Gender digital equality in ICT interventions in health : evidence from IDRC supported projects in developing countries

Also published in Community informatics, vol. 5, no. 3-4, 2009 http://ci-journal.net/index.php/ciej/article/view/526/512The most critical factor for addressing gender inequality in e-Health programs is ensuring that gender analysis is integrated into the design of e-Health initiatives. The paper explores questions of gender inequality, discussed from the perspectives of sociology of health; and in ICT4D with specific reference to e-Health projects. It investigates gender integration in IDRC supported projects in developing countries. These are evaluated to determine whether they integrate gender analysis into the design and implementation of the project, including considerations of gender and social inequality and the constraints to women and men benefiting from e-Health

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Mobiles are leading the way : a review of IDRC projects

The Information Technology for Development (ICT4D) programme of the International Development Research Centre (IDRC) has played a critical role in identifying the operational effectiveness of mobile phones in developing societies. The impact the mobile telephone has had on livelihoods is a central concern of ICT4D. This journal article reviews aspects pf the IDRC ICT4D programme. Case studies illustrate the active social and economic role played by mobile telephones

Centre internship / Stagiaire au CRDI

In the context of the rapid growth of mobile phone penetration in developing countries, mobile telephony is currently considered to be particularly important for development. Yet, until recently, very little systematic evidence was available that shed light on the developmental impacts of mobile telecommunication. The Information and Communication Technology for Development (ICT4D) program of the International Development Research Centre (IDRC), Canada, has played a critical role in filling some of the research gaps through its partnerships with several key actors in this area. The objective of this paper is to evaluate the case of mobile phones as a tool in solving development problems drawing from the evidence of IDRC supported projects. IDRC has supported around 20 projects that cut across several themes such as livelihoods, poverty reduction, health, education, the environment and disasters. The projects will be analyzed by theme in order to provide a thematic overview as well as a comparative analysis of the development role of mobile phones. In exploring the evidence from completed projects as well as the foci of new projects, the paper summarizes and critically assesses the key findings and suggests possible avenues for future research

Gender digital equality in ICT interventions in health: Evidence from IDRC supported projects in developing countries

New information and communication technologies (ICTs) such as mobile phones and the Internet are considered important instruments for advancing social and economic development throughout the world. The benefits of ICTs, however, have not been evenly distributed among individuals with different socioeconomic status. For example, few studies consider how ICTs affect men and women differently. The dearth of studies that integrate gender analysis is particularly true in the case of ICT interventions in the health sector, broadly known as e-Health. e-Health refers to the use of&nbsp; ICTs in different aspects of healthcare including healthcare delivery, administration, education and communication. While there is a growing focus on the potential impact of e-Health application and practices in the developing countries, little attention is given to how the technologies can address women&rsquo;s health concerns or how particular interventions affect men and women differently. The objective of this paper is to explore the gender dimensions of e-Health interventions in developing countries.&nbsp; A select number of projects funded by Canada&rsquo;s International Development Research Centre (IDRC) are systematically analyzed to draw out good practices in integrating gender analysis in e-Health research projects.&nbsp; We conclude by summarizing the good practices and applying them to analyze new projects to ensure gender is integrated adequately.&nbsp; The paper underscores that e-Health interventions in developing countries need to better articulate the social processes of inequality that affect access and use by men and women

Nonprofits' engagement with the private and public sectors: the case of providing essential healthcare in rural Bangladesh

This paper presents a case study which was developed as one of the deliverables of the Teaching Research and Development Grant received from the Academy of Marketing, UK. It presents the case of the BRAC Health Programme that provides essential medicines and healthcare services to the rural poor of Bangladesh through the network of its own micro-finance programme, while utilising government facilities and enhancing the distribution channel of the private sector pharmaceutical companies operating there. Because of lack of financial resources and know-how, the public sector cannot provide essential services like health and education to all the people in developing countries. BRAC's Health Programme tackles this problem to an extent with the help of its community health volunteers who take essential health services to the remote and rural corners of the country. It is a good example of cross-sectoral working in partnership with NGOs in social marketing in developing countries

Determinants of Cellphone Usage among Sea Fisher’s During Marine Fishing in Selected Coastal Villages of Bangladesh

The cell phone can provide numerous benefits to sea fishers who risk their lives and resources for making livelihoods. This article is based on the firm assumption that the use of the cell phone during marine fishing can contribute to income, security and risk reduction. This study adds to the empirical evidence of determinants of cell phone use by fishers during marine fishing. For the purpose of reaching objectives, the study has drawn quantitative data generated through structured face-to-face interviews with 200 randomly selected fishers from three selected villages adjacent to the Bay of Bengal in the mid coastal area of Bangladesh during the period January to February 2016. Descriptive statistics, inferential statistics and binary logistic regression model is used to analyze the data. The study concludes that fishers own cell phone (odds ratio[OR]=6.56, 95 per cent confidence interval [CI]: 1.69,25.44), enjoying the availability of cell phone network (OR=166.20, 95 per cent CI:38.35, 720.28), earned low (OR=20.35, 95 per cent CI:4.24, 97.28) to medium income (OR=9.53, 95 per cent CI:0.99, 91.12) form sea fishing have a greater tendency to use cell phones, while fishers had low information need (OR=0.11, 95 per cent CI:0.01, 1.13) represented lower use of cell phone during marine fishing. Thus, it is essential to build cell phone infrastructure bases in the potential fishing zones of Bangladesh and supplying cell phone devices at subsidised cost

Unlocking Solar Potential: Advancements in Automated Solar Tracking Systems for Enhanced Energy Utilization

The use of solar tracking systems has become vital and has established itself as a vital element in the generation of solar energy by enhancing the collection efficiency. This paper seeks to understand the necessity of shifting from conventional energy sources and why issues like scarcity of fossil fuel, and pollution are some of the hurdles toward achieving sustainable energy. Solar power, in particular, is one of the lights at the end of this tunnel since it pioneers a shift towards the usage of clean energy in the world. The subject of interests of the study is on how tracking systems help in maximizing energy collection from solar systems by interchanging it with the movement of sun’s path. It discusses the method that was followed, which involves selecting component, designing circuit and developing software together with presenting empirical data that was obtained from a three-day, Twenty-four-hour experiment. Outcomes show that there is an improvement on voltage stability, the level of solar irradiation and temperature regulation when the system is applied as compared to static system and its applicability for the enhancement of the renewable energy harnessing methods by using the solar tracking technology. Finally, it outlines the future research directions to continue exploring the proposed methods and its wider impact on renewable energy generation