scholarly journals Improving Supply Chain for Essential Drugs in Low-Income Countries: Results from a Large Scale Randomized Experiment in Zambia

10.1596/32086 ◽  
2019 ◽  
Author(s):  
Monique Vledder ◽  
Jed Friedman ◽  
Mirja Sjöblom ◽  
Thomas Brown ◽  
Prashant Yadav
2019 ◽  
Vol 5 (2) ◽  
pp. 158-177 ◽  
Author(s):  
Monique Vledder ◽  
Jed Friedman ◽  
Mirja Sjöblom ◽  
Thomas Brown ◽  
Prashant Yadav

Sensors ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. 3774
Author(s):  
Pavlos Topalidis ◽  
Cristina Florea ◽  
Esther-Sevil Eigl ◽  
Anton Kurapov ◽  
Carlos Alberto Beltran Leon ◽  
...  

The purpose of the present study was to evaluate the performance of a low-cost commercial smartwatch, the Xiaomi Mi Band (MB), in extracting physical activity and sleep-related measures and show its potential use in addressing questions that require large-scale real-time data and/or intercultural data including low-income countries. We evaluated physical activity and sleep-related measures and discussed the potential application of such devices for large-scale step and sleep data acquisition. To that end, we conducted two separate studies. In Study 1, we evaluated the performance of MB by comparing it to the GT3X (ActiGraph, wGT3X-BT), a scientific actigraph used in research, as well as subjective sleep reports. In Study 2, we distributed the MB across four countries (Austria, Germany, Cuba, and Ukraine) and investigated physical activity and sleep among these countries. The results of Study 1 indicated that MB step counts correlated highly with the scientific GT3X device, but did display biases. In addition, the MB-derived wake-up and total-sleep-times showed high agreement with subjective reports, but partly deviated from GT3X predictions. Study 2 revealed similar MB step counts across countries, but significant later wake-up and bedtimes for Ukraine than the other countries. We hope that our studies will stimulate future large-scale sensor-based physical activity and sleep research studies, including various cultures.


Author(s):  
Colin R. Latchem ◽  
Ajit Maru

About 2 billion people in low-income countries are dependent upon smallholding farming for their livelihoods. These are among the world’s poorest people. Most of them lack land tenure and farm in regions with limited land and water resources. Many must cope with drought, desertification, and environmental damage caused by failed land reforms, large-scale monocropping, overgrazing, logging, destroyed watersheds, and the encroachment of new pests and diseases. They use only the most primitive of tools and they lack the knowledge and skills to improve their farming methods, value-add their produce, and compete in national and global markets. Many of these smallholder communities have been devastated by HIV/AIDS. In some regions of sub-Saharan Africa, food production has dropped by 40%, and it is estimated that over the next 20 years, 26% of the agricultural labour force will be lost to this pandemic. And demographic and economic changes in the low-income nations are increasingly leaving farming in the hands of women, who lack the knowledge and resources to farm efficiently.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Lufunda Lukama ◽  
Chester Kalinda ◽  
Warren Kuhn ◽  
Colleen Aldous

Background. Ear, nose, and throat (ENT) diseases are an oft overlooked global health concern. Despite their high prevalence and associated morbidity and mortality, ENT diseases have remained neglected in health care delivery. In Zambia and many other low-income countries, ENT services are characterized by poor funding, unavailable surgical procedures, and erratic supply of essential drugs. Objective. To investigate ENT service provision in Zambia with regard to availability of surgical procedures and supply of essential drugs. Methods. A descriptive cross-sectional survey was conducted using a piloted structured questionnaire between 17 January 2017 and 2 January 2018. Included in the study were the 109 hospitals registered with the Ministry of Health (MoH) across the 10 provinces of Zambia. Results. Of the participating hospitals, only 5.9% (n=1) and 40% (n=2) of Second-Level Hospitals (SLH) and Third-Level Hospitals (TLH), respectively, carried out tympanoplasty, myringotomy, and grommet insertion (M+G). Frontal trephination and external ethmoidectomy were offered in 11.7% (n=2) and 40% (n=2) of SLH and TLH, respectively. While tracheostomy (39.3%, n=24), tonsillectomy (27.9%, n=17), and adenoidectomy (27.9%, n=17) were the most widely performed head and neck procedures, laryngectomy was carried out by 1 hospital. Between 14.8% (n=9) and 36.1% (n=22) of hospitals lacked antibiotic and/or antiseptic ear drops. Despite 96.7% (n=59) of the respondents acknowledging ENT as an important branch of clinical practice, only 15.3% (n=4) of the hospitals had a budget for ENT. Also, 6.6% (n=4) of the respondents thought the discipline of ENT had received enough attention. Conclusion. ENT service delivery in Zambia is limited with regard to performed surgical procedures and availability of essential drugs, necessitating urgent intervention. The findings from this study may be used to direct national policy on the improvement of provision of ENT services in Zambia.


2020 ◽  
Vol 8 ◽  
Author(s):  
Lee Smith ◽  
Nicola Veronese ◽  
Vincenzo Racalbuto ◽  
Damiano Pizzol

The COVID-19 outbreak was declared by the World Health Organization (WHO) as global pandemic in March 2020. Considering the necessity to implement rapid response to control the pandemic and the fragility and the state of need of low income countries, it will be mandatory to develop a global approach in order to reduce the spread of infection and the creation of community viral reservoirs. So far, we could hypothesize a worst case scenario in which when the COVID-19 outbreak hits a peak in Africa and in low-income countries, the majority of such countries will be unprepared, with low resources allocated for affording the viral emergency and the consequences will be catastrophic with no lesson learnt. In the best case scenario, the COVID-19 will not affect Africa or South America on a large scale and, if the prevention measures will be implemented, we could register a lower incidence of hygiene linked diseases that still represent leading causes of death.


2019 ◽  
Vol 4 (2) ◽  
pp. 60 ◽  
Author(s):  
Kavita Berger ◽  
James Wood ◽  
Bonnie Jenkins ◽  
Jennifer Olsen ◽  
Stephen Morse ◽  
...  

The global burden of infectious diseases and the increased attention to natural, accidental, and deliberate biological threats has resulted in significant investment in infectious disease research. Translating the results of these studies to inform prevention, detection, and response efforts often can be challenging, especially if prior relationships and communications have not been established with decision-makers. Whatever scientific information is shared with decision-makers before, during, and after public health emergencies is highly dependent on the individuals or organizations who are communicating with policy-makers. This article briefly describes the landscape of stakeholders involved in information-sharing before and during emergencies. We identify critical gaps in translation of scientific expertise and results, and biosafety and biosecurity measures to public health policy and practice with a focus on One Health and zoonotic diseases. Finally, we conclude by exploring ways of improving communication and funding, both of which help to address the identified gaps. By leveraging existing scientific information (from both the natural and social sciences) in the public health decision-making process, large-scale outbreaks may be averted even in low-income countries.


2020 ◽  
pp. archdischild-2020-320107
Author(s):  
Trevor Duke ◽  
Francis Pulsan ◽  
Doreen Panauwe ◽  
Ilomo Hwaihwanje ◽  
Martin Sa'avu ◽  
...  

BackgroundPneumonia is the largest cause of child deaths in low-income countries. Lack of availability of oxygen in small rural hospitals results in avoidable deaths and unnecessary and unsafe referrals.MethodWe evaluated a programme for improving reliable oxygen therapy using oxygen concentrators, pulse oximeters and sustainable solar power in 38 remote health facilities in nine provinces in Papua New Guinea. The programme included a quality improvement approach with training, identification of gaps, problem solving and corrective measures. Admissions and deaths from pneumonia and overall paediatric admissions, deaths and referrals were recorded using routine health information data for 2–4 years prior to the intervention and 2–4 years after. Using Poisson regression we calculated incidence rates (IRs) preintervention and postintervention, and incidence rate ratios (IRR).ResultsThere were 18 933 pneumonia admissions and 530 pneumonia deaths. Pneumonia admission numbers were significantly lower in the postintervention era than in the preintervention era. The IRs for pneumonia deaths preintervention and postintervention were 2.83 (1.98–4.06) and 1.17 (0.48–1.86) per 100 pneumonia admissions: the IRR for pneumonia deaths was 0.41 (0.24–0.71, p<0.005). There were 58 324 paediatric admissions and 2259 paediatric deaths. The IR for child deaths preintervention and postintervention were 3.22 (2.42–4.28) and 1.94 (1.23–2.65) per 100 paediatric admissions: IRR 0.60 (0.45–0.81, p<0.005). In the years postintervention period, an estimated 348 lives were saved, at a cost of US$6435 per life saved and over 1500 referrals were avoided.ConclusionsSolar-powered oxygen systems supported by continuous quality improvement can be achieved at large scale in rural and remote hospitals and health care facilities, and was associated with reduced child deaths and reduced referrals. Variability of effectiveness in different contexts calls for strengthening of quality improvement in rural health facilities.Trial registration numberACTRN12616001469404.


2020 ◽  
Vol 14 (1) ◽  
pp. 40-54
Author(s):  
Christopher Hartworth ◽  
Carol Richards ◽  
Ian Convery

This paper examines whether Amartya Sen’s entitlements and capabilities concepts can be transferred in their application from low-income countries to high-income countries, specifically Cumbria, Northern England. Originally used to understand the causes of famine, these concepts have previously been used in several different geographical contexts to broadly understand poverty and inequality but almost entirely in low-income countries. This paper applies these concepts to a United Kingdom context in an attempt to understand the causes of poverty and inequality among people experiencing “livelihood crisis.” The research uses data from two nongovernmental social welfare projects to examine the causes of crisis and the remedial effects of the intervention. Our findings indicate that these concepts can help to explain how people find themselves in crisis in Cumbria. On a broader level, they can also be used to explain poverty, inequality, and disadvantage in communities in the United Kingdom. The authors put forward that entitlements and capabilities provide a useful framework to advance the policy and political debate on the causes of poverty by providing a straightforward language and broad application. Entitlement and capabilities can also assist social welfare programs in framing their aims and objectives and through improved understanding about the causes of inequality, will be better able to support people out of disadvantage by strengthening entitlements and building capabilities, without the necessity of large-scale investment.


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