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Data Collection Tools for Maternal and Child Health in Humanitarian Emergencies: An Updated Systematic Review

Published online by Cambridge University Press:  10 December 2019

Juliana Lima Constantino*
Affiliation:
Department of Epidemilogy and Biostatistics, Universidade Federal Fluminense, Niterói, Brazil
Fernanda Dias Romeiro
Affiliation:
Department of Epidemilogy and Biostatistics, Universidade Federal Fluminense, Niterói, Brazil
Theresa Diaz
Affiliation:
World Health Organization, Geneva, Switzerland
Allisyn C Moran
Affiliation:
World Health Organization, Geneva, Switzerland
Cynthia Boschi-Pinto
Affiliation:
Department of Epidemilogy and Biostatistics, Universidade Federal Fluminense, Niterói, Brazil
*
Correspondence and reprint requests to Juliana Lima Constantino MD, Universidade Federal Fluminense, Avenida Marques do Paraná, 303, Niterói, RJ, Brazil, 24033-900 (e-mail: jlconstantino@id.uff.br)
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Abstract

The worst rates of preventable mortality and morbidity among women and children occur in humanitarian settings. Reliable, easy-to-use, standardized, and efficient tools for data collection are needed to enable different organizations to plan and act in the most effective way. In 2015, the World Health Organization (WHO) commissioned a review of tools for data collection on the health of women and children in humanitarian emergencies. An update of this review was conducted to investigate whether the recommendations made were taken forward and to identify newly developed tools. Fifty-three studies and 5 new tools were identified. Only 1 study used 1 of the tools identified in our search. Little has been done in terms of the previous recommendations. Authors may not be aware of the availability of such tools and of the importance of documenting their data using the same methods as other researchers. Currently used tools may not be suitable for use in humanitarian settings or may not include the domains of the authors’ interests. The development of standardized instruments should be done with all key workers in the area and could be coordinated by the WHO.

Type
Systematic Review
Copyright
Copyright © 2019 World Health Organization under license to Disaster Medicine and Public Health Inc. Published by Cambridge University Press

A humanitarian emergency is an event, or series of events, that represents a critical threat to the health, safety, security, or well-being of a community or other large group of people, usually over a wide area. During such emergencies, maternal and child health continue to be overlooked, leading to staggering consequences and devastating health implications; the worst rates of preventable mortality and morbidity among women and children occur in humanitarian settings and other crises. 1,2 In 2015, over 75% of 84 million people in need of humanitarian assistance were women and children, the majority of whom were impoverished, which aggravates this scenario. Reference Sarah3

The need for high quality and timely information and research in humanitarian emergencies has been a topic of great discussion over the past several years. Recent high profile incidents have exposed gaps in knowledge about the health impacts of disasters or the benefits of specific interventions. Reference Miller, Yeskey, Garantziotis, Blake, Johnston and MacDonald4 In this context, besides funding an organized professional research network, reliable, easy-to-use, standardized, and efficient tools for data collection are needed to enable different organizations to plan and act in the most effective way.

In 2015, the World Health Organization (WHO) commissioned a review of data collection tools concerning the health of women and children in humanitarian emergencies. Reference Pyone, Dickinson and Kerr5 Tools that were available between 2000 and 2014 were identified and reviewed. For each study, the setting where tools were used, the types of data collected, and the type of tools used to collect the data were described. Recommendations were then proposed, including the development of a simplified, standardized tool. An update of the 2015 review to investigate whether this recommendation has been taken forward and to identify possible newly developed tools by type and purpose was conducted. This article describes data collection gaps and recommends the next steps to promote harmonized monitoring of the health status of mothers, newborns, and children under the age of 5 years in humanitarian settings and emergency situations. These tools and the data collected can be used to prioritize actions for programs. Differently from the previous review, this study does not include studies or tools on sexual and reproductive health because this subject will be studied separately for the sake of better clarity in each study field.

METHODS

Search Strategy

In order to update the previous review, the search strategy formerly used was reproduced and a systematic review according to the PRISMA guideline was conducted. 6 MEDLINE, Web of Knowledge, and POPLINE databases were searched for studies in all languages between July 1, 2014 and January 24, 2018. A search for the whole study period, that is, between January 1, 2000 and January 24, 2018, was conducted to amplify the search, adding new studies identified in all languages except English, because the previous review included studies in English only. LILACS was also searched in all languages for the whole study period, because this database had not been included in the previous review. The search incorporated the same medical subject heading (MeSH) terms, key words, and free text as in the 2015 review, excluding the terms regarding sexual and reproductive health. The terms used were “maternal,” “newborn,” “child/child health service*,” “pregnan*,” “neonat*,” under one search string and “disaster,” “post conflict,” “war,” “humanitarian,” “refugee,” “internally displaced” under another string. Similarly, the Boolean operator “OR” was used for the terms under each search string, and “AND” was used to combine both strings.

The website of organizations that work with humanitarian emergencies that were included in the previous search – CARE International, the Centers for Disease Control and Prevention, Harvard Humanitarian Initiative, the Inter-Agency Standing Committee, the International Federation of Red Cross and Red Crescent Societies (IFRC), Knowledge for Health (K4Health), Médecins Sans Frontières (MSF), the Office of the United Nations High Commissioner for Refugees, Oxfam, the Reproductive Health Response in Crises Consortium, Save the Children, the United Nations Population Fund (UNFPA), the Women’s Refugee Commission, WHO, and World Vision – were included in the search. Action Against Hunger, The Population Council, Surgeons Overseas, and The Measure Evaluation Program were also included. The snowballing process included reviewing the reference list and authors of the retained studies and the organizations websites and documents.

Inclusion and Exclusion Criteria

Only studies that described the development or use of data collection tools concerning maternal and child health in humanitarian emergency settings were included. This occurred even if the tools used were not specified or the methods were not described. Because sexual and reproductive health was not incorporated in the current study, sexual/gender-based violence, family planning, and sexually transmitted infections, including HIV/AIDS, were excluded from this review.

Two independent authors searched databases and websites, and if there was not consensus whether or not a study should be included, a third independent reviewer was consulted. First, the titles and abstracts of all studies were screened. Studies were then excluded if they did not meet the inclusion criteria. The ones that met the inclusion criteria were fully read to assess eligibility (Figure 1). Two reviewers summarized the information on tools used, type of data collected, and purpose of the study (Table 1). Data were classified into 2 categories: (1) maternal and newborn (0–28 days) health; and (2) infant (0–11 months) and child (12–59 months) health.

FIGURE 1 Flowchart for study selection.

TABLE 1 Summary Table of Included Studies

ANC = antenatal care; COPE = Coping Orientation to Problems Experienced; FCHV = female community health volunteers; GSF = Gynecologie Sans Frontieres; IDP = internally displaced person; IPV = intimate partner violence; KI = key-informant; NA = not applicable; PTE = potentially traumatic events; SBA = skilled birth attendants; TT = tetanus toxoid.

A narrative synthesis was used to summarize the studies that were included in our review. Reference Lucas, Baird and Arai7 A full report on the findings and methods was also prepared. The report also included a list of all studies that met and those that did not meet the inclusion criteria and all included tools. These are available upon request. Trends in the number of published studies from 2000 to 2017 were assessed statistically. The trend analysis was done using The Joinpoint Regression Analysis Program, version 4.6.0.0. 8

RESULTS

Of the 53 studies retained in the review, 49 reported the number of women and children included in the study sample. Of a total population of 134 889 individuals, 29 171 (22%) were women and 95 317 (71%) were newborns and children under age 5 years. The sample sizes varied from 11 (interviews with midwives regarding pregnant women health in Ebola centers) Reference Erland and Dahl9 to 28 996 (Technical report from the Food and Agriculture Organization of the United Nations assessing the prevalence of acute malnutrition amongst children and under-age-5 mortality rate). 10 Despite the inclusion of other languages, all studies that met the inclusion criteria and were retained were in English.

There was a mean of 5 studies published that used tools for the collection of data on maternal and child health in humanitarian settings per year during the period of January 2000 to July 2014. In the period of August 2014 to December 2017, the mean was of 15 studies per year. The trend analysis showed a significant 12% annual increase in the number of publications during the full period of 2000 to 2017 (Figure 2).

FIGURE 2 Distribution of natural disasters studies by country.

The previous review included 100 studies; however, 28 of them were not included in our analysis because they assessed only sexual and reproductive health. Among the total 125 studies on maternal, newborn, and child health (72 included in the previous review and 53 included in this one), 91 (73%) were related to manmade disasters, including armed conflicts, terrorist attacks, and nuclear accidents, whereas 33 (27%) were carried out following natural disasters or disease outbreaks, such as drought, earthquakes, floods, hurricanes, tsunami, ice storm, and Ebola outbreak. There was no difference in the proportion of the type of study between the 2 periods (74% manmade and 26% natural disaster in 2000–2014; and 73% manmade and 27% natural disaster in 2014–2017). That is, the nature of the emergency investigated remained similar through the years, with about 3 times more studies related to manmade disasters than to natural ones.

Table 1 and Figures 3 and 4 show the distribution of humanitarian emergency studies by country and type of emergency. Of the total 125 studies, only 2 (1.6%) were carried out in South America: 1 in Chile as a follow-up of the 2010 earthquake Reference Arbour, Murray, Yoshikawa, Arriet, Moraga and Vega11 and the other in Colombia regarding armed conflict and forced displacement settings. Reference Krause, Morris and McGinn12 Almost half (61/125) of the included studies were in Africa mostly on manmade disasters, and all referred to armed conflicts. Forty-three (34%) studies were in Asia and 10 (8%) in North America, mostly on natural disasters (9/10). The Democratic Republic of Congo was the single country with most studies regarding manmade disasters, a total of 11, whereas the United States was the country with the most reported studies on natural disasters, a total of 8 studies.

FIGURE 3 Distribution of natural disasters studies by country.

FIGURE 4 Distribution of natural disasters studies by country.

Similar to the findings from the previous review, studies that collected data during the disaster preparedness phase were not identified and were identified in the recovery phase only. Also, like the previous review, studies that had the primary aim of collecting data to support a funding request were not found. Table 2 shows that a variety of indicators were used in the collection of data in the included studies. Some used standardized toolkits for the monitoring and assessment of the situation; however, these tools were not necessarily specific to humanitarian emergencies.

TABLE 2 Data Collection Tools Used and Type of Data Collected for Maternal and Child Health During Humanitarian Emergencies

ANC = antenatal care; TT = tetanus toxoid.

In this updated review, 45 studies focused on the health status of the affected population, and 8 examined the availability and coverage of health services before, during, or after the emergency. Forty-two studies collected data for monitoring and evaluation, 5 were operational research, and 6 studies collected data for needs assessment. One study described a program to create new tools, protocols, networks of researchers, training exercises, and outreach involving diverse groups of stakeholders to help overcome the challenges of disaster research. Reference Miller, Yeskey, Garantziotis, Blake, Johnston and MacDonald4

Data Collection Tools

The previous review identified 17 data collection tools. Since then, 5 new tools were found, most of which consisted of questionnaires. 62-65 Four of the 5 new tools were identified through a search of organization websites; the fifth tool was used in 1 of the studies included in the review. One of the tools, which aimed to collect data on children’s well-being, used a qualitative approach 66 based on guided focus group discussions and interviews. One other tool was specific for post-disaster morbidity of pregnant women, 64 1 assessed both newborn and maternal health, 62 and 1 other focused on child health. 66 Two tools 63,65 were specific for the evaluation of the nutritional status of children during emergencies, including an easy-to-use compilation of tools to measure the nutritional needs during emergencies, at the onset of a crisis or during protracted crisis. 65 The only tool that focused on child health was in Spanish and was developed before 2014 but had not been included in the previous review. This tool, the Escala de Bienestar Infantil en Situación de Emergencia (Scale of Child Well-being in Emergency Situation), 66 was adapted from the Child Status Index 67 for use in Chile in areas affected by the earthquake in 2010. Reference Arbour, Murray, Yoshikawa, Arriet, Moraga and Vega11 In the previous review, no specific tool for children was identified, but rather 4 toolkits had questionnaires that included the collection of some data on child health data. Similar to what was found in the previous review, there was no specific tool identified for newborn health. For this group, data were collected together with those for maternal health.

Our review also identified documents that can be valuable for the development of a standardized data collection tool to be used in humanitarian emergencies, 68,69 because these instruments list essential indicators for women’s health during emergencies. However, only 1 Reference Arbour, Murray, Yoshikawa, Arriet, Moraga and Vega11 of the 53 newly identified studies reported the use of any of the 22 tools found in both reviews. Some studies based their research on the WHO Safe Motherhood Needs Assessment, the Countdown to 2015 indicators, the Surgeons OverSeas Assessment of Surgical Need, the Health Needs Assessment instrument, and the Field Tools and Monitoring and Evaluation Toolkit of the Reproductive Health Response in Conflict Consortium and the Inter-Agency Standing Committee guidelines. Table 3 describes the type of data collected, the approach, and methods of each tool.

TABLE 3 Summary of Data Collection Tools for Maternal and Child Health, Approaches, and Methods of Data Collection in Humanitarian Emergencies

DISCUSSION

This review, together with the previous one, provides the current panorama of the existing tools for data collection in humanitarian settings, as well as the published experience of the use of these tools, regarding maternal and child health. Only tools that were specific to data collection in humanitarian emergencies were included; therefore, all tools that are used in these settings may not have been included. Although most of the tools identified had been reported to have some use in the field during humanitarian emergencies, only 1 of the 53 studies included in our review actually used 1 of the tools identified in our search. Thus, there is still the need to advocate for the harmonization, standardization, and use of existing tools, taking into consideration cultural alignments that may be necessary. Tools that might be useful in this harmonization process were identified, such as the Health Indicators for Disaster-Affected Pregnant Women, Postpartum Women, and Infants 68 and the Guideline for Timed and Targeted Counselling (TTC) Data Collection and Reporting. 69 These documents represent an advance in an agreed core set of indicators for maternal and child health. However, a similar core set of indicators for newborn health is still needed. A tool specific for newborn health would be of great importance because this population is especially vulnerable during emergencies. 70 The Newborn Health in Humanitarian Settings Field Guide 71 could be useful in the development of such a tool, because it provides a series of important indicators on newborn health in humanitarian settings.

The majority of the newly identified studies (42/53) were used to monitor and evaluate ongoing interventions in humanitarian settings. Forty-five (85%) of them focused on the evaluation of health status. The increase in mass emergencies in recent years has highlighted the importance of rapid assessment of health needs for a better allocation of resources and relief management. As a result, the development of techniques for the rapid assessment of health needs has been identified as a priority for effective emergency action. Reference Guha-Sapir72 Despite previous recognition of the need for data collection on disaster preparedness or disaster response, Reference Pyone, Dickinson and Kerr5 no tools or studies on the subject were identified. So, the need to adapt or develop such a tool for this specific phase remains. The Rapid Health Assessment of Refugee or Displaced Populations 73 provides adequate methods for carrying out rapid health assessments and support in the analysis and interpretation of the results.

In this review, only 1 of the 53 included studies used any of the specific tools for data collection. In the previous review, among the 72 included studies, only 12 specified the use of any of the 17 identified tools. Authors may not be aware of the availability of such tools and of the importance of documenting their data using the same methods as other researchers. Also, tools may not be suitable for use in humanitarian settings or may not include the specific domains of the authors’ interests.

A recent study showed that practical information relating to data collection obtained directly from experienced researchers and field workers gave important perspectives regarding the methodology used to obtain information; the importance of language in the development and use of data collection tools; the variety of and need for adaptation of existing data collection tools; and the capacity of staff for data collection in emergency and humanitarian settings. Reference Dickinson, Pyone and van den Broek74 As advocated in the previous review, to spread the use of these tools among researchers, educational programs or trainings should include the use of these toolkits.

CONCLUSIONS

Since the publication of the previous review, very little has been done in terms of the recommendation to evaluate, standardize, and harmonize existing tools. On the contrary, 4 additional tools, newly developed during the last 3 and a half years, were identified. Therefore, the need to advocate remains for the harmonization of existing tools for data collection, for the use of such harmonized tools in studies in the field, and for the alignment of such tools for different types of culture, languages, and populations.

Studies in the field should contain a description of their experience in the use of the chosen data collection tool, its applicability, and the cultural adaptations required. The development of new, easy-to-use, and standardized tools and the adaptation of the existing ones should be done with all key workers in the area, because sharing and comparing information allows a clearer and more consistent picture to emerge, and could be coordinated by WHO.

Funding Statement

This work was funded by the World Health Organization, contract number 201950488.

Conflict of Interest Statement

The authors have no conflicts of interest to declare.

Disclaimer

The authors alone are responsible for the views expressed in this article, which does not necessarily represent the views, decisions, or policies of the institutions with which the authors are affiliated.

References

REFERENCES

UNICEF. Humanitarian action for children 2014. February 2014. www.unicef.org/gambia/Humanitarian_Action_for_Childen_2014_Overview.pdf. Accessed April 20, 2018.Google Scholar
United Nations Development Programme. UNDP fast facts: disaster risk reduction and recovery. April 2014. www.undp.org/content/undp/en/home/librarypage/results/fast_facts/fast-facts--disaster-risk-reduction-and-recovery.html. Accessed January 18, 2018.Google Scholar
Sarah, Z. Women’s, children’s, and adolescents’ health in humanitarian and other crises. BMJ. 2015;351:4346.Google Scholar
Miller, A, Yeskey, K, Garantziotis, S, et al. Integrating health research into disaster response: the new NIH Disaster Research Response Program. In: Blake, D, Johnston, DM, MacDonald, C, eds. Int J Environ Res Public Health. 2016;13(7):676. doi:10.3390/ijerph13070676.CrossRefGoogle Scholar
Pyone, T, Dickinson, F, Kerr, R, et al. Data collection tools for maternal and child health in humanitarian emergencies: a systematic review. Bull World Health Organ. 2015;93(9):648658A. doi:10.2471/BLT.14.148429.CrossRefGoogle ScholarPubMed
The PRISMA Statement. York, UK: Prospero. 2014. http://www.equator-network.org/reporting-guidelines/prisma/. Accessed November 20, 2017.Google Scholar
Lucas, PJ, Baird, J, Arai, L, et al. Worked examples of alternative methods for the synthesis of qualitative and quantitative research in systematic reviews. BMC Med Res Methodol. 2007;7(1):4. doi:10.1186/1471-2288-7-4.CrossRefGoogle ScholarPubMed
Joinpoint Regression Program, Version 4.6.0.0. Statistical Research and Applications Branch, National Cancer Institute, USA; 2018.Google Scholar
Erland, E, Dahl, B. Midwives’ experiences of caring for pregnant women admitted to Ebola centres in Sierra Leone. Midwifery. 2017;55:2328.10.1016/j.midw.2017.08.005CrossRefGoogle ScholarPubMed
Food and Agriculture Organization of the United Nations. Somalia nutrition analysis: Post Deyr 2014/15. Technical Series Report No. VII 58, March 5, 2015.Google Scholar
Arbour, M, Murray, KA, Yoshikawa, H, Arriet, F, Moraga, C, Vega, MAC. Emotional, physical, and social needs among 0-5-year-old children displaced by the 2010 Chilean earthquake: associated characteristics and exposures. Disasters. 2016;41(2):365387. doi:10.1111/disa.12197.CrossRefGoogle ScholarPubMed
Krause, S, Morris, C, McGinn, T. Displaced and desperate: assessment of reproductive health for Colombia’s internally displaced persons. New York: Women’s Commission for Refugee Women and Children, Reproductive Health for Refugees Consortium; 2003.Google Scholar
Sugawara, J, Hoshiai, T, Sato, K, et al. Impact of the Great East Japan Earthquake on regional obstetrical care in Miyagi Prefecture. Prehosp Disaster Med. 2016;31(3):255258.10.1017/S1049023X1600025XCrossRefGoogle ScholarPubMed
Harville, EW, Giarratano, G, Savage, J, et al. Birth outcomes in a disaster recovery environment: New Orleans women after Katrina. Matern Child Health J. 2015;19(11):25122522.10.1007/s10995-015-1772-4CrossRefGoogle Scholar
Bouchghoul, H, Hornez, E, Duval-Arnould, X, et al. Humanitarian obstetric care for refugees of the Syrian war. The first 6 months of experience of Gynécologie Sans Frontières in Zaatari Refugee Camp (Jordan). Acta Obstet Gynecol Scand. 2015;94(7):755759.10.1111/aogs.12638CrossRefGoogle Scholar
Kyozuka, H, Yasuda, S, Kawamura, M, et al. Impact of the Great East Japan Earthquake on feeding methods and newborn growth at 1 month postpartum: results from the Fukushima Health Management Survey. Radiat Environ Biophys. 2016;55:139146.CrossRefGoogle ScholarPubMed
Aakre, I, Lilleengen, AM, Lerseth Aarsand, M, et al. Infant feeding practices in the Saharawi refugee camps Algeria, a cross-sectional study among children from birth to six months of age. Int Breastfeed J. 2016;12:8.10.1186/s13006-016-0098-1CrossRefGoogle ScholarPubMed
Nidzvetska, S, Rodriguez-Llanes, JM, Aujoulat, I, et al. Maternal and child health of internally displaced persons in Ukraine: a qualitative study. In Tchounwou, PB, Efird, JT, Bith-Melander, P, eds. Int J Environ Res Public Health. 2017;14(1):54.10.3390/ijerph14010054CrossRefGoogle Scholar
Brunson, J. Maternal, newborn, and child health after the 2015 Nepal earthquakes: an investigation of the long-term gendered impacts of disasters. Matern Child Health J. 2017;21(12):22672273.10.1007/s10995-017-2350-8CrossRefGoogle ScholarPubMed
Hossain, SMM, Leidman, E, Kingori, J, et al. Nutritional situation among Syrian refugees hosted in Iraq, Jordan, and Lebanon: cross sectional surveys. Confl Health. 2016;10:26.10.1186/s13031-016-0093-6CrossRefGoogle ScholarPubMed
Ahamadani, FA, Louis, H, Ugwi, P, et al. Perinatal health care in a conflict-affected setting: evaluation of health-care services and newborn outcomes at a regional medical centre in Iraq. East Mediterr Health J. 2015;20(12):789795.10.26719/2014.20.12.789CrossRefGoogle Scholar
Mugo, NS, Dibley, MJ, Damundu, EY, et al. “The system here isn’t on patients’ side” – perspectives of women and men on the barriers to accessing and utilizing maternal healthcare services in South Sudan. BMC Health Serv Res. 2018;18(1):10.10.1186/s12913-017-2788-9CrossRefGoogle ScholarPubMed
Rees, SJ, Tol, W, Mohsin, M, et al. A high-risk group of pregnant women with elevated levels of conflict-related trauma, intimate partner violence, symptoms of depression and other forms of mental distress in post-conflict Timor-Leste. Transl Psychiatry. 2016;6:e725.CrossRefGoogle ScholarPubMed
Benage, M, Greenough, PG, Vinck, P, et al. An assessment of antenatal care among Syrian refugees in Lebanon. Confl Health. 2015;9:8.CrossRefGoogle ScholarPubMed
Dong, C, Ge, P, Ren, X, et al. Evaluating the micronutrient status of women of child-bearing age living in the rural disaster areas one year after Wenchuan earthquake. Asia Pac J Clin Nutr. 2014;23(4):671677.Google ScholarPubMed
Gilder, ME, Zin, TW, Wai, NS, et al. Gestational diabetes mellitus prevalence in Maela refugee camp on the Thai–Myanmar border: a clinical report. Global Health Action. 2014;7:10.3402/gha.v7.23887.10.3402/gha.v7.23887CrossRefGoogle Scholar
Corrêa, G, Das, M, Kovelamudi, R, et al. High burden of malaria and anemia among tribal pregnant women in a chronic conflict corridor in India. Confl Health. 2017;11:10.10.1186/s13031-017-0113-1CrossRefGoogle Scholar
Banks, T, Kang, J, Watts, I, et al. High hepatitis B seroprevalence and risk factors for infection in pregnant women on the Thailand-Myanmar border. J Infect Dev Ctries. 2016;10(4):384388.10.3855/jidc.7422CrossRefGoogle ScholarPubMed
Goto, A, Bromet, EJ, Fujimori, K, et al. Immediate effects of the Fukushima nuclear power plant disaster on depressive symptoms among mothers with infants: a prefectural-wide cross-sectional study from the Fukushima Health Management Survey. BMC Psychiatry. 2015;15:59.10.1186/s12888-015-0443-8CrossRefGoogle ScholarPubMed
Sato, M, Nakamura, Y, Atogami, F, et al. Immediate needs and concerns among pregnant women during and after Typhoon Haiyan (Yolanda). PLoS Curr. 2016;8.CrossRefGoogle Scholar
Anastasi, E, Borchert, M, Campbell, OMR, et al. Losing women along the path to safe motherhood: why is there such a gap between women’s use of antenatal care and skilled birth attendance? A mixed methods study in northern Uganda. BMC Pregnancy Childbirth. 2015;15:287.10.1186/s12884-015-0695-9CrossRefGoogle ScholarPubMed
Gizelis, TI, Karim, S, Østby, G, et al. Maternal health care in the time of Ebola: a mixed-method exploration of the impact of the epidemic on delivery services in Monrovia. World Dev. 2017;98:169178.10.1016/j.worlddev.2017.04.027CrossRefGoogle Scholar
Isosävi, S, Diab, SY, Kangaslampi, S, et al. Maternal trauma affects prenatal mental health and infant stress regulation among Palestinian dyads. Infant Ment Health J. 2017;38(5):617633.10.1002/imhj.21658CrossRefGoogle ScholarPubMed
Silove, D, Rees, S, Tay, AK, et al. Pathways to perinatal depressive symptoms after mass conflict in Timor-Leste: a modelling analysis using cross-sectional data. Lancet Psychiatry. 2015;2(2):161167.10.1016/S2215-0366(14)00054-6CrossRefGoogle ScholarPubMed
Brock, RL, O’Hara, MW, Hart, KJ, et al. Peritraumatic distress mediates the effect of severity of disaster exposure on perinatal depression: the Iowa Flood Study. J Trauma Stress. 2015;28(6):515522.10.1002/jts.22056CrossRefGoogle ScholarPubMed
Massad, S, Khammash, U, Shute, R. Political violence and mental health of Bedouin children in the West Bank, Palestine: a cross-sectional study. Med Confl Surviv. 2017;33(3):188206.10.1080/13623699.2017.1368307CrossRefGoogle ScholarPubMed
Sriskandarajah, V, Neuner, F, Catani, C. Predictors of violence against children in Tamil families in northern Sri Lanka. Soc Sci Med. 2015;146:257265.10.1016/j.socscimed.2015.10.010CrossRefGoogle ScholarPubMed
El Kishawi, RR, Soo, KL, Abed, YA, Muda, WAMW. Prevalence and associated factors influencing stunting in children aged 2–5 years in the Gaza Strip-Palestine: a cross-sectional study. BMC Pediatrics. 2017;17:210.10.1186/s12887-017-0957-yCrossRefGoogle ScholarPubMed
Alemayehu, A, Gedefaw, L, Yemane, T, et al. Prevalence, severity, and determinant factors of anemia among pregnant women in South Sudanese Refugees, Pugnido, Western Ethiopia. Anemia. 2016;2016 9817358.10.1155/2016/9817358CrossRefGoogle ScholarPubMed
Hoogenboom, G, Thwin, MM, Velink, K, et al. Quality of intrapartum care by skilled birth attendants in a refugee clinic on the Thai-Myanmar border: a survey using WHO Safe Motherhood Needs Assessment. BMC Pregnancy Childbirth. 2015;15:17.10.1186/s12884-015-0444-0CrossRefGoogle Scholar
Adam, IF, Nakamura, K, Kizuki, M, et al Relationship between implementing interpersonal communication and mass education campaigns in emergency settings and use of reproductive healthcare services: evidence from Darfur, Sudan. BMJ Open. 2015;5:e008285.10.1136/bmjopen-2015-008285CrossRefGoogle ScholarPubMed
Oni, O, Harville, E, Xiong, X, et al. Relationships among stress coping styles and pregnancy complications among women exposed to Hurricane Katrina. J Obstet Gynecol Neonatal Nurs. 2015;44(2):256267.CrossRefGoogle ScholarPubMed
Maheen, H, Hoban, E. Rural women’s experience of living and giving birth in relief camps in Pakistan. PLoS Curr. 2017;9.10.1371/currents.dis.7285361a16eefbeddacc8599f326a1ddCrossRefGoogle Scholar
Laplante, DP, Brunet, A, King, S. The effects of maternal stress and illness during pregnancy on infant temperament: Project Ice Storm. Pediatr Res. 2016;79(1–1):107113.10.1038/pr.2015.177CrossRefGoogle ScholarPubMed
Adam, IF. The influence of maternal health education on the place of delivery in conflict settings of Darfur, Sudan. Confl Health. 2015;9:31.10.1186/s13031-015-0057-2CrossRefGoogle ScholarPubMed
Pham, K, Sharpe, EC, Weiss, WM, et al. The use of a lot quality assurance sampling methodology to assess and manage primary health interventions in conflict-affected West Darfur, Sudan. Popul Health Metr. 2016;14:34.10.1186/s12963-016-0103-3CrossRefGoogle ScholarPubMed
Ing, H, Fellmeth, G, White, J, et al. Validation of the Edinburgh Postnatal Depression Scale (EPDS) on the Thai-Myanmar border. Trop Doct. 2017;47(4):339347.CrossRefGoogle ScholarPubMed
Leidman, E, Tromble, E, Yermina, A, et al. Acute malnutrition among children, mortality, and humanitarian interventions in conflict-affected regions – Nigeria, October 2016–March 2017. MMWR Morb Mortal Wkly Rep. 2017;66(48):13321335.10.15585/mmwr.mm6648a4CrossRefGoogle Scholar
Dawson-Hahn, EE, Pak-Gorstein, S, Hoopes, AJ, et al. Comparison of the nutritional status of overseas refugee children with low income children in Washington State. PLoS One. 2016;11(1):e0147854.10.1371/journal.pone.0147854CrossRefGoogle ScholarPubMed
Bilukha, OO, Jayasekaran, D, Burton, A, et al. Nutritional status of women and child refugees from Syria-Jordan, April–May 2014. MMWR Morbid Mortal Wkly Rep. 2014;63(29);638639.Google ScholarPubMed
Carlson, LC, Lafta, R, Al-Shatari, S, et al. Pediatric injury during conflict and prolonged insecurity in Iraq from 2003–2014. Surgery. 2016;160(2):493500.10.1016/j.surg.2016.03.022CrossRefGoogle ScholarPubMed
Borba, CPC, Ng, LC, Stevenson, A, et al. A mental health needs assessment of children and adolescents in post-conflict Liberia: results from a quantitative key-informant survey. Int J Culture Ment Health. 2016;9(1):5670.10.1080/17542863.2015.1106569CrossRefGoogle ScholarPubMed
Longobardi, C, Veronesi, TG, Prino, LE. Abuses, resilience, behavioural problems and post-traumatic stress symptoms among unaccompanied migrant minors: an Italian cross-sectional exploratory study. Psychiatr Psychol Klin. 2017;17(2): 8792.10.15557/PiPK.2017.0009CrossRefGoogle Scholar
Fredricks, K, Dinh, H, Kusi, M, et al. Community health workers and disasters: lessons learned from the 2015 earthquake in Nepal. Prehosp Disaster Med. 2017;32(6):604609.10.1017/S1049023X1700680XCrossRefGoogle ScholarPubMed
Doocy, S, Lyles, E, Akhu-Zaheya, L, et al. Health service utilization and access to medicines among Syrian refugee children in Jordan. Int J Health Plann Manage. 2016;31(1):97112.CrossRefGoogle ScholarPubMed
Van den Berg, MM, Madi, HH, Khader, A, et al. Increasing neonatal mortality among Palestine refugees in the Gaza Strip. In: Correa-Velez, I, ed. PLoS One. 2015;10(8):e0135092.CrossRefGoogle Scholar
Flynn-O’Brien, KT, Trelles, M, Dominguez, L, et al. Surgery for children in low-income countries affected by humanitarian emergencies from 2008 to 2014: The Médecins Sans Frontières Operations Centre Brussels experience. J Pediatr Surg. 2016;51(4):659669.10.1016/j.jpedsurg.2015.08.063CrossRefGoogle Scholar
Stark, L, Asghar, K, Meyer, S, et al. The effect of gender norms on the association between violence and hope among girls in the Democratic Republic of the Congo. Global Ment Health. 2017;4:e1.10.1017/gmh.2016.31CrossRefGoogle ScholarPubMed
Invisible wounds: the impact of six years of war on the m ental health of Syria’s children. Save the Children. 2017. https://www.savethechildren.org.uk/content/dam/global/reports/emergency-humanitarian-response/invisible-wounds.pdf. Accessed January 22, 2018.Google Scholar
Amone-P’Olak, K, Jones, P, Meiser-Stedman, R, et al. War experiences, general functioning and barriers to care among former child soldiers in Northern Uganda: the WAYS study. J Public Health (Oxf). 2014;36(4):568576.10.1093/pubmed/fdt126CrossRefGoogle ScholarPubMed
Scott, J, Mullen, C, Rouhani, S, et al. A qualitative analysis of psychosocial outcomes among women with sexual violence-related pregnancies in eastern Democratic Republic of Congo. Int J Ment Health Syst. 2017;11:64.10.1186/s13033-017-0171-1CrossRefGoogle ScholarPubMed
CDC Reproductive Health Assessment Questionnaire – Pregn ant and postpartum women. Centers for Disease Control and Prevention. 2014. https://www.cdc.gov/reproductivehealth/emergency/. Accessed January 22, 2018.Google Scholar
Measuring mortality, nutritional status, and food security in crisis situations: SMART methodology. SMART Manual Version 2, 2017.Google Scholar
Collecting supplemental information on pregnant women when conducting post-disaster morbidity surveillance. Centers for Disease Control and Prevention. 2017. https://www.cdc.gov/reproductivehealth/emergency/pdfs/Sample-Protocol-Post-Disaster-Data-Collection-Strategies.pdf. Accessed January 21, 2018.Google Scholar
CMAM Toolkit: rapid start-up resources for emergency nutrition personnel. Save the Children. 2017. https://www.fsnnetwork.org/updated-cmam-toolkit-webinar-rapid-start-resources-emergency-nutrition-personnel. Accessed October 23, 2019.Google Scholar
Escala de Bienestar Infantil en situación de emergencia – EBI. Chile. Santiago de Chile; Chile. Sistema de Protección Integral a la Infancia Crece Contigo, UNICEF Chile; 2010:36.Google Scholar
Child Status Index Tool Kit. 2nd ed. Agency for International Development. 2013. https://www.measureevaluation.org/resources/tools/ovc/child-status-index/child-status-index-tool-kit. Accessed January 18, 2018.Google Scholar
CDC. Health indicators for disaster-affected pregnant and postpartum women and infants. Atlanta, GA: Division of Reproductive Health, National Center for Chronic Disease Prevention & Health Promotion, Centers for Disease Control & Prevention; 2013.Google Scholar
A Guideline for ttC Data Collection and Reporting. World Vision International. 2016. https://www.wvi.org/sites/default/files/Guidance%20on%20TTC%20Data%20Collection%20and%20Reporting.pdf. Accessed January 22, 2018.Google Scholar
Status of Women and Infants in Complex Humanitarian Emergencies – Gasseer. J Midwifery; Women’s Health – Wiley Online Library; 2004.Google Scholar
Newborn Health in Humanitarian Settings Field Guide. United Nations Children’s Fund and Save the Children. 2018. https://www.healthynewbornnetwork.org/hnn-content/uploads/NewBornHealthBook-Production2017-V4b-Press.pdf. Accessed January 21, 2018.Google Scholar
Guha-Sapir, D1. Rapid assessment of health needs in mass emergencies: review of current concepts and methods. World Health Stat Q. 1991;44(3):171181.Google ScholarPubMed
Rapid health assessment of refugee or displaced populations. 3rd ed. 2006. Médecins Sans Frontières. http://refbooks.msf.org/msf_docs/en/rapid_health/rapid_health_en.pdf. Accessed January 21, 2018.Google Scholar
Dickinson, FM, Pyone, T, van den Broek, N. Experiences from the field: maternal, reproductive and child health data collection in humanitarian and emergency situations. Int Health. 2016;8(2):8388. doi:10.1093/inthealth/ihv045.CrossRefGoogle ScholarPubMed
Figure 0

FIGURE 1 Flowchart for study selection.

Figure 1

TABLE 1 Summary Table of Included Studies

Figure 2

FIGURE 2 Distribution of natural disasters studies by country.

Figure 3

FIGURE 3 Distribution of natural disasters studies by country.

Figure 4

FIGURE 4 Distribution of natural disasters studies by country.

Figure 5

TABLE 2 Data Collection Tools Used and Type of Data Collected for Maternal and Child Health During Humanitarian Emergencies

Figure 6

TABLE 3 Summary of Data Collection Tools for Maternal and Child Health, Approaches, and Methods of Data Collection in Humanitarian Emergencies