REfugees in Africa ClusTer (REACT): humanitarian health policy, gender and health economics

非洲难民集群 (REACT)：人道主义卫生政策、性别和卫生经济学

• 批准号: EP/T023619/1
• 负责人: Paul Revill
• 金额: $ 16.91万
• 依托单位: University of York
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=EP%2FT023619%2F1
• 关键词: REfugees; Africa; ClusTer; REACT; humanitarian

There are over 25 million refugees globally, the highest number since the end of the Second World War. ODA-eligible countries, many in Africa, host the majority of the refugee population; Uganda alone hosts 1.36 million refugees and is the third largest refugee-hosting country in the world. The vast majority of refugees are in long-term, protracted displacement situations. At a population level, there can often be stark social and health inequities between host and refugee populations, as well as within the refugee community itself. For example, refugee (and internally displaced) women and girls are less likely than men and boys to have secure access to food, health care, shelter, nationality and documentation, and are more vulnerable to sexual violence and exploitation.The response to protracted displacement settings has commonly been the development of separate parallel health responses in which international donor funding is directed largely towards international NGOs, and less so towards host governments; even where there are efforts to integrate refugee populations within host communities. While helping to address needs in the short-term, this approach risks weakening the public health system response and community cohesion over the longer term. For example, it can cause poorly coordinated and inefficient responses by government and NGOs, fragment national governance mechanisms, divert financing and expertise away from government, and undermine national strategic plans. Parallel approaches also mean that the opportunity to address issues of social and health inequity are limited, through the siloed application of numerous advocacy and development programmes. Overall, the current nature of humanitarian response is unsustainable as it fails to build long term national capacity to respond effectively and equitably as needs arise. The REfugees in Africa ClusTer (REACT) aims to respond to this situation by partnering specialist researchers - in the areas of health governance, political economy, refugee health needs, health economics and gender analysis - with policymakers from the east, central and southern Africa region - comprising Eswatini, Kenya, Lesotho, Malawi, Mauritius, Tanzania, Uganda, Zambia and Zimbabwe; represented collectively by the ECSA Health Community. REACT will cluster two existing large GCRF programmes - Thanzi la Onse (Health of All), led by the University of York, focused on health economics and related research to inform resource allocation in the ECSA region; and RECAP, led by the London School of Hygiene and Tropical Medicine (LHSTM), focused on health in humanitarian crises. It will include partnership of two major research institutes in the ECSA region, based in countries with amongst the largest refugee populations globally - Makerere University, School of Public Health, in Uganda; and KEMRI-Wellcome Trust, in Kenya. The partnership will also benefit from participation of other research groups with major potential to generate knowledge to contribute to designing suitable responses to refugee health needs - the University of Addis Ababa, Ethopia; University of Bergen, Norway; and the Overseas Development Institute in the UK.Following an initial stakeholder mapping, the REACT Cluster team will support the convening of a workshop by the ECSA-HC comprising key specialists and stakeholders from the region; representing affected populations; academia and policy-makers. 4 distinct research themes will be investigated, in work packages led by REACT Co-Investigators; collectively leading to a Working Group report. A full submission to the GCFR Clusters Phase 2 call - highlighting areas for research, ways to strengthen capacity and research-to-policy partnerships - will be developed out of the Working Group report.

全球有超过2500万难民，是第二次世界大战结束以来的最高数字。符合官方发展援助条件的国家，其中许多在非洲，收容了大多数难民；仅乌干达一国就收容了136万难民，是世界第三大难民收容国。绝大多数难民处于长期、长期的流离失所状态。在人口层面上，收容人口和难民之间以及难民社区本身之间往往存在明显的社会和健康不平等。例如，难民(和境内流离失所)妇女和女孩比男子和男孩更不可能安全地获得食物、保健、住所、国籍和证件，更容易受到性暴力和剥削。对长期流离失所情况的反应通常是制定单独的平行卫生对策，其中国际捐助者的资金主要流向国际非政府组织，较少流向东道国政府；即使在努力将难民人口融入收容社区的情况下也是如此。在帮助解决短期需求的同时，这种方法可能会在较长期内削弱公共卫生系统的反应和社区凝聚力。例如，它可能导致政府和非政府组织作出协调不力和效率低下的反应，支离破碎的国家治理机制，转移政府的资金和专业知识，并破坏国家战略计划。平行办法还意味着，通过孤立地实施许多宣传和发展方案，解决社会和健康不平等问题的机会有限。总体而言，目前人道主义反应的性质是不可持续的，因为它未能建立长期的国家能力，以便在出现需要时作出有效和公平的反应。非洲难民专题组旨在通过与来自东部、中部和南部非洲区域的政策制定者--包括埃斯瓦蒂尼、肯尼亚、莱索托、马拉维、毛里求斯、坦桑尼亚、乌干达、赞比亚和津巴布韦--合作，在卫生治理、政治经济、难民健康需求、卫生经济学和性别分析等领域与来自东部、中部和南部非洲的政策制定者结成伙伴关系，以欧洲共同体卫生共同体为集体代表。REACTION将把现有的两个大型全球合作伙伴关系框架方案组合在一起--由约克大学领导的Thanzi la onse(全民健康)方案，侧重于保健经济学和相关研究，为欧洲经委会区域的资源分配提供信息；以及由伦敦卫生和热带医学院领导的Recap方案，侧重于人道主义危机中的卫生问题。它将包括ECSA地区两个主要研究机构的伙伴关系，这两个机构的总部设在全球难民人口最多的国家--乌干达的Makerere大学公共卫生学院和肯尼亚的KEMRI-Wellcome Trust。这一伙伴关系还将受益于其他研究小组的参与，这些研究小组具有产生知识的主要潜力，有助于为难民的健康需求设计适当的应对措施--亚的斯亚贝巴大学、挪威卑尔根大学和英国海外发展研究所。在初步绘制利益攸关方图之后，REACT多国小组将支持ECSA-HC举办一次研讨会，成员包括来自该地区的主要专家和利益攸关方；代表受影响人口；学术界和政策制定者。将在REPACT联合调查员领导的工作包中调查4个不同的研究主题；共同导致工作组报告。将在工作组报告中编写一份向全球气候变化框架公约分组第二阶段呼吁提交的完整报告--强调研究领域、加强能力的方法和研究与政策的伙伴关系。

项目成果

A situation analysis of access to refugee health services in Kenya: Gaps and recommendations - A literature review

肯尼亚难民获得医疗服务的情况分析：差距和建议 - 文献综述

• 发表时间: 2021
• 作者: Jemutai J

A synthesis of key aspects of health systems and policy design affecting the refugee populations in Uganda

影响乌干达难民人口的卫生系统和政策设计关键方面的综合

• 发表时间: 2021
• 作者: Matovu F

A synthesis of key aspects of health systems and policy design affecting the refugee populations across Africa

影响非洲难民人口的卫生系统和政策设计关键方面的综合

• 发表时间: 2020
• 作者: Margini F