Strong coordination and partnerships are key to building the evidence base for SRH in humanitarian settings

18 August, 2018

 

World Humanitarian Day is held every year on 19 August to pay tribute to aid workers who risk their lives in humanitarian service, and to rally support for people affected by crises around the world.

Written by Sarah Knaster, Senior Advisor, Inter-Agency Working Group on Reproductive Health in Crises on behalf of the Data and Research Sub-Working Group. Sarah is based in New York.

 A woman and her malnourished child in Dadaab refugee camp, Kenya. © Frederic Courbet/Panos Pictures

While this year’s World Humanitarian Day provides a welcome opportunity to bring attention to the estimated 134 million people who need humanitarian assistance and protection in 2018 and the humanitarian workers responding to the overwhelming needs, it also prompts the humanitarian community to reflect on how we can do better. [1] To remain accountable to the populations we serve and to the commitments we’ve made; to ensure that funding, policies and programming are evidence-based; and to identify and quickly address knowledge gaps, we must have better data from humanitarian settings. To accomplish this we need strong partnerships, coordination, and communications.

 

The need for more and better data from humanitarian contexts has been well documented in the past several years. The Inter-Agency Working Group (IAWG) on Reproductive Health in Crises’ Global Evaluation of Sexual and Reproductive Health (SRH) in Humanitarian Settings: 2012-2014 documented a dearth of high-quality published research on SRH in humanitarian settings and called on implementing agencies to strengthen data collection and management and for more research and program evaluations to measure the effectiveness of services.[2] These findings align closely with those in a 2017 Lancet paper that examined availability of data in humanitarian settings more broadly.[3]

 

The need for data from humanitarian settings was also highlighted following a 2016 comment published in the Lancet, wherein Helena Nordenstedt and Hans Rosling critiqued a commonly used statistic asserting that 60% of all maternal deaths take place in humanitarian settings.[4] The statistic is calculated based on the total population of the 50 most fragile states in the world, and the authors appropriately took issue with the conflation of humanitarian settings and fragile states. The authors assert that “the use of inaccurate numbers in global health advocacy can misguide where investments are most needed”. While, the correct statistic, “61% of maternal deaths worldwide occur in fragile states, many of them affected by conflict and recurring natural disasters” is an important tool to highlight the inextricable link between poverty, fragility, and crisis, the debate over the statistic’s continued use and implications around funding for humanitarian contexts has elevated existing calls for more and better SRH data from humanitarian settings specifically as a critical component of our collective advocacy.

 

IAWG colleagues have also pointed out that while evidence is certainly limited, what does exist is not always used to inform SRH programming in emergencies. [5],[6] In a subsequent reply in the Lancet, authors Roberts and Blanchet acknowledge this reality and identified three reasons why this might be the case: 1) humanitarian actors may be unaware of existing evidence and capacity building is needed to ensure uptake 2) researchers are not effectively communicating their findings and 3) weaknesses in humanitarian governance. [7]

 

IAWG – a large coalition representing UN, government, non-governmental, research, and donor organizations that advances sexual and reproductive health in humanitarian settings – has a critical role to play in building up the evidence base as well as in addressing the contributing factors of poor uptake of existing evidence. The IAWG Research and Data Sub-Working Group is leading efforts to enhance the use of evidence-based research for SRH in humanitarian settings by promoting robust data analysis, introducing novel research methods, increasing knowledge on SRH epidemiology, and enhancing surveillance of SRH issues in crises. In addition, the sub-working group promotes the use of evidence-based research translated into practice by increasing the use, analysis, and interpretation of SRH data for program policy. They develop partnerships with IAWG members to conduct operational research and share and promote identified research gaps and priorities with key partners, stakeholders and donors.

 

IAWG also ensures information sharing across multiple platforms and strong linkages to existing initiatives such as the Global Roadmap for Improving Data, Monitoring and Accountability in Humanitarian Settings. We are also working to make linkages between the development and humanitarian sectors, adapting, testing and utilizing evidence from non-emergency settings, and calling for strengthening health systems as part of disaster risk reduction and emergency preparedness efforts to improve data collection in crises.

 

Data has a powerful role to play in identifying better ways to meet the reproductive health needs of crisis-affected communities and to ensure that funding and policy decisions are reflective of realities on the ground. On World Humanitarian Day IAWG calls on the humanitarian community to commit to embedding operational research into its programming, to publishing findings, including negative ones, and to widely disseminating new and existing evidence, including to key decision makers such as humanitarian donors and agencies responsible for coordinating humanitarian response.

 

[1] United Nations Office for the Coordination of Humanitarian Affairs (OCHA). “Global Humanitarian Overview 2018.” Available at: https://interactive.unocha.org/publication/global humanitarian overview

[2] Casey S. Evaluations of reproductive health programs in humanitarian settings: a systematic review. Confl and Health. 2015.. https://doi.org/10.1186/1752-1505-9-S1-S1

[3] Blanchet K, Ramesh A, Frison S, et al. Evidence on public health interventions in humanitarian crises. Lancet 2017; 390: 2287–96.

[4] Nordenstadt Helen, Rosling H. Chasing 60% of maternal deaths in the post-fact era. The Lancet. 2016; 388(10054):1864-1865.

[5] Casey S. Evaluations of reproductive health programs in humanitarian settings: a systematic review. Confl and Health. 2015; 9(Suppl 1):S1. https://doi.org/10.1186/1752-1505-9-S1-S1

[6] Chynoweth SK. Advancing reproductive health on the humanitarian agenda: the 2012-2014 global review. 2015. 9 (Suppl 1):I1. https://doi.org/10.1186/1752-1505-9-S1-I1

[7] Roberts B and Blanchet K. Implementing sexual and reproductive health care in humanitarian crises – Authors’ reply. The Lancet. 2017. 391(10132):1771.

 

Please note that blog posts are not peer-reviewed and do not necessarily reflect the views of RHM as an organisation.

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