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The Institute for Global Health and Development

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    Understanding the current state of collaboration in the production and dissemination of adaptation knowledge in Namibia
    (Springer, 2020-02) Ofoegbu, Chidiebere; New, Mark; Nyamwanza, Admire; Spear, Dian
    Adaptation to climate change is challenging in terms of managing knowledge flow among diverse actors. This paper examines the roles of key actors in Namibia in the production and dissemination of climate adaptation knowledge. The intention was to identify opportunities for enhancing collaboration among actors to facilitate knowledge flow and uptake in adaptation action. The Omusati Region was used as a case study in understanding the chain of interactions among actors from local/district to the national level vis-à-vis the production and dissemination of adaptation knowledge in Namibia. The researchers conducted key informant interviews with representatives of key organizations in the Namibian adaptation network operating in the Omusati Region. The selection of the organizations of interviewed respondents was based on a previous climate change adaptation stakeholder and influence network mapping exercise in the region. Results indicate that adaptation knowledge generation by organizations happens mainly in the context of other developmental services. Furthermore, most organizations generate their adaptation knowledge internally through their directorates of research and also through cooperation with other organizations. However, there is little or no collaboration between organizations with respect to dissemination of adaptation knowledge to intended targets. The study, therefore, recommends a more concerted effort towards improving collaboration between organizations, and with local communities in the dissemination of adaptation knowledge as a way of enhancing knowledge uptake. This will have practical implications for the improvement in the rate of knowledge uptake in adaptation actions, particularly at the local level. In this regard, the use of workshop and field day meetings show the best prospect for improving collaboration between organizations in knowledge dissemination.
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    Enablers and barriers to implementing cholera interventions in Nigeria: a community–based system dynamics approach
    (Oxford University Press (OUP), 2024-07-26) Elimian, Kelly; Diaconu, Karin; Ansah, John; King, Carina; Dewa, Ozius; Yennan, Sebastian; Gandi, Benjamin; Forsberg, Birger Carl; Ihekweazu, Chikwe; Alfvén, Tobias
    Nigeria accounts for a substantial cholera burden globally, particularly in its northeast region, where insurgency is persistent and widespread. We used participatory group model building (GMB) workshops to explore enablers and barriers to implementing known cholera interventions, including water, sanitation, and hygiene (WASH), surveillance and laboratory, case management, community engagement, oral cholera vaccine, and leadership and coordination, as well as explore leverage points for interventions and collaboration. The study engaged key cholera stakeholders in the northeastern states of Adamawa and Bauchi, as well as national stakeholders in Abuja. Adamawa and Bauchi States’ GMB participants comprised 49 community members and 43 healthcare providers, while the 23 national participants comprised government ministry, department and agency staff, and development partners. Data were analysed thematically and validated via consultation with selected participants. The study identified four overarching themes regarding the enablers and barriers to implementing cholera interventions: (1) political will, (2) health system resources and structures, (3) community trust and culture, and (4) spill-over effect of COVID-19. Specifically, inadequate political will exerts its effect directly (e.g., limited funding for prepositioning essential cholera supplies) or indirectly (e.g., overlapping policies) on implementing cholera interventions. The healthcare system structure (e.g., centralisation of cholera management in a state capital) and limited surveillance tools weaken the capacity to implement cholera interventions. Community trust emerges as integral to strengthening the healthcare system’s resilience in mitigating the impacts of cholera outbreaks. Lastly, the spill-over effects of COVID-19 helped promote interventions similar to cholera (e.g., WASH) and directly enhanced political will. In conclusion, the study offers insights into the complex barriers and enablers to implementing cholera interventions in Nigeria’s cholera-endemic settings. Strong political commitment, strengthening the healthcare system, building community trust, and an effective public health system can enhance the implementation of cholera interventions in Nigeria.
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    Participation by conflict-affected and forcibly displaced communities in humanitarian healthcare responses: A systematic review
    (Elsevier, 2020-12-09) Rass, Ella; Lokot, Michelle; Brown, Felicity L; Fuhr, Daniela C; Asmar, Michèle Kosremelli; Smith, James; McKee, Martin; Bou-Orm, Ibrahim; Yeretzian, Joumana Stephan; Roberts, Bayard
    Background Community participation in health responses in humanitarian crises is increasingly promoted by humanitarian actors to support adoption of measures that are relevant and effective to local needs. Our aim was to understand the role of community participation in humanitarian health responses for conflict-affected populations (including forcibly displaced populations) in low- and middle-income countries and the barriers and facilitators to community participation in healthcare responses. Methods Using a systematic review methodology, following the PRISMA protocol, we searched four bibliographic databases for publications reporting peer-reviewed primary research. Studies were selected if they reported how conflict-affected populations were involved in healthcare responses in low- and middle-income settings, and associated changes in healthcare responses or health outcomes. We applied descriptive thematic synthesis and assessed study quality using study design-specific appraisal tools. Results Of 18,247 records identified through the database searching, 18 studies met our inclusion criteria. Various types of community participation were observed, with participation mostly involved in implementing interventions rather than framing problems or designing solutions. Most studies on community participation focused on changes in health services (access, utilisation, quality), community acceptability and awareness, and ownership and sustainability. Key barriers and facilitators to community participation included political will at national and local level, ongoing armed conflict, financial and economic factors, socio-cultural dynamics of communities, design of humanitarian responses, health system factors, and health knowledge and beliefs. Included studies were of mixed quality and the overall strength of evidence was weak. More generally there was limited critical engagement with concepts of participation. Conclusion This review highlights the need for more research on more meaningful community participation in healthcare responses in conflict-affected communities, particularly in framing problems and creating solutions. More robust research is also required linking community participation with longer-term individual and health system outcomes, and that critically engages in constructs of community participation.