Mobile clinics for women's and children's health

Abdel‐Aleem, Hany; El-Gibaly, Omaima; El-Gazzar, Amira F; Al-Attar, Ghada

doi:10.1002/14651858.cd009677.pub2

Cited by 17 publications

(6 citation statements)

References 86 publications

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“…Only 22 out of the 31 reviews were at least mentioning the limitations of the original studies. These included lack of theory use, 24 quality of methodology/design, 1 , 15 – 18 , 20 , 24 – 27 poor reporting of the methods or terminology, 19 , 20 , 28 ethical issues, 18 and limited generalizability particularly since very few studies were conducted outside of the USA 29 (supplementary Appendix D).…”

Section: Resultsmentioning

confidence: 99%

“…Most of the evidence was coming from the USA (supplementary Appendix C), with three reviews being able to identify studies only from this country. 22 , 25 , 26 A few reviews targeting Asian populations 1 , 17 , 24 included European and North American trials and therefore did not detect regional variabilities. While there are no sufficient data describing regional differences, Brewer et al.…”

Section: Resultsmentioning

confidence: 99%

“…A short distance to facilities (for instance, mobile mammography units or community hospitals) could increase access to BCS and ultimately increase participation rates. 14 , 25 , 33 Meanwhile, improved logistics, such as access to bus transportation, did not have the same strengths of evidence. 13 , 15 …”

Section: Resultsmentioning

confidence: 99%

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Systematic reviews as a “lens of evidence”: Determinants of participation in breast cancer screening

et al. 2020

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Objective To assess the determinants of the participation rate in breast cancer screening programs by conducting a systematic review of reviews. Methods We conducted a systematic search in PubMed via Medline, Scopus, Embase, and Cochrane identifying the literature up to April 2019. Out of 2258 revealed unique abstracts, we included 31 reviews, from which 25 were considered as systematic. We applied the Walsh & McPhee Systems Model of Clinical Preventive Care to systematize the determinants of screening participation. Results The reviews, mainly in high-income settings, reported a wide range for breast cancer screening participation rate: 16–90%. The determinants of breast cancer screening participation were simple low-cost interventions such as invitation letters, basic information on screening, multiple reminders, fixed appointments, prompts from healthcare professionals, and healthcare organizational factors (e.g. close proximity to screening facility). More complex interventions (such as face-to-face counselling or home visits), mass media or improved access to transport should not be encouraged by policy makers unless other information appears. The repeated participation in mammography screening was consistently high, above 62%. Previous positive experience with screening influenced the repeated participation in screening programs. The reviews were inconsistent in the use of terminology related to breast cancer screening participation, which may have contributed to the heterogeneity in the reported outcomes. Conclusions This study shows that consistent findings of systematic reviews bring more certainty into the conclusions on the effects of simple invitation techniques, fixed appointments and prompts, as well as healthcare organizational factors on promoting participation rate in screening mammography.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Systematic reviews as a “lens of evidence”: Determinants of participation in breast cancer screening

et al. 2020

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“…Meregaglia, 2015 35 5 Muka, 2015 37 4 Chaker, 2015 38 4 Abdel-Aleem, 2016 51 among younger and older women is that the evidence on the benefit/harm ratio of screening mammography in these populations is inconclusive or limited. 3 Nevertheless, the conclusions on the cost-effectiveness of screening mammography among women younger than 50 years old or older than 69 years old could vary from those presented if other clinical outcomes were selected, since the incidence of breast cancer (and so advanced cases prevented) was higher among the older population (while the younger population accumulated more life years gained) or if the individual-based screening approach would be evaluated.…”

Section: Determinants Of the Costeffectiveness Of Mammography Screementioning

confidence: 99%

Systematic reviews as a “lens of evidence”: Determinants of cost‐effectiveness of breast cancer screening

et al. 2019

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Systematic reviews with economic components are important decision tools for stakeholders seeking to evaluate technologies, such as breast cancer screening (BCS) programs. This overview of systematic reviews explores the determinants of the cost‐effectiveness of BCS and assesses the quality of secondary evidence. The search identified 30 systematic reviews that reported on the determinants of the cost‐effectiveness of BCS, including the costs of breast cancer and BCS. While the quality of the reviews varied widely, only four out of 30 papers were considered to be of a high quality. We did not identify publication bias in the original evidence on the cost‐effectiveness of mammography screening; however, we highlight a need for improved clarity in both reporting and data verification. The reviews consisted mainly of studies from high‐income countries. Breast cancer costs varied widely among the studies. Factors leading to higher costs included: time (diagnosis and last months before death), later stage or metastases, recurrence of the disease, age below 64 years and type of follow‐up (more intensive or more specialized). Overall, screening with mammography was considered cost‐effective in the age range 50‐69 years in Western European and Northern American countries but not for older or younger women. Its cost‐effectiveness was questionable for low‐income settings and Asia. Mammography screening was more cost‐effective with biennial screening compared to annual screening and single reading using computer‐aided detection vs double reading. No information on the cost‐effectiveness of ultrasonography was found, and there is much uncertainty on the cost‐effectiveness of CBE because of methodological limitations.

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“…Given the high capital cost of mobile clinics, an experiment to offer free IUDs in static clinics may reveal that this is an even more attractive strategy than tying free IUDs to capital and labor intensive mobile clinics. Further experimental studies are needed especially in low and middle income countries to assess the impact of mobile clinics on women and child health 17 .…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Family Planning Services Offered by Mobile Clinics versus Static Clinics in Assiut, Egypt

Al-Attar

Bishai

El-Gibaly

2017

Afr J Reprod Health

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Cost effectiveness studies of family planning (FP) services are very valuable in providing evidence-based data for decision makers in Egypt. Cost data came from record reviews for all 15 mobile clinics and a matched set of 15 static clinics and interviews with staff members of the selected clinics at Assiut Governorate. Effectiveness measures included couple years of protection (CYPs) and FP visits. Incremental cost-effectiveness ratios (ICER) and sensitivity analyses were calculated. Mobile clinics cost more per facility, produced more CYPs but had fewer FP visits. Sensitivity analysis was done using: total costs, CYP and FP visits of mobile and static clinics and showed that variations in CYP of mobile and static clinics altered the ICER for CYP from $2 -$6. Mobile clinics with their high emphasis on IUDs offer a reasonable cost effectiveness of $4.46 per additional CYP compared to static clinics. The ability of mobile clinics to reach more vulnerable women and to offer more long acting methods might affect a policy decision between these options. Static clinics should consider whether emphasizing IUDs may make their services more cost-effective.

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Mobile clinics for women's and children's health

Cited by 17 publications

References 86 publications

Systematic reviews as a “lens of evidence”: Determinants of participation in breast cancer screening

Systematic reviews as a “lens of evidence”: Determinants of participation in breast cancer screening

Systematic reviews as a “lens of evidence”: Determinants of cost‐effectiveness of breast cancer screening

Cost-Effectiveness Analysis of Family Planning Services Offered by Mobile Clinics versus Static Clinics in Assiut, Egypt

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