Prevalence and factors associated with poor mental health among healthcare professionals in low- and lower-middle-income countries: a systematic review protocol

Abstract

BackgroundA healthy and productive health workforce is central to a well-functioning health system. However, health workers are at high risk of poor psychological wellbeing due to their particularly strenuous work demands. While mental health of health workers is a well-researched issue in high-income countries, research from low- and lower-middle-income countries (LLMIC) has begun to emerge only recently. The review aims to synthesize this body of research, specifically to assess the prevalence of mental health issues among health workers in LLMIC, to identify factors associated with good or poor mental health, and to highlight gaps in knowledge.MethodsWe will perform a systematic search of the published English and French language literature (from inception onwards) in MEDLINE, EMBASE, and PsycINFO. Eligible for inclusion are observational studies (e.g., cross-sectional, case-control, or cohort) and control arms of randomized controlled trials reporting investigations on the nature, prevalence, and factors associated with mental health or psychological wellbeing among formally trained health professionals and health associate professionals delivering health services in formal healthcare facilities in LLMIC. The primary outcomes will be burnout, depression, and general psychological wellbeing. Secondary outcomes include other specific mental health diagnoses, as well as general psychological stress, distress and/or trauma if work-related and explicitly framed as a mental health issue. Two authors will independently examine the studies against the eligibility criteria in the stages of title, abstract, and full-text study selection, as well as assess the risk of bias in included studies using standard checklists depending on study design. Disagreements will be resolved in discussion with the third author. Data will be extracted from included studies using a predefined and piloted coding framework. Given the anticipated heterogeneity of studies, we do not expect to be able to conduct meta-analysis and plan to summarize the extracted data in narrative form. The framework method will be used to organize narrative data by subthemes and explore patterns.DiscussionIn assessing the prevalence of mental health issues among healthcare professionals in LLMIC and identifying factors associated with positive or poor mental health, the review aims to synthesize all possible available information for policy makers and health system managers on a potentially highly important but not yet much-discussed issue and to highlight gaps in currently available knowledge.Systematic review registrationInternational Prospective Register of Systematic Reviews PROSPERO (registration number CRD42019140036)

Much research, but little learned to date: A scoping review on mental health of health workers in low- and lower-middle income countries and roadmap for future research

“…We performed a systematic search of the literature on mental health and psychological wellbeing of clinical skilled healthcare personnel working in all care settings in low-and lower-middle income countries worldwide, up to the end of 2019. The review had initially been intended as a systematic review and metaanalysis of the available evidence; the protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42019140036), and has been published [20]. However, following the search and screening steps and as the high number of relevant studies and the methodological issues highlighted in this article became apparent, we concluded that it would be preferable to rede ne our research question also as a precursor to future research and systematic reviews [21,22].…”

“…In regards to the latter, we also included "motivation" and "satisfaction" as search terms, based on our experience that studies labelled as such sometimes contain mental health measures as part of the motivation or satisfaction measurement tool. The search strategy for MEDLINE is provided in the protocol [20]. Search strategies for the other databases were adapted according to their speci c requirements.…”

Impact of the Covid-19 Pandemic on Mental Health Among Medical Frontliners Working in Metro Manila

“…Relating to the study of Dweik, et. al (2016), other researchers including Dzay, et. al (2019), had focused on the factors and prevalence that are associated with poor mental health among healthcare professionals in low-and lower-middle income countries.…”

“…In analyzing the prevalence of mental health care issues among healthcare professionals in lowand lower-middle-income countries and determining the factors that are associated with positive or poor mental health. The review by Dzay, et. al (2019), aims to have a synthesis of all available information for health system managers and policy makers which also highlight the gaps in identifying other possible parameters.…”

Much research, but little learned to date: A scoping review of the methodological quality of research on mental health of healthcare professionals in low- and lower-middle income countries

“…Our study aims to address this knowledge gap by building on a systematic review of the quantitative literature on mental health and psychological wellbeing of clinical skilled healthcare personnel working in all settings of care in LLMIC worldwide 9,11 . Specifically, the quality issues highlighted by this and prior similar reviews [5][6][7][8] inspired efforts to return to the identified literature to undertake a more detailed quality assessment, with a focus on the measurement of prevalences of mental illness, to generate an in-depth understanding of the methodological strengths and weaknesses and to distil concrete recommendations as to how research could be improved in the future.…”