Primary Health Care Delivery Models in Conflict Settings of Cameroon and Nigeria

Study Overview
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Brief Summary
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The overall objective of this research is to understand the PHC landscape in conflict-affected settings including choice of PHC delivery models and quality interventions used by humanitarian organisations

Detailed Description
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There is sparse evidence to guide the selection and design of primary health care (PHC) services that improves and maintains quality care in humanitarian settings. The Northwest and Southwest regions of Cameroon, and Northeast Nigeria have protracted humanitarian crises. Various models of PHC are used in these settings; ensuring quality of PHC models of care is essential to improve health outcomes. We aim to explore how PHC models are selected by humanitarian organizations and through stakeholder engagement design a toolkit for evaluation of quality in PHC care delivery across different models. The specific objectives of the study are; To map different primary health care delivery models used by public, private and humanitarian organization in the conflict affected settings of NWSW Cameroon and North East Nigeria by conducting a mapping survey To explore the factors influencing the selection of primary health care delivery models used by humanitarian organizations to guide the selection of models of care and strengthening of programming efforts in conflict settings by conducting an exploratory qualitative study To determine the coverage and gaps in services across the different PHC models to develop a pilot questionnaire to evaluate quality in conflict settings by conducting an exploratory qualitative study The humanitarian crisis in North West and South West regions of Cameroon and North East Nigeria, has led to the closure of 269/933 and 617/2367 health facilities respectively with over 2.21 million IDPs and 350,000 returnees(2, 3), creating a huge gap in the availability and accessibility of health services to affected communities. The need to conduct this study becomes even more pertinent to inform program developers and donors on key considerations to make before using different models of care, and how quality can be improved to foster sustainability

Official Title
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Primary Health Care Landscape in Conflict Settings and Choices of Delivery Models in North West and South West Regions of Cameroon and North East Nigeria

Conditions
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Models of Care, Primary Health Care, Conflict-Affected Settings

Intervention / Treatment
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* Behavioral: Program support


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male and female staff of humanitarian organisations, internally displaced persons (confirmed to be a resident of an IDP or host community); Age 21 years of age or older; Ability to provide informed consent or assent to participate in the research Exclusion Criteria: Individuals who are mentally ill or with limitations to communicate well; Those who cannot speak or understand the local languages so that they cannot understand the interviewer. Those who refuse to provide consent to the study or who do not want to participate in the study

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Humanitarian workers<br>Staff working in humanitarian organisations will be recruited for interviews | Behavioral: Program support<br>* The intervention to be evaluated in this study is program design and selection considerations by humanitarian organisations. It will comprise of factors that motivate organisations to chose certain delivery models in providing health care in conflict-affected settings<br>|
| Internally displaced persons<br>Internally displaced persons living in conflict settings will be recruited for interviews | Behavioral: Program support<br>* The intervention to be evaluated in this study is program design and selection considerations by humanitarian organisations. It will comprise of factors that motivate organisations to chose certain delivery models in providing health care in conflict-affected settings<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of frameworks developed | Framework to guide humanitarian organizations in the selection of primary health care models will be collaboratively developed following the results from the study and stakeholders meeting | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of quality oversight toolkit developed | Following the development of a framework to inform the selection of models of care, an oversight toolkit for selecting models of care and monitoring a pragmatic set of quality interventions (QI) will be developed. The toolkit will include a composite score drawing from scores across all domains. This will be used to give an overall assessment score of quality. | 12 months |