-adjusted according to levels of HRH participation and activity-and a needs-based approach to simulate future HRH requirements was used. Most of the data to populate the model were obtained from the OECD's online indicator database. Other data were obtained from targeted internet searches and documents gathered as part of the companion paper. Relevant recent measures for each model parameter were found for at least one of the included countries. In total, 35% of the desired current data elements were found; assumed values were used for the other current data elements. Multiple scenarios were used to demonstrate the sensitivity of the simulations to different assumed future values of model parameters. Depending on the assumed future values of each model parameter, the simulated HRH gaps across the included countries could range from shortfalls of 74 000 midwives, 3.2 million nurses, and 1.2 million physicians to surpluses of 67 000 midwives, 2.9 million nurses, and 1.0 million physicians by 2030. Despite important gaps in the data publicly available online and the short time available to implement it, this paper demonstrates the basic feasibility of a more comprehensive, population needs-based approach to estimating HRH supply and requirements than most of those currently being used. HRH planners in individual countries, working with their respective stakeholder groups, would have more direct access to data on the relevant planning parameters and would thus be in an even better position to implement such an approach.

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

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.

FORENSIC DNA BANKING LEGISLATION IN DEVELOPING COUNTRIES: PRIVACY AND CONFIDENTIALITY CONCERNS REGARDING A DRAFT FROM TURKISH LEGISLATION.

PubMed

Ilgili, Önder; Arda, Berna

This paper presents and analyses, in terms of privacy and confidentiality, the Turkish Draft Law on National DNA Database prepared in 2004, and concerning the use of DNA analysis for forensic objectives and identity verification in Turkey. After a short introduction including related concepts, we evaluate the draft law and provide articles about confidentiality. The evaluation reminded us of some important topics at international level for the developing countries. As a result, the need for sophisticated legislations about DNA databases, for solutions to issues related to the education of employees, and the technological dependency to other countries emerged as main challenges in terms of confidentiality for the developing countries. As seen in the Turkish Draft Law on National DNA Database, the protection of the fundamental rights and freedoms requires more care during the legislative efforts.

Multi-Grade Teaching: A Review of Research and Practice. Education Research Paper.

ERIC Educational Resources Information Center

Little, Angela

The single-grade model of education, based on the division of labor in industry, has come to dominate the school, class, and curriculum organization used by central authorities. Although the multi-grade model is common in developing countries and in rural areas of industrialized countries, the knowledge required for effective multi-grade teaching…

A State of the Art Review on the Impact of Technology on Skill Demand in OECD Countries.

ERIC Educational Resources Information Center

Kim, Young-Hwa

2002-01-01

Review of research since the 1980s shows a consistent trend toward higher skill demands in Organisation for Economic Cooperation and Development countries. There is evidence both that higher skills are needed to implement technology and that implementing technology raises skill requirements. Automation is displacing low-skilled jobs and creating…

Repeated Retention or Dropout? Disputing Hobson's Choice in South African Township Schools

ERIC Educational Resources Information Center

Grossen, Silke; Grobler, Adelene A.; Lacante, Marlies

2017-01-01

South Africa, like many developing countries, is heavily burdened by high dropout and unemployment rates and an undersupply of skilled workers. Grade retention is a common practice when learners do not meet the specific requirements--especially in countries with limited socio-economic resources. In South Africa, 52% of the learners are retained at…

Protecting the ozone layer.

PubMed

Munasinghe, M; King, K

1992-06-01

Stratospheric ozone layer depletion has been recognized as a problem by the Vienna Convention for the Protection of the Ozone Layer and the 1987 Montreal Protocol (MP). The ozone layer shields the earth from harmful ultraviolet radiation (UV-B), which is more pronounced at the poles and around the equator. Industrialized countries have contributed significantly to the problem by releasing chlorofluorocarbons (CFCs) and halons into the atmosphere. The effect of these chemicals, which were known for their inertness, nonflammability, and nontoxicity, was discovered in 1874. Action to deal with the effects of CFCs and halons was initiated in 1985 in a 49-nation UN meeting. 21 nations signed a protocol limiting ozone depleting substances (ODS): CFCs and halons. Schedules were set based on each country's use in 1986; the target phaseout was set for the year 2000. The MP restricts trade in ODSs and weights the impact of substances to reflect the extent of damage; i.e., halons are 10 times more damaging than CFCs. ODS requirements for developing countries were eased to accommodate scarce resources and the small fraction of ODS emissions. An Interim Multilateral Fund under the Montreal Protocol (IMFMP) was established to provide loans to finance the costs to developing countries in meeting global environmental requirements. The IMFMP is administered by the World Bank, the UN Environmental Program, and the UN Development Program. Financing is available to eligible countries who use .3 kg of ODS/person/year. Rapid phaseout in developed countries has occurred due to strong support from industry and a lower than expected cost. Although there are clear advantages to rapid phaseout, there were no incentives included in the MP for rapid phaseout. Some of the difficulties occur because the schedules set minimum targets at the lowest possible cost. Also, costs cannot be minimized by a country-specific and ODS-specific process. The ways to improve implementation in scheduling and incremental costs are indicated.

Genetic counseling globally: Where are we now?

PubMed Central

Laurino, Mercy Ygoña; Barlow‐Stewart, Kristine; Wessels, Tina‐Marié; Macaulay, Shelley; Austin, Jehannine; Middleton, Anna

2018-01-01

The genetic counseling profession is continuing to develop globally, with countries in various stages of development. In some, the profession has been in existence for decades and is increasingly recognized as an important provider of allied health, while in others it is just beginning. In this article, we describe the current global landscape of the genetic counseling specialty field's professional development. Using examples of the United States, United Kingdom, Canada, Australia, South Africa, and various countries in Asia, we highlight the following: (a) status of genetic counseling training programs, (b) availability of credentialing through government and professional bodies (certification, registration, and licensure), and potential for international reciprocity, (c) scope of clinical practice, and (d) health‐care system disparities and cultural differences impacting on practice. The successful global implementation of precision medicine will require both an increased awareness of the importance of the profession of “genetic counselor” and flexibility in how genetic counselors are incorporated into each country's health‐care market. In turn, this will require more collaboration within and across nations, along with continuing engagement of existing genetic counseling professional societies. PMID:29575600

Gender policy developments and policy regimes in 22 OECD countries, 1979-2008.

PubMed

Backhans, Mona C; Burström, Bo; Marklund, Staffan

2011-01-01

This study investigates trends and clustering of gender policy in 22 OECD (Organization for Economic Cooperation and Development) countries during 1979-2008. The starting point was Sainsbury's gender policy regime framework, and the study included indicators reflecting the male bread-winner, individual earner-carer, and separate gender roles regimes. The indicators were followed over seven time points for mean, range, and distribution. Cluster analyses were performed for the years 1979, 1989, 1999, and 2004. In accordance with previous studies, the authors found a Nordic cluster of earner-carer countries, while several Southern European countries and the United States were marked by their low generosity and high pension requirements. Though aspects of the separate gender roles regime have become more widespread, no country could be classified as fully belonging to this regime type. The two aspects of the model--compensatory measures in the pension system, and benefits for caring activities--were never present simultaneously.

Consistency assessment with global and bridging development strategies in emerging markets.

PubMed

Li, Gang; Chen, Josh; Quan, Hui; Shentu, Yue

2013-11-01

Global trial strategy with the participation of all major regions including countries from emerging markets surely increases new drug development efficiency. Nevertheless, there are circumstances in which some countries in emerging markets cannot join the original global trial. To evaluate the extrapolability of the original trial results to a new country, a bridging trial in the country has to be conducted. In this paper, we first evaluate the efficiency loss of the bridging trial strategy compared to that of the global trial strategy as a function of between-study variability from consistency assessment perspective. The provided evidence should encourage countries in emerging markets to make a greater effort to participate in the original global trial. We then discuss sample size requirement for desired assurance probability for consistency assessment based on various approaches for both global and bridging trial strategies. Examples are presented for numerical demonstration and comparisons. Copyright © 2013 Elsevier Inc. All rights reserved.

Agricultural policy and sustainable livestock development.

PubMed

Schillhorn van Veen, T W

1999-01-01

Future agricultural and rural development is, to a large extent, influenced by the projected food needs of 2.5 billion people expected to swell the world population by 2020. This increase will require more food in general and, in view of recent experience in East Asia, more animal products. To achieve this increase will require judicious use of resources, and trade, especially in those countries where natural resources are insufficient to support food production. Achieving food sufficiency in a sustainable manner is a major challenge for farmers, agro-industries, researchers and governments. The latter play an important role as many of the farmers' choices are, to a large extent, directed by government or supra-government, often through macro- and micro-economic policy. In many countries the economic, environmental, trade and agricultural policies have not been conducive to an agricultural development that is risk-free with respect to the environment, animal welfare or public health. The recent decline of government support in agriculture forced farmers in Western countries to think about more risk adverse agricultural practices and more efficient production systems. On the other hand, many countries in Eastern Europe and the former Soviet Union, as well as other developing countries, are still going through a painful process of adjustment to new market conditions. International banks and development agencies have a mandate to help developing countries, but are somewhat restricted both by needing to work directly with governments and by their perceived dogmatic approach to development. Changing policies do, now and in the future, also affect the development of animal disease control programmes, including the control of parasitic diseases. On the one hand there is an increasing interest in risk-free control practices, and on the other hand a demand for greater regulatory control over the production process. As parasitic diseases of animals are closely linked to the environment (i.e. grazing and waste management) and public health (i.e. parasitic zoonoses), the new interest in sustainable agriculture provides a challenge for those concerned with the control and prevention of animal parasitism.

Neonatal follow-up program: Where do we stand?

PubMed Central

2012-01-01

Neonatal follow-up program (NFP) is becoming the corner stone of standard, high quality care provided to newborns at risk of future neuorodevelopmental delay. Most of the recognized neonatal intensive care units in the developed countries are adopting NFP as part of their mandatory care for the best long term outcome of high risk infants, especially very low birth weight (VLBW) infants. Unfortunately, in the developing and in underdeveloped countries, such early detection and intervention programs are rarely existing, mainly because of the lack of awareness of and exposure to such programs in spite of the increasing numbers of surviving sick newborns due to advancement in neonatal care in these countries. This is a review article to explore the Neonatal follow-up programs looking at historical development, benefts and aims, and standard requirements for successful program development that can be adopted in our countries. In conclusion, proper Neonatal follow-up programs are needed to improve neonatal outcome. Therefore all professionals working in the feld of neonatal care in developing countries should cooperate to create such programs for early detection and hence early intervention for any adverse long term outcome in high-risk newborn infants PMID:27493326

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.

To what extent have relaxed eligibility requirements and increased generosity of disability benefits acted as disincentives for employment? A systematic review of evidence from countries with well-developed welfare systems.

PubMed

Barr, Ben; Clayton, Stephen; Whitehead, Margaret; Thielen, Karsten; Burström, Bo; Nylén, Lotta; Dahl, Espen

2010-12-01

Reductions in the eligibility requirements and generosity of disability benefits have been introduced in several Organisation for Economic Cooperation and Development (OECD) countries in recent years, on the assumption that this will increase work incentives for people with chronic illness and disabilities. This paper systematically reviews the evidence for this assumption in the context of well-developed welfare systems. Systematic review of all empirical studies from five OECD countries from 1970 to December 2009 investigating the effect of changes in eligibility requirements or level of disability benefits on employment of disabled people. Sixteen studies were identified. Only one of five studies found that relaxed eligibility was significantly associated with a decline in employment. The most robust study found no significant effect. On generosity, eight out of 11 studies reported that benefit levels had a significant negative association with employment. The most robust study demonstrated a small but significant negative association. There was no firm evidence that changes in benefit eligibility requirements affected employment. While there was some evidence indicating that benefit level was negatively associated with employment, there was insufficient evidence of a high enough quality to determine the extent of that effect. Policy makers and researchers need to address the lack of a robust empirical basis for assessing the employment impact of these welfare reforms as well as potentially wider poverty impacts.

Activism needed for vaccines to reach South.

PubMed

1998-06-30

An AIDS vaccine remains the only feasible strategy for curbing the spread of HIV infection in resource-poor developing countries because of its low cost and logistic simplicity. However, the pace of vaccine development has been slowed by difficulties persuading pharmaceutical companies to invest time and money in such research. These companies do not perceive a financial advantage to vaccine development. The International AIDS Vaccine Initiative is attempting to create a market for an AIDS vaccine. It is also urging developing countries to develop their own vaccines so they have intellectual property rights. Any advances in this area will require political pressure from community activists.

International perspectives on education, training, and practice in clinical neuropsychology: comparison across 14 countries around the world.

PubMed

Grote, Christopher L; Novitski, Julia I

2016-11-01

To review and summarize data provided by special issue authors regarding the education, training, and practice of neuropsychologists from 14 surveyed countries. A table was constructed to present an overview of variables of interest. There is considerable diversity among surveyed countries regarding the education and training required to enter practice as a clinical neuropsychologist. Clinical neuropsychologists are typically well compensated, at least in comparison to what constitutes an average salary in each country. Despite substantial variations in education and training pathways, and availability of neuropsychologists from country to country, two common areas for future development are suggested. First, identification, development, and measurement of core competencies for neuropsychological education and practice are needed that can serve as a unifying element for the world's clinical neuropsychologists. Second, greater emphasis on recognizing and addressing the need for assessment and treatment of diverse populations is needed if the world's citizens can hope to benefit from the expertise of practitioners in our field.

Design of a sustainable prepolarizing magnetic resonance imaging system for infant hydrocephalus.

PubMed

Obungoloch, Johnes; Harper, Joshua R; Consevage, Steven; Savukov, Igor M; Neuberger, Thomas; Tadigadapa, Srinivas; Schiff, Steven J

2018-04-11

The need for affordable and appropriate medical technologies for developing countries continues to rise as challenges such as inadequate energy supply, limited technical expertise, and poor infrastructure persist. Low-field magnetic resonance imaging (LF MRI) is a technology that can be tailored to meet specific imaging needs within such countries. Its low power requirements and the possibility of operating in minimally shielded or unshielded environments make it especially attractive. Although the technology has been widely demonstrated over several decades, it is yet to be shown that it can be diagnostic and improve patient outcomes in clinical applications. We here demonstrate the robustness of prepolarizing MRI (PMRI) technology for assembly and deployment in developing countries for the specific application to infant hydrocephalus. Hydrocephalus treatment planning and management requires only modest spatial resolution, such that the brain can be distinguished from fluid-tissue contrast detail within the brain parenchyma is not essential. We constructed an internally shielded PMRI system based on the Lee-Whiting coil system with a 22-cm diameter of spherical volume. In an unshielded room, projection phantom images were acquired at 113 kHz with in-plane resolution of 3 mm × 3 mm, by introducing gradient fields of sufficient magnitude to dominate the 5000 ppm inhomogeneity of the readout field. The low cost, straightforward assembly, deployment potential, and maintenance requirements demonstrate the suitability of our PMRI system for developing countries. Further improvement in image spatial resolution and contrast of LF MRI will broaden its potential clinical utility beyond hydrocephalus.

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.

Ethical issues in health workforce development.

PubMed Central

Cash, Richard

2005-01-01

Increasing the numbers of health workers and improving their skills requires that countries confront a number of ethical dilemmas. The ethical considerations in answering five important questions on enabling health workers to deal appropriately with the circumstances in which they must work are described. These include the problems of the standards of training and practice required in countries with differing levels of socioeconomic development and different priority diseases; how a society can be assured that health practitioners are properly trained; how a health system can support its workers; diversion of health workers and training institutions; and the teaching of ethical principles to student health workers. The ethics of setting standards for the skills and care provided by traditional health-care practitioners are also discussed. PMID:15868019

Patterns of clinical mentorship in undergraduate nurse education: A comparative case analysis of eleven EU and non-EU countries.

PubMed

Dobrowolska, Beata; McGonagle, Ian; Kane, Roslyn; Jackson, Christine S; Kegl, Barbara; Bergin, Michael; Cabrera, Esther; Cooney-Miner, Dianne; Di Cara, Veronika; Dimoski, Zvonko; Kekus, Divna; Pajnkihar, Majda; Prlić, Nada; Sigurdardottir, Arun K; Wells, John; Palese, Alvisa

2016-01-01

In spite of the number of studies available in the field and policy documents developed both at the national and the international levels, there is no reliable data available regarding the variation of roles occupied by clinical mentors (CMs) across countries. To describe and compare the CM's role; responsibilities; qualifications; employment requirements and experience in undergraduate nurse education as enacted in 11 European Union (EU) and non- EU countries. A case study design. A panel of expert nurse educators from 11 countries within and outside of the EU (Croatia, Czech Republic, England, Iceland, Ireland, Italy, Poland, Serbia, Slovenia, Spain, and the USA). A questionnaire containing both quantitative and qualitative questions was developed and agreed by the panel using a Nominal Group Technique (NGT); four cycles of data collection and analysis were conducted involving key experts in nursing education in each country. In all countries, there are at least two types of clinical mentorship dedicated to undergraduate nursing students: the first is offered by higher education institutions, and the second is offered by health care providers. Variation was noted in terms of profile, responsibilities and professional requirements to act as a CM; however, the CM role is mainly carried out by registered nurses, and in most countries there are no special requirements in terms of education and experience. Those who act as CMs at the bedside continue to manage their usual caseload, thus the role adds to their work burden. Whilst it is imperative to have respect for the different national traditions in undergraduate nurse education, the globalisation of the nursing workforce and greater opportunities for student mobility during the course of their undergraduate education suggests that in areas such as clinical mentorship, jurisdictions, particularly within the EU, should work towards greater system harmonisation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Developing and implementing mental health policy in Zanzibar, a low income country off the coast of East Africa

PubMed Central

2011-01-01

Background The Zanzibar Ministry of Health and Social Welfare, concerned about mental health in the country, requested technical assistance from WHO in 1997. Aims This article describes the facilitation over many years by a WHO Collaborating Centre, of sustainable mental health developments in Zanzibar, one of the poorest countries in the world, using systematic approaches to policy design and implementation. Methods Based on intensive prior situation appraisal and consultation, a multi-faceted set of interventions combining situation appraisal to inform planning; sustained policy dialogue at Union and state levels; development of policy and legislation, development of strategic action plans, establishment of intersectoral national mental health implementation committee, establishment of national mental health coordination system, integration of mental health into primary care, strengthening of primary-secondary care liaison, rationalisation and strengthening of secondary care system, ensuring adequate supply of medicines, use of good practice guidelines and health information systems, development of services for people with intellectual disability, establishment of formal mechanism for close liaison between the mental health services and other governmental, non-governmental and traditional sectors, mental health promotion, suicide prevention, and research and development. Results The policy and legislation introduced in 1999 have resulted in enhanced mental health activities over the ensuing decade, within a setting of extreme low resource. However, advances ebb and flow and continued efforts are required to maintain progress and continue mental health developments. Lessons learnt have informed the development of mental health policies in neighbouring countries. Conclusions A multi-faceted and comprehensive programme can be effective in achieving considerable strengthening of mental health programmes and services even in extremely low resource settings, but requires sustained input and advocacy if gains are to be maintained and enhanced. PMID:21320308

[Research development on disinfection technology for viruses in drinking water].

PubMed

Zhang, Yun; Zhang, Qiang; Liu, Yan; Dai, Ruihua; Liu, Xiang

2010-09-01

With the deterioration of water source pollution, the quality requirements for drinking water of countries will become stricter and stricter, and the microbe index has been one of the important aspects. The introduction of the virus index and the development of disinfection technology focusing on virus have significant importance for the improvement of the drinking water standards and for the protection of people health in every country. To be familiar with the domestic and abroad research development of the disinfection control technology focusing on virus provides certain theory guidance and technological support for continuously improving drinking water standard in our country and for establishing safer drinking water processing technologies. So, this article will comprehensively describes 4 aspects: resistance comparison of virus over every disinfection technology, influential factors of disinfection, research development of new technology, and the mechanisms.

Chinese vaccine products go global: vaccine development and quality control.

PubMed

Xu, Miao; Liang, Zhenglun; Xu, Yinghua; Wang, Junzhi

2015-05-01

Through the continuous efforts of several generations, China has become one of the few countries in the world that is capable of independently addressing all the requirements by the Expanded Program on Immunization. Regulatory science is applied to continuously improve the vaccine regulatory system. Passing the prequalification by WHO has allowed Chinese vaccine products to go global. Chinese vaccine products not only secure disease prevention and control domestically but also serve the needs for international public health. This article describes the history of Chinese vaccine development, the current situation of Chinese vaccine industry and its contribution to the prevention and control of infectious diseases. We also share our experience of national quality control and vaccine regulation during the past decades. China's experience in vaccine development and quality control can benefit other countries and regions worldwide, including the developing countries.

The civil tiltrotor aircraft's potential in developing economies

NASA Technical Reports Server (NTRS)

Alton, Larry R.; Lane, Theodore

1991-01-01

The civilian tiltrotor (CTR) is analyzed as a new transportation technology with the potential for changing one of the key economic factors linked to Third World economic development. It is contended that efficient, low-cost transport services are a necessary condition for the economic development of Third World countries and that the CTR's capabilities and operating costs can provide more efficient transport services than have heretofore been available to such countries. A case study of potential CTR use among the nations of the Carribean Basin region appears to offer both analytical and empirical support to these contentions. The analysis indicates that normal market mechanisms are adequate for development of air cargo services using the CTR's capabilities. It is suggested that implementation of this service may require new institutional arrangements, but overall it is concluded that tiltrotor technology could make an important contribution to the economic development of Third World countries.

Climate Services Information System Activities in Support of The Global Framework for Climate Services Implementation

NASA Astrophysics Data System (ADS)

Timofeyeva-Livezey, M. M.; Horsfall, F. M. C.; Pulwarty, R. S.; Klein-Tank, A.; Kolli, R. K.; Hechler, P.; Dilley, M.; Ceron, J. P.; Goodess, C.

2017-12-01

The WMO Commission on Climatology (CCl) supports the implementation of the Global Framework for Climate Services (GFCS) with a particular focus on the Climate Services Information System (CSIS), which is the core operational component of GFCS at the global, regional, and national level. CSIS is designed for producing, packaging and operationally delivering authoritative climate information data and products through appropriate operational systems, practices, data exchange, technical standards, authentication, communication, and product delivery. Its functions include climate analysis and monitoring, assessment and attribution, prediction (monthly, seasonal, decadal), and projection (centennial scale) as well as tailoring the associated products tUEAo suit user requirements. A central, enabling piece of implementation of CSIS is a Climate Services Toolkit (CST). In its development phase, CST exists as a prototype (www.wmo.int/cst) as a compilation of tools for generating tailored data and products for decision-making, with a special focus on national requirements in developing countries. WMO provides a server to house the CST prototype as well as support operations and maintenance. WMO members provide technical expertise and other in-kind support, including leadership of the CSIS development team. Several recent WMO events have helped with the deployment of CST within the eight countries that have been recognized by GFCS as illustrative for developing their climate services at national levels. Currently these countries are developing climate services projects focusing service development and delivery for selected economic sectors, such as for health, agriculture, energy, water resources, and hydrometeorological disaster risk reduction. These countries are working together with their respective WMO Regional Climate Centers (RCCs), which provide technical assistance with implementation of climate services projects at the country level and facilitate development of regional climate products, starting with the CST. The paper will introduce the CST prototype to the wider meteorological, hydrological, and climatological communities and provide details of its implementation in the context of the global framework.

Tracing the policy implementation of commitments made by national governments and other entities at the Third Global Forum on Human Resources for Health

PubMed Central

van de Pas, Remco; Veenstra, Anika; Gulati, Daniel; Van Damme, Wim; Cometto, Giorgio

2017-01-01

We conducted a follow-up analysis of the implementation of the Human Resources for Health (HRH) commitments made by country governments and other actors at the Third Global Forum on HRH in 2013. Since then member states of the WHO endorsed Universal Health Coverage as the main policy objective whereby health systems strengthening, including reinforcement of the health workforce, can contribute to several Sustainable Development Goals. Now is the right time to trace the implementation of these commitments and to assess their contribution to broader global health objectives. The baseline data for this policy tracing study consist of the categorisation and analysis of the HRH commitments conducted in 2014. This analysis was complemented in application of the health policy triangle as its main analytical framework. An online survey and a guideline for semistructured interviews were developed to collect data. Information on the implementation of the commitments is available in 49 countries (86%). The need for multi-actor approaches for HRH policy development is universally recognised. A suitable political window and socioeconomic situation emerge as crucial factors for sustainable HRH development. However, complex crises in different parts of the world have diverted attention from investment in HRH development. The analysis indicates that investment in the health workforce and corresponding policy development relies on political leadership, coherent government strategies, institutional capacity and intersectoral governance mechanisms. The institutional capacity to shoulder such complex tasks varies widely across countries. For several countries, the commitment process provided an opportunity to invest in, develop and reform the health workforce. Nevertheless, the quality of HRH monitoring mechanisms requires more attention. In conclusion, HRH challenges, their different pathways and the intersectorality of the required responses are a concern for all the countries analysed. There is hence a need for national governments and stakeholders across the globe to share responsibilities and invest in this vital issue in a co-ordinated manner. PMID:29104768

Health workforce metrics pre- and post-2015: a stimulus to public policy and planning.

PubMed

Pozo-Martin, Francisco; Nove, Andrea; Lopes, Sofia Castro; Campbell, James; Buchan, James; Dussault, Gilles; Kunjumen, Teena; Cometto, Giorgio; Siyam, Amani

2017-02-15

Evidence-based health workforce policies are essential to ensure the provision of high-quality health services and to support the attainment of universal health coverage (UHC). This paper describes the main characteristics of available health workforce data for 74 of the 75 countries identified under the 'Countdown to 2015' initiative as accounting for more than 95% of the world's maternal, newborn and child deaths. It also discusses best practices in the development of health workforce metrics post-2015. Using available health workforce data from the Global Health Workforce Statistics database from the Global Health Observatory, we generated descriptive statistics to explore the current status, recent trends in the number of skilled health professionals (SHPs: physicians, nurses, midwives) per 10 000 population, and future requirements to achieve adequate levels of health care in the 74 countries. A rapid literature review was conducted to obtain an overview of the types of methods and the types of data sources used in human resources for health (HRH) studies. There are large intercountry and interregional differences in the density of SHPs to progress towards UHC in Countdown countries: a median of 10.2 per 10 000 population with range 1.6 to 142 per 10 000. Substantial efforts have been made in some countries to increase the availability of SHPs as shown by a positive average exponential growth rate (AEGR) in SHPs in 51% of Countdown countries for which there are data. Many of these countries will require large investments to achieve levels of workforce availability commensurate with UHC and the health-related sustainable development goals (SDGs). The availability, quality and comparability of global health workforce metrics remain limited. Most published workforce studies are descriptive, but more sophisticated needs-based workforce planning methods are being developed. There is a need for high-quality, comprehensive, interoperable sources of HRH data to support all policies towards UHC and the health-related SDGs. The recent WHO-led initiative of supporting countries in the development of National Health Workforce Accounts is a very promising move towards purposive health workforce metrics post-2015. Such data will allow more countries to apply the latest methods for health workforce planning.

[Causes of iron deficiency in children].

PubMed

Olives, J-P

2017-05-01

Iron deficiency and iron deficiency anemia are common conditions worldwide affecting especially children. In developing countries, iron deficiency is caused by poor iron intake and parasitic infection. Poor iron intake linked to inadequate diets, low iron intestinal absorption, chronic blood losses and increased requirements are common causes in high-income countries. © 2017 Elsevier Masson SAS. Tous droits réservés.

The changing relationship between family size and educational attainment over the course of socioeconomic development: evidence from Indonesia.

PubMed

Maralani, Vida

2008-08-01

Many studies from developed countries show a negative correlation between family size and children's schooling, while results from developing countries show this association ranging from positive to neutral to negative, depending on the context. The body of evidence suggests that this relationship changes as a society develops, but this theory has been difficult to assess because the existing evidence requires comparisons across countries with different social structures and at different levels of development. The world's fourth most populous nation in 2007, Indonesia has developed rapidly in recent decades. This context provides the opportunity to study these relationships within the same rapidly developing setting to see if and how these associations change. Results show that in urban areas, the association between family size and children's schooling was positive for older cohorts but negative for more recent cohorts. Models using instrumental variables to address the potential endogeneity of fertility confirm these results. In contrast, rural areas show no significant association between family size and children's schooling for any cohort. These findings show how the relationship between family size and children's schooling can differ within the same country and change over time as contextual factors evolve with socioeconomic development.

A synthesis of drug reimbursement decision-making processes in organisation for economic co-operation and development countries.

PubMed

Barnieh, Lianne; Manns, Braden; Harris, Anthony; Blom, Marja; Donaldson, Cam; Klarenbach, Scott; Husereau, Don; Lorenzetti, Diane; Clement, Fiona

2014-01-01

The use of a restrictive formulary, with placement determined through a drug-reimbursement decision-making process, is one approach to managing drug expenditures. To describe the processes in drug reimbursement decision-making systems currently used in national publicly funded outpatient prescription drug insurance plans. By using the Organisation for Economic Co-operation and Development (OECD) nations as the sampling frame, a search was done in the published literature, followed by the gray literature. Collected data were verified by a system expert within the prescription drug insurance plan in each country to ensure the accuracy of key data elements across countries. All but one country provided at least one publicly funded prescription drug formulary. Many systems have adopted similar processes of drug reimbursement decision making. All but three systems required additional consideration of clinical evidence within the decision-making process. Transparency of recommendations varied between systems, from having no information publicly available (three systems) to all information available and accessible to the public (16 systems). Only four countries did not consider cost within the drug reimbursement decision-making process. There were similarities in the decision-making process for drug reimbursement across the systems; however, only five countries met the highest standard of transparency, requirement of evidence, and ability to appeal. Future work should focus on examining how these processes may affect formulary listing decisions for drugs between countries. © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Published by International Society for Pharmacoeconomics and Outcomes Research (ISPOR) All rights reserved.

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

CONTEMPORARY SITUATIONS AND PROBLEMS OF ROAD/BRIDGE MAINTENANCE TECHNICAL COOPERATION PROJECTS

NASA Astrophysics Data System (ADS)

Nishimiya, Noriaki; Sanui, Kazumasa; Mizota, Yuzo

It is widely acknowledged that roads are the most important transport infrastructure in developing countries. Unlike railroads requiring organizations and systems to operate, individuals can drive on roads. Almost all donors have assisted developing countr ies for new road constructions and rehabilitations. Report of insufficient maintenance in the developing countries, however, has been notable. As a result of the maintenance problems, deterioration of roads is pr ogressing with speed more than expected. It causes the traffic safety problems and an obstacle of economic development. JICA and other donors recognize that this situation can not be overlooked and reci pient countries are increasing their expectation of obtaining assistance on road/bridge maintenance. JICA has implemented over 10 technical cooper ation projects for road/b ridge maintenance in developing countries. JICA conducted a study to review those projects comprehensively. That study aims at obtaining problems, lessons learned and discussion material for policy making and method improvement for future similar pr ojects. This report introduces the outline of the study including additional analysis and recommendations by the authors.

Opportunities for the power industry in South Africa

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

Lynch, R.W.; Pinkney, C.; Feld, L.

1996-11-01

South Africa is a country in the midst of transformation. Political changes within the country, and the ensuing empowerment of the black majority, have created a situation where dramatic improvements are needed in the country`s infrastructure in order to enable it to meet the needs of all its people over the coming decades. Largely as a result of the international embargo placed on South Africa during the apartheid era, the South African government became heavily involved in the country`s energy sector. This involvement included development of a synfuels program, price controls in the oil sector, monopolies in both upstream andmore » downstream oil sectors, and a strong centralized electric power company. In 1994, South Africa became the eleventh member of the Southern Africa Development Community (SADC), an organization which was established in 1980 to synchronize development plans for its member countries. SADC is presently working to formulate a regional energy development plan, and coordinate technical information exchanges and joint research needs. Each of the SADC nations have also begun to develop their regional electricity grids and other parts of their energy infrastructure to plan for the growing needs of the 500 million people who live in sub-Saharan Africa. South Africa, in particular, must make significant changes in each of its energy sectors in the near future, to keep up with its growing energy requirements. These changes translate to opportunity for the US Power Industry.« less

Metal spectra as indicators of development.

PubMed

Graedel, T E; Cao, J

2010-12-07

We have assembled extensive information on the cycles of seven industrial metals in 49 countries, territories, or groups of countries, drawn from a database of some 200,000 material flows, and have devised analytical approaches to treat the suite of metals as composing an approach to a national "materials metabolism." We demonstrate that in some of the more developed countries, per capita metal use is more than 10 times the global average. Additionally, countries that use more than the per capita world average of any metal do so for all metals, and vice versa, and countries that are above global average rates of use are very likely to be above global average rates at all stages of metal life cycles from fabrication onward. We show that all countries are strongly dependent on international trade to supply the spectrum of nonrenewable resources that modern technology requires, regardless of their level of development. We also find that the rate of use of the spectrum of metals stock is highly correlated to per capita gross domestic product, as well as to the Human Development Index and the Global Competitiveness Innovation Index. The implication is that as wealth and technology increase in developing countries, strong demand will be created not for a few key resources, but across the entire spectrum of the industrial metals. Long-term metal demand can be estimated given gross domestic product projections; the results suggest overall metal flow into use in 2050 of 5-10 times today's level should supplies permit.

Metal spectra as indicators of development

PubMed Central

Graedel, T. E.; Cao, J.

2010-01-01

We have assembled extensive information on the cycles of seven industrial metals in 49 countries, territories, or groups of countries, drawn from a database of some 200,000 material flows, and have devised analytical approaches to treat the suite of metals as composing an approach to a national “materials metabolism.” We demonstrate that in some of the more developed countries, per capita metal use is more than 10 times the global average. Additionally, countries that use more than the per capita world average of any metal do so for all metals, and vice versa, and countries that are above global average rates of use are very likely to be above global average rates at all stages of metal life cycles from fabrication onward. We show that all countries are strongly dependent on international trade to supply the spectrum of nonrenewable resources that modern technology requires, regardless of their level of development. We also find that the rate of use of the spectrum of metals stock is highly correlated to per capita gross domestic product, as well as to the Human Development Index and the Global Competitiveness Innovation Index. The implication is that as wealth and technology increase in developing countries, strong demand will be created not for a few key resources, but across the entire spectrum of the industrial metals. Long-term metal demand can be estimated given gross domestic product projections; the results suggest overall metal flow into use in 2050 of 5–10 times today’s level should supplies permit. PMID:21098309

Is globalization good for your health?

PubMed Central

Dollar, D.

2001-01-01

Four points are made about globalization and health. First, economic integration is a powerful force for raising the incomes of poor countries. In the past 20 years several large developing countries have opened up to trade and investment, and they are growing well--faster than the rich countries. Second, there is no tendency for income inequality to increase in countries that open up. The higher growth that accompanies globalization in developing countries generally benefits poor people. Since there is a large literature linking income of the poor to health status, we can be reasonably confident that globalization has indirect positive effects on nutrition, infant mortality and other health issues related to income. Third, economic integration can obviously have adverse health effects as well: the transmission of AIDS through migration and travel is a dramatic recent example. However, both relatively closed and relatively open developing countries have severe AIDS problems. The practical solution lies in health policies, not in policies on economic integration. Likewise, free trade in tobacco will lead to increased smoking unless health-motivated disincentives are put in place. Global integration requires supporting institutions and policies. Fourth, the international architecture can be improved so that it is more beneficial to poor countries. For example, with regard to intellectual property rights, it may be practical for pharmaceutical innovators to choose to have intellectual property rights in either rich country markets or poor country ones, but not both. In this way incentives could be strong for research on diseases in both rich and poor countries. PMID:11584730

Is globalization good for your health?

PubMed

Dollar, D

2001-01-01

Four points are made about globalization and health. First, economic integration is a powerful force for raising the incomes of poor countries. In the past 20 years several large developing countries have opened up to trade and investment, and they are growing well--faster than the rich countries. Second, there is no tendency for income inequality to increase in countries that open up. The higher growth that accompanies globalization in developing countries generally benefits poor people. Since there is a large literature linking income of the poor to health status, we can be reasonably confident that globalization has indirect positive effects on nutrition, infant mortality and other health issues related to income. Third, economic integration can obviously have adverse health effects as well: the transmission of AIDS through migration and travel is a dramatic recent example. However, both relatively closed and relatively open developing countries have severe AIDS problems. The practical solution lies in health policies, not in policies on economic integration. Likewise, free trade in tobacco will lead to increased smoking unless health-motivated disincentives are put in place. Global integration requires supporting institutions and policies. Fourth, the international architecture can be improved so that it is more beneficial to poor countries. For example, with regard to intellectual property rights, it may be practical for pharmaceutical innovators to choose to have intellectual property rights in either rich country markets or poor country ones, but not both. In this way incentives could be strong for research on diseases in both rich and poor countries.

Oil Production Capacity Expansion Costs for the Persian Gulf

EIA Publications

1996-01-01

Provides estimates of development and operating costs for various size fields in countries surrounding the Persian Gulf. In addition, a forecast of the required reserve development and associated costs to meet the expected demand through the year 2010 is presented.

Challenging Assumptions: What Do We Need to Address in Our Disaster Risk Reduction Efforts?

PubMed

Codreanu, Tudor A; Ngo, Hanh; Robertson, Andrew; Celenza, Antonio

2017-04-01

Introduction Specific knowledge and skills are required, especially in the first 72 hours post-disaster, to bridge the time gap until essential services are restored and Emergency Medical Services (EMS) can focus on individuals' needs. This study explores disaster knowledge and preparedness in the first 72 hours as a function of the individual's engagement in discussions about disasters, and several other factors (both at personal and community/country level), as well as the entities/organizations perceived by the individual as being responsible for disaster risk reduction (DRR) education. A prospective, cross-sectional survey of 3,829 final-year high-school students was conducted in nine countries with different levels of disaster risk and economic development. Regression analyses examined the relationship between a 72-hour disaster preparedness composite outcome (ability to make water safe for drinking, knowledge of water potability, home evacuation skill, and improvising a safe room) and a series of independent predictors. Respondents from countries with lower economic development were significantly better prepared for the first 72 hours post-disaster than those from developed countries (OR=767.45; CI=13.75-48,822.94; P=.001). While several independent predictors showed a significant main effect, combined disaster risk education (DRE) efforts, as a partnership between school and local government, had the best predictive value (OR=3.52; CI=1.48-8.41; P=.005). Disaster preparedness in final-year high-school students is significantly better in developing countries. Further improvement requires a convergent effort in aligning the most effective educational policies and actions to best address the individual's and the community needs. Codreanu TA , Ngo H , Robertson A , Celenza A . Challenging assumptions: what do we need to address in our disaster risk reduction efforts? Prehosp Disaster Med. 2017;32(2):134-147.

Initiatives and strategies for development of nanotechnology in nations: a lesson for Africa and other least developed countries

PubMed Central

2014-01-01

It is a known fact that the progress and development of different nations of the world is strongly connected with the type of materials under their use. This paper highlighted the development of nanotechnology in some selected countries of the world through a careful review of their road maps by way of public and private initiatives, funding/investment profile, human resources development, industrial potentials, and focus in order to draw inferences. The peculiar challenges and opportunities for some African nations and other least developed countries (LDC) were drawn for their economic and technological developments. This investigation was simply based on open access literatures. The review showed that although nanotechnology is new globally, most countries of the world have had growing public and private investments aimed at bringing about new materials and systems that can impact positively on their economy and ensure their global competitiveness and sustainability. The global scenario suggests the crucial role of cooperation in a multidisciplinary collaboration/partnership between government ministries, agencies, institutions, and private sector/donor agencies in order to pool enough resource capital required for activities in nanotechnology. PMID:24650295

Initiatives and strategies for development of nanotechnology in nations: a lesson for Africa and other least developed countries.

PubMed

Ezema, Ikechukwu C; Ogbobe, Peter O; Omah, Augustine D

2014-03-20

It is a known fact that the progress and development of different nations of the world is strongly connected with the type of materials under their use. This paper highlighted the development of nanotechnology in some selected countries of the world through a careful review of their road maps by way of public and private initiatives, funding/investment profile, human resources development, industrial potentials, and focus in order to draw inferences. The peculiar challenges and opportunities for some African nations and other least developed countries (LDC) were drawn for their economic and technological developments. This investigation was simply based on open access literatures. The review showed that although nanotechnology is new globally, most countries of the world have had growing public and private investments aimed at bringing about new materials and systems that can impact positively on their economy and ensure their global competitiveness and sustainability. The global scenario suggests the crucial role of cooperation in a multidisciplinary collaboration/partnership between government ministries, agencies, institutions, and private sector/donor agencies in order to pool enough resource capital required for activities in nanotechnology.

Innovative technology in hearing instruments: matching needs in the developing world.

PubMed

McPherson, Bradley

2011-12-01

Hearing instrument technology research is almost entirely focused on the projected needs of the consumer market in the developed world. However, two thirds of the world's population with hearing impairment live in developing countries and this proportion will increase in future, given present demographic trends. In developing regions, amplification and other hearing health needs may differ from those in industrialized nations, for cultural, health, or economic reasons. World Health Organization estimates indicate that at present only a small percentage of individuals in developing countries who are in need of amplification have access to hearing aid provision. New technologies, such as trainable hearing aids, advanced noise reduction algorithms, feedback reduction circuitry, nano coatings for hearing aid components, and innovative power options, may offer considerable potential benefits, both for individuals with hearing impairment in developing countries and for those who provide hearing health care services in these regions. This article considers the possible supporting role of innovative hearing instrument technologies in the provision of affordable hearing health care services in developing countries and highlights the need for research that considers the requirements of the majority of the world population in need of hearing instrument provision.

Initiatives and strategies for development of nanotechnology in nations: a lesson for Africa and other least developed countries

NASA Astrophysics Data System (ADS)

Ezema, Ikechukwu C.; Ogbobe, Peter O.; Omah, Augustine D.

2014-03-01

It is a known fact that the progress and development of different nations of the world is strongly connected with the type of materials under their use. This paper highlighted the development of nanotechnology in some selected countries of the world through a careful review of their road maps by way of public and private initiatives, funding/investment profile, human resources development, industrial potentials, and focus in order to draw inferences. The peculiar challenges and opportunities for some African nations and other least developed countries (LDC) were drawn for their economic and technological developments. This investigation was simply based on open access literatures. The review showed that although nanotechnology is new globally, most countries of the world have had growing public and private investments aimed at bringing about new materials and systems that can impact positively on their economy and ensure their global competitiveness and sustainability. The global scenario suggests the crucial role of cooperation in a multidisciplinary collaboration/partnership between government ministries, agencies, institutions, and private sector/donor agencies in order to pool enough resource capital required for activities in nanotechnology.

Academic and research capacity development in Earth observation for environmental management

NASA Astrophysics Data System (ADS)

Cassells, Gemma; Woodhouse, Iain H.; Patenaude, Genevieve; Tembo, Mavuto

2011-10-01

Sustainable environmental management is one of the key development goals of the 21st century. The importance of Earth observation (EO) for addressing current environmental problems is well recognized. Most developing countries are highly susceptible to environmental degradation; however, the capacity to monitor these changes is predominantly located in the developed world. Decades of aid and effort have been invested in capacity development (CD) with the goal of ensuring sustainable development. Academics, given their level of freedom and their wider interest in teaching and knowledge transfer, are ideally placed to act as catalyst for capacity building. In this letter, we make a novel investigation into the extent to which the EO academic research community is engaged in capacity development. Using the Web of Knowledge publication database (http://wok.mimas.ac.uk), we examined the geographical distribution of published EO related research (a) by country as object of research and (b) by authors' country of affiliation. Our results show that, while a significant proportion of EO research (44%) has developing countries as their object of research, less than 3% of publications have authors working in, or affiliated to, a developing country (excluding China, India and Brazil, which not only are countries in transition, but also have well established EO capacity). These patterns appear consistent over the past 20 years. Despite the wide awareness of the importance of CD, we show that significant progress on this front is required. We therefore propose a number of recommendations and best practices to ease collaboration and open access.

A review of acute and chronic peritoneal dialysis in developing countries

PubMed Central

Abraham, Georgi; Varughese, Santosh; Mathew, Milly; Vijayan, Madhusudan

2015-01-01

Various modalities of renal replacement therapy (RRT) are available for the management of acute kidney injury (AKI) and end-stage renal disease (ESRD). While developed countries mainly use hemodialysis as a form of RRT, peritoneal dialysis (PD) has been increasingly utilized in developing countries. Chronic PD offers various benefits including lower cost, home-based therapy, single access, less requirement of highly trained personnel and major infrastructure, higher number of patients under a single nephrologist with probably improved quality of life and freedom of activities. PD has been found to be lifesaving in the management of AKI in patients in developing countries where facilities for other forms of RRT are not readily available. The International Society of Peritoneal Dialysis has published guidelines regarding the use of PD in AKI, which has helped in ensuring uniformity. PD has also been successfully used in certain special situations of AKI due to snake bite, malaria, febrile illness, following cardiac surgery and in poisoning. Hemodialysis is the most common form of RRT used in ESRD worldwide, but some countries have begun to adopt a ‘PD first’ policy to reduce healthcare costs of RRT and ensure that it reaches the underserved population. PMID:26034593

Agri-Manpower Forecasting and Educational Planning

ERIC Educational Resources Information Center

Ramarao, D.; Agrawal, Rashmi; Rao, B. V. L. N.; Nanda, S. K.; Joshi, Girish P.

2014-01-01

Purpose: Developing countries need to plan growth or expansion of education so as to provide required trained manpower for different occupational sectors. The paper assesses supply and demand of professional manpower in Indian agriculture and the demands are translated in to educational requirements. Methodology: The supply is assessed from the…

Maintaining respect and fairness in the usage of stored shared specimens

PubMed Central

2013-01-01

Background Every year, research specimens are shipped from one institution to another as well as across national boundaries. A significant proportion of specimens move from poor to rich countries. Concerns are always raised on the future usage of the stored specimens shipped to research insitutions from developing countries. Creating awareness of the processes is required in all sectors involved in biomedical research. To maintain fairness and respect in sharing biomedical specimens and reserch products requires safeguarding by Ethics Review Committees in both provider and recepient institutions. Training in basic ethical principles in research is required to all sectors involved in biomedical research so as to level up the research playing field. Discussion By agreeing to provide specimens, individuals and communities from whom samples are collected would have placed their trust and all ensuing up-keep of the specimens to the researchers. In most collaborative set-up, laid down material transfer agreements are negotiated and signed before the shipment of specimens. Researchers, research ethics committees (RECs) and institutions in the countries of origin are supposed to serve as overseers of the specimens. There is need to advocate for honesty in sample handling and sharing, and also need to oversee any written commitments by researchers, RECs and institutions at source as well as in recipient institution. Commitments from source RECs and Institutional Review Boards (IRBs) and in the receiving institution on overseeing the future usage of stored specimens are required; including the ultimate confirmation abiding by the agreement. Training in ethical issues pertaining to sample handling and biomedical research in general is essential at all levels of academic pursuit. While sharing of biological specimens and research data demands honesty and oversight by ethical regulatory agents from both institutions in developing country and recepient institutions in developed countries. Concluding summary Archiving of biological specimens requires reconsideration for the future of biomedical findings and scientific break-throughs. Biomedical ethical regulations still need to established clear viable regulations that have vision for the future of science through shared and archived samples. This discussion covers and proposes essential points that need to be considered in view of future generations and scientific break-throughs. The discussion is based on the experience of working in resource-limited settings, the local regulatory laws and the need to refine research regulations governing sharing and storage of specimens for the future of science. PMID:24565022

Maintaining respect and fairness in the usage of stored shared specimens.

PubMed

Mduluza, Takafira; Midzi, Nicholas; Duruza, Donold; Ndebele, Paul

2013-01-01

Every year, research specimens are shipped from one institution to another as well as across national boundaries. A significant proportion of specimens move from poor to rich countries. Concerns are always raised on the future usage of the stored specimens shipped to research institutions from developing countries. Creating awareness of the processes is required in all sectors involved in biomedical research. To maintain fairness and respect in sharing biomedical specimens and research products requires safeguarding by Ethics Review Committees in both provider and recipient institutions. Training in basic ethical principles in research is required to all sectors involved in biomedical research so as to level up the research playing field. By agreeing to provide specimens, individuals and communities from whom samples are collected would have placed their trust and all ensuing up-keep of the specimens to the researchers. In most collaborative set-up, laid down material transfer agreements are negotiated and signed before the shipment of specimens. Researchers, research ethics committees (RECs) and institutions in the countries of origin are supposed to serve as overseers of the specimens. There is need to advocate for honesty in sample handling and sharing, and also need to oversee any written commitments by researchers, RECs and institutions at source as well as in recipient institution. Commitments from source RECs and Institutional Review Boards (IRBs) and in the receiving institution on overseeing the future usage of stored specimens are required; including the ultimate confirmation abiding by the agreement. Training in ethical issues pertaining to sample handling and biomedical research in general is essential at all levels of academic pursuit. While sharing of biological specimens and research data demands honesty and oversight by ethical regulatory agents from both institutions in developing country and recipient institutions in developed countries. Archiving of biological specimens requires reconsideration for the future of biomedical findings and scientific break-throughs. Biomedical ethical regulations still need to established clear viable regulations that have vision for the future of science through shared and archived samples. This discussion covers and proposes essential points that need to be considered in view of future generations and scientific break-throughs. The discussion is based on the experience of working in resource-limited settings, the local regulatory laws and the need to refine research regulations governing sharing and storage of specimens for the future of science.

Health systems context(s) for integrating mental health into primary health care in six Emerald countries: a situation analysis.

PubMed

Mugisha, James; Abdulmalik, Jibril; Hanlon, Charlotte; Petersen, Inge; Lund, Crick; Upadhaya, Nawaraj; Ahuja, Shalini; Shidhaye, Rahul; Mntambo, Ntokozo; Alem, Atalay; Gureje, Oye; Kigozi, Fred

2017-01-01

Mental, neurological and substance use disorders contribute to a significant proportion of the world's disease burden, including in low and middle income countries (LMICs). In this study, we focused on the health systems required to support integration of mental health into primary health care (PHC) in Ethiopia, India, Nepal, Nigeria, South Africa and Uganda. A checklist guided by the World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) was developed and was used for data collection in each of the six countries participating in the Emerging mental health systems in low and middle-income countries (Emerald) research consortium. The documents reviewed were from the following domains: mental health legislation, health policies/plans and relevant country health programs. Data were analyzed using thematic content analysis. Three of the study countries (Ethiopia, Nepal, Nigeria, and Uganda) were working towards developing mental health legislation. South Africa and India were ahead of other countries, having enacted recent Mental Health Care Act in 2004 and 2016, respectively. Among all the 6 study countries, only Nepal, Nigeria and South Africa had a standalone mental health policy. However, other countries had related health policies where mental health was mentioned. The lack of fully fledged policies is likely to limit opportunities for resource mobilization for the mental health sector and efforts to integrate mental health into PHC. Most countries were found to be allocating inadequate budgets from the health budget for mental health, with South Africa (5%) and Nepal (0.17%) were the countries with the highest and lowest proportions of health budgets spent on mental health, respectively. Other vital resources that support integration such as human resources and health facilities for mental health services were found to be in adequate in all the study countries. Monitoring and evaluation systems to support the integration of mental health into PHC in all the study countries were also inadequate. Integration of mental health into PHC will require addressing the resource limitations that have been identified in this study. There is a need for up to date mental health legislation and policies to engender commitment in allocating resources to mental health services.

English in Action: School Based Teacher Development in Bangladesh

ERIC Educational Resources Information Center

Power, Tom; Shaheen, Robina; Solly, Mike; Woodward, Clare; Burton, Sonia

2012-01-01

In the Least Economically Developed Countries (LEDCs), School Based Teacher Development (SBTD) is sometimes advocated as a potential mechanism for improving the classroom practices experienced by millions of children in a complete school system, as quickly as possible. Robust evidence is required for approaches to be implemented with some…

Using Level 1 E-Learning to Support Socio-Economic Development

ERIC Educational Resources Information Center

Edmundson, Andrea

2007-01-01

The most developed, progressive, and economically stable countries in the world are those that are technologically advanced. Technological change and the building of human capabilities are interrelated: each requires the development of the other for success and the "rethinking [of] educational systems to meet the new challenges of…

Comparison and Cost Analysis of Drinking Water Quality Monitoring Requirements versus Practice in Seven Developing Countries

PubMed Central

Crocker, Jonny; Bartram, Jamie

2014-01-01

Drinking water quality monitoring programs aim to support provision of safe drinking water by informing water quality management. Little evidence or guidance exists on best monitoring practices for low resource settings. Lack of financial, human, and technological resources reduce a country’s ability to monitor water supply. Monitoring activities were characterized in Cambodia, Colombia, India (three states), Jordan, Peru, South Africa, and Uganda according to water sector responsibilities, monitoring approaches, and marginal cost. The seven study countries were selected to represent a range of low resource settings. The focus was on monitoring of microbiological parameters, such as E. coli, coliforms, and H2S-producing microorganisms. Data collection involved qualitative and quantitative methods. Across seven study countries, few distinct approaches to monitoring were observed, and in all but one country all monitoring relied on fixed laboratories for sample analysis. Compliance with monitoring requirements was highest for operational monitoring of large water supplies in urban areas. Sample transport and labor for sample collection and analysis together constitute approximately 75% of marginal costs, which exclude capital costs. There is potential for substantive optimization of monitoring programs by considering field-based testing and by fundamentally reconsidering monitoring approaches for non-piped supplies. This is the first study to look quantitatively at water quality monitoring practices in multiple developing countries. PMID:25046632

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.

Pediatric clinical drug trials in low-income countries: key ethical issues.

PubMed

MacLeod, S M; Knoppert, D C; Stanton-Jean, M; Avard, D

2015-02-01

Potential child participants in clinical research trials in low-income countries are often vulnerable because of poverty, high morbidity and mortality, inadequate education, and varied local cultural norms. However, vulnerability by itself must not be accepted as an obstacle blocking children from the health benefits that may accrue as an outcome of sound clinical research. As greater emphasis is placed on evidence-based treatment of children, it should be anticipated that there will be a growing call for agreement on principles to guide clinical investigations in low-income countries. There is now general acceptance of the view that children must be protected from non-evidence-based interventions and from substandard treatments. The questions remaining relate to how best to stimulate clinical research activity that will serve the needs of infants, children, and youth in developing countries and how best to assign priority to ethically sound research that will meet their clinical requirements. In low-income countries, 39 % of citizens are 13 years of age or younger, and consequently it is certain that clinical investigations of some new therapeutic products will be conducted there more frequently. This review offers some suggestions for approaches that will help to achieve more effective ethical consideration, including (1) improving the quality of research ethics boards; (2) fostering collaborative partnerships among important stakeholders; (3) making concerted efforts to build capacity; (4) improving the quality of the consent and waiver process; and (5) developing improved governance for harmonized ethics platforms. Continuing support by international organizations is required to sustain the establishment and maintenance of stronger research ethics boards to protect children enrolled in clinical trials. This review underscores the importance of developing a culture of solidarity and true partnership between developed and low-income country organizations, which will allow all those involved, and especially child patients, to benefit from the advancement of therapeutics.

Articles by latin american authors in prestigious journals have fewer citations.

PubMed

Meneghini, Rogerio; Packer, Abel L; Nassi-Calò, Lilian

2008-01-01

The journal Impact factor (IF) is generally accepted to be a good measurement of the relevance/quality of articles that a journal publishes. In spite of an, apparently, homogenous peer-review process for a given journal, we hypothesize that the country affiliation of authors from developing Latin American (LA) countries affects the IF of a journal detrimentally. Seven prestigious international journals, one multidisciplinary journal and six serving specific branches of science, were examined in terms of their IF in the Web of Science. Two subsets of each journal were then selected to evaluate the influence of author's affiliation on the IF. They comprised contributions (i) with authorship from four Latin American (LA) countries (Argentina, Brazil, Chile and Mexico) and (ii) with authorship from five developed countries (England, France, Germany, Japan and USA). Both subsets were further subdivided into two groups: articles with authorship from one country only and collaborative articles with authorship from other countries. Articles from the five developed countries had IF close to the overall IF of the journals and the influence of collaboration on this value was minor. In the case of LA articles the effect of collaboration (virtually all with developed countries) was significant. The IFs for non-collaborative articles averaged 66% of the overall IF of the journals whereas the articles in collaboration raised the IFs to values close to the overall IF. The study shows a significantly lower IF in the group of the subsets of non-collaborative LA articles and thus that country affiliation of authors from non-developed LA countries does affect the IF of a journal detrimentally. There are no data to indicate whether the lower IFs of LA articles were due to their inherent inferior quality/relevance or psycho-social trend towards under-citation of articles from these countries. However, further study is required since there are foreseeable consequences of this trend as it may stimulate strategies by editors to turn down articles that tend to be under-cited.

Trauma system evaluation in developing countries: applicability of American College of Surgeons/Committee on Trauma (ACS/COT) basic criteria.

PubMed

Latifi, Rifat; Ziemba, Michelle; Leppäniemi, Ari; Dasho, Erion; Dogjani, Agron; Shatri, Zhaneta; Kociraj, Agim; Oldashi, Fatos; Shosha, Lida

2014-08-01

Trauma continues to be a major health problem worldwide, particularly in the developing world, with high mortality and morbidity. Yet most developing countries lack an organized trauma system. Furthermore, developing countries do not have in place any accreditation process for trauma centers; thus, no accepted standard assessment tools exist to evaluate their trauma services. The aims of this study were to evaluate the trauma system in Albania, using the basic trauma criteria of the American College of Surgeons/Committee on Trauma (ACS/COT) as assessment tools, and to provide the Government with a situational analysis relative to these criteria. We used the ACS/COT basic criteria as assessment tools to evaluate the trauma system in Albania. We conducted a series of semi-structured interviews, unstructured interviews, and focus groups with all stakeholders at the Ministry of Health, at the University Trauma Hospital (UTH) based in Tirana (the capital city), and at ten regional hospitals across the country. Albania has a dedicated national trauma center that serves as the only tertiary center, plus ten regional hospitals that provide some trauma care. However, overall, its trauma system is in need of major reforms involving all essential elements in order to meet the basic requirements of a structured trauma system. The ACS/COT basic criteria can be used as assessment tools to evaluate trauma care in developing countries. Further studies are needed in other developing countries to validate the applicability of these criteria.

Financing the HIV response in sub-Saharan Africa from domestic sources: Moving beyond a normative approach.

PubMed

Remme, Michelle; Siapka, Mariana; Sterck, Olivier; Ncube, Mthuli; Watts, Charlotte; Vassall, Anna

2016-11-01

Despite optimism about the end of AIDS, the HIV response requires sustained financing into the future. Given flat-lining international aid, countries' willingness and ability to shoulder this responsibility will be central to access to HIV care. This paper examines the potential to expand public HIV financing, and the extent to which governments have been utilising these options. We develop and compare a normative and empirical approach. First, with data from the 14 most HIV-affected countries in sub-Saharan Africa, we estimate the potential increase in public HIV financing from economic growth, increased general revenue generation, greater health and HIV prioritisation, as well as from more unconventional and innovative sources, including borrowing, health-earmarked resources, efficiency gains, and complementary non-HIV investments. We then adopt a novel empirical approach to explore which options are most likely to translate into tangible public financing, based on cross-sectional econometric analyses of 92 low and middle-income country governments' most recent HIV expenditure between 2008 and 2012. If all fiscal sources were simultaneously leveraged in the next five years, public HIV spending in these 14 countries could increase from US$3.04 to US$10.84 billion per year. This could cover resource requirements in South Africa, Botswana, Namibia, Kenya, Nigeria, Ethiopia, and Swaziland, but not even half the requirements in the remaining countries. Our empirical results suggest that, in reality, even less fiscal space could be created (a reduction by over half) and only from more conventional sources. International financing may also crowd in public financing. Most HIV-affected lower-income countries in sub-Saharan Africa will not be able to generate sufficient public resources for HIV in the medium-term, even if they take very bold measures. Considerable international financing will be required for years to come. HIV funders will need to engage with broader health and development financing to improve government revenue-raising and efficiencies. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

International perspective on common core competencies for occupational physicians: a modified Delphi study.

PubMed

Lalloo, Drushca; Demou, Evangelia; Kiran, Sibel; Cloeren, Marianne; Mendes, René; Macdonald, Ewan B

2016-07-01

The competencies required of occupational physicians (OPs) have been the subject of peer-reviewed research in Europe and individual countries around the world. In the European Union (EU), there has been development of guidance on training and common competencies, but little research has extended beyond this. The aim of this study was to obtain consensus on and identify the common core competencies required of OPs around the world. A modified Delphi study was carried out among representative organisations and networks of OPs in a range of countries around the world. It was conducted in 2 rounds using a questionnaire based on the specialist training syllabus of a number of countries, expert panel reviews and conference discussions. Responses were received from 51 countries around the world, with the majority from Europe (60%; 59%) and North and South America (24%; 32%) in rounds 1 and 2, respectively. General principles of assessment and management of occupational hazards to health and good clinical care were jointly considered most important in ranking when compared with the other topic areas. Assessment of disability and fitness for work, communication skills and legal and ethical issues completed the top five. In both rounds, research methods and teaching and educational supervision were considered least important. This study has established the current priorities among OPs across 51 countries of the common competencies required for occupational health (OH) practice. These findings can serve as a platform for the development of common core competencies/qualifications within specific geographical regions or internationally. This is particularly pertinent with globalisation of commerce and free movement within the EU. 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/

Forecasting the global shortage of physicians: an economic- and needs-based approach

PubMed Central

Liu, Jenny X; Kinfu, Yohannes; Dal Poz, Mario R

2008-01-01

Abstract Objective Global achievements in health may be limited by critical shortages of health-care workers. To help guide workforce policy, we estimate the future demand for, need for and supply of physicians, by WHO region, to determine where likely shortages will occur by 2015, the target date of the Millennium Development Goals. Methods Using World Bank and WHO data on physicians per capita from 1980 to 2001 for 158 countries, we employ two modelling approaches for estimating the future global requirement for physicians. A needs-based model determines the number of physicians per capita required to achieve 80% coverage of live births by a skilled health-care attendant. In contrast, our economic model identifies the number of physicians per capita that are likely to be demanded, given each country’s economic growth. These estimates are compared to the future supply of physicians projected by extrapolating the historical rate of increase in physicians per capita for each country. Findings By 2015, the global supply of physicians appears to be in balance with projected economic demand. Because our measure of need reflects the minimum level of workforce density required to provide a basic health service that is met in all but the least developed countries, the needs-based estimates predict a global surplus of physicians. However, on a regional basis, both models predict shortages for many countries in the WHO African Region in 2015, with some countries experiencing a needs-based shortage, a demand-based shortage, or both. Conclusion The type of policy intervention needed to alleviate projected shortages, such as increasing health-care training or adopting measures to discourage migration, depends on the type of shortage projected. PMID:18670663

New shipyard layout design for the preliminary phase & case study for the green field project

NASA Astrophysics Data System (ADS)

Song, Young Joo; Woo, Jong Hun

2013-03-01

For several decades, Asian nations such as Korea, Japan and China have been leading the shipbuilding industry since the decline in Europe and America. However, several developing countries such as India, Brazil, etc. are going to make an entrance into the shipbuilding industry. These developing countries are finding technical partners or information providers because they are in situation of little experiences and technologies. Now, the shipbuilding engineering companies of shipbuilding advanced countries are getting a chance of engineering business against those developing countries. The starting point of this business model is green field project for the construction of new shipyard. This business model is started with a design of the shipyard layout. For the conducting of the shipyard layout design, four kinds of engineering parts are required. Those are civil engineering, building engineering, utility engineering and production layout engineering. Among these parts, production layout engineering is most important because its result is the foundation of the other engineering parts and it determines the shipyard capacity during the shipyard operation lifecycle. Previous researches about the shipyard layout design are out of the range from the business requirements because most research cases are in the tower of ivory, which means that there are little consideration of real ship and shipbuilding operation. In this paper, a shipyard layout design for preliminary phase is conducted for the target of newly planned shipyard at Venezuela of South America with an integrated method that is capable of dealing with actual master data from the shipyard. The layout design method of this paper is differentiated from the previous researches in that the actual product data from the target ship and the actual shipbuilding operation data are used for the required area estimation.

Developments in Assisting Countries in Implementing the IAEA Additional Protocol

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

Killinger, Mark H.; Hansen, Linda H.; Cain, Ronald A.

In 2008, the U.S. Department of Energy (DOE) began assisting selected non-nuclear weapon states in planning and preparing for implementation of the International Atomic Energy Agency’s Additional Protocol (AP). Since then, the AP international implementation program has contributed to the substantial progress made by Vietnam, Thailand, Iraq, and Malaysia in preparing for entry-into-force of the AP. An overall engagement plan has been developed with components designed to train government AP implementing agencies, inform policy makers, conduct outreach to industry and universities, make AP reporting software available and useful, and plan a detailed approach for implementing the declaration and complementary accessmore » provisions of the AP. DOE recently began collaborating with Indonesia, which has already entered the AP into force, requiring a second method of engagement somewhat different from that taken with countries that have not entered the AP into force. The AP international implementation program, administered by the International Nuclear Safeguards and Engagement Program, is working more closely with DOE’s International Nonproliferation Export Control Program to ensure countries are aware of and prepared to implement the export/import provisions of the AP. As the AP implementation program matures and helps move countries closer to entry-into-force or improved AP implementation, it is identifying characteristics of a country’s “end-state” that indicate that DOE assistance is no longer required. The U.S. AP Implementation Act and Senate Resolution of Ratification require the Administration to report annually to Congress on measures taken to achieve the adoption of the AP in non-nuclear weapon states. DOE’s AP international implementation program is a significant part of these measures. This paper describes recent developments to increase the scope and effectiveness of the program.« less

The SLMTA programme: Transforming the laboratory landscape in developing countries

PubMed Central

Maruta, Talkmore; Luman, Elizabeth T.; Nkengasong, John N.

2014-01-01

Background Efficient and reliable laboratory services are essential to effective and well-functioning health systems. Laboratory managers play a critical role in ensuring the quality and timeliness of these services. However, few laboratory management programmes focus on the competencies required for the daily operations of a laboratory in resource-limited settings. This report provides a detailed description of an innovative laboratory management training tool called Strengthening Laboratory Management Toward Accreditation (SLMTA) and highlights some challenges, achievements and lessons learned during the first five years of implementation (2009–2013) in developing countries. Programme SLMTA is a competency-based programme that uses a series of short courses and work-based learning projects to effect immediate and measurable laboratory improvement, while empowering laboratory managers to implement practical quality management systems to ensure better patient care. A SLMTA training programme spans from 12 to 18 months; after each workshop, participants implement improvement projects supported by regular supervisory visits or on-site mentoring. In order to assess strengths, weaknesses and progress made by the laboratory, audits are conducted using the World Health Organization’s Regional Office for Africa (WHO AFRO) Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist, which is based on International Organization for Standardization (ISO) 15189 requirements. These internal audits are conducted at the beginning and end of the SLMTA training programme. Conclusion Within five years, SLMTA had been implemented in 617 laboratories in 47 countries, transforming the laboratory landscape in developing countries. To our knowledge, SLMTA is the first programme that makes an explicit connection between the performance of specific management behaviours and routines and ISO 15189 requirements. Because of this close relationship, SLMTA is uniquely positioned to help laboratories seek accreditation to ISO 15189. PMID:26752335

Tsunami Data and Scientific Data Diplomacy

NASA Astrophysics Data System (ADS)

Arcos, N. P.; Dunbar, P. K.; Gusiakov, V. K.; Kong, L. S. L.; Aliaga, B.; Yamamoto, M.; Stroker, K. J.

2016-12-01

Free and open access to data and information fosters scientific progress and can build bridges between nations even when political relationships are strained. Data and information held by one stakeholder may be vital for promoting research of another. As an emerging field of inquiry, data diplomacy explores how data-sharing helps create and support positive relationships between countries to enable the use of data for societal and humanitarian benefit. Tsunami has arguably been the only natural hazard that has been addressed so effectively at an international scale and illustrates the success of scientific data diplomacy. Tsunami mitigation requires international scientific cooperation in both tsunami science and technology development. This requires not only international agreements, but working-level relationships between scientists from countries that may have different political and economic policies. For example, following the Pacific wide tsunami of 1960 that killed two thousand people in Chile and then, up to a day later, hundreds in Hawaii, Japan, and the Philippines; delegates from twelve countries met to discuss and draft the requirements for an international tsunami warning system. The Pacific Tsunami Warning System led to the development of local, regional, and global tsunami databases and catalogs. For example, scientists at NOAA/NCEI and the Tsunami Laboratory/Russian Academy of Sciences have collaborated on their tsunami catalogs that are now routinely accessed by scientists and the public around the world. These data support decision-making during tsunami events, are used in developing inundation and evacuation maps, and hazard assessments. This presentation will include additional examples of agreements for data-sharing between countries, as well as challenges in standardization and consistency among the tsunami research community. Tsunami data and scientific data diplomacy have ultimately improved understanding of tsunami and associated impacts.

Implementing security in a distributed web-based EHCR.

PubMed

Sucurovic, Snezana

2007-01-01

In many countries there are initiatives for building an integrated patient-centric electronic health record. There are also initiatives for transnational integrations. These growing demands for integration result from the fact that it can provide improving healthcare treatments and reducing the cost of healthcare services. While in European highly developed countries computerisation in healthcare sector began in the 1970s and reached a high level, some developing countries, and Serbia among them, have started computerisation recently. This is why MEDIS (MEDical Information System) is aimed at integration itself from the very beginning instead of integration of heterogeneous information systems on a middle layer or using HL7 protocol. The implementation of a national healthcare information system requires using standards as integrated and widely accepted solutions. Therefore, we have started building MEDIS to meet the requirements of CEN ENV 13606 and CEN ENV 13729 standards. The prototype version has a distributed component-based architecture with modern security solutions applied. MEDIS has been implemented as a federated system where the central server hosts basic EHCR information about a patient, and clinical servers contain their own part of patients' EHCR. At present, there is an initial version of prototype planned to be deployed at first in a small community. In particular, open source API for X.509 authentication and authorisation has been developed. Our project meets the requirements for education in health informatics, including appropriate knowledge and skills on EHCR. The points included in this article have been presented on several national conferences and widely discussed. MEDIS has explored a federated, component-based EHCR architecture and related security aspects. In its initial version it shows acceptable performances and administrative simplicity. It emphasizes the importance of using standards in building EHCR in our country, in order to prepare it for future integrations.

The interaction of energy, population and sustainable development

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

Mills, J.I.; Herring, J.S.

1995-12-31

The relationships among, energy, population growth, and sustainable economic development will be of critical importance during the next half century. In previous papers, the authors have modeled the interactions among energy, population and economic development. These studies have shown that the increased availability of economic alternatives, improved health conditions, and sustainable energy supplies have a direct interaction with the rate of population growth. Conversely, their studies and others have shown that poverty, poor health conditions, and the lack of economic alternatives contribute to a vicious cycle in which rapid population growth continues, poverty prevails, and health conditions deteriorate further. Reducingmore » population growth to a sustainable steady state value is, in part, a product of the improved health and living conditions brought on by a well-considered industrialization. Improving the availability and reliability of the electric supply is an integral part of that industrialization. Free trade zones surrounding major ports are becoming a major vehicle for development and gateways to the global economy. By providing the needed electricity to power these enterprise zones, US technology could furnish a vital link in development. Many current projects for providing power to preindustrial countries involve the construction of large, centralized projects. The construction of conventional fossil and nuclear plants requires that the developing countries first develop an infrastructure for both the construction and operation of such plants. Both hydro and steam plants require significant capital investment, either by the host country or by outside development agencies, before the first kilowatt-hour is delivered.« less

Field Application of the Micro Biological Survey Method for the Assessment of the Microbiological Safety of Different Water Sources in Horn of Africa and the Evaluation of the Effectiveness of Moringa Oleifera in Drinking Water Purification

PubMed Central

Losito, Francesca; Arienzo, Alyexandra; Somma, Daniela; Murgia, Lorenza; Stalio, Ottavia; Zuppi, Paolo; Rossi, Elisabetta; Antonini, Giovanni

2017-01-01

Water monitoring requires expensive instrumentations and skilled technicians. In developing Countries as Africa, the severe economic restrictions and lack of technology make water safety monitoring approaches applied in developed Countries, still not sustainable. The need to develop new methods that are suitable, affordable, and sustainable in the African context is urgent. The simple, economic and rapid Micro Biological Survey (MBS) method does not require an equipped laboratory nor special instruments and skilled technicians, but it can be very useful for routine water analysis. The aim of this work was the application of the MBS method to evaluate the microbiological safety of different water sources and the effectiveness of different drinking water treatments in the Horn of Africa. The obtained results have proved that this method could be very helpful to monitor water safety before and after various purification treatments, with the aim to control waterborne diseases especially in developing Countries, whose population is the most exposed to these diseases. In addition, it has been proved that Moringa oleifera water treatment is ineffective in decreasing bacterial load of Eritrea water samples. PMID:28748063

Field Application of the Micro Biological Survey Method for the Assessment of the Microbiological Safety of Different Water Sources in Horn of Africa and the Evaluation of the Effectiveness of Moringa Oleifera in Drinking Water Purification.

PubMed

Losito, Francesca; Arienzo, Alyexandra; Somma, Daniela; Murgia, Lorenza; Stalio, Ottavia; Zuppi, Paolo; Rossi, Elisabetta; Antonini, Giovanni

2017-06-23

Water monitoring requires expensive instrumentations and skilled technicians. In developing Countries as Africa, the severe economic restrictions and lack of technology make water safety monitoring approaches applied in developed Countries, still not sustainable. The need to develop new methods that are suitable, affordable, and sustainable in the African context is urgent. The simple, economic and rapid Micro Biological Survey (MBS) method does not require an equipped laboratory nor special instruments and skilled technicians, but it can be very useful for routine water analysis. The aim of this work was the application of the MBS method to evaluate the microbiological safety of different water sources and the effectiveness of different drinking water treatments in the Horn of Africa. The obtained results have proved that this method could be very helpful to monitor water safety before and after various purification treatments, with the aim to control waterborne diseases especially in developing Countries, whose population is the most exposed to these diseases. In addition, it has been proved that Moringa oleifera water treatment is ineffective in decreasing bacterial load of Eritrea water samples.

"International regime for advancing lunar development"

NASA Astrophysics Data System (ADS)

Beldavs, VZ

2017-09-01

A specific concern regarding the Moon Treaty is the provision for sharing the wealth gained from space with developing countries that have not invested and taken risks in making possible space materials utilization. Article 11, par. 7 states "The main purposes of the international regime to be established shall include: (a) The orderly and safe development of the natural resources of the moon; (b) The rational management of those resources; (c) The expansion of opportunities in the use of those resources; (d) An equitable sharing by all States Parties in the benefits derived from those resources, whereby the interests and needs of the developing countries, as well as the efforts of those countries which have contributed either directly or indirectly to the exploration of the moon, shall be given special consideration." Whether the Moon Treaty in its present form or modified to be acceptable to more parties or the Moon Treaty is ignored, the language of Article 11, paragraph 7 can be used to construct an international regime for lunar development that can meet the requirements of commercial business as well as of states that provide support for lunar development as well as developing countries that may have played a modest role in making lunar development possible. This paper will consider options for constructing an international regime for lunar development.

Making stem cells count for global health.

PubMed

McMahon, Dominique S; Thorsteinsdóttir, Halla

2011-11-01

Developing countries such as China, India and Brazil are making large investments in the stem cell field. Here we argue that hands-on involvement in the field by these countries is essential if the products developed are going to be locally relevant, affordable and appropriate. However, stem cells are a high-risk investment and any global health impacts are still likely to be far off. Even if they are eventually successful, better clinical oversight and measures to ensure access are required for stem cells to have a substantial and equitable impact.

What Is Required In Uganda? The 2007 Report Of The Japan Sci-edu. Support Project

NASA Astrophysics Data System (ADS)

Uchida, Tatsuhiro

2010-07-01

The development of ability for technology and invention is required as self-sustaining growth of science and technology in Asian and African developing countries. Science education that connects to the real world is the required education for the self-sustaining growth. But in fact, it is very common to study for the entrance examination. According to C. Camilla, S. and Sjo/berg, [The Re-emergence of Values in the Science Curriculum. Rotterdam, 2007, Sense Publishers], Ugandan students are the most interested ones in science and technology (I would like to be a scientist, I would like to get a job in technology) in the world. Science education should mortgages future of youth. Especially science education of developing countries should be directly connected to the real world. Because they need a lot of engineers as skilled worker, we implemented physics education that was directly connected with manufacturing by the sci-edu. support project in Uganda. The best results were achieved by contrivance in spite of poverty area. Our education method gave one form of New Science Education in Asia and Africa.

The Belgian commitment to pharmaceutical quality: a model policy to improve quality assurance of medicines available through humanitarian and development programs.

PubMed

Ravinetto, Raffaella; Roosen, Tim; Dujardin, Catherine

2018-01-01

Today, a combination of globalization of pharmaceutical production, lack of regulatory harmonization, and weakness of Medicines Regulatory Authorities, creates the "perfect conditions" for poor-quality medicine to circulate in the global market and to penetrate the less-regulated countries. Medicines regulation is the responsibility of the national regulatory authorities in the recipient country, but in the poorer countries, in practice, the responsibility of supply of quality-assured medicines is often taken by Non-Governmental Organizations and other implementers. But with some notable exceptions, many donors lack a pharmaceutical procurement policy with adequate quality requirements; and many implementers lack the skills and expertise needed to orient themselves in the complex web of global pharmaceutical supply. Thus, patients served by humanitarian or development programs may remain exposed to the risk of poor-quality medicines. When public money is used to purchase medicines for medical programs to be carried out overseas, adequate policies should be in place to assure that the same quality requirements are set that would be required for medicines marketed in the "donor" country. We will describe here a policy recently adopted in Belgium, i.e. the "Commitment to Quality Assurance for Pharmaceutical Products", signed in October 2017 by the Vice Prime Minister and Minister for Development Cooperation and 19 Belgian implementing agencies. By signing the new policy, the counterparts committed to ensure quality of medicines in the programs funded by Belgium's Official Development Assistance, and to build quality-assurance capacity in the recipient countries. Implementers are requested to integrate in their financing applications a section for pharmaceutical quality assurance, with a justified budget. They are also invited to consider how costs could be rationalized and mutualized by aligning the strengths of the various implementers. This model policy has the potential to be considered for adoption by other donors, to help to reduce the current multiple standards in pharmaceutical quality, and to contribute to protect vulnerable communities from the plague of poor-quality medicines. The online version of this article (10.1186/s40545-018-0136-z) contains an additional file, which is available to authorized users.

Challenges associated with tracking resources allocation for reproductive health in sub-Saharan African countries: the UNFPA/NIDI resource flows project experience.

PubMed

Sidze, Estelle M; Beekink, Erik; Maina, Beatrice W

2015-05-05

Universal access to reproductive health services entails strengthening health systems, but requires significant resource commitments as well as efficient and effective use of those resources. A number of international organizations and governments in developing countries are putting efforts into tracking the flow of health resources in order to inform resource mobilization and allocation, strategic planning, priority setting, advocacy and general policy making. The UNFPA/NIDI-led Resource Flows Project ("The UNFPA/NIDI RF Project") has conducted annual surveys since 1997 to monitor progress achieved by developing countries in implementing reproductive health financial targets. This commentary summarizes the Project experiences and challenges in gathering data on allocation of resources for reproductive health at the domestic level in sub-Saharan African countries. One key lesson learnt from the Project experience is the need for strengthening tracking mechanisms in sub-Saharan African countries and making information on reproductive health resources and expenditures available, in particular the private sector resources.

Strategic imperatives for globalization of industries in developing countries: an Indian pharmaceutical industry example.

PubMed

Srivastava, Rajesh; Chandra, Ashish; Kumar, Girish

2004-01-01

The annual global pharmaceutical sales have grown over 466 billion dollars, almost 50% of which comes from North America. Among developing countries, India, with 16% of the world population, accounts for only a small percentage of the global pharmaceutical industry. Until recently, India has had virtually no pharmaceutical industry worth the name producing drugs from basic raw materials and it used to rely mostly on the imports from countries like the USA and England for all its requirements of drugs. On the other hand, India has seen a plethora of multinational pharmaceutical companies come and do business in India. This paper develops a matrix which provides a broad guidance to the mid- to large-size Indian pharmaceutical domestic companies, which should embark on the path to global expansion to establish their might as well.

Gavi's Transition Policy: Moving From Development Assistance To Domestic Financing Of Immunization Programs.

PubMed

Kallenberg, Judith; Mok, Wilson; Newman, Robert; Nguyen, Aurélia; Ryckman, Theresa; Saxenian, Helen; Wilson, Paul

2016-02-01

Gavi, the Vaccine Alliance, was created in 2000 to accelerate the introduction of new and underused vaccines in lower-income countries. The period 2000-15 was marked by the rapid uptake of new vaccines in more than seventy countries eligible for Gavi support. To stay focused on the poorest countries, Gavi's support phases out after countries' gross national income per capita surpasses a set threshold, which requires governments to assume responsibility for the continued financing of vaccines introduced with Gavi support. Gavi's funding will end in the period 2016-20 for nineteen countries that have exceeded the eligibility threshold. To avoid disrupting lifesaving immunization programs and to ensure the long-term sustainable impact of Gavi's investments, it is vital that governments succeed in transitioning from development assistance to domestic financing of immunization programs. This article discusses some of the challenges facing countries currently transitioning out of Gavi support, how Gavi's policies have evolved to help manage the risks involved in this process, and the lessons learned from this experience. Project HOPE—The People-to-People Health Foundation, Inc.

Universal health care and equity: evidence of maternal health based on an analysis of demographic and household survey data.

PubMed

Neal, Sarah; Channon, Andrew Amos; Carter, Sarah; Falkingham, Jane

2015-06-16

The drive toward universal health coverage (UHC) is central to the post 2015 agenda, and is incorporated as a target in the new Sustainable Development Goals. However, it is recognised that an equity dimension needs to be included when progress to this goal is monitored. WHO have developed a monitoring framework which proposes a target of 80% coverage for all populations regardless of income and place of residence by 2030, and this paper examines the feasibility of this target in relation to antenatal care and skilled care at delivery. We analyse the coverage gap between the poorest and richest groups within the population for antenatal care and presence of a skilled attendant at birth for countries grouped by overall coverage of each maternal health service. Average annual rates of improvement needed for each grouping (disaggregated by wealth quintile and urban/rural residence) to reach the goal are also calculated, alongside rates of progress over the past decades for comparative purposes. Marked inequities are seen in all groups except in countries where overall coverage is high. As the monitoring framework has an absolute target countries with currently very low coverage are required to make rapid and sustained progress, in particular for the poorest and those living in rural areas. The rate of past progress will need to be accelerated markedly in most countries if the target is to be achieved, although several countries have demonstrated the rate of progress required is feasible both for the population as a whole and for the poorest. For countries with currently low coverage the target of 80% essential coverage for all populations will be challenging. Lessons should be drawn from countries who have achieved rapid and equitable progress in the past.

76 FR 4089 - Proposed Information Collection; Comment Request; Automated Export System (AES) Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-24

.... Government policies that affect the economy. These data also enable U.S. businesses to develop practical... origin. Also, the equipment number field will be revised to require the container number for all... require a license. For shipments where the origin of the commodity is foreign, the country of origin will...

Palliative care development in the Asia-Pacific region: an international survey from the Asia Pacific Hospice Palliative Care Network (APHN).

PubMed

Yamaguchi, Takashi; Kuriya, Meiko; Morita, Tatsuya; Agar, Meera; Choi, Youn Seon; Goh, Cynthia; Lingegowda, K B; Lim, Richard; Liu, Rico K Y; MacLeod, Roderick; Ocampo, Rhodora; Cheng, Shao-Yi; Phungrassami, Temsak; Nguyen, Yen-Phi; Tsuneto, Satoru

2017-03-01

Although palliative care is an important public healthcare issue worldwide, the current situation in the Asia-Pacific region has not been systematically evaluated. This survey aimed to clarify the current status of palliative care in the Asia-Pacific region. Questionnaires were sent to a representative physician of each member country/region of the Asia Pacific Hospice Palliative Care Network (APHN). The questionnaire examined palliative care service provision, information regarding physician certification in palliative care, the availability of essential drugs for palliative care listed by the International Association for Hospice and Palliative Care (IAHPC) and the regulation of opioid-prescribing practice. Of the 14 member countries/regions of the APHN, 12 (86%) responded. Some form of specialist palliative care services had developed in all the responding countries/regions. Eight member countries/regions had physician certifications for palliative care. Most essential drugs for palliative care listed by the IAHPC were available, whereas hydromorphone, oxycodone and transmucosal fentanyl were unavailable in most countries/regions. Six member countries/regions required permission to prescribe and receive opioids. The development of palliative care is in different stages across the surveyed countries/regions in the Asia-Pacific region. Data from this survey can be used as baseline data for monitoring the development of palliative care in this region. 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/.

AB027. Developing capacity for variant data sharing in low and middle income countries: HVP’s Global Globin 2020 Challenge

PubMed Central

Robinson, Helen M.

2015-01-01

The hemoglobinopathies, collectively, are cause for significant morbidity and mortality. Children are the most severely affected. Despite much of the genetics and biology of hemoglobinopathies being known for a long time, and being used successfully in some countries to systematically reduce burden of disease, many low and medium income countries remain practically untouched by recent developments in human genomics involving the systematic collection and sharing of variation data to fighting hemoglobinopathies (notably thalassaemias and sickle cell disease, but also G6PD). Commitment to systematic variant data collection is increasing, but this is occurring mostly in high-income countries where much of the diagnosis and testing takes place. There is a risk that countries with the highest burden of these diseases are being left behind in a form of “genomic divide”. Capacity to generate quality data on variants, to store this information so that it can be shared internationally, needs to be built in these countries. Tackling hemoglobinopathies is an ideal entry point for these countries to develop the necessary infrastructure and expertise that can expand into other areas of health. This genomic capacity will enable building: (I) the genetic evidence base for better management of delivery of local treatment, care and eventually even cure; (II) a foundation for genomic medicine by working with national, regional and local health care professionals to raise public awareness of the genetic basis of hemoglobinopathies. Global Globin 2020 Challenge has been initiated with two goals: (I) to see growth in the quality and quantity of curated inputs into internationally recognized genetic databases from low- and middle-income countries participating in the project, and to harmonize the sharing of all relevant variant data between countries in accordance with international best practice that integrates all the relevant ethical and regulatory frameworks and policies required to protect patients at the same time that the biotechnical procedures are developed; (II) to ensure that the storage, curation and sharing of the relevant DNA variation information is sustainable in the medium and longer term by expanding and strengthening the international network of professionals, including curators, researchers, clinicians, bioinformaticians, counsellors, patient groups and policymakers. Pursuit of these goals will raise the profile of genomic medicine in low and middle income countries in national, regional and international research organizations. It will also develop the capability of professionals required for diagnosing, treating and counseling carriers in low and middle income countries thus giving them a greater voice and profile among genomic researchers globally so they can actively participate in regional and international partnerships related to genomic research. Initially the GG2020 Challenge will focus on a group of countries that have already formed groups of the relevant professionals including: Belgium, China, Cyprus, Egypt, France, Malaysia, Mexico, Mozambique, Nigeria, South Africa, Venezuela, Vietnam, Portugal, and The Netherlands. Other countries are ready to be included as the project expands. HVP will utilize its relationship with both UNESCO and WHO to ensure that the necessary international standards and procedures are developed in a consultative and harmonized manner.

The Changing Relationship Between Family Size and Educational Attainment Over the Course of Socioeconomic Development: Evidence From Indonesia

PubMed Central

MARALANI, VIDA

2008-01-01

Many studies from developed countries show a negative correlation between family size and children’s schooling, while results from developing countries show this association ranging from positive to neutral to negative, depending on the context. The body of evidence suggests that this relationship changes as a society develops, but this theory has been difficult to assess because the existing evidence requires comparisons across countries with different social structures and at different levels of development. The world’s fourth most populous nation in 2007, Indonesia has developed rapidly in recent decades. This context provides the opportunity to study these relationships within the same rapidly developing setting to see if and how these associations change. Results show that in urban areas, the association between family size and children’s schooling was positive for older cohorts but negative for more recent cohorts. Models using instrumental variables to address the potential endogeneity of fertility confirm these results. In contrast, rural areas show no significant association between family size and children’s schooling for any cohort. These findings show how the relationship between family size and children’s schooling can differ within the same country and change over time as contextual factors evolve with socioeconomic development. PMID:18939668

Poverty reduction and Millennium Development Goals: recognizing population, health, and environment linkages in rural Madagascar.

PubMed

Gaffikin, Lynne; Ashley, Jeffrey; Blumenthal, Paul D

2007-10-23

The Millennium Development Goals (MDGs), committed to by all 191 United Nations member states, are rooted in the concept of sustainable development. Although 2007 (midway) reports indicated that programs are under way, unfortunately many countries are unlikely to reach their goals by 2015 due to high levels of poverty. Madagascar is one such example, although some gains are being made. Attempts of this island nation to achieve its MDGs, expressed most recently in the form of a Madagascar Action Plan, are notable in their emphasis on (1) conserving the country's natural resource base, (2) the effect of demographic trends on development, and (3) the importance of health as a prerequisite for development. Leadership in the country's struggle for economic growth comes from the president of the Republic, in part, through his "Madagascar Naturally" vision as well as his commitment to universal access to family planning, among other health and development interventions. However, for resource-limited countries, such as Madagascar, to get or stay "on track" to achieving the MDGs will require support from many sides. "Madagascar cannot do it alone and should not do it alone." This position is inherent in the eighth MDG: "Develop a global partnership for development." Apparently, it takes a village after all - a global one.

The precautionary principle and other non-tariff barriers to free and fair international food trade.

PubMed

Lupien, John R

2002-07-01

International food trade and world population are growing rapidly. National legislation has been enacted and implemented in many countries to assure good quality and safe foods to meet increased demand. No country is fully self-sufficient in domestic food production to meet population demands, and all require some food imports. Current international food trade agreements call for free and fair food trade between all countries, developed and developing. National food legislation and food production, processing and marketing systems have evolved in most countries to ensure better quality and safer foods. At the international level the work of the FAO/ WHO Codex Alimentarius Commission (Codex) and the World Trade Organization Agreements on Sanitary and Phytosanitary Measures (SPS) and on Technical Barriers to Trade (TBT) and related Uruguay Round agreements have been agreed to by over 140 countries with the aim to promoting the free and fair trade of good quality and safe foods between all countries. The SPS and TBT agreements rely on science-based Codex standards, guidelines, and recommendations as benchmarks for judging international food trade disputes. A number of non-tariff barriers to trade, often related to agricultural subsidies and other food trade payments in developed countries, continue to give rise to complaints to WTO. They also continue to prevent free and fair trade, particularly for developing countries in international food trade. A number of these non-tariff barriers to trade are briefly examined, along with other domestic and international food trade problems, and recommendations for improvements are made.

A Grounded Theory Study of Effective Global Leadership Development Strategies: Perspectives from Brazil, India, and Nigeria

ERIC Educational Resources Information Center

Lokkesmoe, Karen Jane

2009-01-01

This qualitative, grounded theory study focuses on global leadership and global leadership development strategies from the perspective of people from three developing countries, Brazil, India, and Nigeria. The study explores conceptualizations of global leadership, the skills required to lead effectively in global contexts, and recommended…

Development of Entry-Level Competence Tests: A Strategy for Evaluation of Vocational Education Training Systems

ERIC Educational Resources Information Center

Schutte, Marc; Spottl, Georg

2011-01-01

Developing countries such as Malaysia and Oman have recently established occupational standards based on core work processes (functional clusters of work objects, activities and performance requirements), to which competencies (performance determinants) can be linked. While the development of work-process-based occupational standards is supposed…

Hydro development in Costa Rica

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

Young, C.F.

The initial foreign thrust of private power activities was quite naturally by large companies acquiring existing government-owned facilities in relatively large countries. Only recently, it seems, people have discovered that there are countries in Latin America other than Argentina, Brazil, and Mexico, and that there is interest in having the private sector construct new (and often smaller) facilities, with an increasing emphasis on renewable energy. Costa Rica passed its private power law in 1991 and has clearly been the most progressive country in Central America in promoting greenfield development of private power projects. The country has not been exempt, however,more » from the cyclical nature of the support that governments, utilities and regulatory agencies give to private power producers. The initial enthusiasm and willingness to encourage private power producers inevitably give way to requirements and procedures which impair if not thwart the initial intentions of the private power laws.« less

An index to assess the health and benefits of the global ocean.

PubMed

Halpern, Benjamin S; Longo, Catherine; Hardy, Darren; McLeod, Karen L; Samhouri, Jameal F; Katona, Steven K; Kleisner, Kristin; Lester, Sarah E; O'Leary, Jennifer; Ranelletti, Marla; Rosenberg, Andrew A; Scarborough, Courtney; Selig, Elizabeth R; Best, Benjamin D; Brumbaugh, Daniel R; Chapin, F Stuart; Crowder, Larry B; Daly, Kendra L; Doney, Scott C; Elfes, Cristiane; Fogarty, Michael J; Gaines, Steven D; Jacobsen, Kelsey I; Karrer, Leah Bunce; Leslie, Heather M; Neeley, Elizabeth; Pauly, Daniel; Polasky, Stephen; Ris, Bud; St Martin, Kevin; Stone, Gregory S; Sumaila, U Rashid; Zeller, Dirk

2012-08-30

The ocean plays a critical role in supporting human well-being, from providing food, livelihoods and recreational opportunities to regulating the global climate. Sustainable management aimed at maintaining the flow of a broad range of benefits from the ocean requires a comprehensive and quantitative method to measure and monitor the health of coupled human–ocean systems. We created an index comprising ten diverse public goals for a healthy coupled human–ocean system and calculated the index for every coastal country. Globally, the overall index score was 60 out of 100 (range 36–86), with developed countries generally performing better than developing countries, but with notable exceptions. Only 5% of countries scored higher than 70, whereas 32% scored lower than 50. The index provides a powerful tool to raise public awareness, direct resource management, improve policy and prioritize scientific research.

The Health Impact of Child Labor in Developing Countries: Evidence From Cross-Country Data

PubMed Central

Roggero, Paola; Mangiaterra, Viviana; Bustreo, Flavia; Rosati, Furio

2007-01-01

Objectives. Research on child labor and its effect on health has been limited. We sought to determine the impact of child labor on children’s health by correlating existing health indicators with the prevalence of child labor in selected developing countries. Methods. We analyzed the relationship between child labor (defined as the percentage of children aged 10 to14 years who were workers) and selected health indicators in 83 countries using multiple regression to determine the nature and strength of the relation. The regression included control variables such as the percentage of the population below the poverty line and the adult mortality rate. Results. Child labor was significantly and positively related to adolescent mortality, to a population’s nutrition level, and to the presence of infectious disease. Conclusions. Longitudinal studies are required to understand the short- and long-term health effects of child labor on the individual child. PMID:17194870

Inefficiencies in water project design and operation in the third world: An economic perspective

NASA Astrophysics Data System (ADS)

Howe, Charles W.; Dixon, John A.

1993-07-01

Water projects in less developed countries (LDCs) frequently are poorly operated and maintained. As a result, project benefits and development impacts fall short of plans. The problems begin in the project identification, design, and construction stages: donor and host country biases lead to inappropriate projects, unsustainable technologies, and shoddy construction. Later operation and maintenance are then difficult or impossible. Causal factors include donor desire to build monuments and sell technology, provision of excessive capital to favored sectors or institutions, and an unwillingness to require a reasonable quid pro quo from the host country. Host country factors include excessive administrative centralization, lack of rewards for good operation and maintenance, and widespread corruption in forms that seriously distort allocative efficiency. Until individual actors on both sides can be motivated to pursue the long-run good of the LDC, Third World water projects will continue to have low or negative net payoffs.

Evaluating performance of a Lead Road Safety Agency (LRSA) in a low-income country: a case study from Pakistan.

PubMed

Bhatti, Junaid A; Ahmed, Aizaz

2014-01-01

The World Health Organization recommends identifying a Lead Road Safety Agency (LRSA) within the government to coordinate preventive interventions. As LRSAs in developing countries have rarely been evaluated, this case study describes the performance of the LRSA of Pakistan with respect to the World Bank criteria. The designated LRSA, the National Road Safety Secretariat, was put into operation in 2006 and worked for about two years with World Bank funding. The agency had a stand-alone structure headed by an experienced road safety specialist during the first year only and faced difficulty in recruiting other required experts. The LRSA drafted the first National Road Safety Plan, including strategic review of road safety and existing legislation, articulated multisectorial collaboration nationally and provincially, and collected traffic injury data in some districts. Its progress was halted by its dissolution because of funding problems. Currently, two agencies specialising in traffic enforcement and transport research respectively are fulfilling LRSA functions on an ad-hoc basis. Results suggest that sustainability and consistency of LRSAs in developing countries like Pakistan may only be ensured if they are legally protected, inter-ministerial, have permanent funding and are provided with the required expertise through international cooperation, so they can perform their required functions effectively.

Evaluation of ELISA for detection of rabies antibodies in domestic carnivores.

PubMed

Wasniewski, Marine; Cliquet, Florence

2012-01-01

Serological tests of pets have increased as many rabies-free countries have amended their quarantine measures and adopted a scheme requiring rabies vaccination followed by a serological test. A European directive requires the measurement of neutralising antibodies as proof of protection to allow the free movement of pets within the European Union and between third countries non listed in the list C of regulation 998/2003 and European countries. At present, the recommended neutralisation tests (FAVN test or RFFIT) are time-consuming, expensive and require highly trained technicians as well as special laboratory facilities. The rabies ELISA designed by BioPro was developed initially for use for field samples from foxes to check the efficacy of oral vaccination campaigns in Europe. In this study, the specificity, sensitivity and reliability of this commercial rabies ELISA was evaluated for testing sera from dogs and cats involved in international trade. The specificity evaluated in 315 unvaccinated animals was 100%. Concordance of 86.2% was obtained when comparing BioPro ELISA to the gold standard FAVN test in 701 samples from vaccinated dogs and cats. The rabies ELISA developed recently can be considered a valuable method for the assessment of rabies antibodies in vaccinated domestic carnivores in combination with neutralisation tests. Copyright © 2011 Elsevier B.V. All rights reserved.

Preserving the Dinosaurs or At Least Their Knowledge!

DTIC Science & Technology

2015-09-01

used. And, it was taking away from my practice time on the soccer field. Penn’s freshman soccer team was one of the best in the country, requiring...character-building experiences). Another difference is that much of the expertise we gained in the 1980s, such as mine, left government service and...Department. …The 21st century requires us to integrate leadership development practices with emerg - ing opportunities to rethink how we develop

Introduction and Rollout of a New Group A Meningococcal Conjugate Vaccine (PsA-TT) in African Meningitis Belt Countries, 2010–2014

PubMed Central

Djingarey, Mamoudou H.; Diomandé, Fabien V. K.; Barry, Rodrigue; Kandolo, Denis; Shirehwa, Florence; Lingani, Clement; Novak, Ryan T.; Tevi-Benissan, Carol; Perea, William; Preziosi, Marie-Pierre; LaForce, F. Marc

2015-01-01

Background. A group A meningococcal conjugate vaccine (PsA-TT) was developed specifically for the African “meningitis belt” and was prequalified by the World Health Organization (WHO) in June 2010. The vaccine was first used widely in Burkina Faso, Mali, and Niger in December 2010 with great success. The remaining 23 meningitis belt countries wished to use this new vaccine. Methods. With the help of African countries, WHO developed a prioritization scheme and used or adapted existing immunization guidelines to mount PsA-TT vaccination campaigns. Vaccine requirements were harmonized with the Serum Institute of India, Ltd. Results. Burkina Faso was the first country to fully immunize its 1- to 29-year-old population in December 2010. Over the next 4 years, vaccine coverage was extended to 217 million Africans living in 15 meningitis belt countries. Conclusions. The new group A meningococcal conjugate vaccine was well received, with country coverage rates ranging from 85% to 95%. The rollout proceeded smoothly because countries at highest risk were immunized first while attention was paid to geographic contiguity to maximize herd protection. Community participation was exemplary. PMID:26553672

Case Report: Severe Imported Influenza Infections Developed during Travel in Reunion Island.

PubMed

Allyn, Jérôme; Brottet, Elise; Antok, Emmanuel; Dangers, Laurence; Persichini, Romain; Coolen-Allou, Nathalie; Roquebert, Bénédicte; Allou, Nicolas; Vandroux, David

2017-12-01

We report two cases of severe influenza infection imported by tourist patients from their country of origin and developed during travel. While studies have reported cases of influenza infections acquired during travel, here we examine two cases of severe influenza infection contracted in the country of origin that led to diagnosis and therapeutic problems in the destination country. No international recommendation exists concerning influenza vaccination before travel, and few countries recommend it for all travelers. Our study suggests that travel should be canceled when infectious signs are observed before departure. Influenza is a very common infection that is often benign, but sometimes very severe. The most severe cases include shock, acute respiratory distress syndrome (ARDS), myocarditis, rhabdomyolysis, and multiple organ failure. Management can require exceptional therapies, such as extracorporeal membrane oxygenation. A number of studies have focused on influenza infection in travelers. Cases of influenza acquired during travel have been reported in this literature, but no study has examined cases of influenza imported from the country of origin and developed while abroad. The latter situation may lead to 1) diagnostic problems during the nonepidemic season or in places where diagnostic techniques are lacking and 2) therapeutic difficulties resulting from the unavailability of techniques for the management of severe influenza infection in tourist areas. Here, we report two cases of extremely severe influenza infection imported by tourists from their country of origin and developed during travel.

Trade in Services: The Doha Development Agenda Negotiations and U.S. Goals

DTIC Science & Technology

2010-04-07

doctor, enjoying a meal at the restaurant ). However, rapid changes in technology are reducing even these restrictions on services (computer software...establish a presence in the country of the consumer. For example, hotel and restaurant services require a presence in the country of the consumer...wholesale, and franchising services. This access would include both services direct delivery to the customer or remotely through catalogue, video, or

Beyond the permissibility of embryonic and stem cell research: substantive requirements and procedural safeguards.

PubMed

Isasi, Rosario M; Knoppers, Bartha M

2006-10-01

This report provides a comparative analysis of the regulation of embryonic stem cells and cloning research in 50 countries. The development of international stem cell consortia involving the exchange of materials, data and knowledge presumes 'policy know-how' on the varying positions and governing regulations of the various partners; knowledge is essential for the feasibility of such international collaborative projects. Across the spectrum of restrictive-to-liberal policies, requirements regarding the justification for or the setting of substantive limits on (i) embryo use and/or (ii) destruction in research are often present. These goals justify the regulation, the control and even the prohibition of embryonic stem cell and cloning research. Moreover, irrespective of whether a country adopts a restrictive or a liberal approach, there is significant symmetry in both the substantive and the procedural requirements. Procedural safeguards provide another layer of protection and control over the research. In reality, such safeguards may have a greater systemic impact than the substantive requirements. They can be subdivided into three broad categories: (i) safeguards relating to the stage of embryonic development, (ii) safeguards relating to the donors of blastocysts, gametes, embryos and somatic cells and (iii) requirements for research governance.

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

Anesthesia and the role of short-term service delivery in developing countries.

PubMed

Froese, Alison

2007-11-01

To clarify the ongoing need for involvement of anesthesiologists in short-term surgical projects in developing countries, and provide information to guide the selection of, application for, and preparation for these rewarding experiences. The lack of safe anesthesia services severely limits the performance of needed surgical procedures in developing countries around the world. Even in countries where well-trained anesthesiologists are available in major urban centres, resources are often absent or limited for large numbers of people in rural or remote areas. Anesthesiologists are highly sought members of surgical teams. Internet sites provide extensive project information. Projects occur in Central and South America, Africa, Asia and Eastern Europe. Projects can bring specialized surgical expertise to an otherwise well-serviced urban area, or work in remote areas that have surgical services only when a team comes. Available equipment, drugs, housing, food and transportation vary markedly with project site. Flexibility, adaptability and problem-solving skills are essential. Translators provide language assistance. Anesthesiologists who have experience providing anesthetics in settings with less technological support can assist other anesthesiologists in adapting to less sophisticated settings. Severe shortages of trained health professionals plague developing countries, reflecting complex economic and political problems that will require decades for resolution. Until such time as surgical services are widely available and affordable in remote as well as urban areas of developing countries, anesthesiologists will continue to provide a valuable and personally rewarding contribution through short-term assistance.

Developing an approach to assessing the political feasibility of global collective action and an international agreement on antimicrobial resistance.

PubMed

Rogers Van Katwyk, Susan; Danik, Marie Évelyne; Pantis, Ioana; Smith, Rachel; Røttingen, John-Arne; Hoffman, Steven J

2016-01-01

Antimicrobial resistance (AMR) is a global issue. International trade, travel, agricultural practices, and environmental contamination all make it possible for resistant microbes to cross national borders. Global collective action is needed in the form of an international agreement or other mechanism that brings states together at the negotiation table and commits them to adopt or implement policies to limit the spread of resistant microorganisms. This article describes an approach to assessing whether political and stakeholder interests can align to commit to tackling AMR. Two dimensions affecting political feasibility were selected and compared across 82 countries: 1) states' global influence and 2) self-interest in addressing AMR. World Bank GDP ranking was used as a proxy for global influence, while human antibiotic consumption (10-year percent change) was used as a proxy for self-interest in addressing AMR. We used these data to outline a typology of four country archetypes, and discuss how these archetypes can be used to understand whether a proposed agreement may have sufficient support to be politically feasible. Four types of countries exist within our proposed typology: 1) wealthy countries who have the expertise and financial resources to push for global collective action on AMR, 2) wealthy countries who need to act on AMR, 3) countries who require external assistance to act on AMR, and 4) neutral countries who may support action where applicable. Any international agreement will require substantial support from countries of the first type to lead global action, and from countries of the second type who have large increasing antimicrobial consumption levels. A large number of barriers exist that could derail efforts towards global collective action on AMR; issues of capacity, infrastructure, regulation, and stakeholder interests will need to be addressed in coordination with other actors to achieve an agreement on AMR. Achieving a global agreement on access, conservation, and innovation - the three pillars of AMR - will not be easy. However, smaller core groups of interested Initiator and Pivotal Countries could develop policy and resolve many issues. If highly influential countries take the lead, agreements could then be scaled up to achieve global action.

Equatorial Guinea.

PubMed

1989-03-01

Equatorial Guinea is situated on the Gulf of Guinea along the west African coast between Cameroon and Gabon. The people are predominantly of Bantu origin. The country's ties with Spain are significant; in 1959, it became the Spanish Equatorial region ruled by Spain's commissioner general. Recent political developments in Equatorial Guinea include the formation of the Democratic Party for Equatorial Guinea in July of 1987 and the formation of a 60-member unicameral Chamber of Representatives of the People in 1983. Concerning the population, 83% of the people are Catholic and the official language is Spanish. Poverty and serious health, education and sanitary problems exist. There is no adequate hospital and few trained physicians, no dentists, and no opticians. Malaria is endemic and immunization for yellow fever is required for entrance into the country. The water is not potable and many visitors to the country bring bottled water. The tropical climate of Equatorial Guinea provides the climate for the country's largest exports and source of economy; cacao, wood and coffee. Although the country, as a whole, has progressed towards developing a participatory political system, there are still problems of governmental corruption in the face of grave health and welfare conditions. In recent years, the country has received assistance from the World Bank and the United States to aid in its development.

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.

Sustainable development of smallholder crop-livestock farming in developing countries

NASA Astrophysics Data System (ADS)

Ates, S.; Cicek, H.; Bell, L. W.; Norman, H. C.; Mayberry, D. E.; Kassam, S.; Hannaway, D. B.; Louhaichi, M.

2018-03-01

Meeting the growing demand for animal-sourced food, prompted by population growth and increases in average per-capita income in low-income countries, is a major challenge. Yet, it also presents significant potential for agricultural growth, economic development, and reduction of poverty in rural areas. The main constraints to livestock producers taking advantage of growing markets include; lack of forage and feed gaps, communal land tenure, limited access to land and water resources, weak institutions, poor infrastructure and environmental degradation. To improve rural livelihood and food security in smallholder crop-livestock farming systems, concurrent work is required to address issues regarding efficiency of production, risk within systems and development of whole value chain systems. This paper provides a review of several forage based-studies in tropical and non-tropical dry areas of the developing countries. A central tenet of this paper is that forages have an essential role in agricultural productivity, environmental sustainability and livestock nutrition in smallholder mixed farming systems.

Critical role of developing national strategic plans as a guide to strengthen laboratory health systems in resource-poor settings.

PubMed

Nkengasong, John N; Mesele, Tsehaynesh; Orloff, Sherry; Kebede, Yenew; Fonjungo, Peter N; Timperi, Ralph; Birx, Deborah

2009-06-01

Medical laboratory services are an essential, yet often neglected, component of health systems in developing countries. Their central role in public health, disease control and surveillance, and patient management is often poorly recognized by governments and donors. However, medical laboratory services in developing countries can be strengthened by leveraging funding from other sources of HIV/AIDS prevention, care, surveillance, and treatment programs. Strengthening these services will require coordinated efforts by national governments and partners and can be achieved by establishing and implementing national laboratory strategic plans and policies that integrate laboratory systems to combat major infectious diseases. These plans should take into account policy, legal, and regulatory frameworks; the administrative and technical management structure of the laboratories; human resources and retention strategies; laboratory quality management systems; monitoring and evaluation systems; procurement and maintenance of equipment; and laboratory infrastructure enhancement. Several countries have developed or are in the process of developing their laboratory plans, and others, such as Ethiopia, have implemented and evaluated their plan.

"The family is the clinic, the community is the hospital": community mental health in Timor-Leste.

PubMed

Hawkins, Zoe; Tilman, Teofilo

2011-07-01

This paper describes the history and recent development of mental health services in Timor-Leste, a small developing country recovering from conflict. Challenges to effective service delivery are discussed as well as plans for future development. Timor-Leste's mental health service began just over a decade ago. Unlike many other low and middle income countries where hospital-based services predominate, the mental health model in Timor-Leste is entirely community based. However, challenges to effective mental health care delivery are similar to most developing countries and include a lack of sufficient financial resources, human resources, and mental health infrastructure. Addressing these issues successfully requires political will, a greater prioritization of mental health services, close coordination between stakeholders, as well as developments in the area of education, training and infrastructure. Greater understanding and education about the links between mental and physical health would benefit the overall health of the population, and integration of these respective policies may prove a successful method of more equitably redistributing finances and resources.

Developing sustainability: a new metaphor for progress.

PubMed

Bensimon, Cécile M; Benatar, Solomon R

2006-01-01

In this paper, we propose a new model for development, one that transcends the North-South dichotomy and goes beyond a narrow conception of development as an economic process. This model requires a paradigm shift toward a new metaphor that develops sustainability, rather than sustains development. We conclude by defending a 'report card on development' as a means for evaluating how countries perform within this new paradigm.

Application of a contextual instructional framework in a continuing professional development training program for physiotherapists in Rwanda.

PubMed

Dunleavy, Kim; Chevan, Julia; Sander, Antoinette P; Gasherebuka, Jean Damascene; Mann, Monika

2018-06-01

Continuing professional development is an important component of capacity building in low resource countries. The purpose of this case study is to describe the use of a contextual instructional framework to guide the processes and instructional design choices for a series of continuing professional development courses for physiotherapists in Rwanda. Four phases of the project are described: (1) program proposal, needs assessment and planning, (2) organization of the program and instructional design, (3) instructional delivery and (4) evaluation. Contextual facilitating factors and needs informed choices in each phase. The model resulted in delivery of continuing professional development to the majority of physiotherapists in Rwanda (n = 168, 0.48 rural/0.52 urban) with participants reporting improvement in skills and perceived benefit for their patients. Environmental and healthcare system factors resulted in offering the courses in rural and urban areas. Content was developed and delivered in partnership with Rwandan coinstructors. Based on the domestic needs identified in early courses, the program included advocacy and leadership activities, in addition to practical and clinical instruction. The contextual factors (environment, healthcare service organization, need for rehabilitation and status and history of the physiotherapy profession) were essential for project and instructional choices. Facilitating factors included the established professional degree and association, continuing professional development requirements, a core group of active professionals and an existing foundation from other projects. The processes and contextual considerations may be useful in countries with established professional-level education but without established postentry-level training. Implications for Rehabilitation Organizations planning continuing professional development programs may benefit from considering the context surrounding training when planning, designing and developing instruction. The surrounding context including the environment, the organization of healthcare services, the population defined need for rehabilitation, and the domestic status and history of the physiotherapy profession, is important for physiotherapy projects in countries with lower resources. Facilitating factors in low resource countries such as an established professional degree and association, continuing professional development requirements, a core group of active professionals and an existing foundation from other projects impact the success of projects. Methods that may be useful for relevance, dissemination and consistency include involvement of in-country leaders and instructors and attendance in multiple courses with consistent themes. Rehabilitation professionals in low resource countries may benefit from continuing professional development courses that emphasize practical skills, and clinical reasoning, accompanied by clinical mentoring and directed coaching that encourages knowledge transfer to the clinical setting. Active learning approaches and multiple progressive courses provide opportunities to develop peer support through professional communities of practice.

Interventions to prevent respiratory diseases - Nutrition and the developing world.

PubMed

Karim, Tasneem; Muhit, Mohammad; Khandaker, Gulam

2017-03-01

Malnutrition is a major cause of morbidity and mortality in developing countries and nutrition plays a critical role in both acute and chronic respiratory conditions. Inadequacies in the nutritional requirements of a developing lung in utero and in early life can compromise the respiratory system integrity and result in poor lung function, reduced protection against infections, greater likelihood of acute illnesses in childhood and chronic illness in adulthood. Nutritional interventions harness great potential in reducing respiratory illness related morbidity and mortality in the developing world. In this review we have summarized the findings from published systematic reviews/meta-analysis, experimental and observational studies that looked into different nutritional interventions for preventing respiratory diseases in developing countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

General requirements to implement the personal dose equivalent Hp(10) in Brazil

NASA Astrophysics Data System (ADS)

Gomes Lopes, Amanda; Da Silva, Francisco Cesar Augusto

2018-03-01

To update the dosimetry quantity with the international community, Brazil is changing the Individual Dose (Hx) to the Personal Dose Equivalent Hp(10). A bibliographical survey on the technical and administrative requirements of nine countries that use Hp(10) was carried out to obtain the most relevant ones. All of them follow IEC and ISO guidelines for technical requirements, but administrative requirements change from country to country. Based on countries experiences, this paper presents a list of important general requirements to implement Hp(10) and to prepare the Brazilian requirements according to the international scientific community.

Technology and the future of medical equipment maintenance.

PubMed

Wear, J O

1999-05-01

Maintenance of medical equipment has been changing rapidly in the past few years. It is changing more rapidly in developed countries, but changes are also occurring in developing countries. Some of the changes may permit improved maintenance on the higher technology equipment in developing countries, since they do not require onsite expertise. Technology has had an increasing impact on the development of medical equipment with the increased use of microprocessors and computers. With miniaturization from space technology and electronic chip design, powerful microprocessors and computers have been built into medical equipment. The improvement in manufacturing technology has increased the quality of parts and therefore the medical equipment. This has resulted in increased mean time between failures and reduced maintenance needs. This has made equipment more reliable in remote areas and developing countries. The built-in computers and advances in software design have brought about self-diagnostics in medical equipment. The technicians now have a strong tool to be used in maintenance. One problem in this area is getting access to the self-diagnostics. Some manufacturers will not readily provide this access to the owner of the equipment. Advances in telecommunications in conjunction with self-diagnostics make available remote diagnosis and repair. Since components can no longer be repaired, a remote repair technician can instruct an operator or an on-site repairman on board replacement. In case of software problems, the remote repair technician may perform the repairs over the telephone. It is possible for the equipment to be monitored remotely by modern without interfering with the operation of the equipment. These changes in technology require the training of biomedical engineering technicians (BMETs) to change. They must have training in computers and telecommunications. Some of this training can be done with telecommunications and computers.

World Health Organization Public Health Model: A Roadmap for Palliative Care Development.

PubMed

Callaway, Mary V; Connor, Stephen R; Foley, Kathleen M

2018-02-01

The Open Society Foundation's International Palliative Care Initiative (IPCI) began to support palliative care development in Central and Eastern Europe and the Former Soviet Union in 1999. Twenty-five country representatives were invited to discuss the need for palliative care in their countries and to identify key areas that should be addressed to improve the care of adults and children with life-limiting illnesses. As a public health concern, progress in palliative care requires integration into health policy, education and training of health care professionals, availability of essential pain relieving medications, and health care services. IPCI created the Palliative Care Roadmap to serve as a model for government and/or nongovernment organizations to use to frame the necessary elements and steps for palliative care integration. The roadmap includes the creation of multiple Ministry of Health-approved working groups to address: palliative care inclusion in national health policy, legislation, and finance; availability of essential palliative care medications, especially oral opioids; education and training of health care professionals; and the implementation of palliative care services at home or in inpatient settings for adults and children. Each working group is tasked with developing a pathway with multiple signposts as indicators of progress made. The roadmap may be entered at different signposts depending upon the state of palliative care development in the country. The progress of the working groups often takes place simultaneously but at variable rates. Based on our experience, the IPCI Roadmap is one possible framework for palliative care development in resource constrained countries but requires both health care professional engagement and political will for progress to be made. Copyright © 2017. Published by Elsevier Inc.

Estimating the size of key populations at higher risk of HIV infection: a summary of experiences and lessons presented during a technical meeting on size estimation among key populations in Asian countries

PubMed Central

Calleja, Jesus Maria Garcia; Zhao, Jinkou; Reddy, Amala; Seguy, Nicole

2014-01-01

Problem Size estimates of key populations at higher risk of HIV exposure are recognized as critical for understanding the trajectory of the HIV epidemic and planning and monitoring an effective response, especially for countries with concentrated and low epidemics such as those in Asia. Context To help countries estimate population sizes of key populations, global guidelines were updated in 2011 to reflect new technical developments and recent field experiences in applying these methods. Action In September 2013, a meeting of programme managers and experts experienced with population size estimates (PSE) for key populations was held for 13 Asian countries. This article summarizes the key results presented, shares practical lessons learnt and reviews the methodological approaches from implementing PSE in 13 countries. Lessons learnt It is important to build capacity to collect, analyse and use PSE data; establish a technical review group; and implement a transparent, well documented process. Countries should adapt global PSE guidelines and maintain operational definitions that are more relevant and useable for country programmes. Development of methods for non-venue-based key populations requires more investment and collaborative efforts between countries and among partners. PMID:25320676

Ethical issues related to epilepsy care in the developing world.

PubMed

Tan, Chong-Tin; Avanzini, Giuliano

2009-05-01

There are three major issues of ethical concern related to epilepsy care in the developing world. First, is it ethical for a developing country to channel its limited resources from direct epilepsy care to research? The main considerations in addressing this question are the particular research questions to be addressed and whether such research will bring direct benefits to the local community. Second, in a country with limited resources, when does ignoring the high treatment gap become an ethical issue? This question is of particular concern when the community has enough resources to afford treatment for its poor, yet is not providing such care because of gross wastage and misallocation of the national resources. Third, do countries with plentiful resources have an ethical responsibility to help relieve the high epilepsy treatment gap of poor countries? Indeed, we believe that reasonable health care is a basic human right, and that human rights transcend national boundaries. Although health care is usually the responsibility of the nation-state, many modern states in the developing world are arbitrary creations of colonization. There is often a long process from the establishment of a political-legal state to a mature functional nation. During the long process of nation building, help from neighboring countries is often required.

Paediatric emergency and acute care in resource poor settings.

PubMed

Duke, Trevor; Cheema, Baljit

2016-02-01

Acute care of seriously ill children is a global public health issue, and there is much scope for improving quality of care in hospitals at all levels in many developing countries. We describe the current state of paediatric emergency and acute care in the least developed regions of low and middle income countries and identify gaps and requirements for improving quality. Approaches are needed which span the continuum of care: from triage and emergency treatment, the diagnostic process, identification of co-morbidities, treatment, monitoring and supportive care, discharge planning and follow-up. Improvements require support and training for health workers and quality processes. Effective training is that which is ongoing, combining good technical training in under-graduate courses and continuing professional development. Quality processes combine evidence-based guidelines, essential medicines, appropriate technology, appropriate financing of services, standards and assessment tools and training resources. While initial emergency treatment is based on common clinical syndromes, early differentiation is required for specific treatment, and this can usually be carried out clinically without expensive tests. While global strategies are important, it is what happens locally that makes a difference and is too often neglected. In rural areas in the poorest countries in the world, public doctors and nurses who provide emergency and acute care for children are revered by their communities and demonstrate daily that much can be carried out with little. © 2016 The Authors. Journal of Paediatrics and Child Health © 2016 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Adoption of Requirements Engineering Practices in Malaysian Software Development Companies

NASA Astrophysics Data System (ADS)

Solemon, Badariah; Sahibuddin, Shamsul; Ghani, Abdul Azim Abd

This paper presents exploratory survey results on Requirements Engineering (RE) practices of some software development companies in Malaysia. The survey attempted to identify patterns of RE practices the companies are implementing. Information required for the survey was obtained through a survey, mailed self-administered questionnaires distributed to project managers and software developers who are working at software development companies operated across the country. The results showed that the overall adoption of the RE practices in these companies is strong. However, the results also indicated that fewer companies in the survey have use appropriate CASE tools or software to support their RE process and practices, define traceability policies and maintain traceability manual in their projects.

Obesity, the metabolic syndrome, and type 2 diabetes in developing countries: role of dietary fats and oils.

PubMed

Misra, Anoop; Singhal, Neha; Khurana, Lokesh

2010-06-01

Developing countries are undergoing rapid nutrition transition concurrent with increases in obesity, the metabolic syndrome, and type 2 diabetes mellitus (T2DM). From a healthy traditional high-fiber, low-fat, low-calorie diet, a shift is occurring toward increasing consumption of calorie-dense foods containing refined carbohydrates, fats, red meats, and low fiber. Data show an increase in the supply of animal fats and increased intake of saturated fatty acid (SFAs) (obtained from coconut oil, palm oil, and ghee [clarified butter]) in many developing countries, particularly in South Asia and South-East Asia. In some South Asian populations, particularly among vegetarians, intake of n-3 polyunsaturated fatty acids (PUFAs) (obtained from flaxseed, mustard, and canola oils) and long-chain (LC) n-3 PUFAs (obtained from fish and fish oils) is low. Further, the effect of supplementation of n-3 PUFAs on metabolic risk factors and insulin resistance, except for demonstrated benefit in terms of decreased triglycerides, needs further investigation among South Asians. Data also show that intake of monounsaturated fatty acids (MUFAs) ranged from 4.7% to 16.4%en in developing countries, and supplementing it from olive, canola, mustard, groundnut, and rice bran oils may reduce metabolic risk. In addition, in some developing countries, intake of n-6 PUFAs (obtained from sunflower, safflower, corn, soybean, and sesame oils) and trans-fatty acids (TFAs) is increasing. These data show imbalanced consumption of fats and oils in developing countries, which may have potentially deleterious metabolic and glycemic consequences, although more research is needed. In view of the rapid rise of T2DM in developing countries, more aggressive public health awareness programs coupled with governmental action and clear country-specific guidelines are required, so as to promote widespread use of healthy oils, thus curbing intake of SFAs and TFAs, and increasing intake of n-3 PUFAs and MUFAs. Such actions would contribute to decelerating further escalation of "epidemics" of obesity, the metabolic syndrome, and T2DM in developing countries.

Working to improve the management of sarcoma patients across Europe: a policy checklist.

PubMed

Kasper, Bernd; Lecointe-Artzner, Estelle; Wait, Suzanne; Boldon, Shannon; Wilson, Roger; Gronchi, Alessandro; Valverde, Claudia; Eriksson, Mikael; Dumont, Sarah; Drove, Nora; Kanli, Athanasia; Wartenberg, Markus

2018-04-16

The Sarcoma Policy Checklist was created by a multidisciplinary expert group to provide policymakers with priority areas to improve care for sarcoma patients. This paper draws on this research, by looking more closely at how France, Germany, Italy, Spain, Sweden and the United Kingdom are addressing each of these priority areas. It aims to highlight key gaps in research, policy and practice, as well as ongoing initiatives that may impact the future care of sarcoma patients in different European countries. A pragmatic review of the published and web-based literature was undertaken. Telephone interviews were conducted in each country with clinical and patient experts to substantiate findings. Research findings were discussed within the expert group and developed into five core policy recommendations. The five identified priority areas were: the development of designated and accredited centres of reference; more professional training; multidisciplinary care; greater incentives for research and innovation; and more rapid access to effective treatments. Most of the countries studied have ongoing initiatives addressing many of these priorities; however, many are in early stages of development, or require additional funding and resources. Gaps in access to quality care are particularly concerning in many of Europe's lower-resourced countries. Equitable access to information, clinical trials, innovative treatments and quality specialist care should be available to all sarcoma patients. Achieving this across Europe will require close collaboration between all stakeholders at both the national and European level.

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 and application of modern agricultural biotechnology in Botswana: The potentials, opportunities and challenges

PubMed Central

Batlang, Utlwang; Tsurupe, Gorata; Segwagwe, Amogelang; Obopile, Motshwari

2014-01-01

In Botswana, approximately 40% of the population live in rural areas and derive most of their livelihood from agriculture by keeping livestock and practising arable farming. Due to the nature of their farming practises livestock and crops are exposed to diseases and environmental stresses. These challenges offer opportunities for application of biotechnology to develop adaptable materials to the country's environment. On the other hand, the perceived risk of genetically modified organisms (GMOs) has dimmed the promise of the technology for its application in agriculture. This calls for a holistic approach to the application of biotechnology to address issues of biosafety of GMOs. We have therefore assessed the potentials, challenges and opportunities to apply biotechnology with specific emphasis on agriculture, taking cognisance of requirement for its research, development and application in research and teaching institutions. In order to achieve this, resource availability, infrastructure, human and laboratory requirements were analyzed. The analysis revealed that the country has the capacity to carry out research in biotechnology in the development and production of genetically modified crops for food and fodder crops. These will include gene discovery, genetic transformation and development of systems to comply with the world regulatory framework on biosafety. In view of the challenges facing the country in agriculture, first generation biotech crops could be released for production. Novel GM products for development may include disease diagnosis kits, animal disease vaccines, and nutrient use efficiency, drought, and pest and disease resistant food and fodder crops. PMID:25437237

Development and application of modern agricultural biotechnology in Botswana: the potentials, opportunities and challenges.

PubMed

Batlang, Utlwang; Tsurupe, Gorata; Segwagwe, Amogelang; Obopile, Motshwari

2014-07-03

In Botswana, approximately 40% of the population live in rural areas and derive most of their livelihood from agriculture by keeping livestock and practising arable farming. Due to the nature of their farming practises livestock and crops are exposed to diseases and environmental stresses. These challenges offer opportunities for application of biotechnology to develop adaptable materials to the country's environment. On the other hand, the perceived risk of genetically modified organisms (GMOs) has dimmed the promise of the technology for its application in agriculture. This calls for a holistic approach to the application of biotechnology to address issues of biosafety of GMOs. We have therefore assessed the potentials, challenges and opportunities to apply biotechnology with specific emphasis on agriculture, taking cognisance of requirement for its research, development and application in research and teaching institutions. In order to achieve this, resource availability, infrastructure, human and laboratory requirements were analyzed. The analysis revealed that the country has the capacity to carry out research in biotechnology in the development and production of genetically modified crops for food and fodder crops. These will include gene discovery, genetic transformation and development of systems to comply with the world regulatory framework on biosafety. In view of the challenges facing the country in agriculture, first generation biotech crops could be released for production. Novel GM products for development may include disease diagnosis kits, animal disease vaccines, and nutrient use efficiency, drought, and pest and disease resistant food and fodder crops.

Dealing with Uncertainty and Accounting for Social Value Judgments in Assessments of Orphan Drugs: Evidence from Four European Countries.

PubMed

Nicod, Elena; Berg Brigham, Karen; Durand-Zaleski, Isabelle; Kanavos, Panos

To better understand the reasons for differences in reimbursement decisions for orphan drugs in four European countries that were not readily apparent from health technology assessment (HTA) reports and operating procedures. Semistructured interviews with representatives of HTA bodies in England, Scotland, Sweden, and France were conducted. An interview topic guide was developed on the basis of findings from a systematic comparison of HTA decisions for 10 orphan drugs. Qualitative thematic data analysis was applied to the interview transcripts using the framework approach. Eight representatives from the four HTA bodies were interviewed between March and June 2015. Evidentiary requirements and approaches to dealing with imperfect or incomplete evidence were explored, including trial design and duration, study population and subgroups, comparators, and end points. Interviewees agreed that decisions regarding orphan drugs are made in a context of lower quality evidence, and the threshold of acceptable uncertainty varied by country. Some countries imposed higher evidentiary standards for greater clinical claims, which may be more challenging for orphan diseases. The acceptability of surrogate end points was not consistent across countries nor were the validation requirements. The most common social value judgments identified related to innovation, disease severity, and unmet need. Differences were seen in the way these concepts were defined and accounted for across countries. Although agreement was seen in evidentiary requirements or preferences, there were subtle differences in the circumstances in which uncertain evidence may be considered acceptable, possibly explaining differences in HTA recommendations across countries. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Protecting the confidentiality and security of personal health information in low- and middle-income countries in the era of SDGs and Big Data.

PubMed

Beck, Eduard J; Gill, Wayne; De Lay, Paul R

2016-01-01

As increasing amounts of personal information are being collected through a plethora of electronic modalities by statutory and non-statutory organizations, ensuring the confidentiality and security of such information has become a major issue globally. While the use of many of these media can be beneficial to individuals or populations, they can also be open to abuse by individuals or statutory and non-statutory organizations. Recent examples include collection of personal information by national security systems and the development of national programs like the Chinese Social Credit System. In many low- and middle-income countries, an increasing amount of personal health information is being collected. The collection of personal health information is necessary, in order to develop longitudinal medical records and to monitor and evaluate the use, cost, outcome, and impact of health services at facility, sub-national, and national levels. However, if personal health information is not held confidentially and securely, individuals with communicable or non-communicable diseases (NCDs) may be reluctant to use preventive or therapeutic health services, due to fear of being stigmatized or discriminated against. While policymakers and other stakeholders in these countries recognize the need to develop and implement policies for protecting the privacy, confidentiality and security of personal health information, to date few of these countries have developed, let alone implemented, coherent policies. The global HIV response continues to emphasize the importance of collecting HIV-health information, recently re-iterated by the Fast Track to End AIDS by 2030 program and the recent changes in the Guidelines on When to Start Antiretroviral Therapy and on Pre-exposure Prophylaxis for HIV . The success of developing HIV treatment cascades in low- and middle-income countries will require the development of National Health Identification Systems. The success of programs like Universal Health Coverage, under the recently ratified Sustainable Development Goals is also contingent on the availability of personal health information for communicable and non-communicable diseases. Guidance for countries to develop and implement their own guidelines for protecting HIV-information formed the basis of identifying a number of fundamental principles, governing the areas of privacy, confidentiality and security. The use of individual-level data must balance maximizing the benefits from their most effective and fullest use, and minimizing harm resulting from their malicious or inadvertent release. These general principles are described in this paper, as along with a bibliography referring to more detailed technical information. A country assessment tool and user's manual, based on these principles, have been developed to support countries to assess the privacy, confidentiality, and security of personal health information at facility, data warehouse/repository, and national levels. The successful development and implementation of national guidance will require strong collaboration at local, regional, and national levels, and this is a pre-condition for the successful implementation of a range of national and global programs. This paper is a call for action for stakeholders in low- and middle-income countries to develop and implement such coherent policies and provides fundamental principles governing the areas of privacy, confidentiality, and security of personal health information being collected in low- and middle-income countries.

The role of health technology assessment on pharmaceutical reimbursement in selected middle-income countries.

PubMed

Oortwijn, Wija; Mathijssen, Judith; Banta, David

2010-05-01

Middle-income countries are often referred to as developing or emerging economies and face multiple challenges of severe financial stresses in their health care sectors, and high disease burden. The objective of this study is to provide an overview of how health technology assessment (HTA) is used and organized in selected middle-income countries and its role in the process of pharmaceutical coverage. We selected middle-income countries where HTA activities are evident: Argentina, Brazil, China, Colombia, Israel, Mexico, Philippines, Korea, Taiwan, Thailand, and Turkey. We collected and reviewed relevant information to describe the health care and reimbursement systems and how HTA relates to coverage decision-making of pharmaceuticals. This was supplemented by information from a structured survey among professionals working in public and private health insurance, industry, regulatory authorities, ministries of health, academic units or HTA. All countries require market authorization for pharmaceuticals to be sold and most countries have a national plan defining which pharmaceuticals can be reimbursed. However, the use of HTA in reimbursement decisions is still in its early stages with varying levels of HTA guidance implementation. The study provides evidence of the development of HTA in coverage decision-making in middle-income countries. Increased health care spending and the resulting access to modern technology give a strong impetus to HTA. However, HTA is developing with uneven speed in middle-income countries and many countries are building on the organisational and methodological experience from established HTA agencies. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

77 FR 6815 - Agency Information Collection Activities: Country of Origin Marking Requirements for Containers...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... Activities: Country of Origin Marking Requirements for Containers or Holders AGENCY: U.S. Customs and Border... information collection requirement concerning Country of Origin Marking Requirements for Containers or Holders... request for Office of Management and Budget (OMB) approval. All comments will become a matter of public...

Seroprevalence of anti-hepatitis E virus antibodies in domestic pigs in Mexico.

PubMed

García-Hernández, Montserrat Elemi; Cruz-Rivera, Mayra; Sánchez-Betancourt, José Iván; Rico-Chávez, Oscar; Vergara-Castañeda, Arely; Trujillo, María E; Sarmiento-Silva, Rosa Elena

2017-09-21

Hepatitis E virus (HEV) infection is one of the most common causes of acute liver diseases in humans worldwide. In developing countries, HEV is commonly associated with waterborne outbreaks. Conversely, in industrialized countries, HEV infection is often associated with travel to endemic regions or ingestion of contaminated animal products. Limited information on both, human and animal HEV infection in Mexico is available. As a consequence, the distribution of the virus in the country is largely unknown. Here, we assessed the seroprevalence of HEV among swine in different geographical regions in Mexico. Seroprevalence of anti-HEV antibodies in swine herds in Mexico was evaluated in a representative sample including 945 pig serum specimens from different regions of the country using a commercial enzyme-linked immunosorbent assay (ELISA). The overall prevalence of anti-HEV antibodies in swine was 59.4%. The northern region of Mexico exhibited the highest seroprevalence in the country (86.6%), while the central and southern regions in Mexico showed lower seroprevalence, 42.7% and 51.5%, respectively. In Mexico, HEV seroprevalence in swine is high. Importantly, northern Mexico showed the highest seroprevalence in the country. Thus, further studies are required to identify the risk factors contributing to HEV transmission among pigs in the country. Assessment of HEV human infection in the context of viral transmission in swine is required to better understand the epidemiology of hepatitis E in Mexico.

Developing leaders' strategic thinking through global work experience: the moderating role of cultural distance.

PubMed

Dragoni, Lisa; Oh, In-Sue; Tesluk, Paul E; Moore, Ozias A; VanKatwyk, Paul; Hazucha, Joy

2014-09-01

To respond to the challenge of how organizations can develop leaders who can think strategically, we investigate the relation of leaders' global work experiences--that is, those experiences that require the role incumbent to transcend national boundaries--to their competency in strategic thinking. We further examine whether leaders' exposure to a country whose culture is quite distinct from the culture of their own country (i.e., one that is culturally distant) moderates these relationships. Our analyses of 231 upper level leaders reveals that the time they have spent in global work experiences positively relates to their strategic thinking competency, particularly for leaders who have had exposure to a more culturally distant country. We discuss these findings in light of the research on international work experiences and leader development. PsycINFO Database Record (c) 2014 APA, all rights reserved.

The introduction of new vaccines into developing countries. III. The role of intellectual property.

PubMed

Mahoney, Richard T; Pablos-Mendez, Ariel; Ramachandran, S

2004-01-26

The development of new vaccines that address the particular needs of developing countries has been proceeding slowly. A number of new public sector vaccine research and development initiatives have been launched to address this problem. These new initiatives find that they often wish to collaborate with the private sector and, in collaborating with the private sector, they must address issues of intellectual property (IP) management. It has not been well understood why IP management is important and how such management by public sector groups can best be conducted. IP management has become very important because vaccine research and development is driven by the regulatory process. The regulatory process has increased the cost of vaccine development to very high levels especially for the highly sophisticated new vaccines currently under development. Thus, investors seek IP protection for the required large investments. Conversely, we assert this concept as a new insight, IP rights are essential for mobilizing the significant funds necessary to meet regulatory requirements. Thus, IP rights are of value not only for investors but also for the public at large. In the absence of public sector mechanisms to carry out the functions that the private sector currently conducts, the public sector needs to increase its sophistication in IP management and needs to identify and implement strategies that will help the public sector to achieve its public health goals, especially for the poor and, among these individuals, the poor in developing countries. This paper suggests some strategies that might be used by the public sector to help achieve its public health goals, especially for the poor.

Agricultural soil greenhouse gas emissions: a review of national inventory methods.

PubMed

Lokupitiya, Erandathie; Paustian, Keith

2006-01-01

Parties to the United Nations Framework Convention on Climate Change (UNFCCC) are required to submit national greenhouse gas (GHG) inventories, together with information on methods used in estimating their emissions. Currently agricultural activities contribute a significant portion (approximately 20%) of global anthropogenic GHG emissions, and agricultural soils have been identified as one of the main GHG source categories within the agricultural sector. However, compared to many other GHG sources, inventory methods for soils are relatively more complex and have been implemented only to varying degrees among member countries. This review summarizes and evaluates the methods used by Annex 1 countries in estimating CO2 and N2O emissions in agricultural soils. While most countries utilize the Intergovernmental Panel on Climate Change (IPCC) default methodology, several Annex 1 countries are developing more advanced methods that are tailored for specific country circumstances. Based on the latest national inventory reporting, about 56% of the Annex 1 countries use IPCC Tier 1 methods, about 26% use Tier 2 methods, and about 18% do not estimate or report N2O emissions from agricultural soils. More than 65% of the countries do not report CO2 emissions from the cultivation of mineral soils, organic soils, or liming, and only a handful of countries have used country-specific, Tier 3 methods. Tier 3 methods usually involve process-based models and detailed, geographically specific activity data. Such methods can provide more robust, accurate estimates of emissions and removals but require greater diligence in documentation, transparency, and uncertainty assessment to ensure comparability between countries. Availability of detailed, spatially explicit activity data is a major constraint to implementing higher tiered methods in many countries.

Intelligence in Bali--A Case Study on Estimating Mean IQ for a Population Using Various Corrections Based on Theory and Empirical Findings

ERIC Educational Resources Information Center

Rindermann, Heiner; te Nijenhuis, Jan

2012-01-01

A high-quality estimate of the mean IQ of a country requires giving a well-validated test to a nationally representative sample, which usually is not feasible in developing countries. So, we used a convenience sample and four corrections based on theory and empirical findings to arrive at a good-quality estimate of the mean IQ in Bali. Our study…

Mapping health research capacity in 17 countries of the former Soviet Union and south-eastern Europe: an exploratory study.

PubMed

Santoro, Alessio; Glonti, Ketevan; Bertollini, Roberto; Ricciardi, Walter; McKee, Martin

2016-04-01

Policies to improve health status, tackle disease and ensure equitable access to healthcare should be informed by evidence derived from high-quality research. However, health research capacity is unevenly distributed across countries, as revealed by mapping exercises that have been undertaken to provide a basis for concerted action to strengthen capacity. This study systematically describes capacity to undertake health research in the countries of the former Soviet Union and south-eastern Europe and identifies the elements required to create a national health research system. The mapping exercise comprised two elements: a survey of key informants in the respective countries and a bibliometric analysis of scientific publications in the field of public health. Our results confirm that health research remains a low priority in some countries of the WHO European Region. In these countries, most of the literature was produced by researchers outside the country, often to inform international donors. This study provides important information for countries seeking to initiate action to strengthen their research capacity. There is a need for a comprehensive strategy with sustained investment in training and career development of researchers. There is also a need to create new funding systems to provide financial support to those undertaking policy-relevant research. International collaboration and investment in mechanisms to bridge the gap between research and policy are urgently required. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

A comparative review of governments' views on objectives and policy instruments in the field of population and development.

PubMed

1982-01-01

It is possible to assess population policies through statements and decisions taken by governments as they reflect the views and commitments of political authorities in the field of population and development. Cases in the following African countries are reviewed with focus on objectives and policy instruments: Algeria; Angola; Benin; Botswana; Cape Verde; Central African Republic; Congo; Djibouti; Egypt; Ethiopia; Guinea; Gabon; Gambia; Ghana; Equatorial Guinea; Guinea-Bissau; Ivory Coast; Kenya; Lesotho; Liberia; Libyan Arab Jamahiriya; Madagascar; Malawi; Mali; Mauritania; Mauritius; Morocco; Mozambique; Niger; Nigeria; Rwanda; Sao Tome and Principe; Senegal; Seychelles; Sierra Leone; Somalia; Sudan; Swaziland; Togo; Tunisia; Uganda; United Republic of Cameroon; Tanzania; Upper Volta; Zaire; Zambia; and Zimbabwe. The information presented was drawn from the following publications: UN Population Division, "Population Policy Briefs: Current Situation in Developing Countries and Selected Territories," and UNFPA, "Population Programs and Projects," Volume 2, 1980-1981. On the basis of this review the following conclusions are drawn, which could indicate areas in which technical assistance to the Economic Commission for Africa (ECA) member States would be required: among the 50 country members of ECA, 34 countries (68%) have as a development objective the reduction of mortality, and in particular, maternal and child mortality; the 2nd important objective is stabilizing or improving spatial distribution of population, and 44% of the 50 countries have adopted this objective which involves the distribution of population from 1 place to another within a country; the 3rd important objective consists of restricting the migratory flow from rural areas to urban areas; the countries of Botswana, Egypt, Ghana, Kenya, Lesotho, Mauritius, Morocco, Rwanda, Seychelles, Swaziland, and Tunisia adopted the objective of reducing the rate of population growth; 34% of African countries have decided to integrate family planning programs with health services; and only 20% of African countries have announced socioeconomic development as an instrument to solve their population problems.

Judging doctor supply--market or health criteria?

PubMed

Roemer, M I

1988-01-01

Large rural areas of developing countries show severe shortages of physicians, graduate nurses, and other trained health personnel. Countries have tried to alleviate this problem in several ways, including requiring all new medical graduates to 1st undertake periods of service in rural areas, the use of mobile clinic teams from small towns to visit outlying villages on a regular basis, and the use of air ambulances to transport seriously ill persons from isolated places to hospitals in cities. Perhaps the most significant strategy has been the use of trained community workers to provide primary health care for rural and low-income urban populations. Unfortunately, weak supervision of the community workers has often led to unsatisfactory performances. Surprisingly, a recent international congress claimed that many developing countries are training too many doctors, that some developing countries have, or will soon have, 1000s of unemployed physicians. However, comparison with developed countries shows that the "diagnosis" of a country's doctor supply situation may not depend on a universal standard, but on that job market's capacity for absorption of personnel. If specific public health goals are to be reached however, commercial criteria cannot be applied to the evaluation of a nation's health manpower; instead social need must be analyzed and strategies designed to meet them. Policy is shaped by the priority public authorities give to services. Of the 7 developing countries which reported a surplus of doctors, only Colombia and Mexico reported spending more on public health than on the military. In addition, in the other 5 countries, 40% or less of the overall public and private expenditures on health came from the government. When military expenditures absorb a high share of government funds, public support for health services is adversely affected, and individuals and families must depend on their own expenditures to obtain health services. Health services should be recognized as a basic human right, and, therefore, as an obligation of society. To meet this obligation necessary strategies are 1) increase public support, not only by increasing the health share of the general budget, but by other sources such as social security and community financing, 2) require 5-10 years of social service for all medical school graduates, 3) ensure that renumeration for doctors in public service is adequate to support a decent standard of living, 4) continue to train community health workers, but ensure physicians are qualified to supervise them, and, 5) health services and health manpower should be guided by principles of social justice, not by those of commercial market dynamics.

Autologous Serum Therapy in Chronic Urticaria

PubMed Central

Patil, Sharmila; Sharma, Nidhi; Godse, Kiran

2013-01-01

Autologous serum therapy is a promising therapy for treatment resistant urticaria. This is useful in developing countries as this is economical option. Minimum instruments like centrifuge, syringe and needles are required for the procedure. PMID:23723475

Class A and Class B UST Operator Exams

EPA Pesticide Factsheets

Learn about exams developed by EPA to help underground storage tank system owners and operators in Indian country meet the 2015 federal UST regulation requirement that designated operators demonstrate knowledge and pass an exam.

Examining Progress and Equity in Information Received by Women Using a Modern Method in 25 Developing Countries.

PubMed

Jain, Anrudh K

2016-09-01

The information exchanged during a contraceptive visit is important because providers need to understand clients' reproductive intentions and clients need to receive adequate information about methods and possible method-related side effects and problems. Little is known about how information exchange has changed over time and how it might vary across countries or subgroups within a country. Demographic and Health Survey data from 25 developing countries were used to calculate the Method Information Index (MII), a Family Planning 2020 indicator that reflects some aspects of contraceptive information exchanged between providers and clients. For each country, the MII was calculated from each of two surveys about five years apart to examine change in the indicator over time. In addition, the MII was examined for all countries combined and by region. The average MII for all 25 countries increased from 34% at the earlier survey time to 39% at the later survey time; the index values of individual countries ranged from 19% to 64% at survey time 1 and from 13% to 65% at survey time 2. The MII increased over time in 15 countries and declined in 10. In analyses by contraceptive method type, the MII tended to be highest among implant users and lowest among women relying on sterilization. The index was generally higher among women living in urban areas than among those in rural areas, and tended to rise with increases in women's education and household wealth. On the basis of the MII, developing countries have room to improve information exchange between providers and clients. Such improvements would require concerted efforts by programs and donors.

Developed and developing world responsibilities for historical climate change and CO2 mitigation.

PubMed

Wei, Ting; Yang, Shili; Moore, John C; Shi, Peijun; Cui, Xuefeng; Duan, Qingyun; Xu, Bing; Dai, Yongjiu; Yuan, Wenping; Wei, Xin; Yang, Zhipeng; Wen, Tijian; Teng, Fei; Gao, Yun; Chou, Jieming; Yan, Xiaodong; Wei, Zhigang; Guo, Yan; Jiang, Yundi; Gao, Xuejie; Wang, Kaicun; Zheng, Xiaogu; Ren, Fumin; Lv, Shihua; Yu, Yongqiang; Liu, Bin; Luo, Yong; Li, Weijing; Ji, Duoying; Feng, Jinming; Wu, Qizhong; Cheng, Huaqiong; He, Jiankun; Fu, Congbin; Ye, Duzheng; Xu, Guanhua; Dong, Wenjie

2012-08-07

At the United Nations Framework Convention on Climate Change Conference in Cancun, in November 2010, the Heads of State reached an agreement on the aim of limiting the global temperature rise to 2 °C relative to preindustrial levels. They recognized that long-term future warming is primarily constrained by cumulative anthropogenic greenhouse gas emissions, that deep cuts in global emissions are required, and that action based on equity must be taken to meet this objective. However, negotiations on emission reduction among countries are increasingly fraught with difficulty, partly because of arguments about the responsibility for the ongoing temperature rise. Simulations with two earth-system models (NCAR/CESM and BNU-ESM) demonstrate that developed countries had contributed about 60-80%, developing countries about 20-40%, to the global temperature rise, upper ocean warming, and sea-ice reduction by 2005. Enacting pledges made at Cancun with continuation to 2100 leads to a reduction in global temperature rise relative to business as usual with a 1/3-2/3 (CESM 33-67%, BNU-ESM 35-65%) contribution from developed and developing countries, respectively. To prevent a temperature rise by 2 °C or more in 2100, it is necessary to fill the gap with more ambitious mitigation efforts.

Harmonization of good laboratory practice requirements and laboratory accreditation programs.

PubMed

Royal, P D

1994-09-01

Efforts to harmonize Good Laboratory Practice (GLP) requirements have been underway through the Organization for Economic Cooperation and Development (OECD) since 1981. In 1985, a GLP panel was established to facilitate the practical implementation of the OECD/GLP program. Through the OECD/GLP program, Memoranda of Understanding (MOU) agreements which foster requirements for reciprocal data and study acceptance and unified GLP standards have been developed among member countries. Three OECD Consensus Workshops and three inspectors training workshops have been held. In concert with these efforts, several OECD countries have developed GLP accreditation programs, managed by local health and environmental ministries. In addition, Canada and the United States are investigating Laboratory Accreditation programs for environmental monitoring assessment and GLP-regulated studies. In the European Community (EC), the need for quality standards specifying requirements for production and international trade has promoted International Standards Organization (ISO) certification for certain products. ISO-9000 standards identify requirements for certification of quality systems. These certification programs may affect the trade and market of laboratories conducting GLP studies. Two goals identified by these efforts are common to both programs: first, harmonization and recognition of requirements, and second, confidence in the rigor of program components used to assess the integrity of data produced and study activities. This confidence can be promoted, in part, through laboratory inspection and screening processes. However, the question remains, will data produced by sanctioned laboratories be mutually accepted on an international basis?(ABSTRACT TRUNCATED AT 250 WORDS)

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.

Socioeconomic disadvantage and adolescent women's sexual and reproductive behavior: the case of five developed countries.

PubMed

Singh, S; Darroch, J E; Frost, J J

2001-01-01

Differences among developed countries in teenagers' patterns of sexual and reproductive behavior may partly reflect differences in the extent of disadvantage. However, to date, this potential contribution has received little attention. Researchers in Canada, France, Great Britain, Sweden and the United States used the most current survey and other data to study adolescent sexual and reproductive behavior. Comparisons were made within and across countries to assess the relationships between these behaviors and factors that may indicate disadvantage. Adolescent childbearing is more likely among women with low levels of income and education than among their better-off peers. Levels of childbearing are also strongly related to race, ethnicity and immigrant status, but these differences vary across countries. Early sexual activity has little association with income, but young women who have little education are more likely to initiate intercourse during adolescence than those who are better educated. Contraceptive use at first intercourse differs substantially according to socioeconomic status in some countries but not in others. Within countries, current contraceptive use does not differ greatly according to economic status, but at each economic level, use is higher in Great Britain than in the United States. Regardless of their socioeconomic status, U.S. women are the most likely to give birth as adolescents. In addition, larger proportions of adolescents are disadvantaged in the United States than in other developed countries. Comparatively widespread disadvantage in the United States helps explain why U.S. teenagers have higher birthrates andpregnancy rates than those in other developed countries. Improving U.S. teenagers' sexual and reproductive behavior requires strategies to reduce the numbers of young people growing up in disadvantaged conditions and to help those who are disadvantaged overcome the obstacles they face.

Response to issues on GM agriculture in Africa: Are transgenic crops safe?

PubMed

Adenle, Ademola A

2011-10-08

The controversies surrounding transgenic crops, often called Genetically Modified Organisms (GMOs), call for a need to raise the level of public awareness of Genetic Modification (GM) technology in Africa. This should be accomplished by educating the public about the potential benefits and risks that may be associated with this new technology. In the last 15 years, GM crop producing countries have benefited from adoption of this new technology in the form of improved crop productivity, food security, and quality of life. The increased income to resource-poor farmers is a key benefit at the individual level especially as most countries using this technology are in the developing world, including three African countries (South Africa, Burkina Faso and Egypt). Despite clear benefits to countries and farmers who grow GMOs, many people are concerned about suspected potential risks associated with GMOs. This sparks debate as to whether GM technology should be adopted or not. Given the concerns regarding the safety of GMO products, thorough scientific investigation of safe application of GMOs is required. The objective of this paper is to respond to the issues of GM agriculture in Africa and some of the issues surrounding the adoption of GM crops between developed and developing countries. In this article, I analyse relevant papers relating to the adoption of GM technology particularly in developing countries including the few African countries that have adopted GM crops. The issues discussed span a wide range including: safety; potential benefits and risks; disputes between the United States of America (USA) and the European Union (EU) over adoption of GM crops with a focus on Africa continent. This article is concluded by summarising the issues raised and how GM technology can be adopted for agricultural development in Africa.

Response to issues on GM agriculture in Africa: Are transgenic crops safe?

PubMed Central

2011-01-01

The controversies surrounding transgenic crops, often called Genetically Modified Organisms (GMOs), call for a need to raise the level of public awareness of Genetic Modification (GM) technology in Africa. This should be accomplished by educating the public about the potential benefits and risks that may be associated with this new technology. In the last 15 years, GM crop producing countries have benefited from adoption of this new technology in the form of improved crop productivity, food security, and quality of life. The increased income to resource-poor farmers is a key benefit at the individual level especially as most countries using this technology are in the developing world, including three African countries (South Africa, Burkina Faso and Egypt). Despite clear benefits to countries and farmers who grow GMOs, many people are concerned about suspected potential risks associated with GMOs. This sparks debate as to whether GM technology should be adopted or not. Given the concerns regarding the safety of GMO products, thorough scientific investigation of safe application of GMOs is required. The objective of this paper is to respond to the issues of GM agriculture in Africa and some of the issues surrounding the adoption of GM crops between developed and developing countries. In this article, I analyse relevant papers relating to the adoption of GM technology particularly in developing countries including the few African countries that have adopted GM crops. The issues discussed span a wide range including: safety; potential benefits and risks; disputes between the United States of America (USA) and the European Union (EU) over adoption of GM crops with a focus on Africa continent. This article is concluded by summarising the issues raised and how GM technology can be adopted for agricultural development in Africa. PMID:21981823

Obesity and the metabolic syndrome in developing countries: focus on South Asians.

PubMed

Misra, Anoop; Bhardwaj, Swati

2014-01-01

With improvement in the economic situation, an increasing prevalence of obesity and the metabolic syndrome is seen in developing countries in South Asia. Particularly vulnerable population groups include women and children, and intra-country and inter-country migrants. The main causes are increasing urbanization, nutrition transition, reduced physical activity, and genetic predisposition. Some evidence suggests that widely prevalent perinatal undernutrition and childhood 'catch-up' obesity may play a role in adult-onset metabolic syndrome and type 2 diabetes. Data show that atherogenic dyslipidemia, glucose intolerance, thrombotic tendency, subclinical inflammation, and endothelial dysfunction are higher in South Asians than white Caucasians. Many of these manifestations are more severe even at an early age in South Asians than white Caucasians. Metabolic and cardiovascular risks in South Asians are also heightened by their higher body fat, truncal subcutaneous fat, intra-abdominal fat, and ectopic fat deposition (liver fat, muscle fat, etc.). Further, cardiovascular risk cluster manifests at a lower level of adiposity and abdominal obesity. The cutoffs of body mass index and waist circumference for defining obesity and abdominal obesity, respectively, have been lowered for Asians, and same has been endorsed for South Asians in the UK. The economic cost of obesity and related diseases in developing countries, having meager health budget, is enormous. Increasing awareness of these noncommunicable diseases and how to prevent them should be focus of population-wide prevention strategies in South Asian developing countries. Community intervention programs focusing on increased physical activity and healthier food options for schoolchildren are urgently required. Data from such a major intervention program conducted by us on adolescent urban schoolchildren in north India (project MARG) have shown encouraging results and could serve as a model for initiating such programs in other South Asian developing countries.

Obstetric fistula in low and middle income countries.

PubMed

Capes, Tracy; Ascher-Walsh, Charles; Abdoulaye, Idrissa; Brodman, Michael

2011-01-01

Vesicovaginal fistula secondary to obstructed labor continues to be an all-too-common occurrence in underdeveloped nations throughout Africa and Asia. Vesicovaginal fistula remains largely an overlooked problem in developing nations as it affects the most marginalized members of society: young, poor, illiterate women who live in remote areas. The formation of obstetric fistula is a result of complex interactions of social, biologic, and economic influences. The key underlying causes of fistula are the combination of a lack of functional emergency obstetric care, poverty, illiteracy, and low status of women. In order to prevent fistula, some strategies include creation of governmental policy aimed toward reducing maternal mortality/morbidity and increasing availability of skilled obstetric care, as well as attempts to increase awareness about its prevention and treatment among policymakers, service providers, and communities. Whereas prevention will require the widespread development of infrastructure within these developing countries, treatment of fistula is an act which can be done "in the now." Treatment and subsequent reintegration of fistula patients requires a team of specialists including surgeons, nurses, midwives, and social workers, which is largely unavailable in developing countries. However, there is increasing support for training of fistula surgeons through standardized programs as well as establishment of rehabilitation centers in many nations. The eradication of fistula is dependent upon building programs that target both prevention and treatment. © 2011 Mount Sinai School of Medicine.

Articles by Latin American Authors in Prestigious Journals Have Fewer Citations

PubMed Central

Meneghini, Rogerio; Packer, Abel L.; Nassi-Calò, Lilian

2008-01-01

Background The journal Impact factor (IF) is generally accepted to be a good measurement of the relevance/quality of articles that a journal publishes. In spite of an, apparently, homogenous peer-review process for a given journal, we hypothesize that the country affiliation of authors from developing Latin American (LA) countries affects the IF of a journal detrimentally. Methodology/Principal Findings Seven prestigious international journals, one multidisciplinary journal and six serving specific branches of science, were examined in terms of their IF in the Web of Science. Two subsets of each journal were then selected to evaluate the influence of author's affiliation on the IF. They comprised contributions (i) with authorship from four Latin American (LA) countries (Argentina, Brazil, Chile and Mexico) and (ii) with authorship from five developed countries (England, France, Germany, Japan and USA). Both subsets were further subdivided into two groups: articles with authorship from one country only and collaborative articles with authorship from other countries. Articles from the five developed countries had IF close to the overall IF of the journals and the influence of collaboration on this value was minor. In the case of LA articles the effect of collaboration (virtually all with developed countries) was significant. The IFs for non-collaborative articles averaged 66% of the overall IF of the journals whereas the articles in collaboration raised the IFs to values close to the overall IF. Conclusion/Significance The study shows a significantly lower IF in the group of the subsets of non-collaborative LA articles and thus that country affiliation of authors from non-developed LA countries does affect the IF of a journal detrimentally. There are no data to indicate whether the lower IFs of LA articles were due to their inherent inferior quality/relevance or psycho-social trend towards under-citation of articles from these countries. However, further study is required since there are foreseeable consequences of this trend as it may stimulate strategies by editors to turn down articles that tend to be under-cited. PMID:19030227

Harmonizing national forest inventories

Treesearch

Ronald E. McRoberts; Erkki O. Tomppo; Klemens Schadauer; Göran Ståhl

2012-01-01

International agreements increasingly require that countries report estimates of national forest resources. The United Nations Framework Convention on Climate Change requires that countries submit annual reports of greenhouse gas emissions and removals by sources and sinks. The Convention on Biological Diversity requires that countries identify and monitor components...

Health care financing and utilization of maternal health services in developing countries.

PubMed

Kruk, Margaret E; Galea, Sandro; Prescott, Marta; Freedman, Lynn P

2007-09-01

The Millennium Development Goals call for a 75% reduction in maternal mortality between 1990 and 2015. Skilled birth attendance and emergency obstetric care, including Caesarean section, are two of the most important interventions to reduce maternal mortality. Although international pressure is rising to increase donor assistance for essential health services in developing countries, we know less about whether government or the private sector is more effective at financing these essential services in developing countries. We conducted a cross-national analysis to determine the association between government versus private financing of health services and utilization of antenatal care, skilled birth attendants and Caesarean section in 42 low-income and lower-middle-income countries. We controlled for possible confounding effects of total per capita health spending and female literacy. In multivariable analysis, adjusting for confounders, government health expenditure as a percentage of total health expenditure is significantly associated with utilization of skilled birth attendants (P = 0.05) and Caesarean section (P = 0.01) but not antenatal care. Total health expenditure is also significantly associated with utilization of skilled birth attendants (P < 0.01) and Caesarean section (P < 0.01). Greater government participation in health financing and higher levels of health spending are associated with increased utilization of two maternal health services: skilled birth attendants and Caesarean section. While government financing is associated with better access to some essential maternal health services, greater absolute levels of health spending will be required if developing countries are to achieve the Millennium Development Goal on maternal mortality.

A simple and low-cost Internet-based teleconsultation system that could effectively solve the health care access problems in underserved areas of developing countries.

PubMed

Kuntalp, Mehmet; Akar, Orkun

2004-08-01

In many developing countries including Turkey, telemedicine systems are not in wide use due to the high cost and complexity of the required technology. Lack of these systems however has serious implications on patients who live in rural areas. The objective of this paper is to present a simple and economically affordable alternative to the current systems that would allow experts to easily access the medical data of their remote patients over the Internet. The system is developed in client-server architecture with a user-friendly graphical interface and various services are implemented as dynamic web pages based on PHP. The other key features of the system are its powerful security features and platform independency. An academic prototype is implemented and presented to the evaluation of a group of physicians. The results reveal that the system could find acceptance from the medical community and it could be an effective means of providing quality health care in developing countries.

Natural Treatment Systems as Sustainable Ecotechnologies for the Developing Countries

PubMed Central

Mahmood, Qaisar; Pervez, Arshid; Zeb, Bibi Saima; Zaffar, Habiba; Yaqoob, Hajra; Waseem, Muhammad; Zahidullah

2013-01-01

The purpose of natural treatment systems is the re-establishment of disturbed ecosystems and their sustainability for benefits to human and nature. The working of natural treatment systems on ecological principles and their sustainability in terms of low cost, low energy consumption, and low mechanical technology is highly desirable. The current review presents pros and cons of the natural treatment systems, their performance, and recent developments to use them in the treatment of various types of wastewaters. Fast population growth and economic pressure in some developing countries compel the implementation of principles of natural treatment to protect natural environment. The employment of these principles for waste treatment not only helps in environmental cleanup but also conserves biological communities. The systems particularly suit developing countries of the world. We reviewed information on constructed wetlands, vermicomposting, role of mangroves, land treatment systems, soil-aquifer treatment, and finally aquatic systems for waste treatment. Economic cost and energy requirements to operate various kinds of natural treatment systems were also reviewed. PMID:23878819

Prospects for Vascular Access Education in Developing Countries: Current Situation in Cambodia.

PubMed

Naganuma, Toshihide; Takemoto, Yoshiaki

2017-01-01

We report our activities training doctors on vascular access procedures at International University (IU) Hospital in Cambodia through a program facilitated by Ubiquitous Blood Purification International, a nonprofit organization that provides medical support to developing countries in the field of dialysis medicine. Six doctors from Japan have been involved in the education of medical personnel at IU, and we have collectively visited Cambodia about 15 times from 2010 to 2016. In these visits, we have performed many operations, including 42 for arteriovenous fistula, 1 arteriovenous graft, and 1 percutaneous transluminal angioplasty. Stable development and management of vascular access is increasingly required in Cambodia due to increased use of dialysis therapy, and training of doctors in this technique is urgently required. However, we have encountered several difficulties that need to be addressed, including (1) the situation of personnel receiving this training, (2) problems with facilities, including medical equipment and drugs, (3) financial limitations, and (4) problems with management of vascular access. © 2017 S. Karger AG, Basel.

Developing a Nursing Database System in Kenya

PubMed Central

Riley, Patricia L; Vindigni, Stephen M; Arudo, John; Waudo, Agnes N; Kamenju, Andrew; Ngoya, Japheth; Oywer, Elizabeth O; Rakuom, Chris P; Salmon, Marla E; Kelley, Maureen; Rogers, Martha; St Louis, Michael E; Marum, Lawrence H

2007-01-01

Objective To describe the development, initial findings, and implications of a national nursing workforce database system in Kenya. Principal Findings Creating a national electronic nursing workforce database provides more reliable information on nurse demographics, migration patterns, and workforce capacity. Data analyses are most useful for human resources for health (HRH) planning when workforce capacity data can be linked to worksite staffing requirements. As a result of establishing this database, the Kenya Ministry of Health has improved capability to assess its nursing workforce and document important workforce trends, such as out-migration. Current data identify the United States as the leading recipient country of Kenyan nurses. The overwhelming majority of Kenyan nurses who elect to out-migrate are among Kenya's most qualified. Conclusions The Kenya nursing database is a first step toward facilitating evidence-based decision making in HRH. This database is unique to developing countries in sub-Saharan Africa. Establishing an electronic workforce database requires long-term investment and sustained support by national and global stakeholders. PMID:17489921

Soil erosion in developing countries: A politicoeconomic explanation

NASA Astrophysics Data System (ADS)

Thapa, Gopal B.; Weber, Karl E.

1991-07-01

Soil erosion is accelerating in developing countries of Asia, Africa, and Latin America. It has threatened the livelihood of millions of peasants, for agriculture is their economic mainstay. A probe into the forces causing erosion reveals that the elite’s resolve to accumulate ever more wealth and to maintain, consolidate, or expand their sociopolitical power and the necessity of the poor to fulfill their requirements of food, fuelwood, and fodder are the two major factors accelerating soil erosion. Unless the vast masses of poor people are integrated into the national mainstream through the implementation of equitable and redistributive development policies, it is impossible to control the accelerating rate of soil erosion and thus to achieve the objective of sustainable development.

Implementation of the semi-aerobic landfill system (Fukuoka method) in developing countries: a Malaysia cost analysis.

PubMed

Chong, Theng Lee; Matsufuji, Yasushi; Hassan, Mohd Nasir

2005-01-01

Most of the existing solid waste landfill sites in developing countries are practicing either open dumping or controlled dumping. Proper sanitary landfill concepts are not fully implemented due to technological and financial constraints. Implementation of a fully engineered sanitary landfill is necessary and a more economically feasible landfill design is crucial, particularly for developing countries. This study was carried out by focusing on the economics from the development of a new landfill site within a natural clay area with no cost of synthetic liner up to 10 years after its closure by using the Fukuoka method semi-aerobic landfill system. The findings of the study show that for the development of a 15-ha landfill site in Malaysia with an estimated volume of 2,000,000 m(3), the capital investment required was about US 1,312,895 dollars, or about US 0.84 dollars/tonne of waste. Assuming that the lifespan of the landfill is 20 years, the total cost of operation was about US 11,132,536 dollars or US 7.15 dollars/tonne of waste. The closure cost of the landfill was estimated to be US 1,385,526 dollars or US 0.89 dollars/tonne of waste. Therefore, the total cost required to dispose of a tonne of waste at the semi-aerobic landfill was estimated to be US 8.89 dollars. By considering an average tipping fee of about US 7.89 dollars/tonne of waste in Malaysia in the first year, and an annual increase of 3% to about US 13.84 dollars in year-20, the overall system recorded a positive revenue of US 1,734,749 dollars. This is important information for the effort of privatisation of landfill sites in Malaysia, as well as in other developing countries, in order to secure efficient and effective landfill development and management.

Nephrology training curriculum and implications for optimal kidney care in the developing world.

PubMed

Okel, Julius; Okpechi, Ike G; Qarni, Bilal; Olanrewaju, Timothy; Courtney, Mark J; Luyckx, Valerie; Naicker, Sarala; Bello, Aminu K

An effective workforce is essential for delivery of high-quality chronic disease care. Low-income nations are challenged by a dearth and/or maldistribution of an essential workforce required for all chronic disease care including chronic kidney disease (CKD). Nephrology education and training in developed countries have grown at pace with the technological advancement in the practice of medicine in order to meet the standards required of kidney health professionals towards high-quality, patient-centered medical care. The standards designed by institutions and/or professional societies, such as Royal Colleges and Medical Councils in high-income nations with well-developed health systems and infrastructures, are often not easily translatable to issues critical to nephrology practice in low-income nations. Little or no guidance is provided on common nephrological issues of regional nature or pertaining to ethnic minorities and disadvantaged groups living in those countries. There is an emergent need for a training curriculum that meets the needs and peculiarities of the developing nations, and this needs to leverage on the existing and well-validated systems of training across the globe. We evaluated nephrology training programs across 25 upper-middle and high-income nations to identify best practices and opportunities for adoption in low-income nations. We reviewed training guidelines from major professional societies on content and process of training. There are similarities and differences in structure, content, and process of training programs across countries, and there are clearly adoptable concepts/frameworks for application in low-income nations. We provide recommendations and a strategic plan for the future focus of nephrology training in the developing world to align with current trends in technological advancement and development as well as the need for emphasis on prevention of CKD. The essential competencies (patient- and population--based) required of a nephrologist in a developing world setting are outlined with practical measures and an action plan for adoption.

Implementing nationally determined contributions: building energy policies in India’s mitigation strategy

NASA Astrophysics Data System (ADS)

Yu, Sha; Evans, Meredydd; Kyle, Page; Vu, Linh; Tan, Qing; Gupta, Ashu; Patel, Pralit

2018-03-01

The Nationally Determined Contributions are allowing countries to examine options for reducing emissions through a range of domestic policies. India, like many developing countries, has committed to reducing emissions through specific policies, including building energy codes. Here we assess the potential of these sectoral policies to help in achieving mitigation targets. Collectively, it is critically important to see the potential impact of such policies across developing countries in meeting national and global emission goals. Buildings accounted for around one third of global final energy use in 2010, and building energy consumption is expected to increase as income grows in developing countries. Using the Global Change Assessment Model, this study finds that implementing a range of energy efficiency policies robustly can reduce total Indian building energy use by 22% and lower total Indian carbon dioxide emissions by 9% in 2050 compared to the business-as-usual scenario. Among various policies, energy codes for new buildings can result in the most significant savings. For all building energy policies, well-coordinated, consistent implementation is critical, which requires coordination across different departments and agencies, improving capacity of stakeholders, and developing appropriate institutions to facilitate policy implementation.

Accelerating health equity: the key role of universal health coverage in the Sustainable Development Goals.

PubMed

Tangcharoensathien, Viroj; Mills, Anne; Palu, Toomas

2015-04-29

The Sustainable Development Goals (SDGs), to be committed to by Heads of State at the upcoming 2015 United Nations General Assembly, have set much higher and more ambitious health-related goals and targets than did the Millennium Development Goals (MDGs). The main challenge among MDG off-track countries is the failure to provide and sustain financial access to quality services by communities, especially the poor. Universal health coverage (UHC), one of the SDG health targets indispensable to achieving an improved level and distribution of health, requires a significant increase in government investment in strengthening primary healthcare - the close-to-client service which can result in equitable access. Given the trend of increased fiscal capacity in most developing countries, aiming at long-term progress toward UHC is feasible, if there is political commitment and if focused, effective policies are in place. Trends in high income countries, including an aging population which increases demand for health workers, continue to trigger international migration of health personnel from low and middle income countries. The inspirational SDGs must be matched with redoubled government efforts to strengthen health delivery systems, produce and retain more and relevant health workers, and progressively realize UHC.

The convergence of Chinese county government health expenditures: capitation and contribution.

PubMed

Zhang, Guoying; Zhang, Luwen; Wu, Shaolong; Xia, Xiaoqiong; Lu, Liming

2016-08-19

The disparity between government health expenditures across regions is more severe in developing countries than it is in developed countries. The capitation subsidy method has been proven effective in developed countries in reducing this disparity, but it has not been tested in China, the world's largest developing country. The convergence method of neoclassical economics was adopted to test the convergence of China's regional government health expenditure. Data were obtained from Provinces, Prefectures and Counties Fiscal Statistical Yearbook (2003-2007) edited by the Chinese Ministry of Finance, and published by the Chinese Finance & Economics Publishing House. The existence of σ-convergence and long-term and short-term β-convergence indicated the effectiveness of the capitation subsidy method in the New Rural Cooperative Medical Scheme on narrowing county government health expenditure disparities. The supply-side variables contributed the most to the county government health expenditure convergence, and factors contributing to convergence of county government health expenditures per capita were different in three regions. The narrowing disparity between county government health expenditures across regions supports the effectiveness of the capitation subsidy method adopted by China's New Rural Cooperative Scheme. However, subsidy policy still requires further improvement.

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

Weimar, Mark R.; Daly, Don S.; Wood, Thomas W.

Both nuclear power and nuclear weapons programs should have (related) economic signatures which are detectible at some scale. We evaluated this premise in a series of studies using national economic input/output (IO) data. Statistical discrimination models using economic IO tables predict with a high probability whether a country with an unknown predilection for nuclear weapons proliferation is in fact engaged in nuclear power development or nuclear weapons proliferation. We analyzed 93 IO tables, spanning the years 1993 to 2005 for 37 countries that are either members or associates of the Organization for Economic Cooperation and Development (OECD). The 2009 OECDmore » input/output tables featured 48 industrial sectors based on International Standard Industrial Classification (ISIC) Revision 3, and described the respective economies in current country-of-origin valued currency. We converted and transformed these reported values to US 2005 dollars using appropriate exchange rates and implicit price deflators, and addressed discrepancies in reported industrial sectors across tables. We then classified countries with Random Forest using either the adjusted or industry-normalized values. Random Forest, a classification tree technique, separates and categorizes countries using a very small, select subset of the 2304 individual cells in the IO table. A nation’s efforts in nuclear power, be it for electricity or nuclear weapons, are an enterprise with a large economic footprint -- an effort so large that it should discernibly perturb coarse country-level economics data such as that found in yearly input-output economic tables. The neoclassical economic input-output model describes a country’s or region’s economy in terms of the requirements of industries to produce the current level of economic output. An IO table row shows the distribution of an industry’s output to the industrial sectors while a table column shows the input required of each industrial sector by a given industry.« less

Healthy public policy in poor countries: tackling macro-economic policies.

PubMed

Mohindra, K S

2007-06-01

Large segments of the population in poor countries continue to suffer from a high level of unmet health needs, requiring macro-level, broad-based interventions. Healthy public policy, a key health promotion strategy, aims to put health on the agenda of policy makers across sectors and levels of government. Macro-economic policy in developing countries has thus far not adequately captured the attention of health promotion researchers. This paper argues that healthy public policy should not only be an objective in rich countries, but also in poor countries. This paper takes up this issue by reviewing the main macro-economic aid programs offered by international financial institutions as a response to economic crises and unmanageable debt burdens. Although health promotion researchers were largely absent during a key debate on structural adjustment programs and health during the 1980s and 1990s, the international macro-economic policy tool currently in play offers a new opportunity to participate in assessing these policies, ensuring new forms of macro-economic policy interventions do not simply reproduce patterns of (neoliberal) economics-dominated development policy.

[The pharmaceutical industry and the sustainability of healthcare systems in developed countries and in Latin America].

PubMed

Iñesta, Antonio; Oteo, Luis Angel

2011-06-01

The global economic crisis and its impact on public finances in most developed countries are giving rise to cost-containment policies in healthcare systems. Prevailing legislation on medication requires the safety, quality, and efficacy of these products. A few countries include efficiency criteria, primarily for new medication that they wish to include in public financing. The appropriate use of generic and "biosimilar medication" is very important for maintaining the financial equilibrium of the Health Services. The problem in Latin America is that not all multisource products are bioequivalent and not all countries have the resources to conduct bioequivalence studies in vivo. The European Medicines Agency in 2005 adopted guidelines on "biosimilar medicines" and thirteen of them were subsequently approved for general release. Benchmarking of this model by other countries would be important. The influence of the pharmaceutical industry on political and administrative areas is enormous and control is necessary. The pharmaceutical companies claim that they act with corporate social responsibility, therefore, they must ensure this responsibility toward society.

Public perception of hazardousness caused by current trends of municipal solid waste management

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

Al-Khatib, Issam A., E-mail: ikhatib@birzeit.edu; Kontogianni, Stamatia; Abu Nabaa, Hendya

Highlights: • Contribution to the scientific literature by examining the relationship between concern for the environment and waste disposal in the frame of household waste treatment mechanism specifically in developing countries. • The awareness of the citizens satisfaction level and the local existing capacities in developing countries significantly contribute to decision making on MSW management sustainability in Palestine and other developing countries when applied. • Identification of the differences and similarities among DC resulting to failures or success in WM field. - Abstract: Municipal solid waste (MSW) piling up is becoming a serious problem in all developing countries (DC) asmore » a result of inequitable waste collection and treatment. Citizens’ collaboration is partly based on understanding their views and their active involvement in MSW planning; on the other hand the assessment of the perception of hazardousness related with MSW is considered rather important as well since the identification of the weak points of the applied MWM strategy is eased and the level of required training is determined. Researchers implemented a case study in the West Bank (WB) and Gaza Strip (GS) regions of Palestine, taking into consideration previous researches in other developing countries. They reached to safe and useful conclusions regarding the parameters which mean the greatest in the waste management field as far as DC are concerned. Lack of skilled manpower, irregular collection services, inadequate equipment used for waste collection, inadequate legal provisions, and resource constraints are additional factors that are confirmed to be challenging the waste management scenarios in all DCs today. The research takes those factors under consideration but focuses on the educational gap and the results revealed interesting trends a significant relationship between respondent’s educational attainment and their awareness of hazardous waste (hazard perception); the results will indicate the measure taking required to avoid accidents occurred in those regions (burns from toxics, cuts from sharps, etc). National policy and legislation development based on the research outcomes will ensure equitable and accessible services are in place in order to move towards a healthier environment. Specialized health education and training programs on national scale are also needed to enhance awareness on hazardous waste.« less

Problems Facing the Visiting Anesthesia Team in an Underdeveloped Nation and Possible Solutions.

PubMed

Halliday, Norman James

2015-06-01

More than 50% of the population in most developing countries is younger than 18 years, and it has been estimated that 85% of these children may require some sort of surgery before their 15th birthday. Common congenital surgical requirements are for cleft lip and palate, inguinal hernia, meningomyelocele, as well as hydrocephalus. In addition, there is a greater incidence of trauma experienced by pediatric patients. Burn and scald injuries are also common because of the proximity of domestic open fires and boiling pots of water. Infectious conditions such as osteomyelitis and skin abscesses are more frequent in developing countries than in the developed world.Given this backdrop, the visiting anesthesiology team is faced with significant logistic issues related to a large and varied set of surgeries. This requires careful planning to ensure there will be enough personnel, equipment, and drugs available for the trip. Anesthesia teams very often have to rely on their own supplies on these excursions. Careful questioning of previous visiting groups is vital in preparation. For example, it is pointless to bring cases of sevoflurane to an operating room where the anesthesia machine only has a halothane vaporizer.

Measures which host countries and countries of origin could adopt to promote the return of migrants.

PubMed

Debart, M H

1986-03-01

The immigration wave in the 1960s and 1970s brought scores of migrants to Europe. Most intended to work a few years in a foreign country and return to their homeland; however, poor economies in their own countries discouraged their return. At the same time, jobs became scarcer in their host countries. Several European countries today are resorting to measures designed to promote the return of migrants to their countries of origin. This paper outlines the two major options open to governments in their reintegration efforts. Option 1 requires instituting a definite reintegration policy. Public aid to promote reintegration may be provided. For example, the French give aid contingent upon the return of foreign workers in the labor force to the country of origin and not just upon their departure from the host country. Classical methods pay conpensation to the foreign worker; the problem then is to determine at what point to limit the funds. It must be decided whether or not unemployment benefits should be capitalized and whether or not to reimburse social security and old age contributions. It is also desirable for foreign workers to have access to a specialized organization which is able to advise them on setting up a project or business on their return; ideally, this organization should finance the project. Perhaps the best solution is to enlist participation of the governments of the countries of origin to make job openings known to their nationals desiring to return. Option 2 requires that reintegration be introduced into other economic and social programs. Returning foreign workers would be included as a factor in overall policy planning. Vocational training for return migrants could be proposed to job seekers as well as to dismissed workers. A portion of money used to finance housing projects could be earmarked for construction or reservation of housing in the country of origin. Bilateral vocational training programs can be addressed to nationals who want to return home. A portion of bilateral public development aid may also be used in support of reintegration projects. Finally, it should be possible to propose small development projects in the country of origin for nationals desiring to return.

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.

Promoting space research and applications in developing countries through small satellite missions

NASA Astrophysics Data System (ADS)

Sweeting, M.

The high vantage-point of space offers very direct and tangible benefits to developing countries when carefully focused upon their real and particular communications and Earth observation needs. However, until recently, access to space has been effectively restricted to only those countries prepared to invest enormous sums in complex facilities and expensive satellites and launchers: this has placed individual participation in space beyond the sensible grasp of developing countries. However, during the last decade, highly capable and yet inexpensive small satellites have been developed which provide an opportunity for developing countries realistically to acquire and operate their own independent space assets - customized to their particular national needs. Over the last 22 years, the Surrey Space Centre has pioneered, developed and launched 23 nano-micro-minisatellite missions, and has worked in partnership with 12 developing countries to enable them to take their first independent steps into space. Surrey has developed a comprehensive and in-depth space technology know-how transfer and 'hands-on' training programme that uses a collaborative project comprising the design, construction, launch and operation of a microsatellite to acquire an indigenous space capability and create the nucleus of a national space agency and space industry. Using low cost small satellite projects as a focus, developing countries are able to initiate a long term, affordable and sustainable national space programme specifically tailored to their requirements, that is able to access the benefits derived from Earth observation for land use and national security; improved communications services; catalyzing scientific research and indigenous high-technology supporting industries. Perhaps even more important is the long-term benefit to the country provided by stimulating educational and career opportunities for your scientists and engineers and retaining them inside the country rather the all-too-familiar 'brain-drain' seeking employment overseas. The most successful countries have secured their initial investment in acquiring space know-how by following through with the formation of a national space agency or organization to provide a stable nucleus for supporting long-term space activities. Particularly suited to developing countries, Surrey has co-ordinated the first international constellation of small satellites for Earth Observation - the Disaster Monitoring Constellation (DMC). Four enhanced microsatellites have been launched in 2002 & 2003 built collaboratively by Surrey and Algeria, Nigeria, Turkey and UK which now provide daily images of anywhere in the world for disaster management and monitoring other dynamic phenomena such as land use and urban development. The same model of international partnership will be used in follow-on constellations with different sensors (IR, SAR, hyper-spectral) to meet national needs in a sustainable way. In a similar manner whereby the Personal Computer enabled developing countries access to modern information technologies on an affordable budget, small satellites are enabling these same countries to access space within sensible and sustainable expenditures for the direct benefit of their populations.

Rice Breeding and World Food Production

ERIC Educational Resources Information Center

Jennings, Peter R.

1974-01-01

Discusses the relation of technology to the green revolution, the role of plant breeders in inducing change in stagnant agriculture and the tools required by production scientists to increase yields of basic food crops in developing countries. (BR)

Human excreta for plant production.

PubMed

Heinonen-Tanski, Helvi; van Wijk-Sijbesma, Christine

2005-03-01

Human excreta are a natural resource which is always available in all societies. Unfortunately, their value is highly underestimated in present agriculture and horticulture including in many tropical developing countries. Especially human urine is rich in nitrogen. This "free" fertiliser should be used as much as possible and needed. In many cases, human urine and composted human faeces could be fortified with wood ash and kitchen and garden waste to meet the potassium and phosphorus needs of plants and to improve soil structure. Avoiding health risks and dosage requirements are also discussed. The ideas presented here can be used even with the cheap pit latrines that are common in the rural and peri-urban areas of developing countries. They do not require electricity and/or tap water. They may also fit conditions in areas of Eastern Europe where piped water and sewerage are absent and/or people lack money for fertilisers and maintenance of wastewater treatment plants.

Lives Saved Tool (LiST) costing: a module to examine costs and prioritize interventions.

PubMed

Bollinger, Lori A; Sanders, Rachel; Winfrey, William; Adesina, Adebiyi

2017-11-07

Achieving the Sustainable Development Goals will require careful allocation of resources in order to achieve the highest impact. The Lives Saved Tool (LiST) has been used widely to calculate the impact of maternal, neonatal and child health (MNCH) interventions for program planning and multi-country estimation in several Lancet Series commissions. As use of the LiST model increases, many have expressed a desire to cost interventions within the model, in order to support budgeting and prioritization of interventions by countries. A limited LiST costing module was introduced several years ago, but with gaps in cost types. Updates to inputs have now been added to make the module fully functional for a range of uses. This paper builds on previous work that developed an initial version of the LiST costing module to provide costs for MNCH interventions using an ingredients-based costing approach. Here, we update in 2016 the previous econometric estimates from 2013 with newly-available data and also include above-facility level costs such as program management. The updated econometric estimates inform percentages of intervention-level costs for some direct costs and indirect costs. These estimates add to existing values for direct cost requirements for items such as drugs and supplies and required provider time which were already available in LiST Costing. Results generated by the LiST costing module include costs for each intervention, as well as disaggregated costs by intervention including drug and supply costs, labor costs, other recurrent costs, capital costs, and above-service delivery costs. These results can be combined with mortality estimates to support prioritization of interventions by countries. The LiST costing module provides an option for countries to identify resource requirements for scaling up a maternal, neonatal, and child health program, and to examine the financial impact of different resource allocation strategies. It can be a useful tool for countries as they seek to identify the best investments for scarce resources. The purpose of the LiST model is to provide a tool to make resource allocation decisions in a strategic planning process through prioritizing interventions based on resulting impact on maternal and child mortality and morbidity.

[Global environment and health--with emphasis on world nutritional status].

PubMed

Suzuki, T

1993-12-01

Forthcoming global environmental changes threaten to endanger human survival through direct and indirect influences. In this paper, the contemporary world food supply situation and resultant nutritional status was first reviewed on by country and region. When compared with the nutritional energy requirement, countries with an inadequate food supply were concentrated in the developing world, in particular in some parts of Africa. The life expectancy at birth is clearly shorter in such countries, and peoples of African countries with an inadequate food supply have shorter life expectancies than other countries with a similar inadequacy. Global warning is likely to decrease food production in some parts of the world. According to the present estimation using various methods, a future crisis of food production may occur in African countries which are at present most vulnerable to food shortages, as well as in countries which are presently food exporters. Thus, a future crisis of human health conditions caused by the imbalance of food production and trade may be least avoidable in the region of present predicament.

Venezuela 2000 restructures its electric power sector to ensure competitiveness

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

Alvarez, C.E.

1999-11-01

Today, it is well known that the countries that are best equipped to develop their production are not those with the most natural resources but those who have the best trained people, most technical resources and that base their development on competitiveness. The State model is, definitely, not one that offers the greatest advantages, and Venezuela is an example of this. Even when, thanks to the economic boom the country enjoyed in the 70s and 80s, it was able to cost the investments required to develop its infrastructure and to prepare a first class human contingent, over the long term,more » competition was discouraged and waste encouraged. The result was that, even when Venezuela had vast economic resources compared to its relatively small population, it was not able to become the exception to the rule and succeed in applying this model--now considered obsolete in many countries--indefinitely. Another model based on private ownership has begun to take its place, one that has made it possible to cost the increasingly large investments required, involves opening up these sectors to private capital, and uses the phenomenon of globalization--a major driving force behind competition and one that has wrought considerable change in all corners of the increasingly smaller planet. This paper describes the steps that different sectors in the country have been taking to implement this new model in the electric power sector, such as developing draft legislation for regulating the Sector, very shortly to culminate in the passing of an electric power law by Congress; opening up the Sector to private investors (privatization); dividing the electric power industry into four business units (generation, transmission, distribution and marketing); the electric power market; and other innovations currently being implemented.« less

The Effects of Requiring Study Group Participation Associated with Students' Attitudes and Achievements in Developmental Math

ERIC Educational Resources Information Center

Brown, Clayton D.

2012-01-01

It is widely publicized that student attitudes and achievement in math in the United States require improvement. U.S. students have shown lackluster mathematics achievement scores compared to their international peers in other developed countries. As a former high school math instructor, this author observed that the attitude of many high school…

Policy Implications of Deep Decarbonization in the United States

NASA Astrophysics Data System (ADS)

Williams, J.

2015-12-01

Independent research teams from sixteen of the largest greenhouse gas (GHG) emitting countries have participated in a collaborative two-year project developing emission reduction scenarios for their own countries consistent with limiting anthropogenic warming to 2 C or less. This talk discusses the policy implications of the work done by the Deep Decarbonization Pathways Project (DDPP) at the US federal and international levels, including new ways of informing decision makers about the requirements of an energy system transformation.

Global Justice and Intellectual Property Rights: Reforming the International IPR Regime for Balanced Development

ERIC Educational Resources Information Center

Salokannel, Marjut

2006-01-01

Today it is widely recognized that a uniform global intellectual property (IP) system requiring a high level of protection is inherently unjust and affects countries differently depending upon their level of technological and economic development. This article analyzes the functioning of the current international treaty framework having…

Implementation of Multimedia Technologies into the Educational Process in Developed Countries

ERIC Educational Resources Information Center

Sukhomudrenko, Yuliia

2016-01-01

In the context of information technology development of a society requirements to professional training of teachers and forming of their competencies are increasing. The need for provision of media education consistent with challenges of an information society, organization of pedagogues' in the field of media education training, based on media…

Examining the Technology Integration Planning Cycle Model of Professional Development to Support Teachers' Instructional Practices

ERIC Educational Resources Information Center

Hutchison, Amy C.; Woodward, Lindsay

2018-01-01

Background: Presently, models of professional development aimed at supporting teachers' technology integration efforts are often short and decontextualized. With many schools across the country utilizing standards that require students to engage with digital tools, a situative model that supports building teachers' knowledge within their…

Site Management and Productivity in Tropical Forest Plantations

Treesearch

A. Tiarks; E.K.S. Nambiar; C. Cossalter

1998-01-01

Tropical countries are expanding plantation forestry to develop sustainable woodproduction systems. Much of this is based on short rotations of exotic species. These systems require large capital investments, represent intensive land use and increase the demands on the soil. To develop options for maintaining or increasing productivity a partner-project was initiated...

How Can Intercultural School Development Succeed? The Perspective of Teachers and Teacher Educators

ERIC Educational Resources Information Center

Kiel, Ewald; Syring, Marcus; Weiss, Sabine

2017-01-01

The large number of newly arrived individuals from other countries, particularly of young people, has had an enormous impact on the school system in Germany. The present study investigated requirements for successful intercultural school development. The study used investigative group discussions, where the groups were composed of teachers and…

Mind the Gap: Accounting Information Systems Curricula Development in Compliance with IFAC Standards in a Developing Country

ERIC Educational Resources Information Center

Aleqab, Mahmoud Mohmad Ahmad; Nurunnabi, Mohammad; Adel, Dalia

2015-01-01

The authors examine the consistency between the current practices in designing and teaching accounting information systems (AIS) curricula and the International Federation of Accountants (IFAC) requirements for International Education Practice Statement 2 and International Education Standards 2. Utilizing a survey and interviews data in Jordan,…

Qualification and Development Needs for Technical Education.

ERIC Educational Resources Information Center

El Tell, Khalaf; Al-Maaitah, Ayman

Vast and rapid changes in global technologies have made development of a sound and efficient system of technical education (TE) critical for Oman and the other Arab Gulf countries. Producing TE graduates with the skills needed for success in today's global economy requires TE teachers with the following qualifications: mastery of the core skills…

Special Education and Severe Disabilities in Costa Rica: Developing Inclusion in a Developing Country.

ERIC Educational Resources Information Center

Stough, Laura M.

2003-01-01

An overview of special education in Costa Rica is provided. Costa Rica has promulgated four educational service models that extend special education expertise: consulting teachers, educational assistance teams, itinerant teams, and resource centers. Their educational classification system describes the level of modifications required by students.…

Sustainable development goals as the basis of university management towards global competitiveness

NASA Astrophysics Data System (ADS)

Utama, Yos Johan; Ambariyanto, Ambariyanto; Zainuri, Muhammad; Darsono, Darsono; Setyono, Budi; Widowati; Purnomo Putro, Sapto

2018-05-01

Sustainable Development Goals are international agreements of many countries under UN initiation that have certain goals and targets. Achieving these goals and targets of the SDG requires a broad and focused effort from various sectors including higher education. Some of the goals associated with higher education are education, sanitation, innovation and global partnership. Given that higher education is one of the main drivers of the progress of a country, it gives university opportunities to play a bigger role. In addition, the rapid development and changes that occur today also require universities to respond quickly and appropriately. This can be done by developing university management based on the principle of SDG. This paper provides a brief description of the strategies that higher education institutions can take, particularly in responding to the changing world and in achieving the target of the SDGs. Five strategis for the university to encourage faster achievement of the targeted SDGs are proposed, i.e. Improvement of higher education quality, improvement of higher education equity, improvement of sanitarian and environment, improvement of research and innovation, and global partnership.

Canada's implementation of the Paragraph 6 Decision: is it sustainable public policy?

PubMed Central

Cohen-Kohler, Jillian C; Esmail, Laura C; Cosio, Andre Perez

2007-01-01

Background Following the Implementation of Paragraph 6 of the Doha Declaration on TRIPS and Public Health, Canada was among the first countries globally to amend its patent law, which resulted in Canada's Access to Medicines Regime (CAMR). CAMR allows the production and export of generic drugs to developing countries without the requisite manufacturing capacity to undertake a domestic compulsory license. CAMR has been the subject of much criticism lodged at its inability to ensure fast access to urgent medicines for least developing and developing countries in need. Only recently did the Canadian government grant Apotex the compulsory licenses required under CAMR to produce and export antiretroviral therapy to Rwanda's population. Methods The objective of this research is to investigate whether the CAMR can feasibly achieve its humanitarian objectives given the political interests embedded in the crafting of the legislation. We used a political economy framework to analyze the effect of varied institutions, political processes, and economic interests on public policy outcomes. In-depth, semi-structured interviews were conducted with nineteen key stakeholders from government, civil society and industry. Qualitative data analysis was performed using open-coding for themes, analyzing by stakeholder group. Results CAMR is removed from the realities of developing countries and the pharmaceutical market. The legislation needs to include commercial incentives to galvanize the generic drug industry to make use of this legislation. CAMR assumes that developing country governments have the requisite knowledge and human resource capacity to make use of the regime, which is not the case. The legislation does not offer sufficient incentives for countries to turn to Canada when needed drugs may be procured cheaply from countries such as India. In the long term, developing and least developing countries seek sustainable solutions to meet the health needs of their population, including developing their own capacity and local industries. Conclusion CAMR is symbolically meaningful but in practice, limited. The Rwanda case will be noteworthy in terms of the future of the legislation. To meet its intended international health objectives, this legislation needs to be better informed of developing country needs and global pharmaceutical market imperatives. Finally, we contend that serious public policy change cannot strike a balance between all vested interests. Above all, any feasible policy that aims to facilitate compulsory licensing must prioritize public health over trade or economic interests. PMID:18062821

WHO initiative to increase global and equitable access to influenza vaccine in the event of a pandemic: supporting developing country production capacity through technology transfer.

PubMed

Friede, Martin; Palkonyay, Laszlo; Alfonso, Claudia; Pervikov, Yuri; Torelli, Guido; Wood, David; Kieny, Marie Paule

2011-07-01

Should a highly pathogenic avian influenza virus, such as the H5N1 virus type currently circulating in birds, become transmissible among humans, an effective vaccine, rapidly available in vast quantities, would be the best tool to prevent high case-fatalities and the breakdown of health and social services. The number of vaccine doses that could be produced on demand has risen sharply over the last few years; however, it is still alarmingly short of the 13 billion doses that would be needed if two doses were required to protect fully the world's population. Most developing countries would be last in the queue to benefit from a pandemic vaccine. The World Health Organization, together with governments, the pharmaceutical industry and other stakeholders, has been implementing the global pandemic influenza action plan to increase vaccine supply since 2006. Building capacity in developing countries to manufacture influenza vaccine is an integral part of this plan, as well as research and development into more efficacious technologies, e.g. those that allow significant dose-sparing. To this end, the influenza vaccine technology transfer initiative was launched in 2007 and, to date, vaccine manufacturers in 11 developing countries have received grants to acquire the capacity to produce inactivated or live attenuated influenza vaccine for their populations. In addition, a centralized 'hub' has been established to facilitate training in the new technologies for scientists and regulators in the countries. This supplement of Vaccine is devoted to showcasing the interim results of the WHO initiative and the impressive progress made by the developing country manufacturers. Copyright © 2011 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

ASM LabCap's contributions to disease surveillance and the International Health Regulations (2005).

PubMed

Specter, Steven; Schuermann, Lily; Hakiruwizera, Celestin; Sow, Mah-Séré Keita

2010-12-03

The revised International Health Regulations [IHR(2005)], which requires the Member States of the World Health Organization (WHO) to develop core capacities to detect, assess, report, and respond to public health threats, is bringing new challenges for national and international surveillance systems. As more countries move toward implementation and/or strengthening of their infectious disease surveillance programs, the strengthening of clinical microbiology laboratories becomes increasingly important because they serve as the first line responders to detect new and emerging microbial threats, re-emerging infectious diseases, the spread of antibiotic resistance, and the possibility of bioterrorism. In fact, IHR(2005) Core Capacity #8, "Laboratory", requires that laboratory services be a part of every phase of alert and response.Public health laboratories in many resource-constrained countries require financial and technical assistance to build their capacity. In recognition of this, in 2006, the American Society for Microbiology (ASM) established an International Laboratory Capacity Building Program, LabCap, housed under the ASM International Board. ASM LabCap utilizes ASM's vast resources and its membership's expertise-40,000 microbiologists worldwide-to strengthen clinical and public health laboratory systems in low and low-middle income countries. ASM LabCap's program activities align with HR(2005) by building the capability of resource-constrained countries to develop quality-assured, laboratory-based information which is critical to disease surveillance and the rapid detection of disease outbreaks, whether they stem from natural, deliberate or accidental causes.ASM LabCap helps build laboratory capacity under a cooperative agreement with the U.S. Centers for Disease Control and Prevention (CDC) and under a sub-contract with the Program for Appropriate Technology in Health (PATH) funded by the United States Agency for International Development (USAID). Successful activities of ASM LabCap have occurred throughout Africa, Asia, Central America and the Caribbean. In addition, ASM LabCap coordinates efforts with international agencies such as the WHO in order to maximize resources and ensure a unified response, with the intended goal to help build integrated disease surveillance and response capabilities worldwide in compliance with HR(2005)'s requirements.

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.

Current status of nutrition labelling and claims in the South-East Asian region: are we in harmony?

PubMed

Tee, E-Siong; Tamin, Suryani; Ilyas, Rosmulyati; Ramos, Adelisa; Tan, Wei-Ling; Lai, Darwin Kah-Soon; Kongchuntuk, Hataya

2002-01-01

This review includes the situation of nutrition labelling and claims in six countries in South-East Asia: Brunei, Indonesia, Malaysia, Philippines, Singapore and Thailand. With the exception of Malaysia, there is no mandatory nutrition labelling requirements for foods in these countries except for special categories of foods and when nutritional claims are made for fortified or enriched foods. Nevertheless, several food manufacturers, especially multinationals, do voluntarily label the nutritional content of a number of food products. There is, therefore, increasing interest among authorities in countries in the region to start formulating regulations for nutrition labelling for a wider variety of foods. Malaysia has proposed new regulations to make it mandatory to label a number of foodstuffs with the four core nutrients, protein, carbohydrate, fat and energy. Other countries have preferred to start with voluntary labelling by the manufacturers, but have spelt out the requirements for this voluntary labelling. The format and requirements for nutrition labelling differ widely for countries in the region. Some countries, such as Malaysia, closely follow the Codex guidelines on nutrition labelling in terms of format, components to be included and mode of expression. Other countries, such as the Philippines and Thailand, have drafted nutrition labelling regulations very similar to those of the Nutrition Labeling and Education Act (NLEA) of the United States. Nutrition and health claims are also not specifically permitted under food regulations that were enacted before 1998. However, various food products on the market have been carrying a variety of nutrition and health claims. There is concern that without proper regulations, the food industry may not be certain as to what claims can be made. Excessive and misleading claims made by irresponsible manufacturers would only serve to confuse and mislead the consumer. In recent years, there has been efforts in countries in the region to enact regulations on nutrition claims. Recently enacted regulations or amendments to existing regulations of almost all the countries reviewed have included provisions for nutrition claims. Malaysia is in the process of gazetting regulations to clearly stipulate the permitted nutrition claims and the conditions required to make these claims along the guidelines of Codex Alimentarius Commission. Only two countries in the region permit health claims to be made - Indonesia and Philippines. Other countries in the region are following developments in Codex and examining the need for allowing these claims. There are more differences than similarities in the regulations on nutrition labelling and claims among countries in the South-East Asian region as no previous efforts have been made to address these. Hopefully, through this first regional meeting, countries can initiate closer interaction, with a view to working towards greater harmonization of nutrition labelling and health claims in the region.

Classification of the European Union member states according to the relative level of sustainable development.

PubMed

Anna, Bluszcz

Nowadays methods of measurement and assessment of the level of sustained development at the international, national and regional level are a current research problem, which requires multi-dimensional analysis. The relative assessment of the sustainability level of the European Union member states and the comparative analysis of the position of Poland relative to other countries was the aim of the conducted studies in the article. EU member states were treated as objects in the multi-dimensional space. Dimensions of space were specified by ten diagnostic variables describing the sustainability level of UE countries in three dimensions, i.e., social, economic and environmental. Because the compiled statistical data were expressed in different units of measure, taxonomic methods were used for building an aggregated measure to assess the level of sustainable development of EU member states, which through normalisation of variables enabled the comparative analysis between countries. Methodology of studies consisted of eight stages, which included, among others: defining data matrices, calculating the variability coefficient for all variables, which variability coefficient was under 10 %, division of variables into stimulants and destimulants, selection of the method of variable normalisation, developing matrices of normalised data, selection of the formula and calculating the aggregated indicator of the relative level of sustainable development of the EU countries, calculating partial development indicators for three studies dimensions: social, economic and environmental and the classification of the EU countries according to the relative level of sustainable development. Statistical date were collected based on the Polish Central Statistical Office publication.

Cancer Care and Control as a Human Right: Recognizing Global Oncology as an Academic Field.

PubMed

Eniu, Alexandru E; Martei, Yehoda M; Trimble, Edward L; Shulman, Lawrence N

2017-01-01

The global burden of cancer incidence and mortality is on the rise. There are major differences in cancer fatality rates due to profound disparities in the burden and resource allocation for cancer care and control in developed compared with developing countries. The right to cancer care and control should be a human right accessible to all patients with cancer, regardless of geographic or economic region, to avoid unnecessary deaths and suffering from cancer. National cancer planning should include an integrated approach that incorporates a continuum of education, prevention, cancer diagnostics, treatment, survivorship, and palliative care. Global oncology as an academic field should offer the knowledge and skills needed to efficiently assess situations and work on solutions, in close partnership. We need medical oncologists, surgical oncologists, pediatric oncologists, gynecologic oncologists, radiologists, and pathologists trained to think about well-tailored resource-stratified solutions to cancer care in the developing world. Moreover, the multidisciplinary fundamental team approach needed to treat most neoplastic diseases requires coordinated investment in several areas. Current innovative approaches have relied on partnerships between academic institutions in developed countries and local governments and ministries of health in developing countries to provide the expertise needed to implement effective cancer control programs. Global oncology is a viable and necessary field that needs to be emphasized because of its critical role in proposing not only solutions in developing countries, but also solutions that can be applied to similar challenges of access to cancer care and control faced by underserved populations in developed countries.

Generating political priority for newborn survival in three low-income countries.

PubMed

Smith, Stephanie L; Shiffman, Jeremy; Kazembe, Abigail

2014-01-01

Deaths to babies in their first 28 days of life now account for more than 40% of global under-5 child mortality. High neonatal mortality poses a significant barrier to achieving the child survival Millennium Development Goal. Surmounting the problem requires national-level political commitment, yet only a few nation-states have prioritised this issue. We compare Bolivia, Malawi and Nepal, three low-income countries with high neonatal mortality, with a view to understanding why countries prioritise or neglect the issue. The three have had markedly different trajectories since 2000: attention grew steadily in Nepal, stagnated then grew in Malawi and grew then stagnated in Bolivia. The comparison suggests three implications for proponents seeking to advance attention to neglected health issues in low-income countries: the value of (1) advancing solutions with demonstrated efficacy in low-resource settings, (2) building on existing and emerging national priorities and (3) developing a strong network of domestic and international allies. Such actions help policy communities to weather political storms and take advantage of policy windows.

From malaria control to eradication: The WHO perspective.

PubMed

Mendis, Kamini; Rietveld, Aafje; Warsame, Marian; Bosman, Andrea; Greenwood, Brian; Wernsdorfer, Walther H

2009-07-01

Efforts to control malaria have been boosted in the past few years with increased international funding and greater political commitment. Consequently, the reported malaria burden is being reduced in a number of countries throughout the world, including in some countries in tropical Africa where the burden of malaria is greatest. These achievements have raised new hopes of eradicating malaria. This paper summarizes the outcomes of a World Health Organization's expert meeting on the feasibility of such a goal. Given the hindsight and experience of the Global Malaria Eradication Programme of the 1950s and 1960s, and current knowledge of the effectiveness of antimalarial tools and interventions, it would be feasible to effectively control malaria in all parts of the world and greatly reduce the enormous morbidity and mortality of malaria. It would also be entirely feasible to eliminate malaria from countries and regions where the intensity of transmission is low to moderate, and where health systems are strong. Elimination of malaria requires a re-orientation of control activity, moving away from a population-based coverage of interventions, to one based on a programme of effective surveillance and response. Sustained efforts will be required to prevent the resurgence of malaria from where it is eliminated. Eliminating malaria from countries where the intensity of transmission is high and stable such as in tropical Africa will require more potent tools and stronger health systems than are available today. When such countries have effectively reduced the burden of malaria, the achievements will need to be consolidated before a programme re-orientation towards malaria elimination is contemplated. Malaria control and elimination are under the constant threat of the parasite and vector mosquito developing resistance to medicines and insecticides, which are the cornerstones of current antimalarial interventions. The prospects of malaria eradication, therefore, rest heavily on the outcomes of research and development for new and improved tools. Malaria control and elimination are complementary objectives in the global fight against malaria.

Projections of costs, financing, and additional resource requirements for low- and lower middle-income country immunization programs over the decade, 2011-2020.

PubMed

Gandhi, Gian; Lydon, Patrick; Cornejo, Santiago; Brenzel, Logan; Wrobel, Sandra; Chang, Hugh

2013-04-18

The Decade of Vaccines Global Vaccine Action Plan has outlined a set of ambitious goals to broaden the impact and reach of immunization across the globe. A projections exercise has been undertaken to assess the costs, financing availability, and additional resource requirements to achieve these goals through the delivery of vaccines against 19 diseases across 94 low- and middle-income countries for the period 2011-2020. The exercise draws upon data from existing published and unpublished global forecasts, country immunization plans, and costing studies. A combination of an ingredients-based approach and use of approximations based on past spending has been used to generate vaccine and non-vaccine delivery costs for routine programs, as well as supplementary immunization activities (SIAs). Financing projections focused primarily on support from governments and the GAVI Alliance. Cost and financing projections are presented in constant 2010 US dollars (US$). Cumulative total costs for the decade are projected to be US$57.5 billion, with 85% for routine programs and the remaining 15% for SIAs. Delivery costs account for 54% of total cumulative costs, and vaccine costs make up the remainder. A conservative estimate of total financing for immunization programs is projected to be $34.3 billion over the decade, with country governments financing 65%. These projections imply a cumulative funding gap of $23.2 billion. About 57% of the total resources required to close the funding gap are needed just to maintain existing programs and scale up other currently available vaccines (i.e., before adding in the additional costs of vaccines still in development). Efforts to mobilize additional resources, manage program costs, and establish mutual accountability between countries and development partners will all be necessary to ensure the goals of the Decade of Vaccines are achieved. Establishing or building on existing mechanisms to more comprehensively track resources and commitments for immunization will help facilitate these efforts. Copyright © 2013 Elsevier Ltd. All rights reserved.

Consumer-led demand side financing in health and education and its relevance for low and middle income countries.

PubMed

Ensor, Tim

2004-01-01

There is increasing awareness that supply subsidies for health and education services often fail to benefit those that are most vulnerable in a community. This recognition has led to a growing interest in and experimentation with, consumer-led demand side financing systems (CL-DSF). These mechanisms place purchasing power in the hands of consumers to spend on specific services at accredited facilities. International evidence in education and health sectors suggest a limited success of CL-DSF in raising the consumption of key services amongst priority groups. There is also some evidence that vouchers can be used to improve targeting of vulnerable groups. There is very little positive evidence on the effect of CL-DSF on service quality as a consequence of greater competition. Location of services relative to population means that areas with more provider choice, particularly in the private sector, tend to be dominated by higher and middle-income households. Extending CL-DSF in low-income countries requires the development of capacity in administering these financing schemes and also accrediting providers. Schemes could focus primarily on fixed packages of key services aimed at easily identifiable groups. Piloting and robust evaluation is required to fill the evidence gap on the impact of these mechanisms. Extending demand financing to less predictable services, such as hospital coverage for the population, is likely to require the development of a voucher scheme to purchase insurance. This suggests an already developed insurance market and is unlikely to be appropriate in most low-income countries for some time.

Task shifting from physicians to nurses in primary care in 39 countries: a cross-country comparative study.

PubMed

Maier, Claudia B; Aiken, Linda H

2016-12-01

Primary care is in short supply in many countries. Task shifting from physicians to nurses is one strategy to improve access, but international research is scarce. We analysed the extent of task shifting in primary care and policy reforms in 39 countries. Cross-country comparative research, based on an international expert survey, plus literature scoping review. A total of 93 country experts participated, covering Europe, USA, Canada, Australia and New Zealand (response rate: 85.3%). Experts were selected according to pre-defined criteria. Survey responses were triangulated with the literature and analysed using policy, thematic and descriptive methods to assess developments in country-specific contexts. Task shifting, where nurses take up advanced roles from physicians, was implemented in two-thirds of countries (N = 27, 69%), yet its extent varied. Three clusters emerged: 11 countries with extensive (Australia, Canada, England, Northern Ireland, Scotland, Wales, Finland, Ireland, Netherlands, New Zealand and USA), 16 countries with limited and 12 countries with no task shifting. The high number of policy, regulatory and educational reforms, such as on nurse prescribing, demonstrate an evolving trend internationally toward expanding nurses' scope-of-practice in primary care. Many countries have implemented task-shifting reforms to maximise workforce capacity. Reforms have focused on removing regulatory and to a lower extent, financial barriers, yet were often lengthy and controversial. Countries early on in the process are primarily reforming their education. From an international and particularly European Union perspective, developing standardised definitions, minimum educational and practice requirements would facilitate recognition procedures in increasingly connected labour markets. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Lessons Learned from Protective Immune Responses to Optimize Vaccines against Cryptosporidiosis.

PubMed

Lemieux, Maxime W; Sonzogni-Desautels, Karine; Ndao, Momar

2017-12-24

In developing countries, cryptosporidiosis causes moderate-to-severe diarrhea and kills thousands of infants and toddlers annually. Drinking and recreational water contaminated with Cryptosporidium spp. oocysts has led to waterborne outbreaks in developed countries. A competent immune system is necessary to clear this parasitic infection. A better understanding of the immune responses required to prevent or limit infection by this protozoan parasite is the cornerstone of development of an effective vaccine. In this light, lessons learned from previously developed vaccines against Cryptosporidium spp. are at the foundation for development of better next-generation vaccines. In this review, we summarize the immune responses elicited by naturally and experimentally-induced Cryptosporidium spp. infection and by several experimental vaccines in various animal models. Our aim is to increase awareness about the immune responses that underlie protection against cryptosporidiosis and to encourage promotion of these immune responses as a key strategy for vaccine development. Innate and mucosal immunity will be addressed as well as adaptive immunity, with an emphasis on the balance between T H 1/T H 2 immune responses. Development of more effective vaccines against cryptosporidiosis is needed to prevent Cryptosporidium spp.-related deaths in infants and toddlers in developing countries.

Lessons Learned from Protective Immune Responses to Optimize Vaccines against Cryptosporidiosis

PubMed Central

Lemieux, Maxime W.; Sonzogni-Desautels, Karine; Ndao, Momar

2017-01-01

In developing countries, cryptosporidiosis causes moderate-to-severe diarrhea and kills thousands of infants and toddlers annually. Drinking and recreational water contaminated with Cryptosporidium spp. oocysts has led to waterborne outbreaks in developed countries. A competent immune system is necessary to clear this parasitic infection. A better understanding of the immune responses required to prevent or limit infection by this protozoan parasite is the cornerstone of development of an effective vaccine. In this light, lessons learned from previously developed vaccines against Cryptosporidium spp. are at the foundation for development of better next-generation vaccines. In this review, we summarize the immune responses elicited by naturally and experimentally-induced Cryptosporidium spp. infection and by several experimental vaccines in various animal models. Our aim is to increase awareness about the immune responses that underlie protection against cryptosporidiosis and to encourage promotion of these immune responses as a key strategy for vaccine development. Innate and mucosal immunity will be addressed as well as adaptive immunity, with an emphasis on the balance between TH1/TH2 immune responses. Development of more effective vaccines against cryptosporidiosis is needed to prevent Cryptosporidium spp.-related deaths in infants and toddlers in developing countries. PMID:29295550

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.

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.

Role of Scientific Societies in International Collaboration

NASA Astrophysics Data System (ADS)

Fucugauchi, J. U.

2007-12-01

Geophysical research increasingly requires global multidisciplinary approaches. Understanding how deeply interrelated are Earth components and processes, population growth, increased needs of mineral and energy resources, global impact of human activities, and view of our planet as an interconnected system emphasizes the need of international cooperation. International research collaboration has an immense potential and is needed for further development of Earth science research and education. The Union Session is planned to provide a forum for analysis and discussion of the status of research and education of geosciences in developing countries, international collaboration programs and new initiatives for promoting and strengthening scientific cooperation. A theme of particular relevance in the analyses and discussions is the role of scientific societies in international collaboration. Societies organize meetings, publish journals and books and promote cooperation through academic exchange activities. They may further assist communities in developing countries in providing and facilitating access to scientific literature, attendance to international meetings, short and long-term stays and student and young researcher mobility. What else can be done? This is a complex subject and scientific societies may not be seen independently from the many factors involved in research and education. Developing countries present additional challenges resulting from limited economic resources and social and political problems, while urgently requiring improved educational and research programs. Needed are in-depth analyses of infrastructure and human resources, and identification of major problems and needs. What are the major limitations and needs in research and postgraduate education in developing countries? What and how should international collaboration do? What are the roles of individuals, academic institutions, funding agencies, scientific societies? Here we attempt to examine some of these questions from analyses and examples in Latin America. We concentrate on current situation, size and characteristics of research community, education programs, facilities, economic support, and bilateral and multinational collaborations, and then move to perspectives for future development in an international context.

Water security and its challenges for Malaysia

NASA Astrophysics Data System (ADS)

Malek, M. A.; Nor, M. A. M.; P, Leong Y.

2013-06-01

Water Security in Malaysia is a national issue. The Malaysian water services industry faces issues which need to be tackled immediately for it to be viable and sustainable. Among them are the decentralized water services sector, ineffective governance structure, unsustainable tariffs, huge investments required to develop the water supply and sewerage infrastructure, inefficient operation by the operators and high non-revenue water (NRW) losses. In Malaysia, the "Sectorial" approach embedded in the present water management system and its transformation towards "Integrated Water Resources Management" (IWRM), is still in a state of inertia. This paper presents the need to transform, from a "Supply" Management mode (a characteristic of a developing country) to a "Water Demand" Management mode (a characteristic of a developed country). Issues on "Water Demand" Management for the Environment which can be a threat to the need for sustainable development for biodiversity are highlighted here. Reliable water accounting systems are found still lacking in this country, especially in the Agriculture and Environmental Sectors, where figures are still highly based on "traditional" assumptions. Water Quality deterioration remains an issue especially for the Water Supply and Environment Sectors. Available surface water resource is depleting in many regions and states in the Peninsular. Apart from the Reduce, Reuse and Recycle (3R) option for surface water, another option would be to begin a concerted effort for groundwater exploitation. However there are still grey areas of knowledge in the groundwater resources in this country for affirmative decisions and development of appropriate policies. It is also found that, there are no concerted plans to prepare the public for the change from "Supply" Management to "Demand" Management. In a developed nation, this change is through stakeholder platforms and supported by appropriate policies, rules and regulations that are based on validated Sciences, Technologies and Innovations (STI). Transforming from "Supply" Management to "Demand" Management is a formidable task. This requires the wisdom and knowledge of all experts in the Water Resources Sector.

Healthcare waste management practice in the West Black Sea Region, Turkey: A comparative analysis with the developed and developing countries.

PubMed

Ciplak, Nesli; Kaskun, Songul

2015-12-01

The need for proper healthcare waste management has been a crucial issue in many developing countries as it is in Turkey. The regulation regarding healthcare wastes in Turkey was updated in 2005 in accordance with the European Union (EU) waste directives, but it still falls behind meeting the requirements of current waste treatment technologies. Therefore, this study aims to reveal deficiencies, inconsistencies, and improper applications of healthcare waste management in the western part of the Turkish Black Sea Region. In this study, it was revealed that nearly 1 million people live in the region, resulting in 5 million hospital admissions annually. All the healthcare waste produced (1000 tons yr(-1)) is treated in an autoclave plant. However, treating some categories of healthcare wastes in autoclave units mismatches with the EU waste regulations, as alternative treatment technologies are not technically able to treat all types of healthcare wastes. A proper waste management system, therefore, requires an internal segregation scheme to divert these wastes from the main healthcare waste stream. The existing malpractice in the region could cause serious health problems if no measure is taken urgently. It is expected that healthcare waste management in the region and then all across Turkey will be improved with the significant deficiencies and inconsistencies pointed out in this research. In developed countries, specific rules and regulations have already been implemented along with the recommendations for handling of healthcare waste. However, in Turkey, these wastes are treated in autoclave units, which mismatches with the European Union waste regulations, as alternative treatment technologies are not technically capable to treat all types of healthcare wastes. The existing malpractice could cause serious health problems if no measure is taken urgently. The authors demonstrated the existing status of Turkish waste management and revealed deficiencies, inconsistencies, and improper applications in comparison with developed and developing nations to align Turkish practice to European Union requirements.

Pandemic Influenza as 21st Century Urban Public Health Crisis

PubMed Central

Weisfuse, Isaac B.; Hernandez-Avila, Mauricio; del Rio, Carlos; Bustamante, Xinia; Rodier, Guenael

2009-01-01

The percentage of the world’s population living in urban areas will increase from 50% in 2008 to 70% (4.9 billion) in 2025. Crowded urban areas in developing and industrialized countries are uniquely vulnerable to public health crises and face daunting challenges in surveillance, response, and public communication. The revised International Health Regulations require all countries to have core surveillance and response capacity by 2012. Innovative approaches are needed because traditional local-level strategies may not be easily scalable upward to meet the needs of huge, densely populated cities, especially in developing countries. The responses of Mexico City and New York City to the initial appearance of influenza A pandemic (H1N1) 2009 virus during spring 2009 illustrate some of the new challenges and creative response strategies that will increasingly be needed in cities worldwide. PMID:19961676

Cost containment: the Middle East. Saudi Arabia.

PubMed

Chang, R W

1994-08-01

The 1970s and early 1980s saw the phenomenal growth and development of healthcare services in Saudi Arabia. This growth was unique in that it took place in a country that lacked basic infrastructure and trained personnel, but had recently acquired great wealth. Developments that took hundreds of years to occur in other countries took only 20 yrs to attain in Saudi Arabia. This growth posed unique challenges and required novel solutions. Recently, the country has had to cope with a drastic decrease in oil revenue, as well as cutbacks in healthcare funding. Now that the basic foundations of a national healthcare service have been constructed, it remains to be seen whether gains can be consolidated and steady progress made as more and more Saudi nationals take over and run their own public and private healthcare services.

Data sets on pensions and health: Data collection and sharing for policy design

PubMed Central

Lee, Jinkook

2015-01-01

A growing number of countries are developing or reforming pension and health policies in response to population ageing and to enhance the welfare of their citizens. The adoption of different policies by different countries has resulted in several natural experiments. These offer unusual opportunities to examine the effects of varying policies on health and retirement, individual and family behaviour, and well-being. Realizing these opportunities requires harmonized data-collection efforts. An increasing number of countries have agreed to provide data harmonized with the Health and Retirement Study in the United States. This article discusses these data sets, including their key parameters of pension and health status, research designs, samples, and response rates. It also discusses the opportunities they offer for cross-national studies and their implications for policy evaluation and development. PMID:26229178

Rating maternal and neonatal health services in developing countries.

PubMed Central

Bulatao, Rodolfo A.; Ross, John A.

2002-01-01

OBJECTIVE: To assess maternal and neonatal health services in 49 developing countries. METHODS: The services were rated on a scale of 0 to 100 by 10 - 25 experts in each country. The ratings covered emergency and routine services, including family planning, at health centres and district hospitals, access to these services for both rural and urban women, the likelihood that women would receive particular forms of antenatal and delivery care, and supporting elements of programmes such as policy, resources, monitoring, health promotion and training. FINDINGS: The average rating was only 56, but countries varied widely, especially in access to services in rural areas. Comparatively good ratings were reported for immunization services, aspects of antenatal care and counselling on breast feeding. Ratings were particularly weak for emergency obstetric care in rural areas, safe abortion and HIV counselling. CONCLUSION: Maternal health programme effort in developing countries is seriously deficient, particularly in rural areas. Rural women are disadvantaged in many respects, but especially regarding the treatment of emergency obstetric conditions. Both rural and urban women receive inadequate HIV counselling and testing and have quite limited access to safe abortion. Improving services requires moving beyond policy reform to strengthening implementation of services and to better staff training and health promotion. Increased financing is only part of the solution. PMID:12378290

Android and ODK based data collection framework to aid in epidemiological analysis

PubMed Central

Raja, A.; Tridane, A.; Gaffar, A.; Lindquist, T.; Pribadi, K.

2014-01-01

Periodic collection of field data, analysis and interpretation of data are key to a good healthcare service. This data is used by the subsequent decision makers to recognize preventive measures, provide timely support to the affected and to help measure the effects of their interventions. While the resources required for good disease surveillance and proactive healthcare are available more readily in developed countries, the lack of these in developing countries may compromise the quality of service provided. This combined with the critical nature of some diseases makes this an essential issue to be addressed. Taking advantage of the rapid growth of cell phone usage and related infrastructure in developed as well as developing countries, several systems have been established to address the gaps in data collection. Android, being an open sourced platform, has gained considerable popularity in this aspect. Open data kit is one such tool developed to aid in data collection. The aim of this paper is to present a prototype framework built using few such existing tools and technologies to address data collection for seasonal influenza, commonly referred to as the flu. PMID:24678381

Development of a novel controllable, multidirectional, reusable metallic port with a wide working space.

PubMed

Hosaka, Seiji; Ohdaira, Takeshi; Umemoto, Satoshi; Hashizume, Makoto; Kawamoto, Shunji

2013-12-01

Endoscopic surgery is currently a standard procedure in many countries. Furthermore, conventional four-port laparoscopic cholecystectomy is developing into a single-port procedure. However, in many developing countries, disposable medical products are expensive and adequate medical waste disposable facilities are absent. Advanced medical treatments such as laparoscopic or single-port surgeries are not readily available in many areas of developing countries, and there are often no other sterilization methods besides autoclaving. Moreover, existing reusable metallic ports are impractical and are thus not widely used. We developed a novel controllable, multidirectional single-port device that can be autoclaved, and with a wide working space, which was employed in five patients. In all patients, laparoscopic cholecystectomy was accomplished without complications. Our device facilitates single-port surgery in areas of the world with limited sterilization methods and offers a novel alternative to conventional tools for creating a smaller incision, decrease postoperative pain, and improve cosmesis. This novel device can also lower the cost of medical treatment and offers a promising tool for major surgeries requiring a wide working space.

Life cycle assessment of two dwellings: one in Spain, a developed country, and one in Colombia, a country under development.

PubMed

Ortiz-Rodríguez, Oscar; Castells, Francesc; Sonnemann, Guido

2010-05-15

The main objective of this paper is to study and quantify the differences in energy consumption and environmental impacts of two dwellings during the full building life cycle: one in Spain, a developed country, and one in Colombia, a country under development. In both scenarios, we assessed the construction, use and end-of-life phases. Results show that the use phase in the Pamplona house (Colombia) represents a lower percentage for all impacts in the total than in the Barcelona house (Spain). The findings of this study showed that the difference in consumption in Colombia and Spanish dwellings analysed is not only due to the variation in results for bio-climatic differences but also because of the consumption habits in each country. The importance of consumption habits of citizens and the need to decouple socio-economic development from energy consumption are sought for achieving sustainability from a life cycle perspective. There is a crucial necessity to provide satisfaction to basic needs and comfort requirements of population with reasonable and sustainable energy consumption. Then, the type of standard dwelling varies substantially depending on the geographic location where it is built. Climate, technological, cultural, socio-economical differences clearly define the standard of a building in any context and in any region. However, the function is always the same, to provide protection and housing for its habitants. Copyright 2010 Elsevier B.V. All rights reserved.

[Organizational forms of emergency medicine in international comparison].

PubMed

Lipp, M

1993-09-01

The tasks of preclinical emergency medicine systems (PEMS) are to stabilize and maintain the vital functions and to guarantee qualified transport to the hospital. Worldwide, different structures exist as a result of historical developments. Legal regulations for PEMS have been introduced in most of the industrialized countries since 1960. More and more aspects have been subject to detailed regulations. PEMS are provided either by state-owned or by state-controlled (private) organisations. In most of the "underdeveloped" countries legal regulations do not exist and PEMS is often provided by social workers, by the army or by volunteers. In most countries, PEMS are financed by the state with a charge on the patient. In a few states PEMS are totally financed by the public health structure. Modern PEMS are controlled from dispatch centres which receive emergency calls (mostly by telephone) and send the appropriate rescue unit. In most states the staff of dispatch centres are paramedics; in some countries and in some urban areas physicians control the dispatch centre. In PEMS without physicians on the scene, an information exchange between the scene and the hospital can be observed frequently, in contrast to systems with physicians on the scene. Worldwide, ground-based PEMS are preferred, but in most countries an additional air rescue system has been established. The quality and quantity of the technical equipment of the ground-based PEMS differ widely: nationwide regulations exist, however, in the USA and Germany. Generally, there are two main concepts concerning the personnel structure: PEMS are either physician based or not. Requirements for emergency physicians differ greatly: in some countries no formal requirements exist, in others extensive practical and theoretical training is required.(ABSTRACT TRUNCATED AT 250 WORDS)

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

A current global view of environmental and occupational cancers.

PubMed

Yang, Mihi

2011-07-01

This review is focused on current information of avoidable environmental pollution and occupational exposure as causes of cancer. Approximately 2% to 8% of all cancers are thought to be due to occupation. In addition, occupational and environmental cancers have their own characteristics, e.g., specific chemicals and cancers, multiple factors, multiple causation and interaction, or latency period. Concerning carcinogens, asbestos/silica/wood dust, soot/polycyclic aromatic hydrocarbons [benzo(a) pyrene], heavy metals (arsenic, chromium, nickel), aromatic amines (4-aminobiphenyl, benzidine), organic solvents (benzene or vinyl chloride), radiation/radon, or indoor pollutants (formaldehyde, tobacco smoking) are mentioned with their specific cancers, e.g., lung, skin, and bladder cancers, mesothelioma or leukemia, and exposure routes, rubber or pigment manufacturing, textile, painting, insulation, mining, and so on. In addition, nanoparticles, electromagnetic waves, and climate changes are suspected as future carcinogenic sources. Moreover, the aspects of environmental and occupational cancers are quite different between developing and developed countries. The recent follow-up of occupational cancers in Nordic countries shows a good example for developed countries. On the other hand, newly industrializing countries face an increased burden of occupational and environmental cancers. Developing countries are particularly suffering from preventable cancers in mining, agriculture, or industries without proper implication of safety regulations. Therefore, industrialized countries are expected to educate and provide support for developing countries. In addition, citizens can encounter new environmental and occupational carcinogen nominators such as nanomaterials, electromagnetic wave, and climate exchanges. As their carcinogenicity or involvement in carcinogenesis is not clearly unknown, proper consideration for them should be taken into account. For these purposes, new technologies with a balance of environment and gene are required. Currently, various approaches with advanced technologies--genomics, exposomics, etc.--have accelerated development of new biomarkers for biological monitoring of occupational and environmental carcinogens. These advanced approaches are promising to improve quality of life and to prevent occupational and environmental cancers.

Results from a survey of national immunization programmes on home-based vaccination record practices in 2013

PubMed Central

Young, Stacy L.; Gacic-Dobo, Marta; Brown, David W.

2015-01-01

Background Data on home-based records (HBRs) practices within national immunization programmes are non-existent, making it difficult to determine whether current efforts of immunization programmes related to basic recording of immunization services are appropriately focused. Methods During January 2014, WHO and the United Nations Children's Fund sent a one-page questionnaire to 195 countries to obtain information on HBRs including type of record used, number of records printed, whether records were provided free-of-charge or required by schools, whether there was a stock-out and the duration of any stock-outs that occurred, as well as the total expenditure for printing HBRs during 2013. Results A total of 140 countries returned a completed HBR questionnaire. Two countries were excluded from analysis because they did not use a HBR during 2013. HBR types varied across countries (vaccination only cards, 32/138 [23.1%]; vaccination plus growth monitoring records, 31/138 [22.4%]; child health books, 48/138 [34.7%]; combination of these, 27/138 [19.5%] countries). HBRs were provided free-of-charge in 124/138 (89.8%) respondent countries. HBRs were required for school entry in 62/138 (44.9%) countries. Nearly a quarter of countries reported HBR stock-outs during 2013. Computed printing cost per record was

Results from a survey of national immunization programmes on home-based vaccination record practices in 2013.

PubMed

Young, Stacy L; Gacic-Dobo, Marta; Brown, David W

2015-07-01

Data on home-based records (HBRs) practices within national immunization programmes are non-existent, making it difficult to determine whether current efforts of immunization programmes related to basic recording of immunization services are appropriately focused. During January 2014, WHO and the United Nations Children's Fund sent a one-page questionnaire to 195 countries to obtain information on HBRs including type of record used, number of records printed, whether records were provided free-of-charge or required by schools, whether there was a stock-out and the duration of any stock-outs that occurred, as well as the total expenditure for printing HBRs during 2013. A total of 140 countries returned a completed HBR questionnaire. Two countries were excluded from analysis because they did not use a HBR during 2013. HBR types varied across countries (vaccination only cards, 32/138 [23.1%]; vaccination plus growth monitoring records, 31/138 [22.4%]; child health books, 48/138 [34.7%]; combination of these, 27/138 [19.5%] countries). HBRs were provided free-of-charge in 124/138 (89.8%) respondent countries. HBRs were required for school entry in 62/138 (44.9%) countries. Nearly a quarter of countries reported HBR stock-outs during 2013. Computed printing cost per record was

Turning the tide: national policy approaches to increasing physical activity in seven European countries.

PubMed

Bull, Fiona; Milton, Karen; Kahlmeier, Sonja; Arlotti, Alberto; Juričan, Andrea Backović; Belander, Olov; Martin, Brian; Martin-Diener, Eva; Marques, Ana; Mota, Jorge; Vasankari, Tommi; Vlasveld, Anita

2015-06-01

Physical inactivity is one of the four leading behavioural risk factors for non-communicable disease (NCD). Like tobacco control, increasing levels of health-enhancing physical activity (HEPA) will require a national policy framework providing direction and a clear set of actions. Despite frequent calls, there has been insufficient progress on policy development in the majority of countries around the world. This study sought and summarised national HEPA policy in seven European countries (Finland, Italy, the Netherlands, Norway, Portugal, Slovenia and Switzerland). Data collection used a policy audit tool (PAT), a 27-item instrument structured into four sections. All countries reported some legislation or policy across the sectors of education, sport and health. Only some countries reported supportive policy in the transport and environment sectors. Five countries reported a stand-alone HEPA policy and six countries reported national recommendations. HEPA prevalence targets varied in magnitude and specificity and the presence of other relevant goals from different sectors highlighted the opportunity for joint action. Evaluation and the use of scientific evidence were endorsed but described as weak in practice. Only two countries reported a national multisector coordinating committee and most countries reported challenges with partnerships on different levels of policy implementation. Bringing together the key components for success within a national HEPA policy framework is not simple. This in-depth policy audit and country comparison highlighted similarities and differences and revealed new opportunities for consideration by other countries. These examples can inform countries within and beyond Europe and guide the development of national HEPA policy within the NCD prevention agenda. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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.

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.

[Projection of prisoner numbers].

PubMed

Metz, Rainer; Sohn, Werner

2015-01-01

The past and future development of occupancy rates in prisons is of crucial importance for the judicial administration of every country. Basic factors for planning the required penal facilities are seasonal fluctuations, minimum, maximum and average occupancy as well as the present situation and potential development of certain imprisonment categories. As the prisoner number of a country is determined by a complex set of interdependent conditions, it has turned out to be difficult to provide any theoretical explanations. The idea accepted in criminology for a long time that prisoner numbers are interdependent with criminal policy must be regarded as having failed. Statistical and time series analyses may help, however, to identify the factors having influenced the development of prisoner numbers in the past. The analyses presented here, first describe such influencing factors from a criminological perspective and then deal with their statistical identification and modelling. Using the development of prisoner numbers in Hesse as an example, it has been found that modelling methods in which the independent variables predict the dependent variable with a time lag are particularly helpful. A potential complication is, however, that for predicting the number of prisoners the different dynamics in German and foreign prisoners require the development of further models.

The Effects of Domestic Energy Consumption on Urban Development Using System Dynamics

NASA Astrophysics Data System (ADS)

Saryazdi, M. D.; Homaei, N.; Arjmand, A.

2018-05-01

In developed countries, people have learned to follow efficient consumption patterns, while in developing countries, such as Iran, these patterns are not well executed. A large amount of energy is almost consumed in buildings and houses and though the consumption patterns varies in different societies, various energy policies are required to meet the consumption challenges. So far, several papers and more than ten case studies have worked on the relationship between domestic energy consumption and urban development, however these researches did not analyzed the impact of energy consumption on urban development. Therefore, this paper attempts to examine the interactions between the energy consumption and urban development by using system dynamics as the most widely used methods for complex problems. The proposed approach demonstrates the interactions using causal loop and flow diagrams and finally, suitable strategies will be proposed for urban development through simulations of different scenarios.

22 CFR 41.63 - Two-year home-country physical presence requirement.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Two-year home-country physical presence...-year home-country physical presence requirement. (a) Statutory basis for rule. Section 212(e) of the... exchange visitor who seeks a waiver of the two-year home-country residence and physical presence...

22 CFR 41.63 - Two-year home-country physical presence requirement.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Two-year home-country physical presence...-year home-country physical presence requirement. (a) Statutory basis for rule. Section 212(e) of the... exchange visitor who seeks a waiver of the two-year home-country residence and physical presence...

22 CFR 41.63 - Two-year home-country physical presence requirement.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Two-year home-country physical presence...-year home-country physical presence requirement. (a) Statutory basis for rule. Section 212(e) of the... exchange visitor who seeks a waiver of the two-year home-country residence and physical presence...

22 CFR 41.63 - Two-year home-country physical presence requirement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Two-year home-country physical presence...-year home-country physical presence requirement. (a) Statutory basis for rule. Section 212(e) of the... exchange visitor who seeks a waiver of the two-year home-country residence and physical presence...

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.

Health checkup and telemedical intervention program for preventive medicine in developing countries: verification study.

PubMed

Nohara, Yasunobu; Kai, Eiko; Ghosh, Partha Pratim; Islam, Rafiqul; Ahmed, Ashir; Kuroda, Masahiro; Inoue, Sozo; Hiramatsu, Tatsuo; Kimura, Michio; Shimizu, Shuji; Kobayashi, Kunihisa; Baba, Yukino; Kashima, Hisashi; Tsuda, Koji; Sugiyama, Masashi; Blondel, Mathieu; Ueda, Naonori; Kitsuregawa, Masaru; Nakashima, Naoki

2015-01-28

The prevalence of non-communicable diseases is increasing throughout the world, including developing countries. The intent was to conduct a study of a preventive medical service in a developing country, combining eHealth checkups and teleconsultation as well as assess stratification rules and the short-term effects of intervention. We developed an eHealth system that comprises a set of sensor devices in an attaché case, a data transmission system linked to a mobile network, and a data management application. We provided eHealth checkups for the populations of five villages and the employees of five factories/offices in Bangladesh. Individual health condition was automatically categorized into four grades based on international diagnostic standards: green (healthy), yellow (caution), orange (affected), and red (emergent). We provided teleconsultation for orange- and red-grade subjects and we provided teleprescription for these subjects as required. The first checkup was provided to 16,741 subjects. After one year, 2361 subjects participated in the second checkup and the systolic blood pressure of these subjects was significantly decreased from an average of 121 mmHg to an average of 116 mmHg (P<.001). Based on these results, we propose a cost-effective method using a machine learning technique (random forest method) using the medical interview, subject profiles, and checkup results as predictor to avoid costly measurements of blood sugar, to ensure sustainability of the program in developing countries. The results of this study demonstrate the benefits of an eHealth checkup and teleconsultation program as an effective health care system in developing countries.

The Trans Pacific Partnership Agreement, intellectual property and medicines: Differential outcomes for developed and developing countries.

PubMed

Gleeson, Deborah; Lexchin, Joel; Lopert, Ruth; Kilic, Burcu

2018-04-01

The final text of the Trans Pacific Partnership Agreement (TPP), agreed between the 12 negotiating countries in 2016, included a suite of intellectual property provisions intended to expand and extend pharmaceutical company exclusivities on medicines. It drew wide criticism for including such provisions in an agreement that involved developing countries (Vietnam, Peru, Malaysia, Mexico, Chile and Brunei Darussalam) because of the effect on delaying the introduction of low-cost generics. While developing nations negotiated transition periods for implementing some obligations, all parties would have eventually been expected to meet the same standards had the TPP come into force. While the TPP has stalled following US withdrawal, there are moves by some of the remaining countries to reinvigorate the agreement without the United States. The proponents may seek to retain as much as possible of the original text in the hope that the United States will re-join the accord in future. This article presents a comparative analysis of the impact the final 2016 TPP intellectual property chapter could be expected to have (if implemented in its current form) on the intellectual property laws and regulatory regimes for medicines in the TPP countries. Drawing on the published literature, it traces the likely impact on access to medicines. It focuses particularly on the differential impact on regulatory frameworks for developed and developing nations (in terms of whether or not legislative action would have been required to implement the agreement). The article also explores the political and economic dynamics that contributed to these differential outcomes.

The Trans Pacific Partnership Agreement, intellectual property and medicines: Differential outcomes for developed and developing countries

PubMed Central

Gleeson, Deborah; Lexchin, Joel; Lopert, Ruth; Kilic, Burcu

2017-01-01

The final text of the Trans Pacific Partnership Agreement (TPP), agreed between the 12 negotiating countries in 2016, included a suite of intellectual property provisions intended to expand and extend pharmaceutical company exclusivities on medicines. It drew wide criticism for including such provisions in an agreement that involved developing countries (Vietnam, Peru, Malaysia, Mexico, Chile and Brunei Darussalam) because of the effect on delaying the introduction of low-cost generics. While developing nations negotiated transition periods for implementing some obligations, all parties would have eventually been expected to meet the same standards had the TPP come into force. While the TPP has stalled following US withdrawal, there are moves by some of the remaining countries to reinvigorate the agreement without the United States. The proponents may seek to retain as much as possible of the original text in the hope that the United States will re-join the accord in future. This article presents a comparative analysis of the impact the final 2016 TPP intellectual property chapter could be expected to have (if implemented in its current form) on the intellectual property laws and regulatory regimes for medicines in the TPP countries. Drawing on the published literature, it traces the likely impact on access to medicines. It focuses particularly on the differential impact on regulatory frameworks for developed and developing nations (in terms of whether or not legislative action would have been required to implement the agreement). The article also explores the political and economic dynamics that contributed to these differential outcomes. PMID:29706802

Supporting Real Innovation in the 80's--Characteristics of ID Units That Will Make It Happen. A DID/AECT Occasional Paper.

ERIC Educational Resources Information Center

Sachs, Steven G.

Planning the activities for an instructional development unit and evaluating how well it has performed requires a set of standards against which the unit can be compared. This paper proposes a set of standards developed from a variety of references and personal experiences with instructional development units from across the country. Thirty-eight…

Paediatric cataract blindness in the developing world: surgical techniques and intraocular lenses in the new millennium

PubMed Central

Wilson, M E; Pandey, S K; Thakur, J

2003-01-01

Paediatric cataract blindness presents an enormous problem to developing countries in terms of human morbidity, economic loss, and social burden. Managing cataracts in children remains a challenge: treatment is often difficult, tedious, and requires a dedicated team effort. To assure the best long term outcome for cataract blind children, appropriate paediatric surgical techniques need to be defined and adopted by ophthalmic surgeons of developing countries. The high cost of operative equipment and the uneven world distribution of ophthalmologists, paediatricians, and anaesthetists create unique challenges. This review focuses on issues related to paediatric cataract management that are appropriate and suitable for ophthalmic surgeons in the developing world. Practical guidelines and recommendations have also been provided for ophthalmic surgeons and health planners dealing with childhood cataract management in the developing world. PMID:12488254

[Health manpower in the Americas].

PubMed

Nogueira, R P; Brito, P

1986-01-01

The article summarizes the country studies on the development of the health manpower situation published in this issue of Educación médica y Salud, Vol. 20, No. 3, 1986. The countries covered are Argentina, Brazil, Canada, Cuba, Colombia, Mexico, and the United States of America. In these studies, the concept of disequilibrium or lack of balance and proportion was used to describe and examine some specific situations. However, no study took this concept as an object of further theoretical development, and in some it was preferred to replace it explicitly with the term "problem." The following categories of health personnel are considered: physicians, nurses and "other professions" (the latter very briefly). Professional training, the labor market, the relationship between supply and demand and the relationship with the geographic distribution of members of the health professions in the country are discussed. The studies summarized show that the situations and trends are similar in most of the countries, but that specific variations exist owing to structural and situational aspects in each. The most notable differences are seen between the characteristics of the manpower in the developed and in the developing countries. The variations in the English-speaking countries of the Caribbean are also brought out. Finally, there is a discussion of the occupational pyramid of the human resources in the health field, which consists of three horizontal segments. At the vertex are the university-trained categories; the middle is occupied by the technicians and auxiliary personnel, and at the base are the occupations requiring a low educational level.

Issues in the Development of Cross-Cultural Assessments of Speech and Language for Children

ERIC Educational Resources Information Center

Carter, Julie A.; Lees, Janet A.; Murira, Gladys M.; Gona, Joseph; Neville, Brian G. R.; Newton, Charles R. J. C.

2005-01-01

Background: There is an increasing demand for the assessment of speech and language in clinical and research situations in countries where there are few assessment resources. Due to the nature of cultural variation and the potential for cultural bias, new assessment tools need to be developed or existing tools require adaptation. However, there…

Productivity Indicators for the Rural Poor in Developing Countries

ERIC Educational Resources Information Center

James, Jeffrey

2007-01-01

Meeting the Millennium Development Goals will necessarily require a heavy focus on rural areas, where most of the world's poor are to be found. More specifically, policy will need to raise the productivity of this group, which includes farmers, wage labourers and those suffering from disease and malnutrition. Yet, at present, no index exists which…

Using the Internet to Educate the World: The "Earthlearningidea" Website

ERIC Educational Resources Information Center

Kennett, Peter

2012-01-01

The website "Earthlearningidea" was developed for the International Year of Planet Earth in 2007 and continues with one new activity per fortnight. Activities are devised to catch the attention of students and to enable them to enjoy the science of the Earth. Many activities require minimal equipment, for schools in developing countries, but there…

Limiting Central Government Budget Deficits: International Experiences

DTIC Science & Technology

2010-03-11

Economic Cooperation and Development ( OECD ) countries, limit their fiscal deficits. Financial markets support government efforts to reduce deficit...fiscal consolidation efforts and developing medium-term budgetary frameworks for fiscal planning . Fiscal consolidation efforts, however, generally...require policymakers to weigh the effects of various policy trade-offs, including the trade-off between adopting stringent, but enforceable, rules- based

The state of world population and its implications for the US.

PubMed

Fornos, W

1987-07-01

Before the end of the century, annual world population growth is expected to exceed 90 million. Among the consequences of this rapid population growth--most of which will take place in developing countries-- are environmental degradation, urban deterioration, unemployment, hunger, resource depletion, and economic stagnation. Despite this alarming situation, the US Government has reduced appropriations for international population aid from US$290 million in 1985 to $200 million in 1988. In addition, the US has stopped funding the 2 organizations that have been most effective in providing family planning assistance to developing countries: the United Nations Fund for Population Activities and the International Planned Parenthood Federation. The US has adapted a policy that asserts that population is a neutral factor in development and promotes capitalism as a means of lowering fertility. However, experience in developing countries such as Thailand, China, and the Philippines that have undergone dramatic fertility declines attests that family planning efforts can result in economic growth. Over 80% of developing countries have established population control policies yet they will require substantial financial and technical aid from industrialized nations. It is ironic that the US has turned away from a commitment to helping poor countries to voluntarily reduce their high fertility rates at a time when such countries have accepted the necessity of such a goal. It is further ironic that the US expresses concern about the threat of revolution in areas such as Central America, yet fails to comprehend the social unrest and threats to global stability that will emerge as a result of continued population growth. At least a doubling--preferably a tripling--of US population assistance is needed.

Education: The Heart of the Matter.

PubMed

Morriss, Wayne W; Milenovic, Miodrag S; Evans, Faye M

2018-04-01

There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries:(1) Programs must be appropriate for the local environment-there is no "one-size-fits-all" program. In some countries, nonuniversity programs may be appropriate for training providers.(2) It is essential to train local teachers-a number of short courses provide teacher training. Overseas attachments may also play an important role in developing leadership and teaching capacity.(3) Interactive teaching techniques, such as small-group discussions and simulation, have been incorporated into many educational programs. Computer learning and videoconferencing offer additional educational possibilities.(4) Subspecialty education in areas such as obstetric anesthesia, pediatric anesthesia, and pain management are needed to develop leadership and increase capacity in subspecialty areas of practice. Examples include short subspecialty courses and clinical fellowships.(5) Collaboration and coordination are vital. Anesthesiologists need to work with ministries of health and other organizations to develop plans that are matched to need. External organizations can play an important role.(6) Excellent education is required at all levels. Training guidelines could help to standardize and improve training. Resources should be available for research, as well as monitoring and evaluation of educational programs.

Africa's search for communication technologies for education: a reflection on problems and prospects.

PubMed

Ofori-ansa, K

1983-09-01

In postindependence Africa new and more efficient strategies were required to support educational expansion. Political independence was accompanied by an increased demand for education to meet the growing labor force needs of the emerging countries in Africa. It was considered that education, as a means for human resource development, was a viable capital investment necessary to support both social and economic development, yet in many African nations, the educational systems and the traditional teaching methods inherited from colonial rule were not adequate to satisfy the increased demand for trained personnel. In response to the need for educational reforms and expansion, governments of many African countries invested heavily in the development of their education systems. During the 1970s it is estimated that Africa spent between 15-20% of the national budget on education. That high level of expenditure was justified by the increased demand for education. The educational expansion efforts also increased shortages of qualified and competent teachers, shortages of adequate equipment, and physical facilities. New strategies and resources with required to solve these increasing problems. Many African countries began to experiment with the use of mass communication technologies to support their educational reform efforts. There was generally consensus that the mass media, particularly radio and television, had certain qualities that could be exploited either to replace or improve conventional methods of teaching. By the late 1960s at least 16 African countries were using educational broadcasting of 1 form or another. International aid agencies, govermental donor agencies, and private foundations in the industrially advanced countries provided the support base for many African countries in their efforts to use radio and television for educational improvement. Most of these efforts failed to make any significant impact on educational development in Africa. Educational analysts have generally concluded that post-independence educational reforms in Africa failed to achieve thier aims. Some recommendations are offered with the objective of contributing to the ongoing international effort to search for more effective approaches in using communication technologies to support educational development in Africa. Technical assistance programs supporting educational use of modern communication technologies should be perceived in the context of international cooperation, with a 2-way flow, rather than in the context of a donor recipient relationship. Greater emphasis should be placed on thorough country by country assessment of educational needs and problems in order to provide an adequate basis for designing project objectives and project contents to satisfy specific needs. Needs assessment should be tempered with pragmatism and flexibility in approach. Training and orientation for foreign and local exports and increased local participation are among the recommendations.

Abdominal ultrasonographic findings in typhoid fever: a comparison between typhoid patients and those with non-typhoidal Salmonella and Campylobacter jejuni enterocolitis.

PubMed

Kobayashi, Akira; Adachi, Yasuo; Iwata, Yoshinori; Sakai, Yoshiyuki; Shigemitu, Kazuaki; Todoroki, Miwako; Ide, Mituru

2012-03-01

Typhoid fever is a major health problem in many developing countries and its clinical features are similar to other types of bacterial enterocolitis. Definitive diagnosis by blood culture requires several days and is often unfeasible to perform in developing countries. More efficient and rapid diagnostic methods for typhoid are needed. We compared the pathological changes in the bowel and adjacent tissues of patients having typhoid fever with those having bacterial enterocolitis using ultrasonography. A characteristic of patients with non-typhoidal Salmonella and Campylobacter jejuni enterocolitis was mural thickening of the terminal ileum; only mild mural swelling or no swelling was observed in patients with typhoid fever. Mesenteric lymph nodes in patients with typhoid fever were significantly more enlarged compared to patients with other types of bacterial enterocolitis. Our findings suggest typhoid fever is not fundamentally an enteric disease but rather resembles mesenteric lymphadenopathy and ultrasound is a promising modality for diagnosing typhoid fever in developing countries.

Scalp Block for Awake Craniotomy in a Patient With a Frontal Bone Mass: A Case Report

PubMed Central

Amiri, Hamid Reza; Kouhnavard, Marjan; Safari, Saeid

2012-01-01

“Anesthesia” for awake craniotomy is a unique clinical condition that requires the anesthesiologist to provide changing states of sedation and analgesia, to ensure optimal patient comfort without interfering with electrophysiologic monitoring and patient cooperation, and also to manipulate cerebral and systemic hemodynamics while guaranteeing adequate ventilation and patency of airways. Awake craniotomy is not as popular in developing countries as in European countries. This might be due to the lack of information regarding awake craniotomy and its benefits among the neurosurgeons and anesthetists in developing countries. From the economic perspective, this procedure may decrease resource utilization by reducing the use of invasive monitoring, the duration of the operation, and the length of postoperative hospital stay. All these reasons also favor its use in the developing world, where the availability of resources still remains a challenge. In this case report we presented a successful awake craniotomy in patient with a frontal bone mass. PMID:24904791

Narrative review: tetanus-a health threat after natural disasters in developing countries.

PubMed

Afshar, Majid; Raju, Mahesh; Ansell, David; Bleck, Thomas P

2011-03-01

Tetanus is an expected complication when disasters strike in developing countries, where tetanus immunization coverage is often low or nonexistent. Collapsing structures and swirling debris inflict numerous crush injuries, fractures, and serious wounds. Clostridium tetani infects wounds contaminated with dirt, feces, or saliva and releases neurotoxins that may cause fatal disease. Clusters of infections have recently occurred after tsunamis and earthquakes in Indonesia, Kashmir, and Haiti. The emergency response to clusters of tetanus infections in developing countries after a natural disaster requires a multidisciplinary approach in the absence of an intensive care unit, readily available resources, and a functioning cold-chain system. It is essential that injured people receive immediate surgical and medical care of contaminated, open wounds with immunization and immunoglobulin therapy. Successful treatment of tetanus depends on prompt diagnosis of clinical tetanus, treatment to ensure neutralization of circulating toxin and elimination of C. tetani infection, control of spasms and convulsions, maintenance of the airway, and management of respiratory failure and autonomic dysfunction.

Intermittent Solar Ammonia Absorption Cycle (ISAAC) refrigeration for lesser developed countries

NASA Astrophysics Data System (ADS)

Erickson, Donald C.

1990-02-01

The Intermittent Solar Ammonia Absorption Cycle (ISAAC) refrigerator is a solar thermal technology which provides low cost, efficient, reliable ice-making to areas without ready access to electricity. An ISAAC refrigeration system consists of a compound parabolic solar collector, two pressure vessels, a condenser, a cold box or refrigerated space, and simple connective piping -- no moving parts or electrical components. Most parts are simple construction or plumbing grade materials, locally available in many remote areas. This technology has numerous potential benefits in lesser developed countries both by providing a cheap, reliable source of ice, and, since manufacture requires only semi-skilled labor, a source of employment to the local economy. Applications include vaccine storage for health care clinics; fish, meat, and dairy product storage; and personal consumption. Importantly, this technology increases the quality of life for people in lesser developed countries without depleting fossil fuel resources or increasing the release of greenhouse gases such as CO2 and chlorofluorocarbons.

Merging Remote Sensing and Socioeconomic Data to Improve Disaster Risk Assessment

NASA Astrophysics Data System (ADS)

Yetman, G.; Chen, R. S.; Huyck, C. K.

2015-12-01

Natural disasters disproportionately impact developing country economies while also impacting business operations for multi-national corporations that rely on supplies and manufacturing in affected areas. Understanding natural hazard risk is only a first step towards preparedness and mitigation—data on facilities, transportation, critical infrastructure, and populations that may be exposed to disasters is required to plan for events and properly assess risks. Detailed exposure data can be used in models to predict casualty rates, aggregate estimates of building damage or destruction, impacts on business operations, and the scale of recovery efforts required. These model outputs are useful for disaster preparedness planning by national and international organizations, as well as for corporations and the reinsurance industry seeking to better understand their risk exposure. Many of these data are lacking for developing countries. Rapid assessment in areas with minimal data for disaster modeling is possible by combing remote sensing data, sample data on construction methods, facility and critical infrastructure data, and economic and demographic census information. This presentation focuses on the methods used to fuse the physical and socioeconomic data by presenting the results from two projects. The first project seeks to improve earthquake risk assessments in Asia using for the reinsurance industry, while the second project builds an integrated exposure database across five countries in Africa for use by international development organizations.

Information use skills in the engineering programme accreditation criteria of four countries

NASA Astrophysics Data System (ADS)

Bradley, Cara

2014-01-01

The need for twenty-first century information skills in engineering practice, combined with the importance for engineering programmes to meet accreditation requirements, suggests that it may be worthwhile to explore the potential for closer alignment between librarians and their work with information literacy competencies to assist in meeting accreditation standards and graduating students with high-level information skills. This article explores whether and how information use skills are reflected in engineering programme accreditation standards of four countries: Canada, the USA, the UK, and Australia. Results indicate that there is significant overlap between the information use skills required of students by engineering accreditation processes and librarians' efforts to develop information literacy competencies in students, despite differences in terms used to describe these skills. Increased collaboration between engineering faculty and librarians has the potential to raise student information literacy levels and fulfil the information use-related requirements of accreditation processes.

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.

Learning experiences in population education: proposed guidelines and core messages.

PubMed

1984-01-01

As a result of the 1984 Regional Workshop for the Development of Packages of Adequate Learning Requirements in Population Education, the participants tackled the problem of non-institutionalization of population education into the formal and non-formal educational curricula in their countries. Based on their deliberations, several sets of guidelines and core messages were formulated to provide countries with a more definite direction that will hopefully ensure the functional and effective integration of population education in their respective national school and out-of-school curriculum system. Useful packages of learning materials in population education should help realize the country's population policy and goals within the broader framework of socioeconomic development, and the content of the package should comprehensively cover the core messages of the country's Population Information, Education and Communication (IEC) Program. The population knowledge base of the package should be accurate and relevant; the package should provide for graphic and visual presentation and for assessment of effects on the target groups. Proposed core messages in population education discuss the advantages of small family size and delayed marriage, and aspects of responsible parenthood. Other messages discuss population resource development and population-related beliefs and values.

Cost-effectiveness and resource implications of aggressive action on TB in China, India and South Africa: a combined analysis of nine models

PubMed Central

Menzies, Nicolas A; Gomez, Gabriela B; Bozzani, Fiammetta; Chatterjee, Susmita; Foster, Nicola; Baena, Ines Garcia; Laurence, Yoko V; Qiang, Sun; Siroka, Andrew; Sweeney, Sedona; Verguet, Stéphane; Arinaminpathy, Nimalan; Azman, Andrew S; Bendavid, Eran; Chang, Stewart T; Cohen, Ted; Denholm, Justin T; Dowdy, David W; Eckhoff, Philip A; Goldhaber-Fiebert, Jeremy D; Handel, Andreas; Huynh, Grace H; Lalli, Marek; Lin, Hsien-Ho; Mandal, Sandip; McBryde, Emma S; Pandey, Surabhi; Salomon, Joshua A; Suen, Sze-chuan; Sumner, Tom; Trauer, James M; Wagner, Bradley G; Whalen, Christopher C; Wu, Chieh-Yin; Boccia, Delia; Chadha, Vineet K; Charalambous, Salome; Chin, Daniel P; Churchyard, Gavin; Daniels, Colleen; Dewan, Puneet; Ditiu, Lucica; Eaton, Jeffrey W; Grant, Alison D; Hippner, Piotr; Hosseini, Mehran; Mametja, David; Pretorius, Carel; Pillay, Yogan; Rade, Kiran; Sahu, Suvanand; Wang, Lixia; Houben, Rein MGJ; Kimerling, Michael E; White, Richard G; Vassall, Anna

2017-01-01

BACKGROUND The End TB Strategy sets global goals of reducing TB incidence and mortality by 50% and 75% respectively by 2025. We assessed resource requirements and cost-effectiveness of strategies to achieve these targets in China, India, and South Africa. METHODS We examined intervention scenarios developed in consultation with country stakeholders, which scaled-up existing interventions to high but feasible coverage by 2025. Nine independent TB modelling groups collaborated to estimate policy outcomes, and we costed each scenario by synthesizing service utilization estimates, empirical cost data, and expert opinion on implementation strategies. We estimated health impact and resource implications for 2016–2035, including patient-incurred costs. To assess resource requirements and cost-effectiveness, we compared scenarios to a base case representing continued current practice. FINDINGS Incremental TB service costs differed by scenario and country, and in some cases more than doubled current funding needs. In general, expanding TB services substantially reduced patient-incurred costs; and in India and China this produced net cost-savings for most interventions under a societal perspective. In all countries, expanding TB care access produced substantial health gains. Compared to current practice, most intervention approaches appeared highly cost-effective when compared to conventional cost-effectiveness thresholds. INTERPRETATION Expanding TB services appears cost-effective for high-burden countries and could generate substantial health and economic benefits for patients, though funding needs challenge affordability. Further work is required to determine the optimal intervention mix for each country. PMID:27720689

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

Scale is not an Issue : Opportunities for Collaboration among Geoscientists in Latin America and the Caribbean

NASA Astrophysics Data System (ADS)

Carby, B. E.

2015-12-01

Latin American and Caribbean (LAC) countries face multiple hazards such as earthquakes, volcanoes, accelerated erosion, landslides, drought, flooding, windstorms and the effects of climate variability and change. World Bank (2005) data indicate that seventeen of the top thirty-five countries with relatively high mortality risk from 3 or more hazards are located in LAC, El Salvador has the second highest per cent of its population at risk - 77.7% and 7 of the top 10 countries for population exposure to multiple hazards are in LAC. All LAC countries have half or more of GDP exposed to at least one hazard. The report underscores the need for better data and information on hazards and disasters to inform disaster risk reduction (DRR) and supports the view that reduction of disaster risk is essential for achieving Sustainable Development (SD). This suggests that DRR must be integrated into development planning of countries. However the Global Assessment Report notes that globally, there has been little progress in mainstreaming DRR in national development (UNISDR 2009). Without this, countries will not realise development goals. DRR efforts in LAC require an integrated approach including societal input in deciding priority DRR research themes and interdisciplinary, multi-hazard research informing DRR policy and practice. Jiminez (2015) from a study of countries across LAC reports that efforts are being made to link research to national planning through inclusion of policy makers in some university-led research projects. Research by the author in Jamaica reveals that the public sector has started to apply research on hazards to inform DRR policy, programmes and plans. As most research is done by universities, there is collaboration between the public sector and academia. Despite differences in scale among countries across the region, similarities in exposure to multiple hazards and potential hazard impacts suggest that collaboration among researchers in LAC could be beneficial. It is proposed here that this collaboration should go beyond the scientific community and should include sharing of experiences in linking DRR research to national development needs, inclusion of policy makers in research design and implementation and integration of research results in policy and programme development.

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.

Handling e-waste in developed and developing countries: initiatives, practices, and consequences.

PubMed

Sthiannopkao, Suthipong; Wong, Ming Hung

2013-10-01

Discarded electronic goods contain a range of toxic materials requiring special handling. Developed countries have conventions, directives, and laws to regulate their disposal, most based on extended producer responsibility. Manufacturers take back items collected by retailers and local governments for safe destruction or recovery of materials. Compliance, however, is difficult to assure, and frequently runs against economic incentives. The expense of proper disposal leads to the shipment of large amounts of e-waste to China, India, Pakistan, Nigeria, and other developing countries. Shipment is often through middlemen, and under tariff classifications that make quantities difficult to assess. There, despite the intents of national regulations and hazardous waste laws, most e-waste is treated as general refuse, or crudely processed, often by burning or acid baths, with recovery of only a few materials of value. As dioxins, furans, and heavy metals are released, harm to the environment, workers, and area residents is inevitable. The faster growth of e-waste generated in the developing than in the developed world presages continued expansion of a pervasive and inexpensive informal processing sector, efficient in its own way, but inherently hazard-ridden. Copyright © 2012 Elsevier B.V. All rights reserved.

Gene co-ops and the biotrade: translating genetic resource rights into sustainable development.

PubMed

Reid, W V

1996-04-01

The 1992 Convention on Biological Diversity marks a basic change in the international status of genetic resources. Prior to the Convention, these resources were considered to be the "heritage of mankind.' Although the intent of this open access regime was to ensure the widespread availability of genetic resources for agriculture and industry, commercial use of the resources provided no additional economic incentive for conservation by source countries. The Biodiversity Convention corrects this policy failure by establishing that states have sovereign rights over their genetic resources, thereby enabling market incentives to complement various multilateral mechanisms that might directly fund biodiversity conservation. A number of obstacles face countries that are translating this broad right to regulate access into specific policies, laws, and regulations designed to meet conservation and development objectives. A review of these obstacles and of trends in technological development suggest that nations and developing country institutions should take a set of actions to develop access legislation and Material Transfer Agreements, establish biodiversity "cooperatives' and intermediary institutions to facilitate information exchange, develop minimum standards for access legislation, and require that prior informed consent of local communities be obtained by all biodiversity collectors.

Management of Primary Adrenal Insufficiency: Review of Current Clinical Practice in a Developed and a Developing Country.

PubMed

Khan, Uzma; Lakhani, Om J

2017-01-01

Treatment of primary adrenal insufficiency (PAI) requires lifelong hormone replacement with glucocorticoids (GCs) and mineralocorticoids. Impaired quality of life and increased standardized mortality ratio in these patients emphasize the importance of tailoring therapy to individual needs. Role of education is paramount in improving patient compliance and in anticipating and preventing adrenal crises. Although discovery of synthetic GCs was a major breakthrough in treatment of patients with this life-threatening condition, management of PAI continues to be challenging. The obstacles for clinicians appear to vary widely across the globe. While optimization and individualization of therapy after diagnosis of PAI remain the main challenges for clinicians in the developed world, doctors in a developing country face problems at almost every stage from the diagnosis to the treatment and follow-up of these patients; cost of therapy, lack of resources, and funding are the main hindrances. Adherence to therapy and patient education are found to be common issues in most parts of the world. This commentary highlights the challenges from both developed and developing country's perspective in treating PAI; it also provides an update on current management scenario and future treatment options.

Organic livestock production: an emerging opportunity with new challenges for producers in tropical countries.

PubMed

Chander, M; Subrahmanyeswari, B; Mukherjee, R; Kumar, S

2011-12-01

Agrochemicals, veterinary drugs, antibiotics and improved feeds can increase the food supply while minimising production costs in various livestock production systems around the world. However, these days, quality-conscious consumers are increasingly seeking environmentally safe, chemical-residue-free healthy foods, along with product traceability and a high standard of animal welfare, which organic production methods are said to ensure. Organic production is not only a challenge for producers in developing countries, it offers new export opportunities as well. Organic agriculture is practised by 1.8 million producers in 160 countries, and production of organically grown food continues to increase steadily by 15% per year. Most tropical countries are now exporting organic agricultural products but, apart from organic beef from Brazil and Argentina, organic livestock products are yetto take off. Most trade in organic livestock products is restricted to the European Union and other developed nations. Nevertheless, tropical countries cannot afford to neglect this emerging system of animal production. Organic production is knowledge- and management-intensive. Producers must be well versed in organic production standards, principles and practices, which require a high degree of knowledge and skill. In organic production, it is not simply the final product but the whole production process that must be inspected and approved by the accredited certification bodies. Organic livestock farming is still evolving, and further research is needed to make it sustainable. In this paper, the authors review the prospects of organic animal husbandry and its possible constraints in developing and tropical countries.

New frontiers for health information systems using Epi Info in developing countries: structured application framework for Epi Info (SAFE).

PubMed

Ma, J; Otten, M; Kamadjeu, R; Mir, R; Rosencrans, L; McLaughlin, S; Yoon, S

2008-04-01

For more than two decades, Epi Info software has been used to meet the data management, analysis, and mapping needs of public health professionals in more than 181 countries and 13 languages. Until now, most Epi Info systems have been relatively simple, mainly because of a lack of detailed and structured guidance for developing complex systems. We created the structured application framework for Epi Info (SAFE), which is a set of guidelines that allows developers to create both simple and complex information systems using accepted good programming practices. This has resulted in application code blocks that are re-useable and easy to maintain, modify, and enhance. The flexibility of SAFE allows various aggregate and case-based application modules to be rapidly created, combined, and updated to create health information systems or sub-systems enabling continuous, incremental enhancement as national and local capacity increases. SAFE and Epi Info are both cost-free and have low system requirements--characteristics that render this framework and software beneficial for developing countries.

Innovative Medical Technology, Health Technology Assessment, and Health Policy: The Case of Remote Patient Monitoring of Cardiac Implantable Electronic Devices in South Korea.

PubMed

Lee, Sang-Soo; Salole, Eugene

2017-01-01

In many developed countries with universal coverage healthcare systems, payers require new medical technologies to be assessed as safe, effective, and cost-effective through health technology assessment (HTA) before approval for reimbursement coverage and market access. However, in some cases, HTA is not the sole criterion for decision-making and other factors override the evidence. Remote patient monitoring (RPM) for cardiac implantable electronic devices, a novel technology recognized as safe, effective, and cost-effective, and the standard of care in many countries, is prohibited in South Korea. This peculiar situation is apparently due to deficiencies in healthcare policy and the delivery system and also to poor engagement between stakeholders. We propose that a higher level of engagement and trust between stakeholders needs to be developed, and healthcare providers should be involved in the early development of health policy, so that unnecessary barriers to access to useful medical technology are corrected, thereby allowing Koreans to enjoy the benefits available in other developed countries.

Non-transfusion Dependent Thalassemias: A Developing Country Perspective.

PubMed

Mukherjee, Somnath; Das, Rashmi R; Raghuwanshi, Babita

2015-01-01

Non-transfusion-dependent thalassemias (NTDT) encompass a group of hereditary chronic hemolytic anemia, which, as the name indicates, not require regular blood transfusion for survival. These include β-thalassemia intermedia, hemoglobin E/β-thalassemia, and Hemoglobin H disease (α- thalassemia intermedia). Individuals with structural variant of hemoglobin especially Hemoglobin S and Hemoglobin C associated with "α" or "β" thalassemia in heterozygous condition may also present with similar features of NTDT. NTDT patients are not immune to the development of transfusion unrelated complications in the long run. These hereditary chronic hemolytic anemias are still under-recognized in developing countries like India, where the disease burden might be high causing significant morbidity. The pathophysiologic hallmark that characterizes this group of disorders (ineffective erythropoiesis, hemolysis, chronic anemia) leads to a number of serious complications, similar to transfusion dependent thalassemia. So, timely diagnosis and institution of appropriate preventive/remedial measures as well as education of patient population can help decrease the morbidity to a significant extent. In the present review, focus will be on the pathophysiological mechanisms and available management options of NTDT from a developing country perspective like India.

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.

Girls' Access to Education in a Developing Country

NASA Astrophysics Data System (ADS)

Geissinger, Helen

1997-09-01

Papua New Guinea is a developing country which gained its independence from Australia in 1975. Many of its educational structures inherited from the time of the early missions and the colonial administration influence the practices of today. Women have not advanced in the new country as far as was prophesied in the early 1970s leading up to Independence. Although the current poor economic conditions have some effect on women's advancement, the difficulties they face in even obtaining a basic education form one of the major factors which hinder their progress. This paper describes a number of the barriers which prevent girls from accessing education at every level, from gaining enrolment in the first year of school to positioning themselves for university entry. Distance education provides one of the few "second chances" that young Papua New Guineans can gain, provided they can afford the fees and engage with the somewhat independent study required for success.

Sustainable development in an N-rich/n-poor world.

PubMed

Perrings, Charles; Kinzig, Ann; Halkos, George

2014-11-01

Sustainable development requires that per capita inclusive wealth-produced, human, and natural capital-does not decline over time. We investigate the impact of changes in nitrogen on inclusive wealth. There are two sides to the nitrogen problem. Excess use of nitrogen in some places gives rise to N-pollution, which can cause environmental damage. Insufficient replacement of nitrogen in other places gives rise to N-depletion, or loss of nutrient stocks. Neither is explicitly accounted for in current wealth measures, but both affect wealth. We calculate an index of net N-replacement, and investigate its relationship to wealth. In countries with low levels of relative N-loss, we find that the uncompensated loss of soil nitrogen in poorer countries is associated with declining rates of growth of inclusive per capita wealth. What is less intuitive is that increasing fertilizer application in both rich and poor countries can increase per capita inclusive wealth.

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

Einck, John P., E-mail: jeinck@ucsd.edu; Hudson, Alana; Shulman, Adam C.

West Africa has one of the highest incidence rates of carcinoma of the cervix in the world. The vast majority of women do not have access to screening or disease treatment, leading to presentation at advanced stages and to high mortality rates. Compounding this problem is the lack of radiation treatment facilities in Senegal and many other parts of the African continent. Senegal, a country of 13 million people, had a single {sup 60}Co teletherapy unit before our involvement and no brachytherapy capabilities. Radiating Hope, a nonprofit organization whose mission is to provide radiation therapy equipment to countries in themore » developing world, provided a high-dose-rate afterloading unit to the cancer center for curative cervical cancer treatment. Here we describe the implementation of high-dose-rate brachytherapy in Senegal requiring a nonstandard fractionation schedule and a novel treatment planning approach as a possible blueprint to providing this technology to other developing countries.« less

Ageing in place, an overview for the elderly in Malaysia

NASA Astrophysics Data System (ADS)

Tobi, S. U. Mohd; Fathi, M. S.; Amaratunga, D.

2017-10-01

Population ageing is a worldwide phenomenon experienced by developed and developing countries. It occurs when the median age of a country rises and shifts the distribution of that country's population towards older ages. Malaysia is experiencing a dramatic increase in the number of elderly people. Recent medical advances and improvements in hygiene and food supply have led to the people of Malaysia having a longer life expectancy. This paper comprehensively reviews articles and journals to discover the concepts, definitions and issues regarding the ageing population globally and in Malaysia, particularly looking at how elderly people can age in place. The concern over ageing is not just about the size of the old age population but, more importantly, about their health, welfare, care and living arrangements as well as the implications for infrastructure, housing, income and economic growth. The built environment plays a role in defining the conditions for people to live healthy lives, and older people require high-quality built environments that suit their needs across the whole life course - a building stock and infrastructure that supports independent living and enhances quality of life for the ageing population. Lifetime houses which fulfil the desires and vital requirement of most households whilst considering the changing essentials of households with elderly and aged people require careful consideration. This paper will review the key areas of housing for elderly people to support the concept of ageing in place as an independent living lifestyle.

Core competencies in clinical neuropsychology training across the world.

PubMed

Hessen, Erik; Hokkanen, Laura; Ponsford, Jennie; van Zandvoort, Martine; Watts, Ann; Evans, Jonathan; Haaland, Kathleen Y

2018-05-01

This work aimed to review main competency requirements from training models in countries with well-established specialties in clinical neuropsychology and to extract core competencies that likely will apply to clinical neuropsychologists regardless of regional and cultural context. We reviewed standards for post-graduate training in clinical neuropsychology from countries in Europe, Australia, and North America based on existing literature, presentations at international conferences, and from description of the training models from national psychological or neuropsychological associations. Despite differences, the reviewed models share similar core competencies considered necessary for a specialty in clinical neuropsychology: (1) In-depth knowledge of general psychology including clinical psychology (post-graduate level), ethical, and legal standards. (2) Expert knowledge about clinically relevant brain-behavioral relationships. (3) Comprehensive knowledge about, and skills in, related clinical disciplines. (4) In-depth knowledge about and skills in neuropsychological assessment, including decision-making and diagnostic competency according to current classification of diseases. (5) Competencies in the area of diversity and culture in relation to clinical neuropsychology. (6) Communication competency of neuropsychological findings and test results to relevant and diverse audiences. (7) Knowledge about and skills in psychological and neuropsychological intervention, including treatment and rehabilitation. All the models have undergone years of development in accordance with requirements of national health care systems in different parts of the world. Despite differences, the common core competency requirements across different regions of the world suggest generalizability of these competencies. We hope this summary can be useful as countries with less established neuropsychology training programs develop their models.

New approaches to ranking countries for the allocation of development assistance for health: choices, indicators and implications

PubMed Central

Ottersen, Trygve; Grépin, Karen A; Henderson, Klara; Pinkstaff, Crossley Beth; Norheim, Ole Frithjof; Røttingen, John-Arne

2018-01-01

Abstract The distributions of income and health within and across countries are changing. This challenges the way donors allocate development assistance for health (DAH) and particularly the role of gross national income per capita (GNIpc) in classifying countries to determine whether countries are eligible to receive assistance and how much they receive. Informed by a literature review and stakeholder consultations and interviews, we developed a stepwise approach to the design and assessment of country classification frameworks for the allocation of DAH, with emphasis on critical value choices. We devised 25 frameworks, all which combined GNIpc and at least one other indicator into an index. Indicators were selected and assessed based on relevance, salience, validity, consistency, and availability and timeliness, where relevance concerned the extent to which the indicator represented country’s health needs, domestic capacity, the expected impact of DAH, or equity. We assessed how the use of the different frameworks changed the rankings of low- and middle-income countries relative to a country’s ranking based on GNIpc alone. We found that stakeholders generally considered needs to be the most important concern to be captured by classification frameworks, followed by inequality, expected impact and domestic capacity. We further found that integrating a health-needs indicator with GNIpc makes a significant difference for many countries and country categories—and especially middle-income countries with high burden of unmet health needs—while the choice of specific indicator makes less difference. This together with assessments of relevance, salience, validity, consistency, and availability and timeliness suggest that donors have reasons to include a health-needs indicator in the initial classification of countries. It specifically suggests that life expectancy and disability-adjusted life year rate are indicators worth considering. Indicators related to other concerns may be mainly relevant at different stages of the decision-making process, require better data, or both. PMID:29415238

19 CFR 122.49c - Master crew member list and master non-crew member list requirement for commercial aircraft...

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Passport number, if passport required; (9) Passport country of issuance, if passport required; (10) Passport expiration date, if passport required; (11) Pilot certificate number and country of issuance, if...

78 FR 16908 - Determinations Under the African Growth and Opportunity Act

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-19

... STATES TRADE REPRESENTATIVE Determinations Under the African Growth and Opportunity Act AGENCY... substantial progress toward implementing and following, the customs procedures required by the African Growth... lesser developed beneficiary sub-Saharan African country. In Proclamation 7350 (October 2, 2000), the...

The Current Working Conditions in Ugandan Apparel Assembly Plants.

PubMed

Tebyetekerwa, Mike; Akankwasa, Nicholus Tayari; Marriam, Ifra

2017-12-01

The present rapid shift of industrialization from developed to developing countries requires developing countries to understand issues related to work organization, management, and working conditions. There are many factors slackening production, of which working conditions is part. A complete inquiry into the workers' working conditions can enable managements to reduce risks in the workplaces and improve productivity. Understanding and awareness of the benefits of workplace research and a probe into the working conditions in the Ugandan apparel assembly plants are urgently required. A total of 103 (70 women and 33 men) workers from five different plants were interviewed. Together with the top management of various plants, questionnaires about the workers' opinions of their physical working conditions were prepared. Data was collected using two methods: (1) questionnaire; and (2) observation of the workers during their work. The results indicated that poor plant working conditions were mainly contributed by the workers' social factors and the management policies. The government, together with the management, should work to improve the working conditions in the apparel assembly plants, as it greatly affects both.

Nuclear transport in Entamoeba histolytica: knowledge gap and therapeutic potential.

PubMed

Gwairgi, Marina A; Ghildyal, Reena

2018-03-22

Entamoeba histolytica is the protozoan parasite that causes human amoebiasis. It is one of the leading parasitic disease burdens in tropical regions and developing countries, with spread to developed countries through migrants from and travellers to endemic regions. Understanding E. histolytica's invasion mechanisms requires an understanding of how it interacts with external cell components and how it engulfs and kills cells (phagocytosis). Recent research suggests that optimal phagocytosis requires signalling events from the cell surface to the nucleus via the cytoplasm, and the induction of several factors that are transported to the plasma membrane. Current research in other protozoans suggests the presence of proteins with nuclear localization signals, nuclear export signals and Ran proteins; however, there is limited literature on their functionality and their functional similarity to higher eukaryotes. Based on learnings from the development of antivirals, nuclear transport elements in E. histolytica may present viable, specific, therapeutic targets. In this review, we aim to summarize our limited knowledge of the eukaryotic nuclear transport mechanisms that are conserved and may function in E. histolytica.

An overview of Korean patients with mucopolysaccharidosis and collaboration through the Asia Pacific MPS Network.

PubMed

Cho, Sung Yoon; Sohn, Young Bae; Jin, Dong-Kyu

2014-08-01

Mucopolysaccharidosis (MPS) is a constellation of disorders characterized by the accumulation of mucopolysaccharides in tissues and organs. This accumulation results in the deterioration and degeneration of multiple organs. This paper describes the general distribution of types of MPS in patients, their clinical characteristics and genotypes, the development of animal studies and preclinical studies, enzyme replacement therapy in South Korea, and the development of idursulfase beta and clinical trials on idursulfase beta in South Korea. In addition, this paper discusses academic collaboration among specialists in MPS care in the Asia-Pacific region, which includes Japan, Taiwan, Malaysia, and South Korea, through an organization called the Asia-Pacific MPS Network (APMN). The Asia-Pacific MPS Registry, an electronic remote data entry system, has been developed by key doctors in the APMN. Rare diseases require international cooperation and collaboration to elucidate their mechanisms and carry out clinical trials; therefore, an organization such as the APMN is required. Furthermore, international collaboration among Asian countries and countries around the world will be of utmost importance in the future.

An overview of Korean patients with mucopolysaccharidosis and collaboration through the Asia Pacific MPS Network

PubMed Central

Cho, Sung Yoon; Sohn, Young Bae; Jin, Dong-Kyu

2014-01-01

Summary Mucopolysaccharidosis (MPS) is a constellation of disorders characterized by the accumulation of mucopolysaccharides in tissues and organs. This accumulation results in the deterioration and degeneration of multiple organs. This paper describes the general distribution of types of MPS in patients, their clinical characteristics and genotypes, the development of animal studies and preclinical studies, enzyme replacement therapy in South Korea, and the development of idursulfase beta and clinical trials on idursulfase beta in South Korea. In addition, this paper discusses academic collaboration among specialists in MPS care in the Asia-Pacific region, which includes Japan, Taiwan, Malaysia, and South Korea, through an organization called the Asia-Pacific MPS Network (APMN). The Asia-Pacific MPS Registry, an electronic remote data entry system, has been developed by key doctors in the APMN. Rare diseases require international cooperation and collaboration to elucidate their mechanisms and carry out clinical trials; therefore, an organization such as the APMN is required. Furthermore, international collaboration among Asian countries and countries around the world will be of utmost importance in the future. PMID:25364648

A focus on the consumer: social marketing for change.

PubMed

Lucaire, L E

1985-01-01

Social marketing is the application of commercial marketing principles to advance a social cause, issue, behavior, product, or service. Social marketing has added a framework to social efforts that heretofore lacked organization and has inspired projects that otherwise might never have been initiated. In the US, social marketing techniques have been particularly successful in the health field. Although advertising and other communications are central to social marketing, the discipline also depends upon other elements of what is termed the marketing mix: product, price, place, and promotion. Social marketing is a cyclical process involving 6 steps: analysis; planning; development, testing, and refining elements of the plan; implementation; assessment of in-market effectiveness; and feedback. In developing countries, health has similarly been the greatest beneficiary to date of applied social marketing techniques. Family planning programs and oral rehydration therapy (ORT) projects have used social marketing techniques effectively in numerous developing countries. Social marketing has been even more widely applied in the sale of contraceptives in developing countries. Contraceptive social marketing (CSM) programs are well established in Bangladesh, Sri Lanka, India, Thailand, Nepal, Colombia, El Salvador, Jamaica, Mexico, and Egypt. More recently programs have been established in Honduras, Guatemala, Barbados, St. Vincent, and St. Lucia. SOMARC (Social Marketing for Change) is a project funded by the US Agency for International Development (AID) and is working with existing CSM programs and helping to launch new CSM programs. CSM programs are successfully functioning as legitimate marketing organizations in developing countries and are using local private sector resources in the process. Program results are encouraging. Social marketing requires both experience and sensitivity to local conditions. Many developing countries now have their own marketing resources. Local private sector advertising and marketing agencies are helping public and private sector programs. In countries where local resources are scarce, AID has created several programs to provide technical assistance in social marketing.

Innovative farmers and regulatory gatekeepers: Genetically modified crops regulation and adoption in developing countries

PubMed Central

Sinebo, Woldeyesus; Maredia, Karim

2016-01-01

ABSTRACT The regulation of genetically modified (GM) crops is a topical issue in agriculture and environment over the past 2 decades. The objective of this paper is to recount regulatory and adoption practices in some developing countries that have successfully adopted GM crops so that aspiring countries may draw useful lessons and best practices for their biosafatey regulatory regimes. The first 11 mega-GM crops growing countries each with an area of more than one million hectares in 2014 were examined. Only five out of the 11 countries had smooth and orderly adoption of these crops as per the regulatory requirement of each country. In the remaining 6 countries (all developing countries), GM crops were either introduced across borders without official authorization, released prior to regulatory approval or unapproved seeds were sold along with the approved ones in violation to the existing regulations. Rapid expansion of transgenic crops over the past 2 decades in the developing world was a result of an intense desire by farmers to adopt these crops irrespective of regulatory roadblocks. Lack of workable biosafety regulatory system and political will to support GM crops encouraged unauthorized access to GM crop varieties. In certain cases, unregulated access in turn appeared to result in the adoption of substandard or spurious technology which undermined performance and productivity. An optimal interaction among the national agricultural innovation systems, biosafety regulatory bodies, biotech companies and high level policy makers is vital in making a workable regulated progress in the adoption of GM crops. Factoring forgone opportunities to farmers to benefit from GM crops arising from overregulation into biosafety risk analysis and decision making is suggested. Building functional biosafety regulatory systems that balances the needs of farmers to access and utilize the GM technology with the regulatory imperatives to ensure adequate safety to the environment and human health is recommended. PMID:26954893

Improving Allocation And Management Of The Health Workforce In Zambia.

PubMed

Walsh, Fiona J; Musonda, Mutinta; Mwila, Jere; Prust, Margaret Lippitt; Vosburg, Kathryn Bradford; Fink, Günther; Berman, Peter; Rockers, Peter C

2017-05-01

Building a health workforce in low-income countries requires a focused investment of time and resources, and ministries of health need tools to create staffing plans and prioritize spending on staff for overburdened health facilities. In Zambia a demand-based workload model was developed to calculate the number of health workers required to meet demands for essential health services and inform a rational and optimized strategy for deploying new public-sector staff members to the country's health facilities. Between 2009 and 2011 Zambia applied this optimized deployment policy, allocating new health workers to areas with the greatest demand for services. The country increased its health worker staffing in districts with fewer than one health worker per 1,000 people by 25.2 percent, adding 949 health workers to facilities that faced severe staffing shortages. At facilities that had had low staffing levels, adding a skilled provider was associated with an additional 103 outpatient consultations per quarter. Policy makers in resource-limited countries should consider using strategic approaches to identifying and deploying a rational distribution of health workers to provide the greatest coverage of health services to their populations. Project HOPE—The People-to-People Health Foundation, Inc.

Utilizing lean tools to improve value and reduce outpatient wait times in an Indian hospital.

PubMed

Miller, Richard; Chalapati, Nirisha

2015-01-01

This paper aims to demonstrate how lean tools were applied to some unique issues of providing healthcare in a developing country where many patients face challenges not found in developed countries. The challenges provide insight into how lean tools can be utilized to provide similar results across the world. This paper is based on a qualitative case study carried out by a master's student implementing lean at a hospital in India. This paper finds that lean tools such as value-stream mapping and root cause analysis can lead to dramatic reductions in waste and improvements in productivity. The problems of the majority of patients paying for their own healthcare and lacking transportation created scheduling problems that required patients to receive their diagnosis and pay for treatment within a single day. Many additional wastes were identified that were significantly impacting the hospital's ability to provide care. As a result of this project, average outpatient wait times were reduced from 1 hour to 15 minutes along with a significant increase in labor productivity. The results demonstrate how lean tools can increase value to the patients. It also provides are framework that can be utilized for healthcare providers in developed and developing countries to analyze their value streams to reduce waste. This paper is one of the first to address the unique issues of implementing lean to a healthcare setting in a developing country.

One Way Multimedia Broadcasting as a Tool for Education and Development in Developing Nations

NASA Astrophysics Data System (ADS)

Chandrasekhar, M. G.; Venugopal, D.; Sebastian, M.; Chari, B.

2000-07-01

An improved quality of life through education and developmental communication is an important necessity of societal up-liftment in the new millennium, especially in the developing nations. The population explosion and the associated pressure on the scarce resources to meet the basic necessities have made it more or less impossible for most of the nations to invest reasonable resources in realizing adequate channels of formal education. Thanks to the developments in satellite communication and associated technologies, new vistas are available today to provide education and developmental communication opportunities to millions of people, spread across the globe. Satellite based Digital Audio and Multimedia Broadcasting is one such new development that is being viewed as an innovative space application in the coming decades. The potential of DAB technology to reach education, information and entertainment directly to the user through a specially designed receiver could be efficiently utilized by the developing nations to overcome their difficulties in realizing formal channels of education and information dissemination. WorldSpace plans to launch three geo-stationary satellites that would cover most of the developing economies in Africa, the Mediterranean, the Middle East, Asia, Latin America and the Caribbean. Apart from a variety of digital, high quality audio channels providing news, views, education and entertainment opportunities, the end users can also get a responsive multimedia. The multimedia is being planned as a specially packaged offering that can meet the demand of students, professionals as well as certain special groups who have certain specific data and information requirements. Apart from WorldSpace, renowned agencies/firms from different parts of the world shall provide the required content to meet these requirements. Though the Internet option is available, higher telephone charges and the difficulty in getting access have made this option less interesting and unpopular in most of the developing countries. The proposed digital audio and multimedia offering from WorldSpace to millions of consumers spread across more than 120 countries is considered as a unique tool for education and development, particularly in the developing nations. In this paper, an attempt is made to briefly describe the issues associated with education and development in developing countries, the WorldSpace offering and how a developing nation can benefit from this offering in the coming decades.

Geographical aspects of geo-arbitrage: work in Canada and live in countries with low cost of living

NASA Astrophysics Data System (ADS)

Penney, J.; Dramowicz, K.

2016-04-01

The term geo-arbitrage means taking advantage of the difference in living costs between different geographic locations. This paper focuses on geographical aspects of international geo-arbitrage based on differences in the cost of living from one country to another. More precisely, the paper shows the perspective for a Canadian (student, volunteer, entrepreneur, IT person, or retiree) with some sort of mobile income or savings can take advantage of price differences by traveling to other countries. The paper is based on world development indicators, which cover a wide range of criteria when moving to another country. The data were collected for approximately 200 countries and represent the following categories of criteria: cost of living (economic factors), standard of living (such as safety, health care, environmental issues), and personal preferences (such as distance to home, Internet access or popularity of English language). The user input is required to rank or weight the importance of each of the criteria when moving to another country. One model was developed to emphasize the cost of living by controlling the weights ‘behind-the-scenes’. The results produce a list of the top suitable countries to practice geo-arbitrage. Another model allows the user to input weights for each criteria instead of ranks. The results from both models are mapped based on resulting suitability values. The top selected suitable countries are mapped, and the more specific information on each selected country is presented to the user, including the detailed cost of living, and current travel warning.

[The role of a specialised risk analysis group in the Veterinary Services of a developing country].

PubMed

Urbina-Amarís, M E

2003-08-01

Since the World Trade Organization (WTO) Agreement on the Application of Sanitary and Phytosanitary Measures was established, risk analysis in trade, and ultimately in Veterinary and Animal Health Services, has become strategically important. Irrespective of their concept (discipline, approach, method, process), all types of risk analysis in trade involve four periods or phases:--risk identification-- risk assessment--risk management--risk information or communication. All veterinarians involved in a risk analysis unit must have in-depth knowledge of statistics and the epidemiology of transmissible diseases, as well as a basic knowledge of veterinary science, economics, mathematics, data processing and social communication, to enable them to work with professionals in these disciplines. Many developing countries do not have enough well-qualified professionnals in these areas to support a risk analysis unit. This will need to be rectified by seeking strategic alliances with other public or private sectors that will provide the required support to run the unit properly. Due to the special nature of its risk analysis functions, its role in supporting decision-making, and the criteria of independence and transparency that are so crucial to its operations, the hierarchical position of the risk analysis unit should be close to the top management of the Veterinary Service. Due to the shortage of personnel in developing countries with the required training and scientific and technical qualifications, countries with organisations responsible for both animal and plant health protection would be advised to set up integrated plant and animal risk analysis units. In addition, these units could take charge of all activities relating to WTO agreements and regional agreements on animal and plant health management.

Scaling-up health information systems to improve HIV treatment: An assessment of initial patient monitoring systems in Mozambique.

PubMed

Hochgesang, Mindy; Zamudio-Haas, Sophia; Moran, Lissa; Nhampossa, Leopoldo; Packel, Laura; Leslie, Hannah; Richards, Janise; Shade, Starley B

2017-01-01

The rapid scale-up of HIV care and treatment in resource-limited countries requires concurrent, rapid development of health information systems to support quality service delivery. Mozambique, a country with an 11.5% prevalence of HIV, has developed nation-wide patient monitoring systems (PMS) with standardized reporting tools, utilized by all HIV treatment providers in paper or electronic form. Evaluation of the initial implementation of PMS can inform and strengthen future development as the country moves towards a harmonized, sustainable health information system. This assessment was conducted in order to 1) characterize data collection and reporting processes and PMS resources available and 2) provide evidence-based recommendations for harmonization and sustainability of PMS. This baseline assessment of PMS was conducted with eight non-governmental organizations that supported the Ministry of Health to provide 90% of HIV care and treatment in Mozambique. The study team conducted structured and semi-structured surveys at 18 health facilities located in all 11 provinces. Seventy-nine staff were interviewed. Deductive a priori analytic categories guided analysis. Health facilities have implemented paper and electronic monitoring systems with varying success. Where in use, robust electronic PMS facilitate facility-level reporting of required indicators; improve ability to identify patients lost to follow-up; and support facility and patient management. Challenges to implementation of monitoring systems include a lack of national guidelines and norms for patient level HIS, variable system implementation and functionality, and limited human and infrastructure resources to maximize system functionality and information use. This initial assessment supports the need for national guidelines to harmonize, expand, and strengthen HIV-related health information systems. Recommendations may benefit other countries with similar epidemiologic and resource-constrained environments seeking to improve PMS implementation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Comparative Study on the Education System of Traditional Medicine in China, Japan, Korea, and Taiwan.

PubMed

Park, Yu Lee; Huang, Ching Wen; Sasaki, Yui; Ko, Youme; Park, Sunju; Ko, Seong-Gyu

2016-01-01

China, Japan, Korea, and Taiwan have developed modernized education systems in traditional medicine. This study aims to provide an overview of the education systems in these countries and compare them. Data were collected through the websites of government agencies, universities, and relevant organizations. These countries have systemically developed basic medical education (BME), postgraduate medical education (PGME), and continuing medical education (CME) in traditional medicine. BME is provided at colleges of traditional medicine at the undergraduate level and graduate levels. The length of education at the undergraduate level is five, six, and seven years in China, Korea, and Taiwan, respectively; the length at the graduate level is four years in Korea and five years in Taiwan. A seven- or eight-year program combining undergraduate and graduate courses is unique to China. In Japan, unlike in other countries, there are two distinct education systems-one is comprised of courses on traditional medicine included in the curriculum for Western medical doctors, and the other is a three- or four-year undergraduate program for practitioners including acupuncturists and moxibustionists. PGME in Korea consists of one-year internship and three-year residency programs which are optional; however, in China and Taiwan, internship is required for the national licensing examination and further training is in the process of standardization. The required credits for maintenance of CME are eight per year in Korea, 25 per year in China, and 180 over six years in Taiwan. The design of the educational systems in these countries can provide useful information for the development of education in traditional medicine around the world. Copyright © 2016. Published by Elsevier Inc.

The challenges and opportunities of conducting a clinical trial in a low resource setting: the case of the Cameroon mobile phone SMS (CAMPS) trial, an investigator initiated trial.

PubMed

Mbuagbaw, Lawrence; Thabane, Lehana; Ongolo-Zogo, Pierre; Lang, Trudie

2011-06-09

Conducting clinical trials in developing countries often presents significant ethical, organisational, cultural and infrastructural challenges to researchers, pharmaceutical companies, sponsors and regulatory bodies. Globally, these regions are under-represented in research, yet this population stands to gain more from research in these settings as the burdens on health are greater than those in developed resourceful countries. However, developing countries also offer an attractive setting for clinical trials because they often have larger treatment naive populations with higher incidence rates of disease and more advanced stages. These factors can present a reduction in costs and time required to recruit patients. So, balance needs to be found where research can be encouraged and supported in order to bring maximum public health benefits to these communities. The difficulties with such trials arise from problems with obtaining valid informed consent, ethical compensation mechanisms for extremely poor populations, poor health infrastructure and considerable socio-economic and cultural divides. Ethical concerns with trials in developing countries have received attention, even though many other non-ethical issues may arise. Local investigator initiated trials also face a variety of difficulties that have not been adequately reported in literature. This paper uses the example of the Cameroon Mobile Phone SMS trial to describe in detail, the specific difficulties encountered in an investigator-initiated trial in a developing country. It highlights administrative, ethical, financial and staff related issues, proposes solutions and gives a list of additional documentation to ease the organisational process.

The clinical nurse specialist in New Zealand: how is the role defined?

PubMed

Roberts, Jennifer; Floyd, Sue; Thompson, Shona

2011-07-01

New Zealand, like many countries, is developing new advanced nursing practice roles to meet emerging needs. While much has been written about the Nurse Practitioner (NP), the role of Clinical Nurse Specialist (CNS) remains relatively unexplored and lacks national definition. This paper reports the findings from research designed to investigate the role of the CNS and how it is defined by New Zealand District Health Boards (DHBs). The study sought to identify the current requirements and expectations for the CNS role and how it is defined in practice. In 2008, 15 CNS job descriptions were collected from eight DHBs throughout the country generating data that were treated both quantitatively and qualitatively. Overall, few areas of consensus were found regarding the essential requirements for the CNS role and there were inconsistencies in how the roles were defined, most notably concerning requirements for postgraduate qualifications and Professional Development Recognition Programmes. Thematic analysis of the documents generated four key areas relevant to the CNS role. These described the CNS as a leader, a clinical expert, a co-ordinator and an educator. The findings indicate that the CNS role is inconsistently defined in New Zealand, particularly with respect to the postgraduate qualifications required and what is meant by 'expertise'.

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

Jones, D.W.

This paper identifies a number of developments which are prominent during the urbanization of a country and which have particularly strong implications for energy use. Concomitant with urbanization, the industrial composition of the economy's production shifts, with reductions in agriculture and increases in the importance of primary metals, chemicals, and cement, all of which are relatively energy-intensive sectors. Evidence from India indicates that the movement of a worker from agriculture to the least energy-intensive urban activity other than services will quadruple per worker production energy requirements. Next, population concentration associated with urbanization facilitates increases in the scale of production whichmore » in turn encourages the substitution of modern energy for traditional fuels and requires energy for longer deliveries. Also, concentrated, off-farm populations require processing and delivery of food, which are not required for largely agricultural countries. Domestic activity changes send activities which were formerly conducted in the household with little or no energy use, outside, usually into firms, where fuels are used. Urban households also use considerably more transportation than do rural households. Evidence from Hong Kong indicates that pure urban density increases encourage substitutions of modern energy for traditional fuels. Finally, increased real incomes associated with urbanization increase energy consumption, with an elasticity of roughly unity. Aggregate cross-sectional data evidence from sixty developing countries was used to examine the overall magnitude of the effects of urbanization and associated developmental changes on per capita energy use. Controlling for industrial structure, per capita income (per capita gross domestic product), and several other variables, a one-percent increase in urbanization will cause a one-half percent increase in per capita energy use. 81 refs., 5 figs., 63 tabs.« less

Four Spheres of Knowledge Required: An International Study of the Professional Development of Literacy/English Teacher Educators

ERIC Educational Resources Information Center

Kosnik, Clare; Menna, Lydia; Dharamshi, Pooja; Miyata, Cathy; Cleovoulou, Yiola; Beck, Clive

2015-01-01

This paper reports on a research study of 28 literacy teacher educators (LTE) in four countries: Canada, the USA, England and Australia. It identifies three main forms of professional development: informal, formal and communities of practice and four spheres of knowledge: research; pedagogy of higher education; literacy and literacy teaching; and…

Evaluation of the Cross-Cultural Traits Influence on the Behavior of Russian and Chinese Students on the Higher Education Products Market

ERIC Educational Resources Information Center

Romanova, Irina M.; Noskova, Elena V.; Trotsenko, Anastasiya N.

2016-01-01

Development of academic mobility of students from different countries requires evaluating the influence of their cultural traits on the behavior on the educational products market. The subject of present study is the development of methodic approach towards evaluating the cross-cultural traits influence on students' behavior on the higher…

Graduate Students from Developing Countries in U.S. Science Departments. A Handbook for Department Chairs and Faculty Members.

ERIC Educational Resources Information Center

American Association for the Advancement of Science, Washington, DC.

This guide is intended to assist college faculty members working with graduate students from developing nations who may need help bridging the gap between their educational backgrounds and the requirements of graduate science programs which are primarily planned for U.S. students. Differences are noted in the pre-graduate school training of such…

Driving a decade of change: HIV/AIDS, patents and access to medicines for all

PubMed Central

2011-01-01

Since 2000, access to antiretroviral drugs to treat HIV infection has dramatically increased to reach more than five million people in developing countries. Essential to this achievement was the dramatic reduction in antiretroviral prices, a result of global political mobilization that cleared the way for competitive production of generic versions of widely patented medicines. Global trade rules agreed upon in 1994 required many developing countries to begin offering patents on medicines for the first time. Government and civil society reaction to expected increases in drug prices precipitated a series of events challenging these rules, culminating in the 2001 World Trade Organization's Doha Declaration on the Agreement on Trade-Related Aspects of Intellectual Property Rights and Public Health. The Declaration affirmed that patent rules should be interpreted and implemented to protect public health and to promote access to medicines for all. Since Doha, more than 60 low- and middle-income countries have procured generic versions of patented medicines on a large scale. Despite these changes, however, a "treatment timebomb" awaits. First, increasing numbers of people need access to newer antiretrovirals, but treatment costs are rising since new ARVs are likely to be more widely patented in developing countries. Second, policy space to produce or import generic versions of patented medicines is shrinking in some developing countries. Third, funding for medicines is falling far short of needs. Expanded use of the existing flexibilities in patent law and new models to address the second wave of the access to medicines crisis are required. One promising new mechanism is the UNITAID-supported Medicines Patent Pool, which seeks to facilitate access to patents to enable competitive generic medicines production and the development of improved products. Such innovative approaches are possible today due to the previous decade of AIDS activism. However, the Pool is just one of a broad set of policies needed to ensure access to medicines for all; other key measures include sufficient and reliable financing, research and development of new products targeted for use in resource-poor settings, and use of patent law flexibilities. Governments must live up to their obligations to protect access to medicines as a fundamental component of the human right to health. PMID:21439089

Competence development for the promotion of gender equality in development cooperation: the case of the Swedish International Development Cooperation Agency (SIDA).

PubMed

Hannan-andersson, C

1997-01-01

The Swedish International Development Cooperation Agency (SIDA) has created an Action Program for Promoting Equality Between Women and Men in Partner Countries that emphasizes competency development as a means of achieving gender equality. Competency development goes beyond formal training and utilizes existing entry points while creating innovative ones. SIDA's partnership approach requires clear delineation of roles for SIDA personnel and partner countries, with SIDA 1) applying a gender perspective to assessments, 2) initiating a constructive dialogue about gender equality if needed, 3) assessing the need for gender equality promoting competency development, 4) studying the local context, and 5) developing effective local networks. In addition, the needs of different groups within SIDA should be met with appropriate competency development inputs while SIDA continues support to competency development in partner countries by developing local capacity for gender training and gender sensitization at the regional and national levels. At SIDA, gender training has evolved since 1989 to its current focus on the practical and concrete challenges facing participants. In addition, departments and divisions conduct sector- and issue-specific training, and gender equality is integrated in all SIDA training activities on every topic. The challenges for future competency development are to 1) increase the number of men involved in provision of competency development inputs, 2) improve competency at embassy and field levels, and 3) improve competency in policy dialogues.

Determinants of women's satisfaction with maternal health care: a review of literature from developing countries.

PubMed

Srivastava, Aradhana; Avan, Bilal I; Rajbangshi, Preety; Bhattacharyya, Sanghita

2015-04-18

Developing countries account for 99 percent of maternal deaths annually. While increasing service availability and maintaining acceptable quality standards, it is important to assess maternal satisfaction with care in order to make it more responsive and culturally acceptable, ultimately leading to enhanced utilization and improved outcomes. At a time when global efforts to reduce maternal mortality have been stepped up, maternal satisfaction and its determinants also need to be addressed by developing country governments. This review seeks to identify determinants of women's satisfaction with maternity care in developing countries. The review followed the methodology of systematic reviews. Public health and social science databases were searched. English articles covering antenatal, intrapartum or postpartum care, for either home or institutional deliveries, reporting maternal satisfaction from developing countries (World Bank list) were included, with no year limit. Out of 154 shortlisted abstracts, 54 were included and 100 excluded. Studies were extracted onto structured formats and analyzed using the narrative synthesis approach. Determinants of maternal satisfaction covered all dimensions of care across structure, process and outcome. Structural elements included good physical environment, cleanliness, and availability of adequate human resources, medicines and supplies. Process determinants included interpersonal behavior, privacy, promptness, cognitive care, perceived provider competency and emotional support. Outcome related determinants were health status of the mother and newborn. Access, cost, socio-economic status and reproductive history also influenced perceived maternal satisfaction. Process of care dominated the determinants of maternal satisfaction in developing countries. Interpersonal behavior was the most widely reported determinant, with the largest body of evidence generated around provider behavior in terms of courtesy and non-abuse. Other aspects of interpersonal behavior included therapeutic communication, staff confidence and competence and encouragement to laboring women. Quality improvement efforts in developing countries could focus on strengthening the process of care. Special attention is needed to improve interpersonal behavior, as evidence from the review points to the importance women attach to being treated respectfully, irrespective of socio-cultural or economic context. Further research on maternal satisfaction is required on home deliveries and relative strength of various determinants in influencing maternal satisfaction.

Comparing Anesthesiology Residency Training Structure and Requirements in Seven Different Countries on Three Continents.

PubMed

Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias V; Macario, Alex

2017-02-26

Little has been published comparing the graduate medical education training structure and requirements across multiple countries. The goal of this study was to summarize and compare the characteristics of anesthesiology training programs in the USA, UK, Canada, Japan, Brazil, Denmark, and Switzerland as a way to better understand efforts to train anesthesiologists in different countries. Two physicians trained in each of the seven countries (convenience sample) were interviewed using a semi-structured approach. The interview was facilitated by use of a predetermined questionnaire that included, for example, the duration of post-medical school training and national requirements for certain rotations, a number of cases, faculty supervision, national in-training written exams, and duty hour limits. These data were augmented by review of each country's publicly available residency training documents as available on the internet. Post-medical school anesthesia residency duration varied: three years (Brazil), four years (USA), five years (Canada and Switzerland), six years (Japan and Denmark) to nine years (UK), as did the number of explicitly required clinical rotations of a defined duration: zero (Denmark), one (Switzerland and UK), four (Brazil), six (Canada), and 12 (USA). Minimum case requirements exist in the USA, Japan, and Brazil, but not in the other countries. National written exams taken during training exist for all countries studied except Japan and Denmark. The countries studied increasingly aim to have competency-based education with milestone assessments. Training duty hour limits also varied including for example 37 hours/week averaged over a one month with limitations on night duties (Denmark), a weekly average of 48 hours taken over a 17 week period (UK), 50 hours/week maximum (Switzerland), 60 hours/week maximum (Brazil), and 80 hours/week averaged over four weeks (USA). Some countries have highly structured training programs with multiple national requirements with training principally carried out at a home institution. Other countries have a more decentralized and unregulated approach with fewer (if any) specific case or rotation requirements, where the trainee creates his/her own customized training to meet broad objectives and goals. The countries studied have different national training requirements, unique duty hour rules and are at varying stages in transitioning to an outcome based model of residency.

77 FR 23490 - Agency Information Collection Activities: Country of Origin Marking Requirements for Containers...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-19

... Activities: Country of Origin Marking Requirements for Containers or Holders AGENCY: U.S. Customs and Border... of Origin Marking Requirements for Containers or Holders. This is a proposed extension of an... Requirements for Containers or Holders. [[Page 23491

Global support for new vaccine implementation in middle-income countries.

PubMed

Kaddar, Miloud; Schmitt, Sarah; Makinen, Marty; Milstien, Julie

2013-04-18

Middle-income countries (MICs) as a group are not only characterized by a wide range of gross national income (GNI) per capita (US $1026 to $12,475), but also by diversity in size, geography, governance, and infrastructure. They include the largest and smallest countries of the world-including 16 landlocked developing countries, 27 small island developing states, and 17 least developed countries-and have a significant diversity in burden of vaccine-preventable diseases. Given the growth in the number of MICs and their considerable domestic income disparities, they are now home to the greatest proportion of the world's poor, having more inhabitants below the poverty line than low-income countries (LICs). However, they have little or no access to external funding for the implementation of new vaccines, nor are they benefiting from an enabling global environment. The MICs are thus not sustainably introducing new life-saving vaccines at the same rate as donor-funded LICs or wealthier countries. The global community, through World Health Assembly resolutions and the inclusion of MIC issues in several recent studies and important documents-including the Global Vaccine Action Plan (GVAP) for the Decade of Vaccines-has acknowledged the sub-optimal situations in some MICs and is actively seeking to enhance the situation by expanding support to these countries. This report documents some of the activities already going on in a subset of MICs, including strengthening of national regulatory authorities and national immunization technical advisory groups, and development of comprehensive multi-year plans. However, some additional tools developed for LICs could prove useful to MICs and thus should be adapted for use by them. In addition, new approaches need to be developed to support MIC-specific needs. It is clear that no one solution will address the needs of this diverse group. We suggest tailored interventions in the four categories of evidence and capacity-building, policy and advocacy, financing, and procurement and supply chain. For MICs to have comparable rates of introduction as other wealthier countries and to contribute to the global fight against vaccine-preventable diseases, global partners must implement a coordinated and pragmatic intervention strategy in accord with their competitive advantage. This will require political will, joint planning, and additional modest funding. Copyright © 2012 Elsevier Ltd. All rights reserved.

Genetic counseling services and development of training programs in Malaysia.

PubMed

Lee, Juliana Mei-Har; Thong, Meow-Keong

2013-12-01

Genetic counseling service is urgently required in developing countries. In Malaysia, the first medical genetic service was introduced in 1994 at one of the main teaching hospitals in Kuala Lumpur. Two decades later, the medical genetic services have improved with the availability of genetic counseling, genetic testing and diagnosis, for both paediatric conditions and adult-onset inherited conditions, at four main centers of medical genetic services in Malaysia. Prenatal diagnosis services and assisted reproductive technologies are available at tertiary centres and private medical facilities. Positive developments include governmental recognition of Clinical Genetics as a subspecialty, increased funding for genetics services, development of medical ethics guidelines, and establishment of support groups. However, the country lacked qualified genetic counselors. Proposals were presented to policy-makers to develop genetic counseling courses. Challenges encountered included limited resources and public awareness, ethical dilemmas such as religious and social issues and inadequate genetic health professionals especially genetic counselors.

32 CFR 268.9 - Discussion of terms.

Code of Federal Regulations, 2011 CFR

2011-07-01

... customer country unless otherwise stated in the bill. Followup and reporting actions required by this part... central banks. (4) Other institutions (such as corporations, development banks, railways, and utilities... obligors.” (j) Program. “Program” is the law, international treaty, appropriation, or other authority under...

32 CFR 268.9 - Discussion of terms.

Code of Federal Regulations, 2014 CFR

2014-07-01

... customer country unless otherwise stated in the bill. Followup and reporting actions required by this part... central banks. (4) Other institutions (such as corporations, development banks, railways, and utilities... obligors.” (j) Program. “Program” is the law, international treaty, appropriation, or other authority under...

32 CFR 268.9 - Discussion of terms.

Code of Federal Regulations, 2012 CFR

2012-07-01

... customer country unless otherwise stated in the bill. Followup and reporting actions required by this part... central banks. (4) Other institutions (such as corporations, development banks, railways, and utilities... obligors.” (j) Program. “Program” is the law, international treaty, appropriation, or other authority under...

32 CFR 268.9 - Discussion of terms.

Code of Federal Regulations, 2013 CFR

2013-07-01

... customer country unless otherwise stated in the bill. Followup and reporting actions required by this part... central banks. (4) Other institutions (such as corporations, development banks, railways, and utilities... obligors.” (j) Program. “Program” is the law, international treaty, appropriation, or other authority under...

Too Much or Too Little

ERIC Educational Resources Information Center

Obeng, Letitia E.

1975-01-01

All countries require an ample supply of water for agricultural and industrial uses. Most have sufficient water supplies, but availability and accessibility vary. With the development of water irrigation systems, health conditions often deteriorate. The author recommends a water management program to control quality and quantity of available…

Development Challenges and Opportunities Confronting Economies in Transition

ERIC Educational Resources Information Center

Estes, Richard J.

2007-01-01

"Economies in Transition" (hereafter EIT or EITs) are countries in the process of shifting from "command" to "more open", liberalized, free market economic systems. In addition to achieving major structural adjustments to their economies, the transformational process requires the introduction of a high degree of…

Reading with Understanding: A Global Expectation

ERIC Educational Resources Information Center

Shea, Mary; Ceprano, Maria

2017-01-01

This article outlines the complexity of reading with understanding, what is required for full and deep comprehension, the state of affairs with regard to reading comprehension in developed countries, possible etiologies for low performances, and suggestions for instruction in specific skills and strategies to improve students' demonstrated…

We are not alone: international learning for professionals caring for children requiring palliative care.

PubMed

Price, Jayne; Quinn, Karen; McNeilly, Patricia; Heywood, Melissa

2015-06-01

Educational opportunities for professionals working with children requiring palliative care are central to future development within the specialty across countries. International educational initiatives involving a range of professionals are important for learning with and from others working within the field. To explore the experiences and value to students from participating in an international online discussion forum. This article examines one such initiative; the use of an international asynchronous discussion forum with students in Melbourne, Australia and Belfast, UK who work with children and families. The innovation is examined and student perspectives of the forum's value are presented. Students endorsed the value of the forum, identifying three main areas of learning: differences across locations within countries, respecting different views and being open, and need for continued learning within children's palliative care. The overarching theme 'we are not alone' supported the idea that participation in the international discussion forum enabled students to see a broader perspective. Ideas for future developments of similar forums are also explored.

Occupational Health and Safety in Aquaculture: Insights on Brazilian Public Policies.

PubMed

de Oliveira, Pedro Keller; Cavalli, Richard Souto; Kunert Filho, Hiran Castagnino; Carvalho, Daiane; Benedetti, Nadine; Rotta, Marco Aurélio; Peixoto Ramos, Augusto Sávio; de Brito, Kelly Cristina Tagliari; de Brito, Benito Guimarães; da Rocha, Andréa Ferretto; Stech, Marcia Regina; Cavalli, Lissandra Souto

2017-01-01

Aquaculture has many occupational hazards, including those that are physical, chemical, biological, ergonomic, and mechanical. The risks in aquaculture are inherent, as this activity requires particular practices. The objective of the present study was to show the risks associated with the aquaculture sector and present a critical overview on the Brazilian public policies concerning aquaculture occupational health. Methods include online research involved web searches and electronic databases including Pubmed, Google Scholar, Scielo and government databases. We conducted a careful revision of Brazilian labor laws related to occupational health and safety, rural workers, and aquaculture. The results and conclusion support the idea that aquaculture requires specific and well-established industry programs and policies, especially in developing countries. Aquaculture still lacks scientific research, strategies, laws, and public policies to boost the sector with regard to occupational health and safety. The establishment of a safe workplace in aquaculture in developing countries remains a challenge for all involved in employer-employee relationships.

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.

Enhancing public health outcomes in developing countries: from good policies and best practices to better implementation.

PubMed

Woolcock, Michael

2018-06-01

In rich and poor countries alike, a core challenge is building the state's capability for policy implementation. Delivering high-quality public health and health care-affordably, reliably and at scale, for all-exemplifies this challenge, since doing so requires deftly integrating refined technical skills (surgery), broad logistics management (supply chains, facilities maintenance), adaptive problem solving (curative care), and resolving ideological differences (who pays? who provides?), even as the prevailing health problems themselves only become more diverse, complex, and expensive as countries become more prosperous. However, the current state of state capability in developing countries is demonstrably alarming, with the strains and demands only likely to intensify in the coming decades. Prevailing "best practice" strategies for building implementation capability-copying and scaling putative successes from abroad-are too often part of the problem, while individual training ("capacity building") and technological upgrades (e.g. new management information systems) remain necessary but deeply insufficient. An alternative approach is outlined, one centered on building implementation capability by working iteratively to solve problems nominated and prioritized by local actors.

Technical and Political Assessment of Peaceful Nuclear Power Program Prospects in North Africa and the Middle East

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

Windsor, Lindsay K.; Kessler, Carol E.

An exceptional number of Middle Eastern and North African nations have recently expressed interest in developing nuclear energy for peaceful purposes. Many of these countries have explored nuclear research in limited ways in the past, but the current focused interest and application of resources towards developing nuclear-generated electricity and nuclear-powered desalination plants is unprecedented. Consequently, questions arise in response to this emerging trend: What instigated this interest? To what end(s) will a nuclear program be applied? Does the country have adequate technical, political, legislative, nonproliferation, and safety infrastructure required for the capability desired? If so, what are the next stepsmore » for a country in preparation for a future nuclear program? And if not, what collaboration efforts are possible with the United States or others? This report provides information on the capabilities and interests of 13 countries in the region in nuclear energy programs in light of safety, nonproliferation and security concerns. It also provides information useful for determining potential for offering technical collaboration, financial aid, and/or political support.« less

An assessment of research and development leadership in advanced batteries for electric vehicles

NASA Astrophysics Data System (ADS)

Bruch, V. L.

1994-02-01

Due to the recently enacted California regulations requiring zero emission vehicles be sold in the market place by 1998, electric vehicle research and development (R&D) is accelerating. Much of the R&D work is focusing on the Achilles' heel of electric vehicles -- advanced batteries. This report provides an assessment of the R&D work currently underway in advanced batteries and electric vehicles in the following countries: Denmark, France, Germany, Italy, Japan, Russia, and the United Kingdom. Although the US can be considered one of the leading countries in terms of advanced battery and electric vehicle R&D work, it lags other countries, particularly France, in producing and promoting electric vehicles. The US is focusing strictly on regulations to promote electric vehicle usage while other countries are using a wide variety of policy instruments (regulations, educational outreach programs, tax breaks and subsidies) to encourage the use of electric vehicles. The US should consider implementing additional policy instruments to ensure a domestic market exists for electric vehicles. The domestic is the largest and most important market for the US auto industry.

Limits to modern contraceptive use among young women in developing countries: a systematic review of qualitative research

PubMed Central

Williamson, Lisa M; Parkes, Alison; Wight, Daniel; Petticrew, Mark; Hart, Graham J

2009-01-01

Background Improving the reproductive health of young women in developing countries requires access to safe and effective methods of fertility control, but most rely on traditional rather than modern contraceptives such as condoms or oral/injectable hormonal methods. We conducted a systematic review of qualitative research to examine the limits to modern contraceptive use identified by young women in developing countries. Focusing on qualitative research allows the assessment of complex processes often missed in quantitative analyses. Methods Literature searches of 23 databases, including Medline, Embase and POPLINE®, were conducted. Literature from 1970–2006 concerning the 11–24 years age group was included. Studies were critically appraised and meta-ethnography was used to synthesise the data. Results Of the 12 studies which met the inclusion criteria, seven met the quality criteria and are included in the synthesis (six from sub-Saharan Africa; one from South-East Asia). Sample sizes ranged from 16 to 149 young women (age range 13–19 years). Four of the studies were urban based, one was rural, one semi-rural, and one mixed (predominantly rural). Use of hormonal methods was limited by lack of knowledge, obstacles to access and concern over side effects, especially fear of infertility. Although often more accessible, and sometimes more attractive than hormonal methods, condom use was limited by association with disease and promiscuity, together with greater male control. As a result young women often relied on traditional methods or abortion. Although the review was limited to five countries and conditions are not homogenous for all young women in all developing countries, the overarching themes were common across different settings and contexts, supporting the potential transferability of interventions to improve reproductive health. Conclusion Increasing modern contraceptive method use requires community-wide, multifaceted interventions and the combined provision of information, life skills, support and access to youth-friendly services. Interventions should aim to counter negative perceptions of modern contraceptive methods and the dual role of condoms for contraception and STI prevention should be exploited, despite the challenges involved. PMID:19228420

Pharmaceutical strategic purchasing requirements in Iran: Price interventions and the related effective factors

PubMed Central

Bastani, Peivand; Dinarvand, Rasoul; SamadBeik, Mahnaz; Pourmohammadi, Kimia

2016-01-01

Objective: 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. Methods: 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: 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. Conclusion: 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. PMID:26985434

Sexual and reproductive health and rights of adolescent girls: Evidence from low- and middle-income countries

PubMed Central

Santhya, K.G.; Jejeebhoy, Shireen J.

2015-01-01

This paper reviews the evidence on sexual and reproductive health and rights (SRHR) of adolescent girls in low-income and middle-income countries (LMIC) in light of the policy and programme commitments made at the International Conference on Population and Development (ICPD), analyses progress since 1994, and maps challenges in and opportunities for protecting their health and human rights. Findings indicate that many countries have yet to make significant progress in delaying marriage and childbearing, reducing unintended childbearing, narrowing gender disparities that put girls at risk of poor SRH outcomes, expanding health awareness or enabling access to SRH services. While governments have reaffirmed many commitments, policy development and programme implementation fall far short of realising these commitments. Future success requires increased political will and engagement of young people in the formulation and implementation of policies and programmes, along with increased investments to deliver at scale comprehensive sexuality education, health services that are approachable and not judgemental, safe spaces programmes, especially for vulnerable girls, and programmes that engage families and communities. Stronger policy-making and programming also require expanding the evidence on adolescent health and rights in LMICs for both younger and older adolescents, boys and girls, and relating to a range of key health matters affecting adolescents. PMID:25554828

Evaluating the relative environmental impact of countries.

PubMed

Bradshaw, Corey J A; Giam, Xingli; Sodhi, Navjot S

2010-05-03

Environmental protection is critical to maintain ecosystem services essential for human well-being. It is important to be able to rank countries by their environmental impact so that poor performers as well as policy 'models' can be identified. We provide novel metrics of country-specific environmental impact ranks - one proportional to total resource availability per country and an absolute (total) measure of impact - that explicitly avoid incorporating confounding human health or economic indicators. Our rankings are based on natural forest loss, habitat conversion, marine captures, fertilizer use, water pollution, carbon emissions and species threat, although many other variables were excluded due to a lack of country-specific data. Of 228 countries considered, 179 (proportional) and 171 (absolute) had sufficient data for correlations. The proportional index ranked Singapore, Korea, Qatar, Kuwait, Japan, Thailand, Bahrain, Malaysia, Philippines and Netherlands as having the highest proportional environmental impact, whereas Brazil, USA, China, Indonesia, Japan, Mexico, India, Russia, Australia and Peru had the highest absolute impact (i.e., total resource use, emissions and species threatened). Proportional and absolute environmental impact ranks were correlated, with mainly Asian countries having both high proportional and absolute impact. Despite weak concordance among the drivers of environmental impact, countries often perform poorly for different reasons. We found no evidence to support the environmental Kuznets curve hypothesis of a non-linear relationship between impact and per capita wealth, although there was a weak reduction in environmental impact as per capita wealth increases. Using structural equation models to account for cross-correlation, we found that increasing wealth was the most important driver of environmental impact. Our results show that the global community not only has to encourage better environmental performance in less-developed countries, especially those in Asia, there is also a requirement to focus on the development of environmentally friendly practices in wealthier countries.

Vaccines, inspiring innovation in health.

PubMed

Pagliusi, Sonia; Dennehy, Maureen; Kim, Hun

2018-05-19

This report covers the topics of pandemics, epidemics and partnerships, including regulatory convergence initiatives, new technologies and novel vaccines, discussed by leading public and private sector stakeholders at the 18th Annual General Meeting (AGM) of the Developing Countries Vaccine Manufacturers' Network (DCVMN). Contributions of Gavi and the vaccine industry from emerging countries to the growing global vaccine market, by improving the supply base from manufacturers in developing countries and contributing to 58% of doses, were highlighted. The Coalition for Epidemic Preparedness Innovations (CEPI), the International Vaccine Institute (IVI) and others reported on new strategies to ensure speedy progress in preclinical and clinical development of innovative vaccines for future MERS, Zika or other outbreak response. Priorities for vaccine stockpiling, to assure readiness during emergencies and to prevent outbreaks due to re-emerging diseases such as yellow fever, cholera and poliomyelitis, were outlined. The role of partnerships in improving global vaccine access, procurement and immunization coverage, and shared concerns were reviewed. The World Health Organization (WHO) and other international collaborating partners provided updates on the Product, Price and Procurement database, the prequalification of vaccines, the control of neglected tropical diseases, particularly the new rabies elimination initiative, and regulatory convergence proposals to accelerate vaccine registration in developing countries. Updates on supply chain innovations and novel vaccine platforms were presented. The discussions enabled members and partners to reflect on efficiency of research & development, supply chain tools and trends in packaging technologies improving delivery of existing vaccines, and allowing a deeper understanding of the current public-health objectives, industry financing, and global policies, required to ensure optimal investments, alignment and stability of vaccine supply in developing countries. Copyright © 2018. Published by Elsevier Ltd.

Challenges of Ophthalmic Care in the Developing World

PubMed Central

Sommer, Alfred; Taylor, Hugh R.; Ravilla, Thulasiraj D.; West, Sheila; Lietman, Thomas M.; Keenan, Jeremy D.; Chiang, Michael F.; Robin, Alan L.; Mills, Richard P.

2014-01-01

Global blindness exacts an enormous financial and social cost on developing countries. Reducing the prevalence of blindness globally requires a set of strategies that are different from those typically employed in developed countries. This was the subject of the 2013 Knapp symposium at the American Ophthalmological Society Annual Meeting, and this article summarizes the presentations of epidemiologists, health care planners, and ophthalmologists. It explores a range of successful strategies from the multinational Vision 2020 Initiative to disease-specific schemes in cataract, trachoma control, infectious corneal ulceration, cytomegalovirus retinitis, and retinopathy of prematurity. In each example, the importance of an attitudinal set towards the public health becomes clear. There is reason for optimism in the struggle against global blindness, in large measure because of innovative programs like those described here. PMID:24604415

Structural adjustment programmes adversely affect vulnerable populations: a systematic-narrative review of their effect on child and maternal health.

PubMed

Thomson, Michael; Kentikelenis, Alexander; Stubbs, Thomas

2017-01-01

Structural adjustment programmes of international financial institutions have typically set the fiscal parameters within which health policies operate in developing countries. Yet, we currently lack a systematic understanding of the ways in which these programmes impact upon child and maternal health. The present article systematically reviews observational and quasi-experimental articles published from 2000 onward in electronic databases (PubMed/Medline, Web of Science, Cochrane Library and Google Scholar) and grey literature from websites of key organisations (IMF, World Bank and African Development Bank). Studies were considered eligible if they empirically assessed the aggregate effect of structural adjustment programmes on child or maternal health in developing countries. Of 1961 items yielded through database searches, reference lists and organisations' websites, 13 met the inclusion criteria. Our review finds that structural adjustment programmes have a detrimental impact on child and maternal health. In particular, these programmes undermine access to quality and affordable healthcare and adversely impact upon social determinants of health, such as income and food availability. The evidence suggests that a fundamental rethinking is required by international financial institutions if developing countries are to achieve the Sustainable Development Goals on child and maternal health.

Diagnosis of Neisseria gonorrhoeae Using Molecular Beacon

PubMed Central

Patel, Achchhe Lal; Sonkar, Subash Chandra; Kumari, Indu; Saluja, Daman

2015-01-01

Neisseria gonorrhoeae is an important sexually transmitted diseases (STD) causing pathogen worldwide. Due to absence of an affordable diagnostic assay, routine screening of gonococcal infection becomes impossible in developing countries where infection rates are maximum. Treatment is given on the basis of symptoms alone which leads to spread of infection. Thus, development of a rapid, sensitive, specific, and PCR based visual diagnostic assay suitable for developing countries, required for better disease management, is aimed at in present study. Endocervical swabs were collected from patients visiting gynecology department of various hospitals in Delhi. In-house PCR based assay was developed and modified to visual assay using molecular beacon for end-point detection. It was evaluated against Roche AMPLICOR NG kit and rmp gene. Specificity of beacon was confirmed by competition experiments. Diagnostic test was 98.21% specific and 99.59% sensitive whereas negative and positive predicted value were 99.40% and 98.78%, respectively. We also observed that twice the concentration (2X) of premix was stable at 4°C for 4 months and dry swab samples gave concordant results with that of wet swabs. These features make the test best suitable for routine diagnosis of genital infections in developing countries. PMID:25802857

Sustainable Biofuel Crops Project, Final Report

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

Juhn, Daniel; Grantham, Hedley

2014-05-28

Over the last six years, the Food and Agriculture Organization of the United Nations (FAO) has developed the Bioenergy and Food Security (BEFS) Approach to help countries design and implement sustainable bioenergy policies and strategies. The BEFS Approach consists of two sets of multidisciplinary and integrated tools and guidance (the BEFS Rapid Appraisal and the BEFS Detailed Analysis) to facilitate better decision on bioenergy development which should foster both food and energy security, and contribute to agricultural and rural development. The development of the BEFS Approach was for the most part funded by the German Federal Ministry of Food andmore » Agriculture. Recognizing the need to provide support to countries that wanted an initial assessment of their sustainable bioenergy potential, and of the associated opportunities, risks and trade offs, FAO began developing the BEFS-RA (Rapid Appraisal). The BEFS RA is a spreadsheet–based assessment and analysis tool designed to outline the country's basic energy, agriculture and food security context, the natural resources potential, the bioenergy end use options, including initial financial and economic implications, and the identification of issues that might require fuller investigation with the BEFS Detailed Analysis.« less

Overview of Low Carbon Logistics Development in China and Foreign Countries

NASA Astrophysics Data System (ADS)

Cheng, Dongxiang; Zhang, Xiang

2017-12-01

High energy consumption is a major feature of the logistics industry. Under the current low-carbon development requirements, the low carbon development of logistics is bound to be a new direction, and more scholars will turn their attention to low-carbon logistics. This paper presents a detailed introduction to low-carbon logistics from four aspects: the definition of low-carbon logistics, the influencing factors and Countermeasures of development, and the evaluation of carbon emission efficiency.

National health inequality monitoring: current challenges and opportunities.

PubMed

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne; Boerma, Ties

National health inequality monitoring needs considerably more investment to realize equity-oriented health improvements in countries, including advancement towards the Sustainable Development Goals. Following an overview of national health inequality monitoring and the associated resource requirements, we highlight challenges that countries may encounter when setting up, expanding or strengthening national health inequality monitoring systems, and discuss opportunities and key initiatives that aim to address these challenges. We provide specific proposals on what is needed to ensure that national health inequality monitoring systems are harnessed to guide the reduction of health inequalities.

Advanced manufacturing: Technology and international competitiveness

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

Tesar, A.

1995-02-01

Dramatic changes in the competitiveness of German and Japanese manufacturing have been most evident since 1988. All three countries are now facing similar challenges, and these challenges are clearly observed in human capital issues. Our comparison of human capital issues in German, Japanese, and US manufacturing leads us to the following key judgments: Manufacturing workforces are undergoing significant changes due to advanced manufacturing technologies. As companies are forced to develop and apply these technologies, the constituency of the manufacturing workforce (especially educational requirements, contingent labor, job content, and continuing knowledge development) is being dramatically and irreversibly altered. The new workforcemore » requirements which result due to advanced manufacturing require a higher level of worker sophistication and responsibility.« less

Bringing evidence to policy to achieve health-related MDGs for all: justification and design of the EPI-4 project in China, India, Indonesia, and Vietnam.

PubMed

Thomsen, Sarah; Ng, Nawi; Biao, Xu; Bondjers, Göran; Kusnanto, Hari; Liem, Nguyen Tanh; Mavalankar, Dileep; Målqvist, Mats; Diwan, Vinod

2013-03-13

The Millennium Development Goals (MDGs) are monitored using national-level statistics, which have shown substantial improvements in many countries. These statistics may be misleading, however, and may divert resources from disadvantaged populations within the same countries that are showing progress. The purpose of this article is to set out the relevance and design of the "Evidence for Policy and Implementation project (EPI-4)". EPI-4 aims to contribute to the reduction of inequities in the achievement of health-related MDGs in China, India, Indonesia and Vietnam through the promotion of research-informed policymaking. Using a framework provided by the Commission on the Social Determinants of Health (CSDH), we compare national-level MDG targets and results, as well as their social and structural determinants, in China, India, Indonesia and Vietnam. To understand country-level MDG achievements it is useful to analyze their social and structural determinants. This analysis is not sufficient, however, to understand within-country inequities. Specialized analyses are required for this purpose, as is discussion and debate of the results with policymakers, which is the aim of the EPI-4 project. Reducing health inequities requires sophisticated analyses to identify disadvantaged populations within and between countries, and to determine evidence-based solutions that will make a difference. The EPI-4 project hopes to contribute to this goal.

International scientific collaboration in HIV and HPV: a network analysis.

PubMed

Vanni, Tazio; Mesa-Frias, Marco; Sanchez-Garcia, Ruben; Roesler, Rafael; Schwartsmann, Gilberto; Goldani, Marcelo Z; Foss, Anna M

2014-01-01

Research endeavours require the collaborative effort of an increasing number of individuals. International scientific collaborations are particularly important for HIV and HPV co-infection studies, since the burden of disease is rising in developing countries, but most experts and research funds are found in developed countries, where the prevalence of HIV is low. The objective of our study was to investigate patterns of international scientific collaboration in HIV and HPV research using social network analysis. Through a systematic review of the literature, we obtained epidemiological data, as well as data on countries and authors involved in co-infection studies. The collaboration network was analysed in respect to the following: centrality, density, modularity, connected components, distance, clustering and spectral clustering. We observed that for many low- and middle-income countries there were no epidemiological estimates of HPV infection of the cervix among HIV-infected individuals. Most studies found only involved researchers from the same country (64%). Studies derived from international collaborations including high-income countries and either low- or middle-income countries had on average three times larger sample sizes than those including only high-income countries or low-income countries. The high global clustering coefficient (0.9) coupled with a short average distance between researchers (4.34) suggests a "small-world phenomenon." Researchers from high-income countries seem to have higher degree centrality and tend to cluster together in densely connected communities. We found a large well-connected community, which encompasses 70% of researchers, and 49 other small isolated communities. Our findings suggest that in the field of HIV and HPV, there seems to be both room and incentives for researchers to engage in collaborations between countries of different income-level. Through international collaboration resources available to researchers in high-income countries can be efficiently used to enroll more participants in low- and middle-income countries.

Women's perceptions of iron deficiency and anemia prevention and control in eight developing countries.

PubMed

Galloway, Rae; Dusch, Erin; Elder, Leslie; Achadi, Endang; Grajeda, Ruben; Hurtado, Elena; Favin, Mike; Kanani, Shubhada; Marsaban, Julie; Meda, Nicolas; Moore, K Mona; Morison, Linda; Raina, Neena; Rajaratnam, Jolly; Rodriquez, Javier; Stephen, Chitra

2002-08-01

The World Health Organization estimates that 58% of pregnant women in developing countries are anemic. In spite of the fact that most ministries of health in developing countries have policies to provide pregnant women with iron in a supplement form, maternal anemia prevalence has not declined significantly where large-scale programs have been evaluated. During the period 1991-98, the MotherCare Project and its partners conducted qualitative research to determine the major barriers and facilitators of iron supplementation programs for pregnant women in eight developing countries. Research results were used to develop pilot program strategies and interventions to reduce maternal anemia. Across-region results were examined and some differences were found but the similarity in the way women view anemia and react to taking iron tablets was more striking than differences encountered by region, country or ethnic group. While women frequently recognize symptoms of anemia, they do not know the clinical term for anemia. Half of women in all countries consider these symptoms to be a priority health concern that requires action and half do not. Those women who visit prenatal health services are often familiar with iron supplements, but commonly do not know why they are prescribed. Contrary to the belief that women stop taking iron tablets mainly due to negative side effects, only about one-third of women reported that they experienced negative side effects in these studies. During iron supplementation trials in five of the countries, only about one-tenth of the women stopped taking the tablets due to side effects. The major barrier to effective supplementation programs is inadequate supply. Additional barriers include inadequate counseling and distribution of iron tablets, difficult access and poor utilization of prenatal health care services, beliefs against consuming medications during pregnancy, and in most countries, fears that taking too much iron may cause too much blood or a big baby, making delivery more difficult. Facilitators include women's recognition of improved physical well being with the alleviation of symptoms of anemia, particularly fatigue, a better appetite, increased appreciation of benefits for the fetus, and subsequent increased demand for prevention and treatment of iron deficiency and anemia.

The ESTHER hospital partnership initiative: a powerful levy for building capacities to combat the HIV pandemic in low-resource countries.

PubMed

Raguin, Gilles

2016-04-01

Partnerships between hospitals in high income countries and low resource countries are uniquely capable of fulfilling the tripartite needs of care, training, and research required to address health care crises in low resource countries. Of particular interest, at a time when the EBOLA crisis highlights the weaknesses of health systems in resource-poor settings, the institutional resources and expertise of hospitals can also contribute to strengthening health systems with long-term sustainability.We describe a partnership network between French Hospitals and hospitals/health structures in 19 countries that demonstrates the power and efficacy of health partnership in the response to the HIV/AIDS pandemic in sub-Saharan Africa and south East Asia. Through the ESTHER initiative, the partnership network currently provides capacity development, care and treatment to over 165,000 HIV-positive patients at 87 urban and 92 peripheral sites in 17 countries and enrolls 19,000 new HIV positive patients, delivers psychosocial services to 120 000 people and tests more than 35,000 pregnant women for HIV annually. It also, engages communities and assists with the development of a robust electronic information system.Launched in 2002, the ESTHER (Ensemble pour une Solidarite Thérapeutique Hospitalière En Reseau) initiative has grown from small projects with a focus on access to antiretroviral treatment in a limited number of West African countries at its outset into a large and comprehensive HIV/AIDS-control system in Western and Central Africa. The partnership's rapid achievements in the fight against HIV/AIDS, combined with the comprehensive and long-term approach to countries' health care needs, suggest that this "twinning" and medical mentoring model can and should be duplicated and developed to address the ever more pressing demand for response to global health needs in low resource countries.

Amendment of water quality standards in China: viewpoint on strategic considerations.

PubMed

Zhao, Xiaoli; Wang, Hao; Tang, Zhi; Zhao, Tianhui; Qin, Ning; Li, Huixian; Wu, Fengchang; Giesy, John P

2018-02-01

Water quality standards (WQS) are the most important tool for protection of quality of aquatic environments in China and play a decisive role in the management of China's aquatic environments. Due to limited scientific information available previously, WQS were developed largely based on water quality criteria (WQC) or WQS recommended by developed countries, which may not be suitable for current circumstances in China. The Chinese government recently initiated the revision of Environmental Quality Standards for Surface Water (EQSSW) (GB3838-2002) to meet the challenge of environmental protection. This review analyzed how the WQS developed and applied in China differ from those of more developed countries and pointed out that the lack of strong scientific bases for China's WQC pose major limitations of current WQS. We focus on discussing the six aspects that require high attention on how to establish a national WQC system to support the revision of WQS (Table 1) such as development of methodology, refining water function zoning, establish priority pollutants list, improving protection drinking water sources, development of site-specific water quality criteria, and field toxicity test. It is essential that China and other developing countries established a relatively mature system for promulgating, applying, and enforcing WQC and to implement a dynamic system to incorporate most recent research results into periodically updated WQS.

A review of the organization, regulation, and financing practices of postgraduate education in clinical nursing in 12 European countries.

PubMed

Rautiainen, Elina; Vallimies-Patomäki, Marjukka

2016-01-01

The aim of this study was to generate information of postgraduate education in clinical nursing in the EU member states. Data were collected via a structured electronic questionnaire and the questionnaire was sent to the government chief nurses in 26 EU countries in May 2013. Response rate was 46% (n=12). In total, 42 domains of specialization were identified. The most common domains were intensive care, mental health, operating room, emergency care, and pediatrics. Specialization programs were organized by university in two of the respondent countries, as residency program in one country, and as a mix of them in four countries. Regulation practices varied remarkably between the countries: scope of practice, subjects, entry requirements, length of education, description of the minimum competence requirements, and education standards related to the specialization programs were most often regulated by act, decree or other regulation. In some of the countries, no registration was required beyond the initial registration, whereas in some others, registration practices varied depending on the specialization program. New information was gathered on the regulation practices of postgraduate education in clinical nursing in the European Region concerning title provision, entry requirements, and financing practices. The awarded title on specialization programs depended on the level of postgraduate education, and the title might vary between the domains. General clinical experience was included in the entry requirements in seven countries. The government was mainly responsible for financing the postgraduate education in four countries, employer in three countries, and in the rest of the countries, there was a combination of different financiers. The importance of knowledge exchange on postgraduate education across the European countries needs to be acknowledged. Information provided by this study on international regulation practices provides useful information for the policy-makers regarding the organization of the postgraduate education in clinical nursing. Copyright © 2015 Elsevier Ltd. All rights reserved.

Report of the Second Asian Prostate Cancer (A-CaP) Study Meeting.

PubMed

Kim, Choung-Soo; Lee, Ji Youl; Chung, Byung Ha; Kim, Wun-Jae; Fai, Ng Chi; Hakim, Lukman; Umbas, Rainy; Ong, Teng Aik; Lim, Jasmine; Letran, Jason L; Chiong, Edmund; Wu, Tong-Lin; Lojanapiwat, Bannakij; Türkeri, Levent; Murphy, Declan G; Gardiner, Robert A; Moretti, Kim; Cooperberg, Matthew; Carroll, Peter; Mun, Seong Ki; Hinotsu, Shiro; Hirao, Yoshihiko; Ozono, Seiichiro; Horie, Shigeo; Onozawa, Mizuki; Kitagawa, Yasuhide; Kitamura, Tadaichi; Namiki, Mikio; Akaza, Hideyuki

2017-09-01

The Asian Prostate Cancer (A-CaP) Study is an Asia-wide initiative that has been developed over the course of 2 years. The study was launched in December 2015 in Tokyo, Japan, and the participating countries and regions engaged in preparations for the study during the course of 2016, including patient registration and creation of databases for the purpose of the study. The Second A-CaP Meeting was held on September 8, 2016 in Seoul, Korea, with the participation of members and collaborators from 12 countries and regions. Under the study, each participating country or region will begin registration of newly diagnosed prostate cancer patients and conduct prognostic investigations. From the data gathered, common research themes will be identified, such as comparisons among Asian countries of background factors in newly diagnosed prostate cancer patients. This is the first Asia-wide study of prostate cancer and has developed from single country research efforts in this field, including in Japan and Korea. At the Second Meeting, participating countries and regions discussed the status of preparations and discussed various issues that are being faced. These issues include technical challenges in creating databases, promoting participation in each country or region, clarifying issues relating to data input, addressing institutional issues such as institutional review board requirements, and the need for dedicated data managers. The meeting was positioned as an opportunity to share information and address outstanding issues prior to the initiation of the study. In addition to A-CaP-specific discussions, a series of special lectures was also delivered as a means of providing international perspectives on the latest developments in prostate cancer and the use of databases and registration studies around the world.

Paying for family planning.

PubMed

Lande, R E; Geller, J S

1991-11-01

This report discusses the challenges and costs involved in meeting the future needs for family planning in developing countries. Estimates of current expenditures for family planning go as high as $4.5 billion. According to a UNFPA report, developing country governments contribute 75% of the payments for family planning, with donor agencies contributing 15%, and users paying for 10%. Although current expenditures cover the needs of about 315 million couples of reproductive age in developing countries, this number of couples accounts for only 44% of all married women of reproductive age. Meeting all current contraceptive needs would require an additional $1 to $1.4 billion. By the year 2000, as many as 600 million couples could require family planning, costing as much as $11 billion a year. While the brunt of the responsibility for covering these costs will remain in the hand of governments and donor agencies (governments spend only 0.4% of their total budget on family planning and only 1% of all development assistance goes towards family planning), a wide array of approaches can be utilized to help meet costs. The report provides detailed discussions on the following approaches: 1) retail sales and fee-for-services providers, which involves an expanded role for the commercial sector and an increased emphasis on marketing; 2) 3rd-party coverage, which means paying for family planning service through social security institutions, insurance plans, etc.; 3) public-private collaboration (social marketing, employment-based services, etc.); 4) cost recovery, such as instituting fees in public and private nonprofit family planning clinics; and 5) improvements in efficiency.

Responses to the Standard for Exchange of Nonclinical Data (SEND) in non-US countries

PubMed Central

Anzai, Takayuki; Kaminishi, Masamichi; Sato, Keizo; Kaufman, Laura; Iwata, Hijiri; Nakae, Dai

2015-01-01

The Standard for the Exchange of Nonclinical Data (SEND), adopted by the US FDA, is part of a set of regulations and guidances requiring the submission of standardized electronic study data for nonclinical and clinical data submissions. SEND is the nonclinical implementation of SDTM (Study Data Tabulation Model), the standard electronic format for clinical regulatory submissions to FDA. SEND, SDTM, and the associated Controlled Terminology have been developed by CDISC (Clinical Data Interchange Standards Consortium). In order to successfully implement SEND, interdisciplinary contributions between sponsors and CROs, need a model for task allocation. This is being undertaken by the Pharmaceutical Users Software Exchange (PhUSE). Because SEND is currently the preferred submission format of the US FDA only and will become required by it starting in December 2016, only American academic societies and companies are actively involved. An exception to this is the INHAND initiative, which leads the way in standardizing terminology for toxicological pathology. On the other hand, international globalization of other clinical and nonclinical practices is not feasible because there are substantial differences between the US and non-US countries in CRO involvement in drug development. Thus, non-US countries must consider and develop approaches to SEND that meet their needs. This paper summarizes the activities of the major organizations involved in SEND development and implementation, discusses the effective use of SEND, and details a compliance scheme (research material of the Showa University School of Medicine) illustrating how pharmaceutical companies can complete a large amount of work up to an FDA application with the effective utilization of CROs and solution providers. PMID:26028814

Perception of Peace in Students' Drawings

ERIC Educational Resources Information Center

Cengelci Kose, Tuba; Gurdogan Bayir, Omur

2016-01-01

Problem Statement: Societies are facing several kinds of problems in the world today as chaos among the countries, conflicts between different groups, wars and diseases. It can be claimed that solving these problems is impossible unless societies care about humanistic cooperation, tolerance and peace. Individuals required developing fundamental…

Analyzing Agricultural Technology Systems: A Research Report.

ERIC Educational Resources Information Center

Swanson, Burton E.

The International Program for Agricultural Knowledge Systems (INTERPAKS) research team is developing a descriptive and analytic framework to examine and assess agricultural technology systems. The first part of the framework is an inductive methodology that organizes data collection and orders data for comparison between countries. It requires and…

Satellite Systems for Instructional Radio.

ERIC Educational Resources Information Center

Jamison, Dean; And Others

Recent studies suggest that Educational Television (ETV) broadcast from geostationary satellites can markedly reduce the cost and time required to provide educational opportunity for the citizens of large, less-developed countries. The sheer volume of educational needs precludes, however, the possibility of satisfying very many of them with only a…

INVENTORY OF U.S. GREENHOUSE GAS EMISSIONS AND SINKS 1990-2011

EPA Science Inventory

The Environmental Protection Agency submits the U.S. greenhouse gas inventory as an annual reporting requirement under UNFCCC, which the United States and other developed countries signed June 1992 at the Rio Earth Summit. The EPA has submitted the greenhouse gas inventory to the...

INVENTORY OF U.S. GREENHOUSE GAS EMISSIONS AND SINKS 1990-2004

EPA Science Inventory

The Environmental Protection Agency submits the U.S. greenhouse gas inventory as an annual reporting requirement under UNFCCC, which the United States and other developed countries signed June 1992 at the Rio Earth Summit. The EPA has submitted the greenhouse gas inventory to the...

Orange sweet potatoes are an excellent source of vitamin A

USDA-ARS?s Scientific Manuscript database

Vitamin A is an essential nutrient required for proper growth and development, vision, red blood cell production, and immune function. An estimated 208 million women and children suffer from vitamin A deficiency worldwide, making vitamin A deficiency a public health problem in numerous countries. Se...

Pacific island health inequities forecast to grow unless profound changes are made to health systems in the region.

PubMed

Matheson, Don; Park, Kunhee; Soakai, Taniela Sunia

2017-10-01

Objective Twenty years ago the Pacific's health ministers developed a 'Healthy Islands' vision to lead health development in the subregion. This paper reports on a review of health development over this period and discusses the implications for the attainment of the health related Sustainable Development Goals. Methods The review used qualitative and quantitative methods. The qualitative review included conducting semi-structured interviews with Pacific Island Government Ministers and officials, regional agencies, health workers and community members. A document review was also conducted. The quantitative review consisted of examining secondary data from regional and global data collections. Results The review found improvement in health indicators, but increasing health inequality between the Pacific and the rest of the world. Many of the larger island populations were unable to reach the health Millennium Development Goals. The 'Healthy Islands' vision remained an inspiration to health ministers and senior officials in the region. However, implementation of the 'Healthy Islands' approach was patchy, under-resourced and un-sustained. Communicable and Maternal and Child Health challenges persist alongside unprecedented levels of non-communicable diseases, inadequate levels of health finance and few skilled health workers as the major impediments to health development for many of the Pacific's countries. Conclusions The current trajectory for health in the Pacific will lead to increasing health inequity with the rest of the world. The challenges to health in the region include persisting communicable disease and maternal and child health threats, unprecedented levels of NCDs, climate change and instability, as well as low economic growth. In order to change the fortunes of this region in the age of the SDGs, a substantial investment in health is required, including in the health workforce, by countries and donors alike. That investment requires a nuanced response that takes into account the contextual differences between and within Pacific islands, adherence to aid effectiveness principles and interventions designed to strengthen local health systems. What is known about the topic? It is well established that the Pacific island countries are experiencing the double disease burden, and that the non-communicable disease epidemic is more advanced. What does this paper add? This paper discusses the review of 20 years of health development in the Pacific. It reveals that although progress is being made, health development in the region is falling behind that of the rest of the world. It also describes the progress made by the Pacific countries in pursuit of the 'Healthy Islands' concept. What are the implications for practitioners? This paper has significant implications for Pacific countries, donor partners and development partners operating across and within Pacific countries. It calls for a substantial increase in health resourcing and the way development assistance is organised to arrest the increasing inequities in health outcomes between Pacific people and those of the rest of the world.

Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa: a combined analysis of nine models.

PubMed

Menzies, Nicolas A; Gomez, Gabriela B; Bozzani, Fiammetta; Chatterjee, Susmita; Foster, Nicola; Baena, Ines Garcia; Laurence, Yoko V; Qiang, Sun; Siroka, Andrew; Sweeney, Sedona; Verguet, Stéphane; Arinaminpathy, Nimalan; Azman, Andrew S; Bendavid, Eran; Chang, Stewart T; Cohen, Ted; Denholm, Justin T; Dowdy, David W; Eckhoff, Philip A; Goldhaber-Fiebert, Jeremy D; Handel, Andreas; Huynh, Grace H; Lalli, Marek; Lin, Hsien-Ho; Mandal, Sandip; McBryde, Emma S; Pandey, Surabhi; Salomon, Joshua A; Suen, Sze-Chuan; Sumner, Tom; Trauer, James M; Wagner, Bradley G; Whalen, Christopher C; Wu, Chieh-Yin; Boccia, Delia; Chadha, Vineet K; Charalambous, Salome; Chin, Daniel P; Churchyard, Gavin; Daniels, Colleen; Dewan, Puneet; Ditiu, Lucica; Eaton, Jeffrey W; Grant, Alison D; Hippner, Piotr; Hosseini, Mehran; Mametja, David; Pretorius, Carel; Pillay, Yogan; Rade, Kiran; Sahu, Suvanand; Wang, Lixia; Houben, Rein M G J; Kimerling, Michael E; White, Richard G; Vassall, Anna

2016-11-01

The post-2015 End TB Strategy sets global targets of reducing tuberculosis incidence by 50% and mortality by 75% by 2025. We aimed to assess resource requirements and cost-effectiveness of strategies to achieve these targets in China, India, and South Africa. We examined intervention scenarios developed in consultation with country stakeholders, which scaled up existing interventions to high but feasible coverage by 2025. Nine independent modelling groups collaborated to estimate policy outcomes, and we estimated the cost of each scenario by synthesising service use estimates, empirical cost data, and expert opinion on implementation strategies. We estimated health effects (ie, disability-adjusted life-years averted) and resource implications for 2016-35, including patient-incurred costs. To assess resource requirements and cost-effectiveness, we compared scenarios with a base case representing continued current practice. Incremental tuberculosis service costs differed by scenario and country, and in some cases they more than doubled existing funding needs. In general, expansion of tuberculosis services substantially reduced patient-incurred costs and, in India and China, produced net cost savings for most interventions under a societal perspective. In all three countries, expansion of access to care produced substantial health gains. Compared with current practice and conventional cost-effectiveness thresholds, most intervention approaches seemed highly cost-effective. Expansion of tuberculosis services seems cost-effective for high-burden countries and could generate substantial health and economic benefits for patients, although substantial new funding would be required. Further work to determine the optimal intervention mix for each country is necessary. Bill & Melinda Gates Foundation. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Utilisation of gas resources in qatar: A decade of planned development and integration

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

Ferdin, J.P.

Qatar's demand for energy has increased tremendously during the last decade due to expanded economic activity since the early 1970's and subsequent diversification through development of downstream industries. Most of the energy requirement is met by natural gas. The purpose of this paper is to describe the development of a gas oriented producing country and the operating philosophy for maintaining maximum efficiency and preserving the Nation's natural resources.

An empirical evaluation of software quality assurance practices and challenges in a developing country: a comparison of Nigeria and Turkey.

PubMed

Sowunmi, Olaperi Yeside; Misra, Sanjay; Fernandez-Sanz, Luis; Crawford, Broderick; Soto, Ricardo

2016-01-01

The importance of quality assurance in the software development process cannot be overemphasized because its adoption results in high reliability and easy maintenance of the software system and other software products. Software quality assurance includes different activities such as quality control, quality management, quality standards, quality planning, process standardization and improvement amongst others. The aim of this work is to further investigate the software quality assurance practices of practitioners in Nigeria. While our previous work covered areas on quality planning, adherence to standardized processes and the inherent challenges, this work has been extended to include quality control, software process improvement and international quality standard organization membership. It also makes comparison based on a similar study carried out in Turkey. The goal is to generate more robust findings that can properly support decision making by the software community. The qualitative research approach, specifically, the use of questionnaire research instruments was applied to acquire data from software practitioners. In addition to the previous results, it was observed that quality assurance practices are quite neglected and this can be the cause of low patronage. Moreover, software practitioners are neither aware of international standards organizations or the required process improvement techniques; as such their claimed standards are not aligned to those of accredited bodies, and are only limited to their local experience and knowledge, which makes it questionable. The comparison with Turkey also yielded similar findings, making the results typical of developing countries. The research instrument used was tested for internal consistency using the Cronbach's alpha, and it was proved reliable. For the software industry in developing countries to grow strong and be a viable source of external revenue, software assurance practices have to be taken seriously because its effect is evident in the final product. Moreover, quality frameworks and tools which require minimum time and cost are highly needed in these countries.

Transportation and utilization of aggregates for road construction

NASA Astrophysics Data System (ADS)

Fladvad, Marit; Wigum, Børge Johannes; Aurstad, Joralf

2017-04-01

Road construction relies on non-renewable aggregate resources as the main construction material. Sources for high-quality aggregate resources are scattered, and requirements for aggregate quality can cause long transport distances between quarry and road construction site. In European countries, the average aggregate consumption per capita is 5 tonnes per year (European Aggregates Association, 2016), while the corresponding figure for Norway is 11 tonnes (Neeb, 2015). Half the Norwegian aggregate production (sand, gravel and crushed rock) is used for road construction. In Norway, aggregate resources have been considered abundant. However, stricter requirement for aggregate quality, and increased concern for sustainability and environmental issues have spurred focus on reduction of transport lengths through better utilization of local aggregate materials. In this research project, information about pavement design and aggregate quality requirements were gathered from a questionnaire sent to selected experts from the World Road Organization (PIARC), European Committee for Standardization (CEN), and Nordic Road Association (NVF). The gathered data was compared to identify differences and similarities for aggregate use in the participating countries. Further, the data was compared to known data from Norway regarding: - amount of aggregates required for a road structure - aggregate transport lengths and related costs A total of 18 countries participated in the survey, represented by either road authorities, research institutions, or contractors. There are large variations in practice for aggregate use among the represented countries, and the selection of countries is sufficient to illustrate a variety in pavement designs, aggregate sizes, and quality requirements for road construction. There are considerable differences in both pavement thickness and aggregate sizes used in the studied countries. Total thicknesses for pavement structures varies from 220 mm to 2400 mm, and aggregate sizes for unbound materials varies from 19 mm to 600 mm. These results imply great differences in the amount of aggregate transport to road construction sites. Another important factor is the distances between the construction sites and the aggregate sources. For many projects, especially in countries in need of importing aggregates, aggregate transport will have considerable impact on sustainability assessment of the construction projects. If pavement design can be altered with the goal of achieving better utilization of local aggregates through adaption to the quality of local aggregates, aggregate transportation can be reduced. Reduced transport will alter the economical balance of a project, allowing reallocation of costs from transport to e.g. improved aggregate production. The overall result can be more profitable construction projects and a more sustainable development of road structures.

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.

Political economy of tobacco control in low-income and middle-income countries: lessons from Thailand and Zimbabwe. Global Analysis Project Team.

PubMed Central

Chantornvong, S.; Collin, J.; Dodgson, R.; Lee, K.; McCargo, D.; Seddon, D.; Vaughan, P.; Woelk, G.

2000-01-01

Crucial to the success of the proposed Framework Convention on Tobacco Control will be an understanding of the political and economic context for tobacco control policies, particularly in low-income and middle-income countries. Policy studies in Thailand and Zimbabwe employed the analytical perspective of political economy and a research strategy that used political mapping, a technique for characterizing and evaluating the political environment surrounding a policy issue, and stakeholder analysis, which seeks to identify key actors and to determine their capacity to shape policy outcomes. These policy studies clearly revealed how tobacco control in low-income and middle-income countries is also being shaped by developments in the global and regional political economy. Hence efforts to strengthen national control policies need to be set within the context of globalization and the international context. Besides the transnational tobacco companies, international tobacco groups and foreign governments, international agencies and nongovernmental organizations are also playing influential roles. It cannot be assumed, therefore, that the tobacco control strategies being implemented in industrialized countries will be just as effective and appropriate when implemented in developing countries. There is an urgent need to expand the number of such tobacco policy studies, particularly in low-income and middle-income countries. Comprehensive guidelines for tobacco policy analysis and research are required to support this process, as is a broader international strategy to coordinate further tobacco policy research studies at country, regional and global levels. PMID:10994265

International migration and sustainable human development in eastern and southern Africa.

PubMed

Oucho, J O

1995-01-01

International migration in eastern and southern Africa (ESA) is rarely addressed in population and development policies or regional organizations, and regional organizations must in the articulation of sustainable shared development identify the role of international migration. Poor quality data on international migration hampers analysis. Sustainable, shared, and human development within the region are subregional issues. Permanent migration is characterized among ESA countries as increasing demographic ethnic pluralism that may result in redrawing of territorial boundaries and further population movement. Portuguese and Arab settlement and integration in eastern areas resulted in coexistence, while European immigration to South Africa resulted in racial segregation. Modern colonial settlement and the aftermath of political conflict resulted in independent countries after the 1960s and outmigration of nonAfrican groups. Much of the labor migration in ESA is unskilled workers moving to South African mining regions. Labor migration to Zimbabwe and Zambia declined after the 1960s. The formation of the Common Market for ESA and the potential merger with the Preferential Trade Area and South African Development Community is a key approach to integration of migration into regional cooperation and shared development. Refugee movements create the most problems. Prior to 1992 ESA countries accounted for 83.4% of refugees, particularly in Mozambique, Ethiopia, and Somalia. Some countries blame poor economic performance on the deluge of refugees. Illegal migration is currently detected because of the required work permits, but the adoption of the Common Market would obscure this phenomenon. Human development is affected most by migrations related to drought, labor migration to strong economic areas, and return migration. The Inter-Governmental Authority on Drought and Development needs to become more active and establish better policies on nomadic and refugee movements and displaced populations. Movement of educated populations to countries lacking in trained and skilled human resources is a future challenge. Strategies of immigration should facilitate economic development.

'Time is costly': modelling the macroeconomic impact of scaling-up antiretroviral treatment in sub-Saharan Africa.

PubMed

Ventelou, Bruno; Moatti, Jean-Paul; Videau, Yann; Kazatchkine, Michel

2008-01-02

Macroeconomic policy requirements may limit the capacity of national and international policy-makers to allocate sufficient resources for scaling-up access to HIV care and treatment in developing countries. An endogenous growth model, which takes into account the evolution of society's human capital, was used to assess the macroeconomic impact of policies aimed at scaling-up access to HIV/AIDS treatment in six African countries (Angola, Benin, Cameroon, Central African Republic, Ivory Coast and Zimbabwe). The model results showed that scaling-up access to treatment in the affected population would limit gross domestic product losses due to AIDS although differently from country to country. In our simulated scenarios of access to antiretroviral therapy, only 10.3% of the AIDS shock is counterbalanced in Zimbabwe, against 85.2% in Angola and even 100.0% in Benin (a total recovery). For four out of the six countries (Angola, Benin, Cameroon, Ivory Coast), the macro-economic gains of scaling-up would become potentially superior to its associated costs in 2010. Despite the variability of HIV prevalence rates between countries, macro-economic estimates strongly suggest that a massive investment in scaling-up access to HIV treatment may efficiently counteract the detrimental long-term impact of the HIV pandemic on economic growth, to the extent that the AIDS shock has not already driven the economy beyond an irreversible 'no-development epidemiological trap'.

100 million refugees. The world stabilizes through population stability.

PubMed

Sakaiya, T

1993-09-01

Global change has come about due to shifts in the business cycle, a new undeveloped paradigm to replace the Cold War, and a stabilization of expansion and development of modern industrial society. Japan has been transfixed with its own internal domestic affairs, but will feel the consequences of the Industrial Age nearing its end. Industrialization had relied on unlimited resources from the natural environment and the belief that a free-market economy would automatically lead to orderliness and a state of economic equilibrium. Population control has been an issue that has slid over the years as a priority status. In 1800, the population in developed countries was 4 times the population in developing countries; the reverse is becoming true. Mass migration was an unusual phenomena and not the problem it is today. There is a gap between population and productive capacity. Developed countries believed in humanitarian aid for refugees and impoverished peoples, but the numbers were unanticipated. There is no shame for war or civil unrest to drive boat people and hugh numbers to another country. The notion of nation state has changed. The boat people from Cuba were a beginning example of how governments were unconcerned about the loss of population. Afghanistan in 1979 was another example of refugees fleeing civil war. Iraq bombed the Kurds until there was no choice but to leave. Turkey was required to use troops to drive the Kurds back into Iraq. To increase aid indefinitely, or to send out more refugees than it takes in, or to use military forces to kill the invading refugees are not acceptable. An international framework with consensus from developed and developing countries is needed for dealing with mass migrations. Conventions adopted would have to be recognized as in each countries self-interest; disregard of the regulations would have to reflect significant disadvantages to a nation. Several issues are discussed as key in such a global framework: assuring productivity for all by absorbing some refugees, and developing new training programs for the private sector at home, and assuring development aid (technology, capital, markets). A self perpetuating cycle of growth and expansion must be set in motion. Infrastructure development must be replaced with stable employment in the home country.

Characterization of urban waste management practices in developing Asian countries: A new analytical framework based on waste characteristics and urban dimension.

PubMed

Aleluia, João; Ferrão, Paulo

2016-12-01

This paper characterizes municipal solid waste (MSW) management practices in developing Asia, with a focus on low and middle-income countries. The analysis that is conducted supports a proposed framework that maps out the trends observed in the region in relation to two parameters, waste compositions and urban dimension, which was prepared based on a set of national and urban case studies. The management of MSW in developing Asian countries is driven, first and foremost, by a public health imperative: the collection and disposal of waste in order to avoid the spread of disease vectors from uncollected waste. This comes, however, at a high cost, with local government authorities in these countries spending up to 50% of their budgets in the provision of these services. Little or no value is derived from waste, which is typically seen as a liability and not as a resource that can be harnessed. On the other hand, in many cities in developing Asia there is an informal sector that ekes out a living from the recovery of recyclable materials found in waste. Members of this "informal waste sector" are especially active in areas that are not served by formal waste collection systems, such as slums or squatter areas. A distinctive element shared among many cities in developing Asian countries concerns the composition of the municipal solid waste. MSW in those countries tends to be richer in biodegradable organic matter, which usually accounts for more than 50% of the total waste composition, suggesting that biological methods are more appropriate for treating this organic fraction. Conversely, thermal combustion technologies, which are extensively applied in high-income countries, are technically and economically challenging to deploy in light of the lower calorific value of waste streams which are rich in organics and moisture. Specific approaches and methods are therefore required for designing adequate waste management systems in developing Asian countries. In addition, despite some common characteristics shared among cities in developing Asia, their specific circumstances can significantly vary, even within the same country, calling for the need for context-specific waste management approaches. Set against this background, this paper proposes a guiding framework in the form of a matrix that maps out approaches observed in the management of municipal solid waste in cities of developing Asian countries as a function of the city dimension, share of organics on waste streams, and wealth generated by the city. The cities of Surabaya (Indonesia), Bangalore (India), Quy Nhon (Viet Nam), and Matale (Sri Lanka) are showcased as good practices in the region in the management of solid waste, with their experiences used to illustrate the framework laid out in the matrix. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Summary of the United States Food and Drug Administrations’ Food Safety Program for Imported Seafood; One Country’s Approach

PubMed Central

Koonse, Brett

2016-01-01

It is well known that the vast majority of seafood is captured or farmed in emerging countries and exported to developed countries. This has resulted in seafood being the number one traded food commodity in the world. Food safety is essential to this trade. Exporting countries should understand the regulatory food safety programs of the countries they ship to in order to comply with their applicable laws and regulations to avoid violations and disruptions in trade. The United States (U.S.) imports more seafood than any individual country in the world but the European Union (E.U.) countries, as a block, import significantly more. Each importing country has its own programs and systems in place to ensure the safety of imported seafood. However, most countries that export seafood have regulatory programs in place that comply with the import requirements of the E.U. The purpose of this paper is to describe the United States Food and Drug Administration’s (USFDA) imported seafood safety program. The primary audience for the information is foreign government regulators, seafood exporters, and U.S. importers. It can also give consumers confidence that f U.S. seafood is safe no matter which country it originates from. PMID:28231127

The current state of orthopaedic residency in 18 European countries.

PubMed

Madanat, Rami; Mäkinen, Tatu J; Ryan, Daniel; Huri, Gazi; Paschos, Nikolaos; Vide, Joao

2017-04-01

The aim of this study was to compare differences in current orthopaedic and trauma training programs across Europe. A questionnaire was sent to the FORTE (Federation of Orthopaedic Trainees in Europe) representatives of 25 different European countries, of which 18 responded. The questionnaire included demographic information and information concerning the structure of the training programs, including duration, selection, and mandatory training requirements. The number of trainees per specialist varied between countries from a ratio of 1:2 to 1:7. Residency was generally five to six years in all the countries. In more than half of the countries selection was interview-based. Nearly all countries utilized a logbook. About 80% of the participating countries had a final examination. When assessing the components of training it was found that only one country (the United Kingdom) had mandatory minimum requirements for (1) courses, (2) surgical procedures, (3) research and (4) leadership. Nearly 40% of the participating countries had only one or none of these four components as a mandatory training requirement. There are many similarities in training programs, but some important differences remain in overall requirements and final qualification. The main limitation of this study was that we were unable to get data from all the European countries. FORTE will continue to serve as a forum for sharing best practices with the ultimate goal of improving and harmonizing the level of orthopaedic training across Europe. Future studies should aim to include further details about training programs as well as to include data from more countries.

Retinopathy of prematurity: a global perspective of the epidemics, population of babies at risk and implications for control.

PubMed

Gilbert, Clare

2008-02-01

Globally at least 50,000 children are blind from retinopathy of prematurity (ROP) which is now a significant cause of blindness in many middle income countries in Latin American and Eastern Europe. Retinopathy of prematurity is also being reported from the emerging economies of India and China. The characteristics of babies developing severe disease varies, with babies in middle and low income countries having a much wider range of birth weights and gestational ages than is currently the case in industrialized countries. Rates of disease requiring treatment also tend to be higher in middle and low income countries suggesting that babies are being exposed to risk factors which are, to a large extent, being controlled in industrialised countries. The reasons for this "third epidemic" of ROP are discussed as well as strategies for control, including the need for locally relevant, evidence based criteria which ensure that all babies at risk are examined.

IWSSA 2009 PC Co-chairs' Message

NASA Astrophysics Data System (ADS)

Chung, Lawrence; Noguera, Manuel; Subramanian, Nary; Garrido, José Luis

Important changes in society are being predicted for the very near future. In many countries, governments look ahead by increasing reserve funds and budgets for strategically critical areas in order to identify key issues and find effective solutions. Not surprisingly, many institutions are launching research and development programs focused on health-care, elderly people, quality of life, social inclusion, energy, education, ecology, etc. Innovation is required for systems supporting such a new assisted, interactive and collaborative world. System and software designers have to be able to address how to reflect in the same system/software architecture a great amount of (sometimes conflicting) requirements. In particular, user-oriented nonfunctional requirements and developer-oriented non-functional requirements (or design constraints) gain special relevance due to the new environments in which the systems have to operate.

Survival of high-risk pediatric neuroblastoma patients in a developing country.

PubMed

Easton, Joseph C; Gomez, Sergio; Asdahl, Peter H; Conner, J Michael; Fynn, Alcira B; Ruiz, Claudia; Ojha, Rohit P

2016-09-01

Little information is available about survival of high-risk pediatric neuroblastoma patients in developing countries. We aimed to assess survival among high-risk pediatric neuroblastoma patients in La Plata, Argentina. Individuals eligible for our cohort were aged <20 yr when diagnosed with high-risk neuroblastoma and received cancer-directed therapy including stem cell transplantation at Hospital de Niños Sor Maria Ludovica between February 1999 and February 2015. We estimated overall survival probabilities using an extended Kaplan-Meier approach. Our study population comprised 39 high-risk neuroblastoma patients, of whom 39% were aged >4 yr at diagnosis, 54% were male, and 62% had adrenal neuroblastoma. We observed 18 deaths, and the median survival time of our study population was 1.7 yr. The five-yr overall survival probability was 24% (95% CL: 10%, 41%). In contrast, five-yr survival of high-risk neuroblastoma patients ranges between 23% and 76% in developed countries. Survival among high-risk neuroblastoma patients is generally poor regardless of geographic location, but our results illustrate dramatically worse survival for patients in a developing country. We speculate that the observed survival differences could be attenuated or eliminated with improvements in treatment and supportive care, but addressing these issues will require creative solutions because of resource limitations. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Needs Assessment to Identify the Reality of Two Rural School Cases in South Africa: Potential for ICT4D or Not?

ERIC Educational Resources Information Center

Pade-Khene, C.

2012-01-01

Understanding the potential or need for ICT support in education within developing countries, requires an in-depth needs assessment to comprehend, elaborate and set the desired priorities of rural schools. A Needs Assessment was conducted as part of an on-going comprehensive evaluation process of an ICT for development project, the Siyakhula…

Malaysia and the Knowledge Economy: Building a World-Class Higher Education System. Human Development Sector Reports

ERIC Educational Resources Information Center

Regel, Omporn; Salmi, Jamil; Watkins, Alfred; Tan, Hong; Dawkins, John; Saroyan, Alenoush; Vestergaard, Jakob

2007-01-01

This report was prepared at the request of the Government of Malaysia (GOM) as a contribution to the long term development objectives for the university sector under the Ninth Malaysia Plan. The GOM is considering new policy directions to make the country a more competitive player in the world economy. Such a strategy will require bold innovations…

Student Perceptions of Teacher Support and Competencies for Fostering Youth Purpose and Positive Youth Development: Perspectives from Two Countries

ERIC Educational Resources Information Center

Bundick, Matthew J.; Tirri, Kirsi

2014-01-01

With the growing interest in the development of purpose in youth, one important role that requires attention is the school teacher. The current article explores student perceptions of the role teachers can play in fostering purpose in their students in the mid- and late adolescent years, and the teacher competencies that facilitate purpose…

Survey of national guidelines, education and training on phlebotomy in 28 European countries: an original report by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) working group for the preanalytical phase (WG-PA).

PubMed

Simundic, Ana-Maria; Cornes, Michael; Grankvist, Kjell; Lippi, Giuseppe; Nybo, Mads; Kovalevskaya, Svjetlana; Sprongl, Ludek; Sumarac, Zorica; Church, Stephen

2013-08-01

European questionnaire survey was conducted by the European Federation of Clinical Chemistry and Laboratory Medicine Working Group for the Preanalytical Phase (EFLM WG-PA) to assess how phlebotomy is performed in EFLM countries, including differences in personnel, level of education and skills, and to investigate the presence and compliance of national phlebotomy guidelines on this matter. A questionnaire was constructed containing questions elucidating different aspects of the organization behind the phlebotomy praxis on a national basis, including questions on the staff performing phlebotomy, the education of these staff members, and the existence of and adherence to national guidelines. All 39 EFLM member countries were invited to participate. In total 28/39 (72%) EFLM member countries responded. Seven out of the 28 (25%) have national phlebotomy guidelines and five have implemented other guidelines. The estimated compliance with phlebotomy guidance for the laboratories in the countries that have national guidelines available is poor, regardless to whether the phlebotomy was under the laboratory control or not. Most countries were interested in EFLM guidelines and to participate in a pilot EFLM preanalytical phase external quality assessment (EQA) scheme. In the responding EFLM member countries, the majority of phlebotomy is performed by nurses and laboratory technicians. Their basic education is generally 4-5 years of high school, followed by 2-5 years of colleague or university studies. Only a third (10/28; 36%) of the participating member countries has any specific training available as a continuous educational resource. A specific training for phlebotomy is not part of the education required to become qualified in 6/28 (21%) and 9/28 (32%) of countries for nurses and laboratory technicians, respectively. In countries and professions where training is required, most require more than 5 h of training. Based on the results of this survey we conclude the following: 1) There is a need to assess the quality of current practices, compliance to the CLSI H3-A6 guidelines and to identify some most critical steps which occur during phlebotomy, in different healthcare settings, across Europe; 2) Existing CLSI H3-A6 phlebotomy guidelines should be adapted and used locally in all European countries which do not have their own guidelines; 3) National EFLM societies need to be engaged in basic training program development and continuous education of healthcare phlebotomy staff (implementing the certification of competence).

Burnout syndrome as an occupational disease in the European Union: an exploratory study.

PubMed

Lastovkova, Andrea; Carder, Melanie; Rasmussen, Hans Martin; Sjoberg, Lars; Groene, Gerda J de; Sauni, Riitta; Vevoda, Jiri; Vevodova, Sarka; Lasfargues, Gerard; Svartengren, Magnus; Varga, Marek; Colosio, Claudio; Pelclova, Daniela

2018-04-07

The risk of psychological disorders influencing the health of workers increases in accordance with growing requirements on employees across various professions. This study aimed to compare approaches to the burnout syndrome in European countries. A questionnaire focusing on stress-related occupational diseases was distributed to national experts of 28 European Union countries. A total of 23 countries responded. In 9 countries (Denmark, Estonia, France, Hungary, Latvia, Netherlands, Portugal, Slovakia and Sweden) burnout syndrome may be acknowledged as an occupational disease. Latvia has burnout syndrome explicitly included on the List of ODs. Compensation for burnout syndrome has been awarded in Denmark, France, Latvia, Portugal and Sweden. Only in 39% of the countries a possibility to acknowledge burnout syndrome as an occupational disease exists, with most of compensated cases only occurring in recent years. New systems to collect data on suspected cases have been developed reflecting the growing recognition of the impact of the psychosocial work environment. In agreement with the EU legislation, all EU countries in the study have an action plan to prevent stress at the workplace.

The imperative for stronger vaccine supply and logistics systems.

PubMed

Zaffran, Michel; Vandelaer, Jos; Kristensen, Debra; Melgaard, Bjørn; Yadav, Prashant; Antwi-Agyei, K O; Lasher, Heidi

2013-04-18

With the introduction of new vaccines, developing countries are facing serious challenges in their vaccine supply and logistics systems. Storage capacity bottlenecks occur at national, regional, and district levels and system inefficiencies threaten vaccine access, availability, and quality. As countries adopt newer and more expensive vaccines and attempt to reach people at different ages and in new settings, their logistics systems must be strengthened and optimized. As a first step, national governments, donors, and international agencies have crafted a global vision for 2020 vaccine supply and logistics systems with detailed plans of action to achieve five priority objectives. Vaccine products and packaging are designed to meet the needs of developing countries. Immunization supply systems support efficient and effective vaccine delivery. The environmental impact of energy, materials, and processes used in immunization systems is minimized. Immunization information systems enable better and more timely decision-making. Competent and motivated personnel are empowered to handle immunization supply chain issues. Over the next decade, vaccine supply and logistics systems in nearly all developing countries will require significant investments of time and resources from global and national partners, donors, and governments. These investments are critical if we are to reach more people with current and newer vaccines. Copyright © 2012 Elsevier Ltd. All rights reserved.

Dollars and sense. Efforts to reduce perinatal transmission fuel the debate over "haves" and "have nots".

PubMed

Melcombe, L

1998-07-01

HIV has become the single greatest contributor to child mortality in developing countries. Although clinical trials of azidovudine (AZT) in the US and Europe have revealed reductions of 43-66% in perinatal HIV transmission, the cost of this treatment regimen is prohibitive in developing countries. Of interest are recent findings that a short course of AZT (three oral doses daily beginning at 36 weeks' gestation and every 3 hours during labor) produces a 50% reduction in perinatal HIV transmission. The pharmaceutical firm Glaxo Wellcome has announced it will negotiate reduced AZT pricing with developing countries to increase treatment access. It is acknowledged, however, that discounted prices may still remain beyond the reach of countries in sub-Saharan Africa, for example. Even if discounted prices were complemented by other funding sources, the health infrastructure required to provide widespread counseling, testing, and treatment is not in place. Also problematic is the possibility that infants who are protected from perinatal HIV transmission will become infected postnatally as a result of lack of safe alternatives to breast-feeding. Moreover, unless treatment with triple-combination therapies and protease inhibitors is provided to HIV-infected women, their children will face increased mortality risks as a result of orphanhood.

Economic growth and decline in mortality in developing countries: an analysis of the World Bank development datasets.

PubMed

Renton, A; Wall, M; Lintott, J

2012-07-01

The 1999 World Bank report claimed that growth in gross domestic product (GDP) between 1960 and 1990 only accounted for 15% of concomitant growth in life expectancy in developing countries. These findings were used repeatedly by the World Health Organization (WHO) to support a policy shift away from promoting social and economic development, towards vertical technology-driven programmes. This paper updates the 1999 World Bank report using the World Bank's 2005 dataset, providing a new assessment of the relative contribution of economic growth. Time-series analysis. Cross-sectional time-series regression analysis using a random effect model of associations between GDP, education and technical progress and improved health outcomes. The proportion of improvement in health indicators between 1970 and 2000 associated with changes in GDP, education and technical progress was estimated. In 1970, a 1% difference in GDP between countries was associated with 6% difference in female (LEBF) and 5% male (LEBM) life expectancy at birth. By 2000, these values had increased to 14% and 12%, explaining most of the observed health gain. Excluding Europe and Central Asia, the proportion of the increase in LEBF and LEBM attributable to increased GDP was 31% and 33% in the present analysis, vs. 17% and 14%, respectively, estimated by the World Bank. In the poorest countries, higher GDPs were required in 2000 than in 1970 to achieve the same health outcomes. In the poorest countries, socio-economic change is likely to be a more important source of health improvement than technical progress. Technical progress, operating by increasing the size of the effect of a unit of GDP on health, is likely to benefit richer countries more than poorer countries, thereby increasing global health inequalities. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Development of inactivated poliovirus vaccine from Sabin strains: A progress report.

PubMed

Okayasu, Hiromasa; Sein, Carolyn; Hamidi, Ahd; Bakker, Wilfried A M; Sutter, Roland W

2016-11-01

The Global Polio Eradication Initiative (GPEI) has seen significant progress since it began in 1988, largely due to the worldwide use of oral poliovirus vaccine (OPV). In order to achieve polio eradication the global cessation of OPV is necessary because OPV contains live attenuated poliovirus, which in rare circumstances could re-gain wild poliovirus (WPV) characteristics with potential to establish transmission. The GPEI endgame strategy for the period 2013-2018 recommends the globally synchronised sequential cessation of the Sabin strains contained in the OPV, starting with type 2 Sabin. The withdrawal of Sabin type 2 took place in April 2016, with the introduction of at least one dose of inactivated poliovirus vaccine (IPV) as a risk mitigation strategy. The introduction of IPV into 126 countries since 2013 has required a rapid scale-up of IPV production by the two manufacturers supplying the global public sector market. This scale-up has been fraught with challenges, resulting in reductions of 40-50% of initial supply commitments. Consequently, 22 countries will not be supplied until 2018, and another 23 countries will experience serious stock-outs. In the last decade repeated calls-for-action were made to the global community to invigorate their vision and investment in developing "new poliovirus vaccines" including the development of IPV from less-virulent strains, such as Sabin-IPV (S-IPV). The conventional Salk-IPV production is limited to high-income industrialized-country manufacturers due to the containment requirements (i.e., high sanitation, low force-of-poliovirus-infection, and high population immunity). The use of Sabin strains in the production of S-IPV carries a lower biosafety risk, and was determined to be suitable for production in developing countries, expanding the manufacturing base and making IPV more affordable and accessible in the long term. Significant progress in the S-IPV has been made since 2006. S-IPV is now licensed as S-IPV in Japan and as standalone S-IPV in China, demonstrating the feasibility of this vaccine. In addition, production process improvements can further reduce the cost of production. The latter are critical to the economic success of this vaccine in the global market. We summarize the progress made to date in S-IPV technology, the scientific data and economic evidence in support of S-IPV development. Copyright © 2016 International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

Development of a quality assurance handbook to improve educational courses in Africa.

PubMed

Nabwera, Helen M; Purnell, Sue; Bates, Imelda

2008-12-18

The attainment of the Millennium Development Goals has been hampered by the lack of skilled and well-informed health care workers in many developing countries. The departure of health care workers from developing countries is one of the most important causes. One of the motivations for leaving is that developed countries have well-established health care systems that incorporate continuing medical education, which enables health care workers to develop their skills and knowledge base. This provision is lacking in many developing countries. The provision of higher-education programmes of good quality within developing countries therefore, contributes to building capacity of the health care workforce in these countries. The Liverpool School of Tropical Medicine is involved in delivering off-site higher educational programmes to health care workers in Africa. Our colleagues at one of these sites requested a guide to help them ensure that their professional development courses met international educational standards. We reviewed published literature that outlines the principles of quality assurance in higher education from various institutions worldwide. Using this information, we designed a handbook that outlines the quality assurance principles in a simple and practical way. This was intended to enable institutions, even in developing countries, to adapt these principles in accordance with their local resource capacity. We subsequently piloted this handbook at one of the sites in Ghana. The feedback from this aided the development of the handbook. The development of this handbook was participatory in nature. The handbook addresses six main themes that are the minimum requirements that a higher education course should incorporate to ensure that it meets internationally recognized standards. These include: recruitment and admissions, course design and delivery, student assessments, approval and review processes, support for students and staff training and welfare. It has been piloted in Ghana and the feedback was incorporated into the handbook. The handbook is currently available free of charge online and being used by various institutions across the world. We have had responses from individuals and institutions in Africa, Asia, North America and Europe. The principles outlined in the handbook provide a regulatory framework for locally establishing higher education courses of good quality that will contribute to enhancing the teaching and learning experience of students in courses in the developing world. This would contribute to providing a skilled and sustainable health care workforce that would reduce the need for health care workers to travel overseas in search of good higher education courses.

Public Health & Nutrition in the Asia-Pacific: reflections on a quarter century.

PubMed

Cavalli-Sforza, Luca Tommaso

2015-01-01

Some reflections from work in the Asia Pacific Region, mostly with WHO, in the past 25 years, and the changes in nutrition seen in this time are shared. In 1988-89 I helped to start a Centre for Child Nutrition in Chengdu, Sichuan, through the Italian Development Cooperation. The nutritional problems in urban and rural China, 25 years ago, were similar to those elsewhere in the Region. Like China, these countries underwent rapid economic development and changes in health patterns, within two decades. The main problems for child nutrition had to do with infant feeding practices and less breastfeeding: anaemia, protein energy malnutrition and rickets were frequent. How did China and other countries tackle these and other nutrition problems? In the 1990s the global nutrition community started working on a problem-solving framework. In 1992, at the 1st FAO/WHO International Conference on Nutrition, 159 countries agreed to develop national nutrition plans. In 2014, 22 years later, FAO and WHO invited countries to review their national nutrition situation and plans. The epidemiological picture today is profoundly different. Many Asia-Pacific countries have achieved remarkable progress in socio-economic development, including malnutrition reduction. To reach the MDGs and the post-MDG goals being formulated, the remaining under-nutrition problems need to be alleviated, inequalities between sectors of society reduced, and also the growing threat of overweight/obesity and NCDs prevented and controlled. Assessing, monitoring and evaluating programmes to improve progress, now requires focusing not only on biological outcomes, but also on food security, programme process, and the policy environment.

[AIDS, developing countries and ethnopsychiatry].

PubMed

Ehrhardt, N; Defourny, J; Bertrand, J

1995-04-01

This work briefly assesses the history of the AIDS epidemic in different geographic regions and examines factors that render developing countries particularly vulnerable. It reviews the three main techniques of traditional therapeutic systems and examines their implications for psychiatric treatment of AIDS patients from developing countries. Young age structures, low rates of condom usage, women's lack of education and of sexual bargaining power, and the deficiencies of health and educational facilities are among factors that increase risks of HIV in developing countries. Health education geared to specific audiences should encourage condom use and other preventive measures. Among factors to encourage condom use, group decision making appears to be of greatest potential influence on behavior in sub-Saharan Africa and among African immigrants to Europe. To encourage preventive measures and to understand reactions of non-Western populations to HIV, it is desirable to understand the deeper meanings of their cultures and of traditional therapies. It is difficult and misguided to pose a diagnosis according to the criteria of Western psychiatry. Western psychiatry has been proven incompetent in its attempts to treat members of traditional societies, whether immigrants or in their countries of origin. And attempts to integrate traditional healing into a western medical system have not been successful. Traditional systems accomplish therapeutic goals by three major techniques, possession, shamanism, and clairvoyance, or their numerous variants. It is recommended that group sessions be held with immigrants requiring treatment, in which the principal therapist is assisted by translators, who help create a space for the patient intermediate between the two cultures, where the therapies can coexist without conflict.

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.

Squaring the circle: health as a bridge to global solidarity in the Sustainable Development Goals.

PubMed

Williams, B; Taylor, S

2017-05-01

The Sustainable Development Goals (SDGs), launched in September 2015 to follow on from the Millennium Development Goals, require action by all countries. The new goals range from traditional areas of health and education to a newer focus on global trade and environmental protection. We discuss how all countries can be incentivised to engage and commit and argue that thoughtful target-setting and benchmarking, a more aggressive focus on equity and an emphasis on the interdependence of health and non-health development goals are key to meaningful progress. Fundamental shared values and aspirations around health, and in particular child health, within SDG3 may, we argue, offer a platform on which to build genuine global solidarity. 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/.

Developments in legal and medical practice regarding the unborn child and the need to expand prenatal legal protection.

PubMed

Dorscheidt, Jozef H H M

2010-12-01

Developments in legal and medical practice in the Netherlands give rise to questions regarding the legal position of the unborn child. This article provides an overview of these developments and argues--in view of developments in other countries--that current Dutch legislation regarding the unborn child is not up to date. In effect, the article challenges the idea that the actual legal protection of the unborn child under positive Dutch law can be considered proportionate, even sufficient. To support this view the author will show that abortion is not the only matter in which clarity as to the legal protection of the viable unborn child is required. This signalisation provides good cause to reconsider the Dutch perspective on the matter, thus offering a point of reference to countries with a similar interpretation of what constitutes an appropriate legal protection of the unborn child.

Guidelines in lower-middle income countries.

PubMed

Olayemi, Edeghonghon; Asare, Eugenia V; Benneh-Akwasi Kuma, Amma A

2017-06-01

Guidelines include recommendations intended to optimize patient care; used appropriately, they make healthcare consistent and efficient. In most lower-middle income countries (LMICs), there is a paucity of well-designed guidelines; as a result, healthcare workers depend on guidelines developed in Higher Income Countries (HICs). However, local guidelines are more likely to be implemented because they are applicable to the specific environment; and consider factors such as availability of resources, specialized skills and local culture. If guidelines developed in HICs are to be implemented in LMICs, developers need to incorporate local experts in their development. Involvement of local stakeholders may improve the rates of implementation by identifying and removing barriers to implementation in LMICs. Another option is to encourage local experts to adapt them for use in LMICs; these guidelines may recommend strategies different from those used in HICs, but will be aimed at achieving the best practicable standard of care. Infrastructural deficits in LMICs could be improved by learning from and building on the successful response to the human immunodeficiency virus/acquired immunodeficiency syndrome pandemic through interactions between HICs and LMICs. Similarly, collaborations between postgraduate medical colleges in both HICs and LMICs may help specialist doctors training in LMICs develop skills required for guideline development and implementation. © 2017 John Wiley & Sons Ltd.