Community Health Participatory interventions in the prevention and control of non-communicable diseases including mental health in crisis-affected Low-and Middle-Income Countries – a scoping review

TL;DR

This review explores how community-based health interventions can help manage non-communicable diseases in crisis-affected low- and middle-income countries.

Contribution

The study provides a comprehensive overview of CHP interventions for NCDs in crisis settings, highlighting strategies and challenges.

Findings

CHP interventions are increasingly used in both urban and rural areas to empower communities for NCD prevention.

Mental health is a primary focus, but other NCDs and risk factors are also being addressed.

Barriers include limited resources and socio-cultural constraints, while facilitators involve community leadership and cultural adaptations.

Abstract

The rising burden of Non-Communicable Diseases (NCDs) requires a comprehensive strategy by integrating community-based interventions – especially in Low- and Middle-Income Countries (LMICs). Over the past decade, researchers have emphasized communities as key agents of change in health systems. While Community Health Participatory (CHP) interventions show promise in NCD management, their application in crisis-affected contexts remains underexplored. This scoping review examines the adoption of CHP interventions, strategies employed, their barriers and facilitators encountered in crisis-affected LMICs to prevent and control NCDs. Utilising the Arksey and O’Malley framework, comprehensive search was conducted across PubMed, Web of Science, Scopus, and Google Scholar. Primary studies and grey literature in English were included focusing on CHP interventions among adults in such settings. Studies on unrelated health issues, review articles, protocols, and conference abstracts were excluded. Data extraction was conducted using Covidence, with discrepancies resolved through consensus. The narrative analysis of the extracted data was conducted. The review identified varied CHP interventions, with the majority focusing on mental health. The included studies highlighted the role of community engagement and stakeholders’ involvement. Strategies included raising awareness, providing social support and focusing on lifestyle modifications. Barriers to interventions included limited resources, socio-cultural constraints, and logistical challenges, while facilitators involved community leadership and ownership, empathy, cultural adaptations of interventions, and multi-sectoral collaboration.

CHP interventions represent a promising strategy for tackling NCDs in crisis-affected LMICs, however, limited evidence on their long-term impact needs further research.

This review was registered on the Open Science Framework and funding was provided by NIHR-UK (NIHR203248).

Main finding: Community Health Participatory interventions are increasingly applied in both urban and rural settings, utilizing varied strategies while maintaining community involvement as a core element to enhance empowerment for Non-Communicable Disease prevention and control.Added knowledge: This review underscores the emerging focus on Non-Communicable Disease prevention and control in crisis-affected Low- and Middle-Income Countries, expanding beyond mental health to include other Non-Communicable Diseases and related risk factors.Global health impact for policy and action: Integrating Community Health Participatory interventions into crisis-response strategies presents a significant opportunity for Non-Communicable Diseases prevention and control in Low- and Middle-Income Countries, strengthening health system resilience and fostering community cohesion in crisis-affected settings.

Main finding: Community Health Participatory interventions are increasingly applied in both urban and rural settings, utilizing varied strategies while maintaining community involvement as a core element to enhance empowerment for Non-Communicable Disease prevention and control.

Added knowledge: This review underscores the emerging focus on Non-Communicable Disease prevention and control in crisis-affected Low- and Middle-Income Countries, expanding beyond mental health to include other Non-Communicable Diseases and related risk factors.

Global health impact for policy and action: Integrating Community Health Participatory interventions into crisis-response strategies presents a significant opportunity for Non-Communicable Diseases prevention and control in Low- and Middle-Income Countries, strengthening health system resilience and fostering community cohesion in crisis-affected settings.

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