Health care workers in conflict and post-conflict settings: Systematic mapping of the evidence
Health care workers in conflict and post-conflict settings: Systematic mapping of the evidence
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DOI：
10.1371/journal.pone.0233757
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发表时间：
2020-05-29
期刊：
影响因子：
3.7
通讯作者：
Akl, Elie A.
中科院分区：
文献类型：
--
作者：
Bou-Karroum, Lama;El-Harakeh, Amena;Akl, Elie A.
卫生保健工作者对于在冲突地区提供卫生保健服务和在冲突后重建卫生系统至关重要。目的本研究的目的是系统地识别和绘制关于冲突和冲突后环境中卫生保健工作者的已发表证据。我们的最终目标是向研究人员和资助者通报这一主题的研究差距，并通过向相关利益攸关方提供有关全球范围内冲突和冲突后环境中卫生保健武器的综合证据资源，为他们提供支持。方法对相关文献进行系统梳理。我们纳入了广泛的研究设计，涉及在冲突或冲突后环境中提供卫生服务的任何类型的人员。我们对纳入论文的一般特征进行了描述性分析，并根据国家、研究设计和主题构建了两个交互式系统地图。结果在13,863个已确定的引用中，我们总共纳入了474项研究：304项关于冲突环境，149项关于冲突后环境，21项关于冲突和冲突后环境。对于冲突环境，研究最多的国家是伊拉克（15%）、叙利亚（15%）、以色列（10%）和巴勒斯坦（9%）。最常见的出版物类型是冲突环境下的观点文章（39%）和冲突后环境下的初步研究（33%）。此外，第一作者和通讯作者大多来自与论文重点国家不同的国家。对卫生工作者的暴力行为是报告冲突环境的论文中涉及最多的主题，而报告冲突后环境的论文中涉及最多的主题是劳动力绩效。冲突和冲突后环境下的大多数论文都没有报告资金来源（81%和53%）或作者的利益冲突（73%和62%），大约一半的初步研究没有报告伦理批准（45%和41%）。这一系统测绘提供了一个关于全球冲突和冲突后环境中卫生保健工的综合证据数据库，通常需要为有效的劳动力规划和管理以及减少移民的政策和战略提供信息。它还可用于确定与政策相关问题的证据、指导未来初级研究的知识差距和知识集群。
BackgroundHealth care workers (HCWs) are essential for the delivery of health care services in conflict areas and in rebuilding health systems post-conflict.ObjectiveThe aim of this study was to systematically identify and map the published evidence on HCWs in conflict and post-conflict settings. Our ultimate aim is to inform researchers and funders on research gap on this subject and support relevant stakeholders by providing them with a comprehensive resource of evidence about HCWs in conflict and post-conflict settings on a global scale.MethodsWe conducted a systematic mapping of the literature. We included a wide range of study designs, addressing any type of personnel providing health services in either conflict or post-conflict settings. We conducted a descriptive analysis of the general characteristics of the included papers and built two interactive systematic maps organized by country, study design and theme.ResultsOut of 13,863 identified citations, we included a total of 474 studies: 304 on conflict settings, 149 on post-conflict settings, and 21 on both conflict and post-conflict settings. For conflict settings, the most studied counties were Iraq (15%), Syria (15%), Israel (10%), and the State of Palestine (9%). The most common types of publication were opinion pieces in conflict settings (39%), and primary studies (33%) in post-conflict settings. In addition, most of the first and corresponding authors were affiliated with countries different from the country focus of the paper. Violence against health workers was the most tackled theme of papers reporting on conflict settings, while workforce performance was the most addressed theme by papers reporting on post-conflict settings. The majority of papers in both conflict and post-conflict settings did not report funding sources (81% and 53%) or conflicts of interest of authors (73% and 62%), and around half of primary studies did not report on ethical approvals (45% and 41%).ConclusionsThis systematic mapping provides a comprehensive database of evidence about HCWs in conflict and post-conflict settings on a global scale that is often needed to inform policies and strategies on effective workforce planning and management and in reducing emigration. It can also be used to identify evidence for policy-relevant questions, knowledge gaps to direct future primary research, and knowledge clusters.