title: Scoping review: strategies of providing care for children with chronic health conditions in low- and middle-income countries.
abstract: OBJECTIVE
  To identify and review strategies of providing care for children living with chronic health conditions in low- and middle-income countries.
  
  
  METHODS
  We searched MEDLINE and Cochrane EPOC databases for papers evaluating strategies of providing care for children with chronic health conditions in low- or middle-income countries. Data were systematically extracted using a standardised data charting form, and analysed according to Arksey and O'Malley's 'descriptive analytical method' for scoping reviews.
  
  
  RESULTS
  Our search identified 71 papers addressing eight chronic conditions; two chronic communicable diseases (HIV and TB) accounted for the majority of papers (n = 37, 52%). Nine (13%) papers reported the use of a package of care provision strategies (mostly related to HIV and/or TB in sub-Saharan Africa). Most papers addressed a narrow aspect of clinical care provision, such as patient education (n = 23) or task-shifting (n = 15). Few papers addressed the strategies for providing care at the community (n = 10, 15%) or policy (n = 6, 9%) level. Low-income countries were under-represented (n = 24, 34%), almost exclusively involving HIV interventions in sub-Saharan Africa (n = 21). Strategies and summary findings are described and components of future models of care proposed.
  
  
  CONCLUSIONS
  Strategies that have been effective in reducing child mortality globally are unlikely to adequately address the needs of children with chronic health conditions in low- and middle-income settings. Current evidence mostly relates to disease-specific, narrow strategies, and more research is required to develop and evaluate the integrated models of care, which may be effective in improving the outcomes for these children.
authors.affiliation: Centre for International Child Health, Royal Children's Hospital, University of Melbourne, MCRI, Melbourne, VIC, Australia. hamish.graham@rch.org.au.
authors.forename: Hamish
authors.initials: H
authors.lastname: Graham
authors.affiliation: Victorian Aboriginal Health Service, Melbourne, VIC, Australia.
authors.forename: Mariam
authors.initials: M
authors.lastname: Tokhi
authors.affiliation: Centre for International Child Health, Royal Children's Hospital, University of Melbourne, MCRI, Melbourne, VIC, Australia.
authors.forename: Trevor
authors.initials: T
authors.lastname: Duke
mesh_terms: D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002908:Chronic Disease / Q000628:therapy*; D003906:Developing Countries; D006301:Health Services Needs and Demand; D006801:Humans
keywords: adolescent; adolescente; child; chronic disease; delivery of health care; enfant; enfermedades crónicas, prestación de asistencia sanitaria; maladie chronique; niño; prestation des soins de santé; review; revisión; revue