Assessing evidence of inequalities in access to medication for diabetic populations in low- and middle-income countries: a systematic review

Christiani, Yodi, Dhippayom, Teerapon and Chaiyakunapruk, Nathorn (2016) Assessing evidence of inequalities in access to medication for diabetic populations in low- and middle-income countries: a systematic review. International Journal of Qualitative Studies On Health and Well-Being, 9 1: 32505. doi:10.3402/gha.v9.32505


Author Christiani, Yodi
Dhippayom, Teerapon
Chaiyakunapruk, Nathorn
Title Assessing evidence of inequalities in access to medication for diabetic populations in low- and middle-income countries: a systematic review
Journal name International Journal of Qualitative Studies On Health and Well-Being   Check publisher's open access policy
ISSN 1748-2623
1748-2631
Publication date 2016-01-01
Year available 2016
Sub-type Critical review of research, literature review, critical commentary
DOI 10.3402/gha.v9.32505
Open Access Status DOI
Volume 9
Issue 1
Start page 32505
Total pages 15
Place of publication Jaerfaella, Sweden
Publisher Co-Action Publishing
Language eng
Abstract Inequalities in access to medications among people diagnosed with diabetes inlow- and middle-income countries (LMICs) is a public health concern since untreated diabetes can lead to severe complications and premature death.

To assess evidence of inequalities in access to medication for diabetes in adult populations of people with diagnosed diabetes in LMICs.

We conducted a systematic review of the literature using the PRISMA-Equity guidelines. A search of five databases - PubMed, Cochrane, CINAHL, PsycINFO, and EMBASE - was conducted from inception to November 2015. Using deductive content analysis, information extracted from the selected articles was analysed according to the PRISMA-Equity guidelines, based on exposure variables (place of residence, race/ethnicity, occupation, gender, religion, education, socio-economic status, social capital, and others).

Fifteen articles (seven quantitative and eight qualitative studies) are included in this review. There were inconsistent findings between studies conducted in different countries and regions although financial and geographic barriers generally contributed to inequalities in access to diabetes medications. The poor, those with relatively low education, and people living in remote areas had less access to diabetes medications. Furthermore, we found that the level of government political commitment through primary health care and in the provision of essential medicines was an important factor in promoting access to medications.

The review indicates that inequalities exist in accessing medication among diabetic populations, although this was not evident in all LMICs. Further research is needed to assess the social determinants of health and medication access for people with diabetes in LMICs.
Formatted abstract
Background

Inequalities in access to medications among people diagnosed with diabetes in low- and middle-income countries (LMICs) is a public health concern since untreated diabetes can lead to severe complications and premature death.

Objective

To assess evidence of inequalities in access to medication for diabetes in adult populations of people with diagnosed diabetes in LMICs.

Design

We conducted a systematic review of the literature using the PRISMA-Equity guidelines. A search of five databases - PubMed, Cochrane, CINAHL, PsycINFO, and EMBASE - was conducted from inception to November 2015. Using deductive content analysis, information extracted from the selected articles was analysed according to the PRISMA-Equity guidelines, based on exposure variables (place of residence, race/ethnicity, occupation, gender, religion, education, socio-economic status, social capital, and others).

Results

Fifteen articles (seven quantitative and eight qualitative studies) are included in this review. There were inconsistent findings between studies conducted in different countries and regions although financial and geographic barriers generally contributed to inequalities in access to diabetes medications. The poor, those with relatively low education, and people living in remote areas had less access to diabetes medications. Furthermore, we found that the level of government political commitment through primary health care and in the provision of essential medicines was an important factor in promoting access to medications.

Conclusions

The review indicates that inequalities exist in accessing medication among diabetic populations, although this was not evident in all LMICs. Further research is needed to assess the social determinants of health and medication access for people with diabetes in LMICs.
Keyword Access to medication
Diabetes
Inequalities
Low- and middle-income countries
Progress
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: HERDC Pre-Audit
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