Pediatric heart failure: A focus on low-income countries

Table 1 Factors leading to disparity in congenital heart diseases management between high- and low-income countries

High income countries	Middle/Low income countries[2,4,6]
Prenatal factors
Lower birth rate and less consanguinity	High birth rate and more consanguinity
Preconception folic acid	No routine folic acid supplements
Antenatal diagnosis (echocardiography)	Sparsity of antenatal echo
Immediate postnatal factors
Hospital delivery and postnatal examination	Home deliveries are common
Neonatal pulse oximetry screening	No neonatal pulse oximeter screening due to early discharge
Well baby clinic
School screening	Late diagnosis
Access to medical and interventional treatment
Timely access to interventions (cardiac catheterization and surgery)	Poor access to prostaglandins
Availability of technical settings and personnel for high-risk interventions	Poor access to timely interventions
Medical insurance coverage	Few neonatal interventions
	The majority of patients/procedures are not covered by insurance
Follow up
Access to timely follow up	Poor follow up rate
Access to medical and interventional treatment	Poor access to and compliance with medications
The burden of RHD
Low prevalence of rheumatic heart disease	High prevalence of RHD

RHD: Rheumatic heart disease.