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

Simple item page
aut.relation.endpage149
aut.relation.issue2
aut.relation.journalHealth Policy and Planning
aut.relation.startpage129
aut.relation.volume38
dc.contributor.authorBriggs, Andrew M
dc.contributor.authorJordan, Joanne E
dc.contributor.authorSharma, Saurab
dc.contributor.authorYoung, James J
dc.contributor.authorChua, Jason
dc.contributor.authorFoster, Helen E
dc.contributor.authorHaq, Syed Atiqul
dc.contributor.authorHuckel Schneider, Carmen
dc.contributor.authorJain, Anil
dc.contributor.authorJoshipura, Manjul
dc.contributor.authorKalla, Asgar Ali
dc.contributor.authorKopansky-Giles, Deborah
dc.contributor.authorMarch, Lyn
dc.contributor.authorReis, Felipe JJ
dc.contributor.authorReyes, Katherine Ann V
dc.contributor.authorSoriano, Enrique R
dc.contributor.authorSlater, Helen
dc.date.accessioned2023-07-05T22:42:39Z
dc.date.available2023-07-05T22:42:39Z
dc.date.issued2022-07-25
dc.description.abstractMusculoskeletal (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.
dc.identifier.citationHealth Policy and Planning, ISSN: 0268-1080 (Print); 1460-2237 (Online), Oxford University Press (OUP), 38(2), 129-149. doi: 10.1093/heapol/czac061
dc.identifier.doi10.1093/heapol/czac061
dc.identifier.issn0268-1080
dc.identifier.issn1460-2237
dc.identifier.urihttp://hdl.handle.net/10292/16360
dc.languageen
dc.publisherOxford University Press (OUP)
dc.relation.urihttps://academic.oup.com/heapol/article/38/2/129/6649495
dc.rights.accessrightsOpenAccess
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.subjectLow- and middle-income
dc.subjecthealth system
dc.subjectmusculoskeletal
dc.subjectnon-communicable
dc.subjectpolicy
dc.subjectqualitative
dc.subject4203 Health Services and Systems
dc.subject4206 Public Health
dc.subject42 Health Sciences
dc.subject44 Human Society
dc.subjectChronic Pain
dc.subjectHealth Services
dc.subjectPain Research
dc.subjectClinical Research
dc.subject3 Good Health and Well Being
dc.subject1117 Public Health and Health Services
dc.subject1605 Policy and Administration
dc.subject1606 Political Science
dc.subjectHealth Policy & Services
dc.subject4203 Health services and systems
dc.subject4206 Public health
dc.subject4407 Policy and administration
dc.subject.meshHumans
dc.subject.meshDeveloping Countries
dc.subject.meshNoncommunicable Diseases
dc.subject.meshHealth Policy
dc.subject.meshDelivery of Health Care
dc.subject.meshPain
dc.subject.meshHumans
dc.subject.meshPain
dc.subject.meshDeveloping Countries
dc.subject.meshHealth Policy
dc.subject.meshDelivery of Health Care
dc.subject.meshNoncommunicable Diseases
dc.subject.meshHumans
dc.subject.meshDeveloping Countries
dc.subject.meshNoncommunicable Diseases
dc.subject.meshHealth Policy
dc.subject.meshDelivery of Health Care
dc.subject.meshPain
dc.titleContext 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
dc.typeJournal Article
pubs.elements-id460970
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Context and priorities for health systems strengthening for pain and disability in low- and middle-income countries.pdf
Size:
2.75 MB
Format:
Adobe Portable Document Format
Description:
Journal article
Download
Collections
School of Clinical Sciences - Te Kura Mātai Haumanu