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. 2018 May 3;3(2):e000682.
doi: 10.1136/bmjgh-2017-000682. eCollection 2018.

A long way to go: a systematic review to assess the utilisation of sexual and reproductive health services during humanitarian crises

Neha S Singh  1   2 , Sarindi Aryasinghe  2 , James Smith  1 , Rajat Khosla  3 , Lale Say  3 , Karl Blanchet  1
Affiliations

A long way to go: a systematic review to assess the utilisation of sexual and reproductive health services during humanitarian crises

Neha S Singh et al. BMJ Glob Health. .

Abstract

Introduction: Women and girls are affected significantly in both sudden and slow-onset emergencies, and face multiple sexual and reproductive health (SRH) challenges in humanitarian crises contexts. There are an estimated 26 million women and girls of reproductive age living in humanitarian crises settings, all of whom need access to SRH information and services. This systematic review aimed to assess the utilisation of services of SRH interventions from the onset of emergencies in low- and middle-income countries.

Methods: We searched for both quantitative and qualitative studies in peer-reviewed journals across the following four databases: EMBASE, Global Health, MEDLINE and PsychINFO from 1 January 1980 to 10 April 2017. Primary outcomes of interest included self-reported use and/or confirmed use of the Minimum Initial Service Package services and abortion services. Two authors independently extracted and analysed data from published papers on the effect of SRH interventions on a range of SRH care utilisation outcomes from the onset of emergencies, and used a narrative synthesis approach.

Results: Of the 2404 identified citations, 23 studies met the inclusion criteria. 52.1% of the studies (n=12) used quasi-experimental study designs, which provided some statistical measure of difference between intervention and outcome. 39.1% of the studies (n=9) selected were graded as high quality, 39.1% moderate quality (n=9) and 17.4% low quality (n=4). Evidence of effectiveness in increasing service utilisation was available for the following interventions: peer-led and interpersonal education and mass media campaigns, community-based programming and three-tiered network of community-based reproductive and maternal health providers.

Conclusions: Despite increased attention to SRH service provision in humanitarian crises settings, the evidence base is still very limited. More implementation research is required to identify interventions to increase utilisation of SRH services in diverse humanitarian crises settings and populations.

Keywords: Hiv; health services research; maternal health; other infection, disease, disorder, or injury; systematic review.

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Conflict of interest statement

Competing interests: All authors declare support from WHO for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years, no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart: selection process for systematic review on the utilisation of sexual and reproductive health interventions in humanitarian crises settings.
See this image and copyright information in PMC

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