Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-03T02:39:29.707Z Has data issue: false hasContentIssue false
  • English
  • Français

Advances in Monitoring Have Not Translated into Improvements in Humanitarian Health Services

Published online by Cambridge University Press:  28 June 2012

Les Roberts
Les Roberts*
Affiliation:
Associate Clinical Professor of Population and Family Health Program on Forced Migration and Health, Columbia University Mailman School of Public Health, New York, New York, USA
*
E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

This paper is an attempt to review the advances and shortfalls in data collection and use of health data that have occurred during health emergencies in recent decades for the opening session of the Humanitarian and Health Conference at Dartmouth University in September of 2006.

Methods:

Examples of various kinds of successes and failures associated with health data collection are given to highlight advances with an effort to emphasize multi-agency efforts reviewed by outside scholars.

Results:

Health data, particularly surveillance data, have allowed relief workers to set priorities for life-saving humanitarian programs. The main guidelines widely utilized such as those of the US Centers for Disease Control and Prevention, Médecins sans Frontières, and the Sphere Project have considerable similarity due to the consistency of data collected in various crises. Moreover, difficult to see problems and successes have been revealed by coherent surveillance efforts. Yet, these data collection efforts can not show significant improvements in the quality of humanitarian aid in recent years. Moreover, health data often do not appear to have meaningful influence on the prioritizing of relief resources globally or on those political issues that trigger emergencies.

Conclusions:

The field of humanitarian relief is relatively nascent. Methods for documenting basic health measures on the local level have been developed and general health priorities have been documented. Some technical improvements in monitoring still are needed but decision-making is most often limited by the lack of data rather than the problems with data. The ability of health data to influence spending global priorities, legal or political actions undertaken by international organizations, remains very limited.

Keywords

actionassessmentcrisisconflicthealthhumanitarianmonitoringpriorityreliefsurveillance
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 22 , Issue 5 , October 2007 , pp. 384 - 389
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Voigt, A: Medical Responses during the Biafran Conflict. Berkeley Springs, WV: USAID/Office of Foreign Disaster Assistance Training Course, April 1997.Google Scholar
2.Cuny, F: Personal communication, March 1994.Google Scholar
3.US Centers for Disease Control and Prevention: Famine-affected, refugee, and displaced populations: Recommendations for public health issues. MMWR 1992;41(RR-13).Google Scholar
4.Ifekwunigwe, AE, Grasset, N, Glass, R, et al. : Immune response to measles and smallpox vaccinations in malnourished children. J Clin Nutr 1980;33:621–624.CrossRefGoogle ScholarPubMed
5.Toole, MJ, Waldman, RJ: Prevention of excess mortality in refugee and displaced populations in developing countries. JAMA 1990;263(24):3292–3302.CrossRefGoogle ScholarPubMed
6.Goma Epidemiology Group: Public health impact of Rwandan refugee crisis: What happened in Goma, Zaire in July 1994. Lancet 1995;345:339–344.CrossRefGoogle Scholar
7.Mèdicins sans Frontiéres: Refugee Health. London: Macmillan Education Ltd, 1997.Google Scholar
8.The Sphere Project: Humanitarian Charter and Minimum Standards in Disaster Response. Geneva: Sphere Project, 1998.Google Scholar
9.US Centers for Disease Control and Prevention: Epidemiology of Measles–United States, 2001–2003. MMWR 2004;53(31):713–716.Google Scholar
10.Toole MJ: Epidemiological Studies. Honolulu, HI: Health Emergencies in Large Populations Course, July, 1999.Google Scholar
11.US Centers for Disease Control and Prevention: Outbreak of pellagra among Mozambican refugees—Malawi, 1990. MMWR 1991:40(13):209–213.Google Scholar
12.Roberts, L: Unpublished data.Google Scholar
13.Becker, SR, Diop, F, Thornton, JN: Infant and child mortality in two counties of Liberia: Results of a survey in 1988 and trends since 1984. Intl J Epidemiol 1993;22:s56–s63.CrossRefGoogle ScholarPubMed
14.Taylor, WR, Chahnazarian, A, Weinman, J, et al. : Mortality and use of health services surveys in rural Zaire. Intl J Epidemiol 1993;22:s15–s19.CrossRefGoogle ScholarPubMed
15.Burkholder, B. Unpublished data. Atlanta: US Centers for Disease Control and Prevention, 1992.Google Scholar
16.Roberts, L: Unpublished data. New York: International Rescue Committee, 2001.Google Scholar
17.Boss, LP, Toole, M, Yip, R: Assessments of mortality, morbidity, and nutritional status in Somalia during the 1991–1992 famine. Recommendations for standardization of methods. JAMA 1994;272:371–376.CrossRefGoogle ScholarPubMed
18.Spiegel, P, Salama, P, Mahoney, S, van der Veen, A:Quality of malnutrition assessment surveys conducted during famine in Ethiopia. JAMA 2004;292:613–618.CrossRefGoogle ScholarPubMed
19.Overseas Development Institute: The Joint Evaluation of Emergency Assistance to Rwanda: Study III Principal Findings and Recommendations. London: Humanitarian Practice Network, 1996.Google Scholar
20.Van Dyke, M, Waldman, R: The Sphere Project Evaluation Report. New York: Mailman School of Public Health, Columbia University, 2004.Google Scholar
21.Roberts, L, Hofmann, CA: Assessing the impact of humanitarian assistance in the health sector. Emerg Themes Epidemiol 2004;1(1):3.CrossRefGoogle ScholarPubMed
22.Blackwell, T: Funding disparities “grotesque”.National Post 18 August 2006.Google Scholar
23.Ministry of Foreign Affairs of Denmark: Evaluation: Humanitarian and rehabilitation assistance to Kosovo, 1999–2003. Available at http://www.um.dk/en/servicemenu/ publications/developmentpolicy/evaluationassistancekosovo.htm. Accessed 27 July 2007.Google Scholar
24.Roberts, L. Unpublished data, Kabale, Uganda:World Health Organization 1994.Google Scholar
25.Gourevitch, P: We Wish to Inform You that Tomorrow We Will be Killed with Our Families. New York: Farrar, Straus and Giroux 1998.Google Scholar
26.The Republic of Uganda Ministry of Health: Health and mortality survey among internally displaced persons in Gulu, Kitgum and Pader District, northern Uganda. July 2005.Google Scholar
27.Gita, AB, Izama, A: Government contests report on IDP deaths. Nation 04 September 2005.Google Scholar
28.Roberts, L: The Iraq War: Do Civilian Casualties Matter? Audit of Conventional Wisdom. Cambridge: Massachusetts Institute for Technology, Center for International Studies, July 2005.Google Scholar
29.Burnham, G, Lafta, R, Doocy, S, et al. : Mortality after the 2003 invasion of Iraq: a cross-sectional cluster sample survey. Lancet 2006;21:368;1421–1428.CrossRefGoogle Scholar
30.CNN: Study: War blamed for 655,000 Deaths. Available at www.cnn.com/2006/WORLD/meast/10/11/iraq.deaths/index.html. Accessed 27 July 2007.Google Scholar