This paper aims to present a systematic review of literature to identify and synthesize the existing knowledge on role, activities and position of non-formal biomedical prescribers and providers (NFBPs) in developing countries. It argues this cadre is different from two established groups: formal biomedical practitioners and informal health care providers, who usually function outside the “formal” and “informal” domain in terms of their experience, skills, training and negotiating capacity with the biomedical world of practice.
With an operational definition of practitioners who function as “Non-formal biomedical prescribers and provider” the databases searched include: PubMed, JSTOR, SocioFile, Cochrane Library, Anthropology Plus, CINAHL and PsycINFO. Grey literature were searched as well. Searches were limited to published papers since 1 January 2000, in English. A structured data appraisal sheet was used following PRISMA guidelines and applied to the papers to assess their quality.
Of 90 papers initially read, 25 were selected for inclusion in this review. The most frequently-reported activity was drug selling or prescribing without a prescription (15/25 studies). Dispensing on the basis of “floating” prescriptions (i.e. prescriptions that are kept by the patient and have become recurring tickets to receive medication) was also described. Five studies described NFBPs who provided health care (e.g. diarrheal illnesses, gynecological care, and malaria diagnosis and treatment).
The NFBP is often a pragmatic, emergent response to meet everyday primary and emergency health needs, and are imbued with community trust and reliance to provide. However they operate at the margin, and occupy a liminal space, being both medical but not-medical. Their positioning within the biomedical global medicine market is indistinct, grappling with direct and indirect influence by the pharmaceutical industry, and outside the formal regulatory mechanisms.
Sufficiently flexible and thoughtful use of socio-cultural frameworks can lead to more theoretically informed analysis of the research in systematic reviews, and clear recognition of NFBPs as an emerging distinct group needed to develop policy and effective interventions to capitalize on the existing roles and practices of non-formal biomedical prescribers and providers.
Inhaltsverzeichnis (Table of Contents)
- Statement of Authorship and Submission
- Acknowledgment
- List of tables and figures
- Abstract
- Chapter One- Introduction
- Background
- Review objectives and questions
- Rationale for systematic review on the topic
- Structure of the Thesis
- Chapter Two- Methods
- Defining key term “non-formal biomedical providers and prescribers” and a conceptual framework
- Search strategy
- Operational definitions of prescriber and provider
- Database selection
- Inclusion/exclusion criteria
- Review procedures
- Quality assessment of the papers
- Data extraction, abstraction and analysis
- Search results
- Chapter Three- Results
- Study attributes
- Major issues observed in review
- Typologies and definitions: scoping the practice of Non-formal biomedical prescribers or providers (NFBPs)
- Qualifications of the providers and their activities
- Chapter Four- Studying health workers in a pluralistic system: methodological challenges of systematic reviews
- Quality assessment and synthesis of data: methodological challenges in systematic review
- Confusing and unexplained terms used in the literature
- What does prescription mean in developing countries?
- “Self-medication” or consumer interactions in the pharmacy?
- Vendors, distributors, sellers: problematic use of marketing terms in health
- Non-formal Biomedical Prescriber/providers: 'Definition dilemma'
- Chapter Five- Cultural competence and theoretical approaches in positioning non-formal biomedical prescribers and providers
- Cultural competency in health research: A glance at cultural concepts as analytical frames
- Habitus, Capital and Communitas: Cultural economy and NFBPs
- Positioning the community in regard to NFBPs: everyday resistance
- The global pharmaceutical market and NFBPs: neoliberalism in the non-formal clinic
Zielsetzung und Themenschwerpunkte (Objectives and Key Themes)
This systematic review aims to identify and synthesize the existing knowledge on the role, activities, and position of non-formal biomedical prescribers and providers (NFBPs) in developing countries. The review analyzes the literature on NFBPs, exploring how they differ from both formal biomedical practitioners and informal healthcare providers. The review also investigates the challenges of defining and categorizing NFBPs, as well as the impact of cultural factors and global pharmaceutical markets on their practice.
- The role and activities of non-formal biomedical prescribers and providers (NFBPs) in developing countries.
- The challenges of defining and categorizing NFBPs within the context of healthcare systems in developing countries.
- The methodological challenges of conducting systematic reviews on NFBPs, particularly regarding the definition of key terms and the application of cultural concepts.
- The impact of cultural factors and global pharmaceutical markets on the practice of NFBPs.
- The importance of understanding the intersection of formal and informal healthcare systems in developing countries.
Zusammenfassung der Kapitel (Chapter Summaries)
Chapter One provides an introduction to the research topic, outlining the background, objectives, and rationale for the systematic review. It establishes the importance of understanding the role of NFBPs in developing countries, particularly in relation to existing categories of healthcare providers.
Chapter Two outlines the methods used in the systematic review, including the search strategy, database selection, inclusion/exclusion criteria, review procedures, quality assessment, and data extraction and analysis. This chapter describes the process of identifying and selecting relevant research papers for the review.
Chapter Three presents the results of the systematic review, focusing on the attributes of studies included in the review and the major issues observed in the existing literature on NFBPs. This chapter explores the typologies and definitions used to describe NFBPs, as well as the qualifications and activities of these providers.
Chapter Four examines the methodological challenges of studying health workers in a pluralistic healthcare system, particularly the difficulties in defining key terms and applying cultural concepts in systematic reviews. This chapter analyzes the use of terms related to prescription, self-medication, and consumer interactions in the context of developing countries.
Chapter Five explores cultural competence and theoretical approaches in positioning NFBPs. This chapter examines the role of cultural concepts, such as habitus, capital, and communitas, in understanding the practice of NFBPs and their relationship to the community.
Schlüsselwörter (Keywords)
This research project focuses on non-formal biomedical prescribers and providers (NFBPs) in developing countries. Key terms include: non-formal healthcare, biomedical practices, systematic review, cultural competence, global pharmaceutical markets, healthcare systems, developing countries, pluralistic healthcare, and qualitative research methods.
- Citation du texte
- Nur Khan (Auteur), 2015, What are the roles, actions and positions of non-formal biomedical prescribers and providers in developing countries? A systematic literature review, Munich, GRIN Verlag, https://www.grin.com/document/335917
