PDF(Pubmed)
Abstract：
BACKGROUND: The COVID-19 pandemic posed considerable risks to populations affected by humanitarian crises in low- and middle-income countries (LMICs). However, there is limited understanding of how the pandemic may have affected non-COVID health outcomes among crisis-affected populations. Our aim was to examine the evidence on the impact of the COVID-19 pandemic on non-COVID-19 health outcomes for crisis-affected populations in LMICs.
METHODS: A systematic review methodology was applied following PRISMA guidelines. Eligibility criteria were: crisis-affected populations in LMICS; COVID-19; and all health topics, except for sexual and reproductive health which was covered in a linked review. Five bibliographic databases and additional grey literature sources were searched. The search period was from 2019 to 31 July 2022. Eligible papers were extracted and analysed using a narrative synthesis approach based on the study objectives and relevant health access and systems frameworks. A quality appraisal was also conducted.
RESULTS: 4320 articles were screened, and 15 eligible studies were identified and included in this review. Ten studies collected health outcomes data. Eight related to mental health, which generally showed worse mental health outcomes because of the pandemic, and pandemic-related stressors were identified. Two studies assessed physical health outcomes in children, while none addressed physical health outcomes among adults. Nine studies reported on access to healthcare, revealing worse access levels due to the pandemic and noting key barriers to care. Seven studies reported on the impact on health systems, with key challenges including reduced and distorted health care funding, reduced staff capacity, interrupted medicines and supplies, weak information and mixed-messaging, and weak leadership. All fifteen studies on the social determinants of health, particularly highlighting the effect of increasing poverty, the role of gender, and food insecurity on health outcomes. The quality of papers was limited overall.
CONCLUSIONS: This review found some limited evidence indicating negative mental health effects, increased barriers to accessing care, damage to health systems and magnified impacts on the social determinants of health for crisis-affected people during the COVID-19 pandemic. However, the small number and limited quality of the studies make the overall strength of evidence quite weak.
METHODS: A systematic review methodology was applied following PRISMA guidelines. Eligibility criteria were: crisis-affected populations in LMICS; COVID-19; and all health topics, except for sexual and reproductive health which was covered in a linked review. Five bibliographic databases and additional grey literature sources were searched. The search period was from 2019 to 31 July 2022. Eligible papers were extracted and analysed using a narrative synthesis approach based on the study objectives and relevant health access and systems frameworks. A quality appraisal was also conducted.
RESULTS: 4320 articles were screened, and 15 eligible studies were identified and included in this review. Ten studies collected health outcomes data. Eight related to mental health, which generally showed worse mental health outcomes because of the pandemic, and pandemic-related stressors were identified. Two studies assessed physical health outcomes in children, while none addressed physical health outcomes among adults. Nine studies reported on access to healthcare, revealing worse access levels due to the pandemic and noting key barriers to care. Seven studies reported on the impact on health systems, with key challenges including reduced and distorted health care funding, reduced staff capacity, interrupted medicines and supplies, weak information and mixed-messaging, and weak leadership. All fifteen studies on the social determinants of health, particularly highlighting the effect of increasing poverty, the role of gender, and food insecurity on health outcomes. The quality of papers was limited overall.
CONCLUSIONS: This review found some limited evidence indicating negative mental health effects, increased barriers to accessing care, damage to health systems and magnified impacts on the social determinants of health for crisis-affected people during the COVID-19 pandemic. However, the small number and limited quality of the studies make the overall strength of evidence quite weak.
摘要：
背景：COVID-19大流行给中低收入国家（LMICs）受人道主义危机影响的人群带来了相当大的风险。然而,对于大流行如何影响受危机影响人群的非COVID健康结局的了解有限.我们的目的是研究COVID-19大流行对中低收入国家受危机影响人群的非COVID-19健康结果的影响的证据。
方法：按照PRISMA指南应用系统评价方法。资格标准为：LMICS受危机影响的人群；COVID-19；以及所有健康主题，但相关审查涵盖的性健康和生殖健康除外。搜索了五个书目数据库和其他灰色文献来源。搜索期为2019年至2022年7月31日。根据研究目标和相关的健康访问和系统框架，使用叙述综合方法提取和分析了符合条件的论文。还进行了质量评估。
结果：筛选了4320篇文章，15项符合条件的研究被纳入本综述.10项研究收集了健康结果数据。八个与心理健康有关，由于大流行，通常表现出更糟糕的心理健康结果，并确定了与大流行相关的应激源。两项研究评估了儿童的身体健康结果，虽然没有解决成年人的身体健康结果。九项研究报告了获得医疗保健的机会，揭示了由于大流行而导致的更低的获取水平，并注意到护理的关键障碍。七项研究报告了对卫生系统的影响，主要挑战包括减少和扭曲的医疗保健资金，减少员工能力，中断药品和用品，信息薄弱和消息混杂，领导能力薄弱。关于健康社会决定因素的所有15项研究，特别强调贫困加剧的影响，性别的作用，和粮食不安全对健康结果的影响。论文的质量总体上是有限的。
结论：本综述发现一些有限的证据表明对心理健康有负面影响，获得护理的障碍增加，在COVID-19大流行期间，对卫生系统的损害和对受危机影响人群健康的社会决定因素的扩大影响。然而,研究数量少，质量有限，总体证据强度相当弱。
方法：按照PRISMA指南应用系统评价方法。资格标准为：LMICS受危机影响的人群；COVID-19；以及所有健康主题，但相关审查涵盖的性健康和生殖健康除外。搜索了五个书目数据库和其他灰色文献来源。搜索期为2019年至2022年7月31日。根据研究目标和相关的健康访问和系统框架，使用叙述综合方法提取和分析了符合条件的论文。还进行了质量评估。
结果：筛选了4320篇文章，15项符合条件的研究被纳入本综述.10项研究收集了健康结果数据。八个与心理健康有关，由于大流行，通常表现出更糟糕的心理健康结果，并确定了与大流行相关的应激源。两项研究评估了儿童的身体健康结果，虽然没有解决成年人的身体健康结果。九项研究报告了获得医疗保健的机会，揭示了由于大流行而导致的更低的获取水平，并注意到护理的关键障碍。七项研究报告了对卫生系统的影响，主要挑战包括减少和扭曲的医疗保健资金，减少员工能力，中断药品和用品，信息薄弱和消息混杂，领导能力薄弱。关于健康社会决定因素的所有15项研究，特别强调贫困加剧的影响，性别的作用，和粮食不安全对健康结果的影响。论文的质量总体上是有限的。
结论：本综述发现一些有限的证据表明对心理健康有负面影响，获得护理的障碍增加，在COVID-19大流行期间，对卫生系统的损害和对受危机影响人群健康的社会决定因素的扩大影响。然而,研究数量少，质量有限，总体证据强度相当弱。
