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Is patient navigation a solution to the problem of "leaving no one behind"? A scoping review of evidence from low-income countries
Patient navigation interventions, which are designed to enable patients excluded from health systems to overcome the barriers they face in accessing care, have multiplied in high-income countries since the 1990s. However, in low-income countries (LICs), indigents are generally excluded from health p...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938515/ https://www.ncbi.nlm.nih.gov/pubmed/33212491 http://dx.doi.org/10.1093/heapol/czaa093 |
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author | Louart, Sarah Bonnet, Emmanuel Ridde, Valéry |
author_facet | Louart, Sarah Bonnet, Emmanuel Ridde, Valéry |
author_sort | Louart, Sarah |
collection | PubMed |
description | Patient navigation interventions, which are designed to enable patients excluded from health systems to overcome the barriers they face in accessing care, have multiplied in high-income countries since the 1990s. However, in low-income countries (LICs), indigents are generally excluded from health policies despite the international paradigm of universal health coverage (UHC). Fee exemption interventions have demonstrated their limits and it is now necessary to act on other dimensions of access to healthcare. However, there is a lack of knowledge about the interventions implemented in LICs to support the indigents throughout their care pathway. The aim of this paper is to synthesize what is known about patient navigation interventions to facilitate access to modern health systems for vulnerable populations in LICs. We therefore conducted a scoping review to identify all patient navigation interventions in LICs. We found 60 articles employing a total of 48 interventions. Most of these interventions targeted traditional beneficiaries such as people living with HIV, pregnant women and children. We utilized the framework developed by Levesque et al. (Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health 2013;12:18) to analyse the interventions. All acted on the ability to perceive, 34 interventions on the ability to reach, 30 on the ability to engage, 8 on the ability to pay and 6 on the ability to seek. Evaluations of these interventions were encouraging, as they often appeared to lead to improved health indicators and service utilization rates and reduced attrition in care. However, no intervention specifically targeted indigents and very few evaluations differentiated the impact of the intervention on the poorest populations. It is therefore necessary to test navigation interventions to enable those who are worst off to overcome the barriers they face. It is a major ethical issue that health policies leave no one behind and that UHC does not benefit everyone except the poorest. |
format | Online Article Text |
id | pubmed-7938515 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-79385152021-03-11 Is patient navigation a solution to the problem of "leaving no one behind"? A scoping review of evidence from low-income countries Louart, Sarah Bonnet, Emmanuel Ridde, Valéry Health Policy Plan Reviews Patient navigation interventions, which are designed to enable patients excluded from health systems to overcome the barriers they face in accessing care, have multiplied in high-income countries since the 1990s. However, in low-income countries (LICs), indigents are generally excluded from health policies despite the international paradigm of universal health coverage (UHC). Fee exemption interventions have demonstrated their limits and it is now necessary to act on other dimensions of access to healthcare. However, there is a lack of knowledge about the interventions implemented in LICs to support the indigents throughout their care pathway. The aim of this paper is to synthesize what is known about patient navigation interventions to facilitate access to modern health systems for vulnerable populations in LICs. We therefore conducted a scoping review to identify all patient navigation interventions in LICs. We found 60 articles employing a total of 48 interventions. Most of these interventions targeted traditional beneficiaries such as people living with HIV, pregnant women and children. We utilized the framework developed by Levesque et al. (Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health 2013;12:18) to analyse the interventions. All acted on the ability to perceive, 34 interventions on the ability to reach, 30 on the ability to engage, 8 on the ability to pay and 6 on the ability to seek. Evaluations of these interventions were encouraging, as they often appeared to lead to improved health indicators and service utilization rates and reduced attrition in care. However, no intervention specifically targeted indigents and very few evaluations differentiated the impact of the intervention on the poorest populations. It is therefore necessary to test navigation interventions to enable those who are worst off to overcome the barriers they face. It is a major ethical issue that health policies leave no one behind and that UHC does not benefit everyone except the poorest. Oxford University Press 2020-11-19 /pmc/articles/PMC7938515/ /pubmed/33212491 http://dx.doi.org/10.1093/heapol/czaa093 Text en © The Author(s) 2020. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Reviews Louart, Sarah Bonnet, Emmanuel Ridde, Valéry Is patient navigation a solution to the problem of "leaving no one behind"? A scoping review of evidence from low-income countries |
title | Is patient navigation a solution to the problem of "leaving no one behind"? A scoping review of evidence from low-income countries |
title_full | Is patient navigation a solution to the problem of "leaving no one behind"? A scoping review of evidence from low-income countries |
title_fullStr | Is patient navigation a solution to the problem of "leaving no one behind"? A scoping review of evidence from low-income countries |
title_full_unstemmed | Is patient navigation a solution to the problem of "leaving no one behind"? A scoping review of evidence from low-income countries |
title_short | Is patient navigation a solution to the problem of "leaving no one behind"? A scoping review of evidence from low-income countries |
title_sort | is patient navigation a solution to the problem of "leaving no one behind"? a scoping review of evidence from low-income countries |
topic | Reviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938515/ https://www.ncbi.nlm.nih.gov/pubmed/33212491 http://dx.doi.org/10.1093/heapol/czaa093 |
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