Evidence map›Paper›PMID 42145030›Full record

ArticleHealth policy and planning2026

'This is not our mandate': a qualitative case study on the resilience of a humanitarian health programme in Lebanon.

Claudia Truppa, Martina Valente, Giulia Celentano, Catherine Savoy, Luca Ragazzoni, Dell D Saulnier

Abstract read
In one paragraph

Article in Health policy and planning, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Claudia TruppaCRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, via Lanino 1, 28100 Novara, Italy.ORCID 0000-0003-0696-4575
Martina ValenteCRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, via Lanino 1, 28100 Novara, Italy.ORCID 0000-0002-8599-2162
Giulia CelentanoInternational Committee of the Red Cross, Avenue de la Paix 19, 1202 Geneva, Switzerland.ORCID 0000-0003-2403-2982
Catherine SavoyInternational Committee of the Red Cross, Avenue de la Paix 19, 1202 Geneva, Switzerland.ORCID 0009-0005-6534-6605
Luca RagazzoniCRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, via Lanino 1, 28100 Novara, Italy.ORCID 0000-0002-2528-4375
Dell D SaulnierDepartment of Global Public Health, Karolinska Institutet, Tomtebodavägen 18, 171 65 Solna, Stockholm, Sweden.ORCID 0000-0001-7761-0737

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Decision-making in humanitarian crises is rarely based on evidence and often constrained by uncertainty. Humanitarian health organizations such as the International Committee of the Red Cross (ICRC) operate in conflict settings, characterized by multi-layered, complex crises. Understanding how their decision-making processes influence the continuity of humanitarian health operations can provide insight to inform the development of resilience-oriented interventions in these contexts. We conducted a qualitative case study on the ICRC health operations in Lebanon, with the objective of exploring the elements shaping decision-making and understanding how different organizational factors influenced absorptive, adaptive, and transformative capacities in response to disruptive events in a hospital programme. Twenty semi-structured interviews were conducted with ICRC decision makers. Data were analysed through qualitative content analysis. Three themes emerged, describing how decisions were shaped by people and the trust they were able to develop in internal and external relationships; political considerations often overriding public health priorities; and unresolved tensions around the institutional identity and mandate. Resilience capacities were sustained by different factors. Absorptive capacities were primarily sustained by the availability of material resources, as well as operational contingency plans allowing for flexibility in their allocation. Adaptive capacities were strengthened by cohesive social networks among committed team members. Transformative capacities were limited, promoted by the ability to innovate while at the same time constrained by a rigid organizational culture. Our findings suggest that health governance and local leadership need to be strengthened to enable transformative capacities within humanitarian organizations. Through this, accountability and legitimacy can be enhanced, especially amid growing critiques and dramatically contracting funding.

Indexed as

AltruismDecision MakingRelief WorkHumansInterviews as TopicLebanonQualitative ResearchRed Crossconflictcrisishealth governancehealth systems resiliencehumanitarian aidLebanon

Identifiers

PMID42145030
PMCPMC13481681

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.