What do we want to know?
This evidence summary attempts to summarise the review-level evidence on the effectiveness of disaster management approaches in low and middle income countries, and to contextualize the evidence. Interventions have been systematically reviewed as per four phases of disaster management cycle – the 4 Rs (risk mitigation, response readiness, response execution, and recovery).
Who wants to know and why?
The systematic reviews included in this evidence summary cover a wide range of interventions but they vary in their approach, size (number of studies included), scope and method of synthesis. Hence, this evidence summary aims to provide policy-makers with a reliable basis for informed decision-making regarding the applicability and transferability of different disaster management interventions to South Asian settings, with particular emphasis on Bangladesh.
What did we find?
Out of 4,365 studies identified in the extensive search of electronic databases and websites of relevant organizations, 47 systematic reviews were included for analysis and synthesis post applying inclusion and exclusion criteria and quality appraisal of studies. Among the included SRs, 38 SRs reported on a total of 60 outcomes and the remaining SRs were either empty or did not report any outcome. Out of the 60 reported outcomes, evidence was reported for 37 outcomes. Within these 37 outcomes of evidence, positive evidence of effectiveness was provided for 13 outcomes, insufficient evidence for 19 outcomes and inconclusive evidence for three outcomes. Interestingly, evidence of harm was also reported for one outcome. Among 13 reported outcomes with positive evidence of effectiveness, eight SRs provided a narrative synthesis. In the remaining outcomes, three reviews undertook a meta- analysis and two did a numerical analysis.
Each SR included in the evidence summary dealt with one specific disaster management intervention which spread across more than one stage of disaster management. Among the included reviews, the majority of SRs focused on interventions for response execution and few reviews focussed on risk reduction. Given the heterogeneity of the interventions and outcomes reported in the included SRs, narrative synthesis was used for data extraction and synthesis. The study found conclusive evidence of effectiveness (positive or negative) for the following categories of interventions: medical interventions and rehabilitation; capacity, education and training; cash-transfer based approaches; mechanisms and models of coordination; and communication and information.
What are the conclusions?
South Asian countries face various challenges in managing natural disasters due to availability of limited healthcare resources such as infrastructure, health professionals, medical importunes etc. Many countries in South Asia have spent millions of dollars in improving their response and readiness towards disasters. Consequently, the assessment of the efficacy and effectiveness of the response to disasters is required to ensure that resources are used in the most efficient and effective way. Given the major challenges faced by South Asia including Bangladesh, the main interventions which are found to be effective and can be useful for the country in disaster management are:
- use of community based approaches both for medical and communication intervention;
- promoting and strengthening school based disaster education;
- coordination among agencies;
- cash based interventions through local financial institutions.
It emerges from the evidence summary that interventions which were sensitive to the sociocultural context and practices of the target region had a more positive impact and wider acceptance. Thus, there is a need to devise necessary and appropriate strategies to counteract exclusion processes in disaster management for inclusive outcomes. Even though the evidence reviewed offers some insights, there has been a paucity of rigorous research on effectiveness of disaster management approaches for South Asia, which limits the strength of the contextualisation.
How did we get these results?
The team followed standard methodological procedures in preparing this evidence summary that are used in conducting a systematic review. The primary steps were conceptualisation, identification of studies (search, screen), appraisal and data extraction, synthesis, and contextualising. The team conducted comprehensive searches of published and unpublished literature. Two independent research assistants screened all identified studies to determine eligibility for inclusion in the review. From all included studies, data was extracted using a standardized coding tool and we critically appraised the studies using existing tools appropriate for the different study designs.
This report should be cited as:
Nidhi Srivastava, Neha Bharti, Bhawna Tyagi, Sonakshi Saluja, P K Bhattacharya, Shazia Aslam, Veena Aggarwal (2016), Effects of Various Disaster Management Approaches: An Evidence Summary. London: EPPI Centre, Social Science Research Unit, UCL Institute of Education, University College London.