Grant: Travel Awards - Institute Community Support

My current research examines health worker dilemmas and decision-making in humanitarian emergencies. In particular, my research focuses on the multifaceted set of clinical, social and operational challenges that arise in these complex settings and almost immediately become daily and significant dilemmas for local health workers on the frontlines of service delivery. Unlike their expatriate counterparts, local health workers have minimal training on emergency preparedness and response, yet they face overwhelming circumstances when emergencies strike including limited supplies and equipment, increased workload and long working days, lack of pay, dangerous transportation and working conditions, and disconnection from social and professional support systems. How health workers navigate these everyday challenges has been demonstrated as critical to the provision of quality care which ultimately affects health outcomes, but has received inadequate attention. If left unaddressed, these challenges can erode the skills, motivation and retention of local health workers leading to ineffective health care services and exacerbating the already poor health outcomes characteristic of these settings. Working in South Sudan and Rwanda, my research aims to produce evidence of local health workers' dilemmas and decision-making experiences in humanitarian emergencies to inform the design and evaluation of locally-responsive interventions that support the provision of quality essential health care during difficult times and in marginalized areas. Taking an interdisciplinary and participatory approach, I am employing a mix of anthropological and epidemiological methods to incorporate and feature the complexity of the context and health workers' dilemmas into the design and evaluation of the intervention. This research will contribute to the increasing emphasis for evidence to inform policymaking on human resource development and health systems strengthening in humanitarian emergencies.