See the latest information and resources from Elrha in relation to coronavirus (Covid-19)

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We are funding 15 new humanitarian health research studies as part of our Responsive Funding Call for proposals to rapidly contribute to the COVID-19 response. As COVID-19 began to spread around the world, the humanitarian community worked to respond to the impact the pandemic would have on those already affected by crises, and the most vulnerable communities. Having the experience of funding rapid research to support the Ebola outbreaks in both West Africa and DRC, we knew we could play a vital role in supporting the response, equipping practitioners with knowledge and evidence of what works.

We received a total of 465 proposals as part of the urgent call, which launched in March, from those seeking to research the impact of COVID-19 in multiple settings across humanitarian settings. It is thanks to a huge collective effort from the research community, including our Funding Committee, donors and over 65 technical reviewers, that these 15 research studies have been funded. The first studies were awarded within five weeks of submission and started activities in May 2020. All 15 studies have now commenced activities.

This graphic shows a map of our R2HC rapid research to support COVID-19 response study locations. This information is also available in the below study summaries.

The selected studies cover a diverse range of relevant topics including behaviour change, communications and messaging, as well as gender-based violence (GBV) programming questions linked to COVID-19.

Nine of the studies fall into the broad category of social science research investigating refugees and their understanding of COVID-19. Collectively, these studies will contribute to a strong body of evidence on COVID-19. This builds on similar work we’ve previously funded, such as the Anthropology Platform, developed in response to the 2014 Ebola outbreak in West Africa.

A number of the studies further contribute to our work on GBV, inclusion of older people and user-centred design in handwashing.

Graphic showing a breakdown of research themes for our R2HC rapid research to support COVID-19 response.

Partnerships are between researchers and humanitarian actors and practitioners, with over 70 partners involved across the studies, most have not been funded by us before.

Find out more about the studies below.

Learn more about the STUDIES

Theme: Innovative Solutions

Using humanitarian engineering to solve social distancing barriers in refugee humanitarian interventions: A cross-country comparison of Turkey, Lebanon, and Jordan

Nawyn & Gasteyer (Michigan State University) with other partners

This study uses qualitative and quantitative methods to explore how humanitarian non-governmental organisations (NGOs) in three countries tackle the challenge of limiting infection spread of COVID-19 among refugee populations. Cross-country comparisons will be used to examine how NGOs are addressing infection risks, with a view to informing best practice guidance for humanitarian interventions.

Expected outcomes are better understanding of the challenges that NGOs face in trying to minimize spread of infectious disease while administering humanitarian assistance to refugees during a pandemic, and recommendations for NGOs and government officials for overcoming those challenges.

Monitoring and maintenance of handwashing devices during the COVID-19 crisis in a humanitarian context – the role of psychological ownership

Lüthi (Eawag, Swiss Federal Institute of Aquatic Science and Technology) with International Federation of the Red Cross (IFRC)

This controlled trial study aims to increase handwashing in households, and will be conducted in Cox’s Bazaar, Bangladesh. Camp residents and staff will be surveyed to assess functionality, monitoring and maintenance systems of handwashing devices as well as psychological ownership of the devices, to assess whether ownership increases handwashing.

Expected outcomes are improved monitoring and maintenance of both individual and public handwashing devices in the camp settings, and strengthened interventions for handwashing which increase psychological ownership, tailored to the local conditions and the current COVID-19 crisis.

 


Theme: Strengthening humanitarian and healthcare systems

Evaluating the impact of COVID-19 on multi-sectoral humanitarian needs

Mullafiroze & Cha (IMPACT Initiatives) with other partners

This study will use desk-based research with three country case studies to better understand the impacts on people and communities of the COVID-19 pandemic, taking a multi-sectoral approach (drawing on the REACH Multi-Sectoral Needs Assessments). The study team hopes to identify priority sectors and vulnerable groups or populations.

Expected outcomes are a better understanding of the multi-sectoral vulnerability to Covid-19 in the 7 MSNA countries, which can inform research design of the 2020 MSNA process and inform emergency prioritization; and an understanding of how Covid-19 is exacerbating humanitarian needs in these crises, to inform targeting and decision-making of humanitarian response to COVID-19, both within the health sector and other sectors.

Gender-based violence (GBV) risk mitigation among non-protection humanitarian sectors in the context of COVID-19

Scott (Beth Israel Deaconess Medical Center) with UNICEF and others

This mixed-methods study seeks to understand how global guidance on GBV from the Inter-Agency Standing Committee (IASC) on COVID-19 response programming is being implemented in non-protection sectors including through interviews with humanitarian practitioners. It has potential to help inform and adapt the guidance for humanitarian response in the non-protection sectors, in both the COVID-19 and future outbreaks.

Expected outcomes are strengthened global guidance on GBV risk mitigation for use during the current COVID-19 response and future responses; and programme adaptions and improvements by UNICEF, CARE and other humanitarian stakeholders in response to evidence and recommendations emerging from the study.

Health system and community responses to COVID-19: a comparative study focused on Palestinian refugees in Gaza and Lebanon

Diaconu (Queen Margaret University) with UNRWA

This study adopts a realist case-study and mixed-method design to appraise the effectiveness, equity, acceptability and scalability of strategies put in place by health systems in the context of the global COVID-19 pandemic, to sustain routine service delivery and mitigate the impacts of COVID-19. The team will also look at the underlying health system capacities required to support these strategies.

Expected outcomes are timely evidence, in usable formats such as summaries, infographics, and survey analysis reports, to inform ongoing decision-making of UNRWA and other humanitarian actors. Longer-term outcomes include improved understanding of the resilience of health systems responding to the needs of protractedly displaced populations, and on the effective strategies and underlying capacities required for health systems to respond.

 


Theme: Predicting outbreaks

Dial-COVID: remote mitigation through telephone symptom surveillance in refugee settlements in Uganda

O’Laughlin & Pham (University of Washington) with other partners

This study, based in Uganda, focuses on evaluating the acceptability and effectiveness of a mobile telephone interactive voice response (IVR) symptom tracker/information dissemination tool (“Dial-COVID”) for supporting COVID-19 prevention and control measures. The team are testing established technology, already used in low and middle income countries (LMICs), in a refugee population, to apply the findings to the current COVID-19 response.

Expected outcomes are the implementation and validation of Dial-COVID as a COVID-19 surveillance and information dissemination tool, which could be used in other settings; plus improvements in effectiveness and targeting of COVID-19 public health information and interventions for refugees in Uganda.


Theme: Knowledge, behaviours, and community responses to COVID-19 public health measures

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

Hart (University of Bath) with UNRWA

This qualitative research study aims to identify the barriers and enablers for the uptake of public health measures in Palestine refugee camp communities in the Gaza Strip. They will also look at the protection concerns for vulnerable groups arising as a result of public health measures being implemented in the communities.

Expected outcomes are a better- informed UNRWA response to COVID-19 in Palestinian refugee communities, supported by an increased evidence base of current community practices surrounding COVID-19, and data on the interconnection between public health measures and protection issues.

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

Stein (IDInsight) with GiveDirectly

This research, which is an add-on element to an existing randomised controlled trial (RCT) focuses on which refugee households are implementing COVID-19 public health measures and how unconditional cash transfers affect this. The study will also look at household understanding of COVID-19, social distancing measures being implemented, and their effects on household daily life.

Expected outcomes are increased understanding of both how large, unconditional cash transfers influence refugee households to implement COVID-19 public health measures, such as social distancing; and of effects of COVID-19 on the daily lives of refugee households, including whether existing programmes and messaging are effective in increasing knowledge and changing behaviours.

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

Seruwagi (Makerere University) with MOH Uganda and others

This is a mixed-method rapid situation analysis conducted in Uganda’s diverse refugee settings, including Somalis, South Sudanese, Congolese, Rwandans and Burundians. They seek to study refugee lived experiences, assess behavioural shifts and local risk perceptions, and determine how refugees are responding to COVID-19 public health measures in Uganda.

Expected outcomes are models, frameworks and actionable recommendations for humanitarian actors, based on deeper understanding of the impact of the pandemic on social behaviours in refugee settings, particularly regarding local innovations to implement public health measures; the role of community-based responses and networks; the ‘infodemic’; and negative coping mechanisms.

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

Ahmed & Ly, Faculty of Medicine and Odontostomatology (FMOS) of Bamako, Mali, with ARCAD-Santé and others

This qualitative exploratory study aims to contribute to the Malian government’s public health measures in response to COVID-19. The study team aims to understand the challenges and responses to public health measures of IDPs living in Bamako and Ségou, to inform efforts to contextualise and adapt these measures to make them more effective among IDPs. The study would be a pilot for a regional initiative ‘COVID Francophone Africa’ led by the network Francophone Africa and Fragility.

Expected outcomes are improved, evidence-based understanding of the challenges faced by authorities and humanitarian actors in adequately implementing public health measures to inform and adapt in real time the response to COVID-19, and

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

Abdulrahim (Norwegian Refugee Council) with American University of Beirut (AUB)

This study will focus on Syrian refugees in Lebanon aged 50+. Using multi-level analysis, the study team aims to explore how adherence to COVID-19 prevention and control measures among older Syrian refugees varies over time in response to emergent vulnerabilities in the context. The study addresses an important need by addressing a neglected group in humanitarian emergencies – older adults – who are high risk in the COVID-19 outbreak.

Expected outcomes are an improved humanitarian response to COVID-19 by NRC, based on evidence and data. Additionally, evidence and knowledge sharing, including through infographics and social media ‘bites’, will facilitate a coordinated response to COVID-19 among other humanitarian actors in the same location.

Strengthening the humanitarian response to COVID-19 in Colombia

Bowser & Shepard (Brandeis University) with 60 Colombian municipal governments

Until a vaccine is developed, governments will need to apply broad public health measures, including social distancing, to manage COVID-19 risks including for refugees and IDPs. The outcomes of this study are therefore considered to be widely relevant outside Colombia. This study uses both qualitative and quantitative data to determine variation in implementation, and adherence to public health and social distancing policies, within the COVID-19 outbreak among Venezuelan migrant refugees in 60 Colombian municipalities, and analysis of health care costs for the migrant populations.

Expected outcomes are the ability to identify policies and behaviours that have achieved a favourable balance of controlling transmission, while minimizing economic distress on the displaced populations.

 


Theme: Messaging and public health information

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

Heywood (University of Sheffield) with Fondation Hirondelle and others

This qualitative study primarily uses qualitative and content analysis methods to evaluate how radio broadcasters in Burkina Faso can effectively be adapted to address and respond to the information needs of IDPs and to combat misinformation regarding COVID-19. The team will use the findings to directly inform the partner radio station (Studio Yafa) broadcasts through a network of 37 local partner radios, covering zones with the highest concentration of IDPs.

Expected outcomes are a better understanding of the sources and circulation of (mis)information regarding COVID-19 among IDPs and host communities; of IDPs’ information needs in general; and in relation to humanitarian actors in particular.

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

Schomerus (Busara Center for Behavioural Economics) with Danish Refugee Council

This mixed-methods study will take place in six sites, in three countries with large refugee and IDP populations – Kenya, Somalia and DRC. The team will examine how misinformation on COVID-19 spreads, as well as 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 through the selected study areas.

Expected outcomes are frameworks and strategies to deliver targeted, accurate, clear and actionable health information to increase adherence to public health measures, and to combat the spread of misinformation related to COVID-19.

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

Azzalini & White (Oxfam), Action Contre Le Faim (ACF) and London School of Hygiene and Tropical Medicine (LSHTM)

This mixed-methods study will use an intervention called the Community Perception Tracker (CPT) to assess community perceptions during the COVID-19 outbreak around the acceptability of programmes, and behaviour change interventions on key topics, such as handwashing, in Zimbabwe, and Lebanon.

Expected outcomes are improved understanding of behavioural enablers and barriers for people affected by COVID-19, to minimise infection risks, timely adaptation and increased quality of programme interventions, in line with communities’ understanding, priorities and needs. Additionally, enhanced support to field teams to immediately analyse and use the data delivered through the study, and a monitoring and evaluation framework for the use of the CPT in public health programmes.

Funding for this research is made possible through our Research for Health in Humanitarian Crises (R2HC) programme, which is supported by the UK Foreign, Commonwealth and Development Office (FCDO), Wellcome, and the National Institute for Health Research (NIHR).

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