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Lessons from the field: Confronting the challenges of health research in humanitarian crises

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Humanitarian crises, inclusive of armed conflict, forced displacement, natural disasters, and major disease outbreaks, affect hundreds of millions of lives around the world and take a staggering toll on human health, especially in low-resource settings. To better meet the health needs of people affected by humanitarian crises, organizations responding to these crises need to act on reliable evidence. Conducting the research needed to generate this evidence base is particularly challenging, although examples of high-quality, ethical, and actionable research in humanitarian settings do exist.

This collection of Research in Practice articles features analyses of the experiences of teams conducting research in the context of different humanitarian crises. Unlike traditional research papers, these case analyses focus on the research process, emphasizing the importance of research in humanitarian settings and providing critical analysis of unique challenges to conducting research in humanitarian settings and strategies used to address these challenges. The collection is published across Conflict and Health and BMC Public Health and will include ~23 case analyses addressing both protracted and acute crises, spanning ~18 different countries and covering diverse populations, diseases and health risk factors such as maternal and child health, nutrition, aging, mental health, environmental health, infectious disease, WASH, gender based violence and sexual reproductive health.

All case analyses in the collection have undergone the journals’ standard peer review processes and were commissioned by the Fogarty International Center of the U.S. National Institutes of Health as a part of a larger project on Advancing Health Research in Humanitarian Crises.

  1. The 2014–2015 Ebola epidemic in West Africa became a humanitarian crisis that exposed significant gaps in infection prevention and control (IPC) capacity in primary care facilities in Sierra Leone. Operational...

    Authors: Lara Shiu-yi Ho, Ruwan Ratnayake, Rashid Ansumana and Hannah Brown
    Citation: BMC Public Health 2021 21:1603
  2. Turkey hosts nearly four million refugees and 99% live in urban areas. Research in urban settings pose different challenges and opportunities than research in refugee camps. In this article, we aimed to share ...

    Authors: Ozge Karadag, Cengiz Kilic, Edip Kaya and Sarp Uner
    Citation: BMC Public Health 2021 21:1537
  3. Humanitarian crises, such as armed conflict, forced displacement, natural disasters, and major disease outbreaks, take a staggering toll on human health, especially in low-resource settings. Yet there is a dea...

    Authors: Amit S. Mistry, Brandon A. Kohrt, Blythe Beecroft, Nalini Anand and Iman Nuwayhid
    Citation: Conflict and Health 2021 15:38

    The Correction to this article has been published in Conflict and Health 2021 15:49

  4. This case study describes research, which is located in Turkey, where more than 750,000 Syrian refugees reside autonomously in Istanbul. The research developed and pilot tested a novel model for helping urban ...

    Authors: Stevan Merill Weine, Aliriza Arënliu, Vahdet Görmez, Scott Lagenecker and Hakan Demirtas
    Citation: Conflict and Health 2021 15:31
  5. The protection and support of breastfeeding is the most effective intervention to prevent child morbidity and mortality especially in humanitarian crisis.

    Authors: Alessandro Iellamo, Emily Monaghan, Samar A. L. Moghany, Jonathan Latham and Nihal Nassereddin
    Citation: BMC Public Health 2021 21:742

    The Correction to this article has been published in BMC Public Health 2021 21:899

  6. Provision of safe water, sanitation, and hygiene (WASH) to affected populations in humanitarian emergencies is necessary for dignity and communicable disease control. Additional evidence on WASH interventions ...

    Authors: Daniele Lantagne, Lilian Lehmann, Travis Yates, Karin Gallandat, Mustafa Sikder, Marta Domini and Gabrielle String
    Citation: BMC Public Health 2021 21:560
  7. Venezuela is in the throes of a complex humanitarian crisis that is one of the worst in decades to impact any country outside of wartime. This case analysis describes the challenges faced by the ongoing Maraca...

    Authors: Gladys E. Maestre, Rosa V. Pirela, Carmen L. Paz, Jesus D. Melgarejo, Luis J. Mena, Carlos A. Chavez, Reinier Leendertz, Michele Petitto, Eglé Silva, Gustavo E. Calmón, Lama Al-Aswad, Joseph H. Lee and Joseph D. Terwilliger
    Citation: BMC Public Health 2021 21:473
  8. Conducting ethical and rigorous research to measure the effectiveness of humanitarian programs is urgently needed given the global level of displacement and conflict, yet traditional approaches to evaluation r...

    Authors: Kathryn Falb and Jeannie Annan
    Citation: Conflict and Health 2021 15:12
  9. Understanding the burden of common mental health disorders, such as depressive disorder, is the first step in strengthening prevention and treatment in humanitarian emergencies. However, simple random sampling...

    Authors: Danielle N. Poole, Nathaniel A. Raymond, Jos Berens, Mark Latonero, Julie Ricard and Bethany Hedt-Gauthier
    Citation: BMC Public Health 2021 21:272
  10. In South Sudan, the civil war in 2016 led to mass displacement in Juba that rapidly spread to other regions of the country. Access to health care was limited because of attacks against health facilities and wo...

    Authors: Samira Sami, Ribka Amsalu, Alexander Dimiti, Debra Jackson, Kemish Kenneth, Solomon Kenyi, Janet Meyers, Luke C. Mullany, Elaine Scudder, Barbara Tomczyk and Kate Kerber
    Citation: Conflict and Health 2021 15:5
  11. This case analysis describes dilemmas and challenges of ethical partnering encountered in the process of conducting a research study that explored moral and practical dimensions of palliative care in humanitar...

    Authors: Sonya de Laat, Olive Wahoush, Rania Jaber, Wejdan Khater, Emmanuel Musoni, Ibraheem Abu Siam and Lisa Schwartz
    Citation: Conflict and Health 2021 15:2
  12. Rohingya diaspora or Forcibly Displaced Myanmar Nationals (FDMNs), took shelter in the refugee camps of Cox’s Bazar, Bangladesh due to armed conflict in the Rakhine state of Myanmar. In such humanitarian crise...

    Authors: Rushdia Ahmed, Bachera Aktar, Nadia Farnaz, Pushpita Ray, Abdul Awal, Raafat Hassan, Sharid Bin Shafique, Md Tanvir Hasan, Zahidul Quayyum, Mohira Babaeva Jafarovna, Loulou Hassan Kobeissi, Khalid El Tahir, Balwinder Singh Chawla and Sabina Faiz Rashid
    Citation: Conflict and Health 2020 14:83

    The Publisher Correction to this article has been published in Conflict and Health 2020 14:88

  13. Humanitarian settings often present unique scientific challenges and conditions that distinguish them from standard research settings. While a number of these challenges are faced in both standard settings and...

    Authors: Debarati Guha-Sapir and Sarah Elizabeth Scales
    Citation: BMC Public Health 2020 20:1761
  14. Two devastating sequential hurricanes impacted Puerto Rico during September of 2017. The hurricanes were traumatic and created social and ecological upheaval throughout Puerto Rico, and subsequently in communi...

    Authors: D. Vega Ocasio, J. G. Pérez Ramos and T. D. V. Dye
    Citation: BMC Public Health 2020 20:1628
  15. The Indian Ocean tsunami experience in 2004 caused a major loss of life and subsequent emotional trauma for survivors. Psychosocial needs in the aftermath of this disaster were extensive, yet the cohesion and ...

    Authors: R. Padmavati, Vijaya Raghavan, Heather Rera, Megan Kearns, Kotteeswara Rao, Sujit John and R. Thara
    Citation: BMC Public Health 2020 20:1627
  16. The BRANCH Consortium recently conducted 10 mixed-methods case studies to investigate the provision of health and nutrition interventions for women and children in conflict-affected countries, aiming to better...

    Authors: Michelle F. Gaffey, Anushka Ataullahjan, Jai K. Das, Shafiq Mirzazada, Moctar Tounkara, Abdirisak A. Dalmar and Zulfiqar A. Bhutta
    Citation: Conflict and Health 2020 14:69
  17. According to the Internal Displacement Monitoring Centre report on global human displacement, Ethiopia has the highest number of newly displaced people forced to flee their homes. Displaced people have arrived...

    Authors: Getnet Yimer, Wondwossen Gebreyes, Arie Havelaar, Jemal Yousuf, Sarah McKune, Abdulmuen Mohammed and Dónal O’Mathúna
    Citation: Conflict and Health 2020 14:68
  18. In late 2015, the Sierra Leone government established the Comprehensive Program for Ebola Survivors (CPES) to improve the well-being of 3466 registered Ebola virus disease (EVD) survivors. This case analysis o...

    Authors: Soumya Alva, Nicole Davis, Laurentiu Stan, Isotta Pivato and Jeffrey Sanderson
    Citation: BMC Public Health 2020 20:1346
  19. Globally, one in four children lives in a country affected by armed conflict or disaster often accompanied by exposure to a range of adversities including violent trauma and loss. Children involved with armed ...

    Authors: Theresa S. Betancourt, Katrina Keegan, Jordan Farrar and Robert T. Brennan
    Citation: Conflict and Health 2020 14:62
  20. During humanitarian crises, women and children are particularly vulnerable to morbidity and mortality. To address this problem, integrated child health interventions that include support for the well-being of ...

    Authors: M. E. Lasater, G. M. Woldeyes, K. Le Roch, X. Phan, A. Solomon-Osborne and S. M. Murray
    Citation: Conflict and Health 2020 14:52
  21. Evidence of ‘what works’ in humanitarian programming is important for addressing the disruptive consequences of conflict and forced displacement. However, collecting robust scientific evidence, and ensuring co...

    Authors: Catherine Panter-Brick, Mark Eggerman, Alastair Ager, Kristin Hadfield and Rana Dajani
    Citation: Conflict and Health 2020 14:40