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PubMed2004

Healthcare worker safety is a pre-requisite for injection safety in developing countries.

Unsafe injection practices, including the re-use of unsterile needles and syringes, are commonplace in developing country health settings, and contribute substantially to the global burden of blood-borne viral disease. Unsafe injection practices place at risk not only patients, but also healthcare workers, who practice universal precautions inconsistently and are commonly exposed to blood in the course of their work. Global awareness of the link between unsafe injection practices and the burden of blood-borne viral disease was slow to emerge but has grown in the recent years. In 1999, the World Health Organization (WHO) established the Safe Injection Global Network (SIGN), which advocates a range of interventions for the promotion of injection safety. As well as exhorting healthcare workers to use a new needle and syringe for every injection, they should also be encouraged and supported to protect themselves from exposure to blood. It is argued here that promoting the occupational safety of healthcare workers in developing countries is an essential and currently under-valued component of the response to the problem of unsafe injection practices. Protecting healthcare workers from occupational infection with blood-borne viruses has a range of potential benefits, including safer injection practices for patients and less discrimination against people with HIV/AIDS. There is an urgent need for organisational commitment to the occupational safety of healthcare workers in developing countries, along with the provision of training in injection safety and universal precautions, adequate supplies of personal protective equipment, and hepatitis B vaccination.

Blood-Borne Pathogens↗

PubMed2000

HIV Treatment in Developing Countries.

Diagnostic, prognostic and therapeutic advances have had a major impact on HIV at both the individual and community levels in wealthy nations. However, more than 95% of HIV infections occur in developing countries, where personal or national economies cannot support these measures. Therefore, HIV treatment in developing countries must focus on particular aspects of infection, especially prevention and treatment of those opportunistic infections for which inexpensive antimicrobial agents are available and effective. At present, the focus in developing countries is on tuberculosis, Pneumocystis carinii pneumonia (PCP), and pneumococcal pneumonia. The spread of antimicrobial resistance in mycobacteria and pneumococci is of special concern for developing countries, and strategies to limit the spread of resistance should take high priority. The use of specific antiretroviral agents is limited, because of cost, to prevention of mother-to-child transmission, and notable successes have been achieved. While it is unlikely that these agents will become widely available to the general population, targeting treatment at high-risk groups, through a program of post-exposure prophylaxis, may be an affordable strategy in some situations.

Journal Article↗

PubMed1976

Role of the medical auxiliary in the control of sexually transmitted disease in a developing country.

Venereal diseases are becoming a major health problem in many developing countries where the greater part of primary medical care is undertaken by medical auxiliaries. Under these circumstances, the medical auxiliary has an important role to play in the control of these diseases but he can only do this with adequate training, support, and supervision from the professional doctors and specialists. In this paper, the role of the medical auxiliary is outlined and a case is also made for a specially-trained cadre for venereal disease work in busy urban clinics in developing countries.

Africa↗

PubMed1992

The role of the laboratory in a Chlamydia control programme in a developing country.

The laboratory components of a Chlamydia trachomatis disease control programme for a developing country are reviewed. Early diagnosis of chlamydial infections is the most cost effective means of preventing the long term sequelae of trachoma, pelvic inflammatory disease, ectopic pregnancy and infertility, which are now a major public health burden to the health care system in developing countries. Public health strategies are required to establish both a co-ordinated limited system of laboratory services, and to promote the diagnosis and treatment of disease syndromes in the absence of laboratory support. Laboratory tests for the specific diagnoses of chlamydial infections requiring different levels of expertise and equipment can be instituted within settings appropriate to the resources and technical expertise available. Emphasis is given to appropriate cost effective utilization of laboratory testing.

Chlamydia Infections↗

PubMed2003

Global burden of disease: huge inequities in the health status in developing and developed countries.

This paper outlines the Global Burden of Disease study which was conducted for the 1993 World Bank Development Report. The study revealed huge differences in premature death and disability in the world regions examined; sub-Saharan Africa and India had the highest burden of disease. This paper also examines how the large differences in burden of disease between developed and developing countries can be explained by economic factors, highlighting research findings that suggest egalitarian societies are likely to have better health status than countries with capitalistic, market-based economies. This study then examines the efforts of the Global Forum for Health Research to create an integrated approach to global health policy formulation, using global burden of disease data, and concludes with the assertion that adopting such an approach nationally would also assist developed countries like Canada in better dealing with future health challenges.

Chronic Disease↗

PubMed1983

Medical care in developing countries. Assessment and assurance of quality.

In recent years attention in developing countries has concentrated upon strategies to improve the equitable provision of essential health care--the primary health care approach. Very little work has been reported in connection with the quality of medical care, and yet for the successful outcome of care it is necessary that adequate health care processes be carried out. Conceptual, methodological, data, and organizational issues related to quality assessment and assurance are presented. The few examples of reported work concerned with these important aspects of medical care in developing countries are reviewed. Suggestions are made as to how measures to ensure reasonable quality might be further developed and refined.

Developing Countries↗

PubMed2005

New vaccines against enteric bacteria for children in less developed countries.

Diarrheal diseases represent a major threat to infant survival in less developed countries. A real opportunity now exists to help alleviate this problem through the development of safe and effective multicomponent whole-bacterial cell vaccine(s) against enterotoxigenic Escherichia coli and Shigella, two important pathogens for which no licensed vaccine exists. What is preventing realization of this achievement is a lack of focus on the unique needs of children in less developed countries, along with committed and sufficient funding directed toward this goal. Live-attenuated and inactivated whole-cell vaccine candidates, some of which have languished too long, are available for testing, which, if performed in a coordinated fashion, can answer key unresolved issues concerning mucosal vaccination against enteric diseases. These candidate vaccines potentially provide a relatively simple intervention which could, if implemented, reduce the impact of these diseases upon the life and productivity of children.

Bacterial Vaccines↗

PubMed1997

[Epidemiological course of cardiovascular diseases in developing countries].

Though the environmental and medical conditions are very different, similar population characteristics can be observed in the developing countries. The mean age of the population is young. Most people have a rural way of life, but migrations towards towns result in a disorganized urbanization and in habits more predisposing to cardiovascular diseases. Care access is often difficult for the patients. With respect to risk factors, smoking is increasing, hypertension is highly prevalent and severe, a trend towards obesity is frequent in medium or high economical level people. S or C hemoglobin diseases seem to be associated with coronary heart disease. In spite of very insufficient statistical data, it appears that: cardiovascular disease mortality is increasing when total mortality is decreasing: ischemic and hypertensive heart diseases are increasing when streptococcal or nutritional heart diseases are stabilizing or decreasing. The authors seem to be the different developing countries in respect to the crossing of these curves. Some countries have not reached the crossing. Subsaharan Africa for instance. Others have gone beyond the crossing, some Asian countries for instance. Other countries seem to be at the intersection (Mediterranean or Latin American countries). But many countries suffer the double burden of increasing and decreasing diseases. There is a general lack of prevention owing to other competing priorities and also to economical, social and educational difficulties. However in some developing countries feasibility and efficacy of preventive measures have been proved.

Cardiovascular Diseases↗

PubMed1992

The effects of in- and out-migration on urban growth in Turkey (1965-85) and a comparison with the developed countries.

The author examines the relative weight of pull and push factors affecting rural-urban migration in Turkey. Data are from the 1970, 1980, and 1985 censuses. "The results of this study indicate that, for the Turkish case, the effects of migration on urban growth had been contrary to those found in the developed countries, but that, as Turkish development increased over the time period 1965-85, the effects of migration increasingly came to resemble those of developed countries."

Asia↗

PubMed1993

Government intervention in crop protection in developing countries.

Government interventions in the pesticide market are necessary, particularly in developing countries because of a high likelihood of market failure. The green revolution in Asia made governments introduce programmes which relied heavily on pesticide-based solutions to pest problems. With growing environmental concerns in donor and developing countries, a higher priority is given to natural factors of control. From a review of various types of government interventions it is concluded that government investments related to pest management should focus on reducing the dependence on pesticides rather than concentrating on the minimization of their side-effects.

Agriculture↗

PubMed1984

Percutaneous renal biopsy in a developing country: experience with 300 cases.

Percutaneous renal biopsy was performed on 300 occasions in 253 children. Adequate renal tissue was obtained in 94% of cases. Complication occurred on 26 occasions (8.7%). Seven children required blood transfusion. These results are comparable to experience of renal biopsy in the more advanced countries. Percutaneous renal biopsy is feasible in established hospitals in developing countries. Guidelines are provided for doing percutaneous renal biopsy in developing countries.

Biopsy↗

PubMed2002

The future of information technology for health in developing countries.

What is the future of communication technology for health in developing countries? This chapter sets out to answer this question by first considering the background and potential of information technology, identifying some of the issues and trends in communication, and finally following with some challenges and opportunities of how communication technologies can make a difference in health in developing countries. Past research has shown that communication can contribute to all aspects of population, health, and nutrition programs and is relevant in a number of contexts. Some of the trends in using information technology can be classified in the following categories: competition, cognitive-based presentations, comprehensive translation, convergence, and culture. Challenges include finding a way to include the South in the exchange of ideas and information. In addition, reaching a consensus on worldwide quality standards will not be easy. Yet, beyond these challenges, there are many opportunities being created for international development agencies to increase their capacity for impact.

Biomedical Technology↗

PubMed2004

Screening for cervical cancer in developing countries.

Cervical cancer is the most common malignancy amongst females in developing countries, mainly due to a lack of precursor screening. This absence of screening is the result of inherent disadvantages of the Pap smear: high cost, low sensitivity, the need for a laboratory with high human expertise and a complex screening program logistic system. The prerequisites for screening in a developing country include a screening method that is affordable, which can be effectively applied once in a lifetime at the age of 30-35 years, provide an immediate result and thereby allowing for on-site treatment of positive cases. None of the current screening methods comply with these prerequisites. More research is necessary into different combinations of tests, which improve sensitivity. On-site human papillomavirus (HPV) identification, alone or in combination with other tests, is promising. Another promising development is immunization against HPV infection, either as a preventative measure or for stimulating immunity in infected women.

Developing Countries↗

PubMed2002

Rating maternal and neonatal health services in developing countries.

OBJECTIVE: To assess maternal and neonatal health services in 49 developing countries. METHODS: The services were rated on a scale of 0 to 100 by 10 - 25 experts in each country. The ratings covered emergency and routine services, including family planning, at health centres and district hospitals, access to these services for both rural and urban women, the likelihood that women would receive particular forms of antenatal and delivery care, and supporting elements of programmes such as policy, resources, monitoring, health promotion and training. FINDINGS: The average rating was only 56, but countries varied widely, especially in access to services in rural areas. Comparatively good ratings were reported for immunization services, aspects of antenatal care and counselling on breast feeding. Ratings were particularly weak for emergency obstetric care in rural areas, safe abortion and HIV counselling. CONCLUSION: Maternal health programme effort in developing countries is seriously deficient, particularly in rural areas. Rural women are disadvantaged in many respects, but especially regarding the treatment of emergency obstetric conditions. Both rural and urban women receive inadequate HIV counselling and testing and have quite limited access to safe abortion. Improving services requires moving beyond policy reform to strengthening implementation of services and to better staff training and health promotion. Increased financing is only part of the solution.

Benchmarking↗

PubMed2005

Health innovation networks to help developing countries address neglected diseases.

Gross inequities in disease burden between developed and developing countries are now the subject of intense global attention. Public and private donors have marshaled resources and created organizational structures to accelerate the development of new health products and to procure and distribute drugs and vaccines for the poor. Despite these encouraging efforts directed primarily from and funded by industrialized countries, sufficiency and sustainability remain enormous challenges because of the sheer magnitude of the problem. Here we highlight a complementary and increasingly important means to improve health equity: the growing ability of some developing countries to undertake health innovation.

Biomedical Research↗

PubMed1998

The utility of Hayashi's quantification theory type 2 for the rapid assessment of the epidemiological survey in the developing countries--in a case of the vaccine coverage survey in Yunnan Province, China.

It is difficult to conduct the epidemiological survey with accurate statistical theory in the developing countries due to the problems especially emerged in the developing countries such as no availability of the accurate population data, limitation of the time for survey, geographical obstacle and financial problems. In the consideration of the health needs in those countries, results of the epidemiological survey should be reflected in the present health projects as rapidly as possible. The authors conducted the survey for the immunization coverage of oral poliomyelitis vaccine(OPV) in China by the questionnaire and interview. The data was analyzed by using the Hayashi's quantification theory type 2 and made clear about the relationship between the health behaviors for immunization among residents and several factors. It is considered that this theorem can provide the obvious numeral materials about multi-factorial cause effect relationship for the decision making and is useful for the rapid assessment or initial survey in the developing countries.

Chi-Square Distribution↗

PubMedDate not supplied

[A decade of child health research in developing countries].

Child mortality continues to be a public health priority world-wide. Even though under-five mortality rates have declined from an estimated 84 per 1000 in 1985-89 to 67 per 1000 in 1999, wide geographical differences persist. During the 1990 World Summit on Children in New York, the world's policy-makers and researchers made improving children's lives by ensuring that each child receives the best care and attention possible their main goal. The strategies identified to achieve this goal have guided and benefited from the progress in child health research throughout the last decade. Indeed, research into the causes of ill-health informs and guides public health programmes to improve the burden of preventable deaths, but it requires sustained and renewed investments for the developing world. In this review paper we have aimed to describe the magnitude of current child morbidity and mortality in the developing world; to review the main advances in child health research since the 1990 World Summit on Children and evaluate the implication of different institutions involved in international child health; to measure the adequacy between priority research setting and public health needs for child health in developing countries; to identify constraints in the application of the research results; and to define key strategies and research challenges that are required in the next decade to respond to child heath needs in developing countries. This assessment is based on a ten-year literature review through Medline and a survey to key international informants in the field of child health in developing countries, using a trilingual open-ended questionnaire. The literature published from January 1990 to June 2001, covering more than 4,700 references, enabled us to review more than 130 articles. We contacted 91 institutions involved in child health, located in 27 countries from five continents, and the response rate to our survey was 49.5%. The current priority health needs of children in developing countries most frequently stated in the literature are the reduction of the burden of malnutrition, diarrhoeal diseases, respiratory diseases, perinatal health, HIV/AIDS, measles and malaria. Based on the survey results, malnutrition (78% of respondents) and perinatal health were the most frequently quoted. Less than 15% of the survey respondents provided an example of a successful application of research in the field of infectious diseases. Political support and conflict of interest are the main constraints mentioned. Malnutrition and non-communicable diseases are considered as main areas of neglect in the field of child health research. Our study shows that the perception of field actors in child health on research priorities does not always correspond to the reality of health needs of children in developing countries. Furthermore, it appears that descriptive epidemiology, evaluation and priority setting strategies are essential tools to guide adequate research activities and further improvement of child health.

Child↗

PubMedDate not supplied

Ends and means in public health policy in developing countries.

International discussions of public health policy strategies in developing countries have been characterized by strong and conflicting positions. Differences regarding the means of health sector improvement can often be traced to differences about the ends, that is, the goals of the health sector. Three types of health sector goals are reviewed: health status improvement, equity and poverty alleviation, and individual welfare (utility) improvement. The paper argues that all three must be considered in developing health sector reform strategies in all countries. Highly normative policy positions often can be attributed a unidimensional affiliation with one health sector goal and denial of the relevance of the others. The current global interest in using cost-effectiveness analysis to set national health priorities is assessed in light of this eclectic approach. Examples are provided of how a health sector strategy based on cost-effectiveness would give sub-optimal solutions. These examples include situations where a private health care sector exists and provides some degree of substitution for publicly provided services; significantly high income elasticities exist for health care such that higher income beneficiaries may differentially capture public subsidies; and market failures exist in insurance. It is argued that these conditions are virtually universal in developing countries. Thus, rational policy development should explicitly consider multiple goals for the health sector.

Developing Countries↗