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Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
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Understanding fragility: implications for global health research and practice.

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Global health progress is threatened by

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Area of Science:

  • Global Health
  • Health Systems Research
  • Population Health Management

Background:

  • The concept of 'fragility' is increasingly applied in global health.
  • Its precise relationship to health outcomes, service delivery, and utilization is unclear.
  • This ambiguity risks hindering advancements in population health.

Purpose of the Study:

  • To clarify the meaning, definitions, and applications of 'fragility' in global health literature.
  • To conduct the first scoping review on this topic.
  • To identify key attributes and themes related to health fragility.

Main Methods:

  • A scoping review methodology was employed.
  • Searched bibliographic and grey literature (10 sources) and key journals (5).
  • Included documents applying 'fragility' to health systems, services, outcomes, or populations.

Main Results:

  • 377 documents met inclusion criteria, with a significant increase in publications over the last decade.
  • While formal definitions focus on 'fragile and conflict-affected states', diverse applications exist.
  • Fragility is applied at various levels (state to community) and considers stressors beyond conflict, focusing on health system/community interfaces.

Conclusions:

  • Trust emerges as a critical factor at the health system-community interface, influencing health-seeking behaviors.
  • Understanding the multifaceted nature of health fragility is crucial for resilience.
  • Addressing fragility is essential to prevent reversals in population health outcomes.