scholarly journals Effectiveness of Psychosocial Interventions Targeting Hazardous and Harmful Alcohol Use and Alcohol-Related Symptoms in Low- and Middle-Income Countries: A Systematic Review

2020 ◽  
Vol 11 ◽  
Author(s):  
Melissa Preusse ◽  
Frank Neuner ◽  
Verena Ertl
Keyword(s):  
Systematic Review ◽  
Alcohol Use ◽  
Psychosocial Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Harmful Alcohol ◽  
Low And Middle Income

Socioeconomic inequalities in unhealthy lifestyles in low- and middle-income countries

2020 ◽  
Author(s):  
Charlotte Dieteren ◽  
Igna Bonfrer
Keyword(s):  
Alcohol Use ◽  
Tobacco Use ◽  
Socioeconomic Inequalities ◽  
Individual Characteristics ◽  
Middle Income ◽  
The Sustainable Development ◽  
Middle Income Countries ◽  
The Poor ◽  
Harmful Alcohol ◽  
Low And Middle Income

Abstract Background: The heavy and ever rising burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) warrants interventions to reduce unhealthy lifestyles. To effectively target these interventions, it is important to know how unhealthy lifestyles vary with socioeconomic characteristics. This study quantifies prevalence and socioeconomic inequalities in unhealthy lifestyles in LMICs, to identify policy priorities conducive to the Sustainable Development Goal of a one third reduction in deaths from NCDs by 2030.Methods: Data from 1,278,624 adult respondents to Demographic & Health Surveys across 22 LMICs between 2013 and 2018 are used to estimate crude prevalence rates and socioeconomic inequalities in tobacco use, overweight, harmful alcohol use and the clustering of these three in a household. Inequalities are measured by a concentration index and correlated with the percentage of GDP spent on health. We estimate a multilevel model to examine associations of individual characteristics with different unhealthy lifestyles.Results: The prevalence of tobacco use among men ranges from 59.6% (Armenia) to 6.6% (Nigeria). The highest level of overweight among women is 83.7% (Egypt) while this is less than 12% in Burundi, Chad and Timor-Leste. 82.5% of women in Burundi report that their partner is “often or sometimes drunk” compared to 1.3% in Gambia. Tobacco use is concentrated among the poor, except for the low share of men smoking in Nigeria. Overweight, however, is concentrated among the better off, especially in Tanzania and Zimbabwe (Erreygers Index (EI) 0.227 and 0.232). Harmful alcohol use is more concentrated among the better off in Nigeria (EI 0.127), while Chad, Rwanda and Togo show an unequal pro-poor distribution (EI respectively -0.147, -0.210, -0.266). Cambodia exhibits the largest socioeconomic inequality in unhealthy household behaviour (EI -0.253). The multilevel analyses confirm that in LMICs, tobacco and alcohol use are largely concentrated among the poor, while overweight is concentrated among the better-off.Conclusions: This study emphasizes the importance of unhealthy lifestyles in LMICs and the socioeconomic variation therein. Given the different socioeconomic patterns in unhealthy lifestyles - overweight patters in LMICs differ considerably from those in high income countries- tailored interventions towards specific high-risk populations are warranted.

scholarly journals Psychosocial interventions for reducing depression among the elderly in low and middle income countries: A Systematic Review Protocol

2021 ◽  
Author(s):  
Jordan Mutambi Amanyire ◽  
Irene Aheisibwe ◽  
Godfrey Zari Rukundo
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Elderly People ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Psychosocial Interventions ◽  
The Elderly ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Background: According to the World Health Organization, depression is expected to be the largest contributor to the global disease burden by 2030. Depression is the most frequent cause of emotional distress and reduced quality of life among older people affecting over 12% of the individuals aged 65 or older, . Psychosocial interventions have been proven to be effective in the management of depression. Most of the available evidence is from high income settings, with paucity of information in low and middle income countries which carry the biggest burden of depression and other health challenges. In this systematic review, we will document evidence on psychosocial interventions that have been effective in treatment of depression among elderly people in low and middle income countries. Methods: The review will be conducted and reported in accordance to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. We will include journal articles that have documented the psychosocial interventions in the primary prevention of depressive symptoms in elderly people aged 60 or older. We will also include accessible grey literature about the topic. We will include articles that have documented the psychosocial interventions to address depression in elderly patients in low and middle income countries. We will search different search engines and data bases including PubMed, EMBASE, Psych-INFO, Cochrane Library. We will use a meta-analysis, should we find that there is no heterogeneity between included studies.Discussion: This protocol describes a planned systematic review of observational studies reporting psychosocial interventions in the management of depressive symptoms in elderly people aged 60 or older. We anticipate that once this review is complete and published, our findings will be of interest to the elderly with depressive symptoms, their families and caregivers, students, and other healthcare professionals, scientists and policy makers. Systematic review registration: This protocol will not be registered with PROSPERO International prospective register of systematic reviews since the system is no longer accepting new protocols.

scholarly journals The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review

2020 ◽  
pp. 1-13 ◽  
Author(s):  
Leonardo Cubillos ◽  
Sophia M. Bartels ◽  
William C. Torrey ◽  
John Naslund ◽  
José Miguel Uribe-Restrepo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Alcohol Use ◽  
Clinical Severity ◽  
Middle Income ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol ◽  
Middle Income Countries ◽  
Behavioural Health ◽  
Low And Middle Income

Aims and method This systematic review examines the effectiveness and cost-effectiveness of behavioural health integration into primary healthcare in the management of depression and unhealthy alcohol use in low- and middle-income countries. Following PRISMA guidelines, this review included research that studied patients aged ≥18 years with unhealthy alcohol use and/or depression of any clinical severity. An exploration of the models of integration was used to characterise a typology of behavioural health integration specific for low- and middle-income countries. Results Fifty-eight articles met inclusion criteria. Studies evidenced increased effectiveness of integrated care over treatment as usual for both conditions. The economic evaluations found increased direct health costs but cost-effective estimates. The included studies used six distinct behavioural health integration models. Clinical implications Behavioural health integration may yield improved health outcomes, although it may require additional resources. The proposed typology can assist decision-makers to advance the implementation of integrated models.

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