A Systematic Review on inequalities in access to mental healthcare services in low and middle-income countries

Abstract

Objective: To identify health inequalities of access to health services for mental health patients in low and middle-income countries. Methodology: This systematic review was conducted through electronic article search on three journal databases: PubMed, ProQuest and CINAHL Plus with full texts. Additional search was done through Google Scholar and list of references. The articles were selected based on specific criteria and keenly read for quality of information and internal validity. Articles published within the last 10 years (2013-2023) with full-access were included. Results: A total of 4064 articles were retrieved, out of which, 17 were included as eligible. The studies were conducted in various low and middle-income countries, including Brazil, South Africa, Nigeria, Uganda, Kenya, India, Nepal, Ethiopia, Liberia, Surabaya, Rwanda, Jordan, Pakistan, Iran, and Mexico. Twelve studies applied quantitative methods, seven applied qualitative approach and one study used mixed research methodology. Three categories of health inequalities were identified: biological, including gender, age, and comorbidities; social, including race, culture, stigma, trust, family support, fear, attitude, economic status, and literacy-related variables; and structural, including place of residence, distance, accessibility, and availability of the services. Conclusion: Stigma from social norms lead the inequalities in access to mental healthcare services in developing countries.