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Scoping review: Strategies of providing care for children with chronic health conditions in low- and middle-income countries.

Scoping review: Strategies of providing care for children with chronic health conditions in low- and middle-income countries.
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Graham H, Tokhi M, Duke T,


Graham H, Tokhi M, Duke T, (click to view)

Graham H, Tokhi M, Duke T,

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Tropical medicine & international health : TM & IH 2016 8 24() doi 10.1111/tmi.12774

Abstract
OBJECTIVES
To identify and review strategies of providing care for children living with chronic health conditions in low- and middle-income countries.

METHODS
We searched MEDLINE and Cochrane EPOC databases for papers evaluating strategies of providing care for children with chronic health conditions in low- or middle-income countries. Data were systematically extracted using a standardised data charting form, and analysed according to Arksey and O’Malley’s ‘descriptive analytical method’ for scoping reviews.

RESULTS
Our search identified 71 papers addressing 8 chronic conditions; two chronic communicable diseases (HIV, TB) accounted for the majority of papers (n=37, 52%). Nine (13%) papers reported use of a package of care provision strategies (mostly related to HIV and/or TB in sub-Saharan Africa). Most papers addressed a narrow aspect of clinical care provision, such as patient education (n=23) or task-shifting (n=15). Few papers addressed strategies for providing care at the community (n=10, 15%) or policy (n=6, 9%) level. Low-income countries were under-represented (n=24, 34%), almost exclusively involving HIV interventions in sub-Saharan Africa (n=21). Strategies and summary findings are described and components of future models of care proposed.

CONCLUSIONS
Strategies that have been effective in reducing child mortality globally are unlikely to adequately address the needs of children with chronic health conditions in low and middle-income settings. Current evidence mostly relates to disease-specific, narrow strategies and more research is required to develop and evaluate integrated models of care which may be effective in improving outcomes for these children. This article is protected by copyright. All rights reserved.

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