Introduction: From surviving to thriving?

2019 ◽  
pp. 1-12
Author(s):  
Jo Boyden ◽  
Andrew Dawes ◽  
Paul Dornan ◽  
Colin Tredoux
Keyword(s):  
Nutrition Education ◽  
Child Poverty ◽  
Time Data ◽  
Middle Income ◽  
Middle Income Countries ◽  
Psychosocial Wellbeing ◽  
Wide Range ◽  
Development Goals ◽  
Set Up ◽  
Young Lives

This introductory chapter provides a background of the Young Lives study, which began in 2001. Young Lives was set up during a period of optimism for global development associated with the Millennium Declaration, with the aim of informing the Millennium Development Goals to reduce poverty. At the time, data on child poverty in low- and middle-income countries were scarce and inconsistent. It was clear, however, that this was a very significant problem. Young Lives has been collecting detailed information on a wide range of topics — including health, nutrition, education, time use, and psychosocial wellbeing — from 12,000 boys and girls living in diverse sites across the four study countries, as well as from schools attended by some of the children. These study countries include Ethiopia, India, Peru, and Vietnam.

scholarly journals A global perspective on the issue of access to insulin

Diabetologia ◽  
2021 ◽  
Author(s):  
David Beran ◽  
Maria Lazo-Porras ◽  
Camille M. Mba ◽  
Jean Claude Mbanya
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Management ◽  
Multinational Companies ◽  
Global Perspective ◽  
Patient Access ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range ◽  
Pricing And Reimbursement

AbstractThe discovery of insulin in 1921 changed the prognosis for people with type 1 diabetes. A century later, availability and affordability of insulin remain a challenge in many parts of the globe. Using the WHO’s framework on understanding the life cycle of medicines, this review details the global and national challenges that affect patients’ abilities to access and afford insulin. Current research and development in diabetes has seen some innovations, but none of these have truly been game-changing. Currently, three multinational companies control over 95% of global insulin supply. The inclusion of insulin on the WHO’s Prequalification Programme is an opportunity to facilitate entry of new companies into the market. Many governments lack policies on the selection, procurement, supply, pricing and reimbursement of insulin. Moreover, mark-ups in the supply chain also affect the final price to the consumer. Whilst expenses related to diabetes are mostly covered by insurance in high-income countries, many patients from low- and middle-income countries have to pay out of their own pockets. The organisation of diabetes management within the healthcare system also affects patient access to insulin. The challenges affecting access to insulin are complex and require a wide range of solutions. Given that 2021 marks the centenary of the discovery of insulin, there is need for global advocacy to ensure that the benefits of insulin and innovations in diabetes care reach all individuals living with diabetes. Graphical abstract

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 Toward Model-Generated Household Listing in Low- and Middle-Income Countries Using Deep Learning

2018 ◽  
Vol 7 (11) ◽  
pp. 448 ◽  
Author(s):  
Robert Chew ◽  
Kasey Jones ◽  
Jennifer Unangst ◽  
James Cajka ◽  
Justine Allpress ◽  
...  
Keyword(s):  
Sustainable Development ◽  
Object Detection ◽  
Household Surveys ◽  
Building Structures ◽  
Middle Income ◽  
The Sustainable Development ◽  
Detection Model ◽  
Middle Income Countries ◽  
Development Goals ◽  
Low And Middle Income

While governments, researchers, and NGOs are exploring ways to leverage big data sources for sustainable development, household surveys are still a critical source of information for dozens of the 232 indicators for the Sustainable Development Goals (SDGs) in low- and middle-income countries (LMICs). Though some countries’ statistical agencies maintain databases of persons or households for sampling, conducting household surveys in LMICs is complicated due to incomplete, outdated, or inaccurate sampling frames. As a means to develop or update household listings in LMICs, this paper explores the use of machine learning models to detect and enumerate building structures directly from satellite imagery in the Kaduna state of Nigeria. Specifically, an object detection model was used to identify and locate buildings in satellite images. In the test set, the model attained a mean average precision (mAP) of 0.48 for detecting structures, with relatively higher values in areas with lower building density (mAP = 0.65). Furthermore, when model predictions were compared against recent household listings from fieldwork in Nigeria, the predictions showed high correlation with household coverage (Pearson = 0.70; Spearman = 0.81). With the need to produce comparable, scalable SDG indicators, this case study explores the feasibility and challenges of using object detection models to help develop timely enumerated household lists in LMICs.

scholarly journals Risk Factors That Cause Stunting in Indonesia

2017 ◽  
Vol 1 (1) ◽  
pp. 46-48
Author(s):  
Arief Andriyanto ◽  
Faisal Ibnu ◽  
Rina Nur Hidayati
Keyword(s):  
Sustainable Development Goals ◽  
Complementary Feeding ◽  
Family Factors ◽  
Poor Child ◽  
Middle Income ◽  
The Sustainable Development ◽  
Global Challenge ◽  
Middle Income Countries ◽  
Breastfeeding Practices ◽  
Development Goals

The Sustainable Development Goals emphasizing an intervention to prioritize solutions to the global challenge of poor child development in low and middle income countries (LMICs). In 2015, about 25% of children under five years of age in low were stunted (Kim & Subramanian, 2017; Perkins et al., 2017; UNICEF, 2015) The WHO conceptual framework for stunting (2013) identified household and family factors, complementary feeding, breastfeeding practices and infections as the most plausible causes of stunting(Stewart, Iannotti, Dewey, Michaelsen, & Onyango, 2013)

scholarly journals Virtual Connections: Improving Global Neurosurgery Through Immersive Technologies

2021 ◽  
Vol 8 ◽  
Author(s):  
George Higginbotham
Keyword(s):  
Geographical Location ◽  
Long Term Outcomes ◽  
Middle Income ◽  
Novel Technologies ◽  
Additional Information ◽  
Middle Income Countries ◽  
Travel Restrictions ◽  
Development Goals ◽  
Immersive Technologies

The field of neurosurgery has always been propelled by the adoption of novel technologies to improve practice. Although advancements have occurred in the diagnosis, treatment, and long-term outcomes of patients, these have not translated to global patient benefit. Up to five million people each year do not have access to safe and affordable neurosurgical interventions, and those in low- and middle-income countries (LMICs) are disproportionately affected. Current approaches to increase neurosurgical capacity are unlikely to meet the UN Sustainable Development Goals target by 2030, and many of the most successful programs have been disrupted by the travel restrictions of the COVID-19 pandemic. There is therefore a pressing need for creative virtual solutions. An area of growing relevance is the use of immersive technologies: virtual reality (VR) and augmented reality (AR). AR allows additional information to be superimposed onto the surgeon's visual field, thus enhancing intra-operative visualization. This can be used for remote tele-proctoring, whereby an experienced surgeon can virtually assist with a procedure regardless of geographical location. Expert guidance can therefore be given to both neurosurgical trainees and non-neurosurgical practitioners, further facilitating the growing practice of neurosurgical task-shifting in LMICs. VR simulation is another useful tool in remote neurosurgical training, with the potential to reduce the learning curve of complex procedures whilst conserving supplies in low-resource settings. The adoption of immersive technologies into practice is therefore a promising approach for achieving global neurosurgical equity, whilst adapting to the long-term disruptions of the pandemic.

Smartphone-based DIY home microsurgical training with 3D printed microvascular clamps and Japanese noodles

2021 ◽  
Author(s):  
Zhi Yang Ng ◽  
Calum Honeyman ◽  
Alexandre G Lellouch ◽  
Ankur Pandya ◽  
Theodora Papavasiliou
Keyword(s):  
Back Wall ◽  
Internal Validation ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Video Recordings ◽  
Low Middle Income Countries ◽  
Konjac Flour ◽  
3D Printed ◽  
Set Up

We have recently incorporated simple modifications of the konjac flour noodle model to enable DIY home microsurgical training by (i) placing a smartphone on a mug to act as a microscope with at least 3.5-5x magnification, and (ii) rather than cannulating with a 22G needle as described by others, we have found that cannulation with a 23G needle followed by a second pass with an 18G needle will create a lumen (approx. 0.83 mm) without an overly thick and unrealistic “vessel” wall. The current set-up however, did not allow realistic evaluation of anastomotic patency as the noodles became macerated after application of standard microvascular clamps, which also did not facilitate practice of back-wall anastomoses. In order to simulate the actual operative environment as much as possible, we introduced the use of 3D printed microvascular clamps. These were modified from its previous iteration (suitable for use in silastic and chicken thigh vessels) and video recordings were submitted for internal validation by senior surgeons. A “wet” operative field where the knojac noodle lumen can be distended or collapsed, unlike other non-living models, was noted by senior surgeons. With the 3D clamps, the noodle could now be flipped over for back-wall anastomosis and allowed patency testing upon completion as it did not become macerated, unlike that from clinical microvascular clamps. The perceived advantages of this model are numerous. Not only does it comply with the 3Rs of simulation-based training, it can also reduce the associated costs of training by up to a hundred-fold or more when compared to a traditional rat course, and potentially, be extended to low-middle income countries (LMICs) without routine access to microsurgical training for capacity development. That it can be utilised remotely also bodes well with the current limitations on face to-face training due to COVID restrictions and lockdowns.

Universal healthcare in our lifetime? All teach, all learn

2019 ◽  
pp. 144-152
Author(s):  
Mark Britnell
Keyword(s):  
Health Coverage ◽  
National Elections ◽  
Middle Income ◽  
Universal Healthcare ◽  
Middle Income Countries ◽  
The World ◽  
Global Movement ◽  
Development Goals ◽  
The Caribbean ◽  
Universal Health

The United Nation’s Sustainable Development Goals of achieving universal health coverage (UHC) by 2030 have energized many governments to devise bold strategies and make big investments in their health systems. The global movement around UHC has gathered momentum at blistering speed. Within a few years it has transformed the focus of healthcare in low- and middle-income countries from a few diseases to a comprehensive vision of affordable, accessible, and acceptable care for all. In this chapter, Mark Britnell looks at how Philippines, Vietnam, Kenya, India, Indonesia, Columbia, Costa Rica, Panama, Nigeria, South Africa, Cyprus, islands across the Caribbean, and many others have announced significant UHC reforms since the development goals were passed in 2014, and UHC has been a headline issue in a number of national elections. He analyses UHC across the world, and looks to at the future of healthcare globally.

Maternal morbidity

2018 ◽  
pp. 112-116
Author(s):  
Mary McCauley ◽  
Nynke van den Broek
Keyword(s):  
Sustainable Development ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Maternal Morbidity ◽  
Reproductive Age ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health And Wellbeing ◽  
Development Goals ◽  
Low And Middle Income

Maternal morbidity describes complications that have a significant effect on women during and after pregnancy, and are a leading cause of ill-health among women of reproductive age, especially in low- and middle-income countries. With the introduction of the new Sustainable Development Goals, the scope of global maternal health targets has been expanded, moving from a focus on preventing maternal mortality to formulating targets and emphasising the importance of maternal health and wellbeing. This chapter introduces the new concept of maternal morbidity, suggests how this relates to maternal mortality, and summarises what is known about the burden of maternal morbidity globally and what interventions and research are needed to improve maternal health during and after pregnancy, with an emphasis on the context of low- and middle-income countries.

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