Research: Health
Our health research, which informs our programming across the humanitarian-development continuum, is mainly focused on three key sector areas: Ebola virus disease (EVD), COVID-19 vaccination and hesitancy; and sexual and reproductive health (SRH).
Our research on EVD contributed to evidence-based guidelines for the comprehensive management of patients with suspected and confirmed EVD in West Africa and the DRC.
Our studies on COVID-19 vaccination and hesitancy in the DRC, Gaza and Lebanon informed strategies to address vaccine hesitancy based on the cultural context and other local factors in these settings. Our findings and recommendations helped strengthen the technical capacity of national program staff, ministries of health and other institutions, enabling them to adapt local solutions to address the complexities of vaccine hesitancy in their own communities.
Our research on SRH aims to add to the evidence base on individuals’ needs and programmatic best practices, including implementing the Minimum Initial Service Package (MISP) for SRH in acute emergencies, the shift to health systems strengthening, and supporting the community-to-facility continuum of care. Our study on young adolescents’ SRH risks and needs in Ethiopia bridged knowledge gaps in SRH programming for young adolescents in refugee settings. In South Sudan, we conducted two studies on post-abortion care (PAC) and midwifery education. Our recommendations from the PAC study were incorporated into the new national competency-based PAC training materials. Our research into our midwifery education program demonstrated how we successfully increased human resources for health, which contributed to the decrease in maternal and newborn morbidity and mortality in South Sudan.
Health Research: Areas of Focus
Ebola Virus Disease
The Ebola outbreak and response in West Africa (2014–2016) and more recently in the DRC (2018–2020) prompted International Medical Corps to conduct clinical and social science research related to EVD. The magnitude of both outbreaks—the largest and second largest in world history—underscored the urgent need to examine pragmatic and impactful treatment strategies across different settings.
Many of our studies have utilized existing data routinely collected in International Medical Corps’ Ebola treatment centers (ETCs) in the context of patient care, laboratory testing and epidemiologic investigations to study the effectiveness of different diagnostic and therapeutic approaches. Studies also examined the outcomes of EVD on pregnant or pediatric patients, and on patients co-infected with malaria. We have also explored the development and testing of innovative digital technologies to improve patient care and healthcare worker safety and effectiveness in ETCs. We have collaborated on EVD research with partners such as Brown University, Johns Hopkins University, Harvard University, the CDC, the NIH, the WHO and various ministries of health.
In the DRC, we were part of a consortium study team that conducted a randomized controlled trial of four new treatments, which found that both the MAb114 treatment and the REGN-EB3 treatment were better than the ZMapp treatment in reducing deaths from EVD. In partnership with Brown University and the CDC, we conducted a vaccine hesitancy study of healthcare workers (HCWs) and community members (CMs) in three Ebola- affected health zones, highlighting the importance of communicating positive vaccine information to address underlying mistrust of vaccines and reoffering vaccines during Ebola vaccination efforts. Importantly, our research informed International Medical Corps programming by contributing to evidence-based guidelines for the comprehensive management of patients with suspected and confirmed EVD. Since 2014, more than 20 articles related to our EVD research have been published in peer-reviewed journals.
COVID-19 Vaccination & Hesitancy
Our studies on COVID-19 vaccine hesitancy in the DRC, Gaza, and Lebanon, which explored perceptions among refugees, HCWs and CMs, led to findings that addressed existing gaps in our programs and informed the design of new interventions to better meet the specific needs of different vulnerable groups. In our study with CDC and Brown University in the DRC, we found that most HCWs (81.7%) and half of CMs (53.6%) felt at risk of contracting COVID-19; however, their intent to be vaccinated was low. Security concerns that prevented access to vaccination made it less likely for individuals to get vaccinated.
Our study in Gaza found that 49% of adults had received at least one dose of a COVID-19 vaccine by October 2021 and one-third of adults were vaccine hesitant. Age, gender, education level and source of information on vaccines were statistically linked to people’s likelihood of being vaccinated or vaccine hesitant. The survey helped inform our activities under a USAID-funded project for COVID-19 response, which included community outreach to promote vaccination.
Our study in Lebanon, which we partnered on with the Ministry of Public Health and Brown University, found that vaccine acceptance among primary care clients was low before COVID-19 vaccine rollout among refugees and Lebanese nationals but higher after vaccine rollout among Lebanese nationals (57.6%) compared to refugees (32.9%); after vaccine rollout, refugees were the least likely group to accept the vaccine, and older age was associated with greater vaccine acceptance. Based on these findings, we piloted a project called Vaccine Champions in which vaccinated individuals from the refugee community created awareness about the benefits of vaccination and shared their experiences.
Sexual And Reproductive Health
Our research on SRH in humanitarian settings aims to generate new evidence on topics where literature is scarce. For example, we collaborated with Women’s Refugee Commission and Johns Hopkins University on a mixed-methods study to explore the unique experiences, perspectives and needs of very young adolescents in the Kobe refugee camp in Ethiopia. Findings from this research highlighted the importance of introducing early SRH interventions to reinforce positive behaviors and achieve long-term SRH impacts.
In South Sudan, we collaborated with Columbia University on two cross-sectional mixed-methods studies focusing on post-abortion care (PAC) and midwifery education. Our study on PAC in two protection of civilian camps in Juba and two Sudanese refugee camps in Maban identified the need for ongoing support to strengthen PAC services, including post-abortion contraception. Despite widespread abortion stigma, community attitudes were complex and our findings showed a clear opening to address community attitudes and stigma that prevent women from seeking PAC. Study findings were integrated into new national competency-based PAC training materials.
Our study of our midwifery education program in South Sudan highlighted the strengths of the program, such as well-equipped schools with trained and competent teaching staff, practice-driven and competency-based curriculum, and availability of scholarships. The program increased the amount of human resources for health in South Sudan and was perceived to have contributed to the decrease in maternal and newborn morbidity and mortality due to the increase in skilled birth attendant coverage, especially in remote regions, as well as the increase in service utilization at health facilities.