U.S. Efforts to Educate and Train the Poor in Developing Countries. Report to the Congress of the United States by the Comptroller General.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

Agency for International Development (AID) education and training assistance to developing countries is herein reviewed by the General Accounting Office (GAO), with particular attention paid to the changes in emphasis since the 1973 New Directions Mandate by Congress and to the nature of recurring problems in improving education of the poor. One…

Gender, socioeconomic status, and self-rated health in a transitional middle-income setting: evidence from Thailand.

PubMed

Seubsman, Sam-Ang; Kelly, Matthew James; Yiengprugsawan, Vasoontara; Sleigh, Adrian C

2011-09-01

Poor self-rated health (SRH) correlates strongly with mortality. In developed countries, women generally report worse SRH than males. Few studies have reported on SRH in developing countries. The authors report on SRH in Thailand, a middle-income developing country.The data were derived from a large nationwide cohort of 87 134 adult Open University students (54% female, median age 29 years). The authors included questions on socioeconomic and demographic factors that could influence SRH. The Thai cohort in this study mirrors patterns found in developed countries, with females reporting more frequent "poor" or "very poor" SRH (odds ratio = 1.35; 95% confidence interval = 1.26-1.44). Cohort males had better SRH than females, but levels were more sensitive to socioeconomic status. Income and education had little influence on SRH for females. Among educated Thai adults, females rate their health to be worse than males, and unlike males, this perception is relatively unaffected by socioeconomic status.

The Diffusion of IT in the Historical Context of Innovations from Developed Countries

ERIC Educational Resources Information Center

James, Jeffrey

2013-01-01

The well-known s-shaped diffusion of technology curve generally works well in developed countries. But how does it perform in the very different context of developing countries? Across a wide range of new technologies imported from the developed countries it works poorly. In most cases the penetration rate fails to reach 25% of the population. The…

Physiotherapy beyond Our Borders: Investigating Ideal Competencies for Canadian Physiotherapists Working in Resource-Poor Countries

PubMed Central

Cassady, Christina; Meru, Rehana; Chan, Nga Man Carmen; Engelhardt, Julie; Fraser, Michelle

2014-01-01

ABSTRACT Purpose: To explore the perspectives of Canadian physiotherapists with global health experience on the ideal competencies for Canadian physiotherapists working in resource-poor countries. Method: A qualitative interpretive methodology was used, and the Essential Competency Profile for Physiotherapists in Canada, 2009 (ECP), was employed as a starting point for investigation and analysis. Semi-structured one-on-one interviews (60–90 minutes) were conducted with 17 Canadian physiotherapists who have worked in resource-poor countries. Descriptive and thematic analyses were conducted collaboratively. Results: The seven ECP roles—Expert, Communicator, Collaborator, Manager, Advocate, Scholarly Practitioner, and Professional—were all viewed as important for Canadian physiotherapists working in resource-poor countries. Two roles, Communicator and Manager, have additional competencies that participants felt were important. Three novel roles—Global Health Learner, Critical Thinker, and Respectful Guest—were created to describe other competencies related to global health deemed crucial by participants. Conclusions: This is the first study to examine competencies required by Canadian physiotherapists working in resource-poor countries. In addition to the ECP roles, supplementary competencies are recommended for engagement in resource-poor countries. These findings align with ideas in current global health and international development literature. Future research should examine the relevance of these findings to resource-poor settings within Canada. PMID:24719503

Living with systemic lupus erythematosus in the developing world.

PubMed

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

2018-03-26

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

Designing Targeted Educational Voucher Schemes for the Poor in Developing Countries

NASA Astrophysics Data System (ADS)

Shafiq, M. Najeeb

2010-02-01

A targeted educational voucher scheme (TEVS) is often proposed for the poor in developing countries. Essentially, TEVS involves issuing vouchers to poor households, thus enabling them to pay tuition and fees for their children's schooling at participating non-public schools. However, little is known about TEVS' design in developing countries. This article provides the foundation for constructing a TEVS and conducting subsequent scientific evaluations to support, modify or oppose such a system. Specifically, this article uses three policy instruments to design a TEVS: regulation, support services and finance. Regulation here refers to the rules that must be adhered to by participating households, children and schools. Support services refer to services facilitating the participation of children, households, schools, and financial and political supporters. Finance refers to the value of each voucher, total TEVS costs and sources of finance.

The Cost-Effectiveness of Education Interventions in Poor Countries. Policy Insight, Volume 2, Issue 4

ERIC Educational Resources Information Center

Evans, David K.; Ghosh, Arkadipta

2008-01-01

Poor countries need development programs that are both effective and cost-effective. To assess effectiveness, researchers are increasingly using randomized trials (or quasi-experimental methods that imitate randomized trials), which provide a clear picture of which outcomes are attributable to the program being evaluated. This "Policy Insight"…

Unintended consequences of Helicobacter pylori infection in children in developing countries

PubMed Central

Queiroz, Dulciene MM; Rocha, Andreia MC; Crabtree, Jean E

2013-01-01

Helicobacter pylori infection is predominantly acquired early in life. The prevalence of the infection in childhood is low in developed countries, whereas in developing countries most children are infected by 10 y of age. In poor resource settings, where malnutrition, parasitic/enteropathogen and H. pylori infection co-exist in young children, H. pylori might have potentially more diverse clinical outcomes. This paper reviews the impact of childhood H. pylori infection in developing countries that should now be the urgent focus of future research. The extra-gastric manifestations in early H. pylori infection in infants in poor resource settings might be a consequence of the infection associated initial hypochlorhydria. The potential role of H. pylori infection on iron deficiency, growth impairment, diarrheal disease, malabsorption and cognitive function is discussed in this review. PMID:23988829

[The report of the Commission on Macroeconomics and Health: its relevance to the countries of Latin America and the Caribbean].

PubMed

2002-09-01

The Commission on Macroeconomics and Health (CMH) was established by the Director-General of the World Health Organization (WHO) to evaluate the role of health in economic development. On 20 December 2001 the CMH submitted its report to the WHO Director-General. Entitled Macroeconomics and Health: Investing in Health for Economic Development, the CMH report affirms that in order to reduce poverty; and achieve economic development, it is essential to improve the health of the poor; to accomplish this, it is necessary to expand the access that the poor have to essential health services. The Commission believes that more financial resources are needed, that the health expenditures of less-developed and low-income countries are insufficient for the challenges that these countries face, and that high-income countries must increase their financial assistance in order to help solve the main health problems of less-developed and low-income countries. This piece summarizes a report that was prepared by the Program on Public Policy and Health of the Division of Health and Human Development of the Pan American Health Organization (PAHO). The PAHO document analyzes the importance of the CMH report for the countries of Latin America and the Caribbean, focusing on some of the central arguments put forth in the CMH report as they relate to achieving better health conditions in the Americas. These arguments have been organized around three major themes in the CMH report: a) the relationships between health and economic growth, b) the principal health problems that affect the poor in low-income and low-middle-income#10; countries, and c) the gap between the funding needed to address the principal problems that affect these countries and the actual spending levels. #10;

Towards Sustainable Research Capacity Development and Research Ownership for Academic Institutes in Developing Countries: The Malawian Research Support Centre Model

ERIC Educational Resources Information Center

Gomo, Exnevia; Kalilani, Linda; Mwapasa, Victor; Trigu, Chifundo; Phiri, Kamija; Schmidt, Joann; van Hensbroek, Michael Boele

2011-01-01

In lesser-developed African countries, the lack of institutionalised support for research, combined with limited career opportunities and poor remuneration, have contributed to weak research infrastructure and capacity, and a continuing brain drain to developed countries. Malawi's Research Support Centre (RSC) model is novel in that it provides a…

Explaining the Role of Proximate Determinants on Fertility Decline among Poor and Non-Poor in Asian Countries

PubMed Central

Majumder, Nabanita; Ram, Faujdar

2015-01-01

Objectives We examined the overall contributions of the poor and non-poor in fertility decline across the Asian countries. Further, we analyzed the direct and indirect factors that determine the reproductive behaviour of two distinct population sub-groups. Design Data from several new rounds of DHS surveys are available over the past few years. The DHS provides cross-nationally comparable and useful data on fertility, family planning, maternal and child health along with the other information. Six selected Asian countries namely: Bangladesh, India, Indonesia, Nepal, Philippines, and Vietnam are considered for the purpose of the study. Three rounds of DHS surveys for each country (except Vietnam) are considered in the present study. Methods Economic status is measured by computing a “wealth index”, i.e. a composite indicator constructed by aggregating data on asset ownership and housing characteristics using principal components analysis (PCA). Computed household wealth index has been broken into three equal parts (33.3 percent each) and the lowest and the highest 33.3 percent is considered as poor and non-poor respectively. The Bongaarts model was employed to quantify the contribution of each of the proximate determinants of fertility among poor and non-poor women. Results Fertility reduction across all population subgroups is now an established fact despite the diversity in the level of socio-economic development in Asian countries. It is clear from the analysis that fertility has declined irrespective of economic status at varying degrees within and across the countries which can be attributed to the increasing level of contraceptive use especially among poor women. Over the period of time changing marriage pattern and induced abortion are playing an important role in reducing fertility among poor women. Conclusions Fertility decline among majority of the poor women across the Asian countries is accompanied by high prevalence of contraceptive use followed by changing marriage pattern and induced abortion. PMID:25689843

Opportunities for a forest energy industry in a developing country: an example from Moldova

Treesearch

Vitalie Gulca; Robert Deal

2010-01-01

Developing sustainable energy from forest biomass presents both opportunities and challenges for the future generations of Moldova. Located in the southeastern part of Europe between Ukraine and Romania, Moldova is a relatively poor country with limited natural resources compared with other developing European countries such as Albania or Bosnia. This lack of fossil...

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.

Street vending and waste picking in developing countries: a long-standing hazardous occupational activity of the urban poor

PubMed Central

2016-01-01

Uncontrolled urbanization in developing countries has led to widespread urban poverty and increased susceptibility to environmental exposures owing to the hazardous occupational activities of the urban poor. Street vending and waste picking are the dominant works undertaken by the urban poor, and besides the physical hazards, it also exposes them to several pathogens and high levels of air pollutants present in the outdoor environment. The situation has severe consequences for the health of the workers. Eliminating these occupational activities from the urban landscape of developing countries should therefore receive urgent attention from the global health community and governments. In this article, we provide evidence to support this policy recommendation by documenting exposure experiences of the workers, the associated adverse health effects, whilst also outlining measures for addressing the problem sustainably. We conclude that with the adoption of the sustainable development goals (SDG), governments now have a commitment to address poverty and the associated occupational health hazards experienced by the poor through their choices to help achieve the health-related SDG target (3.9) of substantially reducing the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination by 2030. PMID:27467691

Street vending and waste picking in developing countries: a long-standing hazardous occupational activity of the urban poor.

PubMed

Amegah, Adeladza Kofi; Jaakkola, Jouni J K

2016-07-01

Uncontrolled urbanization in developing countries has led to widespread urban poverty and increased susceptibility to environmental exposures owing to the hazardous occupational activities of the urban poor. Street vending and waste picking are the dominant works undertaken by the urban poor, and besides the physical hazards, it also exposes them to several pathogens and high levels of air pollutants present in the outdoor environment. The situation has severe consequences for the health of the workers. Eliminating these occupational activities from the urban landscape of developing countries should therefore receive urgent attention from the global health community and governments. In this article, we provide evidence to support this policy recommendation by documenting exposure experiences of the workers, the associated adverse health effects, whilst also outlining measures for addressing the problem sustainably. We conclude that with the adoption of the sustainable development goals (SDG), governments now have a commitment to address poverty and the associated occupational health hazards experienced by the poor through their choices to help achieve the health-related SDG target (3.9) of substantially reducing the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination by 2030.

[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.

Rising consumption of meat and milk in developing countries has created a new food revolution.

PubMed

Delgado, Christopher L

2003-11-01

People in developing countries currently consume on average one-third the meat and one-quarter of the milk products per capita compared to the richer North, but this is changing rapidly. The amount of meat consumed in developing countries over the past has grown three times as much as it did in the developed countries. The Livestock Revolution is primarily driven by demand. Poor people everywhere are eating more animal products as their incomes rise above poverty level and as they become urbanized. By 2020, the share of developing countries in total world meat consumption will expand from 52% currently to 63%. By 2020, developing countries will consume 107 million metric tons (mmt) more meat and 177 mmt more milk than they did in 1996/1998, dwarfing developed-country increases of 19 mmt for meat and 32 mmt for milk. The projected increase in livestock production will require annual feed consumption of cereals to rise by nearly 300 mmt by 2020. Nonetheless, the inflation-adjusted prices of livestock and feed commodities are expected to fall marginally by 2020, compared to precipitous declines in the past 20 y. Structural change in the diets of billions of people is a primal force not easily reversed by governments. The incomes and nutrition of millions of rural poor in developing countries are improving. Yet in many cases these dietary changes also create serious environmental and health problems that require active policy involvement to prevent irreversible consequences.

Global health and local poverty: rich countries' responses to vulnerable populations.

PubMed

Simms, Chris D; Persaud, D David

2009-01-01

Poverty is an important determinant of ill health, mortality and suffering across the globe. This commentary asks what we can learn about poverty by looking at the way rich countries respond to the needs of vulnerable populations both within their own societies and those of low-income countries. Taking advantage of recent efforts to redefine child poverty in a way that is consistent with the World Health Organization's Commission on Social Determinants of Health, three sets of data are reviewed: levels of child well-being within 23 Organization of Economic Community Development countries; the amount of official development assistance these countries disburse to poor countries; and, government social transfers targeted at families as a percentage of GDP. Analysis shows that countries in Northern Europe tend to have lower levels of child poverty, and are the most generous with social transfers and providing development assistance to poor countries; in contrast, the non-European countries like Australia, Canada, Japan, and the United States, and generally, the G7 countries, are the least generous towards the vulnerable at home and abroad and tend to have the highest levels of child poverty. The findings suggest that nations' responses tend to be ideologically based rather than evidence or needs based and that poverty is neither inevitable nor intractable.

Global pediatric environmental health.

PubMed

Guidotti, Tee L; Gitterman, Benjamin A

2007-04-01

Children are uniquely vulnerable to environmental health problems. Developed countries report as the most common problems ambient (outdoor) air pollution and lead. Developing countries have a wider range of common problems, including childhood injuries, indoor air pollution, infectious disease, and poor sanitation with unsafe water. Globally, the agencies of the United Nations act to protect children and perform essential reporting and standards-setting functions. Conditions vary greatly among countries and are not always better in developing countries. Protecting the health of children requires strengthening the public health and medical systems in every country, rather than a single global agenda.

Poverty's threat.

PubMed

1988-03-01

In the debate on the Report of the World Commission on Environment and Development, chaired by Mrs. Gro Harlem Brundtland, Prime Minister of Norway, delegates to the UN General Assembly asserted that problems generated by the impact of poverty on the environment could not be solved by restricting aid to developing countries unless those countries promised to cease damaging their environment. Rather, most delegates agreed, aid should include the resources which would enable those countries to achieve "sustainable development," i.e., development that does not destroy the environment and deplete natural resources. The United States countered with the opinion that what is needed is not a UN organized "sustainable development program," but rather a grassroots "sustainable development movement" in all countries. Several delegates pointed out that it was the affluent countries which played a large part in the destruction of the environment. The Present of the Maldives, Maumoon Abdul Gayoom, pointed out, for example, that the greenhouse effect, generated by the burning of fossil fuels, would raise the sea level 2 meters, virtually submerging his country. Mrs. Brundtland pointed out that it was not morally acceptable to suggest that the poor remain poor to protect the environment. Governments at all levels, she said, must include environmental concerns in their decision making in all sectors of governmental functioning, e.g., finance, industry, energy, and agriculture.

Obesity and poverty paradox in developed countries.

PubMed

Żukiewicz-Sobczak, Wioletta; Wróblewska, Paula; Zwoliński, Jacek; Chmielewska-Badora, Jolanta; Adamczuk, Piotr; Krasowska, Ewelina; Zagórski, Jerzy; Oniszczuk, Anna; Piątek, Jacek; Silny, Wojciech

2014-01-01

Obesity is a civilization disease and the proportion of people suffering from it continues to grow, especially in the developed countries. Number of obese people in Europe has increased threefold over the last 20 years. The paradox of obesity and poverty relationship is observed especially in the developed and developing countries. In developing countries, along with economic development and income growth, the number of people with overweight and obesity is increasing. This paradox has a relationship with both the easy availability and low cost of highly processed foods containing 'empty calories' and no nutritional value. To date, this paradox has been described in the United States and the United Kingdom, although many European countries are also experiencing high percentages of obese people. Among the reasons for the growing obesity in the population of poor people are: higher unemployment, lower education level, and irregular meals. Another cause of obesity is low physical activity, which among the poor is associated with a lack of money for sports equipment. Due to the large rate of deaths caused by diseases directly linked to obesity, the governments of many countries implement prevention programmes of overweight and obesity. These programmes are based primarily on educating the public about a healthy lifestyle based on healthy eating, daily physical activity and avoiding alcohol and cigarettes.

Beyond Bellagio: addressing the challenge of sustainable child health in developing countries.

PubMed

Bhutta, Z A

2004-05-01

Despite the hype and ostensible investments in child survival strategies, the state of child health in much of the developing world is alarming. Not only are global investments and support programmes for child health by the development agencies declining, but commensurate support for maternal and child health by poor countries themselves is poor. In order to make a meaningful contribution to maternal and child health and survival, a multi-pronged approach is needed which not only focuses on the proximal determinants of child health but also some of the underlying factors governing the status of women in society and expenditures on health and development.

Snakebite in bedroom kills a physician in Cameroon: a case report.

PubMed

Nkwescheu, Armand; Mbasso, Leopold Cyriaque Donfack; Pouth, Franky Baonga Ba; Dzudie, Anastase; Billong, Serge Clotaire; Ngouakam, Hermann; Diffo, Joseph Le Doux; Eyongorock, Hanny; Mbacham, Wilfred

2016-01-01

The World Health Organization (WHO) classifies snake bites as neglected public health problem affecting mostly tropical and subtropical countries. In Africa there are an estimated 1 million snake bites annually with about half needing a specific treatment. Women, children and farmers in poor rural communities in developing countries are the most affected. Case management of snake bites are not adequate in many health facilities in developing countries where personnel are not always abreast with the new developments in snake bite management and in addition, quite often the anti-venom serum is lacking. We report the case of a medical doctor bitten by a cobra in the rural area of Poli, Cameroon while asleep in his bedroom. Lack of facilities coupled with poor case management resulted in a fatal outcome.

Dire need of changes in the methods for assessing university faculty productivity in developing countries.

PubMed

Sheikh, Ali Sibtain Farooq; Mohamed, Mona Adel

2015-01-01

Publishing has become a necessity for promotion of faculty in academia. The faculties in developing countries face considerable difficulties publishing due to their prime focus on clinical approaches and resources for proper research. This often leaves no room for the pressured clinicians but to pursue poor quality publications just for the sake of promotion when the time for their promotion comes. The authors suggest establishing separate promotion tracks besides research in these underprivileged areas in order to avoid infestation of original research with poor ones.

Use of modern contraception by the poor is falling behind.

PubMed

Gakidou, Emmanuela; Vayena, Effy

2007-02-01

The widespread increase in the use of contraception, due to multiple factors including improved access to modern contraception, is one of the most dramatic social transformations of the past fifty years. This study explores whether the global progress in the use of modern contraceptives has also benefited the poorest. Demographic and Health Surveys from 55 developing countries were analyzed using wealth indices that allow the identification of the absolute poor within each country. This article explores the macro level determinants of the differences in the use of modern contraceptives between the poor and the national averages of several countries. Despite increases in national averages, use of modern contraception by the absolute poor remains low. South and Southeast Asia have relatively high rates of modern contraception in the absolute poor, on average 17% higher than in Latin America. Over time the gaps in use persist and are increasing. Latin America exhibits significantly larger gaps in use between the poor and the averages, while gaps in sub-Saharan Africa are on average smaller by 15.8% and in Southeast Asia by 11.6%. The secular trend of increasing rates of modern contraceptive use has not resulted in a decrease of the gap in use for those living in absolute poverty. Countries with large economic inequalities also exhibit large inequalities in modern contraceptive use. In addition to macro level factors that influence contraceptive use, such as economic development and provision of reproductive health services, there are strong regional variations, with sub-Saharan Africa exhibiting the lowest national rates of use, South and Southeast Asia the highest use among the poor, and Latin America the largest inequalities in use.

Socioeconomic and Behavioral Factors Leading to Acquired Bacterial Resistance to Antibiotics in Developing Countries

PubMed Central

Okeke, Iruka N.; Lamikanra, Adebayo

1999-01-01

In developing countries, acquired bacterial resistance to antimicrobial agents is common in isolates from healthy persons and from persons with community-acquired infections. Complex socioeconomic and behavioral factors associated with antibiotic resistance, particularly regarding diarrheal and respiratory pathogens, in developing tropical countries, include misuse of antibiotics by health professionals, unskilled practitioners, and laypersons; poor drug quality; unhygienic conditions accounting for spread of resistant bacteria; and inadequate surveillance. PMID:10081668

Private health insurance: implications for developing countries.

PubMed Central

Sekhri, Neelam; Savedoff, William

2005-01-01

Private health insurance is playing an increasing role in both high- and low-income countries, yet is poorly understood by researchers and policy-makers. This paper shows that the distinction between private and public health insurance is often exaggerated since well regulated private insurance markets share many features with public insurance systems. It notes that private health insurance preceded many modern social insurance systems in western Europe, allowing these countries to develop the mechanisms, institutions and capacities that subsequently made it possible to provide universal access to health care. We also review international experiences with private insurance, demonstrating that its role is not restricted to any particular region or level of national income. The seven countries that finance more than 20% of their health care via private health insurance are Brazil, Chile, Namibia, South Africa, the United States, Uruguay and Zimbabwe. In each case, private health insurance provides primary financial protection for workers and their families while public health-care funds are targeted to programmes covering poor and vulnerable populations. We make recommendations for policy in developing countries, arguing that private health insurance cannot be ignored. Instead, it can be harnessed to serve the public interest if governments implement effective regulations and focus public funds on programmes for those who are poor and vulnerable. It can also be used as a transitional form of health insurance to develop experience with insurance institutions while the public sector increases its own capacity to manage and finance health-care coverage. PMID:15744405

Private health insurance: implications for developing countries.

PubMed

Sekhri, Neelam; Savedoff, William

2005-02-01

Private health insurance is playing an increasing role in both high- and low-income countries, yet is poorly understood by researchers and policy-makers. This paper shows that the distinction between private and public health insurance is often exaggerated since well regulated private insurance markets share many features with public insurance systems. It notes that private health insurance preceded many modern social insurance systems in western Europe, allowing these countries to develop the mechanisms, institutions and capacities that subsequently made it possible to provide universal access to health care. We also review international experiences with private insurance, demonstrating that its role is not restricted to any particular region or level of national income. The seven countries that finance more than 20% of their health care via private health insurance are Brazil, Chile, Namibia, South Africa, the United States, Uruguay and Zimbabwe. In each case, private health insurance provides primary financial protection for workers and their families while public health-care funds are targeted to programmes covering poor and vulnerable populations. We make recommendations for policy in developing countries, arguing that private health insurance cannot be ignored. Instead, it can be harnessed to serve the public interest if governments implement effective regulations and focus public funds on programmes for those who are poor and vulnerable. It can also be used as a transitional form of health insurance to develop experience with insurance institutions while the public sector increases its own capacity to manage and finance health-care coverage.

The global burden of oral diseases and risks to oral health.

PubMed Central

Petersen, Poul Erik; Bourgeois, Denis; Ogawa, Hiroshi; Estupinan-Day, Saskia; Ndiaye, Charlotte

2005-01-01

This paper outlines the burden of oral diseases worldwide and describes the influence of major sociobehavioural risk factors in oral health. Despite great improvements in the oral health of populations in several countries, global problems still persist. The burden of oral disease is particularly high for the disadvantaged and poor population groups in both developing and developed countries. Oral diseases such as dental caries, periodontal disease, tooth loss, oral mucosal lesions and oropharyngeal cancers, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)-related oral disease and orodental trauma are major public health problems worldwide and poor oral health has a profound effect on general health and quality of life. The diversity in oral disease patterns and development trends across countries and regions reflects distinct risk profiles and the establishment of preventive oral health care programmes. The important role of sociobehavioural and environmental factors in oral health and disease has been shown in a large number of socioepidemiological surveys. In addition to poor living conditions, the major risk factors relate to unhealthy lifestyles (i.e. poor diet, nutrition and oral hygiene and use of tobacco and alcohol), and limited availability and accessibility of oral health services. Several oral diseases are linked to noncommunicable chronic diseases primarily because of common risk factors. Moreover, general diseases often have oral manifestations (e.g. diabetes or HIV/AIDS). Worldwide strengthening of public health programmes through the implementation of effective measures for the prevention of oral disease and promotion of oral health is urgently needed. The challenges of improving oral health are particularly great in developing countries. PMID:16211157

Poverty and mental health in Indonesia.

PubMed

Tampubolon, Gindo; Hanandita, Wulung

2014-04-01

Community and facility studies in developing countries have generally demonstrated an inverse relationship between poverty and mental health. However, recent population-based studies contradict this. In India and Indonesia the poor and non-poor show no difference in mental health. We revisit the relationship between poverty and mental health using a validated measure of depressive symptoms (CES-D) and a new national sample from Indonesia - a country where widespread poverty and deep inequality meet with a neglected mental health service sector. Results from three-level overdispersed Poisson models show that a 1% decrease in per capita household expenditure was associated with a 0.05% increase in CES-D score (depressive symptoms), while using a different indicator (living on less than $2 a day) it was estimated that the poor had a 5% higher CES-D score than the better off. Individual social capital and religiosity were found to be positively associated with mental health while adverse events were negatively associated. These findings provide support for the established view regarding the deleterious association between poverty and mental health in developed and developing countries. Copyright © 2014 Elsevier Ltd. All rights reserved.

Risk Protection, Service Use, and Health Outcomes under Colombia’s Health Insurance Program for the Poor

PubMed Central

Miller, Grant; Pinto, Diana

2013-01-01

Unexpected medical care spending imposes considerable financial risk on developing country households. Based on managed care models of health insurance in wealthy countries, Colombia’s Régimen Subsidiado is a publicly financed insurance program targeted to the poor, aiming both to provide risk protection and to promote allocative efficiency in the use of medical care. Using a “fuzzy” regression discontinuity design, we find that the program has shielded the poor from some financial risk while increasing the use of traditionally under-utilized preventive services – with measurable health gains. PMID:25346799

A review and framework for understanding the potential impact of poor solid waste management on health in developing countries.

PubMed

Ziraba, Abdhalah K; Haregu, Tilahun Nigatu; Mberu, Blessing

2016-01-01

The increase in solid waste generated per capita in Africa has not been accompanied by a commensurate growth in the capacity and funding to manage it. It is reported that less than 30% of urban waste in developing countries is collected and disposed appropriately. The implications of poorly managed waste on health are numerous and depend on the nature of the waste, individuals exposed, duration of exposure and availability of interventions for those exposed. To present a framework for understanding the linkages between poor solid waste management, exposure and associated adverse health outcomes. The framework will aid understanding of the relationships, interlinkages and identification of the potential points for intervention. Development of the framework was informed by a review of literature on solid waste management policies, practices and its impact on health in developing countries. A configurative synthesis of literature was applied to develop the framework. Several iterations of the framework were reviewed by experts in the field. Each linkage and outcomes are described in detail as outputs of this study. The resulting framework identifies groups of people at a heightened risk of exposure and the potential health consequences. Using the iceberg metaphor, the framework illustrates the pathways and potential burden of ill-health related to solid waste that is hidden but rapidly unfolding with our inaction. The existing evidence on the linkage between poor solid waste management and adverse health outcomes calls to action by all stakeholders in understanding, prioritizing, and addressing the issue of solid waste in our midst to ensure that our environment and health are preserved. A resulting framework developed in this study presents a clearer picture of the linkages between poor solid waste management and could guide research, policy and action.

Can education change the world? Education amplifies differences in liberalization values and innovation between developed and developing countries.

PubMed

Van Hiel, Alain; Van Assche, Jasper; De Cremer, David; Onraet, Emma; Bostyn, Dries; Haesevoets, Tessa; Roets, Arne

2018-01-01

The present study investigated the relationship between level of education and liberalization values in large, representative samples administered in 96 countries around the world (total N = 139,991). These countries show meaningful variation in terms of the Human Development Index (HDI), ranging from very poor, developing countries to prosperous, developed countries. We found evidence of cross-level interactions, consistently showing that individuals' level of education was associated with an increase in their liberalization values in higher HDI societies, whereas this relationship was curbed in lower HDI countries. This enhanced liberalization mindset of individuals in high HDI countries, in turn, was related to better scores on national indices of innovation. We conclude that this 'education amplification effect' widens the gap between lower and higher HDI countries in terms of liberalized mentality and economic growth potential. Policy implications for how low HDI countries can counter this gap are discussed.

Social capital and health in the least developed countries: A critical review of the literature and implications for a future research agenda

PubMed Central

Story, William T.

2015-01-01

Research on the linkage between social capital and health has grown in recent years; however, there is a dearth of evidence from resource-poor countries. This review examines the association between social capital and physical health (including health behaviours) in the least developed countries (LDCs). Citations were searched using three databases from 1990 to 2011 using the keyword ‘social capital’ combined with the name of each of the 48 LDCs. Of the 14 studies reviewed, 12 took place in Africa and two in South Asia. All used cross-sectional study designs, including five qualitative and nine quantitative studies. The literature reviewed suggests that social capital is an important factor for improving health in resource-poor settings; however, more research is needed in order to determine the best measures for social capital and elucidate the mechanisms through which social capital affects health in the developing world. Future research on social capital and health in the developing world should focus on applying appropriate theoretical conceptualizations of social capital to the developing country context, adapting and validating instruments for measuring social capital, and examining multilevel models of social capital and health in developing countries. PMID:24172027

How community physical, structural, and social stressors relate to mental health in the urban slums of Accra, Ghana.

PubMed

Greif, Meredith J; Nii-Amoo Dodoo, F

2015-05-01

Urban health in developing counties is a major public health challenge. It has become increasingly evident that the dialog must expand to include mental health outcomes, and to shift focus to the facets of the urban environment that shape them. Population-based research is necessary, as empirical findings linking the urban environment and mental health have primarily derived from developed countries, and may not be generalizable to developing countries. Thus, the current study assesses the prevalence of mental health problems (i.e., depression, perceived powerlessness), as well as their community-based predictors (i.e., crime, disorder, poverty, poor sanitation, local social capital and cohesion), among a sample of 690 residents in three poor urban communities in Accra, Ghana. It uncovers that residents in poor urban communities in developing countries suffer from mental health problems as a result of local stressors, which include not only physical and structural factors but social ones. Social capital and social cohesion show complex, often unhealthy, relationships with mental health, suggesting considerable drawbacks in making social capital a key focus among policymakers. Copyright © 2015. Published by Elsevier Ltd.

Nursing shortages and international nurse migration.

PubMed

Ross, S J; Polsky, D; Sochalski, J

2005-12-01

The United Kingdom and the United States are among several developed countries currently experiencing nursing shortages. While the USA has not yet implemented policies to encourage nurse immigration, nursing shortages will likely result in the growth of foreign nurse immigration to the USA. Understanding the factors that drive the migration of nurses is critical as the USA exerts more pull on the foreign nurse workforce. To predict the international migration of nurses to the UK using widely available data on country characteristics. The Nursing and Midwifery Council serves as the source of data on foreign nurse registrations in the UK between 1998 and 2002. We develop and test a regression model that predicts the number of foreign nurse registrants in the UK based on source country characteristics. We collect country-level data from sources such as the World Bank and the World Health Organization. The shortage of nurses in the UK has been accompanied by massive and disproportionate growth in the number of foreign nurses from poor countries. Low-income, English-speaking countries that engage in high levels of bilateral trade experience greater losses of nurses to the UK. Poor countries seeking economic growth through international trade expose themselves to the emigration of skilled labour. This tendency is currently exacerbated by nursing shortages in developed countries. Countries at risk for nurse emigration should adjust health sector planning to account for expected losses in personnel. Moreover, policy makers in host countries should address the impact of recruitment on source country health service delivery.

Inequalities in health and health risk factors in the Southern African Development Community: evidence from World Health Surveys.

PubMed

Umuhoza, Stella M; Ataguba, John E

2018-04-27

Socioeconomic inequalities in health have been documented in many countries including those in the Southern African Development Community (SADC). However, a comprehensive assessment of health inequalities and inequalities in the distribution of health risk factors is scarce. This study specifically investigates inequalities both in poor self-assessed health (SAH) and in the distribution of selected risk factors of ill-health among the adult populations in six SADC countries. Data come from the 2002/04 World Health Survey (WHS) using six SADC countries (Malawi, Mauritius, South Africa, Swaziland, Zambia and Zimbabwe) where the WHS was conducted. Poor SAH is reporting bad or very bad health status. Risk factors such as smoking, heavy drinking, low fruit and vegetable consumption and physical inactivity were considered. Other environmental factors were also considered. Socioeconomic status was assessed using household expenditures. Standardised and normalised concentration indices (CIs) were used to assess socioeconomic inequalities. A positive (negative) concentration index means a pro-rich (pro-poor) distribution where the variable is reported more among the rich (poor). Generally, a pro-poor socioeconomic inequality exists in poor SAH in the six countries. However, this is only significant for South Africa (CI = - 0.0573; p < 0.05), and marginally significant for Zambia (CI = - 0.0341; P < 0.1) and Zimbabwe (CI = - 0.0357; p < 0.1). Smoking and inadequate fruit and vegetable consumption were significantly concentrated among the poor. Similarly, the use of biomass energy, unimproved water and sanitation were significantly concentrated among the poor. However, inequalities in heavy drinking and physical inactivity are mixed. Overall, a positive relationship exists between inequalities in ill-health and inequalities in risk factors of ill-health. There is a need for concerted efforts to tackle the significant socioeconomic inequalities in ill-health and health risk factors in the region. Because some of the determinants of ill-health lie outside the health sector, inter-sectoral action is required.

Learning Style Preferences and Mathematics Achievement of Secondary School Learners

ERIC Educational Resources Information Center

Bosman, Anne; Schulze, Salome

2018-01-01

Mathematics is a key subject necessary to the promotion of economic development, particularly in developing countries; however, South African learners perform poorly in Mathematics when benchmarked against their counterparts in other countries. One way to address this issue is by taking cognisance of the learners' learning styles when teaching.…

Curriculum-Guided Crowd Sourcing of Assessments in a Developing Country

ERIC Educational Resources Information Center

Zualkernan, Imran A.; Raza, Anjana; Karim, Asad

2012-01-01

Success of Wikipedia has opened a number of possibilities for crowd sourcing learning resources. However, not all crowd sourcing initiatives are successful. For developing countries, adoption factors like lack of infrastructure and poor teacher training can have an impact on success of such systems. This paper presents an exploratory study to…

Education for Agriculture and Rural Development in Low-Income Countries: Implications of the Digital Divide.

ERIC Educational Resources Information Center

Gasperini, Lavinia; Mclean, Scott

The "digital divide" refers to inequitable access to information and communication technologies (ICTs) between wealthy and poor countries and between privileged and underprivileged social groups within all countries. This presentation outlines global parameters of the digital divide, discusses the use of ICTs in education in…

Evidence-based healthcare in developing countries.

PubMed

Pearson, Alan; Jordan, Zoe

2010-06-01

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

STATISTICS AND INTELLIGENCE IN DEVELOPING COUNTRIES: A NOTE.

PubMed

Kodila-Tedika, Oasis; Asongu, Simplice A; Azia-Dimbu, Florentin

2017-05-01

The purpose of this study is to assess the relationship between intelligence (or human capital) and the statistical capacity of developing countries. The line of inquiry is motivated essentially by the scarce literature on poor statistics in developing countries and an evolving stream of literature on the knowledge economy. A positive association is established between intelligence quotient (IQ) and statistical capacity. The relationship is robust to alternative specifications with varying conditioning information sets and control for outliers. Policy implications are discussed.

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.

Are we doing enough to prevent poor-quality antimalarial medicines in the developing world?

PubMed

Walker, Erin J; Peterson, Gregory M; Grech, James; Paragalli, Evie; Thomas, Jackson

2018-05-15

Malaria is a deadly parasitic disease that affects more than 3 billion people worldwide, in predominantly resource-poor countries. Despite malaria being preventable and treatable, a large number of adults and children, mostly in Africa, die from this disease each year. One contributor to needless morbidity and mortality is the production and distribution of poor-quality antimalarial medicines; indeed, it is estimated that over 122,000 deaths of children under 5 years of age in sub-Saharan countries were caused by poor-quality antimalarial medicines, in 2013 alone. Poor-quality medicines include those that are deliberately falsified for monetary gain and may contain incorrect amounts or even no active ingredients at all, as well as products that are inadequate due to poor compliance to conventional quality standards and medicines that have degraded over time. Across a number of studies it has been reported that 4-92% of antimalarials tested are poor quality. This represents a massive risk to the population subjected to the use of these medicines, in the form of more severe and prolonged illness, additional costs to individuals who already have very little money, and lack of confidence in treatments. The continuing circulation of poor-quality medicines results from a number of factors, including insufficient regulatory capacity in susceptible countries, inadequate funding to perform regulatory functions, poor coordination between regulatory authorities, and inefficient import/export control systems. To combat the distribution of poor-quality medicines a number of organisations have developed guidelines for the procurement of antimalarials, and programs to educate consumers about the risks of poor-quality medicines and incentivise retailers to identify and report falsified medicines. The development of new technologies to quickly identify poor-quality medicines in the field is also essential, and some significant advances have been made. There has been considerable improvement in the delivery of high-quality antimalarials to those who need them; however, there is still an urgent need for a collective response by the international community, political leaders, regulatory bodies, and pharmaceutical companies. This should include political commitment for enhanced research and development funding, such as for new innovative track-and-trace field devices, and international efforts to strengthen and harmonise drug regulation practices.

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.

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…

Moving toward New Horizons for Marketing Education: Designing a Marketing Training for the Poor in Developing and Emerging Markets

ERIC Educational Resources Information Center

Teklehaimanot, Mebrahtu L.; Ingenbleek, Paul T. M.; Tessema, Workneh K.; van Trijp, Hans C. M.

2017-01-01

In recent years, marketing education has broadened to poor people in developing and emerging countries. In this article, the authors use four empirical studies that apply well-established training design procedures to design a marketing training program for Ethiopian pastoralists. Because pastoralists operate in extremely remote, traditional, and…

A Record of Experience. Catalogue of FFHC/Action for Development Documents, 1971-1976.

ERIC Educational Resources Information Center

Freedom from Hunger Campaign, Rome (Italy).

The FFHC/AD (Freedom From Hunger Campaign/Action for Development) is the Food and Agriculture Organization's (FAO) link with peoples' organizations in the world's poor and rich countries. During its 18 years of activities, FFHC/AD has channelled additional funds collected by private financing agencies in the industrialized countries to rural…

The ethics of developed nations recruiting nurses from developing countries: the case of Malawi.

PubMed

Muula, Adamson S; Mfutso-Bengo, Joseph M; Makoza, Joan; Chatipwa, Elita

2003-07-01

There is currently a global shortage of nurses. Developing countries such as Malawiare among those hardest hit by this shortage. The demands on available nurses have increased and at the same time there is a lack of interest in becoming a nurse owing to the poor working conditions among those still employed in the service. It is questionable if developed nations should recruit nurses from countries such as Malawi, where severe human resource constraints are being experienced. We argue in this article that the current phenomenon of nurses leaving developing nations for western countries is complex. Human rights issues of individual autonomy and public interest are at stake.

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-01-01

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

Global access to infertility care in developing countries: a case of human rights, equity and social justice.

PubMed

Ombelet, W

2011-01-01

According to WHO data more than 180 million couples in developing countries suffer from primary or secondary infertility. The social stigma of childlessness still leads to isolation and abandonment in many developing countries. Differences between the developed and developing world are emerging because of the different availability in infertility care and different socio-cultural value surrounding procreation and childlessness. Although reproductive health education and prevention of infertility are number one priorities, the need for accessible diagnostic procedures and new reproductive technologies (ART) is very high. The success and sustainability of ART in resource-poor settings will depend to a large extend on our ability to optimise these techniques in terms of availability, affordability and effectiveness. Accessible infertility treatment can only be successfully introduced in developing countries if socio-cultural and economic prerequisites are fulfilled and governments can be persuaded to support their introduction. We have to liaise with the relevant authorities to discuss the strengthening of infertility services, at the core of which lies the integration of infertility, contraceptive and maternal health services within public health care structures. After a fascinating period of more than 30 years of IVF, only a small part of the world population benefits from these new technologies. Time has come to give equitable access to effective and safe infertility care in resource-poor countries as well.

A historical and socioeconomic analysis of occupational safety and health in India.

PubMed

Vilanilam, J V

1980-01-01

Workers in poor countries of the so-called Third World are more likely to be affected by the dangers of high technology than their counterparts in wealthier countries. Owing to their lack of education, most workers in the "developing" world are unaware of the hazards of their occupations. Moreover, their general backwardness in sanitation and nutrition and climatic proneness of their geographic region to epidemics cause diseases contracted from the work environment to be aggravated. occupational diseases are often misconstrued as diseases resulting from the general environment. Since unemployment in underdeveloped countries is of a very high order, workers are prepared to accept any job, irrespective of the dangers involved. Labor is cheap and easily replaceable, so employers see no need for improving occupational safety and health. Labor unions are mostly controlled by full-time politicians who consider health a political issue, especially when their party controls the country's government. The seriousness of all these factors is heightened by the existing socioeconomic order in poor countries, in which national medievalism and multinational modernism play a crucial role. In order to understand the prevailing socioeconomic order, one has to analyze the social structures of poor countries in the context of today's world economic structure. India is taken as an example of a "developing" country where all the above-mentioned factors and many others are in operation: backwardness of the worker; poor nutrition; lack of concern for public health; proneness to epidemics; and indifference on the part of employers, politicians, and unions toward occupational health; high unemployment, control of the local economy by multinational corporations; and control of the mass media by feudalistic vested interests. This article attempts to analyze the occupational health and safety issue in India from a historical perspective, and stresses the vital need of structural changes in various fields so that workers can have a safe and healthy working environment.

The Double Burden of Undernutrition and Overnutrition in Developing Countries: an Update.

PubMed

Abdullah, Asnawi

2015-09-01

Many developing countries have achieved a remarkable improvement in nutrition status in the past decades. However, the prevalence of undernutrition remains a serious problem. At the same time, the prevalence of obesity is increasing substantially, and in some countries, it has approached that of developed countries. This article provides an update on this double burden of malnutrition (DBMN) in developing nations. One hundred countries (lower, middle-lower, and upper-middle income countries) were selected and analysed, and to support the analysis, a systematic review of current published studies was performed. The results show that DBMN already exists in almost all developing countries and that the DBMN ratio (i.e., overweight/underweight) has increased as income per capita has increased. DBMN may manifest within the community, household, or individual. In addition to common factors, poor nutrition in early childhood is suggested as another important driving factor behind the rising obesity rate in most developing countries. A life-course approach has been proposed to prevent undernutrition and overnutrition and should be integrated into the development of health systems to control double burden in developing countries.

Spending to save? State health expenditure and infant mortality in India.

PubMed

Bhalotra, Sonia

2007-09-01

There are severe inequalities in health in the world, poor health being concentrated amongst poor people in poor countries. Poor countries spend a much smaller share of national income on health expenditure than do richer countries. What potential lies in political or growth processes that raise this share? This depends upon how effective government health spending in developing countries is. Existing research presents little evidence of an impact on childhood mortality. Using specifications similar to those in the existing literature, this paper finds a similar result for India, which is that state health spending saves no lives. However, upon allowing lagged effects, controlling in a flexible way for trended unobservables and restricting the sample to rural households, a significant effect of health expenditure on infant mortality emerges, the long run elasticity being about -0.24. There are striking differences in the impact by social group. Slicing the data by gender, birth order, religion, maternal and paternal education and maternal age at birth, I find the weakest effects in the most vulnerable groups (with the exception of a large effect for scheduled tribes). Copyright (c) 2007 John Wiley & Sons, Ltd.

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.

Poor nutrition is a serious problem in children with cerebral palsy in Palawan, the Philippines.

PubMed

Socrates, C; Grantham-McGregor, S M; Harknett, S G; Seal, A J

2000-09-01

Children with cerebral palsy (CP) in developed countries have poor nutritional status; however there is little data from developing countries. In Palawan, in the Philippines, the nutritional status of 31 children with CP was compared to that of their siblings (n = 20) and a control group of neighbourhood children (n = 64), matched for age and sex. The children's weights, heights and armspans were measured. The heights of children with CP could not be measured and were estimated from their armspans using an equation relating height to armspan in siblings and controls. Haemoglobin levels of the study cases and siblings were measured. Siblings and controls had similar nutritional status. The children with CP had extremely poor nutritional status, and had significantly smaller weights for height, heights for age and weights for age than siblings or controls. Haemoglobin levels were not significantly different between the children with CP and their siblings. The nutritional status of children with quadriplegic CP was much poorer than that of similar children in the USA. The severity of malnutrition in children with CP is likely to be detrimental to their development, and a nutritional component should be incorporated into rehabilitation programmes. Also, there is a need to examine the nutritional status of children with CP in other developing countries.

Pharmacological strategies for the management of cancer pain in developing countries

PubMed Central

Omoti, Afekhide E.; Omoti, Caroline E.

Pain associated with cancer is often under treated especially in the developing countries where there are problems of poor economy, poor purchasing power of the citizens, absence of effective national health insurance schemes, poor manpower, fake adulterated and expired drugs, poor drug storage conditions; adverse temperature conditions combined with poor power supply which may affect drug efficacy. There is also poor understanding of the physiopharmacology of cancer pain management by health care providers. Assessment of the severity of the pain by location, oncological type, as well as psychosocial, emotional and environmental factors are necessary. The pain often occurs from malignancy, from procedures done to diagnose, stage and treat the malignancy, and from the toxicities of therapy used in treating the cancer. The first priority of treatment is to control pain rapidly and completely, as judged by the patient. The second priority is to prevent recurrence of pain. Analgesic drugs are given ‘by the ladder,’ ‘by the clock’ and ‘by the appropriate route’ using the analgesic ladder guideline proposed by the World Health Organization (WHO). The pharmacological aspects of various drugs used in the management of cancer pain are discussed. PMID:25247009

Poverty, health & intellectual property rights with special reference to India.

PubMed

Satyanarayana, K; Srivastava, S

2007-10-01

This paper examines the nexus between poverty and global health with specific focus on IPR protection and attempts to highlight the current global endeavours to overcome barriers to access to medicines for diseases of the poor. The number of very poor people in the world has increased by 10.4 per cent between 1987 and 2001 to 2735 million. India is now home to the largest number of millionaires in the developing countries. But over 800 million Indians who still survive on Rs 20.0 (US$0.5) a day, and rural poverty is on the rise. The link between poverty and health is well established with the underprivileged are more vulnerable to major health risks due to poor nutrition, inadequate access to clean drinking water, sanitation, exposure to indoor smoke, etc. all of which contribute to the huge and growing burden of disease in the poor countries. The global disease burden is not just huge but growing: over 10 million children die of preventable conditions including vaccine-preventable diseases, about 14 million are killed by infectious diseases every year, 90-95 per cent in poor countries. An estimated third of global population has limited or no access to essential medicines. While the number of poor and unhealthy is growing, Government expenditure on health is dwindling. Many of the diseases of the poor require new medicines and none are forthcoming as there is little R&D for these infections. There are several barriers to access to existing and the newly discovered drugs. One major reason is the general lack of interest by the pharma industry to discover new medicines for diseases of the poor due to very limited market in developing countries. In addition, global intellectual property rights (IPR) protection regimes like the Trade Related Intellectual Property Rights (TRIPS) are considered a major obstacle for the poor access to medicines. There have been some global initiatives on the need to improve affordability and accessibility of medicines. Some strategies to promote R&D on diseases of the poor such as Prize Fund Model, the Medical R&D Treaty and steps to invoke flexibilities in TRIPS read with Doha Declaration are discussed. Health of the poor is a global problem that requires global solutions with global participation and commitment.

Clinical research, prophylaxis, therapy, and care for HIV disease in Africa.

PubMed Central

De Cock, K M; Lucas, S B; Lucas, S; Agness, J; Kadio, A; Gayle, H D

1993-01-01

By the end of the century, citizens of resource-poor countries will constitute 90% of the world's human immunodeficiency virus (HIV)-infected people. Clinical management of such persons in developing countries has been neglected; most AIDS research has concentrated on epidemiology, and donor agencies have generally invested in the prevention of HIV infection. The heavy burden of HIV disease in Africa requires that care for AIDS be addressed, and prevention and care should be seen as interrelated. Prevention and treatment of tuberculosis, the commonest severe infection in persons with AIDS in Africa, illustrate this interrelationship. We outline priorities for applied research on the management of HIV disease in a resource-poor environment, and discuss prophylaxis, therapy for opportunistic diseases, terminal care, and use of antiretroviral therapy. Research should define the standard of care that can realistically be demanded for HIV disease in a resource-poor environment. Research and public health programs for AIDS in developing countries must address AIDS care and attempt to reduce the widening gap between interventions available for HIV-infected persons in different parts of the world. PMID:8214225

Inequality in Human Development: An Empirical Assessment of 32 Countries

ERIC Educational Resources Information Center

Grimm, Michael; Harttgen, Kenneth; Klasen, Stephan; Misselhorn, Mark; Munzi, Teresa; Smeeding, Timothy

2010-01-01

One of the most frequent critiques of the HDI is that is does not take into account inequality within countries in its three dimensions. In this paper, we apply a simply approach to compute the three components and the overall HDI for quintiles of the income distribution. This allows a comparison of the level in human development of the poor with…

A University for the Rural Poor in the Third World.

ERIC Educational Resources Information Center

Gow, Kathryn M.

One possible way of educating residents of developing countries is through a "university for the poor" based on shared village Internet posts and village technology learning centers. Western colleges and universities could donate their courses, and multinational organizations could subsidize the program's administration. Academics could…

Cultural humility and working with marginalized populations in developing countries.

PubMed

Kools, Susan; Chimwaza, Angela; Macha, Swebby

2015-03-01

Population health needs in developing countries are great and countries are scaling up health professional education to meet these needs. Marginalized populations, in particular, are vulnerable to poor health and health care. This paper presents a culturally appropriate diversity training program delivered to Global Health Fellows who are educators and leaders in health professions in Malawi and Zambia. The purpose of this interprofessional education experience was to promote culturally competent and humble care for marginalized populations. © The Author(s) 2014.

Changes in Child Mortality Over Time Across the Wealth Gradient in Less-Developed Countries

PubMed Central

2014-01-01

BACKGROUND: It is unknown whether inequalities in under-5 mortality by wealth in low- and middle-income countries (LMICs) are growing or declining. METHODS: All Demographic and Health Surveys conducted between 2002 and 2012 were used to measure under-5 mortality trends in 3 wealth tertiles. Two approaches were used to estimate changes in under-5 mortality: within-survey changes from all 54 countries, and between-survey changes for 29 countries with repeated survey waves. The principal outcome measures include annual decline in mortality, and the ratio of mortality between the poorest and least-poor wealth tertiles. RESULTS: Mortality information in 85 surveys from 929 224 households and 1 267 167 women living in 54 countries was used. In the subset of 29 countries with repeat surveys, mortality declined annually by 4.36, 3.36, and 2.06 deaths per 1000 live births among the poorest, middle, and least-poor tertiles, respectively (P = .031 for difference). The mortality ratio declined from 1.68 to 1.48 during the study period (P = .006 for trend). In the complete set of 85 surveys, the mortality ratio declined in 64 surveys (from 2.11 to 1.55), and increased in 21 surveys (from 1.58 to 1.88). Multivariate analyses suggest that convergence was associated with good governance (P ≤ .03 for 4 governance indicators: government effectiveness, rule of law, regulatory quality, and control of corruption). CONCLUSIONS: Overall, under-5 mortality in low- and middle-income countries has decreased faster among the poorest compared with the least poor between 1995 and 2012, but progress in some countries has lagged, especially with poor governance. PMID:25384496

Access to essential drugs in poor countries: a lost battle?

PubMed

Pécoul, B; Chirac, P; Trouiller, P; Pinel, J

1999-01-27

Drugs offer a simple, cost-effective solution to many health problems, provided they are available, affordable, and properly used. However, effective treatment is lacking in poor countries for many diseases, including African trypanosomiasis, Shigella dysentery, leishmaniasis, tuberculosis, and bacterial meningitis. Treatment may be precluded because no effective drug exists, it is too expensive, or it has been withdrawn from the market. Moreover, research and development in tropical diseases have come to a near standstill. This article focuses on the problems of access to quality drugs for the treatment of diseases that predominantly affect the developing world: (1) poor-quality and counterfeit drugs; (2) lack of availability of essential drugs due to fluctuating production or prohibitive cost; (3) need to develop field-based drug research to determine optimum utilization and remotivate research and development for new drugs for the developing world; and (4) potential consequences of recent World Trade Organization agreements on the availability of old and new drugs. These problems are not independent and unrelated but are a result of the fundamental nature of the pharmaceutical market and the way it is regulated.

Growing vegetables in developing countries for local urban populations and export markets: problems confronting small-scale producers.

PubMed

Dinham, Barbara

2003-05-01

Vegetables attract high applications of pesticides, and farmers in developing countries use many acutely toxic insecticides to control pests on these crops. With the liberalisation of agricultural markets in developing countries, the number of small-scale farmers growing vegetables for both domestic and export markets is increasing. Demand for supplies of year-round and exotic fruit and vegetables has grown in industrialised countries, but with rising quality standards and traceability requirements it is difficult for small-scale farmers to benefit from this lucrative non-traditional agricultural export trade. The demand is high for vegetables in the expanding cities in developing countries, and farmers in peri-urban areas, or rural areas with good access to the cities, are in a position to find a growing market for their produce. Poor storage facilities will often mean that farmers are forced to sell at peak times when prices are low. Farmers rarely have access to training in pesticide use, and have only limited or no access to advice on the complicated management of pesticides. The Food and Agriculture Organisation of the UN is concerned about high levels of poor quality and adulterated pesticides on sale in developing countries. Surveys repeatedly show that without training, farmers are unable to make good crop decisions: recognition of pests and their predators is generally low, leading to decisions to spray to kill any insect; knowledge of product selection, application rates and timing is poor; different products are often combined in the belief that the effect will be greater; re-entry periods after spraying and essential harvest intervals are not known; and without knowledge of alternatives, farmers will often assume that the only solution to pest problems is to spray more frequently. From a consumer's point of view, few developing countries are able to monitor pesticide residues, particularly for produce grown for home consumption: most countries do not have laboratories for even simple residue testing. Changes in European Maximum Residue Limits means that export crops will be rejected if they contain residues at the Limit of Detection of pesticides not registered in Europe. Season-long field level training in Integrated Pest Management can help farmers to become better decision-makers, and to greatly reduce pesticide use while reducing risks to their own health and environment, producing safer products for consumers, maintaining yields, and increasing incomes.

Income inequality in the developing world.

PubMed

Ravallion, Martin

2014-05-23

Should income inequality be of concern in developing countries? New data reveal less income inequality in the developing world than 30 years ago. However, this is due to falling inequality between countries. Average inequality within developing countries has been slowly rising, though staying fairly flat since 2000. As a rule, higher rates of growth in average incomes have not put upward pressure on inequality within countries. Growth has generally helped reduce the incidence of absolute poverty, but less so in more unequal countries. High inequality also threatens to stall future progress against poverty by attenuating growth prospects. Perceptions of rising absolute gaps in living standards between the rich and the poor in growing economies are also consistent with the evidence. Copyright © 2014, American Association for the Advancement of Science.

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.

Impact of savings groups on the lives of the poor

PubMed Central

Karlan, Dean; Savonitto, Beniamino; Thuysbaert, Bram; Udry, Christopher

2017-01-01

Savings-led microfinance programs operate in poor rural communities in developing countries to establish groups that save and then lend out the accumulated savings to each other. Nonprofit organizations train villagers to create and lead these groups. In a clustered randomized evaluation spanning three African countries (Ghana, Malawi, and Uganda), we find that the promotion of these community-based microfinance groups leads to an improvement in household business outcomes and women’s empowerment. However, we do not find evidence of impacts on average consumption or other livelihoods. PMID:28270615

A short note on economic development and socioeconomic inequality in female body weight.

PubMed

Deuchert, Eva; Cabus, Sofie; Tafreschi, Darjusch

2014-07-01

The origin of the obesity epidemic in developing countries is still poorly understood. It has been prominently argued that economic development provides a natural interpretation of the growth in obesity. This paper tests the main aggregated predictions of the theoretical framework to analyze obesity. Average body weight and health inequality should be associated with economic development. Both hypotheses are confirmed: we find higher average female body weight in economically more advanced countries. In relatively nondeveloped countries, obesity is a phenomenon of the socioeconomic elite. With economic development, obesity shifts toward individuals with lower socioeconomic status. Copyright © 2013 John Wiley & Sons, Ltd.

Two cases of rickets presenting with poor growth, hypotonia, and respiratory problems.

PubMed

Wouters, E; Wojciechowski, M; de Vries, E

2015-06-01

Rickets is a rare disease in developed countries. In children, it is a disease which affects growing bone. Depending on the severity, it can present with a wide variety of symptoms. Because it is such a rare disease in developed countries, symptoms suggesting rickets are often not easily recognized. This can cause a delay in diagnosing and treating rickets. Often unnecessary and sometimes invasive investigations are performed. First leading clues to rickets on physical examination are poor growth, especially length, thickening of wrists, bow legs, and craniotabes. At further examination, special attention should be paid to osteopenia and cupping and fraying at the metaphyses on X-rays. Laboratory results suggestive for rickets are elevated alkaline phosphatase and disturbances in calcium and phosphate homeostasis. In this report, we present two cases presenting with poor growth, severe pain, and respiratory problems secondary to calcipenic rickets.

Annual Research Review: Improved Nutrition--A Pathway to Resilience

ERIC Educational Resources Information Center

Yousafzai, Aisha K.; Rasheed, Muneera A.; Bhutta, Zulfiqar A.

2013-01-01

Background: Early child nutritional deficiencies are prevalent in low- and middle-countries with consequences linked not only to poor survival and growth, but also to poor development outcomes. Children in disadvantaged communities face multiple risks for nutritional deficiencies, yet some children may be less susceptible or may recover more…

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.

Better kitchens and toilets: both needed for better health.

PubMed

Ravindra, Khaiwal; Smith, Kirk R

2018-05-01

Both poor water, sanitation, hygiene (WaSH) and household air pollution (HAP) adversely affect the health of millions of people each year around the globe and specifically in developing countries. The objective of current work is to highlight the importance of HAP in parallel to WaSH for decision making to achieve better health specially in developing countries. There are examples, where developing countries are strengthening efforts to tackle the issue of poor water and sanitation such as 'Clean India Mission' was recently launched by the Government of India. However, there is lack of actions to address the issue related to HAP-to extend the coverage of clean fuel, efficient stoves and ventilated kitchens to the deprived population under the 'Clean India Mission'. Most of the rural household and urban slums in developing countries have only a single room, where people cook and sleep. This leads them to exposure to toxic HAP, which can be minimized by developing country specific indoor air quality guidelines and action framework. Hence, there should be policies to provide them not only the subsidy for clean fuel but also to build properly ventilated kitchens along with the promotion of clean toilets and water supplies. There is a need to strengthen global efforts, to jointly address the challenges associated with the risks related to WaSH and HAP in order to efficiently reduce the global burden of disease. Further, this will also help to timely attain the sustainable development goals for better health and environment.

Information and Rural Development.

ERIC Educational Resources Information Center

Storm, Bonnie L.

1982-01-01

Outlines approaches taken to development in lesser developed countries in the past, discusses the importance of appropriate technology and human development, and summarizes the information needs of the rural poor in developing nations. Information dissemination programs using video- and audiotape technology in Bangladesh, Guatemala, and Peru are…

The contribution of poor and rural populations to national trends in reproductive, maternal, newborn, and child health coverage: analyses of cross-sectional surveys from 64 countries.

PubMed

Victora, Cesar G; Barros, Aluisio J D; França, Giovanny V A; da Silva, Inácio C M; Carvajal-Velez, Liliana; Amouzou, Agbessi

2017-04-01

Coverage levels for essential interventions aimed at reducing deaths of mothers and children are increasing steadily in most low-income and middle-income countries. We assessed how much poor and rural populations in these countries are benefiting from national-level progress. We analysed trends in a composite coverage indicator (CCI) based on eight reproductive, maternal, newborn, and child health interventions in 209 national surveys in 64 countries, from Jan 1, 1994, to Dec 31, 2014. Trends by wealth quintile and urban or rural residence were fitted with multilevel modelling. We used an approach akin to the calculation of population attributable risk to quantify the contribution of poor and rural populations to national trends. From 1994 to 2014, the CCI increased by 0·82 percent points a year across all countries; households in the two poorest quintiles had an increase of 0·99 percent points a year, which was faster than that for the three wealthiest quintiles (0·68 percent points). Gains among poor populations were faster in lower-middle-income and upper-middle-income countries than in low-income countries. Globally, national level increases in CCI were 17·5% faster than they would have been without the contribution of the two poorest quintiles. Coverage increased more rapidly annually in rural (0·93 percent points) than urban (0·52 percent points) areas. National coverage gains were accelerated by important increases among poor and rural mothers and children. Despite progress, important inequalities persist, and need to be addressed to achieve the Sustainable Development Goals. UNICEF, Wellcome Trust. Copyright © 2017 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.

The product space conditions the development of nations.

PubMed

Hidalgo, C A; Klinger, B; Barabási, A-L; Hausmann, R

2007-07-27

Economies grow by upgrading the products they produce and export. The technology, capital, institutions, and skills needed to make newer products are more easily adapted from some products than from others. Here, we study this network of relatedness between products, or "product space," finding that more-sophisticated products are located in a densely connected core whereas less-sophisticated products occupy a less-connected periphery. Empirically, countries move through the product space by developing goods close to those they currently produce. Most countries can reach the core only by traversing empirically infrequent distances, which may help explain why poor countries have trouble developing more competitive exports and fail to converge to the income levels of rich countries.

Challenges in the management of rheumatoid arthritis in developing countries.

PubMed

Mody, Girish M; Cardiel, Mario H

2008-08-01

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

The Gradual Shift of Overweight, Obesity, and Abdominal Obesity Towards the Poor in a Multi-ethnic Developing Country: Findings From the Malaysian National Health and Morbidity Surveys

PubMed Central

Mariapun, Jeevitha; Ng, Chiu-Wan; Hairi, Noran N.

2018-01-01

Background Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth. Methods We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization’s Asian body mass index cut-off points of ≥23.0 kg/m2 and ≥27.5 kg/m2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index. Results Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor. Conclusion As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected. PMID:29657257

The Gradual Shift of Overweight, Obesity, and Abdominal Obesity Towards the Poor in a Multi-ethnic Developing Country: Findings From the Malaysian National Health and Morbidity Surveys.

PubMed

Mariapun, Jeevitha; Ng, Chiu-Wan; Hairi, Noran N

2018-06-05

Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth. We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization's Asian body mass index cut-off points of ≥23.0 kg/m 2 and ≥27.5 kg/m 2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index. Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor. As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected.

Human louse-transmitted infectious diseases.

PubMed

Badiaga, S; Brouqui, P

2012-04-01

Several of the infectious diseases associated with human lice are life-threatening, including epidemic typhus, relapsing fever, and trench fever, which are caused by Rickettsia prowazekii, Borrelia recurrentis, and Bartonella quintana, respectively. Although these diseases have been known for several centuries, they remain a major public health concern in populations living in poor-hygiene conditions because of war, social disruption, severe poverty, or gaps in public health management. Poor-hygiene conditions favour a higher prevalence of body lice, which are the main vectors for these diseases. Trench fever has been reported in both developing and developed countries in populations living in poor conditions, such as homeless individuals. In contrast, outbreaks of epidemic typhus and epidemic relapsing fever have occurred in jails and refugee camps in developing countries. However, reports of a significantly high seroprevalence for epidemic typhus and epidemic relapsing fever in the homeless populations of developed countries suggest that these populations remain at high risk for outbreaks of these diseases. Additionally, experimental laboratory studies have demonstrated that the body louse can transmit other emerging or re-emerging pathogens, such as Acinetobacter baumannii and Yersinia pestis. Therefore, a strict survey of louse-borne diseases and the implementation of efficient delousing strategies in these populations should be public health priorities. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

The politics of environmental concern: A cross-national analysis*

PubMed Central

Nawrotzki, Raphael J.

2016-01-01

Prior research in the U.S. has found that liberals are generally more environmentally concerned than conservatives. The present study explores whether conservatives’ opposition to environmental protection is solely a U.S. or a universal phenomenon and whether this association is contingent on country-level characteristics such as development, environmental conditions, and communist history. Employing data for 19 countries from the ISSP module “Environment II,” this paper explores inter-country variations in the relationship between individual conservatism and environmental concern using multilevel modeling with cross-level interactions. The models reveal a number of intriguing associations. Most important, conservatives’ support for environmental protection varies by country. This variation is a function of country-level characteristics. The strongest opposition of conservatives’ toward environmental protection was observed in developed, capitalist nations, with superior environmental conditions. On the other hand, in less developed countries, and countries characterized by poor environmental quality, conservatives are more environmentally concerned than liberals. PMID:27616877

Why health advocates must get involved in development economics: the case of the International Monetary Fund.

PubMed

Rowden, Rick

2010-01-01

International health advocates have traditionally focused on calling for external strategies for achieving health goals in developing countries, such as more foreign aid, foreign direct investment, loans, and debt cancellation, as opposed to internal approaches, such as building domestic productive capacity and accumulating capital. They have largely neglected questions of development economics, particularly the effectiveness, or lack thereof, of the currently dominant neoliberal development model promoted by the rich countries and aid agencies for poor countries. While critics have been correct to blame the International Monetary Fund for its policies curtailing public health spending in developing countries, their analysis generally neglects the underlying issue of why developing countries are seemingly unable to build their domestic tax base on which health budgets depend. International health advocates should engage with such macroeconomic questions and challenge the failures of the dominant neoliberal economic model that blocks countries from industrializing and building their own productive capacities with which to generate their own resources for financing their health budgets over time.

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.

Prevalence of Vitamin A Deficiency in South Asia: Causes, Outcomes, and Possible Remedies

PubMed Central

Ahmed, Anwaar; Randhawa, Muhammad Atif; Atukorala, Sunethra; Arlappa, Nimmathota; Ismail, Tariq; Ali, Zulfiqar

2013-01-01

Vitamin A deficiency (VAD) has been recognized as a public-health issue in developing countries. Economic constraints, sociocultural limitations, insufficient dietary intake, and poor absorption leading to depleted vitamin A stores in the body have been regarded as potential determinants of the prevalence of VAD in South Asian developing countries. VAD is exacerbated by lack of education, poor sanitation, absence of new legislation and enforcement of existing food laws, and week monitoring and surveillance system. Several recent estimates confirmed higher morbidly and mortality rate among children and pregnant and non-pregnant women of childbearing age. Xerophthalmia is the leading cause of preventable childhood blindness with its earliest manifestations as night blindness and Bitot's spots, followed by blinding keratomalacia, all of which are the ocular manifestations of VAD. Children need additional vitamin A because they do not consume enough in their normal diet. There are three general ways for improving vitamin A status: supplementation, fortification, and dietary diversification. These approaches have not solved the problem in South Asian countries to the desired extent because of poor governmental support and supervision of vitamin A supplementation twice a year. An extensive review of the extant literature was carried out, and the data under various sections were identified by using a computerized bibliographic search via PubMed, Web of Science, and Google Scholar. All abstracts and full-text articles were examined, and the most relevant articles were selected for screening and inclusion in this review. Conclusively, high prevalence of VAD in South Asian developing countries leads to increased morbidity and mortality among infants, children, and pregnant women. Therefore, stern efforts are needed to address this issue of public-health significance at local and international level in lower- and middle-income countries of South Asia. PMID:24592582

Decomposing the gap in missed opportunities for vaccination between poor and non-poor in sub-Saharan Africa: A Multicountry Analyses.

PubMed

Ndwandwe, Duduzile; Uthman, Olalekan A; Adamu, Abdu A; Sambala, Evanson Z; Wiyeh, Alison B; Olukade, Tawa; Bishwajit, Ghose; Yaya, Sanni; Okwo-Bele, Jean-Marie; Wiysonge, Charles S

2018-04-24

Understanding the gaps in missed opportunities for vaccination (MOV) in sub-Saharan Africa would inform interventions for improving immunisation coverage to achieving universal childhood immunisation. We aimed to conduct a multicountry analyses to decompose the gap in MOV between poor and non-poor in SSA. We used cross-sectional data from 35 Demographic and Health Surveys in SSA conducted between 2007 and 2016. Descriptive statistics used to understand the gap in MOV between the urban poor and non-poor, and across the selected covariates. Out of the 35 countries included in this analysis, 19 countries showed pro-poor inequality, 5 showed pro-non-poor inequality and remaining 11 countries showed no statistically significant inequality. Among the countries with statistically significant pro-illiterate inequality, the risk difference ranged from 4.2% in DR Congo to 20.1% in Kenya. Important factors responsible for the inequality varied across countries. In Madagascar, the largest contributors to inequality in MOV were media access, number of under-five children, and maternal education. However, in Liberia media access narrowed inequality in MOV between poor and non-poor households. The findings indicate that in most SSA countries, children belonging to poor households are most likely to have MOV and that socio-economic inequality in is determined not only by health system functions, but also by factors beyond the scope of health authorities and care delivery system. The findings suggest the need for addressing social determinants of health.

Multidimensional poverty and catastrophic health spending in the mountainous regions of Myanmar, Nepal and India.

PubMed

Mohanty, Sanjay K; Agrawal, Nand Kishor; Mahapatra, Bidhubhusan; Choudhury, Dhrupad; Tuladhar, Sabarnee; Holmgren, E Valdemar

2017-01-18

Economic burden to households due to out-of-pocket expenditure (OOPE) is large in many Asian countries. Though studies suggest increasing household poverty due to high OOPE in developing countries, studies on association of multidimensional poverty and household health spending is limited. This paper tests the hypothesis that the multidimensionally poor are more likely to incur catastrophic health spending cutting across countries. Data from the Poverty and Vulnerability Assessment (PVA) Survey carried out by the International Center for Integrated Mountain Development (ICIMOD) has been used in the analyses. The PVA survey was a comprehensive household survey that covered the mountainous regions of India, Nepal and Myanmar. A total of 2647 households from India, 2310 households in Nepal and 4290 households in Myanmar covered under the PVA survey. Poverty is measured in a multidimensional framework by including the dimensions of education, income and energy, water and sanitation using the Alkire and Foster method. Health shock is measured using the frequency of illness, family sickness and death of any family member in a reference period of one year. Catastrophic health expenditure is defined as 40% above the household's capacity to pay. Results suggest that about three-fifths of the population in Myanmar, two-fifths of the population in Nepal and one-third of the population in India are multidimensionally poor. About 47% of the multidimensionally poor in India had incurred catastrophic health spending compared to 35% of the multidimensionally non-poor and the pattern was similar in both Nepal and Myanmar. The odds of incurring catastrophic health spending was 56% more among the multidimensionally poor than among the multidimensionally non-poor [95% CI: 1.35-1.76]. While health shocks to households are consistently significant predictors of catastrophic health spending cutting across country of residence, the educational attainment of the head of the household is not significant. The multidimensionally poor in the poorer regions are more likely to face health shocks and are less likely to afford professional health services. Increasing government spending on health and increasing households' access to health insurance can reduce catastrophic health spending and multidimensional poverty.

Towards a sustainable framework for computer based health information systems (CHIS) for least developed countries (LDCs).

PubMed

Gordon, Abekah Nkrumah; Hinson, Robert Ebo

2007-01-01

The purpose of this paper is to argue for a theoretical framework by which development of computer based health information systems (CHIS) can be made sustainable. Health Management and promotion thrive on well-articulated CHIS. There are high levels of risk associated with the development of CHIS in the context of least developed countries (LDC), thereby making them unsustainable. This paper is based largely on literature survey on health promotion and information systems. The main factors accounting for the sustainability problem in less developed countries include poor infrastructure, inappropriate donor policies and strategies, poor infrastructure and inadequate human resource capacity. To counter these challenges and to ensure that CHIS deployment in LDCs is sustainable, it is proposed that the activities involved in the implementation of these systems be incorporated into organizational routines. This will ensure and secure the needed resources as well as the relevant support from all stakeholders of the system; on a continuous basis. This paper sets out to look at the issue of CHIS sustainability in LDCs, theoretically explains the factors that account for the sustainability problem and develops a conceptual model based on theoretical literature and existing empirical findings.

Current drivers and future directions of global livestock disease dynamics

PubMed Central

Perry, Brian D.; Grace, Delia; Sones, Keith

2013-01-01

We review the global dynamics of livestock disease over the last two decades. Our imperfect ability to detect and report disease hinders assessment of trends, but we suggest that, although endemic diseases continue their historic decline in wealthy countries, poor countries experience static or deteriorating animal health and epidemic diseases show both regression and expansion. At a mesolevel, disease is changing in terms of space and host, which is illustrated by bluetongue, Lyme disease, and West Nile virus, and it is also emerging, as illustrated by highly pathogenic avian influenza and others. Major proximate drivers of change in disease dynamics include ecosystem change, ecosystem incursion, and movements of people and animals; underlying these are demographic change and an increasing demand for livestock products. We identify three trajectories of global disease dynamics: (i) the worried well in developed countries (demanding less risk while broadening the circle of moral concern), (ii) the intensifying and market-orientated systems of many developing countries, where highly complex disease patterns create hot spots for disease shifts, and (iii) the neglected cold spots in poor countries, where rapid change in disease dynamics is less likely but smallholders and pastoralists continue to struggle with largely preventable and curable livestock diseases. PMID:21576468

Determinants of self-rated health in elderly populations in urban areas in Slovenia, Lithuania and UK: findings of the EURO-URHIS 2 survey.

PubMed

Stanojevic Jerkovic, Olivera; Sauliune, Skirmante; Šumskas, Linas; Birt, Christopher A; Kersnik, Janko

2017-05-01

Ageing imposes extra financial burdens on social and health services in developed countries. Self-rated health (SRH) is considered to be both a reliable measurement of overall health status including morbidity and mortality and an important predictor of hospitalization, functional impairment and greater demand for health-care services in the elderly. Our aim was to identify factors associated with poor SRH in elderly populations and investigate possible differences between urban areas in Slovenia, Lithuania and UK. Data were obtained from population-based surveys from the European Urban Health Indicator System Part 2 project. The stratified representative sample (41% men and 59% women) consisted of a total of 2547 respondents aged ≥65 from the urban areas in the three countries. The prevalence of poor SRH was highest in Lithuanian urban areas. The strongest factors associated with poor SRH were low education [OR (odds ratio) 4.3, 95% CI (confidence interval) 2.5-7.3, P < 0.001], restriction of activities attributable to a chronic disease (OR 2.6, 95% CI 2.2-3.0, P < 0.001), inadequate physical activity (OR 1.7, 95% CI 1.2-2.5, P = 0.007) and poor mental health (OR 1.1, 95% CI 1.1-1.2, P < 0.001). The main factors associated with poor SRH by country included the following: living alone (Slovenia) (OR 2.0, 95% CI 1.1-3.7, P = 0,023), female sex (Lithuania) (OR 2.0, 95% CI 1.0-4.2, P = 0.058) and inadequate physical activity (UK) (OR 2.2, 95% CI 1.3-3.6, P = 0,003). Despite different levels of poor SRH, the factors associated with poor SRH were similar for the urban areas of the three countries. Factors associated with poor SRH in the urban areas could also reflect either cultural differences or specific situations for elderly in that country, which need further research. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Brain drain adds to AIDS crisis in developing world.

PubMed

Green, Stanley

2006-01-01

Thousands of desperately needed doctors and other medical professionals leave poor countries because no one there can pay them, or provide safe and effective working conditions. Many go to English-speaking countries that do not train enough medical professionals themselves--such as the U.S., where a quarter of the doctors are foreign trained.

Bringing cancer care to the poor: experiences from Rwanda.

PubMed

Shulman, Lawrence N; Mpunga, Tharcisse; Tapela, Neo; Wagner, Claire M; Fadelu, Temidayo; Binagwaho, Agnes

2014-12-01

The knowledge and tools to cure many cancer patients exist in developed countries but are unavailable to many who live in the developing world, resulting in unnecessary loss of life. Bringing cancer care to the poor, particularly to low-income countries, is a great challenge, but it is one that we believe can be met through partnerships, careful planning and a set of guiding principles. Alongside vaccinations, screening and other cancer-prevention efforts, treatment must be a central component of any cancer programme from the start. It is also critical that these programmes include implementation research to determine programmatic efficacy, where gaps in care still exist and where improvements can be made. This article discusses these issues using the example of Rwanda's expanding national cancer programme.

Debt relief and public health spending in heavily indebted poor countries.

PubMed Central

Gupta, Sanjeev; Clements, Benedict; Guin-Siu, Maria Teresa; Leruth, Luc

2002-01-01

The Heavily Indebted Poor Countries (HIPC) Initiative, which was launched in 1996, is the first comprehensive effort by the international community to reduce the external debt of the world's poorest countries. The Initiative will generate substantial savings relative to current and past public spending on health and education in these countries. Although there is ample scope for raising public health spending in heavily indebted poor countries, it may not be advisable to spend all the savings resulting from HIPC resources for this purpose. Any comprehensive strategy for tackling poverty should also focus on improving the efficiency of public health outlays and on reallocating funds to programmes that are most beneficial to the poor. In order to ensure that debt relief increases poverty-reducing spending and benefits the poor, all such spending, not just that financed by HIPC resources, should be tracked. This requires that countries improve all aspects of their public expenditure management. In the short run, heavily indebted poor countries can take some pragmatic tracking measures based on existing public expenditure management systems, but in the longer run they should adopt a more comprehensive approach so as to strengthen their budget formulation, execution, and reporting systems. PMID:11953794

Does Land Degradation Increase Poverty in Developing Countries?

PubMed Central

2016-01-01

Land degradation is a global problem that particularly impacts the poor rural inhabitants of low and middle-income countries. We improve upon existing literature by estimating the extent of rural populations in 2000 and 2010 globally on degrading and improving agricultural land, taking into account the role of market access, and analyzing the resulting impacts on poverty. Using a variety of spatially referenced datasets, we estimate that 1.33 billion people worldwide in 2000 were located on degrading agricultural land (DAL), of which 1.26 billion were in developing countries. Almost all the world’s 200 million people on remote DAL were in developing countries, which is about 6% of their rural population. There were also 1.54 billion rural people on improving agricultural land (IAL), with 1.34 billion in developing countries. We find that a lower share of people in 2000 on DAL, or a higher share on IAL, lowers significantly how much overall economic growth reduces poverty from 2000 to 2012 across 83 developing countries. As the population on DAL and IAL in developing countries grew by 13% and 15% respectively from 2000 to 2010, these changing spatial distributions of rural populations could impact significantly future poverty in developing countries. PMID:27167738

Development of health biotechnology in developing countries: can private-sector players be the prime movers?

PubMed

Abuduxike, Gulifeiya; Aljunid, Syed Mohamed

2012-01-01

Health biotechnology has rapidly become vital in helping healthcare systems meet the needs of the poor in developing countries. This key industry also generates revenue and creates employment opportunities in these countries. To successfully develop biotechnology industries in developing nations, it is critical to understand and improve the system of health innovation, as well as the role of each innovative sector and the linkages between the sectors. Countries' science and technology capacities can be strengthened only if there are non-linear linkages and strong interrelations among players throughout the innovation process; these relationships generate and transfer knowledge related to commercialization of the innovative health products. The private sector is one of the main actors in healthcare innovation, contributing significantly to the development of health biotechnology via knowledge, expertise, resources and relationships to translate basic research and development into new commercial products and innovative processes. The role of the private sector has been increasingly recognized and emphasized by governments, agencies and international organizations. Many partnerships between the public and private sector have been established to leverage the potential of the private sector to produce more affordable healthcare products. Several developing countries that have been actively involved in health biotechnology are becoming the main players in this industry. The aim of this paper is to discuss the role of the private sector in health biotechnology development and to study its impact on health and economic growth through case studies in South Korea, India and Brazil. The paper also discussed the approaches by which the private sector can improve the health and economic status of the poor. Copyright © 2012 Elsevier Inc. All rights reserved.

Leptospirosis in the Asia Pacific region

PubMed Central

2009-01-01

Background Leptospirosis is a worldwide zoonotic infection that has been recognized for decades, but the problem of the disease has not been fully addressed, particularly in resource-poor, developing countries, where the major burden of the disease occurs. This paper presents an overview of the current situation of leptospirosis in the region. It describes the current trends in the epidemiology of leptospirosis, the existing surveillance systems, and presents the existing prevention and control programs in the Asia Pacific region. Methods Data on leptospirosis in each member country were sought from official national organizations, international public health organizations, online articles and the scientific literature. Papers were reviewed and relevant data were extracted. Results Leptospirosis is highly prevalent in the Asia Pacific region. Infections in developed countries arise mainly from occupational exposure, travel to endemic areas, recreational activities, or importation of domestic and wild animals, whereas outbreaks in developing countries are most frequently related to normal daily activities, over-crowding, poor sanitation and climatic conditions. Conclusion In the Asia Pacific region, predominantly in developing countries, leptospirosis is largely a water-borne disease. Unless interventions to minimize exposure are aggressively implemented, the current global climate change will further aggravate the extent of the disease problem. Although trends indicate successful control of leptospirosis in some areas, there is no clear evidence that the disease has decreased in the last decade. The efficiency of surveillance systems and data collection varies significantly among the countries and areas within the region, leading to incomplete information in some instances. Thus, an accurate reflection of the true burden of the disease remains unknown. PMID:19732423

The contribution of health to the economy in the European Union.

PubMed

Suhrcke, Marc; McKee, Martin; Stuckler, David; Sauto Arce, Regina; Tsolova, Svetla; Mortensen, Jørgen

2006-11-01

Despite increasing recognition of the link between health and economic development in low-income countries, the relationship has to date received scant attention in rich countries. We argue that this lack of attention is not justifiable. While the economic argument for investing in health in rich countries may differ in detail from that in low-income countries, there is considerable and convincing evidence that significant economic benefits can be achieved by improving health not only in poor, but also in rich countries. Better health increases labour supply and productivity and historically, health has been a major contributor to economic growth. In spite of remaining evidence gaps economic policy-makers also in developed countries should consider investing in health as one (of few) ways by which to achieve their economic objectives.

The Global Economic Crisis, Poverty and Education: A Perspective from India

ERIC Educational Resources Information Center

Nambissan, Geetha B.

2010-01-01

Debates on the global economic recession have failed to draw adequate attention to the meaning of the crisis for the poor and their education, especially in later developing societies. In this paper, I focus on the education of children of the poor in India--a country that has experienced economic slowdown rather than recession. Available research…

Mediational pathways connecting secondary education and age at marriage to maternal mortality: A comparison between developing and developed countries.

PubMed

Hagues, Rachel Joy; Bae, DaYoung; Wickrama, Kandauda K A S

2017-02-01

While studies have shown that maternal mortality rates have been improving worldwide, rates are still high across developing nations. In general, poor health of women is associated with higher maternal mortality rates in developing countries. Understanding country-level risk factors can inform intervention and prevention efforts that could bring high maternal mortality rates down. Specifically, the authors were interested in investigating whether: (1) secondary education participation (SEP) or age at marriage (AM) of women were related to maternal mortality rates, and (2) adolescent birth rate and contraceptive use (CU) acted as mediators of this association. The authors add to the literature with this current article by showing the relation of SEP and AM to maternal mortality rates globally (both directly and indirectly through mediators) and then by comparing differences between developed and developing/least developed countries. Path analysis was used to test the hypothesized model using country level longitudinal data from 2000 to 2010 obtained from United Nations publications, World Health Organization materials, and World Bank development reports. Findings include a significant correlation between SEP and AM for developing countries; for developed countries the relation was not significant. As well, SEP in developing countries was associated with increased CU. Women in developing countries who finish school before marriage may have important social capital gains.

Socioeconomic Determinants of Adult Mortality in Namibia Using an Event History Analysis.

PubMed

Kandjimbi, Alina; Nickanor, Ndeyapo; Kazembe, Lawrence N

2014-01-01

Adult mortality remains a neglected public health issue in sub-Saharan Africa, with most policy instruments concentrated on child and maternal health. In developed countries, adult mortality is negatively associated with socioeconomic factors. A similar pattern is expected in developing countries, but has not been extensively demonstrated, because of dearth of data. Understanding the hazard and factors associated with adult mortality is crucial for informing policies and for implementation of interventions aimed at improving adult survival. This paper applied a geo-additive survival model to elucidate effects of socioeconomic factors on adult mortality in Namibia, controlling for spatial frailties. Results show a clear disadvantage for adults in rural areas, for those not married and from poor households or in female-headed households. The hazard of adult mortality was highly variable with a 1.5-fold difference between areas, with highest hazard recorded in north eastern, central west and southern west parts of the country. The analysis emphasizes that, for Namibia to achieve its national development goals, targeted interventions should be aimed at poor-resourced adults, particularly in high-risk areas.

Globalization, poverty and women's health: mapping the connections.

PubMed

Sicchia, Suzanne R; Maclean, Heather

2006-01-01

Poverty and other forms of inequity undermine individual and population health and retard development. Although absolute poverty has reportedly declined in recent years, research suggests that relative poverty or the gap between the rich and poor within and between countries has been exacerbated over this same period. There is growing concern about the feminization of poverty, and the impact globalization is having on this important social problem. Gender inequality persists in all regions, and women and girls continue to be over-represented among the world's poor. This suggests that women are not consistently benefitting from the economic, political and social gains globalization can offer. Instead, it appears that poor women and girls, particularly those living in developing countries, are disproportionately burdened by the costs of these swift changes to the detriment of their personal health and well-being. Immediate action is needed to correct these disparities and ensure that globalization supports both national and international commitments to poverty reduction, and the, promotion of women's health and human rights.

Water and sanitation service delivery, pricing, and the poor: An empirical estimate of subsidy incidence in Nairobi, Kenya

NASA Astrophysics Data System (ADS)

Fuente, David; Gakii Gatua, Josephine; Ikiara, Moses; Kabubo-Mariara, Jane; Mwaura, Mbutu; Whittington, Dale

2016-06-01

The increasing block tariff (IBT) is among the most widely used tariffs by water utilities, particularly in developing countries. This is due in part to the perception that the IBT can effectively target subsidies to low-income households. Combining data on households' socioeconomic status and metered water use, this paper examines the distributional incidence of subsidies delivered through the IBT in Nairobi, Kenya. Contrary to conventional wisdom, we find that high-income residential and nonresidential customers receive a disproportionate share of subsidies and that subsidy targeting is poor even among households with a private metered connection. We also find that stated expenditure on water, a commonly used means of estimating water use, is a poor proxy for metered use and that previous studies on subsidy incidence underestimate the magnitude of the subsidy delivered through water tariffs. These findings have implications for both the design and evaluation of water tariffs in developing countries.

Mobile Phones in Africa: How Much Do We Really Know?

ERIC Educational Resources Information Center

James, Jeffrey; Versteeg, Mila

2007-01-01

Mobile phones are a crucial mode of communication and welfare enhancement in poor countries, especially those lacking an infrastructure of fixed lines. In recent years much has been written about how mobile telephony in Africa is rapidly reducing the digital divide with developed countries. Yet, when one examines the evidence it is not at all…

Tobacco

MedlinePlus

... raise the cost of health care and hinder economic development. In some countries, children from poor households ... illicit trade in tobacco products poses major health, economic and security concerns around the world. It is ...

[Poor, propertyless and pregnant: classification of women's status by country].

PubMed

1988-12-01

A new study called "Poor, propertyless, and pregnant" that classified the condition of women in 99 countries found women in Sweden, Finland, and the US to enjoy the best legal and social conditions and the greatest degree of equality with men. The worst discrimination against women occurred in Bangladesh, Mali, Afghanistan, North Yemen, Pakistan, Nigeria, and Saudi Arabia. Women do not have complete equality with men in any country. But over 60% of the world's female population lives in countries where extensive poverty and sexual discrimination have created conditions of deprivation. One of the principal mechanisms that negatively influences the condition of women is early procreation; early and frequent childbirth obliterates women's chances for education and paid employment. Feminization of poverty is becoming universal, largely because a growing proportion of households are headed by women with dependent children. In developed and developing countries alike, working women with families work a double day. Although the struggle for legal and social equality for women takes different forms in different countries, certain basic measures can be applied by all governments. Reforms are needed to give women access to more remunerative jobs, equal property rights, and access to credit. Greater investments are needed in reproductive health and in education and training for women. Governments, employers, and husbands should recognize the social value of childbirth and child rearing. The study is divided into 5 sections, each of which has 4 series of data, so that each country is evaluated on 20 variables. The 5 sections are health, nuptiality and children, education, economic participation, and social equality. In most developed countries women live an average of 7 years longer than men, but in developing countries the difference is only 2 years. Complications of pregnancy and childbirth cause the deaths of over 500,000 women each year and affect another 5 million, mostly in developing countries. The condition and welfare of women are tightly linked to 3 factors: age at marriage, beginning of procreation, and capacity to regulate and space pregnancies. Women's status is also influenced by whether they are married and their rights to divorce. In developing countries about 45% of women are illiterate, compared to 25% of men. The salaries of women do not equal those of men in any country. Only Finland and Sweden have been unreservedly committed to providing equal political rights and legal protection against sexual discrimination.

Vitamin and mineral deficiencies in the developed world and their effect on the eye and vision.

PubMed

Whatham, Andrew; Bartlett, Hannah; Eperjesi, Frank; Blumenthal, Caron; Allen, Jane; Suttle, Catherine; Gaskin, Kevin

2008-01-01

Vitamin and mineral deficiencies are common in developing countries, but also occur in developed countries. We review micronutrient deficiencies for the major vitamins A, cobalamin (B(12)), biotin (vitamin H), vitamins C and E, as well as the minerals iron, and zinc, in the developed world, in terms of their relationship to systemic health and any resulting ocular disease and/or visual dysfunction. A knowledge of these effects is important as individuals with consequent poor ocular health and reduced visual function may present for ophthalmic care.

Drug policy and administration affecting quality of life of the poor in Thailand.

PubMed

Prutipinyo, Chardsumon; Sirichotiratana, Nithat

2011-09-01

This study aims to analyze drug policy and administration affecting quality of life of the poor in Thailand. Review of official reports and related documents, for the past 10 years (from 2000-2010). By imposing compulsory licensing, the Thai government maintains negotiating power over the price of pharmaceutical products with the patent holders of the original drugs. This gives an opportunity for relevant government agencies to produce or import patented drugs. At present, there are many problems and obstacles. The findings show that developing countries need to strengthen their negotiating power so that the pharmaceutical manufacturers cannot take advantage through mechanisms provided for such as compulsory licensing and provisions for flexibility in Trade-Related Intellectual Property Rights (TRIPS) agreement. Furthermore, these countries must support and empower the local pharmaceutical manufacturers to produce generic drugs. Developing countries should ensure that their populations have confidence in universal coverage service and medical systems regarding the quality of generic drugs.

Towards safety, hygiene and environmental (SHE) management in African small and medium companies.

PubMed

Meité, Vaflahi; Baeyens, Jan; Dewil, Raf

2009-03-01

Although Safety, Health and Environment (SHE) principles are adhered to in companies of developed countries, the application in developing countries is at its infant stage, as shown by the present article where the authors surveyed SHE Practice in 242 companies of 8 West-African countries. The survey demonstrated that (i) the overall performances are poor, although significant improvement can be achieved with a minimum of goodwill and management support; (ii) despite financial difficulties faced by small and medium enterprises (SME), SHE management is a must and should start with a pollution prevention program that will vary with individual needs but some conscious planning effort is always necessary; (iii) it is necessary to prepare for appropriate actions for pollution abatement, adapted to the existing and future production facilities. Although the recorded results are rather poor, there are obviously many possibilities of improvement, with a little goodwill of the SME managers and supervisors. Reaching a standard level of the environmental management is a long but an important process.

Politics and the world's raw materials

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

Lepkowski, W.

1979-06-04

New meaning is given to problems of raw materials scarcity in the development of national policies by mineral-rich developing countries. A combination of socio-economic and political factors is shown in countries like Zaire to be shaping decisions on ore production, which directly affects the economies of industrialized countries and world trade. The developing countries need cash from their ores to finance debts, but capitalism has not produced an adequate infrastructure and has not satisfied the poor. A debate is emerging between those who want to restructure a new international economic order and those who want to use industrial wealth andmore » existing financial institutions to secure order in these countries so that mineral production continues. Critical raw materials imported by the US from developing countries are felt by some to have created a situation of vulnerability as Union Carbide and other multinational corporations have shifted processing operations to the source of the ore. Arguments are presented for both sides of the question of whether a new economic order is needed.« less

World food and agriculture: outlook for the medium and longer term.

PubMed

Alexandratos, N

1999-05-25

The world has been making progress in improving food security, as measured by the per person availability of food for direct human consumption. However, progress has been very uneven, and many developing countries have failed to participate in such progress. In some countries, the food security situation is today worse than 20 years ago. The persistence of food insecurity does not reflect so much a lack of capacity of the world as a whole to increase food production to whatever level would be required for everyone to have consumption levels assuring satisfactory nutrition. The world already produces sufficient food. The undernourished and the food-insecure persons are in these conditions because they are poor in terms of income with which to purchase food or in terms of access to agricultural resources, education, technology, infrastructure, credit, etc., to produce their own food. Economic development failures account for the persistence of poverty and food insecurity. In the majority of countries with severe food-security problems, the greatest part of the poor and food-insecure population depend greatly on local agriculture for a living. In such cases, development failures are often tantamount to failures of agricultural development. Development of agriculture is seen as the first crucial step toward broader development, reduction of poverty and food insecurity, and eventually freedom from excessive economic dependence on poor agricultural resources. Projections indicate that progress would continue, but at a pace and pattern that would be insufficient for the incidence of undernutrition to be reduced significantly in the medium-term future. As in the past, world agricultural production is likely to keep up with, and perhaps tend to exceed, the growth of the effective demand for food. The problem will continue to be one of persistence of poverty, leading to growth of the effective demand for food on the part of the poor that would fall short of that required for them to attain levels of consumption compatible with freedom from undernutrition.

World food and agriculture: Outlook for the medium and longer term

PubMed Central

Alexandratos, Nikos

1999-01-01

The world has been making progress in improving food security, as measured by the per person availability of food for direct human consumption. However, progress has been very uneven, and many developing countries have failed to participate in such progress. In some countries, the food security situation is today worse than 20 years ago. The persistence of food insecurity does not reflect so much a lack of capacity of the world as a whole to increase food production to whatever level would be required for everyone to have consumption levels assuring satisfactory nutrition. The world already produces sufficient food. The undernourished and the food-insecure persons are in these conditions because they are poor in terms of income with which to purchase food or in terms of access to agricultural resources, education, technology, infrastructure, credit, etc., to produce their own food. Economic development failures account for the persistence of poverty and food insecurity. In the majority of countries with severe food-security problems, the greatest part of the poor and food-insecure population depend greatly on local agriculture for a living. In such cases, development failures are often tantamount to failures of agricultural development. Development of agriculture is seen as the first crucial step toward broader development, reduction of poverty and food insecurity, and eventually freedom from excessive economic dependence on poor agricultural resources. Projections indicate that progress would continue, but at a pace and pattern that would be insufficient for the incidence of undernutrition to be reduced significantly in the medium-term future. As in the past, world agricultural production is likely to keep up with, and perhaps tend to exceed, the growth of the effective demand for food. The problem will continue to be one of persistence of poverty, leading to growth of the effective demand for food on the part of the poor that would fall short of that required for them to attain levels of consumption compatible with freedom from undernutrition. PMID:10339517

Non-contributory social transfer programs in developing countries: A new dataset and research agenda.

PubMed

Dodlova, Marina; Giolbas, Anna; Lay, Jann

2018-02-01

Social transfer programs in developing countries are designed to contribute to poverty reduction by increasing the income of the poor in order to ensure minimal living standards. In addition, social transfers provide a safety net for the vulnerable, who are typically not covered by contributory social security. The question of how effective such programs are in achieving these aims has been the subject of numerous impact evaluations. However, the optimal design of such programs is still unclear. Even less is known about whether the adoption and implementation of transfer programs is really driven by poverty and neediness or whether other factors also have an influence. To investigate these and other research questions, we have developed a new dataset entitled Non-Contributory Social Transfer Programs (NSTP) in Developing Countries. One advantage of this dataset is that it traces 186 non-contributory programs from 101 countries back in time and presents them in panel form for the period up until 2015. The second advantage is that it contains all the details regarding the various programs' designs as well as information on costs and coverage in a coded format and thus facilitates both comparative quantitative and in-depth qualitative analyses. While describing the data we discuss a number of examples of how the dataset can be used to explore different issues related to social policies in developing countries. We present suggestive evidence that the adoption of social transfer programs is not based only on pro-poor motives, but rather that social policy choices differ between political regimes.

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 evolution of child health programmes in developing countries: from targeting diseases to targeting people.

PubMed Central

Claeson, M.; Waldman, R. J.

2000-01-01

Mortality rates among children and the absolute number of children dying annually in developing countries have declined considerably over the past few decades. However, the gains made have not been distributed evenly: childhood mortality remains higher among poorer people and the gap between rich and poor has grown. Several poor countries, and some poorer regions within countries, have experienced a levelling off of or even an increase in childhood mortality over the past few years. Until now, two types of programmes--short-term, disease-specific initiatives and more general programmes of primary health care--have contributed to the decline in mortality. Both types of programme can contribute substantially to the strengthening of health systems and in enabling households and communities to improve their health care. In order for them to do so, and in order to complete the unfinished agenda of improving child health globally, new strategies are needed. On the one hand, greater emphasis should be placed on promoting those household behaviours that are not dependent on the performance of health systems. On the other hand, more attention should be paid to interventions that affect health at other stages of the life cycle while efforts that have been made to develop interventions that can be used during childhood continue. PMID:11100618

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

PubMed

London, L

2009-11-01

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

Climate change impacts on rural poverty in low-elevation coastal zones

NASA Astrophysics Data System (ADS)

Barbier, Edward B.

2015-11-01

This paper identifies the low-elevation coastal zone (LECZ) populations and developing regions most vulnerable to sea-level rise and other coastal hazards, such as storm surges, coastal erosion and salt-water intrusion. The focus is on the rural poor in the LECZ, as their economic livelihoods are especially endangered both directly by coastal hazards and indirectly through the impacts of climate change on key coastal and near-shore ecosystems. Using geo-spatially referenced malnutrition and infant mortality data for 2000 as a proxy for poverty, this study finds that just 15 developing countries contain over 90% of the world's LECZ rural poor. Low-income countries as a group have the highest incidence of poverty, which declines somewhat for lower middle-income countries, and then is much lower for upper middle-income economies. South Asia, East Asia and the Pacific and Sub-Saharan Africa account for most of the world's LECZ rural poor, and have a high incidence of poverty among their rural LECZ populations. Although fostering growth, especially in coastal areas, may reduce rural poverty in the LECZ, additional policy actions will be required to protect vulnerable communities from disasters, to conserve and restore key coastal and near-shore ecosystems, and to promote key infrastructure investments and coastal community response capability.

Measuring progress toward the Millennium Development Goals and the missing millions.

PubMed

Carr-Hill, Roy A

2013-01-01

The 2015 target date for achieving the Millennium Development Goals (MDGs) is fast approaching, but there is very little discussion of the validity of the indicators used to measure progress. In particular, there has been little attention given to the problems that arise when assessments of progress are based on household surveys. These are inappropriate for obtaining information about the poorest of the poor. Typically, they omit by design those not in households because they are homeless; those who are in institutions; and mobile, nomadic or pastoralist populations; and, in practice, household surveys will typically under-represent those in fragile, disjointed or multiple occupancy households; and those in urban slums and insecure areas of a country. Those six subgroups constitute a pretty comprehensive ostensive definition of the "poorest of the poor." Between 300 and 500 million people--mainly in developing countries--will be missed worldwide from the sampling frames of household surveys.

Demand-Side Financing in Education: a Critical Examination of a Girls' Scholarship Program in Malawi--(Case Study)

ERIC Educational Resources Information Center

Sineta, Abraham

2012-01-01

Despite the push for universal education, many disadvantaged and poor children in developing countries still do not have access to basic education. This among other reasons is due to poverty where poor families cannot afford the cost of basic education even when it is "free" of tuition (McDonald, 2007). Demand-side financing…

Estimating the impact on health of poor reliability of drinking water interventions in developing countries.

PubMed

Hunter, Paul R; Zmirou-Navier, Denis; Hartemann, Philippe

2009-04-01

Recent evidence suggests that many improved drinking water supplies suffer from poor reliability. This study investigates what impact poor reliability may have on achieving health improvement targets. A Quantitative Microbiological Risk Assessment was conducted of the impact of interruptions in water supplies that forced people to revert to drinking raw water. Data from the literature were used to construct models on three waterborne pathogens common in Africa: Rotavirus, Cryptosporidium and Enterotoxigenic E. coli. Risk of infection by the target pathogens is substantially greater on days that people revert to raw water consumption. Over the course of a few days raw water consumption, the annual health benefits attributed to consumption of water from an improved supply will be almost all lost. Furthermore, risk of illness on days drinking raw water will fall substantially on very young children who have the highest risk of death following infection. Agencies responsible for implementing improved drinking water provision will not make meaningful contributions to public health targets if those systems are subject to poor reliability. Funders of water quality interventions in developing countries should put more effort into auditing whether interventions are sustainable and whether the health benefits are being achieved.

Simplified training for hazardous materials management in developing countries

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

Braithwaite, J.

1994-12-31

There are thousands of dangerous situations happening daily in developing countries around the world involving untrained workers and hazardous materials. There are very few if any agencies in developing countries that are charged with ensuring safe and healthful working conditions. In addition to the problem of regulation and enforcement, there are potential training problems due to the level of literacy and degree of scientific background of these workers. Many of these workers are refugees from poorly developed countries who are willing to work no matter what the conditions. Training methods (standards) accepted as state of the art in the Unitedmore » States and other developed countries may not work well under the conditions found in developing countries. Because these methods may not be appropriate, new and novel ways to train workers quickly, precisely and economically in hazardous materials management should be developed. One approach is to develop training programs that use easily recognizable graphics with minimal verbal instruction, programs similar to the type used to teach universal international driving regulations and safety. The program as outlined in this paper could be tailored to any sized plant and any hazardous material handling or exposure situation. The situation in many developing countries is critical, development of simplified training methods for workers exposed to hazardous materials hold valuable market potential and are an opportunity for many underdeveloped countries to develop indigenous expertise in hazardous materials management.« less

Health, Well-Being and Energy Poverty in Europe: A Comparative Study of 32 European Countries.

PubMed

Thomson, Harriet; Snell, Carolyn; Bouzarovski, Stefan

2017-05-31

Despite growing pan-European interest in and awareness of the wide-ranging health and well-being impacts of energy poverty-which is characterised by an inability to secure adequate levels of energy services in the home-the knowledge base is largely British-centric and dominated by single-country studies. In response, this paper investigates the relationship between energy poverty, health and well-being across 32 European countries, using 2012 data from the European Quality of Life Survey. We find an uneven concentration of energy poverty, poor health, and poor well-being across Europe, with Eastern and Central Europe worst affected. At the intersection of energy poverty and health, there is a higher incidence of poor health (both physical and mental) amongst the energy poor populations of most countries, compared to non-energy poor households. Interestingly, we find the largest disparities in health and well-being levels between energy poor and non-energy poor households occur within relatively equal societies, such as Sweden and Slovenia. As well as the unique challenges brought about by rapidly changing energy landscapes in these countries, we also suggest the relative deprivation theory and processes of social comparison hold some value in explaining these findings.

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.

Compulsory licensing of patented pharmaceutical inventions: evaluating the options

PubMed Central

Reichman, Jerome H.

2010-01-01

In this Comment, the author traces the relevant legislative history pertaining to compulsory licensing of patented pharmaceuticals from the TRIPS (Trade-Related Aspects of Intellectual Property Rights) Agreement of 1994 to the 2003 waiver to, and later proposed amendment of, article 31, which enables poor countries to obtain needed medicines from other countries that possess manufacturing capacity. The Comment then evaluates recent, controversial uses of the relevant legislative machinery as viewed from different critical perspectives. The Comment shows how developing countries seeking access to essential medicines can collaborate in ways that would avoid undermining incentives to innovation and other social costs attributed to compulsory licensing. It ends by defending the legality of recent measures taken to promote public health in developing countries, and by reminding developed countries that unilateral retaliation against such measures is demonstratably illegal under WTO foundational law and jurisprudence. PMID:19493070

Evidence-based medicine training in a resource-poor country, the importance of leveraging personal and institutional relationships

PubMed Central

Tomatis, Cristina; Taramona, Claudia; Rizo-Patrón, Emiliana; Hernández, Fiorela; Rodríguez, Patricia; Piscoya, Alejandro; Gonzales, Elsa; Gotuzzo, Eduardo; Heudebert, Gustavo; Centor, Robert M.; Estrada, Carlos A.

2011-01-01

Rationale, aims and objectives Efforts to implement evidence-based medicine (EBM) training in developing countries are limited. We describe the results of an international effort to improve research capacity in a developing country; we conducted a course aimed at improving basic EBM attitudes and identified challenges. Method Between 2005 and 2009, we conducted an annual 3-day course in Perú consisting of interactive lectures and case-based workshops. We assessed self-reported competence and importance in EBM using a Likert scale (1 = low, 5 = high). Results Totally 220 clinicians participated. For phase I (2005–2007), self-reported EBM competence increased from a median of 2 to 3 (P < 0.001) and the perceived importance of EBM did not change (median = 5). For phase II (2008–2009), before the course, 8–72% graded their competence very low (score of 1–2). After the course, 67–92% of subjects graded their increase in knowledge very high (score of 4–5). The challenges included limited availability of studies relevant to the local reality written in Spanish, participants’ limited time and lack of long-term follow-up on practice change. Informal discussion and written evaluation from participants were universally in agreement that more training in EBM is needed. Conclusions In an EBM course in a resource-poor country, the baseline self-reported competence and experience on EBM were low, and the course had measurable improvements of self-reported competence, perceived utility and readiness to incorporate EBM into their practices. Similar to developed countries, translational research and building the research capacity in developing countries is critical for translating best available evidence into practice. PMID:21276140

Routes to Better Health for Children in Four Developing Countries

PubMed Central

Croghan, Thomas W; Beatty, Amanda; Ron, Aviva

2006-01-01

Despite the availability of effective, affordable interventions for the most common causes of death, more than ten million children in developing countries die each year. This article describes the circumstances of four countries whose reductions in child mortality exceeded what might be expected from their poor economic circumstances, and it asks whether they followed common routes to improved health for children. The findings suggest that contextual factors, such as the degree of economic development, good governance, and strong health care systems, matter less than do targeted health intervention, foreign aid, and technical assistance. In general, these findings contradict prevailing U.S. foreign policy regarding the circumstances in which progress toward health goals can be made. PMID:16771821

Self-Rated Health and Mortality: Does the Relationship Extend to a Low Income Setting?

ERIC Educational Resources Information Center

Frankenberg, Elizabeth; Jones, Nathan R.

2004-01-01

Although a relationship between poor self-reported health status and excess mortality risk has been well-established for industrialized countries, almost no research considers developing countries. We use data from Indonesia to show that in a low-income setting, as in more advantaged parts of the world, individuals who perceive their health to be…

The History of Libraries from the Colonial Period of a Country to Independence.

ERIC Educational Resources Information Center

Yocklunn, John

An overview of libraries in developing nations examines in general terms their historical development during their colonial and post-independence periods and discusses the more salient factors affecting development. These factors include language, distribution of population, topography, poor communication, level of formal education, illiteracy,…

Non-Govermental Organisations Self-Evaluation: Issue of Concern in Nigeria

ERIC Educational Resources Information Center

Olujide, M. G.

2005-01-01

Non-Governmental organizations (NGOs) promote alternative development strategies to those provided by the government. The economic recession being witnessed in developing countries like Nigeria and the poor performance of many government development programmes have made NGOs more relevant than ever. NGOs play an increasingly important role in…

The "Developing" Achievement Gap: Colombian Voucher Reform

ERIC Educational Resources Information Center

Stern, Jonathan M. B.

2014-01-01

The achievement gap in many developing countries is defined in terms of rich/poor and public/private. The prevailing explanation for the "developing" achievement gap is an underfunded, inefficient, and/or inadequately supplied public school sector. Via an analysis of a Colombian voucher experiment, this article examines the extent to…

Strengthening institutional and organizational capacity for social health protection of the informal sector in lesser-developed countries: a study of policy barriers and opportunities in Cambodia.

PubMed

Annear, Peter Leslie; Ahmed, Shakil; Ros, Chhun Eang; Ir, Por

2013-11-01

Reaching out to the poor and the informal sector is a major challenge for achieving universal coverage in lesser-developed countries. In Cambodia, extensive coverage by health equity funds for the poor has created the opportunity to consolidate various non-government health financing schemes under the government's proposed social health protection structure. This paper identifies the main policy and operational challenges to strengthening existing arrangements for the poor and the informal sector, and considers policy options to address these barriers. Conducted in conjunction with the Cambodian Ministry of Health in 2011-12, the study reviewed policy documents and collected qualitative data through 18 semi-structured key informant interviews with government, non-government and donor officials. Data were analysed using the Organizational Assessment for Improving and Strengthening Health Financing conceptual framework. We found that a significant shortfall related to institutional, organisational and health financing issues resulted in fragmentation and constrained the implementation of social health protection schemes, including health equity funds, community-based health insurance, vouchers and others. Key documents proposed the establishment of a national structure for the unification of the informal-sector schemes but left unresolved issues related to structure, institutional capacity and the third-party status of the national agency. This study adds to the evidence base on appropriate and effective institutional and organizational arrangements for social health protection in the informal sector in developing countries. Among the key lessons are: the need to expand the fiscal space for health care; a commitment to equity; specific measures to protect the poor; building national capacity for administration of universal coverage; and working within the specific national context. Copyright © 2013 Elsevier Ltd. All rights reserved.

Maternal and child health project in Nigeria.

PubMed

Okafor, Chinyelu B

2003-12-01

Maternal deaths in developing countries are rooted in womens powerlessness and their unequal access to employment, finance, education, basic health care, and other resources. Nigeria is Africa's most populous country, and it is an oil producing country, but Nigeria has one of the worst maternal mortality rates in Africa. These deaths were linked to deficiencies in access to health care including poor quality of health services, socio-cultural factors, and access issues related to the poor status of women. To address these problems, a participatory approach was used to bring Christian women from various denominations in Eastern Nigeria together. With technical assistance from a research unit in a university in Eastern Nigeria, the women were able to implement a Safe Motherhood project starting from needs assessment to program evaluation. Lessons learned from this program approach are discussed.

What Is the Role of Informal Healthcare Providers in Developing Countries? A Systematic Review

PubMed Central

Sudhinaraset, May; Ingram, Matthew; Lofthouse, Heather Kinlaw; Montagu, Dominic

2013-01-01

Informal health care providers (IPs) comprise a significant component of health systems in developing nations. Yet little is known about the most basic characteristics of performance, cost, quality, utilization, and size of this sector. To address this gap we conducted a comprehensive literature review on the informal health care sector in developing countries. We searched for studies published since 2000 through electronic databases PubMed, Google Scholar, and relevant grey literature from The New York Academy of Medicine, The World Bank, The Center for Global Development, USAID, SHOPS (formerly PSP-One), The World Health Organization, DFID, Human Resources for Health Global Resource Center. In total, 334 articles were retrieved, and 122 met inclusion criteria and chosen for data abstraction. Results indicate that IPs make up a significant portion of the healthcare sector globally, with almost half of studies (48%) from Sub-Saharan Africa. Utilization estimates from 24 studies in the literature of IP for healthcare services ranged from 9% to 90% of all healthcare interactions, depending on the country, the disease in question, and methods of measurement. IPs operate in a variety of health areas, although baseline information on quality is notably incomplete and poor quality of care is generally assumed. There was a wide variation in how quality of care is measured. The review found that IPs reported inadequate drug provision, poor adherence to clinical national guidelines, and that there were gaps in knowledge and provider practice; however, studies also found that the formal sector also reported poor provider practices. Reasons for using IPs included convenience, affordability, and social and cultural effects. Recommendations from the literature amount to a call for more engagement with the IP sector. IPs are a large component of nearly all developing country health systems. Research and policies of engagement are needed. PMID:23405101

Poverty and stroke in India: a time to act.

PubMed

Pandian, Jeyaraj D; Srikanth, Velandai; Read, Stephen J; Thrift, Amanda G

2007-11-01

In developed countries, the predominant health problems are those lifestyle-related illnesses associated with increased wealth. In contrast, diseases occurring in developing countries can largely be attributed to poverty, poor healthcare infrastructure, and limited access to care. However, many developing countries such as India have undergone economic and demographic growth in recent years resulting in a transition from diseases caused by poverty toward chronic, noncommunicable, lifestyle-related diseases. Despite this recent rapid economic growth, a large proportion of the Indian population lives in poverty. Although risk factors for stroke in urban Indian populations are similar to developed nations, it is likely that they may be quite different among those afflicted by poverty. Furthermore, treatment options for stroke are fewer in developing countries like India. Well-organized stroke services and emergency transport services are lacking, many treatments are unaffordable, and sociocultural factors may influence access to medical care for many stroke victims. Most stroke centers are currently in the private sector and establishing such centers in the public sector will require enormous capital investment. Given the limited resources available for hospital treatments, it would be logical to place a greater emphasis on effective populationwide interventions to control or reduce exposure to leading stroke risk factors. There also needs to be a concerted effort to ensure access to stroke care programs that are tailored to suit Indian communities and are accessible to the large majority of the population, namely the poor.

The shape of things to come.

PubMed

Gallagher, C F

1979-01-01

Basic projections for the future made by various international and national planning organizations form the basis for a report on the demographic, economic, and social implications of population growth for the year 2000, both as to the statistics involved and what they mean. The most signficiant factor is that by the end of the century, global population will be greater than 6 billion. Statistics on population patterns are presented for Asia; India; China; Africa; Latin America; North America; Europe, Oceania, and the USSR, including population growth; birthrate; mortality; population projections; population distribution; age of populations; and urbanization. The realities that stand behind these abstract and impersonal statistics of population change will pose significant problems in several major respects: how these increasing populations will support themselves; where they will live; and how they will be fed. These question are closely related, but the need to create jobs might come 1st since decisions about the kind of employment opportunities to be offered and where will directly affect the rural-urban population equation. It is clear that an enormous number of jobs must be found in developing countries by the end of the century, estimated at 500 million more. The economic implications of increasing urbanization in the developing world are explored, and it is noted that Asia, Latin America, and Africa now face the prospect of having to feed as many as 800 million more urbanites by the year 2000. Also, rural population will also continue to grow, and whether agricultural resources can be increased to what extent and how is a critical question. It is concluded that no matter how agriculture is improved or jobs found in developing countries, many will be poorly nourished, badly housed, and inadequately educated. It is finally suggested that by 2000 the Third World as such will no longer exist; instead the world will consist of older developed countries; rapidly developing countries; middle-income countries; oil-surplus countries; and still poor countries, with a movement toward a constantly more diversified echelon of socioeconomic levels of development, both among and within countries.

Plant biotechnology in China.

PubMed

Huang, Jikun; Rozelle, Scott; Pray, Carl; Wang, Qinfang

2002-01-25

A survey of China's plant biotechnologists shows that China is developing the largest plant biotechnology capacity outside of North America. The list of genetically modified plant technologies in trials, including rice, wheat, potatoes, and peanuts, is impressive and differs from those being worked on in other countries. Poor farmers in China are cultivating more area of genetically modified plants than are small farmers in any other developing country. A survey of agricultural producers in China demonstrates that Bacillus thuringiensis cotton adoption increases production efficiency and improves farmer health.

Prevention and control of avian influenza: the need for a paradigm shift in pandemic influenza preparedness.

PubMed

Martinot, A; Thomas, J; Thiermann, A; Dasgupta, N

2007-03-10

Avian influenza presents both challenges and opportunities to leaders around the world engaged in pandemic influenza preparedness planning. Most resource-poor countries will be unable to stockpile antivirals or have access to eventual human vaccines for pandemic flu. Preparedness plans, directed at controlling avian influenza at the source, enable countries simultaneously to promote national and global health, animal welfare and international development. Improving the veterinary infrastructure and capacity of resource-poor countries is one way to prevent potential pandemic flu deaths in resource-rich countries. In this article, Amanda Martinot, James Thomas, Alejandro Thiermann and Nabarun Dasgupta argue that national health leaders need to consider more comprehensive strategies that incorporate veterinary surveillance and improvements in veterinary infrastructure for the control of avian influenza epizootics as part of national pandemic preparedness planning. This, they argue, will require a shift in attitude, from thinking in terms of preparation for an inevitable pandemic to pre-emption of the potential pandemic through prevention measures in the animal population.

World health, populations, sanitation and resources. Part 1.

PubMed

Humphries, S V

1981-07-01

This paper discusses 5 crises that are confronted by mankind: 1) population pressure, 2) the environment, 3) food, 4) energy, and 5) raw materials. Developing countries are those with rapid population growth rates while developed countries have slow growth rates. Sweden, Austria, East and West Germany, and Luxemburg were the only 5 countries with zero population growth in 1980. Other developed countries such as Canada and the USA double in population every 88 and 99 years, respectively. In contrast, developing countries such as Kenya, Zimbabwe, Zambia, and South Africa double every 18, 21, 22, and 25 years respectively. Such population increases cause problems in the environment, transportation, education, crime, and riots. The level of foreign aid for food to developing countries needs to increase or else the economic gap between rich and poor nations will increase on an average from 5:1 to 8:1 in Latin America and to 20:1 in South Asia. Availability of food has increaseed in developed countries whereas in developing countries it has dropped. Use of tropical forest lands as well as the sea bed for a source of food is difficult. There ia an upper limit to the fresh water runoff from land areas of the earth and fresh water is non-renewable. There is also a scarcity of other non-renewable resources, including at least 20 minerals. Finally, the standard of living in prosperous countries must be lowered at the same time as raising it in developing countries.

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.

Health Care System Reforms in Developing Countries

PubMed Central

Han, Wei

2012-01-01

This article proposes a critical but non-systematic review of recent health care system reforms in developing countries. The literature reports mixed results as to whether reforms improve the financial protection of the poor or not. We discuss the reasons for these differences by comparing three representative countries: Mexico, Vietnam, and China. First, the design of the health care system reform, as well as the summary of its evaluation, is briefly described for each country. Then, the discussion is developed along two lines: policy design and evaluation methodology. The review suggests that i) background differences, such as social development, poverty level, and population health should be considered when taking other countries as a model; ii) although demand-side reforms can be improved, more attention should be paid to supply-side reforms; and iii) the findings of empirical evaluation might be biased due to the evaluation design, the choice of outcome, data quality, and evaluation methodology, which should be borne in mind when designing health care system reforms. PMID:25170464

Country of birth, parental background and self-rated health among adolescents: a population-based study.

PubMed

Lindström, Martin; Modén, Birgit; Rosvall, Maria

2014-12-01

The aim of this study was to investigate differences according to country of birth and parental country of birth, in relation to poor self-rated health (SRH), in Swedish adolescents. The Scania public health survey among children and adolescents, conducted in 2012, is a cross-sectional study including most pupils in grade 9 (15 years old), including in 32 of 33 municipalities. The participation rate was 83% (9,791 of 11,735). We performed logistic regressions to investigate the association between the students' country of birth, parental country of birth and poor SRH. Boys born outside Europe had an odds ratio (OR) 2.1 (1.6-2.8) of poor SRH in the unadjusted model, which was reduced to 0.7 (0.4-1.3) in the multiple model, as compared to boys born in Sweden with both or one parent born in Sweden. Boys born in Europe had an OR 0.4 (0.2-0.9) of poor SRH, after multiple adjustments. Girls born in Sweden with both parents born abroad, and girls born outside of Europe had significantly lower ORs of poor SRH in the multiple model. In particular, adjustment for socio-demographic and psychosocial factors reduced the ORs of poor SRH among boys, but did so to a lesser extent among girls. Differences in socio-demographic and psychosocial factors explained the higher odds of poor SRH among boys born outside of Europe. Girls born in Sweden with both parents born abroad, and girls born outside Europe, had significantly lower ORs of poor SRH. Our results indicate that there are gender differences in the factors behind poor self-rated health, according to the country-related background of adolescents in Sweden. © 2014 the Nordic Societies of Public Health.

Application of ICT in strengthening health information systems in developing countries in the wake of globalisation.

PubMed

Simba, Daudi O; Mwangu, Mughwira

2004-12-01

Information Communication Technology (ICT) revolution brought opportunities and challenges to developing countries in their efforts to strengthen the Health Management Information Systems (HMIS). In the wake of globalisation, developing countries have no choice but to take advantage of the opportunities and face the challenges. The last decades saw developing countries taking action to strengthen and modernise their HMIS using the existing ICT. Due to poor economic and communication infrastructure, the process has been limited to national and provincial/region levels leaving behind majority of health workers living in remote/rural areas. Even those with access do not get maximum benefit from ICT advancements due to inadequacies in data quality and lack of data utilisation. Therefore, developing countries need to make deliberate efforts to address constraints threatening to increase technology gap between urban minority and rural majority by setting up favourable policies and appropriate strategies. Concurrently, strategies to improve data quality and utilisation should be instituted to ensure that HMIS has positive impact on people's health. Potential strength from private sector and opportunities for sharing experiences among developing countries should be utilised. Short of this, advancement in ICT will continue to marginalise health workers in developing countries especially those living in remote areas.

Measuring the bias against low-income country research: an Implicit Association Test.

PubMed

Harris, Matthew; Macinko, James; Jimenez, Geronimo; Mullachery, Pricila

2017-11-06

With an increasing array of innovations and research emerging from low-income countries there is a growing recognition that even high-income countries could learn from these contexts. It is well known that the source of a product influences perception of that product, but little research has examined whether this applies also in evidence-based medicine and decision-making. In order to examine likely barriers to learning from low-income countries, this study uses established methods in cognitive psychology to explore whether healthcare professionals and researchers implicitly associate good research with rich countries more so than with poor countries. Computer-based Implicit Association Test (IAT) distributed to healthcare professionals and researchers. Stimuli representing Rich Countries were chosen from OECD members in the top ten (>$36,000 per capita) World Bank rankings and Poor Countries were chosen from the bottom thirty (<$1000 per capita) countries by GDP per capita, in both cases giving attention to regional representation. Stimuli representing Research were descriptors of the motivation (objective/biased), value (useful/worthless), clarity (precise/vague), process (transparent/dishonest), and trustworthiness (credible/unreliable) of research. IAT results are presented as a Cohen's d statistic. Quantile regression was used to assess the contribution of covariates (e.g. age, sex, country of origin) to different values of IAT responses that correspond to different levels of implicit bias. Poisson regression was used to model dichotomized responses to the explicit bias item. Three hundred twenty one tests were completed in a four-week period between March and April 2015. The mean Implicit Association Test result (a standardized mean relative latency between congruent and non-congruent categories) for the sample was 0.57 (95% CI 0.52 to 0.61) indicating that on average our sample exhibited moderately strong implicit associations between Rich Countries and Good Research. People over 40 years of age were less likely to exhibit pro-poor implicit associations, and being a peer reviewer contributes to a more pro-poor association. The majority of our participants associate Good Research with Rich Countries, compared to Poor Countries. Implicit associations such as these might disfavor research from poor countries in research evaluation, evidence-based medicine and diffusion of innovations.

Worldwide burden of COPD in high- and low-income countries. Part III. Asia-Pacific studies.

PubMed

Ko, F W S; Hui, D S C; Lai, C K W

2008-07-01

Chronic obstructive pulmonary disease (COPD) is a global health problem that poses a heavy burden on most countries in the Asia-Pacific region. When compared to industrialised Western countries, the COPD burden in the Asia-Pacific region is higher in terms of the number of deaths, years spent living with disability and years of life lost. Given the high prevalence of tobacco smoking, poor indoor and outdoor air quality and the aging population in many Asian countries, urgent actions need to be taken to reduce the development, morbidity and mortality of this disease.

The post-2015 development agenda for diabetes in sub-Saharan Africa: challenges and future directions

PubMed Central

Renzaho, Andre M. N.

2015-01-01

Background Diabetes is one of the non-communicable diseases (NCDs) which is rising significantly across sub-Saharan African (SSA) countries and posing a threat to the social, economic, and cultural fabric of the SSA population. The inclusion of NCDs into the post-2015 development agenda along with the global monitoring framework provides an opportunity to monitor progress of development programmes in developing countries. This paper examines challenges associated with dealing with diabetes within the development agenda in SSA and explores some policy options. Design This conceptual review draws from a range of works published in Medline and the grey literature to advance the understanding of the post-2015 development agenda and how it relates to NCDs. The paper begins with the burden of diabetes in sub-Sahara Africa and then moves on to examine challenges associated with diabetes prevention, treatment, and management in Africa. It finishes by exploring policy implications. Results With regards to development programmes on NCDs in the SSA sub-continent, several challenges exist: 1) poor documentation of risk factors, 2) demographic transitions (rapid urbanisation and ageing), 3) the complementary role of traditional healers, 4) tuberculosis and the treatment of the acquired immunodeficiency syndrome as risk factors for diabetes, 5) diabetes in complex emergencies, 6) diabetes as an international development priority and not a policy agenda for many SSA countries, and 7) poorly regulated food and beverage industry. Conclusion For the post-2015 development agenda for NCDs to have an impact, sufficient investments will be needed to address legislative, technical, human, and fiscal resource constraints through advocacy, accountability, political leadership, and effective public–private partnership. Striking the right balance between competing demands and priorities, policies, and implementation strategies hold the key to an effective response to diabetes in SSA countries. PMID:25994288

The post-2015 development agenda for diabetes in sub-Saharan Africa: challenges and future directions.

PubMed

Renzaho, Andre M N

2015-01-01

Diabetes is one of the non-communicable diseases (NCDs) which is rising significantly across sub-Saharan African (SSA) countries and posing a threat to the social, economic, and cultural fabric of the SSA population. The inclusion of NCDs into the post-2015 development agenda along with the global monitoring framework provides an opportunity to monitor progress of development programmes in developing countries. This paper examines challenges associated with dealing with diabetes within the development agenda in SSA and explores some policy options. This conceptual review draws from a range of works published in Medline and the grey literature to advance the understanding of the post-2015 development agenda and how it relates to NCDs. The paper begins with the burden of diabetes in sub-Sahara Africa and then moves on to examine challenges associated with diabetes prevention, treatment, and management in Africa. It finishes by exploring policy implications. With regards to development programmes on NCDs in the SSA sub-continent, several challenges exist: 1) poor documentation of risk factors, 2) demographic transitions (rapid urbanisation and ageing), 3) the complementary role of traditional healers, 4) tuberculosis and the treatment of the acquired immunodeficiency syndrome as risk factors for diabetes, 5) diabetes in complex emergencies, 6) diabetes as an international development priority and not a policy agenda for many SSA countries, and 7) poorly regulated food and beverage industry. For the post-2015 development agenda for NCDs to have an impact, sufficient investments will be needed to address legislative, technical, human, and fiscal resource constraints through advocacy, accountability, political leadership, and effective public-private partnership. Striking the right balance between competing demands and priorities, policies, and implementation strategies hold the key to an effective response to diabetes in SSA countries.

Health, Well-Being and Energy Poverty in Europe: A Comparative Study of 32 European Countries

PubMed Central

Thomson, Harriet; Snell, Carolyn; Bouzarovski, Stefan

2017-01-01

Despite growing pan-European interest in and awareness of the wide-ranging health and well-being impacts of energy poverty—which is characterised by an inability to secure adequate levels of energy services in the home—the knowledge base is largely British-centric and dominated by single-country studies. In response, this paper investigates the relationship between energy poverty, health and well-being across 32 European countries, using 2012 data from the European Quality of Life Survey. We find an uneven concentration of energy poverty, poor health, and poor well-being across Europe, with Eastern and Central Europe worst affected. At the intersection of energy poverty and health, there is a higher incidence of poor health (both physical and mental) amongst the energy poor populations of most countries, compared to non-energy poor households. Interestingly, we find the largest disparities in health and well-being levels between energy poor and non-energy poor households occur within relatively equal societies, such as Sweden and Slovenia. As well as the unique challenges brought about by rapidly changing energy landscapes in these countries, we also suggest the relative deprivation theory and processes of social comparison hold some value in explaining these findings. PMID:28561767

[Prevalence and differentiating aspects related to gender with regard to the bullying phenomenon in poor countries].

PubMed

Romera Félix, Eva M; Del Rey Alamillo, Rosario; Ortega Ruiz, Rosario

2011-11-01

There is a large body of scientific knowledge about school violence and bullying in Europe and some other regions of the so-called developed world. However, improvement is scarce in poor and developing regions, as in the case of Latin America and, in particular, Nicaragua. The goal of this work was to determine the prevalence of the bullying phenomenon in Nicaraguan primary schools, to analyze the eventual relationships between the different forms of violence used by the students and to explore, in relation to these aspects, the similarities and differences between boys and girls. For this purpose, we surveyed 3042 pupils of primary school (50.3% girls) using the "Cuestionario sobre Convivencia, Violencia y Experiencias de Riesgo" (COVER, in English, Questionnaire about Living Together, Violence and Risk Experiences). We found that the level of involvement in bullying is significantly higher than in developed countries, that boys are more involved than girls in verbal, physical and psychological bullying, and that there are no differences with regard to social exclusion. The results are discussed, comparing them with studies conducted in different countries but with similar methodologies.

Education and Training in Madagascar: Toward a Policy Agenda for Economic Growth and Poverty Reduction. A World Bank Country Study.

ERIC Educational Resources Information Center

World Bank, Washington, DC.

Madagascar is a poor, primarily rural country in which three-quarters of the population has subsisted below the poverty line for at least two decades. In view of the important role of education in the government's poverty reduction agenda, this report documents the current status of educational development in Madagascar and the key constraints on…

Where Do Poor Women in Developing Countries Give Birth? A Multi-Country Analysis of Demographic and Health Survey Data

PubMed Central

Montagu, Dominic; Yamey, Gavin; Visconti, Adam; Harding, April; Yoong, Joanne

2011-01-01

Background In 2008, over 300,000 women died during pregnancy or childbirth, mostly in poor countries. While there are proven interventions to make childbirth safer, there is uncertainty about the best way to deliver these at large scale. In particular, there is currently a debate about whether maternal deaths are more likely to be prevented by delivering effective interventions through scaled up facilities or via community-based services. To inform this debate, we examined delivery location and attendance and the reasons women report for giving birth at home. Methodology/Principal Findings We conducted a secondary analysis of maternal delivery data from Demographic and Health Surveys in 48 developing countries from 2003 to the present. We stratified reported delivery locations by wealth quintile for each country and created weighted regional summaries. For sub-Saharan Africa (SSA), where death rates are highest, we conducted a subsample analysis of motivations for giving birth at home. In SSA, South Asia, and Southeast Asia, more than 70% of all births in the lowest two wealth quintiles occurred at home. In SSA, 54.1% of the richest women reported using public facilities compared with only 17.7% of the poorest women. Among home births in SSA, 56% in the poorest quintile were unattended while 41% were attended by a traditional birth attendant (TBA); 40% in the wealthiest quintile were unattended, while 33% were attended by a TBA. Seven per cent of the poorest women reported cost as a reason for not delivering in a facility, while 27% reported lack of access as a reason. The most common reason given by both the poorest and richest women for not delivering in a facility was that it was deemed “not necessary” by a household decision maker. Among the poorest women, “not necessary” was given as a reason by 68% of women whose births were unattended and by 66% of women whose births were attended. Conclusions In developing countries, most poor women deliver at home. This suggests that, at least in the near term, efforts to reduce maternal deaths should prioritize community-based interventions aimed at making home births safer. PMID:21386886

Where do poor women in developing countries give birth? A multi-country analysis of demographic and health survey data.

PubMed

Montagu, Dominic; Yamey, Gavin; Visconti, Adam; Harding, April; Yoong, Joanne

2011-02-28

In 2008, over 300,000 women died during pregnancy or childbirth, mostly in poor countries. While there are proven interventions to make childbirth safer, there is uncertainty about the best way to deliver these at large scale. In particular, there is currently a debate about whether maternal deaths are more likely to be prevented by delivering effective interventions through scaled up facilities or via community-based services. To inform this debate, we examined delivery location and attendance and the reasons women report for giving birth at home. We conducted a secondary analysis of maternal delivery data from Demographic and Health Surveys in 48 developing countries from 2003 to the present. We stratified reported delivery locations by wealth quintile for each country and created weighted regional summaries. For sub-Saharan Africa (SSA), where death rates are highest, we conducted a subsample analysis of motivations for giving birth at home. In SSA, South Asia, and Southeast Asia, more than 70% of all births in the lowest two wealth quintiles occurred at home. In SSA, 54.1% of the richest women reported using public facilities compared with only 17.7% of the poorest women. Among home births in SSA, 56% in the poorest quintile were unattended while 41% were attended by a traditional birth attendant (TBA); 40% in the wealthiest quintile were unattended, while 33% were attended by a TBA. Seven per cent of the poorest women reported cost as a reason for not delivering in a facility, while 27% reported lack of access as a reason. The most common reason given by both the poorest and richest women for not delivering in a facility was that it was deemed "not necessary" by a household decision maker. Among the poorest women, "not necessary" was given as a reason by 68% of women whose births were unattended and by 66% of women whose births were attended. In developing countries, most poor women deliver at home. This suggests that, at least in the near term, efforts to reduce maternal deaths should prioritize community-based interventions aimed at making home births safer.

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.

Laboratory challenges in the scaling up of HIV, TB, and malaria programs: The interaction of health and laboratory systems, clinical research, and service delivery.

PubMed

Birx, Deborah; de Souza, Mark; Nkengasong, John N

2009-06-01

Strengthening national health laboratory systems in resource-poor countries is critical to meeting the United Nations Millennium Development Goals. Despite strong commitment from the international community to fight major infectious diseases, weak laboratory infrastructure remains a huge rate-limiting step. Some major challenges facing laboratory systems in resource-poor settings include dilapidated infrastructure; lack of human capacity, laboratory policies, and strategic plans; and limited synergies between clinical and research laboratories. Together, these factors compromise the quality of test results and impact patient management. With increased funding, the target of laboratory strengthening efforts in resource-poor countries should be the integrating of laboratory services across major diseases to leverage resources with respect to physical infrastructure; types of assays; supply chain management of reagents and equipment; and maintenance of equipment.

Understanding and Addressing the Global Need for Orthopaedic Trauma Care.

PubMed

Agarwal-Harding, Kiran J; von Keudell, Arvind; Zirkle, Lewis G; Meara, John G; Dyer, George S M

2016-11-02

➤The burden of musculoskeletal trauma is high worldwide, disproportionately affecting the poor, who have the least access to quality orthopaedic trauma care.➤Orthopaedic trauma care is essential, and must be a priority in the horizontal development of global health systems.➤The education of surgeons, nonphysician clinicians, and ancillary staff in low and middle income countries is central to improving access to and quality of care.➤Volunteer surgical missions from rich countries can sustainably expand and strengthen orthopaedic trauma care only when they serve a local need and build local capacity.➤Innovative business models may help to pay for care of the poor. Examples include reducing costs through process improvements and cross-subsidizing from profitable high-volume activities.➤Resource-poor settings may foster innovations in devices or systems with universal applicability in orthopaedics. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Relationships between population and environment in rural areas of developing countries.

PubMed

Rudel, T I

1991-01-01

Studies that have assessed the impact of population change on the environment in rural areas of selected developing countries are reviewed. The implications are that both developed and developing countries might focus on single aspects of a much larger global problem. Rural areas were selected because the bulk of the world's population lives in rural areas. Population environment interactions are 1st discussed at the global level. Studies on changing import patterns of developing countries are usless in accounting for agricultural policy shifts or other factors that may be unrelated to population growth but may be related to food imports. When the magnitude of food production and population growth is examined, there is a balance established between the two. However, analysis of the spatial distribution of desertification and soil degradation shows greater local level effects. Population/environment relationships are examined in critical ecological zones: tropical deforestation, desertification, land degradation in resource poor zones, and responses to population pressures and resource degradation. The conclusions reached are that better statistics on degradation are needed and that the trends in the human ecology of rural populations have clear implications for government policies on the environment. Agricultural development has been uneven and inequitable such that many peasant populations have suffered a decline in standards of living, particularly in Africa. There has also been an accelerated increase in rates of land degradation in resource poor areas, which are densely populated. The population response has been migration shifts out of resource poor areas to ecologically marginal areas, which has resulted in extensive desertification and deforestation. Expansion of the areas under cultivation has not just increased agricultural production but agriculture and population have invaded ecologically marginal zones in deserts and rain forests. Measurement of the magnitude and geographic distribution of deforestation is enhanced with the use of remote sensing techniques, such as those used in the 1982 UN Food and Agriculture baseline study. Soil degradation is not so easily measured. The implications are that regional development funds need to directed away from critical zones or areas adjacent to critical zones. Research is needed to understand rural to rural migration.

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.

Substance Abuse Disorders Treatment in El Salvador: Analysis of Policy-Making-Related Failure

PubMed Central

Dickson-Gómez, Julia

2016-01-01

Illicit drug use and substance abuse disorders have increased dramatically in developing countries during recent decades. Sadly, treatment for people diagnosed as manifesting and/or attributed with substance abuse disorders in developing countries is usually inadequate to meet demand, not evidence based, and of poor quality. In response, international health organizations have developed best-practice guidelines for substance user treatment in developing countries, although little research has evaluated their implementation. This opinion piece will examine one such effort to improve substance user treatment in El Salvador. It will be argued that the program failed (2007–2008) because of a lack of political will by the Salvadoran government through their Ministry of Health to effectively supervise, monitor, and subsidize substance user treatment. PMID:23186469

Abortion and maternal mortality in the developing world.

PubMed

Okonofua, Friday

2006-11-01

Unsafe abortion is an important public health problem, accounting for 13% of maternal mortality in developing countries. Of an estimated annual 70,000 deaths from unsafe abortion worldwide, over 99% occur in the developing countries of sub-Saharan Africa, Central and Southeast Asia, and Latin America and the Caribbean. Factors associated with increased maternal mortality from unsafe abortion in developing countries include inadequate delivery systems for contraception needed to prevent unwanted pregnancies, restrictive abortion laws, pervading negative cultural and religious attitudes towards induced abortion, and poor health infrastructures for the management of abortion complications. The application of a public health approach based on primary, secondary, and tertiary prevention can reduce morbidity and mortality associated with unsafe abortion in developing countries. Primary prevention includes the promotion of increased use of contraception by women (and by men) at risk for unwanted pregnancy; secondary prevention involves the liberalization of abortion laws and the development of programs to increase access to safe abortion care in developing countries. In contrast, tertiary prevention includes the integration and institutionalization of post-abortion care for incomplete abortion and the early and appropriate treatment of more severe complications of abortion. Efforts to address these problems will contribute both to reducing maternal mortality associated with induced abortion and to achieving the Millennium Development Goals in developing countries.

Poverty and health sector inequalities.

PubMed Central

Wagstaff, Adam

2002-01-01

Poverty and ill-health are intertwined. Poor countries tend to have worse health outcomes than better-off countries. Within countries, poor people have worse health outcomes than better-off people. This association reflects causality running in both directions: poverty breeds ill-health, and ill-health keeps poor people poor. The evidence on inequalities in health between the poor and non-poor and on the consequences for impoverishment and income inequality associated with health care expenses is discussed in this article. An outline is given of what is known about the causes of inequalities and about the effectiveness of policies intended to combat them. It is argued that too little is known about the impacts of such policies, notwithstanding a wealth of measurement techniques and considerable evidence on the extent and causes of inequalities. PMID:11953787

Ethics of Implementing Electronic Health Records in Developing Countries: Points to Consider

PubMed Central

Were, Martin C.; Meslin, Eric M.

2011-01-01

Electronic Health Record systems (EHRs) are increasingly being used in many developing countries, several of which have moved beyond isolated pilot projects to active large-scale implementation as part of their national health strategies. Despite growing enthusiasm for adopting EHRs in resource poor settings, almost no attention has been paid to the ethical issues that might arise. In this article we argue that these ethical issues should be addressed now if EHRs are to be appropriately implemented in these settings. We take a systematic approach guided by a widely accepted ethical framework currently in use for developing countries to first describe the ethical issues, and then propose a set of ‘Points to Consider’ to guide further thinking and decision-making. PMID:22195214

Donor issues in Indonesia: A developing country in South East Asia.

PubMed

Soedarmono, Yuyun S M

2010-01-01

In most developing countries in South East Asia blood services have not been treated properly as an important service to support health program. Indonesia as a large archipelago country in South East Asia has specific obstacles in managing a blood service. To position the country blood service profile especially in term of donor issues, we compared our blood service with that in other South East Asia countries. Indonesia has 17 thousand islands with 220 million inhabitants. Blood services have been mostly run by the Indonesian Red Cross as a government assignment since 1950. Donor recruitment programs have been directed toward 100% of Voluntary Non Remunerated Blood Donor (VNRD), which now have reached 81.3%. Dissemination of information on VNRD, donor recruiter's training and VNRD appreciation programs are strategies to increase and maintain the VNRD. Limited female donors and insufficient blood supply during the fasting month and holidays constitute major challenges. Low hemoglobin level, low body weight and fear are reasons for low number of female donors. Poor management of blood stock during fasting month, long holidays and also poor networking of blood supply are reasons for insufficient blood supply during the year. Considering the great size of Indonesia with different ethnic groups and cultures, worsened by lack of infrastructure, decisive and effective strategies in donor recruitment and retention programs are needed. Copyright 2010 The International Association for Biologicals. Published by Elsevier Ltd. All rights reserved.

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.

From life insurance to safer sex--reflections of a marketing man.

PubMed

Mackay, Bruce

2008-05-01

Much of the writing on health in developing countries focuses on the public sector rather than the private market, and on providers rather than on consumers. A more consumer-oriented perspective would regard the transactions by which most people in most poor countries buy healthcare as the norm, just one among many purchases of a personal service which all of us, as consumers, have to make. This paper contends that asymmetric information is not confined to health and medicine, but is a common problem for consumers whatever the GDP of the country they live in, and however rich and poor they may be. Understanding how consumers overcome these problems yields insights into the ways in which providers have to market their services, and into what, if anything, governments and donors can do to extend, improve or regulate the private healthcare market.

Principlism, medical individualism, and health promotion in resource-poor countries: can autonomy-based bioethics promote social justice and population health?

PubMed Central

2010-01-01

Through its adoption of the biomedical model of disease which promotes medical individualism and its reliance on the individual-based anthropology, mainstream bioethics has predominantly focused on respect for autonomy in the clinical setting and respect for person in the research site, emphasizing self-determination and freedom of choice. However, the emphasis on the individual has often led to moral vacuum, exaggeration of human agency, and a thin (liberal?) conception of justice. Applied to resource-poor countries and communities within developed countries, autonomy-based bioethics fails to address the root causes of diseases and public health crises with which individuals or communities are confronted. A sociological explanation of disease causation is needed to broaden principles of biomedical ethics and provides a renewed understanding of disease, freedom, medical practice, patient-physician relationship, risk and benefit of research and treatment, research priorities, and health policy. PMID:20082703

Principlism, medical individualism, and health promotion in resource-poor countries: can autonomy-based bioethics promote social justice and population health?

PubMed

Azétsop, Jacquineau; Rennie, Stuart

2010-01-18

Through its adoption of the biomedical model of disease which promotes medical individualism and its reliance on the individual-based anthropology, mainstream bioethics has predominantly focused on respect for autonomy in the clinical setting and respect for person in the research site, emphasizing self-determination and freedom of choice. However, the emphasis on the individual has often led to moral vacuum, exaggeration of human agency, and a thin (liberal?) conception of justice. Applied to resource-poor countries and communities within developed countries, autonomy-based bioethics fails to address the root causes of diseases and public health crises with which individuals or communities are confronted. A sociological explanation of disease causation is needed to broaden principles of biomedical ethics and provides a renewed understanding of disease, freedom, medical practice, patient-physician relationship, risk and benefit of research and treatment, research priorities, and health policy.

Rich, poor share stake in poverty, pollution link

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

DeCanio, S.J.

A dirty environment and poverty go together, and this link between environmental protection and economic development is creating a new basis for international cooperation, says Stephen J. DeCanio of the University of California at Santa Barbara. [open quotes]Both developed and developing countries have a stake in solving the development/environment impasse,[close quotes] DeCanio adds. [open quotes]Furthermore, the link between these problems offers a fresh opportunity to make progress on both fronts.[close quotes] He says environmental protection expenditures by developed countries can be used to promote the sustainable economic growth of those countries struggling to escape from poverty. The money could bemore » collected in several ways, he notes: from various types of environmental taxes, such as a carbon tax; from environmental user fees; from [open quotes]debt-for nature[close quotes] swaps; and from tradable emissions permits. Such mechanisms transfer resources to developing countries, where they can be applied to economic development-a desired objective, according to DeCanio. [open quotes]The benefits of equitable worldwide growth and development outweigh any temporary loss of wealth developed countries may experience as a result of environmental transfers,[close quotes] he asserts.« less

An international comparison of women's occupational health issues in the Philippines, Thailand, Malaysia, Canada, Hong Kong and Singapore: the CIDA-SEAGEP study.

PubMed

Choi, Bernard C K

2005-10-01

An international comparison study of women's occupational health issues was carried out in 2000 for the Philippines, Thailand, Malaysia, Canada, Hong Kong and Singapore. The study was funded by the Canadian International Development Agency's Southeast Asia Gender Equity Program. The objective was to compare the issues, risk factors, social determinants, and challenges in women's occupational health, according to the status of economic development as defined by the World Bank. Data were collected through 27 key informant interviews of high-ranking government officials and senior researchers, self-administered questionnaires on country or regional statistics and 16 courtesy calls. Results indicated that women's occupational health problems common in these countries or regions included women's long hours of work (double workday), shift work and a caring role for family and friends. Problems reported in developing countries but not developed countries included poor access to training and protective equipment, and insufficient legislation to protect women's rights. Problems reported in developed countries but not in developing countries included obesity, smoking and not including women in health research. This paper provides insights into the changing environment in the workplace, such as increasing participation of women in the paid workforce and changes in gender differences due to the changing country economy, for improving women's occupational health.

Sustainable urban water systems in rich and poor cities--steps towards a new approach.

PubMed

Newman, P

2001-01-01

The 'big pipes in, big pipes out' approach to urban water management was developed in the 19th century for a particular linear urban form. Large, sprawling car-dependent cities are pushing this approach to new limits in rich cities and it has never worked in poor cities. An alternative which uses new small-scale technology and is more community-based, is suggested for both rich and poor countries. The Sydney Olympics and a demonstration project in Java show that the approach can work.

Country characteristics and acute diarrhea in children from developing nations: a multilevel study.

PubMed

Pinzón-Rondón, Ángela María; Zárate-Ardila, Carol; Hoyos-Martínez, Alfonso; Ruiz-Sternberg, Ángela María; Vélez-van-Meerbeke, Alberto

2015-08-21

Each year 2.5 billion cases of diarrheal disease are reported in children under five years, and over 1,000 die. Country characteristics could play a role on this situation. We explored associations between country characteristics and diarrheal disease in children under 5 years of age, adjusting by child, mother and household attributes in developing countries. This study included 348,706 children from 40 nations. We conducted a multilevel analysis of data from the Demographic and Health Surveys and the World Bank. The prevalence of acute diarrhea was 14 %. Country inequalities (OR = 1.335; 95 % CI 1.117-1.663) and country's low income (OR = 1.488; 95 % CI 1.024-2.163) were associated with diarrhea, and these country characteristics changed the associations of well-known determinants of diarrhea. Specifically, living in poor countries strengthens the association of poor household wealth and mother's lack of education with the disease. Other factors associated with diarrhea were female sex of the child (OR = 0.922; 95 % CI 0.900-0.944), age of the child (OR = 0.978; 95 % CI 0.978-0.979), immunization status (OR = 0.821; 95 % CI 0.799-0.843), normal birthweight (OR = 0.879; 95 % CI 0.834-0.926), maternal age (OR = 0.987; 95 % CI 0.985-0.989), lack of maternal education (OR = 1.416; 95 % CI 1.283-1.564), working status of the mother (OR = 1.136; 95 % CI 1.106-1.167), planned pregnancy (OR = 0.774; 95 % CI 0.753-0.795), a nuclear family structure (OR = 0.949; 95 % CI 0.923-0.975), and household wealth (OR = 0.948; 95 % CI 0.921-0.977). Inequalities and lack of resources at the country level in developing countries -but not health expenditure- were associated with acute diarrhea, independently of child, family and household features. The broad environment considerably modifies well-known social determinants of acute diarrhea and public health campaigns designed to target diarrhea should consider macro characteristics of the country.

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

PubMed Central

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

2006-01-01

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

Confronting Crisis. A Comparative Study of Household Responses to Poverty and Vulnerability in Four Poor Urban Communities. Environmentally Sustainable Development Studies and Monographs Series No. 8.

ERIC Educational Resources Information Center

Moser, Caroline O. N.

This volume presents the main findings of a comparative study of four poor urban communities in countries experiencing economic difficulties during the late 1980s: Chawama (Zambia), Cisne Dos (Ecuador), Commonwealth (the Philippines), and Angyalfold (Hungary). The study extended a longitudinal community panel study begun in Ecuador by using a…

The introduction of new vaccines into developing countries. IV: Global Access Strategies.

PubMed

Mahoney, Richard T; Krattiger, Anatole; Clemens, John D; Curtiss, Roy

2007-05-16

This paper offers a framework for managing a comprehensive Global Access Strategy for new vaccines in developing countries. It is aimed at strengthening the ability of public-sector entities to reach their goals. The Bill and Melinda Gates Foundation and The Rockefeller Foundation have been leaders in stimulating the creation of new organizations - public/private product development partnerships (PDPs) - that seek to accelerate vaccine development and distribution to meet the health needs of the world's poor. Case studies of two of these PDPs - the Salmonella Anti-pneumococcal Vaccine Program and the Pediatric Dengue Vaccine Initiative - examine development of such strategies. Relying on the application of innovation theory, the strategy leads to the identification of six Components of Innovation which cover all aspects of the vaccine innovation process. Appropriately modified, the proposed framework can be applied to the development and introduction of other products in developing countries including drugs, and nutritional and agricultural products.

Transmission of Hepatitis E Virus in Developing Countries

PubMed Central

Khuroo, Mohammad S.; Khuroo, Mehnaaz S.; Khuroo, Naira S.

2016-01-01

Hepatitis E virus (HEV), an RNA virus of the Hepeviridae family, has marked heterogeneity. While all five HEV genotypes can cause human infections, genotypes HEV-1 and -2 infect humans alone, genotypes HEV-3 and -4 primarily infect pigs, boars and deer, and genotype HEV-7 primarily infects dromedaries. The global distribution of HEV has distinct epidemiological patterns based on ecology and socioeconomic factors. In resource-poor countries, disease presents as large-scale waterborne epidemics, and few epidemics have spread through person-to-person contact; however, endemic diseases within these countries can potentially spread through person-to-person contact or fecally contaminated water and foods. Vertical transmission of HEV from infected mother to fetus causes high fetal and perinatal mortality. Other means of transmission, such as zoonotic transmission, can fluctuate depending upon the region and strain of the virus. For instance, zoonotic transmission can sometimes play an insignificant role in human infections, such as in India, where human and pig HEV infections are unrelated. However, recently China and Southeast Asia have experienced a zoonotic spread of HEV-4 from pigs to humans and this has become the dominant mode of transmission of hepatitis E in eastern China. Zoonotic HEV infections in humans occur by eating undercooked pig flesh, raw liver, and sausages; through vocational contact; or via pig slurry, which leads to environmental contamination of agricultural products and seafood. Lastly, blood transfusion-associated HEV infections occur in many countries and screening of donors for HEV RNA is currently under serious consideration. To summarize, HEV genotypes 1 and 2 cause epidemic and endemic diseases in resource poor countries, primarily spreading through contaminated drinking water. HEV genotypes 3 and 4 on the other hand, cause autochthonous infections in developed, and many developing countries, by means of a unique zoonotic food-borne transmission. PMID:27657112

The Professional Development of School Principals

ERIC Educational Resources Information Center

Mathibe, Isaac

2007-01-01

Many schooling systems do not fulfil their mandates because of poor management and leadership. Similarly, the rigidity that one finds in schools does not only stunt schools' capacity to develop, but also leads to schools that are dysfunctional and unproductive. As a result, in countries where there is universal transformation, efficacious…

Solving America's Mathematics Education Problem

ERIC Educational Resources Information Center

Vigdor, Jacob L.

2012-01-01

American students test poorly in mathematics compared to those in other developed--and in some cases, less developed--countries. While we have seen some signs of improved performance in recent years, these improvements are not yet evident among high school students. And the proportion of new college graduates who majored in math-intensive subjects…

Nature and Causes of Locomotor Disabilities in India

ERIC Educational Resources Information Center

Halder, Santoshi; Talukdar, Arindam

2013-01-01

A large proportion of disability around the world is preventable. Levels of disability in many poor countries can be reduced by achieving the international development targets for economic, social and human development. In this paper, the author studied the different contributory and causative factors of locomotor disability, disease states and…

Finding and Then Counting Out-of-School Children

ERIC Educational Resources Information Center

Carr-Hill, Roy

2012-01-01

In developing countries, population estimates and assessments of progress towards the Millennium Development Goals are based increasingly on household surveys. It is not recognised that they are inappropriate for obtaining information about the poorest of the poor. Typically, they omit "by design:" those not in households because they are…

Impact on the world poultry industry of the global shift to biofuels.

PubMed

Aho, P

2007-11-01

The shift to biofuels is a worldwide phenomenon, but the most notable recent development has been the rapid increase in the production of ethanol in the United States. Ethanol production in the United States enjoys a substantial subsidy, tariff protection, and mandated use. The consequence of increasing biofuels production is to raise the cost of feed and food worldwide. Those that suffer from this policy include all consumers of food, most notably the urban poor of developing countries. Those that benefit from the policy are farmers everywhere, including farmers in developing countries.

A balancing act? Work-life balance, health and well-being in European welfare states.

PubMed

Lunau, Thorsten; Bambra, Clare; Eikemo, Terje A; van der Wel, Kjetil A; Dragano, Nico

2014-06-01

Recent analyses have shown that adverse psychosocial working conditions, such as job strain and effort-reward imbalance, vary by country and welfare state regimes. Another work-related factor with potential impact on health is a poor work-life balance. The aims of this study are to determine the association between a poor work-life balance and poor health across a variety of European countries and to explore the variation of work-life balance between European countries. Data from the 2010 European Working Conditions Survey were used with 24,096 employees in 27 European countries. Work-life balance is measured with a question on the fit between working hours and family or social commitments. The WHO-5 well-being index and self-rated general health are used as health indicators. Logistic multilevel models were calculated to assess the association between work-life balance and health indicators and to explore the between-country variation of a poor work-life balance. Employees reporting a poor work-life balance reported more health problems (Poor well-being: OR = 2.06, 95% CI = 1.83-2.31; Poor self-rated health: OR = 2.00, 95% CI = 1.84-2.17). The associations were very similar for men and women. A considerable part of the between-country variation of work-life balance is explained by working hours, working time regulations and welfare state regimes. The best overall work-life balance is reported by Scandinavian men and women. This study provides some evidence on the public health impact of a poor work-life balance and that working time regulations and welfare state characteristics can influence the work-life balance of employees. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Ecology of Freedom: Competitive Tests of the Role of Pathogens, Climate, and Natural Disasters in the Development of Socio-Political Freedom

PubMed Central

Kusano, Kodai; Kemmelmeier, Markus

2018-01-01

Many countries around the world embrace freedom and democracy as part of their political culture. However, culture is at least in part a human response to the ecological challenges that a society faces; hence, it should not be surprising that the degree to which societies regulate the level of individual freedom is related to environmental circumstances. Previous research suggests that levels of societal freedom across countries are systematically related to three types of ecological threats: prevalence of pathogens, climate challenges, and natural disaster threat. Though their incidence overlaps, the literature has not yet provided a competitive test. Drawing upon the ecocultural framework, we tested five rival hypotheses, alternately focused on the above ecological factors and their interactions with economic wealth in explaining country variations in socio-political freedom. Focusing on data from 150 countries, we performed a series of linear mixed-effects regressions predicting freedom in the domains of politics, media, and economy. We found that countries with higher pathogen prevalence were more likely to suppress democracy and media freedom. Economic wealth, however, moderated the effect of pathogen prevalence on economic freedom, with the main effect being only found among wealthy countries, but not among poor countries. In contrast, natural disaster threat predicted political freedom and press freedom only among poor countries, consistent with the idea that disaster threat accompanied by poor resources promote socio-political freedom as a means of increasing collective survival. Throughout our analyses, we found no support for hypotheses based on climatic challenges. In addition, our multilevel approach revealed that country scores for socio-political freedom were highly clustered within world regions, accounting for substantial portions of variance. Overall, the present research offers a nuanced view of the interplay between ecology and wealth in the emergence of socio-political freedom. We discuss new directions in future research considering methodological and theoretical contributions of the present findings.

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.

Occupational asthma in the developing and industrialised world: a review.

PubMed

Jeebhay, M F; Quirce, S

2007-02-01

Occupational asthma is the most common occupational lung disease in industrialised countries, and the second most common occupational lung disease reported after pneumoconioses in developing countries. The median proportion of adult cases of asthma attributable to occupational exposure is between 10% and 15%. The population attributable fraction appears to be similar in industrialised and developing countries characterised by rapid industrialisation (13-15%), but lower in less industrialised developing countries (6%). The high-risk occupations and industries associated with the development of occupational asthma vary depending on the dominant industrial sectors in a particular country. High-risk exposure to cleaning agents and pesticide exposure in developing countries appear to be as important as exposure to isocyanates, cereal flour/grain dust, welding fumes, wood dust and, more recently, hairdressing chemicals, commonly reported in industrialised countries. The reported mean annual incidence of occupational asthma in developing countries is less than 2 per 100 000 population, compared to very high rates of up to 18/100 000 in Scandinavian countries. While occupational asthma remains under-recognised, especially in developing countries, it remains poorly diagnosed and managed and inadequately compensated worldwide. Primary and secondary preventive strategies should be directed at controlling workplace exposures, accompanied by intense educational and managerial improvements. Appropriate treatment remains early removal from exposure to ensure that the worker has no further exposure to the causal agent, with preservation of income. However, up to one third of workers with occupational asthma continue to remain exposed to the causative agent or suffer prolonged work disruption, discrimination and risk of unemployment.

Impact of poor-quality medicines in the 'developing' world.

PubMed

Newton, Paul N; Green, Michael D; Fernández, Facundo M

2010-03-01

Since our ancestors began trading several millennia ago, counterfeit and substandard medicines have been a recurring problem, with history punctuated by crises in the supply of anti-microbials, such as fake cinchona bark in the 1600s and fake quinine in the 1800s. Unfortunately this problem persists, in particular afflicting unsuspecting patients in 'developing' countries. Poor-quality drugs are a vital (but neglected) public health problem. They contribute to a 'crevasse' between the enormous effort in therapeutic research and policy decisions and implementation of good-quality medicines. 2009 Elsevier Ltd. All rights reserved.

Significance of nutrition in pulmonary tuberculosis.

PubMed

Kant, Surya; Gupta, Harshita; Ahluwalia, Savita

2015-01-01

Malnutrition and tuberculosis are both problems mostly of the developing countries. Tuberculosis can lead to malnutrition and malnutrition may predispose to tuberculosis. Poor nutrition leads to protein-energy malnutrition and micronutrients deficiencies which lead to immunodeficiency. This secondary immunodeficiency increases the host's susceptibility to infection and hence increase the risk for developing tuberculosis. Tuberculosis itself leads to reduction in appetite, nutrient malabsorption, micronutrient malabsorption, and altered metabolism leading to wasting and poor nutritional status. Nutritional status and dietary intake and hence nutritional status of patients get improved during antituberculosis treatment.

Water resources management. World Bank policy study; Ordenacion de los recursos hidricos

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

NONE

1994-12-31

This study examines new World Bank policies that deal with scarce water resources in developing countries. The study describes key policy goals that each country program should adopt. Practical ways to modernize irrigation techniques and hydropower systems, to protect ecosystems, minimize resettlement, and maintain biodiversity are outlined. Low-cost methods of providing drinking water for the rural poor and water for industry and agriculture are recommended.

JPRS Report, Near East & South Asia.

DTIC Science & Technology

1992-03-20

that human rural development further leads to rapid urbanisation beings’ basis of sustenance is not only economical but and that urbanisation is...pursued by the ’ urbanisation , traditionally seen as an evil, is responsible capitalist countries if the Plan has a genuine concern for for economic growth...plan that urbanisation can be cially in poor countries. There are no major gains with checked through various policies of the government. It is the

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.

Moral imperialism and multi-centric clinical trials in peripheral countries.

PubMed

Garrafa, Volnei; Lorenzo, Claudio

2008-10-01

Moral imperialism is expressed in attempts to impose moral standards from one particular culture, geopolitical region or culture onto other cultures, regions or countries. Examples of Direct Moral Imperialism can be seen in various recurrent events involving multi-centric clinical trials promoted by developed (central) countries in poor and developing (peripheral) countries, particularly projects related to the theory of double standards in research. After the WMA General Assembly refused to change the Helsinki Declaration - which would have given moral recognition to the above mentioned theory - the USA abandoned the declaration and began to promote regional seminars in peripheral countries with the aim of "training" researchers on ethical perspectives that reflect America's best interests. Individuals who received such training became transmitters of these central countries' ideas across the peripheral countries, representing a form of Indirect Moral Imperialism. The paper proposes the establishment of regulatory and social control systems for clinical trials implemented in peripheral countries, through the formulation of ethical norms that reflect the specific contexts of these countries, along with the drawing up and validation of their own national norms.

Coverage and timing of antenatal care among poor women in 6 Mesoamerican countries.

PubMed

Dansereau, Emily; McNellan, Claire R; Gagnier, Marielle C; Desai, Sima S; Haakenstad, Annie; Johanns, Casey K; Palmisano, Erin B; Ríos-Zertuche, Diego; Schaefer, Alexandra; Zúñiga-Brenes, Paola; Hernandez, Bernardo; Iriarte, Emma; Mokdad, Ali H

2016-08-19

Poor women in the developing world have a heightened need for antenatal care (ANC) but are often the least likely to attend it. This study examines factors associated with the number and timing of ANC visits for poor women in Guatemala, Honduras, Mexico, Nicaragua, Panama, and El Salvador. We surveyed 8366 women regarding the ANC they attended for their most recent birth in the past two years. We conducted logistic regressions to examine demographic, household, and health characteristics associated with attending at least one skilled ANC visit, four skilled visits, and a skilled visit in the first trimester. Across countries, 78 % of women attended at least one skilled ANC visit, 62 % attended at least four skilled visits, and 56 % attended a skilled visit in the first trimester. The proportion of women attending four skilled visits was highest in Nicaragua (81 %) and lowest in Guatemala (18 %) and Panama (38 %). In multiple countries, women who were unmarried, less-educated, adolescent, indigenous, had not wanted to conceive, and lacked media exposure were less likely to meet international ANC guidelines. In countries with health insurance programs, coverage was associated with attending skilled ANC, but not the timeliness. Despite significant policy reforms and initiatives targeting the poor, many women living in the poorest regions of Mesoamérica are not meeting ANC guidelines. Both supply and demand interventions are needed to prioritize vulnerable groups, reduce unplanned pregnancies, and reach populations not exposed to common forms of media. Top performing municipalities can inform effective practices across the region.

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.

Policy directions in urban health in developing countries--the slum improvement approach.

PubMed

Harpham, T; Stephens, C

1992-07-01

The urban development, or housing, sector has a longer experience of addressing the problems of the urban poor in developing countries than the health sector. In recent years the policy of 'slum improvement', which involves both sectors, has attracted the support of international donors. This article documents the development of the slum improvement approach and addresses key issues of the approach which have implications for health planning: covering the poorest dwellers; relocation; land tenure; gentrification; debt burdens and the impact on women. Questions about the approach which still need answering are defined and a summary of the constraints in slum improvement and potential solutions is presented.

Population: fiction and fact.

PubMed

1979-09-01

This article was written to refute some common misunderstandings regarding worldwide population levels and worldwide nutrition levels. The world food supply is able to keep pace with high population growth levels. Worl food production currently meets world need; the problem is a distribution system which allocates food only to those who can pay rather than to those who need it. In many developing countries, the best agricultural lands are reserved for commercial crops rather than for subsistence crops. The U.S. food aid program does not help the most needy nations generally. The rate of world population growth is already slowing down. The desire for large families in developing countries is very often a realistic reaction to the prevailing economic system. Family planning programs will succeed. They will succeed even better in countries where general development planning is undertaken concurrently with family planning. Environmental problems are attributable to the consumption explosion in the rich countries rather than to the population explosion in the poor countries.

The effect of illicit financial flows on time to reach the fourth Millennium Development Goal in Sub-Saharan Africa: a quantitative analysis.

PubMed

O'Hare, Bernadette; Makuta, Innocent; Bar-Zeev, Naor; Chiwaula, Levison; Cobham, Alex

2014-04-01

This paper sets out to estimate the cost of illicit financial flows (IFF) in terms of the amount of time it could take to reach the fourth Millennium Development Goal (MDG) in 34 African countries. We have calculated the percentage increase in gross domestic product (GDP) if IFFs were curtailed using IFF/GDP ratios. We applied the income (GDP) elasticity of child mortality to the increase in GDP to estimate the reduction in time to reach the fourth MDG in 34 African countries. children aged under five years. 34 countries in SSA. Reduction in time to reach the first indicator of the fourth MDG, under-five mortality rate in the absence of IFF. We found that in the 34 SSA countries, six countries will achieve their fourth MDG target at the current rates of decline. In the absence of IFF, 16 countries would reach their fourth MDG target by 2015 and there would be large reductions for all other countries. This drain on development is facilitated by financial secrecy in other jurisdictions. Rich and poor countries alike must stem the haemorrhage of IFF by taking decisive steps towards improving financial transparency.

Cognitive Development among Young Children in Ecuador: The Roles of Wealth, Health, and Parenting

ERIC Educational Resources Information Center

Paxson, Christina; Schady, Norbert

2007-01-01

We examine the relationship between early cognitive development, socioeconomic status (SES), child health, and parenting quality in a developing country. We use a sample of more than 3,000 predominantly poor preschool-aged children from Ecuador, and analyze determinants of their scores on a widely used test of language ability. We find that…

Recruiting medical students into psychiatry in lower income countries.

PubMed

Nortje, Gareth; Seedat, Soraya

2013-08-01

There is a serious shortage of psychiatrists and poor recruitment of new psychiatry trainees worldwide. Low and middle income countries suffer disproportionately on many accounts. A negative attitude towards psychiatry is thought to contribute to poor recruitment of psychiatry trainees. Previous reviews have focused on the attitudes of medical students in high income countries, but factors relevant to attitude and recruitment may be different in lower income countries. Here we review studies of medical students' attitudes towards psychiatry from low and lower-middle income countries, summarize key themes which negatively influence attitudes, and suggest strategies for overcoming them. Major themes include stigma, perceived status of psychiatry, lack of psychiatric trainers, local cultural beliefs, poor working conditions, and quality of patient care.

Why restrictions on the immigration of health workers are unjust.

PubMed

Hidalgo, Javier

2014-12-01

Some bioethicists and political philosophers argue that rich states should restrict the immigration of health workers from poor countries in order to prevent harm to people in these countries. In this essay, I argue that restrictions on the immigration of health workers are unjust, even if this immigration results in bad health outcomes for people in poor countries. I contend that negative duties to refrain from interfering with the occupational liberties of health workers outweighs rich states' positive duties to prevent harm to people in sending countries. Furthermore, I defend this claim against the objection that health workers in poor countries acquire special duties to their compatriots that render them liable to coercive interference. © 2012 John Wiley & Sons Ltd.

Combining instrumental and contextual approaches: nanotechnology and sustainable development.

PubMed

Liao, Nina

2009-01-01

Billions of people live in poverty, with no access to safe drinking water or solutions for other critical health and medical needs. Nanotechnology is poised to create workable solutions for large-scale public health needs in developing countries, including improving water quality and providing life-saving pharmaceuticals. There are two views on how emerging technologies such as nanotechnology can influence and affect developing countries. Instrumentalists believe that the international community can transfer nanotechnology from one context to another and use it to assist the poor. Contextualists warn that nanotechnology can increase inequality in underdeveloped regions. Because of inadequacies in both positions, the international community must adopt a mixed strategy. This article argues that this mixed strategy should target the bottom of the pyramid, develop native capability, implement emergency protocols in projects, create accountability, and engage the public. Managed well, this strategy can propel developing countries toward sustainable development.

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

PubMed

Mohsen Ibrahim, M

2018-05-01

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

Tuberculosis in the tropics.

PubMed

Krause, V L; Britton, W J

1993-09-20

Until recently tuberculosis was considered a well controlled disease, at least in developed countries. In developing countries, more than seven million people are affected by active tuberculosis. This situation is exacerbated by poor infrastructure to support tuberculosis control measures and the interaction between tuberculosis and infection with the human immunodeficiency virus. The three major strategies for controlling tuberculosis remain BCG vaccination in children, appropriate preventive therapy and, most importantly, reducing the sources of infection through case finding and curative treatment. Research and resources to improve on these strategies should be given high priority by the international health community.

The fight against tobacco in developing countries.

PubMed

Mackay, J L

1994-02-01

The battle to reduce the tobacco epidemic is not being won; the epidemic is merely being transferred from rich to poor countries. Tobacco-related mortality will rise from the present annual global toll of 3 million to over 10 million by the year 2025. Currently, most of these deaths are in developed countries but 7 out of the 10 million deaths will occur in developing countries by 2025. Developing countries cannot afford this increase, either in terms of human health or in economic costs, such as medical and health care costs, costs of lost productivity, costs of fires or costs of the misuse of land used to grow tobacco. As many of the tobacco-related illnesses, such as lung cancer or emphysema, are incurable even with expensive technology, the key to tobacco control lies in prevention. The essential elements of a national tobacco control policy are the same for all countries throughout the world--the only differences lie in fine tuning to a country's current situation. While indigenous production and consumption of tobacco remain a problem, of particular concern is the penetration of developing countries by the transnational tobacco companies, with aggressive promotional campaigns and the use of political and commercial pressures to open up markets and to promote foreign cigarettes. This includes specific targeting of women, few of whom currently smoke in developing countries. Also, tobacco advertising revenue prevents the media from reporting on the hazards of tobacco, a particularly serious problem in developing countries where awareness of the harmfulness of tobacco is low.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluating the Relative Environmental Impact of Countries

PubMed Central

Bradshaw, Corey J. A.; Giam, Xingli; Sodhi, Navjot S.

2010-01-01

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. PMID:20454670

Health research in the developing world: a gastroenterological view from Bangladesh.

PubMed

Hamilton, J R

1997-01-01

Ill health is a serious impediment to progress in most poor countries, yet health is not a high priority on foreign aid agendas. Health research, which provides the essential base for sustainable progressive health programs, is barely visible in developing countries. For example, in Bangladesh, one finds unacceptably high morbidity and mortality rates among infants and children, health programs that are struggling and a rudimentary health research establishment; for the huge foreign donor community in that country, health programs and research do not appear to warrant major investments. Diarrheal diseases are at the top of the list of killers in many poor nations including Bangladesh. Recent advances in our understanding of diarrhea suggest that when prevention may not be possible soon, improved active treatment can evolve from an aggressive research effort centered in a developing country and linked to appropriate international partners. Global agencies such as the World Health Organization have demonstrated a declining interest in health research, as reflected in the policies of their Diarrhoeal Disease Control Programme. Major donors to the developing world, the Canadian International Development Agency for example, have had a relatively minor involvement in health and little commitment to health research. University links with the west, private enterprises and specially targeted programs are involved in developing world health research but they have not been able to foster and leave behind sustainable, high quality research programs. The problem should be attacked directly by supporting focused, relevant health research centres in regions of the world where the burden of disease continues to impede progress and where the environment is conducive to high quality research that is well integrated with care delivery programs. An instructive model of this approach is the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh.

Country Immunization Information System Assessments - Kenya, 2015 and Ghana, 2016.

PubMed

Scott, Colleen; Clarke, Kristie E N; Grevendonk, Jan; Dolan, Samantha B; Ahmed, Hussein Osman; Kamau, Peter; Ademba, Peter Aswani; Osadebe, Lynda; Bonsu, George; Opare, Joseph; Diamenu, Stanley; Amenuvegbe, Gregory; Quaye, Pamela; Osei-Sarpong, Fred; Abotsi, Francis; Ankrah, Joseph Dwomor; MacNeil, Adam

2017-11-10

The collection, analysis, and use of data to measure and improve immunization program performance are priorities for the World Health Organization (WHO), global partners, and national immunization programs (NIPs). High quality data are essential for evidence-based decision-making to support successful NIPs. Consistent recording and reporting practices, optimal access to and use of health information systems, and rigorous interpretation and use of data for decision-making are characteristics of high-quality immunization information systems. In 2015 and 2016, immunization information system assessments (IISAs) were conducted in Kenya and Ghana using a new WHO and CDC assessment methodology designed to identify root causes of immunization data quality problems and facilitate development of plans for improvement. Data quality challenges common to both countries included low confidence in facility-level target population data (Kenya = 50%, Ghana = 53%) and poor data concordance between child registers and facility tally sheets (Kenya = 0%, Ghana = 3%). In Kenya, systemic challenges included limited supportive supervision and lack of resources to access electronic reporting systems; in Ghana, challenges included a poorly defined subdistrict administrative level. Data quality improvement plans (DQIPs) based on assessment findings are being implemented in both countries. IISAs can help countries identify and address root causes of poor immunization data to provide a stronger evidence base for future investments in immunization programs.

Solar disinfection of infectious biomedical waste: a new approach for developing countries.

PubMed

Chitnis, V; Chitnis, S; Patil, S; Chitnis, D

2003-10-18

Poor developing countries cannot afford expensive technologies such as incineration for management of infectious biomedical waste. We assessed solar heating as an alternative technology. We immersed simulated infectious waste with added challenge bacteria in water in a box-type solar cooker, which was left in the sun for 6 h. In 24 sets of observations, the amount of viable bacteria was reduced by about 7 log. We also tested infectious medical waste with a heavy load of bacteria (10(8)-10(9)/g) from our hospital's burn unit for solar heat disinfection in 20 experiments. Our results showed a similar 7 log reduction in the amount of viable bacteria. Solar heating thus seems to be a cheap method to disinfect infectious medical waste in less economically developed countries.

Energy access and living standards: some observations on recent trends

NASA Astrophysics Data System (ADS)

Rao, Narasimha D.; Pachauri, Shonali

2017-02-01

A subset of Sustainable Development Goals pertains to improving people’s living standards at home. These include the provision of access to electricity, clean cooking energy, improved water and sanitation. We examine historical progress in energy access in relation to other living standards. We assess regional patterns in the pace of progress and relative priority accorded to these different services. Countries in sub-Saharan Africa would have to undergo unprecedented rates of improvement in energy access in order to achieve the goal of universal electrification by 2030. World over, access to clean cooking fuels and sanitation facilities consistently lag improved water and electricity access by a large margin. These two deprivations are more concentrated among poor countries, and poor people in middle income countries. They are also correlated to health risks faced disproportionately by women. However, some Asian countries have been able to achieve faster progress in electrification at lower income levels compared to industrialized countries’ earlier efforts. These examples offer hope that future efforts need not be constrained by historical rates of progress.

Initial assessment of strategic plans for improving the performance of veterinary services in developing countries: a review of OIE PVS gap analysis reports.

PubMed

Weaver, J; Leon, E; Edan, M; D'Alessio, F

2012-08-01

The World Organisation for Animal Health (OIE) carries out Gap Analysis missions (if a country so wishes) as part of its programme to assess and improve the Performance of Veterinary Services (the 'PVS Pathway') in Member Countries. These Gap Analysis missions have found that many national Veterinary Services comply to only a limited extent with the international standards established by the OIE and that their competence is compromised by poor governance. This failure threatens animal and public health not only nationally but also internationally. The OIE PVS Gap Analysis reports reviewed found that all the Veterinary Services have a strong vision and commitmentto improvement but are held back by a weak chain of command, inadequate and outdated legislation, insufficient funding, weak technical competencies, compromised technical independence, poor communications and limited joint programmes. There are weaknesses across all the core technical areas of trade, animal health, veterinary public health and veterinary laboratories and also in the overall management of the Veterinary Services. The OIE PVS Gap Analysis missions recommend significant increases in budget in all countries.

To Assess Sleep Quality among Pakistani Junior Physicians (House Officers): A Cross-sectional Study.

PubMed

Surani, A A; Surani, A; Zahid, S; Ali, S; Farhan, R; Surani, S

2015-01-01

Sleep deprivation among junior physicians (house officers) is of growing concern. In developed countries, duty hours are now mandated, but in developing countries, junior physicians are highly susceptible to develop sleep impairment due to long working hours, on-call duties and shift work schedule. We undertook the study to assess sleep quality among Pakistani junior physicians. A cross-sectional study was conducted at private and public hospitals in Karachi, Pakistan, from June 2012 to January 2013. The study population comprised of junior doctors (house physicians and house surgeons). A consecutive sample of 350 physicians was drawn from the above-mentioned study setting. The subject underwent two validated self-administered questionnaires, that is, Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). A total of 334 physicians completely filled out the questionnaire with a response rate of 95.4% (334/350). Of 334 physicians, 36.8% (123/334) were classified as "poor sleepers" (global PSQI score > 5). Poor sleep quality was associated with female gender (P = 0.01), excessive daytime sleepiness (P < 0.01), lower total sleep time (P < 0.001), increased sleep onset latency (P < 0.001), and increased frequency of sleep disturbances (P < 0.001). Abnormal ESS scores (ESS > 10) were more prevalent among poor sleepers (P < 0.01) signifying increased level of daytime hypersomnolence. Sleep quality among Pakistani junior physicians is significantly poor. Efforts must be directed towards proper sleep hygiene education. Regulations regarding duty hour limitations need to be considered.

Are urban children really healthier? Evidence from 47 developing countries.

PubMed

Van de Poel, Ellen; O'Donnell, Owen; Van Doorslaer, Eddy

2007-11-01

On average, child health outcomes are better in urban than in rural areas of developing countries. Understanding the nature and the causes of this rural-urban disparity is essential in contemplating the health consequences of the rapid urbanization taking place throughout the developing world and in targeting resources appropriately to raise population health. Using micro-data on child health taken from the most recent Demographic and Health Surveys for 47 developing countries, the purpose of this paper is threefold. First, we document the magnitude of rural-urban disparities in child nutritional status and under-5 mortality across all 47 developing countries. Second, we adjust these disparities for differences in population characteristics across urban and rural settings. Third, we examine rural-urban differences in the degree of socioeconomic inequality in these health outcomes. The results demonstrate that there are considerable rural-urban differences in mean child health outcomes in the entire developing world. The rural-urban gap in stunting does not entirely mirror the gap in under-5 mortality. The most striking difference between the two is in the Latin American and Caribbean region, where the gap in growth stunting is more than 1.5 times higher than that in mortality. On average, the rural-urban risk ratios of stunting and under-5 mortality fall by, respectively, 53% and 59% after controlling for household wealth. Controlling thereafter for socio-demographic factors reduces the risk ratios by another 22% and 25%. We confirm earlier findings of higher socioeconomic inequality in stunting in urban areas and demonstrate that this also holds for under-5 mortality. In a considerable number of countries, the urban poor actually have higher rates of stunting and mortality than their rural counterparts. The findings imply that there is a need for programs that target the urban poor, and that this is becoming more necessary as the size of the urban population grows.

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

PubMed Central

Toycan, Mehmet

2018-01-01

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

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

PubMed

Zayyad, Musa Ahmed; Toycan, Mehmet

2018-01-01

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

Contributions of Alternative (Nonformal) Education in Developing Countries.

ERIC Educational Resources Information Center

Koech, Michael Kipkorir

An analysis of two alternative (nonformal) rural education projects provides data on Rural Craft Training Centers (RCTC's) in Kenya and the Sarvodaya Shramadana Movement (SSM) in Sri Lanka. The RCTC objective is to design pilot rural development strategies for expanding income in selected poor; the SSM objective is to build a "righteous…

Eliciting health care priorities in developing countries: experimental evidence from Guatemala.

PubMed

Font, Joan Costa; Forns, Joan Rovira; Sato, Azusa

2016-02-01

Although some methods for eliciting preferences to assist participatory priority setting in health care in developed countries are available, the same is not true for poor communities in developing countries whose preferences are neglected in health policy making. Existing methods grounded on self-interested, monetary valuations that may be inappropriate for developing country settings where community care is provided through 'social allocation' mechanisms. This paper proposes and examines an alternative methodology for eliciting preferences for health care programmes specifically catered for rural and less literate populations but which is still applicable in urban communities. Specifically, the method simulates a realistic collective budget allocation experiment, to be implemented in both rural and urban communities in Guatemala. We report evidence revealing that participatory budget-like experiments are incentive compatible mechanisms suitable for revealing collective preferences, while simultaneously having the advantage of involving communities in health care reform processes. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Gender, Socioeconomic Status, and Self-Rated Health in a Transitional Middle-Income Setting: Evidence From Thailand

PubMed Central

Seubsman, Sam-ang; Kelly, Matthew James; Yiengprugsawan, Vasoontara; Sleigh, Adrian C.

2011-01-01

Poor self-rated health (SRH) correlates strongly with mortality. In developed countries, women generally report worse SRH than males. Few studies have reported on SRH in developing countries. The authors report on SRH in Thailand, a middle-income developing country. The data were derived from a large nationwide cohort of 87 134 adult Open University students (54% female, median age 29 years). The authors included questions on socioeconomic and demographic factors that could influence SRH. The Thai cohort in this study mirrors patterns found in developed countries, with females reporting more frequent “poor” or “very poor” SRH (odds ratio = 1.35; 95% confidence interval = 1.26-1.44). Cohort males had better SRH than females, but levels were more sensitive to socioeconomic status. Income and education had little influence on SRH for females. Among educated Thai adults, females rate their health to be worse than males, and unlike males, this perception is relatively unaffected by socioeconomic status. PMID:20460290

The associations between unhealthy behaviours, mental stress, and low socio-economic status in an international comparison of representative samples from Thailand and England

PubMed Central

2014-01-01

Background Socioeconomic status is a recognised determinant of health status, and the association may be mediated by unhealthy behaviours and psychosocial adversities, which, in developed countries, both aggregate in low socioeconomic sectors of the population. We explored the hypothesis that unhealthy behavioural choices and psychological distress do not both aggregate in low socioeconomic status groups in developing countries. Methods Our study is based on a cross-sectional comparison between national population samples of adults in England and Thailand. Psychological distress was assessed using the General Health Questionnaire (GHQ-12) or three anxiety-oriented items from the Kessler scale (K6). Socioeconomic status was assessed on the basis of occupational status. We computed a health-behaviour score using information about smoking, alcohol consumption, fruit and vegetable consumption, and physical activity. Results The final sample comprised 40,679 participants. In both countries and in both genders separately, there was a positive association between poor health-behaviour and high psychological distress, and between high psychological distress and low socioeconomic status. In contrast, the association between low socioeconomic status and poor health-behaviour was positive in both English men and women, flat in Thai men, and was negative in Thai women (likelihood ratio test P <0.001). Conclusion The associations between socioeconomic status, behavioural choices, and psychological distress are different at the international level. Psychological distress may be consistently associated with low socioeconomic status, whereas poor health-behaviour is not. Future analyses will test whether psychological distress is a more consistent determinant of socioeconomic differences in health across countries. PMID:24555674

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

PubMed Central

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

2014-01-01

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

Mobile phone text messaging to improve knowledge and practice of diabetic foot care in a developing country: Feasibility and outcomes.

PubMed

Hassan, Zeinab M

2017-06-01

To test the feasibility and effectiveness of using mobile phone text messaging to reinforce learning and the practice of diabetic foot care in a developing country. Ongoing learning reinforcement (2-3 times weekly) by text messaging followed an informal class on diabetic foot care in a community clinic setting. Subjects with cell phone access and no history of diabetic foot wounds or current wounds were recruited for participation (N = 225). Foot examinations and pretesting by survey occurred just before patients departed the clinic; the posttest survey and a final foot examination occurred 12 weeks later. The survey included basic demographic items along with items to measure knowledge and current foot care practices. One sample t tests (raw scores) and Wilcoxon signed-rank tests compared knowledge and practice before and after intervention. Initially, a majority of the sample (76%) reported poor levels of foot care. After 12 weeks <1% reported poor foot care practices. Statistical testing showed significant gains in knowledge (by score and level) and nearly unanimous compliance with daily foot examination. Mobile phone text messaging is an economical, feasible, and effective method for educators to improve diabetic self-care, even in a developing country. © 2017 John Wiley & Sons Australia, Ltd.

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

PubMed

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

2016-08-01

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

Psychological interventions for post-traumatic stress disorder in people living with HIV in Resource poor settings: a systematic review.

PubMed

Verhey, Ruth; Chibanda, Dixon; Brakarsh, Jonathan; Seedat, Soraya

2016-10-01

Post-traumatic stress disorder is pervasive in low- and middle-income countries. There is evidence to suggest that post-traumatic stress disorder is more common among people living with HIV than non-infected matched controls. We carried out a systematic review of interventions for adult post-traumatic stress disorder from resource poor settings with a focus on people living with HIV. We included all studies that investigated interventions for adult post-traumatic stress disorder from resource poor settings with a focus on interventions that were either randomised controlled trials or observational cohort studies carried out from 1980 to May 2015. Of the 25 articles that were identified for full review, two independent reviewers identified seven studies that met our study inclusion criteria. All randomised controlled trials (RCT) (n = 6) used cognitive behavioural therapy-based interventions and focused on people living with HIV in resource poor settings. There was only one study focusing on the use of lay counsellors to address post-traumatic stress disorder but core competencies were not described. There were no intervention studies from Africa, only an observational cohort study from Rwanda. Rigorously evaluated interventions for adult post-traumatic stress disorder in people living with HIV are rare. Most were undertaken in resource poor settings located in high-income countries. There is a need for research on the development and implementation of appropriate interventions for post-traumatic stress disorder in people living with HIV in low- and middle-income countries. © 2016 John Wiley & Sons Ltd.

Social solidarity and willingness to tolerate risk- and income-related cross-subsidies within health insurance: experiences from Ghana, Tanzania and South Africa.

PubMed

Goudge, Jane; Akazili, James; Ataguba, John; Kuwawenaruwa, August; Borghi, Josephine; Harris, Bronwyn; Mills, Anne

2012-03-01

The importance of ill-health in perpetuating poverty is well recognized. In order to prevent the damaging downward spiral of poverty and illness, there is a need for a greater level of social protection, with greater cross-subsidization between the poor and wealthy, and the healthy and those with ill-health. The aim of this paper is to examine individual preferences for willingness to pre-pay for health care and willingness to cross-subsidize the sick and the poor in Ghana, South Africa and Tanzania. Household surveys in the three countries elicited views on cross-subsidization within health care financing. The paper examines how these preferences varied by socio-economic status, other respondent characteristics, and the extent and type of experience of health insurance in the light of country context. In South Africa and Ghana, 62% and 55% of total respondents, respectively, were in favour of a progressive financing system in which richer groups would pay a higher proportion of income than poorer groups, rather than a system where individuals pay the same proportion of income irrespective of their wealth (proportional). In Tanzania, 45% of the total sample were willing to pay for the health care of the poor. However, in all three countries, a progressive system was favoured by a smaller proportion of the most well off than of less well off groups. Solidarity has been considered to be a collective property of a specific socio-political culture, based on shared expectations and developed as part of a communal, historical learning process. The three countries had different experiences of health insurance and this may have contributed to the above differences in expressed willingness to pay between countries. Building and 'living with' institutions that provide affordable universal coverage is likely to be an essential part of the learning process which supports the development of social solidarity.

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

PubMed

Fajans, Peter; Simmons, Ruth; Ghiron, Laura

2006-03-01

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

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

PubMed

Perry, Lora; Malkin, Robert

2011-07-01

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

Interrelationship between growth and development in low and middle income countries.

PubMed

Martorell, Reynaldo; Nguyen, Phuong

2010-01-01

Early childhood growth failure is a significant public health problem in developing countries. We examine relationships between low birthweight and stunting with child development. Compared to children born with normal birthweight, low birth-weight children have substantially poorer cognitive and schooling outcomes later in life. Linear growth failure leading to stunting mostly occurs before age 2 years, with stunting in older children reflecting growth failure in early life. Many studies show that stunting is associated with poor mental and motor development in infants and with low scores in cognitive tests, increased frequency of behavioral problems and poor school achievement in older children. Very few studies have assessed the relative importance for development of prenatal vs. postnatal growth failure and even fewer have done so using appropriate statistical techniques. The limited evidence to date suggests growth during the first 2 years of life is more important than growth at any other time, including the prenatal period, for predicting later cognitive development, schooling and educational achievement. In conclusion, children in settings of poverty who experience growth failure prior to age 2 years have reduced potential to succeed in school and to be productive members of society. Copyright (c) 2010 S. Karger AG, Basel.

Safer Muslim motherhood: Social conditions and maternal mortality in the Muslim world.

PubMed

Liese, Kylea Laina; Maeder, Angela B

2018-05-01

The greatest variation in maternal mortality is among poor countries and wealthy countries that rely on emergency obstetric technology to save a woman's life during childbirth. However, substantial variation in maternal mortality ratios (MMRs) exists within and among poor countries with uneven access to advanced obstetric services. This article examines MMRs across the Muslim world and compares the impact of national wealth, female education, and skilled birth attendants on maternal mortality. Understanding how poor countries have lowered MMRs without access to expensive obstetric technologies suggests that certain social variables may act protectively to reduce the maternal risk for life-threatening obstetric complications that would require emergency obstetric care.

Resource-poor settings: response, recovery, and research: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

PubMed

Geiling, James; Burkle, Frederick M; West, T Eoin; Uyeki, Timothy M; Amundson, Dennis; Dominguez-Cherit, Guillermo; Gomersall, Charles D; Lim, Matthew L; Luyckx, Valerie; Sarani, Babak; Christian, Michael D; Devereaux, Asha V; Dichter, Jeffrey R; Kissoon, Niranjan

2014-10-01

Planning for mass critical care in resource-poor and constrained settings has been largely ignored, despite large, densely crowded populations who are prone to suffer disproportionately from natural disasters. As a result, disaster response has been suboptimal and in many instances hampered by lack of planning, education and training, information, and communication. The Resource-Poor Settings panel developed five key question domains; defining the term resource poor and using the traditional phases of the disaster cycle (mitigation/preparedness/response/recovery). Literature searches were conducted to identify evidence to answer the key questions in these areas. Given a lack of data on which to develop evidence-based recommendations, expert-opinion suggestions were developed, and consensus was achieved using a modified Delphi process. The five key questions were as follows: definition, capacity building and mitigation, what resources can we bring to bear to assist/surge, response, and reconstitution and recovery of host nation critical care capabilities. Addressing these led the panel to offer 33 suggestions. Because of the large number of suggestions, the results have been separated into two sections: part I, Infrastructure/Capacity in the accompanying article, and part II, Response/Recovery/Research in this article. A lack of rudimentary ICU resources and capacity to enhance services plagues resource-poor or constrained settings. Capacity building therefore entails preventative strategies and strengthening of primary health services. Assistance from other countries and organizations is often needed to mount a surge response. Moreover, the disengagement of these responding groups and host country recovery require active planning. Future improvements in all phases require active research activities.

Micronutrient status and intervention programs in Malaysia.

PubMed

Khor, Geok Lin

2005-06-01

Approximately 70% of the world's malnourished children live in Asia, giving that region the highest concentration of childhood malnutrition worldwide. Prevalence of stunting and underweight are high especially in south Asia where one in every two preschool children is stunted. Iron-deficiency anemia affects 40%-50% of preschool and primary schoolchildren. Nearly half of all vitamin A deficiency and xerophthalmia in the world occurs in south and southeast Asia. Iodine deficiency disorders have resulted in high goiter rates in India, Pakistan, and parts of Indonesia. Compared with other developing countries in Asia, the nutrition situation in Malaysia is considerably better, owing to rapid economic and socioeconomic development that has occurred since Malaysia gained its independence in 1957. Prevalence of undernutrition and micronutrient deficiency is markedly lower in Malaysian children. Nonetheless, undernutrition in the form of underweight, stunting, and anemia can be found in poor communities throughout the country. A prevalence of 25% underweight and 35% stunting is reported among young children from poor rural households. Anemia and subclinical forms of vitamin A deficiency were reported in children under 5 years old. Typical of a country in nutrition transition, Malaysia faces the dual burden of malnutrition in children, with the persistence of under-nutrition problems especially among the poor and the emerging overweight problem especially in urban areas. Since 1996, nutrition programs of the government sector are coordinated under the National Plan of Action for Nutrition. These activities and other nutrition intervention efforts by other agencies are discussed in this paper.

Hospital waste management in developing countries: A mini review.

PubMed

Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz; Geng, Yong

2017-06-01

Health care activities can generate different kinds of hazardous wastes. Mismanagement of these wastes can result in environmental and occupational health risks. Developing countries are resource-constrained when it comes to safe management of hospital wastes. This study summarizes the main issues faced in hospital waste management in developing countries. A review of the existing literature suggests that regulations and legislations focusing on hospital waste management are recent accomplishments in many of these countries. Implementation of these rules varies from one hospital to another. Moreover, wide variations exist in waste generation rates within as well as across these countries. This is mainly attributable to a lack of an agreement on the definitions and the methodology among the researchers to measure such wastes. Furthermore, hospitals in these countries suffer from poor waste segregation, collection, storage, transportation and disposal practices, which can lead to occupational and environmental risks. Knowledge and awareness regarding proper waste management remain low in the absence of training for hospital staff. Moreover, hospital sanitary workers, and scavengers, operate without the provision of safety equipment or immunization. Unsegregated waste is illegally recycled, leading to further safety risks. Overall, hospital waste management in developing countries faces several challenges. Sustainable waste management practices can go a long way in reducing the harmful effects of hospital wastes.

Psychosocial working conditions and psychological well-being among employees in 34 European countries.

PubMed

Schütte, Stefanie; Chastang, Jean-François; Malard, Lucile; Parent-Thirion, Agnès; Vermeylen, Greet; Niedhammer, Isabelle

2014-11-01

The aim of this study was to explore the associations between psychosocial working conditions and psychological well-being among employees in 34 European countries. Another objective was to examine whether these associations varied according to occupation and country. The study was based on data from the European Working Conditions Survey 2010 including 33,443 employees, 16,512 men and 16,931 women, from 34 European countries. Well-being was measured by the WHO-5 well-being index. Twenty-five psychosocial work factors were constructed including job demands, role stressors, work hours, job influence and freedom, job promotion, job insecurity, social support, quality of leadership, discrimination and violence at work, and work-life imbalance. The associations between these factors and well-being were examined using multilevel logistic regression analyses. Different models were performed including interaction tests. When all 25 psychosocial work factors were studied simultaneously in the same model with adjustment variables, 13 showed a significant association with poor well-being among both genders: quantitative demands, demands for hiding emotions, low possibilities for development, low meaning of work, low role conflict, low quality of leadership, low social support, low sense of community, job insecurity, low job promotion, work-life imbalance, discrimination, and bullying. The association with low sense of community on poor well-being was particularly strong. A large number of psychosocial work factors were associated with poor well-being. Almost no country and occupational differences were found in these associations. This study gave a first European overview and could be useful to inform cross-national policy debate.

Lipid Biomarkers Identified for Liver Cancer | Center for Cancer Research

Cancer.gov

Hepatocellular carcinoma (HCC) is an aggressive cancer of the liver with poor prognosis and growing incidence in developed countries. Pathology and genetic profiles of HCC are heterogeneous, suggesting that it can begin growing in different cell types. Although human tumors such as HCC have been profiled in-depth by genomics-based studies, not much is known about their overall metabolite modifications and how these changes can form a network that leads to aggressive disease and poor outcome.

Knowledge of commercial bus drivers about road safety measures in Lagos, Nigeria.

PubMed

Okafor Ifeoma, P; Odeyemi Kofoworola, A; Dolapo Duro, C

2013-01-01

Road traffic injuries have persisted as a serious public health problem and much of the health burden is in developing countries. Over-speeding, poor enforcement of traffic regulations and commuter buses have been highly implicated in road traffic injuries in developing countries. The aim of this study was to determine drivers' knowledge of selected road safety measures, i.e. the pre-requisites for driver's license, road signs and speed limits. This was a cross-sectional study carried out in Lagos, Nigeria. Simple random sampling was used to select the two motor parks used for the study and all the consenting commercial minibus drivers operating within the parks (407) were included in the study. Data was collected with a pre-tested, structured, interviewer-administered questionnaire and analyzed with epi-info statistical software. Two hundred and sixty-one (64.1%) of them knew that Visual Acuity test should be done before obtaining driver's license and 53.8% knew the correct minimum age for obtaining driver's license. Only 1% of the drivers had correct knowledge of the driver's license authorities in Nigeria. The drivers had poor knowledge of road signs (59.0%) and poor knowledge of maximum speed limits (100%). The oldest, least educated and least experienced drivers had the poorest level of knowledge. The drivers demonstrated poor knowledge of road safety measures. There is need for driver education to improve their knowledge.

Harnessing information and communication technologies to leverage scarce resources for cancer education, research and practice in developing countries

PubMed Central

Andela, Valentine B

2006-01-01

In developing countries, low levels of awareness, cost and organizational constraints on access to specialized care contribute to inadequate patient help-seeking behavior. As much as 95% of cancer patients in developing countries are diagnosed at late to end stage disease. Consequently, treatment outcome is dismally poor and a vicious cycle sets in, with public mystification of cancer and the admonishment of cancer medicine as a futile effort, all, to the further detriment of patient help-seeking behavior and treatment engagement. The situation spirals down, when the practice of cancer medicine is not gratifying to the medical practitioner and does not appeal as a medical specialty to those in training. The future of cancer medicine in developing countries thus hinges on the demystification of cancer through positive information, coupled to an effective organization that allows for the optimal use of available resources, facilitates access to specialized care and promotes the flow of knowledge and technology amongst various stakeholders. This paper strives to make a cogent argument and highlight the capital importance of information and communication technologies in organizing and leveraging scarce resources for cancer education, research and practice in developing countries. PMID:16390555

Bridging the global health divides.

PubMed

2007-10-01

The information gap between rich and poor countries is widening, and the digital divide is more dramatic than any inequity in health or income.[1] Of 3.47 million articles in 4,091 health-related publications reviewed from 1991 to 2002, 90% were contributed by authors in the 20 most developed nations; writers from the 63 poorest countries accounted for under 2%. Representation from sub-Saharan Africa actually declined over the period, and 96% of the articles were in English. A 2003 survey found only two of 111 editorial board members in a selection of leading medical journals came from low-income countries.[2,3,4].

Bridging the global health divides.

PubMed

2008-10-01

The information gap between rich and poor countries is widening, and the digital divide is more dramatic than any inequity in health or income.[1] Of 3.47 million articles in 4,091 health-related publications reviewed from 1991 to 2002, 90% were contributed by authors in the 20 most developed nations; writers from the 63 poorest countries accounted for under 2%. Representation from sub-Saharan Africa actually declined over the period, and 96% of the articles were in English. A 2003 survey found only two of 111 editorial board members in a selection of leading medical journals came from low-income countries.[2,3,4].

Climate change mitigation policies and poverty in developing countries

NASA Astrophysics Data System (ADS)

Hussein, Zekarias; Hertel, Thomas; Golub, Alla

2013-09-01

Mitigation of the potential impacts of climate change is one of the leading policy concerns of the 21st century. However, there continues to be heated debate about the nature, the content and, most importantly, the impact of the policy actions needed to limit greenhouse gas emissions. One contributing factor is the lack of systematic evidence on the impact of mitigation policy on the welfare of the poor in developing countries. In this letter we consider two alternative policy scenarios, one in which only the Annex I countries take action, and the second in which the first policy is accompanied by a forest carbon sequestration policy in the non-Annex regions. Using an economic climate policy analysis framework, we assess the poverty impacts of the above policy scenarios on seven socio-economic groups in 14 developing countries. We find that the Annex-I-only policy is poverty friendly, since it enhances the competitiveness of non-Annex countries—particularly in agricultural production. However, once forest carbon sequestration incentives in the non-Annex regions are added to the policy package, the overall effect is to raise poverty in the majority of our sample countries. The reason for this outcome is that the dominant impacts of this policy are to raise returns to land, reduce agricultural output and raise food prices. Since poor households rely primarily on their own labor for income, and generally own little land, and since they also spend a large share of their income on food, they are generally hurt on both the earning and the spending fronts. This result is troubling, since forest carbon sequestration—particularly through avoided deforestation—is a promising, low cost option for climate change mitigation.

How Effective Have Thirty Years of Internationally Driven Conservation and Development Efforts Been in Madagascar?

PubMed

Waeber, Patrick O; Wilmé, Lucienne; Mercier, Jean-Roger; Camara, Christian; Lowry, Porter P

2016-01-01

Conservation and development are intricately linked. The international donor community has long provided aid to tropical countries in an effort to alleviate poverty and conserve biodiversity. While hundreds of millions of $ have been invested in over 500 environmental-based projects in Madagascar during the period covered by a series of National Environmental Action Plans (1993-2008) and the protected areas network has expanded threefold, deforestation remains unchecked and none of the eight Millennium Development Goals (MDGs) established for 2000-2015 were likely be met. Efforts to achieve sustainable development had failed to reduce poverty or deliver progress toward any of the MDGs. Cross-sectorial policy adjustments are needed that (i) enable and catalyze Madagascar's capacities rather than deepening dependency on external actors such as the World Bank, the International Monetary Fund and donor countries, and that (ii) deliver improvements to the livelihoods and wellbeing of the country's rural poor.

Gastroenterology in developing countries: Issues and advances

PubMed Central

Mandeville, Kate L; Krabshuis, Justus; Ladep, Nimzing Gwamzhi; Mulder, Chris JJ; Quigley, Eamonn MM; Khan, Shahid A

2009-01-01

Developing countries shoulder a considerable burden of gastroenterological disease. Infectious diseases in particular cause enormous morbidity and mortality. Diseases which afflict both western and developing countries are often seen in more florid forms in poorer countries. Innovative techniques continuously improve and update gastroenterological practice. However, advances in diagnosis and treatment which are commonplace in the West, have yet to reach many developing countries. Clinical guidelines, based on these advances and collated in resource-rich environments, lose their relevance outside these settings. In this two-part review, we first highlight the global burden of gastroenterological disease in three major areas: diarrhoeal diseases, hepatitis B, and Helicobacter pylori. Recent progress in their management is explored, with consideration of future solutions. The second part of the review focuses on the delivery of clinical services in developing countries. Inadequate numbers of healthcare workers hamper efforts to combat gastroenterological disease. Reasons for this shortage are examined, along with possibilities for increased specialist training. Endoscopy services, the mainstay of gastroenterology in the West, are in their infancy in many developing countries. The challenges faced by those setting up a service are illustrated by the example of a Nigerian endoscopy unit. Finally, we highlight the limited scope of many clinical guidelines produced in western countries. Guidelines which take account of resource limitations in the form of “cascades” are advocated in order to make these guidelines truly global. Recognition of the different working conditions facing practitioners worldwide is an important step towards narrowing the gap between gastroenterology in rich and poor countries. PMID:19533805

The effect of illicit financial flows on time to reach the fourth Millennium Development Goal in Sub-Saharan Africa: a quantitative analysis

PubMed Central

Makuta, Innocent; Bar-Zeev, Naor; Chiwaula, Levison; Cobham, Alex

2014-01-01

Objectives This paper sets out to estimate the cost of illicit financial flows (IFF) in terms of the amount of time it could take to reach the fourth Millennium Development Goal (MDG) in 34 African countries. Design We have calculated the percentage increase in gross domestic product (GDP) if IFFs were curtailed using IFF/GDP ratios. We applied the income (GDP) elasticity of child mortality to the increase in GDP to estimate the reduction in time to reach the fourth MDG in 34 African countries. Participants children aged under five years. Settings 34 countries in SSA. Main outcome measures Reduction in time to reach the first indicator of the fourth MDG, under-five mortality rate in the absence of IFF. Results We found that in the 34 SSA countries, six countries will achieve their fourth MDG target at the current rates of decline. In the absence of IFF, 16 countries would reach their fourth MDG target by 2015 and there would be large reductions for all other countries. Conclusions This drain on development is facilitated by financial secrecy in other jurisdictions. Rich and poor countries alike must stem the haemorrhage of IFF by taking decisive steps towards improving financial transparency. PMID:24334911

Nutritional deficiencies in the developing world: current status and opportunities for intervention.

PubMed

Khan, Yasir; Bhutta, Zulfiqar A

2010-12-01

Several contributory factors such as poverty, lack of purchasing power, household food insecurity, and limited general knowledge about appropriate nutritional practices increase the risk of undernutrition in developing countries. The synergistic interaction between inadequate dietary intake and disease burden leads to a vicious cycle that accounts for much of the high morbidity and mortality in these countries. Three groups of underlying factors contribute to inadequate dietary intake and infectious disease: inadequate maternal and child care, household food insecurity, and poor health services in an unhealthy environment. Copyright © 2010 Elsevier Inc. All rights reserved.

Country level economic disparities in child injury mortality.

PubMed

Khan, Uzma Rahim; Sengoelge, Mathilde; Zia, Nukhba; Razzak, Junaid Abdul; Hasselberg, Marie; Laflamme, Lucie

2015-02-01

Injuries are a neglected cause of child mortality globally and the burden is unequally distributed in resource poor settings. The aim of this study is to explore the share and distribution of child injury mortality across country economic levels and the correlation between country economic level and injuries. All-cause and injury mortality rates per 100,000 were extracted for 187 countries for the 1-4 age group and under 5s from the Global Burden of Disease Study 2010. Countries were grouped into four economic levels. Gross domestic product (GDP) per capita was used to determine correlation with injury mortality. For all regions and country economic levels, the share of injuries in all-cause mortality was greater when considering the 1-4 age group than under 5s, ranging from 36.6% in Organization for Economic Cooperation and Development countries to 10.6% in Sub-Saharan Africa. Except for Sub-Saharan Africa, there is a graded association between country economic level and 1-4 injury mortality across regions, with all low-income countries having the highest rates. Except for the two regions with the highest overall injury mortality rates, there is a significant negative correlation between GDP and injury mortality in Latin America and the Caribbean, Eastern Europe/Central Asia, Asia East/South-East and Pacific and North Africa/ Middle East. Child injury mortality is unevenly distributed across regions and country economic level to the detriment of poorer countries. A significant negative correlation exists between GDP and injury in all regions, exception for the most resource poor where the burden of injuries is highest. 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.

Personal review and justice analysis of nursing experiences in Haiti.

PubMed

Emmott, Helen

2008-08-01

Health care providers frequently struggle to develop wise applications of theoretical knowledge. As a nurse studying traditional approaches in ethics while simultaneously volunteering in Haiti, I wrestled with the notion of justice in the midst of radical material inequities. Paul Farmer, physician and anthropologist, provides an analytic perspective for health care providers who work in poor and underserved countries by expanding the liberation theology of the 1970s to include social applications. Analyzing my past experiences in Haiti using Farmer's methodology provided insight into my successes and failures and prompted me to search for personal and professional reasons to provide care for the poor in the future. This type of reflection is essential for health care providers who work with the underserved, regardless of their religion or the country in which they work.

Rotational rural surgery for the poor in developing countries.

PubMed

Aderounmu, A O A; Afolayan, S A; Nasiru, T A; Olaore, J A; Adeoti, M L; Adelasoye, M

2008-07-01

Radio and television announcements advised patients with surgical problems in the rural areas of Osun State, Nigeria, to report at any of the nine zonal headquarters of the state which were closest to their homes in order to receive free treatment. Over 1000 patients reported and 801 received operations on a rotational basis within nine weeks. We studied 719 of these patients, ages between 4 months and 87 years, who had detailed follow-up records. There were 14 different procedures ranging from a hernia repair to the separation of syndactyly. Complications included postoperative pain, haematoma and late superficial wound infection. We concluded that rotational free surgery can help the poor in the third-world countries to receive treatment that they would otherwise not be able to afford.

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

NASA Astrophysics Data System (ADS)

Jafari, Mostafa; Zarghami, Hamid Reza

2016-07-01

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

Linking research to global health equity: the contribution of product development partnerships to access to medicines and research capacity building.

PubMed

Pratt, Bridget; Loff, Bebe

2013-11-01

Certain product development partnerships (PDPs) recognize that to promote the reduction of global health disparities they must create access to their products and strengthen research capacity in developing countries. We evaluated the contribution of 3 PDPs--Medicines for Malaria Venture, Drugs for Neglected Diseases Initiative, and Institute for One World Health--according to Frost and Reich's access framework. We also evaluated PDPs' capacity building in low- and middle-income countries at the individual, institutional, and system levels. We found that these PDPs advance public health by ensuring their products' registration, distribution, and adoption into national treatment policies in disease-endemic countries. Nonetheless, ensuring broad, equitable access for these populations--high distribution coverage; affordability, particularly for the poor; and adoption at provider and end-user levels--remains a challenge.

Income inequality, poverty and socioeconomic development in Bangladesh: an empirical investigation.

PubMed

Islam, I; Khan, H

1986-06-01

By analyzing the data for 1963-1964 through 1976-1977, this paper studies the pattern of income distribution and poverty in Bangladesh, and it also compares the socioeconomic status of the country in the mid-1970s with other developing countries of Asia, Africa, and Latin America. There has been a drastic increase in inequality and poverty in recent years, and this disturbing finding is reinforced by the fact that Bangladesh occupies the lowest position in the Third World in terms of a composite social index. The very poor within the poverty population suffered most, and the increase in the extent of poverty was most noticeable in the rural sector. The broad policy recommendation is that relatively more attention should be given to the social sectors white allocating resources for the country's future development.

What Determines Basic School Attainment in Developing Countries? Evidence from Rural China

ERIC Educational Resources Information Center

Zhao, Meng; Glewwe, Paul

2010-01-01

This paper analyzes recent household survey data from Gansu, a less developed province in Northwest China, to examine school attainment in a poor rural area of China. Censored ordered probit regressions are used to estimate the determinants of years of schooling. Child nutritional status, as measured by height-for-age Z-scores, and household…

The United States and World Development: Agenda 1980.

ERIC Educational Resources Information Center

Sewell, John W.; And Others

This publication examines global problems facing the United States and offers a specific short-term program of action to deal with some of the problems. There are three major parts. Part I describes political and economic developments in both rich and poor countries and comments on the recent record of the United States in its relationships with…

Development and Validation of Simulated Virtual Patients to Impart Early Clinical Exposure in Endocrine Physiology

ERIC Educational Resources Information Center

Gupta, Akriti; Singh, Satendra; Khaliq, Farah; Dhaliwal, Upreet; Madhu, S. V.

2018-01-01

In the country presently, preclinical medical students are not routinely exposed to real patients. Thus, when they start clinical postings, they are found to have poor clinical reasoning skills. Simulated virtual patients (SVPs) can improve clinical skills without endangering real patients. This pilot study describes the development of two SVPs in…

Growth and Development among Infants and Preschoolers in Rural India: Economic Inequities and Caregiver Protective/Promotive Factors

ERIC Educational Resources Information Center

Black, Maureen M.; Fernandez-Rao, Sylvia; Hurley, Kristen M.; Tilton, Nicholas; Balakrishna, Nagalla; Harding, Kimberly B.; Reinhart, Greg; Radhakrishna, Kankipati Vijaya; Nair, Krishnapillai Madhavan

2016-01-01

Economic inequities are common in low and middle-income countries (LMIC), and are associated with poor growth and development among young children. The objectives are to examine whether maternal education and home environment quality: 1) protect children by attenuating the association between economic inequities and children's growth and…

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.

Contracting but not without caution: experience with outsourcing of health services in countries of the Eastern Mediterranean Region.

PubMed Central

Siddiqi, Sameen; Masud, Tayyeb Imran; Sabri, Belgacem

2006-01-01

The public sector in developing countries is increasingly contracting with the non-state sector to improve access, efficiency and quality of health services. We conducted a multicountry study to assess the range of health services contracted out, the process of contracting and its influencing factors in ten countries of the Eastern Mediterranean Region: Afghanistan, Bahrain, Egypt, Islamic Republic of Iran, Jordan, Lebanon, Morocco, Pakistan, the Syrian Arab Republic and Tunisia. Our results showed that Afghanistan, Egypt, Islamic Republic of Iran and Pakistan had experience with outsourcing of primary care services; Jordan, Lebanon and Tunisia extensively contracted out hospital and ambulatory care services; while Bahrain, Morocco and the Syrian Arab Republic outsourced mainly non-clinical services. The interest of the non-state sector in contracting was to secure a regular source of revenue and gain enhanced recognition and credibility. While most countries promoted contracting with the private sector, the legal and bureaucratic support in countries varied with the duration of experience with contracting. The inherent risks evident in the contracting process were reliance on donor funds, limited number of providers in rural areas, parties with vested interests gaining control over the contracting process, as well as poor monitoring and evaluation mechanisms. Contracting provides the opportunity to have greater control over private providers in countries with poor regulatory capacity, and if used judiciously can improve health system performance. PMID:17143460

Contracting but not without caution: experience with outsourcing of health services in countries of the Eastern Mediterranean Region.

PubMed

Siddiqi, Sameen; Masud, Tayyeb Imran; Sabri, Belgacem

2006-11-01

The public sector in developing countries is increasingly contracting with the non-state sector to improve access, efficiency and quality of health services. We conducted a multicountry study to assess the range of health services contracted out, the process of contracting and its influencing factors in ten countries of the Eastern Mediterranean Region: Afghanistan, Bahrain, Egypt, Islamic Republic of Iran, Jordan, Lebanon, Morocco, Pakistan, the Syrian Arab Republic and Tunisia. Our results showed that Afghanistan, Egypt, Islamic Republic of Iran and Pakistan had experience with outsourcing of primary care services; Jordan, Lebanon and Tunisia extensively contracted out hospital and ambulatory care services; while Bahrain, Morocco and the Syrian Arab Republic outsourced mainly non-clinical services. The interest of the non-state sector in contracting was to secure a regular source of revenue and gain enhanced recognition and credibility. While most countries promoted contracting with the private sector, the legal and bureaucratic support in countries varied with the duration of experience with contracting. The inherent risks evident in the contracting process were reliance on donor funds, limited number of providers in rural areas, parties with vested interests gaining control over the contracting process, as well as poor monitoring and evaluation mechanisms. Contracting provides the opportunity to have greater control over private providers in countries with poor regulatory capacity, and if used judiciously can improve health system performance.

Poverty & health: criticality of public financing.

PubMed

Duggal, Ravi

2007-10-01

Countries with universal or near universal access to healthcare have health financing mechanisms which are single-payer systems in which either a single autonomous public agency or a few coordinated agencies pool resources to finance healthcare. This contributes to both equity in healthcare as well as to low levels of poverty in these countries. It is only in countries like India and a number of developing countries, which still rely mostly on out-of-pocket payments, where universal access to healthcare is elusive. In such countries those who have the capacity to buy healthcare from the market most often get healthcare without having to pay for it directly because they are either covered by social insurance or buy private insurance. In contrast, a large majority of the population, who suffers a hand-to-mouth existence, is forced to make direct payments, often with a heavy burden of debt, to access healthcare from the market because public provision is grossly inadequate or non existent. Thus, the absence of adequate public health investment not only results in poor health outcomes but it also leads to escalation of poverty. This article critically reviews the linkages of poverty with healthcare financing using evidence from national surveys and concludes that public financing is critical to good access to healthcare for the poor and its inadequacy is closely associated with poverty levels in the country.

An Overview on Indian Patents on Biotechnology.

PubMed

Mallick, Anusaya; Chandra Santra, Subhas; Samal, Alok Chandra

2015-01-01

The application of biotechnology is a potential tool for mitigating the present and future fooding and clothing demands in developing countries like India. The commercialization of biotechnological products might benefiting the poor`s in developing countries are unlikely to be developed. Biotechnology has the potential to provide a wide range of products and the existing production skills in the industrial, pharmaceuticals and the agricultural sector. Ownership of the intellectual property rights is the key factors in determining the success of any technological invention, which was introduced in the market. It provides the means for technological progress to continue of the industry of the country. The new plans, animal varieties, new methods of treatments, new crops producing food articles as such are the inventions of biotechnology. Biotechnology is the result of the application of human intelligence and knowledge to the biological processes. Most of the tools of biotechnology have been developed, by companies, governments, research in- stitutes and universities in developed nations. These human intellectual efforts deserve protection. India is a developing country with advance biotechnology based segments of pharmaceutical and agricultural industries. The Trade Related Intellectual Property Rights (TRIPS) is not likely to have a significant impact on incentives for innovation creation in the biotechnology sectors. In the recent years, the world has seen the biotechnology sector as one of greatest investment area through the Patent Law and will giving huge profit in future. The Research and Development in the field of biotechnology should be encouraged for explor- ing new tools and improve the biological systems for interest of the common people. Priority should be given to generation, evaluation, protection and effective commercial utilization of tangible products of intellectual property in agriculture and pharmaceuticals. To support the future growth and development in the area of bio- technology and exchange of knowledge should be proper evaluate and secure through patent system.

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

PubMed

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

2013-01-01

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

Distance learning--an educational tool for developing countries.

PubMed

Dobson, M B

2000-01-01

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

Are self-reports of health and morbidities in developing countries misleading? Evidence from India

PubMed Central

Subramanyam, Malavika A; Selvaraj, Sakthivel; Kawachi, Ichiro

2009-01-01

Self reported measures of poor health and morbidities from developing countries tend to be viewed with considerable skepticism. Examination of the social gradient in self-reported health and morbidity measures provides a useful test of the validity of self-reports of poor-health and morbidities. The prevailing view, in part influenced by Amartya Sen, is that socially disadvantaged individuals will fail to perceive and report the presence of illness or health-deficits because an individual’s assessment of their health is directly contingent on their social experience. In this study, we tested whether the association between self-reported poor-health/morbidities and socioeconomic status (SES) in India follows the expected direction or not. Cross sectional logistic regression analyses were carried out on a nationally representative population based sample from the 1998–99 Indian National Family Health Survey (INFHS); and 1995–96 and 2004 Indian National Sample Survey (INSS). Four binary outcomes were analyzed: any self-reported morbidity; self-reported sickness in the last 15 days; self-reported sickness in the past year; and poor self-rated health. In separate adjusted models, individuals with no education reported higher levels of any self-reported, self-reported sickness in the last 15 days, self-reported sickness in the last year, and poor self-rated health compared to those with most education. Contrary to the prevailing thesis, we find that the use of self-rated ill health has face validity as assessed via its relationship to SES. A less dismissive and pessimistic view of health data obtained through self-reports seems warranted. PMID:19019521

Are self-reports of health and morbidities in developing countries misleading? Evidence from India.

PubMed

Subramanian, S V; Subramanyam, Malavika A; Selvaraj, Sakthivel; Kawachi, Ichiro

2009-01-01

Self-reported measures of poor health and morbidities from developing countries tend to be viewed with considerable skepticism. Examination of the social gradient in self-reported health and morbidity measures provides a useful test of the validity of self-reports of poor health and morbidities. The prevailing view, in part influenced by Amartya Sen, is that socially disadvantaged individuals will fail to perceive and report the presence of illness or health-deficits because an individual's assessment of their health is directly contingent on their social experience. In this study, we tested whether the association between self-reported poor health/morbidities and socioeconomic status (SES) in India follows the expected direction or not. Cross-sectional logistic regression analyses were carried out on a nationally representative population-based sample from the 1998 to 1999 Indian National Family Health Survey (INFHS); and 1995-1996 and 2004 Indian National Sample Survey (INSS). Four binary outcomes were analyzed: any self-reported morbidity; self-reported sickness in the last 15 days; self-reported sickness in the past year; and poor self-rated health. In separate adjusted models, individuals with no education reported higher levels of any self-reported, self-reported sickness in the last 15 days, self-reported sickness in the last year, and poor self-rated health compared to those with most education. Contrary to the prevailing thesis, we find that the use of self-rated ill-health has face validity as assessed via its relationship to SES. A less dismissive and pessimistic view of health data obtained through self-reports seems warranted.

Social support network typologies and health outcomes of older people in low and middle income countries--a 10/66 Dementia Research Group population-based study.

PubMed

Thiyagarajan, Jotheeswaran A; Prince, Martin; Webber, Martin

2014-08-01

This study aims to assess the construct validity of the Wenger social support network typology in low and middle income countries. We hypothesize that, in comparison with the integrated network type, the non-integrated network type is associated with loneliness, depression, poor quality of life (less happiness), poor self-reported health, increased disability and higher care needs. Cross-sectional one-phase surveys were conducted of all residents aged 65 and over in catchment areas in eight low and middle income countries (India, China, Cuba, Dominican Republic, Venezuela, Mexico, Peru and Puerto Rico). Wenger's Practitioner Assessment of Network Type (PANT) was used to measure social network type. Family dependent, local self-contained, wider community-focused and private restricted network types were considered non-integrated, in comparison to the locally integrated network type. Overall, 17,031 participants were interviewed. Family dependent and locally integrated network types were the most prevalent. Adjusted pooled estimates across sites showed that loneliness, depression, less happiness, poor health, disability, and need for care were significantly associated with non-integrated network type. The findings of this study support the construct validity of Wenger's network typology in low and middle income countries. However, further research is required to test the criterion validity of Wenger typology using longitudinal data. Identifying older people who are vulnerable could inform the development of social care interventions to support older people and their families in the context of deteriorating health.

Can innovative health financing policies increase access to MDG-related services? Evidence from Rwanda.

PubMed

Sekabaraga, Claude; Diop, Francois; Soucat, Agnes

2011-11-01

Ensuring financial access to health services is a critical challenge for poor countries if they are to reach the health Millennium Development Goals (MDGs). This article examines the case of Rwanda, a country which has championed innovative health care financing policies. Between 2000 and 2007, Rwanda has improved financial access for the poor, increased utilization of health services and reduced out-of-pocket payments for health care. Poor groups' utilization has increased for all health services, sometimes dramatically. Use of assisted deliveries, for example, increased from 12.1% to 42.7% among the poorest quintile; payments at the point of delivery have also been reduced; and catastrophic expenditures have declined. Part of these achievements is likely linked to innovative health financing policies, particularly the expansion of micro-insurance ('mutuelles') and performance-based financing. The paper concludes that the Rwanda experience provides a useful example of effective implementation of policies that reduce the financial barrier to health services, hereby contributing to the health MDGs. Today's main challenge is to build the sustainability of this system. Finally, the paper proposes a simple set of rigorous metrics to assess the impact of health financing policies and calls for implementing rigorous impact evaluation of health care financing policies in low-income countries.

The impact of forced migration on the mental health of the elderly: a scoping review.

PubMed

Virgincar, Ashwini; Doherty, Shannon; Siriwardhana, Chesmal

2016-06-01

The worldwide elderly population fraction is increasing, with the greatest rise in developing countries. Older adults affected by conflict and forced migration mainly taking place in developing countries may be particularly vulnerable to poor mental health due to other age-specific risk factors. This review aims to explore global evidence on the effect of conflict-induced forced migration on the mental health of older adults. Seven bibliographic databases were searched. The title and abstract of 797 results were reviewed for qualitative and quantitative studies meeting inclusion and exclusion criteria. Six studies were selected for the in-depth review. Five papers assessed mental health in older adult populations displaced as refugees. One paper assessed mental health of older adults with varying immigration status. This review highlights the dearth of evidence about the impact of forced migration on the mental health of older adults. Further research is needed to explore the risk factors and processes that contribute to adverse mental health outcomes among older adult populations. This is essential to the development of interventions for this vulnerable and at-risk population, particularly in resource-poor settings.

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.

Pertussis

PubMed Central

Syed, Muhammad A.; Bana, Noureen F.

2014-01-01

Pertussis or whooping cough is a highly infectious, vaccine preventable disease. The incidence of the disease has greatly been reduced since the introduction of the diphtheria, tetanus, pertussis vaccine. Pertussis resurgence has been observed in highly vaccinated populations of Western countries since 1990s. Poor vaccine quality, waning vaccine induced immunity, pathogen adaptation, and enhanced surveillance as well as advancements in diagnostic facilities are some of the reasons considered responsible for the increased reporting of pertussis cases. Pertussis may have been ignored and unnoticed due to its atypical manifestations in partially immunized population or people with waning immunity. We review the reports of pertussis resurgence from different countries and attempt to investigate reasons behind the reappearance of the disease. Pertussis is still an under reported disease and the available data from the developing countries is not a true picture of the story. Therefore, developing countries need to improve their surveillance systems. PMID:25316461

Asthma prevalence and severity in low-resource communities.

PubMed

Cruz, Álvaro A; Stelmach, Rafael; Ponte, Eduardo V

2017-06-01

The prevalence of asthma was thought to be low in most low-income countries, but several reports have indicated this is not always true. This is a narrative review of recent publications on the burden of asthma in low and middle-income countries (LMIC) and underprivileged communities from developed countries. Several studies have reported a low prevalence of asthma is LMIC, but indicate it is increasing. In the last few years, however, many surveys demonstrated this may not always be true. An analysis of the International Study for Asthma and Allergy in Childhood phase III database indicated although the prevalence of asthma among children and adolescents is higher in the developed countries, symptoms of asthma are often more severe in less affluent nations. The rate of uncontrolled asthma is also higher among underprivileged communities of developed countries. Secondary analysis of data generated by the WHO's world health survey performed among adults of 70 countries indicate symptoms of asthma are less frequent in middle-income countries and more frequent in the extremes, low income and high income. This sort of U shaped distribution suggests the disease (or syndrome) comprise more than one major phenotype related to diverse underlying mechanisms. In fact, recent reports show symptoms of asthma among the poor are associated with unhygienic living conditions, which may reduce the risk of atopy but increase the risk of nonatopic wheezing. Urbanization and exposure to air pollution also seem to contribute to an increasing prevalence severity of asthma in LMIC. Access to proper diagnosis and treatment with controller medications for asthma, specially with inhaled corticosteroids is feasible and cost-effective, reduce symptoms, health resource utilization, improves quality of life, and reduce mortality in low-resource settings. Prevalence of asthma was thought to be low in low-income countries, but several reports have indicated this is not always true. Under diagnosis, under treatment, exposure to air pollution, and unhygienic living conditions may contribute to a higher frequency and severity of symptoms of asthma among the poor. Proper diagnosis and treatment with controller medications for asthma is feasible and cost-effective in low-resource settings.

Challenges to implementing Gavi's health system strengthening support in Chad and Cameroon: results from a mixed-methods evaluation.

PubMed

Dansereau, Emily; Miangotar, Yodé; Squires, Ellen; Mimche, Honoré; El Bcheraoui, Charbel

2017-11-16

Since 2005, Gavi has provided health system strengthening (HSS) grants to address bottlenecks affecting immunization services. This study is the first to evaluate the Gavi HSS implementation process in either Cameroon or Chad, two countries with significant health system challenges and poor achievement on the child and maternal health Millennium Development Goals. We triangulated quantitative and qualitative data including financial records, document review, field visit questionnaires, and key informant interviews (KII) with representatives from the Ministries of Health, Gavi, and other partners. We conducted a Root Cause Analysis of key implementation challenges, guided by the Consolidated Framework for Implementation Research. We conducted 124 field visits and 43 KIIs in Cameroon, and 57 field visits and 39 KIIs in Chad. Cameroon's and Chad's HSS programs were characterized by delayed disbursements, significant deviations from approved expenditures, and reprogramming of funds. Nearly a year after the programs were intended to be complete, many district and facility-level activities were only partially implemented and significant funds remained unabsorbed. Root causes of these challenges included unpredictable Gavi processes and disbursements, poor communication between the countries and Gavi, insufficient country planning without adequate technical assistance, lack of country staff and leadership, and weak country systems to manage finances and promote institutional memory. Though Chad and Cameroon both critically needed support to strengthen their weak health systems, serious challenges drastically limited implementation of their Gavi HSS programs. Implementation of future HSS programs in these and similar settings can be improved by transparent and reliable procedures and communication from Gavi, proposals that account for countries' programmatic capacity and the potential for delayed disbursements, implementation practices that foster learning and adaptation, and an early emphasis on developing managerial and other human resources.

Population, Resources, Environment: An Uncertain Future.

ERIC Educational Resources Information Center

Repetto, Robert

1987-01-01

The links between population growth, resource use, and environmental quality are too complex to permit straightforward generalizations about causal relationships. However, rapid population growth has increased the number of poor people in developing countries, thus contributing to the degradation of the environment and the renewable resources of…

Environmental enteric dysfunction is associated with carnitine deficiency and altered fatty acid oxidation

USDA-ARS?s Scientific Manuscript database

Environmental enteric dysfunction (EED), a condition characterized by small intestine inflammation and abnormal gut permeability, is widespread in children in developing countries and a major cause of growth failure. The pathophysiology of EED remains poorly understood. We measured serum metabolite...

Your Health in Your Hands.

ERIC Educational Resources Information Center

Burkitt, D. P.

1983-01-01

Discusses the principle environmental/dietary factors related to diseases characteristic of developed countries. Suggests doubling fiber and starch, cutting sugar/salt in half, and cutting fat by one-third. Indicates that alcohol consumption, poor diet, drug abuse and lack of exercise are detrimental to good health. (JM)

The Association Between Unintended Births and Poor Child Development in India: Evidence from a Longitudinal Study.

PubMed

Singh, Abhishek; Upadhyay, Ashish Kumar; Singh, Ashish; Kumar, Kaushalendra

2017-03-01

Evidence on the association between unintended births and poor child development in developing countries is limited. We used data from three waves of the Young Lives study on childhood poverty conducted in Andhra Pradesh in 2002, 2006-07, and 2009 to examine the association between unintended births and poor child development in India. Multivariable linear regression models were used to examine the association between unintended births and four indicators of child development-height-for-age Z-score (HAZ), Peabody Picture Vocabulary Test (PPVT) score, Mathematics Achievement Test (MAT) score, and Early Grade Reading Assessment (EGRA) test score. The Propensity Score Matching (PSM) technique was also used to analyze data. Children who were reported as unintended at birth had significantly lower HAZ, PPVT, and EGRA scores compared with those who were reported as intended. PSM results support the findings from the multivariable linear regressions. Our findings provide evidence on the association between unintended births and poor child development in India. There may be a need to reposition family planning within India's reproductive and child health care programs. Future studies must take into account the unobserved heterogeneity that our study could not address fully. © 2017 The Population Council, Inc.

Strengthening of Oral Health Systems: Oral Health through Primary Health Care

PubMed Central

Petersen, Poul Erik

2014-01-01

Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work with the newly established WHO Collaborating Centre, Kuwait University, to strengthen the development of appropriate models for primary oral health care. PMID:24525450

Pilot testing of dipsticks as point-of-care assays for rapid diagnosis of poor-quality artemisinin drugs in endemic settings.

PubMed

Guo, Suqin; He, Lishan; Tisch, Daniel J; Kazura, James; Mharakurwa, Sungano; Mahanta, Jagadish; Herrera, Sócrates; Wang, Baomin; Cui, Liwang

2016-01-01

Good-quality artemisinin drugs are essential for malaria treatment, but increasing prevalence of poor-quality artemisinin drugs in many endemic countries hinders effective management of malaria cases. To develop a point-of-care assay for rapid identification of counterfeit and substandard artemisinin drugs for resource-limited areas, we used specific monoclonal antibodies against artesunate and artemether, and developed prototypes of lateral flow dipstick assays. In this pilot test, we evaluated the feasibility of these dipsticks under different endemic settings and their performance in the hands of untrained personnel. The results showed that the dipstick tests can be successfully performed by different investigators with the included instruction sheet. None of the artemether and artesunate drugs collected from public pharmacies in different endemic countries failed the test. It is possible that the simple dipstick assays, with future optimization of test conditions and sensitivity, can be used as a qualitative and semi-quantitative assay for rapid screening of counterfeit artemisinin drugs in endemic settings.

Is Cheap Labor a Magnet for Capital?

ERIC Educational Resources Information Center

Hanson, John R., II

1995-01-01

Contends that it is widely believed that cheap labor in poor countries attracts foreign investors. Asserts that historical evidence indicates that past patterns of direct foreign investment in poor countries are inconsistent with the cheap-labor argument. Includes two figures and one table. (CFR)

Bucharest: poverty or population?

PubMed

1974-01-01

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

Socioeconomic Disparity in Later-Year Group Trajectories of Depressive Symptoms: Role of Health and Social Engagement Change.

PubMed

Lee, Hyunjoo; Park, Sojung; Kwon, Eunsun; Cho, Joonyoung

2017-06-01

This study explored heterogeneous change patterns of South Korean older adults' depressive symptoms by poverty status, focusing on health status and social engagement changes. We used data from four waves (2006-2012) of the Korean Longitudinal Study of Aging (KLoSA). Our sample contained 2461 poor and 1668 non-poor individuals. All were 65 years old or older at baseline. We used latent class growth analysis to identify trajectory groups' depressive symptoms. Multinomial logistic regression was used to examine how a range of changes in health conditions and social engagement was associated with trajectories among poor and non-poor participants. Among the poor, five heterogeneous trajectories with clear patterns were identified: high-to-moderate, stable-high, slightly-increasing, steeply-increasing, and stable-low. Among non-poor, high-to-moderate, steeply-increasing, and stable-low groups were found. A decrease in health conditions was the most vulnerable subgroup's (steeply-increasing) primary risk factor. Poor older adults who reduced participation in, or decreased contact with, social networks were likely to belong to the steeply-increasing group. Our study provides impetus for organizational and/or environmental support systems to facilitate social engagement among poor older adults. Future research should examine whether the significance of social engagement among poor elders applies in less-developed and developed countries.

Cross-National Comparisons of Time Trends in Overweight Inequality by Socioeconomic Status Among Women Using Repeated Cross-Sectional Surveys From 37 Developing Countries, 1989–2007

PubMed Central

Jones-Smith, Jessica C.; Gordon-Larsen, Penny; Siddiqi, Arjumand; Popkin, Barry M.

2011-01-01

Chronic diseases are now among the leading causes of morbidity and mortality in lower income countries. Although traditionally related to higher individual socioeconomic status (SES) in these contexts, the associations between SES and chronic disease may be actively changing. Furthermore, country-level contextual factors, such as economic development and income inequality, may influence the distribution of chronic disease by SES as well as how this distribution has changed over time. Using overweight status as a health indicator, the authors studied repeated cross-sectional data from women aged 18–49 years in 37 developing countries to assess within-country trends in overweight inequalities by SES between 1989 and 2007 (n = 405,550). Meta-regression was used to examine the associations between gross domestic product and disproportionate increases in overweight prevalence by SES, with additional testing for modification by country-level income inequality. In 27 of 37 countries, higher SES (vs. lower) was associated with higher gains in overweight prevalence; in the remaining 10 countries, lower SES (vs. higher) was associated with higher gains in overweight prevalence. Gross domestic product was positively related to faster increase in overweight prevalence among the lower wealth groups. Among countries with a higher gross domestic product, lower income inequality was associated with faster overweight growth among the poor. PMID:21300855

Paucity of family planning.

PubMed

Hawkins, C

1988-04-01

A wall chart compiled by the Population Crisis Committee of Washington D.C. called "World Access to Birth Control" is described. The chart compares developing countries and developed countries with respect to need of effective contraception, using data from the World Fertility Surveys. Up to 250 million women need contraception; a substantial percentage want no more children, over half in several large countries. The chart ranks the United Kingdom as 1st in providing family planning services, information, education and advertising. All of the developed countries were considered good except Russia and Romania, although some had deficiencies, such as Japan for lacking sterilization services. The U.S. ranked 7th, failing to provide women the full range of contraceptive methods, to provide adequate sex education and services to adolescents, and to publish information and adequate advertising about birth control. The USSR was placed 14th on the list of 15 because of poor quality and erratic supplies. Among the developing countries, Libya, Kampuchea and Laos were cited as having no services whatsoever. In contrast, several Asian national family planning programs, notably China, Taiwan, Singapore, South Korea and Hong Kong, had such excellent programs that fertility had declined over 30% in 15 years. In China, fertility has fallen 50% in that time.

Bringing sexual and reproductive health in the urban contexts to the forefront of the development agenda: the case for prioritizing the urban poor.

PubMed

Mberu, Blessing; Mumah, Joyce; Kabiru, Caroline; Brinton, Jessica

2014-09-01

Estimates suggest that over 90 % of population increase in the least developed countries over the next four decades will occur in urban areas. These increases will be driven both by natural population growth and rural-urban migration. Moreover, despite its status as the world's least urbanized region, the urban population in the sub-Saharan Africa region is projected to increase from under 40 % currently to over 60 % by 2050. Currently, approximately 70 % of all urban residents in the region live in slums or slum-like conditions. Sexual and reproductive health (SRH) risks for the urban poor are severe and include high rates of unwanted pregnancies, sexually transmitted infections, and poor maternal and child health outcomes. However, the links between poverty, urbanization, and reproductive health priorities are still not a major focus in the broader development agenda. Building on theoretical and empirical data, we show that SRH in urban contexts is critical to the development of healthy productive urban populations and, ultimately, the improvement of quality of life. We posit that a strategic focus on the sexual and reproductive health of urban residents will enable developing country governments achieve international goals and national targets by reducing health risks among a large and rapidly growing segment of the population. To that end, we identify key research, policy and program recommendations and strategies required for bringing sexual and reproductive health in urban contexts to the forefront of the development agenda.

People on the move.

PubMed

Hancock, G

1979-09-01

Internal migration of the rural poor to urban areas in all Third World countries is the so-called "largest migratory movement in human history." This trend is true for many reasons. Conditions make village life, based on small-scale or subsistence agriculture, less and less bearable. Governmental programs for development seem to concentrate and overinvest in urban areas, to the disadvantage of the countryside. Urban areas have always held a romantic attraction. Modern-day urban areas also offer employment and educational opportunities unequalled in rural areas. The rural poor in many parts of the Third World seem to be getting poorer while the urban poor can at least keep pace with the cost of living.

Can a poverty-reducing and progressive tax and transfer system hurt the poor?

PubMed

Higgins, Sean; Lustig, Nora

2016-09-01

To analyze anti-poverty policies in tandem with the taxes used to pay for them, comparisons of poverty before and after taxes and transfers are often used. We show that these comparisons, as well as measures of horizontal equity and progressivity, can fail to capture an important aspect: that a substantial proportion of the poor are made poorer (or non-poor made poor) by the tax and transfer system. We illustrate with data from seventeen developing countries: in fifteen, the fiscal system is poverty-reducing and progressive, but in ten of these at least one-quarter of the poor pay more in taxes than they receive in transfers. We call this fiscal impoverishment, and axiomatically derive a measure of its extent. An analogous measure of fiscal gains of the poor is also derived, and we show that changes in the poverty gap can be decomposed into our axiomatic measures of fiscal impoverishment and gains.

Are area-level and individual-level socioeconomic factors associated with self-rated health in adult urban citizens? Evidence from Slovak and Dutch cities.

PubMed

Behanova, Martina; Reijneveld, Sijmen A; Nagyova, Iveta; Katreniakova, Zuzana; van Ameijden, Erik J C; Dijkshoorn, Henriëtte; van Dijk, Jitse P

2017-05-01

Evidence shows that living in disadvantaged areas is associated with poor health. This may be due to the socioeconomic (SE) characteristics of both these residents and the areas where they live. Evidence regarding this on Central European (CE) countries is scarce. Our aim was to assess whether the prevalence of poor self-rated health (SRH) was higher in deprived urban areas, whether this can be explained by individual SE status (SES) and whether this differed between Slovakia and the Netherlands per age group. We examined the association of urban-level data and individual-level SE factors from different urban areas in different countries (Slovakia, the Netherlands) using comparable urban health indicators and area indicators. We also obtained unique data from the EU-FP7 EURO-URHIS 2 project. Multilevel logistic regression showed that poor SRH was associated with area deprivation in both countries. Regarding age by country, poor SRH occurred more frequently in the more deprived areas for the younger age group (≤64) in the Netherlands but for the older age group (≥65 years) in Slovakia. Moreover, Slovak citizens reported poor SRH significantly more often than Dutch residents. Individual SES was significantly associated with poor SRH in both age groups and both countries for most area-level SE measures. Individual SES is associated with SRH more strongly than area deprivation. Therefore, it is important to account for relative deprivation at an individual level when considering health-enhancing activities. Moreover, the effect of urban-area deprivation seems to differ between CE and WE countries. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

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

PubMed

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

2018-04-13

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

Cardiometabolic diseases of civilization: history and maturation of an evolving global threat. An update and call to action.

PubMed

Kones, Richard; Rumana, Umme

2017-05-01

Despite striking extensions of lifespan, leading causes of death in most countries now constitute chronic, degenerative diseases which outpace the capacity of health systems. Cardiovascular disease is the most common cause of death in both developed and undeveloped countries. In America, nearly half of the adult population has at least one chronic disease, and polypharmacy is commonplace. Prevalence of ideal cardiovascular health has not meaningfully improved over the past two decades. The fall in cardiovascular deaths in Western countries, half due to a fall in risk factors and half due to improved treatments, have plateaued, and this reversal is due to the dual epidemics of obesity and diabetes type 2. High burdens of cardiovascular risk factors are also evident globally. Undeveloped nations bear the burdens of both infectious diseases and high childhood death rates. Unacceptable rates of morbidity and mortality arise from insufficient resources to improve sanitation, pure water, and hygiene, ultimately linked to poverty and disparities. Simultaneously, about 80% of cardiovascular deaths now occur in low- and middle-income nations. For these reasons, risk factors for noncommunicable diseases, including poverty, health illiteracy, and lack of adherence, must be targeted with unprecedented vigor worldwide. Key messages In developed and relatively wealthy countries, chronic "degenerative" diseases have attained crisis proportions that threaten to reverse health gains made within the past decades. Although poverty, disparities, and poor sanitation still cause unnecessary death and despair in developing nations, they are now also burdened with increasing cardiovascular mortality. Poor adherence and low levels of health literacy contribute to the high background levels of cardiovascular risk.

Perceived teacher affective support in relation to emotional and motivational variables in elementary school science classrooms in Turkey

NASA Astrophysics Data System (ADS)

Sakiz, Gonul

2017-01-01

Background: In recent research, affective learning environments and affective support have been receiving increasing attention for their roles in stimulating students' learning outcomes. Despite its raising importance, little is known about affective support in educational contexts in developing countries. Moreover, international student assessment programmes (e.g. PISA and TIMSS) reveal poor science proficiency of students in most of those countries, which provokes the question of how to make positive changes in students' perspectives and attitudes in science.

The long-term dynamics of mortality benefits from improved water and sanitation in less developed countries.

PubMed

Jeuland, Marc A; Fuente, David E; Ozdemir, Semra; Allaire, Maura C; Whittington, Dale

2013-01-01

The problem of inadequate access to water, sanitation and hygiene (WASH) in less-developed nations has received much attention over the last several decades (most recently in the Millennium Development Goals), largely because diseases associated with such conditions contribute substantially to mortality in poor countries. We present country-level projections for WASH coverage and for WASH-related mortality in developing regions over a long time horizon (1975-2050) and provide dynamic estimates of the economic value of potential reductions in this WASH-related mortality, which go beyond the static results found in previous work. Over the historical period leading up to the present, our analysis shows steady and substantial improvements in WASH coverage and declining mortality rates across many developing regions, namely East Asia and the Pacific, Latin America and the Caribbean, Eastern Europe and the Middle East. The economic value of potential health gains from eliminating mortality attributable to poor water and sanitation has decreased substantially, and in the future will therefore be modest in these regions. Where WASH-related deaths remain high (in parts of South Asia and much of Sub-Saharan Africa), if current trends continue, it will be several decades before economic development and investments in improved water and sanitation will result in the capture of these economic benefits. The fact that health losses will likely remain high in these two regions over the medium term suggests that accelerated efforts are needed to improve access to water and sanitation, though the costs and benefits of such efforts in specific locations should be carefully assessed.

The Long-Term Dynamics of Mortality Benefits from Improved Water and Sanitation in Less Developed Countries

PubMed Central

Jeuland, Marc A.; Fuente, David E.; Ozdemir, Semra; Allaire, Maura C.; Whittington, Dale

2013-01-01

The problem of inadequate access to water, sanitation and hygiene (WASH) in less-developed nations has received much attention over the last several decades (most recently in the Millennium Development Goals), largely because diseases associated with such conditions contribute substantially to mortality in poor countries. We present country-level projections for WASH coverage and for WASH-related mortality in developing regions over a long time horizon (1975–2050) and provide dynamic estimates of the economic value of potential reductions in this WASH-related mortality, which go beyond the static results found in previous work. Over the historical period leading up to the present, our analysis shows steady and substantial improvements in WASH coverage and declining mortality rates across many developing regions, namely East Asia and the Pacific, Latin America and the Caribbean, Eastern Europe and the Middle East. The economic value of potential health gains from eliminating mortality attributable to poor water and sanitation has decreased substantially, and in the future will therefore be modest in these regions. Where WASH-related deaths remain high (in parts of South Asia and much of Sub-Saharan Africa), if current trends continue, it will be several decades before economic development and investments in improved water and sanitation will result in the capture of these economic benefits. The fact that health losses will likely remain high in these two regions over the medium term suggests that accelerated efforts are needed to improve access to water and sanitation, though the costs and benefits of such efforts in specific locations should be carefully assessed. PMID:24116011

Nutrition and national development: the case of Chile.

PubMed

Solimano, G; Hakim, P

1979-01-01

This study is an historical analysis of food consumption and nutrition in Chile emphasizing the influence of political and economic factors on nutritional standards. It attempts to document and explain the persistence of malnutrition as a widespread social problem in Chile even as the country achieved a relatively advanced state of economic development and boasted an unusually progressive record of social legislation. The major findings of the study were: (a) Chile's pattern of development, social reform efforts notwithstanding, consistently discriminated against low-income groups, and (b) this discrimination perpetuated low standards of nutrition and low levels of food consumption among the country's poor and undermined the effectiveness of specific measures to alleviate malnutrition.

Bridging the Gap: establishing the necessary infrastructure and knowledge for teaching and research in neuroscience in Africa.

PubMed

Yusuf, Sadiq; Baden, Tom; Prieto-Godino, Lucia L

2014-06-01

Advances in neuroscience research over the last few decades have increased our understanding of how individual neurons acquire their specific properties and assemble into complex circuits, and how these circuits are affected in disease. One of the important motives driving neuroscience research is the development of new scientific techniques and interdisciplinary cooperation. Compared to developed countries, many countries on the African continent are confronted with poor facilities, lack of funding or career development programs for neuroscientists, all of which deter young scientists from taking up neuroscience as a career choice. This article highlights some steps that are being taken to promote neuroscience education and research in Africa.

The relationship between parity and overweight varies with household wealth and national development.

PubMed

Kim, Sonia A; Yount, Kathryn M; Ramakrishnan, Usha; Martorell, Reynaldo

2007-02-01

Recent studies support a positive relationship between parity and overweight among women of developing countries; however, it is unclear whether these effects vary by household wealth and national development. Our objective was to determine whether the association between parity and overweight [body mass index (BMI) > or =25 kg/m(2)] in women living in developing countries varies with levels of national human development and/or household wealth. We used data from 28 nationally representative, cross-sectional surveys conducted between 1996 and 2003 (n = 275 704 women, 15-49 years). The relationship between parity and overweight was modelled using logistic regression, controlling for several biological and sociodemographic factors and national development, as reflected by the United Nations' Human Development Index. We also modelled the interaction between parity and national development, and the three-way interaction between parity, household wealth and national development. Parity had a weak, positive association with overweight, which varied by household wealth and national development. Among the poorest women and women in the second tertile of household wealth, parity was positively related to overweight only in the most developed countries. Among the wealthiest women, parity was positively related to overweight regardless of the level of national development. As development increases, the burden of parity-related overweight shifts to include poor as well as wealthy women. In the least-developed countries, programmes to prevent parity-related overweight should target wealthy women, whereas such programmes should be provided to all women in more developed countries.

[Children and bankers in Bangladesh].

PubMed

Hartmann, B

1991-06-01

This critique of the World Bank's role in developing country population programs begins with a description of a 1987 case in which an 80-year- old Bangladeshi man was persuaded to undergo vasectomy and then robbed of his incentive payment by the health agent. For over 20 years, the World Bank has pressured 3rd World governments to implement population control programs. Although there are divergent opinions within the World Bank, the most dominant is the neomalthusian view that the poor through their high fertility help perpetuate their own poverty. This view hides the real source of poverty in the Third World: the unequal distribution of resources within these countries and between the developed and developing countries. The World Bank has always been blind to the inequalities, and has associated with the elites of developing countries who monopolize the resources of their countries and thereby impede authentic development. Furthermore, the emphasis on population control distorts social policy and hinders the implementation of safe and voluntary family planning services. In many countries the World Bank has required governments to give greater priority to population control than to basic health services. It has pressured them to relax contraceptive prescription norms and has promoted the more effective methods without regard to proper use or side effects. In Bangladesh the World Bank has sponsored sterilization programs that rely on coercion and incentives. In that country of enormous inequities, 10% of landowners control over 50% of lands, while nearly half the population is landless and chronically underemployed. Political power is concentrated in the military government, which annually receives over 1.5 billion dollars in external aid. External aid primarily benefits the wealthy. 3/4 of the population are undernourished and less than 1/3 are literate or have access to basic health care. The poor of Bangladesh, as in many other countries, feel that their only source of security is to have many children, a significant proportion of whom will not survive. In rural Bangladesh, where chronic hunger and unemployment are rife, the incentives and the pressures of family planning and health workers were sufficient to persuade many persons to undergo sterilization. Payment of commissions to workers to promote sterilization has discouraged them from supplying adequate information about sterilization for fear of losing clients. Population from other donors and wide publicity about the abuses in the sterilization program and the high rates of regret among women undergoing sterilization only for the incentives have led to some modifications, but the World Bank has continued to exert pressure on the Bangladeshi government to develop fertility-control programs. The damaging effects of World Bank population programs can also be seen in Indonesia, Nepal, and other developing countries.

Migration of scientists and the International Centre for Theoretical Physics -- a Personal and Professional Perspective

NASA Astrophysics Data System (ADS)

Sreenivasan, Katepalli R.

2011-03-01

Scientists migrate for a variety of reasons: political problems with their governments, lack of professional opportunities in their countries, the lure of better lives, financial security for them and their families, better education for their off-springs, and so forth. Migration usually occurs from poor and oppressed countries--the two categories are not one and the same--to the rich and the open. It has created, over time, a dilemma for the poor countries: in the midst of all their other problems, how to justify spending on higher education and research when that investment often results in the most enterprising of its citizens to leave their countries behind? (When migration has reversed direction occasionally, it is because of certain necessities of the scientists to be back in their countries or for opportunities that some individuals see for wielding greater scientific power.) The ideal of keeping the best scientists in their own countries, still ensuring that they remain scientifically productive and inspiring to the youth, is what provided the motivation for the creation of the International Centre for Theoretical Physics in Trieste, Italy, where I served as Director for some seven years. In this talk, I will present the story behind the formation of the Centre in 1964, explain its rationale, and analyze its evolution over time to accommodate the changing scene in world; I will discuss how some things have remained the same even as more of them have changed over time. Finally, I will remark on the broad needs of developing countries even though such needs are often very specific to a country.

Globalization, democracy, and child health in developing countries.

PubMed

Welander, Anna; Lyttkens, Carl Hampus; Nilsson, Therese

2015-07-01

Good health is crucial for human and economic development. In particular poor health in childhood is of utmost concern since it causes irreversible damage and has implications later in life. Recent research suggests globalization is a strong force affecting adult and child health outcomes. Yet, there is much unexplained variation with respect to the globalization effect on child health, in particular in low- and middle-income countries. One factor that could explain such variation across countries is the quality of democracy. Using panel data for 70 developing countries between 1970 and 2009 this paper disentangles the relationship between globalization, democracy, and child health. Specifically the paper examines how globalization and a country's democratic status and historical experience with democracy, respectively, affect infant mortality. In line with previous research, results suggest that globalization reduces infant mortality and that the level of democracy in a country generally improves child health outcomes. Additionally, democracy matters for the size of the globalization effect on child health. If for example Côte d'Ivoire had been a democracy in the 2000-2009 period, this effect would translate into 1200 fewer infant deaths in an average year compared to the situation without democracy. We also find that nutrition is the most important mediator in the relationship. To conclude, globalization and democracy together associate with better child health in developing countries. Copyright © 2015 Elsevier Ltd. All rights reserved.

Non-Profit Education Providers vis-a-vis the Private Sector: Comparative Analysis of Non-Governmental Organizations and Traditional Voluntary Organizations in Pakistan

ERIC Educational Resources Information Center

Bano, Masooda

2008-01-01

Under the New Policy Agenda, international development institutions have promoted non-profit organizations (NPOs) in developing countries, on a dual logic: firstly, they deliver social services more efficiently than the state; secondly, they mitigate equity concerns around privatization of basic social services by reaching out to the poor. Based…

Population growth and economic development.

PubMed

Corbridge, S

1989-01-01

The Malthusian and neo-Malthusian approaches to the role of population growth in economic development and resource depletion are briefly outlined. Three arguments are then presented that emphasize demographic determinism, empirical evidence, and cause and effect. The author concludes that non-coercive family planning programs may have a role to play in countries that are unable to reduce inequalities, particularly for the poor and for women.

The Integrated Women's Empowering Programme (IWEP) as an Example for Establishing Basic Structures of a Nationwide Adult Education System in a Poor Country

ERIC Educational Resources Information Center

Sandhaas, Bernd

2008-01-01

Within Ethiopia's overall development strategy, the Integrated Women's Empowerment Programme (IWEP) aims to develop, test and implement a comprehensive nationwide approach to empower women and their households in selected areas of all regions/national states of Ethiopia. The programme provides functional literacy education and livelihood skills…

Essays on Higher Education

ERIC Educational Resources Information Center

Espinoza Gonzalez, Ricardo Andres

2017-01-01

Higher education has changed dramatically in the last 40 years. What was the privilege of rich nations or poor countries' elites is now an integral part of international competition and development strategies. However, the rapid expansion in enrollment has posed significant challenges in terms of providing adequate financing, access and securing…

Why sub-Saharan Africa lags in electronic health record adoption and possible strategies to increase its adoption in this region

PubMed Central

Odekunle, Florence Femi; Odekunle, Raphael Oluseun; Shankar, Srinivasan

2017-01-01

Poor health information system has been identified as a major challenge in the health-care system in many developing countries including sub-Saharan African countries. Electronic health record (EHR) has been shown as an important tool to improve access to patient information with attendance improved quality of care. However, EHR has not been widely implemented/adopted in sub-Saharan Africa. This study sought to identify factors that affect the adoption of an EHR in sub-Saharan Africa and strategies to improve its adoption in this region. A comprehensive literature search was conducted on three electronic databases: PubMed, Medline, and Google Scholar. Articles of interest were those published in English that contained information on factors that limit the adoption of an EHR as well as strategies that improve its adoption in sub-Saharan African countries. The available evidence indicated that there were many factors that hindered the widespread adoption of an EHR in sub-Saharan Africa. These were high costs of procurement and maintenance of the EHR system, lack of financial incentives and priorities, poor electricity supply and internet connectivity, and primary user’s limited computer skills. However, strategies such as implementation planning, financial supports, appropriate EHR system selection, training of primary users, and the adoption of the phased implementation process have been identified to facilitate the use of an EHR. Wide adoption of an EHR in sub-Saharan Africa region requires a lot more effort than what is assumed because of the current poor level of technological development, lack of required computer skills, and limited resources. PMID:29085270

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.

Towards climate justice: how do the most vulnerable weigh environment-economy trade-offs?

PubMed

Running, Katrina

2015-03-01

The world's poor are especially vulnerable to environmental disasters, including the adverse consequences of climate change. This creates a challenge for climate justice advocates who seek to ensure that those least responsible for causing climate change do not bear unwanted burdens of mitigation. One way to promote climate justice could be to pay particular attention to the environmental policy preferences of citizens from poorer, lower-emitting countries. This paper examines opinions on environment-economy trade-offs and willingness to make personal financial contributions to protect the environment among residents of 42 developed and developing countries using data from the 2005-2008 World Values Survey, the 2010 Climate Risk Index, and World Bank development indicators. Results reveal that individuals in developing countries are less likely to support policies to prioritize environmental protection over economic growth but are more willing to donate personal income for pro-environmental efforts compared to citizens of more developed nations. Published by Elsevier Inc.

Health: an essential component of long-term economic and social development.

PubMed

Drobny, A

1977-01-01

Isolated growth of the economy in a developing country, without due consideration of social aspects, does not necessarily increase the welfare of all its population. In such cases, there will always be a large group with poor education and negligible health care. Health services in these countries should not try to duplicate those of the technologically developed nations and should be more health-oriented than disease-oriented. This entails wider utilization of auxiliary and paramedical personnel and, above all, community involvement. At the same time, the teaching of medicine should be based on the needs of the country rather than try to emulate developed countries' programmes, which can only result in dissatisfaction among physicians and/or in emigration. The Inter-American Development Bank considers that health is a component of long-term economic development; it is therefore fostering and participating in the expansion of rural health services with strong emphasis placed on community participation. In this process health education, both of the public and of local and national authorities, is paramount. Of particular importance is the interaction of health officials and the community itself in order to enlist the rural dweller in spontaneous and active participation that will ensure the success of health programmes.

Internet Performance Analysis of South Asian Countries Using End-to-End Internet Performance Measurements

DOE PAGES

Ali, Saqib; Wang, Guojun; Cottrell, Roger Leslie; ...

2018-05-28

Internet performance is highly correlated with key economic development metrics of a region. According to World Bank, the economic growth of a country increases 1.3% with a 10% increase in the speed of the Internet. Therefore, it is necessary to monitor and understand the performance of the Internet links in the region. It helps to figure out the infrastructural inefficiencies, poor resource allocation, and routing issues in the region. Moreover, it provides healthy suggestions for future upgrades. Therefore, the objective of this paper is to understand the Internet performance and routing infrastructure of South Asian countries in comparison to themore » developed world and neighboring countries using end-to-end Internet performance measurements. The South Asian countries comprise nearly 32% of the Internet users in Asia and nearly 16% of the world. The Internet performance metrics in the region are collected through the PingER framework. The framework is developed by the SLAC National Accelerator Laboratory, USA and is running for the last 20 years. PingER has 16 monitoring nodes in the region, and in the last year PingER monitors about 40 sites in South Asia using the ubiquitous ping facility. The collected data is used to estimate the key Internet performance metrics of South Asian countries. The performance metrics are compared with the neighboring countries and the developed world. Particularly, the TCP throughput of the countries is also correlated with different development indices. Further, worldwide Internet connectivity and routing patterns of the countries are investigated to figure out the inconsistencies in the region. Furthermore, the performance analysis revealed that the South Asia region is 7-10 years behind the developed regions of North America (USA and Canada), Europe, and East Asia.« less

Internet Performance Analysis of South Asian Countries Using End-to-End Internet Performance Measurements

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

Ali, Saqib; Wang, Guojun; Cottrell, Roger Leslie

Internet performance is highly correlated with key economic development metrics of a region. According to World Bank, the economic growth of a country increases 1.3% with a 10% increase in the speed of the Internet. Therefore, it is necessary to monitor and understand the performance of the Internet links in the region. It helps to figure out the infrastructural inefficiencies, poor resource allocation, and routing issues in the region. Moreover, it provides healthy suggestions for future upgrades. Therefore, the objective of this paper is to understand the Internet performance and routing infrastructure of South Asian countries in comparison to themore » developed world and neighboring countries using end-to-end Internet performance measurements. The South Asian countries comprise nearly 32% of the Internet users in Asia and nearly 16% of the world. The Internet performance metrics in the region are collected through the PingER framework. The framework is developed by the SLAC National Accelerator Laboratory, USA and is running for the last 20 years. PingER has 16 monitoring nodes in the region, and in the last year PingER monitors about 40 sites in South Asia using the ubiquitous ping facility. The collected data is used to estimate the key Internet performance metrics of South Asian countries. The performance metrics are compared with the neighboring countries and the developed world. Particularly, the TCP throughput of the countries is also correlated with different development indices. Further, worldwide Internet connectivity and routing patterns of the countries are investigated to figure out the inconsistencies in the region. Furthermore, the performance analysis revealed that the South Asia region is 7-10 years behind the developed regions of North America (USA and Canada), Europe, and East Asia.« less

Deficiencies in drinking water distribution systems in developing countries.

PubMed

Lee, Ellen J; Schwab, Kellogg J

2005-06-01

Rapidly growing populations and migration to urban areas in developing countries has resulted in a vital need for the establishment of centralized water systems to disseminate potable water to residents. Protected source water and modern, well-maintained drinking water treatment plants can provide water adequate for human consumption. However, ageing, stressed or poorly maintained distribution systems can cause the quality of piped drinking water to deteriorate below acceptable levels and pose serious health risks. This review will outline distribution system deficiencies in developing countries caused by: the failure to disinfect water or maintain a proper disinfection residual; low pipeline water pressure; intermittent service; excessive network leakages; corrosion of parts; inadequate sewage disposal; and inequitable pricing and usage of water. Through improved research, monitoring and surveillance, increased understanding of distribution system deficiencies may focus limited resources on key areas in an effort to improve public health and decrease global disease burden.

[Spanish international cooperation in health].

PubMed

Mazarrasa-Alvear, Lucía; Montero-Corominas, María José

2004-05-01

In this chapter, there is a view of the relationships between the Spanish policy for international cooperation aid and the main health problems of the developing world, with a gender perspective. The population health is a result of the development inequity between rich and poor countries. The international institutions have established the frame and priorities of the cooperation aid, being poverty eradication the main priority. The compromise of the Millennium Conference was to reduce in 2/3 child mortality and 3/4 maternal mortality before year 2015, to stop and reduce HIV-AIDS, malaria and others serious diseases as tuberculosis and to facilitate developing countries the access to drugs. Although the resources allocated, the total amount for cooperation has been reduced 30% during the last years. The Spanish AOD in health is difficult to account because it is considered among social basic services and it is not addressed to solve the main health problems in the poorest countries.

Rotavirus vaccine RIX4414 (Rotarix™): a pharmacoeconomic review of its use in the prevention of rotavirus gastroenteritis in developing countries.

PubMed

Plosker, Greg L

2011-11-01

This article provides an overview of the clinical profile of rotavirus vaccine RIX4414 (Rotarix™) in the prevention of rotavirus gastroenteritis (RVGE) in developing countries, followed by a comprehensive review of pharmacoeconomic analyses with the vaccine in low- and middle-income countries. RVGE is associated with significant morbidity and mortality among children <5 years of age in developing countries. The protective efficacy of a two-dose oral series of rotavirus vaccine RIX4414 has been demonstrated in several well designed clinical trials conducted in developing countries, and the 'real-world' effectiveness of the vaccine has also been shown in naturalistic and case-control trials after the introduction of universal vaccination programmes with RIX4414 in Latin American countries. The WHO recommends universal rotavirus vaccination programmes for all countries. Numerous modelled cost-effectiveness analyses have been conducted with rotavirus vaccine RIX4414 across a wide range of low- and middle-income countries. Although data sources and assumptions varied across studies, results of the analyses consistently showed that the introduction of the vaccine as part of a national vaccination programme would be very (or highly) cost effective compared with no rotavirus vaccination programme, according to widely used cost-effectiveness thresholds for developing countries. Vaccine price was not known at the time the analyses were conducted and had to be estimated. In sensitivity analyses, rotavirus vaccine RIX4414 generally remained cost effective at the highest of a range of possible vaccine prices considered. Despite these favourable results, decisions regarding the implementation of universal vaccination programmes with RIX4414 may also be contingent on budgetary and other factors, underscoring the importance of subsidized vaccination programmes for poor countries through the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunization).

Chemical composition and sources of particle pollution in affluent and poor neighborhoods of Accra, Ghana

NASA Astrophysics Data System (ADS)

Zhou, Zheng; Dionisio, Kathie L.; Verissimo, Thiago G.; Kerr, Americo S.; Coull, Brent; Arku, Raphael E.; Koutrakis, Petros; Spengler, John D.; Hughes, Allison F.; Vallarino, Jose; Agyei-Mensah, Samuel; Ezzati, Majid

2013-12-01

The highest levels of air pollution in the world now occur in developing country cities, where air pollution sources differ from high-income countries. We analyzed particulate matter (PM) chemical composition and estimated the contributions of various sources to particle pollution in poor and affluent neighborhoods of Accra, Ghana. Elements from earth’s crust were most abundant during the seasonal Harmattan period between late December and late January when Saharan dust is carried to coastal West Africa. During Harmattan, crustal particles accounted for 55 μg m-3 (37%) of fine particle (PM2.5) mass and 128 μg m-3 (42%) of PM10 mass. Outside Harmattan, biomass combustion, which was associated with higher black carbon, potassium, and sulfur, accounted for between 10.6 and 21.3 μg m-3 of fine particle mass in different neighborhoods, with its contribution largest in the poorest neighborhood. Other sources were sea salt, vehicle emissions, tire and brake wear, road dust, and solid waste burning. Reducing air pollution in African cities requires policies related to energy, transportation and urban planning, and forestry and agriculture, with explicit attention to impacts of each strategy in poor communities. Such cross-sectoral integration requires emphasis on urban environment and urban poverty in the post-2015 Development Agenda.

[Overpopulation is bad, but excessive consumption is worse].

PubMed

Susuki, D

1993-12-01

The notion that consumption in developed countries is the main cause of ecological deterioration and planetary contamination is contested by many who assert that overpopulation in the developing world is the main factor. But the great disparity in income and consumption between rich and poor countries cannot be ignored. Each Canadian consumes 16 to 20 times more than an inhabitant of India or China and 60 to 70 times more than an inhabitant of Bangladesh. Consequently, the 1.1 billion inhabitants of industrialized countries cause ecological effects equivalent to what would be produced by 17 to 70 billion inhabitants of developing countries. The planet could not support 5.5 billion persons consuming at the rate of the 1.1 billion in the developed world. Consumption has been encouraged by the government and businesses in the U.S. and is an important factor in the health of the economy. But increases in consumption are not sustainable indefinitely. Much of current consumption results from inefficiency and waste. The life style of the developed countries has a high price in violence, alienation, alcoholism, vandalism, loneliness, pollution, and disturbance of the family and neighborhood. Becoming content with less consumption and striving for a future based on communities with greater self-confidence and self-sufficiency is a reasonable goal from both ecological and social points of view.

Development and validation of a multilateral index to determine economic status in developing countries: the Patient Financial Eligibility Tool (PFET).

PubMed

Saba, Joseph; Audureau, Etienne; Bizé, Marion; Koloshuk, Barbara; Ladner, Joël

2013-04-01

The objective was to develop and validate a multilateral index to determine patient ability to pay for medication in low- and middle-income countries. Primary data were collected in 2009 from 117 cancer patients in China, India, Thailand, and Malaysia. The initial tool included income, expenditures, and assets-based items using ad hoc determined brackets. Principal components analysis was performed to determine final weights. Agreement (Kappa) was measured between results from the final tool and from an Impact Survey (IS) conducted after beginning drug therapy to quantify a patient's actual ability to pay in terms of number of drug cycles per year. The authors present the step-by-step methodology employed to develop the tool on a country-by-country basis. Overall Cronbach value was 0.84. Agreement between the Patient Financial Eligibility Tool (PFET) and IS was perfect (equal number of drug cycles) for 58.1% of patients, fair (1 cycle difference) for 29.1%, and poor (>1 cycle) for 12.8%. Overall Kappa was 0.76 (P<0.0001). The PFET is an effective tool for determining an individual's ability to pay for medication. Combined with tiered models for patient participation in the cost of medication, it could help to increase access to high-priced products in developing countries.

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

PubMed

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

2017-05-25

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

Small business development: who pays?

PubMed

Hellinger, D

1985-11-01

This article traces the trends in the aid community towards income generation and small business projects in developing countries since the 1950s. 1 of the great weakness of the development assistance community in the area of income generation remains the lack of analysis of population differentiation in the communities in which they work. A very different approach to the problem of the informal sector and income generation is one that responds directly to the needs of poor communities. Institutions working within poor communities and supporting multi-sectoral development while strengthening local organizations are much better situated to respond to the diverse needs of the community than are single-sector organizations with only 1 skill or service to offer. To assist significant numbers of poor people, particularly women, grouping of some sort is essential. This is not to say that group enterprise development is an easy process. The intensive and costly organizational and management assistance required to prepare a poor group for credit must be weighed along with the potential for creating a basis of long-range change within the community. To work with individual family enterprizes in a community can also have important social and economic effects, although the long-range impact may be more limited. Today, more than ever, the poor face the challenge of creating new survival mechanisms within their communities. Development agencies and assistance programs have the responsibility to help rather than hinder this process.

Reverse gastric tube oesophageal substitution for staged repair of oesophageal atresia and tracheo-oesophageal fistula.

PubMed

Bode, Christopher Olusanjo; Ademuyiwa, Adesoji Oludotun

2014-01-01

The management of oesophageal atresia and tracheo-oesophageal atresia (OATOF) is very challenging. While in developed countries survival of patients with this condition has improved, the outcome in many developing countries has been poor. Primary repair through a thoracotomy (or video-assisted thoracoscopic surgery where available) is the gold standard treatment of OATOF. However, in our setting where patients typically present late and with minimum support resources such as Neonatal Intensive Care Unit and total parenteral nutrition; staged repair may be the only hope of survival of these patients and this communication highlights the essential steps of this mode of treatment.

Considering long-term care insurance for middle-income countries: comparing South Korea with Japan and Germany.

PubMed

Rhee, Jong Chul; Done, Nicolae; Anderson, Gerard F

2015-10-01

Financing and provision of long-term care is an increasingly important concern for many middle-income countries experiencing rapid population aging. We examine three countries (South Korea, Japan, and Germany) that use social insurance to finance medical care and have developed long-term care insurance (LTCI) systems. These countries have adopted different approaches to LTCI design within the social insurance framework. We contrast their financing systems and draw lessons regarding revenue generation, benefits design, and eligibility. Based on this review, it seems important for middle-income countries to start developing LTCI schemes early, before aging becomes a significant problem and substantial revenues are needed. Early financing also ensures that the service delivery system has time to adapt because most middle-income countries lack the infrastructure for providing long-term care services. One approach is to start with a limited benefit package and strict eligibility rules and expanded the program as the country develops sufficient experience and more providers became available. All three countries use some form of cost-sharing to discourage service overuse, combined with subsidies for poor populations to maintain appropriate access. A major policy choice is between cash benefits or direct provision of services and the approach will have a large impact on the workforce participation of women. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Sexual and reproductive health: Progress and outstanding needs

PubMed Central

Snow, Rachel C.; Laski, Laura; Mutumba, Massy

2015-01-01

We examine progress towards the 1994 International Conference on Population and Development (ICPD) commitment to provide universal access to sexual and reproductive health (SRH) services by 2014, with an emphasis on changes for those living in poor and emerging economies. Accomplishments include a 45% decline in the maternal mortality ratio (MMR) between 1990 and 2013; 11.5% decline in global unmet need for modern contraception; ~21% increase in skilled birth attendance; and declines in both the case fatality rate and rate of abortion. Yet aggregate gains mask stark inequalities, with low coverage of services for the poorest women. Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 80 developing countries highlight persistent disparities in skilled birth attendance by household wealth: in 70 of 80 countries (88%), ≥80% of women in the highest quintile were attended by a skilled provider at last birth; in only 23 of the same countries (29%) was this the case for women in the lowest wealth quintile. While there have been notable declines in HIV incidence and prevalence, women affected by HIV are too often bereft of other SRH services, including family planning. Achieving universal access to SRH will require substantially greater investment in comprehensive and integrated services that reach the poor. PMID:25555027

Family planning: a basic development need.

PubMed

1994-06-01

The 1994 Human Development Report from the United Nations Development Program (UNDP) proposes a 20-20 Human Development Compact based on shared responsibilities between poor and rich nations, whereby poor and rich nations would help unmet basic human development needs such as primary education, primary health care, safe drinking water, and family planning over the next 10 years. This would require an additional US $30 to US $40 billion annually. Developing countries would commit 20% of their budgets to human priority concerns instead of the current 10% by reducing military expenditure, selling off unprofitable public enterprises and abandoning wasteful prestige projects. Donor countries would increase foreign aid from the current average of 7% to 20%. The report will propose a new concept of human security at the World Summit for Social Development to be held in March 1995, calling widespread human insecurity a universal problem. On average, poor nations have 19 soldiers for every one doctor. Global military spending has been declining since 1987 at the rate of 3.6% a year, resulting in a cumulative peace dividend of US $935 billion from 1987 to 1994. But this money has not been expended on unmet human needs. India ordered fighter planes at a cost that could have provided basic education to the 15 million Indian girls now out of school. Nigeria bought tanks from the UK at a cost that could have immunized all 2 million unimmunized children while also providing family planning to nearly 17 million couples. UNDP proposes a phasing out of all military assistance, military bases, and subsidies to arms exporters over a 3-year period. It also recommends the major restructuring of existing aid funds, and proposes a serious study on new institutions for global governance in the next century.

Considering the case for vitamin B12 fortification of flour

USDA-ARS?s Scientific Manuscript database

Reasons to fortify flour with vitamin B12 are considered, which include the high prevalence of depletion and deficiency of this vitamin that occurs in persons of all ages in resource-poor countries and in elderly in wealthier countries, as well as the adverse functional consequences of poor vitamin ...

Wealth, justice and freedom: Objective and subjective measures predicting poor mental health in a study across eight countries.

PubMed

Scholten, Saskia; Velten, Julia; Neher, Torsten; Margraf, Jürgen

2017-12-01

Macro-level factors (MF) such as wealth, justice and freedom measured with objective country-level indicators (objective MF), for instance the Gross Domestic Product (GDP), have been investigated in relation to health and well-being, but rarely in connection with depression, anxiety and stress subsumed as poor mental health. Also, a combination of different objective MF and of how individuals perceive those MF (subjective MF) has not been taken into consideration. In the present study, we combined subjective and objective measures of wealth, justice and freedom and examined their relationship with poor mental health. Population-based interviews were conducted in France, Germany, Poland, Russia, Spain, Sweden, U.K. and U.S.A. (n ≈ 1000 per country). GDP, GINI coefficient, Justice Index and Freedom Index were used as objective MF, whereas subjective MF were perceived wealth, justice and freedom measured at the individual level. Poor mental health was assessed as a combination of symptoms of depression, anxiety and stress. In a random-intercept-model, GINI coefficient and Freedom Index were significant positive country-level, and perceived wealth, justice, and freedom significant negative individual-level predictors of symptoms of poor mental health. Multiple subjective and objective MF should be combined to assess the macrosystem's relationship with poor mental health more precisely. The relationship between MF and poor mental health indicates that the macrosystem should be taken into account as relevant context for mental health problems, too.

THE USE OF RANDOMIZED CONTROLLED TRIALS OF IN-HOME DRINKING WATER TREATMENT TO STUDY ENDEMIC WATERBORNE DISEASE

EPA Science Inventory

Randomized trials of water treatment have demonstrated the ability of simple water treatments to significantly reduce the incidence of gastrointestinal illnesses in developing countries where drinking water is of poor quality. Whether or not additional treatment at the tap reduc...

Performativity in School Management and Leadership in Botswana

ERIC Educational Resources Information Center

Pansiri, Nkobi Owen

2011-01-01

The thesis of this article is that the uncritical adoption of Western models of education management and leadership policies results in poor performance in schools in disadvantaged communities in developing countries. The argument shows that this has led to the institutionalization of generic education policies that are not contingent to the…

Market Tested Business Education: Corporate Sector Perceptions of Saudi Graduates Competencies

ERIC Educational Resources Information Center

Iqbal, Adnan; Zenchenkov, Mikhail

2014-01-01

University-industry collaboration patterns in more advanced economies have greatly impacted expectations for higher educational systems in developing countries. In Saudi Arabia, generally poor innovation performance of domestic industry has been perceived as a constraint in global competitiveness. The purpose of this study was to determine if…

Universal(ly Bad) Service: Providing Infrastructure Services to Rural and Poor Urban Consumers. Policy Research Working Paper.

ERIC Educational Resources Information Center

Clarke, George R. G.; Wallsten, Scott J.

Utility services (telecommunications, power, water, and gas) throughout the world were traditionally provided by large, usually state-owned, monopolies. However, encouraged by technological change, regulatory innovation, and pressure from international organizations, many developing countries are privatizing state-owned companies and introducing…

Evaluation of sectrally-selective materials for multi-layer solar thermal crop drying (abstract)

USDA-ARS?s Scientific Manuscript database

Solar thermal (ST) drying is a ubiquitous method in widespread use for fruit and vegetable crop preservation in developing countries; however, it has had limited commercialization in the United States due to concerns about slow drying rates, poor product quality, and predicted low return-on-investme...

Child Nutritional Status by Rural/Urban Residence: A Cross-National Analysis

ERIC Educational Resources Information Center

Fox, Kiira; Heaton, Tim B.

2012-01-01

Purpose: Rural children in developing countries have poor health outcomes in comparison with urban children. This paper considers 4 questions regarding the rural/urban difference, namely: (1) do individual-level characteristics account for rural/urban differences in child nutritional status; (2) do community-level characteristics account for…

Medical education and the physician workforce of Iraq.

PubMed

Al Mosawi, Aamir Jalal

2008-01-01

The lack of resources in a country experiencing decades of successive wars, blockade, administrative corruption, and poor governance led to deteriorated standards throughout medical education. Although professional certification programs exist, continuing medical education accreditation and credit systems are required to monitor and certify the continuing professional development of physicians.

The Social and Productive Impacts of Zambia's Child Grant

ERIC Educational Resources Information Center

Handa, Sudhanshu; Seidenfeld, David; Davis, Benjamin; Tembo, Gelson

2016-01-01

Accumulated evidence from dozens of cash transfer (CT) programs across the world suggests that there are few interventions that can match the range of impacts and cost-effectiveness of a small, predictable monetary transfer to poor families in developing countries. However, individual published impact assessments typically focus on only one…

Success Stories: Biographical Narratives of Three Women School Principals in Kenya

ERIC Educational Resources Information Center

Mayienga, Damaris Moraa

2013-01-01

Studies indicate that women are poorly represented in school leadership across the various regions of the world particularly in developing countries. Most studies explain this underrepresentation in terms of external or institutional factors that have impeded women's advancement onto school leadership. Such factors include women's lack of…

Human immunization in developing countries: practical and theoretical problems and prospects.

PubMed

Arya, S C

1994-11-01

While measles, pertussis and tetanus were responsible during the early 1990s for nearly two million deaths in developing countries, no deaths were attributable to them in industrialized countries. More than 96% of global deaths by communicable diseases were also from developing countries. Respiratory infections ranked first in communicable morbidity at all ages. Even though vaccines of bacterial or viral origin or a prophylactic for passive immunization are produced in 24, 16 and 15 developing countries, respectively, none of the developing countries manufactures a plasma-derived prophylactic or biological response modifier. Nearly every country relies on import of one or more vaccines. The suboptimal performance of otherwise meritorious products has been due to faulty vaccine administration practices. Expanding populations, poverty and lack of education, cold-chain defects, and inadequate facilities for transport of vaccines to target populations in remote areas have been responsible for the poor performance of vaccines in the community. Mounting foreign debts and budgetary strains resulting from the care and prevention of AIDS/HIV have considerably strained national and international efforts to offer routine vaccinations in childhood and pregnancy. This dismal situation could be tackled through research to obtain environmentally stable products for prophylactic use and monoclonal antibody formulations for passive immunization, and through international financial and technical support. All countries should exercise some technical control of the quality of imported and indigenous vaccines during their use for curative or prophylactic purposes. The involvement of private clinicians in immunizations would strengthen national efforts for control of communicable diseases including AIDS, but this is not enough if the local factors cited above are not improved.

Parents' Attitudes Towards Science and their Children's Science Achievement

NASA Astrophysics Data System (ADS)

Perera, Liyanage Devangi H.

2014-12-01

Although countries worldwide are emphasizing the importance of science education for technological development and global economic competition, comparative findings from standardized international student assessments reveal a huge gap in science scores between developed and developing countries. Certain developed economies too have made little progress in raising science achievement over the past decade. Despite school improvement being placed high on the policy agenda, the results of such actions have been poor. Therefore, there is a need to explore additional ways in which science achievement can be enhanced. This study focuses on the family and examines whether parents' attitudes towards science (how much they value science and the importance they place on it) can influence their children's science achievement. Individual- and school-level data are obtained from the Program for International Student Assessment 2006 survey for 15 Organisation for Economic Co-operation and Development (OECD) and non-OECD countries. Hierarchical linear modelling is employed to estimate the equations. The findings indicate that parents' attitudes towards science have a positive and statistically significant effect on science achievement, after controlling for other important student- and school-level variables. Moreover, students from poor backgrounds appear to benefit from more positive parental science attitudes as much as students from high socioeconomic status, such that equality of student achievement is not affected. This study recommends that schools and teachers encourage parents to play a more pro-active role in their children's science education, as well as educate parents about the importance of science and strategies that can be adopted to support their children's science learning.

Child health inequities in developing countries: differences across urban and rural areas

PubMed Central

Fotso, Jean-Christophe

2006-01-01

Objectives To document and compare the magnitude of inequities in child malnutrition across urban and rural areas, and to investigate the extent to which within-urban disparities in child malnutrition are accounted for by the characteristics of communities, households and individuals. Methods The most recent data sets available from the Demographic and Health Surveys (DHS) of 15 countries in sub-Saharan Africa (SSA) are used. The selection criteria were set to ensure that the number of countries, their geographical spread across Western/Central and Eastern/Southern Africa, and their socioeconomic diversities, constitute a good yardstick for the region and allow us to draw some generalizations. A household wealth index is constructed in each country and area (urban, rural), and the odds ratio between its uppermost and lowermost category, derived from multilevel logistic models, is used as a measure of socioeconomic inequalities. Control variables include mother's and father's education, community socioeconomic status (SES) designed to represent the broad socio-economic ecology of the neighborhoods in which families live, and relevant mother- and child-level covariates. Results Across countries in SSA, though socioeconomic inequalities in stunting do exist in both urban and rural areas, they are significantly larger in urban areas. Intra-urban differences in child malnutrition are larger than overall urban-rural differentials in child malnutrition, and there seem to be no visible relationships between within-urban inequities in child health on the one hand, and urban population growth, urban malnutrition, or overall rural-urban differentials in malnutrition, on the other. Finally, maternal and father's education, community SES and other measurable covariates at the mother and child levels only explain a slight part of the within-urban differences in child malnutrition. Conclusion The urban advantage in health masks enormous disparities between the poor and the non-poor in urban areas of SSA. Specific policies geared at preferentially improving the health and nutrition of the urban poor should be implemented, so that while targeting the best attainable average level of health, reducing gaps between population groups is also on target. To successfully monitor the gaps between urban poor and non-poor, existing data collection programs such as the DHS and other nationally representative surveys should be re-designed to capture the changing patterns of the spatial distribution of population. PMID:16831231

Child health inequities in developing countries: differences across urban and rural areas.

PubMed

Fotso, Jean-Christophe

2006-07-11

To document and compare the magnitude of inequities in child malnutrition across urban and rural areas, and to investigate the extent to which within-urban disparities in child malnutrition are accounted for by the characteristics of communities, households and individuals. The most recent data sets available from the Demographic and Health Surveys (DHS) of 15 countries in sub-Saharan Africa (SSA) are used. The selection criteria were set to ensure that the number of countries, their geographical spread across Western/Central and Eastern/Southern Africa, and their socioeconomic diversities, constitute a good yardstick for the region and allow us to draw some generalizations. A household wealth index is constructed in each country and area (urban, rural), and the odds ratio between its uppermost and lowermost category, derived from multilevel logistic models, is used as a measure of socioeconomic inequalities. Control variables include mother's and father's education, community socioeconomic status (SES) designed to represent the broad socio-economic ecology of the neighborhoods in which families live, and relevant mother- and child-level covariates. Across countries in SSA, though socioeconomic inequalities in stunting do exist in both urban and rural areas, they are significantly larger in urban areas. Intra-urban differences in child malnutrition are larger than overall urban-rural differentials in child malnutrition, and there seem to be no visible relationships between within-urban inequities in child health on the one hand, and urban population growth, urban malnutrition, or overall rural-urban differentials in malnutrition, on the other. Finally, maternal and father's education, community SES and other measurable covariates at the mother and child levels only explain a slight part of the within-urban differences in child malnutrition. The urban advantage in health masks enormous disparities between the poor and the non-poor in urban areas of SSA. Specific policies geared at preferentially improving the health and nutrition of the urban poor should be implemented, so that while targeting the best attainable average level of health, reducing gaps between population groups is also on target. To successfully monitor the gaps between urban poor and non-poor, existing data collection programs such as the DHS and other nationally representative surveys should be re-designed to capture the changing patterns of the spatial distribution of population.

Role of legislation in population and development planning.

PubMed

Jayasuriya, D C

1986-09-01

This article examines how law can influence population and development planning in the Asian and Pacific region. Countries in the region have a variety of legal systems and development dynamics, and variations in both occur even within countries, among different population groups. Population law regulates population growth, composition, and movement and induces behavior and attitudinal changes to enhance quality of life at all levels. Population law often also governs human reproduction (e.g. contraception, abortion), family formation (e.g. age factors, marriage), sexual behavior, (e.g. prostitution, rape), quality of life (e.g. education, employment, women's status), vital events (e.g. birth, death, marriage registration, residence) and the physical environment. Some national constitutions make mention of population/development objectives (China, Thailand) and equality of the sexes (e.g. Sri Lanka), an important step given that some countries have provided legal impediments to population planning; e.g. mang governments have been opposed to the use of IUD. Social trends such as later marriages have been in evidence. Abortion has prevented millions of births in Asia. The effect of illegality of abortion is generally to penalize the poor (who do not have resources to circumvent the law, and to increase female mortality indirectly through increases in abortion under poor medical conditions. Sexual sterilization is problematic in situations of coersion or where the infant mortality rate is high, or childless couples are stigmatized, because of its permanecnce. Law interfaces with contraceptive distribution in issues such as qualifications of distributors and age of recipients. The impact of the law on behavior and quality of life is not always clear. The role of legislation in development should be determined by multidisciplinar study groups, since no profession alone has enough perspective on development. Development policies should be global in nature, and mindful of future realities.

Palliative care, public health and justice: setting priorities in resource poor countries.

PubMed

Blinderman, Craig

2009-12-01

Many countries have not considered palliative care a public health problem. With limited resources, disease-oriented therapies and prevention measures take priority. In this paper, I intend to describe the moral framework for considering palliative care as a public health priority in resource-poor countries. A distributive theory of justice for health care should consider integrative palliative care as morally required as it contributes to improving normal functioning and preserving opportunities for the individual. For patients requiring terminal care, we are guided less by principles of justice and more by the duty to relieve suffering and society's commitment to protecting the professional's obligation to uphold principles of beneficence, compassion and non-abandonment. A fair deliberation process is necessary to allow these strong moral commitments to serve as reasons when setting priorities in resource poor countries.

Early-life conditions and older adult health in low- and middle-income countries: a review

PubMed Central

McEniry, M.

2012-01-01

Population aging and subsequent projected large increases in chronic conditions will be important health concerns in low- and middle-income countries. Although evidence is accumulating, little is known regarding the impact of poor early-life conditions on older adult (50 years and older) health in these settings. A systematic review of 1141 empirical studies was conducted to identify population-based and community studies in low- and middle-income countries, which examined associations between early-life conditions and older adult health. The resulting review of 20 studies revealed strong associations between (1) in utero/early infancy exposures (independent of other early life and adult conditions) and adult heart disease and diabetes; (2) poor nutrition during childhood and difficulties in adult cognition and diabetes; (3) specific childhood illnesses such as rheumatic fever and malaria and adult heart disease and mortality; (4) poor childhood health and adult functionality/disability and chronic diseases; (5) poor childhood socioeconomic status (SES) and adult mortality, functionality/disability and cognition; and (6) parental survival during childhood and adult functionality/disability and cognition. In several instances, associations remained strong even after controlling for adult SES and lifestyle. Although exact mechanisms cannot be identified, these studies reinforce to some extent the importance of early-life environment on health at older ages. Given the paucity of cohort data from the developing world to examine hypotheses of early-life conditions and older adult health, population-based studies are relevant in providing a broad perspective on the origins of adult health. PMID:23316272

Hemodialysis in Asia

PubMed Central

Prasad, Narayan; Jha, Vivekanand

2015-01-01

Background Asia is the largest, most populous and most heterogeneous continent in the world. The number of patients with end-stage renal disease is growing rapidly in Asia. Summary A fully informed report on the status of dialysis therapies including hemodialysis (HD) is limited by the lack of systematic registries. Available data suggest remarkable heterogeneities, with some countries like Taiwan, Japan and Korea exhibiting well-established HD systems, high prevalence and universal access to all patients, while low- and low-middle income countries are unable to provide HD to eligible patients because of high cost and poor healthcare systems. Many Asian countries have unregulated dialysis units, with poor standards of delivery, quality control and outcome reporting. This leads to high mortality due to preventable complications like infections. Modeling data suggest that at least 2.9 million people need dialysis in Asia, which represents a gap in availability of dialysis to the tune of −66%. The population is projected to grow rapidly in the coming years. Several countries are expanding access to HD. Innovative modifications in dialysis practice are being made to optimize outcomes. It is important to develop robust systems of documentation and outcome reporting to evaluate the effects of such changes. HD needs to develop in conjunction with effective preventive programs and improvement of health systems. Key Messages The practice of HD in Asia is growing and evolving. Rapid expansion will improve the currently dismal access to care for large sections of the population. Quality issues need to be addressed if the full benefit of this therapy is to reach the population. Developed countries of Asia can provide substantial messages to developing economies. HD programs must develop in conjunction with prevention efforts. Facts from East and West (1) While developed Western and Asian countries provide end-stage renal disease patients full access to HD, healthcare systems from South and South-East Asia can offer access to HD only to a limited fraction of the patients in need. Even though the annual costs of HD are much lower in less developed countries (for instance 30 times lower in India compared to the US), patients often cannot afford costs not covered by health insurance. (2) The recommended dialysis pattern in the West is at least three sessions weekly with high-flux dialyzers. Studies from Shanghai and Taiwan might however indicate a benefit of twice versus thrice weekly sessions. In less developed Asian countries, a twice weekly pattern is common, sometimes with dialyzer reuse and inadequate water treatment. A majority of patients decrease session frequency or discontinue the program due to financial constraint. (3) As convective therapies are gaining popularity in Europe, penetration in Asia is low and limited by costs. (4) In Asian countries, in particular in the South and South-East, hepatitis and tuberculosis infections in HD patients are higher than in the West and substantially increase mortality. (5) Progress has recently been made in countries like Thailand and Brunei to provide universal HD access to all patients in need. Nevertheless, well-trained personnel, reliable registries and better patient follow-up would improve outcomes in low-income Asian countries. PMID:27536677

Diffusion of novel healthcare technologies to resource poor settings.

PubMed

Malkin, Robert; von Oldenburg Beer, Kim

2013-09-01

A new product has completed clinical trials in a distant, resource poor hospital using a few dozen prototypes. The data looks great. The novel medical device solves a widely felt problem. The next goal is to integrate the device into the country's healthcare system and spread the device to other countries. But how? In order to be widely used, the device must be manufactured and distributed. One option is to license the intellectual property (IP) to an interested third party, if one can be found. However, it is possible to manage the manufacturing and distribution without licensing. There are at least two common means for manufacturing a novel medical device targeted to resource poor settings: (a) formal (contract) manufacturing and (b) informal (local) manufacturing. There are three primary routes to diffusion of novel medical devices in the developing world: (1) local distributors (2) direct international sales and (3) international donations. Perhaps surprisingly, the least effective mechanism is direct importation through donation. The most successful mechanism, the method used by nearly all working medical devices in resource-poor settings, is the use of contract manufacturing and a local distributor. This article is written for the biomedical innovator and entrepreneur who wishes to make a novel healthcare technology or product available and accessible to healthcare providers and patients in the developing world. There are very few documented cases and little formal research in this area. To this end, this article describes and explores the manufacturing and distribution options in order to provide insights into when and how each can be applied to scale up a novel technology to make a difference in a resource poor setting.

The Declaration of Istanbul on Organ Trafficking and Transplant Tourism

PubMed Central

2008-01-01

Organ commercialism, which targets vulnerable populations (such as illiterate and impoverished persons, undocumented immigrants, prisoners, and political or economic refugees) in resource-poor countries, has been condemned by international bodies such as the World Health Organization for decades. Yet in recent years, as a consequence of the increasing ease of Internet communication and the willingness of patients in rich countries to travel and purchase organs, organ trafficking and transplant tourism have grown into global problems. For example, as of 2006, foreigners received two-thirds of the 2000 kidney transplants performed annually in Pakistan. The Istanbul Declaration proclaims that the poor who sell their organs are being exploited, whether by richer people within their own countries or by transplant tourists from abroad. Moreover, transplant tourists risk physical harm by unregulated and illegal transplantation. Participants in the Istanbul Summit concluded that transplant commercialism, which targets the vulnerable, transplant tourism, and organ trafficking should be prohibited. And they also urged their fellow transplant professionals, individually and through their organizations, to put an end to these unethical activities and foster safe, accountable practices that meet the needs of transplant recipients while protecting donors. Countries from which transplant tourists originate, as well as those to which they travel to obtain transplants, are just beginning to address their respective responsibilities to protect their people from exploitation and to develop national self-sufficiency in organ donation. The Declaration should reinforce the resolve of governments and international organizations to develop laws and guidelines to bring an end to wrongful practices. “The legacy of transplantation is threatened by organ trafficking and transplant tourism. The Declaration of Istanbul aims to combat these activities and to preserve the nobility of organ donation. The success of transplantation as a life-saving treatment does not require—nor justify—victimizing the world's poor as the source of organs for the rich” (Steering Committee of the Istanbul Summit). PMID:18701611

The Declaration of Istanbul on Organ Trafficking and Transplant Tourism.

PubMed

2008-09-01

Organ commercialism, which targets vulnerable populations (such as illiterate and impoverished persons, undocumented immigrants, prisoners, and political or economic refugees) in resource-poor countries, has been condemned by international bodies such as the World Health Organization for decades. Yet in recent years, as a consequence of the increasing ease of Internet communication and the willingness of patients in rich countries to travel and purchase organs, organ trafficking and transplant tourism have grown into global problems. For example, as of 2006, foreigners received two-thirds of the 2000 kidney transplants performed annually in Pakistan. The Istanbul Declaration proclaims that the poor who sell their organs are being exploited, whether by richer people within their own countries or by transplant tourists from abroad. Moreover, transplant tourists risk physical harm by unregulated and illegal transplantation. Participants in the Istanbul Summit concluded that transplant commercialism, which targets the vulnerable, transplant tourism, and organ trafficking should be prohibited. And they also urged their fellow transplant professionals, individually and through their organizations, to put an end to these unethical activities and foster safe, accountable practices that meet the needs of transplant recipients while protecting donors. Countries from which transplant tourists originate, as well as those to which they travel to obtain transplants, are just beginning to address their respective responsibilities to protect their people from exploitation and to develop national self-sufficiency in organ donation. The Declaration should reinforce the resolve of governments and international organizations to develop laws and guidelines to bring an end to wrongful practices. "The legacy of transplantation is threatened by organ trafficking and transplant tourism. The Declaration of Istanbul aims to combat these activities and to preserve the nobility of organ donation. The success of transplantation as a life-saving treatment does not require-nor justify-victimizing the world's poor as the source of organs for the rich" (Steering Committee of the Istanbul Summit).

Links between livestock production, the environment and sustainable development.

PubMed

Pradbre, J-P

2014-12-01

This study examines the prospects for strong growth in the supply and demand for animal products worldwide, especially in developing countries, where 80% of the world's population lives. Based on scientific publications, statistics and field observations, it reviews greenhouse gas emission levels from livestock, the ability of ruminant livestock systems to sequester carbon and the capacity of the livestock industry to meet the challenge of sustainable development and to share its benefits while minimising impacts to climate change. Special attention is paid to the situation of the 800 million livestock farmers in the world living at the extreme end of poverty. The study underlines the importance of improving livestock productivity and the interdependence of the economic, environmental and social components of sustainable development. It highlights how, in the least developed countries and most lower-middle-income countries, the pressure exerted by animal diseases hampers efforts to improve livestock productivity. Poor livestock farmers have not sufficiently benefited from development policies and need support to adopt technological advances to meet the challenges of sustainable development and poverty reduction.

Restructuring brain drain: strengthening governance and financing for health worker migration.

PubMed

Mackey, Tim K; Liang, Bryan A

2013-01-15

Health worker migration from resource-poor countries to developed countries, also known as ''brain drain'', represents a serious global health crisis and a significant barrier to achieving global health equity. Resource-poor countries are unable to recruit and retain health workers for domestic health systems, resulting in inadequate health infrastructure and millions of dollars in healthcare investment losses. Using acceptable methods of policy analysis, we first assess current strategies aimed at alleviating brain drain and then propose our own global health policy based solution to address current policy limitations. Although governments and private organizations have tried to address this policy challenge, brain drain continues to destabilise public health systems and their populations globally. Most importantly, lack of adequate financing and binding governance solutions continue to fail to prevent health worker brain drain. In response to these challenges, the establishment of a Global Health Resource Fund in conjunction with an international framework for health worker migration could create global governance for stable funding mechanisms encourage equitable migration pathways, and provide data collection that is desperately needed.

Initiating and developing clinical services, training and research in a low resource setting: the Malawi ENT experience.

PubMed

Mulwafu, Wakisa; Nyirenda, Thomas Elliot; Fagan, Johannes J; Bem, Chris; Mlumbe, Kumvana; Chitule, Jean

2014-07-01

Sub-Saharan Africa countries like Malawi have a paucity of ear, nose and throat (ENT) data, services and training opportunities. To reflect on new Malawian ENT experience and to propose guidelines to poorly resourced countries. Analysis of data predating and following establishment of ENT services in Malawi. In 2008 the first and only Malawian ENT specialist established ENT services with external funding. Fifteen clinical officers have been trained and a nurse placed at each outreach hospital. In 2012, 15,284 consultations were recorded: 543 (3.6%) from outreach clinics. Forty-nine percent needed medical treatment, while 45% needed medical advice. Surgery was performed on 2.7% of patients; 21% for foreign bodies in the nose and throat and 18% for foreign bodies and biopsies of ears. To establish accessible and sustainable specialist ENT services in a poor country requires building on an established local health delivery system, careful planning and investment in personnel, infrastructure, training and data collection. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Restructuring brain drain: strengthening governance and financing for health worker migration

PubMed Central

Mackey, Tim K.; Liang, Bryan A.

2013-01-01

Background Health worker migration from resource-poor countries to developed countries, also known as ‘‘brain drain’’, represents a serious global health crisis and a significant barrier to achieving global health equity. Resource-poor countries are unable to recruit and retain health workers for domestic health systems, resulting in inadequate health infrastructure and millions of dollars in healthcare investment losses. Methods Using acceptable methods of policy analysis, we first assess current strategies aimed at alleviating brain drain and then propose our own global health policy based solution to address current policy limitations. Results Although governments and private organizations have tried to address this policy challenge, brain drain continues to destabilise public health systems and their populations globally. Most importantly, lack of adequate financing and binding governance solutions continue to fail to prevent health worker brain drain. Conclusions In response to these challenges, the establishment of a Global Health Resource Fund in conjunction with an international framework for health worker migration could create global governance for stable funding mechanisms encourage equitable migration pathways, and provide data collection that is desperately needed. PMID:23336617

Who became Poor, Who Escaped Poverty, and Why? Developing and Using a Retrospective Methodology in Live Countries

ERIC Educational Resources Information Center

Krishna, Anirudh

2010-01-01

The Stages-of-Progress methodology helps identify context-specific reasons associated with households' movements into or out of poverty. Developed in 2002, it was used over the next seven years for examining the experiences of 35,567 households in 398 diverse communities of India, Kenya, Uganda, Peru, and North Carolina. This essay looks at the…

Predictors and Pathways of Language and Motor Development in Four Prospective Cohorts of Young Children in Ghana, Malawi, and Burkina Faso

ERIC Educational Resources Information Center

Prado, Elizabeth L.; Abbeddou, Souheila; Adu-Afarwuah, Seth; Arimond, Mary; Ashorn, Per; Ashorn, Ulla; Bendabenda, Jaden; Brown, Kenneth H.; Hess, Sonja Y.; Kortekangas, Emma; Lartey, Anna; Maleta, Kenneth; Oaks, Brietta M.; Ocansey, Eugenia; Okronipa, Harriet; Ouédraogo, Jean Bosco; Pulakka, Anna; Somé, Jérôme W.; Stewart, Christine P.; Stewart, Robert C.; Vosti, Stephen A.; Yakes Jimenez, Elizabeth; Dewey, Kathryn G.

2017-01-01

Background: Previous reviews have identified 44 risk factors for poor early child development (ECD) in low- and middle-income countries. Further understanding of their relative influence and pathways is needed to inform the design of interventions targeting ECD. Methods: We conducted path analyses of factors associated with 18-month language and…

Trends of improved water and sanitation coverage around the globe between 1990 and 2010: inequality among countries and performance of official development assistance

PubMed Central

Cha, Seungman; Mankadi, Paul Mansiangi; Elhag, Mousab Siddig; Lee, Yongjoo; Jin, Yan

2017-01-01

ABSTRACT Background: As the Millennium Development Goals ended, and were replaced by the Sustainable Development Goals, efforts have been made to evaluate the achievements and performance of official development assistance (ODA) in the health sector. In this study, we explore trends in the expansion of water and sanitation coverage in developing countries and the performance of ODA. Design: We explored inequality across developing countries by income level, and investigated how ODA for water and sanitation was committed by country, region, and income level. Changes in inequality were tested via slope changes by investigating the interaction of year and income level with a likelihood ratio test. A random effects model was applied according to the results of the Hausman test. Results: The slope of the linear trend between economic level and sanitation coverage has declined over time. However, a random effects model suggested that the change in slope across years was not significant (e.g. for the slope change between 2000 and 2010: likelihood ratio χ2 = 2.49, probability > χ2 = 0.1146). A similar pro-rich pattern across developing countries and a non-significant change in the slope associated with different economic levels were demonstrated for water coverage. Our analysis shows that the inequality of water and sanitation coverage among countries across the world has not been addressed effectively during the past decade. Our findings demonstrate that the countries with the least coverage persistently received far less ODA per capita than did countries with much more extensive water and sanitation coverage, suggesting that ODA for water and sanitation is poorly targeted. Conclusion: The most deprived countries should receive more attention for water and sanitation improvements from the world health community. A strong political commitment to ODA targeting the countries with the least coverage is needed at the global level. PMID:28604256

A scheme to promote the world's economic development with migration.

PubMed

Simon, J L

1982-01-01

Migration's social value is generally assessed from the perspective of the receiving country. At this time the policies of rich countries allow fewer immigrants to enter than would enter under a laissez faire policy, but this may be a suboptimal policy for the world population as a whole. Those who now migrate from poor to rich countries and those who are prevented from doing so by restrictive laws certainly believe that their economic situation would be improved by such migration. A scheme for improving the worldwide welfare while making appropriate allowance for the preferences of those in the rich countries is discussed. The scheme deals with the migration of poorly schooled and semiskilled people and not the well educated. As the rich countries will not voluntarily open their borders to such immigration, a change in the international system is suggested, giving some power of taxation to an international body. This body would then pay the rich countries to take in immigrants by holding an auction among the rich countries for the immigration contracts. The scheme is analyzed, and it is argued that in the long run this approach is not as politically impossible as it initially seems. The discussion reviews the problem, the system, and the possibilities (the power of migration, the mechanisms in migration's power to raise productivity, earning patterns of immigrant cohorts, and additional possible tests) and the relative effectiveness of migration verses education in the less developed countries. It seems reasonable to send the migrants to countries that want them or can be made to want them, and an auction is a device to determine who wants something relative to someone else. A Supranational Planning Authority (SPA) could hold an auction at which countries would submit the price (per migrant or per migratory family) at which they will undertake the task of relocating migrants. The conditions of the contract would be specified, including the kind and location of housing and amenities for the migrants and the kind of occupational training they would receive. Such a contract could be a profitable means of earning foreign currency for a country. Another side benefit of the scheme is its possible use as an anticyclical device. A difficult question is the lenght (or permanence) of migratory residents. Clearly, a migration scheme will be adopted in the near future, and if it can be implemented it might work wonders for the economic development of the world.

Night Time Light Satellite Data for Evaluating the Socioeconomics in Central Asia

NASA Astrophysics Data System (ADS)

Li, S.; Zhang, T.; Yang, Z.; Li, X.; Xu, H.

2017-09-01

Using nighttime lights data combined with LandScan population counts and socioeconomic statistics, dynamic change was monitored in the social economy of the five countries in Central Asia, from 1993 to 2012. In addition, the spatial pattern of regional historical development was analyzed, using this data. The countries included in this study were Kazakhstan, Kyrgyzstan, Tajikistan, Uzbekistan and Turkmenistan. The economic development in these five Central Asian countries, the movement of the economic center, the distribution of poor areas and the night light development index (NLDI) were studied at a relatively fine spatial scale. In addition, we studied the relationship between the per capita lighting and per capita GDP at the national scale, finding that the per capital lighting correlated with per capita GDP. The results of this study reflect the socioeconomic development of Central Asia but more importantly, show that nighttime light satellite images are an effective tool for monitoring spatial and temporal social economic parameters.

Cross-national comparisons of time trends in overweight inequality by socioeconomic status among women using repeated cross-sectional surveys from 37 developing countries, 1989-2007.

PubMed

Jones-Smith, Jessica C; Gordon-Larsen, Penny; Siddiqi, Arjumand; Popkin, Barry M

2011-03-15

Chronic diseases are now among the leading causes of morbidity and mortality in lower income countries. Although traditionally related to higher individual socioeconomic status (SES) in these contexts, the associations between SES and chronic disease may be actively changing. Furthermore, country-level contextual factors, such as economic development and income inequality, may influence the distribution of chronic disease by SES as well as how this distribution has changed over time. Using overweight status as a health indicator, the authors studied repeated cross-sectional data from women aged 18-49 years in 37 developing countries to assess within-country trends in overweight inequalities by SES between 1989 and 2007 (n=405,550). Meta-regression was used to examine the associations between gross domestic product and disproportionate increases in overweight prevalence by SES, with additional testing for modification by country-level income inequality. In 27 of 37 countries, higher SES (vs. lower) was associated with higher gains in overweight prevalence; in the remaining 10 countries, lower SES (vs. higher) was associated with higher gains in overweight prevalence. Gross domestic product was positively related to faster increase in overweight prevalence among the lower wealth groups. Among countries with a higher gross domestic product, lower income inequality was associated with faster overweight growth among the poor. © The Author 2011. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.

Annual Research Review: Improved nutrition--pathway to resilience.

PubMed

Yousafzai, Aisha K; Rasheed, Muneera A; Bhutta, Zulfiqar A

2013-04-01

Early child nutritional deficiencies are prevalent in low- and middle-countries with consequences linked not only to poor survival and growth, but also to poor development outcomes. Children in disadvantaged communities face multiple risks for nutritional deficiencies, yet some children may be less susceptible or may recover more quickly from malnutrition. A greater understanding is needed about factors which moderate the effects of nutrition-related risks and foster resilience to protect against or ameliorate poor development outcomes. A literature review was undertaken from August to December 2011 and updated in August 2012. Key word searches using terms Nutrition, Malnutrition, Child Development, Responsive Care, Stimulation, Low and Middle Income Countries and Resilience were undertaken using PubMed and Psychinfo. Dietary adequacy is critical for growth and development, but current evidence indicates that nutrition supplementation alone is insufficient to foster resilience to protect against, mitigate, and recover from nutritional threats and to promote healthy development. The combination of nutrition interventions with stimulation and responsive care is necessary. Combined nutrition and psychosocial stimulation approaches can potentially work effectively together to promote protective factors and mitigate risks for poor cognitive, motor, social, and affective functioning helping children to adapt in times of adversity. However, there are gaps in our existing knowledge to combine nutrition and psychosocial stimulation interventions effectively and promote these interventions at scale. Research needs to address barriers at the level of family, community, programme, and policy which have prevented thus far the uptake of combined nutrition and psychosocial intervention strategies. Further investigations are needed on how to provide support to caregivers, enabling them to implement appropriate care for feeding and stimulation. Finally, the effect of combined interventions on pathways of care and protective mediators that foster resilience need to be better understood to determine focus areas for content of combined intervention curricula which help families in high-risk settings. © 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.

Towards mutual trust, transparency and equity in virus sharing mechanism: the avian influenza case of Indonesia.

PubMed

Sedyaningsih, Endang R; Isfandari, Siti; Soendoro, Triono; Supari, Siti Fadilah

2008-06-01

As the country hardest hit by avian influenza, both in poultry and in human, Indonesia's decision to withhold samples of avian influenza virus A (H5N1) has fired up a global controversy. The objective of this paper is to describe the position taken by Indonesia in the events leading to the decision and in those conducted to resolve the situation. The sources for this paper are the Indonesian human influenza A(H5N1) case reports and study results, summaries, minutes and reports of national and international meetings of virus sharing, and other related Indonesian and WHO documents. The International Health Regulations 2005 have been applied in different ways based on different interpretations. While one party insists on the importance of free, non-conditional, virus sharing for risk assessment and risk response, Indonesia--as supported by most of the developing countries--stresses on the more basic principles such as sovereignty of a country over its biological materials, transparency of the global system, and equity between developed and developing nations. This event demonstrates the unresolved imbalance between the affluent high-tech countries and the poor agriculture-based countries. Regional, global and in-country meetings must continue to be conducted to find solutions acceptable to all.

Open Educational Resources (OER): Opportunities and Challenges for Indian Higher Education

ERIC Educational Resources Information Center

Dutta, Indrajeet

2016-01-01

Creation of knowledge workers holds key for success of a country. Unfortunately, many of the countries though having chain of human resources yet are unable to transform human resources to their advantage as they face multiple challenges like poverty, poor economy, poor infrastructure, limited access to education and inadequate technological…

Projecting Poverty at the Household Scale to Assess the Impact of Climate Change on Poor People

NASA Astrophysics Data System (ADS)

Hallegatte, S.; Rozenberg, J.

2015-12-01

This paper quantifies the potential impacts of climate change on poverty in 2030 and 2050, in 92 countries covering 90% of the developing world population. It accounts for the deep uncertainties that characterize future socio-economic evolutions and the lack of data regarding the condition and livelihood of poor people. It also considers many impacts of climate change, another source of uncertainty. We use a micro-simulation model based on household surveys and explore a wide range of uncertainties on future structural change, productivity growth or demographic changes. This results, for each country, in the creation of several hundred scenarios for future income growth and income distribution. We then explore the resulting space of possible futures and use scenario discovery techniques to identify the main drivers of inequalities and poverty reduction. We find that redistribution and structural change are powerful drivers of poverty and inequality reduction, except in low-income countries. In the poorest countries in Africa, reducing poverty cannot rely on redistribution but requires low population growth and productivity growth in agriculture. Once we have explored the space of possible outcomes for poverty and inequalities, we choose two representative scenarios of the best and worst cases and model the impacts of climate change in each of these two scenarios. Climate change impacts are modeled through 4 channels. First, climate change has an impact on labor productivity growth for people who work outside because of higher temperatures. Second, climate change has an impact on human capital because of more severe stunting in some places. Third, climate change has an impact on physical capital via more frequent natural disasters. Fourth, climate change has an impact on consumption because of changes in food prices. Impacts are very heterogeneous across countries and are mostly concentrated in African and South-East Asian countries. For high radiative forcing (RCP8.5), the impact of climate change on poverty is 6 times larger in the pessimistic scenario than in the optimistic scenario, illustrating how development and poverty reduction are powerful adaptation tools. Our results stress the urgency of achieving poverty eradication by 2030 in order to limit the negative impacts of climate change on the poor.

Menstrual Hygiene Management in Resource-Poor Countries

PubMed Central

Kuhlmann, Anne Sebert; Henry, Kaysha; Wall, L. Lewis

2017-01-01

Importance Adequate management of menstrual hygiene is taken for granted in affluent countries; however, inadequate menstrual hygiene is a major problem for girls and women in resource-poor countries, which adversely affects the health and development of adolescent girls. Objective The aim of this article is to review the current evidence concerning menstrual hygiene management in these settings. Evidence Acquisition A PubMed search using MeSH terms was conducted in English, supplemented by hand searching for additional references. Retrieved articles were reviewed, synthesized, and summarized. Results Most research to date has described menstrual hygiene knowledge, attitudes, and practices, mainly in sub-Saharan Africa and South Asia. Many school-based studies indicate poorer menstrual hygiene among girls in rural areas and those attending public schools. The few studies that have tried to improve or change menstrual hygiene practices provide moderate to strong evidence that targeted interventions do improve menstrual hygiene knowledge and awareness. Conclusion and Relevance Challenges to improving menstrual hygiene management include lack of support from teachers (who are frequently male); teasing by peers when accidental menstrual soiling of clothes occurs; poor familial support; lack of cultural acceptance of alternative menstrual products; limited economic resources to purchase supplies; inadequate water and sanitation facilities at school; menstrual cramps, pain, and discomfort; and lengthy travel to and from school, which increases the likelihood of leaks/stains. Areas for future research include the relationship between menarche and school dropout, the relationship between menstrual hygiene management and other health outcomes, and how to increase awareness of menstrual hygiene management among household decision makers including husbands/fathers and in-laws. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completion of this educational activity, the obstetrician/gynecologist should be able to define what is meant by “adequate menstrual hygiene management,” identify the challenges to adequate menstrual hygiene management that exist in resource-poor countries, and describe some of the intervention strategies that have been proposed to improve menstrual hygiene management for girls and women in those countries. PMID:28661550

National economic development and disparities in body mass index: a cross-sectional study of data from 38 countries.

PubMed

Neuman, Melissa; Kawachi, Ichiro; Gortmaker, Steven; Subramanian, Sv

2014-01-01

Increases in body mass index (BMI) and the prevalence of overweight in low- and middle income countries (LMICs) are often ascribed to changes in global trade patterns or increases in national income. These changes are likely to affect populations within LMICs differently based on their place of residence or socioeconomic status (SES). Using nationally representative survey data from 38 countries and national economic indicators from the World Bank and other international organizations, we estimated ecological and multilevel models to assess the association between national levels of gross domestic product (GDP), foreign direct investment (FDI), and mean tariffs and BMI. We used linear regression to estimate the ecological association between average annual change in economic indicators and BMI, and multilevel linear or ordered multinomial models to estimate associations between national economic indicators and individual BMI or over- and underweight. We also included cross-level interaction terms to highlight differences in the association of BMI with national economic indicators by type of residence or socioeconomic status (SES). There was a positive but non-significant association of GDP and mean BMI. This positive association of GDP and BMI was greater among rural residents and the poor. There were no significant ecological associations between measures of trade openness and mean BMI, but FDI was positively associated with BMI among the poorest respondents and in rural areas and tariff levels were negatively associated with BMI among poor and rural respondents. Measures of national income and trade openness have different associations with the BMI across populations within developing countries. These divergent findings underscore the complexity of the effects of development on health and the importance of considering how the health effects of "globalizing" economic and cultural trends are modified by individual-level wealth and residence.

Review: Sustainability of crossbreeding in developing countries; definitely not like crossing a meadow….

PubMed

Leroy, G; Baumung, R; Boettcher, P; Scherf, B; Hoffmann, I

2016-02-01

Crossbreeding, considering either terminal or rotational crossing, synthetic breed creation or breed replacement, is often promoted as an efficient strategy to increase farmers' income through the improvement of productivity of local livestock in developing countries. Sustainability of crossbreeding is however frequently challenged by constraints such as poor adaptation to the local environment or lack of logistic support. In this review, we investigate factors that may influence the long-term success or the failure of crossbreeding programs, based on the scientific literature and country reports submitted for The Second Report on the State of the World's Animal Genetic Resources for Food and Agriculture. Crossbreeding activities vary widely across species and countries. Its sustainability is dependent on different prerequisites such as continual access to adequate breeding stock (especially after the end of externally funded crossbreeding projects), the opportunity of improved livestock to express their genetic potential (e.g. through providing proper inputs) and integration within a reliable market chain. As formal crossbreeding programs are often associated with adoption of other technologies, they can be a catalyst for innovation and development for smallholders. Given the increasing global demand for animal products, as well as the potential environmental consequences of climate change, there is a need for practical research to improve the implementation of long-term crossbreeding programs in developing countries.

Design for Occupational Safety and Health of Workers in Construction in Developing Countries: A Study of Architects in Nigeria.

PubMed

Manu, Patrick; Poghosyan, Anush; Mshelia, Ibrahim Mark; Iwo, Samuel Tekena; Mahamadu, Abdul-Majeed; Dziekonski, Krzysztof

2018-06-14

Design for safety (DfS) of workers is amongst the prominent ways of tackling poor occupational safety and health (OSH) performance in construction. However, in developing countries there is an extremely limited research on DfS. This study thus makes an important contribution to the subject of DfS in developing countries by specifically examining the awareness and practice of DfS amongst architects within the construction sector of Nigeria. A survey of architects, yielding 161 valid responses, was conducted. While there is a high awareness of the concept of DfS, the actual practice is low. Additionally, although there is high interest in DfS training, the engagement in DfS training is low. Significantly, awareness of DfS, training and education related to DfS, and membership of a design professional body have very limited bearing on the practice of DfS by architects. The findings are thus symptomatic of the prevalence of influential DfS implementation barriers within the construction sector. Industry stakeholders should seek to raise the profile of DfS practice within the sector. Furthermore, similar empirical studies in the construction sector of other developing countries would be useful in shedding light on the status of DfS in these countries.

Network Analytical Tool for Monitoring Global Food Safety Highlights China

PubMed Central

Nepusz, Tamás; Petróczi, Andrea; Naughton, Declan P.

2009-01-01

Background The Beijing Declaration on food safety and security was signed by over fifty countries with the aim of developing comprehensive programs for monitoring food safety and security on behalf of their citizens. Currently, comprehensive systems for food safety and security are absent in many countries, and the systems that are in place have been developed on different principles allowing poor opportunities for integration. Methodology/Principal Findings We have developed a user-friendly analytical tool based on network approaches for instant customized analysis of food alert patterns in the European dataset from the Rapid Alert System for Food and Feed. Data taken from alert logs between January 2003 – August 2008 were processed using network analysis to i) capture complexity, ii) analyze trends, and iii) predict possible effects of interventions by identifying patterns of reporting activities between countries. The detector and transgressor relationships are readily identifiable between countries which are ranked using i) Google's PageRank algorithm and ii) the HITS algorithm of Kleinberg. The program identifies Iran, China and Turkey as the transgressors with the largest number of alerts. However, when characterized by impact, counting the transgressor index and the number of countries involved, China predominates as a transgressor country. Conclusions/Significance This study reports the first development of a network analysis approach to inform countries on their transgressor and detector profiles as a user-friendly aid for the adoption of the Beijing Declaration. The ability to instantly access the country-specific components of the several thousand annual reports will enable each country to identify the major transgressors and detectors within its trading network. Moreover, the tool can be used to monitor trading countries for improved detector/transgressor ratios. PMID:19688088

Control of corruption, democratic accountability, and effectiveness of HIV/AIDS official development assistance.

PubMed

Lee, Hwa-Young; Yang, Bong-Ming; Kang, Minah

2016-01-01

Despite continued global efforts, HIV/AIDS outcomes in developing countries have not made much progress. Poor governance in recipient countries is often seen as one of the reasons for ineffectiveness of aid efforts to achieve stated objectives and desired outcomes. This study examines the impact of two important dimensions of governance - control of corruption and democratic accountability - on the effectiveness of HIV/AIDS official development assistance. An empirical analysis using dynamic panel Generalized Method of Moments estimation was conducted on 2001-2010 datasets. Control of corruption and democratic accountability revealed an independent effect and interaction with the amount of HIV/AIDS aid on incidence of HIV/AIDS, respectively, while none of the two governance variables had a significant effect on HIV/AIDS prevalence. Specifically, in countries with accountability level below -2.269, aid has a detrimental effect on incidence of HIV/AIDS. The study findings suggest that aid programs need to be preceded or at least accompanied by serious efforts to improve governance in recipient countries and that democratic accountability ought to receive more critical attention.

Health disparities in Europe's ageing population: the role of social network.

PubMed

Olofsson, Jenny; Padyab, Mojgan; Malmberg, Gunnar

2018-01-01

Previous research suggests that the social network may play very different roles in relation to health in countries with differing welfare regimes. The study aimed to assess the interplay between social network, socioeconomic position, and self-rated health (SRH) in European countries. The study used cross-sectional data on individuals aged 50+ from the fourth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) and includes data from 16 countries. The outcome is poor SRH. All analyses are adjusted for age and stratified by gender. Low satisfaction with the social network was associated with poor SRH among women in all country groups, but predicted poor SRH among males in West/Central and Eastern Europe only. The results from the multivariable analysis showed an increased likelihood of poor SRH among those with relatively lower education, as well as among those with low satisfaction with the social network (women from all country groups and men from Western/Central and Eastern Europe). However, the results from interaction analysis show that poor SRH for those with lower relative position in educational level was greater among those with higher satisfaction with the social network among male and female participants from Northern Europe. The health of individuals who are highly satisfied with their social network is more associated with socioeconomic status in Northern Europe. This study highlights the significance of social network and socioeconomic gradients in health among the elderly in Europe.

Health disparities in Europe’s ageing population: the role of social network

PubMed Central

Olofsson, Jenny; Malmberg, Gunnar

2018-01-01

ABSTRACT Background: Previous research suggests that the social network may play very different roles in relation to health in countries with differing welfare regimes. Objective: The study aimed to assess the interplay between social network, socioeconomic position, and self-rated health (SRH) in European countries. Methods: The study used cross-sectional data on individuals aged 50+ from the fourth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) and includes data from 16 countries. The outcome is poor SRH. All analyses are adjusted for age and stratified by gender. Results: Low satisfaction with the social network was associated with poor SRH among women in all country groups, but predicted poor SRH among males in West/Central and Eastern Europe only. The results from the multivariable analysis showed an increased likelihood of poor SRH among those with relatively lower education, as well as among those with low satisfaction with the social network (women from all country groups and men from Western/Central and Eastern Europe). However, the results from interaction analysis show that poor SRH for those with lower relative position in educational level was greater among those with higher satisfaction with the social network among male and female participants from Northern Europe. The health of individuals who are highly satisfied with their social network is more associated with socioeconomic status in Northern Europe. Conclusions: This study highlights the significance of social network and socioeconomic gradients in health among the elderly in Europe. PMID:29553305

Sick regimes and sick people: a multilevel investigation of the population health consequences of perceived national corruption.

PubMed

Witvliet, Margot I; Kunst, Anton E; Arah, Onyebuchi A; Stronks, Karien

2013-10-01

There is a paucity of empirical work on the potential population health impact of living under a regime marred by corruption. African countries differ in the extent of national corruption, and we explore whether perceived national corruption is associated with population health across all rungs of society. World Health Survey data were analysed on 72 524 adults from 20 African countries. The main outcome was self-reported poor general health. Multilevel logistic regression was used to assess the association between poor health and perceived corruption, while jointly accounting for individual- and country-level human development factors. In this research, we use Transparency International's corruption perception index (CPI), which measures 'both administrative and political corruption' on a 0-10 scale. A higher score pertains to a higher rate of perceived corruption within society. We also examined effect modification by gender, age and socio-economic status. Higher national corruption perception was consistently associated with an increase in poor health prevalence, also after multivariable adjustments, with odds ratio (OR) of 1.62 (95% CI: 1.01-2.60). Stratified analyses by age and gender suggested this same pattern in all subgroups. Positive associations between poor health and perceived corruption were evident in all socio-economic groups, with the association being somewhat more positive among less educated people (OR = 1.61, 95% CI: 1.01-2.58) than among more educated people (OR = 1.40, 95% CI: 0.83-2.37). This study is a cautious first step in empirically testing the general health consequences of corruption. Our results suggest that higher perceived national corruption is associated with general health of both men and women within all socio-economic groups across the lifespan. Further research is needed using more countries to assess the magnitude of the health consequences of corruption. © 2013 John Wiley & Sons Ltd.

Plagiarism, Cheating and Research Integrity: Case Studies from a Masters Program in Peru.

PubMed

Carnero, Andres M; Mayta-Tristan, Percy; Konda, Kelika A; Mezones-Holguin, Edward; Bernabe-Ortiz, Antonio; Alvarado, German F; Canelo-Aybar, Carlos; Maguiña, Jorge L; Segura, Eddy R; Quispe, Antonio M; Smith, Edward S; Bayer, Angela M; Lescano, Andres G

2017-08-01

Plagiarism is a serious, yet widespread type of research misconduct, and is often neglected in developing countries. Despite its far-reaching implications, plagiarism is poorly acknowledged and discussed in the academic setting, and insufficient evidence exists in Latin America and developing countries to inform the development of preventive strategies. In this context, we present a longitudinal case study of seven instances of plagiarism and cheating arising in four consecutive classes (2011-2014) of an Epidemiology Masters program in Lima, Peru, and describes the implementation and outcomes of a multifaceted, "zero-tolerance" policy aimed at introducing research integrity. Two cases involved cheating in graded assignments, and five cases correspond to plagiarism in the thesis protocol. Cases revealed poor awareness of high tolerance to plagiarism, poor academic performance, and widespread writing deficiencies, compensated with patchwriting and copy-pasting. Depending on the events' severity, penalties included course failure (6/7) and separation from the program (3/7). Students at fault did not engage in further plagiarism. Between 2011 and 2013, the Masters program sequentially introduced a preventive policy consisting of: (i) intensified research integrity and scientific writing education, (ii) a stepwise, cumulative writing process; (iii) honor codes; (iv) active search for plagiarism in all academic products; and (v) a "zero-tolerance" policy in response to documented cases. No cases were detected in 2014. In conclusion, plagiarism seems to be widespread in resource-limited settings and a greater response with educational and zero-tolerance components is needed to prevent it.

Societal characteristics and health in the former communist countries of Central and Eastern Europe and the former Soviet Union: a multilevel analysis.

PubMed

Bobak, Martin; Murphy, Mike; Rose, Richard; Marmot, Michael

2007-11-01

To examine whether, in former communist countries that have undergone profound social and economic transformation, health status is associated with income inequality and other societal characteristics, and whether this represents something more than the association of health status with individual socioeconomic circumstances. Multilevel analysis of cross-sectional data. 13 Countries from Central and Eastern Europe and the former Soviet Union. Population samples aged 18+ years (a total of 15 331 respondents). Poor self-rated health. There were marked differences among participating countries in rates of poor health (a greater than twofold difference between the countries with the highest and lowest rates of poor health), gross domestic product per capita adjusted for purchasing power parity (a greater than threefold difference), the Gini coefficient of income inequality (twofold difference), corruption index (twofold difference) and homicide rates (20-fold difference). Ecologically, the age- and sex-standardised prevalence of poor self-rated health correlated strongly with life expectancy at age 15 (r = -0.73). In multilevel analyses, societal (country-level) measures of income inequality were not associated with poor health. Corruption and gross domestic product per capita were associated with poor health after controlling for individuals' socioeconomic circumstances (education, household income, marital status and ownership of household items); the odds ratios were 1.15 (95% confidence interval 1.03 to 1.29) per 1 unit (on a 10-point scale) increase in the corruption index and 0.79 (95% confidence interval 0.68 to 0.93) per $5000 increase in gross domestic product per capita. The effects of gross domestic product and corruption were virtually identical in people whose household income was below and above the median. Societal measures of prosperity and corruption, but not income inequalities, were associated with health independently of individual-level socioeconomic characteristics. The finding that these effects were similar in persons with lower and higher income suggests that these factors do not operate exclusively through poverty.

Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries.

PubMed

Engle, Patrice L; Fernald, Lia C H; Alderman, Harold; Behrman, Jere; O'Gara, Chloe; Yousafzai, Aisha; de Mello, Meena Cabral; Hidrobo, Melissa; Ulkuer, Nurper; Ertem, Ilgi; Iltus, Selim

2011-10-08

This report is the second in a Series on early child development in low-income and middle-income countries and assesses the effectiveness of early child development interventions, such as parenting support and preschool enrolment. The evidence reviewed suggests that early child development can be improved through these interventions, with effects greater for programmes of higher quality and for the most vulnerable children. Other promising interventions for the promotion of early child development include children's educational media, interventions with children at high risk, and combining the promotion of early child development with conditional cash transfer programmes. Effective investments in early child development have the potential to reduce inequalities perpetuated by poverty, poor nutrition, and restricted learning opportunities. A simulation model of the potential long-term economic effects of increasing preschool enrolment to 25% or 50% in every low-income and middle-income country showed a benefit-to-cost ratio ranging from 6·4 to 17·6, depending on preschool enrolment rate and discount rate. Copyright © 2011 Elsevier Ltd. All rights reserved.

Vouchers for health: A demand side output-based aid approach to reproductive health services in Kenya.

PubMed

Janisch, C P; Albrecht, M; Wolfschuetz, A; Kundu, F; Klein, S

2010-01-01

Reaching the United Nation's Millennium Development Goals has been a focus for many countries and development partners. In Kenya, as in many other countries with low levels of development, access to and equity of basic quality health services is limited, especially for the very poor. Among poor populations, maternal mortality is high as access to medical care and financial means are lacking. In 2005, the Governments of Kenya and Germany in cooperation with KfW Banking Group made funds available for the Reproductive Health OBA Voucher Programme offering vouchers for Safe Motherhood, Family Planning and Gender Violence Recovery Services. This programme, herein referred to as Vouchers for Health, was launched in June of 2006 in five Kenyan districts with the aim of providing health services for safe deliveries, long-term family planning methods and victims of gender violence. The way that the programme is being implemented in Kenya demonstrates that the voucher-based approach comprises a variety of key structural elements of a national health insurance scheme: accreditation; quality assurance; reimbursement system; claims processing; integrating the private sector; client choice; provider competition; and access to and equity of services provided.

India changes patent law to meet WTO treaty, making new medicines less available to most citizens, other countries.

PubMed

James, John S

2004-01-01

India changed its pharmaceutical patent law to conform to the U.S.-European system, just ahead of a Jan. 1 World Trade Organization deadline--meaning that most new medicines (patentable in 1995 or later) will be priced out of reach of the great majority of people in India--and in Africa and other poor regions as well. "The real issue for the multinational corporations is not the poor-country markets, which are financially small and unattractive, but the poor-country examples. How would thousands of people in rich countries, especially the U.S., be persuaded to accept death from cancer and other diseases because they cannot pay tens of thousands of dollars a year for a new generation of treatments that could save their lives--if companies in India could manufacture and sell the same treatments for a small fraction of the price?"

Mobile phones in Africa: how much do we really know?

PubMed

James, Jeffrey; Versteeg, Mila

2007-10-01

Mobile phones are a crucial mode of communication and welfare enhancement in poor countries, especially those lacking an infrastructure of fixed lines. In recent years much has been written about how mobile telephony in Africa is rapidly reducing the digital divide with developed countries. Yet, when one examines the evidence it is not at all clear what is really happening. In one country, Tanzania, for example, some observers point to the fact that 97% of the population lives under the mobile footprint, while others show that ownership is very limited. These extreme values prompted us to review the situation in Africa as a whole, in an effort to discover what is really going on.

Disaster Risk Transfer for Developing Countries

NASA Astrophysics Data System (ADS)

Linneroothbayer, J.; Mechler, R.; Pflug, G.; Hochrainer, S.

2005-12-01

Financing disaster recovery often diverts resources from development, which can have long-term effects on economic growth and the poor in developing countries. Moreover, post-disaster assistance, while important for humanitarian reasons, has failed to meet the needs of developing countries in reducing their exposure to disaster risks and assuring sufficient funds to governments and individuals for financing the recovery process. The authors argue that part of disaster aid should be refocused from post-disaster to pre-disaster assistance including financial disaster risk management. Such assistance is now possible with new modeling techniques for estimating and pricing risks of natural disasters coupled with the advent of novel insurance instruments for transferring catastrophe risk to the global financial markets. The authors illustrate the potential for risk transfer in developing countries using the IIASA CATSIM model, which shows the potential impacts of disasters on economic growth in selected developing countries and the pros and cons of financial risk management to reduce those adverse impacts. The authors conclude by summarizing the advantages of investing in risk-transfer instruments (coupled with preventive measures) as an alternative to traditional post-disaster donor assistance. Donor-supported risk-transfer programs would not only leverage limited disaster aid budgets, but would also free recipient countries from depending on the vagaries of post-disaster assistance. Both the donors and the recipients stand to gain, especially since the instruments can be designed to encourage preventive measures. Precedents already exist for imaginative risk-transfer programs in highly exposed developing countries, including national insurance systems, micro-insurance schemes like weather derivatives and novel instruments (e.g., catastrophe bonds) to provide insurance cover for public sector risks.

Assessing the usefulness of the water poverty index by applying it to a special case: Can one be water poor with high levels of access?

NASA Astrophysics Data System (ADS)

Komnenic, V.; Ahlers, R.; Zaag, P. van der

Using indices and indicators in assessment of progress of a developing country has two sides. Such indicators offer an easy-to-understand shorthand/synopsis of issues vital for a country’s development. The other side of the coin, however, is that this synopsis may be distorted due to incorrect data or inapplicability of an index or an indicator to a specific case. This paper assesses the applicability of Water Poverty Index for the countries riparian to the Sava sub-basin, a tributary to the Danube river basin and presents the results of its application. At the same time, the paper discusses the concept of water poverty and the appropriateness of its use in the case of Sava River Basin countries by differentiating the economic poverty in some of those countries from sufficient access to and use of water resources in all of them.

A responsive evaluation of mental health treatment in Cambodia: Intentionally addressing poverty to increase cultural responsiveness in therapy.

PubMed

Seponski, Desiree M; Lewis, Denise C; Megginson, Maegan C

2014-01-01

Mental health issues are significant contributors to the global burden of disease with the highest incidence in resource poor countries; 90% of those in need of mental health treatment reside in low resource countries but receive only 10% of the world's resources. Cambodia, the eighth least developed country in the world, serves as one example of the need to address mental health concerns in low-income, resource poor countries. The current study utilises responsive evaluation methodology to explore how poverty-stricken Cambodian clients, therapists and supervisors experience Western models of therapy as culturally responsive to their unique needs. Quantitative and qualitative data were triangulated across multiple stakeholders using numerous methods including a focus group, interviews, surveys, case illustrations and live supervision observation and analysed using constant comparative analysis. Emerging findings suggest that poverty, material needs, therapy location and financial situations greatly impact the daily lives and mental health conditions of Cambodians and hinder clients' therapeutic progress. The local community needs and context of poverty greatly hinder clients' therapeutic progress in therapy treatment and when therapy does not directly address the culture of poverty, clients did not experience therapy as valuable despite some temporary decreases in mental health symptoms.

Drivers for the renaissance of coal

PubMed Central

Steckel, Jan Christoph; Edenhofer, Ottmar; Jakob, Michael

2015-01-01

Coal was central to the industrial revolution, but in the 20th century it increasingly was superseded by oil and gas. However, in recent years coal again has become the predominant source of global carbon emissions. We show that this trend of rapidly increasing coal-based emissions is not restricted to a few individual countries such as China. Rather, we are witnessing a global renaissance of coal majorly driven by poor, fast-growing countries that increasingly rely on coal to satisfy their growing energy demand. The low price of coal relative to gas and oil has played an important role in accelerating coal consumption since the end of the 1990s. In this article, we show that in the increasingly integrated global coal market the availability of a domestic coal resource does not have a statistically significant impact on the use of coal and related emissions. These findings have important implications for climate change mitigation: If future economic growth of poor countries is fueled mainly by coal, ambitious mitigation targets very likely will become infeasible. Building new coal power plant capacities will lead to lock-in effects for the next few decades. If that lock-in is to be avoided, international climate policy must find ways to offer viable alternatives to coal for developing countries. PMID:26150491

International medical migration: a critical conceptual review of the global movements of doctors and nurses.

PubMed

Bradby, Hannah

2014-11-01

This paper critically appraises the discourse around international medical migration at the turn of the 21st century. A critical narrative review of a range of English-language sources, including grey literature, books and research reports, traces the development and spread of specific causative models. The attribution of causative relations between the movement of skilled medical workers, the provision of health care and population health outcomes illustrates how the global reach of biomedicine has to be understood in the context of local conditions. The need to understand migration as an aspect of uneven global development, rather than a delimited issue of manpower services management, is illustrated with reference to debates about 'brain drain' of Africa's health-care professionals, task-shifting and the crisis in health-care human resources. The widespread presumed cause of shortages of skilled health-care staff in sub-Saharan Africa was overdetermined by a compelling narrative of rich countries stealing poor countries' trained health-care professionals. This narrative promotes medical professional interests and ignores historical patterns of underinvestment in health-care systems and structures. Sociological theories of medicalization suggest that the international marketization of medical recruitment is a key site where the uneven global development of capital is at work. A radical reconfiguration of medical staffing along the lines of 'task-shifting' in rich and poor countries' health-care systems alike offers one means of thinking about global equity in access to quality care. © The Author(s) 2014.

Political Governance and Conflict Management: Why Developing Polities and the Poor Need a Stronger State Structure?

ERIC Educational Resources Information Center

Forje, John W.

2006-01-01

Political governance and quality management are often contested concepts, meaning different things to different people; and often their meanings have shifted historically. The collapse of the governance system behind the iron curtain countries triggered an avalanche in international politics and instituted new governance and management system to…

Students' Perceptions of the Impact of Nutrition Policies on Dietary Behaviors

ERIC Educational Resources Information Center

Vecchiarelli, Stephanie; Takayanagi, Sumiko; Neumann, Charlotte

2006-01-01

Poor dietary habits, rising rates of overweight students, and lack of oversight of vending contracts prompted the Los Angeles Unified School District (LAUSD) to develop and implement 2 of the most comprehensive nutrition policies in the country. The Healthy Beverage Resolution and Obesity Prevention Motion limit the types of and access to…

Limits to Productivity: Improving Women's Access to Technology and Credit.

ERIC Educational Resources Information Center

Schumacher, Ilsa; And Others

While there is significant variation in women's economic participation rates across cultures and situations in Third World countries, the common features in work patterns of poor women are striking. Segmented labor markets predominate throughout the developing world and restrict the demand for female labor to subsistence activities or to jobs in…

Taking Another Path: Community-Based Budgeting

ERIC Educational Resources Information Center

Malinowski, Matthew J.; Davis, Darlene G.

2011-01-01

Given the current economic constraints facing the country, school districts in the U.S. have been pushed to develop annual budgets through a new lens and to accept the reality that budget adoption is a complex, political process. Whether a school district is rich or poor, growing or declining in enrollment, serving a specialized population or…

Optimization of solar thermal dryer designs for the production of sun-dried apricots (Prunus armeniaca)(abstract)

USDA-ARS?s Scientific Manuscript database

Solar thermal (ST) drying is a ubiquitous method that has had widespread use for fruit and vegetable crop preservation in developing countries. Conversely, in the United States solar thermal drying has found limited commercialization due to concerns about slow drying rates and poor product quality. ...

Educational Consequences of Orphanhood and Poverty in Western Kenya

ERIC Educational Resources Information Center

Nyambedha, Erick Otieno; Aagaard-Hansen, Jens

2010-01-01

During the past decades, many developing countries have been severely hit by a combination of poverty and the HIV pandemic. However, there has been a debate about the relative contribution of these two factors. This study showed that poverty and orphanhood were two separate but interrelated factors contributing to poor schooling. There were no…

Early-Life Origins of Life-Cycle Well-Being: Research and Policy Implications

ERIC Educational Resources Information Center

Currie, Janet; Rossin-Slater, Maya

2015-01-01

Mounting evidence across different disciplines suggests that early-life conditions can have consequences on individual outcomes throughout the life cycle. Relative to other developed countries, the United States fares poorly on standard indicators of early-life health, and this disadvantage may have profound consequences not only for population…

The Clean India Mission: Public and Animal Health benefits.

PubMed

Thakur, Rashmi; Singh, Balbir Bagicha; Jindal, Prateek; Singh Aulakh, Rabinder; Singh Gill, Jatinder Paul

2018-06-24

The Clean India Mission is a national campaign that aims for complete elimination of open defecation from the country. In India, 564 million people do not have access to toilets and defecate in the open environment. The 'Millennium development goals' have given increased weightage to elimination of open defecation for improving health, nutrition and productivity of developing country populations. The Indian economy bears an estimated annual total loss (in terms of health, education, access time and tourism) of US$ 54 billion due to lack of toilets, poor hygiene and over US$ 38.5 billion in treatment costs for diseases occurring due to poor hygiene. Out of 1,415 human pathogens, at least more than 10% of pathogens are transmitted through the faecal-oral route. The practice of open defecation helps pathogens persist in the environment and cause diseases.. This review focuses on the current status and harms of open defecation, as well as the public and animal health benefits of implementing 'The Clean India Mission' in India. Copyright © 2018. Published by Elsevier B.V.

Sustaining NGOs in the developing world: a perspective from the developing world.

PubMed

Damodaran, A

1993-01-01

The issue of sustainable development is attracting a lot of attention in the 1990s in the developing world. The author therefore draws upon experience from India, Nepal, and Bangladesh to consider the related issue of sustaining nongovernmental organizations (NGO) in developing countries. Vision, credibility and trust, stable management, pragmatic leadership, good staff, team work, and public accountability are called for to develop and maintain a successful NGO. Further, pre-project studies, realistic budgeting, time frame, relationship between funding agency and NGO, multi-source funding, flexibility, scaling up, and resource mobilization are issues with which NGOs reckon throughout the world. Some criteria for financial sustainability, however, are strongly influenced by conditions and experiences particular to developing countries. In closing, the author stresses that NGOs working with the very poor must strive to sustain any process of social change leading toward community empowerment and social justice.

"Initiate-build-operate-transfer"--a strategy for establishing sustainable telemedicine programs in developing countries: initial lessons from the balkans.

PubMed

Latifi, Rifat; Merrell, Ronald C; Doarn, Charles R; Hadeed, George J; Bekteshi, Flamur; Lecaj, Ismet; Boucha, Kathe; Hajdari, Fatmir; Hoxha, Astrit; Koshi, Dashurije; de Leonni Stanonik, Mateja; Berisha, Blerim; Novoberdaliu, Kadri; Imeri, Arben; Weinstein, Ronald S

2009-12-01

Establishing sustainable telemedicine has become a goal of many developing countries around the world. Yet, despite initiatives from a select few individuals and on occasion from various governments, often these initiatives never mature to become sustainable programs. The introduction of telemedicine and e-learning in Kosova has been a pivotal step in advancing the quality and availability of medical services in a region whose infrastructure and resources have been decimated by wars, neglect, lack of funding, and poor management. The concept and establishment of the International Virtual e-Hospital (IVeH) has significantly impacted telemedicine and e-health services in the Balkans. The success of the IVeH in Kosova has led to the development of similar programs in other Balkan countries and other developing countries in the hope of modernizing and improving their healthcare infrastructure. A comprehensive, four-pronged strategy, "Initiate-Build-Operate-Transfer" (IBOT), may be a useful approach in establishing telemedicine and e-health educational services in developing countries. The development strategy, IBOT, used by the IVeH to establish and develop telemedicine programs, was discussed. IBOT includes assessment of healthcare needs of each country, the development of a curriculum and education program, the establishment of a nationwide telemedicine network, and the integration of the telemedicine program into the healthcare infrastructure. The endpoint is the transfer of a sustainable telehealth program to the nation involved. By applying IBOT, a sustainable telemedicine program of Kosova has been established as an effective prototype for telemedicine in the Balkans. Once fully matured, the program will be transitioned to the national Ministry of Health, which ensures the sustainability and ownership of the program. Similar programs are being established in Albania, Macedonia, and other countries around the world. The IBOT model has been effective in creating sustainable telemedicine and e-health integrated programs in the Balkans and may be a good model for establishing such programs in developing countries.

Essential drugs production in Brazil, Russia, India, China and South Africa (BRICS): opportunities and challenges.

PubMed

Ezziane, Zoheir

2014-12-01

The objective of this work is to elucidate various essential drugs in the Brazil, Russia, India, China and South Africa (BRICS) countries. It discusses the opportunities and challenges of the existing biotech infrastructure and the production of drugs and vaccines in member states of the BRICS. This research is based on a systematic literature review between the years 2000 and 2014 of documents retrieved from the databases Embase, PubMed/Medline, Global Health, and Google Scholar, and the websites of relevant international organizations, research institutions and philanthropic organizations. Findings vary from one member state to another. These include useful comparison between the BRICS countries in terms of pharmaceuticals expenditure versus total health expenditure, local manufacturing of drugs/vaccines using technology and know-how transferred from developed countries, and biotech entrepreneurial collaborations under the umbrella of the BRICS region. This study concludes by providing recommendations to support more of inter collaborations among the BRICS countries as well as between BRICS and many developing countries to shrink drug production costs. In addition, this collaboration would also culminate in reaching out to poor countries that are not able to provide their communities and patients with cost-effective essential medicines.

Essential drugs production in Brazil, Russia, India, China and South Africa (BRICS): opportunities and challenges

PubMed Central

Ezziane, Zoheir

2014-01-01

The objective of this work is to elucidate various essential drugs in the Brazil, Russia, India, China and South Africa (BRICS) countries. It discusses the opportunities and challenges of the existing biotech infrastructure and the production of drugs and vaccines in member states of the BRICS. This research is based on a systematic literature review between the years 2000 and 2014 of documents retrieved from the databases Embase, PubMed/Medline, Global Health, and Google Scholar, and the websites of relevant international organizations, research institutions and philanthropic organizations. Findings vary from one member state to another. These include useful comparison between the BRICS countries in terms of pharmaceuticals expenditure versus total health expenditure, local manufacturing of drugs/vaccines using technology and know-how transferred from developed countries, and biotech entrepreneurial collaborations under the umbrella of the BRICS region. This study concludes by providing recommendations to support more of inter collaborations among the BRICS countries as well as between BRICS and many developing countries to shrink drug production costs. In addition, this collaboration would also culminate in reaching out to poor countries that are not able to provide their communities and patients with cost-effective essential medicines. PMID:25489593

Breast feeding and the older infant.

PubMed

Prentice, A

1991-01-01

The possible benefits and disadvantages to the older infant of breast-feeding being continued after the introduction of solid foods are reviewed. The limited evidence from industrialised countries suggests that prolonged partial breast-feeding has little influence on child health and growth. In contrast, in poor areas of the developing world, the continuation of breast-feeding for 1-2 years after the introduction of other foods appears to have several major benefits. These include the supply of nutrients, the delivery of protective, digestive and trophic agents, and extending the period of infertility in the mother. Partial breast-feeding after 6 months is associated with reduced severity of infectious diseases particularly in severely malnourished individuals. There is no evidence that partial breast-feeding plays a causal role in poor growth performance. In poor areas of the developing world, breast-feeding, together with the provision of adequate amounts of other foods, should be encouraged for the first two years of life.

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 role of multilateral institutions.

PubMed

Kiss, Agi; Castro, Gonzalo; Newcombe, Kenneth

2002-08-15

In line with its mission of alleviating poverty through support for environmentally and socially sustainable economic development, The World Bank (along with some other multilateral development banks) is working to help developing countries capture a share of the emerging global market in greenhouse-gas-emissions reductions ('carbon trading'). Under the Kyoto Protocol of the United Nations Framework Convention on Climate Change (UNFCCC), the Joint Implementation instrument and the Clean Development Mechanism now provide an opening for substantial international resource transfers and potential for supporting sustainable development through the transfer of cleaner technologies or sustainable forestry and agro-forestry practices. For example, carbon sequestration represents a non-extractive non-consumptive sustainable use of living natural resources that can be incorporated within a multiple-use 'integrated ecosystem management' approach. The World Bank initiated the Prototype Carbon Fund (PCF) in April 2000, to help spur the development of a global carbon market and to 'learn by doing' how to use carbon-purchase transactions across a range of energy-sector technologies (and some forestry applications) to achieve environmentally credible and cost-effective emissions reductions that benefit developing countries and economies in transition. Building on the success of the PCF ($145 million raised from public and private-sector investors), The World Bank expects to launch two new funds in 2002: the Biocarbon Fund and the Community Development Carbon Fund. These funds will target synergies between carbon markets and objectives such as biodiversity conservation, combating desertification and small-scale community-driven development. Experience from the PCF shows that developing countries can have a comparative advantage in supplying this global market, as emissions reductions can be achieved in developing countries in the range of $3-$5 per ton of CO(2) equivalent, compared with a marginal abatement cost of $10-$15 per ton of CO(2) equivalent in most countries within the Organization for Economic Cooperation and Development. However, realizing this economic potential over the next decade, and targeting the market to the rural poor, will require substantial assistance with project development and government legal and institutional capacity building. Specific needs include raising awareness of the potential of carbon markets at all levels (particularly in energy and land-use sectors), clarifying property rights, particularly in the case of communally held land and resources, ensuring the existence of an attractive investment climate, eliminating policies that create perverse incentives and constraints, and mitigating logistical, political and 'reputational' risks that could deter private-sector investors. It will also be necessary to find ways to reconcile the short-term needs of the rural poor and the typically long-term revenue stream associated with carbon sequestration.

From Many Lands. Voices of the Poor.

ERIC Educational Resources Information Center

Narayan, Deepa, Ed.; Petesch, Patti, Ed.

This book, the last volume in a three-part series, draws on a large-scale worldwide poverty study to present the views, experiences, and aspirations of poor people in 14 selected countries. In each country, interviews and discussion groups were held in 8-15 rural and urban communities that reflected the most prevalent poverty groups and the…

International telepharmacy education: another venue to improve cancer care in the developing world.

PubMed

Alfaar, Ahmad S; Kamal, Sherif; Abouelnaga, Sherif; Greene, William L; Quintana, Yuri; Ribeiro, Raul C; Qaddoumi, Ibrahim A

2012-01-01

In developed countries, pharmacists play a crucial role in designing and implementing cancer treatments as part of a multidisciplinary oncology team. However, developing countries have a shortage of pharmacists, and their role is generally limited to dispensing and selling drugs. The aim of this study was to investigate the feasibility of providing clinical pharmacy educational activities via international teleconferencing to improve cancer care in developing countries. Meticulous preparation and intense promotion of the workshop were done in Egypt before the telepharmacy conferences began. Multiple connectivity tests were performed to resolve technical problems. Nine telepharmacy conferences were delivered during 3-h sessions that were held on three consecutive days. Talks were subsequently made available via Web streaming. Attendees were requested to complete a survey to measure their satisfaction with the sessions. The teleconference was attended by a total of 345 persons, and it was subsequently reviewed online via 456 log-in sessions from 10 countries. Technical issues (e.g., poor auditory quality) were resolved on the first day of the event. The rate of attendees' responses on the survey was 30.1%, and satisfaction with the event was generally good. Telecommunication is a relatively inexpensive approach that may improve pharmacy practices, especially those used to treat patients with cancer in developing countries. Special attention to patient-based telepharmacy education, including the use of cost-effective technology, should be considered.

Food provisioning experiences of ultra poor female heads of household living in Bangladesh.

PubMed

McIntyre, Lynn; Rondeau, Krista; Kirkpatrick, Sharon; Hatfield, Jennifer; Islam, Khaled Shamsul; Huda, Syed Nazmul

2011-03-01

Ultra poor women in Bangladesh are especially vulnerable to poverty and food insecurity, and they have generally been excluded from recent improvements in hunger and poverty rates in the country. An examination of the food provisioning narratives of 43 ultra poor female heads of household in Bangladesh was conducted in order to deepen understanding of this obstacle to the country's achievement of the First Millennium Development Goal. All participants were the household's sole income provider, had dependent children, and earned less than $1 USD per day. Women were purposively selected based on occupational group, context, and personal characteristics. Ethnographic interviews were conducted in January and February, 2008. Analysis of women's accounts of their daily food routine revealed chronic and pervasive food insecurity punctuated by acute episodes of absolute food deprivation that resulted from seasonal fluctuations in earnings, rising food prices, illness disrupting work, and healthcare costs. Women's accounts of their daily food provisioning experiences suggested compromises in, and trade-offs between, multiple basic needs as a result of inadequate income. Women were further constrained by social norms and gender roles that influenced their ability to work outside the home. Our method of inquiry led us to construct an organizing framework that extends knowledge of ultra poor women in Bangladesh's complex and multi-sphered experience of poverty and food insecurity. Based on these findings, we propose a strategy called whole person development (WPD), which seeks small adjustments to services, programs, and policies based on leverage points identified through in-depth narratives. Copyright © 2011 Elsevier Ltd. All rights reserved.

Empowering the rural poor through EO products and services—An impact assessment

NASA Astrophysics Data System (ADS)

Diwakar, P. G.; Ranganath, B. K.; Gowrisankar, D.; Jayaraman, V.

2008-07-01

With the advent of technology in the form of space-based imaging, network-based computation and information technology, the focus has shifted to how these technologies could change the livelihoods of rural community and put them on the path of developmental processes. Many rural villages in India do not have right kind of infrastructure and connectivity, which makes it difficult for any developmental program to perform successfully. This makes them more vulnerable and further cut off from the mainstream developmental programs in the country. There are large tracts of arid and semi-arid lands in many parts of the country, which requires scientific inputs and improved farming practices for sustenance of poor communities under tough conditions. Unless some simple and cost-effective methods are evolved and taken to the field level, it is difficult to see positive developments in such areas and stop people from migrating to different areas for livelihood options. Integrated watershed development program with innovative practices and holistic approach could bring about positive changes in such poverty stricken areas that host vulnerable groups who experience the hardship due to poor local natural resources conditions and living standards. An optimal combination of space technology and information technology has been successfully used, through participatory methods, to empower the rural poor in realizing better livelihood possibilities. An attempt is made in this paper to find solutions for such problematic areas with some innovative tools and techniques that involve user-friendly delivery of EO products and services for the benefit of the rural community and help them in decision making at local level.

Moving Towards Inclusive Education Policies and Practices? Basic Education for AIDS Orphans and Other Vulnerable Children in Zambia

ERIC Educational Resources Information Center

Robson, Sue; Kanyanta, Sylvester Bonaventure

2007-01-01

The global spread of HIV and AIDS has presented a major threat to development, affecting the health of the poor and many aspects of social and economic development. The greatest impact of the epidemic has been felt in sub-Saharan Africa, and Zambia ranks among the worst hit countries. The Free Basic Education Policy in Zambia upholds the right of…

Optimizing the ‘demographic dividend’ in young developing countries: The role of contractual savings and insurance for financing education

PubMed Central

Ssewamala, Fred M.

2014-01-01

Many developing regions are facing a youth bulge, meaning that young people comprise the highest proportion of the population. These regions are at risk of losing what could be a tremendous opportunity for economic growth and development if they do not capitalize on this young and economically productive population - also referred to as the “demographic dividend,” defined as the increase in economic growth that tends to follow increases in the ratio of the working-age population - essentially the labor force - to dependents. Nations undergoing this population transition have the opportunity to capitalize on the demographic dividend if the right social, economic, and human capital policies are in place. In particular, sub-Saharan Africa, the Middle East, and North Africa are at risk of losing the demographic dividend. These regions face high youth unemployment, low primary school completion, and low secondary school enrollment. This results in an undereducated and unskilled segment of the population. The prohibitive costs of education prevent young people from finishing school, thereby entering the labor market unprepared. This article presents a case for youth-focused financial inclusion programs as one of the antidotes to the masses of poor, undereducated, and low-skilled young people swelling the labor markets of poor developing countries. PMID:26273211

Care for Child Development: an intervention in support of responsive caregiving and early child development.

PubMed

Lucas, J E; Richter, L M; Daelmans, B

2018-01-01

An estimated 43% of children younger than 5 years of age are at elevated risk of failing to achieve their human potential. In response, the World Health Organization and UNICEF developed Care for Child Development (CCD), based on the science of child development, to improve sensitive and responsive caregiving and promote the psychosocial development of young children. In 2015, the World Health Organization and UNICEF identified sites where CCD has been implemented and sustained. The sites were surveyed, and responses were followed up by phone interviews. Project reports provided information on additional sites, and a review of published studies was undertaken to document the effectiveness of CCD for improving child and family outcomes, as well as its feasibility for implementation in resource-constrained communities. The inventory found that CCD had been integrated into existing services in diverse sectors in 19 countries and 23 sites, including child survival, health, nutrition, infant day care, early education, family and child protection and services for children with disabilities. Published and unpublished evaluations have found that CCD interventions can improve child development, growth and health, as well as responsive caregiving. It has also been reported to reduce maternal depression, a known risk factor for poor pregnancy outcomes and poor child health, growth and development. Although CCD has expanded beyond initial implementation sites, only three countries reported having national policy support for integrating CCD into health or other services. Strong interest exists in many countries to move beyond child survival to protect and support optimal child development. The United Nations Sustainable Development Goals depend on children realizing their potential to build healthy and emotionally, cognitively and socially competent future generations. More studies are needed to guide the integration of the CCD approach under different conditions. Nevertheless, the time is right to provide for the scale-up of CCD as part of services for families and children. © 2017 The Authors. Child: Care, Health and Development Published by John Wiley & Sons Ltd.

Population growth and development in the Third World: the neocolonial context.

PubMed

Patterson, J G; Shrestha, N R

1988-01-01

Less developed countries (LDCs) that were colonies of other nations continued operating under the same social and political structures set up by the former ruling nations. The small minority of elites in the LDCs held on to the power acquired during colonial times. In order to preserve their political and financial status after independence, they maintained their close linkages to the capitalist nations and their multinational corporations (MNCs). The elites did not generally have popular support, however. These capitalist nations and their commercial interests continue to dictate most LDCs development process which supports the financial interests of the MNCs and the local elites and not those of the majority, the poor. The poor realize that they are trapped and unable to break away from the economic and political structures, therefore, to assure some form of security, they have many children which exacerbates their poverty. Yet population control policies based on Malthusian theory and those that rely on such undimensional, technical approaches as family planning alone cannot cure the multidimensional social problems of high population growth and poverty. Neither the Malthusian nor Marxist theories totally explain the situation in the LDCs or even provide workable solutions. Research on population and development in LDCs needs to address both the Malthusian concern for the problems posed by high growth rates and the Marxist critique of class struggle in development trends. To eliminate the trap of poverty and dependent economies, each country must design its own remedies based on its history, culture, and geography and alter the prevailing social, economic, and political power structures in favor of the poor. 6 propositions that must be modified to each nation's particular problems and needs are presented to guide LDCs in formulating or reformulating policies to alleviate the problems of population and poverty.

Climate change and developing-country cities: implications for environmental health and equity.

PubMed

Campbell-Lendrum, Diarmid; Corvalán, Carlos

2007-05-01

Climate change is an emerging threat to global public health. It is also highly inequitable, as the greatest risks are to the poorest populations, who have contributed least to greenhouse gas (GHG) emissions. The rapid economic development and the concurrent urbanization of poorer countries mean that developing-country cities will be both vulnerable to health hazards from climate change and, simultaneously, an increasing contributor to the problem. We review the specific health vulnerabilities of urban populations in developing countries and highlight the range of large direct health effects of energy policies that are concentrated in urban areas. Common vulnerability factors include coastal location, exposure to the urban heat-island effect, high levels of outdoor and indoor air pollution, high population density, and poor sanitation. There are clear opportunities for simultaneously improving health and cutting GHG emissions most obviously through policies related to transport systems, urban planning, building regulations and household energy supply. These influence some of the largest current global health burdens, including approximately 800,000 annual deaths from ambient urban air pollution, 1.2 million from road-traffic accidents, 1.9 million from physical inactivity, and 1.5 million per year from indoor air pollution. GHG emissions and health protection in developing-country cities are likely to become increasingly prominent in policy development. There is a need for a more active input from the health sector to ensure that development and health policies contribute to a preventive approach to local and global environmental sustainability, urban population health, and health equity.

Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia: challenges, needs and potential strategies

PubMed Central

Marais, Debbie; Abdulmalik, Jibril; Ahuja, Shalini; Alem, Atalay; Chisholm, Dan; Egbe, Catherine; Gureje, Oye; Hanlon, Charlotte; Lund, Crick; Shidhaye, Rahul; Jordans, Mark; Kigozi, Fred; Mugisha, James; Upadhaya, Nawaraj; Thornicroft, Graham

2017-01-01

Abstract Poor governance has been identified as a barrier to effective integration of mental health care in low- and middle-income countries. Governance includes providing the necessary policy and legislative framework to promote and protect the mental health of a population, as well as health system design and quality assurance to ensure optimal policy implementation. The aim of this study was to identify key governance challenges, needs and potential strategies that could facilitate adequate integration of mental health into primary health care settings in low- and middle-income countries. Key informant qualitative interviews were held with 141 participants across six countries participating in the Emerging mental health systems in low- and middle-income countries (Emerald) research program: Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda. Data were transcribed (and where necessary, translated into English) and analysed thematically using framework analysis, first at the country level, then synthesized at a cross-country level. While all the countries fared well with respect to strategic vision in the form of the development of national mental health policies, key governance strategies identified to address challenges included: strengthening capacity of managers at sub-national levels to develop and implement integrated plans; strengthening key aspects of the essential health system building blocks to promote responsiveness, efficiency and effectiveness; developing workable mechanisms for inter-sectoral collaboration, as well as community and service user engagement; and developing innovative approaches to improving mental health literacy and stigma reduction. Inadequate financing emerged as the biggest challenge for good governance. In addition to the need for overall good governance of a health care system, this study identifies a number of specific strategies to improve governance for integrated mental health care in low- and middle-income countries. PMID:28369396

Between-Country Inequalities in the Neglected Tropical Disease Burden in 1990 and 2010, with Projections for 2020.

PubMed

Stolk, Wilma A; Kulik, Margarete C; le Rutte, Epke A; Jacobson, Julie; Richardus, Jan Hendrik; de Vlas, Sake J; Houweling, Tanja A J

2016-05-01

The World Health Organization (WHO) has set ambitious time-bound targets for the control and elimination of neglected tropical diseases (NTDs). Investing in NTDs is not only seen as good value for money, but is also advocated as a pro-poor policy since it would improve population health in the poorest populations. We studied the extent to which the disease burden from nine NTDs (lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths, trachoma, Chagas disease, human African trypanosomiasis, leprosy, visceral leishmaniasis) was concentrated in the poorest countries in 1990 and 2010, and how this would change by 2020 in case the WHO targets are met. Our analysis was based on 1990 and 2010 data from the Global Burden of Disease (GBD) 2010 study and on projections of the 2020 burden. Low and lower-middle income countries together accounted for 69% and 81% of the global burden in 1990 and 2010 respectively. Only the soil-transmitted helminths and Chagas disease caused a considerable burden in upper-middle income countries. The global burden from these NTDs declined by 27% between 1990 and 2010, but reduction largely came to the benefit of upper-middle income countries. Achieving the WHO targets would lead to a further 55% reduction in the global burden between 2010 and 2020 in each country income group, and 81% of the global reduction would occur in low and lower-middle income countries. The GBD 2010 data show the burden of the nine selected NTDs in DALYs is strongly concentrated in low and lower-middle income countries, which implies that the beneficial impact of NTD control eventually also largely comes to the benefit of these same countries. While the nine NTDs became increasingly concentrated in developing countries in the 1990-2010 period, this trend would be rectified if the WHO targets were met, supporting the pro-poor designation.

Municipal solid waste management challenges in developing countries--Kenyan case study.

PubMed

Henry, Rotich K; Yongsheng, Zhao; Jun, Dong

2006-01-01

This paper provides an overview of the state of municipal solid waste management (MSWM) by local authorities in Kenya as a case study of a low-income developing country. Approaches of possible solutions that can be undertaken to improve municipal solid waste (MSW) services are discussed. Poor economic growth (1.1% in 1993) has resulted in an increase in the poverty level which presently stands at 56%. Migration from the rural areas to the urban areas has resulted in unplanned settlements in suburban areas accommodating about 60% of the urban population on only 5% urban land area. Political interference also hampers smooth running of local authorities. Vulnerability of pollution of surface and groundwater is high because local authorities rarely considered environmental impact in siting MSW disposal sites. Illegal dumping of MSW on the river banks or on the roadside poses environmental and economic threats on nearby properties. Poor servicing of MSW collection vehicles, poor state of infrastructure and the lack of adequate funding militate against optimization of MSW disposal service. The rural economy needs to be improved if rural-urban migration is to be managed. Involvement of stakeholders is important to achieve any meaningful and sustainable MSWM. The role of the informal sector through community-based organizations (CBOs), Non-Governmental Organizations (NGOs) and the private sector in offering solutions towards improvement of MSWM also is explored.

Chronic fatigue in developing countries: population based survey of women in India.

PubMed

Patel, Vikram; Kirkwood, Betty R; Weiss, Helen; Pednekar, Sulochana; Fernandes, Janice; Pereira, Bernadette; Upadhye, Medha; Mabey, David

2005-05-21

To describe the prevalence of and risk factors for chronic fatigue in a developing country; in particular, to determine the association of anaemia, mental health, and gender disadvantage factors with chronic fatigue. Community survey. Primary health centre catchment area in Goa, India. 3000 randomly sampled women aged 18 to 50 years. Data on the primary outcome (reporting of fatigue for at least six months) and psychosocial exposures elicited by structured interview; presence of anaemia determined from a blood sample. 2494 (83%) women consented to participate; 12.1% (95% confidence interval 10.8 to 13.4%) complained of chronic fatigue. In multivariate analyses, older women (P = 0.03) and those experiencing socioeconomic deprivation-less education (P < 0.001), families in debt (P = 0.09), or hunger in the past three months (P = 0.03)-were more likely to report chronic fatigue. After adjustment for these factors, factors indicating gender disadvantage (notably sexual violence by the husband; P < 0.001) and poor mental health (P < 0.001) were strongly associated with chronic fatigue. Although women with a high body mass index had a reduced risk, suggesting an influence of poor nutrition, no association was found between chronic fatigue and haemoglobin concentrations. Chronic fatigue was commonly reported by women in this community study from India. The strongest associations with chronic fatigue were for psychosocial factors indicative of poor mental health and gender disadvantage.

Prostate cancer diagnosis in a resource-poor setting: the changing role of digital rectal examination.

PubMed

Ahmed, Muhammed

2011-07-01

We undertook this study in order to determine the current role of digital rectal examination (DRE) in the diagnosis of prostate cancer in a resource-poor setting. The diagnosis of prostate cancer has been revolutionized by the introduction of prostate-specific antigen (PSA), transrectal ultrasound (TRUS) for biopsy guidance and more efficient biopsy equipment, but they are not readily available in most developing countries. This is a prospective study of 131 patients with suspected prostate cancer based on clinical presentation, DRE and elevated PSA. The presence or absence of cancer was confirmed by biopsy and histologic examination. Patients with screen- or incidentally-detected prostate cancer were excluded. The most common symptom was the development of lower urinary tract symptoms (LUTS). All patients had abnormal DRE and indurated prostate was the most frequent finding (50%). The mean PSA was 33.9 ng/mL: of the 131 patients, 80 (61.1%) had a malignant histology following biopsy, 47 (35.9%) were benign and four (3.0%) were prostate intraepithelial neoplasia (PIN). The low specificity of DRE in the diagnosis of prostate cancer requires that it should be combined with other diagnostic modalities such as PSA and TRUS-guided prostate biopsy. Thus government and health-care providers in resource-poor countries must strive to make these facilities available in order to improve prostate cancer diagnosis.

Dispelling a myth: developing world poverty, inequality, violence and social fragmentation are not good for outcome in schizophrenia.

PubMed

Burns, J

2009-08-01

The WHO multi-site studies of schizophrenia concluded the course and outcome of the disorder was better in developing countries. This has become psychiatric lore. However, the reality is that significant political, social and economic ills that characterize many countries in Africa, Latin America and Asia constitute psychosocial stressors that mediate strongly against better outcome in individuals living with this disorder. Outcome studies of schizophrenia in developing countries are reviewed and concepts of poverty, inequality and violence in relation to the course of the illness in this context are debated. The generally poor state of mental health services and policies in these regions are discussed. The belief that community and family life in the developing world is widely intact and that it provides a nurturing environment that facilitates recovery and promotes social and economic empowerment of serious mentally ill individuals is dispelled as a myth. Idealisation of the under-developed South as a haven for schizophrenia sufferers will only add to the already heavy burden experienced by these individuals, their families and these societies in coping with this disabling disease.

"Initiate-build-operate-transfer" - a strategy for establishing sustainable telemedicine programs not only in the developing countries.

PubMed

Latifi, Rifat

2011-01-01

Establishing sustainable telemedicine has become a goal of many developing countries around the world. Yet, despite initiatives from a select few individuals and on occasion from various governments, often these initiatives never mature to become sustainable programs. The introduction of telemedicine and e-learning in the Balkans has been a pivotal step in advancing the quality and availability of medical services in a region whose infrastructure and resources have been decimated by wars, neglect, lack of funding, and poor management. The concept and establishment of the International Virtual e-Hospital (IVeH) has significantly impacted telemedicine and e-health services in Kosova. The success of the IVeH in Kosova has led to the development of similar programs in other Balkan countries and other developing countries in the hope of modernizing and improving their healthcare infrastructure. A comprehensive, four-pronged strategy developed by IVeH "Initiate-Build-Operate-Transfer" (IBOT), may be a useful approach in establishing telemedicine and e-health educational services not only in developing countries, but in developed countries. The development strategy, IBOT, used by the IVeH to establish and develop telemedicine programs is described. IBOT includes assessment of healthcare needs of each country, the development of a curriculum and education program, the establishment of a nationwide telemedicine network, and the integration of the telemedicine program into the very core of healthcare infrastructure. The end point is the transfer of a sustainable telehealth program to the nation involved. By applying IBOT, a sustainable telemedicine program of Kosova and Albania has been established as an effective prototype for telemedicine in the Balkans. Once fully matured, the program is transitioned to the Ministry of Health, which ensures the sustainability and ownership of the program. Similar programs are being established in Macedonia, Montenegro and other countries around the world. The IBOT model has been effective in creating sustainable telemedicine and e-health integrated programs in the Balkans and may be a good model for establishing such programs in developing countries.

Trends and inequities in where women delivered their babies in 25 low-income countries: evidence from Demographic and Health Surveys.

PubMed

Limwattananon, Supon; Tangcharoensathien, Viroj; Sirilak, Supakit

2011-05-01

In low-income countries, the coverage of institutional births is low. Using data from the two most recent Demographic and Health Surveys (1995-2001 and 2001-2006) for 25 low-income countries, this study examined trends in where women delivered their babies--public or private facilities or non-institutional settings. More than half of deliveries were in institutional settings in ten countries, mostly public facilities. In the other 15 countries, the majority of births were in women's homes, which was often their only option. Between the two survey periods, all five Asian countries studied (except Bangladesh) had an increase of 10-20 percentage points in institutional coverage, whereas none of the 19 sub-Saharan African countries saw an increase of more than 10 percentage points. More urban women and more in the richest (least poor) quintile gave birth in public or private facilities than rural and poorest quintile women. The rich-poor gap of institutional births was wider than the urban-rural gap. Inadequate public investment in health system infrastructure in rural areas and lack of skilled health professionals are major obstacles in reducing maternal mortality. Governments in low-income countries must invest more, especially in rural maternity services. Strengthening private, for-profit providers is not a policy choice for poor, rural communities. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

The other crisis: the economics and financing of maternal, newborn and child health in Asia.

PubMed

Anderson, Ian; Axelson, Henrik; Tan, B-K

2011-07-01

The Global Financial Crisis (GFC) of 2008/2009 was the largest economic slowdown since the Great Depression. It undermined the growth and development prospects of developing countries. Several recent studies estimate the impact of economic shocks on the poor and vulnerable, especially women and children. Infant and child mortality rates are still likely to continue to decline, but at lower rates than would have been the case in the absence of the GFC. Asia faces special challenges. Despite having been the fastest growing region in the world for decades, and even before the current crisis, this region accounted for nearly 34% of global deaths of children under 5, more than 40% of maternal deaths and 60% of newborn deaths. Global development goals cannot be achieved without much faster and deeper progress in Asia. Current health financing systems in much of Asia are not well placed to respond to the needs of women and their children, or the recent global financial and economic slowdown. Public expenditure is often already too low, and high levels of out-of-pocket health expenditure are an independent cause of inequity and impoverishment for women and their children. The GFC highlights the need for reforms that will improve health outcomes for the poor, protect the vulnerable from financial distress, improve public expenditure patterns and resource allocation decisions, and so strengthen health systems. This paper aims to highlight the most recent assessments of how economic shocks, including the GFC, affect the poor in developing countries, especially vulnerable women and children in Asia. It concludes that conditional cash transfers, increasing taxation on tobacco and increasing the level, and quality, of public expenditure through well-designed investment programmes are particularly relevant in the context of an economic shock. That is because these initiatives simultaneously improve health outcomes for the poor and vulnerable, protect them from further financial distress, improve public financing and/or provide a much-needed counter-cyclical stimulus at times of economic slowdown.

Towards a sustainable livestock production in developing countries and the importance of animal health strategy therein.

PubMed

Kaasschieter, G A; de Jong, R; Schiere, J B; Zwart, D

1992-04-01

Livestock and animal health development projects have not always led to substantial increases in animal productivity or in farmers' welfare. Some have even resulted in unsustainable systems, when they were not based on an understanding of (livestock) production systems. The multipurpose functions of livestock and complex relationships between the biological, technical and social components require a systems approach, whereby nutrition, animal health, breeding, biotechnology knowhow, inputs and technologies are used to optimise resource use. The challenge for developed and developing countries is to reverse the current degradation of the environment, and arrive at sustainable increases in crop and livestock production to secure present and future food supplies. For rural development, governments should show long term commitment and political will to support the rural population in development programmes, because smallholders (including women and landless livestock keepers) represent a large labour force in developing countries. Different systems need different approaches. Pastoral systems must focus on effective management of grazing pressure of the rangelands. Communal rangelands management involves not only the development and application of technologies (e.g. feedlots, vaccination campaigns), but also land tenure policies, institutional development, economic return and a reduction in the number of people depending upon livestock. Smallholder mixed farms must aim at intensification of the total production system, in which external inputs are indispensable, but with the emphasis on optimum input-output relationships by reducing resource losses due to poor management. Resource-poor farming systems must aim at the improved management of the various livestock species in backyards and very small farms, and proper packages for cattle, buffaloes, sheep, goats, rabbits and poultry should be developed. Specialised commercial livestock farming systems (poultry, pigs, dairy or meat) can only be sustainable with adequate marketing, supply of quality feed, veterinary services, labour, management and control of pollution. Animal health programmes play a keyrole in the proposed system approach.

Understanding The Relationships Between Noncommunicable Diseases, Unhealthy Lifestyles, And Country Wealth.

PubMed

Bollyky, Thomas J; Templin, Tara; Andridge, Caroline; Dieleman, Joseph L

2015-09-01

The amount of international aid given to address noncommunicable diseases is minimal. Most of it is directed to wealthier countries and focuses on the prevention of unhealthy lifestyles. Explanations for the current direction of noncommunicable disease aid include that these are diseases of affluence that benefit from substantial research and development into their treatment in high-income countries and are better addressed through domestic tax and policy measures to reduce risk-factor prevalence than through aid programs. This study assessed these justifications. First, we examined the relationships among premature adult mortality, defined as the probability that a person who has lived to the age of fifteen will die before the age of sixty from noncommunicable diseases; the major risk factors for these diseases; and country wealth. Second, we compared noncommunicable and communicable diseases prevalent in poor and wealthy countries alike, and their respective links to economic development. Last, we examined the respective roles that wealth and risk prevention have played in countries that achieved substantial reductions in premature mortality from noncommunicable diseases. Our results support greater investment in cost-effective noncommunicable disease preventive care and treatment in poorer countries and a higher priority for reducing key risk factors, particularly tobacco use. Project HOPE—The People-to-People Health Foundation, Inc.

Human Resources for Health Challenges in Nigeria and Nurse Migration.

PubMed

Salami, Bukola; Dada, Foluke O; Adelakun, Folake E

2016-05-01

The emigration of sub-Saharan African health professionals to developed Western nations is an aspect of increasing global mobility. This article focuses on the human resources for health challenges in Nigeria and the emigration of nurses from Nigeria as the country faces mounting human resources for health challenges. Human resources for health issues in Nigeria contribute to poor population health in the country, alongside threats from terrorism, infectious disease outbreaks, and political corruption. Health inequities within Nigeria mirror the geographical disparities in human resources for health distribution and are worsened by the emigration of Nigerian nurses to developed countries such as the United States and the United Kingdom. Nigerian nurses are motivated to emigrate to work in healthier work environments, improve their economic prospects, and advance their careers. Like other migrant African nurses, they experience barriers to integration, including racism and discrimination, in receiving countries. We explore the factors and processes that shape this migration. Given the forces of globalization, source countries and destination countries must implement policies to more responsibly manage migration of nurses. This can be done by implementing measures to retain nurses, promote the return migration of expatriate nurses, and ensure the integration of migrant nurses upon arrival in destination countries. © The Author(s) 2016.

Home hygiene and environmental sanitation: a country situation analysis for India.

PubMed

Nath, K J

2003-06-01

Problems of the environment and of domestic hygiene are always related to poverty of population and the sanitation of settlements. Most cities and towns in developing countries, like India, are characterised by over-crowding, congestion, inadequate water supply and inadequate facilities of disposal of human excreta, waste water and solid wastes. Inadequacy of housing for most urban poor invariably leads to poor home hygiene. Personal and domestic hygiene practices cannot be improved without improving basic amenities, such as water supply, waste water disposal, solid waste management and the problems of human settlements. But even under the prevailing conditions, there is significant scope of improving hygiene practices at home to prevent infection and cross-infection. Unfortunately, in developing countries, public health concerns are usually raised on the institutional setting, such as municipal services, hospitals, environmental sanitation, etc. There is a reluctance to acknowledge the home as a setting of equal importance along with the public institutions in the chain of disease transmission in the community. Managers of home hygiene and community hygiene must act in unison to optimise return from efforts to promote public health. Current practices and perceptions of domestic and personal hygiene in Indian communities, the existing levels of environmental and peri-domestic sanitation and the 'health risk' these pose will be outlined, as well as the need for an integrated action for improving hygiene behaviour and access to safe water and sanitation.

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.

Contraceptive issues of youth and adolescents in developing countries: highlights from the Philippines and other Asian countries.

PubMed

Alesna-Llanto, Emma; Raymundo, Corazon M

2005-10-01

This article highlights contraceptive issues in Asia, home to some 700 million adolescents. It starts with a description of the socio-cultural milieu of adolescents in South and Southeast Asia, their knowledge and use of contraceptives, the myriad barriers to access, and the many innovative programs to broaden contraceptive availability. The reproductive health needs of adolescents in poor countries cannot be solved by merely supplying them with contraceptives--these needs can only be fully addressed in the context of gender equality, poverty alleviation and the conviction that investing in the reproductive health of adolescents is a most urgent priority. Investing in the reproductive health of adolescents will have an impact not only on birth and abortion rates, maternal health, and the spread of STI/HIV but also on the demographics and economic development of the region--and beyond.

Waste management activities and carbon emissions in Africa.

PubMed

Couth, R; Trois, C

2011-01-01

This paper summarizes research into waste management activities and carbon emissions from territories in sub-Saharan Africa with the main objective of quantifying emission reductions (ERs) that can be gained through viable improvements to waste management in Africa. It demonstrates that data on waste and carbon emissions is poor and generally inadequate for prediction models. The paper shows that the amount of waste produced and its composition are linked to national Gross Domestic Product (GDP). Waste production per person is around half that in developed countries with a mean around 230 kg/hd/yr. Sub-Saharan territories produce waste with a biogenic carbon content of around 56% (+/-25%), which is approximately 40% greater than developed countries. This waste is disposed in uncontrolled dumps that produce large amounts of methane gas. Greenhouse gas (GHG) emissions from waste will rise with increasing urbanization and can only be controlled through funding mechanisms from developed countries. Copyright © 2010 Elsevier Ltd. All rights reserved.

Setting the stage for equity-sensitive monitoring of the maternal and child health Millennium Development Goals.

PubMed Central

Wirth, Meg E.; Balk, Deborah; Delamonica, Enrique; Storeygard, Adam; Sacks, Emma; Minujin, Alberto

2006-01-01

OBJECTIVE: This analysis seeks to set the stage for equity-sensitive monitoring of the health-related Millennium Development Goals (MDGs). METHODS: We use data from international household-level surveys (Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS)) to demonstrate that establishing an equity baseline is necessary and feasible, even in low-income and data-poor countries. We assess data from six countries using 11 health indicators and six social stratifiers. Simple bivariate stratification is complemented by simultaneous stratification to expose the compound effect of multiple forms of vulnerability. FINDINGS: The data reveal that inequities are complex and interactive: inferences cannot be drawn about the nature or extent of inequities in health outcomes from a single stratifier or indicator. CONCLUSION: The MDGs and other development initiatives must become more comprehensive and explicit in their analysis and tracking of inequities. The design of policies to narrow health gaps must take into account country-specific inequities. PMID:16878225

Educational inequalities in obesity and gross domestic product: evidence from 70 countries.

PubMed

Kinge, Jonas Minet; Strand, Bjørn Heine; Vollset, Stein Emil; Skirbekk, Vegard

2015-12-01

We test the reversal hypothesis, which suggests that the relationship between obesity and education depends on the economic development in the country; in poor countries, obesity is more prevalent in the higher educated groups, while in rich countries the association is reversed-higher prevalence in the lower educated. We assembled a data set on obesity and education including 412,921 individuals from 70 countries in the period 2002-2013. Gross domestic product (GDP) per capita was used as a measure of economic development. We assessed the association between obesity and GDP by education using a two-stage mixed effects model. Country-specific educational inequalities in obesity were investigated using regression-based inequality indices. The reversal hypothesis was supported by our results in men and women. Obesity was positively associated with country GDP only among individuals with lower levels of education, while this association was absent or reduced in those with higher levels of education. This pattern was more pronounced in women than in men. Furthermore, educational inequalities in obesity were reversed with GDP; in low-income countries, obesity was more prevalent in individuals with higher education, in medium-income and high-income countries, obesity shifts to be more prevalent among those with lower levels of education. Obesity and economic development were positively associated. Our findings suggest that education might mitigate this effect. Global and national action aimed at the obesity epidemic should take this into account. 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/

Assessment of universal health coverage for adults aged 50 years or older with chronic illness in six middle-income countries

PubMed Central

Frenz, Patricia; Grabenhenrich, Linus; Keil, Thomas; Tinnemann, Peter

2016-01-01

Abstract Objective To assess universal health coverage for adults aged 50 years or older with chronic illness in China, Ghana, India, Mexico, the Russian Federation and South Africa. Methods We obtained data on 16 631 participants aged 50 years or older who had at least one diagnosed chronic condition from the World Health Organization Study on Global Ageing and Adult Health. Access to basic chronic care and financial hardship were assessed and the influence of health insurance and rural or urban residence was determined by logistic regression analysis. Findings The weighted proportion of participants with access to basic chronic care ranged from 20.6% in Mexico to 47.6% in South Africa. Access rates were unequally distributed and disadvantaged poor people, except in South Africa where primary health care is free to all. Rural residence did not affect access. The proportion with catastrophic out-of-pocket expenditure for the last outpatient visit ranged from 14.5% in China to 54.8% in Ghana. Financial hardship was more common among the poor in most countries but affected all income groups. Health insurance generally increased access to care but gave insufficient protection against financial hardship. Conclusion No country provided access to basic chronic care for more than half of the participants with chronic illness. The poor were less likely to receive care and more likely to face financial hardship in most countries. However, inequity of access was not fully determined by the level of economic development or insurance coverage. Future health reforms should aim to improve service quality and increase democratic oversight of health care. PMID:27034521

An update on the management of breast cancer in Africa.

PubMed

Vanderpuye, V; Grover, S; Hammad, N; PoojaPrabhakar; Simonds, H; Olopade, F; Stefan, D C

2017-01-01

There is limited information about the challenges of cancer management and attempts at improving outcomes in Africa. Even though South and North Africa are better resourceds to tackle the burden of breast cancer, similar poor prognostic factors are common to all countries. The five-year overall Survival rate for breast cancer patients does not exceed 60% for any low and middle-income country (LMIC) in Africa. In spite of the gains achieved over the past decade, certain characteristics remain the same such as limited availability of breast conservation therapies, inadequate access to drugs, few oncology specialists and adherence to harmful socio-cultural practices. This review on managing breast cancer in Africa is authored by African oncologists who practice or collaborate in Africa and with hands-on experience with the realities. A search was performed via electronic databases from 1999 to 2016. (PubMed/Medline, African Journals Online) for all literature in English or translated into English, covering the terms "breast cancer in Africa and developing countries". One hundred ninety were deemed appropriate. Breast tumors are diagnosed at earlier ages and later stages than in highincome countries. There is a higher prevalence of triple-negative cancers. The limitations of poor nursing care and surgery, inadequate access to radiotherapy, poor availability of basic and modern systemic therapies translate into lower survival rate. Positive strides in breast cancer management in Africa include increased adaptation of treatment guidelines, improved pathology services including immuno-histochemistry, expansion and upgrading of radiotherapy equipment across the continent in addition to more research opportunities. This review is an update of the management of breast cancer in Africa, taking a look at the epidemiology, pathology, management resources, outcomes, research and limitations in Africa from the perspective of oncologists with local experience.

Ensuring the Health, Safety and Preparedness of U.S. Medical Students Participating in Global Health Electives Overseas.

PubMed

Imperato, Pascal James; Bruno, Denise M; Monica Sweeney, M

2016-04-01

Global health electives based in resource-poor countries have become extremely popular with medical students from resource rich ones. As the number of such programs and participants increase, so too do the absolute health and safety risks. It is clear from a number of published reports that many institutions provide little or no meaningful preparedness for students and do little to ensure their health and safety. These deficiencies together can affect students, their foreign hosts, and sponsoring institutions. The School of Public Health at the State University of New York, Downstate Medical Center, and its predecessor, the Department of Preventive Medicine and Community Health, have sponsored a 6-8 week global health elective for fourth year medical students since 1980. The purposes of this elective are to provide students with an opportunity to observe the health care and public health systems in resource-poor countries, provide medical service, and have a cross-cultural experience. Over the course of the past 35 years, 386 students have participated in this global health elective in more than 41 resource-poor countries. Recent annual applications for this elective have been as high as 44 out of a class of 200 students. Over the past 10 years, annual acceptance rates have varied, ranging from a low of 32 % in 2007-2008 to a high of 74 % in 2010-2011 and 2013-2014. Careful screening, including a written application, review of academic records and personal interviews, has resulted in the selection of highly mature, adaptable, and dedicated students who have performed well at overseas sites. Appropriately preparing students for an overseas global health experience in resource-poor countries requires the investment of much professional and staff time and effort. At the SUNY Downstate School of Public Health, these resources have underpinned our Global Health in Developing Countries elective for many years. As a result, the elective is characterized by meticulous organization, extensive preparedness measures for students, and continuous monitoring of site and country safety. The health of students is ensured by one-on-one assessment of immunization needs, anti-malarials, and the provision of a five-day supply of post-exposure HIV prophylaxis. Students sign agreements regarding the legal issues, immunizations, and anti-malarials recommended as well as HIV post-exposure prophylaxis. They are also required to obtain medical evacuation insurance provided by the university, and medical care insurance valid overseas. Student travel plans are also approved as is in-country lodging. The focus of our 6-8 week global health elective is not clinical medicine. Rather, it is to enable students to learn about the health care and public health systems in a resource-poor country. Through that focus, they also come to understand the causes of health and health care disparities that exist in the country to which they are assigned. Our students are greatly advantaged with regard to cross-cultural understanding since our school is located in New York City's Borough of Brooklyn, where 40 % of the population was born outside of the U.S. Our comprehensive effort at risk management for this global health elective includes a thorough debriefing for each student upon his/her return. Special attention is given to ascertaining illness or injury while overseas, and, when necessary, immediate referral is made to an appropriate university clinical department where a student can be appropriately case managed. Meticulous oversight, careful selection of safe overseas sites, and attention to preparing students have resulted in significant risk reduction and successful experiences for the majority of our 386 students. This article describes the model we have developed for ensuring the health, safety, and preparedness of students participating in our global health elective.

Economic development does not improve public mental health spending.

PubMed

Gupta, Susham; Methuen, Caroline; Kent, Priscilla; Chatain, Gregoire; Christie, Daisy; Torales, Julio; Ventriglio, Antonio

2016-08-01

As a result of rapid globalization the Gross Domestic product of countries may have changed, but the gap between the very rich countries and poor countries has changed too, along with a change in social and economic strata within each society; although the rates of psychiatric disorders are affected by industrialization and urbanization, the financial pressures add yet another layer of burden. Global burden of disease due to mental illness is tremendously high and yet, in spite of pressures, there is no equity and increased discrimination related to mental illness. This paper presents some of the issues related to the economic state of the countries. In order to ensure that citizens receive the best treatments available it is important that socio-economic causes and gaps in treatment are identified and dealt with at national levels.

Healthy firms: constraints to growth among private health sector facilities in Ghana and Kenya.

PubMed

Burger, Nicholas E; Kopf, Daniel; Spreng, Connor P; Yoong, Joanne; Sood, Neeraj

2012-01-01

Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have the business processes in place for operating a successful business and health facility.

Barriers to rural households' participation in low-skilled off-farm labor markets: theory and empirical results from northern Ethiopia.

PubMed

Bhatta, Bharat P; Arethun, Torbjørn

2013-12-01

Promotion of low-skilled off-farm rural labor market participation can be an important strategy to improve livelihoods and food security of the poor in developing countries. This paper investigates rural farm households' participation in low-skilled off-farm labor markets with disaggregate data from a survey of 400 households in Tigray, the northern highlands of Ethiopia. Adopting Heckman's two stage approach, we examined households' decisions to participate or not in markets by probit model in the first stage and level of participation by ordinary least squares procedures in the second stage. The results show that households' decision to enter into a labor market significantly depends on the characteristics of the households such as sex, age of the household heads and labor endowments in the households. Similarly, the level of participation in labor markets measured by the amount of off-farm wage income depends on labor endowments in the households and the place where the households are located. Since cash constrained rural households do not find themselves advantageous to participate in off-farm labor markets, the reduction of cash constraint is the major policy implication of the paper. This holds true in general for all cash constrained rural households in developing countries. Similarly, the empirical results in the paper suggest removal of locational barriers to access labor markets. This helps them to earn off-farm income. It is necessary to eliminate (or at least reduce) obstacles for rural households to enter into a market of off-farm wage earning activities. This holds true in general for all rural households in developing countries. This paper is therefore expected to contribute to frame appropriate policy that promotes participation in low-skilled off-farm rural labor markets in developing countries where many rural households are not only poor but also low-skilled.

Healthy Firms: Constraints to Growth among Private Health Sector Facilities in Ghana and Kenya

PubMed Central

Burger, Nicholas E.; Kopf, Daniel; Spreng, Connor P.; Yoong, Joanne; Sood, Neeraj

2012-01-01

Background Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. Methodology/Principal Findings We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. Conclusions/Significance The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have the business processes in place for operating a successful business and health facility. PMID:22383944

What are the forests worth?

PubMed

Fellows, L

1992-05-30

The Earth is a finite environment, thus growth cannot occur indefinitely. Eventually we will run out of space, resources, or anything else that is also finite. Once this fact is recognized, it becomes clear that we must develop in a sustainable way so that we can endure into the future. Overpopulation, vegetation destruction, and pollution are all serious threats to our finite environment. Traditionally, change has been to expensive and politically destabilizing. However, extensive changes in our modes of living must be made so that they become sustainable. In both developed and developing countries, consumptive growth must be replaced with sustainable development. Many developing countries are currently selling their natural resources to the developed countries. When they run out of resources, they will be truly poor. All governments must recognize the value of forests. It is estimated that in terms of medical uses for forest products alone, they will be worth US$11-12 billion (1990 dollars) by 2050. This constitutes a large portion of developing countries economies. Also, 80% of the population of developing countries rely on natural, traditional medicines made from forest products. Even in the US 25% of prescription drugs are based on phytochemicals. Now the drug companies are actively pursuing these resources for their products. It is estimated that 95% of the world species have not been assayed for their chemical value. Technology and money are not the obstacles to sustainable development and forest conservation. It is will and attitude that must be radically changed in order to protect the forests for the ecological and economic value.

A multi-scalar investigation of development and health in Ethiopia: household electrification in a agriculturally dependent and climate sensitive country

NASA Astrophysics Data System (ADS)

Grace, K.; Brown, M. E.; Bakhtsiyarava, M.

2017-12-01

In poor countries, household electricity status is often used as a measure of household resources. Often, the primary use of the variable is to sort the poorest households - those without electricity - from the better-off households - those with electricity. Expanding electrification is also part of a suite of goals developed by health and development and reflected in the Millennium Development Goals (MDG) and now the UN's Sustainable Development Goals. Therefore, this measure is also used in a macro-level description of a country to describe a country's process of urbanization or development. As countries, electrify and expand access to electrification to the poorest households and communities, understanding the role and impact of electrification on the health and development of these communities is necessary. In other words, moving beyond the binomial categorization of a household as electrified or not electrified and instead investigating the ways that electrification impacts communities, households and individuals is a necessary component of understanding contemporary patterns of health and development in the world's poorest countries. The goal of this research is to examine the linkages between health and development using multi-scalar, remotely-sensed measures of electrification in Ethiopia, one of the poorest countries in the world. For this study we use spatially referenced Demographic and Health Survey (DHS) data for Ethiopia from 2000 and 2005. In addition to measures of electrification gathered from the DHS, we also use time-varying satellite based measure of electrification collected by the US Department of Defense. Also, because many rural Ethiopians are dependent on small-scale, rainfed agriculture and therefore highly vulnerable to climate shocks and food insecurity, any investigation of health and development must also consider the local food production context. To support the analysis and provide information on broader measures of food insecurity and wellbeing, we also use livelihood zone data from the Famine Early Warning Systems (FEWS NET), as well as remotely sensed based estimates of rainfall and temperature.

Population-level approaches to universal health coverage in resource-poor settings: lessons from tobacco control policy in Vietnam.

PubMed

Higashi, Hideki; Khuong, Tuan A; Ngo, Anh D; Hill, Peter S

2011-07-01

Population-based health promotion and disease prevention approaches are essential elements in achieving universal health coverage; yet they frequently do not appear on national policy agendas. This paper suggests that resource-poor countries should take greater advantage of such approaches to reach all segments of the population to positively affect health outcomes and equity, especially considering the epidemic of chronic non-communicable diseases and associated modifiable risk factors. Tobacco control policy development and implementation in Vietnam provides a case study to discuss opportunities and challenges associated with such strategies.

[Fake malaria drugs].

PubMed

Bygbjerg, Ib Christian

2009-03-02

The literature on fake medicaments is sparse, even if approximately 15% of all medicaments are fake, a figure that for antimalarials in particular reaches 50% in parts of Africa and Asia. Sub-standard and fake medicines deplete the public's confidence in health systems, health professionals and in the pharmaceutical industry - and increase the risk that resistance develops. For a traveller coming from a rich Western country, choosing to buy e.g. preventive antimalarials over the internet or in poor malaria-endemic areas, the consequences may be fatal. International trade-, control- and police-collaboration is needed to manage the problem, as is the fight against poverty and poor governance.

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

PubMed

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

2017-12-01

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

Cancer research performance in the European Union: a study of published output from 2000 to 2008.

PubMed

Micheli, Andrea; Di Salvo, Francesca; Lombardo, Claudio; Ugolini, Donatella; Baili, Paolo; A Pierotti, Marco

2011-01-01

Although several studies have assessed cancer research performance in individual European countries, comparisons of European Union (EU27) performance with countries of similar population size are not available. We compared cancer research performance in 2000-2008 between EU27 and 11 countries with over 100 million inhabitants. Performance should not have been affected by the 2007-2009 recession. We examined 143 journals considered oncology journals by Journal Citation Reports, accessing them via Scopus. Publications were attributed to countries using a published counting procedure. For number of publications, the USA held a clear lead in 2006-2008 (yearly averages: 10,293 USA vs 9,962 EU27), whereas the EU27 held the lead previously. EU27 was also second to the USA for total impact factor. China markedly improved its cancer publications record over the period. Compared to the USA, EU27 and Japan, the other countries (all developing) had a poor publications record. Comparative cancer research spending data are not available. However from 2002 to 2007, gross domestic expenditure on research and development (UNESCO data) increased by 34% in North America, 161% in China and only 28% in EU27. Thus the European Union is lagging behind North America and may well be eclipsed by China in research and development spending in the near future. We suggest that these new findings should be considered by policymakers in Europe and other countries when developing policies for cancer control.

Contextualized IT Education in Tanzania: Beyond Standard IT Curricula

ERIC Educational Resources Information Center

Tedre, Matti; Bangu, Nicholas; Nyagava, Seth I.

2009-01-01

Tumaini University at Iringa, Tanzania, started a new B.Sc. program in IT in 2007. In the course of planning and implementation of the program, we found out that standard ACM/IEEE IT curricula are not adequate for an IT program in a poor, developing country. The standard curricula describe, in detail, the competences that IT specialists in…

A Basic Engineering English Word List for Less Proficient Foundation Engineering Undergraduates

ERIC Educational Resources Information Center

Ward, Jeremy

2009-01-01

This paper concerns the teaching of English to learners who are studying, or will soon study, engineering and who are expected to do at least part of their studying through textbooks written in English. Such students, especially in universities in developing countries, often find themselves very poorly equipped by their secondary education for…

A Dime a Day: The Possibilities and Limits of Private Schooling in Pakistan

ERIC Educational Resources Information Center

Andrabi, Tahir; Das, Jishnu; Khwaja, Asim Ijaz

2008-01-01

The authors of this article state that Pakistan is severely offtrack in its progress toward the Millennium Development Goals relating to education for all. Its educational performance is poor, both in absolute terms and relative to the average income of the country. Pakistan has received global attention because of the widespread perception that…

Warranting Failure: The "System" that Breeds Poverty and Starves Public Schools

ERIC Educational Resources Information Center

Alexander, Kern; Salmon, Richard G.

2007-01-01

The inscription on the internal pedestal of the Statue of Liberty proclaiming "Give me your tired, your poor, your huddled masses" today is an ideal of another age. Compared with those of other developing countries, U.S. poverty rates are extraordinarily high, as are the odds of remaining in poverty intergenerationally. No longer do…

Dragonflies as Flagships for Sustainable Use of Water Resources in Environmental Education

ERIC Educational Resources Information Center

Clausnitzer, Viola; Simaika, John P.; Samways, Michael J.; Daniel, B. A.

2017-01-01

Sustainable use of freshwater is globally important. Yet implementation of changes in water management is poor, especially in developing countries. This is an indication that, despite our dependence on freshwater, we lack awareness of the need to protect these systems. Here we promote dragonflies as an easy-to-learn tool in environmental education…

The Role of Training in Reducing Poverty: The Case of Agricultural Workers Receiving Microcredit in Bangladesh

ERIC Educational Resources Information Center

Mahmud, Kazi Tanvir; Parvez, Asif; Hilton, David; Kabir, G. M. Shamsul; Wahid, Ishraat Saira

2014-01-01

The policy of providing microcredit and skill training to poor agricultural workers in developing countries is well-established. In this study, an attempt has been made to assess the effectiveness of the training part of that policy. BRAC (formerly the Bangladesh Rural Advancement Committee), the largest non-governmental organization in…

Negative Effect of the British Poor Vocational Education on Its Economic Development after the Second World War

ERIC Educational Resources Information Center

Li, Yong

2007-01-01

England is the oldest nation of industry revolution and the earliest industrialized country in the world. With the colonization system breakdown and economic giants, the United States, Germany, Japan, etc. rising, today England has already lost former days of elegant appearance. The disadvantageous vocational education is one of essential factor…

Poverty in Albania: A Qualitative Assessment. World Bank Technical Paper.

ERIC Educational Resources Information Center

De Soto, Hermine; Gordon, Peter; Gedeshi, Ilir; Sinoimeri, Zamira

This World Bank qualitative assessment of poverty in Albania outlines five objectives: (1) it seeks to develop the understanding of poverty in the country by involving poor Albanians in a process of exploring the causes, nature, extent of poverty and its effects; (2) it is intended to support the Growth and Poverty Reduction Strategy Paper (GPRS),…

The resource curse and child mortality, 1961-2011.

PubMed

Wigley, Simon

2017-03-01

There is now an extensive literature on the adverse effect of petroleum wealth on the political, economic and social well-being of a country. In this study we examine whether the so-called resource curse extends to the health of children, as measured by under-five mortality. We argue that the type of revenue available to governments in petroleum-rich countries reduces their incentive to improve child health. Whereas the type of revenue available to governments in petroleum-poor countries encourages policies designed to improve child health. In order to test that line of argument we employ a panel of 167 countries (all countries with populations above 250,000) for the years 1961-2011. We find robust evidence that petroleum-poor countries outperform petroleum-rich countries when it comes to reducing under-five mortality. This suggests that governments in oil abundant countries often fail to effectively use the resource windfall at their disposal to improve child health. Copyright © 2017 Elsevier Ltd. All rights reserved.

Strengthening public health pesticide management in countries endemic with malaria or other major vector-borne diseases: an evaluation of three strategies.

PubMed

van den Berg, Henk; Yadav, Rajpal S; Zaim, Morteza

2014-09-18

Public health pesticides has been the mainstay control of vectors of malaria and other diseases, and public health pests, but there is increasing concern over how these pesticides are being managed. Poor pesticide management could lead to risks to human health and the environment, or diminish the effectiveness of interventions. Strategies for strengthening the management of public health pesticides, from manufacture to disposal, should be evaluated to propose future directions. The process and outcomes of three strategies were studied in five regions of the WHO (African Region, Eastern Mediterranean Region, South-East Asia Region, Western Pacific Region, and American Region) and 13 selected countries. These strategies are: regional policy development, in-depth country support and thematic support across countries. Consensus, frameworks and action plans on public health pesticide management were developed at regional level. Country support for situation analysis and national action planning highlighted weaknesses over the entire spectrum of pesticide management practices, mainly related to malaria control. The thematic support on pesticide quality control contributed to structural improvements on a priority issue for malaria control across countries. The three strategies showed promising and complementary results, but guidelines and tools for implementation of the strategies should be further improved. Increased national and international priority should be given to support the development of policy, legislation and capacity that are necessary for sound management of public health pesticides.

Large scale land acquisitions and REDD+: a synthesis of conflicts and opportunities

NASA Astrophysics Data System (ADS)

Carter, Sarah; Manceur, Ameur M.; Seppelt, Ralf; Hermans-Neumann, Kathleen; Herold, Martin; Verchot, Lou

2017-03-01

Large scale land acquisitions (LSLA), and Reducing Emissions from Deforestation and forest Degradation (REDD+) are both land based phenomena which when occurring in the same area, can compete with each other for land. A quantitative analysis of country characteristics revealed that land available for agriculture, accessibility, and political stability are key explanatory factors for a country being targeted for LSLA. Surprisingly LSLA occur in countries with lower accessibility. Countries with good land availability, poor accessibility and political stability may become future targets if they do not already have LSLA. Countries which high levels of agriculture-driven deforestation and LSLA, should develop interventions which reduce forest loss driven either directly or indirectly by LSLA as part of their REDD+ strategies. Both host country and investor-side policies have been identified which could be used more widely to reduce conflicts between LSLA and REDD+. Findings from this research highlight the need for and can inform the development of national and international policies on land acquisitions including green acquisitions such as REDD+. Land management must be considered with all its objectives—including food security, biodiversity conservation, and climate change mitigation—in a coherent strategy which engages relevant stakeholders. This is not currently occurring and might be a key ingredient to achieve the targets under the Sustainable Development Goals 2 and 15 and 16 (related to food security and sustainable agriculture and the protection of forests) among others.

Socioeconomic differential in self-assessment of health and happiness in 5 African countries: Finding from World Value Survey.

PubMed

Adesanya A, Oluwafunmilade; Rojas, Bomar Mendez; Darboe, Amadou; Beogo, Idrissa

2017-01-01

Factors that contribute to wealth related inequalities in self-rated health (SRH) and happiness remains unclear most especially in sub-Saharan countries (SSA). This study aims to explore and compare socioeconomic differentials in SRH and happiness in five SSA countries. Using the 2010/2014 World Values Survey (WVS), we obtained a sample of 9,869 participants of age 16 and above from five SSA countries (Nigeria, Ghana, South Africa, Rwanda and Zimbabwe). Socioeconomic inequalities were quantified using the concentration index. The contribution of each predictor to concentration index's magnitude was obtained by means of regression based decomposition analysis. Poor SRH ranges from approximately 9% in Nigeria to 20% in Zimbabwe, whereas unhappiness was lower in Rwanda (9.5%) and higher in South Africa (23.3%). Concentration index was negative for both outcomes in all countries, which implies that poor SRH and unhappiness are excessively concentrated among the poorest socioeconomic strata. Although magnitudes differ across countries, however, the major contributor to wealth-related inequality in poor SRH is satisfaction with financial situation whereas for unhappiness the major contributors are level of income and satisfaction with financial situation. This study underscores an association between wealth related inequalities and poor SRH and unhappiness in the context of SSA. Improving equity in health, as suggested by the commission of social determinants of health may be useful in fighting against the unfair distribution of resources. Thus, knowledge about the self-rating of health and happiness can serve as proxy estimates for understanding the distribution of health care access and economic resources needed for well-being in resident countries.

Livestock services and the poor.

PubMed

Ahuja, V; Redmond, E

2004-04-01

This paper reviews the economic framework for the delivery of livestock services to the poor. It is argued that the demand for livestock products is likely to increase rapidly and the ability of the poor to participate in the opportunities presented by this growth is linked critically to the availability of good service support, both on the input and output side. Governments therefore have a responsibility to supply the necessary public goods (including the institutions and legal frameworks), and the market infrastructure for facilitating the emergence of efficient markets for livestock services. The paper further argues that the dynamics of public policy in developing countries are much more complex than the simple application of economic logic. It is the larger political economy that often dictates policy choices. It is therefore important to integrate political economy and governance issues into the economic debate on livestock service delivery. The paper also reviews the context in which the markets for livestock services will need to function. Different countries are facing very different sets of issues, and the identification of possible interventions in livestock service markets would require careful field research and analysis. In this context, the paper suggests the elements of a research agenda for the next few years.

Pollution, health and development: the need for a new paradigm.

PubMed

Landrigan, Philip J; Fuller, Richard

2016-03-01

Pollution is the largest cause of death in low- and middle-income countries. WHO estimates that 8.9 million persons die each year of diseases caused by pollution - 94% of them in poor countries. By comparison, HIV/AIDS causes 1.5 million deaths per year, and malaria and tuberculosis cause fewer than 1 million each. Diseases caused by pollution are very costly. Pollution can be prevented. In high-income countries, legal and technical control strategies have been developed and yielded great health and economic benefits. The removal of lead from gasoline increased the mean IQ of all American children and has generated an annual economic benefit of $213 billion. Unmet need: Despite its enormous human and economic costs, pollution has been overlooked in the international development agenda. Pollution control currently receives <0.5% of development spending. We have formed The Lancet-GAHP-Mount Sinai Commission on Pollution, Health and Development. This Commission will develop robust analyses of the impacts of pollution on health, economics, and development. It will inform heads of state and global funders about the enormous scale pollution's effects. The ultimate goal is to raise the priority of pollution and increase the resources allocated to control of this urgent public health problem.

The effectiveness of international development assistance from American organizations to deaf communities in Jamaica.

PubMed

Wilson, Amy T

American organizations bringing assistance to deaf people in developing countries unintentionally create relationships of dependency or oppression rather than relationships of support. Using qualitative methods, the author examined the effectiveness of development assistance provided to the Jamaican Deaf community by two American churches, one American nongovernmental organization, and one U.S. federal agency. Documents were reviewed and observations were made. Interviews were conducted with more than 60 deaf and hearing people involved with the American organizations, the Jamaican organizations, and deaf Jamaican beneficiaries. The author concludes that the Jamaican Deaf community was often excluded in planning, designing, or evaluating programs, and was unsatisfied with the American assistance it received. Results also indicate that the American organizations were poorly prepared to work with the Deaf community. Suggestions for American organizations wishing to strengthen and empower deaf people through development assistance in developing countries are proposed.

Self-rated health in Canadian immigrants: analysis of the Longitudinal Survey of Immigrants to Canada.

PubMed

Setia, Maninder Singh; Lynch, John; Abrahamowicz, Michal; Tousignant, Pierre; Quesnel-Vallee, Amelie

2011-03-01

Using a multi-level random effects logistic model, we examine the contribution of source country, individual characteristics and post-migration experiences to the self-rated health (SRH) of 2468 male and 2614 female immigrants from the Longitudinal Survey of Immigrants to Canada (2001-2005). Sex/gender differences were found for all categories of health determinants. Source country characteristics explained away some ethnic differentials in health and had independent negative effects, particularly among women. Thus, women from countries lower on the development index appear at greater risk of poor SRH, and should be at the forefront of public health programmes aimed at new immigrants in Canada. Copyright © 2011 Elsevier Ltd. All rights reserved.

Combined optimization model for sustainable energization strategy

NASA Astrophysics Data System (ADS)

Abtew, Mohammed Seid

Access to energy is a foundation to establish a positive impact on multiple aspects of human development. Both developed and developing countries have a common concern of achieving a sustainable energy supply to fuel economic growth and improve the quality of life with minimal environmental impacts. The Least Developing Countries (LDCs), however, have different economic, social, and energy systems. Prevalence of power outage, lack of access to electricity, structural dissimilarity between rural and urban regions, and traditional fuel dominance for cooking and the resultant health and environmental hazards are some of the distinguishing characteristics of these nations. Most energy planning models have been designed for developed countries' socio-economic demographics and have missed the opportunity to address special features of the poor countries. An improved mixed-integer programming energy-source optimization model is developed to address limitations associated with using current energy optimization models for LDCs, tackle development of the sustainable energization strategies, and ensure diversification and risk management provisions in the selected energy mix. The Model predicted a shift from traditional fuels reliant and weather vulnerable energy source mix to a least cost and reliable modern clean energy sources portfolio, a climb on the energy ladder, and scored multifaceted economic, social, and environmental benefits. At the same time, it represented a transition strategy that evolves to increasingly cleaner energy technologies with growth as opposed to an expensive solution that leapfrogs immediately to the cleanest possible, overreaching technologies.

Methadone maintenance therapy as evidence based drug abuse planning in developed countries: can developing countries afford and learn from this experience?

PubMed

Nsimba, Stephen E D

2010-03-01

Use of illicit substances of abuse is a major public health problem in developed countries like the US. However, this problem of illicit substance use has spread like a tumor to include currently developing countries where most of its youths and adolescents are actively engaged in this illegal practice. This problem is even more worse in poor resource countries, as use of these substances is accompanied with a lot of HIV- risk behaviours, and for cocaine and heroin drug injectors often share injecting equipments hence increasing the chances of contracting and spreading HIV infection. Apart from HIV infection, other infections include hepatitis B, C, abscesses and other ill-health problems such as drug dependence manifested with complex set of behaviours related to mental illnesses. For non-drug injectors, the chances of contracting and spreading HIV through their unsafe/unprotected sexual behaviours especially those having multiple partners is there. Use of these illicit substances have other consequences like compromising the dosing schedule or adherence / poor compliance to ARTs/ARVs among those enrolled. Furthermore, use of illicit substances may be accompanied with domestic sexual violence which is done without using any protective (condoms) measures) leading to HIV/AIDS and unplanned pregnancies. However, various studies and preventive approaches have been tried in the US on drug abusers in order to prevent the associated adverse health outcomes. There are many reasons why people use drugs. In many situations, drugs are being used as artificial problem-solvers such as frustrations, stress or tiredness. Drugs can often make a problem disappear for a short time but not usually the answer for solving the problem. They just help to remove it temporarily. Other people choose to use drugs to enjoy the feelings or for recreational purposes which many drugs produce. For example, many people, especially young people, experiment with using drugs to find out more about the sensations they produce. Drug use is a problem to users when it begins to cause some damage to their physical health, mental health and social well-being. These include mental illness, diseases caused by or related to use of drugs e.g. practice of sharing needles or syringes among drug injectors and also non-drug injectors may acquire HIV/AIDS and Hepatitis, crimes and violence. However, the number of harm associated with the use of drugs is increasing in Tanzania and other developing countries in Sub-Saharan Africa and globally in developed nations like the US and many others.

Gender-specific effects of early nutritional restriction on adult obesity risk: evidence from quasi-experimental studies.

PubMed

Robinson, Whitney R

2012-12-01

In countries undergoing nutrition transition and historically poor minority groups in wealthy countries, obesity tends to be more common in women than men. A potential contributor to this female excess of obesity is a mismatch between perinatal nutritional restriction and a later calorie-rich environment. Several epidemiologic and quasi-experimental studies support a gender-differential effect of early nutritional deprivation on adult obesity. The quasi-experimental studies are of particular interest because results of quasi-experimental studies are typically less vulnerable to confounding bias than observational studies. Four quasi-experimental studies-exploiting 20th century famines that occurred in Europe, Africa, and Asia-provide evidence that perinatal nutritional restriction followed by relative caloric abundance may increase adult obesity risk to a greater extent in women than men. If the findings are accurate and generalizable to contemporary food environments, they suggest that the female offspring of poor, or otherwise nutritionally restricted, women in rapidly developing and wealthy countries may be at particularly high risk of adult obesity. Research into gender-specific effects of early life nutritional deprivation and its interactions with later environmental exposures may provide insight into global gender differences in obesity prevalence.

The effects of ill health on entering and maintaining paid employment: evidence in European countries.

PubMed

Schuring, Merel; Burdorf, Lex; Kunst, Anton; Mackenbach, Johan

2007-07-01

To examine the effects of ill health on selection into paid employment in European countries. Five annual waves (1994-8) of the European Community Household Panel were used to select two populations: (1) 4446 subjects unemployed for at least 2 years, of which 1590 (36%) subjects found employment in the next year, and (2) 57 436 subjects employed for at least 2 years, of which 6191 (11%) subjects left the workforce in the next year because of unemployment, (early) retirement or having to take care of household. The influence of a perceived poor health and a chronic health problem on employment transitions was studied using logistic regression analysis. An interaction between health and sex was observed, with women in poor health (odds ratio (OR) 0.4), men in poor health (OR 0.6) and women (OR 0.6) having less chance to enter paid employment than men in good health. Subjects with a poor health and low/intermediate education had the highest risks of unemployment or (early) retirement. Taking care of the household was only influenced by health among unmarried women. In most European countries, a poor health or a chronic health problem predicted staying or becoming unemployed and the effects of health were stronger with a lower national unemployment level. In most European countries, socioeconomic inequalities in ill health were an important determinant for entering and maintaining paid employment. In public health measures for health equity, it is of paramount importance to include people with poor health in the labour market.

Perceived sexism as a health determinant in Spain.

PubMed

Borrell, Carme; Artazcoz, Lucia; Gil-González, Diana; Pérez, Glòria; Rohlfs, Izabella; Pérez, Katherine

2010-04-01

The goals of the present study are to explore the association between perceived sexism and self-perceived health, health-related behaviors, and unmet medical care needs among women in Spain; to analyze whether higher levels of discrimination are associated with higher prevalence of poor health indicators and to examine whether these relationships are modified by country of origin and social class. The study is based on a cross-sectional design using data from the 2006 Spanish Health Interview Survey. We included women aged 20-64 years (n = 10,927). Six dependent variables were examined: four of health (self-perceived health, mental health, hypertension, and having had an injury during the previous year), one health behavior (smoking), and another related to the use of the health services (unmet need for medical care). Perceived sexism was the main independent variable. Social class and country of origin were considered as effect modifiers. We obtained the prevalence of perceived sexism. Logistic regression models, adjusted for potential confounders, were fitted to study the association between sexism and poor health outcomes. The prevalence of perceived sexism was 3.4%. Perceived sexism showed positive and consistent associations with four poor health outcomes (poor self-perceived health, poor mental health, injuries in the last 12 months, and smoking). The strength of these associations increased with increased scores for perceived sexism, and the patterns were found to be modified by country of origin and social class. This study shows a consistent association between perceived sexism and poor health outcomes in a country of southern Europe with a strong patriarchal tradition.

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

A global, cross cultural study examining the relationship between employee health risk status and work performance metrics.

PubMed

Howarth, Ana; Quesada, Jose; Mills, Peter R

2017-01-01

Health risk assessments (HRA) are used by many organisations as a basis for developing relevant and targeted employee health and well-being interventions. However, many HRA's have a western-centric focus and therefore it is unclear whether the results can be directly extrapolated to those from non-western countries. More information regarding the differences in the associations between country status and health risks is needed along with a more global perspective of employee health risk factors and well-being overall. Therefore we aimed to i) quantify and compare associations for a number of health risk factors based on country status, and then ii) explore which characteristics can aid better prediction of well-being levels and in turn workplace productivity globally. Online employee HRA data collected from 254 multi-national companies, for the years 2013 through 2016 was analysed (n = 117,274). Multiple linear regression models were fitted, adjusting for age and gender, to quantify associations between country status and health risk factors. Separate regression models were used to assess the prediction of well-being measures related to productivity. On average, the developing countries were comprised of younger individuals with lower obesity rates and markedly higher job satisfaction compared to their developed country counterparts. However, they also reported higher levels of anxiety and depression, a greater number of health risks and lower job effectiveness. Assessment of key factors related to productivity found that region of residency was the biggest predictor of presenteeism and poor pain management was the biggest predictor of absenteeism. Clear differences in health risks exist between employees from developed and developing countries and these should be considered when addressing well-being and productivity in the global workforce.

Climate Migration and Moral Responsibility

PubMed Central

Nawrotzki, Raphael

2016-01-01

Even though anthropogenic climate change is largely caused by industrialized nations, its burden is distributed unevenly with poor developing countries suffering the most. A common response to livelihood insecurities and destruction is migration. Using Peter Singer’s “historical principle” this paper argues that a morally just evaluation requires taking causality between climate change and migration under consideration. The historical principle is employed to emphasize shortcomings in commonly made philosophical arguments to oppose immigration. The article concludes that none of these arguments is able to override the moral responsibility of industrialized countries to compensate for harms that their actions have caused. PMID:27668124

Challenges to implementation of the WHO Global Code of Practice on International Recruitment of Health Personnel: the case of Sudan.

PubMed

Abuagla, Ayat; Badr, Elsheikh

2016-06-30

The WHO Global Code of Practice on the International Recruitment of Health Personnel (hereafter the WHO Code) was adopted by the World Health Assembly in 2010 as a voluntary instrument to address challenges of health worker migration worldwide. To ascertain its relevance and effectiveness, the implementation of the WHO Code needs to be assessed based on country experience; hence, this case study on Sudan. This qualitative study depended mainly on documentary sources in addition to key informant interviews. Experiences of the authors has informed the analysis. Migration of Sudanese health workers represents a major health system challenge. Over half of Sudanese physicians practice abroad and new trends are showing involvement of other professions and increased feminization. Traditional destinations include Gulf States, especially Saudi Arabia and Libya, as well as the United Kingdom and the Republic of Ireland. Low salaries, poor work environment, and a lack of adequate professional development are the leading push factors. Massive emigration of skilled health workers has jeopardized coverage and quality of healthcare and health professional education. Poor evidence, lack of a national policy, and active recruitment in addition to labour market problems were barriers for effective migration management in Sudan. Response of destination countries in relation to cooperative arrangements with Sudan as a source country has always been suboptimal, demonstrating less attention to solidarity and ethical dimensions. The WHO Code boosted Sudan's efforts to address health worker migration and health workforce development in general. Improving migration evidence, fostering a national dialogue, and promoting bilateral agreements in addition to catalysing health worker retention strategies are some of the benefits accrued. There are, however, limitations in publicity of the WHO Code and its incorporation into national laws and regulatory frameworks for ethical recruitment. The outlook is bleak for Sudan unless the country designs and implements a robust national policy for migration management and unless prospects for source-destination country collaboration improve within a more sound version of the WHO Code. The WHO Code catalysed some vital steps in managing migration and strengthening the national health workforce in Sudan. Nevertheless, the country has not utilized the full potential of this instrument. Revisions of the WHO Code would benefit much from lessons of its application in the context of developing countries such as Sudan.

Acute suicidal ideation in middle-aged adults from Brazil. Results from the baseline data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

PubMed

Brunoni, André R; Nunes, Maria A; Lotufo, Paulo A; Benseñor, Isabela M

2015-02-28

Suicidal ideation represents an important burden worldwide. However, little is known about it in low-/middle-income countries. We investigated this issue in a large cross-sectional of Brazilian civil servants (ELSA-Brasil, the Brazilian Health Longitudinal Study, n=15,105). Logistic univariate and multivariate analyses were performed to evaluate the strength of association (odds ratio, OR) between clinical and sociodemographic variables with acute life-weariness (tiredness of life) and suicidal thoughts. The presence of major depressive disorder (MDD), common mental disorders (CMDs), stressful life-events (SLEs) and poor self-perceived physical health was also collected. MDD and CMDs were strongly associated with suicidal ideation in univariate and multivariate analyses. For life-weariness thoughts, a modest, consistent association was found for female gender, being single, non-White ethnicity and poor education. SLEs and poor self-perceived physical health were also associated with suicidal ideation. Espiritism-Kardecism, but not other religions or Atheism/Agnosticism, was associated with lower rates of life-weariness and suicidal thoughts. To conclude, suicidal ideation does not differ in Brazil compared to developed countries, being primarily associated with psychiatric disorders and, to a lesser but significant extent, to social disadvantage, SLEs, poor self-perceived health and being single. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Transition from Millennium Development Goals to Sustainable Development Goals from the perspective of the social determinants of health and health equity].

PubMed

Urbina-Fuentes, Manue; Jasso-Gutiérrez, Luis; Schiavon-Ermani, Raffaela; Lozano, Rafael; Finkelman, Jacobo

2017-01-01

The United Nations Declaration of 2000 agreed on eight millennium development goals (MDGs) to be met in 2015. The results show that poverty continues through population growth and advances in both rich and poor countries are threatened by economic crises and inequities in geographic areas and population groups within countries. In a globalized world with great social and economic inequalities, from the perspective of the social determinants of health (SDH), the relevance of the new 17 sustainable development goals (SDGs) is greater. Faced with the health challenges in our country to achieve SDGs, the symposium "The transition from MDGs to SDGs from the perspective of SDH and health equity" was presented at the XLIV Congress of the National Academy of Medicine. The presentations dealt with five important aspects of the transition in Mexico: background and context; the current state of the MDGs in childhood; the impact on gender equity and adolescent fertility; the health system and the theme of environmental health and were presented by Dr. Raffaela Schiavon, Jacobo Finkelman, Luis Jasso and Rafael Lozano.

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.

A Social Movements' Perspective on Human Rights Impact of Mining Liberalization in the Philippines.

PubMed

Aytin, Andrew

2016-02-01

When it comes to minerals like gold, copper, or nickel, the Philippines ranks among the world's richest countries, but it has continued to perform poorly in terms of human and economic development. In the belief that foreign investments will bring development, the government in 1995 liberalized its mining industry allowing full foreign ownership and control of the mining activities. After almost two decades of mining liberalization, the country has never achieved its goal of development but is now reeling from the adverse impacts of large-scale corporate mining on the environment and lives of mining-affected communities. Moreover, human rights violations against anti-mining activists and environmental advocates have escalated at an alarming rate making the country one of the most dangerous places for land and environmental defenders. But social movements are now taking big steps to empower the people, especially the mining-affected communities, to confront the adverse impacts of corporate mining and to reverse the current path of the mining industry to one that aims to achieve national industrialization where national development is prioritized over transnational corporations' interests. © The Author(s) 2016.

Pediatric anesthesia in developing countries.

PubMed

Bösenberg, Adrian T

2007-06-01

To highlight the problems faced in developing countries where healthcare resources are limited, with particular emphasis on pediatric anesthesia. The fact that very few publications address pediatric anesthesia in the developing world is not surprising given that most anesthetics are provided by nonphysicians, nurses or unqualified personnel. In compiling this article information is drawn from pediatric surgical, anesthetic and related texts. In a recent survey more than 80% of anesthesia providers in a poor country acknowledged that with the limited resources available they could not provide basic anesthesia for children less than 5 years. Although many publications could be regarded as anecdotal, the similarities to this survey suggest that the lack of facilities is more generalized than we would like to believe. The real risk of anesthesia in comparison to other major health risks such as human immunodeficiency virus, malaria, tuberculosis and trauma remains undetermined. The critical shortage of manpower remains a barrier to progress. Despite erratic electrical supplies, inconsistent oxygen delivery, paucity of drugs or equipment and on occasion even lack of running water, many provide life-saving anesthesia. Perioperative morbidity and mortality is, however, understandably high by developed world standards.

Urbanisation and child health in resource poor settings with special reference to under-five mortality in Africa.

PubMed

Garenne, Michel

2010-06-01

The health of children improved dramatically worldwide during the 20th century, although with major contrasts between developed and developing countries, and urban and rural areas. The quantitative evidence on urban child health from a broad historical and comparative perspective is briefly reviewed here. Before the sanitary revolution, urban mortality tended to be higher than rural mortality. However, after World War I, improvements in water, sanitation, hygiene, nutrition and child care resulted in lower urban child mortality in Europe. Despite a similar mortality decline, urban mortality in developing countries since World War II has been generally lower than rural mortality, probably because of better medical care, higher socio-economic status and better nutrition in urban areas. However, higher urban mortality has recently been seen in the slums of large cities in developing countries as a result of extreme poverty, family disintegration, lack of hygiene, sanitation and medical care, low nutritional status, emerging diseases (HIV/AIDS and tuberculosis) and other health hazards (environmental hazards, accidents, violence). These emerging threats need to be addressed by appropriate policies and programmes.

Overcoming challenges of catastrophe modelling in data poor regions

NASA Astrophysics Data System (ADS)

Grassby, L.; Millinship, I.; Breinl, K.

2012-04-01

There is an increasing demand for loss accumulation tools in expanding international insurance markets such as India, China and Thailand. This reflects the combination of an increase in exposures in these territories as industry intensifies and urban development expands, as well as several notable natural catastrophes affecting these areas over the past few years (e.g. extreme floods in Mumbai in 2006 and in Thailand in 2011). Large, global insurers and reinsurers are embracing the opportunity to underwrite these exposures but only where adequate tools are available to provide understanding of the hazards, exposures and potential losses. Unlike more developed countries, data availability in these regions is typically limited and of poor resolution, but model development is still required in order to analyse the risk. Some of the modelling challenges associated with data limitations include: (1) dealing with a lack of hydrological data which results in greater uncertainty of the flow rate and event frequency; (2) lower DTM resolution than that available across much of Europe, which underlies the hazard component of the catastrophe model; (3) limited accessibility to data that characterises the Built Environment including information on different building types and their susceptibility to damage; and (4) a lack of claims data from previous events or engineering research into the vulnerability of different building types. This is used to generate of country and structure specific vulnerability curves that explain the relationship between hazard intensity and damages. By presenting an industry specific flood model for data-poor India in collaboration with Allianz Re, we illustrate how we have overcome many of these challenges to allow loss accumulations to be made. The resulting model was successfully validated against the floods in Mumbai and Surat in 2006 and is being developed further with the availability of new data.

Plagiarism, Cheating and Research Integrity: Case Studies from a Masters Program in Peru

PubMed Central

Carnero, Andres M.; Mayta-Tristan, Percy; Konda, Kelika A.; Mezones-Holguin, Edward; Bernabe-Ortiz, Antonio; Alvarado, German F.; Canelo-Aybar, Carlos; Maguiña, Jorge L.; Segura, Eddy R.; Quispe, Antonio M.; Smith, Edward S.; Bayer, Angela M.; Lescano, Andres G.

2017-01-01

Plagiarism is a serious, yet widespread type of research misconduct, and is often neglected in developing countries. Despite its far-reaching implications, plagiarism is poorly acknowledged and discussed in the academic setting, and insufficient evidence exists in Latin America and developing countries to inform the development of preventive strategies. In this context, we present a longitudinal case study of seven instances of plagiarism and cheating arising in four consecutive classes (2011–2014) of an Epidemiology Masters program in Lima, Peru, and describes the implementation and outcomes of a multifaceted, “zero-tolerance” policy aimed at introducing research integrity. Two cases involved cheating in graded assignments, and five cases correspond to plagiarism in the thesis protocol. Cases revealed poor awareness of high tolerance to plagiarism, poor academic performance, and widespread writing deficiencies, compensated with patchwriting and copy-pasting. Depending on the events’ severity, penalties included course failure (6/7) and separation from the program (3/7). Students at fault did not engage in further plagiarism. Between 2011 and 2013, the Masters program sequentially introduced a preventive policy consisting of: (i) intensified research integrity and scientific writing education, (ii) a stepwise, cumulative writing process; (iii) honor codes; (iv) active search for plagiarism in all academic products; and (v) a “zero-tolerance” policy in response to documented cases. No cases were detected in 2014. In conclusion, plagiarism seems to be widespread in resource-limited settings and a greater response with educational and zero-tolerance components is needed to prevent it. PMID:27848191

An economic perspective on Malawi's medical "brain drain".

PubMed

Record, Richard; Mohiddin, Abdu

2006-12-18

The medical "brain drain" has been described as rich countries "looting" doctors and nurses from developing countries undermining their health systems and public health. However this "brain-drain" might also be seen as a success in the training and "export" of health professionals and the benefits this provides. This paper illustrates the arguments and possible policy options by focusing on the situation in one of the poorest countries in the world, Malawi. Many see this "brain drain" of medical staff as wrong with developed countries exploiting poorer ones. The effects are considerable with Malawi facing high vacancy rates in its public health system, and with migration threatening to outstrip training despite efforts to improve pay and conditions. This shortage of staff has made it more challenging for Malawi to deliver on its Essential Health Package and to absorb new international health funding.Yet, without any policy effort Malawi has been able to demonstrate its global competitiveness in the training ("production") of skilled health professionals. Remittances from migration are a large and growing source of foreign exchange for poor countries and tend to go directly to households. Whilst the data for Malawi is limited, studies from other poor countries demonstrate the power of remittances in significantly reducing poverty. Malawi can benefit from the export of health professionals provided there is a resolution of the situation whereby the state pays for training and the benefits are gained by the individual professional working abroad. Solutions include migrating staff paying back training costs, or rich host governments remitting part of a tax (e.g. income or national insurance) to the Malawi government. These schemes would allow Malawi to scale up training of health professionals for local needs and to work abroad. There is concern about the negative impacts of the medical "brain-drain". However a closer look at the evidence for and against the medical "brain-drain" in Malawi suggests that there are potential gains in managing medical migration to produce outcomes that are beneficial to individuals, households and the country. Finally we present several policy options.

An economic perspective on Malawi's medical "brain drain"

PubMed Central

Record, Richard; Mohiddin, Abdu

2006-01-01

Background The medical "brain drain" has been described as rich countries "looting" doctors and nurses from developing countries undermining their health systems and public health. However this "brain-drain" might also be seen as a success in the training and "export" of health professionals and the benefits this provides. This paper illustrates the arguments and possible policy options by focusing on the situation in one of the poorest countries in the world, Malawi. Discussion Many see this "brain drain" of medical staff as wrong with developed countries exploiting poorer ones. The effects are considerable with Malawi facing high vacancy rates in its public health system, and with migration threatening to outstrip training despite efforts to improve pay and conditions. This shortage of staff has made it more challenging for Malawi to deliver on its Essential Health Package and to absorb new international health funding. Yet, without any policy effort Malawi has been able to demonstrate its global competitiveness in the training ("production") of skilled health professionals. Remittances from migration are a large and growing source of foreign exchange for poor countries and tend to go directly to households. Whilst the data for Malawi is limited, studies from other poor countries demonstrate the power of remittances in significantly reducing poverty. Malawi can benefit from the export of health professionals provided there is a resolution of the situation whereby the state pays for training and the benefits are gained by the individual professional working abroad. Solutions include migrating staff paying back training costs, or rich host governments remitting part of a tax (e.g. income or national insurance) to the Malawi government. These schemes would allow Malawi to scale up training of health professionals for local needs and to work abroad. Summary There is concern about the negative impacts of the medical "brain-drain". However a closer look at the evidence for and against the medical "brain-drain" in Malawi suggests that there are potential gains in managing medical migration to produce outcomes that are beneficial to individuals, households and the country. Finally we present several policy options. PMID:17176457

Improving animal health and livestock productivity to reduce poverty.

PubMed

Pradère, J-P

2014-12-01

This study is based on scientific publications, statistics and field observations. It shows the importance of livestock in the economy and in the risk management strategies implemented by poor farming households. A comparison of livestock performance trends with the evolution of rural poverty in developing countries indicates that growth in livestock production alone is not enough to reduce rural poverty. To help reduce poverty, sustainable production should be based on productivity gains. Prerequisites for improving productivity include better public policies, enhanced research and the reduction of animal disease risk. The study draws attention to the economic, social and environmental consequences of inadequate support for animal health and production in the least developed countries, especially those of sub-Saharan Africa.

Research and applications of infrared thermal imaging systems suitable for developing countries

NASA Astrophysics Data System (ADS)

Weili, Zhang; Danyu, Cai

1986-01-01

It is a common situation in most developing countries that the utilization ratio of the sources of energy is low, the reliability service of equipment is poor, the cost of installation maintenance is high, the loss due to conflagration is heavy, and so on. Therefore, they are in urgent need of using infrared thermal imaging technique to improve their energy saving, equipment diagnosis as well as fire searching. But the infrared thermal imaging systems in the world market so far are not suitable for their use. This paper summarizes the research on two dimensional real time infrared thermal imaging systems on the basis of electron beam scanning and pyroelectric detection, as well as their applications in industry in China.

Control of corruption, democratic accountability, and effectiveness of HIV/AIDS official development assistance

PubMed Central

Lee, Hwa-Young; Yang, Bong-Ming; Kang, Minah

2016-01-01

Background Despite continued global efforts, HIV/AIDS outcomes in developing countries have not made much progress. Poor governance in recipient countries is often seen as one of the reasons for ineffectiveness of aid efforts to achieve stated objectives and desired outcomes. Objective This study examines the impact of two important dimensions of governance – control of corruption and democratic accountability – on the effectiveness of HIV/AIDS official development assistance. Design An empirical analysis using dynamic panel Generalized Method of Moments estimation was conducted on 2001–2010 datasets. Results Control of corruption and democratic accountability revealed an independent effect and interaction with the amount of HIV/AIDS aid on incidence of HIV/AIDS, respectively, while none of the two governance variables had a significant effect on HIV/AIDS prevalence. Specifically, in countries with accountability level below −2.269, aid has a detrimental effect on incidence of HIV/AIDS. Conclusion The study findings suggest that aid programs need to be preceded or at least accompanied by serious efforts to improve governance in recipient countries and that democratic accountability ought to receive more critical attention. PMID:27189199

Schizophrenia in women and children: a selective review of literature from developing countries.

PubMed

Chandra, Prabha S; Kommu, John Vijay Sagar; Rudhran, Vidyendran

2012-10-01

Women and children with psychotic disorders in developing countries may be vulnerable and have considerable social disadvantages. Gender disadvantage has implications for all health outcomes including mental illnesses. In the more relevant gender-related context we discuss several important issues which affect women with schizophrenia, namely stigma, caregiver burden, functional outcome, marriage, victimization and help-seeking. The findings indicate that there are variations in clinical and functional outcomes and age of onset of illness between different regions. Drug side effects, such as metabolic syndrome appear to be quite common, adding to disease burden in women from developing countries. Victimization and coercion may contribute to poor quality of life and health concerns such as STIs and HIV. Stigma among women with schizophrenia appears to play a major role in help-seeking, caregiver burden and issues such as marriage and parenting. Gender-sensitive care and practices are few and not well documented. Research in the area of psychoses in children and adolescents from LAMI countries is sparse and is mainly restricted to a few clinic-based studies. More research is needed on organic and medical factors contributing to childhood psychoses, pathways to care, help-seeking, and impact of early detection and community care.

Marketing in developing countries.

PubMed

Pickering, A H

1979-10-27

I fully support the views of Mr. Chetley of War on Want on the marketing of infant foods in developing countries (Oct. 6, p. 747). My experience of eight years medical work in West Africa prompts me to broaden the debate. Advertising and promotional practices used by many European and American pharmaceutical companies are in many instances directed primarily to the non-professional and often poorly educated general public and appear to be geared simply to achieve the maximum volume of sales. Likewise, the cynical disregard of cigarette manufacturers for the dangers of smoking is very apparent in the way in which advertising and promotional campaigns are conducted in developing countries. Fifteen years ago cigarettes were largely imported items but now, certainly in one major West African country, there is a large and flourishing tobacco industry which appears to be run primarily by European interests and which is obviously not there for the health benefit of the people. Is it not a sad reflection on the morality of the society in which we live that, while striving to control unethical and undesirable practices at home, we make little or no effort to regulate those practices abroad when profit is the objective?

Addressing poverty through disease control programmes: examples from Tuberculosis control in India.

PubMed

Kamineni, Vishnu Vardhan; Wilson, Nevin; Das, Anand; Satyanarayana, Srinath; Chadha, Sarabjit; Sachdeva, Kuldeep Singh; Chauhan, Lakbir Singh

2012-03-26

Tuberculosis remains a major public health problem in India with the country accounting for one-fifth or 21% of all tuberculosis cases reported globally. The purpose of the study was to obtain an understanding on pro-poor initiatives within the framework of tuberculosis control programme in India and to identify mechanisms to improve the uptake and access to TB services among the poor. A national level workshop was held with participation from all relevant stakeholder groups. This study conducted during the stakeholder workshop adopted participatory research methods. The data was elicited through consultative and collegiate processes. The research study also factored information from primary and secondary sources that included literature review examining poverty headcount ratios and below poverty line population in the country; and quasi-profiling assessments to identify poor, backward and tribal districts as defined by the TB programme in India. Results revealed that current pro-poor initiatives in TB control included collaboration with private providers and engaging community to improve access among the poor to TB diagnostic and treatment services. The participants identified gaps in existing pro-poor strategies that related to implementation of advocacy, communication and social mobilisation; decentralisation of DOT; and incentives for the poor through the available schemes for public-private partnerships and provided key recommendations for action. Synergies between TB control programme and centrally sponsored social welfare schemes and state specific social welfare programmes aimed at benefitting the poor were unclear. Further in-depth analysis and systems/policy/operations research exploring pro-poor initiatives, in particular examining service delivery synergies between existing poverty alleviation schemes and TB control programme is essential. The understanding, reflection and knowledge of the key stakeholders during this participatory workshop provides recommendations for action, further planning and research on pro-poor TB centric interventions in the country.

Cross-cultural comparison of maternal sleep.

PubMed

Mindell, Jodi A; Sadeh, Avi; Kwon, Robert; Goh, Daniel Y T

2013-11-01

To characterize cross-cultural sleep patterns and sleep problems in a large sample of mothers of children (ages birth to 6 years) in multiple predominantly Asian and predominantly Caucasian countries. Mothers of 10,085 young children (predominantly Asian countries/regions: China, Hong Kong, India, Korea, Japan, Malaysia, Philippines, Singapore, Thailand; predominantly Caucasian countries: Australia, Canada, New Zealand, United Kingdom, United States) completed an internet-based expanded version of the Pittsburgh Sleep Quality Index. Mothers in predominantly Asian countries/regions had later bedtimes, decreased number and duration of night wakings, more nighttime sleep, and more total sleep than mothers from predominantly Caucasian countries, P < 0.001. More than half (54.7%) of mothers reported having poor sleep, ranging from 50.9% of mothers in Malaysia to 77.8% of mothers in Japan. Sleep disturbance symptoms were quite common, especially symptoms related to insomnia, and were more likely to be reported by mothers in predominantly Caucasian countries. However, psychosocial factors, including having children of a younger age, being unemployed, and having a lower education level were the best predictors of poor sleep, whereas culture was not a significant predictor. Overall, mothers in predominantly Asian countries/regions reported later bedtimes but sleeping better and longer than mothers from predominantly Caucasian countries, which is dissimilar to cross-cultural findings of young children. Psychosocial factors were found to be the best predictors of poor sleep, irrespective of culture. Further studies are needed to understand the impact of these findings.

Undernutrition, poor feeding practices, and low coverage of key nutrition interventions.

PubMed

Lutter, Chessa K; Daelmans, Bernadette M E G; de Onis, Mercedes; Kothari, Monica T; Ruel, Marie T; Arimond, Mary; Deitchler, Megan; Dewey, Kathryn G; Blössner, Monika; Borghi, Elaine

2011-12-01

To estimate the global burden of malnutrition and highlight data on child feeding practices and coverage of key nutrition interventions. Linear mixed-effects modeling was used to estimate prevalence rates and numbers of underweight and stunted children according to United Nations region from 1990 to 2010 by using surveys from 147 countries. Indicators of infant and young child feeding practices and intervention coverage were calculated from Demographic and Health Survey data from 46 developing countries between 2002 and 2008. In 2010, globally, an estimated 27% (171 million) of children younger than 5 years were stunted and 16% (104 million) were underweight. Africa and Asia have more severe burdens of undernutrition, but the problem persists in some Latin American countries. Few children in the developing world benefit from optimal breastfeeding and complementary feeding practices. Fewer than half of infants were put to the breast within 1 hour of birth, and 36% of infants younger than 6 months were exclusively breastfed. Fewer than one-third of 6- to 23-month-old children met the minimum criteria for dietary diversity, and only ∼50% received the minimum number of meals. Although effective health-sector-based interventions for tackling childhood undernutrition are known, intervention-coverage data are available for only a small proportion of them and reveal mostly low coverage. Undernutrition continues to be high and progress toward reaching Millennium Development Goal 1 has been slow. Previously unrecognized extremely poor breastfeeding and complementary feeding practices and lack of comprehensive data on intervention coverage require urgent action to improve child nutrition.

Development of a prenatal psychosocial screening tool for post-partum depression and anxiety.

PubMed

McDonald, Sheila; Wall, Jennifer; Forbes, Kaitlin; Kingston, Dawn; Kehler, Heather; Vekved, Monica; Tough, Suzanne

2012-07-01

Post-partum depression (PPD) is the most common complication of pregnancy in developed countries, affecting 10-15% of new mothers. There has been a shift in thinking less in terms of PPD per se to a broader consideration of poor mental health, including anxiety after giving birth. Some risk factors for poor mental health in the post-partum period can be identified prenatally; however prenatal screening tools developed to date have had poor sensitivity and specificity. The objective of this study was to develop a screening tool that identifies women at risk of distress, operationalized by elevated symptoms of depression and anxiety in the post-partum period using information collected in the prenatal period. Using data from the All Our Babies Study, a prospective cohort study of pregnant women living in Calgary, Alberta (N = 1578), we developed an integer score-based prediction rule for the prevalence of PPD, as defined as scoring 10 or higher on the Edinburgh Postnatal Depression Scale (EPDS) at 4-months postpartum. The best fit model included known risk factors for PPD: depression and stress in late pregnancy, history of abuse, and poor relationship quality with partner. Comparison of the screening tool with the EPDS in late pregnancy showed that our tool had significantly better performance for sensitivity. Further validation of our tool was seen in its utility for identifying elevated symptoms of postpartum anxiety. This research heeds the call for further development and validation work using psychosocial factors identified prenatally for identifying poor mental health in the post-partum period. © 2012 Blackwell Publishing Ltd.

MEASURING ECONOMIC GROWTH FROM OUTER SPACE.

PubMed

Henderson, J Vernon; Storeygard, Adam; Weil, David N

2012-04-01

GDP growth is often measured poorly for countries and rarely measured at all for cities or subnational regions. We propose a readily available proxy: satellite data on lights at night. We develop a statistical framework that uses lights growth to augment existing income growth measures, under the assumption that measurement error in using observed light as an indicator of income is uncorrelated with measurement error in national income accounts. For countries with good national income accounts data, information on growth of lights is of marginal value in estimating the true growth rate of income, while for countries with the worst national income accounts, the optimal estimate of true income growth is a composite with roughly equal weights. Among poor-data countries, our new estimate of average annual growth differs by as much as 3 percentage points from official data. Lights data also allow for measurement of income growth in sub- and supranational regions. As an application, we examine growth in Sub Saharan African regions over the last 17 years. We find that real incomes in non-coastal areas have grown faster by 1/3 of an annual percentage point than coastal areas; non-malarial areas have grown faster than malarial ones by 1/3 to 2/3 annual percent points; and primate city regions have grown no faster than hinterland areas. Such applications point toward a research program in which "empirical growth" need no longer be synonymous with "national income accounts."

Challenges of Human Papillomavirus Infection and Associated Diseases in Low-Resource Countries.

PubMed

Nweke, Michael Chukwugoziem; Okolo, Clement Abu; Daous, Yara; Esan, Olukemi Ayotunde

2018-06-01

- The prevalence of human papillomavirus (HPV) infection varies worldwide. The high-risk viruses are usually associated with cancers of the cervix, vagina, and vulva in women, cancer of the penis in men, and cancers of the anus, tonsils, oropharynx, and base of the tongue in both sexes. - To review literature about the challenges and burden associated with HPV infection in low-resource (ie, developing) countries, focusing on sub-Saharan Africa. To review the prevention, incidence, prevalence, morbidity, and mortality of HPV infections in sub-Saharan Africa. To review the therapy and management of HPV infections in low-resource countries in comparison to developed countries. - Peer-reviewed literature and experience of some of the authors. - Sub-Saharan Africa has high HPV infection prevalence rates, with predominance of high-risk subtypes 16, 18, and 45. The difficulty of access to health care has led to higher morbidity and mortality related to HPV-related cancers. Improvement in screening programs will help in monitoring the spread of HPV infections. Survival studies can be more informative if reliable cancer registries are improved. HPV vaccination is not yet widely available and this may be the key to curtailing the spread of HPV infections in resource-poor countries.

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

PubMed

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

2013-04-01

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

International Telepharmacy Education: Another Venue to Improve Cancer Care in the Developing World

PubMed Central

AlFaar, Ahmad S.; Kamal, Sherif; AbouElnaga, Sherif; Greene, William L.; Quintana, Yuri; Ribeiro, Raul C.

2012-01-01

Abstract Objective: In developed countries, pharmacists play a crucial role in designing and implementing cancer treatments as part of a multidisciplinary oncology team. However, developing countries have a shortage of pharmacists, and their role is generally limited to dispensing and selling drugs. The aim of this study was to investigate the feasibility of providing clinical pharmacy educational activities via international teleconferencing to improve cancer care in developing countries. Materials and Methods: Meticulous preparation and intense promotion of the workshop were done in Egypt before the telepharmacy conferences began. Multiple connectivity tests were performed to resolve technical problems. Nine telepharmacy conferences were delivered during 3-h sessions that were held on three consecutive days. Talks were subsequently made available via Web streaming. Attendees were requested to complete a survey to measure their satisfaction with the sessions. Results: The teleconference was attended by a total of 345 persons, and it was subsequently reviewed online via 456 log-in sessions from 10 countries. Technical issues (e.g., poor auditory quality) were resolved on the first day of the event. The rate of attendees' responses on the survey was 30.1%, and satisfaction with the event was generally good. Conclusions: Telecommunication is a relatively inexpensive approach that may improve pharmacy practices, especially those used to treat patients with cancer in developing countries. Special attention to patient-based telepharmacy education, including the use of cost-effective technology, should be considered. PMID:22667696

Social determinants of cardiovascular disease outcomes in Indians.

PubMed

Jeemon, Panniyammakal; Reddy, K S

2010-11-01

Cardiovascular diseases (CVD) are the leading cause of death and disability in both developed and developing countries. In developed countries socio-economic mortality differentials have been studied extensively showing that the low socio-economic group suffers the highest mortality. As the epidemiological transition is taking place against a background of economic globalization, CVD risk factors among the urban poor and middle class are rapidly increasing in India. Recent evidences from India also suggest reversal of social gradient with excess burden of CVD morbidity in the low socio-economic group. Understanding the social determinants of environmental and behavioural exposures, in determining the risk factors for cardiovascular disease is an important challenge for public health professionals as well as communities. Socio-economic disadvantage is not simply a proxy for poor cardiovascular risk factor status, but also an indication of the likely trajectory that an individual or a community may follow in the course of their life. The paucity of intervention research seeking to address the role of social determinants in shaping lifestyle practices among individuals in culturally and socially diverse population groups within India is definitely a measure of inadequacy in public health research. This review article provides an overview of the role of social determinants of CVD and its possible conceptual pathways with special focus on acute coronary syndrome (ACS) outcomes among Indians.

Vitamins and neural and cognitive developmental outcomes in children.

PubMed

Benton, David

2012-02-01

The role of vitamin status in the development of the brain and the subsequent functioning of the brain was considered. There are data with a range of vitamins, from animal studies and human studies in developing countries, suggesting that a clinical deficiency during the critical period when the brain is developing causes permanent damage. To date there is, however, with the exception of cases of clinical deficiency such as those that might be associated with a vegan diet, little evidence that variations in the diet of those living in industrialised countries have a lasting developmental influence. Similarly, later in life clinical deficiencies of various vitamins disrupt cognition although there is to date limited evidence that variations in the intake of single vitamins in industrialised societies influence functioning. It may well be, however, unreasonable to expect that vitamins examined in isolation will be associated with differences in cognitive functioning. The output of the brain reflects millions of metabolic processes, each potentially susceptible to any of a range of vitamins. A diet poor in one respect is likely to be poor in other respects as well. As such, the preliminary reports in double-blind placebo-controlled trials that aspects of cognition and behaviour respond to supplementation with multi-micronutrients may indicate the way forward.

Climate Change and Developing-Country Cities: Implications For Environmental Health and Equity

PubMed Central

Corvalán, Carlos

2007-01-01

Climate change is an emerging threat to global public health. It is also highly inequitable, as the greatest risks are to the poorest populations, who have contributed least to greenhouse gas (GHG) emissions. The rapid economic development and the concurrent urbanization of poorer countries mean that developing-country cities will be both vulnerable to health hazards from climate change and, simultaneously, an increasing contributor to the problem. We review the specific health vulnerabilities of urban populations in developing countries and highlight the range of large direct health effects of energy policies that are concentrated in urban areas. Common vulnerability factors include coastal location, exposure to the urban heat-island effect, high levels of outdoor and indoor air pollution, high population density, and poor sanitation. There are clear opportunities for simultaneously improving health and cutting GHG emissions most obviously through policies related to transport systems, urban planning, building regulations and household energy supply. These influence some of the largest current global health burdens, including approximately 800,000 annual deaths from ambient urban air pollution, 1.2 million from road-traffic accidents, 1.9 million from physical inactivity, and 1.5 million per year from indoor air pollution. GHG emissions and health protection in developing-country cities are likely to become increasingly prominent in policy development. There is a need for a more active input from the health sector to ensure that development and health policies contribute to a preventive approach to local and global environmental sustainability, urban population health, and health equity. PMID:17393341

Hygiene, atopy and wheeze-eczema-rhinitis symptoms in schoolchildren from urban and rural Ecuador.

PubMed

Cooper, Philip J; Vaca, Maritza; Rodriguez, Alejandro; Chico, Martha E; Santos, Darci N; Rodrigues, Laura C; Barreto, Mauricio L

2014-03-01

Rural residence is protective against atopy and wheeze-rhinitis-eczema symptoms in developed countries, an effect attributed to farming and poor hygiene exposures. There are few data from developing countries addressing this question. We compared atopy and wheeze-rhinitis-eczema symptoms between urban and rural Ecuador, and explored the effects of farming and poor hygiene exposures. We performed cross sectional studies of schoolchildren living in rural and urban Ecuador. Data on symptoms and farming/hygiene exposures were collected by parental questionnaire, atopy by allergen skin prick test reactivity and geohelminth infections by stool examinations. Among 2526 urban and 4295 rural schoolchildren, prevalence was: atopy (10.0% vs 12.5%, p=0.06), wheeze (9.4% vs 10.1%, p=0.05), rhinitis (8.1% vs 6.4%, p=0.02) and eczema (5.9% vs 4.7%, p=0.06). A small proportion of symptoms were attributable to atopy (range 3.9-10.7%) with greater attributable fractions for respiratory symptoms observed in urban schoolchildren. Respiratory symptoms were associated with poor hygiene/farming exposures: wheeze with lack of access to potable water; and rhinitis with household pets, no bathroom facilities and contact with large farm animals. Birth order was inversely associated with respiratory symptoms. Area of residence and atopy had few effects on these associations. Urban schoolchildren living in Ecuador have a similar prevalence of atopy, eczema and wheeze but a higher prevalence of rhinitis compared with rural children. Some farming and poor hygiene exposures were associated with an increase in the prevalence of wheeze or rhinitis while birth order was inversely associated with these symptoms.

Hygiene, atopy and wheeze–eczema–rhinitis symptoms in schoolchildren from urban and rural Ecuador

PubMed Central

Cooper, Philip J; Vaca, Maritza; Rodriguez, Alejandro; Chico, Martha E; Santos, Darci N; Rodrigues, Laura C; Barreto, Mauricio L

2014-01-01

Background Rural residence is protective against atopy and wheeze–rhinitis–eczema symptoms in developed countries, an effect attributed to farming and poor hygiene exposures. There are few data from developing countries addressing this question. We compared atopy and wheeze–rhinitis–eczema symptoms between urban and rural Ecuador, and explored the effects of farming and poor hygiene exposures. Methods We performed cross sectional studies of schoolchildren living in rural and urban Ecuador. Data on symptoms and farming/hygiene exposures were collected by parental questionnaire, atopy by allergen skin prick test reactivity and geohelminth infections by stool examinations. Results Among 2526 urban and 4295 rural schoolchildren, prevalence was: atopy (10.0% vs 12.5%, p=0.06), wheeze (9.4% vs 10.1%, p=0.05), rhinitis (8.1% vs 6.4%, p=0.02) and eczema (5.9% vs 4.7%, p=0.06). A small proportion of symptoms were attributable to atopy (range 3.9–10.7%) with greater attributable fractions for respiratory symptoms observed in urban schoolchildren. Respiratory symptoms were associated with poor hygiene/farming exposures: wheeze with lack of access to potable water; and rhinitis with household pets, no bathroom facilities and contact with large farm animals. Birth order was inversely associated with respiratory symptoms. Area of residence and atopy had few effects on these associations. Conclusions Urban schoolchildren living in Ecuador have a similar prevalence of atopy, eczema and wheeze but a higher prevalence of rhinitis compared with rural children. Some farming and poor hygiene exposures were associated with an increase in the prevalence of wheeze or rhinitis while birth order was inversely associated with these symptoms. PMID:24105783

Healthcare and healthcare systems: inspiring progress and future prospects

PubMed Central

2016-01-01

Background Healthcare systems globally have experienced intensive changes, reforms, developments, and improvement over the past 30 years. Multiple actors (governmental and non-governmental) and countries have played their part in the reformation of the global healthcare system. New opportunities are presenting themselves while multiple challenges still remain especially in developing countries. Better way to proceed would be to learn from historical patterns while we plan for the future in a technology-driven society with dynamic demographic, epidemiological and economic uncertainties. Methods A structured review of both peer-reviewed and gray literature on the topic was carried out. Results On the whole, people are healthier, doing better financially and live longer today than 30 years ago. The number of under-5 mortality worldwide has declined from 12.7 million in 1990 to 6.3 million in 2013. Infant and maternal mortality rates have also been reduced. However, both rates are still considered high in Africa and some Asian countries. The world’s population nearly doubled in these 30 years, from 4.8 billion in 1985 to 7.2 billion in 2015. The majority of the increasing population was coming from the least developed countries, i.e., 3.66 to 5.33 billion. The world will be short of 12.9 million health-care workers by 2035; today, that figure stands at 7.2 million. Health care expenditures among countries also show sharp differences. In high income countries, per person health expenditure is over USD 3,000 on average, while in poor countries, it is as low as USD 12, WHO estimate of minimum spending per person per year needed to provide basic, life-saving services is USD 44. The challenges faced by the global health system over the past 30 years have been increased in population and urbanization, behavioral changes, rise in chronic diseases, traumatic injuries, infectious diseases, specific regional conflicts and healthcare delivery security. Over the next 30 years, most of the world population growth will occur in the urban areas of poor countries. The rapid, unplanned and unsustainable style of urban development will make developing countries cities the key focal points for emerging environmental and health hazards. Changes will be seen in design, culture and practices of hospitals to better meet the needs of patients, families and providers. Top driving factors of global healthcare system for next 30 years will be leading causes of mortalities, non-health factors (impact of nutrition, sanitation and women’s empowerment), investment in health workforce and growth of medical tourism in future healthcare scenario. Conclusions Evaluating the patterns of previous 30 years and predicting the progress and challenges of future health system are no rocket science. Medical care will be more self-directed in a more tech-savvy population as information will be more accessible and user friendly with higher quality. Health driving factors such as clean water, sanitation and food will take the center stage in humanities struggle and even increase population size. PMID:28293581

Healthcare and healthcare systems: inspiring progress and future prospects.

PubMed

Durrani, Hammad

2016-01-01

Healthcare systems globally have experienced intensive changes, reforms, developments, and improvement over the past 30 years. Multiple actors (governmental and non-governmental) and countries have played their part in the reformation of the global healthcare system. New opportunities are presenting themselves while multiple challenges still remain especially in developing countries. Better way to proceed would be to learn from historical patterns while we plan for the future in a technology-driven society with dynamic demographic, epidemiological and economic uncertainties. A structured review of both peer-reviewed and gray literature on the topic was carried out. On the whole, people are healthier, doing better financially and live longer today than 30 years ago. The number of under-5 mortality worldwide has declined from 12.7 million in 1990 to 6.3 million in 2013. Infant and maternal mortality rates have also been reduced. However, both rates are still considered high in Africa and some Asian countries. The world's population nearly doubled in these 30 years, from 4.8 billion in 1985 to 7.2 billion in 2015. The majority of the increasing population was coming from the least developed countries, i.e., 3.66 to 5.33 billion. The world will be short of 12.9 million health-care workers by 2035; today, that figure stands at 7.2 million. Health care expenditures among countries also show sharp differences. In high income countries, per person health expenditure is over USD 3,000 on average, while in poor countries, it is as low as USD 12, WHO estimate of minimum spending per person per year needed to provide basic, life-saving services is USD 44. The challenges faced by the global health system over the past 30 years have been increased in population and urbanization, behavioral changes, rise in chronic diseases, traumatic injuries, infectious diseases, specific regional conflicts and healthcare delivery security. Over the next 30 years, most of the world population growth will occur in the urban areas of poor countries. The rapid, unplanned and unsustainable style of urban development will make developing countries cities the key focal points for emerging environmental and health hazards. Changes will be seen in design, culture and practices of hospitals to better meet the needs of patients, families and providers. Top driving factors of global healthcare system for next 30 years will be leading causes of mortalities, non-health factors (impact of nutrition, sanitation and women's empowerment), investment in health workforce and growth of medical tourism in future healthcare scenario. Evaluating the patterns of previous 30 years and predicting the progress and challenges of future health system are no rocket science. Medical care will be more self-directed in a more tech-savvy population as information will be more accessible and user friendly with higher quality. Health driving factors such as clean water, sanitation and food will take the center stage in humanities struggle and even increase population size.

The influence of neighbourhood formality status and socio-economic position on self-rated health among adult men and women: a multilevel, cross sectional, population study from Aleppo, Syria

PubMed Central

2013-01-01

Background There is substantial evidence from high income countries that neighbourhoods have an influence on health independent of individual characteristics. However, neighbourhood characteristics are rarely taken into account in the analysis of urban health studies from developing countries. Informal urban neighbourhoods are home to about half of the population in Aleppo, the second largest city in Syria (population>2.5 million). This study aimed to examine the influence of neighbourhood socioeconomic status (SES) and formality status on self-rated health (SRH) of adult men and women residing in formal and informal urban neighbourhoods in Aleppo. Methods The study used data from 2038 survey respondents to the Aleppo Household Survey, 2004 (age 18–65 years, 54.8% women, response rate 86%). Respondents were nested in 45 neighbourhoods. Five individual-level SES measures, namely education, employment, car ownership, item ownership and household density, were aggregated to the level of neighbourhood. Multilevel regression models were used to investigate associations. Results We did not find evidence of important SRH variation between neighbourhoods. Neighbourhood average of household item ownership was associated with a greater likelihood of reporting excellent SRH in women; odds ratio (OR) for an increase of one item on average was 2.3 (95% CI 1.3-4.4 (versus poor SRH)) and 1.7 (95% CI 1.1-2.5 (versus normal SRH)), adjusted for individual characteristics and neighbourhood formality. After controlling for individual and neighbourhood SES measures, women living in informal neighbourhoods were less likely to report poor SRH than women living in formal neighbourhoods (OR= 0.4; 95% CI (0.2- 0.8) (versus poor SRH) and OR=0.5; 95%; CI (0.3-0.9) (versus normal SRH). Conclusions Findings support evidence from high income countries that certain characteristic of neighbourhoods affect men and women in different ways. Further research from similar urban settings in developing countries is needed to understand the mechanisms by which informal neighbourhoods influence women’s health. PMID:23496934

The influence of neighbourhood formality status and socio-economic position on self-rated health among adult men and women: a multilevel, cross sectional, population study from Aleppo, Syria.

PubMed

Ahmad, Balsam; Ryan, Vicky; Maziak, Wasim; Pless-Mulloli, Tanja; White, Martin

2013-03-16

There is substantial evidence from high income countries that neighbourhoods have an influence on health independent of individual characteristics. However, neighbourhood characteristics are rarely taken into account in the analysis of urban health studies from developing countries. Informal urban neighbourhoods are home to about half of the population in Aleppo, the second largest city in Syria (population>2.5 million). This study aimed to examine the influence of neighbourhood socioeconomic status (SES) and formality status on self-rated health (SRH) of adult men and women residing in formal and informal urban neighbourhoods in Aleppo. The study used data from 2038 survey respondents to the Aleppo Household Survey, 2004 (age 18-65 years, 54.8% women, response rate 86%). Respondents were nested in 45 neighbourhoods. Five individual-level SES measures, namely education, employment, car ownership, item ownership and household density, were aggregated to the level of neighbourhood. Multilevel regression models were used to investigate associations. We did not find evidence of important SRH variation between neighbourhoods. Neighbourhood average of household item ownership was associated with a greater likelihood of reporting excellent SRH in women; odds ratio (OR) for an increase of one item on average was 2.3 (95% CI 1.3-4.4 (versus poor SRH)) and 1.7 (95% CI 1.1-2.5 (versus normal SRH)), adjusted for individual characteristics and neighbourhood formality. After controlling for individual and neighbourhood SES measures, women living in informal neighbourhoods were less likely to report poor SRH than women living in formal neighbourhoods (OR= 0.4; 95% CI (0.2- 0.8) (versus poor SRH) and OR=0.5; 95%; CI (0.3-0.9) (versus normal SRH). Findings support evidence from high income countries that certain characteristic of neighbourhoods affect men and women in different ways. Further research from similar urban settings in developing countries is needed to understand the mechanisms by which informal neighbourhoods influence women's health.

Overcoming phase 1 delays: the critical component of obstetric fistula prevention programs in resource-poor countries

PubMed Central

2012-01-01

Background An obstetric fistula is a traumatic childbirth injury that occurs when labor is obstructed and delivery is delayed. Prolonged obstructed labor leads to the destruction of the tissues that normally separate the bladder from the vagina and creates a passageway (fistula) through which urine leaks continuously. Women with a fistula become social outcasts. Universal high-quality maternity care has eliminated the obstetric fistula in wealthy countries, but millions of women in resource-poor nations still experience prolonged labor and tens of thousands of new fistula sufferers are added to the millions of pre-existing cases each year. This article discusses fistula prevention in developing countries, focusing on the factors which delay treatment of prolonged labor. Discussion Obstetric fistulas can be prevented through contraception, avoiding obstructed labor, or improving outcomes for women who develop obstructed labor. Contraception is of little use to women who are already pregnant and there is no reliable screening test to predict obstruction in advance of labor. Improving the outcome of obstructed labor depends on prompt diagnosis and timely intervention (usually by cesarean section). Because obstetric fistulas are caused by tissue compression, the time interval from obstruction to delivery is critical. This time interval is often extended by delays in deciding to seek care, delays in arriving at a hospital, and delays in accessing treatment after arrival. Communities can reasonably demand that governments and healthcare institutions improve the second (transportation) and third (treatment) phases of delay. Initial delays in seeking hospital care are caused by failure to recognize that labor is prolonged, confusion concerning what should be done (often the result of competing therapeutic pathways), lack of women’s agency, unfamiliarity with and fear of hospitals and the treatments they offer (especially surgery), and economic constraints on access to care. Summary Women in resource-poor countries will use institutional obstetric care when the services provided are valued more than the competing choices offered by a pluralistic medical system. The key to obstetric fistula prevention is competent obstetrical care delivered respectfully, promptly, and at affordable cost. The utilization of these services is driven largely by trust. PMID:22809234