What might it take to increase leadership of local actors in humanitarian mortality estimation?

In the first blog introducing this series, Adrienne Testa, from the UK Humanitarian Innovation Hub and Elrha discussed how fundamental it is to measure excess mortality if response actors want to understand the severity of a humanitarian crisis and guide aid prioritisation. In our second blog we focus on the work of a consortium led by IMPACT Initiatives. This consortium is drawing attention to the roles that national and local actors play in mortality data collection and use by decision-makers and what is needed to design more localised mortality estimation systems in humanitarian contexts.

The structural barriers we need to talk about

Many of the challenges for local and national actors to collect mortality data and inform responses are well known, but poorly documented. They have fewer opportunities for technical training; face inequitable access to financial resources for activities; and structural barriers limit their representation in coordination forums where decision-making occurs about whether mortality data should be collected, who collects it, and what findings can mean. Meanwhile, international actors frequently have a seat at the table, and therefore control the narrative, deciding what data matters and how it will shape response priorities.

Yet, local and national actors – including non-governmental organisations (NGOs), universities, and public health institutes – are often ideally placed to collect mortality estimates and inform response decisions. They have established connections and access to affected communities and contextual understanding of how to appropriately and effectively operate. They understand political sensitivities and how to navigate these so that mortality estimation findings will carry legitimacy with key stakeholders and decision-makers. Crucially, locally-led mortality estimation initiatives challenge long-standing power imbalances associated with colonial, top-down approaches to humanitarian assistance.

Recognising this, three partners in our consortium, Evidence for Change, London School of Tropical Hygiene and Tropical Medicine and SIMAD University, were funded by the Humanitarian Innovation Hub in 2024-25 to imagine what an ideal mechanism might look like to systematically trigger mortality data collection for accountable decision-making in crises. Consultation with global humanitarian stakeholders confirmed:

Funding local actors’ priorities and strengthening capacities

With follow-on funding from UKHIH-Elrha in 2025-26, our consortium expanded. We teamed up with IMPACT Initiatives along with their partners at Addis Ababa and Mekelle Universities in Ethiopia and World Needs and Help, an NGO in the Democratic Republic of Congo (DRC). Together, we’re working to better understand real-world opportunities and obstacles faced by national actors when implementing mortality estimation activities. Our goal is to use this evidence to strengthen advocacy for approaches that support and prioritise local actors in this vital work.

Rather than imposing a predefined research plan, each national partner has selected, tailored and implemented a mortality estimation activity to their context. Our consortium operates a ‘help desk’ to foster peer-learning and strengthen capacities across contexts. Activities include:

Somalia: New approaches in a fragmented landscape

• Our previous work in Somalia demonstrated the effectiveness of well-designed data collection exercises to influence humanitarian decision-making - when findings were communicated - in a timely fashion and to the right people. However, we also saw how fragmented the current data landscape is, with mortality data not always collaboratively shared between institutions, and major gaps in mortality data coverage, particularly in areas outside government control.
• SIMAD University is therefore running a qualitative study with community burial attendants in hard-to-reach areas of Somalia, exploring what would be needed for this to become a feasible and acceptable mechanism of mortality reporting to bridge data gaps.
• Drawing on a nutrition and mortality surveillance system originally developed in the NGO sector, Evidence for Change is training female health workers to collect mortality data within a large-scale community-based government programme.

Ethiopia: Regional partnerships for regional aid prioritisation

• Previously, universities across Ethiopia ran demographic surveillance sites in their local areas, with mortality and other data flowing to government authorities. Conflict dismantled many of these surveillance programmes.
• Addis Ababa and Mekelle Universities, which previously ran surveillance sites, are now partnering with regional health authorities in drought-affected Somali region and conflict-hit Tigray to conduct mortality surveys to help guide regional aid prioritisation.
• Mekelle University is also including a verbal autopsy component to describe the causes of death, something regional authorities found particularly valuable about the pre-war surveillance system because it helped them monitor the health of populations.

Democratic Republic of Congo: Navigating insecurity and mistrust

• Engagements with both formal and informal authorities in eastern Congo can create tension or mistrust, complicating operational permissions and community access. Nevertheless, World Needs and Help is initiating a mortality survey in a conflict‑affected North Kivu region, to document the human toll of ongoing violence and displacement.
• While the organisation has no prior experience in mortality estimation, our consortium helped them expand their technical skillset. Their experience supporting needs assessments among various partners across the east means they are well positioned to navigate the complex challenges to ensure mortality estimation is possible.

Alongside these activities, we are documenting how teams have approached the process, keeping a close eye on context. We are building on social science methodological approaches we developed in phase 1 to help us understand how politics, institutional identities and other evolving challenges shape the ways mortality actors work.

Equitable and sustainable systems change

None of these challenges have quick fixes. Building an equitable and sustainable approach to mortality estimation will require the concerted efforts of many stakeholders, working together to drive change. Our own consortium is part of that broader momentum. By documenting barriers and testing solutions today, our hope is to inform the strategy that will address these challenges tomorrow, supporting UKHIH’s drive for true systems innovation in humanitarian action.