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5 Results for Contextual Factors

5.6 Urbanisation

5.6.2 Expert Interviews

Key findings from the expert interviews were as follows:

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

  • Meaningful indicators for the measurement of urban health, including ones which are location-specific, able to differentiate between health states arising out of chronic deprivation and acute crisis, and able to measure associated tipping points or threshold criteria.
  • Optimal methods of integrating humanitarian health interventions into existing urban healthcare infrastructures.
  • Strategies to improve the baseline health status and robustness of health systems in rapidly urbanising populations to mitigate the detrimental health impacts of crises.
  • Civil engineering and urban planning directed towards disaster preparedness, prevention and mitigation.
  • Management of chronic disease during collapse of health systems in urban settings.
  • Community-based humanitarian healthcare interventions.
  • Monitoring and surveillance methodologies of health in urban settings.
  • Efficient methods in the identification of and targeted intervention in specific populations (e.g. IDPs, refugees, women) within non-camp urban settings.
  • Slum populations.
  • Estuarine populations.
  • Populations living on landslide prone or soft land areas unsuitable for urbanisation.

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, other situations of urban violence and where there is a lack of social capital between researchers and affected communities.

TYPE OF STUDIES NEEDED:

  • Randomised and controlled trials would be an impractical, unfeasible and unethical means of seeking evidence on this contextual factor. However, stratification of data by similarities of interest in neighbourhoods and communities for comparative analysis is needed.
  • 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. Grey literature can be very location specific which can be particularly useful.
  • 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:

  • Government statistics are the most widely used standards for this contextual factor, although it is acknowledged that they can be technically inaccurate or reflect a political agenda.
  • Other guidelines and standards which are particularly useful include: (i) UN Habitat reports and guidelines, (ii) IASC guidelines, (iii) ALNAP guidelines, (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 importance put on the need for evidence in the management of chronic disease during collapse of health systems in urban crises, where a minority of experts believed this to be an over-emphasised research priority reflecting a current vogue.

View Publication View Executive Summary View Executive Summary - French

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