Health in Humanitarian Crises Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Centre for Maternal, Adolescent, Reproductive and Child Health (MARCH), London School of Hygiene & Tropical Medicine, London, United Kingdom.
PLoS One. 2018 Jul 6;13(7):e0199300. doi: 10.1371/journal.pone.0199300. eCollection 2018.
An estimated 32 million women and girls of reproductive age living in emergency situations, all of whom require sexual and reproductive health (SRH) information and services. This systematic review assessed the effect of SRH interventions, including the Minimum Initial Service Package (MISP) on a range of health outcomes from the onset of emergencies.
We searched EMBASE, Global Health, MEDLINE and PsychINFO databases from January 1, 1980 to April 10, 2017. This review was registered with the PROSPERO database with identifier number CRD42017082102. We found 29 studies meet the inclusion criteria. We found high quality evidence to support the effectiveness of specific SRH interventions, such as home visits and peer-led educational and counselling, training of lower-level health care providers, community health workers (CHWs) to promote SRH services, a three-tiered network of health workers providing reproductive and maternal health services, integration of HIV and SRH services, and men's discussion groups for reducing intimate partner violence. We found moderate quality evidence to support transport-based referral systems, community-based SRH education, CHW delivery of injectable contraceptives, wider literacy programmes, and birth preparedness interventions. No studies reported interventions related to fistulae, and only one study focused on abortion services.
Despite increased attention to SRH in humanitarian crises, the sector has made little progress in advancing the evidence base for the effectiveness of SRH interventions, including the MISP, in crisis settings. A greater quantity and quality of more timely research is needed to ascertain the effectiveness of delivering SRH interventions in a variety of humanitarian crises.
据估计，有 3200 万育龄期妇女和女孩生活在紧急情况下，她们都需要性与生殖健康（SRH）信息和服务。本系统评价评估了 SRH 干预措施（包括最低初始服务包[MISP]）对紧急情况开始时一系列健康结果的影响。
我们检索了 EMBASE、全球健康、MEDLINE 和 PsychINFO 数据库，检索时间为 1980 年 1 月 1 日至 2017 年 4 月 10 日。本研究在 PROSPERO 数据库注册，注册号为 CRD42017082102。我们发现 29 项研究符合纳入标准。我们发现高质量证据支持某些 SRH 干预措施的有效性，如家访和同伴主导的教育和咨询、基层卫生保健提供者培训、社区卫生工作者（CHWs）促进 SRH 服务、提供生殖和孕产妇保健服务的三级卫生工作者网络、HIV 和 SRH 服务的整合以及减少亲密伴侣暴力的男性讨论小组。我们发现中等质量证据支持基于交通的转介系统、基于社区的 SRH 教育、CHW 提供注射避孕方法、更广泛的扫盲方案和生育准备干预措施。没有研究报告与瘘管病相关的干预措施，只有一项研究关注堕胎服务。
尽管人道主义危机中对 SRH 的关注有所增加，但该部门在为包括 MISP 在内的 SRH 干预措施在危机环境中的有效性提供循证依据方面进展甚微。需要更多及时的、高质量和数量更大的研究来确定在各种人道主义危机中提供 SRH 干预措施的有效性。
