Systematic review of lay consultation in symptoms and illness experiences in informal urban settlements of low-income and middle-income countries

Abstract

ObjectivesLay consultation is the process of discussing a symptom or an illness with lay social network members. This can have positive or negative consequences on health-seeking behaviours. Understanding how consultation with lay social networks works in informal urban settlements of low-income and middle-income countries (LMICs) is important to enable health and policy-makers to maximise its potential to aid healthcare delivery and minimise its negative impacts. This study explored the composition, content and consequences of lay consultation in informal urban settlements of LMICs.DesignMixed-method systematic review.Data sourcesSix key public health and social science databases, Google Scholar and reference lists of included studies were searched for potential articles.Eligibility criteriaPapers that described discussions with lay informal social network members during symptoms or illness experiences.Data analysis and synthesisQuality assessment was done using the Mixed Methods Appraisal Tool. Data were analysed and synthesised using a stepwise thematic synthesis approach involving two steps: identifying themes within individual studies and synthesising themes across studies.Results13 studies were included in the synthesis. Across the studies, three main categories of networks consulted during illness: kin, non-kin associates and significant community groups. Of these, kin networks were the most commonly consulted. The content of lay consultations were: asking for suggestions, negotiating care-seeking decisions, seeking resources and non-disclosure due to personal or social reasons. Lay consultations positively and negatively impacted access to formal healthcare and adherence to medical advice.ConclusionLay consultation is mainly sought from social networks in immediate environments in informal urban settlements of LMICs. Policy-makers and practitioners need to utilise these networks as mediators of healthcare-seeking behaviours.PROSPERO registration numberCRD42020205196.

Health information sources and health‐seeking behaviours of Filipinos living in medically underserved communities: Empirical quantitative research

“…Most Filipinos in our sample relied on recommendations from family and friends to improve their health and avoid getting sick. Previous studies have also demonstrated reliance on family and friends for health information, especially among older adults (Onuegbu et al., 2021). Similarly, older adults in rural Taiwan also resorted to seeking health support from family and friends (Chen, 2020).…”

“…Thus, seeking health information from family and friends is common in LIMCs. It is a way for individuals to obtain health information and practical resources to aid their health‐seeking decisions (Onuegbu et al., 2021). Our findings also support and further characterize the impact of social relationships on the health and healthcare‐seeking behaviours of people from other ethnic minority groups (Eley et al., 2019).…”

Neighbourhood effect and inequality in access to essential health services among mother–child paired samples: a decomposition analysis of data from 58 low- and middle-income countries

“…Beyond the known pathway of association between slum residence, access to health and health outcomes, some studies have explored the role of social networks in slum residence and its impact on health-seeking behaviour and health outcomes. A recent systematic review by Onegbu and colleagues [ 29 ] reported the frequent use of lay consultation (health advice seeking amongst personal networks) among slum dwellers and how it positively and negatively affects health-seeking behaviour and adherence to medical expert advice. At the peak of Ebola virus infection in countries like Liberia, social networks in slums were identified as one of the strongest means of receiving relevant information – both misinformation and those based on evidence [ 20 , 30 ].…”

Use, characteristics and influence of lay consultation networks on treatment-seeking decisions in slums of Nigeria: a cross-sectional survey

“…There is empirical evidence suggesting slum dwellers interact with personal network members including family, friends and neighbours during illness and obtain a range of resources 5 7 29 30. A recent systematic review demonstrated that lay consultation have positive and negative consequences on treatment seeking behaviours in slum settings of LMICs 31. However, there are evidence gaps on network characteristics, how personal networks and online networks are combined and how the network characteristics impact on personal health seeking decisions.…”

“… 5 7 29 30 A recent systematic review demonstrated that lay consultation have positive and negative consequences on treatment seeking behaviours in slum settings of LMICs. 31 However, there are evidence gaps on network characteristics, how personal networks and online networks are combined and how the network characteristics impact on personal health seeking decisions. Getting this evidence requires egocentric techniques, which are used in network studies to elicit information about a network from an ego (individual); this is lacking in slum studies.…”