Abstract
IntroductionLow-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.MethodsAn 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.ResultsReports 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.ConclusionInnovative 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.
Highlights
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
The aim of the present study is to provide the first systematic review of Global Health Capacity Building (GHCB) initiatives delivered in LMICs within the MENA region
Search strategy Multiple search strategies were employed in this systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in order to identify GHCB initiatives implemented among LMICs in the MENA region
Summary
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. Low-to Middle-Income Countries (LMICs) in specific tend to face greater health challenges among countries in the region, largely due to their decreased resources in comparison to Higher-Income Countries (HIC) in the region In recent years, this has been exacerbated by conflicts occurring in many countries that contributed in limited investment towards building the health workforce to meet the health and conflict-related needs, but to an exodus of a large number of experienced health workers, further straining limited resources [3]. Many schools and institutions that provide health-related training and education in LMICs face important shortcomings in equipment, physical space, curricula, training materials, faculty, staff, and funding [7, 8] These challenges suppress efforts to improve the quality of training and to expand the diversity and number of health-related programs, which negatively affect their responses to global health threats [7]. This is especially true for LMICs that lack the necessary resources to mobilize efficiently and effectively trained and distributed human resources for health [10]
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