What are the practices to identify and prioritize vulnerable populations affected by urban humanitarian emergencies?: A systematic review protocol | Crisis | Emergency Management

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The purpose of this document is to clearly describe the proposed research questions and methodology for an evidence synthesis on practices to identify and prioritize vulnerable populations affected by urban humanitarian emergencies. This protocol outlines the reasons for this evidence synthesis, how the review will be conducted, plans for critical appraisal of included studies and methods of synthesis. The aim of the synthesis is to consolidate the practices (including tools, methods and metrics) reported by practitioners and academics to identify and prioritize vulnerable people, households or communities within populations affected by humanitarian emergencies, including those displaced within and to urban areas. This synthesis is funded through the Humanitarian Evidence Programme, a UK Aid-funded partnership between Oxfam and Feinstein International Center (FIC) at the Friedman School of Nutrition at Tufts University. The Humanitarian Evidence Programme aims to synthesize evidence in the humanitarian sector and communicate the findings to stakeholders, with the ultimate goal of improving humanitarian policy and practice.
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  Humanitarian Evidence Programme What are the practices to identify and prioritize vulnerable populations affected by urban humanitarian emergencies? A systematic review protocol of methods and specific tools used to target the most at–need individuals, households and/or communities in urban crises  What are the practices to identify and prioritize vulnerable populations affected by urban humanitarian emergencies? 2   Authors Dr. Ronak B. Patel, Stanford University Ms. Laura Phelps, Norwegian Refugee Council Prof. David Sanderson, University of New South Wales Ms. Jami King, Harvard T.H. Chan School of Public Health Contact   Dr. Ronak Patel Stanford University, 300 Pastuer Drive, Department of Emergency Medicine  Alway Building M-121, Stanford, CA 94305 415-425-4849 Funding This is report commissioned by the Humanitarian Evidence Programme, a partnership between Oxfam and Feinstein International Center at Tufts University, and funded by the Department for International Development. This material has been funded by UK aid from the UK Government, however, the views expressed do not necessarily reflect the UK Government’s official policies.   Picture View of Kathmandu in February 2016. Kieran Doherty/Oxfam.  © Copyright  Authors of the systematic reviews protocols on the Oxfam GB website (policy-practice.oxfam.org.uk/publications) hold the copyright for the text of their protocols. Oxfam GB owns the copyright for all material on the website it has developed, including the contents of the databases, manuals, and keywording. Oxfam and authors give permission for users of the site to display and print the contents of the site for their own non-commercial use, providing that the materials are not modified, copyright and other proprietary notices contained in the materials are retained, and the source of the material is cited clearly. Otherwise users are not permitted to duplicate, reproduce, re-publish, distribute, or store material from this website without express written permission.  What are the practices to identify and prioritize vulnerable populations affected by urban humanitarian emergencies? 3   CONTENTS 1   BACKGROUND 4   1.1   Aims and rationale for review 4   1.2   Definitional and conceptual issues 5   1.2.1   Timeframe 5   1.2.2   Vulnerability 5   1.2.3   Urban 5   1.2.4   Humanitarian action 6   1.2.5   Emergency 6   1.2.6   Low and middle income countries 7   1.3   Research, policy and practice background 7   1.4   Objectives 8   2.   METHODS USED 9   2.1   User involvement 9   2.1.1    Approach and rationale 9   2.2   Identifying and describing studies 9   2.2.1   Defining relevant studies: Inclusion and exclusion criteria 9   2.2.2   Identification of potential studies: Search strategy 12   2.2.3   Screening studies: Applying inclusion and exclusion criteria 14   2.2.4   Data extraction for included studies 15   2.2.5   Identifying and describing studies: Quality appraisal 16   2.2.6    Assessing the quality of studies 16   2.3   Synthesis process 16   2.3.1   Selection of studies for synthesis, and identification of outcome data for synthesis 16   2.3.2   Process to combine/synthesize data 16   2.3.3   Deriving conclusions and implications 17   REFERENCES 18   APPENDICES 20   Appendix A. Example search strategy for PubMed 20   Appendix B. Data extraction form (DRAFT) 21    What are the practices to identify and prioritize vulnerable populations affected by urban humanitarian emergencies? 4   1 BACKGROUND 1.1 AIMS AND RATIONALE FOR REVIEW International organizations working in humanitarian crisis settings recognize the need to improve urban emergency response and preparedness, which necessitates improved methods for assessing vulnerability within urban populations. Currently, the Sphere Handbook of guidelines and best practices for humanitarian response is being adapted to include the urban context (The Sphere Project, 2015). The Inter-Agency Standing Committee’s   (IASC’s)  strategy report on meeting humanitarian challenges in urban areas explains the need for targeting and enumerating vulnerable individuals and communities to better direct services (IASC, 2010). Similarly, the Active Learning Network for Accountability and Performance in Humanitarian Action (ALNAP) highlights the need for ‘ specific efforts [to] be made to identify those groups who have particular need or high levels of need ’  in urban emergencies (Sanderson and Knox-Clarke, 2012). More prominently and very timely, the first ever World Humanitarian Summit (WHS) will review current practice and help inform future humanitarian challenges through global and expert consultations. Various working groups are an integral part of this process. They are charged with drafting the urban charter and recommendations for urban crisis response, such as the urban expert working group, to which the review team belongs and currently contributes. The Global Alliance for Urban Crises has also evolved out of these efforts. The alliance brings together a broad array of stakeholders to specifically recognize the growing and unique challenge of urban crises, promote this agenda at the WHS and beyond and work to improve operational practice in urban crises. Recent crises have further emphasized the need for vulnerability assessment criteria and functional targeting methods. In Nepal, efforts by the government to equitably distribute resources in the wake of the earthquake resulted in many organizations being spread too thin and caused concern within humanitarian organizations that the most vulnerable were being overlooked because they lacked title deeds and/or proper identification. The Disaster Emergency Committee (DEC) and the Humanitarian Coalition’s review of the Nepal earthquake response pushes for improved targeting that considers the proportional impact of a disaster on vulnerable groups  –  the targeting needed either before or after a crisis to identify those most vulnerable to the impact of a shock (DEC/HC, 2015). Similarly, relief efforts in Port-Au-Prince following the 2010 Haiti earthquake also highlighted the need for improved resource targeting, where, for example, a majority of the population lived below Sphere standards prior to the earthquake and inadequate targeting of response resulted in uneven resource distribution (ALNAP/DAC/UNEG, 2010).  As organizations struggle to identify vulnerable populations in urban crises, they are challenged by the fact that in many rapidly growing and fragile cities, many people are living in extreme vulnerability even before the onset of an acute crisis. We find that large urban populations live well below Sphere minimum standards at baseline, as found in a forthcoming paper by the review principal investigator and previous data collection in Nairobi slums (Concern Worldwide, 2014). This baseline vulnerability calculates directly into risk to health and well-being and translates back into loss when an acute crisis strikes (WHO, 2002). In these environments, practitioners report being overwhelmed by need and may adopt blanket targeting or essentially arbitrary/non-vulnerability based selection. The increasing need for guidance in urban crises, where Sphere and previous practices do not hold relevance, makes this review question particularly important and inviting to this team. The answers to the review question also play an important role in preparedness, as the practices used to identify vulnerable populations in urban crises can be complementary to the pre-disaster phase of the humanitarian crisis cycle.
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