The second wave of ReBUILD for Resilience’s research features five projects. The studies range from frontline hospital staff resilience in worn-torn Yemen to community health worker support in Cameroon. Each is funded through our Responsive Fund – a flexible way for all partners and associate partners to access funds to support responsive activities.
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Partners: Al-Sabeen Hospital for Maternity and Children & Al-Thawra General Modern Teaching Hospital, Sana’a, Yemen, and Liverpool School of Tropical Medicine, UK
Yemen’s ongoing war plus the COVID-19 pandemic, outbreaks of cholera, diphtheria and dengue fever, have devastated the country’s health system, with only 51% of health facilities classified as fully functional. This new study will explore the lived experiences, coping mechanisms and resilience capacities of Yemen’s frontline health workers via staff in Yemen’s emergency departments in Sana’a City. Through participatory action research, the research partners will map the resilience capacities of the health workers and allied staff to develop low-cost interventions that can help staff to respond to shocks.
Partners: Oxford Policy Management, Queen Margaret University and Liverpool School of Tropical Medicine, UK
Over the last few years, OPM has undertaken a wide range of research on health systems’ responses to COVID-19 and other emergencies. Bringing together findings from these different projects can provide more understanding of contextual influences and broader cross-country learning about effective approaches. OPM is synthesising findings from these and other OPM reports, focusing on two main areas: community health workers (CHWs) and governance.
The CHW synthesis will examine CHWs’ experiences and roles during COVID-19, the effects of COVID-19 on their routine service delivery, challenges experienced and support provided. The governance synthesis will focus on the effectiveness of coordination structures and cross-sector partnerships for emergency response. Through these syntheses, OPM aims to provide lessons on how to support an effective CHW role, strengthen coordination and build partnerships as part of enhancing resilience capacities in fragile and shock-prone settings.
Partners: Queen Margaret University and Institute of Tropical Medicine, Belgium
In Cameroon’s conflict-affected anglophone regions, the health system faces many challenges to providing access to quality health care services. In recent years armed conflict has restricted access to essential health services in these regions, with 40% of health facilities no longer functional and 16 out of 18 health districts in the South West region considered unsafe for health workers. Furthermore, the crisis has seen a massive drop in vaccination coverage leaving the regions prone to the re-emergence of infectious diseases and increased mortality.
This study will ask how community health worker (CHW) programmes can be adapted to respond to the needs of CHWs and communities in such fragile contexts. It will consider the need for effective strategies to improve CHWs’ performance and address knowledge gaps in the contextual factors affecting them.
More on this work in Cameroon here.
Partners: Liverpool School of Tropical Medicine, UK, American University of Beirut, Lebanon and HERD International, Nepal
The aim of this study is to explore how participatory action research can support close-to-community (CTC) providers to address gender norms and power relations within their communities and in the health systems, focusing on Lebanon and Nepal.
It will build on previous ReBUILD for Resilience research and bring together CTC providers to address two interrelated issues that clearly emerged during that formative research: 1) challenging gender norms and navigating power dynamics within their communities and 2) gender and power issues experienced by CTC providers themselves such as supervision, support, and juggling multiple responsibilities. Working with CTC providers we will co-develop low-cost interventions that can support them in addressing these harmful gender norms.
Partners: Queen Margaret University, UK and London School of Hygiene and Tropical Medicine, UK
Sierra Leone, like other low- and middle-income countries (LMICs), has instituted several health reforms to ensure that the national health system is robust enough to provide quality health care that is accessible and affordable to the Sierra Leonean population. Reproductive, maternal, child, and adolescent health (RMNCAH) is a national priority, however, progress is slow.
This research aims to employ an ethnographic methodology to generate data from multiple perspectives and contexts to understand the power dynamics and contestations in the implementation of the RMNCAH policy in Sierra Leone and contribute to the use of ethnographic methodology in policy implementation research in LMICs.
More on this work in Sierra Leone here.
Image: Mother and baby at Makeni Regional Hospital, Sierra Leone. H6 Partners & Abbie Trayler-Smith via Flickr [opens new tab]