The effectiveness of workplace health promotion in low- and middle-income countries.

Although many literature reviews synthesize literature regarding workplace health promotion (WHP) interventions, systematic reviews on the effectiveness of and factors influencing the operation of WHP activities in low- and middle-income countries (LMIC) are scarce. Therefore, we systematically reviewed evaluation studies to examine the effectiveness and factors related to the implementation of WHP programmes in LMIC. Twenty-six peer-reviewed and grey evaluation studies, published before November 2017, were included from electronic databases (PubMed, The Cochrane Library, PsycINFO, EMBASE and Web of Science) and manual searching. The results revealed that WHP intervention in LMIC was effective in reducing health risks in a wide range of industries and settings, including in resource-poor contexts such as small enterprises and the manufacturing industry. The main factors positively influencing the effectiveness of the intervention are long intervention time period, and needs-based and active intervention strategies. In addition, commitment from workplace leaders, the involvement of workers and support from authorities and professionals are factors contributing to a successful WHP programme. However, the evidence regarding the effectiveness of WHP in LMIC regarding the health outcomes and business productivity is inconclusive due to the several remaining methodological limitations. Future developments of more rigorous methods of evaluating the effectiveness of WHP activities should be addressed to produce higher-quality evidence that would inform future practice.