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5 Results for Contextual Factors

5.5 Security of healthcare workers

5.5.2 Expert Interviews

Key findings from the expert interviews were as follows:

PRIORITY GAPS IN THE AVAILABLE EVIDENCE ON SECURITY OF HEALTHCARE WORKERS WHICH NEED TO BE FILLED INCLUDE:

  • Increased risks posed by integrated UN missions.
  • Impact of using foreign over local healthcare workers.
  • Identification of risk factors associated with security threats to healthcare workers.
  • Impact of asymmetry of power within a conflict setting on security.
  • Impact of international involvement on security.
  • Impact of religious context on security.
  • Impact of end-user perception on security.
  • Political role of healthcare worker kidnappings in conflict negotiation.
  • Certain populations experiencing crisis, including adolescents, the disabled, the elderly, those with chronic disease, and urban refugees.

ISSUES RELATED TO THE TYPE OF CRISIS AND SECURITY OF HEALTHCARE WORKERS:

  • Gathering evidence and the study of this contextual factor is difficult in the context of armed conflict since this in itself may be dangerous to the investigator.

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 (i) Geneva Conventions and (ii) existing institutional guidelines of the agencies or organisations within which humanitarian workers operate are the most widely used standards for this contextual factor.
  • Other guidelines and standards which are particularly useful include: (i) IASC guidelines, (ii) ALNAP guidelines, (iii) International Crisis Group (ICG) reports, (iv) policy statements of agencies, and (v) 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 political role of healthcare worker kidnappings in conflict negotiations, where only a minority of experts believed this to be a research priority.

View Publication View Executive Summary View Executive Summary - French HHER 2021 Update

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