Challenges and strategies for implementers and evaluators working in conflict settings

This article addresses logistical, methodological, and ethical challenges in conflict zones, offering strategies through implementation science frameworks like RE-AIM and CFIR.

It offers approaches and evaluation frameworks to navigate complexities.

This article by Bond, Klein, and Gates (2023) explores how implementation science frameworks, specifically RE-AIM and the Consolidated Framework for Implementation Research (CFIR), can address challenges in conducting evaluations in conflict zones. The authors suggest that evaluators can benefit from the strategies documented by implementation scientists in navigating dynamic humanitarian settings. The article details logistical, methodological, and ethical challenges in conflict zone evaluations and how implementation frameworks can mitigate these issues, while also recognizing their limitations. The authors conclude with future research directions, emphasizing collaborative team approaches, ethical guidance, and improved reporting and dissemination.

Key content

Key takeaways from the resource include:

Implementation and evaluation challenges in conflict zones

This section of the article discusses the unique challenges faced by practitioners and evaluators working in conflict zones, which are areas with militarized violence, political instability, and state-sanctioned intimidation. The challenges include:

• Logistical Challenges: Limited access to sites and difficulty in tracking participants due to forced displacement.

• Methodological Challenges: Inappropriateness of traditional study designs like randomized control trials, and obstacles in collecting reliable data due to security restrictions.

• Ethical Challenges: Ensuring the safety and security of evaluators and participants, and obtaining honest feedback from vulnerable groups who may fear reprisal.

Frameworks to guide implementation and evaluation practice

This section of the article explores how implementation science frameworks can provide strategies to mitigate challenges in conflict settings, focusing on two main frameworks: RE-AIM and CFIR.

RE-AIM framework

This sub-section explains the RE-AIM framework, which offers a structured approach to evaluate the impact and implementation of interventions in complex settings:

• Reach: Evaluates who the intervention affects and how to effectively reach the target population.

• Effectiveness: Measures the impact of the intervention on intended outcomes.

• Adoption: Assesses the uptake of the intervention by target settings.

• Maintenance: Considers the long-term sustainability and continued use of the intervention.

CFIR (Consolidated Framework for Implementation Research)

This sub-section delves into the CFIR framework, which helps in understanding and addressing barriers and facilitators at multiple levels:

• Outer Setting: Considers external factors that influence implementation, such as political and social environments.

• Inner Setting: Examines internal organizational factors that affect implementation.

• Characteristics of the Intervention: Looks at the attributes of the intervention itself.

• Characteristics of Individuals: Focuses on the people involved in the implementation process.

• Process of Conducting the Intervention: Evaluates the steps taken to implement the intervention.

Strategies from RE-AIM and CFIR frameworks to address implementation-evaluation challenges in conflict settings

This section of the article outlines practical strategies derived from the RE-AIM and CFIR frameworks to address the challenges in conflict settings:

• Collaborative Approaches: Engaging diverse stakeholders to ensure context-sensitive evaluations.

• Rapid, Pragmatic Assessments: Using iterative evaluation methods to reduce time in the field and enhance safety.

• Hybrid Designs: Combining elements of effectiveness and implementation research to gain a comprehensive understanding of interventions in conflict settings.

Discussion

This section of the article emphasizes the importance of using implementation science frameworks to navigate the complexities of conflict zones:

• Collaborative Team Approaches: Promoting collaboration across agencies and stakeholder groups to improve evaluation practices.

• Bridging Siloes: Encouraging knowledge sharing between implementation and evaluation sciences to enhance best practices.

• Hybrid Designs: Advocating for the use of hybrid study designs to evaluate both implementation and effectiveness.

Conclusion

This section of the article concludes by underscoring the critical need for rigorous and ethical evaluations in humanitarian interventions within conflict zones:

• Frameworks: Highlighting the value of RE-AIM and CFIR in addressing the unique challenges of these settings.

• Future Directions: Calling for further research on ethical guidance, reporting, dissemination strategies, and capacity building to ensure sustainable and effective evaluation practices.