Addressing barriers to exclusive breast-feeding in low- and middle-income countries: a systematic review and programmatic implications

AbstractObjectiveDespite numerous global initiatives on breast-feeding, trend data show exclusive breast-feeding (EBF) rates have stagnated over the last two decades. The purpose of the present systematic review was to determine barriers to exclusive breast-feeding in twenty-five low- and middle-income countries and discuss implications for programmes.DesignA search of Scopus, MEDLINE, CINAHL and PsychINFO was conducted to retrieve studies from January 2000 to October 2015. Using inclusion criteria, we selected both qualitative and quantitative studies that described barriers to EBF.SettingLow- and middle-income countries.SubjectsFollowing application of systematic review criteria, forty-eight articles from fourteen countries were included in the review.ResultsSixteen barriers to EBF were identified in the review. There is moderate evidence of a negative association between maternal employment and EBF practices. Studies that examined EBF barriers at childbirth and the initial 24 h post-delivery found strong evidence that caesarean section can impede EBF. There is moderate evidence for early initiation of breast-feeding and likelihood of practising EBF. Breast-feeding problems were commonly reported from cross-sectional or observational studies. Counselling on EBF and the presence of family and/or community support have demonstrated improvements in EBF.ConclusionsImproving the counselling skills of health workers to address breast-feeding problems and increasing community support for breast-feeding are critical components of infant and young child feeding programming, which will aid in attaining the 2025 World Health Assembly EBF targets. Legislation and regulations on marketing of breast-milk substitutes, paid maternity leave and breast-feeding breaks for working mothers require attention in low- and middle-income countries.

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Community-based interventions for preventing COVID-19 transmission in low- and middle-income countries: A systematic review

10.21203/rs.3.rs-98441/v1 ◽

2020 ◽

Author(s):

Master R.O. Chisale ◽

Sheena Ramazanu ◽

Joseph Tsung-Shu Wu ◽

Frank W. Sinyiza ◽

Thokozani Bvumbwe ◽

...

Keyword(s):

Systematic Review ◽

World Health ◽

Flow Diagram ◽

Main Body ◽

Community Based Interventions ◽

Community Based ◽

Middle Income ◽

Factors Affecting ◽

Middle Income Countries ◽

Low And Middle Income

Abstract Background World Health Organisation (WHO) has approved and recommended several public health measures to halt the Coronavirus Disease 2019 (COVID-19) pandemic. The implementation of recommended interventions vary between higher income and Low and Middle-Income Countries (LMICs). The economical constraints within LMICs posed challenges in accessing resources for COVID-19 prevention. The study aimed to identify the workable community-based interventions being utilised in LMICs.Main body We applied systematic review approach for this study. Included articles were searched in eight online databases. The analysis was guided by the acceptable of best practice developed by the PROSPERO and COCHRANE for systematic search and selection of articles using pre-defined search terms. Furthermore, a PRISMA flow diagram was used to show the number of articles retrieved, retained, excluded with rationales given for every action. Studies conducted on community-based intervention for preventing COVID-19 and levels of knowledge, attitudes and practice (KAP) on community-based intervention for preventing COVID-19 regardless of the design were included. A mixed method appraisal tool (MMAT) was used to appraise studies.Six studies from LMICs were included for detail analysis after the systematic review screening process from 10,100 articles. The quality assessment using MMAT tool appraised these articles were all in highest quality. Among the six articles, 10 community-based interventions were implemented in LMICs. The three key workable and implemented interventions are: use of masks, social distance and hand wash. The review identified varying levels of KAP between LMICs and social-demographical factors affecting KAP in these settings.Conclusion This systematic review has identified the community-based interventions implemented in LMICs to prevent COVID-19 during the pandemic and key factors affecting the level of KAP among the population. This study re-affirms the importance of effective and suitable implementation of the identified interventions. More studies need to be conducted in LMICs to establish the effectiveness and adoption of the implemented and recommended interventions.

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Barriers and facilitators to implementation of oral rehydration therapy in low- and middle-income countries: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0249638 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249638

Author(s):

Obidimma Ezezika ◽

Apira Ragunathan ◽

Yasmine El-Bakri ◽

Kathryn Barrett

Keyword(s):

Systematic Review ◽

Implementation Research ◽

Oral Rehydration Therapy ◽

Barriers And Facilitators ◽

World Health ◽

Successful Implementation ◽

Middle Income ◽

Oral Rehydration ◽

Middle Income Countries ◽

Low And Middle Income

Background Oral rehydration therapy (ORT) is an effective and cheap treatment for diarrheal disease; globally, one of the leading causes of death in children under five. The World Health Organization launched a global campaign to improve ORT coverage in 1978, with activities such as educational campaigns, training health workers and the creation of designate programming. Despite these efforts, ORT coverage remains relatively low. The objective of this systematic review is to identify the barriers and facilitators to the implementation of oral rehydration therapy in low and middle-income countries. Methods A comprehensive search strategy comprised of relevant subject headings and keywords was executed in 5 databases including OVID Medline, OVID Embase, OVID HealthStar, Web of Science and Scopus. Eligible studies underwent quality assessment, and a directed content analysis approach to data extraction was conducted and aligned to the Consolidated Framework for Implementation Research (CFIR) to facilitate narrative synthesis. Results The search identified 1570 citations and following removal of duplicates as well as screening according to our inclusion/exclusion criteria, 55 articles were eligible for inclusion in the review. Twenty-three countries were represented in this review, with India, Bangladesh, Egypt, Nigeria, and South Africa having the most representation of available studies. Study dates ranged from 1981 to 2020. Overarching thematic areas spanning the barriers and facilitators that were identified included: availability and accessibility, knowledge, partnership engagement, and design and acceptability. Conclusion A systematic review of studies on implementation of ORT in low- and middle-income countries (LMICs) highlights key activities that facilitate the development of successful implementation that include: (1) availability and accessibility of ORT, (2) awareness and education among communities, (3) strong partnership engagement strategies, and (4) adaptable design to enhance acceptability. The barriers and facilitators identified under the CIFR domains can be used to build knowledge on how to adapt ORT to national and local settings and contribute to a better understanding on the implementation and use of ORT in LMICs. The prospects for scaling and sustaining ORT (after years of low use) will increase if implementation research informs local applications, and implementers engage appropriate stakeholders and test assumptions around localized theories of change from interventions to expected outcomes. Registration A protocol for this systematic review was developed and uploaded onto the PROSPERO international prospective register of systematic reviews database (Registration number: CRD420201695).

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Re: Agreement between current status and retrospective data for prevalence and duration of exclusive breast feeding from low‐ and middle‐income countries surveys: Methodological issues

Paediatric and Perinatal Epidemiology ◽

10.1111/ppe.12614 ◽

2019 ◽

Vol 34 (1) ◽

pp. 99-99 ◽

Cited By ~ 1

Author(s):

Abolghsem Shokri ◽

Siamak Sabour

Keyword(s):

Breast Feeding ◽

Current Status ◽

Retrospective Data ◽

Methodological Issues ◽

Middle Income ◽

Exclusive Breast Feeding ◽

Middle Income Countries ◽

Low And Middle Income

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Re: Agreement between current status and retrospective data for prevalence and duration of exclusive breast feeding from low‐ and middle‐income countries surveys

Paediatric and Perinatal Epidemiology ◽

10.1111/ppe.12617 ◽

2019 ◽

Vol 34 (1) ◽

pp. 100-101

Author(s):

Ana Elisa Madalena Rinaldi ◽

Catarina Machado Azeredo ◽

Leandro Alves Pereira ◽

Bernardo Lessa Horta ◽

Wolney Lisboa Conde

Keyword(s):

Breast Feeding ◽

Current Status ◽

Retrospective Data ◽

Middle Income ◽

Exclusive Breast Feeding ◽

Middle Income Countries ◽

Low And Middle Income

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Lay-delivered talk therapies for adults affected by humanitarian crises in low- and middle-income countries

Conflict and Health ◽

10.1186/s13031-021-00363-8 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Grace K. Ryan ◽

Andreas Bauer ◽

Tarik Endale ◽

Onaiza Qureshi ◽

Asmae Doukani ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Evidence Synthesis ◽

World Health ◽

Cochrane Library ◽

Middle Income ◽

Middle Income Countries ◽

Link Type ◽

Humanitarian Crises ◽

Low And Middle Income

Abstract Background Published by the World Health Organization (WHO) and United Nations High Commissioner for Refugees (UNHCR) in 2015, the mental health Gap Action Programme Humanitarian Intervention Guide (mhGAP-HIG) recommends brief versions of structured psychological interventions for people experiencing symptoms of common mental disorders (CMDs). mhGAP-HIG acknowledges a growing body of evidence suggesting these interventions can be delivered by lay workers to people affected by humanitarian crises in low- and middle-income countries (LMICs). However, there has not yet been a systematic review and synthesis of this evidence. This paper reports the results of a systematic review of qualitative, quantitative, and mixed-methods studies assessing the implementation and/or effectiveness of talk therapies for CMDs when provided by lay workers in LMICs to adults who have survived or are currently living in humanitarian situations. Methods Seven electronic databases were searched: MEDLINE, Embase, PsycINFO, PsycEXTRA, Global Health, Cochrane Library, and ClinicalTrials.gov. We also hand-searched the contents pages of three academic journals, reference lists of 30 systematic reviews, and online resource directories of two mental health networks. A preliminary list of included studies was circulated to topical experts for review, and all included studies were backward and forward searched. All titles, abstracts, and full-texts were independently double-screened. Quality appraisal and data extraction were carried out by a single reviewer and checked by a second reviewer, using standardised tools. Any disagreements were discussed and referred to a third reviewer as needed. Results We identified 23 unique studies and carried out a narrative synthesis of patient and implementation outcome data. Every evaluation of the effectiveness of lay-delivered talk therapies for adults affected by humanitarian crises in LMICs showed some treatment effect for at least one CMD, and often multiple CMDs. Implementation research generally found these interventions to be acceptable, appropriate and feasible to implement, with good fidelity to manualised therapies. Conclusion Although results are promising, particularly for individually-delivered talk therapies based on cognitive behavioural therapy techniques, there is a high degree of heterogeneity in this literature. We make several recommendations on how to improve the quality and generalisability of research on this topic, to facilitate further evidence synthesis. Trial registration PROSPERO registration number: CRD42017058287.

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Elasticity of alcohol consumption, alcohol-related harms, and drinking initiation in low- and middle-income countries: A systematic review and meta-analysis

The International Journal of Alcohol and Drug Research ◽

10.7895/ijadr.v2i1.50 ◽

2013 ◽

Vol 2 (1) ◽

pp. 45-58 ◽

Cited By ~ 29

Author(s):

Bundit Sornpaisarn ◽

Kevin Shield ◽

Joanna Cohen ◽

Robert Schwartz ◽

Jürgen Rehm

Keyword(s):

Systematic Review ◽

Alcohol Consumption ◽

Publication Bias ◽

Meta Analysis ◽

World Health ◽

Middle Income ◽

Middle Income Countries ◽

Meta Analyses ◽

Alcohol Price ◽

Low And Middle Income

Sornpaisarn, B., Shield, K. Cohen, J., Schwartz, R. & Rehm, J. (2013). Elasticity of alcohol consumption, alcohol-related harms, and drinking initiation in low- and middle-income countries: A systematic review and meta-analysis. International Journal of Alcohol and Drug Research, 2(1), 45-58. doi: 10.7895/ijadr.v2i1.50 (http://dx.doi.org/10.7895/ijadr.v2i1.50)Aim: To systematically review research outlining the effects of price and taxation on alcohol consumption, alcohol-related harms, and drinking initiation in low- and middle-income countries (LMIC).Design: The systematic review and meta-analyses were conducted according to internationally standardized protocols (Preferred Reporting Items for Systematic Review and Meta-Analysis; PRISMA). Data were collected up to June 2011 by searching the peer-reviewed article databases MEDLINE, EMBASE, PsycINFO, and EconLit, along with the World Health Organization’s gray literature Database of Abstracts of Reviews of Effects, and by reference tracking. The meta-analyses were performed using random effects analysis, tests for publication bias, and sensitivity analyses.Measures: Any type of association between alcohol price and/or taxation and alcohol consumption, alcohol-related harms, and alcohol drinking initiation in LMIC.Findings: Our systematic search disclosed 12 studies that outlined an association between alcohol price or taxation and alcohol consumption in LMIC, while no articles were found that outlined a relationship between taxation and/or price and alcohol-related harms or drinking initiation in LMIC. The elasticity estimates were –0.64 (95% CI: –0.80 to –0.48) for total consumption of alcohol, –0.50 (95% CI: –0.78 to –0.21) for consumption of beer, and –0.79 (95% CI: –1.09 to –0.49) for consumption of other alcoholic beverages. Publication bias did not significantly affect the estimated elasticities.Conclusion: Price elasticity of demand for alcohol in LMIC is similar to that found in high-income countries. There is an imperative need for research on the association between alcohol price or taxation and alcohol-related harms and drinking initiation in LMIC.

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