<p>The refugee problem is a canker in contemporary human affairs without the ‘limboness’ that protractedness adds to it. Yet many refugee situations, especially in Africa, become forgotten emergencies as women assume new roles both at the family and community level, whilst children are born and bred in camps which were meant to be temporary in the first place.</p><p>This study explores the life situation of Liberian Refugee Women and Children at the Gomoa Budumburam Refugee Settlement in Ghana. It examines the livelihood means they employ as a means of coping, emphasisng their security and educational concerns. It touches on the challenges faced by the camp children or the youth a they strive to deal with their situation and assign meaning to their lives. Actor-oriented theories help conceptualise ways in which the refugees display agency in mediating the structures that enable them and/or constrain them in their protracted displacement. In view of the need to find solutions to the refugee problem, the three proposed solutions are examined in the light of the reasons informing refugees’ choice of one solution over the other. The concepts of Space and Place help analyse the realities of the solutions available vis-à-vis the preferred choice of the refugees. Highlighting the importance of hearing refugees’ voice on problems and solutions they consider viable in their situation, a qualitative methodological approach is employed. This is complemented by observations, focus group discussions, informal conversations as well as secondary data sources.</p><p>The analysis relates the data collected to the outlined objectives, research questions and theories. It brings to the fore the resourcefulness displayed by the refugees as they employ various strategies to cope on a short and long term basis. The study has also revealed the refugees’ ideas about “home” as where one makes it, rather than a nostalgic country of origin to which one must return for life to be complete. (S) GBV has been highlighted as an area needing more attention than that accorded it presently if the causes of women’s vulnerabilities are to be addressed in a wholesome way. Suggestions have been made based on refugees’ recommendation as well as that of the organizations in place and the researcher’s.</p>

The refugee problem is a canker in contemporary human affairs without the ‘limboness’ that protractedness adds to it. Yet many refugee situations, especially in Africa, become forgotten emergencies as women assume new roles both at the family and community level, whilst children are born and bred in camps which were meant to be temporary in the first place. This study explores the life situation of Liberian Refugee Women and Children at the Gomoa Budumburam Refugee Settlement in Ghana. It examines the livelihood means they employ as a means of coping, emphasisng their security and educational concerns. It touches on the challenges faced by the camp children or the youth a they strive to deal with their situation and assign meaning to their lives. Actor-oriented theories help conceptualise ways in which the refugees display agency in mediating the structures that enable them and/or constrain them in their protracted displacement. In view of the need to find solutions to the refugee problem, the three proposed solutions are examined in the light of the reasons informing refugees’ choice of one solution over the other. The concepts of Space and Place help analyse the realities of the solutions available vis-à-vis the preferred choice of the refugees. Highlighting the importance of hearing refugees’ voice on problems and solutions they consider viable in their situation, a qualitative methodological approach is employed. This is complemented by observations, focus group discussions, informal conversations as well as secondary data sources. The analysis relates the data collected to the outlined objectives, research questions and theories. It brings to the fore the resourcefulness displayed by the refugees as they employ various strategies to cope on a short and long term basis. The study has also revealed the refugees’ ideas about “home” as where one makes it, rather than a nostalgic country of origin to which one must return for life to be complete. (S) GBV has been highlighted as an area needing more attention than that accorded it presently if the causes of women’s vulnerabilities are to be addressed in a wholesome way. Suggestions have been made based on refugees’ recommendation as well as that of the organizations in place and the researcher’s.

Although Skilled Birth Attendance has been universally acknowledged as essential to progress in the field of maternal health (WHO, 2004), Human Resources for Health (HRH) deficits are currently impeding the sustainability of essential maternal health interventions on a global scale. Over the past 30 years, the Shoklo Malaria Research Unit (SMRU), along with other agencies such as non-governmental organizations and community-based organizations, have developed a self-contained health system, which provides health services, including maternity care, to migrants and refugees at the Thailand-Myanmar Border. The staff necessary to the provision of care in SMRU’s clinics are mostly recruited from within the migrant and refugee populations, and trained internally by SMRU. In the last decade, SMRU has experienced high-turnover rates and shortages of Skilled Birth Attendants (SBA). Consequently, their current maternity workforce is characterized by an acute shortage of SBAs who have attained senior status, and a higher concentration of SBAs at the assistant and junior levels. As a response to these HRH challenges, this case study aimed to conduct a multi-level analysis of obstacles and enablers to professional development amongst Skilled Birth Attendants working for SMRU. This single descriptive case study with embedded units of analysis, which incorporated non-participant observation, a template-based personnel file review, individual interviews, and focus groups at two of SMRU’s Birthing Units, represented a unique opportunity to observe and analyze the multiple influences that interact at various levels of a relatively self-contained health system. By highlighting the obstacles and enablers present within the system, this study purposed to identify means by which to empower lower level SBAs, support their professional development, and create a more sustainable maternity workforce. The study found that SMRU has been successful in providing its SBAs with the appropriate midwifery skills to fulfill a limited scope of practice, and in fostering strong intra-professional relationships that allow the SBAs to motivate and mentor each other. Achieving workforce sustainability with a model of care that implements task-shifting requires a balance of appropriate and constructive consultation structures without enabling the stagnation of SBAs’ skills and confidence. This study also reveals the importance of context and culture to a health system’s capacity to optimally plan and implement its HRH functions. Finally, in the case of SMRU, persistent recruitment and retention concerns underscore that workforce sustainability cannot be achieved through professional development alone. Therefore, this study reveals a need for further inquiry into the complexities of maternal health workforce planning in contexts of protracted displacement, and the challenges associated with developing appropriate supervisory structures for lower level health professionals.