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      Service coverage and health workforce allocation strategies for geriatric and palliative care in low- and middle-income countries : A protocol for a systematic review and meta-analysis

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          Abstract

          Background:

          Advances in medical science coupled with increased people's income results an elevated average of life expectancy even in the resource poor countries. The growing number of aged population, however, has drawn little attention in health system discourse of low- and Middle-Income Countries (LMICs). Nevertheless, ensuring availability of appropriate service and properly trained and skilled health workforce is an absolute necessity for a functional geriatric and palliative healthcare. Given the lack of specialist geriatricians in LMICs contexts, there are other health workforce strategies that might be effective in building a proper health system response to this growing demand. Therefore, we aimed to identify and synthesize evidence on the existing health workforce-related strategies taken to provide geriatric and palliative care in LMICs.

          Methods:

          We will follow the recommendations provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Following the PRISMA guidelines, we will search the Medline/PubMed, Scopus, Web of Science and Cochrane database from January 2011 to December 2021 using a comprehensive search strategy. Two independent reviewers will screen the title and abstracts text using the specified inclusion and exclusion criteria. For the finally included articles, full manuscripts will be retrieved, and reviewers will appraise and extract data using standardized form independently. The third reviewer will resolve any disagreements appear in the process. The findings of the review be synthesized using the narrative synthesis approach to analyse descriptive quantitative and qualitative data. Furthermore, meta-analysis will be done provided that the data meet certain requirement as per Cochrane guideline. Rayyan software will be used to manage and synthesize data. Revman software will be used to do meta-analysis, if data support.

          Results:

          Findings of this review will be published in a peer-reviewed journal.

          Conclusion:

          This systematic review will identify the existing effective strategies taken to provide geriatric and palliative care, in LMICs.

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          Most cited references22

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          The World report on ageing and health: a policy framework for healthy ageing.

          Although populations around the world are rapidly ageing, evidence that increasing longevity is being accompanied by an extended period of good health is scarce. A coherent and focused public health response that spans multiple sectors and stakeholders is urgently needed. To guide this global response, WHO has released the first World report on ageing and health, reviewing current knowledge and gaps and providing a public health framework for action. The report is built around a redefinition of healthy ageing that centres on the notion of functional ability: the combination of the intrinsic capacity of the individual, relevant environmental characteristics, and the interactions between the individual and these characteristics. This Health Policy highlights key findings and recommendations from the report.
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            In an empirical evaluation of the funnel plot, researchers could not visually identify publication bias.

            Publication bias and related biases can lead to overly optimistic conclusions in systematic reviews. The funnel plot, which is frequently used to detect such biases, has not yet been subjected to empirical evaluation as a visual tool. We sought to determine whether researchers can correctly identify publication bias from visual inspection of funnel plots in typical-size systematic reviews. A questionnaire with funnel plots containing 10 studies each (the median number in medical meta-analyses) was completed by 41 medical researchers, including clinical research fellows in a meta-analysis class, faculty in clinical care research, and experienced systematic reviewers. On average, participants correctly identified 52.5% (95% CI 50.6-54.4%) of the plots as being affected or unaffected by publication bias. The weighted mean percent correct, which adjusted for the fact that asymmetric plots are more likely to occur in the presence of publication bias, was also low (48.3 to 62.8%, depending on the presence or absence of publication bias and heterogeneous study effects). Researchers who assess for publication bias using the funnel plot may be misled by its shape. Authors and readers of systematic reviews need to be aware of the limitations of the funnel plot.
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              World report on ageing and health

              (2015)
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Lippincott Williams & Wilkins (Hagerstown, MD )
                0025-7974
                1536-5964
                11 March 2022
                11 March 2022
                : 101
                : 10
                : e29030
                Affiliations
                Health Systems and Population Studies Division, icddr, b, Dhaka, Bangladesh.
                Author notes
                []Correspondence: Dipika Shankar Bhattacharyya, Health Systems and Population Studies Division, icddr, b, Mohakhali, Dhaka, 1000, Bangladesh (e-mail: dipikashankar@ 123456gmail.com ).
                Author information
                http://orcid.org/0000-0003-0887-8937
                http://orcid.org/0000-0002-9176-0800
                http://orcid.org/0000-0003-4114-1486
                http://orcid.org/0000-0001-8702-7094
                Article
                MD-D-22-01105 29030
                10.1097/MD.0000000000029030
                8913098
                bd28870d-b841-45de-9ad3-6202742affc1
                Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 17 February 2022
                : 18 February 2022
                Funding
                Funded by: Styrelsen för Internationellt Utvecklingssamarbete
                Award ID: no
                Award Recipient : Dipika Shankar Bhattacharyya
                Categories
                4600
                Research Article
                Study Protocol Systematic Review
                Custom metadata
                TRUE

                geriatric care,health workforce,human resources for health,lmics,palliative care,service coverage

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