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Narrative synthesis systematic review of Pakistani women's health outcomes from primary care interventions.
Rizvi Jafree, Sara; Mahmood, Qaisar Khalid; Mujahid, Sohail; Asim, Muhammad; Barlow, Jane.
  • Rizvi Jafree S; Sociology, Forman Christian College, Lahore, Punjab, Pakistan sarajafree@fccollege.edu.pk.
  • Mahmood QK; Department of Gender Studies, University of the Punjab, Lahore, Punjab, Pakistan.
  • Mujahid S; Department of Sociology, University of Chakwal, Chakwal, Punjab, Pakistan.
  • Asim M; Department of Community Health Sciences, Aga Khan University Hospital Clinical Laboratories, Karachi, Federal Capital Territory, Pakistan.
  • Barlow J; Department of Social Policy, University of Oxford, Oxford, UK.
BMJ Open ; 12(8): e061644, 2022 08 01.
Article in English | MEDLINE | ID: covidwho-1973846
ABSTRACT

OBJECTIVE:

Women living in Pakistan have complex health problems including infectious and non-communicable diseases, accident and injuries, and mental health problems. While a majority of these women rely on primary healthcare services for all of their healthcare needs, there has to date been no overview of the extent of their effectiveness. The objective of this review was to (1) synthesise the available evidence regarding the effectiveness of primary care based interventions aimed at improving women's mental and physical health and (2) identify the factors that promote effectiveness for women's health outcomes.

METHODS:

Five academic databases were searched, including PubMed, BMC Medicine, Medline, CINAHL and the Cochrane Library. A search was also made of the grey literature. The quality of included studies was assessed using a standardised critical appraisal tool, and the findings summarised using a narrative synthesis.

RESULTS:

In total, 18 studies were included in the review. Eight involved evaluations of counselling interventions, three health education and awareness interventions, two social and psychosocial interventions, and five were evaluations of combination interventions. Twelve of the included studies were randomised controlled trials. Of these 14 reported significant outcomes, and 4 further interventions showed partially favourable results. However, interventions mostly targeted women's mental or reproductive health.

CONCLUSIONS:

While the evidence is limited in terms of quality and what has been evaluated, a number of interventions appear to be effective in improving outcomes for women. The three key approaches include the adoption of an active door-to-door and group-based approach; utilisation of community peers who can deliver care cost-effectively and who are more accepted in the community; and the integration of financial vouchers to support uptake in poor populations. PROSPERO REGISTRATION NUMBER CRD42020203472.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Health Education / Women's Health Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Female / Humans Country/Region as subject: Asia Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2022-061644

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Health Education / Women's Health Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Female / Humans Country/Region as subject: Asia Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2022-061644