Sociology, Forman Christian College, Lahore, Punjab, Pakistan
Department of Gender Studies, University of the Punjab, Lahore, Punjab, Pakistan.
BMJ Open. 2022 Aug 1;12(8):e061644. doi: 10.1136/bmjopen-2022-061644.
Women living in Pakistan have complex health problems including infectious and non-communicable diseases, accident and injuries, and mental health problems. While a majority of these women rely on primary healthcare services for all of their healthcare needs, there has to date been no overview of the extent of their effectiveness. The objective of this review was to (1) synthesise the available evidence regarding the effectiveness of primary care based interventions aimed at improving women's mental and physical health and (2) identify the factors that promote effectiveness for women's health outcomes.
Five academic databases were searched, including PubMed, BMC Medicine, Medline, CINAHL and the Cochrane Library. A search was also made of the grey literature. The quality of included studies was assessed using a standardised critical appraisal tool, and the findings summarised using a narrative synthesis.
In total, 18 studies were included in the review. Eight involved evaluations of counselling interventions, three health education and awareness interventions, two social and psychosocial interventions, and five were evaluations of combination interventions. Twelve of the included studies were randomised controlled trials. Of these 14 reported significant outcomes, and 4 further interventions showed partially favourable results. However, interventions mostly targeted women's mental or reproductive health.
While the evidence is limited in terms of quality and what has been evaluated, a number of interventions appear to be effective in improving outcomes for women. The three key approaches include the adoption of an active door-to-door and group-based approach; utilisation of community peers who can deliver care cost-effectively and who are more accepted in the community; and the integration of financial vouchers to support uptake in poor populations.
CRD42020203472.
居住在巴基斯坦的女性面临着复杂的健康问题，包括传染病和非传染性疾病、事故和伤害以及心理健康问题。尽管大多数女性依赖初级医疗保健服务来满足她们所有的医疗需求，但迄今为止，还没有对其有效性的全面评估。本研究的目的是：(1) 综合现有关于基于初级保健的干预措施对改善女性身心健康的有效性的证据；(2) 确定促进女性健康结果的有效性的因素。
检索了五个学术数据库，包括 PubMed、BMC 医学、Medline、CINAHL 和 Cochrane 图书馆。还对灰色文献进行了搜索。使用标准化的批判性评估工具评估纳入研究的质量，并使用叙述性综合方法总结研究结果。
共有 18 项研究纳入了综述。其中 8 项涉及咨询干预措施的评估，3 项涉及健康教育和意识干预措施，2 项涉及社会和心理社会干预措施，5 项涉及联合干预措施。纳入的 12 项研究为随机对照试验。其中 14 项报告了显著的结果，4 项进一步的干预措施显示出部分有利的结果。然而，干预措施主要针对女性的心理健康或生殖健康。
尽管证据在质量和评估内容方面有限，但一些干预措施似乎对改善女性的结果有效。三个关键方法包括：采用积极的上门和基于小组的方法；利用社区同伴，他们可以以具有成本效益的方式提供护理，并且在社区中更受欢迎；以及整合财政凭证，以支持贫困人口的接受度。
PROSPERO 注册号：CRD42020203472。
