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Soup distribution during the Islamic holy month of Ramadan in Gaza City in April 2020, amid the COVID-19 pandemic. Photo: Mohammed Zaanoun

At the start of the pandemic, in 2020, Elrha released a rapid response funding call, and funded 15 studies to contribute to COVID-19 humanitarian response. These studies covered topics including behaviour change, communications and messaging, as well as gender-based violence (GBV) — all linked to COVID-19.

This blog is the first of a two part series, where we are profiling nine social science behavioural research studies — with a focus on the experience of refugees and their understanding of COVID-19.

1. COVID-19 in the Gaza Strip: community practices in Palestine refugee camps

Partners: University of Bath, IOD Parc, European University Institute

Based in refugee camps in Gaza, this study aimed to explore how disadvantaged communities responded to the COVID-19 pandemic and the impacts of public health measures designed to mitigate infection spread. The study also examined access to health services and protection concerns.

The research study addressed the lack of evidence surrounding how refugee communities responded to public health directives established in response to COVID-19 in Gaza.

As Dr. Caitlin Procter, the Lead Researcher at the European University Institute says: “It is critical to understand how communities living in protracted displacement are managing COVID-19.”

Explore the study profile: COVID-19 in Gaza: community practices in refugee camps

2. Cash transfers and COVID-19: Experiences from Kiryandongo refugee settlement, Uganda

Partners: Give Directly, IDinsight

Food insecurity should be considered alongside assessment of future risks of COVID-19 infection in the settlement. This study found that one-off cash transfers did not achieve food security for all refugees- but provided moderate protection from food insecurity.

There is a lack of evidence about the effects of large cash transfers in context of prolonged displacement. This includes the influence of cash transfers on health behaviours during shocks.

The study found that refugee households are food insecure. Both households that had or had not received their cash transfer were food insecure in October 2020.

Dr Daniel Stein, Principal Investigator states: “Life for refugees is difficult at the best of times, and the COVID-19 crisis has compounded many of challenges refugee households already face.”

Want to know more? Cash transfers and COVID-19: Experiences from Kiryandongo, Uganda

IDinsight field team. Photo: IDInsight

3. Knowledge, adherence and the lived experiences of refugees in COVID-19: A comparative assessment of urban and rural refugee settings in Uganda

Partners: Makerere University, Gulu University — Uganda, Lutheran World Federation (LWF), Agency for Cooperation in Research and Development- Uganda (ACORD-U), Ministry of Health — Uganda

This study provided an assessment and analysis of COVID-19 lived experiences, adherence to policy guidelines and key related issues in Uganda’s diverse refugee settings. The research study wanted to examine the extent to which refugee communities were aware of COVID-19 and compliant with related measures and guidelines whilst documenting lived experiences and behavioural shifts in Uganda’s diverse refugee setting.

Findings suggest that refugees were overall knowledgeable about COVID-19, although up to 40% exhibited knowledge gaps and plenty of myths existed. There was non-adherence to most guidelines, and between 25% — 70% had adopted behaviour likely to lead to risk of COVID-19 transmission. Reasons behind the inclination towards this behaviour included socioeconomic, cultural, and structural barriers within the refugee settings.

Read more: REFugee Lived Experiences, Compliance and Thinking (REFLECT) in COVID-19

Hand washing with soap demonstration. Photo: ACORD.

4. Implementation of public health measures among internally displaced people during the COVID-19 pandemic in Francophone Africa: Pilot study of Mali

Partners: University of Sciences Techniques and Technologies of Bamako (USTTB), Arcad Sante Plus, Santé Mali Rhones Alpes and Action Contre La Faim.

With government authorities implementing public health measures, this qualitative study spotlights the experiences of Internally Displaced Persons (IDPs) and stakeholders in Mali.

Evidence shows that the lack of facilities for quarantine and isolation, physical space for building new facilities, and financial resources are the main challenges that needs immediate public health response.

Not only economic concerns (such as loss of income), but also psychosocial barriers including unwillingness to break with existing social behaviours prove that IDPs have been less inclined to comply with social distancing and quarantine measures.

According to Dr. Mohamed Ag Ali, Principal Investigator, “To slow or stop the spread of COVID-19 among vulnerable people such as IDPs, public health measures must be adapted to their socioeconomic realities.”

Read more about this research project: Implementation of public health measures during the COVID-19 pandemic in French-speaking Africa: Case of Mali

5. Using radio and social media to address misinformation about COVID-19 amongst Internally Displaced Persons in Burkina Faso

Partners: University of Sheffield, CNRST, Ouagadougou, Burkina Faso; Fondation Hirondelle, Switzerland; Studio Yafa, Burkina Faso

This study looked at the use of radio as a public health messaging tool for vulnerable crisis-affected communities during the COVID-19 pandemic. The findings were then used by partner radio stations, to adapt public health-related programming for IDPs through sharing of relevant and reliable information, acting as a survival tool, and provided space for exchange, solidarity and communion between IDPs and host communities.

The study aimed to improve awareness, understanding and confidence amongst affected populations regarding best practice in relation to the prevention of COVID-19 spread. Here’s what principal investigator Emma Heywood had to say:

“Working with a trusted Burkinabe radio source, and through a participatory collaboration, we hope to not only raise awareness amongst this population regarding COVID-related best practices but also raise the voices of these communities.”

Read more: Internally Displaced Persons, radio and COVID-related misinformation in Burkina Faso

Outside broadcast of “Let’s talk Coronavirus” recorded by Studio Yafa at an IDP camp in Kaya, Burkina Faso, 18/12/20. Photo: Olympia de Maismont/Fondation Hirondelle

6. Tracking adherence of older refugees to COVID-19 preventive measures in response to changing vulnerabilities: A multi-level, panel study to inform humanitarian response in Lebanon

Partner: Norwegian Refugee Council, Faculty of Health Sciences, American University of Beirut

Research led by Norwegian Refugee Council has focused on tracking adherence to COVID-19 preventive control measures among older Syrian refugees in Lebanon, to examine vulnerabilities — such as reduced accessibility to non-COVID healthcare services.

First wave data collection found that misinformation was prevalent in the community, and videos were produced to tackle specific areas of misinformation and disseminated through UNHCR communication trees and to all NRC beneficiaries in Lebanon.

Take a look: Changing vulnerabilities and COVID-19 adherence: Older refugees in Lebanon

Tarek* and Fatima* are supported under occupancy free of charge (OFC), NRC works with property owners in Lebanese communities to upgrade unfinished houses and apartments to a habitable condition in exchange for hosting Syrian families rent-free for a period of 12 months. Photo: Joshua Berson.

7. Understanding the impact of misinformation on the uptake of and adherence to COVID-19 related public health measures in refugee and IDP settings across Kenya, Somalia and the Democratic Republic of Congo

Partners: Danish Refugee Council, Busara Center for Behavorial Economics

This mixed-methods study will take place in six sites, in three countries with large refugee and IDP populations — Kenya, Somalia and DRC.

The purpose of the study is to examine how misinformation on COVID-19 spreads, as well as identify sources and channels of misinformation. The study will also identify effective counter measures. The evidence will enable better understanding of how misinformation is currently being spread.

The first step is to map how refugees and IDPs access, use and spread information on COVID-19 and what information is transmitted via these channels. The mapping will also support the research team to understand how these behavioural insights influence anxieties, beliefs and trust and whether people judge information as trustworthy.

Dr. Mareike Schomerus, Principal Investigator said, “Unless we understand how anxieties and beliefs shape who is trusted, we cannot expect to address acute public health concerns or chronic social and political tension.”

Interested in this topic? Misinformation and COVID-19-related health measures in displacement settings

8. Strengthening the humanitarian response to COVID-19 in Colombia

Partners: Los Andes University, Colombia, Brandeis University

Brandeis University led a study on adherence to COVID-19 public health policies across 60 Columbian municipalities, looking at how to overcome disparities between Venezuelan migrants and Columbian nationals in accessing essential healthcare services.

Barriers such as lack of physical space, lack of knowledge about COVID-19, limitations of services, and attitudes about COVID-19 proved the challenges Venezuelans face in comparison to Colombians living in the same municipality.

Findings from the study also showed mask use and mobility restrictions were highly effective at limiting COVID-19 infection spread. Although the policy restrictions did not stop people from moving, movement reduced on the weekend.

Read more: Strengthening the humanitarian response to COVID-19 in Colombia

9. Tracking Community Perceptions: A vital voice in curbing the spread of COVID-19 and other infectious diseases

Partners: London School of Hygiene and Tropical Medicine (LSHTM), Action Contre la Faim (ACF), Africa Ahead (Zimbabwe), Oxfam

Community engagement has been recognised as a core pillar of outbreak response.

This research aimed to improve understanding of behavioural enablers and barriers for communities affected by COVID-19, and to enable humanitarian actors to rapidly adapt and correct their programme activities in line with people’s understanding, priorities and needs, with resulting behaviour change that helps minimise infection risks.

Evidence showed that the Community Perceptions Tracker (CPT), helped to track trends in community attitudes towards the COVID-19 pandemic which then informed adaptations to preventative programmes.

“By conducting this research, we hope to understand how it is utilised by staff to improve programmes and whether this results in meaningful improvements for populations.” — Sian White, Principal Investigator.

The research study: Tracking Community Perceptions: curbing the spread of COVID-19

Fred Karembo from ACF’s local nutrition and food security partner Nutrition Action Zimbabwe (NAZ) speaking to young mothers currently at a quarantine centre in Mutare, Zimbabwe about how they are keeping themselves and their infants healthy during this time. Photo: Taku Ngirazie, ACF.

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