Bowsher Gemma, El Achi Nassim, Augustin Katrin, Meagher Kristen, Ekzayez Abdulkarim, Roberts Bayard, Patel Preeti
R4HC-MENA, R4HSSS & Conflict & Health Research Group, King's College London, Strand Ln, London WC2R 2LS, UK.
R4HC-MENA, Global Health Institute, American University of Beirut, Beirut 1107 2020, Lebanon.
Health Policy Plan. 2021 Jun 25;36(6):974-981. doi: 10.1093/heapol/czab042.
The role of eHealth in conflict settings is increasingly important to address geographic, epidemiologic and clinical disparities. This study categorizes various forms of eHealth usage in conflict and aims to identify gaps in evidence to make recommendations for further research and practice. The analysis was carried out via a narrative hermeneutic review methodology. Articles that fulfilled the following screening criteria were reviewed: (1) describing an eHealth intervention in active conflict or ongoing insurgency, (2) an eHealth intervention targeting a conflict-affected population, (3) an e-learning platform for delivery in conflict settings and (4) non-interventional descriptive reviews relating to eHealth in conflict. Of the 489 papers eligible for screening, 46 merited final inclusion. Conflict settings described include Somalia, Sudan, Afghanistan, Syria, Iraq, Pakistan, Chechnya, Gaza and the Democratic Republic of Congo. Thirty-six studies described specific eHealth initiatives, while the remainder were more generic review papers exploring general principles. Analysis resulted in the elucidation of three final categories of current eHealth activity in conflict-affected settings: (1) eHealth for clinical management, (2) e-learning for healthcare in conflict and (3) eHealth for information management in conflict. Obvious disparities in the distribution of technological dividends from eHealth in conflict are demonstrated by this review. Conflict-affected populations are predominantly subject to ad hoc and voluntary initiatives delivered by diaspora and civil society organizations. While the deployment of eHealth technologies in conflict settings is increasingly normalized, there is a need for further clarification of global norms relating to practice in this context.
在冲突环境中,电子健康对于解决地理、流行病学和临床方面的差异愈发重要。本研究对冲突中电子健康的各种使用形式进行了分类,旨在找出证据方面的差距,为进一步的研究和实践提出建议。分析是通过叙事诠释学综述方法进行的。对符合以下筛选标准的文章进行了综述:(1)描述在活跃冲突或持续叛乱中的电子健康干预措施;(2)针对受冲突影响人群的电子健康干预措施;(3)在冲突环境中提供服务的电子学习平台;(4)与冲突中的电子健康相关的非干预性描述性综述。在489篇符合筛选条件的论文中,有46篇值得最终纳入。所描述的冲突环境包括索马里、苏丹、阿富汗、叙利亚、伊拉克、巴基斯坦、车臣、加沙和刚果民主共和国。36项研究描述了具体的电子健康举措,其余的则是探索一般原则的更一般性综述论文。分析得出了受冲突影响环境中当前电子健康活动的三个最终类别:(1)用于临床管理的电子健康;(2)冲突中医疗保健的电子学习;(3)冲突中信息管理的电子健康。本次综述表明,冲突中电子健康技术红利的分配存在明显差异。受冲突影响的人群主要受制于侨民和民间社会组织开展的临时和自愿举措。虽然在冲突环境中部署电子健康技术正日益常态化,但在此背景下,仍需要进一步明确与实践相关的全球规范。