Sustainable development for global mental health: a typology and systematic evidence mapping of external actors in low-income and middle-income countries
Sustainable development for global mental health: a typology and systematic evidence mapping of external actors in low-income and middle-income countries
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DOI：
10.1136/bmjgh-2019-001826
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发表时间：
2019-11-01
影响因子：
8.1
通讯作者：
Iemmi, Valentina
中科院分区：
文献类型：
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作者：
Iemmi, Valentina
精神障碍占低收入和中等收入国家（LMICs）的疾病和费用的巨大负担，但吸引的资源很少。由于低收入国家的政府经常面临经济压力，因此迫切需要了解外部资金状况。这项研究开发了一个新的类型学的外部演员在全球健康适应可持续发展目标（SDGs）时代，并使用它来系统地映射现有的证据外部演员在全球心理health.Methods的概念化的文献和可持续发展目标，包括11种类型的外部演员在中低收入国家的健康。检索了5个数据库（EconLit、Embase、Global Health、MEDLINE、PsycINFO），以查找2000年1月1日至2018年7月31日期间发表在同行评审期刊上的英文、法文、意大利文、葡萄牙文或西班牙文手稿，并报告了有关中低收入国家精神障碍外部因素的信息。记录通过摘要筛选，然后根据纳入标准进行全文筛选。结果共纳入79篇文献，其中10篇文献为文献综述。其中5项是定量研究，分析了过去20年来全球精神卫生发展援助的资源流动情况。其余的是定性研究，描述了外部行为者：其中大多数是在过去十年中发表的，重点是非洲、公共部门（双边和多边政府组织）和第三部门组织（非政府组织）。结论本研究揭示了在可持续发展目标时代，从外部参与者生态系统中为全球精神卫生释放额外资金的机会，并强调了协调努力和使用可持续的道德方法支付的必要性。需要进一步研究，以了解所有外部行为体及其在不同环境中的贡献分配情况。
Introduction Mental disorders account for a substantial burden of disease and costs in low-income and middle-income countries (LMICs), but attract few resources. With LMIC governments often under economic pressure, an understanding of the external funding landscape is urgently needed. This study develops a new typology of external actors in global health adapted for the sustainable development goals (SDGs) era and uses it to systematically map available evidence on external actors in global mental health.Methods The new typology was developed in line with conceptualisation in the literature and the SDGs to include 11 types of external actors for health in LMICs. Five databases (EconLit, Embase, Global Health, MEDLINE, PsycINFO) were searched for manuscripts published in peer-reviewed journals in English, French, Italian, Portuguese or Spanish between 1 January 2000 and 31 July 2018 and reporting information on external actors for mental disorders in LMICs. Records were screened by abstract, then full-text against inclusion criteria. Data were extracted and synthesised using narrative analysis.Results 79 studies were included in the final review. Five were quantitative studies analysing the resource flow of development assistance for mental health globally over the last two decades. The remainder were qualitative studies providing a description of external actors: the majority of them were published in the last decade, focused on Africa, and on public sector (bilateral and multilateral governmental organisations) and third sector organisations (non-governmental organisations). Evidence was particularly scarce for for-profit organisations and individual households.Conclusion This study reveals opportunities for unlocking additional funding for global mental health in the SDG-era from an ecosystem of external actors, and highlights the need to coordinate efforts and to use sustainable, ethical approaches to disbursements. Further research is needed to understand all external actors and the allocation of their contributions in different settings.