The 2030 Sustainable Development Goals call for the disaggregation of all indicators by disability and other characteristics so as to "leave no one behind" from development progress. Data on disability, however, is acknowledged to be lacking, which is essential for informing policy and planning. Consequently, this study estimates the prevalence of disability in the Maldives and compares indicators of poverty and living conditions between people with and without disabilities, using nationally-representative, population-based data (n = 5363). The prevalence of disability was estimated at 6.8%. Overall, this research finds that people with disabilities are at risk of being left behind from progress across multiple Sustainable Development Goal domains, including in combatting income poverty, food insecurity and exclusion from health, education, work and social participation, and vulnerability to violence. Further, amongst people with disabilities, people with cognitive and mental health impairments, people living outside the capital, Male', and children and working-age adults tend to face the highest levels of deprivation.

ObjectiveZoledronic acid and denosumab were funded by the Australian government for the management of osteoporosis at an equivalent price to alendronate. The price of alendronate has declined by around 65 %, but the price of the other two therapies has remained stable. Using data published since the listing, this paper reports current estimates of the value of denosumab compared to alendronate from an Australian health system perspective.MethodsA cohort-based state transition model was developed that predicted changes in bone mineral density (BMD), and calibrated fracture probabilities as a function of BMD, age and previous fracture to estimate differences in costs and QALYs gained over a 10-year time horizon.ResultsThe base-case incremental cost per QALY gained for denosumab versus alendronate was $246,749. There is a near zero probability that denosumab is cost-effective at a threshold value of $100,000 per QALY gained. If the price of denosumab was reduced by 50 %, the incremental cost per QALY gained falls to $50,068.DiscussionCurrent Australian legislation precludes price reviews when comparator therapies come off patent. The presented analysis illustrates a review process, incorporating clinical data collected since the original submission to inform a price at which denosumab would provide value for money.

Being a small island and low-middle income country (LMIC) heavily dependent on global markets for sustaining its basic needs and health system, Maldives faced specific challenges during the COVID-19 pandemic. This was reinforced through tensions between the heavily centralized healthcare delivery and a partially decentralized public health system. Using the pillars of pandemic response proposed by

Background and objectives Researchers are exploring the epidemiology, clinical characteristics, treatment, vaccination and the challenges faced by healthcare authorities. However less focus is being paid towards the impact of COVID-19 on mental health of the patients. This study is a cross-sectional study, measuring the prevalence of emotional distress among patients with COVID-19 in the Maldivian population. Methods This study was conducted in Maldivian nations above 18 of age with COVID-19 who were admitted in isolation facilities. Patients who were on treatment for any other chronic medical conditions, severe and critical COVID-19 disease were excluded. This study was conducted over a period of 2 months by administering a local translated version of DASS21 questionnaire. Results The total of 195 patients were included in this study. The mean age of the patients was 40 (CI at 95% 38–42) years. The respondents were 48.7% men and 51.3% women. Overall, 9% of patients with COVID-19 had depression while 23% of patients had anxiety and 12% of the patients had stress. There was a statistically significant relationship between gender and depression, anxiety and stress (p < 0.01). Symptomatic cases had a significantly higher level of stress than asymptomatic patients (p < 0.05), but no significant association was observed with symptomatic status and anxiety or depression. Conclusion The management of patients with COVID-19 should be multi-disciplinary with special focus on the mental wellbeing of our patients. We should aim to establish proper communication with the patients in order to identify emotional distress and provide appropriate mental health care.

Disability-targeted cash transfers are increasingly used by governments in low- and middle-income countries as a tool to address poverty and exclusion among people with disabilities. However, in many settings, accurate estimates of coverage and an understanding of factors affecting uptake are needed for effective delivery. This study explores coverage of the Disability Allowance in the Maldives, an unconditional, non-means tested cash transfer (2000 MVR or US$130 per month) and factors affecting uptake. It uses mixed methods, combining data from a nationally representative population-based survey with qualitative research among people with disabilities who are and are not receiving the Disability Allowance. This research found that 25.6% of people with disabilities across the Maldives are receiving the Disability Allowance. Coverage was lowest for women, older adults, people living in the capital (Malé), wealthier households and people with sensory impairments. Factors affecting uptake included lack of information about the programme, perceptions of disability and eligibility criteria, geographical and financial factors, and stigma.