Crisis Settings Research Articles

Transmission of Financial Crisis: Evidence of Sub-Sahara Africa (SSA)

The world was struck by a chain of financial crisis between 2006 and 2012. In 2007, began the subprime crisis which gave way to European debt crisis in 2010. As the world tried to recover in 2009, this European debt crisis and Greece sovereign debt (2011) set in. The study investigates through descriptive techniques, correlation and regression, evidence and openings through which these crisis reached and how it affected Sub-Sahara Africa. Using three indicators; GDP growth rate, export/GDP ratio and inflation, we found statistically evidence of the financial tumor in this continent. With numerous indicators of financial crisis we could limit ourselves to three because the data source provided us with more detail information. We suggested that African government multinational and local firms should have expert that can predict and mitigate the impact of a financial crisis.

Snakes, Ladders, and Information about Sexually Transmitted Infections: Evaluation of a Peer Educator Training on the Thailand-Burma Border

The longstanding conflict and civil strife in Burma has had significant consequences on the sexual and reproductive health (SRH) of ethnic minority groups, including adolescents. The Adolescent Reproductive Health Zone in Chiang Mai, Thailand promotes adolescent SRH rights and access to services by having peer educators travel to their hometowns in Burma and lead intensive youth-focused trainings on a variety of topics and issues. In order to evaluate the impact of an intensive three-day workshop dedicated to improving knowledge of sexually transmitted infections (STIs) among peer educators through didactic, experiential, and skill-building exercises, we administered a pre-, post-, and longitudinal assessment. All 13 participants completed both the pre-test and post-test; 11 of 13 participants (85%) completed the longitudinal evaluation administered three months after the training. Our results indicate that both individual and aggregate STI knowledge increased from baseline and that this knowledge was retained. Moreover, the training increased participants’ confidence in their outreach abilities, informed changes in the curricular modules, and led to the implementation of new teaching and learning techniques, especially the incorporation of games and activities. Our findings showcase a successful initiative and suggest similar adolescent peer health educator programs could be undertaken in this protracted crisis and conflict setting.

The influence of humanitarian crises on social functioning among civilians in low- and middle-income countries: A systematic review

ABSTRACTOur aim was to systematically review how social functioning is measured, conceptualised, impacted, and associated with mental disorders in populations affected by humanitarian crises. Quantitative studies conducted with civilian populations affected by humanitarian crises in low- and middle-income countries with outcomes of social functioning were examined up to 2014. Data sources included Medline, Embase, PsycInfo, and Global Health, and 8 grey literature sources, yielding 14,350 records, of which 20 studies met inclusion criteria. A descriptive synthesis analysis was used, and the final selected studies assessed for quality using a modified Newcastle-Ottawa Scale. In the 20 studies, social functioning was conceptualised in 6 categories: family functioning, friendship quality, functional impairment, overall social functioning, social adaptation, and social relations. Seventeen studies were cross-sectional, two were cohort, and one a controlled trial. The quality of the studies was generally moderate. The limited evidence suggests that social functioning is a relevant variable. Greater crisis exposure is associated with more severe depression and lower social functioning. The protective role of familial and social resources for social functioning is highlighted in different crisis settings. However, greater research on social functioning and mental health is required.

Singapore. Education, culture and the Singapore developmental state: ‘World-soul’ lost and regained? By Yeow-Tong Chia Houndmills; New York: Palgrave Macmillan, 2015. Pp. 263. Notes, Bibliography, Index.

Education, culture and the Singapore state: 'World-soul' lost and regained? By YEOW-TONG CHIA Houndmills; New York: Palgrave Macmillan, 2015. Pp. 263. Notes, Bibliography, Index. This book seeks to show that 'the history of citizenship education in Singapore is essentially the history of crisis management in the context of a state' (p. 10). It argues that 'the Singapore developmental state maintained its hegemony and legitimacy' (p. 180) through reforms and recalibrations of its educational policies in response to perceived crises of nation-building. Other than an introduction and a concluding reflection chapter, the book is divided into six chapters framed around each set of crises--the 'Crisis of Merdeka', the 'Crisis of national survival', the 'Crisis of deculturalisation', the 'Crises of legitimacy, national identity and Asian values', the 'Crisis of historical amnesia' and the 'Crisis of national security and social cohesion'. Each crisis forms the explanatory context for a major citizenship education programme which the Singapore government introduced between the 1950s and the present day. The book will resonate with young Singaporeans like myself who experienced and encountered many of these policies and pedagogical materials. Its strength is Chia's rich and detailed use of documents such as policy reports and curriculum materials to demonstrate how the Singapore government's educational objectives translated into the introduction and revision of programmes and curriculum materials aimed at the inculcation of a common consciousness, and a common set of values and ideals, among Singapore's young. This contribution will help students and scholars unfamiliar with Singapore to understand the central role the national education system plays in nation-building and state-formation through 'socializing students into their roles as future citizens in Singapore' (p. 1). They will also gain an awareness of the cultural challenges and social problems Singapore faced throughout its post-1945 history that motivated this long-standing and ongoing use of citizenship education to forge a national identity. A history of Singapore's education system, as this book shows, is partly a history of how Singaporeans are brought up to not just be well-skilled participants in economic development, but also morally-upright, cohesive and patriotic citizens. In other respects, the book's arguments and observations are more provocative and insightful for a non-Singaporean academic audience than a Singaporean one. While Chia neatly brings together the extensive literature written on the topic before 2010, the engagement of more recent scholarship produced in the last few years might warrant reconsideration of some observations, for instance, that 'the post 1965 history of Singapore is only just beginning to be written' (p. …

Vertical integration and profitability of the agrifood industry in an economic crisis context

In a setting of economic and financial crisis, most companies experienced a reduction in their profitability. Thus, our study allows us to identify vertical integration strategies developed by companies to overcome the crisis. This paper is aimed at unveiling the determining factors of the profitability of Spanish agrifood firms, depending on whether they are backwards vertically integrated or not. In order to attain our objective, we implemented a first difference regression model. The main contributions of the article lie in the incorporation of a variable that distinguishes integrated firms from the rest and the separate analysis of the two groups of firms. The results suggest that firms that seek to differentiate themselves, either through offering a specific product or through providing higher quality with a view to maintaining their reputation, are more likely to adopt vertical integration due to the higher transaction costs of relations with suppliers. The grouping carried out in this study is shown to be highly relevant as asset structure implies different strategies for actions aimed at increasing profitability.

Digital age as ethical maze: citizen journalism ethics during crises in Zimbabwe and South Africa

ABSTRACTThis article discusses citizen journalism ethics in crisis settings. It argues for an ontological critique of citizen journalism ethics where the practice must not be judged in relation to the moral taboos of mainstream journalism. Situating citizen journalism within the broader context of liquid modernity and networked practices, the article argues that the practice marks the rise of personalised ethics and morality without ethical codes. Citizen journalism ethics in crisis settings are seen as ambivalent, nascent, fluid, individualised, situational, and sometimes contradictory. The personalisation of ethics also means that professional codes of conduct shift from codes to individual moral impulses in a complex melange of the deontic, virtuous and teleological, that is informed by higher-order ethics of freedom, human rights, social justice, media pluralism and citizen participation. Using case study and discourse analysis methods, the article concludes that citizen journalism represents something that remains deeply futuristic, where ethics are likely to crystallise around deprofessionalised and deinstitutionalised personal responsibilities.

Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda.

ObjectivesMaternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services.MethodsThis was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach.ResultsThe availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support.ConclusionsPost-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services.

Improving maternal, newborn and women's reproductive health in crisis settings

This is the protocol for a review and there is no abstract. The objectives are as follows:To identify, synthesise and evaluate the effects of health system and other interventions aimed at improving maternal, newborn and women's reproductive health in crisis settings.

Mechanisms underpinning interventions to reduce sexual violence in armed conflict: A realist-informed systematic review.

Sexual violence is recognised as a widespread consequence of armed conflict and other humanitarian crises. The limited evidence in literature on interventions in this field suggests a need for alternatives to traditional review methods, particularly given the challenges of undertaking research in conflict and crisis settings. This study employed a realist review of the literature on interventions with the aim of identifying the mechanisms at work across the range of types of intervention. The realist approach is an exploratory and theory-driven review method. It is well suited to complex interventions as it takes into account contextual factors to identify mechanisms that contribute to outcomes. The limited data available indicate that there are few deterrents to sexual violence in crises. Four main mechanisms appear to contribute to effective interventions: increasing the risk to offenders of being detected; building community engagement; ensuring community members are aware of available help for and responses to sexual violence; and safe and anonymous systems for reporting and seeking help. These mechanisms appeared to contribute to outcomes in multiple-component interventions, as well as those relating to gathering firewood, codes of conduct for personnel and legal interventions. Drawing on pre-existing capacity or culture in communities is an additional mechanism which should be explored. Though increasing the risk to offenders of being detected was assumed to be a central mechanism in deterring sexual violence, the evidence suggests that this mechanism operated only in interventions focused on gathering firewood and providing alternative fuels. The other three mechanisms appeared important to the likelihood of an intervention being successful, particularly when operating simultaneously. In a field where robust outcome research remains likely to be limited, realist methods provide opportunities to understand existing evidence. Our analysis identifies the important potential of building in mechanisms involving community engagement, awareness of responses and safe reporting provisions into the range of types of intervention for sexual violence in crises.

Evaluations of outcomes for children and youth from NGO-supported microeconomic interventions: a research synthesis

Economic strengthening (ES) approaches are increasingly applied in resource-poor environments, including in humanitarian crisis settings, in order to achieve a wide variety of socio-economic goals. At the same time, randomized control trial (RCT) methodology has become more prevalent in evaluations of ES and other microeconomic interventions. This review is a systematic research synthesis of randomized impact evaluations of NGO-implemented interventions in low-income countries that work to build income and/or economic assets either of the caregiver, the household, or the individual child, adolescent, or youth, where the evaluation looked at any child-level or youth-level outcomes. The papers evaluate interventions that work to build household or individual income and/or assets, such as conditional and unconditional cash and asset transfers, savings, and training. We find a wide variety of direct and indirect interventions that can potentially affect children. Most of the statistically significant findings from these studies are good for children across a range of outcome measures; however among the studies included here, there is no discernible pattern of any particular intervention category (skills training, savings, etc.) being more effective than any other at achieving better outcomes for children. In many outcome categories, researchers could find no short-term impact on children from ES programming at all. Unintended negative effects for children were found in over 20 per cent of the studies in our document set. By focusing on RCT evaluations of non-governmental programmes, we provide information about the highest quality evaluations of interventions that may be feasible to implement for programmers interested in this topic.

On mission in the cosmopolitan world

The Swedish missionary, Alma Johansson, witnessed the 1915 Armenian Genocide. Like many foreign missionaries and diplomats, Johansson was caught in the middle of the violence and was then forced to take on wider tasks and develop skills other than what she had primarily been sent out for. After the war, she developed new aid work among Armenian refugees in Thessaloniki. In order to understand Alma Johansson’s humanitarian endeavour, I will use the moral philosophical theory of ethics of care as an analytical tool and connect it to moral cosmopolitanism. Ethics of care is still a relatively unexplored field within cosmopolitanism. Cosmopolitanism is rather discussed through abstract accounts of universal principles and of the significance of impartiality, individual rights and justice. The ethics of care emphasizes instead the importance of context, interdependence, relationships and responsibilities to concrete others. From the case of Alma Johansson, the author discusses and analyses the values and practices of interpersonal caring relationships in the specific transnational and humanitarian setting of the Armenian refugee crisis. How are cosmopolitan values expressed in the narratives of Alma Johansson? In what sense can she as a missionary be interpreted as a cosmopolitan caregiver and an intermediary of cosmopolitan values?

International Cooperation in Early Warning and Conflict Prevention Global V Regional Approaches – Un and Eu Models

This article analyses the cooperation and the correspondence of the UN and EU's early warning approaches in a comparative manner and explains how early warnings activities relate to preventive policies and how the latter are integrated into their organisational programming. Furthermore, it surveys the literature on early warning and response strategies applied 0y international institutions and organisations and draws evidence from authors' experience in creating EW systems under the UNDP programmes in different countries. The article argues that the EU and UN early warning and conflict prevention models represent a mixture of top-down and 0ottom-up systems with complex network dynamics, partially overlapping and partially independent incremental policies. This process leads to a greater dialogue than in conflict prevention and contri0utes to a very slow 0ut simultaneous change in the way that actors operate in crisis and post-conflict settings. Finally, it also evaluates strengths and weaknesses of the applied warning and response mechanisms and addresses some of the constraints to response and development strategies.

Development of a brief screening tool for women's mental health assessment in refugee settings: A psychometric evaluation.

The detection of common mental disorders in humanitarian crisis settings requires a screening tool that is feasible to use as well as sensitive and specific. The Self-Report Questionnaire, developed by the World Health Organization in 1994 to detect presence or absence of common mental health disorders, has frequently been used among conflict-affected and refugee populations. Our goal was to identify a highly predictive and reliable subset of items to serve as a screening tool that can be used in busy, over-crowded, and low-resource primary health care settings to identify women who need mental health attention. We analyzed the responses on a version of the Self-Report Questionnaire expanded to include two suicidality items from 810 displaced women living in refugee camps in Rwanda. Screening items were selected and evaluated for predictive ability using logistic regression in a cross-validation process, sensitivity and specificity using receiver operating characteristic curve analysis, and internal consistency analysis. A five-item screening tool resulted. Those items are "Do you feel unhappy?", Do you feel easily nervous, tense, or worried?", "Have you lost interest in things?", "Do you have trouble thinking clearly?" and "Has the thought of ending your life been on your mind?". The Self-Report Questionnaire-5 may be an important tool for identifying common mental disorders as well as suicide ideation and behaviors when assessing mental health among women in crisis situations. Further evaluation of this tool is warranted.

Strategic Science: New Frameworks To Bring Scientific Expertise To Environmental Disaster Response

Strategic Science: New Frameworks To Bring Scientific Expertise To Environmental Disaster Response

Mapping the playing field—a novel web-based strategy to identify non-governmental actors in global surgery

BackgroundIn the face of staggering global unmet need for surgical care, non-governmental organisations (NGOs) play a substantial part in the surgical workforce, providing surgical care for those who are without it. The number of NGOs providing surgical care in low-income and middle-income countries (LMICs) is unknown. This information is needed to determine the scope of such care, its contributions to global surgical case volume, to improve collaboration in an effort to maximise efficiency, and to inform national surgical workforce planning. We aimed to create a comprehensive, publicly available catalogue of NGOs providing surgery in LMICs. MethodsWe used the United Nations Rule Of Law definition to define NGOs. We included low-income, lower-middle- income, and upper-middle-income countries as defined by World Bank lending groups. Delivery of surgical care by an NGO was defined as the therapeutic manipulation of tissues taking place within an operating room, and was distinguished from the financial or logistical support of such care. We screened an online humanitarian clearing house (ReliefWeb), a large public NGO database (Idealist.org), two surgical volunteerism databases (Operation Giving Back and the Society for Pediatric Anesthesia), and the US State Department Private Volunteer Organizations database, did a review of the literature, and used a social media outlet (Twitter) to identify organisations meeting criteria for inclusion. A complementary analysis additionally provided a list of organisations delivering exclusively surgical care from a search of the OmniMed database, the Foundation Center Online Directory, UK Charity Commission, Australia Charity Commission, New Zealand Charity Commission, and the Canada Revenue Agency Charity Search. FindingsWe identified 313 unique organisations, working in all 139 LMICs. Organisations often used more than one model of care and engaged in several surgical specialties. Both short-term surgical missions (206 organisations, 66%) and long-term partnerships (213, 68%) were common models, with 40 organisations (13%) engaging in humanitarian interventions in crisis settings. The most commonly represented specialty was general surgery (120, 38%), but subspecialty surgery such as ophthalmology (88, 28%) and cleft lip and palate surgery (70, 22%) were also frequently performed. InterpretationTo our knowledge, this is the most complete directory of NGOs undertaking surgery in resource-limited settings in existence. However, it is difficult to determine whether this review is exhaustive. Further work is needed to determine the total and relative contributions of these organisations to global surgical volume. This database will be made available for public use and should be maintained and updated to further coordinate global efforts and maximise impact. FundingNone.

Health in the service of state-building in fragile and conflict affected contexts: an additional challenge in the medical-humanitarian environment.

BackgroundGlobal health policy and development aid trends also affect humanitarian health work. Reconstruction, rehabilitation and development initiatives start increasingly earlier after crisis, unleashing tensions between development and humanitarian paradigms. Recently, development aid shows specific interest in contexts affected by conflict and fragility, with increasing expectations for health interventions to demonstrate transformative potential, including towards more resilient health systems as a contribution to state-building agendas.DiscussionCurrent drives towards state-building opportunities in health interventions is mainly based on political aspirations, with little conclusive evidence on linking state-building efforts to conflict prevention, neither on transformative effects of health systems support. Moreover, negative consequences are possible in such volatile environments. We explore how to anticipate, discuss and monitor potential negative effects of current state-building approaches on health interventions, including on humanitarian aid.Overriding health systems approaches might increase tension in fragile and conflict affected contexts, because at odds with goals typically associated with immediate emergency response to populations’ needs. Especially in protracted crisis, quality and timeliness of humanitarian response can be compromised, with strain on impartiality, targeting the most vulnerable, prioritising direct health benefits and most effective strategies.State-building focus could shift health aid priorities away from sick people and disease. Precedence of state institutions support over immediate, effective health service delivery can reduce population level results.As consequence people might question health workers’ intention to privilege health above political, ethnic or other alliances, altering health and humanitarian workers’ perception. Particularly in conflict, neither health system nor state are impartial bystanders.SummaryIn spite of scarce evidence on benefits of health systems support for state-building, current dominant line of thought among donors might influence aid strategies and modalities in settings of crisis, conflict and longer-term health system fragility. Negative consequences may arise from dominance of political agendas over health needs, with risk for effectiveness, nature and perception of health interventions. Potential effects in at least three key health areas merit critical review: quality of humanitarian health interventions, tangible contributions to population level health benefits, perception of health and humanitarian workers. To keep health needs as yardstick to determine effective health and humanitarian priority investments, is challenging.

Development of the Emergency Medical Services Role Identity Scale (EMS-RIS)

This article describes the development and validation of the theoretically grounded Emergency Medical Services Role Identity Scale (EMS-RIS), which measures four domains of EMS role identity. The EMS-RIS was developed using a mixed methods approach. Key informants informed item development and the scale was validated using a representative probability sample of EMS personnel. Factor analyses revealed a conceptually consistent, four-factor solution with sound psychometric properties as well as evidence of convergent and discriminant validities. Social workers work with EMS professionals in crisis settings and as their counselors when they are distressed. The EMS-RIS provides useful information for the assessment of and intervention with distressed EMS professionals, as well as how role identity may influence occupational stress.

The Clash of Cosmopolitanisms: The European Union from Cosmopolitization to Neo-Liberalization

It is clear that the European Union (EU) is currently in the worst crisis situation it has ever been in. The forms of social solidarity, inter-national cooperation, and trans-national structures and processes that many commentators have seen as the basis of ‘cosmopolitan’ Europe’ are under severe strain. Dec-ades of apparent cosmopolitization - of political bodies, economic networks, social connections and the patterns of everyday life - seem to be rapidly going into reverse, being pulled apart or self-destructing. If the last several decades could be understood as involving the increasing appearance and strength (albeit unevenly and in contested ways) of cosmopolitan features both within the EU as an entity and ‘inside’ its external borders, then today the tearing fabric of ‘European’ life seems to point in the opposite direction. This paper poses the question: how ‘cosmopolitan’ really was the EU before the current set of crises, and how have the latter undermined what cosmopolitan features there were? The argument proposed is that the EU was from the very beginning ambivalently cosmopolitan, for it was structured around a liberal-economic, market-based cosmopolitanism, as well as a rights-based conception of citizenship and democ-racy, a kind of legal-political cosmopolitanism. Both forms of cosmopolitanism existed up until recently in a highly ambivalent relationship with each other. But as over time, and especially from the late 1970s, liber-al-economic cosmopolitanism mutated into neo-liberal cosmopolitanism, then the tensions between the two cosmopolitanisms now stand out very starkly, and have reached breaking point. The nature and con-sequences of this situation are diagnosed.

PROTOCOL: Improving Maternal, Newborn and Women's Reproductive Health in Crisis Settings

PROTOCOL: Improving Maternal, Newborn and Women's Reproductive Health in Crisis Settings

Strategies for appropriate and helpful teacher response to stressful situations caused by disruptive students in the classroom

Whether you have been teaching for 20 years or have just started your teaching career, there’s always a possibility you will have a student in your classroom with disruptive behavior. This behavior can go beyond the limits of what is considered to be acceptable in a learning environment. An obvious example of disruptive behavior is when the student verbally attacks, is late for class, experiences angry outbursts, social problems, etc. or simply rebels against something that is happening beyond the classroom door. However, very rarely are we, as teachers, aware of the possibility that the student might be having a mental health crisis. We, the Language Centre at South East European University, have encountered various stressful situations, while at the same time we struggle for balance and try to find appropriate responses for students’ complaints about grades, “unfair” treatment, the policy of the faculty, etc. In an effort to resolve this dilemma, we will conduct research within the Language Centre through interviews with the academic and administrative staff as well as the students and their supervisors. In our presentation, we will present several strategies to deal with stressful situations that affect the entire learning environment, including the teachers themselves, such as: defining the problem, the reason behind it, the time of occurrence, its impact, introducing meta-communication and early communication by setting early expectations, ways to stay calm when responding to a crisis event and setting limits. We will also explore basic principles related to classroom management and a variety of strategies for early intervention in order to create a dynamic learning environment that promotes learning safety. Keywords: Disruptive behaviour, strategies, safe learning environment