Title :

Is patient navigation a solution to the problem of "leaving no one behind"? A scoping review of evidence from low-income countries

Author(s) :

Louart, Sarah [Auteur]
Centre Lillois d’Études et de Recherches Sociologiques et Économiques - UMR 8019 [CLERSÉ]
Bonnet, Emmanuel [Auteur]
Unité mixte internationale Résiliences [UMI RESILIENCES]
Ridde, Valery [Auteur]
Centre population et développement [CEPED - UMR_D 196]

Journal title :

Health Policy and Planning

Volume number :

36

Pages :

101-116

Publisher :

Oxford University Press (OUP)

Publication date :

2021

ISSN :

0268-1080

HAL domain(s) :

Sciences de l'Homme et Société/Sociologie
Sciences du Vivant [q-bio]/Santé publique et épidémiologie

English abstract : [en]

Patient navigation interventions, which are designed to enable patients excluded from health systems to overcome the barriers they face in accessing care, have multiplied in high-income countries since the 1990s. However, ...
Show more >Patient navigation interventions, which are designed to enable patients excluded from health systems to overcome the barriers they face in accessing care, have multiplied in high-income countries since the 1990s. However, in low-income countries (LICs), indigents are generally excluded from health policies despite the international paradigm of universal health coverage (UHC). Fee exemption interventions have demonstrated their limits and it is now necessary to act on other dimensions of access to healthcare. However, there is a lack of knowledge about the interventions implemented in LICs to support the indigents throughout their care pathway. The aim of this paper is to synthesize what is known about patient navigation interventions to facilitate access to modern health systems for vulnerable populations in LICs. We therefore conducted a scoping review to identify all patient navigation interventions in LICs. We found 60 articles employing a total of 48 interventions. Most of these interventions targeted traditional beneficiaries such as people living with HIV, pregnant women and children. We utilized the framework developed by Levesque et al. (Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health 2013;12:18) to analyse the interventions. All acted on the ability to perceive, 34 interventions on the ability to reach, 30 on the ability to engage, 8 on the ability to pay and 6 on the ability to seek. Evaluations of these interventions were encouraging, as they often appeared to lead to improved health indicators and service utilization rates and reduced attrition in care. However, no intervention specifically targeted indigents and very few evaluations differentiated the impact of the intervention on the poorest populations. It is therefore necessary to test navigation interventions to enable those who are worst off to overcome the barriers they face. It is a major ethical issue that health policies leave no one behind and that UHC does not benefit everyone except the poorest.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CNRS
Univ. Littoral Côte d’Opale

Collections :

• Centre Lillois d'Études et de Recherches Sociologiques et Économiques (CLERSE) - UMR 8019

Research team(s) :

Économies et sociétés : développement, richesse, innovation et régulation

Submission date :

2024-01-30T10:22:46Z
2024-02-06T16:40:48Z
2024-02-13T11:02:44Z
2024-02-13T12:48:22Z