Delivering non-communicable disease interventions to women and children in conflict settings: A systematic review

Authors

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

Document Type

Article

Department

Women and Child Health

Abstract

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.

Comments

Pagination are not provided by the author/publisher

Publication (Name of Journal)

BMJ Global Health

Recommended Citation

Shah, S., Munyuzangabo, M., Gaffey, M. F., Kamali, M., Jain, R. P., Als, D., Meteke, S., Radhakrishnan, A., Siddiqui, F. J., Ataullahjan, A., Bhutta, Z. A. (2020). Delivering non-communicable disease interventions to women and children in conflict settings: A systematic review. BMJ Global Health, 5(Suppl 1), e002047.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_wc/103

Creative Commons License

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