Delivering non-communicable disease interventions to women and children in conflict settings

A systematic review

Bibliographic Data

ID21880536
AuthorsShailja Shah (0000-0003-2329-5027, Hospital for Sick Children), Mariella Munyuzangabo (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), Reena P Jain (0000-0001-7004-5093, Hospital for Sick Children), Daina Als (0000-0003-1569-4511, Hospital for Sick Children), Sarah Meteke (Hospital for Sick Children), Amruta Radhakrishnan (0009-0003-0140-2693, Hospital for Sick Children), Fahad Javaid Siddiqui (0000-0002-9046-5105, Hospital for Sick Children), Anushka Ataullahjan (0000-0001-5261-5523, Hospital for Sick Children), Zulfiqar A Bhutta (0000-0003-0637-599X, Aga Khan University, corresponding author)
Year2020
Volume5
IssueSuppl 1
Pagese002047
Publication date2020-04-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2019-002047
PMID32341086
OpenAlexW3019622174
LanguageEN
Citations received10
References cited28

BACKGROUND: Non-communicable diseases (NCDs) are the leading cause of death worldwide. In the context of conflict settings, population displacement, disrupted treatment, infrastructure damage and other factors impose serious NCD intervention delivery challenges, but relatively little attention has been paid to addressing these challenges. Here we synthesise the available indexed and grey literature reporting on the delivery of NCD interventions to conflict-affected women and children in low- and middle-income countries (LMICs). METHODS: A systematic search in MEDLINE, Embase, CINAHL and PsycINFO databases for indexed articles published between 1 January 1990 and 31 March 2018 was conducted, and publications reporting on NCD intervention delivery to conflict-affected women or children in LMICs were included. A grey literature search of 10 major humanitarian organisation websites for publications dated between 1 January 2013 and 30 November 2018 was also conducted. We extracted and synthesised information on intervention delivery characteristics and delivery barriers and facilitators. RESULTS: Of 27 included publications, most reported on observational research studies, half reported on studies in the Middle East and North Africa region and 80% reported on interventions targeted to refugees. Screening and medication for cardiovascular disease and diabetes were the most commonly reported interventions, with most publications reporting facility-based delivery and very few reporting outreach or community approaches. Doctors were the most frequently reported delivery personnel. No publications reported on intervention coverage or on the effectiveness of interventions among women or children. Limited population access and logistical constraints were key delivery barriers reported, while innovative technology use, training of workforce and multidisciplinary care were reported to have facilitated NCD intervention delivery. CONCLUSION: Large and persistent gaps in information and evidence make it difficult to recommend effective strategies for improving the reach of quality NCD care among conflict-affected women and children. More rigorous research and reporting on effective strategies for delivering NCD care in conflict contexts is urgently needed. PROSPERO REGISTRATION NUMBER: CRD42019125221

CINAHL · Environmental health · Family medicine · Grey literature · MEDLINE · Non-communicable disease · Observational study · Outreach · Pathology · Political science · Population · Psychological intervention · PsycINFO · Public health · Systematic review · Global Maternal and Child Health · Global Public Health Policies and Epidemiology · Health and Conflict Studies · Medicine · Nursing

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