Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;6(6):e005190.
doi: 10.1136/bmjgh-2021-005190.

Unravelling 'low-resource settings': a systematic scoping review with qualitative content analysis

Chanel van Zyl  1 , Marelise Badenhorst  2 , Susan Hanekom  1 , Martin Heine  3
Affiliations

Unravelling 'low-resource settings': a systematic scoping review with qualitative content analysis

Chanel van Zyl et al. BMJ Glob Health. 2021 Jun.

Abstract

Introduction: The effects of healthcare-related inequalities are most evident in low-resource settings. Such settings are often not explicitly defined, and umbrella terms which are easier to operationalise, such as 'low-to-middle-income countries' or 'developing countries', are often used. Without a deeper understanding of context, such proxies are pregnant with assumptions, insinuate homogeneity that is unsupported and hamper knowledge translation between settings.

Methods: A systematic scoping review was undertaken to start unravelling the term 'low-resource setting'. PubMed, Africa-Wide, Web of Science and Scopus were searched (24 June 2019), dating back ≤5 years, using terms related to 'low-resource setting' and 'rehabilitation'. Rehabilitation was chosen as a methodological vehicle due to its holistic nature (eg, multidisciplinary, relevance across burden of disease, and throughout continuum of care) and expertise within the research team. Qualitative content analysis through an inductive approach was used.

Results: A total of 410 codes were derived from 48 unique articles within the field of rehabilitation, grouped into 63 content categories, and identified nine major themes relating to the term 'low-resource setting'. Themes that emerged relate to (1) financial pressure, (2) suboptimal healthcare service delivery, (3) underdeveloped infrastructure, (4) paucity of knowledge, (5) research challenges and considerations, (6) restricted social resources, (7) geographical and environmental factors, (8) human resource limitations and (9) the influence of beliefs and practices.

Conclusion: The emerging themes may assist with (1) the groundwork needed to unravel 'low-resource settings' in health-related research, (2) moving away from assumptive umbrella terms like 'low-to-middle-income countries' or 'low/middle-income countries' and (3) promoting effective knowledge transfer between settings.

Keywords: health systems; public health; qualitative study; review.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
PRISMA flow chart. LRS, low-resource setting; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2
Density map of countries in which ‘low-resource settings’ were described.
Figure 3
Figure 3
Nine major themes were identified that describe a low-resource setting.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Barreto ML. Health inequalities: a global perspective. Cien Saude Colet 2017;22:2097–108. 10.1590/1413-81232017227.02742017 - DOI - PubMed
    1. World Health Organisation . WHO | social determinants of health. WHO, 2020. Available: http://www.who.int/social_determinants/en/ [Accessed 31 Aug 2020].
    1. Marmot M, Allen J, Bell R, et al. . Who European review of social determinants of health and the health divide. Lancet 2012;380:1011–29. 10.1016/S0140-6736(12)61228-8 - DOI - PubMed
    1. Arcaya MC, Arcaya AL, Subramanian SV. Inequalities in health: definitions, concepts, and theories. Glob Health Action 2015;8:27106. 10.3402/gha.v8.27106 - DOI - PMC - PubMed
    1. Kawachi I, Subramanian SV, Almeida-Filho N. A glossary for health inequalities. J Epidemiol Community Health 2002;56:647–52. 10.1136/jech.56.9.647 - DOI - PMC - PubMed

Publication types