NIHR Global Health Research Group on Building Partnerships for Resilience: strengthening responses to health shocks from the grassroots

AIM: To develop and strengthen an international partnership to conduct research to inform policy and practice that improves effective community-led responses to environment-related public-health crises. BACKGROUND: Human health and wellbeing face threats from increasingly frequent and disruptive shocks including outbreaks (some pandemic) of zoonotic infections (Ebola Covid19) and severe environmental change heightened by climate change that lead to changes in food security disease patterns and disasters. These challenges are interconnected yet policy and governance systems have failed to achieve holistic cross-sector responses. Unpredictability of crises makes it hard to plan for them. Social science work has shown that resilience for responding to shocks is most effectively built at community level. However no robust data exist on the mechanisms by which formal health and other sectors can engage with learn from and support resilience-building at the grassroots to develop effective health responses. Our Group will gather evidence from Ethiopia Madagascar Sierra Leone Uganda which have experienced a range of public health crises. DESIGN AND METHODS: Our multi-disciplinary comparative case-study approach will apply cutting edge combinations of social science methods across five objectives over three years:1) Synthesise evidence on how communities local health systems and other formal and informal entities have responded to health crises and with what effect :Narrative synthesis of literature from databases and websites of Government UN donor and third sector agencies. Synthesis of existing qualitative and epidemiological datasets (COVID-19; Ebola; environmental disasters and stresses) held by partners.2) Design effective approaches for public health crisis-response at grassroots: Identify common principles of effective responses; develop evaluation indicators measuring effectiveness; design prototype response models (i.e. ideal evidence-based approaches that are likely to effectively establish and sustain community-led public health responses).3) Evaluate models for effective community-led responses to public-health crises. Case studies of models identified as effective during evidence synthesis: in-depth interviews and focus groups; ethnographic work in district health offices and village communities. If outbreaks/health crises occur during project implementation we will prospectively implement and evaluate prototype approaches: same methods as for case studies.4) Formulate guidance and create dialogue with stakeholders on how to strengthen local resilience for effective responses to public health crises.5) Strengthen and consolidate sustainable partner research and management capacities to strengthen policy and practice in crisis-response.COMMUNITY ENGAGEMENTCommunity engagement is central to our research questions process and results: e.g. “citizen science” approaches grassroots innovation and identifying common drivers of success. Community members will be involved and trained as volunteers/researchers.DISSEMINATIONMultiple pathways include: National (Ministries of Health Agriculture Environment other sector Ministries; Population-Health-Environment (PHE) networks); Global/Regional (academic networks; emergency response organisations; funding agencies; WHO).