Sexual and reproductive health in disasters: A systematic review of digital health and multipurpose prevention technologies

Abstract Sexual and reproductive health (SRH) is critically vulnerable during disasters, where disruption of services intersects with heightened risks of unintended pregnancy, maternal morbidity, and gender-based violence. Multipurpose prevention technologies (MPTs) and digital health innovations have emerged as potential strategies to strengthen disaster-resilient SRH systems. This systematic review, conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, aimed to map and synthesize evidence on the role of MPTs and digital health platforms in advancing inclusive, disaster-responsive SRH care. Searches were conducted in PubMed, Scopus, Embase, Web of Science, and selected gray literature repositories from 2000 to March 2025. Eligible studies included peer-reviewed articles and reports addressing SRH in disaster or humanitarian contexts with reference to MPTs, digital health interventions, or inclusivity. Screening was performed independently by two reviewers, with risk of bias assessed using AMSTAR-2, ROBIS, NOS, and AACODS tools. A total of 4123 records were identified, 3045 screened after deduplication, and 412 full-texts assessed. Overall, 126 studies met the inclusion criteria. Most were published after 2015, reflecting growing global interest. Evidence clustered around four domains: Clinical and logistical applications of MPTs; digital health for continuity of SRH services; equity and inclusivity for marginalized populations; and system-level integration of innovation, policy, and resilience. Barriers included regulatory gaps, technological limitations, and sociocultural constraints. Risk of bias assessments revealed moderate-to-high variability, limiting the certainty of findings. This review demonstrates the promise of MPTs and digital health in disaster contexts but underscores the need for robust, equity-centered evaluations. No external funding was received, and the review was not registered in PROSPERO.