Research evidence on strategies enabling integration of electronic health records in the health care systems of low‐ and middle‐income countries: A literature review

2019 ◽  
Vol 34 (2) ◽  
Author(s):  
Manish Kumar ◽  
Javed Mostafa
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Electronic Health Records ◽  
Research Evidence ◽  
Health Care Systems ◽  
Health Records ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Systems ◽  
Low And Middle Income

scholarly journals Structural Barriers to Diagnosis and Treatment of Cancer in Low- and Middle-Income Countries: The Urgent Need for Scaling Up

2016 ◽  
Vol 34 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Eduardo Cazap ◽  
Ian Magrath ◽  
T. Peter Kingham ◽  
Ahmed Elzawawy
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Cancer Care ◽  
Health Care Systems ◽  
Diagnosis And Treatment ◽  
Middle Income ◽  
Health Crisis ◽  
Middle Income Countries ◽  
Care Systems ◽  
Low And Middle Income

Noncommunicable diseases are now recognized by the United Nations and WHO as a major public health crisis. Cancer is a main part of this problem, and health care systems are facing a great challenge to improve cancer care, control costs, and increase systems efficiency. The disparity in access to care and outcomes between high-income countries and low- and middle-income countries is staggering. The reasons for this disparity include cost, access to care, manpower and training deficits, and a lack of awareness in the lay and medical communities. Diagnosis and treatment play an important role in this complex environment. In different regions and countries of the world, a variety of health care systems are in place, but most of them are fragmented or poorly coordinated. The need to scale up cancer care in the low- and middle-income countries is urgent, and this article reviews many of the structural mechanisms of the problem, describes the current situation, and proposes ways for improvement. The organization of cancer services is also included in the analysis.

scholarly journals Measures to strengthen primary health-care systems in low- and middle-income countries

2020 ◽  
Vol 98 (11) ◽  
pp. 781-791 ◽  
Author(s):  
Etienne V Langlois ◽  
Andrew McKenzie ◽  
Helen Schneider ◽  
Jeffrey W Mecaskey
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Health ◽  
Care Systems ◽  
Low And Middle Income

Strengthening health care worker engagement with early adolescence in low- and middle-income countries: an overdue area for action

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Marni Sommer ◽  
Garrison Daly ◽  
Caroline Kabiru ◽  
Pema Lhaki ◽  
Neville Okwaro ◽  
...  
Keyword(s):  
Health Care ◽  
Early Adolescence ◽  
Health Care Workers ◽  
Health Care Systems ◽  
Young Adolescents ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Workers ◽  
Care Systems ◽  
Low And Middle Income

AbstractThe very young adolescent population (ages 10–14) is currently under-served by health care systems, particularly in low- and middle-income countries. Although there is a substantial and growing effort to reach adolescents with the health services and commodities they need, such efforts often overlook the period of early adolescence given this population’s lower vulnerability to risk-taking behaviors. However, early adolescence is a period of significant change, with the onset of puberty introducing physiological, emotional, and social changes in girls’ and boys’ lives. This period also represents a time of intensifying gendered norms, and the transition of youth from childhood focused health care (e.g. deworming programs, nutrition interventions) to additional mid- and older adolescent related care [e.g. human papilloma virus (HPV) vaccine, and contraceptive provision). Strengthening young adolescents’ engagement with health care workers around preventative and promotive health behaviors could have profound impacts on their health and wellbeing, which in turn could have cascading effects across the course of their lives. Critically, young adolescents would gain trust in health care systems, and be more likely to return when significant health issues arise later in adolescence or adulthood. Such an effort requires sensitizing health care workers and building their capacity to respond to young adolescents’ unique needs, by defining a package of actions that they are mandated to provide, training them, providing them with desk reference tools, and putting in place systems to provide supportive supervision and collaborative learning on the one hand, and encouraging caregivers to connect their pubescent-aged boys and girls with the health care system, on the other hand. This paper presents an argument for increased focus in particular on building attitudes and capacities of health care workers on engaging with early adolescents, applying Principle 3 of the Society of Adolescent Medicine’s position paper entitled “Health Care Reform and Adolescents.”

scholarly journals A Landscape Study Highlights the Urgent Need for Evidence Based Strategies to Enable Electronic Health Records Integration in the National Healthcare Systems of Low- and Middle-Income Countries

2021 ◽  
Vol 16 (3) ◽  
pp. 140-142
Author(s):  
Joanne M. Muellenbach
Keyword(s):  
Electronic Health Records ◽  
Grey Literature ◽  
Healthcare Systems ◽  
Health Records ◽  
Middle Income ◽  
Middle Income Countries ◽  
National Healthcare ◽  
Electronic Health ◽  
International Experts ◽  
Low And Middle Income

A Review of: Kumar, M., & Mostafa, J. (2020). Electronic health records for better health in lower- and middle-income countries: A landscape study. Library Hi Tech, 38(4), 751–767. https://doi.org/10.1108/LHT-09-2019-0179  Abstract Objective – To identify how low- and middle-income countries (LMICs) approached the development of national and subnational electronic health records (EHRs) and to understand the challenges related to EHR research priorities and sustainability. Design – Landscape study consisting of a review of the scientific literature, country-focused grey literature, and consultation with international experts.   Setting – Hospitals and healthcare systems within LMICs.  Subjects – The 402 publications retrieved through a systematic search of four scientific electronic databases along with 49 publications found through a country-focused analysis of grey literature and 14 additional publications found through consultation with two international experts.  Methods – On 15 May 2019, the authors comprehensively searched four major scientific databases: Global Health, PubMed, Scopus, and Web of Science. They also searched the grey literature and repositories in consultation with country-based international digital health experts. The authors subsequently used Mendeley reference management software to organize and remove duplicate publications. Peer-reviewed publications that focused on developing national EHRs within LMIC healthcare systems were included for the title and abstract screening. Data analysis was mainly qualitative, and the results were organized to highlight stakeholders, health information architecture (HIA), and sustainability. Main Results – The results were presented in three subsections. The first two described critical stakeholders for developing national and subnational EHRs and HIA, including country eHealth foundations, EHRs, and subsystems. The third section presented and discussed pressing challenges related to EHR sustainability. The findings of the three subsections were further explored through the presentation of three LMIC case studies that described stakeholders, HIA, and sustainability challenges. Conclusion – The results of this landscape study highlighted the scant evidence available to develop and sustain national and subnational EHRs within LMICs. The authors noted that there appears to be a gap in understanding how EHRs impact patient-level and population outcomes within the LMICs. The study revealed that EHRs were primarily designed to support monitoring and evaluating health programs focused on a particular disease or group of diseases rather than common health problems. While national governments and international donors focused on the role of EHRs to improve patient care, the authors highlighted the urgent need for further research on the development of EHRs, with a focus on efficiency, evaluation, monitoring, and quality within the national healthcare enterprise.

Access as a policy-relevant concept in low- and middle-income countries

2009 ◽  
Vol 4 (2) ◽  
pp. 179-193 ◽  
Author(s):  
DI MCINTYRE ◽  
MICHAEL THIEDE ◽  
STEPHEN BIRCH
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Policy ◽  
Comprehensive Evaluation ◽  
Health Care Systems ◽  
Three Dimensions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Access To Health ◽  
Care Systems

Abstract:Although access to health care is frequently identified as a goal for health care policy, the precise meaning of access to health care often remains unclear. We present a conceptual framework that defines access to health care as theempowermentof an individual to use health care and as a multidimensional concept based on the interaction (or degree of fit) between health care systems and individuals, households, and communities. Three dimensions of access are identified: availability, affordability, and acceptability, through which access can be evaluated directly instead of focusing on utilisation of care as a proxy for access. We present the case for the comprehensive evaluation of health care systems as well as the dimensions of access, and the factors underlying each dimension. Such systemic analyses can inform policy-makers about the ‘fit’ between needs for health care and receipt of care, and provide the basis for developing policies that promote improvements in the empowerment to use care.

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