Health in Humanitarian Crises Centre, London School of Hygiene and Tropical Medicine, London, UK.
Faculty of Public Health and Policy and Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Lancet. 2017 Nov 18;390(10109):2287-2296. doi: 10.1016/S0140-6736(16)30768-1. Epub 2017 Jun 8.
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.
人们日益认识到，需要采取循证干预措施，以提高人道主义应对行动的效果和效率。然而，人们对人道主义危机中的卫生干预措施的广泛程度和质量知之甚少。我们描述了一项系统评价的结果，旨在检查人道主义危机中的公共卫生干预措施的证据数量和质量，以确定关键的研究空白。我们确定了 1980 年至 2014 年间发表的符合纳入标准的 345 项研究。证据的数量因健康主题而有很大差异，从传染病（n=131）、营养（n=77）到非传染病（n=8）和水、环境卫生和个人卫生（n=6）。我们观察到常见的研究设计和方法上的弱点，这大大降低了确定干预措施因果关系和归因的能力。考虑到过去三十年来与健康有关的人道主义活动大幅增加，以及呼吁建立更有力的循证基础，本文强调了人道主义环境中卫生干预措施研究的数量和质量有限，并支持扩大这项研究的呼吁。
