The Humanitarian Health Evidence Review

Study design

• More evidence is needed on the effectiveness and cost-effectiveness of rehabilitative interventions. More before and after studies are needed to assess the impact of interventions.
• There is a need for more high quality, methodologically robust, evidence and studies that assess long-term health outcomes. While there is a reasonable quantity of evidence related to injury, much of this evidence is low quality, cross-sectional in nature, and conducted by clinical practitioners.
• Follow-up studies would enable better assessment of long-term health outcomes, functionality, and quality of life (e.g. standardised assessment forms for physical function as well as environmental factors in disaster victims to enable comparative research). In particular, there is a lack of high-quality evidence related to the effect of rehabilitative interventions on physical disabilities.
• More research is needed to better understand the mechanisms that enable a continuum of care as programmes transition from the acute to the longer term, development phase.

Indicators, standards, and guidelines

• Research is needed to develop appropriate quality standards and measurements of service performance.

Context

• More research should be conducted during crises in Africa and the Americas in order to develop and evidence base for context-specific interventions.
• More evidence must be collected following natural disasters, as illustrated by the response to the 2010 Haitian Earthquake.
• More evidence must be collected related to physical rehabilitation in refugee camp contexts.
• More studies are needed that evaluate interventions in the preparedness phase, and the subsequent impact they have on health outcomes.

Delivery of health interventions

• More research is needed on how to integrate rehabilitation into the general health system, and how to integrate local services in the delivery of humanitarian health interventions.
• More research is needed to understand the complexity of mainstreaming disability into humanitarian health interventions.