Sexual and reproductive health interventions during humanitarian crises
Citation: Singh NS, Smith J, Aryasinghe S, et al. Evaluating the effectiveness of sexual and reproductive health services during humanitarian crises: a systematic review. PloS ONE. 2018;13(7):e0199300.
Language: Abstract and full text available in EN.
Free to view: Yes.
Funding sources: Department of Reproductive Health & Research, World Health Organization.
What is this? Health emergencies can place a great strain on sexual and reproductive health services.
In this systematic review, the authors searched for studies of the effects of sexual and reproductive health (SRH) interventions during humanitarian crises. They restricted their searches to articles published in English or French between 1 January 1980 and 10 April 2017. They included 3 randomised trials, and 17 cross-sectional, 7 pre-post and 2 cohort studies.
What works: Sexual and reproductive health outcomes are improved by home visits and peer-led education and counselling, training of lower-level healthcare workers, use of community health workers (CHWs), a three-tiered network of healthcare workers providing SRH services, integration of HIV and SRH services, and men’s discussion groups addressing intimate partner violence (high quality evidence).
Transport-based referral systems, community-based SRH education, CHW delivery of injectable contraceptives, wider literacy programmes and birth preparedness interventions may also improvise SRH outcomes (moderate quality evidence).
What doesn’t work: Nothing noted.
What’s uncertain: The effects of interventions focused on adolescents, LGBTQ populations or people with disabilities are uncertain due to the lack of available studies.
The effects of interventions addressing the clinical management of rape or the prevention of, and response to vaginal injuries and fistulae was also uncertain.
Implications: The authors of the review concluded that, despite increased attention to SRH in humanitarian crises, there has been little progress in advancing the evidence base for the effectiveness of SRH interventions. They called for more research into the effects of SRH interventions in a variety of humanitarian crises; in particular for adolescents, safe abortion care, post-abortion care, vaginal injury and fistulae, prevention of sexual and gender-based violence, and the clinical management of rape.
Other considerations: The authors of the review discussed their findings in the context of gender and age.
This summary was prepared by Catherine Haynes, checked by Cristián Mansilla and Yasmeen Saeed, and finalized by Mike Clarke,