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Showing results for tags 'Middle income countries'.
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Content ArticleAlthough there have been significant advancements over the past decades, substantial gaps in safety and quality remain in healthcare delivery, especially in low- and middle-income countries (LMICs) and the public sector. Even within the same country, there are notable geographical disparities in equitable access to safe care. Healthcare organizations (HCOs) and countries worldwide face numerous challenges and have competing priorities for focused interventions, often struggling to invest adequately in safety and quality. In alignment with the Global Patient Safety Action Plan 2021-2030 and JCI’s vision, JCI introduces Patient Safety Pathways. This pioneering initiative aims to develop, strengthen, sustain, and enhance patient safety initiatives with actionable plans, especially for organisations in the early stages of establishing their patient safety and quality infrastructure. JCI is working in collaboration with countries and organizations to advance safer patient care. The Patient Safety Pathways initiative focuses on the needs of HCOs starting their journey towards eliminating avoidable patient harm by creating pathways for incremental improvements and transformative changes. This collaboration includes working with Ministries of Health (MOHs), national and international HCOs, and patient advocacy organizations at various stages of development to enhance the quality of healthcare and patient safety. The Pathways Initiative components: Patient Safety Grand Rounds A series of online discussions to engage thought leaders in patient safety at policy, systems, and healthcare delivery levels through open dialogue, collaborative learning, problem-solving, and sharing of best practices and success stories. JCI Training of Trainers Develop a cadre of trainers as “Patient Safety Champions.” These champions will be equipped with the necessary knowledge and tools who in turn can help develop skills and competencies for healthcare professionals, fostering a culture of safety at the national and organizational level. Needs assessment and technical support Tailored technical support to selected HCOs from LMICs, based on their identified needs and gaps.
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News Article
Lack of access to antibiotics is driving spread of superbugs, finds research
Patient Safety Learning posted a news article in News
Less than 7% of people with severe drug-resistant infections in poorer countries get the antibiotics they need, a new study suggests, with researchers warning that not only is this causing suffering and deaths, but is also likely to be driving antimicrobial resistance (AMR). With AMR forecast to cause 1.9m deaths a year by 2050, they are calling for urgent action, akin to the fight earlier this century to get HIV drugs to Africa’s virus hotspots. “The stark reality is that most people with highly drug-resistant infections are not getting access to the antibiotics they need,” said Dr Jennifer Cohn, a senior author of the study. AMR is a process whereby bacteria and other pathogens evolve resistance to treatments typically used against them. One driver is the overuse of antibiotics, with greater exposure to drugs offering bacteria more chances to learn how to evade them. But a focus on overuse has meant access has been neglected, the experts warn. Read full story Source: The Guardian, 30 April 2025 -
Content ArticleDespite progress in reducing neonatal and child mortality, inequalities in access to age-appropriate medicines remain, particularly in low-income and middle-income countries. The Global Accelerator for Paediatric Formulations (GAP-f), a WHO-hosted network established in 2020, addresses these gaps by uniting 33 partners to promote innovation and access to child-friendly medicine formulations. This article describes phase 2 (2022–24) of GAP-f's work, which focused on: therapeutic areas where innovation and access efforts often did not have stakeholder alignment and coordination of designing and implementing innovative clinical trial methodology. engaging with regulators to address systemic barriers. identifying novel technologies for safe and effective delivery. collaborating across stakeholders for product roll out.
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Content ArticleHospital accreditation programmes are globally recognised as an important tool for enhancing quality and safety in healthcare; however, many programs in low- and middle-income countries (LMICs) are discontinued shortly after their establishment. This scoping review synthesized published evidence on factors influencing the establishment and sustainability of hospital accreditation programs in LMICs, to provide guidance to health stakeholders involved in these processes. The included studies reported upon a broad range of patterns, innovations, influencers, enablers, and barriers concerning accreditation program establishment in LMICs. Key questions emerged, including the degree of government involvement, incorporation of international standards versus development of bespoke standards, the use of local versus external surveyors, the use of financial and other incentives to promote engagement, and mandatory versus voluntary approaches of program implementation. Resource constraints were recognised as the most important barriers to sustainable establishment, while the influence of global accreditation and donor agencies were viewed as presenting both positive and negative impacts. Health stakeholders are encouraged to reflect upon and apply the ACES-GLEAM framework, incorporating the guiding principles outlined in this paper, to help establish hospital accreditation programs in LMICs in a way that facilitates sustainability and effectiveness over time.
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News Article
An invisible medical shortage: Oxygen
Patient Safety Learning posted a news article in News
Oxygen is vital to many medical procedures. But a safe, affordable supply is severely lacking around the world, according to a new report. At the height of the Covid-19 pandemic, millions of people in poor nations died literally gasping for breath, even in hospitals. What they lacked was medical oxygen, which is in short supply in much of the world. On Monday, a panel of experts published a comprehensive report on the shortage. Each year, the report noted, more than 370 million people worldwide need oxygen as part of their medical care, but fewer than 1 in 3 receive it, jeopardising the health and lives of those who do not. Access to safe and affordable medical oxygen is especially limited in low- and middle-income nations. “The need is very urgent,” said Dr. Hamish Graham, a pediatrician and a lead author of the report. “We know that there’s more epidemics coming, and there’ll be another pandemic, probably like Covid, within the next 15 to 20 years.” The report, published in The Lancet Global Health, comes just weeks after the Trump administration froze foreign aid programmes, including some that could improve access to oxygen. Boosting the availability of medical oxygen would require an investment of about $6.8 billion, the report noted. “Within the current climate, that’s obviously going to become a bit more of a challenge,” said Carina King, an infectious disease epidemiologist at the Karolinska Institute and a lead author of the report. “We’re not pitting oxygen against other priorities, but rather that it should be embedded within all of those programs and within those priorities,” Dr. King said. “It’s completely fundamental to a functioning health system.” Read full story (paywalled) Source: The New York Times, 17 February 2025 -
News ArticleInfections that were once easy to cure with antibiotics are becoming untreatable, and a novel treatment for bacterial infection is the holy grail for teams of researchers around the world. However, severe financial challenges have left the pipeline of new antibiotics thin and fragile – and treatments are unavailable in many of the places they are most needed. Big pharmaceutical companies have left the field in search of greater profits elsewhere, and talented researchers have opted for new jobs in more stable sectors. The number of deaths caused by drug-resistant bacteria in 2019 was 1.27 million, and economic costs are on track to exceed $1tn (£765bn) by 2030. The death rate is highest in sub-Saharan Africa, where children under five are particularly affected. “This is a problem which truly affects the whole world, rich and poor countries alike,” says Jeremy Knox, the head of infectious disease policy at Wellcome. “[But] the impact is definitely asymmetrical. People in low and middle-income countries are bearing a far greater burden.” Global leaders will gather in New York this month to discuss antimicrobial resistance (AMR) at the UN general assembly. They will consider how to convince researchers and companies it is worth their while to create new replacement drugs, and how to improve access to tests and treatments. Read full story Source: The Guardian, 16 September 2024
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News Article
WHO publishes first ever list of fungal infections that pose ‘major threat’
Patient Safety Learning posted a news article in News
The World Health Organization has published its first ever list of lethal fungal infections that represent a threat to public health. Experts have noticed an increase in deadly fungal disease, with drug-resistant bacterial infections now responsible for roughly 1.27 million deaths every year. “Fungal pathogens are a major threat to public health as they are becoming increasingly common and resistant to treatment,” WHO said. The types of fungal infections listed often affect severely ill patients and those with significant underlying problems with their immune system, including people with cancer, HIV or AIDs, organ transplants, chronic respiratory disease or tuberculosis. “Emerging from the shadows of the bacterial antimicrobial resistance pandemic, fungal infections are growing, and are ever more resistant to treatments, becoming a public health concern worldwide,” said Dr Hanan Balkhy, WHO assistant director-general, antimicrobial resistance, said. In its new report, the WHO warns that there is only limited access to quality diagnostics and treatment for these developing fungal diseases. Medicines are often unavailable in low and middle income countries, leading to increased deaths among these populations. One deadly fungal pathogen, Candida auris, which is resistant to multiple drugs, is particularly difficult to eradicate from hospitals - even with intensive infection prevention measures, the WHO said. This means hospital wards often have to be shut down for prolonged periods of time when Candida auris is detected. Read full story Source: The Independent, 26 October 2022 -
Content ArticleDespite global consensus that access to pharmaceuticals as a lifesaving commodity is a fundamental human right, 2 billion people globally still lack access to medicines. In this blog, Karrar Karrar, Access to Medicines Adviser at Save the Children, looks at why weak regulatory systems are a major patient safety issue in low- and middle-income countries. He highlights that lack of regulatory capacity results in falsified, substandard and fake medicines making their way into local pharmacies and hospitals. It also delays patient access to new medicines due to lengthy processing times. Karrar argues that governments must prioritise investments in strengthening national regulatory systems and increase cross-country collaboration to strengthen regional and global regulatory networks and systems.
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Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Tony talks to us about making patient safety everyone’s responsibility, the importance of open communication and how his understanding of different global health systems has broadened his perspective on what matters in patient care. -
News Article
Five million children worldwide die before fifth birthday, says UN
Patient-Safety-Learning posted a news article in News
Five million children worldwide died before their fifth birthday in 2021, with almost half (47%) dying during their first month, according to new UN figures. Most of the deaths could have been prevented with better healthcare, say campaigners, adding that deaths among newborn babies haven’t reduced significantly since 2017. Children born in sub-Saharan Africa are 15 times more likely to die in childhood than children in Europe and North America. UN figures also show that 1.9 million babies were stillborn during 2021, more than three-quarters (77%) in sub-Saharan Africa and in south Asia. The risk of a woman having a stillborn baby in sub-Saharan Africa is seven times greater than for women in Europe and North America. Read full story Source: The Guardian, 10 January 2022 -
Content ArticleWorld Pharmacist Day is an initiative by the International Pharmaceutical Federation (FIP) to promote the role that pharmacists play in improving patient safety. In this blog, Roohil Yusuf, Global Pharmacy Advisor at Save the Children, looks at the work of different partners in delivering safe pharmacy services in Afghanistan, Yemen and Sudan.
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Content ArticleTo overcome this preventable disease we need to invest in failing infrastructure and tackle humanitarian crises at cholera’s roots, says Petra Khoury in this BMJ article. Once thought to be close to eradication, cholera is back—dehydrating and killing people within hours and ravaging communities across six continents. Despite the alarming numbers of cases and deaths over the past year, decision makers are averting their eyes, leaving people to die from a preventable and treatable disease. The healthcare community should sound the alarm for immediate actions. A strong and global emergency response is urgently needed, but it is only a first step. More than ever the world must invest in water and sanitation systems and prepare communities before outbreaks occur.
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Content ArticleGlobally, the under-five mortality rate (U5MR) fell to 38 deaths per 1,000 live births in 2021, while under-five deaths dropped to 5.0 million. Although this demonstrates a decrease, this immense, intolerable and mostly preventable loss of life was carried unequally around the world , and children continue to face widely differing chances of survival based on where they are born. In contrast to the global rate, children born in sub-Saharan Africa are subject to the highest risk of childhood death in the world with a 2021 U5MR of 74 deaths per 1,000 live births – 15 times higher than the risk for children in Europe and Northern America and 19 times higher than in the region of Australia and New Zealand This report outlines and analyses figures from The United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME) to examine levels and trends in child mortality around the world during 2022. Key findings Almost everywhere in the world, a child born today has a better chance at surviving to age 5 than in 1990, but inequities persist among and within countries Divergent chances of survival start from the earliest ages Globally and across all regions, the probability of dying between the ages of 5 and 24 is lower than for children under 5 years old, yet more than 2 million children, adolescents and youth aged 5—24 died in 2021
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EventuntilMedication-related harm accounts for up to half of the overall preventable harm in medical care. Patients in low- and middle-income countries are twice more likely to experience preventable medication harm than patients in high-income countries. Considering this huge burden of harm, “Medication Safety” has been selected as the theme for World Patient Safety Day 2022. To commemorate the day, WHO is organizing a Global Virtual Event, calling on all stakeholders to join efforts globally for “Medication Without Harm”. During the event, stakeholders will discuss medication safety issues within the strategic framework of the WHO Global Patient Safety Challenge: Medication Without Harm, including 1) Patients and the public, 2) Health and care workers, 3) Medicines, and 4) Systems and practices of medication. Interpretations will be available in Arabic, Chinese, English, French, Hindi, Portuguese, Russian and Spanish. Register for the webinar Save the date-flyer_Global Virtual Event WPSD 2022_15 September 2022.pdf
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Content Article
Bulletin of the World Health Organization
Patient Safety Learning posted an article in WHO
The Bulletin of the World Health Organization is a fully open-access monthly journal of public health with a special focus on low and middle-income countries. -
Content ArticleWorldwide, more than 99% of the burden of measles infections and deaths affects populations in low-income and middle-income countries. Measles accounts for 3% of the global mortality of children younger than five years, constituting 90% of deaths from measles, and rubella is the main vaccine-preventable cause of birth defects. Vaccine coverage, both through routine immunisation and supplementary immunisation activities, remains below targets for measles elimination, with considerable heterogeneity between and within countries. This Lancet article looks at how microneedle patches (MNPs) could potentially improve coverage of childhood vaccinations by providing a more thermostable, individual-dose, injection-free vaccine delivery device suitable for administration by local, non-medical personnel. MNPs could also reduce wasted vaccine doses, needle-stick injuries and breaks in the cold chain, as well as making waste management easier.
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Content ArticleThis editorial in The Lancet Infectious Diseases reflects on the consequences of the infected blood scandal, in which more than 30,000 people in the UK were infected after receiving contaminated blood products in the 1970s and 1980s. It examines the systems in place for blood donation and transfusion in low and middle income countries (LMICs) and argues that the chance of a blood scandal coming to light in LMICs is much higher. This is because blood donations in many LMICs go against the WHO recommendation of national blood systems being based on blood supply from voluntary donors. Instead, they rely heavily on paid-for donations and family or replacement donations, which are unsafe due to the higher prevalence of bloodborne infections.
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EventuntilPatient safety is a critical global public health issue and is essential if health systems are to advance and achieve universal health coverage (UHC). Every year, an inadmissible number of patients are harmed or die because of unsafe and poor-quality healthcare, exerting a very high global burden especially in low- and middle-income countries (LMICs). Even before the pandemic, 1 in 10 patients in high-income countries were harmed from safety lapses during their hospital care. This number is greater in LMICs where adverse events in healthcare contribute to around 2.6 million hospital deaths each year. With the unprecedented COVID-19 pandemic, patient safety has become an even more crucial area for international cooperation. The United Kingdom of Great Britain and Northern Ireland invites you to join a high-level event on patient safety, co-sponsored by the World Health Organization, to: Illustrate the scale and significant burden of avoidable harm in healthcare globally and its impact on patients, families, healthcare workers, health system finances, communities and societies. Advocate a vision for eliminating avoidable harm in healthcare and demonstrate the need to prioritise patient safety as a global health priority, including by supporting strategic patient safety initiatives. Advocate for all countries to designate patient safety officers responsible for the coordination of patient safety implementation at national and facility levels. Register
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Content ArticleLast November, the UK, under its G7 Presidency, convened an event on patient safety entitled Patient Safety: from Vision to Reality, co-sponsored with the World Health Organization (WHO). The event was designed to build upon recent prominent initiatives taken forward by the UK Government and partner Member States to demonstrate the importance of taking action and facilitating collaboration to advance patient safety as an urgent global priority. This includes: annual Global Ministerial Summits on Patient Safety (from 2016) a Resolution on Global Action on Patient Safety (adopted by the World Health Assembly in 2019); and, the Global Patient Safety Collaborative developed in 2018 by the UK Government in partnership with the WHO to support patient safety improvement in low- and middle-income countries. Coupled with WHO’s Global Patient Safety Action Plan 2021-2030 and an annual World Patient Safety Day on 17th September, such initiatives will ensure that momentum can be maintained in order to tackle the truly global issue of patient safety within the wider context of strengthening national health systems. The link below is a recording of the event.
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Content Article
In this interview, Dr Alice Ladur talks about her experience of using the Whose Shoes? approach to increase male partners’ involvement in maternity care in Uganda. Whose Shoes? is a co-production tool that uses a board game to help participants share experiences and reflect on their experiences of services. Alice describes the importance and impact of involving partners and families in antenatal care and highlights the value of adapting interventions to specific cultures and locations. -
Content Article
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This is the first in our new series of Patient Safety Spotlight interviews, where we talk to different people about their role and what motivates them to make health and social care safer. Josie tells us about the nursing error that first sparked her interest in patient safety, how a just culture helps healthcare workers and systems learn from their mistakes, and how her love of skiing has inspired her to think differently about risk in healthcare. -
Content Article
Blog - Safe medicine saves lives (14 January 2022)
Patient-Safety-Learning posted an article in Medication
In this blog, Roohil Yusuf, Global Pharmacy Advisor at Save the Children, looks at the different factors involved in providing access to life-saving medication, including planning, sourcing, use and management of medicines. She tells the story of Habibah, a three-year-old girl from Nigeria, who was able to access medication for Severe Acute Nutrition and tuberculosis at one of Save the Children's treatment centres. She also looks at the dangers of counterfeit and expired medicines, and explores how organisations can take steps to prevent poor quality, counterfeit or expired medicines being given to patients. -
Content ArticleThe “WHO handbook for national quality policy and strategy” outlines an approach for the development of national policies and strategies to improve the quality of care. Such policy and strategy can help clarify the structures, roles and responsibilities within national quality efforts, support the institutionalisation of a culture of quality, and secure buy-in from health system leaders and stakeholders. The handbook is not a prescriptive process guide but is designed to support teams developing policies and strategies in this area, and very much recognizes the varied expertise, experience and resources available to countries. It outlines eight essential elements to be considered by teams developing national quality policy and strategy: national health goals and priorities; local definition of quality; stakeholder mapping and engagement; situational analysis; governance and organizational structure; improvement methods and interventions; health management information systems and data systems; quality indicators and core measures. The NQPS handbook was co-developed with countries each finding themselves at different stages of the development and execution of national quality policies and strategies and was informed by the review of a sample of more than 20 existing quality strategies across low-, middle- and high-income countries globally.
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Content ArticleThere has been little evaluation of strategies to strengthen regulation in LMIC, a notable exception being the Kenya Patient Safety Impact Evaluation (KePSIE), a collaboration between the Kenyan Ministry of Health and the World Bank. KePSIE is one of the worlds largest trials on improving patient safety, testing at scale complementary approaches to protect patients and prevent disease outbreaks. KePSIE provides validated tools to measure patient safety and assess facility performance in resource-poor primary care settings across multiple domains; development of an inspection checklist in collaboration with the country and large-scale pilot of inspections using a professional cadre and globally relevant empirical evidence on the effectiveness of government inspections and consumer empowerment to ensure patient safety.
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Content ArticleHealth systems in low and middle income countries (LMIC) are increasingly pluralistic, involving a wide mix of public, not-for-profit and for-profit providers. Regulation should be a key foundation of the Government's stewardship role of these heterogeneous facilities, but performance of this function is generally weak, with serious consequence for patient safety and quality of care. There has been little evaluation of strategies to strengthen regulation in LMIC, a notable exception being the Kenya Patient Safety Impact Evaluation (KePSIE), a collaboration between the Kenyan Ministry of Health and the World Bank. This randomised controlled trial is assessing the impact of a set of innovative regulatory interventions in public and private facilities in three Kenyan counties. These comprise the use of the Joint Health Inspections Checklist (JHIC), which synthesises the areas covered by all the regulatory Boards and Councils; increased inspection frequency; risk-based inspections where warnings, sanctions and time to re-inspection depend on inspection scores; and display of regulatory results outside facilities. The KePSIE trial will provide a rigorous quantitative assessment of these regulatory strategies. The results are expected to make an important contribution to the limited evidence base on regulation and regulatory reform. The findings will be of substantial benefit to those concerned with regulatory reform and the improvement of quality and safety more generally in Kenya and other LMIC settings.
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