Research for stronger health systems during and after crisis

ReBUILD for Resilience Research

 Doctor tends to boy sitting on mother's knee as  armed man guards them

Image: Leyla Hassan Ahmed, an International Rescue Committee clinical officer, examines a young patient in a Mogadishu as an armed guard provides security. Credit Peter Biro/IRC

ReBUILD for Resilience is a six-year research programme which will have multiple strands and contexts of interest.

We have kicked off that work with four projects funded through our Responsive Fund - a flexible way for all partners and associate partners to access funds to support responsive activities. All of the funded programmes are COVID-19 focused.  

Work is beginning and we expect to see the results early in 2021. Follow us on Twitter for the latest updates on our progress.

 

Community and health system stressors and coping mechanisms during COVID 19: case study from Myanmar

Partners: Burnet Institute and Central Epidemiology Unit, Ministry of Health and Sport, Myanmar and Queen Margaret University

The study aims to understand the lived experiences of linked communities and primary care-level health workers in the context of the COVID-19 pandemic and to contribute to the resilience of the health system in responding to COVID 19.
 
Insein has been chosen because of its high COVID-19 caseload and its response in the early phase of the pandemic (eg the closure of a private hospital and high transmission via close community gatherings).


Understanding health system resilience to respond to COVID-19 in a federalised context: a case study of health workforce management at sub-national level in Nepal

Partners: HERD International, Queen Margaret University and Liverpool School of Tropical Medicine

This study will examine health sector policy, preparedness and responses to COVID-19 in Nepal, focusing on policies, provisions and implementation approaches for health workforce management at the sub-national level. It will explore Nepal’s health system resilience and the lessons learnt from its COVID-19 response, and aims to understand if and how it has demonstrated absorption, adaptation and transformation to support resilient health system.

The study will focus on understanding the health workforce management system in this federalised context as a tracer for the wider health system, at the local level for COVID-19 response and in the delivery of non-COVID routine health services. This will help us develop a framework for future research in health workforce management.


The gendered experience of close to community providers in fragile and shock-prone (FASP) settings: implications for policy and practice during and post COVID-19

Partners: Liverpool School of Tropical Medicine, HERD International, American University of Beirut, Burnet Institute Myanmar and COMAHS

COVID-19 is increasingly affecting our FASP study settings of Lebanon, Nepal, Myanmar and Sierra Leone. Close to Community (CTC) providers are part of the response to the pandemic in these settings. However, there are evidence gaps, including how policy and practice (eg support structures) have adapted to the realities of the COVID-19 pandemic, and the CTC providers’ experiences during the pandemic and how these are gendered.

This study will explore the roles of CTC health care providers and their gendered experiences during the COVID-19 pandemic FASP settings. We will conduct document reviews, interviews with CTC providers and key informants in Lebanon, Nepal, Myanmar and Sierra Leone.

This study will contribute evidence on gender equitable approaches to supporting CTC providers in FASP contexts to fulfil their vital roles in the COVID-19 response and future disease outbreaks and shocks.

 

Health system resilience amid outbreaks: understanding the politics of sexual and reproductive health service adaptation in eastern Democratic Republic of Congo

Partners: Queen Margaret University and International Rescue Committee

During epidemics women and girls often experience reduced access to non-outbreak related sexual and reproductive health (SRH) services. For example, during the West Africa Ebola Virus Disease outbreak, excess maternal and neonatal deaths exceeded the number of deaths from Ebola, and the current COVID-19 pandemic might have similar effects. While guidance and tools to adapt SRH protocols and programmes to emergencies exist, often SRH services targeting women are dismissed as non-essential despite the mortality risks.

This study will examine decision-making dynamics around adaptations to the Minimum Initial Service Package for Reproductive Health in Emergencies in North Kivu in the context of COVID-19. It will examine relationships across local civil society organisations, international non-governmental organisations, Health Cluster, UN agencies, national/subnational government, the private sector, and international donors with a view to understanding the politics of SRH service adaptation during an outbreak, what (or who) drives willingness to innovate and adapt, and if possible, what are the repercussions of doing so or not.

 

Further information

 

Partners

 

Research associates