RT Journal Article
SR Electronic
T1 Delivering trauma and rehabilitation interventions to women and children in conflict settings: a systematic review
JF BMJ Global Health
JO BMJ Global Health
FD BMJ Publishing Group Ltd
SP e001980
DO 10.1136/bmjgh-2019-001980
VO 5
IS Suppl 1
A1 Reena P Jain
A1 Sarah Meteke
A1 Michelle F Gaffey
A1 Mahdis Kamali
A1 Mariella Munyuzangabo
A1 Daina Als
A1 Shailja Shah
A1 Fahad J Siddiqui
A1 Amruta Radhakrishnan
A1 Anushka Ataullahjan
A1 Zulfiqar A Bhutta
YR 2020
UL http://gh.bmj.com/content/5/Suppl_1/e001980.abstract
AB Background In recent years, more than 120 million people each year have needed urgent humanitarian assistance and protection. Armed conflict has profoundly negative consequences in communities. Destruction of civilian infrastructure impacts access to basic health services and complicates widespread emergency responses. The number of conflicts occurring is increasing, lasting longer and affecting more people today than a decade ago. The number of children living in conflict zones has been steadily increasing since the year 2000, increasing the need for health services and resources. This review systematically synthesised the indexed and grey literature reporting on the delivery of trauma and rehabilitation interventions for conflict-affected populations.Methods A systematic search of literature published from 1 January 1990 to 31 March 2018 was conducted across several databases. Eligible publications reported on women and children in low and middle-income countries. Included publications provided information on the delivery of interventions for trauma, sustained injuries or rehabilitation in conflict-affected populations.Results A total of 81 publications met the inclusion criteria, and were included in our review. Nearly all of the included publications were observational in nature, employing retrospective chart reviews of surgical procedures delivered in a hospital setting to conflict-affected individuals. The majority of publications reported injuries due to explosive devices and remnants of war. Injuries requiring orthopaedic/reconstructive surgeries were the most commonly reported interventions. Barriers to health services centred on the distance and availability from the site of injury to health facilities.Conclusions Traumatic injuries require an array of medical and surgical interventions, and their effective treatment largely depends on prompt and timely management and referral, with appropriate rehabilitation services and post-treatment follow-up. Further work to evaluate intervention delivery in this domain is needed, particularly among children given their specialised needs, and in different population displacement contexts.PROSPERO registration number CRD42019125221.