Competency-Based Standardized Training for Humanitarian Providers: Making Humanitarian Assistance a Professional Discipline

Abstract

The number of people employed in international humanitarian care is growing at a yearly rate of 6%. The demand for better coordination, accountability, and training has led to a need for standardized humanitarian training programs for providers. Training should be based on comprehensive core competencies that providers must demonstrate in addition to their skill-specific competencies. This report explores the competencies specific to humanitarian training that are practice- and application-oriented, teachable, and measurable. Competency-based, standardized programs will be used to select humanitarian workers deployed in future crises and to guide the professionalization of this discipline.

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DisasterMedicineandPublicHealthPreparedness
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CompetencyBasedStandardizedTrainingforHumanitarianProviders:
MakingHumanitarianAssistanceaProfessionalDiscipline
KirstenJohnson,LeanneIdzerda,RachelBaras,JessicaCamburn,KarenHein,PeterWalkerandFrederickM.Burkle
DisasterMedicineandPublicHealthPreparedness/FirstViewArticle/June2013,pp14
DOI:10.1017/dmp.2013.10,Publishedonline:23April2013
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CompetencyBasedStandardizedTrainingforHumanitarianProviders:MakingHumanitarianAssistanceaProfessional
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ORIGINAL RESEARCH
Competency-Based Standardized Training for
Humanitarian Providers: Making Humanitarian
Assistance a Professional Discipline
Kirsten Johnson, MD, MPH, Leanne Idzerda, Rachel Baras, Jessica Camburn,
Karen Hein, MD, Peter Walker, PhD, and Frederick M. Burkle, MD, MPH, DTM
ABSTRACT
The number of people employed in international humanitarian care is growing at a yearly rate of 6%.
The demand for better coordination, accountability, and training has led to a need for standardized
humanitarian training programs for providers. Training should be based on comprehensive core
competencies that providers must demonstrate in addition to their skill-specific competencies. This
report explores the competencies specific to humanitarian training that are practice- and application-
oriented, teachable, and measurable. Competency-based, standardized programs will be used to select
humanitarian workers deployed in future crises and to guide the professionalization of this discipline.
Key Words: humanitarian response, training and education, competencies, adult learning, professionalization,
standards of care
Since the 1960s, the number of people employed
in the field of humanitarian assistance has
increased at an annual growth rate of about
6%.
1
Initially, humanitarian assistance was provided
in an ad hoc manner, with little coordination,
accountability, or quality standards of care in service
delivery. Humanitarian providers come from a variety
of backgrounds. While they may bring specific skill
sets such as project management, logistics, security
management, medicine, and nursing, they often lack
the skills, tools, and knowledge specifically required to
work as a team member in complex humanitarian
settings and the ability to adjust and adapt their
professional skills to resource-poor settings.
Until recently, few established educational paths and
standardized courses have existed, and the available
ones have not always been based on known
competencies related to complex field-based require-
ments. Fortunately, over the past decade well-designed
humanitarian research, practice, and policy-based
curricula and vocational training programs have
evolved, especially in academic-affiliated centers that
are predominantly but not totally restricted to the
developed world.
In spite of the advances of the humanitarian sector in
terms of building evidence-based training and service
delivery, humanitarian intervention has remained
uncoordinated and mostly ad hoc, forcing the
global humanitarian community to demand improved
quality of performance during and after every major
international disaster.
2
Recently, the United Nation’s
Inter-Agency Standing Committee (IASC) and the
World Health Organization’s (WHO) Global Health
Cluster evaluated the response to the humanitarian
crisis in Haiti in January 2010 and highlighted the
lack of coordination, transparency, accountability, and
oversight of the deployed humanitarian workers.
2,3
The authors of these reports indicate that the
discipline that best defines humanitarian professionals
requires a combination of specific skill competencies
related to their profession combined with core
humanitarian competencies obtained through specia-
lized training, education, and simulation experiences
provided by accredited academic affiliated training
centers (Figure 1). We explore the competencies
specific to humanitarian training that are practice-
and application-oriented, teachable, and measurable.
COMPETENCY-BASED PROFESSIONALIZATION
Until recently, work toward a broader and inclusively
coordinated effort of the humanitarian community of
provider organizations and agencies has been ignored.
This lapse has been in large part due to the lack of
a singular ‘‘global authority in crises’’
4
that would
hold the composite humanitarian community both
accountable and coordinated.
4-6
While the concept
has been introduced, it remains politically charged
and without effective debate to date. However, a
movement to develop a professional program for
individual aid providers has begun to move forward
Disaster Medicine and Public Health Preparedness 1
Copyright &2013 Society for Disaster Medicine and Public Health, Inc. DOI: 10.1017/dmp.2013.10

both to create standardized humanitarian training programs
and a mechanism for humanitarian workers to develop,
enhance, and track their skills. At the very core of
standardization lies the need for an agreed set of comprehen-
sive, common humanitarian competencies that define the
foundation of humanitarian education and practice.
7
The intent of this movement is to have standardized training
programs that (1) offer certification based on completion of
common core competency-based curricula, and (2) courses
that can be registered and offered to stakeholders such as
international organizations (IOs) and nongovernmental
organizations (NGOs) to assist in the selection of humanitar-
ian workers deployable in all disaster and crisis situations.
As such, standardized competency-based training programs
will serve to catalyze and pave the way toward professiona-
lization of humanitarian professionals and better define what
constitutes the humanitarian discipline.
Competency-based training forms the basis of most profes-
sional degrees and academic-affiliated training programs.
Core competencies have been defined in certain professional
fields that require similar knowledge, skills, tools, and quality-
based performance. Because public health constitutes a
significant part of humanitarian assistance, one can refer to
skill-based competencies defined by the Association of
Schools of Public Health, which developed a list for global
health tracks in Masters of Public Health programs in US
universities.
8,9
Similarly, the Centers for Disease Control and
Prevention, in the Terrorism Injuries: Information Dissemi-
nation and Exchange program, and the American Medical
Association, in the Center for Public Health Preparedness
and Disaster Response,
10,11
have developed core competencies
that could be reasonably expected of all relevant health system
responders. These organizations define the competencies for
disaster response and global public health training, which
encompass domestic and international health, including
health conditions, organized social responses, and a systems
framework that can be used as a model to develop a
competency framework of course work and performance for
humanitarian providers.
The Consortium of British Humanitarian Agencies (CBHA)
is one of the first humanitarian organizations to build a
humanitarian competency framework that includes learning
and evaluation specific to humanitarian training and field-
craft.
12
The CBHA has been created to strengthen the
coordination and capacity of the NGO sector to deliver
appropriate, high quality, and humanitarian assistance
quickly to populations affected by disaster. It consists of
15 UK-based NGOs that have committed to implementing
5 objectives that support this purpose.
12,13
These objectives are
>Increasing access to fast, efficient, and effective funding for
front-line humanitarian work;
>Increasing numbers of competent national and
international managers and leaders;
>Increasing agency surge capacity to respond appropriately
to new emergencies;
>Strengthening humanitarian logistics systems; and
>Learning and education.
The core humanitarian competencies framework developed
by the CBHA consists of 30 core competencies distributed
among 6 categories and divided into 2 main sections: core
behaviors for all staff and additional behaviors for first-level
line managers. Most humanitarian stakeholders now recognize
this framework as the standard for categorizing competencies.
Integrated into the core humanitarian competencies frame-
work is a leadership behavior framework. This latter framework
is presented as a separate table in the CBHA document to
highlight the importance of leadership and to provide a
separate, leadership-focused framework for agencies interested
in humanitarian care.
13
In 2010, the enhancing learning and research for human-
itarian assistance (ELRHA) program built on CBHA’s
humanitarian competency framework in its scoping study
on professionalizing the humanitarian sector.
1
The ELRHA
study involves extensive consultation with humanitarian
workers and key stakeholders. It also looks at other initiatives
developed by NGOs and IOs including CARE, World Vision,
Save the Children, Oxfam, and the Red Cross movement that
included comprehensive competency maps for staff assessment
and recruitment, simulations, and training. The ELRHA
report lists 21 core competencies divided into 4 categories:
managing yourself; working with others; achieving results; and
using resources.
All competencies are separated into 3 levels of behavioral
criteria that become more specific the higher the level.
FIGURE 1
Competencies Required by a Humanitarian
Professional.
FM Burkle, Jr
Standardized Training for Humanitarian Providers
Disaster Medicine and Public Health Preparedness2

The ELRHA study indicates that core competencies for
humanitarian training and practice must be incorporated into
the minimum knowledge-base and skills required for the field
in addition to the behavior, moral, and ethical motivation on
which humanitarian work is founded. Although humanitarian
core competencies can be separated into categories such as
knowledge, skills, and attitudes, these categories are not
independent of one another. Thus, a complex interplay exists
and requires multiple elements of learning that are not always
sufficiently translatable or acquired in the classroom and may
be difficult to measure.
The ELRHA study
1
provides a series of recommendations
relating to humanitarian competencies. The eighth recom-
mendation states the ‘‘the listing/table of humanitarian
competencies should be further developed,’’ as an urgent
task for a potential International Humanitarian Professional
Association (IHPA). The sooner consensus can be achieved
on the competencies, the sooner training institutions can
start offering courses capable of being certified by the IHPA.
This recognition for further development of the humanitarian
core competency framework is introduced in the final
recommendations of the CBHA report.
13
DISCUSSION
As occurred after the 2010 hurricane in Haiti and in other
large-scale humanitarian crises, the small NGOs and
humanitarian workers are often young and inexperienced
providers who lack a professional approach and knowledge of
the situation and needs on site. In Haiti, understanding of the
Haitian context was limited and communication with the
local population was insufficient. Also lacking was the ability
to consolidate and report vital information and to assist in
providing better support coping strategies.
2
The challenges
arising from the Haitian hurricane response were not new,
and they produced a number of questions relevant to the
selection, training, and qualification of humanitarian service
providers. It has been recognized now that solely deploying an
aid provider with only specific professional skills (medicine,
nursing, project management, security management, or
logistics) does not necessarily lead to quality performance,
whether these professionals act individually or as members of
foreign medical teams.
Even before the 2010 earthquake in Haiti, a need for
improved quality and accountability by humanitarian orga-
nizations and individuals in the field was widely recognized.
During the years a number of singularly focused and specific
initiatives have focused on enhancing the quality of
performance, service delivery, and accountability of aid in
the humanitarian sector. These include the Sphere Project,
14
Livestock Emergency Guidelines and Standards,
15
the
Humanitarian Accountability Partnership International,
16
the Active Learning Network for Accountability and
Performance in Humanitarian Action,
17
People In Aid,
18
the Good Enough Guide by the Emergency Capacity Building
Project,
19
the Compass method by Groupe Urgence,
Re
´habilitation, De
´veloppement,
20
the Synergie Qualite
´guide
by Coordination Solidarite
´, Urgence, De
´veloppement,
21
and
the Inter-Agency Network for Education in Emergencies,
22
among others.
During the past decade, the need for competency-based
training and standardization of curricula in the humanitarian
sector has become clearer. Today more than 100 graduate-
level degree programs in humanitarian assistance are offered
by universities in North America and Europe; not-for-profit
and private companies provide certification courses; military-
sponsored training programs in humanitarian response and
civil-military interaction exist; and international NGOs
(eg, Me
´decins Sans Frontiers, the Red Cross movement,
and the United Nations agencies such as WHO and the
United Nations High Commission for Refugees) provide their
workers with required predeployment training.
International efforts in competency-based professionalization
are demonstrated by CBHA’s and ELRHA’s work, which
highlight the importance of further developing competencies
as a necessary precursor to standardizing courses, certifying
humanitarian providers, keeping a registry of certified
providers, and creating an international humanitarian
professional organization that would ensure the ongoing
professional status, research, standards of care, advocacy, and
monitoring of member training centers. Recommendations
for moving this concept forward include linking the CBHA
competencies to measurable learning objectives, creating
metrics to evaluate competency-based learning, employing
the competency-based curriculum in the classroom and in
simulation exercises through different organizations and
institutions, and apply the monitoring and evaluation tools
in a standardized framework in the field.
Finally, the current generation has already recognized
that their productive years will be spent in some aspect
of globalization. It is now the humanitarian community’s
place to support, partner, and positively engage with
academia and academic-affiliated training centers worldwide
to ensure that a competency-based professionalization process
is successful.
About the Authors
Department of Family Medicine, McGill University, Montreal Canada (Dr
Johnson); School of Human Nutrition, University of Stellenbosch, South Africa
(Idzerda); Feinstein International Center, Tufts University, Medford, MA
(Baras and Dr Walker); Save the Children, UK (Camburn); Department of
Family & Community Medicine Geisel School of Medicine at Dartmouth College,
Hanover NH (Dr Hein); Harvard Humanitarian Initiative, Cambridge, MA
(Dr Burkle).
Address correspondence and reprint requests to Kirsten Johnson, MD, MPH;
Department of Family Medicine, McGill University, 515-517 Pine Ave W,
Montreal, Quebec, Canada H2W1S4 (e-mail: kirsten.johnson@mcgill.ca).
Standardized Training for Humanitarian Providers
Disaster Medicine and Public Health Preparedness 3

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