Non-communicable disease interventions for women and children in conflict settings
Citation: Shah S, Munyuzangabo M, Gaffey MF, et al. Delivering non-communicable disease interventions to women and children in conflict settings: a systematic review. BMJ Global Health. 2020;5:e002047.
Language: Abstract and full text available in EN.
Free to view: Yes.
Funding sources: International Development Research Centre (Canada), Norwegian Agency for Development Cooperation, Bill & Melinda Gates Foundation and UNICEF.
What is this? Disrupted and delayed treatment of non-communicable diseases (NCDs) during armed conflicts and other humanitarian emergencies may lead to poorer outcomes for patients and increased costs.
In this systematic review, the authors searched for articles reporting the delivery of NCD interventions to conflict-affected children, adolescents and women (aged 15 to 49 years) in low- or middle-income countries (LMICs). They restricted their searches to articles published in English after 1 January 1990 and did the searches in March 2018. They included 26 observational studies and 1 randomised trial, which were conducted in East Asia and the Pacific (1 study), Europe and Central Asia (6), the Middle East and North Africa (14), Sub-Saharan Africa (3) and South Asia (3).
What was found: The most commonly studied NCD-related interventions were screening and medication for cardiovascular disease and diabetes.
Doctors were the most frequently reported type of healthcare worker for delivering the interventions.
The authors of the review found no reports of population-level intervention coverage or effectiveness of these interventions.
Key barriers to delivery were limited population access and logistical constraints.
Key facilitators of delivery were innovative technology, workforce training and multidisciplinary care.
Implications: The authors of the review concluded that more focus is needed on strengthening cohort monitoring systems to enhance regular access to patients and promote sustainable care. They also stated that the evidence gap makes it difficult to recommend effective strategies for improving NCD care among conflict-affected women and children.
Other considerations: The authors of the review discussed their findings in the context of place of residence, gender and sex.
This summary was prepared by Catherine Haynes, checked by Yasmeen Saeed and Cristián Mansilla, and finalized by Mike Clarke.