What works in psychosocial programming in humanitarian contexts in low- and middle-income countries: a systematic review of the evidence
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While there is growing evidence for the effectiveness of mental health interventions in low- and middle-income countries and humanitarian contexts, this is lacking for psychosocial programming. We aimed to summarise the evidence for psychosocial programming in these contexts through a systematic review (PROSPERO: CRD42017069066) of peer-reviewed and grey literature of programme evaluations. A total of n = 42,435 unique records were initially identified, with n = 211 records meeting full inclusion criteria. We identified 51 randomised controlled trials of 47 different interventions. The remaining studies used different evaluation methodology. Only three interventions had more than one experimental/quasi-experimental evaluation: Brief Intervention and Contact, Problem Management Plus and Child Friendly Spaces. While there are many studies of interventions, it was challenging to identify the same intervention across studies, leaving almost no interventions with more than one rigorous study supporting their use and many interventions that are poorly described. This makes it difficult to choose between them or even to implement them. Future research should focus on replication of well-described interventions in multiple different sites, to place future intervention selection on a more scientific basis. There is also a need to better understand the impact of psychosocial programmes in sectors other than health and protection, such as nutrition. These sectors may provide critical delivery mechanisms for psychosocial programming to broaden the reach of such interventions.
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There is growing acknowledgement of a lack of evidence base for the vast majority of commonly implemented MHPSS programmes, such as short-term psychological interventions.
“there is a growing acknowledgement of the lack of an evidence base for the vast majority of commonly implemented MHPSS programmes, such as short-term psychological interventions (IASC 2014;Haroz et al. 2020;Chiumento et al. 2017;Summerfield 2008;Bangpan 2019).”
From Throwing therapy at the problem mental health and humanitarian intervention in Palabek refugee settlement, northern Uganda (2023) · cites this paper as Haroz et al. 2020
The Introduction says commonly implemented psychosocial support interventions have been evaluated less rigorously than mental-health treatments, and the Discussion reports that almost no psychosocial interventions have been studied multiple times. This supports the concern about a weak evidence base, but the paper does not establish that short-term psychological interventions are an example of programmes lacking evidence; it describes a growing evidence base for mental-health interventions. (LLM, conf=0.85)
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“Future research should focus on replication of well-described interventions in multiple different sites, to place future intervention selection on a more scientific basis (Haroz et al., 2020, p. 3).”
BackgroundTippens, J. A., Erwin, S., Eller, K., Gross, R. M. D., Bearss, B., Kemp, B. R., Mollard, E. K., Njiru, L., Okwarah, P., Palmer-Wackerly, A. L., et al. (2023) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-023-01516-y · Cited by 14 · see citing works
“examined 216 psychosocial programs in humanitarian settings and found no interventions targeting older adults [19].”
The social outcomes of psychosocial support: A grey literature scoping review
Ubels, T., Kinsbergen, S., Tolsma, J., & Koch, D. (2022) · SSM - Mental Health · doi:10.1016/j.ssmmh.2022.100074 · Cited by 13 · see citing works
Massazza, A., May, C. R., Roberts, B., Tol, W. A., Bogdanov, S., Nadkarni, A., & Fuhr, D. C. (2022) · Social Science & Medicine · doi:10.1016/j.socscimed.2022.114994 · Cited by 19 · see citing works
Self-citationGreene, M. C., Bonz, A. G., Cristobal, M., Angulo, A., Armijos, A., Guevara, M. E., Vega, C., Benavides, L., Corrales, C., de la Cruz, A., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.37 · Cited by 12 · see citing works
“Research on promotion and prevention interventions that emphasize the social dimensions of wellbeing is scant and often suffers frommethodological limitations (Haroz et al., 2020).”
BackgroundSelf-citationIm, H., Verbillis-Kolp, S., Atiyeh, S., Bonz, A. G., Eadeh, S., George, N., & Wadu, A. M. (2023) · Health & Social Care in the Community · doi:10.1155/2023/6696415 · Cited by 12 · see citing works
Bleile, A. C. E., Koppenol‐Gonzalez, G. V., Verreault, K., Abeling, K., Hofman, E., Vriend, W., Hasan, A., & Jordans, M. J. D. (2021) · International Journal of Mental Health Systems · doi:10.1186/s13033-021-00450-6 · Cited by 12 · see citing works
Martínez‐Torre, S., Carreño, C., Sordo, L., Llosa, A. E., Ousley, J., Waziri, A., Mathela, R., Umar, R. D., Usman, J., & Sagrado, M. J. (2022) · Conflict and Health · doi:10.1186/s13031-022-00473-x · Cited by 11 · see citing works
Frasco, E., Sherr, L., & Burgess, R. A. (2024) · Journal of Community & Applied Social Psychology · doi:10.1002/casp.2848 · Cited by 9 · see citing works
van Herpen, M. M., Dückers, M., Schaap, R., Olff, M., & Brake, H. T. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.832840 · Cited by 7 · see citing works
Nemiro, A., Jones, T., Tulloch, O., & Snider, L. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.6 · Cited by 7 · see citing works
“Reviews with a wider scope (e.g. Gouweloos et al., 2014; Pedersen et al., 2015; Jordans et al., 2016; Bangpan et al., 2019; Dickson and Bangpan, 2018; Haroz et al., 2020) have not combined their findings with an analysis of how this research has been taken up in policy and practice.”
BackgroundDückers, M. (2021) · Intervention · doi:10.4103/intv.intv_49_20 · Cited by 5 · see citing works
Nguyen, A. J., Russell, T., Skavenski, S. V. W., Bogdanov, S., Lomakina, K., Іванюк, І. В., Aldridge, L. R., Bolton, P. A., Murray, L. K., & Bass, J. (2023) · Global Health Science and Practice · doi:10.9745/ghsp-d-22-00488 · Cited by 11 · see citing works
Self-citationGreene, M. C., Wimer, G., Larrea, M., Jimenez, I. M., Armijos, A., Angulo, A., Guevara, M. E., Vega, C., Heard, E., Demis, L. Y., et al. (2024) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2024.29 · Cited by 5 · see citing works
“There is growing evidence supporting the effectiveness of community-based mental health and psychosocial interventions for (Bangpanetal.,2019;Turrini etal.,2019;Barbuietal.,2020;Harozetal.,2020),includingfor displacedandemergency-affectedpopulationsinLatinAmerica (Bonilla-Escobaretal.,2018;2023).”
BackgroundSelf-citationEl-Khodary, B., Christensen, I. R., Abou-Dagga, S. I., Raji, S., & Lyden, S. C. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.761303 · Cited by 4 · see citing works
“Educational approaches and interventions are requested (Haroz et al., 2020).”
BackgroundInfluentialFactors Influencing Improvement of Trauma-Related Symptoms Among Somali Refugee Youth in Urban Kenya
Im, H., & Swan, L. E. T. (2022) · Community Mental Health Journal · doi:10.1007/s10597-021-00928-0 · Cited by 4 · see citing works
“, 2019) and monitor and evaluate both the process and effectiveness of interventions (see Augustinavicius et al., 2018; Haroz et al., 2020; Tol et al., 2013), using rigorous and sustainable methods that are culturally informed and community-grounded.”
BackgroundThe Accumulating Evidence-Base Regarding Child Friendly Spaces: Policy and Practice Implications
Ager, A., & Metzler, J. (2022) · Intervention · doi:10.4103/intv.intv_12_22 · Cited by 4 · see citing works
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“…there is a relative lack of evidence for more prevention-oriented or low-intensity psychosocial programs aimed at improving or promoting mental health in humanitarian contexts in low-and middle-income countries, as demonstrated by an extensive systematic literature review (Haroz et al., 2020).”
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Lasater, M. E., Woldeyes, G. M., Roch, K. L., Poku, O. B., Phan, X., Bhardwaj, A., Kassa, G., Solomon-Osborne, A., & Murray, S. M. (2025) · Global Health Action · doi:10.1080/16549716.2025.2563422 · Cited by 3 · see citing works
“This review also noted that while individual-focused PSS were most frequently studied, they posed evaluation challenges as they were designed to be broad in nature (i.e. psychoeducation, mindfulness) and flexible in their use [13].”
Christensen, I. R. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1339332 · Cited by 2 · see citing works
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- Authors
- Haroz, E., Nguyen, A., Lee, C., Tol, W., Fine, S., & Bolton, P.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Haroz, EmilyE
- ORCID
- Bolton, Paul
- Venue
- Intervention
- Published
- 2020
- Volume
- 18
- Issue
- 1
- Pages
- 3
- ISSN
- 1571-8883 (ISSN-L)
- OpenAlex
- W3042651666
- Cited by
- 61
- References
- 0
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 8 · 2023: 20 · 2022: 16 · 2021: 7 · 2020: 1
- FWCI
- 1.35
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Intervention (publishedVersion, cc-by-nc-sa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- humanitarian settings, low- and middle-income countries, mental health interventions, program evaluation, intervention effectiveness, Problem Management Plus, child-friendly spaces, intervention replication
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