RAPID HEALTH ASSESSMENT PROTOCOLS FOR EMERGENCIES
( By WHO - OMS, 1999 )

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1 - Developing the best working practices

Ensuring good team work


· International personnel should ensure that national staff participate in the assessment. Likewise, national personnel should include local or district staff in the exercise.

· At field level, introduce yourself and outline quickly the objectives and the method of the assessment. Do not intimidate your interlocutors with unheard-of United Nations or NGO names and abbreviations. Carry visiting cards.

· Explain what you are doing and why. The best way not to be an “emergency tourist” is to discuss on the spot your preliminary conclusions and give new ideas and hints on what you are going to do with the information gathered. Leave behind a copy of your questionnaire as a contribution or as a start-up for a local information system.

· If part of a multisectoral or multi-organizational team:




- work together at developing and readjusting case definitions and methods;

- share your questionnaire forms and familiarize yourself with those of other sectors (if the team has to split up to cover more ground in less time, any member should be able to collect data on any issue); and

- reserve half an hour every day for mutual debriefing.


Making the best of available information


· In emergencies, hard data may appear unattainable. But cross-matching data can provide an idea of the overall quality of information. Likewise, by contacting as many sources as possible, you may be able to put together an unexpected quantity of secondary data.

· The lack (or poor quality) of information is in itself information. A sector or area that does not report is one that has a problem.

· Inaccessibility may be the greatest constraint to the assessment. Try to quantify how much of the situation is actually reflected by your data, defining the accessible areas, the “grey zones” and the “black holes” on the map.

· The situation may change quickly. Collect the most recent data and continue monitoring after the rapid assessment. Circulate and discuss preliminary conclusions while processing the final report.

· Keep a record of geographical distances between major points, such as organizations’ offices, warehouses, and water sources. This will assist in planning emergency response.

· Carry with you reference values (e.g. cut-off values for death rates and standard nutritional requirements) for on-the-spot evaluation and preliminary planning. (Annex 2 carries a list of reference values that have proved useful in Africa and that can be adapted for other regions.)

· Keep separate notes of factual observations and personal impressions; if you have a personal computer, record them daily.


Being a good citizen


· Before leaving the capital or provincial headquarters, offer to carry mail, newspapers, or a reasonable amount of supplies to the field stations; carry with you some small luxury, such as fruit or a newspaper, to leave behind.

· Realize that emergency response field-workers labour under heavy workloads and difficult living conditions and that they will stay behind, while you come and go. Pose your questions in a non-threatening way, show appreciation for the good being done, and express criticism constructively.

· If, in the field, you find relevant documents (e.g. registers and reports), copy the information. Never take away the originals with you.

· Be ready to assist in medical evacuations from the field, making room for sick or wounded in your vehicle or plane.


Reviewing common sources of error

Common sources of error may be logistic, organizational, or technical.

Logistic


· Transportation and fuel are insufficient for the assessment.

· Communications between field, regional, and national levels are inadequate: the authorities in charge of the area(s) targeted for assessment are not informed on time and are not ready to assist the team.


Organizational


· A lead organization is not designated, the responsibilities of the various organizations are not well defined, and a team leader is not appointed.

· Key decision-makers and potential donors are either not informed that an assessment is being undertaken, or feel pressured to respond to political demands before the findings are known - resulting in inappropriate assistance.

· The assessment is conducted too late or it takes too long.

· Information is collected that is not needed for the planning of the emergency response.


Technical


· Specialists with appropriate skills and experience are not involved in the assessment.

· Programmes that could be implemented immediately, on the basis of past experience, are unnecessarily delayed until the assessment is complete.

· Assessment conclusions are based on data that do not represent the true needs of the affected population (e.g. from non-representative surveys).

· Information received from field-workers and official interviews is taken at face value, without cross-checking all sources.

· A surveillance system is developed too slowly, thus preventing monitoring and evaluation of the emergency response programme.

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