Delivery of sexual and reproductive health interventions in conflict settings: a systematic review.

Journal: BMJ global health

Volume: 5

Issue: Suppl 1

Year of Publication: 2021

Affiliated Institutions:  Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada. Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada zulfiqar.bhutta@sickkids.ca.

Abstract summary 

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.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.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.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.CRD42019125221.

Authors & Co-authors:  Munyuzangabo Mariella M Khalifa Dina Sami DS Gaffey Michelle F MF Kamali Mahdis M Siddiqui Fahad J FJ Meteke Sarah S Shah Shailja S Jain Reena P RP Als Daina D Radhakrishnan Amruta A Ataullahjan Anushka A Bhutta Zulfiqar A ZA

Study Outcome 

Source Link: Visit source

Statistics
Citations :  United Nations Population Fund (UNFPA) Report of the International Conference on population and development, Cairo. New York: United Nations, 1995: 5–13.
Authors :  12
Identifiers
Doi : e002206
SSN : 2059-7908
Study Population
Women
Mesh Terms
Adolescent
Other Terms
child health;health systems evaluation;mental health & psychiatry;public health;systematic review
Study Design
Cross Sectional Study
Study Approach
Quantitative,Systemic Review
Country of Study
Publication Country
England