A systematic review of global health capacity building initiatives in low-to middle-income countries in the Middle East and North Africa region

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Abstract

Introduction

Low-and Middle-Income Countries (LMICs) in the Middle East and North Africa (MENA) region are facing increasing global health challenges with a reduced ability to manage them. Global Health Capacity Building (GHCB) initiatives have the potential to improve health workforce performance and health outcomes, however little is known about the GHCB topics and approaches implemented in this region. This is the first systematic review of GHCB initiatives among LMICs in the MENA region.

Methods

An academic database search of Medline (OVID), PubMed, Scopus, Embase.com, and Open Grey was conducted for articles published between January 2009 and September 2019 in English. Next, a grey literature search following a recommended search framework was conducted. Reviewed records addressed a global health topic, had a capacity building component, looked at specific learning outcomes, and reflected an LMIC in the MENA. Primary outcomes included country, topic, modality, pedagogy, and population.

Results

Reports of GHCB initiatives were retrieved from grey sources (73.2%) and academic sources (26.8%). Most GHCB initiatives were mainly conducted face-to-face (94.4%) to professional personnel (57.5%) through a theoretical pedagogical approach (44.3%). Dominant global health themes were non-communicable diseases (29.2%), sexual and reproductive health (18.4%), and mental health (14.5%). When matched against the Global Burden of Disease data, important gaps were found regarding the topics of GHCB initiatives in relation to the region’s health needs. There were limited reports of GHCB initiatives addressing conflict and emergency topics, and those addressing non-communicable disease topics were primarily reported from Egypt and Iran.

Conclusion

Innovative and practicum-based approaches are needed for GHCB initiatives among LMICs in the MENA region, with a focus on training community workers. Regional and country-specific analyses of GHCB initiatives relative to their health needs are discussed in the manuscript based on the results of this review.

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Most cited references 50

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Global Supply of Health Professionals

Nigel Crisp, Lincoln Chen (2014)

New England Journal of Medicine, 370(10), 950-957

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Trade, investment and public health: compiling the evidence, assembling the arguments

Ronald Labonté (2019)

Trade has long been an axiomatic characteristic of globalization, although international rules governing trade are of more recent vintage. Notably in the post-World War II period, an ever increasing number of countries began negotiating treaties to reduce, first, tariff barriers and, later, non-tariff barriers (government measures of any sort) that could impede the cross-border flow of goods. The rationale, in part, was that countries that became more entwined economically would be less likely to go to war with each other. It wouldn’t be in their own economic interests to do so, or at least that of the firms based within their borders but engaged in transnational trade and dependent upon global supply chains. At first primarily an undertaking of developed (high-income) countries, developing (low and middle-income countries) slowly enjoined in what, in 1995, became the World Trade Organization. The WTO locked in scheduled declines in tariffs (border taxes), albeit with lesser obligations on developing country members (a problematic nomenclature given the vast geographic, economic, and development differences between such countries, but which nonetheless persists within the WTO). Importantly, a slew of new agreements that coincided with the establishment of the WTO also sought to liberalize trade in services (not just goods) (The General Agreement on Trade in Services), create new rules for agricultural trade (Agreement on Agriculture), expand intellectual property rights protections (The Agreement on Trade-Related Aspects of Intellectual Property Rights), limit trade-distorting government subsidies (Agreement on Subsidies and Countervailing Measures), and ensure that government food, health, or environmental regulations would not pose an unnecessary barrier to trade (the Technical Barriers to Trade and the Sanitary and Phytosanitary Measures Agreements). Outside of the WTO system, bilateral or regional investment treaties granting special rights to foreign investors to sue governments for actions perceived to affect the value of their investment (such as direct expropriation or passage of new laws and regulations considered ‘tantamount to expropriation’) similarly exploded in number, dispute frequency, and the size of monetary claims. The breadth and depth of these post-1995 Agreements meant that few areas of general public health concern are potentially untouched.

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Social sciences research in neglected tropical diseases 2: A bibliographic analysis

Daniel Reidpath, Pascale Allotey, Subhash Pokhrel (2011)

Background There are strong arguments for social science and interdisciplinary research in the neglected tropical diseases. These diseases represent a rich and dynamic interplay between vector, host, and pathogen which occurs within social, physical and biological contexts. The overwhelming sense, however, is that neglected tropical diseases research is a biomedical endeavour largely excluding the social sciences. The purpose of this review is to provide a baseline for discussing the quantum and nature of the science that is being conducted, and the extent to which the social sciences are a part of that. Methods A bibliographic analysis was conducted of neglected tropical diseases related research papers published over the past 10 years in biomedical and social sciences. The analysis had textual and bibliometric facets, and focussed on chikungunya, dengue, visceral leishmaniasis, and onchocerciasis. Results There is substantial variation in the number of publications associated with each disease. The proportion of the research that is social science based appears remarkably consistent (<4%). A textual analysis, however, reveals a degree of misclassification by the abstracting service where a surprising proportion of the "social sciences" research was pure clinical research. Much of the social sciences research also tends to be "hand maiden" research focused on the implementation of biomedical solutions. Conclusion There is little evidence that scientists pay any attention to the complex social, cultural, biological, and environmental dynamic involved in human pathogenesis. There is little investigator driven social science and a poor presence of interdisciplinary science. The research needs more sophisticated funders and priority setters who are not beguiled by uncritical biomedical promises.

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Author and article information

Contributors

Shadi Saleh: ss117@aub.edu.lb

Journal

Journal ID (nlm-ta): Global Health

Journal ID (iso-abbrev): Global Health

Title: Globalization and Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1744-8603

Publication date (Electronic): 3 July 2020

Publication date PMC-release: 3 July 2020

Publication date Collection: 2020

Volume: 16

Electronic Location Identifier: 56

Affiliations

[1 ]GRID grid.22903.3a, ISNI 0000 0004 1936 9801, Global Health Institute at the American University of Beirut, Faculty of Health Sciences at the American University of Beirut, ; Beirut, Lebanon

[2 ]GRID grid.22903.3a, ISNI 0000 0004 1936 9801, Saab Medical Library at the American University of Beirut, ; Beirut, Lebanon

Article

Publisher ID: 585

DOI: 10.1186/s12992-020-00585-0

PMC ID: 7333284

PubMed ID: 32620141

SO-VID: 167339f5-8887-4acb-8282-7589998da519

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 12 March 2020

Date accepted : 17 June 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100000193, International Development Research Centre;

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ScienceOpen disciplines: Health & Social care

Keywords: capacity building,global health,middle east and north africa,low to middle income countries

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ScienceOpen disciplines: Health & Social care

Keywords: capacity building, global health, middle east and north africa, low to middle income countries

A systematic review of global health capacity building initiatives in low-to middle-income countries in the Middle East and North Africa region

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Abstract

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Global Health Next Generation Network

Most cited references 50

Global Supply of Health Professionals

Trade, investment and public health: compiling the evidence, assembling the arguments

Social sciences research in neglected tropical diseases 2: A bibliographic analysis

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