Synthesising evidence from other sectors to strengthen health system responses to mass displacement: supporting Rohingya refugees in Bangladesh

自2017年8月以来，大批罗辛亚难民逃离缅甸，在孟加拉国东南部的考克斯巴扎定居，那里有两个登记在册的难民营--库图巴隆和纳亚帕拉--正在运营。该区域的卫生系统在为如此庞大的人口提供服务方面面临巨大压力，尽管在世卫组织和考克斯巴扎民间外科医生办公室的协调下，150个国家和国际合作伙伴正在通过270个静态和流动卫生设施提供卫生服务。卫生系统面临的几个挑战包括：大量收容人口和难民；在即将到来的季风季应对迫在眉睫的新出现的卫生需求；减轻与洪水、山体滑坡和龙卷风有关的风险，因为洪水、山体滑坡和龙卷风可能破坏卫生基础设施，并限制人们获得卫生设施。来自英国伦敦卫生和热带医学院以及孟加拉国达卡大学和BRAC大学的一组研究人员提议综合其他人道主义部门的经验教训，以加强卫生系统对孟加拉国流离失所的罗辛亚人的支持。在这个18个月的项目中，我们将调查以下问题：卫生部门可以从其他部门获得什么经验教训，以加强当地卫生系统对大规模流离失所的反应？这项基础研究将包括三个部分：1.证据综合：我们将根据最近发表的证据综合综述，对非卫生文献进行综述。框架制定：我们将在证据综合的基础上制定一个卫生系统复原力框架。案例研究：我们将在孟加拉国考克斯巴扎尔的Balukhali难民营进行案例研究，通过检查当地卫生系统如何受到难民涌入的影响并适应其变化来测试我们的框架。我们建议在达卡举办一次传播讲习班，与区域利益攸关方接触，并纳入他们对卫生系统对大规模流离失所反应的稳健性和复原力的投入。我们将至少向国际同行评议的期刊提交一份手稿，并准备一份技术报告，使非学术从业者能够从研究中受益。

Since August 2017, a large influx of Rohingya refugees have fled Myanmar and settled in Cox's Bazar in south-eastern Bangladesh, where two registered refugee camps, Kutupalong and Nayapara are operational. The health system in the region is facing tremendous pressure in serving such a large population, although 150 national and international partners coordinated by WHO and the Civil Surgeon's Office of Cox's Bazar, are providing health service delivery through 270 static and mobile health facilities. Several health system challenges include large host and refugee populations; responding to immediate, emerging health needs during the upcoming monsoon season and mitigating risks related to floods, landslides and cyclones, which could damage health infrastructure, and limit population access to health facilities. A team of researchers from London School of Hygiene and Tropical Medicine in the UK and University of Dhaka and BRAC University in Bangladesh are proposing to synthesize lessons from other humanitarian sectors to strengthen health system responses to support displaced Rohingya in Bangladesh. During this 18 month project we will investigate the following question 'What lessons can the health sector apply from other sectors to strengthen local health system responses to mass displacement?'This foundation study will have three components: 1. Evidence synthesis: We will conduct a review of non-health literature following from recently published evidence synthesis reviews.2. Framework development: We will draw from the evidence synthesis to develop a health systems resilience framework.3. Case study: We will conduct a case study in Balukhali refugee camp in Cox's Bazar, Bangladesh, to test our framework by examining how the local health system has been affected by and adapted to the refugee influx. We propose to conduct a dissemination workshop in Dhaka, to engage with regional stakeholders and incorporate their inputs on the robustness and resilience of health system responses to mass displacement. We will submit at least one manuscript to an international peer-reviewed journal and prepare a technical report to enable non-academic practitioners to benefit from the research.