Confl Health. 2015 Jun 08;9:20. doi: 10.1186/s13031-015-0045-6. eCollection 2015.
Assessments of health services availability in humanitarian emergencies: a review of assessments in Haiti and Sudan using a health systems approach.
Conflict and health
Jason W Nickerson, Janet Hatcher-Roberts, Orvill Adams, Amir Attaran, Peter Tugwell
Affiliations
Affiliations
- Bruyère Research Institute, 85 Primrose Ave, Room 308-B, Ottawa, ON K1R 6M1 Canada ; Institute of Population Health, University of Ottawa, Ottawa, ON Canada ; WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, ON K1R 6M1 Canada.
- WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, ON K1R 6M1 Canada.
- Orvill Adams and Associates, Ottawa, ON Canada.
- Faculties of Law and Medicine, University of Ottawa, Ottawa, ON Canada.
- WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, ON K1R 6M1 Canada ; Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5 Canada.
PMID: 26106443
PMCID: PMC4477304 DOI: 10.1186/s13031-015-0045-6
Abstract
BACKGROUND: Assessing the availability of health services during humanitarian emergencies is essential for understanding the capacities and weaknesses of disrupted health systems. To improve the consistency of health facilities assessments, the World Health Organization has proposed the use of the Health Resources Availability Mapping System (HeRAMS) developed in Darfur, Sudan as a standardized assessment tool for use in future acute and protracted crises. This study provides an evaluation of HeRAMS' comprehensiveness, and investigates the methods, quality and comprehensiveness of health facilities data and tools in Haiti, where HeRAMS was not used.
METHODS AND FINDINGS: Tools and databases containing health facilities data in Haiti were collected using a snowball sampling technique, while HeRAMS was purposefully evaluated in Sudan. All collected tools were assessed for quality and comprehensiveness using a coding scheme based on the World Health Organization's health systems building blocks, the Global Health Cluster Suggested Set of Core Indicators and Benchmarks by Category, and the Sphere Humanitarian Charter and Minimum Standards in Humanitarian Response. Eight assessments and databases were located in Haiti, and covered a median of 3.5 of the 6 health system building blocks, 4.5 of the 14 Sphere standards, and 2 of the 9 Health Cluster indicators. None of the assessments covered all of the indicators in any of the assessment criteria and many lacked basic data, limiting the detail of analysis possible for calculating standardized benchmarks and indicators. In Sudan, HeRAMS collected data on 5 of the 6 health system building blocks, 13 of the 14 Sphere Standards, and collected data to allow the calculation of 7 of the 9 Health Cluster Core Indicators and Benchmarks.
CONCLUSIONS: There is a need to agree upon essential health facilities data in disrupted health systems during humanitarian emergencies. Although the quality of the assessments in Haiti was generally poor, the large number of platforms and assessment tools deployed suggests that health facilities data can be collected even during acute emergencies. Further consensus is needed to establish essential criteria for data collection and to establish a core group of health systems assessment experts to be deployed during future emergencies.
References
- BMC Int Health Hum Rights. 2012 Dec 06;12:34 - PubMed
- Disasters. 2004 Dec;28(4):388-404 - PubMed
- Lancet. 2009 Mar 28;373(9669):1068-9 - PubMed
- PLoS Med. 2011 Apr;8(4):e1001025 - PubMed
- Bull World Health Organ. 2005 Aug;83(8):584-9 - PubMed
- Prehosp Disaster Med. 2011 Jun;26(3):196-201 - PubMed
- Reprod Health Matters. 2008 May;16(31):10-21 - PubMed
- BMC Health Serv Res. 2013 Mar 25;13:113 - PubMed
- Lancet. 2006 Oct 21;368(9545):1421-8 - PubMed
- PLoS Med. 2011 Aug;8(8):e1001083 - PubMed
- Int J Gynaecol Obstet. 2006 Jun;93(3):285-91 - PubMed
- PLoS Curr. 2012 Sep 05;4:e5014b1b407653 - PubMed
- Lancet. 2002 Jul 27;360(9329):330-3 - PubMed
- Lancet. 2010 Jan 23;375(9711):294-300 - PubMed
- BMJ. 2001 Sep 29;323(7315):740-2 - PubMed
- Emerg Themes Epidemiol. 2007 Jun 01;4:12 - PubMed
- Health Aff (Millwood). 2010 Dec;29(12):2223-30 - PubMed
- PLoS Med. 2008 Jul 1;5(7):e146 - PubMed
- Emerg Med J. 2013 Jan;30(1):e8 - PubMed
- Confl Health. 2014 Nov 25;8:24 - PubMed
- N Engl J Med. 2005 Feb 3;352(5):435-8 - PubMed
- Prehosp Disaster Med. 2003 Jan-Mar;18(1):6-13 - PubMed
- BMC Health Serv Res. 2005 Feb 17;5(1):14 - PubMed
- Bull World Health Organ. 2005 Mar;83(3):163 - PubMed
- BMJ. 2005 Dec 24;331(7531):1485-6 - PubMed
- J R Soc Med. 2005 Sep;98(9):390-5 - PubMed
- Confl Health. 2014 Jul 23;8:11 - PubMed
- Lancet. 2012 May 26;379(9830):1936-7 - PubMed
- PLoS Med. 2005 May;2(5):e107 - PubMed
- Confl Health. 2009 Feb 25;3:2 - PubMed
- Prehosp Disaster Med. 2012 Apr;27(2):184-9 - PubMed
- N Engl J Med. 2008 Jan 31;358(5):484-93 - PubMed
- Prehosp Disaster Med. 2012 Feb;27(1):90-3 - PubMed
- Health Policy Plan. 2015 Jun;30(5):675-86 - PubMed
- JAMA. 2004 Aug 4;292(5):613-8 - PubMed
- JAMA. 2010 Aug 4;304(5):567-8 - PubMed
- Lancet. 2012 Jun 16;379(9833):2223-5 - PubMed
- Emerg Themes Epidemiol. 2007 Jun 01;4:7 - PubMed
- Prehosp Disaster Med. 2012 Dec;27(6):577-82 - PubMed
- BMJ. 2000 Jul 8;321(7253):101-5 - PubMed
Publication Types