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Table 1 Definitions and differences between humanitarian assistance and global health

From: Implementation science in humanitarian assistance: applying a novel approach for humanitarian care optimization

 

Humanitarian Assistance

Similarities

Global Health

Environment

• Natural disaster, conflict and war zones, refugee camp settings

• “Acute on chronic” disastersa, disease outbreak (Ebola), conflict affected populations in LMICs

• Usually stable contexts in under-resourced health systems

Approachb

• Deliver absent services in chaotic settings, work in parallel to public or other organization health systems

• Low-resource settings, importance of professional development and ethics

• Integrated partnerships with existing health systems, oversite from Ministry of Health

Objectives

• Novel service delivery, limited stability in chaotic environments, bear witness to rights violations

• Improve health services for vulnerable populations

• Improve upon existing health services through training, access, research, and policy

Mechanisms

• Direct medical care, supporting and staffing clinics, evacuation, documentation of atrocities

• Training of local staff for acute needs, reciprocal learning, research collaborations

• Education, training and research capacity building, policy efforts, multi-institutional grants

Ownership

• Flexibility for international organizations to self-manage programs independently from in-country systems

• Space for co-design and mutual benefit

• Default to ownership by local stakeholders, operate with perspectives of being a “guest”

Temporality

• Most are short-term engagements, though time can range depending on setting and local context

• Protracted humanitarian disasters can extend long-term; educational or research global health initiatives can be finite

• Long-term partnership through actionable commitment should be the default engagement

Sustainability

• Service should last as long as it is needed in an acute disaster, not necessarily a need for longitudinal or sustained commitment

• Eventual transitions to local systems of operation

• Core tenant of equitable global health which should be integrated in nearly all efforts

Scope

• Intrinsic limitations of practice which should be acknowledged including resources and security

• Program effectiveness and reach often limited by funds or political agendas

• Less limitations for investment in longer-term initiatives and capacity building

  1. Major differences and similarities between humanitarian assistance and global health
  2. a “Acute on chronic” is a term increasingly used to describe acute disasters which occur in areas with already damaged health systems. It is derived from the term in clinical medicine to describe an acute exacerbation of a chronic medical condition, but here used to describe what is observed when disasters affect already weakened country and regional health systems. Examples include the 2014–16 Ebola outbreak in West Africa, which was still struggling from the aftermath of decades of war and underfunded public health systems, Haitian earthquake in 2010, and the Turkish-Syrian earthquake further destabilizing displaced Syrian refugees
  3. bCategory definitions can be understood as the following: Environment describes the context in which global health or humanitarian assistance actions take place; approach describes the purpose and overarching method for engagement; Objectives describes actor goals in each setting; Mechanisms describes the specific interventions and programs employed in these settings; Ownership describes responsible actors within each context; Temporality highlights typical length of program involvement; Sustainability refers to necessity for longitudinal commitment within each context; and Scope describes the breadth or focus with which each field can be defined
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Implementation Science

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