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5 Results for Contextual Factors

5.1 Access to healthcare

5.1.2 Expert Interviews

Key findings from the expert interviews were as follows:

PRIORITY GAPS IN THE AVAILABLE EVIDENCE ON ACCESS TO HEALTHCARE WHICH NEED TO BE FILLED INCLUDE:

  • Real-time mapping of access to healthcare of end-users.
  • Optimising healthcare access in crisis areas outside government control for both end-users and healthcare¬†workers.
  • Health disparities arising from access inequities between resident and transiting populations within a crisis location.
  • Role of mobile phones and other digital technologies in improving health access for end-users.
  • Certain populations experiencing crisis, including adolescents, the disabled, the elderly, those with chronic disease, and prisoners or detainees.

ISSUES RELATED TO THE TYPE OF CRISIS AND ACCESS TO HEALTHCARE:

  • Gathering evidence and study contextual factors is most difficult in the context of armed conflict and in situations where infrastructure has suffered severe and extensive destruction, such as is typical after earthquakes.

TYPE OF STUDIES NEEDED:

  • Randomised and controlled trials would be an impractical, unfeasible and unethical means of seeking evidence on contextual factors.
  • The greatest source of shared knowledge likely lies within the grey literature, but the extent to which this can be used as scientific evidence is highly variable and its usefulness would be dependent on the reputation of the agency producing it.
  • By nature, innovations aimed at systemic transformative change need to transcend evidence-based interventions and therefore the quest for evidence must itself be carefully directed.

USE OF GUIDELINES AND STANDARDS IN THE STUDY OR PROGRAMMATIC DEVELOPMENT OF ACCESS TO HEALTHCARE:

  • The Geneva Conventions are the most widely used standards for contextual factors.
  • Other guidelines and standards which are particularly useful include: (i) government sources and statistics, (ii) International Crisis Group (ICG) reports, (iii) existing institutional guidelines, (iv) policy statements of agencies, (v) needs assessments of agencies, and (vi) informal peer advice.
  • Other than the Institutional Review Board (IRB) process, there are very few standardised ethical guidelines in the field of humanitarian research and programmatic development.

There was excellent consensus on the perceived research gaps in contextual factors among the humanitarian experts interviewed.

View Publication View Executive Summary View Executive Summary - French

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