Utilization of traditional medicine in primary health care in low- and middle-income countries: a systematic review

2020 ◽  
Vol 35 (8) ◽  
pp. 1070-1083
Author(s):  
Jae Kyoun Kim ◽  
Kyeong Han Kim ◽  
Yong Cheol Shin ◽  
Bo-Hyoung Jang ◽  
Seong-Gyu Ko
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Primary Health Care ◽  
Traditional Medicine ◽  
National Health ◽  
Health Workers ◽  
Referral System ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Health

Abstract This paper reports the findings from the first systematic review of the utilization of traditional medicine (TM) in primary health care (PHC) in low- and middle-income countries (LMICs). PHC is an important component of health care and essential for achieving universal health coverage (UHC). For countries where there is a gap in PHC, TM plays a vital role. It is widely used and has the potential to increase the coverage of PHC and UHC. Hence in situations where TM is recognized in a considerable magnitude, there are scarce evidence and minimal regulation on it and TM practitioners (TMPs). This study aims to identify the current situation in the utilization of TM in PHC or UHC in LMICs. A systematic review and thematic synthesis of qualitative and quantitative studies have been conducted. A total of 56 articles met the criteria and were included in the review. In all, 14 analytic themes have been developed including the current use of TM in PHC, higher accessibility of TM, medical pluralism, national health system, national health policy and national health insurance to include TM, including TMPs in the referral system, utilizing TMPs as community health workers, the needs of scientific research on TM and the need for training both TMPs and conventional medical staffs for better collaboration. The study concluded that it is necessary to further focus on TM in the macro level on strengthening the referral system by including TM to establish a comprehensive service delivery network under UHC and in the micro level to focus on training the TMPs and conventional medicine health workers on both areas to attain more in-depth understanding of each other, which can lead to better collaboration and quality patient care.

scholarly journals Prevalence and factors associated with burnout among frontline primary health care providers in low- and middle-income countries: A systematic review

2018 ◽  
Vol 2 ◽  
pp. 4 ◽  
Author(s):  
Sagar Dugani ◽  
Henrietta Afari ◽  
Lisa R. Hirschhorn ◽  
Hannah Ratcliffe ◽  
Jeremy Veillard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Health Workers ◽  
Care Providers ◽  
Middle Income ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Primary Health

Background: Primary health care (PHC) systems require motivated and well-trained frontline providers, but are increasingly challenged by the growing global shortage of health care workers. Burnout, defined as emotional exhaustion, depersonalization, and low personal achievement, negatively impacts motivation and may further decrease productivity of already limited workforces. The objective of this review was to analyze the prevalence of and factors associated with provider burnout in low and middle-income countries (LMICs). Methods: We performed a systematic review of articles on outpatient provider burnout in LMICs published up to 2016 in three electronic databases (EMBASE, MEDLINE, and CAB). Articles were reviewed to identify prevalence of factors associated with provider burnout. Results: A total of 6,182 articles were identified, with 20 meeting eligibility criteria. We found heterogeneity in definition and prevalence of burnout. Most studies assessed burnout using the Maslach Burnout Inventory. All three dimensions of burnout were seen across multiple cadres (physicians, nurses, community health workers, midwives, and pharmacists). Frontline nurses in South Africa had the highest prevalence of high emotional exhaustion and depersonalization, while PHC providers in Lebanon had the highest reported prevalence of low personal achievement. Higher provider burnout (for example, among nurses, pharmacists, and rural health workers) was associated with high job stress, high time pressure and workload, and lack of organizational support. Conclusions: Our comprehensive review of published literature showed that provider burnout is prevalent across various health care providers in LMICs. Further studies are required to better measure the causes and consequences of burnout and guide the development of effective interventions to reduce or prevent burnout.

scholarly journals Prevalence and factors associated with burnout among frontline primary health care providers in low- and middle-income countries: A systematic review

2018 ◽  
Vol 2 ◽  
pp. 4 ◽  
Author(s):  
Sagar Dugani ◽  
Henrietta Afari ◽  
Lisa R. Hirschhorn ◽  
Hannah Ratcliffe ◽  
Jeremy Veillard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Health Workers ◽  
Care Providers ◽  
Middle Income ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Primary Health

Background: Primary health care (PHC) systems require motivated and well-trained frontline providers, but are increasingly challenged by the growing global shortage of health care workers. Burnout, defined as emotional exhaustion, depersonalization, and low personal achievement, negatively impacts motivation and may further decrease productivity of already limited workforces. The objective of this review was to analyze the prevalence of and factors associated with provider burnout in low and middle-income countries (LMICs). Methods: We performed a systematic review of articles on outpatient provider burnout in LMICs published up to 2016 in three electronic databases (EMBASE, MEDLINE, and CAB). Articles were reviewed to identify prevalence of factors associated with provider burnout. Results: A total of 6,182 articles were identified, with 20 meeting eligibility criteria. We found heterogeneity in definition and prevalence of burnout. Most studies assessed burnout using the Maslach Burnout Inventory. All three dimensions of burnout were seen across multiple cadres (physicians, nurses, community health workers, midwives, and pharmacists). Frontline nurses in South Africa had the highest prevalence of high emotional exhaustion and depersonalization, while PHC providers in Lebanon had the highest reported prevalence of low personal achievement. Higher provider burnout (for example, among nurses, pharmacists, and rural health workers) was associated with high job stress, high time pressure and workload, and lack of organizational support. Conclusions: Our comprehensive review of published literature showed that provider burnout is prevalent across various health care providers in LMICs. Further studies are required to better measure the causes and consequences of burnout and guide the development of effective interventions to reduce or prevent burnout.

scholarly journals Prevalence and factors associated with burnout among frontline primary health care providers in low- and middle-income countries: A systematic review

2018 ◽  
Vol 2 ◽  
pp. 4 ◽  
Author(s):  
Sagar Dugani ◽  
Henrietta Afari ◽  
Lisa R. Hirschhorn ◽  
Hannah Ratcliffe ◽  
Jeremy Veillard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Emotional Exhaustion ◽  
Care Providers ◽  
Middle Income ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Primary Health

Background: Primary health care (PHC) systems require motivated and well-trained frontline providers, but are increasingly challenged by the growing global shortage of health care workers. Burnout, defined as emotional exhaustion, depersonalization, and low personal achievement, negatively impacts motivation and may further decrease productivity of already limited workforces. The objective of this review was to analyze the prevalence of and factors associated with provider burnout in low and middle-income countries (LMICs). Methods: We performed a systematic review of articles on outpatient provider burnout in LMICs published up to 2016 in three electronic databases (EMBASE, MEDLINE, and CAB). Articles were reviewed to identify prevalence of and risk factors associated with provider burnout. Results: A total of 6,182 articles were identified, with 20 meeting eligibility criteria. We found heterogeneity in definition and prevalence of burnout. Most studies assessed burnout using the Maslach Burnout Inventory. All three dimensions of burnout were seen across multiple cadres (physicians, nurses, community health workers, and pharmacists). Frontline nurses in South Africa had the highest prevalence of high emotional exhaustion and depersonalization, while PHC providers in Lebanon had the highest reported prevalence of low personal achievement. Higher provider burnout was associated with high job stress, high time pressure and workload, and lack of organizational support. Conclusions: Our comprehensive review of published literature showed that provider burnout is an important problem across various health care providers in LMICs. Further studies are required to better measure the prevalence, causes and consequences of burnout, and guide the development of effective interventions to reduce or prevent burnout.

scholarly journals Diagnosing dementia and cognitive dysfunction in the elderly in primary health care: A systematic review

2019 ◽  
Vol 13 (2) ◽  
pp. 144-153 ◽  
Author(s):  
Lucas N.C. Pelegrini ◽  
Gabriela M.P. Mota ◽  
Caio F. Ramos ◽  
Edson Jesus ◽  
Francisco A.C. Vale
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Primary Health Care ◽  
Cognitive Dysfunction ◽  
Low Income ◽  
Low Income Countries ◽  
Public Health Issue ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Health

ABSTRACT. Dementia is a public health issue making the screening and diagnosing of dementia and its prodromal phases in all health settings imperative. Objective: using PRISMA, this systematic review aimed to identify how low-, middle-, and high-income countries establish dementia and cognitive dysfunction diagnoses in primary health care. Methods: studies from the past five years in English, Spanish, and Portuguese were retrieved from Scopus, PubMed, Embase, Lilacs, Scielo, and Web of Science. Of 1987 articles, 33 were selected for analysis. Results: only three articles were from middle-income countries and there were no studies from low-income countries. The most used instrument was the Mini-Mental State Examination (MMSE). Mild Cognitive Impairment (MCI) and dementia criteria were based on experts’ recommendation as well as on the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD-10), respectively. Conclusion: differences between these criteria among high- and middle-income countries were observed.

scholarly journals Inequalities in Older age and Primary Health Care Utilization in Low- and Middle-Income Countries: A Systematic Review

2021 ◽  
pp. 002073142110412
Author(s):  
Qian Gao ◽  
A. Matthew Prina ◽  
Yuteng Ma ◽  
David Aceituno ◽  
Rosie Mayston
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Primary Health Care ◽  
Health Insurance ◽  
Older People ◽  
Older Age ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Health ◽  
Low And Middle Income

The objective of this research was to systematically review and synthesize quantitative studies that assessed the association between socioeconomic inequalities and primary health care (PHC) utilization among older people living in low- and middle- income countries (LMICs). Six databases were searched, including Embase, Medline, Psych Info, Global Health, Latin American and Caribbean Health Sciences Literature (LILACS), and China National Knowledge Infrastructure, CNKI, to identify eligible studies. A narrative synthesis approach was used for evidence synthesis. A total of 20 eligible cross-sectional studies were included in this systematic review. The indicators of socioeconomic status (SES) identified included income level, education, employment/occupation, and health insurance. Most studies reported that higher income, higher educational levels and enrollment in health insurance plans were associated with increased PHC utilization. Several studies suggested that people who were unemployed and economically inactive in older age or who had worked in formal sectors were more likely to use PHC. Our findings suggest a pro-rich phenomenon of PHC utilization in older people living in LMICs, with results varying by indicators of SES and study settings.

scholarly journals Organisation of primary health care systems in low- and middle-income countries: review of evidence on what works and why in the Asia-Pacific region

2019 ◽  
Vol 4 (Suppl 8) ◽  
pp. e001487 ◽  
Author(s):  
Rebecca Dodd ◽  
Anna Palagyi ◽  
Stephen Jan ◽  
Marwa Abdel-All ◽  
Devaki Nambiar ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Engagement ◽  
Asia Pacific ◽  
Pacific Region ◽  
Asia Pacific Region ◽  
Middle Income ◽  
Middle Income Countries ◽  
What Works ◽  
Primary Health

IntroductionThis paper synthesises evidence on the organisation of primary health care (PHC) service delivery in low-income and middle-income countries (LMICs) in the Asia Pacific and identifies evidence of effective approaches and pathways of impact in this region.MethodsWe developed a conceptual framework describing key inputs and outcomes of PHC as the basis of a systematic review. We searched exclusively for intervention studies from LMICs of the Asia-Pacific region in an effort to identify ‘what works’ to improve the coverage, quality, efficiency, equity and responsiveness of PHC. We conducted a narrative synthesis to identify key characteristics of successful interventions.ResultsFrom an initial list of 3001 articles, we selected 153 for full-text review and included 111. We found evidence on the impact of non-physician health workers (NPHWs) on coverage and quality of care, though better integration with other PHC services is needed. Community-based services are most effective when well integrated through functional referral systems and supportive supervision arrangements, and have a reliable supply of medicines. Many studies point to the importance of community engagement in improving service demand. Few studies adopted a ‘systems’ lens or adequately considered long-term costs or implementation challenges.ConclusionBased on our findings, we suggest five areas where more practical knowledge and guidance is needed to support PHC systems strengthening: (1) NPHW workforce development; (2) integrating non-communicable disease prevention and control into the basic package of care; (3) building managerial capacity; (4) institutionalising community engagement; (5) modernising PHC information systems.

scholarly journals Guide posts for investment in primary health care and projected resource needs in 67 low-income and middle-income countries: a modelling study

2019 ◽  
Vol 7 (11) ◽  
pp. e1500-e1510 ◽  
Author(s):  
Karin Stenberg ◽  
Odd Hanssen ◽  
Melanie Bertram ◽  
Callum Brindley ◽  
Andreia Meshreky ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Low Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Health ◽  
Resource Needs ◽  
Modelling Study

Models of community-based primary care for epilepsy in low- and middle-income countries

Neurology ◽  
2020 ◽  
Vol 94 (4) ◽  
pp. 165-175 ◽  
Author(s):  
Gagandeep Singh ◽  
Meenakshi Sharma ◽  
Anand Krishnan ◽  
Tarun Dua ◽  
Francesco d'Aniello ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Treatment Adherence ◽  
Community Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Community Awareness ◽  
Primary Health ◽  
Low And Middle Income

ObjectiveTo review systematically community-based primary care interventions for epilepsy in low- and middle-income countries to rationalize approaches and outcome measures in relation to epilepsy care in these countries.MethodsA systematic search of PubMed, EMBASE, Global Index Medicus, CINAHL, and Web of Science was undertaken to identify trials and implementation of provision of antiseizure medications, adherence reinforcement, and/or health care provider or community education in community-based samples of epilepsy. Data on populations addressed, interventions, and outcomes were extracted from eligible articles.ResultsThe 24 reports identified comprise mostly care programs addressing active convulsive epilepsy. Phenobarbital has been used most frequently, although other conventional antiseizure medications (ASMs) have also been used, but none of the newer. Tolerability rates in these studies are high, but overall attrition is considerable. Other approaches include updating primary health care providers, reinforcing treatment adherence in clinics, and raising community awareness. In these programs, the coverage of existing treatment gap in the community, epilepsy-related mortality, and comorbidity burden are only fleetingly addressed. None, however, explicitly describe sustainability plans.ConclusionsCost-free provision, mostly of phenobarbital, has resulted in short-term seizure freedom in roughly half of the people with epilepsy in low- and middle-income countries. Future programs should include a range of ASMs. These should cover apart from seizure control and treatment adherence, primary health care provider education, community awareness, and referral protocols for specialist care. Programs should incorporate impact assessment at the local level. Sustainability in the long term as much as resilience and scalability should be addressed in future initiatives.

Strengthening Primary Health Care in Low- and Middle-Income Countries

2013 ◽  
Vol 26 (4) ◽  
pp. 339-348 ◽  
Author(s):  
John Rule ◽  
Duc Anh Ngo ◽  
Tran Thi Mai Oanh ◽  
Augustine Asante ◽  
Jennifer Doyle ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Health ◽  
Low And Middle Income
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