Publications

    Phuong Pham, Manasi Sharma, Kennedy Kihangi Bindu, Pacifique Zikomangane, Rachel C. Nethery, Eric Nilles, and Patrick Vinck. 2/16/2022. “Protective Behaviors Associated With Gender During the 2018-2020 Ebola Outbreak in Eastern Democratic Republic of the Congo.” JAMA Network Open. Read PublicationAbstract

    Importance: In 2018 to 2020, the Democratic Republic of the Congo experienced the world’s second largest Ebola virus disease (EVD) outbreak, killing 2290 individuals; women were disproportionately infected (57% of all cases) despite no evidence of differential biological EVD risk. Understanding how gender norms may influence exposure to EVD, intensity, and prognosis as well as personal protective behaviors against the virus is important to disease risk reduction and control interventions.

    Objective: To assess whether men and women differ in personal protective behaviors (vaccine acceptance, health-seeking behaviors, physical distancing) and the mediating role of EVD information and knowledge, perceived disease risk, and social relations.

    Design, Setting, and Participants: This cross-sectional, multistage cluster survey study of 1395 randomly selected adults was conducted in the Ebola-affected regions of North Kivu from April 20, 2019, to May 10, 2019. Path analyses were conducted using structural equation modeling to examine associations among study variables. Statistical analysis was conducted from August 2019 to May 2020.

    Main Outcomes and Measures: The main behavioral outcomes of interest were (1) vaccine acceptance, (2) formal health care seeking, and (3) self-protective behaviors. The primary factor of interest was self-reported gender identity. We also assessed sociodemographic factors.

    Results: Among the study’s 1395 participants, 1286 (93%) had Nande ethnicity and 698 (50%) were women; the mean (SD) age was 34.5 (13.1) years. Compared with female participants, male participants reported significantly higher levels of education, wealth, and mobile phone access. There were associations found between gender and all EVD preventive behavioral outcomes, with evidence for mediation through EVD knowledge and belief in rumors. Men reported greater EVD knowledge accuracy compared with women (mean [SE] score for men: 12.06 [0.13] vs women: 11.08 [0.16]; P < .001), and greater knowledge accuracy was associated with increases in vaccine acceptance (β = 0.37; P < .001), formal care seeking (β = 0.39; P < .001), and self-protective behaviors (β = 0.35; P < .001). Lower belief in rumors was associated with greater vaccine acceptance (β = −0.30; P < .001), and greater EVD information awareness was associated with increased adoption of self-protective behaviors (β = 0.23; P < .001).

    Conclusions and Relevance: This survey study found gender differences in adopting preventive protective behaviors against EVD. These findings suggest that it is critical to design gender-sensitive communication and vaccination strategies, while engaging women and their community as a whole in any response to infectious disease outbreaks. Research on the potential link between gender and sociodemographics factors associated with disease risk and outcomes is needed.

    Erica Nelson and Saira Khan. 8/1/2021. “Climate and Migration in East and the Horn of Africa: Spatial Analysis of Migrants’ Flows Data”.Abstract

    The International Organization for Migration (IOM) Regional Data Hub (RDH) for the East and Horn of Africa partnered with the Humanitarian Geoanalytics Program (HumGeo) at the Harvard Humanitarian Initiative (HHI) to analyze the complexities of and interactions between migration, conflict, environmental changes, and climate-related events in Yemen, and the East and Horn of Africa between 2018 and 2020.

    This research aims to answer the following questions through a variety of geospatial analyses:

    1) How did out-migration rates in any given administrative region change over time and, was it statistically significant compared to administrative regions around it?

    2) How do the numbers of migrants and the overall migration trends vary across space and time, for each cited reason for migration (aka ‘driver of migration’)?

    3) How do environmental variables, e.g. temperature and precipitation, correlate with outmigration in in the East and Horn of Africa?

    This study provides new insights into out-migration patterns in the region, demonstrates a novel way to investigate changing reasons for out-migration using a variety of spatial analysis methods, and establishes a foundation for future studies to analyze the complex and evolving relationship between migration and climate change that will continue to intensify in the years to come.

    Erica Nelson and Saira Khan. 8/2021. Climate and Migration in East and the Horn of Africa: Spatial Analysis of Migrants’ Flows Data.Abstract

    The drivers of human displacement are becoming more and more complex, ranging from conflict and persecution to the increasingly pertinent variables of heightened mobility and social media influences. Of rapidly but appropriately escalating concern is the impact of climate change. While the intensity and severity of climate-induced disasters and climate-related migration will be unevenly distributed across space and time, the World Bank estimates that approximately 140 million people will be displaced globally due to climate-related reasons by 2050. The effects of climate change are expected to be particularly pronounced in Africa, where rising temperatures, unpredictable anomalous rainfall and high vulnerability to extreme natural hazards will continue to exacerbate conflict and harm local and regional human, economic, and environmental security.

    In the East and Horn of Africa (EHoA) in particular, the dependence on rain-fed agriculture and pastoralism means that livelihoods and food security are inextricably linked and affected by long-term or sudden environmental changes and natural hazards. The extreme natural hazards that have struck EHoA in recent years have caused widespread hunger, displacement, loss of critical infrastructure and livelihoods, and death

    In an effort to understand the complex variables that influence migration, the International Organization for Migration (IOM) developed the Displacement Tracking Matrix (DTM) to track and gather information about populations on the move. The Flow Monitoring Registry (FMR) captures a wealth of data about the migratory routes, the demographics and nationality of migrants, reasons for migration, modes of transportation used to facilitate movement, and vulnerabilities experienced by these populations. While the descriptive data provides a wealth of information, more can be done to analyze the complexities of and interactions between migration, conflict, environmental changes, and climate-related events. Climate projections further suggest that environmental changes will likely further lead to decreased water availability, lowered agricultural productivity, and increased disease transmission in the region, producing complex ramifications regarding local and regional conflicts, economics, politics, and migration.

    The porous borders in EHoA have contributed to some of the highest volumes of cross border movement in the world. In 2020 alone, EHoA hosted 6.5 million internally displaced persons (IDPs) and 3.5 million refugees and asylum seekers.6 In the same year, the Horn of Africa experienced unusually high levels of precipitation leading to disastrous floods and landslides and creating ideal conditions for an detrimental locust plague towards the end of 2019 that devastated crops and disrupted livelihoods. The extreme precipitation experienced across much of the Horn in 2019 was preceded by anomalous rainfall the previous year. 2018 was particularly hot and dry in the Horn of Africa, with positive temperature anomalies of around 2°C and below-average precipitation contributing to drought-like conditions in Somalia, Eritrea, and Djibouti while Kenya and Sudan experienced above-average precipitation.8 The drought-like conditions in Somalia, Eritrea, and Djibouti contributed to widespread food insecurity that affected approximately 12 million people. These extreme weather conditions are increasingly exacerbating the already complex and interconnected factors driving migration in the Horn of Africa, and are only expected to escalate in the future.

    For this study, the IOM RDH in Nairobi partnered with the Humanitarian Geoanalytics Program at the Harvard Humanitarian Initiative to leverage spatial analytics to investigate migration flows in the East and Horn of Africa and Yemen. Geospatial analytics hold tremendous potential to introduce new ways of thinking, build research capacity, study impacts, and facilitate costeffective programming. The adoption of geospatial methods into research oriented towards populations on the move, gives us the capacity to accurately characterize the spatial heterogeneity of migrating populations. Furthermore, by incorporating environmental variables into this spatial analysis, we begin to reveal relationships previously undiscovered that could contribute to a richer understanding regarding migration in the region.

    Erica Nelson, Saira Khan, Swapna Thorve, and P. Gregg Greenough. 12/2020. “Modeling pastoralist movement in response to environmental variables and conflict in Somaliland: Combining agent-based modeling and geospatial data.” PLOS ONE.Abstract

    This study explores how pastoralists respond to changing environments in Somaliland . An agent-based model is used to simulate the movement of nomadic pastoralists based on typologically diverse, historical data of environmental, interpersonal, and transactional variables in Somaliland and Puntland between 2008 and 2018. Through subsequent application of spatial analysis such as choropleth maps, kernel density mapping, and standard deviational ellipses, we characterize the resultant pastoralist population distribution in response to these variables.

    Saira Khan, Isaac Baker, and Rob Baker. 11/2019. Satellite Imagery Interpretation Guide of Landscape Features in Somaliland.Abstract

    This guide outlines the tools and techniques to establish a foundation for visual analysis and discusses how these techniques can assist in identifying notable landscape features pertaining to agriculture, settlements, water catchment, and livestock in northern Somalia. To the knowledge of the Signal Program analysts, there is no systematic open-source remote sensing documentation of frequently occurring natural and man-made features in Somalia. This guide helps users to identify and analyze these features, particularly humanitarian practitioners supporting activities in the Horn of Africa. This project, titled “Children on the Move: Using Satellite Data Analysis in Conflict/Famine-Affected Areas,” was carried out in collaboration with UNICEF, the GovLab at NYU, and the Signal Program on Human Security and Technology at Harvard Humanitarian Initiative.

    Saira Khan, Rob Baker, Caitlin Howarth, Erica Nelson, Isaac Baker, Natalia Adler, and Stefaan Verhulst. 11/2019. Lessons Learned Report: Using Satellite Data Analysis in Conflict/Famine-Affected Areas.Abstract
    This report captures the lessons learned during a project titled, “Children on the Move: Using Satellite Data Analysis in Conflict/Famine-Affected Areas.” This document details the project’s progression and the rationale for transitioning from satellite imagery analysis to agent-based modeling as the primary mode of analysis. This project was conducted in collaboration with the Governance Lab at New York University, the Signal Program on Human Security and Technology at Harvard Humanitarian Initiative, and UNICEF. 
    Emmanuel Tronc, Rob Grace, and Anaïde Nahikian. 6/2019. “Realities and Myths of the “Triple Nexus”: Local Perspectives on Peacebuilding, Development, and Humanitarian Action in Mali”.Abstract

     

    Despite decades of development programming for a country once upheld as a “model democracy” in Africa, Mali remains a country destabilized by extreme poverty; escalating violence and instability; and diminishing prospects for Malians’ futures in education, livelihoods, and stability. Even in light of an ongoing international presence and intervention in the country, and millions of dollars raised and spent each year on humanitarian programming, the persistent degradation of governance, livelihoods, and security continues.

    What drives this state of affairs? How have international and regional actors contributed to sustaining a stagnating state at the expense of civilian populations and in the interest of preventing transnational Sahelian turmoil from expanding into the Maghreb and beyond to
    European borders? What are the expectations and aspirations of local communities as they navigate the interconnected influences of extremist groups, government actors, and international military forces?

    This paper examines these questions and offers reflections on various dynamics of the international response and the perceptions of local communities in this context. In particular, this analysis assesses the viability of the “triple nexus” concept, which aims—in protracted
    and complex crises such as Mali—to forge an operational and policy alignment between international peacebuilding, development, and humanitarian efforts. The paper is based on a desk analysis of relevant literature, as well as over 130 interviews and consultations
    undertaken with a variety of stakeholders, including government and non-state armed group representatives, civil society members, activists, journalists, humanitarians, analysts, diplomats, entrepreneurs, beneficiaries, displaced people, and students. The interviews were conducted in Mali, particularly in Bamako and in Central Mali, as well as abroad, between December 2018 and March 2019. The paper proceeds in four parts. Part I examines the key elements driving instability in this context. Part II focuses on international responses. Part III discusses the implications for the “triple nexus.” Part IV offers concluding remarks.

     

    Ronak B. Patel and Jay Chadhuri. 3/2019. “Revisiting the Sphere standards: comparing the revised Sphere standards to living standards in three urban informal settlements in Nairobi, Kenya.” Journal of International Humanitarian Action, 4, 6. Read PublicationAbstract
    Humanitarian actors have long used the Sphere Handbook and its minimum standards to guide operational practice. The new revision attempts to update these standards partly to address urban crises that have challenged the humanitarian system. Yet, these indicators have never been based on a substantial body of evidence or data from the varied living standards found in cities or specifically informal settlements. This study aims to contextualize the Sphere standards for urban populations by comparing a sample of the revised key indicators to living standards in three urban informal settlements of Nairobi, Kenya, during a non-crisis period to examine their relevance and applicability, and discuss the implications.
    Patrick Vinck, Phuong Pham, Kenedy Bungu, Juliet Bedford, and Eric Nilles. 3/2019. “Institutional trust and misinformation in the response to the 2018–19 Ebola outbreak in North Kivu, DR Congo: a population-based survey.” The Lancet Infectious Diseases, 19, 5, Pp. 529-536. Read PublicationAbstract
    The current outbreak of Ebola in eastern DR Congo, beginning in 2018, emerged in a complex and violent political and security environment. Community-level prevention and outbreak control measures appear to be dependent on public trust in relevant authorities and information, but little scholarship has explored these issues. We aimed to investigate the role of trust and misinformation on individual preventive behaviours during an outbreak of Ebola virus disease (EVD).
    Emmanuel Tronc and Anaïde Nahikian. 12/2018. Fragile Future: The human cost of conflict in Afghanistan. Read PublicationAbstract
    This context analysis examines the humanitarian, political, societal, and economic dimensions that make the protracted conflict in Afghanistan intractable and precarious for civilian populations. The report is based on field visits to numerous regions in Afghanistan in July 2018 — which included interviews and consultations with a variety of actors, including political stakeholders, humanitarian agencies, and populations affected by conflict — as well as a review of recent and relevant literature. The purpose of this analysis is to (1) provide a current assessment of the conflict, drawing from field interviews and an in- depth assemblage of various reports and resources, (2) examine the interconnected and interdependent interests fueling the conflict, and (3) suggest that if these dynamics persist in the way they have for decades, recent elections and peace talks will represent yet another setback for Afghan communities and a peaceful future for the country.
    Emmanuel Tronc, Rob Grace, and Anaïde Nahikian. 11/2018. Humanitarian Access Obstruction in Somalia: Externally Imposed and Self-Inflicted Dimensions . Read PublicationAbstract

    Access obstruction in conflict settings has emerged as a critical operational and policy concern across the humanitarian sector, but there remains a dearth of analysis regarding the ways in which humanitarian organizations perpetuate self-inflicted access obstacles. Drawing on qualitative interviews conducted with local and international actors negotiating frontline humanitarian access in Somalia, this paper will examine the ways in which this context elucidates this phenomenon. Toward this end, this paper examines two dimensions of humanitarian access obstruction in this context. The first set of dynamics consists of externally imposed obstacles that stem from governmental actors, Al-Shabaab, access "gatekeepers" motivated by financial gain, and the insecure nature of the environment. The second set of dynamics consists of self-inflicted dimensions of access obstruction that emanate from decisions that international humanitarian organizations (IHOs) have made at the strategic or policy level. These issues include the physical "bunkerization" of IHOs, programmatic shortcomings, the discounting of local humanitarian actors' agency, and the ways that IHOs exhibit programmatic partiality in response to donors' interests and counterterrorism legislation. Through examining these issues, this paper highlights fact that, although the discourse on humanitarian access obstruction tends to emphasize difficulties arising from externally imposed obstacles, it is also important to interrogate the value and methods of humanitarian programming itself.

    Phuong Pham, Vandana Sharma, Rebecca Hémono, Jessica Jean-Francois, and Jennifer Scott. 5/2018. DEPP Evaluation Summative Phase Report.Abstract
    This report provides the summative results from the three-year external impact evaluation of the Disasters and Emergencies Preparedness Programme (DEPP) conducted by a team at the Harvard Humanitarian Initiative (HHI). The DEPP was a £40 million programme funded by the Department for International Development (DFID) that aimed to strengthen skills and capacity and improve the quality and speed of humanitarian response in countries that are at risk of natural disasters or emergencies.
    Phuong Pham, Vandana Sharma, Rebecca Hémono, Jessica Jean-Francois, and Jennifer Scott. 5/2018. DEPP Evaluation Summative Phase Report Annexes.Abstract

    This report provides the summative results from the three-year external impact evaluation of the Disasters and Emergencies Preparedness Programme (DEPP) conducted by a team at the Harvard Humanitarian Initiative (HHI). The DEPP was a £40 million programme funded by the Department for International Development (DFID) that aimed to strengthen skills and capacity and improve the quality and speed of humanitarian response in countries that are at risk of natural disasters or emergencies.

    This document provides the annexes of the report. 

    Mark Latonero, Danielle Poole, and Jos Berens. 3/2018. Refugee Connectivity: A Survey of Mobile Phones, Mental Health, and Privacy at a Syrian Refugee Camp in Greece.Abstract
    The report, Refugee Connectivity: A Survey of Mobile Phones, Mental Health, and Privacy at a Syrian Refugee Camp in Greece, is the result of 2017 field research by Data & Society, the Harvard Humanitarian Initiative’s (HHI) Signal Program on Human Security and Technology, and Centre for Innovation at Leiden University. Lead authors of the report are Mark Latonero, Ph.D. of Data & Society, Danielle Poole of HHI/Signal and the Harvard School of Public Health, and Jos Berens, formerly of Leiden University. 
    Susan Andrea Bartels, Saja Michael, Sophie Roupetz, Stephanie Garbern, Lama Kilzar, Harveen Bergquist, Nour Bakhache, Colleen Davison, and Annie Bunting. 1/2018. “Making sense of child, early and forced marriage among Syrian refugee girls: a mixed methods study in Lebanon.” BMJ Global Health, 3, 1. Read PublicationAbstract

    The Syrian conflict has resulted in over 2.3 million child refugees in the Middle East and the prevalence of early marriage has reportedly increased among displaced Syrian families. This study explores the underlying factors contributing to child marriage among Syrian refugees in Lebanon with the goal of informing community-based strategies to address the issue.

    In July–August 2016, trained interviewers collected self-interpreted stories in Lebanon using Cognitive Edge’s SenseMaker, a mixed-method data collection tool. Participants included married and unmarried Syrian girls, Syrian parents as well as married and unmarried men. Each participant shared a story about the experiences of Syrian girls and then interpreted the story by plotting their perspectives on a variety of questions. Patterns in the responses were analysed in SPSS and the accompanying qualitative narratives were reviewed to facilitate interpretation of the quantitative results.

    Beth J. Maclin, Hannah Wild, Nirma D. Bustamante, and Ronak B. Patel. 12/2017. Investigating Gender Based Insecurity & Mobility: Addis Ababa Country Report.Abstract

    This study of gender based insecurity in Addis Ababa found that women and girls are vulnerable in public and private spaces at any time to assault and harassment, though they are at greater risk for physical violence, including rape, at night. They sacrifice time, money, education, socializing, and their mental health to mitigate the risks they face moving around their community and the city.
    Overall, men commit almost all of the violence described by participants. Much of the insecurity is blamed on unemployed young men that abuse drugs and alcohol. Some also linked unemployment with massive migration from other areas of the country to Addis Ababa. Two cultural factors seem to inform violence against women. First, society normalizes men and boys touching and saying inappropriate things to women and girls, which then leads to increasingly violent forms of abuse. Additionally, limited police response to gender-based violence creates a culture of impunity, which furthers a cultural acceptance of violence against women. Several strategies that draw from participant coping strategies and an analysis of the sources of insecurity can be explored and are detailed at the end of this report.

    This formative research seeks to determine the experiences, sources and effects of GBV and GBI among the urban extreme poor of Dhaka, Bangladesh; Port-au-Prince, Haiti; and Addis Ababa, Ethiopia, with the goal of informing the development of a pilot survey instrument to measure the prevalence and impact of GBI in selected urban slums of the same three cities. 

    Ronak B. Patel, Beth J. Maclin, Nirma D. Bustamante, and Hannah Wild. 12/2017. Investigating Gender Based Insecurity & Mobility: Multi-City Report.Abstract

    Rapid urbanization is the most significant demographic shift taking place. By the year 2050, it is predicted that 70% of the world population will be urban. The urban poor live in a state of chronic crisis and reside in extremely dense informal settlements without basic infrastructure or services. High levels of insecurity are of particular concern. Due to their unofficial status, density, high concentrations of poverty and, often, high turnover, urban informal settlements are either extremely difficult to police or effectively remain un-policed and ungoverned. While all residents of urban informal settlements face significant insecurity and susceptibility to violent crimes, women are especially vulnerable. 

    This formative research seeks to determine the experiences, sources and effects of GBV and GBI among the urban extreme poor of Dhaka, Bangladesh; Port-au-Prince, Haiti; and Addis Ababa, Ethiopia, with the goal of informing the development of a pilot survey instrument to measure the prevalence and impact of GBI in selected urban informal settlements of the same three cities. 

    Katherine Albutt, Jocelyn Kelly, Justin Kabanga, and Michael VanRooyen. 4/2017. “Stigmatisation and rejection of survivors of sexual violence in eastern Democratic Republic of the Congo.” Disasters, 41, 2, Pp. 211-227. Read PublicationAbstract
    Studies report that between 6 per cent and 29 per cent of survivors of sexual violence in eastern Democratic Republic of the Congo (DRC) are rejected by their families and communities. This research project was designed to provide insights into survivors' experiences of stigmatisation and rejection. Surveys were conducted with 310 women as they sought psychosocial services in eastern DRC. In total, 44.3 per cent of women reported suffering rejection after sexual violence. The majority of women felt that their status in the household (58.0 per cent) and community (54.9 per cent) diminished after rape. The odds of rejection were greater among women reporting ongoing displacement, pregnancy owing to sexual violence, worsening family relations, and diminished community status. This work highlights the extremely high levels of loss associated with the war in eastern DRC, particularly among survivors of sexual violence. The rejection of a survivor of rape has concrete and devastating psychosocial consequences.
    10/2016. “Declaration from Academic Humanitarian Training Centers on Syria”.Abstract
    Given the current humanitarian crisis in Syria where patients, healthcare workers, and hospitals are under attack, we the undersigned, without presumption of authority or judgment, stand in solidarity with our healthcare colleagues and declare their right to international health neutrality. For many decades, we have provided global healthcare professionals with education and training in humanitarian assistance in sudden onset disasters and conflicts worldwide. In this training and education, each and every healthcare provider, both civilian and military, is made aware of the inherent protections provided to them under international humanitarian law (IHL), including the four Geneva Conventions of 1949, as well as the principles and rules of IHL applicable to the conduct of hostilities, including the targeting of hospitals and medical facilities. These must be upheld. 
    Patrick Vinck and Phuong Pham. 1/2016. Peacebuilding and Reconstruction Polls: Eastern Democratic Republic of the Congo, Poll Report #5 .Abstract
    This poll is the fifth in a series of polls that will be conducted to provide reliable data and analysis on peace, security, justice and reconstruction in the Democratic Republic of the Congo. The project is a joint initiative of the Harvard Humanitarian Initiative (HHI) and the United Nations Development Programme (UNDP), in collaboration with MONUSCO Civil Affairs. HHI is responsible for the data collection, and independent analysis, and reporting of the results, in collaboration with partners at the Université Libre des Pays des Grands Lacs, Université Catholique de Bukavu, and Université de Bunia.

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