Healthcare Programmes for Truck Drivers in Sub-Saharan Africa: A Systematic Review and Meta-Analysis
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
Truck drivers have unique health needs, and by virtue of their continuous travel, experience
difficulty in accessing healthcare. Currently, planning for effective care is hindered by lack
of knowledge about their health needs and about the impact of on-going programmes on
this population’s health outcomes. We reviewed healthcare programmes implemented for
sub-Saharan African truck drivers, assessed the evaluation methods, and examined impact
on health outcomes.
Methods
We searched scientific and institutional databases, and online search engines to include all
publications describing a healthcare programme in sub-Saharan Africa where the main clients
were truck drivers. We consulted experts and organisations working with mobile populations
to identify unpublished reports. Forest plots of impact and outcome indicators with
unadjusted risk ratios and 95% confidence intervals were created to map the impact of
these programmes. We performed a subgroup analysis by type of indicator using a randomeffects
model to assess between-study heterogeneity. We conducted a sensitivity analysis
to examine both the summary effect estimate chosen (risk difference vs. risk ratio) and
model to summarise results (fixed vs. random effects).
Results
Thirty-seven publications describing 22 healthcare programmes across 30 countries were
included from 5,599 unique records. All programmes had an HIV-prevention focus with
only three expanding their services to cover conditions other primary healthcare services.
Twelve programmes were evaluated and most evaluations assessed changes in input, output, and outcome indicators. Absence of comparison groups, preventing attribution of
the effect observed to the programme and lack of biologically confirmed outcomes were the
main limitations. Four programmes estimated a quantitative change in HIV prevalence
or reported STI incidence, with mixed results, and one provided anecdotal evidence of
changes in AIDS-related mortality and social norms. Most programmes showed positive
changes in risk behaviours, knowledge, and attitudes. Our conclusions were robust in sensitivity
analyses.
Conclusion
Diverse healthcare programmes tailored to the needs of truck drivers implemented in 30
sub-Saharan African countries have shown potential benefits. However, information gaps
about availability of services and their effects impede further planning and implementation
of effective healthcare programmes for truck drivers.
Truck drivers have unique health needs, and by virtue of their continuous travel, experience
difficulty in accessing healthcare. Currently, planning for effective care is hindered by lack
of knowledge about their health needs and about the impact of on-going programmes on
this population’s health outcomes. We reviewed healthcare programmes implemented for
sub-Saharan African truck drivers, assessed the evaluation methods, and examined impact
on health outcomes.
Methods
We searched scientific and institutional databases, and online search engines to include all
publications describing a healthcare programme in sub-Saharan Africa where the main clients
were truck drivers. We consulted experts and organisations working with mobile populations
to identify unpublished reports. Forest plots of impact and outcome indicators with
unadjusted risk ratios and 95% confidence intervals were created to map the impact of
these programmes. We performed a subgroup analysis by type of indicator using a randomeffects
model to assess between-study heterogeneity. We conducted a sensitivity analysis
to examine both the summary effect estimate chosen (risk difference vs. risk ratio) and
model to summarise results (fixed vs. random effects).
Results
Thirty-seven publications describing 22 healthcare programmes across 30 countries were
included from 5,599 unique records. All programmes had an HIV-prevention focus with
only three expanding their services to cover conditions other primary healthcare services.
Twelve programmes were evaluated and most evaluations assessed changes in input, output, and outcome indicators. Absence of comparison groups, preventing attribution of
the effect observed to the programme and lack of biologically confirmed outcomes were the
main limitations. Four programmes estimated a quantitative change in HIV prevalence
or reported STI incidence, with mixed results, and one provided anecdotal evidence of
changes in AIDS-related mortality and social norms. Most programmes showed positive
changes in risk behaviours, knowledge, and attitudes. Our conclusions were robust in sensitivity
analyses.
Conclusion
Diverse healthcare programmes tailored to the needs of truck drivers implemented in 30
sub-Saharan African countries have shown potential benefits. However, information gaps
about availability of services and their effects impede further planning and implementation
of effective healthcare programmes for truck drivers.
Editor(s)
Goldenberg, SM
Date Issued
2016-06-22
Date Acceptance
2016-05-23
Citation
PLOS One, 2016, 11 (6)
ISSN
1932-6203
Publisher
Public Library of Science
Journal / Book Title
PLOS One
Volume
11
Issue
6
Copyright Statement
© 2016 Lalla-Edward et al. This is an
open access article distributed under the terms of the
Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are
credited.
open access article distributed under the terms of the
Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are
credited.
License URL
Subjects
General Science & Technology
MD Multidisciplinary
Publication Status
Published
Article Number
e0156975