LMIC and the Covid-19 Pandemic Burden

Mohammad Abu-Jeyyab, School of Medicine, Mutah University, Al-Karak

As the globe prepares for COVID-19, public trust is critical for governments to combat the epidemic properly. With the COVID-19 problem still unfolding, it is too early to assess how nations in the Middle East and North Africa have responded to the epidemic. However, the lack of public faith in and competence of healthcare systems throughout the area suggests that COVID-19 may be a daunting political, public health, and economic issue for many MENA nations.

Covid-19 has spread across all continents as a pandemic. With an increase in the number of cases globally, even countries with the most outstanding healthcare systems are feeling the effects of the disease. As a result, the restricting spread becomes much more difficult in low and middle-income countries (LMICs) with limited access to resources and poor healthcare infrastructure. Low- and middle-income countries (LMICs) are more vulnerable to outbreaks and pandemics, as well as a lack of infrastructure and congestion. During an emergency, healthcare facilities are strained and nearly depleted. The typical supply chain has been disrupted, and consumables are in short supply.

The lazarettos inspired the early notion of establishing hospitals to limit infection transmission. The mechanisms of infectious transmission were well-known even before microorganisms were found. Based on the same information but according to revolutionary technology, such hospitals have now been established downtown, at the most highly performing technological plateau.[1]

Since the Covid-19 illness spreads mainly through the pulmonary system, these patients should preferably be placed in negative pressure isolation wards, emergency departments (EDs), and intensive care units (ICUs).

To deal with such crises, prosperous societies have clever institutions and infrastructure built in from the start [2]. However, on the opposite side of the globe, healthcare systems in poor and middle-income nations require further improvement to address the impending pandemic.

In low and middle-income countries, few healthcare facilities have separate buildings or even wards with negative air pressure ventilation mode settings to accommodate infectious diseases such as Covid-19, Tuberculosis, Typhoid, Orthopoxvirise-smallpox and monkeypox-and other respiratory transmitted diseases. [2]

Several variables contribute to the flawedhealthcare system. As a guiding principle, the lower the national income, the poorer the health care equality, and the fewer the protocoled services. For example, there are no separatehealthcare beds, insufficient ventilatory or cardio-respiratory support facilities, and a high provider-receptor ratio. In terms of numbers, below are some examples of doctor population ratios in low and middle-income countries: Afghanistan has a population of 0.304:1,000, Bangladesh has a population of 0.389:1,000, and Pakistan has a population of 0.806:1,000, compared to France, which has a population of 3.227:1,000, Germany has a population of 4.125:1,000, Russia has a population of 3.306:1,000, and the United States has a population of 2.554:1,000. [3]

For instance, the covid-19 burden was mirrored in the maternal-fetal units. Over 3.8 million deliveries are attended by maternity professionals each year, with more than 10% of newborns requiring treatment in a neonatal intensive care unit (NICU) [4]. Caring for pregnant women and their sick newborns is physically and emotionally draining, with a quarter to half of the healthcare professionals reporting extreme weariness, poor work-life balance, depression, or diminished well-being[5]. Because of the more protective methods, the rising requirement to utilise PPE more efficiently, and the influence of a large number of admissions among these patients, this effect was established more during the Covid-19 pandemic period.

Furthermore, the financial burden on healthcare practitioners contributed to the instability of healthcare systems, particularly in low-income nations.

Consequently, these countries' technology is inferior to that of developing countries. More specifically, the paper method registrations, the power outage, and the inadequate medical materials supplements (PPEs, Oxygen supplements, and the deficient medications needed in treating these patients).

Politicians and governments in LMICs must act quickly and decisively to keep it under control. The time has arrived to adopt a truly global response to this illness. They should learn from prior epidemics to prevent future outbreaks from spreading out of control, especially with an attack with such inexplicable widescale expansion. It is particularly vital in less developed areas to equip medical staff with the required instruments. Governments should enhance financing for research focused on determining the reasons for MPX's rapid, widespread breakout and the shift in transmission patterns.


[1] Bataille, J., &Brouqui, P. (2017). Building an Intelligent Hospital to Fight Contagion. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 65(suppl_1), S4–S11. https://doi.org/10.1093/cid/cix402
[2] Angrup, A., Kanaujia, R., Ray, P., &Biswal, M. (2020). Healthcare facilities in low- and middle-income countries affected by COVID-19: Time to upgrade basic infection control and prevention practices. Indian journal of medical microbiology, 38(2), 139–143. https://doi.org/10.4103/ijmm.IJMM_20_125.
[3] Kumar, R., & Pal, R. (2018). India achieves WHO recommended doctor population ratio: A call for a paradigm shift in public health discourse! Journal of family medicine and primary care, 7(5), 841–844. https://doi.org/10.4103/jfmpc.jfmpc_218_18
[4] Edwards, E. M., &Horbar, J. D. (2018). Variation in Use by NICU Types in the United States. Pediatrics, 142(5), e20180457. https://doi.org/10.1542/peds.2018-0457
[5] Haidari, E., Main, E. K., Cui, X., Cape, V., Tawfik, D. S., Adair, K. C., Sexton, B. J., & Profit, J. (2021). Maternal and neonatal health care worker well-being and patient safety climate amid the COVID-19 pandemic. Journal of perinatology: official journal of the California Perinatal Association, 41(5), 961–969. https://doi.org/10.1038/s41372-021-01014-9

Mohammad Abu-Jeyyab

A highly motivated sixth year medical student at Mutah University, with experience in conducting clinical research and quality improvement projects (clinical audits) in multiple clinical medicine fields. Published many different research articles. Currently leading and working on multiple levels of clinical research and audits including hospital, regional, national, and international studies. Working in a couple of international peer reviewed medical journals as an invited editor. Founded Mutah Research and Audits society (MRAS), a medical student research society at Mutah University in Jordan.

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