A systematic review of cost-effective methods of international humanitarian response

Humanitarian relief organizations face many challenges due to the increasing number of both natural and man-made disasters such as drought, famine, war, and conflict. According to the United Nations, these challenges will continue to increase because of the risen vulnerability of humanitarian supply chains, especially regarding cost, accuracy, and duration. In this systematic review, we explore methods of lowering the cost of humanitarian responses, more specifically in regard to the education and training of aid workers.


Introduction
Humanitarian relief organizations face many challenges in responding to the increasing number of both natural and man-made disasters such as drought, famine, war, and conflict. They are the ones, who in close collaboration with governments give the first aid to communities in need. Even though humanitarian relief organizations are specialized towards these types of operations, the responsibility of helping and protecting affected communities usually falls under the government's jurisdiction and authority. Research shows that the lack of funds and services to respond to such disasters has made it almost impossible for governments to implement immediate solutions. That is why, the international community and humanitarian relief organizations, consider it as a moral obligation to help the affected populations from unexpected environmental, political, and economic conditions.
The United Nations has declared that the global demand for humanitarian response will rise because of the risen vulnerability of the humanitarian supply chains, especially 1 Corresponding author: e-mail: erblin.shehu@oshksh.gov.al 2 e-mail: spahiu16@itu.edu.tr regarding cost, accuracy, and duration. Even though humanitarian supply chains follow a universal pattern, they heavenly depend on the type of humanitarian emergency. According to Kovacs (2007), there are three different types of humanitarian emergencies, sudden-onset emergencies such as earthquakes and floods, slow-onset emergencies such as drought and epidemics, and complex emergencies war and famine. In many occasions, they need specific ways to deal with and policymakers should be taking each one of them into consideration before designing and implementing the necessary policies. In addition, they need to take into consideration different types of humanitarian organizations, because their difference in size and local presence defines the number of funds that need to be spent in humanitarian response. Even though it might seem that the best way to reduce the cost of humanitarian responses, is by moving away from the one-size-fits-all response model, evidence shows that the vulnerability has come because of inadequate training, lack of collaboration as well as low recognition and management of logistics. The purpose of this systematic review is to explore methods of lowering the cost of humanitarian responses, more specifically in regards to the education and training of aid workers.

Material and methods
A ProQuest Central search for either "costeffective international humanitarian aid" or "cost-effective international humanitarian response" was conducted. The search was limited to articles whose subject was the humanitarian response. We intended to limit the search to recent articles, papers, and scientific studies conducted through years 2005-2016 about developing countries; however, this did not result in a considerable amount of articles to review. Therefore, we included articles with no restraints regarding time and location. For each article that met the search criteria, we collected information on the population, objectives of the article, results as well as strengths and limitations of the study.
All articles meeting our search criteria were categorized as either conceptual or researchfocused papers. Conceptual articles were defined as those articles that did not give an actual solution of lowering the cost of humanitarian response but expressed the point views of the authors as potential ways of administering these processes. Researchfocused papers were defined as articles that included empirical data as well as in-field studies about effective ways of humanitarian aid response from the local, national and international community.
A total of 6,449 articles were identified by searching ProQuest Central for either "costeffective international humanitarian aid" or "cost-effective international humanitarian response". Thirty-five articles were found after we limited the search to only peer-reviewed articles whose subject was the humanitarian response. Of the thirty-five articles identified, we found that only nine articles were treating specific examples of humanitarian response operations; these best-practice articles were the ones that were used.

Results and discussion
When it comes to responses in situations of man-made and natural disasters, our systematic review finds many challenges faced by affected communities. For example, weather conditions are a critical factor in deciding the occurrence of natural disasters. The time and place of their occurrence and the nature and magnitude of the demand are both unpredictable in the case of disaster relief operations to intervene (Lijo and Ramesh 223). That is why having an emergency program that will deal in real-time with situations like these, is becoming a necessity for many governments across the world.
Many of the articles reviewed in this study, emphasize the importance of agility in humanitarian supply chains during an emergency relief operation. Agility has been defined as the ability to thrive and prosper in an environment of constant and unpredictable change (Oloruntoba and Gray 116). A typical humanitarian supply chain starts with the Government donor, then with the international agency, from an international agency to an international NGO, then to a local NGO in aidrecipient countries, then it follows with a community-based organization, and finally, it ends up with the consumer who is the aid recipient. This is considered a fairly long process and it requires the involvement of several governments and independent NGOs, as well as the use of several transport modes. That is why international humanitarian supply chains need to assess their potential as agile supply chains to become more strategic and more influential in minimizing the effects of natural disasters. However, we should not think of natural disasters as being unique and therefore will require a customized response. Instead, we should consider the similarities to accelerate the mobilization of resources and actors. Identified similarities, in terms of transport resources, storage locations, etc. must trigger actions following standardized procedures, which is the only way to improve the resilience of humanitarian supply chains (Chandes and Paché 323). The importance of sustainable plans, as well as the use of these effective strategies regarding agility, are found to be key in easing future events of man-made and natural disasters. (Albala-Bertrand226).

Strategies to lower the cost of humanitarian response
A strategy that could be applied and followed to lower the cost of humanitarian response is better training of the volunteers and aid workers. There are already many programs in the United States that aim to better train aid workers. Recently, it is seen that the incorporation of service-learning programs could have an essential impact in lowering the cost of When a country is not able to cope with a disaster it calls for international assistance. But the immediate response from international aid agencies depends on how fast a country declares the state of emergency (Kovács and Spens 516). The main issue stands on how humanitarian aid agencies manage their funds and logistics, especially while knowing the fact that logistics efforts account for 80 percent of disaster relief (Kovács and Spens "humanitarian logistics" 99). A lot of emphasis is being put on making the officers of these organizations establish a common knowledge of the work and mission of other organizations in the country. Only on this basis, closer collaboration can be developed, and therefore more common projects would be created which will affect reducing the amount of money being spent by organizations with the same mission. Also, the emphasis is put on training the aid workers in recipient countries. A lot of money is being spent annually through bilateral and multilateral methods, but a lot of those funds are lost throughout the humanitarian aid supply chain, especially because many of the aid workers in the recipient countries do not have enough training. However, the combination of the lack of supplies, lack of training, and absence of mandates leads to situations such as the personnel being equipped with life vests for floods but not having been trained to swim, while navy personnel having sufficient training but no life vests to distribute to beneficiaries (Kovács and Spens 517).
humanitarian responses. These servicelearning programs are methods that incorporate community work into the curriculum, giving students real-world learning experiences that enhance their academic learning while providing a tangible benefit for the community (Goffnett,Helferich,and Buschlen 162). By being a method that develops student citizenship through education and service, high education institutions are very well positioned to support humanitarian organizations. The main reason is that this way, students would be able to imply the knowledge they have gotten throughout this course, in real-life humanitarian emergencies. The positivity and usefulness that we can find in these programs, come as a potential way of lowering the cost of humanitarian response. Students who will be working and helping throughout the process of humanitarian response will be working as volunteers. So, the funds that usually go towards paying trained workers and paying for their benefits, would be saved and then used in other projects, or as an immediate fund that goes where affected communities need it the most. However, many researchers do not support the idea of sending students to help in a humanitarian emergency, because they think that they are most likely to make mistakes, especially because they will be working as volunteers. Evidence disagrees with these statements by mentioning the fact that students will be getting the same level of training as typical aid workers, so if there will be any issues throughout the process, it would be because of other factors and not because of inadequate training of the students. So far, in pilot courses of service-learning programs, students received specific learning goals, and instruction regarding logistics and humanitarian aid through relevant lectures, presentations, readings, videos, research and writing activities, guest speakers, and discussions to expand their knowledge and complement their insight (168). Also, various methods were employed throughout the entire course to stimulate analysis and reflection as well as to facilitate deeper learning (Goffnett,Helferich and Buschlen 168). This could be an effective strategy that policymakers and organizations can imply to reduce the cost of humanitarian responses.
Another strategy that can be implied is collaboration and cooperation of projects with other organizations and local partners that might have the same mission and might work in the same area. This could be achieved by making sure that organizations headquarter in those countries that have declared emergency, have information about other organizations and local partners. This way policymakers can try to coordinate the work for more effective humanitarian responses. However, this has been a challenge for years, because there is a lot of competition between different organizations who might operate in the same area, about which one will be first on the site. The front office media exposure of the organization leads to the requirements to be first on-site because it triggers a donation to the organization meanwhile the back office of logistical operations puts the needs of the beneficiaries first (Kovács and Spens 512). Also, another challenge faced by organizations, while conducting a humanitarian response is the knowledge of which other humanitarian organizations are present in the region. Regional maps of organizational presence have been developed for development aid, but who will respond to a particular sudden-onset disaster is less clear (Kovács and Spens 512). However, if policymakers focus more on how to coordinate the fieldwork among different organizations, it will create an opportunity to reduce the cost of humanitarian response. A suggestion might be to use only a common group of well-trained aid workers that will take care of infield interventions and will be paid in parts from each organization with the same mission and that is placed in the same area.

Conclusions
On a national level, firstly governments of the affected countries should start creating different programs that will educate the population about disaster proneness. If these governments suffer from the lack of resources to establish these kinds of operations, then nongovernmental organizations can intervene in facilitating the process through training which does not require huge amounts of funds to be done. This way, the uncertainty of where is the aid going and how is it being used at a local level is avoided, while there are huge amounts of money given annually by developed countries towards countries in need. On the other side, government aid countries are including programs and courses in their higher education institutions about civic engagement, service, disaster, and famine response. Service-learning programs have been shown to positively impact humanitarian agencies and communities by helping to rebuild the lives of those affected by disaster (Goffnett,Helferich,and Buschlen 174). The reason is that students get the chance to imply their studies in the field while at the same time they are providing the service opportunity to agencies and NGOs, which do not have to spend their funds in hiring more and more people to help in the disaster relief programs.
Overall, the best cost-effective ways of humanitarian response have to do with fundamental reforms in the way humanitarian supply chains work. Wiser fund spending and better management of aid are the key factors in determining the cost of humanitarian response. This systematic review indicates that the education and training of aid workers set the foundations of long-term solutions for future cost-effective strategies. Policies need to be implemented at every level of the humanitarian supply chain to make the transportation of aids and funds faster, with no mistakes, and therefore cost-effective.