GCRF: RECAP - Research capacity building and knowledge generation to support preparedness and response to humanitarian crises and epidemics

Lead Research Organisation: London Sch of Hygiene and Trop Medicine
Department Name: Public Health and Policy

Abstract

RECAP will focus on acute and protracted humanitarian crises related to armed conflict, natural disasters, forced migration, and epidemics. Humanitarian crises and their impact on health and related sectors can pose major obstacles to international development and the achieving the SDGs. Effective decision-making by humanitarian actors is essential in humanitarian response. Accurate and timely information and evidence is essential in achieving effective decision-making. For example, through setting evidence-based standards and performance measurement against those standards, assessing needs and effectiveness in meeting those needs, ensuring value for money, and supporting accountability to recipients of humanitarian programmes and those programmes. Yet current interventions are impeded by limited data, capacity, guidance, and ethical preparedness with consequent implications for accountability. Work on protection is central to supporting accountability through seeking to ensure authorities and other humanitarian actors respect their obligations and the rights of individuals and vulnerable populations.

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. RECAP will focus on the sectors of health and protection through overlapping research and capacity building activities. For the research, there are 6 interconnected, interdisciplinary research Objectives/work-packages. These research objectives will also act as platforms for capacity building through applied research methods training. The capacity building activities will be realised through 4 capacity building Objectives on: training on specific research methods linked to the RECAP research; building institutional capacity for a sustainable and supportive research environment; supporting individual researcher capability and career progression; and building UK capability in multi-disciplinary research on health and protection in humanitarian crises. It will be a four year programme.

RECAP's strategy to grow research capacity and capability is to establish a unique network of leading academic and non-governmental organisations (NGOs) working on health and protection in the context of humanitarian crises. RECAP will be led by the London School of Hygiene and Tropical Medicine (LSHTM) and includes the University of Sierra Leone (USL), the American University of Beirut (AUB), the Refugee Law Initiative at the School of Advanced Study (SAS) in London University, Oxford University, and the London School of Economics and Political Science (LSE). NGOs are the front line actors in humanitarian preparedness and response and so are vital to RECAP. The RECAP NGO partners are Médecins Sans Frontières (MSF), the International Rescue Committee (IRC), Save the Children UK, and BRAC. They will assist through logistics, technical and other forms of support in the RECAP countries.

RECAP will use a hub-and-spoke model; with hubs of the UK, Sierra Leone, and Lebanon for capacity building and research; and spokes of further research sites in NGO partner programmes in ODA countries affected by humanitarian crises (most likely to be Myanmar, South Sudan, Uganda, Democratic Republic of Congo, subject to security and logistical issues).

The expected outcomes of RECAP will be: strengthened research capacity and capability among university and NGO partners; the development of a new research network through regional hubs of research and training excellence in the UK, Sierra Leone and Lebanon; research and capacity-building outputs (including open access software platforms and research and training guidelines); and impact through contributions to humanitarian guidelines, programmes and policies. These will strengthen decision-making and accountability in humanitarian crises to improve health, protection and broader development outcomes.

Planned Impact

Humanitarian crises and their influence on health, protection and related sectors pose major obstacles to international development and the achieving the SDGs. Accurate and timely information and evidence is essential in achieving effective decision-making. For example, through setting evidence-based standards and performance measurement against those standards, assessing needs and effectiveness in meeting those needs, ensuring value for money, and supporting accountability to recipients of humanitarian programmes and those commissioning and funding those programmes. Yet current humanitarian decision-making and programmes are impeded by limited data, evidence, capacity, guidance, and ethical preparedness. The RECAP programme seeks to address these challenges through strengthening research capacity and capability to improve decision-making and accountability to help support preparedness and response to humanitarian crises.

RECAP's capacity building, research, and activities to promote pathways to impact, would be expected to have impact through: improved capacity to obtain and use evidence and information; leading to improved decision-making, services and accountability; resulting in improved humanitarian outcomes for crisis-affected populations living in ODA countries and so supporting progress towards the SDGs. This following stakeholders would be expected to be positively impacted by RECAP.

1. Individuals and communities affected by humanitarian crises would benefit through improved humanitarian services, activities and accountability, which would lead to improved health, protection and related development outcomes (e.g. economic benefits among crisis-affected individuals through improved productivity and earnings and reduced health care expenditure).

2. RECAP universities would be positively impacted through: the development of new networks and the sharing of new ideas, approaches, methods and skills; the capacity building of individual researchers; institutional-level capacity building seeking to embed sustainable research capacity; and through developing links with NGO partners to foster better understanding of each other's' priorities, approaches and challenges (see also Academic Beneficiaries).

3. NGO researchers, data managers and decision-makers would benefit from the strengthened research, knowledge, information and decision-making capacity. The findings will also help support development of improved metrics and guidelines to improve the effectiveness of NGO activities. The ethics-related work in RECAP would also support more ethically-informed responses to the complex ethical dilemmas inherent in NGO operational activities in humanitarian crises.

4. Local government staff will also benefit from improved information and knowledge to inform effective-decision-making. They will also be involved in some of the applied methods training which would support their research and decision-making capacity.

5. Humanitarian funding and policy-making agencies (e.g. UN agencies) and governments would benefit from: improved information on the performance of operational agencies and the health and protection sectors more broadly; strengthened accountability mechanisms and information; strengthened metrics and guidelines to improve performance measurement; and improved ability to support equitable and efficient programmes (e.g. through the work on cost-effectiveness and other economic analyses).

The impact of RECAP will extend beyond the immediate programme beneficiaries and country sites. The variety of geographic locations and intended generalisability of many of the research and capacity building activities will benefit a broad range of settings affected by humanitarian crises. We will also publically share the capacity building materials for the methods training and institutional capacity building support to maximise their global reach and escalate their benefits.
 
Description Preparatory work, literature reviews, and/or early stages of fieldwork have been conducted in all RECAP work packages. As suggested in the guidance, we have limited this section to a few selected key findings that have emerged from our work.
The first key findings relate to two pieces of methodological and empirical work on improving metrics and performance measurement in humanitarian response (Work Package 1) led by Francesco Checchi and his team at London School of Hygiene and Tropical Medicine. The first piece of work was conducted with the RECAP partner Médecins Sans Frontières (MSF) through a completed a field-based evaluation of the 2017 emergency response in the Somali region of Ethiopia. This evaluation provided an opportunity to field test some of the concepts and methods proposed by Work Package One, particularly the feasibility of measuring core performance indicators, and carrying out an assessment of the appropriateness of the response. The findings also highlighted a number of weaknesses in decision-making that could be improved through the use of the developed methodology. These findings have been shared in a report with MSF and a dissemination presentation and meeting with MSF. MSF are now exploring how to incorporate the methods into their monitoring systems. The methods will continue to be developed and applied in other settings with RECAP partners. The second piece of work in Work Package One with partial funding from RECAP was the development and implementation of statistical methods to improve estimation reliability of mortality from humanitarian crises. This was applied to the ongoing conflict in South Sudan, with the findings estimating 382,000 excess deaths between December 2013 to April 2018, with half directly caused by violence. This is considerably higher than has previously been estimated. This has been written up as a paper (currently under review at the Lancet) and a report launched in early October 2018.
The second key finding is from the methodological innovation and empirical findings related to epidemic modelling (Work Package 2) led by John Edmunds and his team at the London School of Hygiene and Tropical Medicine. This applied new methods for real-time modelling to the Diphtheria outbreak among Rohingha refugees in Bangladesh using data collected from RECAP partner MSF. The model generated reliable forecasts and helped support decision-making by MSF on operational aspects of the outbreak response, such as hospital bed and staff needs, and with advocacy for control measures. The findings showed that real-time modelling enabled feedback of key information about the potential scale of the epidemic, resource needs, and mechanisms of transmission to decision-makers at a time when this information was largely unknown. The findings have been written up as a paper (under review) and presented at the MSF Scientific Day conference on 24 May 2018 (see https://www.msf.org.uk/day-one-2018-research) it will also be presented by MSF staff at the Annual Meeting of the American Society for Tropical Medicine and Hygiene in October 2018 (see https://www.abstractsonline.com/pp8/#!/4692/session/87). The Work Package 2 team have also conducted work with MSF on the impact of mass vaccination campaigns on measles outbreaks in Katanga in the Democratic Republic of Congo (paper drafted), and are currently applying these methods to other epidemic outbreaks, with findings being shared with operational agencies and written up as academic papers and presentations.
The third key finding relates to work conducted for Work Package 5 (accountability). This is based on social science and legal research through literature reviews, presentations and workshops discussions at events at the London School of Hygiene and Tropical Medicine and the Refugee Law Initiative. This work has highlighted major deficits in humanitarian accountability from a performance perspective; in conceptual understanding and enforcement, and weaknesses in conceptual links and operational coordination between health and protection sector work on accountability. The work has also identified a number of ways in which accountability can be strengthened, including between the health and protection sectors. The outputs so far are a book chapter ('Accountability' by Bayard Roberts (RECAP PI)), two draft literature review papers by the Refugee Law Initiative, and the presentations mentioned above. This work will also be presented at a colloquium at Yale University (4 October 2018). We have also planned a series of joint one-day workshops led by the Refugee Law Initiative and London School of Hygiene and Tropical Medicine to develop these ideas and proposals further (entitled 'Humanitarian accountability in Displacement Contexts: Academic - Practitioner Conversations). These will consist of presentations in the morning by relevant research, operational, and policy agencies; and then a closed round-table discussion in the afternoon attended by researchers, practitioners and policy-makers to propose clear recommendations and future plans. Outputs from each workshop will be reports, blogs, and journal articles.
Exploitation Route The findings have already been taken forward and put to use by others. For example, the Work Package One research in Ethiopia has helped to inform MSF decision-making in Ethiopia, and is also prompting work on improving the collection of key data to support their decision-making in other crisis-settings. For the Work Package 2 modelling work on the Diphtheria outbreak in Rohingha refugees in Bangladesh, the findings were applied in real-time by MSF to support their health service provision and bed allocation.
Sectors Education,Healthcare

 
Description The findings have already been taken forward and put to use by other agencies. The two most pertinent examples of this are the key findings generated by Work Package One and Work Package Two. Work Package One research in Ethiopia has helped to inform MSF decision-making in Ethiopia, and is also prompting work on improving the collection of key data to support their decision-making in other crisis-settings. The findings were shared with MSF through a report, presentation and workshop. The Work Package 2 modelling work on the Diphtheria outbreak in Rohingha refugees in Bangladesh resulted in the modelling findings being applied in real-time by MSF to support their health service provision and bed allocation in their activities for the Rohingha refugees in Bangladesh. The modelling findings were shared with MSF on a real-time basis. They were also presented at a conference, and have been written up as a scientific paper (under review). By using improved methods and data to support decision-making, both of these activities should considerably increase the efficiency and effectiveness of health services provided in these crises. This should result in improved health outcomes and quality of life among the affected populations.
First Year Of Impact 2018
Sector Healthcare
Impact Types Societal,Policy & public services

 
Description Modelling data to support real time decision-making for the diphtheria outbreak in Rohingha refugees in Bangladesh
Geographic Reach Asia 
Policy Influence Type Influenced training of practitioners or researchers
Impact The Work Package 2 modelling work provided real time data to Médecins Sans Frontières (MSF) on the Diphtheria outbreak in Rohingha refugees in Bangladesh. MSF used this data to support their health service provision and bed allocation in their activities for the Rohingha refugees in Bangladesh. This allowed for more appropriate and efficient responses by MSF to patients with diptheria.
 
Description Collaboratio with Médecins Sans Frontières (Manson Unit) 
Organisation Médecins Sans Frontières (MSF)
Country France 
Sector Charity/Non Profit 
PI Contribution Collaboration on research and capacity strengthening activities and support to increase and uptake of activities
Collaborator Contribution Collaboration on research and capacity strengthening activities and support to increase and uptake of activities
Impact Delegates from MSF participated and presented at the RECAP Kick-Off meeting in February 2018. Presentation slides are available on request.
Start Year 2017
 
Description Collaboration with BRAC 
Organisation BRAC Centre
Country Bangladesh 
Sector Charity/Non Profit 
PI Contribution This collaboration is part of the RECAP project and will contribute to new reseach, capacity strengthening and impact activities.
Collaborator Contribution Support in developing plans for research, capacity strengthening, and impact.
Impact The lead person from BRAC participated and presented at the RECAP Kick-Off meeting in February 2018. Presentation slides are available on request.
Start Year 2018
 
Description Collaboration with King's College London and their GCRF Grow funded project 'R4HC'. 
Organisation King's College London
Country United Kingdom 
Sector Academic/University 
PI Contribution The RECAP project is collaborating with the GCRF Grow funded 'R4HC' funded project led by King's College London as the R4HC project has capacity strengthening activities with the American University of Beirut (also a RECAP partner). Further details on R4HC can be found at https://r4hc-mena.org/
Collaborator Contribution We are planning joint capacity strengthening activities to maximise efficiency and impact and reduce the burden on the partner (American University of Beirut).
Impact We have collaborated on a short blog related to our common theme of our work which is on humanitarian response (please see https://r4hc-mena.org/2018/09/12/joanne-liu-speaking-on-the-cost-of-fear-humanitarian-crises-in-the-age-of-anxiety-at-the-2018-pumphandle-lecture/ ). The main collaboration of joint capacity strenthening activities will take place in late 2018/early 2019.
Start Year 2018
 
Description Collaboration with Liverpool School of Tropical Medicine for capacity strengthening activities 
Organisation Liverpool School of Tropical Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution We have contracted Liverpool School of Tropical Medicine to support our capacity strengthening work on RECAP. This is to conduct a needs assessment on capacity needs at the American Univeristy of Beirut, in partnership with the London School of Hygiene and Tropical Medicine and the American University of Beirut. We are also collaborating with them by building on the capacity strengthening work they previously conducted with our RECAP partner the University of Sierra Leone. This collaboration utilises the expertise at Liverpool School of Tropical Medicine and builds new links between the different institutions.
Collaborator Contribution Liverpool School of Tropical Medicine will bring their expertise and experience on capacity strengthening work to the project, including their previous work with the University of Sierra Leone.
Impact This activities are planned to commence in October 2018.
Start Year 2018
 
Description Collaboration with Nuffield Department of Population Health at Oxford University 
Organisation University of Oxford
Department Nuffield Department of Population Health
Country United Kingdom 
Sector Academic/University 
PI Contribution Collaboration on research and capacity strengthening activities
Collaborator Contribution Technical input for research and capacity strengthening activities
Impact Delegates from Oxford participated and presented at the RECAP Kick-Off meeting in February 2018. Presentation slides are available on request.
Start Year 2018
 
Description Collaboration with Save the Children UK 
Organisation Save the Children
Country United States 
Sector Charity/Non Profit 
PI Contribution This collaboration is part of the RECAP project and will contribute to new reseach, capacity strengthening and impact activities
Collaborator Contribution Developing research, capacity strengthening plans, and impact plans
Impact Delegates from Save the Children participated and presented at the RECAP Kick-Off meeting in February 2018. Presentation slides are available on request.
Start Year 2018
 
Description Collaboration with the American University of Beirut 
Organisation American University of Beirut
Department Faculty of Health Sciences
Country Lebanon 
Sector Academic/University 
PI Contribution This collaboration is part of the RECAP project and will contribute to new reseach, capacity strengthening and impact activities.
Collaborator Contribution Support in developing plans for research, capacity strengthening, and impact.
Impact A visit took place in November 2017 by the RECAP PI (Bayard Roberts) and capacity strengthening Co-I (Hazel McCullough) to Beirut to discuss with collaboration and joint project activities with the American University of Beirut. The ToR and report are available on request. Delegates from the American University of Beirut participated and presented at the RECAP Kick-Off meeting in February 2018. Presentation slides are available on request.
Start Year 2018
 
Description Collaboration with the International Rescue Committee 
Organisation International Rescue Committee
Country United States 
Sector Charity/Non Profit 
PI Contribution This collaboration is part of the RECAP project and will contribute to new reseach, capacity strengthening and impact activities.
Collaborator Contribution Support in developing plans for research, capacity strengthening, and impact.
Impact Delegates from IRC participated and presented at the RECAP Kick-Off meeting in February 2018. Presentation slides are available on request.
Start Year 2018
 
Description Collaboration with the LSE 
Organisation London School of Economics and Political Science (University of London)
Department Department of International Development
Country United Kingdom 
Sector Academic/University 
PI Contribution This collaboration is part of the RECAP project and will contribute to new reseach, capacity strengthening and impact activities. Support in developing plans for research, capacity strengthening, and impact.
Collaborator Contribution Support in developing plans for research, capacity strengthening, and impact.
Impact Book chapter in a book edited by our partner at the LSE (Professor Tim Allen). The book reference is:Roberts B. Accountability, in Allen T (Ed). Humanitarianism: A Dictionary of Concepts. Routledge. 2018. Delegates from LSE also participated and presented at the RECAP Kick-Off meeting in February 2018. Presentation slides are available on request. In addition, LSHTM staff directly collaborating with LSE have been made honorary LSHTM staff.
Start Year 2018
 
Description Collaboration with the Refugee Law Initiative (School of Advanced Study, University of London) 
Organisation University of London
Department Refugee Law Initiative
PI Contribution This collaboration is part of the RECAP project and will contribute to new reseach, capacity strengthening and impact activities.
Collaborator Contribution Support in developing plans for research, capacity strengthening, and impact.
Impact Delegates from the Refugee Law Inititative participated and presented at the RECAP Kick-Off meeting in February 2018. Presentation slides are available on request.
Start Year 2018
 
Description Collaboration with the UK Rapid Support Team 
Organisation University of Glasgow
Department Public Health
Country United Kingdom 
Sector Academic/University 
PI Contribution There are a number of potentially beneficial links for research and particularly capacity strengthening between RECAP and the UK's Rapid Support Team which can be deployed to tackle outbreaks of disease anywhere in the world within 48 hours (https://www.gov.uk/government/news/uk-team-of-health-experts-to-tackle-global-disease-outbreaks).
Collaborator Contribution We have held discussions in London and Sierra Leone to develop joint activities to maximise our impact. These will be further developed into specific joint activities. We have also included the Deputy Director of the UK's Rapid Support Team on the RECAP Advisory Committee.
Impact None yet
Start Year 2018
 
Description Collaboration with the University of Sierra Leone 
Organisation University of Sierra Leone
PI Contribution This collaboration is part of the RECAP project and will contribute to new reseach, capacity strengthening and impact activities.
Collaborator Contribution Support in developing plans for research, capacity strengthening, and impact.
Impact A visit took place in January 2018 by the RECAP PI (Bayard Roberts) to Freetown to discuss with collaboration and joint project activities with the University of Sierra Leone. The ToR and report are available on request. The Co-I from the University of Sierra Leone participated and presented at the RECAP Kick-Off meeting in February 2018.
Start Year 2018
 
Description Forced migration: gaps in mental health research and accountability 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact This was a presentaton for a colloqium at Yale University on forced migraton (4 October 2018) and which referrred to the RECAP project and issues it seeks to address.
Year(s) Of Engagement Activity 2018
 
Description Health interventions in humanitarian crises - where is the health economics? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other audiences
Results and Impact This was a presentation on 26 October 2017 to the Centre for Health Economics programme at York University (who hold another GCRF Grow cohort project). It was titled 'Health interventions in humanitarian crises - where is the health economics?' I included a number of slides on the RECAP project. After the presentations, I also had a meeting with the PI (Mark Sculpher) and staff from a GCRF Grow project held by the team there. The presentation and meeting helped to develop research ideas for the RECAP project and build connections with other GCRF projects.
Year(s) Of Engagement Activity 2017
 
Description IDPs and Public Health 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This was a presentation at a an event entitled 'Special Workshop: Revitalising IDP Research' organised by the Refugee Law Initiative (a RECAP parnter). It included slides on RECAP.
Year(s) Of Engagement Activity 2018
URL https://rli.sas.ac.uk/events/event/14942
 
Description Presentation at session on humanitarian health research for LSHTM week 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other audiences
Results and Impact This was a presentation on the RECAP project for a session on humanitarian health research held as part of the 'LSHTM week'. The audience consisted principally of academics from LSHTM and other research institutes.
Year(s) Of Engagement Activity 2017
 
Description Presentation on Strengthening accountability in health sector responses to humanitarian crises and forced migration. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact This was a key note presentation at the Heidelberg University Global Health Forum on 30 November 2017. Audience members included approximately 50 in person plus an online audinece. I included in the presentation a number of slides specifically on the RECAP project. This helped to rasie the profile of the project and the issues addressed in it.
Year(s) Of Engagement Activity 2017
URL https://www.klinikum.uni-heidelberg.de/fileadmin/inst_hygiene/parasitologie/Press/programm__Global_H...
 
Description Real-Time Epidemic Analysis and Forecasting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Accepted conference presentation by MSF staff of the findings of the diptheria and measles modelling data at the Annual Meeting of the American Society for Tropical Medicine and Hygiene in October 2018
Year(s) Of Engagement Activity 2018
URL https://www.abstractsonline.com/pp8/#!/4692/session/87
 
Description Real-time analysis of the Diphtheria outbreak in forcibly displaced Myanmar nationals in Bangladesh 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This was a presentaton at the Scientific Day Conference in London on 24 May 2018 organised by Médecins Sans Frontières (MSF) UK. The presentation related to the modelling work in Work Package 2 and presented the methods and findings from the work conducted in Work Package 2 on real-time analysis of the Diphtheria outbreak in forcibly displaced Myanmar nationals in Bangladesh.
Year(s) Of Engagement Activity 2018
URL https://www.msf.org.uk/msf-scientific-days-2018-overview
 
Description Title of Improving evidence-based decision-making and accountability in humanitarian response: Opportunities from the RECAP project 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Third sector organisations
Results and Impact This was an event organised by the NGO Evidence Aid and was titled 'Improving evidence-based decision-making and accountability in humanitarian response: Opportunities from the RECAP project'. It was held on the 6th of November 2017 at the London School of Hygiene and Tropical Medicine. It was a debate-type format on the role of evidence in humanitarian reseponse. Participants were me (PI of the RECAP project) and senior staff from the humanitarian NGOs Save the Children, ALNAP, and Evidence Aid. It was attended by approximately 150 people in-person plus online audiences. It involved a presentation by me on RECAP, and then structured questions from the Chair to the panel, and questions from the audience. The event provided a good opportunity to present the RECAP project and then discuss key issues addressed in RECAP. The audience were a mix of NGO practitioners, researchers, students and general public. The Q&A sessions raised valuable points that will be instructive to RECAP. It also provided good connections with relevant individuals and their organisations (e.g. with ALNAP).
Year(s) Of Engagement Activity 2017
URL https://www.lshtm.ac.uk/newsevents/events/improving-evidence-based-decision-making-and-accountabilit...