Coordinating the Provision of Health Services in Humanitarian Crises: a Systematic Review of Suggested Models.

Tamara Lotfi,Chaza Akik,Andrea Darzi,Fadi El-Jardali,Mira Itani,Hneine Brax,Ghayda Hassan,Elie Akl,Ahmed El Rahyel,Mona Osman,Rayan Hajjar,Lama Bou-Karroum,Jamale El Eid

doi:10.1371/currents.dis.95e78d5a93bbf99fca68be64826575fa

Tamara Lotfi, Chaza Akik + Show 11 more

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https://doi.org/10.1371/currents.dis.95e78d5a93bbf99fca68be64826575fa

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Abstract

Background: Our objective was to identify published models of coordination between entities funding or delivering health services in humanitarian crises, whether the coordination took place during or after the crises.Methods: We included reports describing models of coordination in sufficient detail to allow reproducibility. We also included reports describing implementation of identified models, as case studies. We searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library. We also searched websites of relevant organizations. We followed standard systematic review methodology.Results: Our search captured 14,309 citations. The screening process identified 34 eligible papers describing five models of coordination of delivering health services: the “Cluster Approach” (with 16 case studies), the 4Ws “Who is Where, When, doing What” mapping tool (with four case studies), the “Sphere Project” (with two case studies), the “5x5” model (with one case study), and the “model of information coordination” (with one case study). The 4Ws and the 5x5 focus on coordination of services for mental health, the remaining models do not focus on a specific health topic. The Cluster approach appears to be the most widely used. One case study was a mixed implementation of the Cluster approach and the Sphere model. We identified no model of coordination for funding of health service.Conclusion: This systematic review identified five proposed coordination models that have been implemented by entities funding or delivering health service in humanitarian crises. There is a need to compare the effect of these different models on outcomes such as availability of and access to health services.

Highlights

Our objective was to identify published models of coordination between entities funding or delivering health services in humanitarian crises, whether the coordination took place during or after the crises
The lack of coordination between stakeholders complicated food delivery in the humanitarian crises in Iraq, Darfur and Palestine.[7]. Another example is the response to the Haiti earthquake, which was described as worst natural disaster in modern history, that lacked coordination and resources.[8]
Of the 14,309 citations identified by the electronic literature search, 34 papers met our inclusion criteria and described five models of coordination of delivering health services: the Cluster approach8,9,1132 ; the 4Ws “Who is Where, When, doing What” mapping tool 3336; the Sphere project 9,23,37,38; the 5x5 model 39; and a model of information coordination[40]

Summary

Introduction

Our objective was to identify published models of coordination between entities funding or delivering health services in humanitarian crises, whether the coordination took place during or after the crises. There is evidence of lack of coordination between organizations providing health services in public health emergencies.[4,6] For example, the lack of coordination between stakeholders complicated food delivery in the humanitarian crises in Iraq, Darfur and Palestine.[7] Another example is the response to the Haiti earthquake, which was described as worst natural disaster in modern history, that lacked coordination and resources.[8]

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Conclusion