scholarly journals Impact of traditional bonesetters on contemporary fracture care in Low and Middle Income Countries (LMICs): a systematic review

2019 ◽  
Author(s):  
Ndubuisi Onyemaechi ◽  
William N.A. Menson ◽  
Xan Goodman ◽  
Samantha Slinkard ◽  
Obinna E Onwujekwe ◽  
...  

Abstract Background: The review aimed at systematically examining the evidence in articles that assess the clinical effects and impact of traditional bonesetters on contemporary fracture care in Low and Middle Income Countries (LMICs).Methods: A systematic review was conducted. Articles were identified by database searching ((PubMed, Embase, ScienceDirect, SCOPUS, and Web of Science). Searching, selecting and reporting were conducted according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) Statement. The key words that were used in search for literature were: “Bonesetter”, “fracture healer” and “traditional bone setting”. Publications included for review were original articles, set in an LMIC and directly talked about the role and/or impact of traditional bonesetters in providing fracture care. Papers that focused on Low and Middle Income (LMIC) settings were reviewed.Results: A total of 176 papers were screened for eligibility and 15 studies were finally included. Nine were prospective studies, while 6 were retrospective studies. Most of the studies focused on clinical impacts of bone setter intervention. The evidence from the publications show that the main clinical effects of traditional bonesetters had been deleterious, but they had the potential to contribute positively when trained.Conclusion: Few well designed studies are available that assessed the impact of traditional bonesetters. Reported cases and reviews indicate their impact to be deleterious. However, the potential exist that when trained, these deleterious impact can be reduced through training for traditional bonesetters who contribute to fracture care in many LMICs.

2021 ◽  
Author(s):  
Elizabeth K Kirkwood ◽  
Caitlin Clymer ◽  
Kheminda Imbulana ◽  
Sumaya Mozumder ◽  
Michael John Dibley ◽  
...  

BACKGROUND The rapid, widespread growth of mobile technologies, in low-and-middle-income countries, can offer groundbreaking ways to disseminate public health interventions. However, gender-based inequalities present a challenge for women to access mobile technology. Research has shown that mHealth interventions can impact gender relations in positive and negative ways, yet few mHealth programs use a gender sensitive lens when designing, implementing, or analyzing programs. OBJECTIVE This systematic review aims to identify and summarize the findings of qualitative research studies which explore the impact of mobile health interventions on gender relations as a result of participating in such initiatives in low-and-middle income countries. METHODS We performed a systematic literature review to examines empirical evidence of changes in gender relations attributed to their participation in an mHealth intervention in a low-and-middle income country. Peer-reviewed articles included needed to evaluate an mHealth intervention and were published between 2013 and 2020. Articles were excluded that used mHealth that solely targeted health workers, did not assess a specific intervention or used mobile technology for data collection only or were formative or exploratory in nature. The search terms were entered into four key electronic databases, Medline, Excerpta Médica Database (EMBASE), PsycINFO, and Scopus generating a comprehensive list of potentially relevant peer-reviewed articles. Thematic analysis was used to identify, analyze, and report themes emerged from our data. RESULTS From the 578 full text articles retrieved, fourteen articles were eligible for inclusion. None of the articles appraised gender from the outset. Articles uncovered findings on gender relations through the course of the intervention or post program evaluation. Most studies took place in Sub-Saharan Africa with the remainder in South and South East Asia. Articles focused on maternal and child health, HIV diagnosis and treatment, and reproductive health. This review found mHealth programs could enhance spousal communication, foster emotional support between couples, improve women’s self-efficacy and autonomy in seeking health information and services, and increase involvement in health-related decision making. Despite the positive impacts, some mHealth interventions had an adverse effect, reinforcing the digital divide, upholding men as gatekeepers of information and sole decision makers and exacerbating relationship problems. CONCLUSIONS These results suggest given the rapid, persistent upscale of mobile health interventions in low-and-middle income settings, it is imperative to design interventions that consider the impact they may have on power dynamics and gender relations. Future research is needed to fill evidence gaps on gender and mHealth, acknowledging that women are not passive beneficiaries and need to actively participate and be empowered by mHealth interventions. CLINICALTRIAL The systematic review is registered with Prospero (CRD42021218001)


BMJ ◽  
2014 ◽  
Vol 348 (apr15 6) ◽  
pp. g2267-g2267 ◽  
Author(s):  
E. K. Gough ◽  
E. E. M. Moodie ◽  
A. J. Prendergast ◽  
S. M. A. Johnson ◽  
J. H. Humphrey ◽  
...  

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027851
Author(s):  
Maximilian Salcher-Konrad ◽  
Huseyin Naci ◽  
David McDaid ◽  
Suvarna Alladi ◽  
Deborah Oliveira ◽  
...  

IntroductionThere are more people living with dementia in low- and middle-income countries (LMICs) than in high-income countries. Evidence-based interventions to improve the lives of people living with dementia and their carers are needed, but a systematic mapping of methodologically robust studies in LMICs and synthesis of the effectiveness of dementia interventions in these settings is missing.Methods and analysisA systematic review and meta-analysis will be conducted to answer the question: Which dementia interventions were shown to be effective in LMICs and how do they compare to each other? Electronic database searches (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, WHO Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit, Cochrane Database of Systematic Reviews) will be complemented by hand searching of reference lists and local knowledge of existing studies from an international network of researchers in dementia from LMICs. Studies will be eligible for inclusion if they were published between 2008 and 2018, conducted in LMICs and evaluated the effectiveness of a dementia intervention using a study design that supports causal inference of the treatment effect. We will include both randomised and non-randomised studies due to an anticipated low number of well-conducted randomised trials in LMICs and potentially greater external validity of non-randomised studies conducted in routine care settings. In addition to narrative synthesis of the interventions, feasibility of pairwise and network meta-analyses will be explored to obtain pooled effects of relative treatment effects.Ethics and disseminationSecondary analysis of published studies, therefore no ethics approval required. Planned dissemination channels include a peer-reviewed publication as well as a website, DVD and evidence summaries.Prospero registration numberCRD42018106206.


2021 ◽  
Author(s):  
Moses Ocan ◽  
Brenda Allen Kawala ◽  
Ephraim Kisangala ◽  
Regina Ndagire ◽  
Rachel Nante Wangi ◽  
...  

Abstract Background: Globally, health care workers continue to be infected, fall ill and die at the frontline of the Coronavirus disease 2019 (COVID-19) fight, an indicator of inadequate safety in health facilities. This rapid evidence synthesis aims to highlight the impacts of COVID-19 on healthcare workers in low-and middle-income countries (LMICs) in terms of infections, illnesses and deaths. Methods: A systematic review will be done. Article search will be performed by an experienced librarian in PubMed, MEDLINE Ovid, Google Scholar, COVID-END, Cochrane library and targeted search from other relevant sources. MeSH terms and Boolean operators “AND” and “OR” will be used in the article search. Independent reviewers will screen the retrieved articles using a priori criteria. Data abstraction will be done using an excel based abstraction tool and synthesized using structured narratives and summary of findings tables. Discussion and anticipated use of results: This evidence synthesis seeks to analyze the impact of COVID-19 on the healthcare systems of low- and middle-income countries. Information on healthcare worker infections, illness, and deaths due to COVID-19, will be collated from published research articles. This will help guide decision makers in establishing low- cost high impact interventions to mitigate the effects of COVID-19 in the health work force.Protocol registration: PROSPERO CRD 42020204174


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