Beyond Neglect: Long-term Care Research in Low and Middle Income Countries

Abstract

Long-term care (LTC) continues to be a neglected policy issue in most low and middle income countries. This paper assesses whether research on LTC contributes to or reinforces that neglect. This paper assesses the global geographical distribution of published research on LTC and relates this distribution to the demand for LTC. This is a systematic review of published research abstracted in PubMed and in relevant journals not routinely abstracted in PubMed. The keyword search term “long-term care policy” produced 4488 hits. These were personally screened by the author for relevance, according to the United Nations definition of LTC. A total of 1417 studies were identified as relevant. The validity of this approach was assessed by using the keyword search term “long-term care” (72,215 hits) for a selected set of countries. The study found an extreme bias towards more developed regions, which accounted for 37.5% of people aged 65 years and older in 2010, but accounted for 95.5% of relevant PubMed listings. Africa, Latin America and the Caribbean, and India stand out as particularly under-represented and account for 27.6% of people aged 65 years and older, but only account for 0.7% of relevant PubMed listings. There has been no previously published research on the geographical distribution of research on LTC. This study demonstrates an extreme degree of bias towards high income countries and away from low and middle income countries. These biases reflect and contribute to ongoing neglect by policymakers.