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. 2013 Oct 3;3(10):e003332.
doi: 10.1136/bmjopen-2013-003332.

Bibliographic review of research publications on access to and use of medicines in low-income and middle-income countries in the Eastern Mediterranean Region: identifying the research gaps

Arash Rashidian  1 , Nader Jahanmehr, Samer Jabbour, Shehla Zaidi, Fatemeh Soleymani, Maryam Bigdeli
Affiliations

Bibliographic review of research publications on access to and use of medicines in low-income and middle-income countries in the Eastern Mediterranean Region: identifying the research gaps

Arash Rashidian et al. BMJ Open. .

Abstract

Objectives: We assessed the situation of academic publications on access to and use of medicines (ATM) in low-income and middle-income countries (LMICs) of the Eastern Mediterranean Region (EMR). We aimed to inform priority setting for research on ATM in the region.

Design: Bibliographic review of published studies.

Setting: LMICs in EMR.

Inclusion criteria: Publications on ATM issues originating from or focusing on EMR LMICs covering the period 2000-2011. Publications involving multinational studies were included if at least one eligible country had been included in the study.

Information sources and data extraction: We conducted comprehensive searches of the PubMed, Social Science Citation Index and Science Citation Index. We used the WHO ATM framework for data extraction and synthesis. We analysed the data according to the ATM issues, health system levels, year of publication and the countries of origin or focus of the studies.

Results: 151 articles met the inclusion criteria. Most articles (77%) originated from LMICs in EMR, suggesting that the majority of evidence on ATM in the region is home-grown. Over 60% of articles were from Iran, Pakistan, Jordan and Lebanon (in order of volume), while we found no studies assessing ATM in Somalia, Djibouti and South Sudan, all low-income countries. Most studies focused on the rational use of medicines, while affordability and financing received limited attention. There was a steady growth over time in the number of ATM publications in the region (r=0.87).

Conclusions: There is a growing trend, over the years, of more studies from the region appearing in international journals. There is a need for further research on the financing and affordability aspects of ATM in the region. Cross-border issues and the roles of non-health sectors in access to medicines in the region have not been explored widely.

Keywords: EPIDEMIOLOGY; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; PUBLIC HEALTH.

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Figures

Figure 1
Figure 1
Flow chart of search strategies in electronic databases for access to and appropriate use of medicines.
Figure 2
Figure 2
Distribution of the country of origin (A) and the country of focus* (B) for publications on access to and appropriate use of medicines issues in the Eastern Mediterranean Region's low-income and middle-income countries.
Figure 3
Figure 3
The increasing number of access to and appropriate use of medicines publications per year and Eastern Mediterranean Region. Note: 2011 publications cover only the first half of this year.
See this image and copyright information in PMC

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