Abstract
BACKGROUND: Non-communicable diseases (NCDs) encounter significant challenges in humanitarian emergencies due to limited resources and disrupted health systems. Systematic reviews can provide valuable insights into the effectiveness of interventions for NCDs in these settings. This overview aims to synthesize and critically appraise the current body of evidence from systematic reviews on public health interventions for NCDs in humanitarian emergencies. METHODS: We conducted an overview of systematic reviews following the Cochrane guidelines for Overviews of Reviews and the Preferred Reporting Items for Overviews of Reviews (PRIOR). We searched four electronic databases (PubMed, Medline, Scopus, and Global Health) for relevant systematic reviews. We extracted and synthesized data on interventions and outcomes from systematic reviews focusing on cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. We performed a narrative synthesis and used A Measurement Tool to Assess Systematic Reviews (AMSTAR 2) to evaluate the methodological quality of the included systematic reviews. RESULTS: Our search yielded 1,993 citations. Sixteen systematic reviews met our inclusion criteria and were included in the analysis. Six systematic reviews focused on multiple NCDs and combined interventions, five on cancer, five on diabetes, two on cardiovascular diseases, and there were no reviews on chronic respiratory diseases. The included systematic reviews highlighted the effectiveness of interventions such as electronic health records (EHRs) and primary healthcare for managing NCDs. Culturally tailored interventions involving community members and religious leaders were also found to be promising, particularly in improving cancer screening outcomes. Numerous barriers to implementation were also noted, and these included financial, logistical, and cultural challenges. Nonetheless, the overall quality of the included systematic reviews was low, with 81% being rated as "critically low confidence". CONCLUSIONS: This overview provides a comprehensive synthesis of the current evidence on interventions for NCDs in humanitarian emergencies. While certain interventions show promise, the quality of evidence is generally low. Future systematic reviews should prioritize implementing rigorous methods and transparent reporting. Additionally, more studies are needed to examine the cost-effectiveness of interventions, as evidence on costs and cost-effectiveness was almost non-existent. PROTOCOL REGISTRATION: The protocol was registered on the Open Science Framework (OSF) and can be accessed at [ https://doi.org/10.17605/OSF.IO/HF4QN ].