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WHO guidance for refugees in camps: systematic review

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Blundell, Harriet ORCID: https://orcid.org/0000-0003-0139-2547, Milligan, Rachael, Norris, Susan L and Garner, Paul ORCID: https://orcid.org/0000-0002-0607-6941 (2019) 'WHO guidance for refugees in camps: systematic review'. BMJ Open, Vol 9, Issue 9, e027094.

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Abstract

Objectives The circumstances of people living in refugee camps means that they have distinct medical care requirements. Our objective is to describe clinical guidance in published WHO guidelines that refer to people living in refugee camps; and how evidence and context are used and reported in making recommendations.

Design Systematic review and analysis of WHO guidelines approved by the organisation’s quality oversight body and published between 2007 and 2018. We sought for key terms related to camps and humanitarian settings, and identified text that included guidance. We compared this to Mèdecins Sans Frontièrs (MSF) guidelines.

Results No WHO guideline published in the last 10 years focused exclusively on clinical guidance for healthcare in camp settings. Seven guidelines contained guidance about camps; three made recommendations for camps—but only two used formal evidence summaries. We did not find any structured consideration of the situation in camps used in the decision-making process. We examined seven WHO guidelines and six chapters within guidelines that concerned humanitarian settings: none of these documents contained recommendations based on formal evidence summaries for camp settings. One of the eight MSF guidelines was devoted to clinical care in refugees and the authors had clearly linked the health problems and recommendations to the setting, but this guideline is now >20 years old.

Conclusions There is an absence of up-to-date, evidence-based medical treatment guidelines from WHO and MSF that comprehensively address the clinical needs for people living in camps; and there is no common framework to help guideline groups formulate recommendations in these settings. WHO may wish to consider context of special populations more formally in the evidence to decision-making approach for clinical guidelines relevant to primary care.

Item Type: Article
Subjects: WA Public Health > WA 100 General works
WA Public Health > Health Problems of Special Population Groups > WA 300 General. Refugees
WA Public Health > WA 4 Works on general hygiene
WA Public Health > Health Administration and Organization > WA 530 International health administration
WA Public Health > Statistics. Surveys > WA 950 Theory or methods of medical statistics. Epidemiologic methods
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1136/bmjopen-2018-027094
Depositing User: Christianne Esparza
Date Deposited: 06 Sep 2019 09:16
Last Modified: 06 Sep 2019 10:16
URI: https://archive.lstmed.ac.uk/id/eprint/11995

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