A long way to go: a systematic review to assess the utilisation of sexual and reproductive health services during humanitarian crises
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INTRODUCTION: Women and girls are affected significantly in both sudden and slow-onset emergencies, and face multiple sexual and reproductive health (SRH) challenges in humanitarian crises contexts. There are an estimated 26 million women and girls of reproductive age living in humanitarian crises settings, all of whom need access to SRH information and services. This systematic review aimed to assess the utilisation of services of SRH interventions from the onset of emergencies in low- and middle-income countries. METHODS: We searched for both quantitative and qualitative studies in peer-reviewed journals across the following four databases: EMBASE, Global Health, MEDLINE and PsychINFO from 1 January 1980 to 10 April 2017. Primary outcomes of interest included self-reported use and/or confirmed use of the Minimum Initial Service Package services and abortion services. Two authors independently extracted and analysed data from published papers on the effect of SRH interventions on a range of SRH care utilisation outcomes from the onset of emergencies, and used a narrative synthesis approach. RESULTS: Of the 2404 identified citations, 23 studies met the inclusion criteria. 52.1% of the studies (n=12) used quasi-experimental study designs, which provided some statistical measure of difference between intervention and outcome. 39.1% of the studies (n=9) selected were graded as high quality, 39.1% moderate quality (n=9) and 17.4% low quality (n=4). Evidence of effectiveness in increasing service utilisation was available for the following interventions: peer-led and interpersonal education and mass media campaigns, community-based programming and three-tiered network of community-based reproductive and maternal health providers. CONCLUSIONS: Despite increased attention to SRH service provision in humanitarian crises settings, the evidence base is still very limited. More implementation research is required to identify interventions to increase utilisation of SRH services in diverse humanitarian crises settings and populations.
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From previous systematic reviews focusing on SRH services and programmes, only one reported a study where ENC was evaluated.
“From the previous systematic reviews focusing on the effectiveness, utilisation of and evaluation of SRH services and programmes,2 16 17 only one reported a study where ENC was evaluated.2”
From A systematic review of newborn health interventions in humanitarian settings (2022) · cites this paper as [17]
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Self-citation
- Authors
- Singh, N. S., Aryasinghe, S., Smith, J., Khosla, R., Say, L., & Blanchet, K.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- World Health Organization (CH)
- Corresponding author
- Singh, Neha S
- Venue
- BMJ Global Health
- Publisher
- BMJ
- Published
- 2018-05
- Volume
- 3
- Issue
- 2
- Pages
- e000682
- ISSN
- 2059-7908 (ISSN-L)
- PMC
- PMC5935157
- OpenAlex
- W2800491443
- Cited by
- 144
- References
- 31
- Citations by year
- 2026: 24 · 2025: 15 · 2024: 21 · 2023: 24 · 2022: 22 · 2021: 23 · 2020: 8 · 2019: 6 · 2018: 1
- FWCI
- 1.72
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMJ Global Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Spiral (Imperial College London) (submittedVersion, other-oa)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Funders
- World Health Organization - Department of Reproductive Health and Research
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- sexual and reproductive health services, humanitarian crisis, service utilization, abortion services, women and girls, peer education, mass media campaigns, community-based programs, low- and middle-income countries
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