Aims and objectives: To explore differences in health outcomes between unpaid caregivers and noncaregivers living in low-and middle-income countries (LMICs). Background: Previous meta-analyses found worse health outcomes for unpaid caregivers in high-income nations. However, no meta-analysis has considered unpaid caregivers from LMICs. A systematic integration of this topic may contribute to nursing care for unpaid caregivers in LMICs. Design: Systematic review and meta-analysis of observational studies. Methods: Following PRISMA statement, studies were searched for using the CINAHL, PubMed and SciELO databases, limited to publications until 31 December 2019. Random-and fixed-effects meta-analyses were used for data synthesis. Results: Fourteen studies from Africa, Asia and South America were included. Unpaid caregivers of people with ill-health were more anxious and depressed than noncaregivers. Studies conducted in Asia and South America reported poorer health outcomes for unpaid caregivers than noncaregivers, whereas the trend for African studies was the opposite. Unpaid caregivers of healthy individuals may have better health status than noncaregivers, particularly those caring between 1-14 hr per week. Of the six studies which examined gender differences, two studies informed worse health outcomes for women, one presented the opposite effect, and three found no differences. Conclusions: Individual, social, cultural and systemic factors play an important role in the health outcomes of unpaid caregivers in LMICs. More evidence is needed from LMICs. As unpaid caregivers are predominantly female, urgent attention to the health outcomes of female unpaid caregivers is required. Relevance to clinical practice: The management of mental health problems, particularly anxiety and depression, should be an integral part of nursing care for unpaid caregivers living in LMICs. To further promote the health of unpaid caregivers in developing countries, stakeholders should consider launching educational campaigns that assist caregivers in finding ways to meet their cultural obligations while also reinforcing caregiver self-care. K E Y W O R D S gender, health outcomes, low-and middle-income countries, meta-analysis, systematic review, unpaid care | 3951 MAGAÑA et Al.

ResumenPor medio de este estudio se analiza el papel de las mujeres y de las familias en la producción de los cuidados en salud desde los discursos que producen los equipos de salud y el análisis de las fi chas familiares en un CESFAM de una localidad urbano-rural de la Región Metropolitana. Se concluye que a pesar de las reformas modernizadoras impulsadas por el Estado en el sector salud, se perpetúa el lugar tradicional de las mujeres y su condición de género, así como un ideario de familia sustentado en la clásica división sexual del trabajo. Asimismo se aprecia que a pesar de la centralidad del papel de las mujeres en la producción de la salud familiar, este permanece invisibilizado y sólo se transparenta con relación a la responsabilidad de estas en las problemáticas familiares.Palabras clave: Modelo de Salud Familiar, género, diversidad familiar y organización de los cuidados AbstractWe have analyzed the role of women and their families regarding the health group speeches and the analysis of the family records from CESFAM in an urban rural place in the Metropolitan region. It is concluded that in spite of the modern reforms boosted by the state health department the traditional role of women and their genre condition remains the same as well as their way of living supported by the classical sex division in their jobs. At the same time it is observed that in spite of the central role of women in maintaining the family health, this remains unseen and it is only observed in their responsibilities in the family circumstances

Objective To develop and validate a brief screening instrument for postpartum depression in resource‐constrained primary care settings. Method Secondary data analysis of a cohort of 305 mothers (Mdnage = 26) attending well‐child check‐ups in six primary care centers in Santiago, Chile, answered the Edinburgh Postnatal Depression Scale (EPDS), the 36‐Item Short Form Health Survey, and the Mini International Neuropsychiatric Interview depression module. A predictive model for postpartum depression was built using logistic and least absolute shrinkage and selection operator regressions, with bootstrap validation. Results A three‐item version of the EPDS exhibited excellent discriminative capacity (c statistic = 0.95) and showed no significant differences versus the full version of the EPDS (χ2(1) = 1.75, p = .187). The best trade‐off between sensitivity (92.86%) and specificity (86.70%) was achieved at a cut‐off score of 8/9. Conclusions The three‐item version of the EPDS can save clinicians valuable time, which might potentially improve communication of results to patients.

ResumenEl presente artículo pretende aportar, desde un enfoque de género, al desarrollo de las intervenciones psicosociales y a la comprensión de la problemática que -en la subjetividad de las mujeres-suscita la catástrofe desencadenada por el terremoto y tsunami del 27 de Febrero del 2010. Desde una metodología cualitativa se realizó un análisis micro-social, cuyo dispositivo metodológico consideró: 1. Entrevistas en profundidad a mujeres dirigentas sociales de organizaciones de las regiones del Maule y Bío-Bío; 2. Revisión de datos de fuentes secundarias; 3. Opinión de expertas en temas de género. Los resultados obtenidos son puestos en discusión con el modelo propuesto por Gaborit (2006) y dan cuenta de la conformación de una "Subjetividad Femenina Terremoteada" que, producto de la desarticulación de los espacios de cuidado, reconstruyen su subjetividad por medio de la participación comunitaria, volviéndose protagonistas en la reconstrucción de la vida cotidiana.Palabras clave: Subjetividad femenina, tareas de cuidado, participación comunitaria, terremoto y reconstrucción. AbstractThis paper intends contribute, from a gender approach, to the development of psychosocial interventions and understanding of the problematic-that the subjectivity of women-raises the disaster triggered by the earthquake and tsunami of February 27, 2010. From a qualitative methodology was carried out micro-social analysis, which methodological device considered: 1. In-depth interviews with women social leaders of organizations of the regions of Maule and Bio-Bio 2. Review of secondary sources, 3.Opinion of experts on gender issues. The results are placed in discussion with the model proposed by Gaborit (2006) and show the formation of a "female subjectivity's earthquake ", that product of the breakdown of care spaces, reconstruct their subjectivity through community participation, becoming protagonists in the reconstruction of everyday life.

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