Assessing Health and Social Capital in Refugee Settlements

WHAT HUMANITARIAN NEED IS BEING ADDRESSED?

This project addressed the need for access to reliable information which is critical for both effective coordination among humanitarian partners, and the provision of quality health services in refugee settlements.

Currently in northern Uganda, there are an estimated 833,785 refugees in 23 long-term settlements spread over five districts. Typical health monitoring relies on routine data and periodic complex surveys (eg. cluster surveys) which cannot measure gaps in access or utilisation of services within a refugee community. Real-time information is needed at, and below, the settlement level with an understanding of the crucial barriers to access and uptake of services in this context.

What is the innovative solution and how will it improve existing humanitarian practice?

In this project, rapid mixed methods was used to provide accurate, decentralised and contextualised information for planning and monitoring purposes.

The services assessed included:

• primary health care,
• water/sanitation,
• child protection and livelihood,
• coupled with an investigation of maternal social capital.

Our innovation used a mixed methods approach to collect, interpret, and prioritise Lot Quality Assurance Sampling (LQAS) and qualitative data for programme planning. Our approach provided a tested process and useful information for NGOs to determine what aspects of their services are weak, and in which locations the improvements are needed. This included understanding variation in health seeking behaviours and the influence of social capital on service uptake in refugee communities.

Our approach provided results more rapidly and at a lower cost than conventional surveys. At scale, our innovation improved the planning and management of health services to meet diverse refugee needs.

What did this project achieve?

Previously, with HIF support, Liverpool School of Tropical Medicine (LSTM) adapted Lot Quality Assurance Sampling to rapidly assess the health status of internally displaced persons (IDPs) in South Sudan and provide real-time information needed by agencies to improve health services. You can read more about this project on the project profile here: Lot Quality Assurance Sampling Survey Techniques.

Following the achievements in the last project, LSTM were awarded a HIF diffusion grant to scale their innovation. Based in northern Uganda, the diffusion project supported rapid health monitoring at scale using the adapted IDP-LQAS in long-term refugee settlements.

We compared LQAS indicators in both refugee and host communities coupled with the use of rapid qualitative methods to explore enablers and barriers to the uptake of health services. Outputs included multiple ways to share findings and build capacity among practitioners to interpret and use mixed data to strengthen programmes for refugee communities.

Outputs included:

• Hosting a data use workshop with NGO and government actors.
• Holding a dissemination event to share project results among key humanitarian stakeholders.
• Developing a packaged mixed methods toolkit including the adapted IDP-LQAS, rapid qualitative approach and prioritisation/planning techniques.
• Conducting a webinar and produce a conference paper to diffuse the toolkit.