This course introduces a set of public health problems experienced by people affected by natural disasters and/or conflict. It discusses the many changes in people’s lives when they are uprooted by a disaster, ranging from changes in disease patterns, access to health care, livelihoods, shelter, sanitary conditions, nutritional status, etc. We will explore what humanitarian interventions could look like if we want to mitigate the effects of disasters. The course content is a mix of theoretical knowledge and many practical examples from recent disasters. We think this course is unique because it contains so many practical ‘real-life’ examples and is taught be instructors and guest lecturers who together have over 200 years of experience in this field. The course consists of 10 modules totaling approximately 9-10 hours of delivered content with an additional 2-3 hours of self-work (quizzes and writing and evaluating a short peer-review assignment) as well as lively discussions forums. The course has been designed in a way that each module builds on the lessons of previous modules. However, modules can be accessed in any order and some can stand alone. You do not have to pay for this course if you choose to enroll without a certificate. Sometimes referred to as auditing, enrolling without a certificate means that you will have access to all of the videos, quizzes, assignments, and discussions. The only difference is that you will not receive a certificate upon completion. Click the Enroll Without A Certificate link to sign up and begin the course. Even if you enroll in a session that has yet to begin, you may access most of the course materials right away by clicking the Preview Course Materials link. However, you will have to wait for the session to begin before posting on the discussion forum or accessing the final peer-reviewed assessment. Visit the Learner Help Center for details about session schedules.
Livelihoods Support Programming
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Из курса от партнера Johns Hopkins University
Public Health in Humanitarian Crises
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Module 4: Livelihoods and Food Security in Humanitarian Crises
Disasters affect livelihoods. This module illustrates how and what livelihoods strategies families use to cope with a crisis. We also describe what food security entails and ways to assess it. We look at various livelihoods support programs that can be used in disaster settings.
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Gilbert Burnham, MDProfessor
International Health
Mija VerversSenior Associate
Health Systems
In this section we will go back to the family of Ahmed and Sara and
see what potential you might see in response programs could look like.
Earlier we discussed the effects of a disaster on this family's livelihoods and
also on their food security.
What could be done to mitigate the effects?
What could the government and/or the humanitarian community do in this
situation to ensure that Ahmed, Sara, and their children remain safe?
And that they don't need to resort to damaging coping strategies in
order to remain healthy, safe, and food secure?
In this last part of this module we will look at interventions that aim to address
livelihood needs, including food security.
Food needs may be the most important in a certain context,
but cannot be seen in isolation of other needs.
A livelihood approach looks much broader, and
assessment will direct us what is the best approach.
Imagine that an assessment in a humanitarian context recommends the need
for livelihood support programs such programs could have different objectives.
I give you some examples, an objective could be livelihood provisioning,
which aims to meet basic needs and minimize expenditures.
It could also aim for livelihood protection.
This means that the program intends to protect human,
social, fiscal, and financial assets.
Livelihood protection could also intend to prevent asset depletion and
negative coping strategies.
Another objective could be livelihood promotion which aims to improve human,
social, political, financial, assets.
Let's make this more concrete.
You can generally categorize the livelihood support programs in one or
more of the following.
And they aim to achieve one or more of the previously mentioned objectives.
Programs that address livelihood, consumables, and productive assets,
employment, enterprise development, financial services.
Let's look at each of them and I will give some concrete examples.
Livelihood consumables are used to meet basic needs.
While productive assets can be used to generate income and profit.
In some situations,
food assistance undoubtedly can be appropriate humanitarian response.
Especially when there is very limited food available or accessible to families
it might prevent people to selling productive efforts, or to migrate.
And assistance in water and sanitation, blankets, shelter etc could be needed too.
Unconditional cash donations can be used for livelihood consumables, such as food
or blankets, but also for buying productive assets, for example, equipment.
A concrete example, is to program providing cash via ATM and
bank machines to the Iraqi refugees in Jordan some years ago.
The beneficiaries were targeted based on socioeconomic criteria which included
vulnerability and income.
An evaluation showed that most of the cash grants were used to cover for
basic needs, mainly rent and food.
The evaluation also showed that very little was invested in productive assets,
given that the Iraqi refugees at the time were not allowed to work
without work permits.
Distribution of, for example, vegetable seeds and
some tools can help to acquire food.
Remember the example I gave in my introductory talk, fishing nets or
cages could be provided directly for obtaining food.
These examples mostly refer to livelihood provisioning and livelihood protection.
I will go a little bit more in detail later on these two food and
cash assistance.
Another example of livelihood support programs concerns employment.
Employment programs can include initiatives that create temporary jobs,
such as cash for work programs.
For instance, clearing debris from a flood or
earthquake is an example of such a temporary job.
Vocational training can increase the employability of a person.
He or she can be enrolled in a training as carpenter, or
tailor, training in small business management or bike repair.
These are just examples of the many options possible.
They refer mostly to livelihood protection and promotion.
Supporting entrepreneurship, or
enterprise development, are other examples of livelihood support programs.
In this case it aims to promote livelihoods.
The support to small businesses can restart local economies and
increase economic self-sufficiency.
This can be done through many ways.
Such as, as previously mentioned, training.
But also by providing start-up kits for business such as brick-laying or a bakery.
Or providing a start-up kit with tools for a hairdresser who wants to pick up his or
her profession again.
Small loans or grants can be given to set up small businesses for poultry breeding
and egg production or for setting up catering service or an Internet cafe.
Or anything else where there is a demand
assuming that those involved have acquired sufficient skills.
And lastly, livelihood support can be given by facilitating access to formal or
informal financial services, such as banks,
micro-finance institutions, insurance schemes, remittance services.
Now let's take that last example and look for
a moment at the situation of Ahmed and Sara.
What if they had family somewhere in Europe or
in other countries outside where they are who were willing to
provide financial support to them so they can survive better?
This support could ease their suffering and
refrain them from applying damaging coping strategies.
A good livelihood support program could help them access remittance
facilities such as a bank, a post office, or money transfer operators.
As previously mentioned, I want to come back a bit more to these two examples of
livelihood support programs.
First, food assistance.
Food assistance makes up a huge part of the budget of humanitarian assistance.
Let us look at food assistance in general and
in any given context and any given disaster.
The objectives for food assistance can vary, but need to be clear.
Food assistance can be used to meet immediate food needs and
prevent the deterioration of the nutritional status.
This means it can be used for saving lives.
To avoid further impoverishment or destitution, food assistance
can protect or recover livelihoods by preventing the sale of assets.
This would have been perhaps a good objective in the context of Ahmed and
Sara and their community if their homes would be still habitable.
Food assistance can also help to save time for productive and
other essential activities.
If people need to search for food, it can be sometimes better to provide the food so
they can try to find work instead.
Another objective especially in a rural more agricultural society
could be that food assistance is used to avoid premature harvesting or
to protect seeds from being eaten.
Destitute families will not wait for the harvest to be completely ready.
They will already harvest what is there even if the crops
have not fully matured yet.
Food assistance could also be provided to avoid people from taking risks for
their security.
For example, combatants might recently have put a lot of land mines in an area.
And therefore, people cannot safely access their harvest or livestock.
Or imagine a situation where people are trying to gather fruit in the wild,
women and children in particular are prone to physical harm by local militias.
Food assistance can be used to prevent families from migrating altogether.
Food assistance can be aimed at everybody in a certain geographical area or
at only a selected group with certain specific vulnerabilities.
The recipients would then have to meet certain criteria.
Food assistance can be provided unconditionally, or
there might be conditions, for example, food for work.
This means people get food as a kind of salary, whilst providing some labor that
serves the community, such as cleaning rubble from roads.
This kind of food assistance can be controversial as it might
not start with the ones that need it.
The provided food can be cooked or raw and
given when raw as take home rations.
The food can aim to meet all nutritional requirements.
Or aim for
partially meeting these, as people still have other means to obtain food.
In the module on nutrition,
I will give some additional examples of food assistance programs.
Food assistance can also have negative effects.
Evidence has shown that sudden influx of food assistance
might lower prices of similar or related commodities.
Therefore undermining livelihoods of surrounding producers.
Food assistance recipients might be exposed to looting and abuse.
Ill considered local purchases may deplete regional reserves and
contribute to the rise of market food prices.
And lastly, evidence has shown that poor targeting and
timing of food assistance will cause additional harmful effects.
It is important to balance out positive and negative effects.
Currently, food assistance takes up one of the largest expenditures
in humanitarian assistance for the United Nations.
Now a bit more on cash transfers.
I would like to go a little bit more in detail on cash
as a form of humanitarian assistance.
Cash as a commodity has come more and more in the spotlight as a commodity to use for
people affected by disasters.
I suggest you watch this video.
It is a short animation video and
introduces cash grants that can be used for multiple purposes.
It provides an overview of their use, advantages, and
implications for the different actors of the humanitarian system.
If you have some time I can also recommend to watch the other video
on ten things you need to know about cash transfers, but I leave that up to you.
Maybe I've now whetted your appetite for
the use of cash in humanitarian programming after having seen the videos.
Let's look at the scale of its use.
In 2015, it was estimated that cash transfers made up only 6%
of all humanitarian assistance.
With cash transfers we refer here to all programs where cash or vouchers for
goods or services are directly provided to the beneficiaries.
However, these programs are on the increase and
scaling up cash has been identified as a key priority in humanitarian assistance.
In 2016, the United Nations Secretary General called in the report for
the World Humanitarian Summit for cash as the preferred and
default method to support people in emergencies wherever possible.
In this slide, you see the official documents.
I would like to finish with one short video,
a very illustrative example of how cash was used after an earthquake in Nepal.
I would like to summarize now a few of the main
learning points of this module on livelihoods, food security, and cash.
Every family has some kind of livelihood assets which can be physical of nature,
financial, human, social, political, and natural.
They can change due to a disaster.
Families have different coping mechanisms to deal with a disaster.
They depend largely on what assets they have left.
Coping mechanisms can be damaging especially if productive assets
are depleted.
The well being of the family members can then be at risk.
Livelihood support programs can alleviate human suffering through support with, for
instance, livelihood consumables such as food or cash, productive assets,
employment, enterprise development, and financial services.
In the future, cash transfer programs will increase its share in
humanitarian assistance as it has many advantages.
Prior to any implementation of any program that addresses food and
security, a thorough assessment needs to be done that includes analyses
of availability of food, access to food, and utilization of food.
We have now come to the end of this module.
I hope you understand now better why it is so
important to look at livelihoods in a disaster context.
If you are at most interested in public health, you need to understand
what decisions people need to take and why they take them.
There are so many pressing priorities for people.
You cannot separate health from all the other important elements in life.
I want to thank you for taking the time to go through this module with me.
[MUSIC]
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