MAPPING AND IDENTIFYING BARRIERS AND FACILITATORS TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT INTERVENTIONS FOR WAR-AFFECTED CHILDREN.

Abstract

Aim: to map MHPSS interventions for war-affected children, and to identify the barriers and facilitators for interventions target¬ing different layers of the MHPSS pyramid; to assess differences in methodology and study design to give a general outlook for potential future evaluation of interventions. Materials and methods: A scoping review was conducted by utilising PubMed, Scopus, PsychINFO scientific databases (765 articles were found). In addition to IASC MHPSS intervention pyramid as our framework, we used a combination of inductive and de¬ductive coding to find common themes in facilitators and barriers to the effectiveness of interventions within each layer. To geographically illustrate the locations of war-affected areas and their correlating intervention types, we developed a visual map. Conclusions: The phenomenon of unequal distribution of interventions (concentrated in West Asia, North and sub-Saharan Africa, with no interventions (found in literature) in South American or South-East Asia). III-rd level of IASC MHPSS Pyramid "focused, non-specialized supports", received great deal of efforts in MHPSS interventions conducted for children in war-affected areas. Main barriers: increasing trauma-related symptoms; lack of parental or caregiver support impaired successful intervention out¬comes for war-affected children; lack of political will and financial resources, difficulties in priority-setting, or an insufficient health workforce ongoing conflicts. Main facilitators: culturally appropriate design and collaboration with local stakeholders; caregiver involvement in interventions for war-affected children.