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The National Hospital Insurance Fund (NHIF) of Kenya was upgraded to improve access to healthcare for impoverished households, expand universal health coverage (UHC), and boost the uptake of essential reproductive, maternal, newborn and child health (RMNCH) services. However, premiums may be unaffordable for the poorest households. The Innovative P...
Contexts in source publication
Context 1
... description of the study sample Table 2 shows the baseline means of our main variables of interest in the treatment and control groups (see supplementary Table SA1 for means at midline and endline in the supplementary online material). To examine potential imbalance in baseline outcomes and covariates, separate balance tests were conducted for the baseline means of all variables by regressing the baseline outcome (or covariate) on a treatment indicator. ...Context 2
... examine potential imbalance in baseline outcomes and covariates, separate balance tests were conducted for the baseline means of all variables by regressing the baseline outcome (or covariate) on a treatment indicator. The findings (Table 2 final column) demonstrated that the differences between the treatment and control group at baseline were not statistically significant, except for one variable (short-acting contraceptive use, P = 0.054). This is to be expected, given the random assignment of communities to treatment arms. ...Context 3
... shows that the randomization process was effective. Table 2 panel A shows that nearly all women reported at least one ANC visit for their most recent live birth (97-100%) and a substantial share of women received four or more ANC visits (67-78%). Out of four common ANC services, a tetanus toxoid injection was least common (59-63%), while iron supplements, folic acid and malaria prevention measures were all reported by >90% of women. ...Context 4
... addition, less than half (42-50%) of newborns received a PNC check-up. Table 2 panel B shows that 45-50% of women aged 15 to 49 used some form of modern contraceptive, with the rate for short-acting contraceptives being lower in the control group at 17% compared to 28% in the treatment group (P = 0.054). The share of women using long-acting contraceptives was slightly higher in the control group (28%) than in the treatment group (22%) but not significantly different. ...Context 5
... 27-32% of women exhibited an unmet need for family planning at baseline. We observed 84-85% of children 0-59 months old sleeping under a bednet the day before the survey (Table 2 panel C). Among children aged 9-59 months, Health Policy and Planning, 2024, Vol. ...Citations
Objective
Armed conflicts cause substantial disruptions to health care systems, necessitating innovative approaches to crisis management. Systematic reviews play a critical role in evaluating adaptive health innovations implemented during such conflicts, shedding light on their impact on crisis management and health outcomes within affected communities.
Methods
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search in PubMed, Scopus, Cochrane Library, and Web of Science resulted in 5432 articles. The review covered studies published since 2000 that addressed crisis management innovations. A rigorous selection process based on PICO criteria was employed to include relevant high-quality studies.
Results
Following screening, 21 studies were identified, demonstrating considerable innovation in health systems in conflict-affected regions. The key innovations were decentralized management structures, community health worker programs, and mobile health units, all aimed at enhancing service delivery under difficult circumstances. In spite of this, persistent challenges like infrastructure destruction, limited resources, and security risks remain substantial obstacles to the availability of health care.
Discussion
Findings highlight the critical role played by resilient health systems in mitigating the negative effects related to armed conflicts. While some innovations are promising, problems like resource constraints, infrastructure destruction, and data collection challenges remain unresolved. The review’s strengths lie in its systematic nature and extensive coverage of the literature, while potential publication bias and language restrictions should be acknowledged as limitations.
Conclusions
The present review highlights the key role of adaptive health responses in crisis management and demands more research on their long-term effects and scalability. Future research must examine comparisons across a number of nations and utilize technology, including telemedicine and digital platforms, to strengthen health care resilience in areas impacted by conflict.
