Progress and outcomes of health systems reform in the United Arab Emirates: a systematic review

Abstract Background There is a growing concern that the quality of health systems in humanitarian crises and the care they provide has received little attention. To help better understand current practice and research on health system quality, this paper aimed to examine the evidence on the quality of health systems in humanitarian settings. Methods This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The context of interest was populations affected by humanitarian crisis in low- and middle- income countries (LMICs). We included studies where the intervention of interest, health services for populations affected by crisis, was provided by the formal health system. Our outcome of interest was the quality of the health system. We included primary research studies, from a combination of information sources, published in English between January 2000 and January 2019 using quantitative and qualitative methods. We used the High Quality Health Systems Framework to analyze the included studies by quality domain and sub-domain. Results We identified 2285 articles through our search, of which 163 were eligible for full-text review, and 55 articles were eligible for inclusion in our systematic review. Poor diagnosis, inadequate patient referrals, and inappropriate treatment of illness were commonly cited barriers to quality care. There was a strong focus placed on the foundations of a health system with emphasis on the workforce and tools, but a limited focus on the health impacts of health systems. The review also suggests some barriers to high quality health systems that are specific to humanitarian settings such as language barriers for refugees in their host country, discontinued care for migrant populations with chronic conditions, and fears around provider safety. Conclusion The review highlights a large gap in the measurement of quality both at the point of care and at the health system level. There is a need for further work particularly on health system measurement strategies, accountability mechanisms, and patient-centered approaches in humanitarian settings.

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Frameworks to assess health systems governance: a systematic review

Health Policy and Planning ◽

10.1093/heapol/czx007 ◽

2017 ◽

Vol 32 (5) ◽

pp. 710-722 ◽

Cited By ~ 37

Author(s):

Thidar Pyone ◽

Helen Smith ◽

Nynke van den Broek

Keyword(s):

Systematic Review ◽

Health Systems ◽

Health Systems Governance

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Readiness of Sub-Saharan Africa Healthcare Systems for the New Pandemic, Diabetes: A Systematic Review

Journal of Diabetes Research ◽

10.1155/2018/9262395 ◽

2018 ◽

Vol 2018 ◽

pp. 1-12 ◽

Cited By ~ 2

Author(s):

Bernardo Nuche-Berenguer ◽

Linda E. Kupfer

Keyword(s):

Systematic Review ◽

Health Systems ◽

Diabetes Care ◽

Healthcare Workers ◽

Scale Up ◽

Sub Saharan Africa ◽

Diagnostic Tools ◽

Inclusion Criteria ◽

Care Health ◽

Sub Saharan

Background. Effective health systems are needed to care for the coming surge of diabetics in sub-Saharan Africa (SSA). Objective. We conducted a systematic review of literature to determine the capacity of SSA health systems to manage diabetes. Methodology. We used three different databases (Embase, Scopus, and PubMed) to search for studies, published from 2004 to 2017, on diabetes care in SSA. Results. Fifty-five articles met the inclusion criteria, covering the different aspects related to diabetes care such as availability of drugs and diagnostic tools, the capacity of healthcare workers, and the integration of diabetes care into HIV and TB platforms. Conclusion. Although chronic care health systems in SSA have developed significantly in the last decade, the capacity for managing diabetes remains in its infancy. We identified pilot projects to enhance these capacities. The scale-up of these pilot interventions and the integration of diabetes care into existing robust chronic disease platforms may be a feasible approach to begin to tackle the upcoming pandemic in diabetes. Nonetheless, much more work needs to be done to address the health system-wide deficiencies in diabetes care. More research is also needed to determine how to integrate diabetes care into the healthcare system in SSA.

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Challenges in Public Health Systems Reform in Kosovo

European Journal of Public Health ◽

10.1093/eurpub/ckv175.031 ◽

2015 ◽

Vol 25 (suppl_3) ◽

Author(s):

I Begolli ◽

N Ramadani ◽

D Zajmi ◽

M Berisha ◽

G Pavlekovic

Keyword(s):

Public Health ◽

Health Systems ◽

Public Health Systems ◽

Health Systems Reform

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The Epidemiology and Economic Burden of Obesity and Related Cardiometabolic Disorders in the United Arab Emirates: A Systematic Review and Qualitative Synthesis

Journal of Obesity ◽

10.1155/2018/2185942 ◽

2018 ◽

Vol 2018 ◽

pp. 1-23 ◽

Cited By ~ 6

Author(s):

Hadia Radwan ◽

Rami A. Ballout ◽

Hayder Hasan ◽

Nader Lessan ◽

Mirey Karavetian ◽

...

Keyword(s):

Systematic Review ◽

United Arab Emirates ◽

Middle Eastern ◽

Grey Literature ◽

Epidemiological Studies ◽

Overweight And Obesity ◽

Noncommunicable Diseases ◽

Qualitative Synthesis ◽

Cardiometabolic Disorders ◽

The Cost

Background. Noncommunicable diseases (NCDs) are considered as a global health problem and considered as a public health priority with the more considerable increasing trend of obesity and cardiometabolic disorders rates in the Middle Eastern countries. This systematic review aims at assessing the prevalence, incidence rates, and trends, as well as the cost of obesity and related cardiometabolic disorders in the United Arab Emirates (UAE). Methods. A highly sensitive strategy was used to retrieve original observational studies, addressing the epidemiology and cost of obesity and related cardiometabolic disorders in the UAE, irrespective of nationality (nationals and expatriates). The search was conducted on April 4, 2017, within numerous electronic databases and the grey literature. Standardized and validated methods were used for data extraction and analysis as well as quality assessment. Results. 6789 records were retrieved, of which 36 were deemed eligible. High prevalence rates were reported for obesity, diabetes, hypertension, and metabolic syndrome in all studies. However, the definitions and methods employed by the studies were highly variable. The risk of bias in the epidemiological studies ranged between low and medium. Only one study reported the cost of illness for diabetes. In this study, the estimated cost per patient was $2,015 (adjusted to the year 2015), and it became twofold and sixfold higher in patients with microvascular and macrovascular complications, respectively. Conclusions. Obesity and related cardiometabolic disorders are highly prevalent in the UAE, but quoting a precise prevalence for them is difficult given the methodological heterogeneity of the epidemiological studies addressing them. Nonetheless, we detected a 2-3-fold increase in the prevalence of overweight and obesity in the UAE between 1989 and 2017. It is hopeful that this systematic review will provide an insight into direct future studies, especially longitudinal studies exploring obesity and cardiometabolic risks and their costs.

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Optimization of community-based mental health services: a systematic review

Mental Health Review Journal ◽

10.1108/mhrj-01-2020-0006 ◽

2020 ◽

Vol 25 (3) ◽

pp. 221-239

Author(s):

Ahmad Anas Almi ◽

Jamilah Hanum Abdul Khaiyom

Keyword(s):

Mental Health ◽

Systematic Review ◽

Mental Health Services ◽

Health Services ◽

Health Systems ◽

Health Centre ◽

Mental Health Systems ◽

Community Based ◽

Content Type ◽

Facilitating Factors

Purpose This paper aims to review the literature of community-based mental health services (CMHS) optimization in Malaysia that focus on the aspects of perceived challenges or barriers and facilitating factors for community-based mental health centre (CMHC). Design/methodology/approach Relevant peer-reviewed literature was identified and being reviewed in three databases and one local journal. Findings Nine studies were eligible for inclusion and the extracted data were summarized into a narrative review. The evidence provided for what constituting an optimal implementation of CMHS in Malaysia appeared lacking. However, there are adequate recommendations and suggestions on the component of facilitating factors; on how to increase service user’s engagement towards the improvement of mental health systems. Research limitations/implications Research in the literature had focussed on the optimization aspects from the perspective of the service user. Additionally, this had been discussed through the lens of a variety of mental health systems and not specifically on the community-based perspectives. Originality/value This current systematic review provides valuable and important evidence that further explorations of the existing experiences of the mental health care professionals in delivering CMHS in Malaysia CMHC. The review serves as the foundation for future research to explain the local explanatory framework on what are the best practise models for local CMHS.

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Epidemiology of Thalassemia in Gulf Cooperation Council Countries: A Systematic Review

BioMed Research International ◽

10.1155/2020/1509501 ◽

2020 ◽

Vol 2020 ◽

pp. 1-15

Author(s):

Amani Abu-Shaheen ◽

Humariya Heena ◽

Abdullah Nofal ◽

Doaa A. Abdelmoety ◽

Abdulrahman Almatary ◽

...

Keyword(s):

Systematic Review ◽

High Risk ◽

United Arab Emirates ◽

Observational Studies ◽

Gulf Cooperation Council ◽

Cross Sectional ◽

Gcc Countries ◽

Premarital Screening ◽

Risk Areas ◽

Epidemiological Profile

Background. Thalassemia has a burden on the healthcare systems of many countries. About 56000 conceptions result in thalassemia, globally. Objective. To assess the epidemiological profile of thalassemia in the Gulf Cooperation Council (GCC) countries. Methods. A systematic search was conducted in MEDLINE/PubMed (National Library of Medicine), CINAHL, and Embase. Relevant observational studies reporting the epidemiology of thalassemia among the GCC population were selected. Data on the prevalence, frequency, and complications of thalassemia were extracted. The quality of the retrieved studies was assessed according to the Newcastle–Ottawa Quality Assessment Scale. Results. Eighteen studies (14 cross-sectional studies, two retrospective observational studies, and two retrospective analysis) with a total of 3343042 participants were included in this systematic review. Of the 18 studies, 11 studies were conducted in Saudi Arabia, two in the Kingdom of Bahrain, one in Kuwait, three in the United Arab Emirates (UAE), and one in Qatar. The prevalence of thalassemia among children below five years of age ranged from 0.25% to 33%, while it was 0.9% in children above five years and from 0.035% to 43.3% among adult thalassemia patients. The most-reported risk factors were consanguineous marriage and high-risk marriage. There was a lack of data regarding mortality rates in thalassemia. Conclusions. Despite the premarital screening and genetic counseling (PMSGC) program for thalassemia, the incidence of high-risk couple marriages in GCC countries cannot be effectively diminished. This study suggested that the PMSGC program should adopt more attention for the high-risk areas, to enhance the level of consciousness about the hemoglobinopathy diseases and the consequences of consanguinity among the at-risk couple.

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Built to last? The sustainability of health system improvements, interventions and change strategies: a study protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2017-018568 ◽

2017 ◽

Vol 7 (11) ◽

pp. e018568 ◽

Cited By ~ 8

Author(s):

Jeffrey Braithwaite ◽

Luke Testa ◽

Gina Lamprell ◽

Jessica Herkes ◽

Kristiana Ludlow ◽

...

Keyword(s):

Systematic Review ◽

Health System ◽

Health Systems ◽

Full Text ◽

English Language ◽

Secondary Data ◽

Primary Data ◽

Change Strategies ◽

Screening Process ◽

Sustainable Health

IntroductionThe sustainability of healthcare interventions and change programmes is of increasing importance to researchers and healthcare stakeholders interested in creating sustainable health systems to cope with mounting stressors. The aim of this protocol is to extend earlier work and describe a systematic review to identify, synthesise and draw meaning from studies published within the last 5 years that measure the sustainability of interventions, improvement efforts and change strategies in the health system.Methods and analysisThe protocol outlines a method by which to execute a rigorous systematic review. The design includes applying primary and secondary data collection techniques, consisting of a comprehensive database search complemented by contact with experts, and searching secondary databases and reference lists, using snowballing techniques. The review and analysis process will occur via an abstract review followed by a full-text screening process. The inclusion criteria include English-language, peer-reviewed, primary, empirical research articles published after 2011 in scholarly journals, for which the full text is available. No restrictions on location will be applied. The review that results from this protocol will synthesise and compare characteristics of the included studies. Ultimately, it is intended that this will help make it easier to identify and design sustainable interventions, improvement efforts and change strategies.Ethics and disseminationAs no primary data were collected, ethical approval was not required. Results will be disseminated in conference presentations, peer-reviewed publications and among policymaker bodies interested in creating sustainable health systems.

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