Management of hypertension in low and middle income countries: Challenges and opportunities

2005 ◽  
Vol 1 (4) ◽  
pp. 275-284 ◽  
Author(s):  
Sailesh Mohan ◽  
Norm Campbell ◽  
Arun Chockalingam
Keyword(s):  
Middle Income ◽  
Middle Income Countries ◽  
Challenges And Opportunities ◽  
Low And Middle Income

scholarly journals Education, Work, and Motherhood in Low and Middle Income Countries: A Review of Equality Challenges and Opportunities for Women with Disabilities

2018 ◽  
Vol 6 (1) ◽  
pp. 82-93 ◽  
Author(s):  
Belaynesh Tefera ◽  
Marloes L. Van Engen ◽  
Alice Schippers ◽  
Arne H. Eide ◽  
Amber Kersten ◽  
...  
Keyword(s):  
Cultural Practices ◽  
Women With Disabilities ◽  
Middle Income ◽  
Governmental Organization ◽  
Middle Income Countries ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Challenges And Opportunities ◽  
The Government ◽  
Low And Middle Income

This study looks at the equality challenges and opportunities for women with disabilities in low and middle income countries (LMICs) to participate and succeed in education, employment and motherhood. It is based on a systematic review of the literature from academic and non-governmental organization databases. The search of these databases yielded 24 articles, which were subsequently passed through open, axial, and selective coding. The resulting review found that women with disabilities in LMICs have severe difficulty participating and succeeding in education, employment and motherhood due to a number of interrelated factors: (i) hampered access to education, employment, intimacy and marriage, (ii) stigma and cultural practices resulting in discrimination and prejudice, and (iii) lack of support from family, teachers and institutions—all of which are exacerbated by poverty. Support from families, communities, the government, and non-governmental organizations improves women’s ability to fulfil their social roles (as students, employees and mothers), resulting in a better quality of life. Strategies that create awareness, minimize poverty and facilitate justice may improve the opportunities for women with disabilities in LMICs to participate in education, employment and motherhood, as well as their ability to succeed in these domains.

Challenges and possibilities of developing cardiac surgery in a peripheral hospital of low- and middle-income countries

Perfusion ◽  
2020 ◽  
Vol 36 (1) ◽  
pp. 38-43
Author(s):  
Kaushal K Tiwari ◽  
Julia Grapsa ◽  
Shankar Laudari ◽  
Michal Pazdernik ◽  
Dominique Vervoort
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Surgical Care ◽  
Capital City ◽  
World Population ◽  
Middle Income ◽  
Middle Income Countries ◽  
Peripheral Hospital ◽  
Challenges And Opportunities ◽  
Low And Middle Income

Objective: Over a million cardiac surgeries are performed every year around the globe. However, approximately 93% of world population living in low- and middle-income countries have no access to cardiac surgery. The incidence of rheumatic and congenital heart disease is high in Nepal, while only 2,500-3,000 cardiac surgeries are performed annually. The aim of our study is to analyze challenges and opportunities of establishing a cardiac surgery program in a peripheral hospital of Nepal. Methods: We analyzed our effort to establish a cardiac surgery program in a peripheral hospital in Nepal. Results: Out of 2,659 consulted and diagnosed patients, we performed 85 open-heart surgeries in 4 years. Mean age of patients was 38.35 ± 14.13 years. The majority of patients were male (62.4% of patients) with 65.9% suffering from rheumatic heart disease. Average intensive care unit stay and hospital stay were 2.32 ± 1.1 and 8.29 ± 2.75 days, respectively. No in-hospital mortality was observed. Conclusion: We conclude that developing cardiac surgical care in a peripheral hospital of a developing country is feasible with support from government, foreign colleagues, local teams, and non-governmental organizations. The availability of a regular cardiac surgery service in the periphery of the country makes such services more accessible for the patients and helps in reducing the long waiting lists and unmanageable workload in the established cardiac centers in the capital city.

scholarly journals Wastewater-Based Epidemiology for Cost-Effective Mass Surveillance of COVID-19 in Low- and Middle-Income Countries: Challenges and Opportunities

Water ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 2897
Author(s):  
Sadhana Shrestha ◽  
Emi Yoshinaga ◽  
Saroj K. Chapagain ◽  
Geetha Mohan ◽  
Alexandros Gasparatos ◽  
...  
Keyword(s):  
Population Size ◽  
Cost Effective ◽  
Management Systems ◽  
Current Evidence ◽  
Wastewater Management ◽  
Middle Income ◽  
Middle Income Countries ◽  
Challenges And Opportunities ◽  
Mass Surveillance ◽  
Low And Middle Income

Wastewater-based epidemiology (WBE) is an approach that can be used to estimate COVID-19 prevalence in the population by detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in wastewater. As the WBE approach uses pooled samples from the study population, it is an inexpensive and non-invasive mass surveillance method compared to individual testing. Thus, it offers a good complement in low- and middle-income countries (LMICs) facing high costs of testing or social stigmatization, and it has a huge potential to monitor SARS-CoV-2 and its variants to curb the global COVID-19 pandemic. The aim of this review is to systematize the current evidence about the application of the WBE approach in mass surveillance of COVID-19 infection in LMICs, as well as its future potential. Among other parameters, population size contributing the fecal input to wastewater is an important parameter for COVID-19 prevalence estimation. It is easier to back-calculate COVID-19 prevalence in the community with centralized wastewater systems, because there can be more accurate estimates about the size of contributing population in the catchment. However, centralized wastewater management systems are often of low quality (or even non-existent) in LMICs, which raises a major concern about the ability to implement the WBE approach. However, it is possible to mobilize the WBE approach, if large areas are divided into sub-areas, corresponding to the existing wastewater management systems. In addition, a strong coordination between stakeholders is required for estimating population size respective to wastewater management systems. Nevertheless, further international efforts should be leveraged to strengthen the sanitation infrastructures in LMICs, using the lessons gathered from the current COVID-19 pandemic to be prepared for future pandemics.

scholarly journals Bringing Preventive RSV Monoclonal Antibodies to Infants in Low- and Middle-Income Countries: Challenges and Opportunities

Vaccines ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 961
Author(s):  
Jintanat Ananworanich ◽  
Penny M. Heaton
Keyword(s):  
Healthcare Delivery ◽  
World Health ◽  
Surveillance Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Challenges And Opportunities ◽  
Syncytial Virus ◽  
Health Organization ◽  
Tract Infections ◽  
Low And Middle Income

Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infections (LRTIs) in infants. Most deaths occur in infants under 3 months old, and those living in low and middle-income countries (LMICs). There are no maternal or infant RSV vaccines currently approved. An RSV monoclonal antibody (mAb) could fill the gap until vaccines are available. It could also be used when a vaccine is not given, or when there is insufficient time to vaccinate and generate an antibody response. The only currently approved RSV mAb, palivizumab, is too costly and needs monthly administration, which is not possible in LMICs. It is imperative that a safe, effective, and affordable mAb to prevent severe RSV LRTI be developed for infants in LMICs. Next generation, half-life extended mAbs in clinical development, such as nirsevimab, show promise in protecting infants against RSV LRTI. Given that a single dose could cover an entire 5-month season, there is an opportunity to make RSV mAbs affordable for LMICs by investing in improvements in manufacturing efficiency. The challenges of using RSV mAbs in LMICs are the complexities of integrating them into existing healthcare delivery programs and surveillance systems, both of which are needed to define seasonal patterns, and monitor for escape mutants. Collaboration with key stakeholders such as the World Health Organization and Gavi, the Vaccine Alliance, will be essential for achieving this goal.

scholarly journals Crowdsourcing to identify social innovation initiatives in health in low- and middle-income countries

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Lindi van Niekerk ◽  
Arturo Ongkeko ◽  
Rachel Alice Hounsell ◽  
Barwani Khaura Msiska ◽  
Don Pascal Mathanga ◽  
...  
Keyword(s):  
Social Innovation ◽  
Collective Intelligence ◽  
Middle Income Country ◽  
Income Country ◽  
Middle Income ◽  
Middle Income Countries ◽  
Distributed Problem Solving ◽  
Challenges And Opportunities ◽  
Crowdsourcing Contest ◽  
Low And Middle Income

Abstract Background Crowdsourcing is a distributed problem-solving and production mechanism that leverages the collective intelligence of non-expert individuals and networked communities for specific goals. Social innovation (SI) initiatives aim to address health challenges in a sustainable manner, with a potential to strengthen health systems. They are developed by actors from different backgrounds and disciplines. This paper describes the application of crowdsourcing as a research method to explore SI initiatives in health. Methods The study explored crowdsourcing as a method to identify SI initiatives implemented in Africa, Asia and Latin America. While crowdsourcing has been used in high-income country settings, there is limited knowledge on its use, benefits and challenges in low- and middle-income country (LMIC) settings. From 2014 to 2018, six crowdsourcing contests were conducted at global, regional and national levels. Results A total of 305 eligible projects were identified; of these 38 SI initiatives in health were identified. We describe the process used to perform a crowdsourcing contest for SI, the outcome of the contests, and the challenges and opportunities when using this mechanism in LMICs. Conclusions We demonstrate that crowdsourcing is a participatory method, that is able to identify bottom-up or grassroots SI initiatives developed by non-traditional actors.

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