Paper details
| Paper authors | Isabel Munoz Beaulieu, Magnolia Miller, Alayne Adams, Raphael Lencucha, Lisa Schwartz, Salim Sohani, Matthew Hunt |
| In panel on | Ethical Exits and Future Trajectories: Reimagining Closure, Localisation and Humanitarian Practice |
| Paper presenter(s) will be presenting |
In-Person / |
Abstract
Introduction: Humanitarian aid provides emergency relief in response to conflicts, disasters, disease outbreaks and other crises. Yet, its impacts often extend beyond the immediate response—especially for health-related projects. Once an emergency abates, project objectives are met, or if there are insufficient funds or resources to continue operations, humanitarian organizations will exit. A lack of planning for effective transitions of services or failures to address potential service gaps can disrupt continuity of care and undermine social determinants of health. While humanitarian medical organizations may have frameworks to guide responsible exit strategies, implementing these strategies in fragile environments remains a challenge. To better understand how humanitarian organizations frame and address the long-term impact of interventions, this project maps and analyzes institutional and sectoral policies on delivering humanitarian health aid in ways that promote lasting benefits and address ongoing community needs after humanitarian health projects close.
Methods: A policy document analysis was undertaken using the READ 4-step approach: (1) preparing and organizing documents, (2) extracting relevant data, (3) analyzing data, and (4) distilling key findings. To ensure comprehensive document collection, we conducted targeted online and database searches, including databases from ReliefWeb and Humanitarian Library and sectoral and organizational websites from humanitarian medical organizations (e.g., Médecins Sans Frontières, Médecins du Monde) and organizations with extensive health programs (e.g., IFRC). We also consulted with key informants and applied reference chaining to identify additional documents. Document selection involved independent title and abstract screening by two reviewers, followed by full-text review based on inclusion criteria. The analysis is guided by the "3-i" Framework—focusing on institutions, ideas, and interests—to examine documents that guide action such as policies, strategies, and guidance notes. The analytic structure is being systematically organized using the 3-i framework, with relevant themes identified within each of the three categories.
Results: The initial document collection yielded 193 documents, with 100 documents selected for full-text review. Key aspects of recommendations focused on addressing long-term impacts in humanitarian emergencies included strategies to sustain project services and benefits, strengthen health systems, and mitigate the lasting effects of interventions and recurring crises on affected communities. Long-term considerations were frequently framed within the context of exit strategies, environmental policies, and in relation to broader organizational commitments, such as the Sustainable Development Goals.
Conclusion: In a rapidly changing global health landscape, addressing the lasting impact of humanitarian health interventions is essential to build long-term and sustainable solutions for communities impacted by crises. These findings can support discussion and debate about humanitarian medical organizations’ approaches to promote enduring benefits following the closure of their projects.
