Preventive Medicine in Humanitarian Emergencies
4. Evaluation of the Needs During an Emergency
Population Health Evaluations Including Emergency Needs Assessments
oBjectives
- Recall major components of a population evaluation: demographics, predisaster health conditions, an emergency needs assessment, health-care system evaluation, and establishing a surveillance program.
- Complete the major components of an emergency needs assessment. Draft disaster response plans using community resources (transportation, communication, security).
Population Evaluation
Pediatricians can facilitate post-disaster recovery in their communities by helping to assess local population conditions. It is important to obtain as much hard data as possible – do not depend on speculation. Too often, disaster relief efforts are hindered and resources squandered by well intentioned people acting without the background of sound epidemiological data. Box 6 describes the components of a population evaluation.
BOX 6. Population evaluation
- Demographic data
- Measures of health status prior to the disaster
- Evaluation of the emergency needs
- Establishment of a morbidity/mortality surveillance system
Demographic Data
In a disaster, collecting data on population characteristics (number, age groups, ethnicity, gender) is critical. The crudest form of counting people is by air. This is by far the least accurate way of assessing the scope of a disaster, but it may be all that is possible in some situations. Visual estimates from the ground may be used as well to get a quick count of the affected population.
More accurate method to assess the affected population and its structure is by using standard sampling techniques, such as systematic household sampling. The most accurate way to gather demographic information is to count all individuals and list them by age group and sex. Vulnerable groups (such as children under 5 years and/or without a family, breastfeeding mothers, pregnant women, the elderly, and the injured) need particular attention and must be identified.
Although counting people and rate demographic data, it will be difficult to determine the true nature of what is happening in a community, and scarce resources may be wasted.
Pre-disaster Health Conditions groups may be tedious, this is a top priority (Box 7). Humanitarian agencies such as UNHCR, WFP, OCHA register beneficiaries so consider obtaining population denominators from such agencies.
BOX 7. Demographic data
- Affected population count (high priority)
- Visual estimation
- Sampling
- Census
- Population structure: male/female and age segments (<5 years, 5-15 years, >15 years)
- Risk groups: young children, pregnant and lactating women, elderly and wounded people
Without accurate demographic data, it will be difficult to determine the true nature of what is happening in a community, and scarce resources may be wasted.
Read the case and consider your answers. Additional case questions appear in later chapters; answers are provided in Chapter 8, Case Resolution.
Case (Cont.):
3. How does the information on the incubation period (in addition to the clinical data) contribute to the differential diagnosis of the disease?
4. Identify the vehicle or vehicles of the infection.