PDF(Pubmed)
Abstract：
UNASSIGNED: The global population impacted by humanitarian crises continues to break records each year, leaving strained and fractured health systems reliant upon humanitarian assistance in more than 60 countries. Yet little is known about implementation of maternal and perinatal death surveillance and response (MPDSR) within crisis-affected contexts. This scoping review aimed to synthesise evidence on the implementation of MPDSR and related death review interventions in humanitarian settings.
UNASSIGNED: We searched for peer-reviewed and grey literature in English and French published in 2016-22 that reported on MPDSR and related death review interventions within humanitarian settings. We screened and reviewed 1405 records, among which we identified 25 peer-reviewed articles and 11 reports. We then used content and thematic analysis to understand the adoption, appropriateness, fidelity, penetration, and sustainability of these interventions.
UNASSIGNED: Across the 36 records, 33 unique programmes reported on 37 interventions within humanitarian contexts in 27 countries, representing 69% of the countries with a 2023 United Nations humanitarian appeal. Most identified programmes focussed on maternal death interventions; were in the pilot or early-mid implementation phases (1-5 years); and had limited integration within health systems. While we identified substantive documentation of MPDSR and related death review interventions, extensive gaps in evidence remain pertaining to the adoption, fidelity, penetration, and sustainability of these interventions. Across humanitarian contexts, implementation was influenced by severe resource limitations, variable leadership, pervasive blame culture, and mistrust within communities.
UNASSIGNED: Emergent MPDSR implementation dynamics show a complex interplay between humanitarian actors, communities, and health systems, worthy of in-depth investigation. Future mixed methods research evaluating the gamut of identified MPDSR programmes in humanitarian contexts will greatly bolster the evidence base. Investment in comparative health systems research to understand how best to adapt MPDSR and related death review interventions to humanitarian contexts is a crucial next step.
UNASSIGNED: We searched for peer-reviewed and grey literature in English and French published in 2016-22 that reported on MPDSR and related death review interventions within humanitarian settings. We screened and reviewed 1405 records, among which we identified 25 peer-reviewed articles and 11 reports. We then used content and thematic analysis to understand the adoption, appropriateness, fidelity, penetration, and sustainability of these interventions.
UNASSIGNED: Across the 36 records, 33 unique programmes reported on 37 interventions within humanitarian contexts in 27 countries, representing 69% of the countries with a 2023 United Nations humanitarian appeal. Most identified programmes focussed on maternal death interventions; were in the pilot or early-mid implementation phases (1-5 years); and had limited integration within health systems. While we identified substantive documentation of MPDSR and related death review interventions, extensive gaps in evidence remain pertaining to the adoption, fidelity, penetration, and sustainability of these interventions. Across humanitarian contexts, implementation was influenced by severe resource limitations, variable leadership, pervasive blame culture, and mistrust within communities.
UNASSIGNED: Emergent MPDSR implementation dynamics show a complex interplay between humanitarian actors, communities, and health systems, worthy of in-depth investigation. Future mixed methods research evaluating the gamut of identified MPDSR programmes in humanitarian contexts will greatly bolster the evidence base. Investment in comparative health systems research to understand how best to adapt MPDSR and related death review interventions to humanitarian contexts is a crucial next step.
摘要：
受人道主义危机影响的全球人口每年都在不断打破纪录，使紧张和破碎的卫生系统依赖于60多个国家的人道主义援助。然而，在受危机影响的情况下，对孕产妇和围产期死亡监测和响应（MPDSR）的实施知之甚少。此范围审查旨在综合有关在人道主义环境中实施MPDSR和相关死亡审查干预措施的证据。
■我们搜索了2016-22年出版的英文和法文的同行评审和灰色文献，这些文献报道了人道主义环境下的MPDSR和相关死亡审查干预措施。我们筛选并审查了1405条记录，其中我们确定了25篇同行评审的文章和11篇报告.然后，我们使用内容和主题分析来了解采用情况，适当性，保真度，穿透力,以及这些干预措施的可持续性。
■在36条记录中，33个独特的方案报告了27个国家在人道主义背景下的37项干预措施，占2023年联合国人道主义呼吁的国家的69％。大多数已确定的方案侧重于孕产妇死亡干预措施；处于试点或早期中期实施阶段（1-5年）；在卫生系统中的整合有限。虽然我们确定了MPDSR和相关死亡评估干预措施的实质性文件，与收养有关的证据仍然存在巨大差距，保真度，穿透力,以及这些干预措施的可持续性。在人道主义背景下，实施受到严重的资源限制的影响，可变领导力，无处不在的指责文化，和社区内的不信任。
■紧急MPDSR实施动态显示了人道主义行为者之间复杂的相互作用，社区,和卫生系统，值得深入研究。未来的混合方法研究评估人道主义背景下已确定的MPDSR计划的范围将极大地增强证据基础。投资于比较卫生系统研究，以了解如何最好地将MPDSR和相关的死亡审查干预措施适应人道主义背景是至关重要的下一步。
■我们搜索了2016-22年出版的英文和法文的同行评审和灰色文献，这些文献报道了人道主义环境下的MPDSR和相关死亡审查干预措施。我们筛选并审查了1405条记录，其中我们确定了25篇同行评审的文章和11篇报告.然后，我们使用内容和主题分析来了解采用情况，适当性，保真度，穿透力,以及这些干预措施的可持续性。
■在36条记录中，33个独特的方案报告了27个国家在人道主义背景下的37项干预措施，占2023年联合国人道主义呼吁的国家的69％。大多数已确定的方案侧重于孕产妇死亡干预措施；处于试点或早期中期实施阶段（1-5年）；在卫生系统中的整合有限。虽然我们确定了MPDSR和相关死亡评估干预措施的实质性文件，与收养有关的证据仍然存在巨大差距，保真度，穿透力,以及这些干预措施的可持续性。在人道主义背景下，实施受到严重的资源限制的影响，可变领导力，无处不在的指责文化，和社区内的不信任。
■紧急MPDSR实施动态显示了人道主义行为者之间复杂的相互作用，社区,和卫生系统，值得深入研究。未来的混合方法研究评估人道主义背景下已确定的MPDSR计划的范围将极大地增强证据基础。投资于比较卫生系统研究，以了解如何最好地将MPDSR和相关的死亡审查干预措施适应人道主义背景是至关重要的下一步。
