Psychological Resilience, Fragility and the Health Workforce: Lessons on Pandemic Preparedness from Liberia and Sierra Leone

COVID-19 presents a time to redefine vulnerability; however, in discussions of vulnerability, the health workforce, particularly in regard to their psychosocial well-being, is often forgotten. Healthcare workers (HCWs) in fragile settings are constantly exposed to health system shocks, including; conflict, disease outbreaks and natural disasters, which compound the everyday challenges of working in an under-resourced health system. Based on a commitment to serve their communities, they often cope with repeated shocks and protracted crises through innovation and creative thinking. However, they also experience repeated acute and chronic stressors that can lead to psychological distress. For some, prolonged exposure to risk of psychological distress can lead to personal growth, for others, continuous exposure to chronic stress and uncertainty can lead to psychological injury

How are Research for Development Programmes Implementing and Evaluating Equitable Partnerships to Address Power Asymmetries?

The complexity of issues addressed by research for development (R4D) requires collaborations between partners from a range of disciplines and cultural contexts. Power asymmetries within such partnerships may obstruct the fair distribution of resources, responsibilities and benefits across all partners. This paper presents a cross-case analysis of five R4D partnership evaluations, their methods and how they unearthed and addressed power asymmetries. It contributes to the field of R4D partnership evaluations by detailing approaches and methods employed to evaluate these partnerships. Theory-based evaluations deepened understandings of how equitable partnerships contribute to R4D generating impact and centring the relational side of R4D. Participatory approaches that involved all partners in developing and evaluating partnership principles ensured contextually appropriate definitions and a focus on what partners value. The online version contains supplementary material available at 10.1057/s41287-023-00578-w. [Abstract copyright: © The Author(s) 2023.

How are Research for Development Programmes Implementing and Evaluating Equitable Partnerships to Address Power Asymmetries?

The complexity of issues addressed by research for development (R4D) requires collaborations between partners from a range of disciplines and cultural contexts. Power asymmetries within such partnerships may obstruct the fair distribution of resources, responsibilities and benefits across all partners. This paper presents a cross-case analysis of five R4D partnership evaluations, their methods and how they unearthed and addressed power asymmetries. It contributes to the field of R4D partnership evaluations by detailing approaches and methods employed to evaluate these partnerships. Theory-based evaluations deepened understandings of how equitable partnerships contribute to R4D generating impact and centring the relational side of R4D. Participatory approaches that involved all partners in developing and evaluating partnership principles ensured contextually appropriate definitions and a focus on what partners value

Improving accountability for equitable health and well-being in urban informal spaces: Moving from dominant to transformative approaches

This article critically reviews the literature on urban informality, inequity, health, well-being and accountability to identify key conceptual, methodological and empirical gaps in academic and policy discourses. We argue that critical attention to power dynamics is often a key missing element in these discourses and make the case for explicit attention to the operation of power throughout conceptualization, design and conduct of research in this space. We argue that: (a) urban informality reflects the exercise of power to confer and withhold advantage; (b) the dominant biomedical model of health poorly links embodied experiences and structural contexts; (c) existing models of accountability are inadequate in unequal, pluralistic governance and provision environments. We trace four conceptual and empirical directions for transformative approaches to power relations in urban health equity research

How are research for development programmes implementing and evaluating equitable partnerships to address power asymmetries?

The complexity of issues addressed by research for development (R4D) requires collaborations between partners from a range of disciplines and cultural contexts. Power asymmetries within such partnerships may obstruct the fair distribution of resources, responsibilities and benefits across all partners. This paper presents a cross-case analysis of five R4D partnership evaluations, their methods and how they unearthed and addressed power asymmetries. It contributes to the field of R4D partnership evaluations by detailing approaches and methods employed to evaluate these partnerships. Theory-based evaluations deepened understandings of how equitable partnerships contribute to R4D generating impact and centring the relational side of R4D. Participatory approaches that involved all partners in developing and evaluating partnership principles ensured contextually appropriate definitions and a focus on what partners value

Implications of COVID-19 for safeguarding in international development research: learning, action and reflection from a research hub

COVID-19 brings uncertainties and new precarities for communities and researchers, altering and amplifying relational vulnerabilities (vulnerabilities which emerge from relationships of unequal power and place those less powerful at risk of abuse and violence). Research approaches have changed too, with increasing use of remote data collection methods. These multiple changes necessitate new or adapted safeguarding responses. This practice piece shares practical learnings and resources on safeguarding from the Accountability for Informal Urban Equity hub, which uses participatory action research, aiming to catalyse change in approaches to enhancing accountability and improving the health and well-being of marginalised people living and working in informal urban spaces in Bangladesh, India, Kenya and Sierra Leone. We outline three new challenges that emerged in the context of the pandemic (1): exacerbated relational vulnerabilities and dilemmas for researchers in responding to increased reports of different forms of violence coupled with support services that were limited prior to the pandemic becoming barely functional or non-existent in some research sites, (2) the increased use of virtual and remote research methods, with implications for safeguarding and (3) new stress, anxiety and vulnerabilities experienced by researchers. We then outline our learning and recommended action points for addressing emerging challenges, linking practice to the mnemonic ‘the four Rs: recognise, respond, report, refer’. COVID-19 has intensified safeguarding risks. We stress the importance of communities, researchers and co-researchers engaging in dialogue and ongoing discussions of power and positionality, which are important to foster co-learning and co-production of safeguarding processes

How are research for development programmes implementing and evaluating equitable partnerships to address power asymmetries?

The complexity of issues addressed by research for development (R4D) requires collaborations between partners from a range of disciplines and cultural contexts. Power asymmetries within such partnerships may obstruct the fair distribution of resources, responsibilities and benefits across all partners. This paper presents a cross-case analysis of five R4D partnership evaluations, their methods and how they unearthed and addressed power asymmetries. It contributes to the field of R4D partnership evaluations by detailing approaches and methods employed to evaluate these partnerships. Theory-based evaluations deepened understandings of how equitable partnerships contribute to R4D generating impact and centring the relational side of R4D. Participatory approaches that involved all partners in developing and evaluating partnership principles ensured contextually appropriate definitions and a focus on what partners value

How to prevent and address safeguarding concerns in global health research programmes: practice, process and positionality in marginalised spaces

Safeguarding is rapidly rising up the international development agenda, yet literature on safeguarding in related research is limited. This paper shares processes and practice relating to safeguarding within an international research consortium (the ARISE hub, known as ARISE). ARISE aims to enhance accountability and improve the health and well-being of marginalised people living and working in informal urban spaces in low-income and middle-income countries (Bangladesh, India, Kenya and Sierra Leone). Our manuscript is divided into three key sections. We start by discussing the importance of safeguarding in global health research and consider how thinking about vulnerability as a relational concept (shaped by unequal power relations and structural violence) can help locate fluid and context specific safeguarding risks within broader social systems. We then discuss the different steps undertaken in ARISE to develop a shared approach to safeguarding: sharing institutional guidelines and practice; facilitating a participatory process to agree a working definition of safeguarding and joint understandings of vulnerabilities, risks and mitigation strategies and share experiences; developing action plans for safeguarding. This is followed by reflection on our key learnings including how safeguarding, ethics and health and safety concerns overlap; the challenges of referral and support for safeguarding concerns within frequently underserved informal urban spaces; and the importance of reflective practice and critical thinking about power, judgement and positionality and the ownership of the global narrative surrounding safeguarding. We finish by situating our learning within debates on decolonising science and argue for the importance of an iterative, ongoing learning journey that is critical, reflective and inclusive of vulnerable people