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5 Results for Contextual Factors

5.3 Health assessment methods

5.3.1 Health assessment methods

  • The search strategy on this contextual factor captured 663 related peer-reviewed articles, the vast majority of which (580) either did not discuss humanitarian crises or did not consider health assessment methods in such situations.
  • There is a relatively modest body of available evidence considering health assessment methods during humanitarian crises (83 papers).
  • There is increasing interest in the methodologies of assessment, evaluation and estimation of health and health- related factors during humanitarian crises, with 63/83 (76%) of all studies conducted since 1980 being published in the last decade.
  • The majority of available evidence is of low to moderate quality: 13/83 (16%) of papers were from category C evidence, 36/83 (43%) were from category B, and 34/83 (41%) were from category A.
  • All studies were observational. 16/83 (19%) of studies were descriptive in design and of these 9/16 (56%) were comparative. 67/83 (81%) employed a cross-sectional design and of these 13/67 (19%) were comparative. In the comparative studies, the points of comparison included assessment methods within different settings, different affected populations, and between different assessment methodologies themselves.
  • Of the location-identified research on health assessment methods during humanitarian crises, the most commonly studied region was Asia (29/83, 35%), followed by Africa (26/83, 31%), then the Middle East (11/83, 13%). The most commonly studied countries were Afghanistan and Thailand (six papers each), followed by Iraq, Pakistan, Sudan and Uganda (five papers each). A further 8/83 (10%) papers considered multiple (more than two) different countries across regions.
  • Evidence for the different types of humanitarian crises focused heavily on armed conflict: 60/83 (72%) considered these; 20/83 (24%) considered natural disasters, in particular earthquakes (8) and tsunamis (4); and 3/83 (4%) considered both types of crises.
  • Most papers (46/83, 55%) focused on the general population, 16/83 (19%) considered IDP, 15/83 (18%) considered refugees, and 6/83 (7%) included more than one population type.
  • Most papers (45/83, 54%) considered both urban and rural settings, 34/83 (41%) considered only the rural setting, and 4/83 (5%) considered only the urban environment.
  • Regarding the types of public health interventions, 68/83 (82%) articles used health assessment methods for care planning. 9/83 (11%) articles assessed health in the context of the use of existing health services. 3/83 (4%) articles studied health assessment methods to inform aspects of disaster preparedness.
  • Excess mortality and morbidity was the health topic most assessed in these studies (26/83, 31%), followed closely by nutrition and food security (25/83, 30%). 19/83 (23%) studies assessed mental health, 8/83 (10%) assessed basic or general health, and 3/83 (4%) focused on population estimation.
  • A large array of different health assessment methods was studied covering a range of health topics. Within each health topic, there was little consistency in the assessment methods used with the exception of two health topics: nutrition and mental health. Of the nutritional assessment methods, anthropometric measurements (such as weight-for-height in children) were almost universally used. Of the mental health assessment methods, several assessment scales or checklists were used in more than one study: the Hopkins Symptoms Checklist was used in five studies, and the Harvard Trauma Questionnaire, Depression Self-Rating Scale, SF-36 Health Survey and Afghan Symptom Checklist (ASCL) were each used in two studies.
  • Concerning stage of crisis, 42/83 (51%) studies focused on the acute phase, 13/83 (16%) on early recovery, and 28/83 (34%) on chronic situations.
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