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Factors affecting the attractiveness of medical tourism destination: an empirical study on India- review article

Sultana S, Haque A, Momen A, Yasmin F

Iran J Public Health, 2014 Jul;43(7):867-76.
PMID: 25909055

In this edge, medical tourism is not a new idea. Medical treatment is one of the essential demands of human beings and it requires high quality and intensive care. Beside western world, few developing countries are playing key roles as medical tourism destinations. India is one of the leading names among these countries. The purpose of the paper is to find the factors influencing the attractiveness of India as a health tourism destination.

Matched MeSH terms: Developing Countries
Fulltext Formulating a Need-Based Faculty Development Model for Medical Schools in Indonesia

Ambarsarie R, Mustika R, Soemantri D

Malays J Med Sci, 2019 Nov;26(6):90-100.
PMID: 31908590 DOI: 10.21315/mjms2019.26.6.9

Background: The focus of medical schools in developing countries is on fulfilling a quantity of faculty members. A faculty development model will help formulate programmes that accommodate faculty members' needs as well as institutional demands. This study aims to formulate a faculty development model relevant for medical schools in developing countries, specifically Indonesia.
Methods: This is a qualitative study with a phenomenological approach. It starts with a literature review using large databases, followed by interviews with 10 representative experts from medical schools in Indonesia.
Results: Based on the 10 studies retrieved, several components of faculty development were identified as the basis for the model. Ten experts gave input for the model. Components of the model can be grouped into: (i) content, which is materials that need to be delivered; (ii) process components, which depict aspects related to the preparation, execution and evaluation of sustainable faculty development; and (iii) components in the educational system that affect faculty development implementation.
Conclusion: A comprehensive review and development process has likely made this faculty development model suitable for medical schools in Indonesia. Breaking the model into components may help medical schools to prioritise certain aspects related to faculty development programmes.

Matched MeSH terms: Developing Countries
Determinants of multimorbidity in low- and middle-income countries: A systematic review of longitudinal studies and discovery of evidence gaps

Tan MMC, Barbosa MG, Pinho PJMR, Assefa E, Keinert AÁM, Hanlon C, et al.

Obes Rev, 2024 Feb;25(2):e13661.
PMID: 38105610 DOI: 10.1111/obr.13661

Multimorbidity-the coexistence of at least two chronic health conditions within the same individual-is an important global health challenge. In high-income countries (HICs), multimorbidity is dominated by non-communicable diseases (NCDs); whereas, the situation may be different in low- and middle-income countries (LMICs), where chronic communicable diseases remain prominent. The aim of this systematic review was to identify determinants (including risk and protective factors) and potential mechanisms underlying multimorbidity from published longitudinal studies across diverse population-based or community-dwelling populations in LMICs. We systematically searched three electronic databases (Medline, Embase, and Global Health) using pre-defined search terms and selection criteria, complemented by hand-searching. All titles, abstracts, and full texts were independently screened by two reviewers from a pool of four researchers. Data extraction and reporting were according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methodological quality and risk of bias assessment was performed using the Newcastle-Ottawa Scale for cohort studies. Data were summarized using narrative synthesis. The search yielded 1782 records. Of the 52 full-text articles included for review, 8 longitudinal population-based studies were included for final data synthesis. Almost all studies were conducted in Asia, with only one from South America and none from Africa. All studies were published in the last decade, with half published in the year 2021. The definitions used for multimorbidity were heterogeneous, including 3-16 chronic conditions per study. The leading chronic conditions were heart disease, stroke, and diabetes, and there was a lack of consideration of mental health conditions (MHCs), infectious diseases, and undernutrition. Prospectively evaluated determinants included socio-economic status, markers of social inequities, childhood adversity, lifestyle behaviors, obesity, dyslipidemia, and disability. This review revealed a paucity of evidence from LMICs and a geographical bias in the distribution of multimorbidity research. Longitudinal research into epidemiological aspects of multimorbidity is warranted to build up scientific evidence in regions beyond Asia. Such evidence can provide a detailed picture of disease development, with important implications for community, clinical, and interventions in LMICs. The heterogeneity in study designs, exposures, outcomes, and statistical methods observed in the present review calls for greater methodological standardisation while conducting epidemiological studies on multimorbidity. The limited evidence for MHCs, infectious diseases, and undernutrition as components of multimorbidity calls for a more comprehensive definition of multimorbidity globally.

Matched MeSH terms: Developing Countries
Fulltext Relationships between cancer pattern, country income and geographical region in Asia

Ng CJ, Teo CH, Abdullah N, Tan WP, Tan HM

BMC Cancer, 2015;15:613.
PMID: 26335225 DOI: 10.1186/s12885-015-1615-0

BACKGROUND: Cancer incidence and mortality varies across region, sex and country's economic status. While most studies focused on global trends, this study aimed to describe and analyse cancer incidence and mortality in Asia, focusing on cancer site, sex, region and income status.
METHODS: Age-standardised incidence and mortality rates of cancer were extracted from the GLOBOCAN 2012 database. Cancer mortality to incidence ratios (MIRs) were calculated to represent cancer survival. The data were analysed based on the four regions in Asia and income.
RESULTS: Cancer incidence rate is lower in Asia compared to the West but for MIR, it is the reverse. In Asia, the most common cancers in men are lung, stomach, liver, colorectal and oesophageal cancers while the most common cancers in women are breast, lung, cervical, colorectal and stomach cancers. The MIRs are the highest in lung, liver and stomach cancers and the lowest in colorectal, breast and prostate cancers. Eastern and Western Asia have a higher incidence of cancer compared to South-Eastern and South-Central Asia but this pattern is the reverse for MIR. Cancer incidence rate increases with country income particularly in colorectal and breast cancers but the pattern is the opposite for MIR.
CONCLUSION: This study confirms that there is a wide variation in cancer incidence and mortality across Asia. This study is the first step towards documenting and explaining the changing cancer pattern in Asia in comparison to the rest of the world.

Matched MeSH terms: Developing Countries/economics; Developing Countries/statistics & numerical data
A preliminary study of using active vision guided robotic arm for bone drilling in a developing country

Abdullah MZ, Awang MS, Tan YC, Abdullah JM

J Neurol Surg A Cent Eur Neurosurg, 2014 Mar;75(2):155-7.
PMID: 23636911 DOI: 10.1055/s-0032-1330954

The study assesses the capability and accuracy of a robotic arm to perform burr holes.

Matched MeSH terms: Developing Countries
Fulltext End stage renal failure mimicking as acute renal failure in developing countries

Lal C, Gupta A, Khaira A, Tiwari SC

Med J Malaysia, 2009 Jun;64(2):184.
PMID: 20058588

Sir, We here are highlighting the scenario of presentation of renal dysfunction in developing countries like India where a large number of patients present clinically as acute renal failure (ARF) but on thorough evaluation found to have advanced stages of chronic kidney disease (CKD stages 4 and 5)1 . Historically these patients are symptomatic for few days prior to presenting. Preceding slight unwell-ness is ignored either by patient or his family physician. They are often being treated with non-specific medications like analgesics and multivitamins which act as placebo. Iron deficiency anemia is unevaluated for a renal cause. Non-standardized laboratories under diagnose early CKD. Ultrasound imaging too is of poor quality. All the more there are no nationalized health screening programmes. To add to the dismal scenario, at the tertiary care centres they are initially admitted as ARF, with a hope of significant recovery. But later on they turn out to be CKD 5.

Matched MeSH terms: Developing Countries
Fulltext Preventing tuberculosis in healthcare workers of the radiology department: a Malaysian perspective

Tan L, Kamarulzaman A

Biomed Imaging Interv J, 2006 Jan;2(1):e3.
PMID: 21614220 MyJurnal DOI: 10.2349/biij.2.1.e3

Tuberculosis (TB) is a well recognised occupational hazard for healthcare workers (HCWs). Concerns on the safety of healthcare settings in Malaysia was raised following a report of 25 HCWs working in 11 general hospitals in Malaysia who were infected with TB in 2004 being publicised in the media recently. As the disease burden in general is high in Malaysia, due attention should be given to this disease in our healthcare facilities including the radiology department, an often neglected area in TB infection control programmes. This article focuses on the key control measures that can be implemented in radiology departments in a developing country with limited resources.

Matched MeSH terms: Developing Countries
E-health implementation challenges in Iranian medical centers: a qualitative study in Iran

Sharifi M, Ayat M, Jahanbakhsh M, Tavakoli N, Mokhtari H, Wan Ismail WK

Telemed J E Health, 2013 Feb;19(2):122-8.
PMID: 23374035 DOI: 10.1089/tmj.2012.0071

E-health encompasses a wide scope and has excellent potential to grow in the future. Growing numbers of experts believe that e-health will fuel the next breakthroughs in health system improvements throughout the world. There is frequent evidence that largely indicates failures or unsustainable e-health implementations in different countries for different reasons. Iran is also a developing country that is presently applying this promising technology for its traditional healthcare delivery.

Matched MeSH terms: Developing Countries
Fulltext Genitourinary tuberculosis: an atypical clinical presentation

Lim PS, Atan IK, Naidu A

Case Rep Obstet Gynecol, 2012;2012:727146.
PMID: 23320216 DOI: 10.1155/2012/727146

Genitourinary tuberculosis is one of the common forms of extrapulmonary tuberculosis. We report a case of atypical genitourinary tuberculosis: massive uterovaginal prolapse with cervical lesion mimicking cervical carcinoma. This particular case highlights the problem of healthcare in most of the developing countries. Lack of patient education, awareness, and access to a healthcare system resulted in a complicated situation. In an endemic area or in an immunocompromised individual, a higher index of suspicion would allow early recognition and treatment institution to minimise its late consequences as well as spreading of the disease. Though anti-TB is the mainstay of treatment, surgical intervention might be needed in selected cases.

Matched MeSH terms: Developing Countries
Predictors affecting breast self-examination practice among undergraduate female students in Klang Valley, Malaysia

Akhtari-Zavare M, Lattif LA, Juni MH, Md Said S, Ismail IZ

J Obstet Gynaecol Res, 2015 Dec;41(12):1982-7.
PMID: 26554636 DOI: 10.1111/jog.12819

Abstract
AIM:
Breast cancer is the most common cancer among women worldwide, including Malaysia. In developing countries, predictors affecting breast self-examination (BSE) practice are different. This cross-sectional study was conducted to determine the prevalence of BSE practice and the predictors affecting BSE practice among undergraduate female students in Klang Valley, Malaysia.

MATERIAL AND METHODS:
A cross-sectional study was conducted among 820 female undergraduate students to assess the BSE performance and related determinants of BSE practice in Klang Valley, Malaysia. Data were collected via a self-administered structured questionnaire that was developed for this study.

RESULTS:
The mean age of the respondents was 21.7 ± 1.2 years old. Most of them were single (96.8%), Malay (91.9%) and 19.6% of the participants performed BSE regularly. Multivariate logistic regression modeling revealed that BSE performance was more likely among women who have checked their breast with a doctor (odds ratio = 2.04, P = 0.00), and women who have personal history of breast disease (odds ratio = 4.43, P = 0.03).

CONCLUSION:
The findings showed a low BSE practice rate among young Malaysian women. Hence, the community's breast health awareness is needed to improve breast cancer prevention among young Malaysian women.

KEYWORDS:
Malaysia; breast self-examination; predictors

Matched MeSH terms: Developing Countries
Mechanisation of large-scale agricultural fields in developing countries-a review

Onwude DI, Abdulstter R, Gomes C, Hashim N

J Sci Food Agric, 2016 Mar 4.
PMID: 26940194 DOI: 10.1002/jsfa.7699

Mechanisation of large scale agricultural fields often requires the application of modern technologies such as mechanical power, automation, control and robotics. These technologies are generally associated with relatively well developed economies. The application of these technologies in some developing countries in Africa and Asia is limited by factors such as technology compatibility with the environment, availability of resources to facilitate the technology adoption, cost of technology purchase, government policies, adequacy of technology and appropriateness in addressing the needs of the population. As a result, many of the available resources have been used inadequately by farmers, who continue to rely mostly on conventional means of agricultural production, using traditional tools and equipment in most cases. This has led to low productivity and high cost of production amongst others. Thus, this paper attempts to evaluate the application of present day technology and its limitations to the advancement of large scale mechanisation in developing countries of Africa and Asia. Particular emphasis is given to a general understanding of the various levels of mechanization, present day technology, its management and application to large scale agricultural fields. This review also focuses on/ gives emphasis to future outlook that will enable a gradual, evolutionary, and sustainable technological change. The study concludes that large scale-agricultural farm mechanisation for sustainable food production in Africa and Asia must be anchored on a coherent strategy based on the actual needs and priorities of the large- scale farmers.

Matched MeSH terms: Developing Countries
Fulltext Chronic tibial osteomyelitis in children. A case review at hospital tengku ampuan afzan, kuantan

Shukrimi A, Ariff MS, Zamzuri Z, Mai Ashikin NT

Med J Malaysia, 2015 Feb;70(1):48-51.
PMID: 26032532 MyJurnal

Osteomyelitis in children has various clinical manifestations causing diagnostic and therapeutic difficulties. Inappropriate treatment of acute osteomyelitis may lead to chronic, serious and complicated condition. Chronic osteomyelitis continues to be a major cause of morbidity and disability in children living in developing countries. We present three cases of tibial osteomyelitis that have different presentations and sequalae. Our intention is to alert our colleagues, particularly primary physicians, regarding the variety of presentation and the important of early diagnosis and treatment to reduce the risk of morbidity following osteomyelitis.

Matched MeSH terms: Developing Countries
Perception of community pharmacists towards the barriers to enhanced pharmacy services in the healthcare system of Dubai: a quantitative approach

Rayes IK, Hassali MA, Abduelkarem AR

Pharm Pract (Granada), 2015 06 15;13(2):506.
PMID: 26131039

BACKGROUND: In many developing countries, pharmacists are facing many challenges while they try to enhance the quality of services provided to patients approaching community pharmacies.
OBJECTIVE: To explore perception of community pharmacists in Dubai regarding the obstacles to enhanced pharmacy services using a part of the results from a nation-wide quantitative survey.
METHODS: A questionnaire was distributed to 281 full-time licensed community pharmacists in Dubai. The questionnaire had 5 inter-linked sections: demographic information, information about the pharmacy, interaction with physicians, pharmacists' current professional role, and barriers to enhanced pharmacy services.
RESULTS: About half of the respondents (45.4%, n=90) agreed that pharmacy clients under-estimate them and 52.5% (n=104) felt the same by physicians. About 47.5% (n=94) of the respondents felt that they are legally unprotected against profession's malpractice. Moreover, 64.7% (n=128) stated that pharmacy practice in Dubai turned to be business-focused. In addition, 76.8% (n=252) found that one of the major barriers to enhanced pharmacy services is the high business running cost. Pharmacists screened tried to prove that they are not one of the barriers to optimized pharmacy services as 62.7% (n=124) disagreed that they lack appropriate knowledge needed to serve community and 67.7% (n=134) gave the same response when asked whether pharmacy staff lack confidence when treating consumers or not.
CONCLUSIONS: Although being well established within the community, pharmacists in Dubai negatively perceived their own professional role. They stated that there are number of barriers which hinder optimized delivery of pharmacy services like under-estimation by pharmacy clients and other healthcare professionals, pressure to make sales, and high running cost.

Matched MeSH terms: Developing Countries
Excision biopsy of lymph node--needle fixing technique

Arumainathan U, Kumar M, Raman R

Trop Doct, 2003 Jan;33(1):31.
PMID: 12568517
Matched MeSH terms: Developing Countries
The World Wide Web is a net disservice to medical physicists in developing countries

Ng KH, Niroomand-Rad A, Hendee WR

Med Phys, 2001 Dec;28(12):2391-3.
PMID: 11797940
Matched MeSH terms: Developing Countries
A veil over the East

Women Action, 1995.
PMID: 12291844
Matched MeSH terms: Developing Countries
JICWELS' MCH training program in the Aiiku Institute: Asian MCH workshop

Hirayama M, Oyama O, Asano M

Acta Paediatr Jpn, 1993 Dec;35(6):579-82.
PMID: 8109245

Taking a form of Official Development Aid (ODA), the Japan International Cooperation of Welfare Services (JICWELS) and Imperial Gift Foundation, Boshi-Aiiku-Kai (Aiiku Association for Maternal and Child Health and Welfare) have extended a study program on maternal and child health (MCH) since 1989 on the commission of the Ministry of Health and Welfare. 'Community participation' is the key to the first international study program focused solely on MCH. The purpose of the program is to help to improve the planning and administration in the field of MCH. Through this, the information and experience attained in Japanese MCH activities are introduced especially by participation in community-level activities of 'Aiiku-Han' in which local citizens play a major role. The operation system of the Asian MCH Workshop, contents of the workshop, evaluation and future prospects are discussed.

Matched MeSH terms: Developing Countries
Malaysia emphasizes couples' right to decide family size

Popul Headl, 1994 May;?(230):3.
PMID: 12288612

PIP: Malaysia recently reiterated its commitment to protect the right of couples to choose the number and spacing of their children and to have the information and means to do so. This policy is in accord with Malaysia's belief that the individual is at the center of all socioeconomic and environmental programs. Thus, Malaysia acknowledges the importance of promoting better understanding of the relationship between population and sustainable development. This focus will enable Malaysia to emphasize areas such as maternal mortality, family planning, and breast feeding and to establish special programs for marginalized, disadvantaged, and vulnerable groups of people. Malaysia also acknowledges the importance of establishing a pool of trained researchers in population and development issues.

Matched MeSH terms: Developing Countries
The developmental niche: a theoretical framework for analyzing the household production of health

Harkness S, Super CM

Soc Sci Med, 1994 Jan;38(2):217-26.
PMID: 8140448

Recent efforts to promote child survival and development internationally have focused new attention on the importance of the household as a mediator of both environmental risks and programmatic interventions to promote better health. In this paper, we introduce a theoretical framework, the 'developmental niche,' derived from studies of children's behavior and development in different cultural contexts, as a tool for analyzing the household production of health. The developmental niche is conceptualized in terms of three basic components: (1) the physical and social settings of the child's everyday life; (2) culturally regulated customs of child care and child rearing; and (3) the psychology of the caretakers. The relevance of each of these components to the household production of health is illustrated through examples from research in several cultures, including Malaysia, Kenya, Bangladesh, India, and the U.S. Further discussion centers on three corollaries of the developmental niche framework that point to the interactive relationships among the three components, between the niche and the larger environment, and between the niche and the child (or any individual seen from a developmental perspective). It is suggested that this approach is useful for identifying and collecting relevant information on household-level factors that affect health outcomes, and thus for organizing more effective interventions. At a theoretical level, the developmental niche framework also facilitates understanding processes of mutual adaptation between the individual and the environment as they are filtered through the constraints of household settings, customs and caretaker psychologies.

Matched MeSH terms: Developing Countries
Testing (HIV). Quick test receives Singapore approval

AIDS Wkly Plus, 1996 Apr 22.
PMID: 12290908
Matched MeSH terms: Developing Countries

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