COVID-19 research – ReBUILD for Resilience Responsive Fund

The first strand of ReBUILD for Resilience’s research focuses on four COVID-19 related projects. They were funded through our Responsive Fund – a flexible way for all partners and associate partners to access funds to support responsive activities.

 

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The gendered experience of close-to-community providers in fragile and shock-prone (FASP) settings: implications for policy and practice during and post COVID-19

Partners: Liverpool School of Tropical Medicine, HERD International, American University of Beirut, Burnet Institute Myanmar and COMAHS

 

COVID-19 is has markedly affected our FASP study settings of Lebanon, Nepal, Myanmar and Sierra Leone. Close-to-community (CTC) providers are part of the response to the pandemic in these settings. However, there are evidence gaps, including how policy and practice (eg support structures) have adapted to the realities of the COVID-19 pandemic, and the CTC providers’ experiences during the pandemic and how these are gendered.

 

This study explored the roles of CTC health care providers and their gendered experiences during the COVID-19 pandemic FASP settings. We have conducted document reviews, interviews with CTC providers and key informants in Lebanon, Nepal, Myanmar and Sierra Leone.

 

This study contributes evidence on gender equitable approaches to supporting CTC providers in FASP contexts to fulfil their vital roles in the COVID-19 response and future disease outbreaks and shocks.

 

Watch and read a presentation based on this work:  The comparative agility of the community health worker cadre in fragile & conflict-affected contexts.

Read a brief on our work in Sierra Leone: The gendered experience of close-to-community providers in Sierra Leone

Read a brief of our work in Lebanon: The gendered experience of close-to-community providers in Lebanon

Read a report of recommendations from our work in Lebanon: Recommendations for supervisors of female health workers

Watch presentations based on the Lebanon & Nepal strands of this work: Close-to-community providers, gender and COVID-19 webinar

Health system resilience amid outbreaks: understanding the politics of sexual and reproductive health service adaptation in eastern Democratic Republic of Congo

Partners: Queen Margaret University and International Rescue Committee

 

During epidemics women and girls often experience reduced access to non-outbreak related sexual and reproductive health (SRH) services. For example, during the West Africa Ebola outbreak, excess maternal and neonatal deaths exceeded the number of deaths from Ebola, and the current COVID-19 pandemic might have similar effects. While guidance and tools to adapt SRH protocols and programmes to emergencies exist, often SRH services targeting women are dismissed as non-essential despite the mortality risks.

 

This study examined decision-making dynamics around adaptations to the Minimum Initial Service Package for Reproductive Health in Emergencies in North Kivu in the context of COVID-19. It examined relationships across local civil society organisations, international non-governmental organisations, Health Cluster, UN agencies, national/subnational government, the private sector, and international donors with a view to understanding the politics of SRH service adaptation during an outbreak, what (or who) drives willingness to innovate and adapt, and if possible, what are the repercussions of doing so or not.

 

Read a report on this study: Health system resilience during COVID-19: understanding sexual and reproductive health service adaptation in North Kivu

Understanding health system resilience to respond to COVID-19 in a federalised context: a case study of health workforce management at sub-national level in Nepal

Partners: HERD International, Queen Margaret University and Liverpool School of Tropical Medicine

 

This study examined health sector policy, preparedness and responses to COVID-19 in Nepal, focusing on policies, provisions and implementation approaches for health workforce management at the sub-national level. It explored Nepal’s health system resilience and the lessons learnt from its COVID-19 response, and aimed to understand if and how it demonstrated absorption, adaptation and transformation to support resilient health system.

 

The study focused on understanding the health workforce management system in this federalised context as a tracer for the wider health system, at the local level for COVID-19 response and in the delivery of non-COVID routine health services. This will help us develop a framework for future research in health workforce management.

 

Read a presentation based on this work: Understanding health system resilience to respond to COVID-19: a case study of COVID-19 policy response and health workforce management in Nepal

Community and health system stressors and coping mechanisms during COVID-19: case study from Myanmar

Partners: Burnet Institute Myanmar and Queen Margaret University

 

This study aimed to understand the lived experiences of linked communities and primary care-level health workers in the context of the COVID-19 pandemic and to contribute to the resilience of the health system in responding to COVID-19.

 

Insein was chosen because of its high COVID-19 caseload and its response in the early phase of the pandemic (eg the closure of a private hospital and high transmission via close community gatherings).

"ReBUILD for Resilience brings together partners to share experiences, to discuss our contexts, and to create an appropriate model that helps build resilience in health systems across the country and beyond"

Sushil Baral, HERD International