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5 Results for Contextual Factors

5.4 Coordination

5.4.2 Expert Interviews

Key findings from the expert interviews were as follows:

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

  • OCHA’s ‘fitness-for-purpose’ for addressing health needs
  • Non UN/OHCA-centric mechanisms of coordination
  • Impact of integrated UN missions on healthcare delivery
  • Role of UNHCR in the coordination of healthcare delivery to IDPs and refugees
  • How international communities coordinate with local government
  • Advantages and disadvantages of pooled funding within the UN structure
  • Cost-benefit analysis of coordination of humanitarian public health interventions
  • Role of generating competitive market forces between agencies in improving coordination and healthcare delivery efficiency
  • Certain populations experiencing crisis, including adolescents, the disabled, the elderly, those with chronic disease, IDP and refugees, and urban populations.

ISSUES RELATED TO THE TYPE OF CRISIS AND COORDINATION:

  • Gathering evidence and the study of this contextual factor is most limited and difficult in the context of armed conflict.

TYPE OF STUDIES NEEDED:

  • Randomised and controlled trials would be an impractical, unfeasible and unethical means of seeking evidence on this contextual factor.
  • 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 is seen to 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 IASC guidelines are the most widely used standards for this contextual factor.
  • Other guidelines and standards which are particularly useful include: (i) UNEG (UN Evaluation Group) norms and standards, (ii) ALNAP guidelines, (iii) International Crisis Group (ICG) reports, (iv) existing institutional guidelines, (v) policy statements 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 this contextual factor among the humanitarian experts interviewed. The area where there was a lack of consensus was in the role of UNHCR in the coordination of healthcare delivery to IDPs and refugees, where only a minority of experts believed this to be a research priority.

View Publication View Executive Summary View Executive Summary - French

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