Background Musculoskeletal (MSK) disorders are one of the main causes of disability among adults globally. The burden of MSK disorders varies greatly between different regions and is the highest in low- and middle income- countries. This study sought to investigate trends in the burden of MSK disorders across the MENA region, utilizing the GBD 2019 dataset. Methods This study utilized data from the Global Burden of Disease (GBD). Using age standardized rates of prevalence and disability-adjusted life-years (DALYs), we report trends in the burden of MSK disorders in The Middle East and North Africa (MENA) region between 1990 and 2019. Furthermore, we analyze trends in risk factors contributing to MSK disorders. Results In 2019, the age-standardized rate prevalence and DALYs for all MSK disorders among both genders was 17706 [95% UI = 16641, 18794] and 1782 [95% UI = 1278, 2366], respectively. Low back pain continued to be the most prevalent MSK condition in 2019. Afghanistan had the lowest age standardized DALYs rate attributed to MSK disorders (1408 per 100,000; 95% UI = 980–1899), while Iran had the highest burden of 2007 per 100,000 (95% UI = 1440–2655). In 2019, occupational risks, high body mass index, and tobacco smoking were the main risk factors for DALYs of MSK disorders. Conclusion MSK disorders carry a large burden of disease in the MENA region, and multiple risk factors contribute to this increased burden in the past decades. Interventions that address risk factors have the potential to improve health outcomes among the population. Future research should continue to explore the burden of MSK disorders and better understand how to intervene.

ObjectivesThis study sought to conduct a systematic review of the literature on the impact of the COVID-19 pandemic on sleep health among Middle Eastern and North African (MENA) populations, understudied geographic regions including with regards to sleep health.SettingA systematic literature search of studies published from inception to 27 March 2022 was conducted on multiple databases using developed keywords.ParticipantsStudies were included if they (1) investigated one or more aspects/dimensions of sleep health as an outcome (eg, sleep duration, sleep quality, sleep problems); (2) measured the impact of a COVID-19 pandemic-related domain (eg, impact of quarantine, work from home, lifestyle changes); (3) focused on at least one MENA region population; (4) were peer-reviewed; (5) included ≥100 participants; (6) were written in English and (7) had full-text article publicly available.Primary and secondary outcomes measuredPrimary outcomes were sleep duration, sleep quality and sleep problems.ResultsIn line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 164 studies were included for data extraction. The Newcastle-Ottawa scale for cross-sectional studies was used to assess the quality of the studies. Overall, the COVID-19 pandemic significantly impacted sleep duration, sleep quality and presence and severity of sleep disorders in MENA populations, including adults, children, students, healthcare workers and people with chronic illnesses. The directionality and strength of associations, as well as the determinants of sleep health, varied by subpopulations.ConclusionsLongitudinal studies are needed to understand the longer-term impact of the COVID-19 pandemic on the sleep health of MENA populations. Sleep health interventions and policy measures should be tailored to the need of each subpopulation.PROSPERO registration numberCRD42022321128.

Background Musculoskeletal (MSK) disorders are one of the main causes of disability among adults globally. The burden of MSK disorders varies greatly between different regions and is the highest in low- and middle income- countries. This study sought to investigate trends in the burden of MSK disorders across the MENA region, utilizing the GBD 2019 dataset. Methods This ecological study utilized data from the Global Burden of Disease (GBD) to report on the burden of musculoskeletal (MSK) disorders in The Middle East and North Africa (MENA) region between 1990 and 2019. Our analysis involved descriptive statistics and sociodemographic trends and did not employ any specific statistical analyses. Using age-standardized rates of prevalence and disability-adjusted life-years (DALYs), we reported trends in the burden of MSK disorders, as well as national variation between different countries. Furthermore, we analyzed trends in risk factors contributing to MSK disorders by age and gender. Results The longitudinal analysis from 1990 to 2019 showed an increase in the age-standardized rate for prevalence and DALYs of MSK disorders by 5% and 4.80%, respectively. Low back pain continued to be the most prevalent MSK condition, while RA and other MSK disorders had the largest percentage increase for DALYs between 1990 and 2019. The study found that Afghanistan had the lowest age standardized DALYs rate attributed to MSK disorders, while Iran, Turkey, and Jordan had the highest. Further, Syria showed the most dramatic decrease while Saudi Arabia had the most notable increase in age standardized DALY rates from 1990 to 2019. In 2019, occupational risks, high body mass index, and tobacco smoking were the main risk factors for MSK disorders, with occupational risks being the largest contributor, and between 1990 and 2019, there was a decrease in the contribution of occupational risks but an increase in the contribution of high body mass index as a risk factor. Conclusion This study highlights the significant burden of MSK disorders in the MENA region, with various risk factors contributing to its increasing prevalence in recent decades. Further research is needed to better understand the underlying factors and potential interventions that could improve health outcomes. Addressing MSK disorders should be a public health priority in the region, and efforts should be made to develop effective strategies to prevent and manage this debilitating condition.

Over the past three decades, there has been an unprecedented growth in development assistance for health through different financing models, ranging from donations to results-based approaches, to improve health in low- and middle-income countries. Since then, the global burden of disease has started to shift. However, it is still not entirely clear what the comparative effect of the different financing models is. To assess the effect of these financing models on various healthcare targets, we systematically reviewed the peer-reviewed and gray literature. We identified 19 studies and found that results-based financing approaches have an overall positive impact on institutional delivery rates and numbers of healthcare facility visits, though this impact varies greatly by context.Donors might be better served by providing a results-based financing scheme combining demand and supply side health-related schemes. It is essential to include rigorous monitoring and evaluation strategies when designing financing models.