Challenges and opportunities for implementation of substance misuse interventions in conflict-affected populations.
Challenges and opportunities for implementation of substance misuse interventions in conflict-affected populations.
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DOI：
10.1186/s12954-018-0267-1
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发表时间：
2018-11-28
影响因子：
4.4
通讯作者：
Tol WA
中科院分区：
文献类型：
--
作者：
Greene MC;Kane JC;Khoshnood K;Ventevogel P;Tol WA
酗酒和滥用其他药物是受冲突影响人口中重要但被忽视的公共卫生问题。在这篇文章中，我们回顾了在低收入和中等收入国家的冲突和冲突后环境中实施药物滥用治疗和预防服务的挑战和战略的文献。我们确定了9项研究，描述了对居住在阿富汗、克罗地亚、印度、肯尼亚、科索沃、巴基斯坦和泰国的受冲突影响人口的干预措施。这9项研究中有6项侧重于难民人口。报告揭示了在实施干预措施方面的挑战，以及我们认为在实施组织的内部和外部环境中存在的有希望的做法和对未来实施的建议。外部环境中存在的挑战包括政治优先程度低、缺乏协调和一体化，以及对获得药物滥用服务的宣传有限。内部环境中的挑战涉及相互竞争的优先事项和供应商短缺。资源的限制存在于内部和外部环境中。污名化是一个挑战，威胁到物质使用服务的实施和利用的情况下，物质使用的干预措施不符合系统或执行组织的作用，结构，价值观和权威。未来的研究应侧重于制定，应用和评估克服这些挑战的战略，以取得进展，满足受冲突影响的人群对药物滥用服务的需求。
Alcohol and other drug misuse are significant but neglected public health issues in conflict-affected populations. In this article, we review the literature on the challenges and strategies for implementing substance misuse treatment and prevention services in conflict and post-conflict settings in low- and middle-income countries. We identified nine studies describing interventions in conflict-affected populations residing in Afghanistan, Croatia, India, Kenya, Kosovo, Pakistan, and Thailand. Six of these nine studies focused on refugee populations. Reports revealed challenges to intervention implementation, as well as promising practices and recommendations for future implementation that we characterized as existing in the inner and outer contexts of an implementing organization. Challenges existing in the outer context included low political prioritization, lack of coordination and integration, and limited advocacy for access to substance misuse services. Challenges within the inner context related to competing priorities and a shortage of providers. Resource limitations existed in both the inner and outer contexts. Stigma was a challenge that threatened implementation and utilization of substance use services in situations when substance use interventions were not congruent with the roles, structure, values, and authority of the system or implementing organization. Future research should focus on developing, applying, and evaluating strategies for overcoming these challenges in order to make progress toward meeting the need for substance misuse services in conflict-affected populations.
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影响因子：
3.5
作者：
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