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An analytic perspective of a mixed methods study during humanitarian crises in South Sudan: translating facility- and community-based newborn guidelines into practice

BACKGROUND: In South Sudan, the civil war in 2016 led to mass displacement in Juba that rapidly spread to other regions of the country. Access to health care was limited because of attacks against health facilities and workers and pregnant women and newborns were among the most vulnerable. Translati...

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Autores principales: Sami, Samira, Amsalu, Ribka, Dimiti, Alexander, Jackson, Debra, Kenneth, Kemish, Kenyi, Solomon, Meyers, Janet, Mullany, Luke C., Scudder, Elaine, Tomczyk, Barbara, Kerber, Kate
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802238/
https://www.ncbi.nlm.nih.gov/pubmed/33436047
http://dx.doi.org/10.1186/s13031-021-00339-8
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author Sami, Samira
Amsalu, Ribka
Dimiti, Alexander
Jackson, Debra
Kenneth, Kemish
Kenyi, Solomon
Meyers, Janet
Mullany, Luke C.
Scudder, Elaine
Tomczyk, Barbara
Kerber, Kate
author_facet Sami, Samira
Amsalu, Ribka
Dimiti, Alexander
Jackson, Debra
Kenneth, Kemish
Kenyi, Solomon
Meyers, Janet
Mullany, Luke C.
Scudder, Elaine
Tomczyk, Barbara
Kerber, Kate
author_sort Sami, Samira
collection PubMed
description BACKGROUND: In South Sudan, the civil war in 2016 led to mass displacement in Juba that rapidly spread to other regions of the country. Access to health care was limited because of attacks against health facilities and workers and pregnant women and newborns were among the most vulnerable. Translation of newborn guidelines into public health practice, particularly during periods of on-going violence, are not well studied during humanitarian emergencies. During 2016 to 2017, we assessed the delivery of a package of community- and facility-based newborn health interventions in displaced person camps to understand implementation outcomes. This case analysis describes the challenges encountered and mitigating strategies employed during the conduct of an original research study. DISCUSSION: Challenges unique to conducting research in South Sudan included violent attacks against humanitarian aid workers that required research partners to modify study plans on an ongoing basis to ensure staff and patient safety. South Sudan faced devastating cholera and measles outbreaks that shifted programmatic priorities. Costs associated with traveling study staff and transporting equipment kept rising due to hyperinflation and, after the July 2016 violence, the study team was unable to convene in Juba for some months to conduct refresher trainings or monitor data collection. Strategies used to address these challenges were: collaborating with non-research partners to identify operational solutions; maintaining a locally-based study team; maintaining flexible budgets and timelines; using mobile data collection to conduct timely data entry and remote quality checks; and utilizing a cascade approach for training field staff. CONCLUSIONS: The case analysis provides lessons that are applicable to other humanitarian settings including the need for flexible research methods, budgets and timelines; innovative training and supervision; and a local research team with careful consideration of sociopolitical factors that impact their access and safety. Engagement of national and local stakeholders can ensure health services and data collection continue and findings translate to public health action, even in contexts facing severe and unpredictable insecurity.
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spelling pubmed-78022382021-01-13 An analytic perspective of a mixed methods study during humanitarian crises in South Sudan: translating facility- and community-based newborn guidelines into practice Sami, Samira Amsalu, Ribka Dimiti, Alexander Jackson, Debra Kenneth, Kemish Kenyi, Solomon Meyers, Janet Mullany, Luke C. Scudder, Elaine Tomczyk, Barbara Kerber, Kate Confl Health Research in Practice BACKGROUND: In South Sudan, the civil war in 2016 led to mass displacement in Juba that rapidly spread to other regions of the country. Access to health care was limited because of attacks against health facilities and workers and pregnant women and newborns were among the most vulnerable. Translation of newborn guidelines into public health practice, particularly during periods of on-going violence, are not well studied during humanitarian emergencies. During 2016 to 2017, we assessed the delivery of a package of community- and facility-based newborn health interventions in displaced person camps to understand implementation outcomes. This case analysis describes the challenges encountered and mitigating strategies employed during the conduct of an original research study. DISCUSSION: Challenges unique to conducting research in South Sudan included violent attacks against humanitarian aid workers that required research partners to modify study plans on an ongoing basis to ensure staff and patient safety. South Sudan faced devastating cholera and measles outbreaks that shifted programmatic priorities. Costs associated with traveling study staff and transporting equipment kept rising due to hyperinflation and, after the July 2016 violence, the study team was unable to convene in Juba for some months to conduct refresher trainings or monitor data collection. Strategies used to address these challenges were: collaborating with non-research partners to identify operational solutions; maintaining a locally-based study team; maintaining flexible budgets and timelines; using mobile data collection to conduct timely data entry and remote quality checks; and utilizing a cascade approach for training field staff. CONCLUSIONS: The case analysis provides lessons that are applicable to other humanitarian settings including the need for flexible research methods, budgets and timelines; innovative training and supervision; and a local research team with careful consideration of sociopolitical factors that impact their access and safety. Engagement of national and local stakeholders can ensure health services and data collection continue and findings translate to public health action, even in contexts facing severe and unpredictable insecurity. BioMed Central 2021-01-12 /pmc/articles/PMC7802238/ /pubmed/33436047 http://dx.doi.org/10.1186/s13031-021-00339-8 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. 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 in a credit line to the data.
spellingShingle Research in Practice
Sami, Samira
Amsalu, Ribka
Dimiti, Alexander
Jackson, Debra
Kenneth, Kemish
Kenyi, Solomon
Meyers, Janet
Mullany, Luke C.
Scudder, Elaine
Tomczyk, Barbara
Kerber, Kate
An analytic perspective of a mixed methods study during humanitarian crises in South Sudan: translating facility- and community-based newborn guidelines into practice
title An analytic perspective of a mixed methods study during humanitarian crises in South Sudan: translating facility- and community-based newborn guidelines into practice
title_full An analytic perspective of a mixed methods study during humanitarian crises in South Sudan: translating facility- and community-based newborn guidelines into practice
title_fullStr An analytic perspective of a mixed methods study during humanitarian crises in South Sudan: translating facility- and community-based newborn guidelines into practice
title_full_unstemmed An analytic perspective of a mixed methods study during humanitarian crises in South Sudan: translating facility- and community-based newborn guidelines into practice
title_short An analytic perspective of a mixed methods study during humanitarian crises in South Sudan: translating facility- and community-based newborn guidelines into practice
title_sort analytic perspective of a mixed methods study during humanitarian crises in south sudan: translating facility- and community-based newborn guidelines into practice
topic Research in Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802238/
https://www.ncbi.nlm.nih.gov/pubmed/33436047
http://dx.doi.org/10.1186/s13031-021-00339-8
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