Service coverage and health workforce allocation strategies for geriatric and palliative care in low and middle-income countries: A systematic review

The rapidly expanding older population across Low- and Middle-Income Countries (LMICs) underscores the urgent need to strengthen the health systems. However, the extent of service coverage and healthcare workforce allocation strategies for geriatric and palliative care in LMICs remains inadequately explored. To address this, we conducted this systematic review, following the standard guidelines, to synthesize available data from four databases spanning 2011 to 2022. Utilizing the Risk of Bias Assessment tool for non-randomized studies (ROBANS) for quantitative studies and the JBI (formerly known as Joanna Briggs Institute) checklist for qualitative research, we assessed the risk of bias and the quality in the included studies. Despite a comprehensive search, only three eligible studies were found, revealing a scarcity of research. The identified challenges include deficiencies in leadership, governance, financing, and essential resources, leading to compromised service coverage. The health workforce, often limited and lacking inadequate training, exacerbates the situation. Our evidence synthesis proposes some potential solutions such as telemedicine and cross-country collaboration through distance learning mechanisms to address these issues. The findings and recommendations from this review offer valuable insights applicable across various healthcare service contexts within LMICs and advocate for more health systems research in this topic area.