Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Global Health & Tropical Medicine, Instituto de Higiene e Medicina Tropical, Nova University of Lisbon, Lisbon, Portugal.
Int J Health Policy Manag. 2022 Oct 19;11(10):2003-2021. doi: 10.34172/ijhpm.2021.155. Epub 2021 Nov 7.
The aim of this research was to synthetise the existing evidence on the impact of epidemic-related lockdown measures on women and children's health in low- and lower-middle-income countries (LLMICs).
A mixed-methods systematic review was conducted of qualitative, quantitative and mixed-methods evidence. Between 1st and 10th of November 2021, seven scientific databases were searched. The inclusion criteria were that the paper provided evidence on the impact of lockdown and related measures, focused on LLMICs, addressed impacts on women and child's health, addressed epidemics from 2000-2020, was peer-reviewed, provided original evidence, and was published in English. The Joanne Briggs Institute's critical appraisal tools were used to assess the quality of the studies, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting. The evidence from the papers was grouped by type of lockdown measure and categories of impact, using a narrative data-based convergent synthesis design.
The review process identified 46 papers meeting the inclusion criteria from 17 countries that focussed on the coronavirus disease 2019 (COVID-19) and Ebola epidemics. The evidence on the decrease of utilisation of health services showed plummeting immunisation rates and faltering use of maternal and perinatal services, which was linked to a growth of premature deaths. Impacts on the mental health of children and women were convincingly established, with lockdowns associated with surges in depression, anxiety and low life satisfaction. Vulnerability may be compounded by lockdowns, as livelihoods were disrupted, and poverty levels increased.
Limitations included that searches were conducted in late-2020 as new research was being published, and that some evidence not published in English may have been excluded. Epidemic-related lockdown measures carry consequences for the health of women and children in lower-income settings. Governments will need to weigh the trade-offs of introducing such measures and consider policies to mitigate their impacts on the most vulnerable.
本研究旨在综合现有关于大流行相关封锁措施对中低收入国家（LMICs）妇女和儿童健康影响的证据。
对定性、定量和混合方法证据进行了混合方法系统评价。2021 年 11 月 1 日至 10 日，检索了 7 个科学数据库。纳入标准为：论文提供了关于封锁和相关措施影响的证据，重点关注 LLMICs，关注对妇女和儿童健康的影响，关注 2000-2020 年的流行病，经过同行评审，提供原始证据，并以英文发表。使用乔安妮·布里格斯研究所的批判性评估工具评估研究质量，并按照系统评价和荟萃分析报告的首选报告项目（PRISMA）指南进行报告。使用叙述性基于数据的收敛综合设计，根据封锁措施类型和影响类别对论文中的证据进行分组。
审查过程从 17 个国家确定了 46 篇符合纳入标准的论文，这些论文集中于 2019 年冠状病毒病（COVID-19）和埃博拉疫情。利用卫生服务的减少表明免疫接种率大幅下降，孕产妇和围产期服务使用情况不佳，这与早产死亡率的增加有关。儿童和妇女心理健康的影响得到了令人信服的证实，封锁与抑郁、焦虑和低生活满意度的增加有关。封锁可能会使脆弱性加剧，因为生计受到干扰，贫困水平上升。
限制包括 2020 年底进行搜索，因为新的研究正在发表，并且可能排除了一些未以英文发表的证据。与大流行相关的封锁措施对低收入环境中妇女和儿童的健康产生影响。政府将需要权衡引入这些措施的利弊，并考虑减轻其对最弱势群体影响的政策。
