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Context and priorities for health systems strengthening for pain and disability in low- and middle-income countries: a secondary qualitative study and content analysis of health policies

Musculoskeletal (MSK) health impairments contribute substantially to the pain and disability burden in low- and middle-income countries (LMICs), yet health systems strengthening (HSS) responses are nascent in these settings. We aimed to explore the contemporary context, framed as challenges and oppo...

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Autores principales: Briggs, Andrew M, Jordan, Joanne E, Sharma, Saurab, Young, James J, Chua, Jason, Foster, Helen E, Haq, Syed Atiqul, Huckel Schneider, Carmen, Jain, Anil, Joshipura, Manjul, Kalla, Asgar Ali, Kopansky-Giles, Deborah, March, Lyn, Reis, Felipe J J, Reyes, Katherine Ann V, Soriano, Enrique R, Slater, Helen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9923377/
https://www.ncbi.nlm.nih.gov/pubmed/35876078
http://dx.doi.org/10.1093/heapol/czac061
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author Briggs, Andrew M
Jordan, Joanne E
Sharma, Saurab
Young, James J
Chua, Jason
Foster, Helen E
Haq, Syed Atiqul
Huckel Schneider, Carmen
Jain, Anil
Joshipura, Manjul
Kalla, Asgar Ali
Kopansky-Giles, Deborah
March, Lyn
Reis, Felipe J J
Reyes, Katherine Ann V
Soriano, Enrique R
Slater, Helen
author_facet Briggs, Andrew M
Jordan, Joanne E
Sharma, Saurab
Young, James J
Chua, Jason
Foster, Helen E
Haq, Syed Atiqul
Huckel Schneider, Carmen
Jain, Anil
Joshipura, Manjul
Kalla, Asgar Ali
Kopansky-Giles, Deborah
March, Lyn
Reis, Felipe J J
Reyes, Katherine Ann V
Soriano, Enrique R
Slater, Helen
author_sort Briggs, Andrew M
collection PubMed
description Musculoskeletal (MSK) health impairments contribute substantially to the pain and disability burden in low- and middle-income countries (LMICs), yet health systems strengthening (HSS) responses are nascent in these settings. We aimed to explore the contemporary context, framed as challenges and opportunities, for improving population-level prevention and management of MSK health in LMICs using secondary qualitative data from a previous study exploring HSS priorities for MSK health globally and (2) to contextualize these findings through a primary analysis of health policies for integrated management of non-communicable diseases (NCDs) in select LMICs. Part 1: 12 transcripts of interviews with LMIC-based key informants (KIs) were inductively analysed. Part 2: systematic content analysis of health policies for integrated care of NCDs where KIs were resident (Argentina, Bangladesh, Brazil, Ethiopia, India, Kenya, Malaysia, Philippines and South Africa). A thematic framework of LMIC-relevant challenges and opportunities was empirically derived and organized around five meta-themes: (1) MSK health is a low priority; (2) social determinants adversely affect MSK health; (3) healthcare system issues de-prioritize MSK health; (4) economic constraints restrict system capacity to direct and mobilize resources to MSK health; and (5) build research capacity. Twelve policy documents were included, describing explicit foci on cardiovascular disease (100%), diabetes (100%), respiratory conditions (100%) and cancer (89%); none explicitly focused on MSK health. Policy strategies were coded into three categories: (1) general principles for people-centred NCD care, (2) service delivery and (3) system strengthening. Four policies described strategies to address MSK health in some way, mostly related to injury care. Priorities and opportunities for HSS for MSK health identified by KIs aligned with broader strategies targeting NCDs identified in the policies. MSK health is not currently prioritized in NCD health policies among selected LMICs. However, opportunities to address the MSK-attributed disability burden exist through integrating MSK-specific HSS initiatives with initiatives targeting NCDs generally and injury and trauma care.
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spelling pubmed-99233772023-02-13 Context and priorities for health systems strengthening for pain and disability in low- and middle-income countries: a secondary qualitative study and content analysis of health policies Briggs, Andrew M Jordan, Joanne E Sharma, Saurab Young, James J Chua, Jason Foster, Helen E Haq, Syed Atiqul Huckel Schneider, Carmen Jain, Anil Joshipura, Manjul Kalla, Asgar Ali Kopansky-Giles, Deborah March, Lyn Reis, Felipe J J Reyes, Katherine Ann V Soriano, Enrique R Slater, Helen Health Policy Plan Original Article Musculoskeletal (MSK) health impairments contribute substantially to the pain and disability burden in low- and middle-income countries (LMICs), yet health systems strengthening (HSS) responses are nascent in these settings. We aimed to explore the contemporary context, framed as challenges and opportunities, for improving population-level prevention and management of MSK health in LMICs using secondary qualitative data from a previous study exploring HSS priorities for MSK health globally and (2) to contextualize these findings through a primary analysis of health policies for integrated management of non-communicable diseases (NCDs) in select LMICs. Part 1: 12 transcripts of interviews with LMIC-based key informants (KIs) were inductively analysed. Part 2: systematic content analysis of health policies for integrated care of NCDs where KIs were resident (Argentina, Bangladesh, Brazil, Ethiopia, India, Kenya, Malaysia, Philippines and South Africa). A thematic framework of LMIC-relevant challenges and opportunities was empirically derived and organized around five meta-themes: (1) MSK health is a low priority; (2) social determinants adversely affect MSK health; (3) healthcare system issues de-prioritize MSK health; (4) economic constraints restrict system capacity to direct and mobilize resources to MSK health; and (5) build research capacity. Twelve policy documents were included, describing explicit foci on cardiovascular disease (100%), diabetes (100%), respiratory conditions (100%) and cancer (89%); none explicitly focused on MSK health. Policy strategies were coded into three categories: (1) general principles for people-centred NCD care, (2) service delivery and (3) system strengthening. Four policies described strategies to address MSK health in some way, mostly related to injury care. Priorities and opportunities for HSS for MSK health identified by KIs aligned with broader strategies targeting NCDs identified in the policies. MSK health is not currently prioritized in NCD health policies among selected LMICs. However, opportunities to address the MSK-attributed disability burden exist through integrating MSK-specific HSS initiatives with initiatives targeting NCDs generally and injury and trauma care. Oxford University Press 2022-07-25 /pmc/articles/PMC9923377/ /pubmed/35876078 http://dx.doi.org/10.1093/heapol/czac061 Text en © The Author(s) 2022. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://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 Original Article
Briggs, Andrew M
Jordan, Joanne E
Sharma, Saurab
Young, James J
Chua, Jason
Foster, Helen E
Haq, Syed Atiqul
Huckel Schneider, Carmen
Jain, Anil
Joshipura, Manjul
Kalla, Asgar Ali
Kopansky-Giles, Deborah
March, Lyn
Reis, Felipe J J
Reyes, Katherine Ann V
Soriano, Enrique R
Slater, Helen
Context and priorities for health systems strengthening for pain and disability in low- and middle-income countries: a secondary qualitative study and content analysis of health policies
title Context and priorities for health systems strengthening for pain and disability in low- and middle-income countries: a secondary qualitative study and content analysis of health policies
title_full Context and priorities for health systems strengthening for pain and disability in low- and middle-income countries: a secondary qualitative study and content analysis of health policies
title_fullStr Context and priorities for health systems strengthening for pain and disability in low- and middle-income countries: a secondary qualitative study and content analysis of health policies
title_full_unstemmed Context and priorities for health systems strengthening for pain and disability in low- and middle-income countries: a secondary qualitative study and content analysis of health policies
title_short Context and priorities for health systems strengthening for pain and disability in low- and middle-income countries: a secondary qualitative study and content analysis of health policies
title_sort context and priorities for health systems strengthening for pain and disability in low- and middle-income countries: a secondary qualitative study and content analysis of health policies
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9923377/
https://www.ncbi.nlm.nih.gov/pubmed/35876078
http://dx.doi.org/10.1093/heapol/czac061
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