Impact case study database

Collins’ work has embedded health and people-centred resilience into disaster reduction programmes at the UN, including the WHO. This impact is delivered at the international strategic and monitoring levels, but also in terms of implementation planning, including laying the groundwork for generating the needed contextual data in the most at-risk communities. Impact is also felt on the ground in Mozambique and Kenya where work with the UN Development Programme (UNDP) and international NGO, No Strings International, has seen the people-centred approach to local environment and health resilience implemented in vulnerable communities. This approach built on existing local knowledge and enhanced community responsiveness, including new public health policies, teacher training, and hand-washing facilities in Nairobi schools.

4.1 Embedding health in the Sendai Framework for Disaster Risk Reduction

The Sendai Framework for Disaster Risk Reduction (SFDRR) is the UN’s framework for disaster risk reduction, adopted in 2015. It replaced the Hyogo Framework for Action (HFA) which was in place between 2005 and 2015. The adoption of SFDRR marks the first time that the fields of health and disaster risk management were substantially interwoven at the global, multisectoral policy level. Collins’ research findings have directly informed the SFDRR by placing a people-centred and community-empowering approach to health at the heart of the UN’s DRR response. Through research-led ‘ expert contributions’ to ‘ stakeholder consultations and the Sendai Framework negotiations’ and providing ‘ a key voice for people and public health in the Science and Technology Advisory Group of the UN Office for DRR’ Collins’ research has ‘helped to ensure that health was central to the final agreed text of the SFDRR 2015-2030’ [ E1]. Jonathon Abrahams, Officer for Health Policy in DRR at the WHO, who coordinated the UN process of putting health at the centre of the Sendai Framework, explains, ‘ there is a clear focus in the Sendai framework principles of a people-centred and inclusive approach which has been at the core of Professor Collins’ work which has served as a continual reminder to focus on action at the local level’ [ E1]. In the foreword to the SFDRR, Margareta Wahlström, Former United Nations Special Representative of the Secretary-General for Disaster Risk Reduction, notes that a focus on health resilience is one of the ‘ significant shifts’ as the SFDRR replaces the HFA [ E2, p4]. Health is ‘ strongly promoted throughout’ [ E2, p4] but one of the seven targets of the SFDRR is to ‘ Substantially reduce disaster damage to critical infrastructure and disruption of basic services, among them health and educational facilities, including through developing their resilience by 2030’ [ E2, p11, target d].

Collins’ work has guided development of the WHO’s Health Emergency and Disaster Risk Management (HEDRM) Framework which is designed to deliver on the SFDRR commitments. Abrahams, in coordinating Health Policy in DRR at the WHO, says, ‘ Collins has been an instrumental member of the core group that has taken forward the WHO Thematic Platform for HEDRM’ and developed the HEDRM Framework in 2019. This Framework, with 194 countries committed to its rules, ‘ provides guidance to ministries of health and … multisectoral health stakeholders on the functions required to reduce the risks and consequences of emergencies and disasters’ [ E1].

195 countries are required to report on progress against the SFDRR annually. In addition to guiding the health policy of the SFDRR, Mami Mizutori, the current Special Representative for UNDRR to the Secretary General, explains the importance of Collins’ ongoing role in the Framework’s successful execution, saying, his ‘ engagement and thought leadership in this critical phase of the implementation of the Sendai Framework in close coherence with the Sustainable Development Goals and Paris Climate Agreement has helped lay the ground for UNDRR and our partners to better promote and support risk-informed decision-making and investment across all 2030 agendas’ [ E3].

In 2019, the UNDRR commissioned Collins to write a report on the uses of action data in DRR to enhance the capacity of international agencies and local communities to deliver the appropriate data that underpins the most effective responses to disaster risk [ E4]. Ricardo Mena, Director of UN Office for DRR, explains Collins worked closely with his office ‘ to apply his research findings on Action Data and significant project experience’ into this report, and that this ‘ policy document provides the framework for the UNDRR Science and Technology Advisory Group (STAG) Data Working Group, a key element of the Sendai Framework implementation’ [ E5]. As a result, there is now a ‘ new emphasis on Action Data at the heart of the ongoing implementation and monitoring of the Sendai Framework’ [ E5].

4.2 Implementing a people-centred approach in vulnerable communities

To support implementation of community capacity enhancement policies on the ground, Collins has worked closely with the UN Development Programme (UNDP) in Mozambique. Dr Titus Kuuyuor, Chief Technical Advisor for DRR/Climate Change Adaptation at UNDP for Mozambique, confirms that Collins’ research and research-informed expertise has addressed challenges the UNDP and other development agencies face at the community level. Dr Kuuyuor explains: ‘ most agencies, including UNDP, are based in Maputo and [are] unable to provide ongoing capacity development and advice due to the distances involved, exacerbated by the high staff turnover’ [ E6]. Collins’ research on locally informed responses and capacity led to community volunteers serving on Local Risk Management Boards, creating ‘an important link between community level disaster risk management and government’ and changing UNDP policy towards ‘enhancing community knowledge and skills in preparedness and planning and developing early warning systems’ [ E6]. As Dr Kuuyuor puts it: ‘ after working with Collins … we refocused our capacity-strengthening initiatives on different scales and … working with local officials in communities is proving far more effective for embedding resilience to disasters’ [ E6].

Beyond the UN, Collins has worked with NGOs directly embedded within communities to enhance their locally led response capacity, engaging with Collins’ research and expert advice on local resilience to implement child-led approaches to risk communication [ E7]. No Strings International (NSI), an NGO working internationally to improve children’s health and hygiene, ‘ revised [their] practices towards a child-centred risk reduction approach in Nairobi’ [ E7, p2]. Rosie Waller, Programme Manager for NSI, explains that the application of the child-centred approach has helped with ‘ engaging the children, getting them excited to learn about hand-washing, and embed best hygiene practices in school and taking those lessons home to share with their family’ [ E7, p2]. NSI work in five schools in Nairobi taught hand-washing and good hygiene to all pupils aged 6 to 15. They use puppetry, interactive crafts, and performance activities to engage and place children at the centre of the learning experience [ E8]. This approach has urged greater responsibility than is customary in classrooms, embedding the children as agents of change for risk reduction while at the same time heightening their awareness of personal wellbeing [ E7]. The Ministry of Education have since adopted this approach, ‘there is now an emphasis on child-centred methodologies or strategies, which helps the children to absorb more of what they are taught … these [new methodologies] are passed on to the master trainers who train TOT's (Trainers of Trainers), who then train the teachers. When you have trained teachers, you have trained children’ [ E7, p7]. In addition, children practice this at home ‘so the whole community are now affected’ [ E7, p11]. To spread these benefits of child-centred learning, ‘ public health strategy is now to train the teachers and school health club together with the head of the school and the school management committee, which includes parents … due to this there is a lot of improvement’ [ E7, p12]. Successes have been rewarded by an expansion in classroom sanitation facilities: ‘If you go to the schools now, water points are in almost all of the schools and being used correctly’ [ E7, p8]. Erik Inda, the Public Health Hygiene Coordinator for 2,500 schools in Nairobi, has ‘ seen a measurable decrease in faecal and related diseases at the class level’ where these projects have run [ E7, p5].