scholarly journals Proposal for Establishing a New Radiotherapy Facility

2021 ◽  
pp. 41-55
Author(s):  
Mohamed Aldehaim ◽  
Jack Phan
Keyword(s):  
Cost Effective ◽  
Technical Aspect ◽  
Clinical Aspect ◽  
Patient Treatment ◽  
Treatment Needs ◽  
High Quality ◽  
Middle Income ◽  
Middle Income Countries ◽  
Effective Treatment Modality ◽  
Cost Effective Treatment

AbstractCancer is a growing burden globally. Radiotherapy has proven to be a critical and cost-effective treatment modality for a cure in greater than 50% of cancer patients. There are numerous obstacles and challenges in establishing new radiotherapy facilities and programs, especially in low- and middle-income countries. It is known that the clinical aspect, as well as procedure related to the physical and technical aspect of patient treatment, needs to be subjected to careful planning in order to ensure safe and high-quality radiotherapy. This process required the engagement of various professionals from different backgrounds.This chapter aims to define radiotherapy value, assessing a radiation facility’s clinical, infrastructure, and resources need to establish a new radiotherapy facility.

scholarly journals Validation of a low-cost, carbon dioxide-based cryoablation system for percutaneous tumor ablation

2018 ◽  
Author(s):  
Bailey Surtees ◽  
Sean Young ◽  
Yixin Hu ◽  
Guannan Wang ◽  
Evelyn McChesney ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Low Cost ◽  
Treatment Options ◽  
Cost Effective ◽  
Outer Diameter ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cost Effective Treatment ◽  
Constrained Environments

AbstractBreast cancer rates are rising in low- and middle-income countries (LMICs), yet there is a lack of accessible and cost-effective treatment. As a result, the cancer burden and death rates are highest in LMICs. In an effort to meet this need, our work presents the design and feasibility of a low-cost cryoablation system using widely-available carbon dioxide as the only consumable. This system uses an 8-gauge outer-diameter needle and Joule-Thomson expansion to percutaneously necrose tissue with cryoablation. Bench top experiments characterized temperature dynamics in ultrasound gel demonstrated that isotherms greater than 2 cm were formed. Further, this system was applied to mammary tumors in anin vivorat model and necrosis was verified by histopathology. Finally, freezing capacity under a large heat load was assessed with anin vivoporcine study, where volumes of necrosis greater than 1.5 cm in diameter confirmed by histopathology were induced in a highly perfused liver after two 7-minute freeze cycles. These results demonstrate the feasibility of a carbon-dioxide based cryoablation system for improving solid tumor treatment options in resource-constrained environments.

scholarly journals Achieving Viral Suppression in 90% of People Living With Human Immunodeficiency Virus on Antiretroviral Therapy in Low- and Middle-Income Countries: Progress, Challenges, and Opportunities

2018 ◽  
Vol 66 (10) ◽  
pp. 1487-1491 ◽  
Author(s):  
Jean B Nachega ◽  
Nadia A Sam-Agudu ◽  
Lynne M Mofenson ◽  
Mauro Schechter ◽  
John W Mellors
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Suppression ◽  
Cost Effective ◽  
Term Treatment ◽  
Middle Income ◽  
Middle Income Countries ◽  
Long Term Treatment ◽  
Wide Range ◽  
Immunodeficiency Virus ◽  
Low And Middle Income

Abstract Although significant progress has been made, the latest data from low- and middle-income countries show substantial gaps in reaching the third “90%” (viral suppression) of the UNAIDS 90-90-90 goals, especially among vulnerable and key populations. This article discusses critical gaps and promising, evidence-based solutions. There is no simple and/or single approach to achieve the last 90%. This will require multifaceted, scalable strategies that engage people living with human immunodeficiency virus, motivate long-term treatment adherence, and are community-entrenched and ‑supported, cost-effective, and tailored to a wide range of global communities.

scholarly journals Much research, but little learned to date: A scoping review on mental health of health workers in low- and lower-middle income countries and roadmap for future research

2021 ◽  
Author(s):  
Julia Lohmann ◽  
Denny John ◽  
Aso Dzay
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Health Workers ◽  
Tertiary Care ◽  
Psychological Wellbeing ◽  
Future Research ◽  
Measurement Tool ◽  
High Quality ◽  
Middle Income ◽  
Middle Income Countries

Abstract BackgroundSARS-CoV-2 has resulted in unprecedented research efforts on health workers’ work realities and their potential mental health impacts. To understand the latter, high-quality evidence on the baseline situation is paramount. With the aim of providing a comprehensive overview of existing evidence and to inform future research, we undertook a scoping review of the quantitative literature on mental health and psychological wellbeing of clinical skilled healthcare personnel working in all settings of care in low- and lower-middle income countries (LLMIC).MethodsWe performed a systematic search of the literature up to the end of 2019, in English or French language, in MEDLINE, EMBASE, PsychINFO, Global Health, and CAIRN. We included both studies estimating levels of mental health and studies investigating associations with other factors. We extracted data on study characteristics and methodology, and assessed the methodological quality of the included studies along nine criteria.ResultsWe found 143 relevant studies, 135 including data on mental health levels and 126 including data on associations with other factors. The studies covered 26 of the world’s 78 LLMICs, with most studies conducted in India, Nigeria, Pakistan, or Egypt, in urban secondary- and tertiary-care settings. 67% of studies assessed burnout, 25% general psychological wellbeing, and 20% other mental health outcomes. Only 19% of studies were of high quality due to shortcomings particularly in regards to sample representativeness, context-specific measurement tool validity, and reporting of methodological detail. We found much heterogeneity in investigated associated factors. Studies focused almost exclusively on potential determinants of mental health, while none linked mental health to objectively measured performance outcomes.ConclusionWe conclude that despite its impressive size, we can learn comparatively little from the current body of literature. Based on our findings, we outline areas for expansion, methodological improvement, and standardization of reporting in future research on mental health of health workers.Systematic review registrationPROSPERO no. CRD42019140036

scholarly journals School vision screening programmes in reducing uncorrected refractive error among children in Low and Middle-Income countries-LMIC (systematic review)

2020 ◽  
Vol 10 (4) ◽  
pp. 91-105
Author(s):  
Abraham Opare ◽  
Leila H Abdullahi ◽  
Deon Minnies ◽  
Colin Cook ◽  
Maylene Shung-King ◽  
...  
Keyword(s):  
Academic Performance ◽  
School Children ◽  
Refractive Error ◽  
Positive Impact ◽  
Cost Effective ◽  
Vision Screening ◽  
Middle Income ◽  
Middle Income Countries ◽  
School Vision ◽  
Uncorrected Refractive Error

ackground: The prevalence of uncorrected refractive error among school-age children is on the rise with detrimental effect on academic performance and socio-economic status of those affected. School vision screening programmes appear to be an effective way of identifying children with uncorrected refractive errors so early intervention can be made. Despite the increasing popularity of school vision screening programmes over the past few years, there is a lot of debate on its effectiveness in reducing the proportion of children with uncorrected refractive error in the long term, especially in settings where resources are limited. Some studies argue that school vision screening programmes are effective while other studies have reported otherwise. The purpose of this systematic review was to assess the effectiveness of school vision screening programmes in reducing uncorrected refractive error among children in low and middle income countries using evidence from published studies. Methods and findings: A comprehensive and systematic strategy was used to search various databases including PubMed, Cochrane Central Register of Controlled Trials (CENTRAL) which contains the Cochrane Eyes and vision Trial Register, the Cochrane Library, Medline (1980-2018), CINAHL, Academic Search Premier, Web of Science, the WHO’s Library Information System, Africa-Wide and Scopus. The search was restricted to articles published in English. Randomized control trials, cross-sectional studies, case-control studies and cohort studies were included in this review. Participants included school children with refractive error. Full-text review of search results, data extraction and risk of bias assessment was done by two independent reviewers. The certainty of the evidence was assessed using the GRADE approach and data were pooled using the random-effect model. Thirty studies met the inclusion criteria. This review found moderate certainty evidence indicating that school vision screenings may be effective in reducing uncorrected refractive error among school children by 81% (95% CI: 77%; 84%), 24% (95% CI: 13%; 35%) and 20% (95% CI: 18%; 22%) at two, six, and more than six months respectively after its introduction. Results: Results of this review also suggest that school vision screening may be effective in achieving 54% (95% CI: 25%; 100%), 57% (95% CI: 46%; 70%), 37% (95% CI: 26%; 52%), and 32% (95% CI: 14%; 72%) spectacle-wear compliance among school children at less than three months, at three months, at six months and at more than six months respectively after its introduction (low to moderate certainty evidence). This review further found moderate to high certainty evidence indicating that school vision screening, together with provision of spectacles, may be relatively cost effective, safe and has a positive impact on the academic performance of school children. Conclusion: The findings of this review show that school vision screening, together with provision of spectacles, may be a safe and cost-effective way of reducing the proportion of children with uncorrected refractive error, with long-term positive impact on academic performance of children. Most of the studies included in this review were, however, conducted in Asia. Research to investigate the effectiveness of school vision screening programmes in other parts of the world like Africa where few studies have been conducted is highly recommended

Management of dental fluorosis by amodified treatment strategy amidst a global pandemic

2020 ◽  
Vol 12 (2) ◽  
pp. 46-49
Author(s):  
Dr Nileena Mary Cherian ◽  
Dr K. C Ponnappa ◽  
Dr SalinNanjappa ◽  
Dr K. K Nanjamma
Keyword(s):  
Case Report ◽  
Treatment Strategy ◽  
Treatment Modality ◽  
Dental Treatment ◽  
Dental Fluorosis ◽  
Cost Effective ◽  
Treatment Scenario ◽  
Global Pandemic ◽  
Effective Treatment Modality ◽  
Cost Effective Treatment

In recent months, the dental treatment scenario has changed due to the outbreak of the Covid 19 pandemic. Most of the aerosol generating procedures have been avoided. This case report, describes a conservative, less aerosol generating and cost-effective treatment modality, for the immediate aesthetic management of moderate fluorosis using enamel microabrasion technique.

E-Government for Health Facilities in Africa

2015 ◽  
pp. 21-27
Author(s):  
Paul Macharia ◽  
Davies Kimanga ◽  
Onesimus Kamau
Keyword(s):  
Information And Communication Technologies ◽  
Clinical Care ◽  
Health Financing ◽  
Cost Effective ◽  
Healthcare Services ◽  
Bring Your Own Device ◽  
Workplace Flexibility ◽  
Middle Income ◽  
Middle Income Countries ◽  
Information And Communication

Low and Middle Income Countries (LMICs) face healthcare worker shortages, skill mix imbalances, and maldistributions; there is concern in their quality and productivity. Africa's infrastructural developments also are way behind the rest of the world, and this gap is widening. Scalable, cost-effective, and long-term strategies in healthcare services are greatly needed. This chapter explores how Information and Communication Technologies (ICTs) could play an important role in improving healthcare. Components of e-health, an emerging field in medicine, clinical care, and public health are discussed. The role of m-health is explored, identifying the benefits of integrating mobile phone technologies in healthcare. To meet the health financing deficiencies, the chapter also explores how Bring-Your-Own-Device (BYOD) could drive healthcare professionals' productivity through increased workplace flexibility.

scholarly journals Immunisation financing and programme performance in the Middle East and North Africa, 2010 to 2017

2019 ◽  
Vol 4 (2) ◽  
pp. e001248
Author(s):  
Helen Saxenian ◽  
Nahad Sadr-Azodi ◽  
Miloud Kaddar ◽  
Kamel Senouci
Keyword(s):  
Economic Growth ◽  
Middle East ◽  
North Africa ◽  
Low Income ◽  
Health Sector ◽  
Cost Effective ◽  
Middle Income ◽  
Middle Income Countries ◽  
Life Saving ◽  
Fiscal Space

Immunisation is a cornerstone to primary health care and is an exceptionally good value. The 14 low-income and middle-income countries in the Middle East and North Africa region make up 88% of the region’s population and 92% of its births. Many of these countries have maintained high immunisation coverage even during periods of low or negative economic growth. However, coverage has sharply deteriorated in countries directly impacted by conflict and political unrest. Approximately 1.3 million children were not completely vaccinated in 2017, as measured by third dose of diphtheria–pertussis–tetanus vaccine. Most of the countries have been slow to adopt the newer, more expensive life-saving vaccines mainly because of financial constraints and the socioeconomic context. Apart from the three countries that have had long-standing assistance from Gavi, the Vaccine Alliance, most countries have not benefited appreciably from donor and partner activities in supporting their health sector and in achieving their national and subnational immunisation targets. Looking forward, development partners will have an important role in helping reconstruct health systems in conflict-affected countries. They can also help with generating evidence and strategic advocacy for high-priority and cost-effective services, including immunisation. Governments and ministries of health would ensure important benefits to their populations by investing further in their immunisation programmes. Where possible, the health system can create and expand fiscal space from efficiency gains in harmonising vaccine procurement mechanisms and service integration; broader revenue generation from economic growth; and reallocation of government budgets to health, and from within health, to immunization.

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