Initial health status assessment for a displaced population

  • il y a 10 ans
The initial, rapid assessment must determine the magnitude of the disaster or emergency in progress. It details the health status and needs of the displaced or refugee population and permits an appropriate operational response.

To carry out the initial assessment, certain essential data must be gathered very quickly – often in less than a week. In particular, this includes demographics, health, nutrition, immunisation coverage, access to health care and basic necessities such as water, sanitation and shelter.

Monitoring any deaths in the population is a top priority.


A) Information sources for the initial assessment
The initial assessment among the population gives a quick overview accurate enough to tailor often large-scale relief operations. Remember that a simple analysis, frequently based on common sense, is expected at every step. During an emergency situation, the initial diagnosis relies on several types of data, sources and methods.



The population can be estimated in a day using, among others, rapid techniques such as mapping,; this provides the denominator needed for activity planning. These data will be validated later with more accurate censuses.

The mortality rate, which reflects the severity of the situation, is the first health indicator to be documented; this is done with a population survey.
After that, the mortality data should be monitored daily via a simple surveillance system for deaths using community health workers.

Surveys using samples of the population provide information on family composition and the percentage of children under 5 years, who are more vulnerable, as well as any deaths and basic water, shelter, hygiene and sanitation needs.
The measles immunisation coverage and prevalence of malnutrition can also be assessed during these surveys. Depending on the context, a limited number of other questions will be added, such as whether people have a registration card and about any violence to which they have been subjected.


An epidemic alert and surveillance system for killer diseases is essential, especially for acute diarrhoea, respiratory infections, malaria and measles. The data are obtained from treatment registers from MSF or other operators. If necessary, specific epidemiological investigations should be conducted.

The data provided by humanitarian aid distribution systems should be consulted and cross-checked with other sources. Data from general distributions of food and household kits such as buckets, mosquito nets and soap can also be useful for getting a general picture of the families being helped.


B) Access to health care
While we measure the effectiveness of the operation by monitoring mortality and morbidity, the population must have access to appropriate emergency medical and surgical care, including the necessary drugs and supplies. There should also be a specialised programme to verify the nutritional coverage of children with severe acute malnutrition, and in some cases adults during major food crises.

C) Resources
Efficient operations require significant resources in a very short time frame.
It is necessary to verify the availability of general resources sufficient for emergency operations. This means human, financial and logistical resources, with appropriate transport – not to mention water, hygiene and sanitation.

D) Coordination and security
Coordination between relief operators is essential, especially during large-scale operations with mass population displacement. Security issues are always a priority, both for the population and for aid workers.


Conclusion
Information from the initial assessment can be used to inform about the health status of the population, to target the emergency operations to be conducted and to better plan them with the resources needed. Everything should be interpreted taking into account the local social, political, security, geographic and climatic context, which requires that the operators have knowledge about the site where the population has taken refuge. The information can also be used to speak out about the situation of the refugees or IDPs.

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