Challenges in access and provision of medical aid for children after natural disasters in low and lower-middle income countries : a scoping review

Abstract

Background: The impact of natural disasters on human populations has become an area of particular interest in global health. Climatic changes have led to an increased frequency of such catastrophes. Although the number of disasters in high income versus low and lower-middle income countries does not differ much, the number of people affected by them are disproportionately larger in low and lower-middle income countries. These countries are also home to majority of the children population in the world and the impacts of natural disasters are particularly challenging for them. The low resources of these countries are put to test in disasters, requiring international aid to alleviate the effects of the disaster. Medical aid appears to be a key component to address the healthcare of the affected population, placing even more importance on children. However, challenges exist which need to be identified and addressed.

Aim: To capture and map the current state of knowledge and to identify gaps in knowledge regarding accessibility of medical aid for children.

Methods: The nature of the research question led to implementation of a scoping review. This allowed incorporation of grey literature along with peer reviewed published literature for the analysis. Scoping review was conducted in six steps, (i) identifying the research question, (ii) identifying relevant studies, (iii) study selection, (iv) charting the data, (v) collating, summarizing and reporting the results, (vi) consultations. Consultations were carried out at Save the Children Sweden Stockholm Office where a two month internship period was also completed during the study period.

Results: A thematic analysis of the findings was done using the SDH for health inequities framework to organize the findings and are presented in combination with the discussion due to the narrative nature of the analysis. Firstly, there is a lack of policies at government and organization level for stratification of medical aid for children. Secondly, exposure of the children population to a natural disaster differs in different contexts, but the recognized effects have not been incorporated into policy development. Thirdly, vulnerabilities of children, which might be worsened, are not taken into account during provision of medical aid due to lack of policies to prioritize them.

Conclusion: There is a significant gap in knowledge regarding medical aid provision for children and the related challenges in the aftermath of a natural disaster. It also points to inequities experienced by children which needs global attention. Policies need to be established to prioritize children after natural disasters to improve provision of medical aid.