A scoping review on the availability and utilization of essential opioid analgesics in Sub-Saharan Africa.

Autor: Yao JS; College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA., Kibu OD; Division of Health Policy and Research, Nkafu Policy Institute, Yaoundé, Cameroon; Department of Public Health, University of Buea, Cameroon; Faculty of Health Science, University of Buea, Cameroon., Asahngwa C; Division of Health Policy and Research, Nkafu Policy Institute, Yaoundé, Cameroon; Department of Anthropology, University of Yaoundé 1, Yaoundé, Cameroon., Ngo NV; Division of Health Policy and Research, Nkafu Policy Institute, Yaoundé, Cameroon., Ngwa W; Division of Health Policy and Research, Nkafu Policy Institute, Yaoundé, Cameroon., Jasmin HM; Health Science Library, University of Tennessee Health Science Center, Memphis, TN, USA., Gobina RM; Division of Health Policy and Research, Nkafu Policy Institute, Yaoundé, Cameroon; Health Science Library, University of Tennessee Health Science Center, Memphis, TN, USA; Buea Regional Hospital, Buea, Cameroon., Foretia DA; Division of Health Policy and Research, Nkafu Policy Institute, Yaoundé, Cameroon; Center for Multicultural and Global Health, University of Tennessee Health Science Center, Memphis, TN, USA; Global Surgery Institute, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA. Electronic address: dforetia@uthsc.edu.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2023 Oct; Vol. 226 (4), pp. 409-421. Date of Electronic Publication: 2023 Mar 27.
DOI: 10.1016/j.amjsurg.2023.03.013
Abstrakt: Background: Management of acute, post-operative, and chronic pain requires access to and availability of opioids. While often oversupplied in high-income countries, significant shortages exist in low- and middle-income countries. We conducted a scoping review on availability and usage of opioids in Sub-Saharan Africa (SSA).
Methods: The five-stage approach of Arksey and O'Malley (2005) was used. MEDLINE via PubMed, EMBASE, and SCOPUS were search and results categorized into themes: 1) Local/regional availability and supply, 2) Consumption patterns, 3) Legislation and policy, 4) Costs and financing, 5) Knowledge and cultural beliefs, and 6) Education and training.
Results: 6923 studies were identified from which 69 (1%) met inclusion criteria. Five key findings were: 1) Significant shortages exist, especially in rural areas, 2) Non-opioid analgesics commonly used as first-line acute pain management, 3) Barriers to market entry and bureaucratic processes prevent local production, 4) Significant knowledge gaps/myths exist amongst healthcare practitioners on opioid use, and 5) Continuous education and short courses will be critical.
Conclusions: Major challenges significantly limit availability and utilization of essential opioids in SSA. Reforms needed to upscale training and education, increase uptake by professionals, and increase market entry.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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