Characteristics of included studies (N = 93).

IntroductionConflict, fragility and political violence, that are taking place in many countries in the Middle East and North Africa (MENA) region have devastating effects on health. Digital health technologies can contribute to enhancing the quality, accessibility and availability of health care services in fragile and conflict-affected states of the MENA region. To inform future research, investments and policy processes, this scoping review aims to map out the evidence on digital health in fragile states in the MENA region.MethodWe conducted a scoping review following the Joanna Briggs Institute (JBI) guidelines. We conducted descriptive analysis of the general characteristics of the included papers and thematic analysis of the key findings of included studies categorized by targeted primary users of different digital health intervention.ResultsOut of the 10,724 articles identified, we included 93 studies. The included studies mainly focused on digital health interventions targeting healthcare providers, clients and data services, while few studies focused on health systems or organizations managers. Most of the included studies were observational studies (49%). We identified no systematic reviews. Most of the studies were conducted in Lebanon (32%) followed by Afghanistan (13%) and Palestine (12%). The first authors were mainly affiliated with institutions from countries outside the MENA region (57%), mainly United Kingdom and United States. Digital health interventions provided a platform for training, supervision, and consultation for health care providers, continuing education for medical students, and disease self-management. The review also highlighted some implementation considerations for the adoption of digital health such as computer literacy, weak technological infrastructure, and privacy concerns.ConclusionThis review showed that digital health technologies can provide promising solutions in addressing health needs in fragile and conflict-affected states. However, rigorous evaluation of digital technologies in fragile settings and humanitarian crises are needed to inform their design and deployment.引言：中东与北非（Middle East and North Africa, MENA）地区多国频发的冲突、脆弱性与政治暴力事件，对民众健康造成了毁灭性影响。数字健康技术可助力提升中东与北非脆弱及受冲突影响国家的医疗服务质量、可及性与可获得性。为给未来的研究、投资与政策制定提供参考依据，本范围综述旨在梳理该地区脆弱国家中数字健康相关的研究证据。 方法：本研究遵循乔安娜·布里格斯研究所（Joanna Briggs Institute, JBI）指南开展范围综述。我们对纳入文献的一般特征进行描述性分析，并针对按不同数字健康干预目标主要使用者分类的纳入研究的关键发现开展主题分析。 结果：在初筛获得的10724篇文献中，最终纳入93项研究。纳入研究主要聚焦面向医疗服务提供者、服务对象与数据服务的数字健康干预，仅有少数研究关注医疗系统或组织管理者。大部分纳入研究为观察性研究（49%），未检索到系统综述。纳入研究中，开展于黎巴嫩的占比最高（32%），其次为阿富汗（13%）与巴勒斯坦（12%）。第一作者主要隶属于中东与北非地区以外的机构（57%），以英国与美国的机构为主。数字健康干预为医疗服务提供者提供了培训、督导与咨询的平台，为医学生提供了继续教育途径，并支持疾病自我管理。本综述同时指出了数字健康推广需关注的若干实施要点，包括计算机素养不足、技术基础设施薄弱以及隐私安全顾虑。 结论：本综述表明，数字健康技术可为脆弱及受冲突影响地区的健康需求解决提供颇具前景的方案。但仍需针对脆弱环境与人道主义危机中的数字技术开展严谨的评估，以为其设计与部署提供依据。