Delivery of sexual and reproductive health interventions in conflict settings

A systematic review

Datos Bibliográficos

ID21881069
AutoresMariella Munyuzangabo (Hospital for Sick Children), Dina Sami Khalifa (0000-0002-2950-9068, Hospital for Sick Children), Michelle F Gaffey (0000-0002-1800-8145, Hospital for Sick Children), Mahdis Kamali (0000-0003-1980-778X, Hospital for Sick Children), Fahad Javaid Siddiqui (0000-0002-9046-5105, Hospital for Sick Children), Sarah Meteke (Hospital for Sick Children), Shailja Shah (0000-0003-2329-5027, Hospital for Sick Children), Reena P Jain (0000-0001-7004-5093, Hospital for Sick Children), Daina Als (0000-0003-1569-4511, Hospital for Sick Children), Amruta Radhakrishnan (0009-0003-0140-2693, Hospital for Sick Children), Anushka Ataullahjan (0000-0001-5261-5523, Hospital for Sick Children), Zulfiqar A Bhutta (0000-0003-0637-599X, Aga Khan University, autor de correspondencia)
Año2020
Volumen5
NúmeroSuppl 1
Páginase002206
Fecha de publicación2020-07-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaBMJ Global Health (JOURNAL)
Identificadores de la revistaISSN: 2059-7908 • E-ISSN: 2059-7908
EditorialBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2019-002206
PMID32694131
OpenAlexW3044988104
IdiomaEN
Citas recibidas8
Referencias citadas35

BACKGROUND: It is essential to provide comprehensive sexual and reproductive health (SRH) interventions to women affected by armed conflict, but there is a lack of evidence on effective approaches to delivering such interventions in conflict settings. This review synthesised the available literature on SRH intervention delivery in conflict settings to inform potential priorities for further research and additional guidance development. METHODS: We searched MEDLINE, Embase, CINAHL and PsycINFO databases using terms related to conflict, women and children, and SRH. We searched websites of 10 humanitarian organisations for relevant grey literature. Publications reporting on conflict-affected populations in low-income and middle-income countries and describing an SRH intervention delivered during or within 5 years after the end of a conflict were included. Information on population, intervention and delivery characteristics were extracted and narratively synthesised. Quantitative data on intervention coverage and effectiveness were tabulated, but no meta-analysis was undertaken. RESULTS: 110 publications met our eligibility criteria. Most focused on sub-Saharan Africa and displaced populations based in camps. Reported interventions targeted family planning, HIV/STIs, gender-based violence and general SRH. Most interventions were delivered in hospitals and clinics by doctors and nurses. Delivery barriers included security, population movement and lack of skilled health staff. Multistakeholder collaboration, community engagement and use of community and outreach workers were delivery facilitators. Reporting of intervention coverage or effectiveness data was limited. DISCUSSION: There is limited relevant literature on adolescents or out-of-camp populations and few publications reported on the use of existing guidance such as the Minimal Initial Services Package. More interventions for gender-based violence were reported in the grey than the indexed literature, suggesting limited formal research in this area. Engaging affected communities and using community-based sites and personnel are important, but more research is needed on how best to reach underserved populations and to implement community-based approaches. PROSPERO REGISTRATION NUMBER: CRD42019125221

CINAHL · Environmental health · Family medicine · Grey literature · MEDLINE · Outreach · Political science · Population · Psychological intervention · PsycINFO · Reproductive health · Global Maternal and Child Health · Intimate Partner and Family Violence · Medicine · Migration, Health and Trauma · Nursing