scholarly journals Community monitoring interventions to curb corruption and increase access and quality of service delivery in low‐ and middle‐income countries: a systematic review

2016 ◽  
Vol 12 (1) ◽  
pp. 1-204 ◽  
Author(s):  
Ezequiel Molina ◽  
Laura Carella ◽  
Ana Pacheco ◽  
Guillermo Cruces ◽  
Leonardo Gasparini
Keyword(s):  
Systematic Review ◽  
Quality Of Service ◽  
Service Delivery ◽  
Middle Income ◽  
Middle Income Countries ◽  
Community Monitoring ◽  
Access And Quality ◽  
Low And Middle Income

scholarly journals Psychological interventions for bipolar disorder in low- and middle-income countries: systematic review

BJPsych Open ◽  
2018 ◽  
Vol 4 (5) ◽  
pp. 375-384 ◽  
Author(s):  
Mekdes Demissie ◽  
Charlotte Hanlon ◽  
Rahel Birhane ◽  
Lauren Ng ◽  
Girmay Medhin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Bipolar Disorder ◽  
Low Income ◽  
Hospital Admissions ◽  
Psychological Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

BackgroundAdjunctive psychological interventions for bipolar disorder have demonstrated better efficacy in preventing or delaying relapse and improving outcomes compared with pharmacotherapy alone.AimsTo evaluate the efficacy of psychological interventions for bipolar disorder in low- and middle-income countries.MethodA systematic review was conducted using PubMed, PsycINFO, Medline, EMBASE, Cochrane database for systematic review, Cochrane central register of controlled trials, Latin America and Caribbean Center on Health Science Literature and African Journals Online databases with no restriction of language or year of publication. Methodological heterogeneity of studies precluded meta-analysis.ResultsA total of 18 adjunctive studies were identified: psychoeducation (n = 14), family intervention (n = 1), group cognitive–behavioural therapy (CBT) (n = 2) and group mindfulness-based cognitive therapy (MBCT) (n = 1). In total, 16 of the 18 studies were from upper-middle-income countries and none from low-income countries. All used mental health specialists or experienced therapists to deliver the intervention. Most of the studies have moderately high risk of bias. Psychoeducation improved treatment adherence, knowledge of and attitudes towards bipolar disorder and quality of life, and led to decreased relapse rates and hospital admissions. Family psychoeducation prevented relapse, decreased hospital admissions and improved medication adherence. CBT reduced both depressive and manic symptoms. MBCT reduced emotional dysregulation.ConclusionsAdjunctive psychological interventions alongside pharmacotherapy appear to improve the clinical outcome and quality of life of people with bipolar disorder in middle-income countries. Further studies are required to investigate contextual adaptation and the role of non-specialists in the provision of psychological interventions to ensure scalability and the efficacy of these interventions in low-income country settings.Declaration of interestNone.

scholarly journals Quality of stroke guidelines in low- and middle-income countries: a systematic review

2021 ◽  
Vol 99 (09) ◽  
pp. 640-652E
Author(s):  
Joseph Yaria ◽  
Artyom Gil ◽  
Akintomiwa Makanjuola ◽  
Richard Oguntoye ◽  
Jaime Miranda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Systematic review of early abortion services in low- and middle-income country primary care: potential for reverse innovation and application in the UK context

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Jacy Zhou ◽  
Rebecca Blaylock ◽  
Matthew Harris
Keyword(s):  
Primary Care ◽  
Service Delivery ◽  
Middle Income ◽  
Middle Income Countries ◽  
Service Delivery Models ◽  
Primary Care Settings ◽  
The Uk ◽  
Delivery Models ◽  
Low And Middle Income

Abstract Background In the UK, according to the 1967 Abortion Act, all abortions must be approved by two doctors, reported to the Department of Health and Social Care (DHSC), and be performed by doctors within licensed premises. Removing abortion from the criminal framework could permit new service delivery models. We explore service delivery models in primary care settings that can improve accessibility without negatively impacting the safety and efficiency of abortion services. Novel service delivery models are common in low-and-middle income countries (LMICs) due to resource constraints, and services are sometimes provided by trained, mid-level providers via “task-shifting”. The aim of this study is to explore the quality of early abortion services provided in primary care of LMICs and explore the potential benefits of extending their application to the UK context. Methods We searched MEDLINE, EMBASE, Global Health, Maternity and Infant Care, CINAHL, and HMIC for studies published from September 1994 to February 2020, with search terms “nurses”, “midwives”, “general physicians”, “early medical/surgical abortion”. We included studies that examined the quality of abortion care in primary care settings of low-and-middle-income countries (LMICs), and excluded studies in countries where abortion is illegal, and those of services provided by independent NGOs. We conducted a thematic analysis and narrative synthesis to identify indicators of quality care at structural, process and outcome levels of the Donabedian model. Results A total of 21 indicators under 8 subthemes were identified to examine the quality of service provision: law and policy, infrastructure, technical competency, information provision, client-provider interactions, ancillary services, complete abortions, client satisfaction. Our analysis suggests that structural, process and outcome indicators follow a mediation pathway of the Donabedian model. This review showed that providing early medical abortion in primary care services is safe and feasible and “task-shifting” to mid-level providers can effectively replace doctors in providing abortion. Conclusion The way services are organised in LMICs, using a task-shifted and decentralised model, results in high quality services that should be considered for adoption in the UK. Collaboration with professional medical bodies and governmental departments is necessary to expand services from secondary to primary care.

scholarly journals Quality of medicines for life-threatening pregnancy complications in low- and middle-income countries: A systematic review

PLoS ONE ◽  
2020 ◽  
Vol 15 (7) ◽  
pp. e0236060 ◽  
Author(s):  
Maria Regina Torloni ◽  
Mercedes Bonet ◽  
Ana Pilar Betrán ◽  
Carolina C. Ribeiro-do-Valle ◽  
Mariana Widmer
Keyword(s):  
Systematic Review ◽  
Pregnancy Complications ◽  
Middle Income ◽  
Middle Income Countries ◽  
Life Threatening ◽  
Low And Middle Income

scholarly journals The prevalence of depression symptoms among infertile women: a systematic review and meta-analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Zahra Kiani ◽  
Masoumeh Simbar ◽  
Sepideh Hajian ◽  
Farid Zayeri
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Depression Symptoms ◽  
Middle Income ◽  
Infertile Women ◽  
Middle Income Countries ◽  
Pooled Prevalence ◽  
Prevalence Of Depression ◽  
Low And Middle Income

Abstract Background Infertile women’s mental health problems, including depression, are key fertility health issues that affect infertile women more severely than infertile men. Depression may threaten the health of individuals and reduce the quality of their lives. Considering the role and impact of depression on responses to infertility treatments, a systematic review and meta-analysis were conducted to investigate the prevalence of depression symptoms among infertile women. Methods International databases (PubMed, Cochrane Library, Web of Sciences, Scopus, Embase, and PsycINFO), national databases (SID and Magiran), and Google Scholar were searched by two independent reviewers for articles published from 2000 to April 5, 2020. The search procedure was performed in both Persian and English using keywords such as “depression,” “disorders,” “infertility,” “prevalence,” and “epidemiology.” The articles were evaluated in terms of their titles, abstracts, and full texts. The reviewers evaluated the quality of the articles using the Newcastle–Ottawa Scale, after which they analyzed the findings using STATA version 14. The I2 and Egger’s tests were performed to examine heterogeneity and publication bias, respectively. Results Thirty-two articles were subjected to the meta-analysis, and a random effects model was used in the examination given the heterogeneity of the articles. The samples in the reviewed studies encompassed a total of 9679 infertile women. The lowest and highest pooled prevalence rates were 21.01% (95% confidence interval [CI]: 15.61–34.42), as determined using the Hospital Anxiety and Depression Scale, and 52.21% (95% CI: 43.51–60.91), as ascertained using the Beck Depression Inventory, respectively. The pooled prevalence values of depression among infertile women were 44.32% (95% CI: 35.65–52.99) in low- and middle-income countries and 28.03% (95% CI: 19.61–36.44) in high-income countries. Conclusion The prevalence of depression among infertile women was higher than that among the general population of a given country. Especially in low- and middle-income countries, appropriate measures, planning, and policy that target the negative effects of depression on infertile women’s lives should be established to reduce related problems.

scholarly journals Challenges of Health Care Reforms (HCRS) in Low and Middle-Income Countries (LMICs): A Qualitative Systematic Review

2021 ◽  
Author(s):  
Farbod Ebadi FardAzar ◽  
Azam Choopani ◽  
Seyed Ahmad Ahmadi Teymourlouy ◽  
Seyed Hasan Arkian
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Human Resources ◽  
Exclusion Criteria ◽  
Health Care Reforms ◽  
Middle Income ◽  
Middle Income Countries ◽  
Text Reading ◽  
Low And Middle Income

Abstract Background: Healthcare reforms (HCRs) are performed by many resource-limited countries to improve the quality of health care. However, reforms do not always lead to the expected benefits and implementation problems are not fully considered due to lack of a systematic analysis of HCRs in these countries. Thus, the present study aimed to review the challenges of health care reforms in low and middle-income countries systematically.Method: A systematic review of qualitative studies was used in the present study. Data were searched in five databases. The references related to the selected articles were searched for any relevant study irrespective of gray literature. The articles were screened based on PRISMA. The duplicates were removed, others were screened based on the title and abstract, and the eligible ones were selected for full-text reading and those matched with inclusion and exclusion criteria were selected for review. Framework analyses were used for data analysis, and the quality of the studies was evaluated by the CASP checklist for qualitative studies.Results: 702 articles were found, among which 149 were duplicated, 553 were selected to primary screening, 390 were excluded, and 163 were selected for full text reading. Finally, 151 articles were excluded, and 12 matched with the inclusion and exclusion criteria were included in the study.Conclusion:Health reforms in low and middle-income countries have faced different challenges in financing, human resources, drugs and medicine, infrastructures, and governance, which can be influenced the delivery of qualified services. Thus, in order to design and implement any health care reforms in these countries, it is recommended for policymakers to take appropriate decisions about agenda setting, regulations and guidelines, sustainability of financing resources, collaborations, accountabilities and responsibilities, as well as the way of providing human resources, infrastructures, needed drugs, and medicine. In addition, the way of accessing services in rural and remote areas should be clarified. Finally, the reforms should be made very intelligently to direct the funds for the right needs and priorities in the countries where the donors’ interests may be affected.

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