TY - JOUR
T1 - A scoping review on the availability and utilization of essential opioid analgesics in Sub-Saharan Africa
AU - Yao, Jane S.
AU - Kibu, Odette D.
AU - Asahngwa, Constantine
AU - Ngo, Ngo V.
AU - Ngwa, Wilfred
AU - Jasmin, Hilary M.
AU - Gobina, Ronald M.
AU - Foretia, Denis A.
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/10
Y1 - 2023/10
N2 - Background: Management of acute, post-operative, and chronic pain requires access to and availability of opioids. While often oversupplied in high-income countries, significant shortages exist in low- and middle-income countries. We conducted a scoping review on availability and usage of opioids in Sub-Saharan Africa (SSA). Methods: The five-stage approach of Arksey and O'Malley (2005) was used. MEDLINE via PubMed, EMBASE, and SCOPUS were search and results categorized into themes: 1) Local/regional availability and supply, 2) Consumption patterns, 3) Legislation and policy, 4) Costs and financing, 5) Knowledge and cultural beliefs, and 6) Education and training. Results: 6923 studies were identified from which 69 (1%) met inclusion criteria. Five key findings were: 1) Significant shortages exist, especially in rural areas, 2) Non-opioid analgesics commonly used as first-line acute pain management, 3) Barriers to market entry and bureaucratic processes prevent local production, 4) Significant knowledge gaps/myths exist amongst healthcare practitioners on opioid use, and 5) Continuous education and short courses will be critical. Conclusions: Major challenges significantly limit availability and utilization of essential opioids in SSA. Reforms needed to upscale training and education, increase uptake by professionals, and increase market entry.
AB - Background: Management of acute, post-operative, and chronic pain requires access to and availability of opioids. While often oversupplied in high-income countries, significant shortages exist in low- and middle-income countries. We conducted a scoping review on availability and usage of opioids in Sub-Saharan Africa (SSA). Methods: The five-stage approach of Arksey and O'Malley (2005) was used. MEDLINE via PubMed, EMBASE, and SCOPUS were search and results categorized into themes: 1) Local/regional availability and supply, 2) Consumption patterns, 3) Legislation and policy, 4) Costs and financing, 5) Knowledge and cultural beliefs, and 6) Education and training. Results: 6923 studies were identified from which 69 (1%) met inclusion criteria. Five key findings were: 1) Significant shortages exist, especially in rural areas, 2) Non-opioid analgesics commonly used as first-line acute pain management, 3) Barriers to market entry and bureaucratic processes prevent local production, 4) Significant knowledge gaps/myths exist amongst healthcare practitioners on opioid use, and 5) Continuous education and short courses will be critical. Conclusions: Major challenges significantly limit availability and utilization of essential opioids in SSA. Reforms needed to upscale training and education, increase uptake by professionals, and increase market entry.
KW - Essential opioids
KW - Low-and middle-income countries
KW - Opioid analgesics
KW - Opioid availability
KW - Sub-Saharan Africa
UR - http://www.scopus.com/inward/record.url?scp=85151572888&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85151572888&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2023.03.013
DO - 10.1016/j.amjsurg.2023.03.013
M3 - Article
C2 - 37024407
AN - SCOPUS:85151572888
SN - 0002-9610
VL - 226
SP - 409
EP - 421
JO - American journal of surgery
JF - American journal of surgery
IS - 4
ER -