This case study series documents the experience of R2HC-funded research teams in engaging with people affected by crisis. The full case series can be found here.

STUDY BACKGROUND

Understanding the drivers of migration and their health impacts on Internally Displaced People in southern Somalia

The University College of London and Concern Worldwide collaborated on this study.

Forced migration is common in southern Somalia, an area that continues to be affected by conflict, instability, seasonal drought and flooding, and disease outbreaks. A combination of factors led to profound food insecurity and health crisis across much of Somalia in 2017.

A research team comprising academics at the UCL Institute for Global Health and staff from Concern Worldwide led a qualitative study to describe the drivers of forced migration and the perceived health impact on internally displaced people (IDPs) during this period.

Utilising narrative and participatory mapping approaches, the study team established detailed push-and-pull factors, including a more nuanced understanding of health needs, the dynamics of movement, and social, economic and political issues during the 1) pre-migration, 2) movement, 3) arrival and settlement and 4) return phases.

APPROACHES TO ENGAGING WITH PEOPLE AFFECTED BY CRISES

DESIGN PHASE

Established connections with communities

The study team had experience conducting a large nutritional study and implementing a nutrition and mortality surveillance in the same region. This established presence allowed the research team to develop relationships, which meant they knew the community and gatekeepers in advance of the R2HC-funded research. During this phase, the study team had a number of informal conversations with community members on their ability to remember their migration routes, which helped to assess the feasibility of participatory mapping as an approach for subsequent research

IMPLEMENTATION PHASE

Participatory methods are reliant on community participation

The study team utilised participatory community mapping (PCM) to supplement focus group discussions and key informant interviews. PCM is a process of map-making that attempts to make visible the association between land and local communities using cartographic illustrations. The study team focused on people who had migrated from the Lower Shabelle and Bay regions to internally displaced persons (IDP) camps in the Afgooye Corridor, on the outskirts of Mogadishu. Originally the research team was using pre-printed large-scale maps of Somalia, but these were not sufficiently detailed to be useful to the participants in explaining their journeys. The hand-drawing of detailed maps by participants proved much more successful in illustrating routes and means used to reach the IDP camps, along with difficult decisions and health impacts. Working with individuals to capture information in this alternative format allowed for the easier visualisation and comprehension of knowledge that would have been difficult to represent in the form of a verbal or written narrative.

“The research coordinators knew the dialect and were known by camp residents. The community was informed that they would not receive assistance based on responses given, which made it easier to ask questions and get accurate answers”

– Mohamed Jelle

The involvement of local Somali staff and regional staff of Somali origin helped to address certain security-related travel restrictions, but also helped to ensure that implementation proceeded with cultural sensitivity. Gender dynamics were acknowledged, and as such qualitative data collection was conducted by two female qualitative researchers. Recognition of these gendered and other social and cultural dynamics allowed the research team to build rapport, trust and openness among different respondent groups.

POST-RESEARCH PHASE

The research partnership with Concern was beneficial when planning for local dissemination events, as they had existing networks within target communities.

ENABLERS OF PARTICIPATION

The long history of engagement with the study population from previous studies was a facilitating factor. Engaging local staff was supportive of participation both for access reasons, but also to ensure that gender and cultural nuances were respected. The willingness to change tactic away from pre-printed maps and to employ hand-drawn visual mapping was beneficial in eliciting perspectives from the research participants to a level of detail that was more suited to explaining their complex journeys and challenges. The partnership with Concern was felt to be helpful in the dissemination phase.

“Without the use of the [Participatory Community Mapping], getting this detailed information and mental mapping of the migration routes and associated health risks would have been difficult.”
– Andrew Seal

BARRIERS TO PARTICIPATION

Access to communities was challenging due to insecurity, but this was mitigated through the engagement of local staff.

FIND OUT MORE

To find out more about this research, please see the study profile.

ACKNOWLEDGEMENTS

With thanks to Dr Andrew Seal and Dr Mohamed Jelle for their contributions to this case study, and the study team, partners, and study participants for their contributions to this research.