SEVENTH INTER-REGIONAL TRAINING COURSE ON PUBLIC HEALTH AND EMERGENCY MANAGEMENT IN ASIA AND THE PACIFIC PHEMAP 7 RAPID HEALTH ASSESSMENTS module 9

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 2 Data Collection Methods * Mid Upper Arm Circumference; Knowledge Attitudes and Practices) Probability sampling Non-probability sampling A detailed study in which information is systematically collected in a sample of population (morbidity, mortality, nutrition, KAP*) When the situation stabilises and response has been activated Surveys visual inspection analysis of records interview of key informants rapid surveys (MUAC*, etc.) a quick collection of information to confirm the emergency, measure the impact, identify health needs and guide response As soon as it is possible to go to the area Rapid Health Assessment satellite imagery flights mapping drive / walk through a quick, preliminary inspection of the disaster area immediately after a disaster Rapid Reconnaissance HOWWHATWHENTYPE

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 3 Hypothetical Timeframe Alert Decision 1 What happened? Where? Rapid Health Assessment? When? Pre- assessment Sitrep ?? Preparation To do what? (TOR) Which team? Where? How? ( methods) How? (logistics) hours Rapid Health Analysis Decision 2 Emergency? Y/N What needs? What constraints? What local resources? Response? Which resources? What evolution? 1-2 days Emergency 0 Action? If yes, which one, which resources required? Reference values Sitrep Presents main findings Gives recommend actions: What to do? Why? By whom? 1 day Action Decision 3 Who does what? When? How? With whom? ?? Political / financial considerations

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 4 Categories of Information The assessment involves the collection of three key categories of information: Analysis of the damage to:  critical resources  critical infrastructure and fixtures  critical services Analysis of the needs of the response agencies  immediate needs arising from the situation  future needs arising from damage / disruption to services / infrastructure Analysis of the needs of the victims  immediate needs arising from the situation  future needs arising from damage / disruption to services / infrastructure

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 5 Rapid Health Assessment tasks … The first task is to assess function of all the health facilities in the area (hospitals, clinics, laboratories, warehouses, blood banks, administration): a.Staff – dead, injured, missing, absent a.Access – can staff / people reach the facility a.Buildings – damages, safety, loss of electricity / gas / water, loss of fuel (diesel) a.Supplies and equipment damaged or lost, including vehicles

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 6 Rapid Health Assessment tasks … The next task is to assess needs arising from loss function : a.Temporary services needed? a.Repairs needed? a.Replacements needed (staff and materials)?

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 7 Rapid Health Assessment tasks The next task is to assess urgent health needs of the population: a.Overview of actual and potential causes of morbidity and mortality, and numbers of cases The final report will make recommendations on: a.Resource needs b.Management and organisational needs c.Logistics and communication needs

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 8 Use the Coordination Mechanism It is not necessary to go to the field to collect detailed information from other sectors At the daily coordination meetings, reports and assessments from other sectors are shared – these can be sent as ANNEXES to health sector reports The Emergency Reporting System should take over from assessments as soon as possible

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 9 Planning a Rapid Health Assessment Set the assessment objectives, team skill needs and time frame Collect the data:  reviewing existing information  inspecting the affected area  interviewing key people  carrying out a rapid survey Analyse and interpret the findings Issue orders and instructions Disseminate the report and communicate the findings

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 10 Preparing for an Rapid Health Assessment What information should I collect before going to the field? What collection methods are appropriate given:  the specific context of the emergency, and  weather, security, time, logistics, technical, cultural constraints? What will the main sources of information? Is an interpreter needed?

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 11 Preparing for an Rapid Health Assessment What is the composition of the team and the role of each team member? What are the security, logistics and communication needs of the team? What equipment to take – maps, contact information, forms, specimen bottles, paper / pens, personal items

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 12 Rapid Health Assessment: Common Mistakes No policy or guidelines on assessment No standard collection formats No training in assessment skills Different sectors use different terms and methods Data cannot be consolidated Too much irrelevant or duplicate data collected Too much time taken – accurate is better than precise Those collecting the data don’t know how it will be used and don’t have opportunity to improve the assessment system

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 13 Health Sector Assessments by Hazard Class 1.Natural Hazards focus first on recording damage to health sector, then on the needs of the health facilities to restore some function, then on the meeting needs arising from actual and potential causes of morbidity and mortality 1.Technological Hazards focus on capacity to meet the needs arising from the actual and potential causes of morbidity and mortality

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 14 Health Sector Assessments by Hazard Class 1.Biological hazards focus on capacity to meet the needs arising from the actual and potential causes of morbidity and mortality 1.Societal Hazards In conflict - focus first on recording damage to health sector, then on the needs of the health facilities to restore some function, then on the meeting needs arising from actual and potential causes of morbidity and mortality In other situations - focus on capacity to meet the needs arising from the actual and potential causes of morbidity and mortality

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 15 Different Needs, Equal Opportunities Data on the population affected by a crisis should always be broken down by age, sex and other relevant factors => without information on who is affected and who is most at risk, interventions may be off-target. Data on who benefits from assistance in an emergency should also be reported by age, sex and other relevant factors => without this information, it is impossible to ascertain if assistance is reaching those most in need, if certain individuals / groups are marginalised, etc.

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 16 Different Needs, Equal Opportunities “Being counted shows that each individual is recognised and included and can exercise his / her rights” E.g.: Nutrition needs of pregnant or lactating women in Sri Lankan refugee camps, after the Tsunami Different needs Different ways of meeting needs => Equal opportunities

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 17 Recap: the Purpose of Assessments To give decision makers information that will allow them to make timely and appropriate interventions to: save lives minimise injury and illness prevent escalation prevent spread support recovery planning

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 18 Advantages of a Standard Template prepared for the people who need to use the information (managers, decision makers) controls what kind of information is collected  standardised protocols for data collection  standardised terminology, technologies, methods and procedures  enforces “Zero” reporting facilitates preparation of consolidated reports facilitates rapid analysis and dissemination

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 19 Disadvantages of a Standard Template prepared by the people who need the information  those collecting the information have no input into design controls what kind of information is collected  non standard information cannot be included standardises the terms used  qualitative information might not be captured

MODULE 9.HEALTH ASSESSMENTSPHEMAP 7 | 20 THANK YOU