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Social Science in Humanitarian Action Key considerations: Ebola preparedness and readiness in Goma, DRC
Peyton, D.; I. Gercama and J. Bedford
Social Science in Humanitarian Action: A Communication for Development Platform
(2019)
C1
This brief summarises key considerations about the social, political and economic context of Gom
...
a in relation to the outbreak of Ebola in the DRC as of March 2019. Goma is the administrative capital of North Kivu province and a major urban centre in the Great Lakes Region. The city is home to an estimated 1.5 million people and serves as an important economic and transportation hub that links eastern Congo to the broader East African sub-region. The arrival of Ebola in Goma would substantially increase the at-risk population and heighten the potential for cross-border transmission to neighbouring countries, particularly Rwanda. This brief therefore focuses on local social and political structures that can be leveraged to promote preparedness and readiness actions.
more
The region of Latin America and the Caribbean (LAC) has high levels of income inequality and urbanization. This leaves a large percentage of the population exposed
...
and vulnerable to infectious disease outbreaks (1). The COVID-19 outbreak occurred suddenly, within a complex economic, social and political context and at a time of low economic growth and high levels of informal labour. Structural challenges of poverty, deep inequality across different dimensions, and weak health and social protection systems exacerbated the region’s vulnerability to the pandemic
more
The health and socioeconomic crisis triggered by the COVID-19 pandemic has hit the countries of Latin America hard and laid bare the profound inequities about which numerous international, regional
...
and national reports have sounded warnings in recent decades. In this context, the historical political and economic exclusion and marginalization of the more than 800 indigenous peoples in the region has been accentuated as a result of insufficient State responses to the crisis, which have not adequately considered the collective rights of these peoples and have had little cultural relevance.
This document provides an overview of the situation of indigenous peoples in the region in the face of the COVID-19 pandemic. It analyses both the State’s and indigenous peoples’ own responses to the crisis, as well as offering a set of recommendations to rectify the neglect of these peoples in the management of the pandemic, centring on their collective rights.
more
Front. Public Health 9:622809
The control and elimination of schistosomiasis have over the last two decades involved several strategies, with the current strategy by the World Health Organization (WHO) focusing mainly on treatment with praziquantel
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during mass drug administration (MDA). However, the disease context is complex with an interplay of social, economic, political, and cultural factors that may affect achieving the goals of the Neglected Tropical Disease (NTD) 2021-2030 Roadmap. There is a need to revisit the current top-down and reactive approach to schistosomiasis control among sub-Saharan African countries and advocate for a dynamic and diversified approach.
more
The United Nations Children's Fund (UNICEF), the International Organization for Migration (IOM), Georgetown University, and the United Nations University have today launched new guidelines to provide the first-ever global policy framework that will
...
help protect, include, and empower children on the move in the context of climate change.
The Guiding Principles for Children on the Move in the Context of Climate Change provides a set of 9 principles that address the unique and layered vulnerabilities of children on the move both internally and across borders as a result of the adverse impacts of climate change. Currently, most child-related migration policies do not consider climate and environmental factors, while most climate change policies overlook the unique needs of children.
The guidelines note that climate change is intersecting with existing environmental, social, political, economic, and demographic conditions contributing to people’s decisions to move. In 2020 alone, nearly 10 million children were displaced in the aftermath of weather-related shocks. With around one billion children – nearly half of the world’s 2.2 billion children – living in 33 countries at high risk of the impacts of climate change, millions more children could be on the move in the coming years.
Developed in collaboration with young climate and migration activists, academics, experts, policymakers, practitioners, and UN agencies, the guiding principles are based on the globally ratified Convention on the Rights of the Child and are further informed by existing operational guidelines and frameworks.
Recommendations for safeguarding the rights and well-being of children regardless of their location or migration status.
The guiding principles provide national and local governments, international organizations and civil society groups with a foundation to build policies that protect children’s rights. The organizations and institutions are calling on governments, local and regional actors, international organizations, and civil society groups to embrace the guiding principles to help protect, include, and empower children on the move in the context of climate change.
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Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity
...
and limited capacity to facilitate deliberations on the different ethical dilemmas. These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
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Medical care for people caught up in armed conflict and other insecure environments saves lives and alleviates suffering. It is one of the most immediate
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and high priority needs of an affected population and is often the first type of response activated and/or requested by authorities and affected communities. Medical teams working in armed conflict and other insecure environments
frequently face serious threats to their security and safety, challenges to patient access, and at times limited acceptance by affected communities in which they work and parties to the conflict. Such difficulties are likely to increase (6) and
thereby creating a critical need to establish contact and trust with all sides in conflicts and in other insecure environments to ensure operational continuity. This trust can best be achieved when all sides perceive the medical teams to be neutral, impartial, and independent, and specifically not aiding (or being perceived to aid) any one party to achieve a military, political or economic
advantage. For medical teams that are deploying increasingly closer to the frontlines, the implications of and consequences for both staff and patients of teams not being fully prepared, and/or not fully comprehending the context in which they work, can be severe. Medical response can easily be hindered or compromised by intentional or unintentional acts and the behaviour and
conduct of the teams themselves
more
Myanmar continues to present a complex and dynamic operating context where ongoing socio-economic and
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political challenges, including conflict, displacement, widespread poverty and food insecurity, hinder development efforts. An estimated 24.8 percent of its 54 million population live near or below the poverty line. Many struggle with inadequate physical, social and economic access to sufficient, safe and nutritious food, with women, girls, persons with disabilities and minorities affected most.
more
The Bolivarian Republic of Venezuela has been facing a prolonged socio-political and economic situation that has profoundly
...
and negatively impacted social and health indicators. The COVID-19 pandemic further aggravated the humanitarian context in the
country, which stretched the limits of an already weakened national health system. Violence and social conflicts, hyperinflation, constant political tensions, the persistence of migratory movements, and intensification of climate threats and natural hazards
have worsened the living conditions and health status of populations in vulnerable situations, including women, children, and indigenous people. A large influx of returnees back to Venezuela (Bolivarian Republic of) marked the first
two years of the pandemic. However, the country’s continued deteriorating political, socio-economic, and human rights situation resulted in renewed increased migration of Venezuelans in 2022. The profile of Venezuelan migrants has progressively changed
over the years, from single men in search of better economic opportunities to families with women and children in situations of extreme vulnerability. The increasingly irregular and unsafe journeys of those migrants are constantly putting their lives at high risk
more
Antimicrobial resistance (AMR) is a serious public health concern with economic, social and political implications that are global in s
...
cope, and cross all environmental and ethnic boundaries. As a global threat, AMR risks the achievements of modern medicine, and has the potential to impact overall global development. It is important, therefore, to elevate AMR beyond health as part of a larger development agenda in the context of the Sustainable Development Goals (SDGs). This report provides in-depth technical discussions in areas that have direct implications to the containment of AMR as a development agenda. The report is organized in five chapters which served as the technical background documents for the Biregional Technical Consultation on AMR in Asia, 14-15 April 2016. More information from the meeting is available in the WHO Meeting Report: Biregional Technical Consultation on Antimicrobial Resistance in Asia. The meeting was the first time senior officials from the Ministry of Health and Ministry of Agriculture across Asia came together to tackle AMR
more
Oral diseases are among the most common chronic diseases worldwide and constitute a major public health problem due to the huge health and economic
...
burden on individuals, families, societies, and health care systems. The recent emphasis on the role of determinants of health, common risk factors and their recognition in the context of the growing burden of noncommunicable diseases (NCDs) provides good opportunities for integrating oral health into NCD prevention and control efforts. This Strategy for oral health in South-East Asia, 2013-2020, presents guidance to Member States in developing national policy and action plans to improve oral health within existing socioeconomic, cultural, political and health system contexts. It expresses the consensus on major strategies in the area of oral health promotion as well as oral disease prevention and control for the South-East Asia Region aiming at reducing the health and socioeconomic burden resulting from oral diseases, reducing oral health inequities, and improving the quality of life of the population.
more
Communication Risk in Public Health Emergencies
recommended
A WHO Guideline for Emergency Risk Communication (ERC) policy and practice.
Recent public health emergencies, such as the Ebola virus disease outbreak in West Africa (2014–2015), the emergence of the Zika virus syndrome in 2015–2016
...
and multi-country yellow fever outbreaks in Africa in 2016, have highlighted major challenges and gaps in how risk is communicated during epidemics and other health emergencies. The challenges include the rapid transformation in communications technology, including the near-universal penetration of mobile telephones, the widespread use and increasingly powerful influence of digital media which has had an impact on ‘traditional’ media (newspapers, radio and television), and major changes in how people access and trust health information. Important gaps include considerations of context – the social, economic, political and cultural factors influencing people’s perception of risk and their risk-reduction behaviours.
more
This Strategy and Plan of Action on Health Promotion within the Context of the Sustainable Development
Goals 2019-2030 seeks to renew health promotion (HP) through social,
...
political, and technical actions,
addressing the social determinants of health (SDH), he conditions in which people are born, grow, live,
work, and age (1). It seeks to improve health and reduce health inequities within the framework of
the 2030 Agenda for Sustainable Development.
more
The One Health approach can help achieve progress and promotes synergies on national and global priorities by generating synergies at the human-animal-environmental interface. While evidence is stil
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l scare, it is likely that the approach is highly cost-effective and improves effectiveness of core public health systems, through reducing morbidity, mortality, and economic costs of disease outbreaks. It also contributes to economic development through strengthening public health systems at the human-animal-environment interface protects health, agricultural production, and
ecosystem services
more
PHSM are vital in reducing the risk and scale of infectious disease transmission and lowering hospitalization and deaths. Examples include contact
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tracing, quarantine and isolation, mask use, ventilation, school or workplace measures, mobility restrictions and travel requirements.
While these measures are essential, decision-making on PHSM becomes particularly complex during rapidly evolving health emergencies, with incomplete information and under significant public and political pressure, especially when the pathogen is novel or poorly understood. In such contexts, guidance needs to be agile and responsive, developed and adapted based on emerging evidence and shifting epidemiological patterns. Decision-makers are frequently confronted with difficult trade-offs, having to balance measures that are:
─ effective but socially disruptive;
─ cost-effective but logistically burdensome;
─ beneficial for public health but economically disruptive; or
─ practical but inequitable or unethical
more
Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers
...
and salaried, professional or lay health workers with a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
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This report brings attention to achieving gender equality in the context of women, girls, and the HIV response. This six-month consultation in 2016 with adolescent women
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and young girls found that #WhatWomenWant is: collaboration and joint action by all to invest in women's HIV and Sexual and Reproductive Health and Rights (SRHR), to be leaders and articulate the priorities of women and girls in all their diversity, and to speak to the new Political Declaration on AIDS and the SDG framework as a tool for civil society to meet their agenda to achieve gender equality in the HIV and SRHR response.
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To understand the patterns of Rwanda’s achievements in health development, it is important to explore how Rwanda addresses the Social Determinants of Health (SDH) particularly those related to routine conditions in which people are born, live and
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work. It is in this particular context that a case study on Rwanda’s Performance in Addressing Social Determinants of Health was conducted by the Rwanda Ministry of Health, with technical and financial support from the World Health Organization (WHO). The overall goal of the exercise was to document Rwanda's recent initiatives that contribute to the advancements of the Rio Political Declaration on Social Determinants of Health.
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This report situates disability and inclusion within the broader context of sustainable development, with a particular focus on the Sustainable Development Goals (SDGs). The paper provides backgroun
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d on the historical role of the UN in promoting inclusion and outlines the current trends and challenges facing people with disabilities globally. The following section presents these challenges within the context of the SDGs, showing that disability needs to be tackled if the SDGs are to be achieved. It concludes with a number of recommendations for a disability-inclusive 2030 agenda for sustainable development
more
