The importance of evidence
2 April, 2019
Professor Doris Schopper, CERAH Director
Last week CERAH hosted an event at the Graduate Institute with Evidence Aid, the London School of Hygiene & Tropical Medicine and ICRC to discuss how evidence can help humanitarian programmers understand what works, where, why, and for whom. A new guide explores this subject.
The event heard that evidence can also tell us what does not work to avoid repeating mistakes in the future. There are challenges however, including gaps in evidence gathering, the length of time it can take to gather while the situation changes, a lack of understanding in the findings and jargon used, and a lack of integration of the evidence into planning. But when it works it proves worthwhile with programmes adapting, sometimes radically, based on the evidence.
Two interesting examples were discussed where evidence-based research led to changes in approach which are briefly shared here.
First of all, in the early 2000’s, therapeutic feeding in response to acute malnutrition was usually given at in-patient services based at regional medical centres. Often this approach did not work well as it was not possible for the mother and child to travel far. A series of studies found that community-based out-patient services were much more successful, and a review in 2002 showed that 51% of children were more likely to recover if they were treated in out-patient facilities. This has now become common practice.
The second example looked at self-restraint amongst the armed forces. A study by ICRC looked at what influenced soldiers more to practice self-restraint when faced with conflict situations that could harm civilians or other non-combatants. The study looked at the influence of IHL (International Humanitarian Law) and the more informal influence of peer-pressure. The study found that individually both deterrents had a positive effect, however when combined together the result was increased self -restraint. Such findings are crucial to developing appropriate training.
The panel went on to discuss the need to change the perception and culture towards evidence in the humanitarian sector. They also debated the need to incentivize the use of evidence and increase awareness of its potential to improve programming and ensure that evaluations and research are integrated into all the stages of humanitarian response cycle to ensure learnings are recognized so that approaches can be adapted in a timely way.
As the chair of the panel, I commented that;
“As a public health professional, basing what I do and teach on, means evidence is central to my work. However, in other disciplinary fields, this may not always be common practice. In addition at times evidence may be difficult to gather. And although research allowing us to gather high quality evidence may be difficult to carry out in humanitarian settings, we should at least engage in rigorous monitoring and evaluation to understand what works best.”