Impact of international deployments on epidemic response in low- and middle-income countries (LMICs): A mixed-methods systematic review protocol

Abstract

Background: Substantial resources are invested globally for deploying personnel with technical and operational skillsets to support outbreak response in the low- and middle-income countries (LMICs). In deploying to a country there is an underlying commitment to strengthen national outbreak response capacity. However, eliciting specific impacts of an international deployment on enhancing a country’s outbreak response, readiness, and preparedness capacities remain a challenge. This review examines how deployments contribute to containing public health threats in LMICs. Specifically, this review aims to: (i) explore the different international deployment models and/or approaches; (ii) identify and describe the impacts of international deployments to support national outbreak preparedness, readiness and response; and (iii) identify the facilitators and the barriers to improving public health emergency response and recovery capacities of the LMICs. Methods: The reviewers will search the following databases for peer-reviewed articles published between January 2012 and June 2023: MEDLINE, Embase, Global Health, Globus Index Medicus, Web of Science and Google Scholar using Medical Subject Headings (MeSH) and keywords. ReliefWeb and websites of relevant humanitarian and health organisations will be searched for grey literature. The identified articles will be assessed for meeting the eligibility criteria. Two independent reviewers will screen the titles and abstracts and review the full texts of the selected articles. A customised data extraction form will be utilised. The quality of included peer-reviewed articles will be assessed using the Quality Assessment with Diverse Studies (QuADS)appraisal tool. Grey literature will be assessed using the AACODS checklist. Results from eligible articles will be analysed qualitatively using thematic synthesis. Descriptive statistics will be generated to summarise quantitative results. A parallel-results convergent synthesis approach will be used to narratively triangulate the qualitative and the quantitative findings. The results will be reported according to the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement and synthesis without meta-analysis (SWiM) guideline. Discussion: This systematic review will identify the contributions of international deployments in improving LMICs’ public health emergency response capacities. The findings may help to refine international assistance strategies to support outbreak response efforts in the LMICs. Systematic review registration:PROSPERO CRD42023404346