A scoping review of the wider and long-term impacts of attacks on healthcare in conflict zones

摘要

Attacks on health care in conflict zones are widespread and show no signs of relenting. Since 2011 several organizations have systemically collected data of these attacks and revealed their scale. However, little is known of the consequences of these attacks. The purpose of this scoping review was to explore the literature on attacks on health care in conflict zones to understand what is known of the wider and long-term impacts. Using the Arksey and O'Malley framework we identified 233 articles for inclusion. Extracting descriptions of impacts, we were able to categorize this information into 15 broad themes. However, there are limitations in the data collection on impacts. Firstly it is not systemically collected after every attack or in all regions where attacks take place. Secondly, this data stops short of working down the chain of impacts to describe the full range of consequences. Lastly, the literature does not often distinguish between the impacts of attacks on health care and the impact of conflict on health. Discussion is needed as to how we define and understand attacks on health care and therefore the impacts of these attacks. Systematic methods for data collection on the impacts of attacks on healthcare are also needed to produce comprehensive data sets.