Tehran University of Medical Sciences Institute of Public Health Research

Health in Emergency & Disaster Department (HE&DD)

Rapid Assessment in Disaster

Ali Ardalan MD, MPH, PhD

Assistant Professor

Learning Objectives:

By the end of the session, participants will be able to:

Explain the characteristics of data & information

after disasters

Explain the importance & main applications of

rapid assessments following disasters

Develop a rapid assessment form

To criticize a rapid assessment report

• Lack of information as the strongest indicator of a crisis

• Lack of information is not = to lack of data

Disaster impact on information

• Routine information systems collapse

• Population movements lack of reliable denominators

• Collection & analysis of data clash with other priority activities

Disaster impact on information

Zones

Earthquake- stricken area

No information is available, or what is available is flawed to

such a degree to be useless. Therefore:

Postpone any decision until new data become available:

Paralysis by analysis

OR

Given gravity of crisis, there is not time to gather

reliable data; Proceed quickly with field activities

Main Myth of Health Information in Crises

The opportunity cost of information in emergencies

Accuracy and comprehensiveness

Cos

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Non-routine data collection methods in emergencies

Type When What How

Rapid reconnaissance

Immediately after a disaster

A quick, preliminary inspection of the disaster area

Satellite imagery Overflights Mapping Drive/walk through

RHA As soon as it is

possible to go to the area

A quick collection of information to confirm the emergency, measure the impact, identify health needs and guide response

Visual inspection Analysis of records Interview of key

informants Rapid surveys

(MUAC, etc)

Surveys When the situation stabilises and response has been activated

A detailed study in which information is systemati-cally collected in a sample of population (morbidity, mortality, nutrition, KAP)

Probability sampling Non-probability s.

The 10 Priorities in Emergency

1. Rapid assessment of health status2. Mass immunization against measles!

3. Environmental hygiene and water availability

4. Food availability

5. Shelter

6. Case management, therapeutic protocols

7. Prevention and control of epidemic prone diseases

8. Health information system (public health)9. Human resources

10. Coordination of interventions

source : Refugee Health, MSF

Rapid Assessment

Rapid Health Assessment

Rapid Public Health Assessment

Rapid Epidemiological Assessment

Rapid…………… ?.

Purpose of Rapid Health Assessment (RHA)

The purpose of a rapid assessment is to:

Confirm the emergency

Describe the type, impact and possible evolution of the emergency

Measure its present and potential health impact

Assess the adequacy of existing response capacity & immediate

additional needs

Recommend priority action for immediate response

Disseminate findings widely

RA: Main issues

Area of information?

Source of information?

Which instrument?

Team composition?

Report format?

RA: Area of Information

MAIN ISSUE

Nature of the emergency:• Main causative hazard • Additional hazards • Projected evolution

Affected area• Administrative division • Access to area:

Main routes and conditions Distance from the closest town outside the affected area Closest operational airport, port or navigable river

Affected population:• Characteristics (e.g residents, refugees, IDPs) • Number/estimates • Sex/age breakdown • Patterns of settlement/movement • Source of information & method of data collection

RA: Area of Information

HEALTH IMPACT

Direct impact: reasons for alert• Main causes of morbidity and mortality• CMR • Under-5 Mortality Rate • Malnutrition status • Reports/rumours of outbreak• Other reasons for concern:

e.g. traumas/injures due to landmines, etc

Indirect health impact • e.g. damage to water plants, other vital infrastructures or

lifelines

Pre-emergency baseline morbidity and mortality data

Projected evolution of the health situation: • Main causes of concern in the coming months

RA: Area of Information

VITAL NEEDS: THE CURRENT SITUATION

• Water

• Excreta disposal

• Food

• Shelter and environment on site

• Soap and buckets

• Fuel and cooking utensils

• Clothing and blankets

RA: Area of Information

CRITICAL CONSTRAINTS

• Security

• Transport and logistics

• Social/political and geographical constraints

RA: Area of Information

RESPONSE CAPACITY

Activities already underway Measles coverage

National contingency plans, procedures, guidelines and special expertise

Operational support• Location of field forward control post • Health system: Closest functioning health unit and

referral system • External assistance: Closest organization and relevant

resources • Capacity for reprogramming the resources above • State of communications• Storage capacity close to affected area and supply lines

RA: Area of Information

RESPONSE CAPACITY

Operational coordination:

• Lead agency

• Mechanisms

• Flows of information

Strategic coordination

• Relations between government and UN country team

• National institutions for emergency management

• Standing agreements with neighbouring areas

• Relations between government and international community at large

RA: Source of information

• Visual inspection

• Analysis of records

• Interview of key informants

• Rapid surveys

RA: Instrument

• Minimal Essential Data Set (MEDS)

• Evaluation Criteria

RA Instrument: International Source

1. WHO: Rapid Health Assessment Protocol for Emergencies

2. UNICEF: Handbook for Emergencies

3. IFRC: Handbook for Delegates

4. Sphere: Humanitarian Charter & Minimum Standards in Disaster

Response

5. MSF: Refugee Health

6. OFDA: Field Operation Guide

7. CDC: Famine-Affected, Refugee, and displaced populations:

Recommendations for Public Health Issues

RA Instrument: Evaluation Criteria

1. Disaster specificity (Specific / Non-specific)

2. Assessment focus: (Site-targeted / System targeted)

3. Metadata (Captured / Not captured)

4. Information priorities (Critical / Non-critical)

5. Performance indicators (SMART / not SMART)

6. Benchmarks (Present / Absent)

7. Data structure (Checklist / Template)

8. Portability (High / Intermediate / Low)

9. Time needed (Stated / Unstated)

10. Field utility (High / Low)

RA: Team Composition

• Public health professional

• Epidemiologist

• Environmental health expert

• …

RA: Report Format

RA: Report Format

RA: Information User

Wide spectrum:

• UN Agencies

• NNGOs & INGOs

• MOH departments

• Health sector partners

• Media

• …

RA: Common Problems

Poorly coordinated; each organization doing

different assessment

Findings not disseminated

Findings ignored

Ongoing information system not established

Contact info:

e-mail: aardalan@gmail.com

Office/FAx: +98-21- 88951401

Mobile: +98- 9123050192

Ali Ardalan MD MPH PhD

Assistant Professor

Health Emergency & Disaster Department (HE&DD)

Institute of Public Health Research

Tehran University of Medical Sciences