Evidence on public health interventions in humanitarian crises

Abstract

Recognition of the need for evidence-based interventions to help to improve the effectiveness and efficiency of humanitarian responses has been increasing. However, little is known about the breadth and quality of evidence on health interventions in humanitarian crises. We describe the findings of a systematic review with the aim of examining the quantity and quality of evidence on public health interventions in humanitarian crises to identify key research gaps. We identified 345 studies published between 1980 and 2014 that met our inclusion criteria. The quantity of evidence varied substantially by health topic, from communicable diseases (n=131), nutrition (n=77), to non-communicable diseases (n=8), and water, sanitation, and hygiene (n=6). We observed common study design and weaknesses in the methods, which substantially reduced the ability to determine causation and attribution of the interventions. Considering the major increase in health-related humanitarian activities in the past three decades and calls for a stronger evidence base, this paper highlights the limited quantity and quality of health intervention research in humanitarian contexts and supports calls to scale up this research.

Medical conditions and treatment in a transit camp in Serbia for Syrian, Afghani, and Iraqi migrants

“…Both issues could affect the observed prevalence rates and observed demographic correlates of the diagnoses and treatments. These limitations and others were observed in other similar situations and conditions within the humanitarian context (Blanchet et al 2017). Nevertheless, this study provides a glimpse into the health status of the migrants arriving in Europe.…”

Research agenda-setting on cash programming for health and nutrition in humanitarian settings

“…Maternal and child health was most commonly cited (n = 5), followed by mental and psychosocial health (n = 4), WASH and diarrhoea (n = 1), HIV (n = 1), Ebola and cholera (n = 1), and chronic disease (n = 1). Literature reviews also mentioned specific diseases and health concerns requiring investigating, including HIV/AIDS ( (Gaarder et al 2010;Lund et al 2011), sexual and reproductive health (Blanchet et al 2015), chronic disease (Gaarder et al 2010), maternal morbidity, early initiation of breastfeeding, and WASH (Mishra and Battistin 2017). This list roughly overlaps with our findings.…”

“…Identification of research areas and prioritisation is needed to ensure that limited resources for humanitarian research are used to address the most important questions that could not be answered in more stable environments. As a result, the international community is investing through collaborations such as the Research for Health in Humanitarian Crises Evidence Reviews (Blanchet et al 2015), Consortium for Research on Food Assistance for Nutritional Impact (REFANI) (Fenn 2015), the Cash Learning Partnership (CALP) work in summarising the current state of CTP (CALP 2018), and global cluster efforts such as this one, to identify and validate research agendas to guide investments. To the best of our knowledge, there is no consensus on a research agenda on the use of CTP for health and nutrition in humanitarian contexts at the global level.…”

Humanitarian medicine is more than a technical exercise

“…Mohamed Elamein and colleagues, 1 as part of the Lancet Series on health in humanitarian crises, [2][3][4][5] present evidence on the use of the Monitoring Violence against Health Care tool to detect and verify attacks on health-care services and describe their effect in Syria. The tragic story these statistics tell highlights the need for action to stop attacks against health-care settings and workers in Syria and elsewhere in the world.…”