Transcript Slide 1

Health Workforce in Emergency
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Health Workforce
 all persons currently participating in the health
labor market or health care delivery
Health Workers
 all people engaged in actions whose primary intent is
to enhance health
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Physician, Nursing and midwifery personnel
dentistry personnel
pharmaceutical personnel
laboratory health workers
environmental and public health workers
community and traditional health workers
other health service providers
health management and support workers
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Public health workforce
 is diverse and includes all those whose prime
responsibility is the provision of core public health
activities, irrespective of their organizational base
 they are central to the performance of health
systems, very little is known about its composition,
training or performance.
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Front-line health workforce
 consists of all actors supporting and strengthening the
health, safety and resilience of communities to
emergencies at the local level including communitybased health workers, mid-level health workers and
volunteers such as those affiliated with Red Cross/Red
Crescent societies, civil society and actors from other
relevant sectors
 essential component of the health workforce
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Front-line health workforce
 Nurses and midwives play a significant role in emergencies
and are often at the front line at the community-level
 Direct emergency risk management
 They play critical role in training, supervising and
equipping community-based health workers for their
role in emergencies
 reduce health related risks and limit the impact of
emergencies on communities along with other key sectors
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Roles of the front-line health workforce
in Risk Reduction
1. Health risk assessment.
 Identify the hazards and vulnerabilities that
will form the basis of planning
2. Epidemiology functions.
 Maintain and improve the systems to monitor,
detect, and investigate potential hazards,
particularly those that are environmental,
radiological, toxic, or infectious.
3. Public engagement.
 Educate, engage, and mobilize the public to be
full and active participants in public health
emergency
First National preparedness.
Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Roles of the front-line health workforce
in Risk Reduction
4. Mitigation strategies.
 Develop, test, and improve community mitigation
strategies (ex isolation, quarantine, social distancing)
5. Public information and communication
 Develop, practice, and improve the capability to
rapidly provide accurate and credible information to
the public in culturally appropriate ways
6. Resource Management
 Identify critical resources for public health emergency
response and practice and improve the ability to
deliver these resources throughout the supply chain
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Roles of the front-line health workforce
in Risk Reduction
7. Operations
 Ready workers and volunteers with skills and
capabilities to perform in health emergency
8. Leadership.
 Local leaders to mobilize resources, engage the
community, develop interagency relationships,
communicate with the public
9. Provide accurate and credible messages to the
public during a crisis
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Roles of the front-line health workforce
in emergencies
 providing critical front line health services
 key actors in conducting:
i. health education and promotion,
ii. social mobilization,
iii. delivery of health services,
iv. community-based health risk assessments,
v. emergency health operations,
vi. first aid, basic life support,
vii. support to epidemic control, among others
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
FHW contributes to safe/resilient community
1. Improving health outcomes on a routine basis
(reducing underlying vulnerability)
 Prevention and management of common illnesses
 Promotion of key family practices and health
promotion for disease prevention,
 Provide selected essential newborn and sexual and
reproductive health intervention
 Support facility-based health promotion,
prevention and management of chronic illnesses
 Support essential trauma care at basic facility level
 Providing community-based rehabilitation for
people with disabilities
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
FHW contributes to safe/resilient community
2. Prevent, mitigate and prepare for emergencies
 Conducting risk assessment(hazards, vulnerabilities and
capacitates)
 Help detect, prevent, and manage diseases of epidemic or
pandemic potential
 Contribute to climate change adaptation (CCA) activities
through reducing vulnerability of communities, short term
forecasting and working closer with other key sectors
 Providing risk awareness and health promotion messages
including health education and social mobilization
 Contribute to emergency preparedness for families,
communities and health systems
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
FHW contributes to safe/resilient community
3. Responding to and recovering from emergencies
 Continue priority essential health services at the home
and in the community
 Provide first aid and basic life support
 Provide psychosocial services and community support
through community participation, providing
information to reduce anxiety and psychological first aid
 Support mass casualty management including essential
trauma care at basic facility level and essential surgical
care
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
FHW contributes to safe/resilient community
4. Play vital role in achievement of the health related
Millennium Development Goals (MDGs)
5. They are component of well functioning health systems
to deliver lifesaving services
6. During emergency they perform health service delivery
at household and community levels reducing the
demand for health facility-based services and can
improve access to services when health systems are
destroyed, disrupted or overwhelmed
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Thank You
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Capacity Building for Health
Workforce
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Learning Objectives
By the end of this module, the participant should
be able to:
Describe the elements of capacity to manage health
risks of emergencies
Identify key elements of capacity for specific health
service delivery functions
Describe the role of a health emergency manager in
health emergency management systems and in
developing health emergency management capacity
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Defining Capacity
Sum of:
capability
resources
relationships
Aims
Within
community
organization
country
region
world
– Reducing illness,
disability and
death from risks
– Promoting health,
safety and
security
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Defining Capacity
System definition of capacity
• Capacity includes capability (knowledge, attitude
and skills) of the component parts, the resources
(financial, equipment) which support the system,
and the relationships which together form the
system.
Capacity is a quantitative measure
• Measurement of human and material resources
i.e. number or volume or size. For example, the
capacity of the hospital is 500 beds
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Health Workforce
 all persons currently participating in the health
labor market or health care delivery
Health Workers
 all people engaged in actions whose primary intent is
to enhance health
•
•
•
•
•
•
•
•
Physician, Nursing and midwifery personnel
dentistry personnel
pharmaceutical personnel
laboratory health workers
environmental and public health workers
community and traditional health workers
other health service providers
health management and support workers
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Relevance of Risk Management to HEM
Capacity Development
Risk ∞
Hazard x Vulnerability
Capacity
In managing Risk: Capacity is needed to:
• Reduce Hazard
• Reduce vulnerability
• Increase Capacity
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Health Emergency Management
Capacity
Capacity to perform the following functions:
 Reduce hazard
Preparedness
 Reduce vulnerability
 Respond to reduce and manage
consequences
Response
 Recover and reconstruct for better
Recovery
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Disaster Risk Management Framework
Response
(Capacity utilization)
Preparedness
(Capacity building)
Recovery
(Capacity rebuilding
for better)
(Capacity to
Reduce/prevent
Hazard)
Prevention
(Capacity to
Lessen Impact
of hazard)
Mitigation
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
ANATOMY OF COMMUNITY RISK MANAGEMENT
hazard
indicators:
probability
scale/magnitude/
strength/intensity
spread
duration
biological hazards:
season, infectivity,
latency, transmission
resistance, etc.
natural phenomena
famine
diseases of epidemic
potential
events/crowds
intoxification
infestations
transport accidents
structural failures
industrial accidents
chemical accidents
pollution
refugees
war
terrorism
community
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vulnerability
indicators:
People:
access to health care
measles vaccination
under 5 nutrition
under 5 mortality
access to clean water
access to sanitation
adequate housing
employment/ income
female literacy
Property:
health infrastructure
vehicles
medical supplies
Services:
curative care services
ambulance services
public health services
health info system
Environment:
water/soil/air quality
readiness
Community
risk
=
multisectoral, all hazards
indicators:
indicators:
policy, plans, procedures
knowledge, skills, attitudes
resources
legislation
national & sectoral policy
administrative procedures
response & recovery plans
preparedness plans
technical guidelines
management structure
institutional managements
information systems
warning systems
human resources
material resources
financial resources
simulations & training
education
public information
community participation
research
publications
risk of:
death
injury (mental/
physical)
disease
(mental/physical)
loss of life
displacement
loss of property
loss of income
secondary hazards
breakdown in
security
damage to
infrastructure
breakdown in
services
Contamination
Prevention & Mitigation
Vulnerability Reduction
Emergency Preparedness
Community Risk
=

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Programme
Programme
Programme
Management
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Preparedness Capacity to manage
risks of emergencies
1. Provide necessary •Legal framework
• Policies
tools
• Guidelines
• Procedures
• Resources
• Plans
• Knowledge
• Attitude
• Skills
Organizations
Systems
People
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Preparedness Capacity to manage
risks of emergencies
Leadership/Good
Governance
2. Health System
Development
Health Workforce
Service Delivery
Information
Medical Products,
Vaccines & Technologies
Health Financing System
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
3. Human Resource Development
Programme
Categories of Stakeholders
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Leaders
Managers
Operation Center Staff
Responders
Community
Trainers
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
4. Governance
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Policy, planning, priorities and political commitment
Legal and regulatory systems
Integration with development policies and planning
Integration with emergency response and recovery
Institutional mechanisms, capacities and structures;
allocation of responsibilities
 Partnership
 Accountability
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
4. Risk Assessment
 Hazards/Risks data assessment
 Vulnerability and impact data assessment
 Scientific and technical capacities and innovation
5. Knowledge and Education
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Public awareness, knowledge and skills
Information management sharing
Education and training
Cultures, attitudes, motivation
Learning and research
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
6. Risk Management and
Vulnerability Reduction
Environment and natural resource management
Health and well being
Sustainable livelihoods
Social protection
Financial instruments
Physical protection; structural and technical
measures
 Planning regimes
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First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
7. Disaster Preparedness and
Response
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Organizational capacities and coordination
Early Warning Systems
Preparedness and contingency planning
Emergency resources and infrastructure
Emergency response and recovery
Participation, volunteerism, accountability
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
8. Established network and
partnerships
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Coordination
Referral system
Established network
Common agreements and SOPs
Established areas of collaboration
Inventory and sharing of resources
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Q&A
How do we develop trainings or
training Program?
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Developing a training or
training program
1. Target audience
2. TNA
3. Training Curriculum
4. Training calendar
5. Training database
6. Application of training
7. Monitoring and Evaluation
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Stakeholders Training Needs Analysis
(Roles and Functions)
Stakeholders
Preparedness
1. Leaders
2. Managers
3. Hospital
Responders
4. Public Health
Responders
5. OPCEN Staff
6. Community
Response
Recovery
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Stakeholders Training Needs Analysis
(core competencies to carry out functions)
Stakeholders
Preparedness
1. Leaders
2. Managers
3. Hospital
Responders
4. Public Health
Responders
5. OPCEN Staff
6. Community
Response
Recovery
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Stakeholders’ Training Program/Curriculum
Training Title
Training Content
Stakeholders
Training Title
1. Leaders
2. Managers
3. Hospital
Responders
4. Public Health
Responders
5. OPCEN Staff
6. Community
Training Content
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Thank You
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Response Teams
for immediate deployment
RHA Team
ICS Support
Team
Evac. Center
Team
Rapid Assessment
First Aid
Search and Rescue
EMS (transport and
logistics)
Evacuation Center
First Aid Team
SAR Team
EMS Team
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Response Teams for further Deployment
(After 24 hours)
Medical
Team
MHPSS Team
Logistics
Management
Team
WASH Team
Response
Operation at
Evac. Center
Hospital Team
As needed
Nutrition Team
Surveillance
Team
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Health Roles in Managing Risks Over Time
stage
immediate
timeframe
first 24
hours
general needs
search and rescue
evacuation / shelter
food
water
public information
system
health needs
first aid
triage
primary medical care
transport / ambulances
acute medical and surgical care
emergency communication, logistics and reporting systems (including injury and disability
registers)
security
emergency epidemiological surveillance for
energy (fuel, heating,
Vector Born Disease, Vaccine Preventable
light, etc.)
Disease, Diseases of Epidemic Potential
environmental health
control of disease of public health significance
services for:
control of acute intestinal and respiratory
•vector control
disease
shortend of first •personal hygiene
care of the dead
term
week
•sanitation, waste
disposal etc.
general curative services
nutritional surveillance and support (including
micronutrient supplementation)
measles vaccination and Vitamin A
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Health Roles in Managing Risks
stage
medium
term
long term
conclusion
timeframe
end of
first
month
general needs
protection (legal
and physical)
employment
public transport
public
communications
psychosocial
services
end of 3 education
months agriculture
environmental
protection
compensation /
reconstruction
health needs
(re) establishment of the health information system
restoration of preventive health care services such
as EPI, MCH, etc.
restoration of priority disease control programmes
such as TB, malaria, etc.
restoration of services of non-communicable
diseases / obstetrics
care of the disabled
reconstruction and rehabilitation
specific training programmes
health information campaigns / health education
programmes
disability and psychosocial care
evaluation of lessons learned
restitution /
rehabilitation
revision of policies, guidelines, procedures and plans
prevention and
preparedness
upgrade knowledge and skills, change attitudes
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Response Teams for further Deployment
Considerations:
Need to establish health system
Need to support the treatment of injuries
Need to support the medical cases
Provision of public health services to include disease
surveillance
 Support for resource management
 Support risk communication
 Provide protection and safety of victims and
responders
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First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
EPIDEMIC EMERGENCIES
RESPONSE CAPACITIES
Case definition
Admission criteria
Specific morbidity
and mortality
Case confirmation
Case management
OUTBREAK
NEEDS
- in the community
Discharge criteria
Contact tracing
- in health facilities
Vector control
Environmental controls
- in health facilities
Surveillance system
Referral system
Professional education
Risk for health and lab workers
Public Information and
awareness
Laboratory plans
Difficult access
Hospital plans
Supplies and equipment
Agent unknown
Borders control
Quarantine
Animal culling
First National Course on Public Health Emergency Management
Commerce/ trade
12 – 23 March 2011. Muscat, Oman
General or Cross-cutting Functions
 Communication and transport
 Information management
 Health surveillance
 Mental health
 Reproductive health
 Environmental health
 Food safety, emergency feeding and
nutrition
 Water supply management
 Waste management
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Specific Emergency Response and
Emergency Recovery Functions
 First aid, self-aid and first-responder
health assistance
 Incident site management
 Assessing needs
 Mass-casualty management
 Decontamination
 Epidemiological investigation
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Specific Emergency Response and
Emergency Recovery Functions
 Forensic investigation
 Management of the dead and the missing/
fatality management
 Shelter and temporary accommodation (including
evacuation shelters)
 Community support
 Longer-term issues (health effects, recovery,
rehabilitation, reconstruction)
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Role of the Health Emergency Manager
• Determine the risk and plan to manage it
• Identify the capacity needed in terms of
Organization, Systems and People
• Determine strategies to reach the goals set
• Determine resource requirements (Compare from
what is available to what is required and what is
the gap)
• Look for resources, identify partners, co share
• Determine a point person, time frame and indicators
• Monitor and evaluate
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman