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Principal Investigators: Stephanie J. Nawyn & Stephen Gasteyer (Michigan State University)

Research Snapshot: Humanitarian COVID-19 safety protocols

To provide services to refugees safely during the COVID-19 pandemic, NGOs have instituted safety protocols to mitigate the risk of spreading infection in crisis settings. This study aimed to better understand how these protocols were being followed on the ground and examine barriers to adherence.

View Research Snapshot

What did the study set out to achieve?

Humanitarian NGOs face significant challenges to limiting infection spread while assisting refugees. Using data from on-the-ground service provision to refugees in thirteen locations in Lebanon, Jordan, and Turkey, the overall goal of the study was to determine what interventions could be implemented that would mitigate barriers to practices that aimed to slow the spread of COVID-19 among refugee populations.

In accordance with the study’s original aims, the study focused on social distancing, mask wearing, and hand hygiene, measuring how well those protocols were followed during different types of services and with different refugee populations. Barriers such as lack of physical space, lack of knowledge about COVID-19, limitations of the services, and attitudes about COVID-19 were measured.

Stephanie J. Nawyn

Principal Investigator

Often the key to understanding how refugee assistance can be improved is to understand what barriers service providers face in everyday work, and what innovations they develop in response. By comparing a range of contexts, we hope to produce recommendations for sustainable best practices that come from the ground up.

What were the key findings?

After conducting 1,454 interviews with staff and 215 unique observations of service provision at four partner NGOs assisting refugees in Lebanon, Turkey, and Jordan, the study found:

  • In situations that were inherently higher risk, people were more adherent to safety protocols and there was subsequently less infection risk. Conversely, there were more potential infection vectors when people felt safer.
  • It was expected that availability of hand hygiene resources like soap and sanitiser would be a challenge. In fact, refugees and NGO staff did not always use such resources when they were available.
  • Cultures of protocol adherence seem to operate in service spaces, with norms emerging around specific protocols such that one protocol might be followed well while another protocol might have lax adherence.

What does this mean for policymakers and practitioners?

One of the more concerning findings of this study was the prevalence of COVID skepticism among refugees. Humanitarian service providers will need to consider how COVID skepticism might affect not just their refugee clients’ adherence to safety protocols, but also their willingness to be vaccinated in the future.

The findings also suggest that local cultures emerge around COVID-skepticism and adherence to different safety protocols. Humanitarian NGOs need to consider the specifics of each site as a local culture that might be quite different from others. They should not assume that protocols are followed in the same way across all of their service centers, or that because one protocol is followed well that others are too.

Next steps

The research team are preparing to distribute the recommendations from their study through a written final report and a series of five webinars offered in English and Arabic.

Please check this study webpage for the latest updates, outputs from the study, and contact information.


Related Resources

Report COVID-19

Protecting Refugees from COVID-19. Identifying Barriers to Safer Practices During Humanitarian Assistance in Turkey, Jordan, and Lebanon

Article, Peer Reviewed COVID-19, Health Systems & Services

Resilience to Nested Crises: The Effects of the Beirut Explosion on COVID-19 Safety Protocol Adherence During Humanitarian Assistance to Refugees

Latest Updates

Report published

May 2021

A report, summarising the key findings of the research, was published.


Webinar: COVID-19 Policies vs. Practices of Humanitarian NGOs

Nov 2020

In this webinar, the study team present findings from humanitarian NGOs assisting refugees in Lebanon, Jordan, and Turkey to identify where there are gaps in practices intended to reduce the spread of SARS-CoV-2, and what barriers exist to more safely administering humanitarian aid.


Website created

Sept 2020

The study team created a website for those wishing to find out more about the project, the team, and keep up to date with the latest progress.

Syrian refugee girls receive educational and social support from Safa for Development in southeastern Turkey. Photo Credit: Safa for Development
Amel Association staff provide health services to Palestinian refugees in Lebanon. Photo credit: Amel Association

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