Unintended Consequences of COVID-19 Public Health and Social Measures in Camps and Camp-Like Settings: A Systematic Review and Conceptual Analysis

Abstract

Objectives: This study examines unintended consequences (UIC) of public health and social measures (PHSM) in camps and camp-like settings and assesses the pathways through which these UIC arise. Methods: We conducted a systematic review and conceptual analysis of UIC from PHSM aimed at preventing SARS-CoV-2 spread in these settings. PHSM were classified using the WHO taxonomy and the CONSEQUENT framework to analyse UIC pathways. The most frequent PHSM groups were: a) surveillance and response, b) social and physical distancing, and c) operational measures. Results: We identified 113 predominantly negative UIC impacting physical and mental health, healthcare access, economic stability, and social interactions. UIC occurred in both high- and low-income countries. Key mechanisms linking PHSM to UIC included mistrust, increased risk factors, lack of information, and uncertainty. Conclusion: This study reveals the complex interactions between PHSM and UIC and their broad mostly negative effects on marginalised populations. To reduce UIC in future health emergencies, they must be considered in pandemic planning with all stakeholders. Trust-building should be central in health interventions and PHSM design for more effective and equitable responses.