Rapid review tools
Rapid review and tools to collect data in the context of the COVID-19 pandemic
COVID-19 has come to dominate almost all the world’s attention and that certainly includes development action. But other major development issues have not gone away and are in many cases getting worse as part of the fall-out from COVID-19. As we struggle to understand these impacts the pandemic continues to evolve and changes what we thought we knew and what we thought would be its impacts on the priorities we had before the pandemic. This fluid context demands that we increase our capacity to conduct rapid reviews to understand how COVID is changing the communities we work with, their priorities, and the socio-economic conditions that determine their lives and livelihoods.
The Global Polio Eradication Initiative is no exception. It stopped much of its work to focus relevant resources on COVID-19 activities including immunisation campaigns. As it begins to consider restarting campaigns it is faced with understanding how the attitudes and perceptions of the communities it works with have changed. What will be the reaction to door to door campaigns following (or perhaps during) a period of physical distancing? How can such activities in ways that are safe and are perceived to be safe? How has COVID impacted on local health care infrastructure and people’s perception of it? How do people feel about how their government handled the pandemic – has it raised or lowered confidence in government health care delivery? Have different groups been affected differently and will some groups react differently to polio campaigns? Has risk perception related to COVID-19 and demand for a vaccine impacted how communities will respond to polio vaccination?
All of these questions (and many more) are critically important to answer and all need to be answered quickly. Furthermore, the evolving and fluid context means the answers will need to be tracked over time as they may change. This requires the quick application of rapid research. Our focus here is to use polio as a specific lens and example but this need to understand the impact of COVID on the world in which development action occurs extends across all sectors and should have resonance for any development initiative.
What is rapid review?
Let’s begin with a very brief overview of what rapid research is. A good place to start is a guide produced by the World Health Organization (WHO) and the Alliance for Health Policy and Systems Research - Rapid reviews to strengthen health policy and systems: a practical guide. This guide describes rapid review as ‘a timely and affordable approach that can provide actionable and relevant evidence to strengthen health policy and systems’. They are not a substitute for longer term systematic reviews but when done with proper attention to the questions asked and a careful approach to streamlining methods they can provide policy makers and programme managers with evidence of high enough quality to make strategic decisions in emergency situations. The approach is necessarily fluid but a useful set of training slides can be found at this link. A relevant example of this type of research is a study from 2018 produced for WHO which gathered lessons from grey literature on risk communication during recent emergency situations - Emergency Risk Communication: Lessons Learned from a Rapid Review of Recent Gray Literature on Ebola, Zika, and Yellow Fever.
Are there examples of how to do this type of evidence gathering during COVID?
For the polio programme it will be important to understand how community experiences during COVID are likely to impact their response to restarting campaigns. We have listed some of areas above that will require monitoring and evidence to understand the new context that has emerged. WHO has developed a standard protocol it calls ‘COVID-19 Snapshot Monitoring’ (COSMO Standard) which provides a framework for rapid and adaptive monitoring over time and to assess the relations between risk perceptions, knowledge, and misinformation to preparedness and protective behaviour regarding COVID-19. The Social Science in Humanitarian Action Platform has prepared a document called Compliance with Physical Distancing Measures for COVID-19 and Implications for RCCE in Eastern and Southern Africa which contains ideas for communication with influencers and for developing feedback loops that will support the sharing of information to understand evolving community concerns and perceptions related to COVID and immunisation/polio. There are also some useful tables for categorizing and tracking government measures related to physical distancing and their impact on individuals and communities.
In Somalia Africa's Voices Foundation (AVF) reached out to citizens using its established multimedia interactive platform, Imaqal ("listen to me") to conduct a rapid diagnostic on COVID-19-related community questions, concerns, and risk perceptions to help inform risk communication and community engagement (RCCE). The findings were used to provide responders with a snapshot of how the people of Somalia were thinking about the epidemic in its early days. The findings are captured in Somali Views in the Early Days of COVID-19: A Rapid Diagnostic.
In Kenya interactive radio was used to develop an understanding of people's perceptions and concerns around risk and preparedness. It provided information so that outbreak responses could address their fears - Two-way mass and individual health communications and rapid socio-epidemiological insights to support Kenya's COVID-19 response
In conclusion
COVID-19 has created an unprecedented situation in which much of what we once understood about the communities we engaged with is changing and changing quickly and in some senses radically. As we move through the stages of the pandemic and begin to re-engage on development issues we will need to understand these changes and how the lives and priorities of those we work with have changed. For polio eradication this will mean understanding such things as how communities are likely to react to vaccination campaigns, what they will accept as safe practices in a world of risk requiring physical distance, and how much confidence they have in health services or the ability of government and other development actors to provide such services safely. All of this evidence and more needs to be gathered quickly to inform policy and programme design against a backdrop of impending or expanding outbreaks and the urgency of getting back to the work of protecting children from vaccine preventable disease. We cannot restart this work safely and with confidence that communities and caregivers will accept it without this evidence. Nor can we delay restarting at the earliest possible moment – a moment that should be dictated by the epidemiology of SARS-CoV-2 and not by a lack of evidence. Rapid review has a critical role to play in the safe, timely and community informed restart of polio eradication and many other critical lifesaving development programmes.
Some further resources that may also be of use:
Global Kids Online Tools for Researchers
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