{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T02:14:13Z","timestamp":1792721653654,"version":"4.5.0"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:00:00Z","timestamp":1715731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004417","name":"Global Fund","doi-asserted-by":"crossref","award":["20168770"],"award-info":[{"award-number":["20168770"]}],"id":[{"id":"10.13039\/100004417","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100014976","name":"Liverpool School of Tropical Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014976","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Humanitarian crises and disasters affect millions of people worldwide. Humanitarian aid workers are civilians or professionals who respond to disasters and provide humanitarian assistance. In doing so, they face several stressors and traumatic exposures. Humanitarian aid workers also face unique challenges associated with working in unfamiliar settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the occurrence of and factors associated with mental ill-health among humanitarian aid workers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Search strategy<\/jats:title>\n                    <jats:p>CINAHL plus, Cochrane library, Global Health, Medline, PubMed, Web of Science were searched from 2005\u20132020. Grey literature was searched on Google Scholar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Selection criteria<\/jats:title>\n                    <jats:p>PRISMA guidelines were followed and after double screening, studies reporting occurrence of mental ill-health were included. Individual narratives and case studies were excluded, as were studies that reported outcomes in non-humanitarian aid workers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Data analysis<\/jats:title>\n                    <jats:p>Data on occurrence of mental ill-health and associated factors were independently extracted and combined in a narrative summary. A random effects logistic regression model was used for the meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec006\">\n                    <jats:title>Main results<\/jats:title>\n                    <jats:p>Nine studies were included with a total of 3619 participants, reporting on five types of mental ill-health (% occurrence) including psychological distress (6.5%-52.8%); burnout (8.5%-32%); anxiety (3.8%-38.5%); depression (10.4%-39.0%) and post-traumatic stress disorder (0% to 25%). Hazardous drinking of alcohol ranged from 16.2%-50.0%. Meta-analysis reporting OR (95% CI) among humanitarian aid workers, for psychological distress was 0.45 (0.12\u20131.64); burnout 0.34 (0.27\u20130.44); anxiety 0.22 (0.10\u20130.51); depression 0.32 (0.18\u20130.57) and PTSD 0.11 (0.03\u20130.39). Associated factors included young age, being female and pre-existing mental ill-health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec007\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mental ill-health is common among humanitarian aid workers, has a negative impact on personal well-being, and on a larger scale reduces the efficacy of humanitarian organisations with delivery of aid and retention of staff. It is imperative that mental ill-health is screened for, detected and treated in humanitarian aid workers, before, during and after their placements. It is essential to implement psychologically protective measures for individuals working in stressful and traumatic crises.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0292107","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T13:37:36Z","timestamp":1715780256000},"page":"e0292107","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":21,"title":["The occurrence of and factors associated with mental ill-health amongst humanitarian aid workers: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"19","author":[{"given":"Lily","family":"Cameron","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"McCauley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nynke","family":"van den Broek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9379-1400","authenticated-orcid":true,"given":"Hannah","family":"McCauley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,5,15]]},"reference":[{"key":"pone.0292107.ref001","article-title":"Aid Worker Security Report 2021: Crime risks and responses in humanitarian operations.","author":"A Stoddard","year":"2021","journal-title":"Humanitarian Outcomes."},{"issue":"6","key":"pone.0292107.ref002","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1017\/S1049023X19005016","article-title":"Safety and Security in International Humanitarian Missions\u2014Assessing the Stress Level of Responders in Critical Situations during a Realistic Full-Scale Training.","volume":"34","author":"A Spall","year":"2019","journal-title":"Prehospital and disaster medicine."},{"key":"pone.0292107.ref003","volume-title":"Global Humanitarian Overview","author":"UNOCHA","year":"2021"},{"issue":"8","key":"pone.0292107.ref004","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1097\/NMD.0b013e3181ea1fa9","article-title":"The mental health impact of volunteering in a disaster setting: a review.","volume":"198","author":"SB Thormar","year":"2010","journal-title":"Journal of Nervous & Mental Disease."},{"issue":"4","key":"pone.0292107.ref005","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1111\/j.1440-172X.2009.01766.x","article-title":"Interventions to reduce psychosocial disturbance following humanitarian relief efforts involving natural disasters: an integrative review","volume":"15","author":"DS Walsh","year":"2009","journal-title":"International Journal of Nursing Practice (Wiley-Blackwell)."},{"issue":"1","key":"pone.0292107.ref006","first-page":"50","article-title":"Humanitarian well-being: Addressing the intimate partner to promote humanitarian well-being","volume":"17","author":"K. 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