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Collective action for better health outcomes
HEALTH CLUSTER COORDINATION TRAINING
May 2019, Brazzaville
Rapid Health Assessment
Collective action for better health outcomes
Health cluster action
• Health Management Information System (HMIS)• Vaccination coverage estimation• Health Cluster Bulletin• Ad hoc Infographics
Health System Performance
• Public Health Situation Analysis (PHSA)• Rapid Health Assessment• Humanitarian Emergency Settings Perceived Needs (HESPER) Scale• Early Warning Alert and Response System (EWARS)• Population Mortality estimation•Monitoring Violence against Health (MVH)
Flow chart of Public Health Information Services
Health Status and Threats for affected
Populations
•Who, What Where (3W) matrix• Partners’ List• Health Resources Availability Monitoring System (HeRAMS)
Health Resources and Availability
Operational Indicator Monitoring
Collective action for better health outcomes
Purpose
• Follow, update and complete PHSA (info gaps)
• Monitor of needs based on the comparison of
affected people perceptions and experts’
judgement on health sector issues
• Feed Sectoral and Intersectoral analysis (HNO,
MIRA) products with health sector contribution
Collective action for better health outcomes
Rationale
• PHSA info gaps not addressable through SDR
• Other PHIS primary data tools (EWARS, HeRAMS, HIS) are only facility based and focused, not on)
• A tool to rapidly assess affected people perceptions(alert, availability, satisfaction, sufferance) and on health seeking behaviours (use and awareness does not exists
• Other tools focused on perception (HESPER) are mostly intersectoral and have too small health parts or too specific to the mandate of their implementer (UNHCR, WFP, etc…)
Collective action for better health outcomes
Methodology
Phase 1: Preparation
Phase 2: Data collection
Phase 3: Interpretation and reporting
Collective action for better health outcomes
Phase 1 Preparation
PHSA info gap analysis
Assessment plan
Adaptation of pre
designed tools
Team coordination
Collective action for better health outcomes
METHODOLOGY DECISONS
7
Repo rt
Repo rt
Remote key informantinterviews
Remote sensing avaiable?Other secondary sou rces?
Key informant known and accessible?Respondent safety gua ranteed?
Time , expe rtise , resou rces available?
Access to a ffected a reas?
Yes
No
Yes
No
Yes
Limited Yes
Sampling and
selection criteriaPurposive samplingGeog raphic level
Purposive samplingA ffected g roup level
A ffectedpopul ation
Estim ation methodsSecondary d ata
Estim ation methodsSecondary d ata
D ata collectiontechniques
Di rect observ ationKey informantinterview
Di rect observ ationKey informant interviewC ommunity g roupdiscussion
No
Collective action for better health outcomes
Key
questions
Secondary
sources Comparisons
Info or
indicator
Primary
sources
Question in questionnaire
Collective action for better health outcomes
Primary data sources: KEY INFORMANTS
Lay• Affected
• Beneficiaries
• Vulnerable groups
Experts• Health workers
• Humanitarian workers
• National Staff
Collective action for better health outcomes
Phase 2 Data collection
Select Assessment SitesSelect Assessment Sites based on agreed criteria i.e. IDP camps, IDP’s with host families, affected population at place of origin
Mobilize Inter-sectoral assessment teamsConstitute assessment teams from variety of humanitarian actors to conduct assessment.
Conduct community or community/affected group level interviewsBased on structured questionnaire conduct key informant interviews complimented by observation based check list
Identify key informant for interviews
Structured questionnaire
Use direct observation- See - Hear- Smell- Touch
Collective action for better health outcomes
Key informant interviews
Household survey
Focus group discussions
Time and cost
Part
icip
ato
ry fo
cus
Data collection techniques
Direct observation
Individuals survey
Secondary data review
Community group discussions
Time and cost
Phase 1 Phase 2 Phase 3
Sectoral Assessments
Collective action for better health outcomesTime and cost
Pre
cisi
on
an
d a
ccu
racy
Rapid – ‘quick and
dirty’ and exploratory
Initial – targeted and explanatory
In depth – comprehensive
and confirmatory
SAMPLING
Convenience sampling
Purposive sampling(MIRA)
Representative sampling
Phase 1 Phase 2 Phase 3
MIRASectoral Assessments
Collective action for better health outcomes
Data collection Sources and Sampling
according to type of Key Informant
Lay
• Interview
• FGDs
• Community
Interviews
Expert
• FGD
• Delphi
• Monitoring
Framework
Collective action for better health outcomes
Phase 3 Analysis, interpretation and reporting
• Wrap up of response from lay people (KIs)
• Wrap up of responses from experts
• Analysis of responses based on analytical
framework
• Triangulation (some questions will be
asked to ‘lay’ and to ‘expert’ informants
and then compared
Collective action for better health outcomes
Scope/analytical framework
simple and quick
broad but necessarily shallow
Attitudes awareness
practices and use of
biomedical and traditional care
Access availability and perception of the quality of
healthcare
Health status needs and
perception of risk among
affected populations
Collective action for better health outcomes
Quiz!!!!!!!!
What type of information to be
asked?
And to whom???
Collective action for better health outcomes
1. Alert
• Unusual number of deaths (Human)
• Unusual number of deaths (Animal)
Collective action for better health outcomes
2. Access to health
Distance to health facilities (in time)
Obstacles to accessing health
Specific groups facing obstacles to
access health
Presence of female health workers
Collective action for better health outcomes
3. SRMH
• Female healthcare workers presence
• ANC/PNC
• Where do women give birth?
• Cesarean Section
Collective action for better health outcomes
4. Health Seeking Behaviours
• Health seeking behaviours of people
affected
• What do you do when you/your
familiars get sick?
• Do you have a vaccination card?
Collective action for better health outcomes
5. Copying Mechanism
• What do people do when they are faced
with a lack of access to health facilities?
• What are people doing to face lack of
drugs? OR What do people do when they
need medication?
Collective action for better health outcomes
6. MPHSS
• Is a large number of persons in your
community currently so upset to be
unable to conduct usual daily activities
(for example getting out of bed, ability to
work, to take care of family…)?
• Provision of MPHSS available?
Collective action for better health outcomes
7. Market
• Availability of drugs
• Can you pay drugs prescribed?
Collective action for better health outcomes
8. WASH/IPC
• Quality of the water (bacteriological..)
• Quality of the water (taste, access to
source)
• Main water sources
• Water in health facilities
Collective action for better health outcomes
9. AAP
• How are health care workers perceived
(to be adapted to contexts..)….
• Is treatment perceived as approriate?
Collective action for better health outcomes
Thanks! • Comments and suggestions
• Brunie@who.int
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