A scoping review on barriers to implementation of health education programs in low to middle income countries
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20193503Keywords:
Health education programs, Barriers, Low to middle income countriesAbstract
We aimed to map literature on the barriers to effective implementation of health education programs (HEPs) in low to middle income countries (LMICs) to guide future implementation research. We employed a rigorous scoping review design. Our review was guided by the Arksey and O’Malley framework, 2005, further enhanced by Levac et al. The keyword search was comprehensive for relevant studies presenting evidence on barriers to implementation of HEPs in LMICs from Google Scholar, PubMed, EBSCOHost (CINAHL and Academic Search Complete) databases and grey literature. The first search identified 3,092 articles, of which 1,412 duplicates were eliminated. An additional 1,632, 34 and 7 articles did not meet the inclusion criteria based on sequential title screen, abstract review and full text review respectively. Seven studies met the inclusion criteria for the actual scoping review. Findings of the review revealed three categories of barriers to effective implementation of HEPs in LMICs grouped as individual or patient level, community level and population level barriers. A key barrier to effective implementation of HEPs in LMICs revealed from the review was socio-economic challenges, which result from resource constraints. This calls for adequate allocation of the limited resources toward health education to ensure effective implementation of HEPs in LMICs and improve health outcomes.
References
Kumar S, Preetha G. Health promotion: an effective tool for global health. Indian J Community Med. 2012;37(1):5-12.
Hubley JH. Community development and health education. J Institute Health Educ. 1980;18:113-20.
Hubley JH. Principles of health education. Br Med J. 1984;289:1054-6.
WHO/Unicef Primary Health Care. Report of the International Conference on Primary Health Care (Alam Ata Declariation). WHO, Geneva. 1980.
Coe G, de Beyer J. The imperative for health promotion in universal health coverage. Glob Health Sci Pract. 2014;2(1):10-22.
Pearson M, Chilton R, Wyatt K, Abraham C, Ford T, Woods HB, et al. Implementing health promotion programmes in schools: a realist systematic review of research and experience in the United Kingdom. Implement Sci. 2015;10:149.
Lobo R, Petrich M, Burns SK. Supporting health promotion practitioners to undertake evaluation for program development. BMC Public Health. 2014;14:13-5.
Darlington EJ, Violon N, Jourdan D. Implementation of health promotion programmes in schools: an approach to understand the influence of contextual factors on the process?. BMC Public Health. 2018;18(1):163.
Gucciardi E, Cameron JI, Liao CD, Palmer A, Stewart DE. Program design features that can improve participation in health education interventions. BMC Med Res Methodol. 2007;7:47.
Cancelliere C, Cassidy JD, Ammendolia C, Côté P. Are workplace health promotion programs effective at improving presenteeism in workers? A systematic review and best evidence synthesis of the literature. BMC Public Health. 2011;11:395.
Backman DR, Kohatsu ND, Paciotti BM, Byrne JV, Kizer KW. Health Promotion Interventions for Low-Income Californians Through Medi-Cal Managed Care Plans, 2012. Prev Chronic Dis. 2015;12:196.
Arksey H, O'Malley L. Scoping studies: Towards a Methodological Framework. Int J Soc Res Methodol. 2005;8:19–32.
Varming AR, Torenholt R, Møller BL, Vestergaard S, Engelund G. Addressing challenges and needs in patient education targeting hardly reached patients with chronic diseases. Indian J Endocrinol Metab. 2015;19(2):292-5.
Rohleder P, Swartz L, Schneider M, Eide AH. Challenges to providing HIV prevention education to youth with disabilities in South Africa. Disability Rehab. 2012;34(8):619-24.
Wierenga D, Engbers LH, Van Empelen P, Duijts S, Hildebrandt VH, Van Mechelen W. What is actually measured in process evaluations for worksite health promotion programs: A systematic review. BMC Public Health. 2013;17:1190.
Beshir SA, Bt Hamzah NH. Health promotion and health education: perception, barriers and standard of practices of community pharmacists. Int J Health Promotion Educ. 2014;52(4):174-80,
Silva KL, Sena RR, Belga SM, Silva PM, Rodrigues AT. Promoção da saúde: desafios revelados em práticas exitosas (Health promotion: challenges revealed in successful practices). Rev Saude Publica. 2014;48(1):76-85.
Borghini A, Poscia A, La Milia DI, Milovanovic S, Stojanovic J, Pattavina F, et al. Institutional analysis of workplace health promotion for elderly in 10 Countries: Pro-Health65+ Umberto Moscato. Eur J Public Health. 2016;26(suppl_1):ckw166-085.
Mohapatra SC, Sengupta P. Health Programs in a Developing Country- why do we Fail? Health Systems Policy Res. 2016;3:1-7.
Timmerman GM. Using self-care strategies to make lifestyle changes. J Holistic Nursing. 1999;17(2):169-83.
Ory MG, Jordon PJ, Bazzarre T. The Behavior Change Consortium: setting the stage for a new century of health behavior-change research. Health Educ Res. 2002;17(5):500-11.
Pender NJ, Murdaugh CL, Parsons MA. Health Promotion in Nursing Practice. 5th ed. Upper Saddle River, NJ: Prentice-Hall; 2006.
Martinez C, Bacigalupe G, Cortada JM, Grandes G, Sanchez A, Pombo H, et al. The implementation of health promotion in primary and community care: a qualitative analysis of the 'Prescribe Vida Saludable' strategy. BMC Fam Pract. 2017;18(1):23.
Timmerman GM. Addressing barriers to health promotion in underserved women. Fam Community Health. 2007;30(1):34-42.
Crane PB, McSweeney JC. Exploring older women's lifestyle changes after myocardial infarction. MedSurg Nursing. 2003;12:170-6.
James CS. Factors influencing food choices, dietary intake, and nutrition-related attitudes among African Americans: application of a culturally sensitive model. Ethnicity and Health. 2004;9(4):349-67.
Stuifbergen AK, Becker H, Timmerman GM, Kullberg V. The use of individualized goal setting to facilitate behavior change in women with multiple sclerosis. The Journal of Neuroscience Nursing. 2003;35(2):94-99, 106.
Rongen A, Robroek SJ, van Ginkel W, Lindeboom D, Altink B, Burdorf A. Barriers and facilitators for participation in health promotion programs among employees: a six-month follow-up study. BMC Public Health. 2014;14:573.
Sadana R, Chowdhury AM, Chowdhury R, Petrakova A. Strengthening public health education and training to improve global health. Bull World Health Organ. 2007;85(3):163.
De Jesus M. Institutional barriers and strategies to health promotion: perspectives and experiences of Cape Verdean women health promoters. J Immigr Minor Health. 2008;12(3):398-407.
Bergström H, Elinder LS, Wihlman U. Barriers and facilitators in health education for adults with intellectual disabilities—a qualitative study. Health Educ Res. 2014;29(2):259-71.
Jacob KS. Repackaging mental health programs in low- and middle-income countries. Indian J Psychiatry. 2011;53(3):195-8.
