Program on Forced Migration and Health

APPLIED RESEARCH

Inter-Agency Guide to the Evaluation of Psychosocial Programming in Emergencies.

Ager, A, Ager, W, Stavrou, V. & Boothby, N. (2011) Inter-Agency Guide to the Evaluation of Psychosocial Programming in Emergencies. New York: UNICEF.

Faculty with the Program on Forced Migration and Health, including Alastair Ager and Neil Boothby, have led the development of an Inter-Agency Guide to the Evaluation of Psychosocial Programming in Humanitarian Crises to assist organizations working in the field of psychosocial support. Access the guide here.

Child Protection Rapid Assessment (CPRA) toolkit

Lindsay Stark and Alastair Ager, led the first comprehensive field-test of the new Child Protection Rapid Assessment (CPRA) toolkit developed by the global protection cluster’s Child Protection Working Group (CPWG). The assessment – conducted in Indonesia between mid-June and late-July - was focused on communities affected by the eruption of the Merapi volcano in late 2010. The assessment in Central Java was conceived not only as a means to provide feedback on the effectiveness and operation of the assessment tool but, critically, to equip Indonesian personnel with the competencies to complete such an assessment in the context of a future rapid-onset emergency.

The assessment was a collaboration between Columbia University and The Center on Child Protection – a teaching and research center jointly established by Columbia University, the University of Indonesia, UNICEF and the Government of Indonesia. The Center on Child Protection secured significant ‘buy-in’ from the Government of Indonesia, UNICEF and non-governmental organizations for the assessment, and the training and preparations that preceded it. Akbar Halim, an Indonesian child protection specialist with the Center on Child Protection, and Andrew Lewis, an MPH student from Columbia University, led the training of over a dozen child protection workers, with preparations including the development of an Indonesian version of the CPRA using appropriately clear and sensitive language regarding a range of child protection issues. From those trained, a group of six – drawn from across district, regional and national government positions – were then deployed to conduct key informant and community interviews – and related direct observational assessments – across the parts of Sleman and Magelang districts most severely affected by the eruption and subsequent population displacement.

The assessment identified a number of serious child protection concerns, including increases in use of child labor and vulnerabilities to sexual abuse and exploitation. The assessment team arranged for briefing sessions following the assessment not only with relevant government authorities, but also with all community leaders that had participated in the assessment. In late July, the team then presented findings at an inter-agency debriefing in Jakarta, attended by staff of the Ministry of Social Welfare, the Ministry of Women’s Empowerment and Child Protection, UNICEF, and several local and international NGOs. There is clear government commitment to build upon the experience – and clear value – of this assessment to put in place a national strategy for capacity development and deployment of such assessments in the contexts of humanitarian emergencies.

This work provides a powerful example of how the Center on Child Protection provides a means for Indonesian faculty, governmental agencies and non-governmental groups to connect on issues of both national relevance and global significance. The training, preparation and assessment saw significant global learning brought into the Indonesian context. The experience of the assessment now ensures that learning from Indonesia will be shared globally, most promptly in a planned CPWG meeting in September in Geneva when use and deployment of the CPRA will be reviewed.

Neil Boothby Completes 39 Country Study on Education in Emergencies and Fragile States.

UNICEF’s Education in Emergencies and Post-Crisis Transition (EEPCT) Program began in 2006 as a 5-year, $201 million dollar partnership between UNICEF and the Dutch Government. Additional support for the EEPCT program was provided through a contribution of €4 million from the European Commission. Intended as a strategic intervention in support of the Millennium Development Goals and the Education for All movement, the EEPCT program looks to help achieve these targets by increasing institutional capacity and providing direct program support. EEPCT currently supports programming in 39 countries and territories, and global initiatives such as the Inter-Agency Education Clusters and the Inter-Agency Network for Education in Emergencies.

In June 2010, Professor Neil Boothby was selected to co-lead a progress evaluation on implementation of the EEPCT program, along with Peter Buckland of the World Bank. The objective of this research project was to take stock of the first three years of implementation to determine the EEPCT Program’s effectiveness, efficiency and indicative impact and sustainability in relation to its objectives. The evaluation included recommendations to improve future programming and support more-informed decision-making by UNICEF headquarters, regional and country offices, and relevant stakeholders.

Boothby and Buckland oversaw the activities of a 28 person team, including three PFMH graduate students. The research focused on 39 countries, with concentrated research in six case study countries. The evaluation employed a theory-based approach that focused on program outputs and outcomes while also allowing for a more in-depth understanding of the internal workings of the program.

The research was finalized in March 2011. The final report provides insights into:
• Strengths and weakness of the program’s global objectives and the extent to which they are transferred and adapted at the country level;
• How contextual factors—including differences between emergencies, transitions and fragility contexts--have contributed to—or have mitigated against—the achievement of intended and unintended results; and
• Strengths and weaknesses in program’s implementation within and between global, regional and country levels.

Neil Boothby leads feasibility study on establishing a global surveillance system for attacks on education

The 1990 World Conference on Education for All launched the Education for All (EFA) movement to set global goals for educational achievement by the end of the millennium. In 2000, the international education community met again to establish educational benchmarks to reach by the year 2015, complementary to – but more specific than – Millennium Development Goals 2 and 3.

The right to education and the goals of Education for All are threatened in many countries by armed attacks, assassinations, abductions, forced recruitment, other violence and threats against students and their teachers, as well as destruction, looting, and occupation of education buildings. The body of knowledge of such attacks is currently limited. Neil Boothby, Allan Rosenfield Professor of Forced Migration and Health, and director of the CPC Network, is leading a feasibility study on how a global surveillance System for Attacks on Education can be developed. Alastair Ager (PFMH faculty), Robert Quinn (Scholars at Risk), Jessica Alexander (PFMH research associate) and Brian Root (PFMH research associates) are key members of the research team.

The study is funded by Education Above All (EAA), the Qatar-based policy research and advocacy organization. Is purpose is to figure out how to move from the present fragmented monitoring situation to a system that is structured and coordinated, in order to provide:

Advanced understanding of the issues pertaining to the protection of education from attack;
A more robust evidence base for:
- -Research
- -Identified good practices
- -Improved programming
- -Strengthened policy formulation
- -Increased accountability and diminished impunity; as well as
- -Enhanced advocacy for each of the above objectives.

The report resulting from the feasibility study is envisaged to serve as the basis for decisions on whether a new comprehensive surveillance system is a desirable or, instead, EAA and partner institutions should commit to strengthening existing monitoring and documentation systems to obtain the requisite data and information. The final report, available June 1, 2011, will provide recommendations as to the feasibility of a phased roll-out of system creation or strengthening.

Learning Into Action Conference - Child Protection

The Learning Into Action Conference in Geneva, Switzerland, was held from June 23rd-25th, 2010. This event was hosted by the Child Protection Working Group (CPWG) and the Child Protection in Crisis Network (CPC Network).

The purpose of this meeting was to improve the care and protection of children in crisis-affected countries by bringing together practitioners and researchers to: engage global child protection practitioners around new learning involving child protection practice; increase understanding of different methodologies that can be used to strengthen program practice; and reflect on the needs for evidence in the sector that can inform the wider CPWG learning agenda.

The learning conference was an opportunity for individuals actively engaged in the implementation of, and serviced-based research regarding, child protection in emergencies. Participants discussed, shared, and grew the field around the themes of building child protection systems, positive practices in child protection programming, evaluation and assessment methodologies, and measuring the magnitude of protection concerns. Together, these sessions met the objectives of:

- enabling and facilitating mutual North-South, NGO-academic learning and dialogue;

- identifying, disseminating and discussing current learning about effective practice and how to address different child protection issues;

- building inter-agency capacity to do systematic and outcome evaluations and other forms of documentation and learning that contribute to quality practice, policy development and advocacy; and

- helping define a learning agenda for the child protection sub-cluster.

Learning Into Action Conference attendees in Geneva

In Geneva: Lindsay Stark, Santi Kusumaningrum, Neil Boothby

Rethinking Gender-Based Violence - the Neighborhood Method

Over the past five years, the CPC Network researchers and key nongovernmental organization (NGO) partners have used the neighborhood method to measure rates of rape and other forms of gender-based violence (GBV) in refugee/IDP camps in Uganda, Liberia, Sri Lanka, and Ethiopia, and on a national scale in the Central African Republic. Such research has produced an unexpected and startling finding: in all five countries and settings, researchers found that a woman was much more likely to be raped in her own home by someone she knew than she was to be raped by a stranger. While some women were attacked outside their homes, the majority of women victims were abused by their husbands or boyfriends. This was also true for other forms of GBV including physical abuse. This research has far-reaching implications for efforts to curb GBV in post-conflict communities, which currently have a heavy emphasis on stranger rape. Nothing short of a full reassessment of current programs, priorities, and funding for GBV prevention in areas impacted by conflict is needed. Read the full report.

Read reports and articles on Neighborhood Method research:

Central African Republic

Inter-agency Child Protection Emergency Assessment Tool Kit

Columbia University is currently leading a process of field-based learning to feed into revision of the 'Inter-agency Child Protection Emergency Assessment Tool Kit'. As a part of this process, Columbia University, UNICEF and the Government of Ethiopia collaborated to document key child welfare concerns in the Gambella region of Ethiopia to support better child protection programming, emergency preparedness and response, with an emphasis on child protection systems in emergencies. Findings from the assessment have been shared with key government, UN and NGO agencies. Lessons learned on the utility of the Tool Kit are being synthesized with learning from a series of other country assessments including Central African Republic, the occupied Palestinian Territories, the Republic of Georgia and Iraq, and recommendations on further revisions to the Tool Kit were shared at the Child Protection Working Group sub-cluster meeting in January 2010.

The first inter-agency evaluation of psychosocial programs in the occupied Palestinian territories

Columbia University has played a key role - along with UNICEF and other partners - in supporting the first inter-agency evaluation of psychosocial programs in the occupied Palestinian territories (oPt). The project aims to build the evidence base to better understand the overall effectiveness of psychosocial programs, and to learn more about how to best address the psychosocial needs of children and their families in oPt. Using an ethnographic approach, agencies identified a shared set of indicators of what well-being means under occupation. These findings were used to develop a common quantitative measure, which was used across the West Bank and Gaza. Preliminary findings from the evaluation suggest that children are showing surprisingly high degrees of resiliency regardless of whether they are involved in an intervention, but that children enrolled in psychosocial programs show significantly higher levels of resiliency and well being.

Care and Protection of Children in Crisis Affected Countries

To strengthen consensus on possible care and protection interventions for children in countries affected by crisis, the Program on Forced Migration and Health within Columbia University's Mailman School of Public Health led a three-year initiative that focuses on early reintegration and post crisis recovery programs for at-risk and displaced children. USAID's Displaced Children and Orphans Fund funded the program. The central goal of the program was to improve the care and protection of children affected by armed conflict and natural disasters. The project included an extensive literature review and structured consultation with expert practitioners to establish key areas where a stronger evidence-base is required. A structured Delphi analysis provided a robust review of perceived global best practice. The project piloted new assessment methodologies allowing critical child-care and protection needs to be identified and used in field settings to strengthen the evidence-base for effective child-care and protection programs. Working with practitioners and policymakers, the Program formulated recommendations for the design, evaluation, and implementation of child-focused programs and works to mainstream findings into US, UN and wider humanitarian policy agendas. The synthesis report summarizes the progress of the CPC Initiative towards improved care and protection of children in emergencies. This includes progress in the conceptualization of protection needs and response; progress in developing methods for assessing protection needs and the impact of programming; and, crucially, progress in identifying emerging best practice in key areas of protection programming.
The Care and Protection of Children Initiative Spring 2008 and the Fall 2008 newsletter are available.

Faculty: Neil Boothby, Alastair Ager, Mike Wessells

Mapping Child Protection Surveillance Systems in Indonesia

In the summer of 2010, Neil Boothby, Lindsay Stark and a team from Columbia University and the University of Indonesia worked with UNICEF and partners within the Government of Indonesia to map the current child protection surveillance system in Indonesia and to develop a set of recommendations for a new framework which will ultimately improve data monitoring and evaluation mechanisms. While prevalence and evaluation data are currently very limited, the team determined that there is fairly good case management data, and actors are beginning to develop common databases on key protection issues. There is, however, high potential to develop a rigorous village level surveillance system in Indonesia. Villages are highly structured--with a village head as well as village sub-heads and neighborhood heads exist in all communities and are responsible for a range of administrative, social and economic issues. The team is working on a plan and an agreement with the government, to ensure these community leaders collect data about five child protection concerns on a regular basis. Part of the new surveillance system will involve the use of SMS or text messaging to record and transmit child protection data and alerts, thereby creating both a more time and efficient data exchange chain. The team has also reached an agreement with UNICEF, the Ministry of Planning, and the University of Indonesia to work together to develop government capacity to undertake prevalence studies and program evaluations over the next three years.

Faculty: Neil Boothby

Averting Maternal Death and Disability

The Averting Maternal Death and Disability (AMDD) Program is a global program of research, advocacy, and technical support dedicated to reducing maternal mortality and morbidity. AMDD works to expand equitable access to emergency obstetric care (EmOC) and these efforts support wider health systems strengthening goals. Since 1999, AMDD has worked closely with international agencies, NGOs, and governments in more than 50 countries to enable them to deliver critical maternal and newborn services equitably and at scale.

Faculty: Lynn Freedman, Helen de Pinho, Koye Oyerinde

Longitudinal Research on Stress in Humanitarian Aid Workers

The rise in low-intensity conflicts in the 1990's found humanitarian aid workers frequently in the line of fire that affected the functioning and productivity of agency programs. Only a longitudinal approach can establish predictive relationships between personal, organizational and duty-related stressors, and mental health and organizational productivity. Alastair Ager (who serves on the Board of the Antares Foundation, the implementing partner for this research) is collaborating with colleagues from the Center for Disease Control and Prevention, the University of Amsterdam, Fuller Theological Seminary, Pepperdine University, Tulane University School of Public Health and Mount Sinai School of Medicine in this ground-breaking study. The study goal is to provide in-depth and scientifically valid information regarding mental health status of humanitarian workers working under stress and in hardship. Specific objectives are: to identify aspects of work associated with elevated risk of poor mental health and burnout in aid workers; to identify the risk and resilience factors moderating the impact of such stressors on or staff functioning; and to provide recommendations for selection, training, and management of aid workers, and effective intervention for stressed individuals.

Faculty: Alastair Ager

Reproductive Health Access, Information and Services in Emergencies (RAISE)

The Reproductive Health Access, Information and Services in Emergencies (RAISE) Initiative is catalysing change in how reproductive health is addressed by all sectors involved in emergency response, from field services to advocacy, from local aid providers to global relief movements. Developed by Columbia University's Heilbrunn Department of Population and Family Health in the Mailman School of Public Health and Marie Stopes International (MSI), the RAISE Initiative aims to address the full range of reproductive health needs for refugees and internally displaced persons (IDPs) by building partnerships with humanitarian and development agencies, governments, United Nations (UN) bodies, advocacy agencies and academic institutions. Through the expertise of our staff and leading research institutions; the power of cooperative partnerships with leading agencies and across multiple sectors; and the development of consistent, clearly established objectives for reproductive health, the RAISE initiative is well positioned to address the pressing reproductive health needs of populations affected by emergencies. The RAISE Initiative represents a strengthened commitment to the provision of fully integrated and comprehensive reproductive health services for all.

Faculty: Therese McGinn

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