Determinants of Use of Biotherapeutics in sub-Saharan Africa

Shah, Rajiv; Dey, Dzifa; Pietzonka, Thomas; Obeng, Paul; Ashiru, Bisola; Schiestl, Martin; Cavey, Andrew; Nkansah, Edwin; Radiere, Guerric; Spector, J. Michael; Scott, Christiaan

doi:10.1016/j.tips.2020.11.012

Cited by 12 publications

(6 citation statements)

References 36 publications

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“…The nighttime gap has been described in relation to birth and infant mortality, and distance from a 24-h provider has been identified as a critical driver of care-seeking behaviours at night [35]. To address gaps in care, communities in Sub-Saharan Africa have shown interest and participation in innovative healthcare delivery models incorporating telemedicine and delivery elements [36][37][38]. These innovations are supported by high rates of household cell phone ownership; 92.5% across Ghana (mean of regions) and 97.9% in Greater Accra in 2019 [39].…”

Section: Discussionmentioning

confidence: 99%

Evaluating the prerequisites for adapting a paediatric nighttime telemedicine and medication delivery service to a setting with high malarial burden: A cross‐sectional pre‐implementation study

Flaherty

Klarman

Zakariah

et al. 2023

Tropical Med Int Health

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ObjectiveWe sought to evaluate the prerequisites (demand, interest, feasibility) for adapting a paediatric nighttime telemedicine and medication delivery service (TMDS) to Ghana.MethodsA cross‐sectional survey of households and associated healthcare providers was conducted in urban and rural Ghana. Households were identified through randomised geospatial sampling; households with at least one child <10 years were enrolled. Household surveys collected information relating to demographics, household resources, standardised case scenarios, recent paediatric health events, satisfaction with healthcare access, and interest in TMDS intervention models. Providers were identified by households and enrolled. Provider surveys collected provider type, hours of operation, services, and opinions of a TMDS model.ResultsA total of 511 (263 urban, 248 rural) households and 18 providers (10 urban, 8 rural) were surveyed. A total of 262 health events involving children <10 years were reported, of which 47% occurred at night. Care was sought for >70% of health events presenting at night; however, care‐seeking was delayed until morning or later for >75% of these events; 54% of households expressed dissatisfaction with their current access to paediatric care at night; 99% of households expressed that a nighttime TMDS service for children would be directly useful to their families. Correspondingly, 17 of 18 providers stated that a TMDS was needed in their community; >99% of households had access to a cellular phone. All households expressed willingness to use their phones to call a TMDS and allow a TMDS provider into their homes at night. Willingness to pay and provider‐recommended price points varied by setting.ConclusionsPrerequisites for adapting a TMDS to Ghana were met. A nighttime paediatric TMDS service was found to be needed, appealing, and feasible in Ghana. These data motivate the adaptation of a TMDS to urban and rural Ghana.

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Section: Discussionmentioning

confidence: 99%

Evaluating the prerequisites for adapting a paediatric nighttime telemedicine and medication delivery service to a setting with high malarial burden: A cross‐sectional pre‐implementation study

Flaherty

Klarman

Zakariah

et al. 2023

Tropical Med Int Health

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“…For example, in well developed countries helicopters have been used to deliver lifesaving ASV and interventions. Due to the financial implications of the delivery method in low-income countries, we suggest that to deliver life-saving ASVs in remote areas [36].…”

Section: Implication For Health System Strengthening and Practicementioning

confidence: 99%

Community and health system factors influencing snake envenomation management practices in three districts of Ghana: a qualitative inquiry from health stakeholders and snakebite victims

Dzenu

Afaya

Ayanore

2023

Preprint

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Introduction Snakebite is a neglected public health issue affecting individuals of all ages in many tropical countries. Venom from snakebite is a potentially life-threatening disease associated with severe morbidities and mortalities. However, literature on snakebite envenoms management practices remains understudied. This study sought to explore community and health system factors influencing snake envenomation management practices in three districts in the Oti region of Ghana. Also, we assessed the current adherence to snakebite treatment protocols to the national and World Health Organization (WHO) recommended protocols. Methods The study adopted an exploratory descriptive qualitative study design. Purposive sampling technique was used to recruit participants for the study. The participants included snakebite victims, traditional healers, and health professionals. In-depth interviews and focused group discussions were used to collect data from the participants. All the interviews were audio recorded and transcribed verbatim and exported to Atlas Ti for data management and analyses. The transcribed data were analyzed using the content analysis method to develop the categories for the study findings Findings Twenty-six (26) participants were recruited including 16 males and 10 females. The study found three main factors that influenced snake envenomation management practices. These factors included health system factors, community-level factors, and adherence to national and WHOrecommended protocols. The health system factors included the unavailability of anti-snake venom, high-cost ASV, and inadequate or no supply of ASV from Ghana Health Service. The community factors included delay in seeking treatment, transportation, and accessibility challenges, and non-community acceptance facility treatment of snakebites. Almost all the health care professional who provide care for snakebite victims adhered to the WHO recommendations. Conclusion The evidence adduced from this study could be used by public health practitioners to empower the community by increasing awareness of the prevention of snakebites, first aid, and appropriate treatment-seeking behavior. Culturally appropriate interventions that seek to increase awareness to improve the acceptability of hospital management and sensitize the community for early referral of snakebite victims to the nearest health facility having anti-venom treatment. Authors summary The negative responses by the community’s acceptance of the kind of treatment given in the health facilities and the unavailability of Anti-snake Venom (ASV) in the study districts' health facilities inhibit the management of snakebites.

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“…The industry’s ability to introduce newer, more affordable biosimilars is negatively impacted by the lack of regulatory convergence and uniform biosimilar development criteria in many African countries, which have prevented multicountry development programmes for these medications 4…”

Section: Biosimilars In Africa: the Challengesmentioning

confidence: 99%

“…However, unfortunately, these biological therapies are very expensive and far beyond the means of resource-–limited African countries 3. Achieving cost-effectiveness is especially important in the African context, in order to make these important biological medical therapies available to significantly alter the prognosis of the disease 4. Of note, biosimilar use is only one way to have more cost-effective treatment of rheumatic diseases in combination with many other strategies that can significantly reduce healthcare drug costs, such as avoiding loading doses, using low-dose initial therapy and use of and use of concomitant conventional synthetic DMARD 5…”

Section: Introductionmentioning

confidence: 99%

Potential for biosimilars in rheumatology in Africa

2023

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Biosimilars are products which are highly similar to a reference biologic product (RBP). In Africa, regulatory frameworks for biosimilar approval are still in development in many countries and few biosimilars for rheumatic diseases are currently available. The use of biosimilar medicines in Africa provides an important opportunity to treat more rheumatology patients with biologic drugs. This editorial aims to shed a light on the potential benefits, challenges and current efforts, regarding the use of biosimilars in Africa in Rheumatology.

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Determinants of Use of Biotherapeutics in sub-Saharan Africa

Cited by 12 publications

References 36 publications

Evaluating the prerequisites for adapting a paediatric nighttime telemedicine and medication delivery service to a setting with high malarial burden: A cross‐sectional pre‐implementation study

Evaluating the prerequisites for adapting a paediatric nighttime telemedicine and medication delivery service to a setting with high malarial burden: A cross‐sectional pre‐implementation study

Community and health system factors influencing snake envenomation management practices in three districts of Ghana: a qualitative inquiry from health stakeholders and snakebite victims

Potential for biosimilars in rheumatology in Africa

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