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Leresche E, Hossain M, De Rubeis ML, Hermans V, Burtscher D, Rossi R, Lonsdale C, Singh NS. How is the implementation of empirical research results documented in conflict-affected settings? Findings from a scoping review of peer-reviewed literature. Confl Health 2023; 17:39. [PMID: 37605198 PMCID: PMC10464477 DOI: 10.1186/s13031-023-00534-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 07/19/2023] [Indexed: 08/23/2023] Open
Abstract
Implementation science scholars argue that knowing 'what works' in public health is insufficient to change practices, without understanding 'how', 'where' and 'why' something works. In the peer reviewed literature on conflict-affected settings, challenges to produce research, make decisions informed by evidence, or deliver services are documented, but what about the understanding of 'how', 'where' and 'why' changes occur? We explored these questions through a scoping review of peer-reviewed literature based on core dimensions of the Extended Normalization Process Theory. We selected papers that provided data on how something might work (who is involved and how?), where (in what organizational arrangements or contexts?) and why (what was done?). We searched the Global Health, Medline, Embase databases. We screened 2054 abstracts and 128 full texts. We included 22 papers (of which 15 related to mental health interventions) and analysed them thematically. We had the results revised critically by co-authors experienced in operational research in conflict-affected settings. Using an implementation science lens, we found that: (a) implementing actors are often engaged after research is produced to discuss feasibility; (b) new interventions or delivery modalities need to be flexible; (c) disruptions affect how research findings can lead to sustained practices; (d) strong leadership and stable resources are crucial for frontline actors; (e) creating a safe learning space to discuss challenges is difficult; (f) feasibility in such settings needs to be balanced. Lastly, communities and frontline actors need to be engaged as early as possible in the research process. We used our findings to adapt the Extended Normalization Process Theory for operational research in settings affected by conflicts. Other theories used by researchers to document the implementation processes need to be studied further.
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Affiliation(s)
- Enrica Leresche
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
| | - Mazeda Hossain
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
- Global Health, Nottingham Trent University, Nottingham, UK
| | | | - Veerle Hermans
- LuxOR, Médecins Sans Frontières Operational Centre Brussels, Luxembourg, Luxembourg
| | - Doris Burtscher
- Médecins Sans Frontières Vienna Evaluation Unit, Vienna, Austria
| | - Rodolfo Rossi
- Centre for Operational Research and Experience (CORE), International Committee of the Red Cross, Geneva, Switzerland
| | - Cordelia Lonsdale
- Elrha's Research for Health in Humanitarian Crises Programme, Cardiff, UK
| | - Neha S Singh
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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Leresche E, Hossain M, Rossi R, Truppa C, Barth CA, Mactaggart I, Leaning J, Singh N. Do we really want to know? The journey to implement empirical research recommendations in the ICRC's responses in Myanmar and Lebanon. DISASTERS 2023; 47:437-463. [PMID: 35617255 DOI: 10.1111/disa.12549] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Efforts to reduce the gap between the research evidence base and humanitarian responses have focused on producing quality evidence and ensuring its use in decision-making. Yet, how evidence translates into field-level implementation is not well understood in humanitarian contexts. This study analysed how recommendations produced through academic research partnerships were implemented by the International Committee of the Red Cross (ICRC) in Lebanon and Myanmar. The methodology included: social network analysis to represent collective dynamics; document reviews to assess implementation; qualitative interviews to comprehend why actors engaged; and a critical appraisal of these combined results. The application of Extended Normalization Process Theory provided information on 'anticipation of constraints' (access to information, staff turnover, context specificity, and the need to engage as a cohesive group). Future research efforts should concentrate explicitly on identifying and tackling implementation barriers such as power imbalances and ethical dilemmas related to service delivery by humanitarian actors.
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Affiliation(s)
- Enrica Leresche
- MPH is a Doctorate of Public Health Candidate in the Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Mazeda Hossain
- MSc, PhD is an Associate Professorial Research Fellow at the Centre for Women, Peace and Security, London School of Economics and Political Science, United Kingdom
- Honorary Associate Professor in the Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Rodolfo Rossi
- MSc, MPH is an Epidemiologist in the Health Unit at the International Committee of the Red Cross, Switzerland
| | - Claudia Truppa
- MD, MSc was a Health Coordinator at the International Committee of the Red Cross, Lebanon at the time of the study
- Now a PhD Candidate at CRIMEDIM - Centre for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Novara, Italy
| | - Cornelia Anne Barth
- MSc was a Physical Rehabilitation Specialist at the International Committee of the Red Cross, Switzerland at the time of the study
- Now a PhD Candidate at University College, Dublin, Ireland
| | - Islay Mactaggart
- MA, PhD is an Assistant Professor in Disability and Global Health in the Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Jennifer Leaning
- MD SMH is a Senior Research Fellow at the FXB Center for Health and Human Rights, Harvard University, United States
- Retired Professor of the Practice, Harvard Chan School of Public Health, United States
| | - Neha Singh
- MPH, PhD is an Associate Professor in the Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
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Khalid AF, Grimshaw JM, Parakh ND, Charide R, Rab F, Sohani S. Decision-makers' experiences with rapid evidence summaries to support real-time evidence informed decision-making in crises: a mixed methods study. BMC Health Serv Res 2023; 23:282. [PMID: 36966293 PMCID: PMC10039327 DOI: 10.1186/s12913-023-09302-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/16/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND There is a clear need for research evidence to drive policymaking and emergency responses so that lives are saved and resources are not wasted. The need for evidence support for health and humanitarian crisis is even more pertinent because of the time and practical constraints that decision-makers in these settings face. To improve the use of research evidence in policy and practice, it is important to provide evidence resources tailored to the target audience. This study aims to gain real-world insights from decision-makers about how they use evidence summaries to inform real-time decision-making in crisis-settings, and to use our findings to improve the format of evidence summaries. METHODS This study used an explanatory sequential mixed method study design. First, we used a survey to identify the views and experiences of those who were directly involved in crisis response in different contexts, and who may or may not have used evidence summaries. Second, we used the insights generated from the survey to help inform qualitative interviews with decision-makers in crisis-settings to derive an in-depth understanding of how they use evidence summaries and their desired format for evidence summaries. RESULTS We interviewed 26 decision-makers working in health and humanitarian emergencies. The study identified challenges decision-makers face when trying to find and use research evidence in crises, including insufficient time and increased burden of responsibilities during crises, limited access to reliable internet connection, large volume of data not translated into user friendly summaries, and little information available on preparedness and response measures. Decision-makers preferred the following components in evidence summaries: title, target audience, presentation of key findings in an actionable checklist or infographic format, implementation considerations, assessment of the quality of evidence presented, citation and hyperlink to the full review, funding sources, language of full review, and other sources of information on the topic. Our study developed an evidence summary template with accompanying training material to inform real-time decision-making in crisis-settings. CONCLUSIONS Our study provided a deeper understanding of the preferences of decision-makers working in health and humanitarian emergencies about the format of evidence summaries to enable real-time evidence informed decision-making.
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Affiliation(s)
- Ahmad Firas Khalid
- Centre for Implementation Research, Canadian Institutes of Health Research Health System Impact Fellowship, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
- School of Global Health, York University, Toronto, ON, Canada.
- Health in Emergencies, Canadian Red Cross, Ottawa, ON, Canada.
| | - Jeremy M Grimshaw
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Nandana D Parakh
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Rana Charide
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Faiza Rab
- Health in Emergencies, Canadian Red Cross, Ottawa, ON, Canada
| | - Salim Sohani
- Health in Emergencies, Canadian Red Cross, Ottawa, ON, Canada
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Kobeissi L, Pyone T, Moran AC, Strong KL, Say L. Scaling up a monitoring and evaluation framework for sexual, reproductive, maternal, newborn, child, and adolescent health services and outcomes in humanitarian settings: A global initiative. DIALOGUES IN HEALTH 2022; 1:None. [PMID: 36569812 PMCID: PMC9767412 DOI: 10.1016/j.dialog.2022.100075] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 10/02/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
Background Reliable and rigorously collected sexual, reproductive, maternal, newborn, child, and adolescent (SRMNCAH) data from humanitarian settings are often sparse and variable in quality across different settings due to the lack of a standardised set of indicators across the different agencies working in humanitarian settings. This paper aims to summarise a WHO-led global initiative to develop and scale up an SRMNCAH monitoring and evaluation framework for humanitarian settings. Methods This research revolved around three phases. The first and the last phase involved global consultations with lead international agencies active in SRMNCAH in humanitarian settings. The second phase tested the feasibility of the proposed indicators in Afghanistan, Bangladesh, the Democratic Republic of the Congo, and Jordan, using different qualitative research methods (interviews with 92 key informants, 26 focus group discussions with 142 key stakeholders, facility assessments and observations at 25 health facilities or sites). Results Among the 73 proposed indicators, 47 were selected as core indicators and 26 as additional indicators. Generally, there were no major issues in collecting the proposed indicators, except for those indicators that relied on death reviews or population-level data. Service availability and morbidity indicators were encouraged. Abortion and SGBV indicators were challenging to collect due to political and sociocultural reasons. The HIV and PMTCT indicators were considered as core indicators, despite potential sensitivity in some settings. Existing data collection and reporting systems across the four assessed humanitarian settings were generally fragmented and inconsistent, mainly attributed to the lack of coordination among different agencies. Interpretation Implementing agencies need to collaborate effectively to scale up this agreed-upon set of SRMNCAH framework to enhance accountability and transparency in humanitarian settings.
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Affiliation(s)
- Loulou Kobeissi
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Thidar Pyone
- Science Division, World Health Organization, Geneva, Switzerland
| | - Allisyn C. Moran
- Department of Maternal, Newborn, Child, and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Kathleen L. Strong
- Department of Maternal, Newborn, Child, and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Lale Say
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Altare C, Weiss W, Ramadan M, Tappis H, Spiegel PB. Measuring results of humanitarian action: adapting public health indicators to different contexts. Confl Health 2022; 16:54. [PMID: 36242013 PMCID: PMC9569100 DOI: 10.1186/s13031-022-00487-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/28/2022] [Accepted: 10/07/2022] [Indexed: 11/25/2022] Open
Abstract
Humanitarian crises represent a significant public health risk factor for affected populations exacerbating mortality, morbidity, disabilities, and reducing access to and quality of health care. Reliable and timely information on the health status of and services provided to crisis-affected populations is crucial to establish public health priorities, mobilize funds, and monitor the performance of humanitarian action. Numerous efforts have contributed to standardizing and presenting timely public health information in humanitarian settings over the last two decades. While the prominence of process and output (rather than outcome and impact) indicators in monitoring frameworks leads to adequate information on resources and activities, health outcomes are rarely measured due to the challenges of measuring them using gold-standard methods that are difficult to implement in humanitarian settings. We argue that challenges in collecting the gold-standard performance measures should not be a rationale for neglecting outcome measures for critical health and nutrition programs in humanitarian emergencies. Alternative indicators or measurement methods that are robust, practical, and feasible in varying contexts should be used in the interim while acknowledging limitations or interpretation constraints. In this paper, we draw from existing literature, expert judgment, and operational experience to propose an approach to adapt public health indicators for measuring performance of the humanitarian response across varied contexts. Contexts were defined in terms of parameters that capture two of the main constraints affecting the capacity to obtain performance information in humanitarian settings: (i) access to population or health facilities; and (ii) availability of resources for measurement. Consequently, 2 × 2 tables depict four possible scenarios: (A) a situation with accessible populations and with available resources; (B) a situation with available resources but limited access to affected populations; (C) a situation with accessible populations and limited resources; and (D) a situation with both limited access and limited resources. Methods and data sources can vary from large population-based surveys, rapid assessments of populations or health facilities, routine health management information systems, or data from sentinel sites in the community or among facilities. Adapting indicators and methods to specific contexts of humanitarian settings increases the potential for measuring the performance of humanitarian programs beyond inputs and outputs by assessing health outcomes, and consequently improving program impact, reducing morbidity and mortality, and improving the quality of lives amongst persons affected by humanitarian emergencies.
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Affiliation(s)
- Chiara Altare
- Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - William Weiss
- Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Marwa Ramadan
- Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Hannah Tappis
- Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Jhpiego, Baltimore, MD, USA
| | - Paul B Spiegel
- Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Shalash A, Abu-Rmeileh NME, Kelly D, Elmusharaf K. The need for standardised methods of data collection, sharing of data and agency coordination in humanitarian settings. BMJ Glob Health 2022; 7:bmjgh-2021-007249. [PMID: 36210070 PMCID: PMC9540843 DOI: 10.1136/bmjgh-2021-007249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/15/2022] [Indexed: 11/03/2022] Open
Abstract
Humanitarian crises and emergencies are prevalent all over the world. With a surge in crises in the last decade, humanitarian agencies have increased their presence in these areas. Initiatives such as the Sphere Project and the Minimum Initial Service Package known as MISP were formed to set standards and priorities for humanitarian assistance agencies. MISP was initiated to coordinate and standardise data and collection methods and involve locals for programme sustainability. Developing policies and programmes based on available data in humanitarian crises is necessary to make evidence-based decisions. Data sharing between humanitarian agencies increases the effectiveness of rapid responses and limits duplication of services and research. In addition, standardising data collection methods helps alleviate the risk of inaccurate information and allows for comparison and estimates among different settings. Big data is a new collection method that can help assemble timely data if resources are available and turn the data into information. Further research on setting priority indicators for humanitarian situations can help guide agencies to collect quality data.
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Affiliation(s)
- Aisha Shalash
- Institute of Community and Public Health, Birzeit University, Ramallah, Palestine, State of,School of Medicine, University of Limerick, Limerick, Ireland
| | - Niveen M E Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, Ramallah, Palestine, State of
| | - Dervla Kelly
- School of Medicine, University of Limerick, Limerick, Ireland
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White S, Heath T, Mutula AC, Dreibelbis R, Palmer J. How are hygiene programmes designed in crises? Qualitative interviews with humanitarians in the Democratic Republic of the Congo and Iraq. Confl Health 2022; 16:45. [PMID: 36056391 PMCID: PMC9438112 DOI: 10.1186/s13031-022-00476-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 08/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hygiene behaviour change programmes are complex to design. These challenges are heightened during crises when humanitarian responders are under pressure to implement programmes rapidly despite having limited information about the local situation, behaviours and opinions-all of which may also be rapidly evolving. METHODS We conducted in-depth interviews with 36 humanitarian staff involved in hygiene programme design in two crisis-affected settings-one a conflict affected setting (Iraq) and the other amid a cholera outbreak (Democratic Republic of the Congo). Interviews explored decision-making in each phase of the humanitarian project cycle and were thematically analysed. RESULTS Participants considered the design and implementation of hygiene programmes in crises to be sub-optimal. Humanitarians faced sector-specific challenges as well as more general constraints associated with operating within the humanitarian system. Programme-design decisions were made naturalistically and relied heavily on the intuitions and assumptions of senior staff. National organisations were often side-lined from programme design processes despite being in a better position to gather situational data. Consequently, programme design and decision-making processes adopted by humanitarians were similar across the two settings studied and led to similar types of hygiene promotion activities being delivered. CONCLUSION Hygiene programming in crises-affected settings could be strengthened by initiatives targeted at supporting humanitarian staff during the pre-implementation programme design phase. This may include rapid assessment tools to better understand behavioural determinants in crisis-affected contexts; the use of a theory of change to inform the selection of programme activities; and funding mechanisms which encourage equitable partnerships, phased programming, regular adaptation and have programmatic components targeted at sustainability and sector capacity building. Initiatives aimed at sector reform should be cognisant of inter and intra-organisational dynamics, the ways that expertise is created and valued by the sector, and humanitarian habits and norms that arise in response to system constraints and pressures. These micro-organisational processes affect macro-level outcomes related to programme quality and acceptability and determine or limit the roles of national actors in programme design processes.
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Affiliation(s)
- Sian White
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
| | - Thomas Heath
- Independent Consultant, Goma, Democratic Republic of the Congo
| | | | - Robert Dreibelbis
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Jennifer Palmer
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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White S, Heath T, Khalid Ibrahim W, Ihsan D, Blanchet K, Curtis V, Dreibelbis R. How is hygiene behaviour affected by conflict and displacement? A qualitative case study in Northern Iraq. PLoS One 2022; 17:e0264434. [PMID: 35239702 PMCID: PMC8893612 DOI: 10.1371/journal.pone.0264434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 02/10/2022] [Indexed: 12/30/2022] Open
Abstract
This research aimed to qualitatively explore whether the determinants of handwashing behaviour change according to the duration of displacement or the type of setting that people are displaced to. We conducted an exploratory qualitative study in three different post-conflict settings in Northern Iraq–a long-term displacement camp, a short-term displacement camp, and villages where people were returning to post the conflict. We identified 33 determinants of handwashing in these settings and, of these, 21 appeared to be altered by the conflict and displacement. Determinants of handwashing behaviour in the post-conflict period were predominantly explained by disruptions to the physical, psychological, social and economic circumstances of displaced populations. Future hygiene programmes in post-conflict displacement settings should adopt a holistic way of assessing determinants and design programmes which promote agency, build on adaptive norms, create an enabling environment and which are integrated with other aspects of humanitarian response.
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Affiliation(s)
- Sian White
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Thomas Heath
- Operations Department, Action Contre la Faim, Paris, France
| | - Waleed Khalid Ibrahim
- Independent Researcher, Nutrition and Dietetics Department, College of Medical Technology, Cihan University, Erbil, Kurdistan Region of Iraq
| | - Dilveen Ihsan
- Independent Researcher, Dohuk, Kurdistan Region of Iraq
| | - Karl Blanchet
- Geneva Centre of Humanitarian Studies, Université de Genève, Geneva, Switzerland
| | - Val Curtis
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Robert Dreibelbis
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Abstract
This paper provides a framework to analyze the maturity of humanitarian logistics systems to face crisis situations related to recurrent events, and thus to identify the main areas of action and the community needs in terms of crisis logistics planning. First, the main notions of humanitarian logistics systems planning, and the theoretical contribution of maturity models are presented. Second, a maturity model for humanitarian logistics systems is proposed and the main categories of elements defining maturity extracted from literature. Then, the methodology to define the main elements of the maturity model via evidence is presented. This methodology combines a literature overview, a documentary analysis, and the development of three case studies, two located in Colombia and one in Peru. The main elements that characterize capability maturity model in humanitarian logistics systems facing recurrent crises are identified, from which the administration of donations, design of a distribution network, and the choice of suppliers are highlighted. The practical implications of the framework are proposed to allow its use to anticipate humanitarian logistics system for future crises. The framework allowed a first analysis guide and will be further extended.
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Khalid AF, Lavis JN, El-Jardali F, Vanstone M. Supporting the use of research evidence in decision-making in crisis zones in low- and middle-income countries: a critical interpretive synthesis. Health Res Policy Syst 2020; 18:21. [PMID: 32070370 PMCID: PMC7027202 DOI: 10.1186/s12961-020-0530-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/21/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Decision-makers in crisis zones are faced with the challenge of having to make health-related decisions under limited time and resource constraints and in light of the many factors that can influence their decisions, of which research evidence is just one. To address a key gap in the research literature about how best to support the use of research evidence in such situations, we conducted a critical interpretive synthesis approach to develop a conceptual framework that outlines the strategies that leverage the facilitators and address the barriers to evidence use in crisis zones. METHODS We systematically reviewed both empirical and non-empirical literature and used an interpretive analytic approach to synthesise the results and develop the conceptual framework. We used a 'compass' question to create a detailed search strategy and conducted electronic searches in CINAHL, EMBASE, MEDLINE, SSCI and Web of Science. A second reviewer was assigned to a representative sample of articles. We purposively sampled additional papers to fill in conceptual gaps. RESULTS We identified 21 eligible papers to be analysed and purposively sampled an additional 6 to fill conceptual gaps. The synthesis resulted in a conceptual framework that focuses on evidence use in crisis zones examined through the lens of four systems - political, health, international humanitarian aid and health research. Within each of the four systems, the framework identifies the most actionable strategies that leverage the facilitators and address the barriers to evidence use. CONCLUSIONS This study presents a new conceptual framework that outlines strategies that leverage the facilitators and address the barriers to evidence use in crisis zones within different systems. This study expands on the literature pertaining to evidence-informed decision-making.
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Affiliation(s)
- Ahmad Firas Khalid
- Health Policy PhD Program, McMaster University, Hamilton, ON, Canada.
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.
| | - John N Lavis
- Health Policy PhD Program, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
- Department of Political Science, McMaster University, Hamilton, ON, Canada
| | - Fadi El-Jardali
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Department of Health Management & Policy, American University of Beirut, Beirut, Lebanon
- enter for Systematic Review in Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon
| | - Meredith Vanstone
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
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Examining Conditions that Influence Evaluation use within a Humanitarian Non-Governmental Organization in Burkina Faso (West Africa). SYSTEMIC PRACTICE AND ACTION RESEARCH 2019. [DOI: 10.1007/s11213-019-09504-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dijkzeul D, Sandvik KB. A world in turmoil: governing risk, establishing order in humanitarian crises. DISASTERS 2019; 43 Suppl 2:S85-S108. [PMID: 30821357 DOI: 10.1111/disa.12330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This special issue of Disasters on humanitarian governance focuses on risk and order. Its contributions show the tensions between humanitarian normative ideals and practical consequences, as many of the ordering effects are associated with either intended or unintended consequences. This introduction offers a conceptual framing of humanitarian governance. Defining humanitarian governance as a subset of global governance, the paper shows how humanitarians have attempted to improve the consequences of their work by fighting instrumentalisation and instituting rationalisation processes. It adapts four questions, originally formulated by Michael Barnett (), to examine the ways in which humanitarian governance functions in more detail: what kind of world is being imagined and produced through the specific concern with order and risk? Who governs? How is this a form of humanitarian governance and how is it organised? And finally, what are the principal techniques of such governance? The conclusion summarises the main findings and sets an agenda for further research.
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Affiliation(s)
- Dennis Dijkzeul
- Professor, Institute for International Law of Peace and Armed Conflict, Ruhr University Bochum, Germany
| | - Kristin Bergtora Sandvik
- Professor, Faculty of Law, University of Oslo, and Research Professor, Peace Research Institute Oslo, Norway
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Moline J, Goentzel J, Gralla E. Approaches for Locating and Staffing FEMA's Disaster Recovery Centers. DECISION SCIENCES 2019. [DOI: 10.1111/deci.12359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Julia Moline
- Federal Emergency Management Agency Washington DC 20024
| | - Jarrod Goentzel
- Center for Transportation and LogisticsMassachusetts Institute of Technology Cambridge MA 02142
| | - Erica Gralla
- Engineering Management and Systems EngineeringThe George Washington University Washington DC 20052
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Abstract
Current debates about precision medicine take different perspectives on its relevance and value in global health. The term has not yet been applied to disaster medicine or humanitarian health, but it may hold significant value. An interpretation of the term for global public health and disaster medicine is presented here for application to vulnerable populations. Embracing the term may drive more efficient use and targeting of limited resources while encouraging innovation and adopting the new approaches advocated in current humanitarian discourse. PatelRB. Precision health in disaster medicine and global public health. Prehosp Disaster Med. 2018;33(6):565-566.
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Blanchet K, Ramesh A, Frison S, Warren E, Hossain M, Smith J, Knight A, Post N, Lewis C, Woodward A, Dahab M, Ruby A, Sistenich V, Pantuliano S, Roberts B. Evidence on public health interventions in humanitarian crises. Lancet 2017; 390:2287-2296. [PMID: 28602563 DOI: 10.1016/s0140-6736(16)30768-1] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Recognition of the need for evidence-based interventions to help to improve the effectiveness and efficiency of humanitarian responses has been increasing. However, little is known about the breadth and quality of evidence on health interventions in humanitarian crises. We describe the findings of a systematic review with the aim of examining the quantity and quality of evidence on public health interventions in humanitarian crises to identify key research gaps. We identified 345 studies published between 1980 and 2014 that met our inclusion criteria. The quantity of evidence varied substantially by health topic, from communicable diseases (n=131), nutrition (n=77), to non-communicable diseases (n=8), and water, sanitation, and hygiene (n=6). We observed common study design and weaknesses in the methods, which substantially reduced the ability to determine causation and attribution of the interventions. Considering the major increase in health-related humanitarian activities in the past three decades and calls for a stronger evidence base, this paper highlights the limited quantity and quality of health intervention research in humanitarian contexts and supports calls to scale up this research.
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Affiliation(s)
- Karl Blanchet
- Health in Humanitarian Crises Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Anita Ramesh
- Faculty of Public Health and Policy and Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Severine Frison
- Faculty of Public Health and Policy and Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Emily Warren
- Faculty of Public Health and Policy and Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Mazeda Hossain
- ECOHOST-The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - James Smith
- Health in Humanitarian Crises Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Abigail Knight
- Health in Humanitarian Crises Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Nathan Post
- ECOHOST-The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Aniek Woodward
- ECOHOST-The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - Maysoon Dahab
- ECOHOST-The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - Alexander Ruby
- ECOHOST-The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Bayard Roberts
- ECOHOST-The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK.
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L'Hermitte C, Brooks B, Bowles M, Tatham PH. Investigating the strategic antecedents of agility in humanitarian logistics. DISASTERS 2017; 41:672-695. [PMID: 27982461 DOI: 10.1111/disa.12220] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study investigates the strategic antecedents of operational agility in humanitarian logistics. It began by identifying the particular actions to be taken at the strategic level of a humanitarian organisation to support field-level agility. Next, quantitative data (n=59) were collected on four strategic-level capabilities (being purposeful, action-focused, collaborative, and learning-oriented) and on operational agility (field responsiveness and flexibility). Using a quantitative analysis, the study tested the relationship between organisational capacity building and operational agility and found that the four strategic-level capabilities are fundamental building blocks of agility. Collectively they account for 52 per cent of the ability of humanitarian logisticians to deal with ongoing changes and disruptions in the field. This study emphasises the need for researchers and practitioners to embrace a broader perspective of agility in humanitarian logistics. In addition, it highlights the inherently strategic nature of agility, the development of which involves focusing simultaneously on multiple drivers.
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Affiliation(s)
- Cécile L'Hermitte
- Lecturer at the Waikato Management School, University of Waikato, New Zealand
| | - Benjamin Brooks
- Senior Research Fellow at the National Centre for Ports and Shipping Australian Maritime College, University of Tasmania, Australia
| | - Marcus Bowles
- Adjunct Professor at the Centre for Regional and Rural Futures, Deakin University, Australia
| | - Peter H Tatham
- Professor of Humanitarian Logistics at the Department of International Business and Asian Studies, Griffith Business School, Griffith University, Australia
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