Health interventions implemented in post-disaster South Asia: A scoping review

Abstract

Increasing in frequency and impact worldwide, disasters (both man-made and natural) continue to affect millions of people each year. According to the United Nations Economic and Social Commission for Asia and the Pacific, floods are the most frequent disaster with the largest economic impact in South Asia. This paper identifies theoretical models, types of health issues, and the qualitative and quantitative approaches used for health interventions implemented in South Asia post-disaster. It also locates gaps in the implemented public health interventions, research studies and evaluation of interventions.We conducted a scoping review by searching PubMed, ProQuest Research Library, ProQuest Health Management, Social Sciences Full Text (H.W. Wilson), Sociological Abstracts, PsycINFO, Communication & Mass Media Complete, Academic Search Premier, Communication Abstracts, PAIS International, and Google from January 2006 to April 2021. We found and included experimental, quasi-experimental, qualitative and observational studies (empirical research) that described the implementation of a health intervention, and had a South Asia focus as well as a well-defined outcome with scope for replication. Two reviewers screened and abstracted articles independently. The data were charted, and a narrative review of the results was made.After screening 2532 titles and abstracts, 84 studies reported in 64 publications were retrieved. From the 84 studies 66 articles were rejected leaving 18 studies that were chosen for the scoping review. A majority of the interventions implemented psychosocial rehabilitation programs (n = 6) using community-based participatory approaches (n = 10). Programs relayed information through both interpersonal (n = 1) and mass communication (n = 2). The interventions that were conceived keeping the local cultural context (n = 9) in view were more successful. Issues that need to be resolved in future interventions include the need to engage disempowered groups such as women and to address sexual and reproductive issues (n = 2). Despite evidence of infectious disease (n = 2), none of the studies focused on its treatment or prevention. Findings strongly suggested the prevalence of mental health issues (n = 10) among victims of disaster and the urgent need to address psychiatric disorders. Only one study (n = 1) developed protocols for the rehabilitation of physically impaired earthquake victims.We found that a few studies used theories from psychosocial care and communication and applied quantitative and qualitative methods in designing health interventions in post-disaster South Asia. Most of the studies focused on psychosocial rehabilitation because there was recurrent evidence of mental health issues among victims of disasters. Future research could focus on the gaps identified in this study: developing, implementing, and evaluating, psychosocial capacity-building measures, and developing community mental health systems and skills training.