scholarly journals Cross-Cultural Understanding of Health Assessments for People with Intellectual Disability: An Australian resource in the Philippines

2015 ◽  
Vol 8 (2) ◽  
pp. 1-9
Author(s):  
C. E. Brolan ◽  
M. T. Gomez ◽  
N. G. Lennox ◽  
R. S Ware

The Convention on the Rights of Persons with Disabilities has resulted in the involvement of high income countries in international development assistance to people with disabilities in low and middle income countries.  Healthcare tools designed in high income countries and delivered in low and middle income countries may not be appropriate to the context of the lives of people with disabilities.  We undertook a short qualitative study of participants’ views of an Australian-designed comprehensive health assessment tool, with participation from a WHO-Collaborating non-government organisation in regional Philippines. We also examined the participants’ perceptions of the barriers to healthcare for Filipinos with intellectual disabilities.  Responses to the comprehensive health assessment tool were positive although participants agreed that both linguistic and cultural translation would enhance wider use of the tool. The barriers identified included poverty, family isolation, stigma and communication issues as preventing appropriate healthcare delivery to Filipinos with intellectual disability. Consideration must be given to the complexities of transference of healthcare resources to a low and middle income country context, as well as the systemic and cultural barriers to appropriate healthcare provision to people with disabilities.

2015 ◽  
Vol 36 (10) ◽  
pp. 1208-1214 ◽  
Author(s):  
Kristy Weinshel ◽  
Angela Dramowski ◽  
Ágnes Hajdu ◽  
Saul Jacob ◽  
Basudha Khanal ◽  
...  

BACKGROUNDHealthcare-associated infection rates are higher in low- and middle-income countries compared with high-income countries, resulting in relatively larger incidence of patient mortality and disability and additional healthcare costs.OBJECTIVETo use the Infection Control Assessment Tool to assess gaps in infection control (IC) practices in the participating countries.METHODSSix international sites located in Argentina, Greece, Hungary, India, Nepal, and South Africa provided information on the health facility and the surgical modules relating to IC programs, surgical antibiotic use and surgical equipment procedures, surgical area practices, sterilization and disinfection of equipment and intravenous fluid, and hand hygiene. Modules were scored for each country.RESULTSThe 6 international sites completed 5 modules. Of 121 completed sections, scores of less than 50% of the recommended IC practices were received in 23 (19%) and scores from 50% to 75% were received in 43 (36%). IC programs had various limitations in many sites and surveillance of healthcare-associated infections was not consistently performed. Lack of administration of perioperative antibiotics, inadequate sterilization and disinfection of equipment, and paucity of hand hygiene were found even in a high-income country. There was also a lack of clearly written defined policies and procedures across many facilities.CONCLUSIONSOur results indicate that adherence to recommended IC practices is suboptimal. Opportunities for improvement of IC practices exist in several areas, including hospital-wide IC programs and surveillance, antibiotic stewardship, written and posted guidelines and policies across a range of topics, surgical instrument sterilization procedures, and improved hand hygiene.Infect. Control Hosp. Epidemiol. 2015;36(10):1208–1214


2009 ◽  
Vol 21 (6) ◽  
pp. 1116-1126 ◽  
Author(s):  
Guk-Hee Suh ◽  
Anders Wimo ◽  
Serge Gauthier ◽  
Daniel O'Connor ◽  
Manabu Ikeda ◽  
...  

ABSTRACTBackground: Alzheimer's drugs are believed to have limited availability and to be unaffordable in low- and middle-income countries compared to high-income countries. The price, availability and affordability of Alzheimer's drugs have not been reported before.Methods: During 2007 an international survey was conducted in 21 countries in six continents (Argentina, Australia, Brazil, the Dominican Republic, France, India, Japan, Macedonia, Mexico, New Zealand, Nigeria, the Philippines, Portugal, Serbia, South Korea, Switzerland, Taiwan, Thailand, Uganda, the U.K. and the U.S.A.). Prices of Alzheimer's drugs were compared using the affordability index (the total number of units purchasable with one's daily income) derived from purchasing power parity (PPP) converted prices as well as raw prices.Results: Donepezil is available in all 21 countries, whereas the newer drugs are less available. A 5 mg tablet of branded originator donepezil costs just US$0.26 in India and US$0.31 in Mexico, whereas it costs US$6.64 in the U.S.A. Pricing conditions of rivastigmine, galantamine and memantine appear to be similar to that of donepezil. The cheapest branded originators are from India and Mexico. However, in terms of PPP, Alzheimer's drugs in other low- and middle-income countries are much more expensive than in high-income countries. Most people in low- and middle-income countries cannot afford Alzheimer's drugs.Conclusions: Alzheimer's drugs, albeit available, are often unaffordable for those who need them most. It is hoped that equitable differential pricing will be applied to Alzheimer's drugs.


Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1038
Author(s):  
Ana Carolina B. Leme ◽  
Sophia Hou ◽  
Regina Mara Fisberg ◽  
Mauro Fisberg ◽  
Jess Haines

Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies. The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020. English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs. Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs. Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3%. HIC have higher consumption of discretionary foods, while results were mixed for LMIC. Grains and dairy were consumed below recommendations in both HIC and LMIC. Consumption of animal proteins (>30%), particularly red meat, exceeded the recommendations. Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country’s guidelines. Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Hernan O Bayona ◽  
Mayowa Owolabi ◽  
Wayne Feng ◽  
James R Sawers ◽  
Paul Olowoyo ◽  
...  

Introduction: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low- and Middle-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. Focus therefore, should be on approaches enabling healthcare systems to improve control of vascular risk factors. Objective: We aimed to compare important features of stroke prevention guidelines between LMICs and High Income Countries (HICs). Methods: We systematically searched PubMed, AJOL, SciELO, and LILACS databases for stroke prevention guidelines published between January 2005 and December 2015 by country. Primary search items included: “Stroke” and “Guidelines”. We critically appraised the articles for evidence level, issuance frequency and implementation aspects to clinical practice. Results: Among 45 stroke prevention guidelines published, 28 (62%) met eligibility criteria: 7 from LMICs (25%) and 21 from HICs (75%). LMIC-issued guidelines were less likely to have conflict of interest declarations (57% vs. 100%, p=0.01), involve high quality systematic reviews (57% vs. 95%, p= 0.03), had good dissemination channels (14% vs 71%, p=0.02). The patient views and preferences were the most significant stakeholder considerations in HICs (43%, p=0.04) compared with LMICs. Conclusion: The quality and quantity of stroke prevention guidelines in LMICs are less than those of HICs and need to be significantly improved upon.


2016 ◽  
Vol 8 (11) ◽  
pp. 278 ◽  
Author(s):  
Aprill Z. Dawson ◽  
Rebekah J. Walker ◽  
Jennifer A. Campbell ◽  
Leonard E. Egede

<p><strong>INTRODUCTION: </strong>Low and middle-income countries face a continued burden of chronic illness and non-communicable diseases while continuing to show very low health worker utilization. With limited numbers of medical schools and a workforce shortage the poor health outcomes seen in many low and middle income countries are compounded by a lack of within country medical training.</p><p><strong>METHODS: </strong>Using a systematic approach, this paper reviews the existing literature on training outcomes in low and middle-income countries in order to identify effective strategies for implementation in the developing world. This review examined training provided by high-income countries to low- and middle-income countries.</p><p><strong>RESULTS: </strong>Based on article eligibility, 24 articles were found to meet criteria. Training methods found include workshops, e-learning modules, hands-on skills training, group discussion, video sessions, and role-plays. Of the studies with statistically significant results training times varied from one day to three years. Studies using both face-to-face and video found statistically significant results.</p><p><strong>DISCUSSION:</strong> Based on the results of this review, health professionals from high-income countries should be encouraged to travel to low- middle-income countries to assist with providing training to health providers in those countries.</p>


2021 ◽  
Author(s):  
Dani Jennifer Barrington ◽  
Hannah Robinson ◽  
Emily Wilson ◽  
Julie Hennegan

Background: There is growing recognition of the importance of menstruation in achieving health, education, and gender equality for all. New policies in high income countries (HICs) have responded to anecdotal evidence that many struggle to meet their menstrual health needs. Qualitative research has explored lived experiences of menstruating in HICs and can inform intervention approaches. Methods and findings: Primary, qualitative studies capturing experiences of menstruation in HICs were eligible for inclusion. Systematic database and hand searching identified 11485 records. Following screening and quality appraisal using the EPPI-Centre checklist, 104 studies (120 publications) detailing the menstrual experiences of over 3800 individuals across sixteen countries were included. We used the integrated model of menstrual experiences developed from studies in low- and middle-income countries (LMICs) as a starting framework and deductively and inductively identified antecedents contributing to menstrual experiences; menstrual experiences themselves and impacts of menstrual experiences. Included studies described consistent themes and relationships that fit well with the LMIC integrated model, with modifications to themes and model pathways identified through our analysis. The socio-cultural context heavily shaped menstrual experiences, manifesting in strict behavioural expectations to conceal menstruation and limiting the provision of menstrual materials. Resource limitations contributed to negative experiences, where dissatisfaction with menstrual practices and management environments were expressed along with feelings of disgust if participants felt they failed to manage their menstruation in a discrete, hygienic way. Physical menstrual factors such as pain were commonly associated with negative experiences, with mixed experiences of healthcare reported. Across studies participants described negative impacts of their menstrual experience including increased mental burden and detrimental impacts on participation and personal relationships. Positive experiences were more rarely reported, although relationships between cis-women were sometimes strengthened by shared experiences of menstrual bleeding. Included studies reflected a broad range of disciplines and epistemologies. Many aimed to understand the constructed meanings of menstruation, but few were explicitly designed to inform policy or practice. Few studies focused on socioeconomically disadvantaged groups relevant to new policy efforts.Conclusions: We developed an integrated model of menstrual experience in HICs which can be used to inform research, policy and practice decisions by emphasising the pathways through which positive and negative menstrual experiences manifestReview protocol registration: The review protocol registration is PROSPERO: CRD42019157618.


Sign in / Sign up

Export Citation Format

Share Document