Transcript Slide 1

Planning Protocols and
Procedures
(Monitoring and Evaluation
Updating Plan)
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Learning objectives
By the end of this session, you should be
able to:
 Discuss basic principles of evaluation
 Identify key lessons learned for health
emergency managers from recent disasters
 Identify areas for action in HEM capacity
development
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
How can we Define Evaluation? (1)
 The classic perspective:
o Concerned with the achievement of objectives
 The broad perspective:
o Achievement of objectives is a key, but it is
only part of what an evaluation might be
concerned with
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
How can we Define Evaluation? (2)
Key elements are:
 The need for systematic collection of
information
 The wide range of topics to which evaluation
can be applied
 To be effective, the evaluation results has to be
used by someone
 The wide variety of purposes of evaluations
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
What’s the Difference between
Research & Evaluation?
 Research & evaluations use the same
toolbox
 However, for a different purpose
• Research aims to prove…
• Evaluation aims to improve…
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Why do we do evaluations?
It’s all about interventions or programs to:
 Inform planning
 Define progress
 Examine efficiency
 Examine effectiveness or achievement
 Inform decision-making
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
How Could you Find out the Purpose
of an Evaluation?
 Who asked for evaluation?
 Who pays for the evaluation?
 Why do these people want an evaluation?
 What are the decisions that need to be made?
 What information is required to facilitate decision
making?
 Who is going to be affected by evaluation
outcomes?
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Classifying Evaluation Purposes
 Needs assessments
 Before planning to understand context & needs
 Program monitoring
 Compliance with policy/plan
 Validity of assumptions & pre-conditions
 Formative evaluation
 Efficiency
 Summative evaluation
 Effectiveness
 Decision-making
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Evaluation Logic
Purpose
Why do we do this?
Questions
What do we want to know?
Objectives
What information is needed?
Methods
The way
information
Results
Processed data or information
Conclusions
Answers to questions
Recommendations
Suggestions for decision-making
we
collect/analyze
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
What Methods can you Think of to
Collect Information?
 Documentation research
 Observations
 Surveys interviews
 Individual interviews
 In-depth interviews
 Focus group discussions
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Quantitative Data Sources & Methods
Conditions within
samples of a
subgroup
Documented information
on population groups
Indirect measures
Observation
Survey interviews
Characteristics of samples
of a community or
subgroup
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Qualitative Data Sources & Methods
Behaviour
Community perspective
normative view
Observation
Focus groups
In-depth
interviews
Key informants
In-depth knowledge
Individual
interviews
Indirect
measures
Individual perspective Documented
intra-cultural variation information
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
About Methods
 Questions will tell you what information you need
 Information needed will tell you what methods
could be used
 Local context & resource limits will tell you what
methods are feasible
 Keep it as simple as possible
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
In Summary
To find out something useful about an intervention or
program, use whatever you have in your toolbox that will
get the job done…
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Small Group Discussions
 Based on personal experience, what are the
lessons learned in terms of HEM?
 Compare experiences & build consensus on
common lessons learned
 List on a flipchart your group results
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
SYNOPSIS OF EVALUATIONS ON
THE HEALTH EMERGENCY RESPONSE TO SEA
REGION TSUNAMI
KEY LESSONS LEARNED FOR HEM
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Sources
 The Phuket Conference Papers (2005)
 Tsunami Evaluation Coalition (2005)
 The WHO-SEARO Tsunami evaluation (2006)
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Lessons Learned in Context of HEM
• Early warning
systems
• Incident command
system
• Health info system
• Resource management
• Capacity assessment
• Risk communication
• Risk reduction
• Donation management
• Policy
• Operations management
• Needs assessment
• Recovery &
reconstruction
• Emergency planning
• Capacity development
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Early Warning Systems
Coordination
developed
structures
need
to
be
Flexible surveillance systems need to be
promoted
Surveillance
systems
need
development in terms of local
building:
further
capacity
Personnel
Infrastructure
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Health Information System
Management
Surveillance systems focused too exclusively on CD
Need to develop surveillance systems that are
capable of covering all aspects of health
Surveillance and monitoring must be strengthened
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Capacity Assessment
Private & other sectors should be involved in
disaster reduction
Preparedness,
mitigation
measures
&
capacity building are more cost-effective than
enhancing damage response
Vulnerability indicators need to be defined
I.e. safe hospitals
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Risk Reduction
The importance of risk reduction need to be
advocated
Health sector & facilities’ ability to recover from
disaster stresses need to be improved
There is a need to develop vulnerability indicators
Integrate mitigation activities into the recovery
process
PHC staff should receive training in disaster risk
reduction
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Policy
Countries that did relatively well in HEM in terms
of national & international coordination had:
Well-developed policies & systems
Strong health systems
Clear lines of authority
Problems encountered post tsunami are not
new:
Policy without enforcement is powerless
Coordination policy-practice too often doesn’t happen
Relevant indicators on effectiveness, efficiency,
costs, & benefits of both preparedness &
response are needed
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Needs Assessment-1
A pragmatic approach to needs assessment
Assessment must be relevant to decision making
Assessments must be timely
Invest in national assessment capacity
Strengthen the capacity of national and local
authorities to carry out cross-sector needs
assessments
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Needs Assessment-2
The need to streamline the international
assessment mechanism
Dysfunctional
Competitive
Not shared
The need for a common information system
of beneficiaries
Mainly statistics
It does not tell who needs what
It does not facilitate matching needs & offers
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Emergency Planning & Response-1
Disaster preparedness is crucial
The quality of early responses is affected by the
degree of preparedness
Lack of effective coordination: most common
complaint
Internal
External
Between policy & practice
Across sectors & agencies
Information management
Reporting formats should facilitate decision-making
Media relationships including pre-disaster
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Emergency Planning & Response-2
Flash appeals: a solution causing problems…
Disaster preparedness must include training on
Flash Appeal
Timing of funding was a problem
Imbalanced demands: curative care & public
health
Funding worsening inequities
Consider psychosocial support mechanisms
Health system deficiencies
Alien expertise
Community-based mechanisms
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Incident Command System Operations
A 24-hour contingency response system should
be in place
WHO internal relationships in response to the
Tsunami raised questions:
Coordination
Sharing of information
Chains of decision making
First teams in the field should always be
composed of experienced staff and not
consultants
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Resource Management-1
Recruitment & briefing of consultants calls
for care
There is scope to strengthen regional &
national financial resource mobilization
capacity including:
Disaster preparedness
Mitigation
Response
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Resource Management-2
WHO should assure its leadership in public health in
its relations with UN agencies and NGOs
MOH should assure its leadership in public health in
its relations with other ministries and international
donors
Collaboration with the military is important and
should be fostered
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Risk Communication
Working with the media is important so that
reporting is:
Technically sound
Epidemiologically sound
We need to enhance the relationship with the
media through:
Training of HEM managers
Regular briefing of media
Sharing some of the lessons learned
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Donation Management
Make international response more relevant
to needs assessment
Humanitarian
industry
response
is
an
unregulated
Setting priorities and distribution of tasks among
actors requires significant improvement
Assessing needs is pointless if decision making is
not reformed
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Operations Management
Standard Operating Procedures (SOPs) are essential
and need to be developed & reviewed
Situation reports need to be standardized and
regular
Logistics, supplies & donations can be troublesome
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Recovery & Reconstruction-1
Planning & preparedness can reduce the impact of
disasters
There is a need for a strong public health
infrastructure
Planning and coordination
reconstruction is essential
of
recovery
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
&
Recovery & Reconstruction-2
Early responses do affect long term system
functioning with consequences for health services
Researchers & implementers need to speak the
same language
Relationships between national & local governments
and international agencies are crucial for the course
of development
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Capacity Development-1
Provide leadership
Strengthening organizational & management
capacities
Human resource development:
International & national level staff are the sole
barrier to improved health sector capacity
Not by quick fix short courses
Incorporate “Health Management in Disasters” in
curricula of all relevant disciplines
Not HEM but HM knowing emergencies
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Capacity Development-2
Develop partnerships & networks
Professional associations
Multi-sectoral
National
Regional
Inter-regional
Develop & share knowledge
Case studies
Research
Continuous learning
HEM integrated in health curricula
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Putting it together-1
Build capacity in risk management & vulnerability
reduction
Policy & legislation development
Develop disaster management lines of authority
& control
Allocate resources for risk mgt & vulnerability
reduction
Address the need for improved needs assessments
Relevant to decision-making
Multi-sectoral
Population-based
Inclusive
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Putting it together-2
Enforce public health practice:
Psycho-social support
Gender equity
Child health
Management of the dead & missing
Involvement of health volunteers
IEC for watsan
Develop benchmarks & standards of practice
Vulnerability indicators
Surveillance systems
Needs assessments
Indicators on effectiveness, efficiency, costs, &
benefits of both preparedness & response
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Putting it together-3
Improve management & coordination of
responses
Internal
External assistance
Policy-practice
Develop logistics of supplies
Legislation
Relevance
Capacity building
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Putting it together-4
Improve donation management
Timely
Sustainable
Relevant
Flexible
Foster contribution of other sectors
Civil-military liaisons
Public-private sector liaisons
NGOs’ inclusion not marginalization
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Putting it together-5
Develop media relations
IEC prior and during disasters
Combat disaster myths
Guidance on media relations
Developing capacity
HEM leadership
HEM capacity
Human resources
Networking & partnerships
Knowledge development
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Capacity Development in HEM
Strengthening
Development
Evaluation
& Research
Capacity
Building
Awareness
Advocacy
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Plenary Discussion
At the end of the day…considering:
The roles of HEM in disasters and
The lessons learned from disasters
How would describe the strengths &
weaknesses in terms of HEM for your
country?
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman