Browsing by Subject "developing countries"

Now showing 1 - 3 of 3

Open Access
Brain death determination: the imperative for policy and legal initiatives in Sub-Saharan Africa.
(Glob Public Health, 2015-11-13) Waweru-Siika, Wangari; Clement, Meredith Edwards; Lukoko, Lilian; Nadel, Simon; Rosoff, Philip M; Naanyu, Violet; Kussin, Peter S
The concept of brain death (BD), defined as irreversible loss of function of the brain including the brainstem, is accepted in the medical literature and in legislative policy worldwide. However, in most of Sub-Saharan Africa (SSA) there are no legal guidelines regarding BD. Hypothetical scenarios based on our collective experience are presented which underscore the consequences of the absence of BD policies in resource-limited countries (RLCs). Barriers to the development of BD laws exist in an RLC such as Kenya. Cultural, ethnic, and religious diversity creates a complex perspective about death challenging the development of uniform guidelines for BD. The history of the medical legal process in the USA provides a potential way forward. Uniform guidelines for legislation at the state level included special consideration for ethnic or religious preferences in specific states. In SSA, medical and social consensus on the definition of BD is a prerequisite for the development BD legislation. Legislative policy will (1) limit prolonged and futile interventions; (2) mitigate the suffering of families; (3) standardise clinical practice; and (4) facilitate better allocation of scarce critical care resources in RLCs. There is a clear-cut need for these policies, and previous successful policies can serve to guide these efforts.
Open Access
Economic Consequences of Population Change in the Third World
(1988) Kelley, AC
The impact of rapid population growth on economic development in third world countries is explored. "Section I provides an empirical point of reference by summarizing some of the salient demographic trends in the Third World. Section II takes up analytical perspectives useful to assessing the impacts of population on development. A preliminary empirical appraisal of the relationship between population and economic growth is provided in Section III, followed in Sections IV-VI by an examination of the effects of demographic change on the scale of production, the rate of saving and the composition of investment, and the rate and form of technical change in agriculture. Section VII concludes with a summary assessment and some qualifications relating to government policies, ecology, and values.
Open Access
The Pratt Pouch Provides a Three-Fold Access Increase to Antiretroviral Medication for Births outside Health Facilities in Southern Zambia.
(Open Biomed Eng J, 2016) Dahinten, Alexander P; Malkin, Robert A
INTRODUCTION: Modern day antiretroviral therapy allows HIV+ pregnant women to lower the likelihood of viral transmission to their infants before, during, and after birth from 20-45% to less than 5%. In developing countries, where non-facility births may outnumber facility births, infant access to safe antiretroviral medication during the critical first three days after birth is often limited. A single-dose, polyethylene pouch ("Pratt Pouch") addresses this challenge by allowing the medication to be distributed to mothers during antenatal care. METHODS: The Pratt Pouch was introduced as part of a one year clinical feasibility study in two districts in Southern Province, Zambia. Participating nurses, community health workers, and pharmacists were trained before implementation. Success in achieving improved antiretroviral medication access was assessed via pre intervention and post intervention survey responses by HIV+ mothers. RESULTS: Access to medication for HIV-exposed infants born outside of a health facility increased from 35% (17/51) before the introduction of the pouch to 94% (15/16) after (p<0.05). A non-significant increase in homebirth rates from 33% (pre intervention cohort) to 50% (post intervention cohort) was observed (p>0.05). Results remained below the national average homebirth rate of 52%. Users reported minimal spillage and a high level of satisfaction with the Pratt Pouch. CONCLUSION: The Pratt Pouch enhances access to infant antiretroviral medication in a rural, non-facility birth setting. Wide scale implementation could have a substantial global impact on HIV transmission rates from mother to child.