Musculoskeletal (MSK) health impairments contribute substantially to the pain and disability burden in low- and middle-income countries (LMICs), yet health systems strengthening (HSS) responses are nascent in these settings. We aimed to explore the contemporary context, framed as challenges and opportunities, for improving population-level prevention and management of MSK health in LMICs using secondary qualitative data from a previous study exploring HSS priorities for MSK health globally and (2) to contextualize these findings through a primary analysis of health policies for integrated management of non-communicable diseases (NCDs) in select LMICs. Part 1: 12 transcripts of interviews with LMIC-based key informants (KIs) were inductively analysed. Part 2: systematic content analysis of health policies for integrated care of NCDs where KIs were resident (Argentina, Bangladesh, Brazil, Ethiopia, India, Kenya, Malaysia, Philippines and South Africa). A thematic framework of LMIC-relevant challenges and opportunities was empirically derived and organized around five meta-themes: (1) MSK health is a low priority; (2) social determinants adversely affect MSK health; (3) healthcare system issues de-prioritize MSK health; (4) economic constraints restrict system capacity to direct and mobilize resources to MSK health; and (5) build research capacity. Twelve policy documents were included, describing explicit foci on cardiovascular disease (100%), diabetes (100%), respiratory conditions (100%) and cancer (89%); none explicitly focused on MSK health. Policy strategies were coded into three categories: (1) general principles for people-centred NCD care, (2) service delivery and (3) system strengthening. Four policies described strategies to address MSK health in some way, mostly related to injury care. Priorities and opportunities for HSS for MSK health identified by KIs aligned with broader strategies targeting NCDs identified in the policies. MSK health is not currently prioritized in NCD health policies among selected LMICs. However, opportunities to address the MSK-attributed disability burden exist through integrating MSK-specific HSS initiatives with initiatives targeting NCDs generally and injury and trauma care.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9923377 | PMC |
| http://dx.doi.org/10.1093/heapol/czac061 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Immunologic investigations into transgene directed immune-mediated myositis following delandistrogene moxeparvovec gene therapy.
Sci Rep
January 2025
Sarepta Therapeutics, Inc., Cambridge, MA, USA.
Delandistrogene moxeparvovec is an rAAVrh74 vector-based gene transfer therapy that delivers a transgene encoding delandistrogene moxeparvovec micro-dystrophin, an engineered, functional form of dystrophin shown to stabilize or slow disease progression in DMD. It is approved in the US and in other select countries. Two serious adverse event cases of immune-mediated myositis (IMM) were reported in the phase Ib ENDEAVOR trial (NCT04626674).
View Article and Find Full Text PDFValidation of musculoskeletal segmentation model with uncertainty estimation for bone and muscle assessment in hip-to-knee clinical CT images.
Sci Rep
January 2025
Division of Information Science, Graduate School of Science and Technology, Nara Institute of Science and Technology, 8916-5 Takayama-cho, Ikoma, Nara, 630-0192, Japan.
Deep learning-based image segmentation has allowed for the fully automated, accurate, and rapid analysis of musculoskeletal (MSK) structures from medical images. However, current approaches were either applied only to 2D cross-sectional images, addressed few structures, or were validated on small datasets, which limit the application in large-scale databases. This study aimed to validate an improved deep learning model for volumetric MSK segmentation of the hip and thigh with uncertainty estimation from clinical computed tomography (CT) images.
View Article and Find Full Text PDFA deep multiple instance learning framework improves microsatellite instability detection from tumor next generation sequencing.
Nat Commun
January 2025
Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Microsatellite instability (MSI) is a critical phenotype of cancer genomes and an FDA-recognized biomarker that can guide treatment with immune checkpoint inhibitors. Previous work has demonstrated that next-generation sequencing data can be used to identify samples with MSI-high phenotype. However, low tumor purity, as frequently observed in routine clinical samples, poses a challenge to the sensitivity of existing algorithms.
View Article and Find Full Text PDFDoes birth weight or preterm birth predict worse pain prognosis in adulthood? A Northern Finland Birth Cohort Study followed up to 46 years of age.
J Pain
December 2024
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Although pain is a highly common symptom, only a subset of individuals develops chronic and disabling conditions. Delving into the predictors for poor musculoskeletal pain (MSK) outcomes in adulthood may help identify those needing early prevention and intervention. This study aimed to evaluate whether birth weight or preterm birth predicts worse prognosis of MSK pain in adulthood.
View Article and Find Full Text PDFCo-occurrence of mental distress and insomnia associates with more severe musculoskeletal pain - Northern Finland Birth Cohort 1966 study.
J Psychosom Res
December 2024
Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Research Unit of Population Health, University of Oulu, Oulu, Finland; Wellbeing Services County of Lapland, Rovaniemi, Finland.
Objective: This cross-sectional study demonstrates the differences in the dimensions of musculoskeletal (MSK) pain between participants with mental distress and/or insomnia among general population with MSK pain within the past 12 months.
Methods: Participants of Northern Finland Birth Cohort 1966 (NFBC1966) were studied (n = 4316). They were divided into groups based on their mental distress and insomnia status (co-occurring mental distress and insomnia [CMI], isolated mental distress [M] and insomnia [I], and absence of both [AMI]).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!