A systematic review protocol for identifying the effectiveness of greenhouse gas mitigation interventions for health care systems in low- and middle-income countries

Background: Climate change is predicted to be our century's most significant health threat. In 2021, 46 countries committed to environmentally sustainable low carbon health care systems. Of those, 34 were from low- and middle-income countries (LMICs). Currently, health systems are responsible for 4.4% of global greenhouse gas (GHG) emissions, with health systems in high-income countries (HICs) contributing the largest proportion to the sector's GHG emissions. However, future increases are predicted in LMICs in the absence of robust GHG mitigation. This systematic review aims to identify evidence-based GHG mitigation interventions to guide the transformation of health care systems towards net zero, specifically in LMICs. Additionally, potential synergies between interventions that aid adaption to climate change and mitigate GHG emissions will be investigated. Methods: This protocol will follow the 'Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist of recommended items to address in a systematic review protocol'. A comprehensive search will be conducted on electronic databases identified as relevant. Search terms were identified to capture all relevant peer-reviewed, primary research published between 1990 and 2022. The risk of bias will be assessed, and the quality of evidence graded. The eventual narrative synthesis will feed into a theory of change framework on GHG mitigation of health care systems in LMICs. Discussion: This systematic review will synthesise the existing evidence around GHG mitigation interventions across all scopes of emissions, including scope 1 (health care operations), scope 2 (energy), and scope 3 (supply chains). It can be used to inform recommendations on how health care systems in LMICs can reduce emissions while prioritising which actions to take to gain the most significant reductions in GHG emissions, considering ease of implementation, scope and cost. Finally, this can catalyse further research in this area which is urgently needed.

A systematic review protocol for identifying the effectiveness of greenhouse gas mitigation interventions for health care systems in low- and middle-income countries

Background: Climate change is predicted to be our century's most significant health threat. In 2021, 46 countries committed to environmentally sustainable low carbon health care systems. Of those, 34 were from low- and middle-income countries (LMICs).  Currently, health systems are responsible for 4.4% of global greenhouse gas (GHG) emissions, with health systems in high-income countries (HICs) contributing the largest proportion to the sector's GHG emissions. However, future increases are predicted in LMICs in the absence of robust GHG mitigation. This systematic review aims to identify evidence-based GHG mitigation interventions to guide the transformation of health care systems towards net zero, specifically in LMICs. Additionally, potential synergies between interventions that aid adaption to climate change and mitigate GHG emissions will be investigated. Methods: This protocol will follow the 'Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist of recommended items to address in a systematic review protocol'. A comprehensive search will be conducted on electronic databases identified as relevant. Search terms were identified to capture all relevant peer-reviewed, primary research published between 1990 and 2022. The risk of bias will be assessed, and the quality of evidence graded. The eventual narrative synthesis will feed into a theory of change framework on GHG mitigation of health care systems in LMICs. Discussion: This systematic review will synthesise the existing evidence around GHG mitigation interventions across all scopes of emissions, including scope 1 (health care operations), scope 2 (energy), and scope 3 (supply chains). It can be used to inform recommendations on how health care systems in LMICs can reduce emissions while prioritising which actions to take to gain the most significant reductions in GHG emissions, considering ease of implementation, scope and cost. Finally, this can catalyse further research in this area which is urgently needed.

Research Education in Medical Curricula: a Global Analysis

BACKGROUND

Research is a key component of medical practice, with involvement of medical students crucial for the future of healthcare. A major limitation for medical students is the lack of exposure to research education and projects. The purpose of this study was to analyse the exposure of medical students worldwide to research education and opportunities and their satisfaction with research in their curriculum and compare results between regions.

METHODS

The International Federation of Medical Students Associations (IFMSA), through its Research Standing Committee, developed a questionnaire to understand the current situation worldwide regarding medical students' access to research and research education in the medical curriculum. Students from all years from across the five regions of the IFMSA were eligible.

RESULTS

A total of 619 responses representing 290 universities and 88 countries were received. Although 97.6% of medical students believed that research should be approached in their education, only 19.6% considered it was sufficiently addressed. Regarding education, only 36% of all respondents reported having specific mandatory research courses, with higher percentages in the Asia-Pacific and European countries. Even though an association between research opportunities and research participation was found, only 30% of students reported having specific places in research teams. Lastly, 39.3% had never participated in a research project.

CONCLUSION

Research education is a vital component of medical education, and medical students consider its inclusion as essential for their education. However, not enough emphasis on research education is placed across the globe, with most students seeking research opportunities to train themselves outside the formal curriculum.