DAMAGE ASSESSMET AND NEEDS ANALYSIS FOR THE …的損害評估和需求分析…

1、health sector assessmentsin emergencies3rd annual regional training course on the management of public health risks in disasters for the eastern mediterranean mphr 3cairo, 20-31 may 2007damage assessment and needs analysis (dana)a multi-sectoral, team activity that uses standard protocols to collect

2、 data that is analysed to define: the main problems in relief the causative factors of those problems what needs to be done? the extent of those problems how much of which resources are needed? the likely trends for how long? the constraints (climatic, geographic, political, social, logistical, orga

3、nisational etc.)the information is used to: set priorities and targets for the relief operation allocate specific responsibilities to participating agencieswhich information?the basic needs: shelter/clothing water/sanitation food/preparation energy/fuel security acute medical care personal hygiene w

4、aste management etc.the population: demography, culture, geography, climate baseline causes of morbidity and mortalitythe support systems: coordination communication logistics information flows resource flowswhy assess damage? guides planning for repair, rebuilding and reconstruction guides the sett

5、ing of relief priorities: function and safety issues can a service be delivered, is a building safe (building “triage”) evacuate or not ? can people access the service? repair or provide a temporary service? needs caused by damage: direct needs e.g. treat the injured will the damages affect this? in

6、direct needs caused by damage e.g. loss of access to water supplyquestions and answerswork in your groups to answer the following question (30 minutes): what are the health needs in emergencies ?construct the following table.needs in an emergencyvector born disease, vaccine preventable disease, dise

7、ases of epidemic potential, diseases of public health significance, potentially unstable chronic disease)categories of informationthe assessment involves the collection of two key categories of information: analysis of the damage to: critical resources critical infrastructure and fixtures critical s

8、ervices analysis of the needs of the victims immediate needs arising from the situation future needs arising from damage/disruption to services/infrastructureinformation on victimsa report describing the impact of a hazard will provide the number of: number of casualties killed; injured; sick; disab

9、led; by age, sex, location and probable cause of death number of affected total; severe; critical;classification based on severitythe following is used to describe the severity of the impact on people: affected all those living within the geographical area involved severely affected those who have l

10、ost one or more of their lifelines critically affected those who have lost all of their lifelines or who have been displaced i.e. those totally dependent on others to support themcritical services basic needs and lifelinesbasic needs are the minimum requirements needed for the survival of the affect

11、ed population (also called “pre-requisites for health”): water food shelter (and clothing in cold climates) energy (fuel) (acute medical care)lifelines are services that are needed to deliver the basic needs: utilities (water, electricity, gas) sources and networks communications systems transport n

12、etworks (air, sea, road) distribution systemsfirst priority of government restore lifelines and meet basic needsassessing facilities and servicesfor each facility or service in the affected area, the assessment classifies facilities according to function: destroyed / no function possible more than 5

13、0% reduction in capacity less than 50% reduction in capacity undamaged / full functionpublic health consequences of disasters temporary population displacements increased numbers of deaths and injuries new cases of disease and disability exacerbation of and increased numbers of cases of psychologica

14、l and social behaviour disorders food shortages and nutritional deficiencies environmental disruption causing hazards vectors, waste management, sanitation destruction of infrastructure disruption to routine health services disruption to routine disease surveillance and control services diversion of

15、 capital investment funds to emergency relief and the rehabilitation or reconstruction of essential infrastructure vulnerabilitiescapacities emergencyindirect impactsdirect impactshealth response search and rescuefirst aidtriagemedical evacuationprimary care disease surveillance and controlcurative

16、careblood bankslaboratoriesreferral systemspecial units (burns, spinal) evacuation centresshelterwaterfood and nutritionenergysecurity environmental healthprimary health care care of the deadpsychosocial caredisability care recoveryreconstructionassociated factors climate/weather/time of daylocation

17、security situationpolitical environmenteconomic environmentsocio-cultural environmentmorale, solidarity, spiritcompetence, corruptiondamageandneedsemergencies and healthcommunityuse the coordination mechanismit is not necessary to go to the field to collect detailed information from other sectorsat

18、the daily coordination meetings, reports and assessments from other sectors are shared these can be sent as annexes to health sector reportsthe emergency reporting system should take over from assessments as soon as possiblereference valuesprepare tools to assist planningpublic health predictors tem

19、plate.xls health sector assessments by hazard class1.natural hazardsfocus first on recording damage to health sector, then on the needs of the health facilities to restore some function, then on the meeting needs arising from actual and potential causes of morbidity and mortality 2.technological haz

20、ardsfocus on capacity to meet the needs arising from the actual and potential causes of morbidity and mortality 3.biological hazardsfocus on capacity to meet the needs arising from the actual and potential causes of morbidity and mortality4.societal hazardsin conflict - focus first on recording dama

21、ge to health sector, then on the needs of the health facilities to restore some function, then on the meeting needs arising from actual and potential causes of morbidity and mortality in other situations - focus on capacity to meet the needs arising from the actual and potential causes of morbidity

22、and mortalityneeds assessment and programme monitoringassess resources andassess health statusinfrastructure(morbidity, mortality, nutrition)programme indicatorsis there damage to health sector infrastructure?1water, sanitation, waste, shelter, food supply and nutrition services in place / meeting n

23、eedsis there damage to health sector resources?is there a major health problem? no2curative, preventative, promotional and rehabilitative services in place / meeting needsis there damage to lifelines? 3situation specific preventative actions being taken vector control, measles vaccination, vitamin a

24、, public awareness, antenatal care etc yes yes4guidelines issued and being followedcan the health system cope?yes5reporting and surveillance systems for injury, disease, nutrition, water quality, vectors, food safety, mental health, disability in placecan the community cope?6referral systems in plac

25、e, including laboratories, psychosocial, chronic diseases and disability care no7essential drugs and equipment available, appropriate and sufficientstrengthen existing services/ organise temporary services8management, logistics, security and communications systems in place / meeting needsmobilise additional resources9staff safety, information, training needs being metseek expert advice10community health information / health education needs being meetorganise epidemiological studies and surveys11plans for rehabilitation an