ReviewSage open pediatrics
Barriers to Healthcare Access for Children With Congenital Heart Disease in Low- and Middle-Income Countries: A Systematic Review Using the SHEL Framework.
Review in Sage open pediatrics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Access to timely and appropriate care for children with congenital heart disease (CHD) remains highly inequitable in low- and middle-income countries (LMICs). Objectives: This systematic review synthesizes recent evidence on barriers to healthcare access for pediatric CHD and applies the SHEL human factors framework to analyze system-level determinants. Design: This updated systematic review extends a prior analysis, applying PRISMA guidelines. Search was conducted in PubMed/MEDLINE, Scopus, and Web of Science. Regional trends were mapped via WHO classifications. Results: Most studies reported barriers related to environmental factors, followed by workforce limitations, infrastructure constraints, and policy or organizational deficiencies. Many obstacles originated at the primary care level, contributing to delayed diagnosis and referral. Although all regions exhibited barriers across SHEL domains, their relative distribution varied by region. Conclusion: These findings highlight that improving CHD outcomes in LMICs requires integrated health system strengthening across levels of care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.