Digital health in fragile states in the Middle East and North Africa (MENA) region: A scoping review of the literature

El‐Jardali, Fadi; Bou-Karroum, Lama; Jabbour, Mathilda; Bou-Karroum, Karen; Aoun, Andrew; Salameh, Sabine; Mecheal, Patricia; Sinha, Chaitali

doi:10.1371/journal.pone.0285226

Cited by 12 publications

(5 citation statements)

References 108 publications

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“…Results indicated that patients supported its use for scheduling and communication with healthcare providers, yet no comparisons were made to other populations. 41 In our study, the prevalence of HIT use for scheduling appointments and communicating with healthcare provider by e-mail was higher among MENA adults than White adults. MENA adults were more likely to use the internet to schedule appointments than US-born White adults in the unadjusted regression model; yet findings were no longer significant after adjusting for age, sex, education, and chronic conditions.…”

Section: Discussionmentioning

confidence: 51%

“…Most studies have described recommendations for creating systems for electronic medical records and mobile applications and fail to account for the perspectives of individual users. 40 , 41 Two studies in Lebanon evaluated patient perceptions of the usefulness of patient-portals for communication with healthcare providers. Results indicated that patients supported its use for scheduling and communication with healthcare providers, yet no comparisons were made to other populations.…”

Section: Discussionmentioning

confidence: 99%

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Health information technology use among foreign-born adults of Middle Eastern and North African decent in the United States

Smith,

Kindratt

2023

Preprint

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Health information technology (HIT) use among foreign-born adults of Middle Eastern and North African (MENA) descent living in America is an understudied population. They are currently categorized as “White” in the United States (US) on federal forms. The purpose was to uncover the prevalence of HIT use among MENA immigrants compared to US- and foreign-born White adults before and after adjusting for other factors. The 2011–2018 National Health Interview Survey data (n = 161,613; ages 18 + years) was analyzed. HIT uses evaluated were searching for health information, filling prescriptions, scheduling appointments, and communicating with healthcare providers via email (last 12 months). Crude and multivariable logistic regression models were used to estimate the odds of each HIT use, any HIT use, and all HIT uses before and after adjustment. The most common HIT use was looking up health information, with 46.4% of foreign-born adults of MENA, 47.8% of foreign-born White, and 51.2% of US-born White adults reporting its use (p = .0079). Foreign-born adults of MENA descent had lower odds (OR = 0.64; 95%CI = 0.56–0.74) of reporting any HIT use, but no difference in reporting all HIT uses compared to US-born White adults in adjusted models. This is the first study to explore HIT use among Americans of MENA descent. Patterns of HIT use among adults of MENA descent differ from White adults. Results contribute to growing body of literature showing the health of Americans of MENA descent differs from White Americans. A separate racial/ethnic identifier is needed to better capture HIT uses among populations of MENA descent.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Health information technology use among foreign-born adults of Middle Eastern and North African decent in the United States

Smith,

Kindratt

2023

Preprint

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“…This is in line with the observed regional disparities in the findings of a review article that identified challenges and opportunities in MENA’s health systems, such as financial, organizational, and behavioral factors [ 35 ]. Also, the digital health technologies in less fortunate and conflict-affected areas of the MENA region have been explored and revealed some considerations for the adoption of digital health, such as computer literacy, weak technological infrastructure, and privacy concerns, which align with the acknowledgment of varying concerns among participants from different MENA regions [ 36 ]. Both discussions suggest the importance of considering regional, cultural, and contextual factors in shaping attitudes toward AI in pharmacy practice to address possible challenges in diverse settings.…”

Section: Discussionmentioning

confidence: 99%

Ethical considerations and concerns in the implementation of AI in pharmacy practice: a cross-sectional study

Hasan,

Jaber,

Khabour

et al. 2024

BMC Med Ethics

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Background Integrating artificial intelligence (AI) into healthcare has raised significant ethical concerns. In pharmacy practice, AI offers promising advances but also poses ethical challenges. Methods A cross-sectional study was conducted in countries from the Middle East and North Africa (MENA) region on 501 pharmacy professionals. A 12-item online questionnaire assessed ethical concerns related to the adoption of AI in pharmacy practice. Demographic factors associated with ethical concerns were analyzed via SPSS v.27 software using appropriate statistical tests. Results Participants expressed concerns about patient data privacy (58.9%), cybersecurity threats (58.9%), potential job displacement (62.9%), and lack of legal regulation (67.0%). Tech-savviness and basic AI understanding were correlated with higher concern scores (p < 0.001). Ethical implications include the need for informed consent, beneficence, justice, and transparency in the use of AI. Conclusion The findings emphasize the importance of ethical guidelines, education, and patient autonomy in adopting AI. Collaboration, data privacy, and equitable access are crucial to the responsible use of AI in pharmacy practice.

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“…The identified studies in our review did note service adaptations to support access, such as self-care and family care, remote and longer-term prescribing, home delivery for medications, and increased use of technology such as for telemedicine. These potentially positive adaptations and use of technology could be further developed to help increase access to health care for crisis-affected populations, but evaluations are required to better understand the implementation, acceptability, effectiveness, and equity implications of these adaptations [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

The effect of COVID-19 on the non-COVID health outcomes of crisis-affected peoples: a systematic review

Thompson,

Kyaw,

Singh

et al. 2024

Confl Health

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Background The COVID-19 pandemic posed considerable risks to populations affected by humanitarian crises in low- and middle-income countries (LMICs). However, there is limited understanding of how the pandemic may have affected non-COVID health outcomes among crisis-affected populations. Our aim was to examine the evidence on the impact of the COVID-19 pandemic on non-COVID-19 health outcomes for crisis-affected populations in LMICs. Methods A systematic review methodology was applied following PRISMA guidelines. Eligibility criteria were: crisis-affected populations in LMICS; COVID-19; and all health topics, except for sexual and reproductive health which was covered in a linked review. Five bibliographic databases and additional grey literature sources were searched. The search period was from 2019 to 31 July 2022. Eligible papers were extracted and analysed using a narrative synthesis approach based on the study objectives and relevant health access and systems frameworks. A quality appraisal was also conducted. Findings 4320 articles were screened, and 15 eligible studies were identified and included in this review. Ten studies collected health outcomes data. Eight related to mental health, which generally showed worse mental health outcomes because of the pandemic, and pandemic-related stressors were identified. Two studies assessed physical health outcomes in children, while none addressed physical health outcomes among adults. Nine studies reported on access to healthcare, revealing worse access levels due to the pandemic and noting key barriers to care. Seven studies reported on the impact on health systems, with key challenges including reduced and distorted health care funding, reduced staff capacity, interrupted medicines and supplies, weak information and mixed-messaging, and weak leadership. All fifteen studies on the social determinants of health, particularly highlighting the effect of increasing poverty, the role of gender, and food insecurity on health outcomes. The quality of papers was limited overall. Conclusion This review found some limited evidence indicating negative mental health effects, increased barriers to accessing care, damage to health systems and magnified impacts on the social determinants of health for crisis-affected people during the COVID-19 pandemic. However, the small number and limited quality of the studies make the overall strength of evidence quite weak.

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Digital health in fragile states in the Middle East and North Africa (MENA) region: A scoping review of the literature

Cited by 12 publications

References 108 publications

Health information technology use among foreign-born adults of Middle Eastern and North African decent in the United States

Health information technology use among foreign-born adults of Middle Eastern and North African decent in the United States

Ethical considerations and concerns in the implementation of AI in pharmacy practice: a cross-sectional study

The effect of COVID-19 on the non-COVID health outcomes of crisis-affected peoples: a systematic review

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