The impacts of natural disasters, epidemics and pandemics on women’s health in the Pacific: a narrative synthesis

Abstract

Background: The Pacific region has an inherent vulnerability to natural disasters, epidemics and pandemics. The aim of this review was to examine the impact of natural disasters and epidemics on women’s health in the Pacific Island region. Natural disasters include events such as flooding, cyclones, earthquakes, volcanic eruptions and sea level rise. Epidemics and pandemics include events such as zika virus and COVID-19. The Pacific region includes the islands of Melanesia, Micronesia and Polynesia in the Pacific Ocean. Methods: An abstract and title search was performed in the following databases: SCOPUS, PubMed, Web of Science, CINAHL and the Hawaii Pacific Journal Index database. Manuscripts were identified using a search strategy that included keywords for natural disaster, epidemic and pandemic, women’s health and Pacific Island United Nations Small Island Developing States (SIDS) names. Duplicates and articles not relevant to the aim of this review were excluded. No limitation was placed on date or document type for the purpose of the search, however only original articles were included in the review. Findings: A total of 850 abstracts were identified; 106 were excluded as duplicates or not relevant. Nine original articles were included in the review, published between 2003 and 2019. A narrative synthesis was undertaken given the heterogenous nature of the studies. Studies evaluated the impact of events including a volcanic eruption and cyclone affecting Vanuatu, a dengue virus epidemic in New Caledonia, HIV in Papua New Guinea and Zika virus in French Polynesia. Themes identified included women’s special vulnerability, a negative reproductive impact, adverse maternity and infant impacts, psychological distress, food insecurity and health workforce shortage issues. Conclusion: A limited number of studies were found, and the findings vary depending on the nature of the event, study population and resources available.  All studies described negative impacts. Key areas to focus on are the health workforce, in particular mental health support, food security and antenatal care. Findings may not be generalisable and more research on the impact of natural disasters and epidemics on women’s health in the Pacific is required to inform local responses and aid efforts.