Impact of Armed Conflicts on Continuity and Coordination of Care: A Systematic Review

Introduction: Continuity of care (COC) and care coordination (CAC) are essential for promotive, preventive, curative, and rehabilitative services within people-centered health systems. However, maintaining COC and CAC is particularly challenging during emergencies and disasters, such as armed conflicts. Armed conflicts result in casualties, population displacement, attacks against healthcare infrastructure and workers, and supply chain disruptions. This systematic review synthesizes evidence on mechanisms and consequences of the impact of armed conflicts on COC and CAC, to provide evidence for future interventions and policies to strengthen healthcare delivery in conflict settings. Methods: This systematic review follows the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and PRISMA guidelines. The search strategy targets two key concepts—armed conflicts and continuity/coordinated care—and the resulting strings were run on PubMed MEDLINE, Scopus, and Web of Science. In addition to peer-reviewed sources, grey literature was manually retrieved from reports, policy documents, and digital resources of relevant international organizations responding to or researching conflict situations. Eligible studies had to: (i) be available in English, French, Italian, or Spanish; (ii) address armed conflicts’ impact on COC and CAC; (iii) focus on conflict-affected populations regardless of demographics; and (iv) be published between 01.01.2010 and 31.07.2024. Results: The ongoing data extraction process aims to capture the study details, while the specific COC/CAC aspects affected by armed conflicts are being deductively categorized using the World Health Organization’s “Continuity of Care and Coordination of Care frameworks”. Emerging themes will be identified inductively to refine relevant concepts. Data will be synthesized based on the extraction form and thematic analysis. Conclusion: This systematic review aims to provide evidence-based recommendations on mitigating the destructive impact of armed conflicts on COC and CAC and supporting health service delivery during active wars and military confrontations.