scholarly journals Assessment of Retinoblastoma Capacity in the Middle East, North Africa, and West Asia Region

2020 ◽  
pp. 1531-1539
Author(s):  
Michala Burges ◽  
Ibrahim Qaddoumi ◽  
Rachel C. Brennan ◽  
Lisa Krull ◽  
Natasha Sahr ◽  
...  
Keyword(s):  
Middle East ◽  
Pediatric Oncology ◽  
North Africa ◽  
Multidisciplinary Care ◽  
Focal Therapy ◽  
Green Laser ◽  
Distributed Data ◽  
Middle Income ◽  
Pediatric Oncologist ◽  
Tiered System

PURPOSE We aimed to evaluate the capacity to treat retinoblastoma in the Middle East, North Africa, and West Asia region. METHODS A Web-based assessment that investigated retinoblastoma-related pediatric oncology and ophthalmology infrastructure and associated capacity at member institutions of the Pediatric Oncology East and Mediterranean group was distributed. Data were analyzed in terms of availability, location, and confidence of use for each resource needed for the management of retinoblastoma. Resources were categorized by diagnostics, focal therapy, chemotherapy, advanced treatment, and supportive care. Responding institutions were further divided into an asset-based tiered system. RESULTS In total, responses from 23 institutions were obtained. Fifteen institutions reported the availability of an ophthalmologist, 12 of which held primary off-site appointments. All institutions reported the availability of a pediatric oncologist and systemic chemotherapy A significant portion of available resources was located off site. Green laser was available on site at seven institutions, diode laser at six institutions, cryotherapy at 12 institutions, and brachytherapy at nine institutions. There existed marked disparity between the availability of some specific ophthalmic resources and oncologic resources. CONCLUSION The assessment revealed common themes related to the treatment of retinoblastoma in low- and- middle-income countries, including decentralization of care, limited resources, and lack of multidisciplinary care. Resource disparities warrant targeted intervention in the Middle East, North Africa, and West Asia region to advance the management of retinoblastoma in the region.

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.

scholarly journals Cancer Registration in the Middle East, North Africa, and Turkey: Scope and Challenges

2021 ◽  
pp. 1101-1109
Author(s):  
Zahi Abdul-Sater ◽  
Ali Shamseddine ◽  
Ali Taher ◽  
Fouad Fouad ◽  
Ghassan Abu-Sitta ◽  
...  
Keyword(s):  
Middle East ◽  
Cancer Registry ◽  
North Africa ◽  
Online Survey ◽  
Control Strategies ◽  
Cancer Control ◽  
Population Based ◽  
Cancer Registration ◽  
Middle Income ◽  
Conflict Zones

PURPOSE National cancer control strategies have been identified as essential tools for reducing and managing the growing burden of cancer in low- and middle-income countries. Cancer registration is an instrumental component of any cancer control strategy, providing the data to inform effective cancer policy. In the Middle East, North Africa, and Turkey (MENAT) region, cancer registration varies immensely and faces multifaceted challenges including protracted conflict. This study investigates and maps out the present capacities and outputs of cancer registration in the MENAT region and identifies thematic barriers facing implementation and utilization of cancer registry data. MATERIALS AND METHODS We used a self-administered online survey with open and close-ended questions targeting national and institutional cancer registry managers in the MENAT countries. RESULTS Registry managers from 19 MENAT countries reported the presence of 97 population-based, 48 hospital-based, and 24 pathology-based registries. Most population-based registries were well- or partially developed. Lack of accurate death records, complete medical records, and communication between stakeholders and deficiencies in trained personnel were critical challenges that were more severe in active conflict zones and neighboring conflict-affected regions. Cancer registration challenges included weak health infrastructure, absence of legislation mandating cancer registration, and disruption of cancer registration because of active conflict and loss of funding. Refugee host countries, such as Lebanon, Turkey, and Jordan, also reported conflict-related challenges including refugee mobility and lack of accurate data on forced migrants. CONCLUSION This study provides a much-needed understanding of the current landscape and contextual challenges affecting cancer registration in the MENAT. These data are important for identifying areas on which to focus regional capacity-strengthening initiatives.

scholarly journals Cross-national clinical and functional remission rates: Worldwide Schizophrenia Outpatient Health Outcomes (W-SOHO) study

2011 ◽  
Vol 199 (3) ◽  
pp. 194-201 ◽  
Author(s):  
Josep Maria Haro ◽  
Diego Novick ◽  
Jordan Bertsch ◽  
Jamie Karagianis ◽  
Martin Dossenbach ◽  
...  
Keyword(s):  
Middle East ◽  
Health Outcomes ◽  
East Asia ◽  
North Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Using Data ◽  
Cross National

BackgroundEvidence suggests that schizophrenia may have a better outcome for individuals living in low- and middle-income countries compared with affluent settings.AimsTo determine the frequency of symptom and functional remission in out-patients with schizophrenia in different regions of the world.MethodUsing data from the Worldwide-Schizophrenia Outpatient Health Outcomes (W-SOHO) study we measured clinical and functional remission in out-patients with schizophrenia in different regions of the world, and examined sociodemographic and clinical factors associated with these outcomes. The 11 078 participants analysed from 37 participating countries were grouped into 6 regions: South Europe, North Europe, Central and Eastern Europe, Latin America, North Africa and Middle East, and East Asia.ResultsIn total, 66.1% achieved clinical remission during the 3-year follow-up (range: 60.1% in North Europe to 84.4% in East Asia) and 25.4% achieved functional remission (range: 17.8% in North Africa and Middle East to 35.0% in North Europe). Regional differences were not explained by participants' clinical characteristics. Baseline social functioning, being female and previously untreated were consistent predictors of remission across regions.ConclusionsClinical outcomes of schizophrenia seem to be worse in Europe compared with other regions. However, functional remission follows a different pattern.

scholarly journals Maternal education and equity in breastfeeding: trends and patterns in 81 low- and middle-income countries between 2000 and 2019

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Paulo A. R. Neves ◽  
Aluisio J. D. Barros ◽  
Giovanna Gatica-Domínguez ◽  
Juliana S. Vaz ◽  
Phillip Baker ◽  
...  
Keyword(s):  
Higher Education ◽  
Middle East ◽  
South Asia ◽  
North Africa ◽  
Exclusive Breastfeeding ◽  
Formal Education ◽  
Maternal Education ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Background In low- and middle-income countries (LMICs), low levels of formal maternal educational are positively associated with breastfeeding whereas the reverse is true among women with higher levels of formal education. As such, breastfeeding has helped to reduce health equity gaps between rich and poor children. Our paper examines trends in breastfeeding and formula consumption by maternal educational in LMICs over nearly two decades. Methods We used 319 nationally representative surveys from 81 countries. We used WHO definitions for breastfeeding indicators and categorized maternal education into three categories: none, primary, and secondary or higher. We grouped countries according to the World Bank income groups and UNICEF regions classifications. The trend analyses were performed through multilevel linear regression to obtain average absolute annual changes in percentage points. Results Significant increases in prevalence were observed for early initiation and exclusive breastfeeding across all education categories, but more prominently in women with no formal education for early breastfeeding and in higher level educated women for exclusive breastfeeding. Small decreases in prevalence were seen mostly for women with no formal education for continued breastfeeding at 1 and 2 years. Among formula indicators, only formula consumption between 6 and 23 months decreased significantly over the period for women with primary education. Analysis by world regions demonstrated that gains in early and exclusive breastfeeding were almost universally distributed among education categories, except in the Middle East and North Africa where they decreased throughout education categories. Continued breastfeeding at 1 and 2 years increased in South Asia, Latin America and the Caribbean, and Eastern Europe and Central Asia for primary or higher education categories. Declines occurred for the group of no formal education in South Asia and nearly all education categories in the Middle East and North Africa with a decline steeper for continued breastfeeding at 2 years. With a few exceptions, the use of formula is higher among children of women at the highest education level in all regions. Conclusions Over the course of our study, women with no formal education have worsening breastfeeding indicators compared to women with primary and secondary or higher education.

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