Global Health Cluster Orientation Package

Global Health Cluster Orientation Package

Module 4:

Guidance, Tools and Resources

Module 4: Learning Objectives

On completion of this module participants will be aware of:

• The tools and guidance which have been developed by the Global Health Cluster

• The aims and practical applications of these tools and guidance

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The Health Cluster Guide

The Global Health Cluster has developed a practical guide for country-level implementation of the Health Cluster

Available in English and French:www.who.int/hac/global_health_cluster/guide

• online• hard copy• CD/ROM

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• Country level: outlines how the Health Cluster Lead Agency(WHO) and partners can work together during humanitarian crises

• Highlights the key principles of humanitarian health action

• Explains how working in partnership can increase the effectiveness and efficiency of health interventions

The Health Cluster Guide

Each Chapter:

• Highlights key points• Summarises activities to be carried out and

issues to consider• Lists and explains the tools and guidelines

available• Indicates challenges likely to be faced• Provides practical hints and references for

further guidance

The Health Cluster Guide (2)

http://www.who.int/hac/global_health_cluster/guide/en/index.html

The Health Cluster Guide

Chapter 1: Role and functioning of a health cluster

Chapter 2: Assuring effective coordination

Chapter 3: Assessing and monitoring the health situation

Chapter 4: Analysing and prioritizing

Chapter 5: Developing a strategy; planning

Chapter 6: Ensuring standards

Chapter 7: Advocacy and resource mobilization

Chapter 8: Monitoring cluster performance

Chapter 9: Standard services and indicator list

The Health Cluster GuideContent

A. Generic Terms of Reference for Sector Leads

B. Types and phases of assessment in a humanitarian crisis

C. General principles for all data collection activities

D. Drawing up an assessment plan, schedule and budget

E. Stakeholder analysis

F. Priority Cross-cutting Issues

G. Analysing response options; examples of negative effects

H. SPHERE standards

The Health Cluster GuideAnnexes

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Four categories :• Health Resources Availability (A 1-8)• Health Services Coverage (C 1-6)• Risk Factors (R 1-7)• Health Outcomes (0 1-5)

Total of 26 suggested indicators

Core health indicators

Information is needed on:

• Health status and risks• Resources availability• System performance

Assessing the health situation

Data and analysis should be:• Regularly up-dated • Collected with the maximum possible

involvement of national and sub-national health authorities and other partners

• Based on common, gender-sensitive indicators, standards, protocols and case definitions

• Disseminated in time to inform decisions on the planning and management of response activities

Assessing the health situation (2)

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Health Status and Risks

Health Resource and Availability

Health System Performance

• Current health status of affected population groups (mortality & morbidity & major causes) & health risks (e.g. potential outbreaks)

Initially• facilities• personnel• supplies and services

state and non state

Later - • all above &• other health system

components (management, finance, etc.)

• Coverage and quality of available services

• Access for all population groups to services and their utilisation of services

Core aspects of information needs

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1. Initial Rapid Assessment (IRA)2. Health Resource Availability and Mapping System (He RAMS)3. Early Warning and Response System

(EWARS) and the HANDS software produced by the Health and Nutrition Tracking Service

4. UNHCR Health Information System (HIS)

Tools for data collection & analysis

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Recent experience of inter-agency, inter-cluster rapid assessments in a number of countries has shown:

• Extremely haphazard and ill-prepared needs assessments

• No standard tool available• Multiple assessments/surveys with variety

of methodologies from different agencies

IRA tool: background

• A multi cluster/multi sectoral tool• Collects, compiles and analyses information

on: the health status of the population the determinants of health (nutrition, water supply, sanitation, etc.) current health services characteristics (coverage, resources, services available, access, etc.)

• Should ideally be carried out within 72 hours of the onset of a crisis situation

IRA tool (2)

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• Developed jointly by global health, nutrition, WASH and shelter clusters

• Should be conducted jointly with Health, WASH, Nutrition & Shelter clusters - with Health Cluster or Inter-cluster leadership

• May need minimal customisation at country level

IRA tool (3)

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The tool includes:

• Guidelines• Assessment form for data collection• An Aide Memoire for field teams• Data entry and analysis template & software

IRA tool (4)

• Promotes and supports good practices in mapping the availability of the health resources and services in emergencies

• Strengthens the Health Cluster's informed decision making and coordination

Health resources & services availability mapping system (HeRams)

HERAMS is a software-based information system. Developed to support the collection, collation and analysis of information on the available health resources and services in emergencies.

HeRAMS (2)

There are two versions of HeRAMS:• The Initial He RAMS (“i-He RAMS”) used

during the first few days/weeks of an acute crisis to record and analyse aggregate data on the numbers of active health partners, numbers of functioning health facilities by type, numbers of key health staff (doctors, nurses, midwives), and the level of health services available by administrative level (e.g. district, sub-district)

HeRAMS (3)

• The (“Full”) HeRAMS should be used as soon as feasible and then throughout the duration of a crisis to record and analyse data on the available resources and the specific services at each “point of delivery”.

HeRAMS (4)

HeRams data Structure

Metadata

Point of Delivery

Modality of Delivery

Health Services

Health Personnel

Additional Modules

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• Weekly routine reporting of health data from health facilities

• Immediate reporting of specific critical conditions

• May be built around pre-existing surveillance systems

Early Warning and Response SystemEWARS

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• Events Analysis & Nutrition Data Surveillance • Developed by Health & Nutrition Tracking

Service (HNTS) based in Geneva• An Excel application which can be used to

capture and analyse data generated by EWARS

Health information and Nutrition Tracking System HANDS

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• A UNHCR developed system to support the collection of standardised, facility-based surveillance data in refugee settings

• Promotes using core Global Health Cluster indicators in humanitarian crises

Health Information System (HIS)

Health Status of Affected

Populations

Initial Rapid Assessment(IRA)

Early Warning Systems (HINTS)

Health Resources

Availability

Health System

Performance

Health Resources Availability Mapping

System(HeRAMS)

Routine reporting, ad hoc surveys,

HIS, etc.

Identification of GAPS in the Humanitarian Response

Targets – Benchmarks – Thresholds – etc.

Information needs

Information for HCC and HC partners is needed on:

Tools available

… for the collection, collation and analysis of this information:

Desired situation

… expressed in terms of specific programmatic targets,

international standards, benchmarks, etc.

“Removing User Fees for Primary Health Care Services During Humanitarian Crises”

Provides guidance for the removal of user fees for the provision of primary health care services during humanitarian crises.

Global Health Cluster Position Papers

“Civil-military Coordination in Humanitarian Situations”

Provides insight to the problematic situation that many partners face while working at country level and to provide guidance on how to coordinate with military actors in a humanitarian health response

GHC Position Papers (2)

Module 4: Key Messages (1)

• The Health Cluster Guide provides stakeholders with information and resources for country level implementation

• The 26 suggested Core Health Indicators have been developed to assist the decision making at country level (including coordination, advocacy and fund raising)

Module 4: Key Messages (2)

• The Initial Rapid Assessment (IRA) tool is a multi cluster/multi sectoral tool which provides essential information in the first phase of an emergency

• Health Resource Availability Mapping System (He Rams) is a framework for the assessment and monitoring of health resources and services availability

Module 4: Key Messages (3)

The Health Cluster position paper:

“Removing User Fees for Primary Health Care Services During Humanitarian Crises”

states that user fees should not be charged for primary health care services during humanitarian crises

Resources

• Health Cluster Guide http://www.who.int/hac/global_health_cluster/guide/en/index.html

• Tools – in English and French http://www.who.int/hac/global_health_cluster/guide/tools/en/index.html

Resources (2)

• Gap Guidance Materials “Assisting the Health Sector Coordination Mechanism to Identify and fill gaps in the Humanitarian Response” IASC/GHC Sub Group on Management and Coordination

• Position Paper on User fees http://www.who.int/hac/global_health_cluster/about/policy_strategy/EN_final_position_paper_on_user_fees.pdf

Discussion & Questions