Delivering infectious disease interventions to women and children in conflict settings: A systematic review

Authors

Sarah Meteke, Hospital for Sick Children, Toronto, Ontario, Canada
Marianne Stefopulos, Hospital for Sick Children, Toronto, Ontario, Canada
Daina Als, Hospital for Sick Children, Toronto, Ontario, Canada
Michelle Gaffey, Hospital for Sick Children, Toronto, Ontario, Canada
Mahdis Kamali, Hospital for Sick Children, Toronto, Ontario, Canada
Fahad J. Siddiqui, Hospital for Sick Children, Toronto, Ontario, Canada
Mariella Munyuzangabo, Hospital for Sick Children, Toronto, Ontario, Canada
Reena P. Jain, Hospital for Sick Children, Toronto, Ontario, Canada
Shailja Shah, Hospital for Sick Children, Toronto, Ontario, Canada
Amruta Radhakrishnan, Hospital for Sick Children, Toronto, Ontario, Canada
Anushka Ataullahjan, Hospital for Sick Children, Toronto, Ontario, Canada
Zulfiqar Ahmed Bhutta, Aga Khan UniversityFollow

Document Type

Article

Department

Women and Child Health

Abstract

Background: Conflict has played a role in the large-scale deterioration of health systems in low-income and middle-income countries (LMICs) and increased risk of infections and outbreaks. This systematic review aimed to synthesise the literature on mechanisms of delivery for a range of infectious disease-related interventions provided to conflict-affected women, children and adolescents.
Methods: We searched Medline, Embase, CINAHL and PsychINFO databases for literature published in English from January 1990 to March 2018. Eligible publications reported on conflict-affected neonates, children, adolescents or women in LMICs who received an infectious disease intervention. We extracted and synthesised information on delivery characteristics, including delivery site and personnel involved, as well as barriers and facilitators, and we tabulated reported intervention coverage and effectiveness data.
Results: A majority of the 194 eligible publications reported on intervention delivery in sub-Saharan Africa. Vaccines for measles and polio were the most commonly reported interventions, followed by malaria treatment. Over two-thirds of reported interventions were delivered in camp settings for displaced families. The use of clinics as a delivery site was reported across all intervention types, but outreach and community-based delivery were also reported for many interventions. Key barriers to service delivery included restricted access to target populations; conversely, adopting social mobilisation strategies and collaborating with community figures were reported as facilitating intervention delivery. Few publications reported on intervention coverage, mostly reporting variable coverage for vaccines, and fewer reported on intervention effectiveness, mostly for malaria treatment regimens.
Conclusions: Despite an increased focus on health outcomes in humanitarian crises, our review highlights important gaps in the literature on intervention delivery among specific subpopulations and geographies. This indicates a need for more rigorous research and reporting on effective strategies for delivering infectious disease interventions in different conflict contexts.

Comments

Pagination are not provided by the author/publisher

Publication (Name of Journal)

BMJ Global Health

Recommended Citation

Meteke, S., Stefopulos, M., Als, D., Gaffey, M., Kamali, M., Siddiqui, F. J., Munyuzangabo, M., Jain, R. P., Shah, S., Radhakrishnan, A., Ataullahjan, A., Bhutta, Z. A. (2020). Delivering infectious disease interventions to women and children in conflict settings: A systematic review. BMJ Global Health, 5(Suppl 1), e001967- .
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_wc/102

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.