A forgotten group duringhumanitarian crises: a systematic review of sexual and reproductive healthinterventions for young people including adolescents in humanitarian settings

by Lauren Jennings, Asha S George, Tanya Jacobs, KarlBlanchet, Neha S Singh

Conflict and Health, Vol 13, Article 57, 27 November 2019  DOI: 10.1186/s13031-019-0240-y (Open access)

Background: Young people including adolescentsface barriers to healthcare and increased risk of poor sexual and reproductivehealth (SRH), which are exacerbated in humanitarian settings. Our systematicreview assessed the evidence on SRH interventions for young people includingadolescents in humanitarian settings, strategies to increase their utilisationand their effects on health outcomes.

Methods: We searched peer-reviewed and greyliterature published between 1980 and 2018 using search terms for adolescents,young people, humanitarian crises in low- and middle- income countries and SRHin four databases and relevant websites. We analysed literature matchingpre-defined inclusion criteria using narrative synthesis methodology, andappraised for study quality.

Findings: We found nine peer-reviewed and fivegrey literature articles, the majority published post-2012 and mostly high- ormedium-quality, focusing on prevention of unintended pregnancies, HIV/STIs,maternal and newborn health, and prevention of sexual and gender-basedviolence. We found no studies on prevention of mother-to-child transmission(PMTCT), safe abortion, post-abortion care, urogenital fistulae or femalegenital mutilation (FGM). Thirteen studies reported positive effects onoutcomes (majority were positive changes in knowledge and attitudes), sevenstudies reported no effects in some SRH outcomes measured, and one studyreported a decrease in number of new and repeat FP clients. Strategies toincrease intervention utilisation by young people include adolescent-friendlyspaces, peer workers, school-based activities, and involving young people.

Discussion: Young people, including adolescents,continue to be a neglected group in humanitarian settings. While we foundevidence that some SRH interventions for young people are being implemented, thereare insufficient details of specific intervention components and outcomemeasurements to adequately map these interventions. Efforts to address this keypopulation’s SRH needs and evaluate effective implementation modalities requireurgent attention. Specifically, greater quantity and quality of evidence onprogrammatic implementation of these interventions are needed, especially forcomprehensive abortion care, PMTCT, urogenital fistulae, FGM, and for LGBTQIpopulations and persons with disabilities. If embedded within a broader SRHprogramme, implementers and/or researchers should include young people-specificstrategies, targeted at both girls/women and boys/men where appropriate, andcollect age- and sex-disaggregated data to help ascertain if this population’sdiverse needs are being addressed.

Notes: Forfurther sources, see Table 3 in the paper: Characteristics and key findings ofstudies.

This paper was included in a review by the Inter-AgencyWorking Group on Reproductive Health in Crises in November 2019.

PHOTO: UNOffice for the Coordination of Humanitarian Affairs (UNOCHA), 24 September2018