Table 1

Critical differences affecting health and health care in high-income versus low-income and middle-income countries [19,23]

High-income countries

Low-income and middle-income countries


Gross national income per capita

High ≥US$9,386; upper middle US$3,036 to $9,385

Low ≤US$765 or lower; middle US$766 to $3,035


Access to health care

Initial access usually through primary care with established referral networks, which may include high indirect costs

Limited to very basic primary care especially in rural areas and/or established referral networks, which invariably include high indirect costs


Healthcare funding

National programs, private insurance, out-of-pocket expenses

Often ill-funded, may rely on donors/volunteering services. Indirect costs and informal payments can represent major barriers to care


Common epilepsy etiologies

Neoplastic, cerebrovascular

(Post-)infectious, antenatal, post-traumatic


HIV prevalence

Low

Can be moderate to high


Cultural perception of seizures

Biomedical model

Traditional medicine, spiritual approach; contagion beliefs common


Socio-cultural attitudes towards epilepsy

Neutral public perception or at least social presentation of neutrality

Overt negative public perception, stigmatization, and discrimination common


Katchanov and Birbeck BMC Medicine 2012 10:107   doi:10.1186/1741-7015-10-107

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