Leaving no one behind; How can evidence-based approaches support progress towards UHC and global health goals during conflict and protracted crises?
Date: Thursday 11th October 2018
How do we ensure evidence-based approaches in protracted crises, incorporating a long-term view towards UHC, while providing immediate health needs?
You can also download a briefing paper which has been produced for this session.
Aimed at those working in both humanitarian and development roles, this participatory session will collate experiences and insights, and develop recommendations for better evidence use for long-term, equitable health outcomes.
Moderator: Ben Heaven Taylor - Director of Evidence Aid
Fatima Adamu - National Programme Manager Women for Health programme, DAI Global Health Ltd, Northern Nigeria
Abdulkarim Ekzayez - Syrian medical doctor & consultant to Idleb Health Directorate, NW Syria (Kings College, London)
Haja Wurie - College of Medicine and Allied Health Sciences, Sierra Leone, and ReBUILD Research Programme Consortium
Campbell Katito - Health Systems Strengthening Manager, Health Pooled Fund, South Sudan (and DAI Global Health Ltd)
Katie Bigmore - Senior Expert at Integrity Research and Consultancy
And you! All those with their own experiences and interest in this area is invited to join this session, to share their insights and knowledge during the table discussion session. All inputs will contribute to the overall session outputs, and contribute to ongoing international processes around the humanitarian-development interface for health.
A briefing paper has been developed ahead of this session, outlining the background context of health service delivery in conflict and protracted crises, current developments and initiatives to improve coordination and approaches to support both humanitarian and development objectives, and the challenges and issues for the use of evidence to support these efforts.
You can download this brief here.
About the session
With the principle of ‘leaving no-one behind’ embedded in the Sustainable Development Goals, and significant momentum around target 3.8 on universal health coverage (UHC), international organisations, governments, donors, implementers and advocacy organisations agree that as well as addressing immediate health needs of vulnerable populations in the most challenging settings, this should be done in a way that supports longer-term equitable health system development. But how do we ensure an evidence-based approach to the provision of health care in emergencies and protracted crises which incorporates a long-term view towards provision of UHC?
Despite the inherent practical and ethical challenges to conducting and using research in these settings, such research is being done, although it is difficult to gain evidence on how approaches may affect long-term health system development in post-conflict and recovery periods. Over time in protracted crises, knowledge and experience is gained by organisations implementing programmes and supporting health systems. But sharing data and knowledge that could inform ‘best practice’ can be difficult and contested, within fragmented systems of organisations.
An alternative evidence source is research carried out in ‘post-conflict’ settings. Whilst still challenging, these settings can allow robust research using ‘historical’ approaches, producing evidence not only on how the health system performed during and immediately after conflict, but on long-term health system development and access for vulnerable populations. Evidence from high income countries may also be relevant. But how valid is it to extrapolate robust findings from such contexts to today’s very different protracted crisis settings?
The objective of this session is to explore innovative approaches to generating and using evidence to implement UHC-orientated healthcare programmes in conflict/crisis-affected settings. The target audience includes implementers, decision makers, researchers, donors and others working in both humanitarian and development roles.
The session will initially use the example issue of health worker incentives to contrast different types/sources of knowledge and evidence. All participants will then be invited to share their own experiences of evidence generation/use relevant to these settings, through facilitated group discussions, with a focus on evidence type and relevance/applicability for both immediate needs and longer-term development outcomes. Insights from different expert perspectives on the use of evidence in these settings will wrap up the session.
There will be three sections, with full participant involvement in the second:
1. Evidence generation on health worker incentives in conflict/crisis: Contrasting experiences
Three short case studies will be presented. Campbell Katito will present on experiences from the Health Pooled Fund’s health workforce work in South Sudan. Haja Wurie will present on research into health worker incentives from 4 post-conflict settings. Fatima Adamu will present on implementation research on rural midwife incentives in Northern Nigeria.
2. Strengthening research/evidence in conflict/crisis: Participants’ experiences
A facilitated sharing of participants’ own experiences of the use of research evidence to inform long-term health system strengthening (HSS) in conflict and protracted crisis settings – including the demand for and use of evidence, as well as the generation of evidence through research.
Table facilitators will guide the process, and note takers will record all contributions. Experiences shared will be used in session outputs. Guiding questions will include: Were long-term HSS considerations recognised and prioritised by decision makers and implementers? Was there a recognition that evidence could inform appropriate approaches, and was evidence looked for? In conducting research, where did data come from? How was this accessed? How was this used to inform policy and practice? How was evidence received and used by different types of actors?
3. Recommendations for evidence-based approaches towards global health goals in conflict/crisis
Ben Heaven Taylor (Evidence Aid) will moderate a discussion with panellists experienced in decision-making/implementation of health systems programmes in conflict-affected settings: Dr Abdulkarim Ekzayez (Chatham House), Katie Bigmore (Integrity), Campbell Katito (HPF, South Sudan). Based on the panel’s experiences, including what they have brought from table discussions and initial presentations, the moderator will lead the discussion and ask for recommendations to enable better access to an appropriate ‘portfolio’ of relevant evidence, to support both immediate needs during crisis, and long-term equitable health systems development.
Who is the session supported by?
ReBUILD Research Programme