scholarly journals Barriers to Accessing Maternal Care in Low Income Countries in Africa: A Systematic Review

2020 ◽  
Vol 17 (12) ◽  
pp. 4292
Author(s):  
Rana Dahab ◽  
Dikaios Sakellariou
Keyword(s):  
Systematic Review ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Low Income ◽  
Cultural Beliefs ◽  
Poor Quality ◽  
Health Facilities ◽  
Low Income Countries ◽  
Health Providers ◽  
Equitable Access

The new Sustainable Development Goals (SDGs) to 2030 aim to reduce maternal mortality and provide equitable access to maternal healthcare. Compromised access to maternal health facilities in low-income countries, and specifically in Africa, contribute to the increased prevalence of maternal mortality. We conducted a systematic review to investigate access barriers to maternal health in low-income countries in Africa since 2015, from the perspective of both community members and health providers. The findings show that the most important barriers to maternal health are transportation barriers to health facilities, economic factors, and cultural beliefs, in addition to lack of family support and poor quality of care. Further research is required to guide policymakers towards firm multi-sectoral action to ensure appropriate and equitable access to maternal health in line with the SDGs to 2030.

scholarly journals Oral Health Status among Migrants from Middle- and Low-Income Countries to Europe: A Systematic Review

2021 ◽  
Vol 18 (22) ◽  
pp. 12203
Author(s):  
Dorina Lauritano ◽  
Giulia Moreo ◽  
Francesco Carinci ◽  
Vincenzo Campanella ◽  
Fedora Della Della Vella ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Status ◽  
Oral Health ◽  
Low Income ◽  
Dental Health ◽  
Cultural Beliefs ◽  
Oral Health Status ◽  
Low Income Countries ◽  
Cochrane Library ◽  
Caries Experience

Introduction. Economic inequality, political instability and globalization have contributed to the constant growth of the migration phenomenon in recent years. In particular, a total of 4.2 million people migrated to Europe during 2019 and most of them settled in Germany, France and Italy. Objectives. The objective of this study was to conduct a systematic review of studies analyzing the oral health condition among migrants from middle- and low-income countries to Europe and assessing the eventual association between their sociodemographic and socioeconomic characteristics and oral health status. Materials and Methods. A systematic review was conducted in PubMed, Cochrane Library, Scopus and Science Direct databases. After titles, abstracts and full-text examination, only 27 articles were selected on the basis of inclusion criteria and consequently included for quality assessments and data extraction. Results. Most of the studies reported a higher prevalence of caries experience, a poorer periodontal health and more difficulties in accessing dentalcare services among migrant groups compared with the non-migrant population. Inequalities were mostly associated with ethnic background, economic condition and social grade. Conclusion. Our review demonstrates the lack of dental health among migrants, underlining that their cultural beliefs and their social and economic living conditions could influence their oral health.

A commentary on “Economic impact of surgery on households and individuals in low income countries: A systematic review” (Int J Surg 2021; 90: 105956)

2021 ◽  
pp. 105991
Author(s):  
Michael Gregorio Ortega-Sierra ◽  
María del Carmen Castillo-Montalvo ◽  
Jesús Alberto Manotas-Berdugo ◽  
Jonhatan Guillermo Jiménez-Chimá ◽  
Maria Paz Bolaño-Romero
Keyword(s):  
Systematic Review ◽  
Economic Impact ◽  
Low Income ◽  
Low Income Countries

scholarly journals Birth companionship in a government health system: a pilot study in Kigoma, Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paul Chaote ◽  
Nguke Mwakatundu ◽  
Sunday Dominico ◽  
Alex Mputa ◽  
Agnes Mbanza ◽  
...  
Keyword(s):  
Low Income ◽  
Pilot Project ◽  
Low Income Countries ◽  
Respectful Maternity Care ◽  
Health Providers ◽  
Structured Interviews ◽  
Government Officials ◽  
Government Health ◽  
Project Data ◽  
Birth Companion

Abstract Background Having a companion of choice throughout childbirth is an important component of good quality and respectful maternity care for women and has become standard in many countries. However, there are only a few examples of birth companionship being implemented in government health systems in low-income countries. To learn if birth companionship was feasible, acceptable and led to improved quality of care in these settings, we implemented a pilot project using 9 intervention and 6 comparison sites (all government health facilities) in a rural region of Tanzania. Methods The pilot was developed and implemented in Kigoma, Tanzania between July 2016 and December 2018. Women delivering at intervention sites were given the choice of having a birth companion with them during childbirth. We evaluated the pilot with: (a) project data; (b) focus group discussions; (c) structured and semi-structured interviews; and (d) service statistics. Results More than 80% of women delivering at intervention sites had a birth companion who provided support during childbirth, including comforting women and staying by their side. Most women interviewed at intervention sites were very satisfied with having a companion during childbirth (96–99%). Most women at the intervention sites also reported that the presence of a companion improved their labor, delivery and postpartum experience (82–97%). Health providers also found companions very helpful because they assisted with their workload, alerted the provider about changes in the woman’s status, and provided emotional support to the woman. When comparing intervention and comparison sites, providers at intervention sites were significantly more likely to: respond to women who called for help (p = 0.003), interact in a friendly way (p < 0.001), greet women respectfully (p < 0.001), and try to make them more comfortable (p = 0.003). Higher proportions of women who gave birth at intervention sites reported being “very satisfied” with the care they received (p < 0.001), and that the staff were “very kind” (p < 0.001) and “very encouraging” (p < 0.001). Conclusion Birth companionship was feasible and well accepted by health providers, government officials and most importantly, women who delivered at intervention facilities. The introduction of birth companionship improved women’s experience of birth and the maternity ward environment overall.

scholarly journals A Systematic Review of Neurosurgical Care in Low-Income Countries

2020 ◽  
Vol 5 ◽  
pp. 100068
Author(s):  
Hannah K. Weiss ◽  
Roxanna M. Garcia ◽  
Jesutofunmi A. Omiye ◽  
Dominique Vervoort ◽  
Robert Riestenberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Income ◽  
Low Income Countries

scholarly journals Challenges of Virtual Medical Sciences Education during the COVID-19 Pandemic: A Systematic Review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Farhad Salari ◽  
Vida Sepahi
Keyword(s):  
Systematic Review ◽  
Medical Education ◽  
Low Income ◽  
Virtual Education ◽  
Low Income Countries ◽  
Medical Sciences ◽  
Study Selection ◽  
E Learning ◽  
Multiple Challenges ◽  
Sudden Transition

Context: Since the onset of the COVID-19 pandemic, there have been numerous higher education challenges. Medical universities have been urged to dispel students from educational and clinical settings and led them toward virtual education. This sudden transition has been accompanied by multiple challenges. Objectives: The present study aimed to evaluate the challenges of virtual medical education in the COVID-19 pandemic. Study Selection: This systematic review was performed by reviewing the current literature on the research subject and the studies conducted in this regard during March 2019 to April 2021 by searching via five key search engines and databases, including Google Scholar, ScienceDirect, PubMed, Scopus, and ERIC. Results: In total, 23 studies were assessed, and different virtual education challenges in medical universities were classified into three categories of structural challenges, student-related challenges, and teacher-related challenges. In addition, strategies were proposed for overcoming the identified challenges. Conclusions: Since medical education was not properly pursued before the COVID-19 pandemic and the necessary infrastructures are lacking in this area, designing and implementing such programs could bring about fundamental challenges in several countries (especially developing and low-income countries), thereby decreasing their success rate. On the other hand, the coronavirus crisis could be an opportunity to identify the weaknesses, shortcomings, and infrastructural deficiencies in e-learning and address these issues effectively.

scholarly journals International barriers and facilitators for cervical cancer screening among young people: a systematic review

2021 ◽  
Author(s):  
Abirami Kirubarajan ◽  
Shannon Leung ◽  
Xinglin Li ◽  
Matthew Yau ◽  
Mara Sobel
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Young People ◽  
Cervical Cancer Screening ◽  
Low Income ◽  
Healthcare Providers ◽  
Barriers And Facilitators ◽  
Low Income Countries ◽  
Age Group

Background Though cervical cancer is one of the leading causes of death globally, its incidence is nearly entirely preventable. Young people have been an international priority for screening. However, in both high-income and low-income countries, young people have not been screened appropriately according to country-specific guidelines and in many countries, screening rates for this age-group have even dropped. Objectives The aim of this systematic review was to systematically characterize the existing literature on barriers and facilitators for cervical cancer screening among young people globally. Search Strategy We conducted a systematic review following PRISMA guidelines of four databases: Medline-OVID, EMBASE, CINAHL, and ClinicalTrials.Gov. Selection Criteria We only examined original, peer-reviewed literature. Databases were examined from inception until the date of our literature searches (12/03/2020). Articles were excluded if they did not specifically discuss cervical cancer screening, were not specific to young people, or did not report outcomes or evaluation. Data Collection and Analysis All screening and extraction was completed in duplicate with two independent reviewers. Main Results Of the 2177 original database citations, we included 36 studies that met inclusion criteria. Our systematic review found that there are three large categories of barriers for young people: lack of knowledge/awareness, negative perceptions of the test, and practical barriers to testing. Facilitators included stronger relationships with healthcare providers, social norms, support from family, and self-efficacy. Conclusions Health systems worldwide should address the barriers and facilitators to increase cervical cancer screening rates in young people. Further research is required to understand this age group.

scholarly journals Clinical effectiveness of drugs in hospitalized patients with COVID-19 infection: a systematic review and meta-analysis.

2020 ◽  
Author(s):  
Roberto Ariel Abeldano Zuniga ◽  
Silvia Coca ◽  
Giuliana Abeldano ◽  
Ruth Ana Maria Gonzalez Villoria
Keyword(s):  
Systematic Review ◽  
Clinical Improvement ◽  
Low Income ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Hospitalized Patients ◽  
Low Income Countries ◽  
Qualitative Synthesis

Objective. The aim was to assess the clinical effectiveness of drugs used in hospitalized patients with COVID-19 infection. Method. We conducted a systematic review of randomized clinical trials assessing treatment with remdesivir, chloroquine, hydroxychloroquine, lopinavir, ritonavir, dexamethasone, and convalescent plasma, for hospitalized patients with a diagnosis of SARS-CoV-2 infection. The outcomes were mortality, clinical improvement, duration of ventilation, duration of oxygen support, duration of hospitalization), virological clearance, and severe adverse events. Results. A total of 48 studies were retrieved from the databases. Ten articles were finally included in the data extraction and qualitative synthesis of results. The meta-analysis suggests a benefit of dexamethasone versus standard care in the reduction of risk of mortality at day 28; and the clinical improvement at days 14 and 28 in patients treated with remdesivir. Conclusions. Dexamethasone would have a better result in hospitalized patients, especially in low-resources settings. Significance of results. The analysis of the main treatments proposed for hospitalized patients is of vital importance to reduce mortality in low-income countries; since the COVID-19 pandemic had an economic impact worldwide with the loss of jobs and economic decline in countries with scarce resources. Keywords: Drugs; Antivirals; Clinical improvement; Mortality; COVID-19; SARS-CoV2.

Comparing the Effects of Unsustainable Production and Consumption of Food on Health and Policy Across Developed and Less Developed Countries

2021 ◽  
pp. 1011-1035
Author(s):  
Josue Mbonigaba
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Food Consumption ◽  
Low Income ◽  
Developed Countries ◽  
High Income ◽  
Low Income Countries ◽  
Less Developed Countries ◽  
Review Of The Literature ◽  
Production And Consumption

The unsustainable food consumption across high-income countries (HICs) and low-income countries (LICs) is expected to differ in nature and extent, although no formal evidence in this respect has been documented. Documenting this evidence is the aim of this chapter. Specifically, the chapter seeks to answer the following questions: 1) Do the contexts in less developed countries (LDCs) and developed countries (DCs) make the nature and extent of unsustainability in food consumption different? 2) Do the mechanisms of the linkage between unsustainability of food consumption and health outcomes independent of countries' contexts? 3) Are current policies against unsustainable food consumption equally effective in DCs and LDCs? These questions are answered by means of a systematic review of the literature for the period 2000-2017. The findings are that the nature and extent of unsustainability is quite different across contexts of LICs and HICs.

Establishing the Effectiveness of Interventions Provided to First Responders to Prevent and/or Treat Mental Health Effects of Response to a Disaster: A Systematic Review

2020 ◽  
pp. 1-12
Author(s):  
W. Tyler Winders ◽  
Nirma D. Bustamante ◽  
Stephanie Chow Garbern ◽  
Corey Bills ◽  
Amin Coker ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Effects ◽  
Low Income ◽  
Psychiatric Symptoms ◽  
Psychological Intervention ◽  
First Responders ◽  
Low Income Countries ◽  
Depth Analysis ◽  
Mental Health Effects

ABSTRACT Objectives: This review systematically explores the current available evidence on the effectiveness of interventions provided to first responders to prevent and/or treat the mental health effects of responding to a disaster. Methods: A systematic review of Medline, Scopus, PsycINFO, and gray literature was conducted. Studies describing the effectiveness of interventions provided to first responders to prevent and/or treat the mental health effects of responding to a disaster were included. Quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and the Critical Appraisal Skills Programme (CASP) checklist. Results: Manuscripts totaling 3869 met the initial search criteria; 25 studies met the criteria for in-depth analysis, including 22 quantitative and 3 qualitative studies; 6 were performed in low- and middle-income countries (LMICs); 18 studies evaluated a psychological intervention; of these, 13 found positive impact, 4 found no impact, and 1 demonstrated worsened symptoms after the intervention. Pre-event trainings decreased psychiatric symptoms in each of the 3 studies evaluating its effectiveness. Conclusions: This review demonstrates that there are likely effective interventions to both prevent and treat psychiatric symptoms in first responders in high-, medium-, and low-income countries.

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