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5 Results for Contextual Factors

5.5 Security of healthcare workers

5.5.1 Security of healthcare workers

  • The search strategy on this contextual factor captured a modest number of related peer-reviewed articles (344), the vast majority of which (328) either did not discuss humanitarian crises or did not consider the impact of security of healthcare workers on a public health intervention during crisis.
  • There is very limited available evidence assessing the impact of security of healthcare workers on the effectiveness of health interventions during humanitarian crises (16 papers).
  • There is increasing interest in the characterisation of the impact of security of healthcare workers on health interventions during humanitarian crises, with 11/16 (69%) of all studies conducted since 1980 being published in the last decade.
  • The large majority of available evidence is of low to moderate quality: 12/16 (75%) of papers were from category C evidence; 2/16 (13%) were from category B; and only 2/16 (13%) were from category A.
  • All studies were observational. The large majority (14/16, 88%) were descriptive in design; the remaining (2/16, 13%) were cross-sectional. No studies were comparative.
  • Of the location-identified research on the security of healthcare workers in humanitarian crises, Afghanistan, Iraq and Jordan had 2/16 (13%) articles specifically written on each of them; 1 article out of 16 (6%) studied Pakistan specifically. Indeed, these countries have been affected by some of the most violent armed conflicts in recent history. The remaining 9/16 (57%) studies considered multiple (more than two) different countries across regions.
  • All studies considered the security of healthcare workers in armed conflict; of these, 3/16 (19%) studies also considered natural disasters.
  • Nearly all papers (14/16, 88%) focused on the general population; just 2/16 (13%) considered only refugees. No studies considered only IDPs.
  • Nearly all papers (14/16, 88%) considered both urban and rural settings; just 2/16 (13%) considered rural settings alone. There were no studies on urban settings alone.
  • Evidence on the security of healthcare workers public health interventions during humanitarian crises concentrated around four main themes. The first, examined by 6/16 (38%) of the studies, is the different forms of violence faced by healthcare workers, including murder, gun violence, kidnappings and physical threats. The second theme, considered by 5/16 (31%) studies, is strategies on how security of healthcare workers could be improved. The third, considered by 3/16 (19%), is how violence against healthcare workers decimates health systems. Finally, 2/16 (13%) studies explored methods of measuring violence towards healthcare workers during humanitarian crises.
  • Regarding the types of public health interventions 10/16 (63%) articles considered security of healthcare workers in settings of international medical assistance or existing services supplemented by international intervention. The remaining articles (6/16, 38%) considered security of healthcare workers in local existing medical services only.
  • Basic, general, emergency and primary healthcare services together formed the public healthcare area most studied regarding security of healthcare workers (15/16, 94%). One paper considered the health topic of obstetric services specifically.
  • Concerning stage of crisis, 4/16 (25%) studies focused on the acute phase, none (0%) on early recovery, and the vast majority (8/16, 75%) on chronic situations.
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