High-income Countries Research Articles

Regional integration and export performance of Pakistan: Empirical evidence from the Shanghai Cooperation Organization (SCO).

The study examines export impact of Pakistan's integration into Shanghai Cooperation Organization (SCO) on its export's performance. We apply Poisson Pseudo-Maximum Likelihood (PPML) on augmented gravity model to estimate trade data from the period before and after permanent membership with Shanghai Cooperation Organization in 2017. The study aims to explore changes in exports volume and analyze the key mechanism through which Shanghai Cooperation Organization promotes exports. The study assesses that after integration which key exports sector such as agriculture or manufacturing sectors are affected more significantly. The initial findings suggest that SCO integration positively affect and provide access to Central Asian markets, leading to modest but noticeable promotion in exports promotion. In heterogeneity analysis we find that exports of Pakistan are more significant with low and middle-income level countries compared to higher-income level countries. Additionally, exports in the manufacturing sector benefited more than in the agriculture sector. The significant and positive findings of mechanism analysis indicate that the belt and road (B&R) initiative and bilateral trade agreements are the key factors to enhanced exports. The overall impact remains moderated by structural changes in Pakistan economy, such as poor infrastructure, deficiency in energy sector and limited trade relations with its neighbors India and Iran. The study concludes that although the SCO integration has positively promoted exports of Pakistan however, it requires to address domestic economic constraints and capitalize more effectively the benefits of SCO membership through regional cooperation mechanism. For more potential benefits in the region SCO needs to expand B&R connectivity, encourage more trade agreements, and adopt favorable environment to attract high income countries in the organization. The study provides the base for future research in depth analysis of long-term impact of SCO integration on Pakistan exports.

The future of cystic fibrosis: A global perspective.

The severity of lung disease as well as other disease manifestations have dramatically improved in those patients with cystic fibrosis (CF) that both have mutations responsive to small molecule- based therapies with CF transmembrane regulator (CFTR) modulators and do have access to these drugs. Unfortunately, these medications are not available to many patients with CF across the globe with access largely limited to high income countries. For those eligible to CFTR modulators new questions have arisen regarding the ongoing need for other medications addressing CF lung disease as well current care models with tight monitoring. This article aims to summarize how CF care may change in the future making a plea to expand the availability of highly effective medications to every child with CF that could benefit from treatment.

Association of Abdominal Obesity and Diabetes among the Adult Tribal Population in Tamil Nadu

Background: Previously overweight and obesity are considered to be an issue of high-income countries but now increasingly becoming more prevalent in low-income and middle-income countries. Obesity and overweight are growing health issues in India. It is important to determine the quantum of the risk contribution by individual risk factor siuch as abdominal obesity. Aims: To find out the association of abdominal obesity and diabetes among the adult tribal population. Methods and Material: A cross-sectional study was conducted using multi-stage random sampling techniques. Using a pretested validated modified Stepwise questionnaire, a detailed interview with the participants aged above 30 years were performed. Random blood sugar and anthropometric parameters were estimated for all the participants. Chi-square test and multivariate regression analysis were used to study association. Results: Prevalence of abdominal obesity was 49.6% [211] among the study participants. Prevalence of diabetes was 7.8% [33] among the study population and 92.2% [392] of them were nondiabetic. Normal WHR was seen among 27.3% [9] of the diabetic individuals. High WHR was seen among 72.7% [24] of diabetic individuals. Gender, Illiterate, BMI, and waist-hip ratio shows significant association with diabetes. Conclusions: The prevalence of abdominal obesity was higher in the study population. As this burden among tribal people is on the increasing trend when compared with other general populations, effective strategies to prevent this have to be devised among the tribal population.

Heterogenous impact of energy security and environmental regulations on energy transition: Exploring the disparity between high-income and middle-income countries

This study investigates the impact of energy security, environmental regulation, economic complexity, globalization, and geopolitical risk on the process of energy transition. To this end Methods of Moment Quantile regression is employed on panel data of twenty-one high-income countries and nine middle-income countries from 1996 to 2018. Findings indicate that energy insecurity and environmental regulation have positive impact on energy transition in both high income and middle-income countries. However, high geopolitical risk significantly reduces the positive effects of energy insecurity on energy transition. Further, the quantile regression reveals the heterogenous impact of these factors across the energy transition distribution. In view of such findings, the policy implications suggest that the governments in high-income countries should take advantage of the favorable aspects of energy insecurity and geopolitical risk to transform their energy structure, enforce stringent environmental policies and manage the negative implications of economic complexity on energy transition. Governments in middle-income countries should try to use effectively the energy insecurity and the globalization process. There is a need to control the negative influence of geopolitical risk on energy transformation.

What can we know about legal minors who inject drugs? Exploring register data in three high-income countries

Background Research on legal minors who inject drugs is rare and beset with methodological problems. We explore the potential of register data for researching this population and present illustrative analyses contributing to the knowledge base. Method We obtained register data with national coverage from three high-income countries and assessed its analytic potential across two research themes. Descriptive analyses of the obtained data explored prevalence, mean age of debut, delay to accessing services, and treatment needs. Results There were differences in register types and variables collected within and between each country. The analytical potential of register data was assessed as good. Prevalence of injecting debut before the age of 18 (IDU < 18) was 29% (Sweden), 23% (Switzerland), and 5%–9% (Wales). IDU < 18 took longer to access services in each country than those with debut as adults. Complex treatment needs were identified, including mental health, education, and housing. Conclusion Register data is a viable method for better understanding this small, ‘hidden’ population, albeit with important caveats. Adolescent drug services may need to deliver or link to a range of treatment responses beyond drug use. Innovative outreach, and legal and policy change may be needed to ensure harm reduction access while injecting continues.

Prediction of 90-day mortality risk after unplanned emergency department visits of advanced stage cancer patients

PurposeCancer represents the leading cause of mortality in high-income countries. In the last years, the rate of emergency department (ED) visits by cancer patients has increased 5.5-fold. These ED visits impose a significant economic burden and may indicate the progression of the oncologic disease. The goal of this retrospective study was to identify patient-derived risk factors, especially focusing on serum albumin and body mass index (BMI) for 90-day mortality following unplanned ED visits by cancer patients.MethodsA retrospective chart review of all patients with an ICD-10 diagnosis for cancer undergoing palliative treatment presenting at the ED between 2016 and 2018 at the General Hospital of Vienna was performed. Laboratory values, emergency severity index (ESI), and BMI were collected at the ED presentation. 90-day mortality (90MM) was calculated from the ED presentation.ResultsA total of 448 cancer patients were included. Lung cancer (19.2%) and pancreaticobiliary cancer (15.6%) were the most frequent diagnoses. The main reasons for ED visits were pain (20.5%) and fever (17.4%). Sixty-nine percent of patients had to be admitted and 17.5% of patients died during hospitalization. 90MM was highest for patients with low albumin (< 35 g/L vs. > 35 g/L: 60.4% vs. 31.4%; p < .0001). When incorporating albumin levels and BMI, patients with both values below the cutoff had the highest risk for death (HR 4.01, 95% CI 2.30–7.02).ConclusionCancer patients face a high risk for hospitalization when presenting at the ED. The 90MM rate is highest in patients with low BMI and albumin levels. This highlights an especially vulnerable cohort of cancer patients for whom supportive care and palliative care have to be optimized.

AI-enabled workflow for automated classification and analysis of feto-placental Doppler images.

Extraction of Doppler-based measurements from feto-placental Doppler images is crucial in identifying vulnerable new-borns prenatally. However, this process is time-consuming, operator dependent, and prone to errors. To address this, our study introduces an artificial intelligence (AI) enabled workflow for automating feto-placental Doppler measurements from four sites (i.e., Umbilical Artery (UA), Middle Cerebral Artery (MCA), Aortic Isthmus (AoI) and Left Ventricular Inflow and Outflow (LVIO)), involving classification and waveform delineation tasks. Derived from data from a low- and middle-income country, our approach's versatility was tested and validated using a dataset from a high-income country, showcasing its potential for standardized and accurate analysis across varied healthcare settings. The classification of Doppler views was approached through three distinct blocks: (i) a Doppler velocity amplitude-based model with an accuracy of 94%, (ii) two Convolutional Neural Networks (CNN) with accuracies of 89.2% and 67.3%, and (iii) Doppler view- and dataset-dependent confidence models to detect misclassifications with an accuracy higher than 85%. The extraction of Doppler indices utilized Doppler-view dependent CNNs coupled with post-processing techniques. Results yielded a mean absolute percentage error of 6.1 ± 4.9% (n = 682), 1.8 ± 1.5% (n = 1,480), 4.7 ± 4.0% (n = 717), 3.5 ± 3.1% (n = 1,318) for the magnitude location of the systolic peak in LVIO, UA, AoI and MCA views, respectively. The developed models proved to be highly accurate in classifying Doppler views and extracting essential measurements from Doppler images. The integration of this AI-enabled workflow holds significant promise in reducing the manual workload and enhancing the efficiency of feto-placental Doppler image analysis, even for non-trained readers.

To what extent did mortality from COVID-19 in England and Wales differ for migrants compared to non-migrants in 2020 and 2021? A descriptive, observational study.

Seventeen percent of people living in the UK are migrants. In high-income countries, migrants have been shown to have better all-cause mortality but worse mortality for some specific causes such as infectious diseases. This observational study aims to quantify the extent to which mortality from coronavirus disease 2019 (COVID-19) differed between migrants and non-migrants for the population of England and Wales, 2020-2021. We use Official National Statistics data to compare mortality from COVID-19 in 2020 and 2021 by country/region of birth, expressed as the standardized mortality ratio with those born in England and Wales as the reference population. Migrants from 17 of 19 countries/regions examined had higher mortality from COVID-19 than non-migrants. The highest mortality was those born in Bangladesh (females SMR = 3.39, 95% CIs 3.09-3.71; males 4.41, 95% CIs 4.09-4.75); Pakistan (females 2.73, 95% CIs 2.59-2.89; males 3.02, 95% CIs 2.89-3.14); and the Caribbean (females 2.03, 95% CIs 1.87-2.20; males 2.48, 95% CIs 2.37-2.60). Migrants born in Antarctica and Oceania (females 0.54, 95% CI 0.42-0.40; males 0.71, 95% CI 0.51-0.88), and North and Central America (females 0.95, 95% CI 0.80-1.11; males 0.85, 95% CI 0.72-0.99) had lower mortality than non-migrants. Most migrant populations had higher mortality from COVID-19 than non-migrants in England and Wales. Policy-makers must work to integrate migration status into routine data collection to inform future research and understand the causes of the inequalities seen.

Breaking down barriers; unravelling the root causes and effects of brain drain in Pakistan.

Respected Editor, The term ‘brain drain’ refers to the migration of highly skilled and educated professionals from one country to another in search of better employment and living conditions. Brain drain has a detrimental impact on developing nations, leaving a counterproductive outcome due to the depletion of skilled human resources. According to the Pakistan Overseas Employment Corporation, around 21,000 professionals have migrated to other countries in the last 15 years.1 Brain drain has a pervasive effect across various domains, with healthcare being primarily one of the greatly affected. The most prevalent reason is the insufficient stipends and substandard workplace settings for professionals. Doctors work tirelessly yet are forced to face the injustice of the system, incidents of violence, and exploitation at the hands of their superiors. Most doctors (83%) agreed that meager salary packages and inequitable overtime duties motivated them to move abroad.2 Political instability in Pakistan has also affected the resettlement of healthcare individuals nationwide. Up to 81% of doctors are compelled to leave the country due to constant political turmoil.3 Blatant misogyny and cultural bounds have deterred women from working, contradicting the high female enrollment in medical colleges of Pakistan. Moreover, because of the brain drain, Pakistan is losing an insurmountable intellectual capital and educational investment, resulting in enormous pressure on the healthcare professionals who stay behind, contributing to the collapse of the already vulnerable system. Usually, the emigrants are of the privileged class which creates disparity because the ones left behind end up facing impecunious conditions and unfair working hours. The migration rate of healthcare professionals in Pakistan is increasing progressively. The United States, the United Kingdom, Canada, and Australia are four high-income countries where 56% of international medical graduates (IMGs) emigrate from low-income countries to have a better quality of life, monetary incentives, job opportunities, better education, and training. Furthermore, just three nations India, Pakistan, and the Philippines are home to 45% of IMGs.4,5 Therefore, we suggest that the government adopt strategies that will accommodate doctors, introducing remunerative packages and more employment opportunities to persuade them to serve their nation. The government should ameliorate the workplace environment to international standards, ensuring the safety and security of the professionals. Additionally, educational and training grounds should be provided to individuals to develop their skills. These immediate measures must be taken to minimize the escalating brain drain and aid in revamping the healthcare system of Pakistan.

Neurological Complications and Outcomes in Critically Ill Patients With COVID-19: Results From International Neurological Study Group From the COVID-19 Critical Care Consortium.

In this COVID-19 Critical Care Consortium (CCCC) sub-study, we qualified neurological complications associated with SARS-CoV2 infection. The CCCC is an international, multicenter study. Eligible patients were COVID-19 patients admitted to intensive care units (ICU) across 23 centers between 1/7/2020 to 6/23/2022. Incidence of neurological complications was estimated as number of events per hospital days and per admission using Poisson regression. Associations between neurological complications and risk factors were assessed using multivariable Poisson regression. 713 patients were included. Median age = 56years (interquartile range (IQR) = 45-65). Neurological complications reported in 61/480 patients (12.7%) with the majority being ischemic stroke (2.9%), intracranial hemorrhage (ICH) (2.8%), and seizures (2.6%). Multivariable analysis for neurological complications per admitted days showed comorbid neurological conditions (incidence rate ratio (IRR) = 6.35, 2.57-15.7) were an independent risk factor for ischemic stroke. Extracorporeal membrane oxygenation (IRR = 5.32, 1.52-18.6), low-middle income countries (LMIC) vs high income countries (HIC) (IRR = 4.70, 1.62-13.7), and age >55 (IRR = 3.66, 1.23-10.9) were independent risk factors for ICH. Co-morbid neurological conditions (IRR = 3.43, 1.11-10.6), LMIC vs HIC (IRR = 8.69, 2.15-35.2), July-December 2020 vs January-June 2020 (IRR = 0.17, 0.04-0.69) and age >55 (IRR = 4.05, 1.15-14.3) were independent risk factors for seizure. Decision-making should incorporate salient risk factors to inform management of SARS-CoV2 infection and avoid neurological complications.

Historic and current achievements of the temperance movement in the control of alcohol and its adverse health consequences

SettingThe study aims to assess firstly, the historical (pre-2000) achievements in the control of alcohol and its adverse health consequences in the nine developed countries with mass temperance movements. Currently (post-2000), it looks at achievements in developed countries more generally, including these nine countries. MethodsThe study is a policy analysis conducted within an historical timeframe. This principally involves the historical impacts on government schemes regulating alcohol as well as individual alcohol consumption and its consequences. Trends since 2000 in alcohol consumption in young people in high-income temperance cultures are also examined. Results and conclusionSubstantial alcohol-related public health impacts have occurred in almost all of the nine countries, either on relevant government schemes and/or individual alcohol consumption. Regarding government schemes, five of the nine temperance countries, and in part a sixth (the US), retain government store monopoly systems, offering heavily-taxed spirits with limits on their accessibility. Impacts on individual consumption in these countries, where studied, were positive. Consumption in young people since 2000 in high income countries is lower in temperance than non-temperance countries.It is concluded that temperance culture has had substantial and enduring governmental and individual public health impacts relating to alcohol consumption.

The New Strategy to Improve Indonesia's National Economic Growth

Post-order new economic growth has decreased. The source of the decline in economic growth is that state revenues in the oil and gas sector have decreased. Indonesia needs more consistent high economic growth to accelerate Indonesia's leap to become a high-income country. In this situation Thus, there are several challenges so that Indonesia can achieve growth targets and, at the same time maintain growth The challenges that must be faced​ in the form of quality sources of Power are human beings who still have valued investment in resources Power life and wealth intellectuals who are still low, plus with Posture exports that have not been worth economy high. With this, an appropriate policy strategy is needed for the three things above to become locomotives of future economic growth. Although Indonesia needs high economic growth, several boundaries must be adhered to, namely, the nature of economic growth must be inclusive, so as not to widen the gap in social inequality. A growth economy must be supported by a diversity of rich life and, at the same time intended to guard sustainability naturally as a source of main Continuity of Development and Justice between generations.

Cross-country distribution dynamics of carbon emissions and intensity: Before and after the global financial crisis

Our study employs the distribution dynamics approach to uncover transition probabilities and the long-term evolution of relative per capita carbon emissions (REPC) and relative carbon intensity (REPGDP) across 204 countries. We split the period of analysis into pre-crisis (2000-2007), and post-crisis (2007-2016) and divided countries into four income groups. The results indicate the emergence of new convergence clubs post-crisis in both REPC and REPGDP. On the one hand, the majority (many) of the low- (high) income countries congregate to extremely low (above the global average) REPC levels in the long run. On the other hand, most of the upper-medium- (high) income economies cluster around REPGDP levels far above (below) the global average. Finally, using mobility probability plots, we identify above-average carbon emitters with the highest probabilities of diverging further above the global average in the coming years. The study delivers nascent evidence supporting the usefulness of the MPP display tool in clarifying the positions and responsibilities of specific countries in future agreements on climate change. The results support the argument for using both measures of carbon emissions as a suite of future multilateral climate negotiations and policies.

The Experiences of Women Transitioning from Unhoused to Housed in High-Income Countries: A Systematic Review and Meta-Aggregation

There are pathways in and out of homelessness that are gender-specific. However, little is known about the range of existing studies on the experiences of women who recently transitioned from homeless to housed in high-income countries. To date, no systematic reviews have brought together qualitative analyses from studies exploring women’s experiences who are re-housed in high-income countries. To fill this gap in existing literature, we performed a systematic review, utilizing the methods described by the Joanna Briggs Institute (JBI) (Lockwood et al., 2020) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Moher et al., 2010) to understand the meaning and experience of women exiting homelessness in high-income countries. We combined the search terms related to women, homelessness, and housing transitions and deployed them in six databases. Our research yielded 3025 titles and abstracts following the removal of duplicates. After conducting a title and abstract screening, 91 full-text articles remained. 14 articles were deemed to meet pre-established inclusion criteria. Our meta-aggregation revealed four themes generated through our analysis: a) ongoing presence of trauma in women’s lives; b) healing through providing support to others; c) lack of control over circumstances that enable survival; and d) support in housing decreases marginalization. This review deepens knowledge of the current research priorities as well as practical policy and practice strategies that can be utilized to support recently rehoused women to prevent recurrent periods of homelessness and its devastating impacts.

Rethinking diversification: Assessing the impact of energy concentration on climate change in rentier and non-rentier countries

Energy diversification, a critical strategy for environmental protection, has been surprisingly understudied in academic discourse. This paper seeks to address this gap by investigating the relationship between energy diversification and climate change in 76 countries from 1990 to 2020. We employ panel data techniques, and the system generalized method of moments (SYS-GMM) to analyze the impact of energy diversification, as measured by the Herfindahl-Hirschman Index, on CO2 emissions. Additionally, control variables such as economic growth, trade openness, foreign direct investment, information and technology adoption, natural resource rents, and urbanization are included in the model. The analysis is re-estimated for various country groupings based on income level and resource dependence (rentier vs. non-rentier). The findings reveal a significant positive association between energy concentration and CO2 emissions across all country groups, with the most pronounced impact is observed in middle-income, resource-rich economies (i.e., middle-income rentiers). The study also highlights differing effects of diversification on CO2 emissions between high-income and middle-income nations, which reflects the prevalence of non-rentier economies among high-income countries and rentier economies in middle-income countries. The causal relationship between CO2 emissions and energy diversification in different groups of countries is tested using the panel Granger causality test. The results reveal strong bidirectional causality between CO2 emissions and energy diversification in all country groups analyzed, except for middle-income rentier countries. By elucidating the multifaceted relationship between energy diversification and climate change, this study aims to provide valuable policy recommendations to advance sustainable development and environmental management.

Exploring the impact of digital economy on energy transition: Insights from natural resource rent dynamics

Digital economy is of great significance for countries to achieve energy transformation and sustainable development. However, the limited nature of natural resources has affected the development of digital economy. Although the research on digital economy and energy transition is increasing, few studies systematically link digital economy to energy transition from the perspective of natural resource rent. The FMOLS line regression and threshold nonlinear regression approaches are developed to quantify the linear and non-linear impact of digital economy on energy transition. The results of the linear model demonstrate that digital economy plays a more substantial role in driving energy transition in high-income countries compared to low- and middle-income countries. Furthermore, there exists a threshold effect of natural resource rents on the impact of digital economy on energy transition. In cases where natural resource rents are low, the development of digital economy significantly promotes energy transition. Robustness tests, such as shortening the sample period and increasing control variables, confirm the reliability of regression findings. This study contributes by uncovering regional heterogeneity in the relationship between digital economy development and energy transition. Particularly for low- and middle-income countries with low natural resource rents, fostering digital technology’s positive impact on energy transition yields higher marginal benefits. High-income countries should continue investing in innovation and research and development for sustainable energy technologies, while low- and middle-income nations should seek international financial support and investment while maintaining minimal reliance on natural resources to harness the potential advantages offered by digital technologies.

Participation of fathers and siblings in home rehabilitation programmes for children with neuro-developmental delay: a scoping review

BackgroundThe role of, and impact on, mothers caring for children with neuro-developmental delay (NDD) is well documented. However, the role of fathers and siblings in families of children with NDD remains significantly understudied, particularly in low- and middle-income countries (LMICs). There has been an increased call for holistic rehabilitation of children with NDD at the family level. This study aimed to explore the involvement of fathers and siblings in the home rehabilitation programmes of children with NDD.MethodsA scoping review was conducted using the Joanna Briggs Institute (JBI) Peters et al.'s methodology and reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Articles were retrieved from PUBMED, ScienceDirect, PsycINFO, SCOPUS, PEDro, and Google Scholar. Reference lists of relevant studies were also manually searched.ResultsThirty research articles were identified. Father and sibling participation in home-based rehabilitation and caregiving is low in LMICs compared to high-income countries due to economic factors and cultural beliefs. Reduced participation stresses mothers and reduces developmental outcomes in children with NDD.ConclusionsThis review highlights the need for rehabilitation professionals to encourage father and sibling participation in caregiving for children with NDD in home rehabilitation programmes.

Systematic review of the evidence for treatment and management of common skin conditions in resource-limited settings: An update.

The skin is the largest and most visible organ of the human body. As such, skin infections can have a significant impact on overall health, social wellbeing and self-image. In 2019, we published a systematic review of the treatment, prevention and public health control of skin infections including impetigo, scabies, crusted scabies and tinea in resource-limited settings where skin infections are endemic. This current review serves as an update to assess the evidence for treatment of these conditions as well as atopic dermatitis, molluscum contagiosum and head lice in endemic settings. The data from this systematic review have supported an update to the Australian National Healthy Skin guidelines. A systematic review was conducted using two separate searches in MEDLINE, PubMed, Embase, CINAHL, Cochrane and Web of Science. The first search was an update of the 2018 systematic review using the same search strategy for the same skin conditions to identify emerging literature from 2018 to 2022. The second search strategy used the same key terms but with the addition of atopic dermatitis, head lice and molluscum contagiosum from 1960 to 2022. Eligible studies included Indigenous peoples and populations in resource-limited settings with a diagnosis of impetigo, scabies, crusted scabies, tinea capitis, atopic dermatitis, molluscum contagiosum or who presented with head lice. Studies conducted in high-income countries were excluded. Articles were screened for inclusion independently by one author with a second group of reviewers independently double screening. Data extraction and an in-depth quality assessment conducted by one author and checked by two others. Of 1466 original articles identified, 68 studies were included and key findings outlined for impetigo, scabies, crusted scabies, atopic dermatitis, head lice and molluscum contagiosum. Recommendations for each condition based on the available evidence are provided. The importance of assessing literature relevant to the populations with heavy burden of skin infections is outlined in this systematic review. We have summarised updates to this literature, which may benefit in developing guidelines for skin infection management similar to the National Healthy Skin Guidelines for Australia.

The impact of government spending on well-being: a case of upper middle-income countries and high-income countries

The impact of government spending on well-being: a case of upper middle-income countries and high-income countries

Intracranial pressure monitoring and treatment practices in severe traumatic brain injury between low-and middle-income countries and high-income countries: Data or dogma?

Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. Intracranial pressure (ICP) monitoring forms the cornerstone of most severe TBI (sTBI) management guidelines, yet treatment practices vary between high income countries (HIC) and low/middle-income countries (LMICs). We sought to find the reasons for variation in ICP monitoring and treatment practices between neurosurgeons in low- and high-income countries. We developed a 34-item anonymous survey questionnaire on ICP monitoring and treatments, which was emailed to neurosurgeons of various neurosurgical societies (Africa, Asia, Europe, and North America) who manage TBI. One hundred and six respondents from 23 countries completed the questionnaire. Sixty-nine were from Africa, 16 were from North America, 12 were from Western Europe, and 8 were from Asia. About 48.72% of respondents from LMICs versus 96.43% from HICs have had training on ICP use. Among practitioners who monitor ICP invasively in <50% of patients that need it, 41.6% and 37.5% from LMIC cited availability and cost as the major constraints, versus 3.3% and 6.67%, respectively, in HIC. Only 7 (8.97%) from LMIC follow Brain Trauma Foundation guidelines all the time compared to 17.86% from HIC. When asked about their knowledge of randomized controlled trial(RCT), 78.57% of respondents from HIC versus 11.54% from LMIC knew about RCTs that tested the role of ICP monitoring in sTBI. Significant differences exist in ICP monitoring and treatment in patients with sTBI between high and LMICs. Cost and availability are the main determinants of ICP monitor usage. Practice pattern among the respondents was not completely supported by evidence.