Bielefeld School of Public Health

Christian Bernhard Franz (MPP)

Title: Unhealthy Certainty – Studying mechanisms to deal with radical uncertainty in pandemic preparedness and response

Background: Pandemic threats confront policy makers worldwide with radical uncertainty. Radical uncertainty refers to equivocal situations where the uncertainty about the outcomes of actions is so profound that it leads to two challenges: First, it is impossible to sufficiently structure the problem to formulate alternative courses of action. Second, it is impossible to represent the future in terms of a knowable and exhaustive list of outcomes to which probabilities can be assigned. If this uncertainty is not addressed, it can lead to paralysis in decision-making, inefficient resource allocation, and the loss of public trust or non-compliance with public health recommendations.

Objective: This PhD-project investigates the mechanisms created to avoid these consequences: How do they come about? What renders them effective or defunct?

Material and methods: Policy analysis, expert interviews, computational text analysis.

Practical relevance: Institutional mechanisms are created before, during, and after pandemics to address uncertainty (even if not explicitly). The results are particularly relevant for policymakers to design these mechanisms effectively.

Email address: c.franz@uni-bielefeld.de

Brogan Luke Geurts (MSc)

Title: Navigating Uncertainty: The Daily Business of Community Health Workers in Madagascar

Background: Health systems and communities around the world continue to face a number of compounding uncertainties as global issues – and their regional and local repercussions – continue to put them under stress, oscillating between economic, political, health or climate related crisis.

Objective: To identify policy and program components which can strengthen community health worker responses to uncertainty around potential health threats and support the sustainment of an adaptive and resilient health system in Madagascar.

Material and methods: The project takes a mixed-methods sequential exploratory and systems thinking approach, utilizing qualitative methods followed by a quasi-experimental study.

Practical relevance: The doctoral dissertation is expected to provide evidence for mechanism to incorporate community and CHW epistemologies and knowledge of uncertainties into public health policy in Madagascar and sub-Saharan Africa.

Email address: brogan.geurts@uni-bielefeld.de

Andreas W. Gold (MSc)

Title: Coordination of Healthcare for Refugees in Germany – the role and tasks of non-medical healthcare professionals

Background: The health system should respond appropriately, effectively and efficiently to people's health needs. However, health services for refugees in Germany are often not coordinated, resulting in inefficient care structures and unmet needs. Low-threshold services provided by non-physician health professionals can improve the care situation and are already established in some countries, but have so far rarely implemented in Germany.

Objective: The aim of this PhD project is to systematically collect evidence on existing national and international models of care for improved coordination of health care for refugees. It will identify good practice approaches and derive recommendations for the establishment and expansion of low-threshold services.

Material and methods: The approach is multi-methodological. In addition to a systematic literature review, primary data will be collected and qualitative and quantitative methods of empirical social research will be used.

Practical relevance: The results will be used for the information of practitioners, public administrations and decision makers and for the identification of further research and development needs.

Email address: andreas.gold@uni-bielefeld.de

Maren Hintermeier (MSc)

Title: The health of migrants and refugees during the pandemic - An analysis of infection risks and the impact of pandemic measures

Background: The COVID-19 pandemic has exacerbated the already precarious living conditions of migrants and refugees. This group of people was often not initially taken into account in the pandemic plans. Even at the beginning of the pandemic, studies reported an increased risk of infection among refugees and migrants.

Objective: The aim is therefore to analyse the infection risks of COVID-19 and the impact of pandemic measures on this population group.

Material and methods: An analysis of media reports and a rapid systematic review were conducted at the beginning of the pandemic. A further systematic review, updating the rapid review, will cover the period up to mid-2023 and use meta-analyses and a synthesis of qualitative studies. In addition, inequalities between refugees and asylum seekers in shared accommodation centres compared to the general population in Germany will be quantified through an analysis using the observed/expected approach.

Practical relevance: The relevance to practice is to synthesise and consolidate findings so that future pandemic preparedness plans and control measures can adequately take migrants and refugees into account and possible unintended consequences can be avoided.

Email address: maren.hintermeier@uni-bielefeld.de

Niklas Nutsch (MSc)

Title: Social Determinants of Mental Health in Postmigration Phase: Association between different Types of Social Capital and Mental Health of Asylum Seekers and Refugees

Background: Epidemiological studies show the high burden of mental health problems among refugee populations. Stressful living conditions in host countries during the postmigration phase can have negative effects on mental health. The theory of social capital refers to the nature and extent of interpersonal relationships within social groups. It can be seen as a multidimensional key resource that allows refugees to cope with different postmigration demands.

Objective: Aim of the research project is to examine the association between different types of social capital and mental health among asylum seekers and refugees within the postmigration context.

Material and methods: Methods include systematic reviews to provide an up-to-date summary of the existing evidence on the research topic as well as secondary data analyses based on panel data of the IAB-BAMF-SOEP Survey of Refugees that is representative for Germany.

Practical relevance: Evidence provided by the studies can inform policy makers to implement policies that reduce health inequalities and promote mental health in the population.

Email address: niklas.nutsch@uni-bielefeld.de

Malin Siv Roppel (MSc)

Title: Digital Literacy of German Public Health Workforces

Background: The German public health sector is subject to complex digital transformation processes. It is crucial to enable its workforce to be an essential component of this process through digital literacy.

Objective: The Ph.D. project investigates the demands of digital literacy of the German public health workforce as well as ways for successful dissemination. This research focuses on the stakeholders and dialogue groups involved in the digital transformation of German public health services, as well as their environment and demands for digital literacy.

Material and methods: The Ph.D project has five objectives. Each have a distinct methodology including a scoping review, mixed-method research, and policy analysis. Objective six will merge the results of objectives 1-5 into a policy brief.

 Practical relevance: The results of this research will inform the creation of adult education frameworks within the German public health services. The findings can be applied to adult education institutions, universities, and public health institutions.

Email address: malin.roppel@uni-bielefeld.de

Victoria Saint (MSc)

Title: Exploring the equity, social determinants of health and gender considerations for antimicrobial resistance (AMR) through a mixed-methods approach

Background: Antimicrobial resistance (AMR) is one of the biggest threats to population health, food security and sustainable development globally. To date, equity, social and gender dimensions have not been systematically considered in efforts to address AMR across research, policy and practice spheres.

Objective: The overarching aim is to systematically explore and unpack the equity, social determinants of health (SDH) and gender dimensions of AMR. The research includes a focus on how these issues are understood and addressed by national and global policies and stakeholders.

Material and methods: A multi-methods approach is used, including policy analysis and key informant interviews, interdisciplinarily underpinned by a public health and political science lens.

Practical relevance: The research will generate evidence on the equity, SDH and gender dimensions of AMR, as well as knowledge about how stakeholders at global and national level understand and perceive these dimensions. The research can inform prioritisation, design and implementation of future research, policy and practice.

Email address: victoria.saint@uni-bielefeld.de

Parisa Rahimitabar (MSc)

Title: Health of Afghan Refugees in Iran and Germany – Population and Health Systems Perspectives

Background: Iran, in the Middle Eastern region, and Germany, in Europe, are the main countries hosting the largest populations of refugees from Afghanistan. There is a need for more accurate observations and systematic data collection on the health and living conditions of Afghan refugee populations residing in these host countries.

Objective: This international collaborative doctoral research is the first comprehensive study between Iran and Germany aiming to assess the health and living conditions of Afghan refugees in Iran and to compare these conditions with those of the same population residing in Germany, considering the performance of healthcare systems and existing policies and plans related to refugee health in these host countries.

Materials and Methods: This research employs mixed methods involving both primary and secondary data.

Practical Relevance: The findings may assist both governments in refining policies and health plans to enhance the health and living conditions of Afghan refugee populations and to facilitate their integration.

Email address: parisa.rahimitabar@uni-bielefeld.de