The Humanitarian Health Evidence Review

Key findings from the expert interviews were as follows:

• Compared to other sectors (e.g. WASH, nutrition), the CD sector is more diverse, leading to problems when CD practitioners try to coordinate interventions and research – particularly with other sectors.
• The two largest problems facing CD research in these settings are: i) lack of coordination in response, ii) lack of consensus on standards to employ for each situation.
• Context is very important and further research is needed, for example, on how vaccination schedules should be reconsidered per each population and crisis type (by situation, partners on the ground).
• As a sector, CD follows norms and guidelines – most notably Sphere, but individual agencies have their own guidelines and protocols, causing problems, e.g. the NATO response in Afghanistan had joined forces from different countries, meaning over 10 different malaria protocols were being used at the same time, in the same region.
• Sphere’s CD indicators are not easy to measure for those practicing in the field. This has also led to a divergence of indicators, with several organisations developing their own (e.g. CDC, NGOs).
• WHO agencies need to take more leadership in this sector, as there is currently no single authoritative body to which CD practitioners defer. Experts agree this was, in theory, supposed to be the responsibility of the WHO but there is little guidance, which leads to each agency working largely in isolation.