To explore the barriers to and facilitators of adolescents in Low-Middle-Income- Countries (LMICs) seeking mental health care: Protocol for a Mixed-Methods Systematic Review

2021 ◽  
Author(s):  
Sudha Subhadra Kallakuri ◽  
Pallab K Maulik ◽  
Prachi Kaistha ◽  
Maree Hackett
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mixed Methods ◽  
Study Design ◽  
Critical Appraisal ◽  
Mental Illnesses ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

Abstract Background: Adolescence is a very important transitional phase for an individual as they move from childhood to adulthood. In 2007, the World Health Organization reported that 16% of the global burden of disease and injuries occur among adolescents i.e. those aged between 10 and 19 years, most of them starting by the age of 14 years and usually become serious; if left unrecognised or unattended at that point in time. Several risk factors are associated with increases in the mental health disorders. It is pertinent to promote interventions which teach life skills like regulating one’s emotions, building resilience, and dealing with difficult situations with confidence and strength. This mixed-methods systematic review aims to synthesise best available evidence on the barriers and facilitators to help seeking for mental illnesses among adolescents in Low-Middle-Income Countries Methods and Analyses: The systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Systematic searches will be carried out in electronic databases like PubMed,EMBASE, PsychINFO, Sociofile, CINAHL to identify studies relevant to the review question. At the first stage, titles and abstracts of articles retrieved through the searches will be examined against the eligibility criteria. The second stage will involve independent full-text screening of included articles by two reviewers. All qualitative, quantitative, and mixed method research studies which explicitly answer the research questions will be considered in this review. Methodological appraisal (Risk of Bias) will be conducted using the Joanna Briggs Institute's standardized critical appraisal tools or other standardized critical appraisal tools contingent on the study design by two reviewers. Data will be extracted on the aims/purpose, study design, geographical location, study population, study duration, interventions (if applicable) outcomes, and results of included studies. Data analyses will be conducted using the convergent approach to analysis of mixed methods research using JBI guidance. Discussion: The research will help to identify gaps in knowledge and generate evidence for health departments to look more specifically at the mental health of adolescents and challenges of addressing them. Systematic Review Registration: PROSPERO: CRD42020214349

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

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.

scholarly journals Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments

2021 ◽  
Vol 6 (5) ◽  
pp. e004324
Author(s):  
John Whitaker ◽  
Nollaig O'Donohoe ◽  
Max Denning ◽  
Dan Poenaru ◽  
Elena Guadagno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Evidence Synthesis ◽  
Rapid Assessment ◽  
Sub Saharan Africa ◽  
Trauma Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Three Delays

BackgroundThe large burden of injuries falls disproportionately on low/middle-income countries (LMICs). Health system interventions improve outcomes in high-income countries. Assessing LMIC trauma systems supports their improvement. Evaluating systems using a Three Delays framework, considering barriers to seeking (Delay 1), reaching (Delay 2) and receiving care (Delay 3), has aided maternal health gains. Rapid assessments allow timely appraisal within resource and logistically constrained settings. We systematically reviewed existing literature on the assessment of LMIC trauma systems, applying the Three Delays framework and rapid assessment principles.MethodsWe conducted a systematic review and narrative synthesis of articles assessing LMIC trauma systems. We searched seven databases and grey literature for studies and reports published until October 2018. Inclusion criteria were an injury care focus and assessment of at least one defined system aspect. We mapped each study to the Three Delays framework and judged its suitability for rapid assessment.ResultsOf 14 677 articles identified, 111 studies and 8 documents were included. Sub-Saharan Africa was the most commonly included region (44.1%). Delay 3, either alone or in combination, was most commonly assessed (79.3%) followed by Delay 2 (46.8%) and Delay 1 (10.8%). Facility assessment was the most common method of assessment (36.0%). Only 2.7% of studies assessed all Three Delays. We judged 62.6% of study methodologies potentially suitable for rapid assessment.ConclusionsWhole health system injury research is needed as facility capacity assessments dominate. Future studies should consider novel or combined methods to study Delays 1 and 2, alongside care processes and outcomes.

scholarly journals Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review

2021 ◽  
Vol 6 (2) ◽  
pp. e004213
Author(s):  
Grace McCutchan ◽  
Bahr Weiss ◽  
Harriet Quinn-Scoggins ◽  
Anh Dao ◽  
Tom Downs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Cancer Treatment ◽  
Help Seeking ◽  
Middle Income ◽  
Cancer Symptoms ◽  
Middle Income Countries ◽  
Help Seeking Behaviour ◽  
Psychosocial Influences

IntroductionStarting cancer treatment early can improve outcomes. Psychosocial factors influencing patients’ medical help-seeking decisions may be particularly important in low and lower middle-income countries (LMIC) where cancer outcomes are poor. Comprehensive review evidence is needed to understand the psychosocial influences on medical help-seeking for cancer symptoms, attendance for diagnosis and starting cancer treatment.MethodsMixed-methods systematic review registered on PROSPERO (CRD42018099057). Peer-reviewed databases were searched until April 2020 for studies assessing patient-related barriers and facilitators to medical help-seeking for cancer symptoms, diagnosis and treatment in adults (18+ years) living in LMICs. Quality of included studies was assessed using the Critical Appraisal Skills Programme tool. Data were synthesised using meta-analytic techniques, meta-ethnography or narrative synthesis as appropriate.ResultsOf 3963 studies identified, 64 were included. In quantitative studies, use of traditional, complementary and alternative medicine (TCAM) was associated with 3.60 higher odds of prolonged medical help-seeking (95% CI 2.06 to 5.14). Qualitative studies suggested that use of TCAM was a key barrier to medical help-seeking in LMICs, and was influenced by causal beliefs, cultural norms and a preference to avoid biomedical treatment. Women face particular barriers, such as needing family permission for help-seeking, and higher stigma for cancer treatment. Additional psychosocial barriers included: shame and stigma associated with cancer such as fear of social rejection (eg, divorce/disownment); limited knowledge of cancer and associated symptoms; and financial and access barriers associated with travel and appointments.ConclusionDue to variable quality of studies, future evaluations would benefit from using validated measures and robust study designs. The use of TCAM and gender influences appear to be important barriers to help-seeking in LMIC. Cancer awareness campaigns developed with LMIC communities need to address cultural influences on medical help-seeking behaviour.

scholarly journals EXPLORING COVID-19 VACCINE ACCEPTANCE AND HESITANCY DETERMINANTS

2021 ◽  
Vol 03 (01) ◽  
pp. 80-91
Author(s):  
Tauheed Zahra ◽  
◽  
Farhan Ahmad Faiz ◽  
Farrah Ahmed ◽  
◽  
...  
Keyword(s):  
Educational Background ◽  
Vital Role ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Social Worlds ◽  
Vaccine Acceptance ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Health Organization

The World Health Organization recognizes vaccine related myths and conspiracies as the world's top threat to public health safety, particularly in low middle-income countries. The current study aims to explore the beliefs of the general public towards the vaccine acceptance and the hesitancy. The study explicates the COVID 19 vaccine acceptance and hesitancy determinants through an in-depth qualitative approach. A total of 30 male and female millennials from different education backgrounds were interviewed through an interview guide. This study reveals that people have different beliefs related to the vaccine authenticity which plays a vital role in the reluctance towards it. Findings from paper is similar to literature that people from good educational background have similar thoughts towards COVID 19 vaccination. Disregard for the vaccine was caused by various factors, such as misinformation, safety concerns, and personal knowledge. This level of distrust was associated with the social worlds that participants experienced during the pandemic. COVID-19 vaccine hesitancy is a complex relationship that involves the spread of misinformation. Vaccine programs should provide a focused, localized, and empathetic response to counter misinformation. Keywords: COVID-19, vaccines, myths, hesitancy, vaccines awareness, pandemic, conspiracy, corona virus

scholarly journals Seroprevalence of SARS CoV-2 infection in Low and Middle-Income Countries and risk classification in the context of rolling out vaccine candidate across these countries : Protocol for a systematic review and meta-analysis

2021 ◽  
Author(s):  
Martin Ackah ◽  
Louise Ameyaw ◽  
Kwadwo Owusu Akuffo ◽  
Cynthia Osei Yeboah ◽  
Nana Esi Wood ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Vaccine Candidate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Research Database ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Low And Middle Income

Abstract Background Seroprevalence of SARS Cov-2 provides a good indication of the extent of exposure and spread in the population, as well as those likely to benefit from a vaccine candidate. To date, there is no published or ongoing systematic review on the seroprevalence of COVID-19 in Low- and Middle-Income Countries (LMICs). This systematic review and meta-analysis will estimate SARS Cov-2 seroprevalence and the risk factors for SARS Cov-2 infection in LMICs.Methods We will search PubMed, EMBASE, WHO COVID-19 Global research database, Google Scholar, the African Journals Online, LILAC, HINARI, medRxiv, bioRxiv and Cochrane Library for potentially useful studies on seroprevalence of COVID-19 in LMICs from December 2019 to December 2020 without language restriction. Two authors will independently screen all the articles, select studies based on pre-specified eligibility criteria and extract data using a pre-tested data extraction form. Any disagreements will be resolved through discussion between the authors. The pooled seroprevalence of SARS CoV-2 for people from LMICs will be calculated. Random effects model will be used in case of substantial heterogeneity in the included studies, otherwise fixed-effect model will be used. A planned subgroup, sensitivity and meta-regression analyses will be performed. For comparative studies, the analyses will be performed using Review Manager v 5.4; otherwise, STATA 16 will be used. All effect estimates will be presented with their confidence intervals.Discussion The study will explore and systematically review empirical evidence on SARS Cov-2 seroprevalence in LMICs, and to assess the risk factors for SARS Cov-2 infection in Low Middle Income Countries in the context of rolling out vaccines in these countries. Finally, explore risk classifications to help with the rolling out of vaccines in LMICs.Systematic review registration: The protocol for this review has been registered in PROSPERO (CRD422020221548).

scholarly journals Epidemics, Lockdown Measures and Vulnerable Populations: A Mixed-Methods Systematic Review of the Evidence of Impacts on Mother and Child Health in Low-And- Lower Middle-Income Countries

2021 ◽  
Author(s):  
Giuliano Russo ◽  
Tiago Silva Jesus ◽  
Kevin Deane ◽  
Abdinasir Yusuf Osman ◽  
David McCoy
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Inclusion Criteria ◽  
Middle Income ◽  
Middle Income Countries ◽  
Premature Deaths ◽  
Trade Offs ◽  
Mother And Child ◽  
New Research ◽  
The Impact

Background: The aim of this research was to synthetise the existing evidence on the impact of epidemic-related lockdown measures on women and children’s health in low-and-lower-middle-income countries. Methods: A mixed-methods systematic review was conducted of qualitative, quantitative and mixed-methods evidence. Between November 1st-10th 2021, seven scientific databases were searched. The inclusion criteria were that the paper provided evidence on the impact of lockdown and related measures, focused on low-and-lower-middle-income countries, addressed impacts on women and child’s health, addressed epidemics from 2000-2020, was peer-reviewed, provided original evidence, and was published in English. The Joanne Briggs Institute’s critical appraisal tools were used to assess the quality of the studies, and the PRISMA guidelines for reporting. The evidence from the papers was grouped by type of lockdown measure and categories of impact, using a narrative data-based convergent synthesis design. Results: The review process identified 46 papers meeting the inclusion criteria from 17 countries whichall focussed on the COVID-19 and Ebola epidemics. The evidence on the decrease of utilisation of health services showed plummeting immunisation rates and faltering use of maternal and perinatal services, which was linked to a growth of premature deaths. Impacts on the mental health of children and women is well-established, with lockdowns associated with surges in depression, anxiety and low life satisfaction. Vulnerability may be compounded by lockdowns, as livelihoods are disrupted, and poverty levels increase. Conclusion: Limitations included that searches were conducted in late-2020 as new research was being published, and that some evidence not published in English may have been excluded. Epidemic-related lockdown measures carry consequences for the health of women and children in lower-income settings. Governments will need to weigh the trade-offs of introducing such measures and consider policies to mitigate their impacts on the most vulnerable.

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

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.

Correlates of relationship issues among youth: Findings from a large scale youth mental health promotion program in India

2020 ◽  
Author(s):  
Pradeep Banandur ◽  
Gopalan Kalpana ◽  
Shikha G Pai ◽  
Mutharaju Arelingaiah ◽  
Sathya R Velu ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
Large Scale ◽  
Health Promotion Program ◽  
Middle Income ◽  
Factors Affecting ◽  
Safety Issues ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Health Promotion Interventions

Abstract Background : Relationships and mental health have a bidirectional effect. The effect of relationships on mental health is stronger than vice versa. We analyzed two-year case records of 8595 beneficiaries aged 15-35 years attending youth guidance centres (Yuva Spandana Kendras) in Karnataka, India to understand factors affecting relationship issues. Methods : Multivariate logistic regression was performed with any beneficiary reporting having a relationship issue as outcome. Results : Occupation, marital status, health and lifestyle issues, personality issues, safety issues, gender, sex, & sexuality issues, suicidality, alcohol, and different emotions experienced,had significant association with relationship issues. Investing in health promotion interventions focusing on these precursors of relationship issues amongst youth seems strategic. Conclusion : Our findings have implications for other states in India and other low-middle-income countries like India.

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