Perinatal palliative care in low- and middle-income countries: a scoping review.

Journal: Annals of palliative medicine

Volume: 13

Issue: 6

Year of Publication: 2024

Affiliated Institutions:  Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA; Duke Global Health Institute, Durham, NC, USA. Atrium Health Levine Children's Hospital, Charlotte, NC, USA; Department of Pediatrics, Wake Forest University School of Medicine, Charlotte, NC, USA. Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA. Department of Pediatrics, University of Louisville School of Medicine Norton Children's Medical Group, Louisville, KY, USA. Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA. Department of Pediatrics, Brigham and Women's Hospital, Harvard University, Boston, MA, USA. Department of Pediatrics, University of Washington, Seattle, WA, USA. Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA. Kilimanjaro Christian Medical Center, Moshi, Tanzania. Kilimanjaro Christian Medical Center, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania. Hospital Herrera Llerandi, Guatemala City, Guatemala; Universidad Francisco Marroquin, Guatemala City, Guatemala. Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA; Department of Population Health Sciences, Duke University, Durham, NC, USA. School of Nursing, Duke University, Durham, NC, USA.

Abstract summary 

2.4 million neonatal deaths and 2.6 million stillbirths occur each year. Over 98% of perinatal loss occurs in low- and middle-income countries. Despite the global burden of perinatal loss, access to relevant perinatal palliative and psychosocial care is poor and understudied.In this review, we synthesize perinatal palliative care literature from low- and middle-income countries. We focus on the clinical practice of perinatal palliative care and educational models being used in resource-constrained settings. We used a systematic scoping review approach, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist. The PubMed, Scopus, Embase, Cochrane, CINAHL, and Global Health (embsco) databases were searched. There were no date or language restrictions placed during the search. Study selection was conducted using Covidence to facilitate a staged review process.A total of 10,145 articles remained after removing duplicate studies. Following the three-staged review, 81 studies were included in our analysis. The largest portion of published perinatal palliative care literature focused on clinical care (n=44). Nine studies focused on provider training in perinatal palliative care and 28 studies addressed parent or family experience. Of the included studies, 84.9% had a first or last author from a low- or middle-income country and 91.8% included an author from the country of focus in the manuscript. The findings presented in this scoping review reveal that healthcare workers and families desire improved guidelines about perinatal palliative care that reflect the realities of local culture and resources. Additionally, providers need enhanced training in perinatal palliative care techniques and management approaches that can be applied in a range of clinical settings.Global perinatal palliative care strategies must encompass compassionate communication with families, psychosocial support after stillbirth or neonatal death, and emotional and mental health support for healthcare workers who provide perinatal palliative care.

Authors & Co-authors:  Rent Sharla S Titchiner Daniela D Rholl Erin E Lyle Allison A Diego Ellen E North Krysten K Rahiem Sahar S Garmon Avery A Gaffur Raziya R Shayo Aisa A Diez Recinos Ana Lucia AL Lemmon Monica M Docherty Sharron L SL

Study Outcome 

Source Link: Visit source

Statistics
Citations : 
Authors :  13
Identifiers
Doi : 10.21037/apm-24-87
SSN : 2224-5839
Study Population
Female
Mesh Terms
Humans
Other Terms
Perinatal;global health;neonatal;palliative care
Study Design
Study Approach
Systemic Review
Country of Study
Publication Country
China