Health Shock Indicators in Developing Countries: A Systematic Review

Health is a central part of human capitaland an important challenge indeveloping countries. Due to high out-of-pocket payments and poor access to insurance systems, health issues aresignificant concerns, particularly for the poor. Therefore, any household health shock creates countless consequences at micro and macro levels. This study aims to identify indicators of health shock in developing countries via a qualitative systematic review.

A systematic search was performed in databases including PubMed, Science Direct, Wiley, Oxford, Emerald, DOAJ and Google Scholar by applying related keywords and without any time limit. Obtained srticles were selected based on inclusion and exclusion criteria. Subsequently, required information was extracted and results were reported narratively.

A total of 1608 studieswere retrieved, out of which164 were included in the reviewaccording to a PRISMA method and considering inclusion and exclusion criteria. Seven main indicators including, illness, mortality, self-reported health, health expenses, hospitalization, Body Mass Index(BMI)and Activities of Daily Living(ADL)were used to measure health shock, among which, illness and mortality were the most common and most cited. Ninety-sixof the articles used several indicators.

Considering the adverse consequences of health shock, recognizing its indicators is useful in establishing health promotion interventions and plans. Therefore, governments must focus on health shock indicators, taking into account the severity of the shock, economic status of households, and health system characteristics. Moreover, support policies and mechanisms such as insurance are necessary to compensate household consumption reduction and earning losses resulting from health shocks.