Evidence map›Paper›PMID 32341086›Full record

SynthesisBMJ global health2020

Delivering non-communicable disease interventions to women and children in conflict settings: a systematic review.

Shailja Shah, Mariella Munyuzangabo, Michelle F Gaffey, Mahdis Kamali, Reena P Jain, Daina Als, Sarah Meteke, Amruta Radhakrishnan, Fahad J Siddiqui, Anushka Ataullahjan and 1 more

Abstract readSystematic Review
In one paragraph

Synthesis in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Shailja ShahCentre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
Mariella MunyuzangaboCentre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
Michelle F GaffeyCentre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
Mahdis KamaliCentre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
Reena P JainCentre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.ORCID 0000-0001-7004-5093
Daina AlsCentre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
Sarah MetekeCentre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
Amruta RadhakrishnanCentre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
Fahad J SiddiquiCentre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
Anushka AtaullahjanCentre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
Zulfiqar A BhuttaCentre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada zulfiqar.bhutta@sickkids.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNon-communicable diseases (NCDs) are the leading cause of death worldwide. In the context of conflict settings, population displacement, disrupted treatment, infrastructure damage and other factors impose serious NCD intervention delivery challenges, but relatively little attention has been paid to addressing these challenges. Here we synthesise the available indexed and grey literature reporting on the delivery of NCD interventions to conflict-affected women and children in low- and middle-income countries (LMICs).

methodsA systematic search in MEDLINE, Embase, CINAHL and PsycINFO databases for indexed articles published between 1 January 1990 and 31 March 2018 was conducted, and publications reporting on NCD intervention delivery to conflict-affected women or children in LMICs were included. A grey literature search of 10 major humanitarian organisation websites for publications dated between 1 January 2013 and 30 November 2018 was also conducted. We extracted and synthesised information on intervention delivery characteristics and delivery barriers and facilitators.

resultsOf 27 included publications, most reported on observational research studies, half reported on studies in the Middle East and North Africa region and 80% reported on interventions targeted to refugees. Screening and medication for cardiovascular disease and diabetes were the most commonly reported interventions, with most publications reporting facility-based delivery and very few reporting outreach or community approaches. Doctors were the most frequently reported delivery personnel. No publications reported on intervention coverage or on the effectiveness of interventions among women or children. Limited population access and logistical constraints were key delivery barriers reported, while innovative technology use, training of workforce and multidisciplinary care were reported to have facilitated NCD intervention delivery.

conclusionLarge and persistent gaps in information and evidence make it difficult to recommend effective strategies for improving the reach of quality NCD care among conflict-affected women and children. More rigorous research and reporting on effective strategies for delivering NCD care in conflict contexts is urgently needed. PROSPERO REGISTRATION NUMBER: CRD42019125221.

Indexed as

Armed ConflictsDelivery of Health CareAdolescentAdultAfricaChildFemaleHumansMaleMiddle EastNoncommunicable DiseasesPovertycardiovascular diseasediabetesmaternal healthpublic healthsystematic review

Identifiers

PMID32341086
PMCPMC7202786

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.