Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon.
Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
PLoS One. 2020 May 29;15(5):e0233757. doi: 10.1371/journal.pone.0233757. eCollection 2020.
Health care workers (HCWs) are essential for the delivery of health care services in conflict areas and in rebuilding health systems post-conflict.
The aim of this study was to systematically identify and map the published evidence on HCWs in conflict and post-conflict settings. Our ultimate aim is to inform researchers and funders on research gap on this subject and support relevant stakeholders by providing them with a comprehensive resource of evidence about HCWs in conflict and post-conflict settings on a global scale.
We conducted a systematic mapping of the literature. We included a wide range of study designs, addressing any type of personnel providing health services in either conflict or post-conflict settings. We conducted a descriptive analysis of the general characteristics of the included papers and built two interactive systematic maps organized by country, study design and theme.
Out of 13,863 identified citations, we included a total of 474 studies: 304 on conflict settings, 149 on post-conflict settings, and 21 on both conflict and post-conflict settings. For conflict settings, the most studied counties were Iraq (15%), Syria (15%), Israel (10%), and the State of Palestine (9%). The most common types of publication were opinion pieces in conflict settings (39%), and primary studies (33%) in post-conflict settings. In addition, most of the first and corresponding authors were affiliated with countries different from the country focus of the paper. Violence against health workers was the most tackled theme of papers reporting on conflict settings, while workforce performance was the most addressed theme by papers reporting on post-conflict settings. The majority of papers in both conflict and post-conflict settings did not report funding sources (81% and 53%) or conflicts of interest of authors (73% and 62%), and around half of primary studies did not report on ethical approvals (45% and 41%).
This systematic mapping provides a comprehensive database of evidence about HCWs in conflict and post-conflict settings on a global scale that is often needed to inform policies and strategies on effective workforce planning and management and in reducing emigration. It can also be used to identify evidence for policy-relevant questions, knowledge gaps to direct future primary research, and knowledge clusters.
在冲突地区和冲突后重建卫生系统时，卫生保健工作者（HCWs）是提供卫生保健服务的关键。
本研究旨在系统地确定和绘制冲突和冲突后环境中 HCWs 的文献证据。我们的最终目标是让研究人员和资助者了解这一主题的研究空白，并通过为相关利益攸关方提供全球范围内冲突和冲突后环境中 HCWs 的全面证据资源，为他们提供支持。
我们对文献进行了系统的制图。我们纳入了广泛的研究设计，涉及在冲突或冲突后环境中提供卫生服务的任何类型的人员。我们对纳入文献的一般特征进行了描述性分析，并根据国家、研究设计和主题构建了两个互动式系统地图。
在 13863 条鉴定引用中，我们共纳入了 474 项研究：304 项关于冲突环境，149 项关于冲突后环境，21 项关于冲突和冲突后环境。对于冲突环境，研究最多的国家是伊拉克（15%）、叙利亚（15%）、以色列（10%）和巴勒斯坦国（9%）。最常见的出版物类型是冲突环境中的意见文章（39%），冲突后环境中的主要研究（33%）。此外，大多数第一作者和对应作者都隶属于与论文关注国家不同的国家。针对卫生工作者的暴力是报告冲突环境的论文中最常涉及的主题，而针对冲突后环境的论文中最常涉及的主题是劳动力绩效。在冲突和冲突后环境中的大多数论文都没有报告资金来源（81%和 53%）或作者的利益冲突（73%和 62%），大约一半的主要研究没有报告伦理批准（45%和 41%）。
本系统制图提供了一个关于全球范围内冲突和冲突后环境中 HCWs 的全面证据数据库，这通常是为了为有效的劳动力规划和管理以及减少移民提供政策和战略信息。它还可用于确定与政策相关问题的证据、知识差距以指导未来的主要研究以及知识集群。
