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Achieving impactful treatment for paediatric endocrine disorders in low- to middle-income countries (LMICs): a
Hannah Elise Olson1, Carrie Dolan2
1Health Sciences, William and Mary, Williamsburg, Virginia, USA heolson2005@outlook.com.
Insights
Primary care, emphasizing task shifting, is the most effective approach for treating pediatric endocrine disorders in low- and middle-income countries. This strategy maximizes resources and improves health outcomes where specialized care is limited.
Area of Science:
- Endocrinology
- Global Health
- Public Health Policy
Background:
- Endocrine disorders affect over 10% of the global population, with significant undiagnosed cases, particularly in low- and middle-income countries (LMICs).
- Limited research provides comprehensive guidance for managing the increasing prevalence of pediatric endocrine conditions in resource-constrained settings.
Purpose of the Study:
- To provide evidence-based recommendations for efficient, effective, and accessible treatment of pediatric thyroid conditions and diabetes in LMICs.
- To identify optimal healthcare administration approaches for managing pediatric endocrine disorders in LMICs.
Main Methods:
- A scoping review following PRISMA-ScR and JBI methodology.
- Searched multiple databases (PubMed, Scopus, etc.) for peer-reviewed publications on intervention strategies for pediatric chronic diseases in LMICs.
- Included studies on government initiatives, mobile health, specialized programs, and primary care interventions.
Main Results:
- Primary care, with a focus on task shifting, emerged as the most effective approach for treating pediatric endocrine disorders in LMICs.
- Evaluated various healthcare models including specialized care, government programs, and mobile health initiatives.
Conclusions:
- Primary care is the optimal strategy for treating pediatric endocrine conditions in LMICs, outperforming specialized care or government interventions.
- Implementing primary care initiatives is crucial for achieving significant health outcomes while optimizing limited healthcare funding in LMICs.
Objectives:
Endocrine disorders, such as hypo/hyperthyroidism and diabetes, affect over 5% of the world's population, with an additional 5% of cases remaining undiagnosed. Despite the increasing prevalence of endocrine disorders, especially in low- to middle-income countries (LMICs), limited research offers comprehensive guidance on treating this complex medical field. This scoping review aims to provide evidence-based recommendations for efficient, effective and accessible treatment of paediatric thyroid conditions and diabetes in LMICs.
Design:
Scoping review guidelines outlined by the Preferred Reporting Items for Systematic and Meta-Analysis Extension for Scoping Reviews, using the Joanna Briggs Institute (JBI) methodology to analyse healthcare administration approaches in LMICs.
Data Sources:
PubMed, Google Scholar, MEDLINE, EconLit, Science Direct and Scopus were searched using a set of search terms from 19 December 2023 to 16 January 2024. An additional high-level search was performed in May 2025.
Eligibility Criteria:
Selection of a variety of peer-reviewed publications with a setting in LMICs. Articles were included if they described an intervention strategy related to select paediatric chronic diseases, endocrine conditions or non-communicable diseases. The treatment strategies in question were government initiatives, mobile health, specialised programmes and primary care.
Data Extraction And Synthesis:
One reviewer manually reviewed articles and documented findings on Microsoft Excel. In accordance with JBI methodological guidelines, no risk of bias assessment or quality appraisal of included studies was conducted.
Results:
After reviewing primary care, specialised care, government intervention programmes and mobile care initiatives within developing countries, primary care with an emphasis on task shifting emerged as the best approach for treating paediatric endocrine disorders.
Conclusion:
Despite recommendations favouring specialised care or government interventions, primary care proves to be the optimal method for treating endocrine conditions. Given limited healthcare funding in LMICs, implementing primary care initiatives can achieve significant health outcomes while maximising resources.
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