The Humanitarian Health Evidence Review

Evidence gaps identified by key informants included:

• The evidence base for CD interventions in crisis settings needs to be strengthened, starting with the development of agreed protocols and indicators, e.g.Sphere indicators must be reframed into something context-specific.
• Specific evidence gaps exist around many issues related to communicable disease, including: the diseases themselves (e.g. pertussis, hepatitis A and E, and measles), methods to measure them (e.g. Lot Quality Assurance Sampling (LQAS)), and standard measurements such as mortality (e.g. age and gender specific).
• Designs to conduct and assess immunisations are problematic, with LQAS being employed by many but debated by a few experts who question its appropriateness.
• CD is context, disease and crisis specific – e.g. currently there is almost no evidence on CD control in Syrian populations; age/gender specific information is needed, even on mortality.
• Surveillance must be enhanced across all settings, once indicators are agreed upon; current surveillance focuses on measles but target ages are changing and schedules being revised.
• There is no evidence on whether a coordinated humanitarian approach will improve targets; research could be done on current versus coordinated approaches.
• Huge gap in understanding of human side of CD control; more anthropological/sociological research is needed for CD intervention success (e.g. acceptability).
• Research could validate clinical versus laboratory confirmed outcomes for CD interventions.