Determining Spatial Heterogeneity in the Prevalence of Anaemia among Women aged 15-49 in India for the Years 2019–2021

## **CommunityFirst Paradigm Shift as Decolonised Approach to Humanitarian Emergency Response**

**Rachel Kiddell-Monroe** SeeChange Initiative, Montreal, Canada

The COVID-19 pandemic has revealed the limits of humanitarian crisis response. For many Indigenous, displaced, and other vulnerable communities, humanitarian assistance either never arrives, arrives too late,

or is imposed on communities without regard for their needs, priorities, cultures, and assets. This presentation aims to explain the CommunityFirst (CF) approach, which addresses this gap and shows how sustainable and community-owned solutions provide vulnerable communities the agency to respond to their health crises their way. Our CF approach recognizes that when the community leads and owns its health crisis response, the impacts are more effective and appropriate. This, in turn, makes crisis responses more lasting and replicable. CF is defined as a cycle of engagement, co-creation, and reflection to leverage a community's agency and resources before, during, and after a health crisis. Our CF approach brings forward adaptive solutions to health crises that are desired, designed, and owned by communities themselves. This methodology supports communities in 12 countries across the Americas and Africa to respond to health crises, including tuberculosis and COVID-19. Currently, we are expanding this approach in Latin America with Doctors Without Borders, and our results from this collaboration will be shared during this event. Since 2018, we have seen many qualitative results, including community leaders feeling more equipped to organize, prepare and respond to health crises, as well as improved emotional health and well-being during crisis response, stronger community health advocacy, and greater community awareness of prevention strategies. One issue in humanitarian assistance is questioning the value of quantitative results in monitoring and evaluation. The question is, what results and outcomes need to be measured that focus on what the community needs and wants? Further, vulnerable communities often lack the financial resources to lead their own crisis response. Leveraging the concept of trust-based funding, we discuss how to ensure independent sources of income are managed by the community to respond to health crises as they arise. By sharing a new framework for humanitarian action, we can impact how humanitarian organizations work, how communities demand their place in an emergency response, and how global policymakers fund humanitarian responses.

Rachel Kiddell-Monroe

SeeChange Initiative, Montreal, Canada

SeeChange seeks to invigorate vulnerable cmmunities to address humanitarian health crises. Our purpose is guided by our values of humanity, solidarity, humility and dignity.

Our objective is to co-design solutions with communities that leverage their agency and resources before, during and after a humanitarian health crisis.

Since 2018, we have accompanied over 20 communities in Argentina, Canada, Colombia, Ghana,Guatemala, Honduras, Kenya, Mexico, Peru, Sierra Leone and Venezuela



