scholarly journals Practical Application of Linear Growth Measurements in Clinical Research in Low- and Middle-Income Countries

2017 ◽  
Vol 88 (1) ◽  
pp. 79-90 ◽  
Author(s):  
Jan M. Wit ◽  
John H. Himes ◽  
Stef van Buuren ◽  
Donna M. Denno ◽  
Parminder S. Suchdev
Keyword(s):  
Clinical Research ◽  
Linear Growth ◽  
Practical Application ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Scaling-Up Access to Family Planning May Improve Linear Growth and Child Development in Low and Middle Income Countries

PLoS ONE ◽  
2014 ◽  
Vol 9 (7) ◽  
pp. e102391 ◽  
Author(s):  
Günther Fink ◽  
Christopher R. Sudfeld ◽  
Goodarz Danaei ◽  
Majid Ezzati ◽  
Wafaie W. Fawzi
Keyword(s):  
Family Planning ◽  
Child Development ◽  
Linear Growth ◽  
Scaling Up ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Early childhood linear growth failure in low- and middle-income countries

2020 ◽  
Author(s):  
Jade Benjamin-Chung ◽  
Andrew Mertens ◽  
John M Colford ◽  
Alan E Hubbard ◽  
Mark J van der Laan ◽  
...  
Keyword(s):  
Linear Growth ◽  
Preventive Intervention ◽  
Growth Failure ◽  
Pooled Analysis ◽  
Cross Sectional ◽  
Middle Income ◽  
Growth Standards ◽  
Intervention Delivery ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractGlobally 149 million children under five are estimated to be stunted (length more than 2 standard deviations below international growth standards). Stunting, a form of linear growth failure, increases risk of illness, impaired cognitive development, and mortality. Global stunting estimates rely on cross-sectional surveys, which cannot provide direct information about the timing of onset or persistence of growth failure— a key consideration for defining critical windows to deliver preventive interventions. We performed the largest pooled analysis of longitudinal studies in low- and middle-income countries to date (n=31 cohorts, 62,993 children, ages 0-24 months), allowing us to identify the typical age of linear growth failure onset and to investigate recurrent faltering in early life. The highest incidence of stunting onset occurred from birth to age 3 months. From 0 to 15 months, less than 5% of children per month reversed their stunting status, and among those who did, stunting relapse was common. Early timing and low reversal rates emphasize the importance of preventive intervention delivery within the prenatal and early postnatal phases coupled with continued delivery of postnatal interventions through the first 1000 days of life.

scholarly journals A Practical Measure of Health Facility Efficiency: an Innovation in the Application of Routine Health Information to Determine Health Worker Productivity in Ethiopia

2021 ◽  
Author(s):  
Md Zabir Hasan ◽  
Girmaye D. Dinsa ◽  
Peter Berman
Keyword(s):  
Health Worker ◽  
Health Facility ◽  
Health Workers ◽  
Principal Component ◽  
Practical Application ◽  
Summary Measure ◽  
Worker Productivity ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract BackgroundA simple indicator of technical efficiency, such as productivity of health workers, measured using routine health facility data, can be a practical approach that can inform initiatives to improve efficiency in low and middle-income countries. This paper presents a proof of concept of using routine information from primary healthcare (PHC) facilities to measure health workers’ productivity and its application in three regions of Ethiopia.MethodsIn four steps, we constructed a productivity measure of the health workforce of Health Centers (HCs) and demonstrated its practical application: (1) developing an analytical dataset using secondary data from health management information systems (HMIS) and human resource information system (HRIS); (2) principal component analysis and factor analysis to estimate a summary measure of output from five indicators (annual service volume of outpatient visits, family planning, first antenatal care visits, facility-based deliveries by skilled birth attendance, and children [<1 year] with three pentavalent vaccines); (3) calculating a productivity score by combining the summary measure and the total number of health workers (input); and (4) implementing regression models to identify the determinant of productivity and ranking HCs based on their adjusted productivity score. ResultsWe developed an analytical dataset of 1,128 HCs; however, significant missing values and outliers were reported in the data. The principal component and factor scores developed from the five output measures were highly consistent (correlation coefficient = 0.98). We considered the factor score as the summary measure of outputs for estimating productivity. A very weak association was observed between the summary measure of output and the total number of staff. The result also highlighted a large variability in productivity across similar health facilities in Ethiopia, represented by the significant dispersion in summary measure of output occurring at similar levels of the health workers. ConclusionsWe successfully demonstrated the analytical steps to estimate health worker productivity and its practical application using HMIS and HRIS. The methodology presented in this study can be readily applied in low and middle-income countries using widely available data – such as DHIS2 – that will allow further explorations to understand the causes of technical inefficiencies in the health system.

scholarly journals Is Independent Clinical Research Possible in Low- and Middle-Income Countries? A Roadmap to Address Persistent and New Barriers and Challenges

2021 ◽  
pp. 1-10
Author(s):  
Carlos H. Barrios ◽  
Max S. Mano
Keyword(s):  
Clinical Research ◽  
Academic Research ◽  
High Income ◽  
Ethical Framework ◽  
Middle Income ◽  
Ongoing Research ◽  
Middle Income Countries ◽  
Important Challenge ◽  
Barriers And Challenges ◽  
Low And Middle Income

Cancer is an increasing and significant problem for both high- and low- and middle-income countries. Basic, translational, and clinical research efforts have been instrumental in generating the outstanding improvements we have witnessed over the last few decades, answering important questions, and improving patient outcomes. Arguably, a substantial portion of currently ongoing research is sponsored by the pharmaceutical industy and specifically addresses questions under industry interests, most of which apply to high-income countries, leaving behind problems related to the much larger and underserved population of patients with cancer in low- and middle-income countries. In this scenario, discussing independent academic research is an important challenge, particularly for these countries. Although different countries and institutions face different problems while establishing independent research agendas, some generalizable barriers can be identified. A solid regulatory and ethical framework, a strong and sustainable technical supporting infrastructure, and motivated and experienced investigators are all paramount to build a viable and productive academic research program. Securing funding for research, although not the only hurdle, is certainly one of the most basic hurdles to overcome. Noticeably, and as an added impediment, public and governmental support for cancer research has been decreasing in high-income countries and is almost nonexistent in the rest of the world. We propose an initial careful diagnostic assessment of the research resource scenario of each institution/country and adjustment of the strategic development plan according to four different research resource restriction levels. Although not necessarily applicable to all situations, this model can be helpful if adjusted to each local or regional situation.

Epilepsy management and clinical research could be improved in low and middle income countries (LMICs) by epinet database

2015 ◽  
Vol 357 ◽  
pp. e24
Author(s):  
J. Jost ◽  
V. Ratsimbazafy ◽  
P.M. Preux ◽  
C.R. Newton ◽  
M. Tripathi ◽  
...  
Keyword(s):  
Clinical Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Convalescent plasma therapy in patients with moderate-to-severe COVID-19: A study from Indonesia for clinical research in low- and middle-income countries

2021 ◽  
pp. 100931
Author(s):  
Marliana S. Rejeki ◽  
Nana Sarnadi ◽  
Retno Wihastuti ◽  
Vininta Fazharyasti ◽  
Wisvici Y. Samin ◽  
...  
Keyword(s):  
Clinical Research ◽  
Plasma Therapy ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals A practical measure of health facility efficiency: an innovation in the application of routine health information to determine health worker productivity in Ethiopia

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Md Zabir Hasan ◽  
Girmaye D. Dinsa ◽  
Peter Berman
Keyword(s):  
Health Worker ◽  
Health Facility ◽  
Health Workers ◽  
Principal Component ◽  
Practical Application ◽  
Summary Measure ◽  
Worker Productivity ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Background A simple indicator of technical efficiency, such as productivity of health workers, measured using routine health facility data, can be a practical approach that can inform initiatives to improve efficiency in low- and middle-income countries. This paper presents a proof of concept of using routine information from primary healthcare (PHC) facilities to measure health workers’ productivity and its application in three regions of Ethiopia. Methods In four steps, we constructed a productivity measure of the health workforce of Health Centers (HCs) and demonstrated its practical application: (1) developing an analytical dataset using secondary data from health management information systems (HMIS) and human resource information system (HRIS); (2) principal component analysis and factor analysis to estimate a summary measure of output from five indicators (annual service volume of outpatient visits, family planning, first antenatal care visits, facility-based deliveries by skilled birth attendants, and children [< 1 year] with three pentavalent vaccines); (3) calculating a productivity score by combining the summary measure of outputs and the total number of health workers (input), and (4) implementing regression models to identify the determinant of productivity and ranking HCs based on their adjusted productivity score. Results We developed an analytical dataset of 1128 HCs; however, significant missing values and outliers were reported in the data. The principal component and factor scores developed from the five output measures were highly consistent (correlation coefficient = 0.98). We considered the factor score as the summary measure of outputs for estimating productivity. A very weak association was observed between the summary measure of output and the total number of staff. The result also highlighted a large variability in productivity across similar health facilities in Ethiopia, represented by the significant dispersion in summary measure of output occurring at similar levels of the health workers. Conclusions We successfully demonstrated the analytical steps to estimate health worker productivity and its practical application using HMIS and HRIS. The methodology presented in this study can be readily applied in low- and middle-income countries using widely available data—such as DHIS2—that will allow further explorations to understand the causes of technical inefficiencies in the health system.

scholarly journals Interventions to improve linear growth during exclusive breastfeeding life-stage for children aged 0-6 months living in low- and middle-income countries: a systematic review and network and pairwise meta-analyses

2019 ◽  
Vol 3 ◽  
pp. 1720 ◽  
Author(s):  
Jay J. H. Park ◽  
Ellie Siden ◽  
Ofir Harari ◽  
Louis Dron ◽  
Reham Mazoub ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Head Circumference ◽  
Linear Growth ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Mean Difference ◽  
Kangaroo Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Background: Exclusive breastfeeding (EBF) during the first six months of life is critical for child’s linear growth. While there is strong evidence in favor of EBF, the evidence with regards to other interventions for linear growth is unclear. We evaluated intervention domains of micronutrients, food supplements, deworming, maternal education, water sanitation and hygiene (WASH), and kangaroo care, for their comparative effectiveness on linear growth. Methods: For this review, we searched for randomized clinical trials (RCTs) of the interventions provided to infants aged 0-6 months and/or their breastfeeding mothers in low- and middle-income countries reporting on length-for-age z-score (LAZ), stunting, length, and head circumference. We searched for reports published until September 17th, 2019 and hand-searched bibliographies of existing reviews. For LAZ and stunting, we used network meta-analysis (NMA) to compare the effects of all interventions except for kangaroo care, where we used pairwise meta-analysis to compare its effects versus standard-of-care. For length and head circumference, we qualitatively summarized our findings. Results: We found 29 RCTs (40 papers) involving 35,119 mother and infant pairs reporting on the effects of aforementioned interventions on linear growth outcomes. Our NMA on LAZ found that compared to standard-of-care, multiple micronutrients administered to infants (MMN-C) improved LAZ (mean difference: 0.20; 95% credible interval [CrI]: 0.03,0.35), whereas supplementing breastfeeding mothers with MMN did not (MMN-M, mean difference: -0.02, 95%CrI: -0.18,0.13). No interventions including MMN-C (relative risk: 0.74; 95%CrI: 0.36,1.44) reduced risk for stunting compared to standard-of-care. Kangaroo care, on the other hand, improved head circumference (mean difference: 0.20 cm/week; 95% confidence intervals [CI]: 0.09,0.31 cm/week) and length (mean difference: 0.23 cm/week; 95%CI: 0.10,0.35 cm/week) compared to standard-of-care.   Conclusion: Our study found important improvements for kangaroo care, but we did not find sufficient evidence for other interventions. Registration: PROSPERO CRD42018110450; registered on 17 October 2018.

Sign in / Sign up

Export Citation Format

Share Document