scholarly journals Systematic review of strategies to increase access to health services among children over five in low- and middle-income countries

2018 ◽  
Vol 23 (5) ◽  
pp. 476-507 ◽  
Author(s):  
Tess Bright ◽  
Lambert Felix ◽  
Hannah Kuper ◽  
Sarah Polack
Keyword(s):  
Systematic Review ◽  
Health Services ◽  
Access To Health Services ◽  
Middle Income ◽  
Middle Income Countries ◽  
Access To Health ◽  
Low And Middle Income

scholarly journals Expanding the use of community health workers in urban settings: a potential strategy for progress towards universal health coverage

2019 ◽  
Author(s):  
Brian Wahl ◽  
Susanna Lehtimaki ◽  
Stefan Germann ◽  
Nina Schwalbe
Keyword(s):  
Health Services ◽  
Community Health ◽  
Low Income ◽  
Urban Areas ◽  
Access To Health Services ◽  
Middle Income ◽  
Urban Settings ◽  
Middle Income Countries ◽  
Access To Health ◽  
Low And Middle Income

Abstract Community health worker (CHW) programmes have been used for decades to improve access to health services in rural settings in low- and middle-income countries. With more than half of the world’s population currently living in urban areas and this population expected to grow, equitable access to health services in urban areas is critically important. To understand the extent to which CHW programmes have been successfully deployed in low-income urban settings, we conducted a review of the literature between 2000 and 2018 to identify studies evaluating and describing CHW programmes implemented fully or partially in urban or peri-urban settings. We identified 32 peer-reviewed articles that met our inclusion criteria. Benefits have been documented in several urban settings in low- and middle-income countries including those to address TB/HIV, child health, maternal health and non-communicable diseases through a variety of study designs.

scholarly journals Cost of Utilising Maternal Health Services in Low- and Middle-Income Countries: A Systematic Review

2020 ◽  
Author(s):  
Aduragbemi Banke-Thomas ◽  
Francis Ifeanyi Ayomoh ◽  
Ibukun-Oluwa Omolade Abejirinde ◽  
Oluwasola Banke-Thomas ◽  
Ejemai Amaize Eboreime ◽  
...  
Keyword(s):  
Systematic Review ◽  
Maternal Health ◽  
Health Services ◽  
Maternal Health Services ◽  
Maternal Health Service ◽  
Inclusion Criteria ◽  
Middle Income ◽  
Cost Drivers ◽  
Middle Income Countries ◽  
Low And Middle Income

Background: Cost is a major barrier to maternal health service utilisation for many women in low- and middle-income countries (LMICs). However, comparable evidence of the available cost data in these countries is limited. We conducted a systematic review and comparative analysis of costs of utilising maternal health services in these settings. Methods: We searched peer-reviewed and grey literature databases for articles reporting cost of utilising maternal health services in LMICs published post-2000. All retrieved records were screened and articles meeting the inclusion criteria selected. Quality assessment was performed using the relevant cost-specific criteria of the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. To guarantee comparability, disaggregated costs data were inflated to 2019 US dollar equivalents. Total adjusted costs and cost drivers associated with utilising each service were systematically compared. Where heterogeneity in methods or non-disaggregated costs was observed, narrative synthesis was used to summarise findings. Results: Thirty-six studies met our inclusion criteria. Many of the studies costed multiple services. However, the most frequently costed services were utilisation of normal vaginal delivery (22 studies), caesarean delivery (13), and antenatal care (ANC) (10). The least costed services were post-natal care (PNC) and post-abortion care (PAC) (5 each). Studies used varied methods for data collection and analysis and their quality ranged from low to high with most assessed as average or high. Generally, across all included studies, cost of utilisation progressively increased from ANC and PNC to delivery and PAC, and from public to private providers. Medicines and diagnostics were main cost drivers for ANC and PNC while cost drivers were variable for delivery. Women experienced financial burden of utilising maternal health services and also had to pay some unofficial costs to access care, even where formal exemptions existed. Conclusion: Consensus regarding approach for costing maternal health services will help to improve their relevance for supporting policy-making towards achieving universal health coverage. If indeed the post-2015 mission of the global community is to "leave no one behind," then we need to ensure that women and their families are not facing unnecessary and unaffordable costs that could potentially tip them into poverty.

scholarly journals A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries

2018 ◽  
Vol 15 (10) ◽  
pp. 2165 ◽  
Author(s):  
Tess Bright ◽  
Sarah Wallace ◽  
Hannah Kuper
Keyword(s):  
Systematic Review ◽  
Health Services ◽  
People With Disabilities ◽  
Population Level ◽  
Assistive Devices ◽  
Rehabilitation Services ◽  
Middle Income ◽  
Diverse Range ◽  
Middle Income Countries ◽  
Low And Middle Income

Rehabilitation seeks to optimize functioning of people with impairments and includes a range of specific health services—diagnosis, treatment, surgery, assistive devices, and therapy. Evidence on access to rehabilitation services for people with disabilities in low- and middle-income countries (LMICs) is limited. A systematic review was conducted to examine this in depth. In February 2017, six databases were searched for studies measuring access to rehabilitation among people with disabilities in LMICs. Eligible measures of access to rehabilitation included: use of assistive devices, use of specialist health services, and adherence to treatment. Two reviewers independently screened titles, abstracts, and full texts. Data was extracted by one reviewer and checked by a second. Of 13,048 screened studies, 77 were eligible for inclusion. These covered a broad geographic area. 17% of studies measured access to hearing-specific services; 22% vision-specific; 31% physical impairment-specific; and 44% measured access to mental impairment-specific services. A further 35% measured access to services for any disability. A diverse range of measures of disability and access were used across studies making comparability difficult. However, there was some evidence that access to rehabilitation is low among people with disabilities. No clear patterns were seen in access by equity measures such as age, locality, socioeconomic status, or country income group due to the limited number of studies measuring these indicators, and the range of measures used. Access to rehabilitation services was highly variable and poorly measured within the studies in the review, but generally shown to be low. Far better metrics are needed, including through clinical assessment, before we have a true appreciation of the population level need for and coverage of these services.

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