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Rohingya refugees from Myanmar in Bangladesh. © 2017 Probal Rashid, Courtesy of Photoshare

RECAP

Research capacity strengthening and knowledge generation to support preparedness and response to humanitarian crises and epidemics.

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The RECAP team at the kick-off meeting in London February 2018
The RECAP team at the kick-off meeting in London February 2018
About
Columns About RECAP
About RECAP
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Kapise refugee camp for refugees from Mozambique, Mwanza, Malawi. © 2016 Erico Waga, Courtesy of Photoshare
Kapise refugee camp for refugees from Mozambique, Mwanza, Malawi. © 2016 Erico Waga, Courtesy of Photoshare

Project rationale

There are an estimated 172 million people worldwide affected by armed conflict, including 59 million people forcefully displaced from their homes as refugees or internally displaced persons (IDPs). In addition, natural disasters affect around 175 million people annually. Outbreaks of infectious diseases often follow on from humanitarian crises and consequent health systems weaknesses. Humanitarian crises and their impact on health, protection and related sectors pose major obstacles to international development and the achieving the Sustainable Development Goals (SDGs).

Effective decision-making by humanitarian actors is vital to the effectiveness of humanitarian responses. Accurate and timely information and evidence is essential in achieving effective decision-making. Yet current humanitarian decision-making and programmes are impeded by limited data, evidence, capacity, guidance, and ethical preparedness.  Accountability is a vital component in improving humanitarian responses and is reliant on good information and evidence. However, gaps remain in understanding and implementation of accountability mechanisms.

Vision and activities

RECAP’s vision is to strengthen research capacity and capability to generate knowledge on how to improve decision-making and accountability to help support preparedness and response to humanitarian crises and epidemics.

RECAP focuses on the sectors of health and protection. It has six research Work Streams and four capacity strengthening Work Streams.

The 6 research Work Streams are:

Work Stream One: Developing and evaluating improved metrics to support humanitarian response

The objective is to develop, pilot and evaluate the application of improved metrics for agency and sector performance in humanitarian settings. The activities involve identifying a set of service availability, coverage and quality indicators to quantify the performance of humanitarian responses aimed at reducing excess morbidity and mortality and improving human security. We will then develop methods to rapidly quantify each indicator in a crisis context, ranging from analysis of programmatic data to rapid service audits to small sample surveys. We will then develop an open access software platform and set of guidance documents to enable implementation of this work by humanitarian staff. Feasibility of the methodology will be explored through qualitative research and economic analysis.

Lead: Francesco Checchi

Work Stream Two: Strengthening epidemic modelling for real-time decision-making

The objective is to develop and apply new modelling techniques for epidemic preparedness and response to guide real-time decision-making. The methods involve collecting and combining data from a large number of previous outbreaks for our chosen disease case studies. For each outbreak we will simultaneously collate data on population and turnover estimates, relevant environmental factors, host factors and timelines of key events. Field surveys will also be performed in a range of settings to obtain estimates of transmission related parameters (including demographic and behavioural parameters). For the analysis, spatially explicit statistical models will be fitted to the outbreak data to describe and quantify associations between outcome variables and inputs. Mechanistic models will also be developed and fitted to the data using Bayesian methods to gain a better understanding of key variables (identified from the statistical analysis) on the observed epidemiological picture and impact of control policies. The models will inform a real-time platform to assess epidemic progression and policy evaluation. The results will help improve preparedness for future outbreaks and provide input to the design of appropriate indicators.

Lead: John Edmunds

Work Stream Three:  Applied use of economic methods in humanitarian crises

The objective is to develop and apply economic methods to inform decision-making in humanitarian settings. More specifically, it seeks to: (i) examine population and provider preferences for financing and human resource arrangements and coverage; (ii) estimate the costs and cost-effectiveness of interventions and packages of care to inform resource allocation decisions; (iii) examine trends in levels and the nature of external humanitarian funds, external aid flows for the general population, and government funding before and during humanitarian crises; and (iv) develop toolkits to inform decision making on preferred models of financing, cost-effectiveness and packages of care in crisis settings. Methods include conducting surveys and qualitative research, collection of routine data, and analysis of national government spending and international aid flows.

Lead: Josephine Borghi

Work Stream Four: Improved use of data for decision-making by humanitarian agencies

The objective is to evaluate the current use of data and evidence in operational decision-making and the potential for innovative decision-making approaches and technologies in humanitarian settings. The methods include: literature review; an online survey to characterise currently used information systems and to identify supportive features; qualitative and more ethnographic research with RECAP members and other key stakeholders, including drawing on examples and case-studies emerging from across other RECAP research Work Streams. We will evaluate information systems use through country case studies embedded in crisis-affected settings using qualitative methods, health economics, and information science.

Lead: Karl Blanchet

Work Stream Five: Exploring accountability and enforcement frameworks in humanitarian crises

The objective is to explore accountability frameworks and enforcement mechanisms in humanitarian settings. The methods include legal and social sciences research methods through desk-based research and field work in in Lebanon, Sierra Leone, Myanmar, northern Uganda and South Sudan. The field studies draw on ethnographic and qualitative research with crisis-affected and forcibly displaced individuals and those involved in organising and providing humanitarian services. This participatory methodology intends to facilitate joint knowledge production and explore how the capabilities of beneficiaries to hold humanitarian actors to account can be enhanced.

Health leads: Melissa Parker and Tim Allen

Protection lead: David Cantor

 

Work Stream Six: Exploring ethical preparedness and provision in humanitarian crises

The objective is to explore and support ethical preparedness and provision in humanitarian crises. The specific research questions include: (i) what are ethical issues experienced by frontline humanitarian staff and what are some of the solutions they’ve devised? (ii) In what ways can ethically informed practice be supported among frontline staff? (iii) How can ethical issues around health and protection work and research on child, family and gender-based be better understood and addressed? The research methods include ethnographic and qualitative research with crisis-affected and forcibly displaced individuals and those involved in organising and providing humanitarian services.

Lead: Patricia Kingori

The four capacity strengthening work streams are:

Work Stream 7: Strengthening capacity in research methods

We will conduct training on the methods used in the RECAP Research Streams to support applied learning through the inclusion of local researchers in the design, conduct, analysis and write-up of the research.  The training activities listed here mainly take place at the University of Sierra Leone and the American University of Beirut and through online materials, and be open to university and NGO partners and selected key stakeholders.

Work Stream 8: Strengthening institutional capacity for conducting humanitarian research

We seek to enhance institutional research capacity to develop a sustainable and supportive research environment. Key activities include: support for new or existing institutional group within the University of Sierra Leone and the American University of Beirut with a particular focus on humanitarian-related research; establishing or supporting existing multi-disciplinary research groups; conducting a needs assessment at the University of Sierra Leone and the American University of Beirut focusing on six research capacity management and support themes.

Work Stream 9: Supporting individual researcher capability and career progression

RECAP will provide the following specific support to individual researchers at the University of Sierra Leone and the American University of Beirut: postdoctoral support, include two fellowships; a research leadership programme;  a competitive funding scheme of two small grants for early career researchers at the University of Sierra Leone and the American University of Beirut;  core training for early/mid-career researchers at the University of Sierra Leone and the American University of Beirut and partner NGOs; placement schemes; a mentoring and development programme for early career researchers; supporting curriculum development; and  training on the use of research /information for humanitarian decision support for NGO and government decision-makers.

Work Stream 10: Building capability in the United Kingdom for research on health and protection in humanitarian crises

RECAP will create new positions within the partner universities to strengthen capacity for humanitarian-related research. It will also connect researchers from these universities with our partners at the American University of Beirut and the University of Sierra Leone; and build research networks between university partners and NGOs and strengthen understanding of their different needs, priorities, and challenges.

Expected outputs and outcomes

  • A new research network and regional hubs of research excellence and training
  • Strengthened research capacity and capability among university and NGO partners to conduct high quality and high impact research
  • Scientific research papers and outputs
  • Open access software platforms and research guidelines
  • Contributions to humanitarian guidelines, programmes and policies

The RECAP leadership team

Principal Investigators  
Overall Principal Investigator Professor Bayard Roberts (London School of Hygiene and Tropical Medicine)
Lebanon Principal Investigator Professor Abla Mehio Sibai (American University of Beirut)
Sierra Leone Principal Investigator Professor Mohamed Samai (College of Medicine and Allied Health Sciences, University of Sierra Leone)

Research Co-Investigators

Capacity strengthening Co-Investigators

Partnership

RECAP is led by the London School of Hygiene and Tropical Medicine in partnership with universities and non-governmental organisations (NGOs) working on health and protection in humanitarian crises.

RECAP uses a hub-and-spoke model; with hubs of Lebanon, Sierra Leone, and UK for capacity strengthening and research; and spokes of further research sites in NGO partner programmes in countries affected by humanitarian crises. The partners are:

LSHTM logo
The London School of Hygiene and Tropical Medicine The University of Sierra Leone (College of Medicine and Allied Health Sciences) The American University of Beirut (Faculty of Health Sciences) Oxford University (Nuffield Department for Population Health) The Refugee Law Initiative at the School of Advanced Study in London University
The London School of Economics and Political Science (LSE) Médecins Sans Frontières (MSF OCA) International Rescue Committee (IRC) Save the Children UK BRAC
Research
RECAP Research
Research RECAP
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An elderly couple at the site of their house in Nanglebari, Nepal, that was destroyed by the 2015 earthquake. © 2016 Leesha Manju, Courtesy of Photoshare
An elderly couple at the site of their house in Nanglebari, Nepal, that was destroyed by the 2015 earthquake. © 2016 Leesha Manj

RECAP’s research portfolio consists of the following six Work Streams.

Work Stream One: Developing and evaluating improved metrics to support humanitarian response

The objective is to develop, pilot and evaluate the application of improved metrics for agency and sector performance in humanitarian settings. The activities involve identifying a set of service availability, coverage and quality indicators to quantify the performance of humanitarian responses aimed at reducing excess morbidity and mortality and improving human security. We will then develop methods to rapidly quantify each indicator in a crisis context, ranging from analysis of programmatic data to rapid service audits to small sample surveys. We will then develop an open access software platform and set of guidance documents to enable implementation of this work by humanitarian staff. Feasibility of the methodology will be explored through qualitative research and economic analysis.

Lead: Francesco Checchi

Work Stream Two: Strengthening epidemic modelling for real-time decision-making

The objective is to develop and apply new modelling techniques for epidemic preparedness and response to guide real-time decision-making. The methods involve collecting and combining data from a large number of previous outbreaks for our chosen disease case studies. For each outbreak we will simultaneously collate data on population and turnover estimates, relevant environmental factors, host factors and timelines of key events. Field surveys will also be performed in a range of settings to obtain estimates of transmission related parameters (including demographic and behavioural parameters). For the analysis, spatially explicit statistical models will be fitted to the outbreak data to describe and quantify associations between outcome variables and inputs. Mechanistic models will also be developed and fitted to the data using Bayesian methods to gain a better understanding of key variables (identified from the statistical analysis) on the observed epidemiological picture and impact of control policies. The models will inform a real-time platform to assess epidemic progression and policy evaluation. The results will help improve preparedness for future outbreaks and provide input to the design of appropriate indicators.

Lead: John Edmunds

Work Stream Three:  Applied use of economic methods in humanitarian crises

The objective is to develop and apply economic methods to inform decision-making in humanitarian settings. More specifically, it seeks to: (i) examine population and provider preferences for financing and human resource arrangements and coverage; (ii) estimate the costs and cost-effectiveness of interventions and packages of care to inform resource allocation decisions; (iii) examine trends in levels and the nature of external humanitarian funds, external aid flows for the general population, and government funding before and during humanitarian crises; and (iv) develop toolkits to inform decision making on preferred models of financing, cost-effectiveness and packages of care in crisis settings. Methods include conducting surveys and qualitative research, collection of routine data, and analysis of national government spending and international aid flows.

Lead: Josephine Borghi

Work Stream Four: Improved use of data for decision-making by humanitarian agencies

The objective is to evaluate the current use of data and evidence in operational decision-making and the potential for innovative decision-making approaches and technologies in humanitarian settings. The methods include: literature review; an online survey to characterise currently used information systems and to identify supportive features; qualitative and more ethnographic research with RECAP members and other key stakeholders, including drawing on examples and case-studies emerging from across other RECAP research Work Streams. We will evaluate information systems use through country case studies embedded in crisis-affected settings using qualitative methods, health economics, and information science.

Lead: Karl Blanchet

Work Stream Five: Exploring accountability and enforcement frameworks in humanitarian crises

The objective is to explore accountability frameworks and enforcement mechanisms in humanitarian settings. The methods include legal and social sciences research methods through desk-based research and field work in in Lebanon, Sierra Leone, Myanmar, northern Uganda and South Sudan. The field studies draw on ethnographic and qualitative research with crisis-affected and forcibly displaced individuals and those involved in organising and providing humanitarian services. This participatory methodology intends to facilitate joint knowledge production and explore how the capabilities of beneficiaries to hold humanitarian actors to account can be enhanced.

Health leads: Melissa Parker and Tim Allen

Protection lead: David Cantor

Work Stream Six: Exploring ethical preparedness and provision in humanitarian crises

The objective is to explore and support ethical preparedness and provision in humanitarian crises. The specific research questions include: (i) what are ethical issues experienced by frontline humanitarian staff and what are some of the solutions they’ve devised? (ii) In what ways can ethically informed practice be supported among frontline staff? (iii) How can ethical issues around health and protection work and research on child, family and gender-based be better understood and addressed? The research methods include ethnographic and qualitative research with crisis-affected and forcibly displaced individuals and those involved in organising and providing humanitarian services.

Lead: Patricia Kingori

 

Capacity strengthening
Capacity strengthening columns RECAP
Capacity strengthening RECAP
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An Ebola burial worker in Bombali, Sierra Leone. © 2014 Peter Kilmarx, Courtesy of Photoshare
An Ebola burial worker in Bombali, Sierra Leone. © 2014 Peter Kilmarx, Courtesy of Photoshare

RECAP’s capacity building portfolio is addressed through the following four Work Streams.

Work Stream 7: Strengthening capacity in research methods

We will conduct training on the methods used in the RECAP Research Streams to support applied learning through the inclusion of local researchers in the design, conduct, analysis and write-up of the research.  The training activities listed here mainly take place at the University of Sierra Leone and the American University of Beirut and through online materials, and be open to university and NGO partners and selected key stakeholders.

Work Stream 8: Strengthening institutional capacity for conducting humanitarian research

We seek to enhance institutional research capacity to develop a sustainable and supportive research environment. Key activities include: support for new or existing institutional group within the University of Sierra Leone and the American University of Beirut with a particular focus on humanitarian-related research; establishing or supporting existing multi-disciplinary research groups; conducting a needs assessment at the University of Sierra Leone and the American University of Beirut focusing on six research capacity management and support themes.

Work Stream 9: Supporting individual researcher capability and career progression

RECAP will provide the following specific support to individual researchers at the University of Sierra Leone and the American University of Beirut: postdoctoral support, include two fellowships; a research leadership programme;  a competitive funding scheme of two small grants for early career researchers at the University of Sierra Leone and the American University of Beirut;  core training for early/mid-career researchers at the University of Sierra Leone and the American University of Beirut and partner NGOs; placement schemes; a mentoring and development programme for early career researchers; supporting curriculum development; and  training on the use of research /information for humanitarian decision support for NGO and government decision-makers.

Work Stream 10: Building capability in the United Kingdom for research on health and protection in humanitarian crises

RECAP will create new positions within the partner universities to strengthen capacity for humanitarian-related research. It will also connect researchers from these universities with our partners at the American University of Beirut and the University of Sierra Leone; and build research networks between university partners and NGOs and strengthen understanding of their different needs, priorities, and challenges.

Capacity strengthening Leads:

Dr. Hazel Mccullough (London School of Hygiene and Tropical Medicine)
Professor Mohamed Samai (College of Medicine and Allied Health Sciences)
Professor Jocelyn DeJong (American University of Beirut)

External training opportunities