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dc.rights.licenseThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.contributor.authorRaven, Joanna
dc.contributor.authorBaral, Sushil
dc.contributor.authorWurie, Haja
dc.contributor.authorWitter, Sophie
dc.contributor.authorSamai, Mohamed
dc.contributor.authorPaudel, Pravin
dc.contributor.authorSubedi, Hom Nath
dc.contributor.authorMartineau, Tim
dc.contributor.authorElsey, Helen
dc.contributor.authorTheobald, Sally
dc.date.accessioned2018-06-29T22:03:25Z
dc.date.available2018-06-29T22:03:25Z
dc.date.issued2018-02-07
dc.identifierER5198
dc.identifier.citationRaven, J., Baral, S., Wurie, H., Witter, S., Samai, M., Paudel, P., Subedi, H., Martineau, T., Elsey, H. & Theobald, S. (2018) What adaptation to research is needed following crises: A comparative, qualitative study of the health workforce in Sierra Leone and Nepal. Health Research Policy and Systems, 16 [6].
dc.identifier.issn1478-4505
dc.identifier.urihttps://doi.org/10.1186/s12961-018-0285-1
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/5198
dc.description.abstractBackground: Health workers are critical to the performance of health systems; yet, evidence about their coping strategies and support needs during and post crisis is lacking. There is very limited discussion about how research teams should respond when unexpected crises occur during on-going research. This paper critically presents the approaches and findings of two health systems research projects that explored and evaluated health worker performance and were adapted during crises, and provides lessons learnt on re-orientating research when the unexpected occurs. Methods: Health systems research was adapted post crisis to assess health workers' experiences and coping strategies. Qualitative in-depth interviews were conducted with 14 health workers in a heavily affected earthquake district in Nepal and 25 frontline health workers in four districts in Ebola-affected Sierra Leone. All data were transcribed and analysed using the framework approach, which included developing coding frameworks for each study, applying the frameworks, developing charts and describing the themes. A second layer of analysis included analysis across the two contexts, whereas a third layer involved the research teams reflecting on the approaches used to adapt the research during these crises and what was learned as individuals and research teams. Results: In Sierra Leone, health workers were heavily stigmatised by the epidemic, leading to a breakdown of trust. Coping strategies included finding renewed purpose in continuing to serve their community, peer and family support (in some cases), and religion. In Nepal, individual determination, a sense of responsibility to the community and professional duty compelled staff to stay or return to their workplace. The research teams had trusting relationships with policy-makers and practitioners, which brought credibility and legitimacy to the change of research direction as well as the relationships to maximise the opportunity for findings to inform practice. Conclusions: In both contexts, health workers demonstrated considerable resilience in continuing to provide services despite limited support. Embedded researchers and institutions are arguably best placed to navigate emerging ethical and social justice challenges and are strategically positioned to support the co-production of knowledge and ensure research findings have impact.
dc.publisherBioMed Central
dc.relation.ispartofHealth Research Policy and Systems
dc.rights© The Author(s). 2018
dc.titleWhat adaptation to research is needed following crises: A comparative, qualitative study of the health workforce in Sierra Leone and Nepal
dc.typearticle
dcterms.accessRightspublic
dc.date.updated2019-04-06
dc.description.facultysch_iih
dc.description.volume16 [6]
dc.identifier.doihttp://doi:10.1186/s12961-018-0285-1
dc.description.ispublishedpub
dc.description.eprintid5198
rioxxterms.typearticle
refterms.dateAccepted2018-01-15
refterms.dateFCA2018-02-12
refterms.dateFCD2018-02-12
refterms.depositExceptionpublishedGoldOA
qmu.authorWitter, Sophie
qmu.centreInstitute for Global Health and Development
dc.description.statuspub
refterms.versionVoR


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