• Title/Summary/Keyword: LMICs

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Comparison of the Universal Health Coverage Index among Africa Countries (아프리카 국가 간 보편적 의료보장(UHC) 지표 비교)

  • Oh, Chang Seok
    • The Korean Journal of Health Service Management
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    • v.12 no.2
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    • pp.89-99
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    • 2018
  • Objectives : To compare the degree of achievement of Universal Health Coverage (UHC) among 39 developing countries in Africa and to investigate the correlation between health care financing and the UHC index. Methods : For data, 14 UHC indexes were used in 2015 supplied by the World Health Organization (WHO). In addition, this study used a 10% of threshold point corresponding to the catastrophic health expenditures and a 25% of threshold points as a health care financing index. Results : It was found that there were significant difference among Least Low Developed Countries (LLDCs), Other Low Income Countries (Other LICs), Lower Middle Income Countiies (LMICs), Upper Middle Income Countires (UMICs) to compare the average value by nation on the UHC index. This study showed that the UHC index of LLDCs was lowest, but the average value was higher as it moved towards LMICs and UMICs. In addition, it was found that there was an average value difference among the groups like LLDCs, Other LICs, LMICs and UMICs. As a result of comparison, it was found that the spending of household health expenditure increased as LLDCs moved towards UMICs when the burden of household health expenditure was 25%. Conclusions : This study aimed to compare the UHC indexes of African nations and to investigate the correlation between the degree of spending of total expenditure on health and burden of household health expenditure and UHC, and its effect.

HPV Infection and Cervical Abnormalities in HIV Positive Women in Different Regions of Brazil, a Middle-Income Country

  • Freitas, Beatriz C;Suehiro, Tamy T;Consolaro, Marcia EL;Silva, Vania RS
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8085-8091
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    • 2016
  • Human papillomavirus is a virus that is distributed worldwide, and persistent infection with high-risk genotypes (HR-HPV) is considered the most important factor for the development of squamous cell cervical carcinoma (SCC). However, by itself, it is not sufficient, and other factors may contribute to the onset and progression of lesions. For example, infection with other sexually transmitted diseases such as human immunodeficiency virus (HIV) may be a factor. Previous studies have shown the relationship between HPV infection and SCC development among HIV-infected women in many regions of the world, with great emphasis on low- and middle-income countries (LMICs). Brazil is considered a LMIC and has great disparities across different regions. The purpose of this review was to highlight the current knowledge about HPV infection and cervical abnormalities in HIV+ women in Brazil because this country is an ideal setting to evaluate HIV impact on SCC development and serves as model of LMICs and low-resource settings.

Pre-pregnancy Diet to Maternal and Child Health Outcome: A Scoping Review of Current Evidence

  • Fadila Wirawan;Desak Gede Arie Yudhantari;Aghnaa Gayatri
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.2
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    • pp.111-127
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    • 2023
  • Objectives: Pre-pregnancy diet has an important role in preparing for healthy generation. However, evidence on this issue has been scarce. A scoping review synthesising current evidence will support the demand to map 'what has been researched' on pre-pregnancy diet and maternal and child health. Methods: Systematic search was performed using PICOS (Population, Intervention, Comparison, Outcomes, and Study design) framework in electronic databases. Articles were screened for eligibility, summarized, and the quality was assessed using the National Institute of Health assessment tool. The review structure complies with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guide. Results: Forty-two articles were included after full-text screening. Twenty-five studies were in high-income countries (HICs), six in each upper-middle income, five in lower-middle income countries (LMICs), and one in low-income countries (LIC). Based on the regions: North America (n=16), Europe (n=5), South America (n=4), Australia (n=4), Asia (n=5), Middle East (n=2), and sub-Saharan Africa (n=1). The two-most observed diet-related exposures were dietary pattern (n=17) and dietary quality (n=12). The most assessed outcome was gestational diabetes mellitus (n=28) and fetal and newborn anthropometry (n=7). The average quality score±standard deviation was 70±18%. Conclusions: Research related to pre-pregnancy diet is still concentrated in HICs. The context of diet may vary; therefore, future research is encouraged in LMICs and LICs context, and Mediterranean, South-East Asia, Pacific, and African regions. Some maternal and child nutrition-related morbidity, such as anemia and micronutrient deficiencies, have not been discussed. Research on these aspects will benefit to fill in the gaps related to pre-pregnancy diet and maternal and child health.

Changes in Vietnamese Male Smokers' Reactions Towards New Pictorial Cigarette Pack Warnings Over Time

  • Tran, Thu Ngan;Le, Vu Anh;Nguyen, Thi Tuyet My;Nguyen, Ngoc Bich
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup1
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    • pp.71-78
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    • 2016
  • Printing of pictorial health warnings (PHWs) on cigarette packages became obligatory by the Vietnam Law on Prevention and Control of Tobacco Harm in May 2013. Literature from high-income countries suggests that PHWs motivate smokers to quit smoking although their long-term effects have been questioned due to reduction of impact over time. This study aimed to assess the salience of PHWs and smokers' reactions towards PHWs over time. In May 2014 and May 2015, a cross-sectional questionnaire-based household survey was administered to respectively 1,462 and 1,509 Vietnamese male smokers aged 18 to 35. The result showed that salience of the PHWs 2 years after the implementation was higher than at the point of 1 year after the implementation. The proportion of respondents who tried to avoid noting the PHWs was reduced from 35% in wave 1 to 23% in wave 2. However, "Tried to avoid looking/thinking about the PHWs" increased 1.5 times the odds of presenting quit intention compared to those respondents who did not try to avoid looking/thinking about the PHWs (OR=1.5; 95%CI: 1.2-2.0). In conclusion, avoidance regarding PHWs may not work as a barrier when aiming at a higher level of quit intention. Salience of the PHWs may increase in the period shortly after their introduction onto packs but can be expected to decrease with time. In other words, it might be advisable to change or renew PHWs after a period of implementation to maintain their beneficial effects.

Detection of Human Papillomavirus among Women with Atypical Squamous Cells of Undetermined Significance Referred to Colposcopy: Implications for Clinical Management in Low- and Middle-Income Countries

  • de Abreu, Andre LP;Gimenes, Fabricia;Malaguti, Natalia;Pereira, Monalisa W;Uchimura, Nelson S;Consolaro, Marcia EL
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3637-3641
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    • 2016
  • To determine the prevalence of human papillomavirus (HPV) among women with atypical squamous cells of undetermined significance (ASC-US) referred to colposcopy and the implications for clinical management in low- and middle-income countries (LMIC), the present study was conducted. We included 200 women living in $Maring{\acute{a}}$/Brazil referred to colposcopy service between August 2012 and March 2013 due to an abnormal cytology from ASC-US until high-grade intraepithelial lesion (HSIL). HPV was detected and genotyped by polymerase chain reaction (PCR). The mean age was $36.8{\pm}10.5$ years, and women with and without ASC-US had similar mean ages ($37.4{\pm}11.5$ and $36.4{\pm}9.96$ years, respectively). The highest prevalence of ASC-US occurred at 20-24 years (40%). HPV-DNA was positive in 164 (82.0%) women.Of the 57 women with ASC-US, 30 (52.6%) were HPV-DNA-positive and 21 (70%) were high-risk HPV-positive (HR-HPV); the latter was similar to women without ASC-US (76.9%) but with other abnormal cytological findings present. Our data demonstrated that performing tests for HR-HPV can be used for management of women with ASC-US to support the decision of which women should be referred for an immediate or later colposcopy. The same conclusions can be applied to other LMICs for which HPV testing for primary screening has not been adopted.