Background Burn injury is associated with significant mortality and disability. Resilient and responsive health systems are needed for optimal response and care for people who sustain burn injuries. However, the extent of health systems research (HSR) in burn care is unknown. This review aimed to systematically map the global HSR related to burn care.
Methods An evidence gap map (EGM) was developed based on the World Health Organization health systems framework. All major medical, health and injury databases were searched. A standard method was used to develop the EGM.
Results A total of 6586 articles were screened, and the full text of 206 articles was reviewed, of which 106 met the inclusion criteria. Most included studies were cross-sectional (61%) and were conducted in hospitals (71%) with patients (48%) or healthcare providers (29%) as participants. Most studies were conducted in high-income countries, while only 13% were conducted in low-and middle-income countries, accounting for 60% of burns mortality burden globally. The most common health systems areas of focus were service delivery (53%), health workforce (33%) and technology (19%). Studies on health policy, governance and leadership were absent, and there were only 14 qualitative studies.
Conclusions Major evidence gaps exist for an integrated health systems response to burns care. There is an inequity between the burden of burn injuries and HSR. Strengthening research capacity will facilitate evidence-informed health systems and policy reforms to sustainably improve access to affordable, equitable and optimal burn care and outcomes.
- Systematic Review
- Public Health
- Health Services
Data availability statement
All data relevant to the study are included in the article.
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Twitter @docVRK, @margiepeden
Contributors VRK conceptualised the study with inputs from MP and JJ. VRK did the literature search. VRK and PS screened the literature, with support from JJ and MP. VRK did data extraction, and PS verified the data. VRK conducted the analysis and PS, JJ, MP and SA provided inputs. VRK wrote the manuscript. MP, JJ, RN and SA provided critical comments to revise the manuscript. All authors reviewed and approved the final manuscript. VRK has access to all data and act as guarantor.
Funding VRK is supported by Tuition Fees Scholarship from the University of New South Wales (UNSW), Sydney, Australia. JJ is supported by Emerging Leadership level-2 fellowship by the National Health and Medical Research Council, Australia.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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