What questions we should be asking about COVID-19 in humanitarian settings: perspectives from the Social Sciences Analysis Cell in the Democratic Republic of the Congo

Carter, Simone; Gobat, Nina; Zambruni, Jérôme Pfaffmann; Bedford, Juliet; Kleef, Esther van; Jombart, Thibaut; Mossoko, Mathias; Nkakirande, Dorothée Bulemfu; Colorado, Carlos Navarro; Ahuka‐Mundeke, Steve

doi:10.1136/bmjgh-2020-003607

Cited by 26 publications

(29 citation statements)

References 18 publications

(7 reference statements)

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“…As noted in the introduction, there continues to be a widely acknowledged “evidence-gap” in how social science can improve epidemic preparedness and response, justifying reticence for some. There are, for example, few robust examples or case studies of social science improving a response, with most literature focused on Ebola [ 11 , 12 ], but even here causative mechanisms are unclear. It is hard to quantify or measure the impact of qualitative studies, and more challenging to account for the cumulate effects of small day-to-day operational changes brought about by insights and attitudinal shifts by response managers and field teams as they approach and solve problems.…”

Section: Resultsmentioning

confidence: 99%

“…Epidemic social science, as an emerging field of practice, is already generating new forms of operational data and insights to facilitate critical self-reflection and adaptive learning – for example, in the 2018–20 Ebola epidemic in eastern DRC [ 11 , 12 ]. Among the 75 experts consulted for this paper, and based on additional focus groups and literature review, we found a general feeling that the widespread adoption of social science techniques, and better integration of community knowledge and participation, will challenge the status quo of the existing humanitarian system, scientific and medical education and global and national governance regimes.…”

Section: Discussionmentioning

confidence: 99%

“…For example, social science has been prioritized as a key action area in the WHO, IFRC and UNICEF-lead COVID-19 Collective Service to Coordinate Risk Communication and Community Engagement (RCCE) for the global COVID-19 response. • UNICEF and partners has established the Centres d’Analyses des Sciences Sociales (CASS) model, during the 2019 Ebola outbreaks in DRC [ 12 ]. Through the CASS mechanism, UNICEF is supporting Ministries of Health in taking leadership on using applied social science for real-time public health responses.…”

Section: Introductionmentioning

confidence: 99%

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Integrating the social sciences in epidemic preparedness and response: A strategic framework to strengthen capacities and improve Global Health security

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Background The importance of integrating the social sciences in epidemic preparedness and response has become a common feature of infectious disease policy and practice debates. However to date, this integration remains inadequate, fragmented and under-funded, with limited reach and small initial investments. Based on data collected prior to the COVID-19 pandemic, in this paper we analysed the variety of knowledge, infrastructure and funding gaps that hinder the full integration of the social sciences in epidemics and present a strategic framework for addressing them. Methods Senior social scientists with expertise in public health emergencies facilitated expert deliberations, and conducted 75 key informant interviews, a consultation with 20 expert social scientists from Africa, Asia and Europe, 2 focus groups and a literature review of 128 identified high-priority peer reviewed articles. We also analysed 56 interviews from the Ebola 100 project, collected just after the West African Ebola epidemic. Analysis was conducted on gaps and recommendations. These were inductively classified according to various themes during two group prioritization exercises. The project was conducted between February and May 2019. Findings from the report were used to inform strategic prioritization of global investments in social science capacities for health emergencies. Findings Our analysis consolidated 12 knowledge and infrastructure gaps and 38 recommendations from an initial list of 600 gaps and 220 recommendations. In developing our framework, we clustered these into three areas: 1) Recommendations to improve core social science response capacities, including investments in: human resources within response agencies; the creation of social science data analysis capacities at field and global level; mechanisms for operationalizing knowledge; and a set of rapid deployment infrastructures; 2) Recommendations to strengthen applied and basic social sciences, including the need to: better define the social science agenda and core competencies; support innovative interdisciplinary science; make concerted investments in developing field ready tools and building the evidence-base; and develop codes of conduct; and 3) Recommendations for a supportive social science ecosystem, including: the essential foundational investments in institutional development; training and capacity building; awareness-raising activities with allied disciplines; and lastly, support for a community of practice. Interpretation Comprehensively integrating social science into the epidemic preparedness and response architecture demands multifaceted investments on par with allied disciplines, such as epidemiology and virology. Building core capacities and competencies should occur at multiple levels, grounded in country-led capacity building. Social science should not be a parallel system, nor should it be “siloed” into risk communication and community engagement. Rather, it should be integrated across existing systems and networks, and deploy interdisciplinary knowledge “transversally” across all preparedness and response sectors and pillars. Future work should update this framework to account for the impact of the COVID-19 pandemic on the institutional landscape.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Integrating the social sciences in epidemic preparedness and response: A strategic framework to strengthen capacities and improve Global Health security

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“…IMOA brings together data on behaviour, perceptions, health service use, epidemiological trends of other health outcomes, movement mapping and market prices against a timeline of applied NPIs. 37 …”

Section: Mitigating Negative Health Impacts: Health System and Community Approachesmentioning

confidence: 99%

COVID-19 response: mitigating negative impacts on other areas of health

2021

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‘Vertical’ responses focused primarily on preventing and containing COVID-19 have been implemented in countries around the world with negative consequences for other health services, people’s access to and use of them, and associated health outcomes, especially in low-income and middle-income countries (LMICs). ‘Lockdowns’ and restrictive measures, especially, have complicated service provision and access, and disrupted key supply chains. Such interventions, alongside more traditional public health measures, interact with baseline health, health system, and social and economic vulnerabilities in LMICs to compound negative impacts. This analysis, based on a rapid evidence assessment by the Social Science in Humanitarian Action Platform in mid-2020, highlights the drivers and evidence of these impacts, emphasises the additional vulnerabilities experienced by marginalised social groups, and provides insight for governments, agencies, organisations and communities to implement more proportionate, appropriate, comprehensive and socially just responses that address COVID-19 in the context of and alongside other disease burdens. In the short term, there is an urgent need to monitor and mitigate impacts of pandemic responses on health service provision, access and use, including through embedding COVID-19 response within integrated health systems approaches. These efforts should also feed into longer-term strategies to strengthen health systems, expand universal healthcare coverage and attend to the social determinants of health—commitments, both existing and new—which governments, donors and international agencies must make and be held accountable to. Crucially, affected communities must be empowered to play a central role in identifying health priorities, allocating resources, and designing and delivering services.

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“…This is not the first time we have seen these intersections; we can distil useful lessons from the 2018-2020 Ebola outbreak in the DRC to inform our current syndemic. 7 KEY LEARNINGS FROM THE 2018-2020 EBOLA RESPONSE IN THE DRC The DRC is known to have a high prevalence of GBV with 68% of women reporting lifetime exposure to physical, sexual or emotional violence. 8 Moreover, researchers estimate that an estimated 48 rapes occurred every hour in the DRC within the year prior to the 2007 Demographic Health Survey.…”

Section: Gbv and Covid-19: A Syndemic Perspectivementioning

confidence: 99%

The syndemic of COVID-19 and gender-based violence in humanitarian settings: leveraging lessons from Ebola in the Democratic Republic of Congo

et al. 2020

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What questions we should be asking about COVID-19 in humanitarian settings: perspectives from the Social Sciences Analysis Cell in the Democratic Republic of the Congo

Cited by 26 publications

References 18 publications

Integrating the social sciences in epidemic preparedness and response: A strategic framework to strengthen capacities and improve Global Health security

Integrating the social sciences in epidemic preparedness and response: A strategic framework to strengthen capacities and improve Global Health security

COVID-19 response: mitigating negative impacts on other areas of health

The syndemic of COVID-19 and gender-based violence in humanitarian settings: leveraging lessons from Ebola in the Democratic Republic of Congo

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