Health promotion at the workplace setting: a protocol for a systematic review of effectiveness and sustainability of current practice in low-income and middle-income countries

IntroductionLow-income and middle-income countries (LMICs) are experiencing a growing disease burden due to non-communicable diseases (NCDs). Changing behavioural practices, such as diets high in saturated fat, salt and sugar and sedentary lifestyles, have been associated with the increase in NCDs. Health promotion at the workplace setting is considered effective in the fight against NCDs and has been reported to yield numerous benefits. However, there is a need to generate evidence on the effectiveness and sustainability of workplace health promotion practice specific to LMICs. We aim to synthesise the current literature on workplace health promotion in LMICs focusing on interventions effectiveness and sustainability.Methods and analysisWe will conduct a systematic review of published studies from LMICs up to 31 March 2019. We will search the following databases: EMBASE, MEDLINE, PubMed, Web of Science, Scopus, ProQuest and CINAHL. Two reviewers will independently screen potential articles for inclusion and disagreements will be resolved by consensus. We will appraise the quality and risk of bias of included studies using two tools from the Cochrane handbook for systematic reviews of interventions. We will present a narrative overview and assessment of the body of evidence derived from the comprehensive review of the studies. The reported outcomes will be summarised by study design, duration, intensity/frequency of intervention delivery and by the six-priority health promotion action areas set out in the Ottawa Charter. We will conduct a thematic analysis to identify the focus areas of current interventions. This systematic review protocol has been prepared according to the Preferred Reporting Items for Systematic reviews and Meta- analyses for Protocols 2015 statement.Ethics and disseminationThis study does not require ethics approval. We will disseminate the results of this review through peer-reviewed publications and conference presentations.Trial registration numberCRD42018110853.

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The effectiveness of workplace health promotion in low- and middle-income countries

Health Promotion International ◽

10.1093/heapro/daz091 ◽

2019 ◽

Vol 35 (5) ◽

pp. 1220-1229 ◽

Cited By ~ 1

Author(s):

Cong Tuan Pham ◽

Dung Phung ◽

Thi Vinh Nguyen ◽

Cordia Chu

Keyword(s):

Health Promotion ◽

Manufacturing Industry ◽

Workplace Health Promotion ◽

Evaluation Studies ◽

Cochrane Library ◽

Workplace Health ◽

Middle Income ◽

Middle Income Countries ◽

Wide Range ◽

Low And Middle Income

Abstract Although many literature reviews synthesize literature regarding workplace health promotion (WHP) interventions, systematic reviews on the effectiveness of and factors influencing the operation of WHP activities in low- and middle-income countries (LMIC) are scarce. Therefore, we systematically reviewed evaluation studies to examine the effectiveness and factors related to the implementation of WHP programmes in LMIC. Twenty-six peer-reviewed and grey evaluation studies, published before November 2017, were included from electronic databases (PubMed, The Cochrane Library, PsycINFO, EMBASE and Web of Science) and manual searching. The results revealed that WHP intervention in LMIC was effective in reducing health risks in a wide range of industries and settings, including in resource-poor contexts such as small enterprises and the manufacturing industry. The main factors positively influencing the effectiveness of the intervention are long intervention time period, and needs-based and active intervention strategies. In addition, commitment from workplace leaders, the involvement of workers and support from authorities and professionals are factors contributing to a successful WHP programme. However, the evidence regarding the effectiveness of WHP in LMIC regarding the health outcomes and business productivity is inconclusive due to the several remaining methodological limitations. Future developments of more rigorous methods of evaluating the effectiveness of WHP activities should be addressed to produce higher-quality evidence that would inform future practice.

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Economics of physical activity in low-income and middle- income countries: a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-037784 ◽

2021 ◽

Vol 11 (1) ◽

pp. e037784

Author(s):

Priyanga Diloshini Ranasinghe ◽

Subhash Pokhrel ◽

Nana Kwame Anokye

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Economic Evaluation ◽

Drug Treatment ◽

Chronic Diseases ◽

Low Income ◽

Economic Burden ◽

Eligibility Criteria ◽

Middle Income ◽

Middle Income Countries

BackgroundPromotion of physical activity (PA) among populations is a global health investment. However, evidence on economic aspects of PA is sparse and scattered in low-income and middle-income countries (LMICs).ObjectiveThe objective of this study was to summarise the available evidence on economics of PA in LMICs, identify potential target variables for policy and report gaps in the existing economic evidence alongside research recommendations.Data sourcesA systematic review of the electronic databases (Scopus, Web of Science and SPORTDiscus) and grey literature.Study eligibility criteriaCost-of-illness studies, economic evaluations, interventions and descriptive studies on economic factors associated with PA using preset eligibility criteria.Study appraisal and synthesis of methodsScreening, study selection and quality appraisal based on standard checklists performed by two reviewers with consensus of a third reviewer. Descriptive synthesis of data was performed.ResultsThe majority of the studies were from upper-middle-income countries (n=16, 88.8%) and mainly from Brazil (n=9, 50%). Only one economic evaluation study was found. The focus of the reviewed literature spanned the economic burden of physical inactivity (n=4, 22%), relationship between PA and costs (n=6, 46%) and socioeconomic determinants of PA (n=7, 39%). The findings showed a considerable economic burden due to insufficient PA, with LMICs accounting for 75% of disability-adjusted life years (DALYs) globally due to insufficient PA. Socioeconomic correlates of PA were identified, and inverse relationship of PA with the cost of chronic diseases was established. Regular PA along with drug treatment as a treatment scheme for chronic diseases showed advantages with a cost–utility ratio of US$3.21/quality-adjusted life year (QALY) compared with the drug treatment-only group (US$3.92/QALY) by the only economic evaluation conducted in the LMIC, Brazil.LimitationsMeta-analysis was not performed due to heterogeneity of the studies.Conclusions and recommendationsEconomic evaluation studies for PA promotion interventions/strategies and local research from low-income countries are grossly inadequate. Setting economic research agenda in LMICs ought to be prioritised in those areas.PROSPERO registration numberCRD42018099856.

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Cardiorespiratory health effects of particulate ambient air pollution exposure in low-income and middle-income countries: a systematic review and meta-analysis

The Lancet Planetary Health ◽

10.1016/s2542-5196(17)30166-3 ◽

2017 ◽

Vol 1 (9) ◽

pp. e368-e380 ◽

Cited By ~ 36

Author(s):

Katherine Newell ◽

Christiana Kartsonaki ◽

Kin Bong Hubert Lam ◽

Om P Kurmi

Keyword(s):

Systematic Review ◽

Air Pollution ◽

Low Income ◽

Meta Analysis ◽

Ambient Air ◽

Ambient Air Pollution ◽

Middle Income ◽

Middle Income Countries ◽

Air Pollution Exposure ◽

Pollution Exposure

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Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-321385 ◽

2021 ◽

pp. archdischild-2020-321385

Author(s):

Omar Irfan ◽

Fiona Muttalib ◽

Kun Tang ◽

Li Jiang ◽

Zohra S Lassi ◽

...

Keyword(s):

Systematic Review ◽

Disease Severity ◽

World Bank ◽

Low Income ◽

Meta Analysis ◽

Severe Disease ◽

Income Level ◽

Clinical Findings ◽

Middle Income ◽

Middle Income Countries

ObjectiveCompare paediatric COVID-19 disease characteristics, management and outcomes according to World Bank country income level and disease severity.DesignSystematic review and meta-analysis.SettingBetween 1 December 2019 and 8 January 2021, 3350 articles were identified. Two reviewers conducted study screening, data abstraction and quality assessment independently and in duplicate. Observational studies describing laboratory-confirmed paediatric (0–19 years old) COVID-19 were considered for inclusion.Main outcomes and measuresThe pooled proportions of clinical findings, treatment and outcomes were compared according to World Bank country income level and reported disease severity.Results129 studies were included from 31 countries comprising 10 251 children of which 57.4% were hospitalised. Mean age was 7.0 years (SD 3.6), and 27.1% had a comorbidity. Fever (63.3%) and cough (33.7%) were common. Of 3670 cases, 44.1% had radiographic abnormalities. The majority of cases recovered (88.9%); however, 96 hospitalised children died. Compared with high-income countries, in low-income and middle-income countries, a lower proportion of cases were admitted to intensive care units (ICUs) (9.9% vs 26.0%) yet pooled proportion of deaths among hospitalised children was higher (relative risk 2.14, 95% CI 1.43 to 3.20). Children with severe disease received antimicrobials, inotropes and anti-inflammatory agents more frequently than those with non-severe disease. Subgroup analyses showed that a higher proportion of children with multisystem inflammatory syndrome (MIS-C) were admitted to ICU (47.1% vs 22.9%) and a higher proportion of hospitalised children with MIS-C died (4.8% vs 3.6%) compared with the overall sample.ConclusionPaediatric COVID-19 has a favourable prognosis. Further severe disease characterisation in children is needed globally.

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Outcomes of HIV treatment from the private sector in low-income and middle-income countries: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2019-031844 ◽

2020 ◽

Vol 10 (1) ◽

pp. e031844

Author(s):

Gitau Mburu ◽

Ewemade Igbinedion ◽

Sin How Lim ◽

Aung Zayar Paing ◽

Siyan Yi ◽

...

Keyword(s):

Systematic Review ◽

Private Sector ◽

Clinical Outcomes ◽

Low Income ◽

Hiv Treatment ◽

Future Research ◽

Publication Date ◽

Middle Income ◽

Middle Income Countries ◽

Secondary Outcomes

IntroductionPrivate sector provision of HIV treatment is increasing in low-income and middle-income countries (LMIC). However, there is limited documentation of its outcomes. This protocol reports a proposed systematic review that will synthesise clinical outcomes of private sector HIV treatment in LMIC.Methods and analysisThis review will be conducted in accordance with the preferred reporting items for systematic review and meta-analyses protocols. Primary outcomes will include: (1) proportion of eligible patients initiating antiretroviral therapy (ART); (2) proportion of those on ART with <1000 copies/mL; (3) rate of all-cause mortality among ART recipients. Secondary outcomes will include: (1) proportion receivingPneumocystis jirovecipneumonia prophylaxis; (2) proportion with >90% ART adherence (based on any measure reported); (3) proportion screened for non-communicable diseases (specifically cervical cancer, diabetes, hypertension and mental ill health); (iv) proportion screened for tuberculosis. A search of five electronic bibliographical databases (Embase, Medline, PsychINFO, Web of Science and CINAHL) and reference lists of included articles will be conducted to identify relevant articles reporting HIV clinical outcomes. Searches will be limited to LMIC. No age, publication date, study-design or language limits will be applied. Authors of relevant studies will be contacted for clarification. Two reviewers will independently screen citations and abstracts, identify full text articles for inclusion, extract data and appraise the quality and bias of included studies. Outcome data will be pooled to generate aggregative proportions of primary and secondary outcomes. Descriptive statistics and a narrative synthesis will be presented. Heterogeneity and sensitivity assessments will be conducted to aid interpretation of results.Ethics and disseminationThe results of this review will be disseminated through a peer-reviewed scientific manuscript and at international scientific conferences. Results will inform quality improvement strategies, replication of identified good practices, potential policy changes, and future research.PROSPERO registration numberCRD42016040053.

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