Ongoing Projects

Lead Faculty: Shannon Doocy

The overarching objective of the study is to identify lessons learned and best practices related to the sustainability of SPIR’s outcomes, along with their barriers and facilitators to those selected lessons and practices, to develop design recommendations and implementation priorities with strategic value for improving the sustainability of future RFSAs. Specific research aims include:

Aim 1. Identify SPIR lessons learned and best practices activities, the pathways to and persistence of outcomes, (un)intended consequences of SPIR activities in the three sectors of focus (Agriculture/Natural Resource Management (NRM); Livelihoods, and Gender/Youth).

Aim 2. Summarize barriers and facilitators of sustainability for selected sectors [and activity with outcomes/impacts] by the four sustainability domains of resources, capacity, motivation and linkages. 

Aim 3. Identify commonalities and differences of SPIR outcomes and their barriers/facilitators between SPIR and the and experiences of other RSFAs and similar multi-sectoral food security programs in Ethiopia and globally with a strategic focus on PSNP system development.

Aim 4. Develop recommendations to improve design, implementation, and close out of future RSFAs that result in more effective interventions leading to higher graduation rates among PSNP clients.

Lead Faculty: Kate Falb

American Indian adolescent girls face significant challenges concerning their mental health, often exacerbated by historical trauma and systemic inequalities born from racist and sexist settler colonial practices. These cultural factors, including the loss of cultural identity and connection to ancestral lands, can contribute to feelings of isolation and depression among American Indian adolescent girls. Moreover, the intergenerational transmission of trauma resulting from colonialism, forced assimilation policies, and the legacy of boarding schools, which included the specific targeting of girls within historical-cultural assimilation practices, given girls’ central roles in building the next generation of American Indian families and communities continues to impact their mental well-being. This mixed methods, tribally driven participatory research study aims to understand the feasibility, acceptability, and perceived effectiveness, including pathways of change of a strengths-based, intergenerational program (Girl Societies) for American Indian adolescent girls that aims to revitalize protective matriarchal cultural practices.

Lead Faculty: Kate Falb

This two-year research study aims to: (1) understand the interconnected sexual and reproductive health (SRH) and gender-based violence experiences (GBV) needs and priorities faced by older women and women and girls with disabilities in humanitarian settings, including a focus on conflict-related sexual violence; (2) identify modifiable barriers across the humanitarian system to better meet their needs in varied humanitarian settings; and (3) illustrate promising practices and collaboratively develop new strategies to address their prioritized needs. By gathering insights from these local organizations and actors, the study seeks to inform policy and practice to better support older women and women and girls with disabilities’ rights, health, and well-being in crisis situations. The study will tentatively employ qualitative methods in the first year through remote in-depth interviews and, in the second year, will partner with a local organization to co-develop prioritized programming models identified through the qualitative research through collaborative, participatory workshops.

Lead Faculty: Paul Spiegel

The Johns Hopkins University Nexus convening award will support three series to convening to improve anticipatory and adaptive humanitarian programming, and to inform the global humanitarian policy agenda in the face of climate change, conflict, displacement, and health to prevent calamity and promote resilience before a crisis occurs by harnessing the potential lifesaving power of data science and emerging technologies. Specifically, the convenings will: 1) Map and magnify JHU Efforts: Mapping actors and initiatives related to climate change, conflict, displacement, and humanitarian crises across the university; 2) Data for action: Analyzing the right data at the right time to improve humanitarian decision- making; and, 3) Develop the Climate Change, Conflict, Displacement and Humanitarian Crises Lab.

Lead Faculty: Paul Spiegel

Reactive vaccination campaigns aim to rapidly increase the population level of immunity and reduce the number of susceptible people who could be infected with the circulating disease, therefore reducing the spread of the pathogen. However, the implementation of reactive campaign faces a variety of challenges that delay or completely hinder their implementation. This study aims to identify key barriers and enablers to the implementation of reactive vaccination campaigns after an outbreak has been declared and formulate solutions to improve timeliness and implementation of such campaigns.

The current Israel-Gaza war, which began on October 7, 2023, has had an immense humanitarian impact. This project aims to provide projections of excess mortality for different causes of excess mortality (mortality modules) in Gaza under three scenarios: 1) ceasefire, 2) status quo (continuation of conditions observed during the period of the war preceding the projections, and 3) escalation. These estimations will provide decision-makers and responders information to plan for and respond to different scenarios. The data may also be used to inform diplomatic efforts addressing this conflict. 

The current projection is for February 7 – August 6, 2024. Over the next five months, the project expects to publish periodic updates of the projections. The scenarios may be altered to reflect the evolution of the crisis, improved data or revised models.

The project is an independent academic collaboration between researchers from the London School of Hygiene & Tropical Medicine and the Johns Hopkins Center for Humanitarian Health at Johns Hopkins University and is funded by the UK Humanitarian Innovation Hub. 

For the complete report and more information about the project, visit https://gaza-projections.org 

The findings do not necessarily represent the views of the funder, the Johns Hopkins University, or the London School of Hygiene & Tropical Medicine.

The authors are solely responsible for the analysis and interpretation.

The funder had no role in shaping the analyses, this report, or other scientific outputs of the project.

This publication is partly based on third-party-generated data herein analyzed and interpreted, and it is not intended to question or challenge such data. 

Any geographical entities or references to armed conflict events are only for the purpose of the analysis/report, and do not imply acknowledgment or endorsement of facts relating to these geographical entities or events.

Lead Faculty: Shannon Doocy

JHSPH will provide research services to WFP in both humanitarian and development contexts with the aim of characterizing outcomes of WFP interventions and promoting evidence-based programming.

Lead Faculty: Jessica Fanzo

To empower civil society groups to bring about a right to food approach to food systems in the four countries in which it is taking place; to bring about food systems grounded in the right to food rights

Lead Faculty: Shannon Doocy

Act as the research learning partner for a Catholic Relief Services-led consortium working to provide emergency food assistance (in-kind and cash transfers) in Ethiopia.

Lead Faculty: Courtland Robinson

The research aims to estimate prevalence rates and risk factors associated with trafficking and forced labor in the brick kiln industry in Pakistan. We are one of seven grantees worldwide conducting these studies which will not only provide estimates of forced labor for policy and program interventions but also compare and contrast estimation methodologies to improve global measures of human trafficking and forced labor in low and middle income country settings.

Lead Faculty: Chiara Altare

To reduce the risk of COVID-19 infections as well as in response to local and global non-pharmaceutical interventions, national governments, UNHCR and partners adapted their implementation strategies to maintain health service provision as much as possible, in both refugee camps/settlements and in urban areas. It is therefore of strategic importance to document how strategies and activities were adapted in different contexts and which approaches were most effective to respond to refugees’ needs. This will guide future policy and program implementation in these countries and in other forced displacement settings, where resources remain limited. Furthermore, understanding which adaptations may be worth being maintained beyond the COVID-19 context to facilitate access to services would contribute improving the design of health service provision strategies in forced displaced settings. This study aims are therefore threefold:

1. Estimate how health service provision and outcomes have changed during the COVID-19 pandemic in refugee camps/settlements, and in selected urban health facilities providing services to refugees.

2. Characterize adaptations in health service delivery modalities and strategies implemented by Ministry of Health (MoH), UNHCR and partners to maintain health services provision; identify which adaptations were most effective and accepted, as well as which modifications should be maintained beyond the context of COVID-19.

3. Integrate a community perspective by investigating how refugees were involved in designing and implementing adaptations, how these were perceived, which barriers refugees encountered, and how they adapted health seeking behaviors during the pandemic. 

Lead Faculty: Nancy Glass

The study provides a unique opportunity with a proven Congolese partner to examine the combined and synergistic effects of two proven structural interventions; 1) Rabbits for Resilience (RFR), youth-led economic empowerment program; and 2) Indashyikirwa (IK), a couples/parents-based gender equality program on adolescent mental health. Using a clustered randomized controlled trial with three groups (RFR only, IK only, RFR + IK), we examine the combined and synergistic effects of the interventions and the pathways through which RFR and IK improves adolescent mental health.

Lead Faculty: C. Nicholas Cuneo

The HEAL Refugee Health and Asylum Collaborative is a partnership among Johns Hopkins University, Esperanza Center/Catholic Charities, Asylee Women Enterprise (AWE), and Loyola University Maryland to expand access to responsive health care and supportive services for immigrant survivors of torture and trauma seeking refuge in the U.S.

www.healasylum.org

Lead Faculty: Nicholas C. Cuneo

The JHU-IRAP Medical-Legal Partnership at the US-Mexico Border supports ongoing remote forensic physical and psychological evaluations of asylum seekers in Ciudad Juárez whose legal cases are being supported by IRAP. This service delivery is coupled with ongoing research on conditions at the US-Mexico border and the effect of a dynamic border policy landscape on the health and human rights of migrants.

Lead Faculty: Shannon Doocy

Act as the research learning partner for a Catholic Relief Services led consortium working to provide humanitarian assistance and promote resilience in Ethiopia.

Lead Faculty: Shannon Doocy

Provide technical support for the evaluation of Save the Child cash transfer and child protection programming in ongoing humanitarian responses in Lebanon and Colombia.

Lead Faculty: Paul Spiegel

The Ensuring Quality Access and Learning (EQUAL) for Mothers and Newborns in Conflict-affected Contexts Consortium will generate operationally-relevant, demand-driven evidence to reduce maternal and perinatal mortality and morbidities in low-income, conflict-affected contexts (LI-CAC), and ensure translation of evidence to practice and policy using consortium partner influence, networks, and capacity strengthening (CS) efforts.

https://equalresearch.org/

Lead Faculty: Sarah Murray, Karine Le Roch, Amanda Nguyen

We are conducting a randomized controlled study accompanied by the collection of mixed methods implementation data to assess the effectiveness of ACF's Baby Friendly Spaces (BFS) program delivered to Rohingya refugee mothers in Cox's Bazar, Bangladesh. Although psychosocial support programs are implemented globally to refugees, there is a lack of formal scientific research documenting evidence of their impact on caregivers of young children or providing guidance for their effective implementation. Responding to this gap in knowledge, we aim to: evaluate the extent to which BFS services contribute to improved maternal and child health outcomes for forcibly displaced lactating Rohingya mothers and their young children; examine key implementation factors related to these outcomes (e.g., fidelity, sustainability); and explore what would be needed to adapt this program for delivery to Bangladeshi mothers and their young children seeking services in host community clinics within Cox’s Bazar.

Lead Faculty: Paul Spiegel

Lancet Migration will work in a complementary manner with multilateral agencies, non-governmental organisations, faith groups, donors, and governments to provide a platform for documenting progress at global, regional and national level, towards better health for all migrants, host populations and those left behind, based on sound indicators and robust data. We will build on our existing networks and collaborators to consolidate regional hubs, comprised of academic, policy and operational partners at national, regional and global level, and work closely with existing policy work on migration and health, to transform evidence into action.
Lancet Migration will have two primary objectives:
1. Undertake and support high quality, multidisciplinary scientific research to address the evidence gaps in the field of migration and health; and
2. Stimulate public engagement, advocacy, and policy shaping activities to transform evidence into action.

https://migrationhealth.org/

Lead Faculty: Andrea Wirtz

We intend to understand more experiences of violence among Latinx immigrants in the US and methods to better engage this population in health research. Specific Aims include: 1. To develop and adapt quantitative survey instruments to assess interpersonal violence among Latino immigrants. Qualitative methods (focus groups and in-depth interviews) will be used to identify various forms and contexts of violence victimization experienced by Latinx immigrants that are not currently captured by existing instruments. Cognitive testing approaches will elicit feedback on selected instruments and pilot adapted methods.

Lead Faculty: Mija-tesse Ververs

This scientific repository is compiled by the Johns Hopkins Center for Humanitarian Health and provides an overview of what peer-reviewed journal articles currently state on COVID-19, maternal and child health (including infants), and nutrition. As the pandemic is ongoing, more and more research results are published. With this service, this project provides the user with a snapshot of what is published with updates every week. The users' group comprises health professionals, researchers, policymakers, donors, etc. working all over the world on COVID-19. 

Lead Faculty: Chiara Altare

There is little known about COVID-19 transmission and risk factors in humanitarian settings, as well as its broader impact on health outcomes and health services. Recent attempts to estimate the spread of infections as well as the indirect consequences of COVID-19 produced gloomy scenarios. Such models, however, rely on various assumptions, for which data from low- and middle-income countries (LMICs) or humanitarian settings are sparse, increasing variability of results. There is, therefore, a need for quality data from different humanitarian contexts to inform decision-making and strategies for the current and future responses, as well as future models according to different contexts.

This project aims to:

1) Improve the understanding of COVID-19 epidemiology in humanitarian settings;

2) Assess the broader impact of the pandemic on non-COVID-19 morbidity and mortality, as well as on health services utilization by vulnerable groups;

3) Investigate how physical distancing and other Public Health and Social Measures affect social interaction and health-seeking behavior, and

4) Document policies and monitor interventions and measure their impact on the epidemiology of COVID-19 and non-COVID-19 diseases.

Both routine health facility and surveillance data, as well as primary data, will be used for this analysis. Work will be conducted in North Kivu (the Democratic Republic of the Congo), Bangui (Central African Republic), and Cox’s Bazar district (Bangladesh), in collaboration with Action Contre la Faim and the REACH initiative.

Project aims on building national leadership in humanitarian programming.

Lead Faculty: Gilbert Burnham

Project aims on providing data to integrate refugee reproductive health services with Ethiopian national health services. 

Lead Faculty: Leonard Rubenstein

Multiple studies confirm a global consensus that attacks against healthcare in armed conflict, including access constraints, violence, and insecurity, represent a major threat to health, particularly for vulnerable groups and women. Gathering evidence about attacks has, to date, been crucial in raising awareness of the issue. Yet the consequences of attacks against healthcare in armed conflict remain a majory knowledge gap. According to the WHO, ‘while the consequences of such attacks are as yet largely undocumented, they are presumed to be significant – negatively affecting short-term health care delivery as well as the longer-term health and well-being of affected populations, health systems, the health workforce, and ultimately our global public health goals.’ Better understanding of these consequences could help promote the resilience of health programs, enable more effective measures to mitigate the impact of attacks at multiple levels, inform accountability mechanisms, and advance advocacy efforts aimed to prevent attacks, in addition to contributions toward the health and well-being of health workers and affected populations.

The project’s core objectives are as follows:

1. To generate new evidence about the impact of attacks on healthcare on health systems, humanitarian and health actors and their staff, affected communities, and patients.

2. To develop, test, and document methodological approaches to assess impact that can be applied in challenging environments.

This is an ongoing consortium of four universities based the University of Manchester (UK) involving research projects in Afghanistan (University of Geneva lead), Central African Republic (JHU lead), Colombia (University of California Berkeley lead), and Nepal (University of Manchester lead), along with publications on research methods, systematic reviews of the literature, and other activities. There’s a web site for the consortium, https://riah.manchester.ac.uk

Lead Faculty: Sara Bennett

The research focuses on integration; the extent to which host country health facilities provide services to both refugees and national populations (potentially with financial support from external agencies), in a manner whereby both populations are able to receive equally appropriate care, of an adequate quality. Subsumed within this concept of integration are also the notions that (i) health workers from the refugee population are able to work and provide health care services, and (ii) that financial mechanisms established to support services are integrated with financing channels employed by the host nation. Therefore, we will assess integration from three different perspective: the service delivery model, the integration of refugee health workers and the financing mechanism.

Research question 1: What are the perceptions and experiences of stakeholders (international, regional and national) as well as host and refugee populations towards refugees’ integration in health systems and how does this differ across contexts?

Research question 2: What factors, at the structural, institutional and individual/community levels, have shaped the adoption and implementation (or lack thereof) of country policies that support the integration of refugees into health systems?

Research question 3: To what extent are refugees integrated (or not) into national health systems, and how has this affected availability, access and quality of health services for both refugees and national population?

Research question 4: What financial mechanisms and flows have been employed to support the integration of refugees into health systems and how has this affected financial sustainability of health services for both refugees and national populations?

Lead Faculty: Leonard Rubenstein

Through research and leadership of global coalition, develop mechanisms for protection of health care from violence in conflict; promote action by states to take key steps toward protection; and ensure accountability for perpetrators of violence against health care.

https://www.safeguardinghealth.org

Lead Faculty: Linnea Zimmerman

PMA-Ethiopia, implemented in collaboration between Addis Ababa University, Ethiopian Public Health Association and Johns Hopkins Bloomberg School of Public Health, is designed to generate both cross-sectional and longitudinal data on a variety of reproductive, maternal, and newborn health indicators that can inform both national and regional governments.

Lead Faculty: Gilbert Burnham, Shannon Doocy

To assess compliance with treatment and control of disease over three years among vulnerable and low income populations in Ghana (with a companion study in the Philippines for which Shannon Doocy is the co-investigator).

Lead Faculty: Gilbert Burnham

This study will examine causes of mortality and access to health services among populations trapped in Mosul, Iraq, during the period of ISIS control.